ECP Reference Number,Site Name,Organization Name,National Provider Identifier,ECP Category,Site Street Address 1,Site Street Address 2,Site City,Site State,Site Zip Code,Site County,Org Street Address 1,Org Street Address 2,Org City,Org State,Org Zip Code,Org County,POC 1 Name,POC 1 Title,POC 1Phone #,POC 1Phone Ext,POC 1 Email,POC 2 Name,POC 2 Title,POC 2Phone #,POC 2Phone Ext,POC 2 Email,URL
AK-000001,Adak Medical Clinic,"EASTERN ALEUTIAN TRIBES, INC. (EAT)",1285796094,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tribal Health Program operated under P.L. 93-638",2105 Main St,PO Box 2105,Adak,AK,99546-2105,Aleutians West,"3380 C Street, Ste.100",,Anchorage,AK,99503,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,www.eatribes.org
AK-000002,Akhiok Village Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",3rd Ave,,Akhiok,AK,99615,Kodiak Island,3449 East Rezanof Drive,,Kodiak,AK,99615,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000003,Yukon-Kuskokwim Health Corporation Akiachak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Main St,PO Box 51089,Akiachak,AK,99551-0089,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000004,Yukon-Kuskokwim Health Corporation Akiak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",148 Post Rd,PO Box 216,Akiak,AK,99552,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000005,ANESIA KUDRIN MEMORIAL CLINIC,"Eastern Aleutian Tribes, Inc.",1558423392,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",113 Main St,PO Box 113,Akutan,AK,99553-0113,Aleutians East,"3380 C Street, #100",,Anchorage,AK,99503,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operation,907-277-1440,,edgars@eatribes.net,www.eatribes.org
AK-000006,Yukon-Kuskokwim Health Corporation Alakanuk Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Anderson Street Clinic Drive,PO Box 288,Alakanuk,AK,99554-0288,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000007,ALLAKAKET HEALTH CLINIC,Tanana Chiefs Conference (DENA' NENA' HENASH),1821201278,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",Koyokuk River Junction,,Allakaket,AK,99720,Yukon Koyukuk,"122 First Avenue, Suite 600",,Fairbanks,AK,99701,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/Chairman,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactallakaket
AK-000008,SVT Health & Wellness,SELDOVIA VILLAGE TRIBE,1336178847,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",34361 Old Sterling Hwy,,Anchor Point,AK,99556-9500,Kenai Peninsula,880 E End Rd,,Homer,AK,99603,Kenai Peninsula,Emily Read,SVTHW Director,907-226-2208,,eread@svt.org,Uran Piedra,Tribal Controller,907-226-2228,686,upiedra@svt.org,
AK-000009,Quyana Club House,Southcentral Foundation,1144274986,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",225 Eagle St,,Anchorage,AK,99501-2626,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-012433,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,2550 Denali St,Suite 1307,Anchorage,AK,99503-2752,Anchorage,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
AK-000010,Pediatric Cardiology of Alaska,Pediatric Cardiology of Alaska,1528203551,Other ECP Providers,3841 Piper St,Suite T345,Anchorage,AK,99508-4694,Anchorage,P.O. Box 5371,M/S RC- 406,Seattle,WA,90145-5005,King,Eileen O'Connor,Sr. Director Contracting and Payor Relations,206-987-5209,,eileen.oconnor@seattlechildrens.org,Diana Kroemer,"Director, Contracting and Payor Relations",206-987-0672,,diana.kroemer@seattlechildrens.org,http://www.seattlechildrens.org/clinics-programs/heart/contact-locations/pediatric-cardiology-alaska/
AK-000011,Bleeding Disorder Center of Alaska,Providence Medical Group,1093956278,Hemophilia Treatment Centers,3851 Piper St,Suite U120,Anchorage,AK,99502,Anchorage,3300 Providence Drive,Suite U239,Anchorage,AK,99508,Anchorage,Kyme Groller,Nurse Coordinator,907-212-6712,,kyme.groller@providence.org,Laura Schulz,Medical Director,907-212-6885,,laura.schulz2@providence.org,
AK-000012,The Pathway Home,Southcentral Foundation,1639102882,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",4000 San Ernesto Ave,,Anchorage,AK,99508-2874,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000013,Anchorage Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",4001 Lake Otis Pkwy,Suite 101,Anchorage,AK,99508-5200,Anchorage,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,http://www.plannedparenthood.org/health-center/alaska/anchorage/99508/anchorage-health-center-3254-91810
AK-000014,Dena A Coy Residential,Southcentral Foundation,1184678559,"Inpatient Hospitals (other than children's hospitals), Urban Indian Health Program",4130 San Ernesto Ave,,Anchorage,AK,99508-2875,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-4552,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000015,Alaska Native Medical Center (inpatient hospital),Alaska Native Tribal Health Consortium,1437368891,"Indian Health Service, Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",4315 Diplomacy Dr,,Anchorage,AK,99508-5926,Anchorage,4000 Ambassador Dr,,Anchorage,AK,99508,Anchorage,Roald Helgesen,CEO,907-729-2876,,rhelgesen@anthc.org,Jennifer Mitchell,Senior Director Revenue Cycle,907-729-1946,,jamitchell@anthc.org,
AK-000016,Alaska Native Medical Center (multiple outpatient ECP categories),Alaska Native Tribal Health Consortium,1437368891,"Dental Providers, Family Planning Providers, Indian Health Service, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tribal Health Program operated under P.L. 93-638",4315 Diplomacy Dr,,Anchorage,AK,99508-5926,Anchorage,4000 Ambassador Dr,,Anchorage,AK,99508,Anchorage,Roald Helgesen,CEO,907-729-2876,,rhelgesen@anthc.org,Jennifer Mitchell,Senior Director Revenue Cycle,907-729-1946,,jamitchell@anthc.org,
AK-000017,Alaska Native Medical Center - Southcentral Foundation Clinics,Southcentral Foundation,1437189339,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",4315 Diplomacy Dr,,Anchorage,AK,99508-5926,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000018,SCF ANMC CLINIC,SOUTHCENTRAL FOUNDATION DENTAL CLINICS,1861533408,Dental Providers,4315 Diplomacy Dr,Dental Clinic,Anchorage,AK,99508-5926,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508,Anchorage,"KATHRYN SUZANNE MILLER CPC, CDC",PATIENT ACCOUNTS MANAGER,907-317-6070,,SMILLER@SOUTHCENTRALFOUNDATION.COM,JENNIFER WIESKAMP,PATIENT ACCOUNTS MANAGER,907-350-4810,,JWIESKAMP@SOUTHCENTRALFOUNDATION.COM,
AK-000019,Anchorage Native Primary Care Center Behavioral Health Clinic,Southcentral Foundation,1124064894,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",4320 Diplomacy Dr,,Anchorage,AK,99508-5925,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000020,Behavioral Health Fireweed,Southcentral Foundation,1932159076,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",4341 Tudor Centre Dr,,Anchorage,AK,99508-5904,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000021,SCF FIREWEED DENTAL CLINIC,SOUTHCENTRAL FOUNDATION DENTAL CLINICS,1861533408,Dental Providers,4341 Tudor Centre Dr,Fireweed Dental,Anchorage,AK,99508-5904,Anchorage,4501 Diplomacy Dr,,Anchorage,AK,99508,Anchorage,"KATHRYN SUZANNE MILLER CPC, CDC",PATIENT ACCOUNTS MANAGER,907-317-6070,,SMILLER@SOUTHCENTRALFOUNDATION.COM,JENNIFER WIESKAMP,PATIENT ACCOUNTS MANAGER,907-350-4810,,JWIESKAMP@SOUTHCENTRALFOUNDATION.COM,
AK-000022,"Anchorage Neighborhood Health Center, Inc.","ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.",1669475166,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4951 Business Park Blvd,,Anchorage,AK,99503-7174,Anchorage,4951 Business Park Blvd,,Anchorage,AK,99503-7174,Anchorage,Tammy Green,Chief Executive Officer,907-743-7368,,tgreen@anhc.org,Katherine L Blank,Chief Financial Officer,907-743-7321,,kblank@anhc.org,www.anhc.org
AK-000023,Clinical Services - Department of Health and Human Services,Municipality of Anchorage,1104979806,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",825 L St,Suite No. 102,Anchorage,AK,99501-3337,Anchorage,825 L St,,Anchorage,AK,99501-3337,Anchorage,Kamala Stiner,Nursing Supervisor for Reproductive Clinic,907-343-4070,,kamala.stiner@anchorageak.gov,Kristen Lawgon,Assistant Manager,907-343-4703,,kristen.lawgon@anchorageak.gov,http://www.muni.org/Departments/Health/DirectServices/Pages/default.aspx
AK-000024,SEARHC Jessie Norma Jim Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1215983945,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",725 Relay Rd,,Angoon,AK,99820,Hoonah Angoon,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000025,ANIAK SUB-REGIONAL CLINIC,Yukon-Kuskokwim Health Corporation,1689857658,Federally Qualified Health Centers - Medical Services,269 Morgans Rd,PO Box 269,Aniak,AK,99557-0269,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Susan Hoeldt,SRC Administrator,907-675-4556,,susan_hoeldt@ykhc.org,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,https://www.ykhc.org/
AK-000026,YUKON-KUSKOKWIM HEALTH CORPORATION ANVIK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Charlie Wulf Road,PO Box 89,Anvik,AK,99558-0089,Yukon Koyukuk,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000027,ARCTIC VILLAGE HEALTH CLINIC,COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS,1578753067,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",100 Main St,,Arctic Village,AK,99722,Yukon Koyukuk,3rd And Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,Joyce W Hughes,Grants/Contracts Manager,907-662-7527,527,jhughes@catg.org,Melinda L Peter,Health Director,907-662-7529,529,mlpeter@catg.org,www.catg.org
AK-000028,APIAI Atka Village Clinic,"Aleutian Pribilof Islands Association, Inc. (APIAI)",1093939233,"Federally Qualified Health Centers - Medical Services, Indian Health Service",900 A Health Ln,,Atka,AK,99547,Aleutians West,1131 E International Airport Rd,,Anchorage,AK,99518-1408,Aleutians West,Dimitri Philemonof,President/CEO,907-276-2700,,dimitrip@apiai.org,Jessica Mata Rukovishnikoff,Primary Care Services Regional Director,907-276-2700,265,jmataruko@apiai.org,www.apiai.org
AK-000029,Yukon-Kuskokwim Health Corporation Atmautluak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",101 Boardwalk Way,PO Box 6588,Atmautluak,AK,99559-6588,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000030,Samuel Simmonds Memorial Hospital (inpatient hospital),Arctic Slope Native Association,1306933643,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",7000 Uula St,,Barrow,AK,99723,North Slope,PO Box 29,,Barrow,AK,99723,North Slope,Luke Welles,Vice President of Finance,907-852-4611,352,luke.welles@arcticslope.org,Richard Hall,Hospital Administrator,907-852-4611,137,richard.hall@arcticslope.org,www.arcticslope.org
AK-000031,Samuel Simmonds Memorial Hospital (multiple outpatient ECP categories),Arctic Slope Native Association,1306933643,"Dental Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",7000 Uula St,,Barrow,AK,99723,North Slope,PO Box 29,,Barrow,AK,99723,North Slope,Luke Welles,Vice President of Finance,907-852-4611,352,luke.welles@arcticslope.org,Richard Hall,Hospital Administrator,907-852-4611,137,richard.hall@arcticslope.org,www.arcticslope.org
AK-000032,BEAVER HEALTH CLINIC,COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS,1205027505,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",101 Main St,,Beaver,AK,99724,Yukon Koyukuk,3rd And Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,Joyce W Hughes,Grants/Contracts Manager,907-662-7527,527,jhughes@catg.org,Melinda L Peter,Health Director,907-662-7529,529,mlpeter@catg.org,www.catg.org
AK-000033,Yukon-Kuskokwim Health Corporation Womens Care and Support Center,Yukon-Kuskokwim Health Corporation,1821476599,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1260 A Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559-0528,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,James Sweeney,VP of Hospital Services,907-543-6953,,james_sweeney@ykhc.org,Patricia Smith,Patient Care Services Administrator,907-543-6270,,patricia_smith@ykhc.org,https://www.ykhc.org/elementor-popup/womens-health-pre-maternal/
AK-000034,Yukon-Kuskokwim Health Corporation McCann Treatment Center,Yukon-Kuskokwim Health Corporation,1194945170,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5016 Noel Polty Blvd.,PO Box 528,Bethel,AK,99559-0528,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,James Sweeney,VP of Hospital Services,907-543-6953,,james_sweeney@ykhc.org,Patricia Smith,Patient Care Services Administrator,907-543-6270,,patricia_smith@ykhc.org,
AK-000035,BETHEL FAMILY CLINIC,BETHEL FAMILY CLINIC,1124078019,Federally Qualified Health Centers - Medical Services,631 Main St,,Bethel,AK,99559,Bethel,631 Main St,,Bethel,AK,99559,Bethel,LaTesia Guinn,Executive Director,907-543-3773,,lguinn@bethelclinic.org,,,907-543-3773,,,
AK-000036,Yukon Kuskokwim Delta Regional Hospital,Yukon-Kuskokwim Health Corporation,1063567691,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559-0528,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,James Sweeney,VP of Hospital Services,907-543-6953,,james_sweeney@ykhc.org,Patricia Smith,Patient Care Services Administrator,907-543-6270,,patricia_smith@ykhc.org,
AK-000037,Yukon-Kuskokwim Health Corporation Behavioral Health,Yukon-Kuskokwim Health Corporation,1346466232,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",829 Chief Eddie Hoffman Hwy,Suite 150,Bethel,AK,99559,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,James Sweeney,VP of Hospital Services,907-543-6953,,james_sweeney@ykhc.org,Patricia Smith,Patient Care Services Administrator,907-543-6270,,patricia_smith@ykhc.org,
AK-000038,Yukon-Kuskokwim Health Corporation Dental,Yukon-Kuskokwim Health Corporation,1326262726,Dental Providers,829 Chief Eddie Hoffman Hwy,Suite 184,Bethel,AK,99559,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559-0528,Bethel,James Sweeney,VP of Hospital Services,907-543-6953,,james_sweeney@ykhc.org,Patricia Smith,Patient Care Services Administrator,907-543-6270,,patricia_smith@ykhc.org,https://www.ykhc.org/
AK-000039,FRANK TOBUK SR. HEALTH CENTER,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1 Bettles Rd,,Bettles,AK,99726,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,
AK-000040,CHALKYITSIK VILLAGE CLINIC,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",8 Kutchin Rd,,Chalkyitsik,AK,99788,Yukon Koyukuk,122 1st Ave.,,Fairbanks,AK,99701,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactchalkyitsik
AK-000041,YUKON-KUSKOKWIM HEALTH CORPORATION CHEFORNAK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Panruk Rd,PO Box 49,Chefornak,AK,99561-0049,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000042,Chugachmiut Chenega Bay Clinic,Chugachmiut Association,1700057676,"Community Mental Health Centers, Indian Health Service, Rural Health Clinics",625 Main St,,Chenega Bay,AK,99574,Valdez Cordova,1840 Bragaw St Ste 110,,Anchorage,AK,99508-3463,Anchorage,Kelley Baker,Health Division Director,907-441-8565,,kelley@chugachmiut.org,Jan Vanderpool,Executive Director,907-562-4155,,jan@chugachmiut.org,"www.chugachmiut,org"
AK-000043,YUKON-KUSKOKWIM HEALTH CORPORATION CHEVAK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",212 Willow St,PO Box 212,Chevak,AK,99563-0212,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000044,BBAHC Chignik Bay Clinic,Bristol Bay Area Health Corporation (BBAHC),1871654582,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Chignik Bay,AK,99564,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/chignik_bay
AK-000045,BBAHC Chignik Lagoon Clinic,Bristol Bay Area Health Corporation (BBAHC),1578623641,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Chignik Lagoon,AK,99565,Lake and Peninsula,6000 Kanakanak Rd,,Dillingham,AK,99576,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/chignik_lagoon
AK-000046,BBAHC Chignik Lake Clinic,Bristol Bay Area Health Corporation (BBAHC),1962563676,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",36 Alder Rd,,Chignik Lake,AK,99548,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/chignik_lake
AK-000047,Chistochina Clinic,Mt. Sanford Tribal Consortium,1609990670,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",Mile Post 34.5 Tok Cut Off Highway,,Chistochina,AK,99586,Valdez Cordova,P.O. Box 357,,Gakona,AK,99586,Valdez Cordova,George Drinkwater,Health Services Director,907-259-4498,,gtd@mstc.org,Evelyn Beeter,President / CEO,907-822-5399,302,ebeeter@mstc.org,
AK-000048,CIRCLE VILLAGE CLINIC,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",161 Steese Hwy,,Circle,AK,99733-9800,Yukon Koyukuk,122 1st Ave,,Fairbanks,AK,99701,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactcircle
AK-000049,BBAHC Clarks Point Clinic,Bristol Bay Area Health Corporation (BBAHC),1922160464,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Clarks Point,AK,99569,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/clarks_point
AK-000050,TLCHC-COFFMAN COVE,ALASKA ISLAND COMMUNITY SERVICES,1689729980,Federally Qualified Health Centers - Medical Services,105 NW Kodiak Drive,,Coffman Cove,AK,99918,Prince Of Wales Hyder,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000051,ANNA LIVINGSTON MEMORIAL CLINIC,"EASTERN ALEUTIAN TRIBES, INC.",1124180963,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",65 Main St,,Cold Bay,AK,99571,Aleutians East,3380 C St Ste 100,,Anchorage,AK,99503-3949,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,https://www.eatribes.org/communities/cold-bay/
AK-000052,Copper River Native Association,Copper River Native Association (CRNA),1164745691,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Mile 111.5 Richardson Hwy,PO Box H,Copper Center,AK,99573-0508,Valdez Cordova,Mile 111.5 Richardson Hwy,PO Box H,Copper Center,AK,99573-0508,Valdez Cordova,Arleen Lenard,Patient Financial Services Director,907-822-8847,,alenard@crnative.org,Eirik Brennan Mcferrin,Health Director,907-822-8819,,emcferrin@crnative.org,http://crnative.org/
AK-000053,CRNA Wrangell Mountain Dental Clinic,Copper River Native Association (CRNA),1306987532,Dental Providers,Mile 111.5 Richardson Hwy,PO Box H,Copper Center,AK,99573-0508,Valdez Cordova,Mile 111.5 Richardson Hwy,PO Box H,Copper Center,AK,99573,Valdez Cordova,Arleen Lenard,Patient Financial Services Director,907-822-8847,,alenard@crnative.org,Eirik Mcferrin,Health Director,907-822-8819,,emcferrin@crnative.org,www.crnative.org
AK-000054,Ilanka Community Health Center,Native Village of Eyak,1821074535,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",705 Second St,,Cordova,AK,99574,Valdez Cordova,110 Nicholoff Way,PO Box 1388,Cordova,AK,99574,Valdez Cordova,Cindy Frohnapfel,Business Office Coordinator,907-424-3622,,cindy.frohnapfel@eyak-nsn.gov,Cindy Bradford,Deputy Health Director,907-424-3622,,cindy.bradford@eyak-nsn.gov,
AK-000055,YUKON-KUSKOKWIM HEALTH CORPORATION CROOKED CREEK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",401 Main St,PO Box 49,Crooked Creek,AK,99575-0049,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000056,Interior Alaska Medical Clinic,CROSS ROAD MEDICAL CENTER,1346677754,Federally Qualified Health Centers - Medical Services,2730 Alaska Hwy,,Delta Junction,AK,99737,Southeast Fairbanks,Mile 187 Glenn Hwy,,Glennallen,AK,99588,Valdez Cordova,Susan Sura,Grants Manager,907-822-5686,,ssura@crossroadmc.org,Joel Medendorp,CEO,907-822-5686,23,jmedendorp@crossroadmc.org,www.crossroadmc.org
AK-000057,Kanakanak Hospital Inpatient,Bristol Bay Area Health Corporation (BBAHC),1962688309,"Indian Health Service, Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",6000 Kanakanak Rd,,Dillingham,AK,99576,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Brandy Jensen,Revenue Cycle Manager,907-842-9394,6394,bjensen@bbahc.org,
AK-000058,Kanakanak Hospital Outpatient,Bristol Bay Area Health Corporation (BBAHC),1831270842,"Dental Providers, Indian Health Service, Other ECP Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",6000 Kanakanak Rd,,Dillingham,AK,99576-0130,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Brandy M Jensen,Revenue Cycle Manager,907-842-9394,6394,bjensen@bbahc.org,
AK-000059,Dot Lake Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",8 Charles St,,Dot Lake,AK,99737,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactdot
AK-000060,Eagle Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Long Lake Rd,,Eagle,AK,99738,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacteagle
AK-000061,TLCHC-EDNA BAY,ALASKA ISLAND COMMUNITY SERVICES,1508912668,Federally Qualified Health Centers - Medical Services,1 Edna Bay Rd,,Edna Bay,AK,99901-9803,Ketchikan Gateway,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000062,Yukon-Kuskokwim Health Corporation Eek Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",2 Council St,PO Box 69,Eek,AK,99578-0069,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000063,BBAHC Egegik Clinic,Bristol Bay Area Health Corporation (BBAHC),1699836007,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Egegik,AK,99579,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/egegik
AK-000064,BBAHC Ekwok Clinic,Bristol Bay Area Health Corporation (BBAHC),1104988799,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Ekwok,AK,99580,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/ekwok
AK-000065,EMMONAK SUB-REGIONAL CLINIC,Yukon-Kuskokwim Health Corporation,1124201199,Federally Qualified Health Centers - Medical Services,215 Kwiguk St,PO Box 246,Emmonak,AK,99581-0246,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Susan Hoeldt,SRC Administrator,907-675-4556,,susan_hoeldt@ykhc.org,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,https://www.ykhc.org/
AK-000066,Alaska Island Community Clinic Excursion Inlet Cannery Site,ALASKA ISLAND COMMUNITY SERVICES,1861740284,Federally Qualified Health Centers - Medical Services,Cannery Site,,Excursion Inlet,AK,99827,Haines,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000067,Stevens Village Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",122 1st Ave,,Fairbanks,AK,99701-4871,Fairbanks North Star,2 Riverway St.,,Stevens Village,AK,99774,Yukon Koyukuk,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactstevens
AK-012434,Center for Vein Restoration,Center for Vein Restoration,1316407992,Other ECP Providers,1405 Kellum St,Suite 201,Fairbanks,AK,99701-4189,Fairbanks North Star,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,3889,credentialing@centerforvein.com,Dawn Folkenberg,credentialing specialist,240-965-3889,,credentialing@centerforvein.com,centerforvein.com
AK-000068,INTERIOR COMMUNITY HEALTH CENTER,INTERIOR COMMUNITY HEALTH CENTER,1588739015,"Dental Providers, Federally Qualified Health Centers - Medical Services",1606 23rd Ave,,Fairbanks,AK,99701-6407,Fairbanks North Star,1606 23rd Ave,,Fairbanks,AK,99701-6407,Fairbanks North Star,Thomas Martin,CFO,907-455-4567,,thomas.martin@inhc.org,,,907-455-4567,,,
AK-000069,Chief Andrew Issac Health Center,"Tanana Chiefs Conference, Inc. (TCC)",1821201278,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1717 W Cowles St,,Fairbanks,AK,99701-5926,Fairbanks North Star,122 1st Ave Ste 600,,Fairbanks,AK,99701,Fairbanks North Star,Victor Joseph,President/Chairman,907-452-8251,,victor.joseph@tananachiefs.org,,,,,,https://www.tananachiefs.org/services/health/chief-andrew-isaac-health-center/
AK-000070,Fairbanks Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1867 Airport Way,Suite 160B,Fairbanks,AK,99701-4062,Fairbanks North Star,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,http://www.plannedparenthood.org/health-center/alaska/fairbanks/99701/fairbanks-health-center-2603-91810
AK-000071,Anna Hoblet Memorial Clinic,"EASTERN ALEUTIAN TRIBES, INC.",1841352689,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",49 Main St,,False Pass,AK,99583,Aleutians East,3380 C St Ste 100,,Anchorage,AK,99503-3949,Aleutians East,Edgar Smith,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Operation Director,907-277-1440,,edgars@eatribes.net,https://www.eatribes.org/communities/false-pass/
AK-000073,BIRCH CREEK VILLAGE CLINIC,COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS,1225228729,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",101 Main St,,Fort Yukon,AK,99740,Yukon Koyukuk,3rd And Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,Joyce W Hughes,Grants/Contracts Manager,907-662-7527,527,jhughes@catg.org,Melinda L Peter,Health Director,907-662-7529,529,mlpeter@catg.org,www.catg.org
AK-000072,YUKON FLATS HEALTH CENTER,COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS,1871704395,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",101 Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,3rd And Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,Joyce W Hughes,Grants/Contracts Manager,907-662-7527,527,jhughes@catg.org,Melinda L Peter,Health Director,907-662-7529,529,mlpeter@catg.org,www.catg.org
AK-000074,Edgar Nollner Health Center,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",77 Antoski Rd,,Galena,AK,99741,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Josephine Malamute,Director,907-452-8251,3607,,https://www.tananachiefs.org/services/wellness-prevention/suicide/
AK-000075,Girdwood Health Clinic,Girdwood Health Clinic Inc,1851662233,Federally Qualified Health Centers - Medical Services,131 Lindblad Ave,,Girdwood,AK,99587-1130,Anchorage,131 Lindblad Avenue,PO Box 1130,Girdwood,AK,99587-1130,Anchorage,Jill Veatch,Office Manager,907-783-1355,,j.veatch@ghcak.org,Tawny Buck,Executive Director,907-783-1355,,t.buck@ghcak.org,girdwoodhealthclinic.org
AK-000076,Robert Marshall Building,Copper River Native Association,1306987532,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tribal Health Program operated under P.L. 93-638",Mile 111.5 Richardson Hwy,,Glennallen,AK,99588,Valdez Cordova,PO Box H,,Copper Center,AK,99573,Valdez Cordova,Paul Rude,CEO,907-822-5241,,paulrude@crnative.org,Kris Winter,Health Services Director,907-822-5241,119,kwinter@crnative.org,www.crnative.org
AK-000077,Cross Road Medical Center,CROSS ROAD MEDICAL CENTER,1609871391,Federally Qualified Health Centers - Medical Services,Mile 187 Glenn Hwy,,Glennallen,AK,99588,Valdez Cordova,Mile 187 Glenn Hwy,,Glennallen,AK,99588,Valdez Cordova,Susan Sura,Grants Manager,907-822-3203,,ssura@crossroadmc.org,Joel Medendorp,CEO,907-822-5686,23,jmedendorp@crossroadmc.org,www.crossroadmc.org
AK-000078,BBAHC Goodnews Bay Clinic,Bristol Bay Area Health Corporation (BBAHC),1194886895,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Goodnews Bay,AK,99589,Bethel,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/goodnews_bay
AK-000079,YUKON-KUSKOKWIM HEALTH CORPORATION GRAYLING CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",49 Main St,PO Box 110,Grayling,AK,99590-0110,Yukon Koyukuk,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000080,Alaska Island Community Services Gustavus Community Clinic,ALASKA ISLAND COMMUNITY SERVICES,1902178627,Federally Qualified Health Centers - Medical Services,42 Dolly Varden Ln,,Gustavus,AK,99826,Hoonah Angoon,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000081,HAINES HEALTH CENTER,SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM,1932184298,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",131 1st Ave S,,Haines,AK,99827,Haines,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000082,INTERIOR COMMUNITY HEALTH CENTER,INTERIOR COMMUNITY HEALTH CENTER,1609942754,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",Usibelli Spur Rd,,Healy,AK,99743,Denali,1606 23rd Ave,,Fairbanks,AK,99701-6407,Fairbanks North Star,Thomas Martin,CFO,907-455-4567,,thomas.martin@inhc.org,,,,,,
AK-000083,YUKON-KUSKOKWIM HEALTH CORPORATION HOLY CROSS CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",21 3rd St,PO Box 95,Holy Cross,AK,99602-0095,Yukon Koyukuk,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000084,Kachemak Bay Family Planning Clinic,Kachemak Bay Family Planning Clinic,1477684561,"Family Planning Providers, Sexually Transmitted Disease Clinics",3959 Ben Walters Ln,,Homer,AK,99603-7707,Kenai Peninsula,3959 Ben Walters Ln,,Homer,AK,99603,Kenai Peninsula,Catriona Reynolds,Interim Executive Director,907-235-3436,,catriona@kbfpc.org,Catriona Reynolds,Clinic Manager,907-235-3436,,catriona@kbfpc.org,http://kbfpc.org/
AK-000085,SVT Health & Wellness,SELDOVIA VILLAGE TRIBE,1336178847,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",880 E End Rd,,Homer,AK,99603-7201,Kenai Peninsula,880 E End Rd,,Homer,AK,99603,Kenai Peninsula,Emily Read,SVTHW Director,907-226-2208,,eread@svt.org,Uran Piedra,Tribal Controller,907-226-2228,686,upiedra@svt.org,
AK-000086,SEARHC Hoonah Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1285849943,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",490 Gartina Highway,,Hoonah,AK,99829,Hoonah Angoon,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000087,HOOPER BAY SUB-REGIONAL CLINIC,Yukon-Kuskokwim Health Corporation,1316180029,Federally Qualified Health Centers - Medical Services,Airport Rd,PO Box 49,Hooper Bay,AK,99604-0049,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Susan Hoeldt,SRC Administrator,907-675-4556,,susan_hoeldt@ykhc.org,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,https://www.ykhc.org/
AK-000088,Marilyn E. Koyukuk Evans Health Center,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",204 Blue Ave,,Hughes,AK,99745,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacthughes
AK-000089,Rose Ambrose Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",166 Spring Camp Rd,,Huslia,AK,99746,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacthuslia
AK-000090,SEARHC Alma Cook Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1073728168,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",Eight Street Extension,,Hydaburg,AK,99922,Prince Of Wales Hyder,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000091,Igiugig Clinic,Southcentral Foundation,1144699216,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",4030 Salmon Way,,Igiugig,AK,99613,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMRA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000092,NILAVENA SUBREGIONAL CLINIC,Southcentral Foundation,1912954272,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",101 Airport Rd,,Iliamna,AK,99606,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000093,SEARHC Ethal Lund Medical Center,Southeast Alaska Regional Health Consortium (SEARHC),1942284765,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",1200 Salmon Creek Ln,,Juneau,AK,99801-7861,Juneau,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000094,FRONT STREET COMMUNITY HEALTH CENTER,Front Street Health Center,1205255957,Federally Qualified Health Centers - Medical Services,225 Front St,,Juneau,AK,99801-1244,Juneau,225 Front St,,Juneau,AK,99801-1244,Juneau,Claudette Thor,Clinic Manager,907-364-4528,,claudettet@searhc.org,MARK WALKER,Director of Behavioral Health,907-874-5000,,MWALKER@SEARHC.ORG,https://frontstreetchc.org/
AK-000095,Juneau Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",3231 Glacier Hwy,,Juneau,AK,99801-7842,Juneau,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,http://www.plannedparenthood.org/health-center/alaska/juneau/99801/juneau-health-center-3865-91810
AK-000096,Bartlett Regional Hospital,Bartlett Regional Hospital,1891849261,Inpatient Hospitals (other than children's hospitals),3260 Hospital Dr,,Juneau,AK,99801-7808,Juneau,3260 Hospital Drive,,Juneau,AK,99801,Juneau,Alan C Ulrich,Chief Financial Officer,907-796-8402,,aulrich@bartletthospital.org,Chuck Bill,Chief Executive officer,907-796-8438,,cbill@bartletthospital.org,www.bartletthospital.org
AK-000097,SEARHC Kake Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1114973849,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",105 Totem Way,,Kake,AK,99830,Petersburg,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,6644,rachels@searhc.org,,,,,,www.searhc.org
AK-000098,YUKON-KUSKOKWIM HEALTH CORPORATION UPPER KALSKAG CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Lot 3 Block 11 Tract C,PO Box 9,Kalskag,AK,99607-0009,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000099,Kaltag Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",32 2nd St,,Kaltag,AK,99748,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactkaltag
AK-000100,Karluk Health Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",26 Alex Brown St,,Karluk,AK,99608,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000101,SEARHC Kasaan Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1962616821,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",First And Jones,,Kasaan,AK,99950,Ketchikan Gateway,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000102,Yukon-Kuskokwim Health Corporation Kasigluk Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",9 Akulmiut,PO Box 99,Kasigluk,AK,99609-0099,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000103,PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA - DENTAL,"PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.",1700984614,Dental Providers,395 Main Street Loop,,Kenai,AK,99611-7727,Kenai Peninsula,230 EAST MARYDALE AVENUE,,Soldotna,AK,99669,Kenai Peninsula,AL WALL,CEO,907-260-7314,,CEO@PCHSAK.ORG,JENNIFER YOUNGBERG,CFO,907-260-7312,,JYOUNGBERG@PCHSAK.ORG,WWW.PCHSAK.ORG
AK-000104,Dena'ina Health Center (Kenai),Kenaitze Indian Tribe (KIT),1932114600,"Dental Providers, Family Planning Providers, Indian Health Service, Tribal Health Program operated under P.L. 93-638",508 Upland St,,Kenai,AK,99611-8026,Kenai Peninsula,PO Box 988,,Kenai,AK,99611-0988,Kenai Peninsula,Macayla Cloyd,Billing Account Representative,907-335-7210,,mcloyd@kenaitze.org,Nina Marion,Co-Owner,907-335-7519,,nmarion@kenaitze.org,
AK-000105,"PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC. - KENAI MEDICAL AND BEHAVIORAL HEALTH CENTER","PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.",1700984614,Federally Qualified Health Centers - Medical Services,805 Frontage Rd,,Kenai,AK,99611-9104,Kenai Peninsula,230 E Marydale Ave,,Soldotna,AK,99669-7648,Kenai Peninsula,AL WALL,CEO,907-260-7314,,CEO@PCHSAK.ORG,JENNIFER YOUNGBERG,CFO,907-260-7312,7312,JYOUNGBERG@PCHSAK.ORG,WWW.PCHSAK.ORG
AK-000106,Ketchikan Indian Community,KIC Tribal Health,1043533946,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",2960 Tongass Ave,,Ketchikan,AK,99901-5742,Ketchikan Gateway,2960 Tongass Ave,,Ketchikan,AK,99901,Ketchikan Gateway,John R Reeves III,Health Administrator,907-228-9264,9264,jreevesiii@kictribe.org,Arlene Dilts Jackson,Tribal Administrator,907-228-9299,9299,adjackson@kictribe.org,
AK-000107,KING COVE CLINIC,"EASTERN ALEUTIAN TRIBES, INC.",1649332446,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",100 Slocum Dr,,King Cove,AK,99612,Aleutians East,3380 C St Ste 100,,Anchorage,AK,99503-3949,Aleutians East,Jennifer Smith,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,www.eatribes.org
AK-000108,BBAHC King Salmon Clinic,Bristol Bay Area Health Corporation (BBAHC),1891856894,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,King Salmon,AK,99613,Bristol Bay,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/king_slamon
AK-000109,Yukon-Kuskokwim Health Corporation Kipnuk Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",101 Council Drive,PO Box 183,Kipnuk,AK,99614-0183,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000110,SEARHC Alicia Roberts Medical Center,Southeast Alaska Regional Health Consortium (SEARHC),1306173752,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",7300 Klawock Hollis Highway,,Klawock,AK,99925,Prince Of Wales Hyder,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000111,SEARHC Klukwan Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1306173752,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",11 Chilkat Ave,,Klukwan,AK,99827,Haines,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,6644,rachels@searhc.org,,,,,,www.searhc.org
AK-000112,Kodiak Community Health Center,Kodiak Island Health Care Foundation,1326047044,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1911 E Rezanof Dr,,Kodiak,AK,99615-6602,Kodiak Island,1911 E. Rezanof Drive,,Kodiak,AK,99615,Kodiak Island,Judy C Rathje,Executive Director,907-481-5000,5005,jrathje@kodiakchc.org,Maggie Nevin,Operations Director,907-481-5000,5006,mnevin@kodiakchc.org,
AK-000113,KANA (Mill Bay Health Clinic),KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",2414 Mill Bay Rd,,Kodiak,AK,99615-6654,Kodiak Island,3449 East Rezanof Drive,,Kodiak,AK,99615,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000114,KANA (Alutiiq Enwia Clinic-Kodiak),KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",3449 E Rezanof Dr,,Kodiak,AK,99615-6952,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000115,Kokhanok Clinic,Southcentral Foundation,1043689169,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1008 Main St,,Kokhanok,AK,99606,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5225,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000116,BBAHC Koliganek Clinic,Bristol Bay Area Health Corporation (BBAHC),1013079607,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Koliganek,AK,99576,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/koliganek
AK-000117,Yukon-Kuskokwim Health Corporation Kongiganak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",23 Main Way,PO Box 5089,Kongiganak,AK,99545-5089,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000118,YUKON-KUSKOKWIM HEALTH CORPORATION KOTLIK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",35 Main St,PO Box 20268,Kotlik,AK,99620-0268,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000119,Maniilaq Association,Maniilaq Association,1316995210,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",436 5th Ave and Stevens Way,PO Box 43,Kotzebue,AK,99752-0043,Northwest Arctic,733 Second Ave.,PO Box 256,Kotzebue,AK,99752-0256,Northwest Arctic,Paul Hansen,Hospital Administrator,907-442-7150,,phansen@maniilaq.org,Timothy Schuerch,President/CEO,907-442-7677,,timothy.schuerch@maniilaq.org,www.maniilaq.org
AK-000120,Maniilaq Association,Maniilaq Association,1316995210,"Community Mental Health Centers, Dental Providers, Indian Health Service, Tribal Health Program operated under P.L. 93-638",436 Fifth And Stevens Way,PO Box 43,Kotzebue,AK,99752-0043,Northwest Arctic,733 Second Ave.,PO Box 256,Kotzebue,AK,99752-0256,Northwest Arctic,Viola Babcock,Hospital Administrator,907-442-7136,,viola.babcock@maniilaq.org,Viola Babcock,Director of Patient Financial Services,907-442-7136,,viola.babcock@maniilaq.org,www.maniilaq.org
AK-000121,Koyukuk Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",100 Spruce St,,Koyukuk,AK,99754,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactkoyukuk
AK-000122,Yukon-Kuskokwim Health Corporation Kwethluk Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",49 Airport Rd,PO Box 69,Kwethluk,AK,99621-0069,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,,,,,,
AK-000123,Yukon-Kuskokwim Health Corporation Kwigillingok Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",69 North Main St,PO Box 69,Kwigillingok,AK,99622-0069,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000124,Larsen Bay Health Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",3rd St,,Larsen Bay,AK,99624,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000125,BBAHC Levelock Clinic,Bristol Bay Area Health Corporation (BBAHC),1366502767,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Levelock,AK,99625,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/levelock
AK-000126,YUKON-KUSKOKWIM HEALTH CORPORATION LIME VILLIAGE CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1 Clinic Rd,General Delivery,Lime Village,AK,99557,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,,,,,,
AK-000127,YUKON-KUSKOKWIM HEALTH CORPORATION LOWER KALSKAG CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Church Road 1,PO Box 9,Lower Kalskag,AK,99626-0009,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,,,,,,
AK-000128,Manley Hot Springs Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Mile 160 Elliot Hwy,,Manley Hot Springs,AK,99756,Yukon Koyukuk,122 1st Ave,,Fairbanks,AK,99701,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactmanley
AK-000129,BBAHC Manokotak Clinic,Bristol Bay Area Health Corporation (BBAHC),1740340991,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Manokotak,AK,99628,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/manokotak
AK-000130,YUKON-KUSKOKWIM HEALTH CORPORATION MARSHAL CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1305 Allman Ave,PO Box 10,Marshall,AK,99585-0010,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000131,McGrath Sub-Regional Health Center,Southcentral Foundation,1063467223,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",10 DNR Rd,,McGrath,AK,99627,Yukon Koyukuk,4501 DIPLOMACY DRIVE,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000132,YUKON-KUSKOKWIM HEALTH CORPORATION MEKORYUK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",43 Airport Rd,PO Box 43,Mekoryuk,AK,99630-0043,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000133,Mentasta Lake Clinic,Mt. Sanford Tribal Consortium,1609990670,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",Mile 7 Mentasta Spur Rd,,Mentasta Lake,AK,99586,Valdez Cordova,P.O. Box 357,,Gakona,AK,99586,Valdez Cordova,George Drinkwater,Health Services Director,907-259-4498,,gtd@mstc.org,Evelyn Beeter,President / CEO,907-822-5399,302,ebeeter@mstc.org,
AK-000134,"Evelyn Alexander ""To Draak"" Health Clinic",DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",203 Lakeview St.,,Minto,AK,99758,Yukon Koyukuk,122 1st Ave.,,Fairbanks,AK,99701,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactminto
AK-000135,YUKON-KUSKOKWIM HEALTH CORPORATION MOUNTAIN VILLAGE CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Old Airport Rd,PO Box 32207,Mountain Village,AK,99632-0207,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000136,"CAMAI COMMUNITY HEALTH CTR, INC.","BRISTOL BAY, BOROUGH OF",1679718019,Federally Qualified Health Centers - Medical Services,2 School Rd,Camai Community Medical Clini,Naknek,AK,99633,Bristol Bay,1 Main St,,Naknek,AK,99633,Bristol Bay,Stephen Herting,Executive Director,907-246-6155,311,director@camaichc.org,Heidi Maupin,Executive Administrative Assistant,907-246-6155,316,hmaupincchc@gmail.com,www.camaichc.org
AK-000137,BBAHC Naknek Clinic,Bristol Bay Area Health Corporation (BBAHC),1770645780,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Naknek,AK,99633,Bristol Bay,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/naknek
AK-000138,Chugachmiut Nanwalek Clinic,Chugachmiut Association,1902077829,"Community Mental Health Centers, Indian Health Service, Rural Health Clinics",64834 Nikita St,,Nanwalek,AK,99603,Kenai Peninsula,1840 Bragaw St Ste 110,,Anchorage,AK,99508-3463,Anchorage,Kelley Baker,Health Division Director,907-441-8565,,kelley@chugachmiut.org,Jan Vanderpool,Executive Director,907-562-4155,,jan@chugachmiut.org,www.chugachimiut.org
AK-000139,Yukon-Kuskokwim Health Corporation Napakiak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1082 Mission Rd,PO Box 70,Napakiak,AK,99559,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000140,Yukon-Kuskokwim Health Corporation Napaskiak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",6044 Board Walk Way,PO Box 6044,Napaskiak,AK,99559-6044,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000141,TLCHC-NAUKATI,ALASKA ISLAND COMMUNITY SERVICES,1952422859,Federally Qualified Health Centers - Medical Services,Naukati Community Church,,Naukati,AK,99921,Prince Of Wales Hyder,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000142,NELSON LAGOON CLINIC,"EASTERN ALEUTIAN TRIBES, INC.",1003970062,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",40 Main St,PO Box 40,Nelson Lagoon,AK,99571-0040,Aleutians East,3380 C St Ste 100,,Anchorage,AK,99503-3949,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,www.eatribes.org
AK-000143,Mary C. Demientieff Health Clinic (Nenana),DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",806 G St,,Nenana,AK,99760,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactnenana
AK-000144,BBAHC New Stuyahok Clinic,Bristol Bay Area Health Corporation (BBAHC),1720148976,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,New Stuyahok,AK,99636,Dillingham,PO Box 130,,Dillingham,AK,99576,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/new_stuyahok
AK-000145,YUKON-KUSKOKWIM HEALTH CORPORATION Newtok Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5508 Airport Way,PO Box 5508,Newtok,AK,99559-5508,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000146,YUKON-KUSKOKWIM HEALTH CORPORATION NIGHTMUTE CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Kuuraralria St,PO Box 90011,Nightmute,AK,99690-0011,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000147,Nikolski Village Clinic,"Aleutian/Pribilof Islands Association, Inc. (APIAI)",1730303975,"Federally Qualified Health Centers - Medical Services, Indian Health Service",111 Lakeview Rd,,Nikolski,AK,99638,Aleutians West,1131 E International Airport Rd,,Anchorage,AK,99518-1408,Aleutians West,Dimitri Philemonof,President/CEO,907-276-2700,,dimitrip@apiai.org,Jessica Mata Rukovishnikoff,Primary Care Services Regional Director,907-276-2700,265,jmataruko@apiai.org,www.apiai.org
AK-000148,Ninilchik Village Tribal Council (Ninilchik Community Clinic,Ninilchik Village Tribe,1609093723,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",15765 Kingsley Rd,,Ninilchik,AK,99639-9759,Kenai Peninsula,PO Box 39070,,Ninilchik,AK,99639-0070,Kenai Peninsula,Ivan Encelewski,Executive Director,907-567-3313,,ivan@ninilchiktribe-nsn.gov,Janet Mullen,Tribal Health Director,907-567-3370,4,jmullen@ninilchiktribe-nsn.gov,
AK-000149,Nondalton Clinic,Southcentral Foundation,1740659192,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",69 Main St,,Nondalton,AK,99640,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000150,BBAHC Aleknagik Clinic,Bristol Bay Area Health Corporation (BBAHC),1235291246,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,North Aleknagik,AK,99555,Dillingham,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/aleknagik
AK-000151,Northway Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",9.1 Mile Northway Village,,Northway,AK,99764,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactnorthway
AK-000152,Nulato Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",10 Nikaghun St.,,Nulato,AK,99765,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactnulato
AK-000153,YUKON-KUSKOKWIM HEALTH CORPORATION NUNAM IQUA CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",29 Main St,PO Box 29,Nunam Iqua,AK,99666-0029,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000154,Yukon-Kuskokwim Health Corporation Nunapitchuk Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",103 Johnson Sloop,PO Box 50,Nunapitchuk,AK,99641-0050,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000155,Old Harbor Health Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",600 Birch St,,Old Harbor,AK,99643,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000156,Yukon-Kuskokwim Health Corporation Oscarville Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",103 Oscarville Lane,PO Box 6149,Oscarville,AK,99559,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000157,Ouzinkie Health Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",3rd And C St.,,Ouzinkie,AK,99644,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000158,Pedro Bay Clinic,Southcentral Foundation,1952770307,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",2516 Mountain Circle Dr,,Pedro Bay,AK,99647,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Lake And Peninsula,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald Olson,VP Finance,907-729-4939,,lolson@scf.cc,
AK-000159,SEARHC Pelican Health Clinic,Southeast Alaska Regional Health Consortium (SEARHC),1659585479,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",167 Salmon Way,,Pelican,AK,99832,Hoonah Angoon,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000160,BBAHC Perryville Clinic,Bristol Bay Area Health Corporation (BBAHC),1528128782,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Perryville,AK,99648,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/perryville
AK-000161,SEARHC Petersburg Clinic,Southeast Alaska Regional Health Consortium (SEARHC),1447438502,"Dental Providers, Indian Health Service, Tribal Health Program operated under P.L. 93-638",202 Gjoa St,,Petersburg,AK,99833,Petersburg,3100 Channel Drive,,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000162,BBAHC Pilot Point Clinic,Bristol Bay Area Health Corporation (BBAHC),1174683825,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Pilot Point,AK,99649,Lake and Peninsula,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/pilot_point
AK-000163,YUKON-KUSKOKWIM HEALTH CORPORATION PILOT STATION CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5089 Airport St,PO Box 5089,Pilot Station,AK,99650-0089,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000164,YUKON-KUSKOKWIM HEALTH CORPORATION PITKA'S POINT CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",River Front,PO Box 164,Pitka's Point,AK,99658-0164,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000165,BBAHC Platinum Clinic,Bristol Bay Area Health Corporation (BBAHC),1285796870,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Platinum,AK,99651,Bethel,6000 Kanakanak Rd,,Dillingham,AK,99576,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/platinum
AK-000166,TLCHC-POINT BAKER,ALASKA ISLAND COMMUNITY SERVICES,1578600490,Federally Qualified Health Centers - Medical Services,Community Building,,Point Baker,AK,99927,Prince Of Wales Hyder,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000167,Port Alsworth Clinic,Southcentral Foundation,1770953903,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1 Flight Line Rd,,Port Alsworth,AK,99653-9801,Lake and Peninsula,4501 Diplomacy Dr,,Anchorage,AK,99508-5519,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald Olson,VP Finance,907-729-4939,,lolson@scf.cc,
AK-000168,Chugachmiut Anesia Anahonak Moonin Clinic (Port Graham),Chugachmiut Association,1902077837,"Community Mental Health Centers, Indian Health Service, Rural Health Clinics",5530 Main St,,Port Graham,AK,99603,Kenai Peninsula,1840 Bragaw St Ste 110,,Anchorage,AK,99508-3463,Anchorage,Kelley Baker,Health Division Director,907-444-8565,,kelley@chugachmiut.org,Jan Vanderpool,Executive Director,907-562-4155,,jan@chugachmiut.org,www.chugachmiut.org
AK-000169,BBAHC Port Heiden Clinic,Bristol Bay Area Health Corporation (BBAHC),1740342658,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,Port Heiden,AK,99613,Bristol Bay,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/port_heiden
AK-000170,Port Lions Health Clinic,KODIAK AREA NATIVE ASSOCIATION (KANA),1205883907,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",500 Molina,,Port Lions,AK,99550,Kodiak Island,3449 Rezanof Dr E,,Kodiak,AK,99615-6952,Kodiak Island,Amy Durand,Grants Coordinator,907-486-9890,,amy.durand@kodiakhealthcare.org,Andy Teuber,President/CEO,907-486-9800,,,
AK-000171,TLCHC-PORT PROTECTION,ALASKA ISLAND COMMUNITY SERVICES,1710033501,Federally Qualified Health Centers - Medical Services,Community Building,,Port Protection,AK,99927,Prince Of Wales Hyder,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000172,Yukon-Kuskokwim Health Corporation Quinhagak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Main Carter Rd,PO Box 149,Quinhagak,AK,99655-0149,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000173,Rampart Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",10 Wiehl Way,,Rampart,AK,99767,Yukon Koyukuk,122 1st Ave,,Fairbanks,AK,99701,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactrampart
AK-000174,Altona Brown Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",74 Ruby Rd,,Ruby,AK,99768,Yukon Koyukuk,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contactruby
AK-000175,YUKON-KUSKOKWIM HEALTH CORPORATION Russian Mission Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1 Main Rd,PO Box 58,Russian Mission,AK,99657-0058,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000176,St. George Traditional Clinic,"Aleutian Pribilof Islands Association, Inc. (APIAI)",1013079755,"Federally Qualified Health Centers - Medical Services, Indian Health Service",934 Main St,,Saint George,AK,99591,Aleutians West,1131 E International Airport Rd,,Anchorage,AK,99518-1408,Aleutians West,Dimitri Philemonof,President/CEO,907-276-2700,,dimitrip@apiai.org,Jessica Mata Rukovishnikoff,Primary Care Services Regional Director,907-276-2700,265,jmataruko@apiai.org,www.apiai.org
AK-000177,ST MARY'S SUB-REGIONAL CLINIC,Yukon-Kuskokwim Health Corporation,1851574826,Federally Qualified Health Centers - Medical Services,310 Hospital Rd,PO Box 310,Saint Marys,AK,99658-0310,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Susan Hoeldt,SRC Administrator,907-675-4556,,susan_hoeldt@ykhc.org,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,
AK-000178,ST PAUL HEALTH CENTER,Southcentral Foundation,1922405406,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1000 Polovina Turnpike Rd,,Saint Paul,AK,99660,Aleutians West,4501 Diplomacy Dr,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000179,Sand Point Health Center,"Eastern Aleutian Tribes, Inc (EAT)",1346662608,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",172 Red Cove Rd,,Sand Point,AK,99661,Aleutians East,"3380 C St, #100",,Anchorage,AK,99503,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,www.eatribes.org
AK-000180,YUKON-KUSKOKWIM HEALTH CORPORATION SCAMMON BAY CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",128 Front St,PO Box 150,Scammon Bay,AK,99662-0150,Kusilvak,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000181,SVT Health & Wellness,SELDOVIA VILLAGE TRIBE,1336178847,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",206 Main St,,Seldovia,AK,99663,Kenai Peninsula,880 E End Rd,,Homer,AK,99603,Kenai Peninsula,Emily Read,SVTHW Director,907-226-2208,,eread@svt.org,Uran Piedra,Tribal Controller,907-226-2228,686,upiedra@svt.org,
AK-000182,Chugachmiut North Star Health Clinic,Chugachmiut Association,1750618856,"Community Mental Health Centers, Indian Health Service, Rural Health Clinics",201 3rd Ave,,Seward,AK,99664,Kenai Peninsula,1840 Bragaw St Ste 110,,Anchorage,AK,99508-3463,Anchorage,Kelley Baker,Health Service Director,907-441-8565,,kelley@chugachmiut.org,Jan Vanderpool,Executive Director,907-562-4155,,jan@chugachmiut.org,www.chugachmiut.org
AK-012370,North Star Health Clinic,Chugachmiut,1194889287,"Dental Providers, Indian Health Service",201 3rd Ave,,Seward,AK,99664-2088,Kenai Peninsula,1840 Bragaw Street,Suite 110,Anchorage,AK,99508,Anchorage,Kelley Baker,Health Service Division Director,907-441-8565,,kelley@Chugachmiut.org,Melody Walace,Regional Manager,907-224-3490,,melody@chugachmiut.org,www.chugachmiut.org
AK-000183,Seward Community Health Center,City of Seward,1356772024,Federally Qualified Health Centers - Medical Services,417 1st Ave,,Seward,AK,99664,Kenai Peninsula,PO Box 2895,,Seward,AK,99664,Kenai Peninsula,Patrick Linton,Executive Director,907-224-8505,,plinton@sewardhealthcenter.org,,,,,,www.sewardhealthcenter.org
AK-000184,YUKON-KUSKOKWIM HEALTH CORPORATION SHAGELUK CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Main St,PO Box 54,Shageluk,AK,99665-0054,Yukon Koyukuk,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000185,Mt. Edgecumbe Hospital (Sitka) - SEARHC,Southeast Alaska Regional Health Consortium (SEARHC),1720062524,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",222 Tongass Dr,,Sitka,AK,99835-9416,Sitka,3100 Channel Drive,Suite 300,Juneau,AK,99801-7809,Juneau,Rachel Stauffer,Patient Financial Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000186,Sitka Medical Center,SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM,1538521026,Outpatient Hospital Clinics,700 Katlian St,Suite E,Sitka,AK,99835-7359,Sitka,"3100 Channel Dr, Ste 300",,Juneau,AK,99801,Sitka,Rachel Stauffer,PFS Manager,907-463-6644,,rachels@searhc.org,James Marks,Revenue Cycle Director,907-463-4000,,jamesm@searhc.org,
AK-000187,DAHL MEMORIAL CLINIC,"SKAGWAY, CITY OF",1063574200,Federally Qualified Health Centers - Medical Services,350 14th Ave,,Skagway,AK,99840,Skagway,7th & Spring,,Skagway,AK,99840,Skagway,Michelle Moss O'Boyle,Executive Director,907-983-2255,6,s.oboyle@skagway.org,Este Fielding,Administrative Manager,907-983-2255,5,e.fielding@skagway.org,www.dahlclinic.org
AK-000188,YUKON-KUSKOKWIM HEALTH CORPORATION SLEETMUTE CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",43 Main St,PO Box 43,Sleetmute,AK,99668-0043,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000189,Soldotna Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",130 E Redoubt Ave,,Soldotna,AK,99669-8012,Kenai Peninsula,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,http://www.plannedparenthood.org/health-center/alaska/soldotna/99669/soldotna-health-center-2604-91810
AK-000190,"PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC. - SOLDOTNA MEDICAL AND BEHAVIORAL HEALTH CENTER","PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.",1700984614,Federally Qualified Health Centers - Medical Services,230 E Marydale Ave,,Soldotna,AK,99669-7648,Kenai Peninsula,230 EAST MARYDALE AVENUE,,Soldotna,AK,99669,Kenai Peninsula,AL WALL,CEO,907-260-7314,,CEO@PCHSAK.ORG,JENNIFER YOUNGBERG,CFO,907-260-7312,7312,JYOUNGBERG@PCHSAK.ORG,WWW.PCHSAK.ORG
AK-000191,BBAHC South Naknek Clinic,Bristol Bay Area Health Corporation (BBAHC),1417018193,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",Main St,,South Naknek,AK,99670,Bristol Bay,PO Box 130,,Dillingham,AK,99576-0130,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/south_naknek
AK-000192,YUKON-KUSKOKWIM HEALTH CORPORATION STONY RIVER CLINIC,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Birch Road,General Delivery,Stony River,AK,99557-9999,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000193,C'eyiits' Hwnax Life House Community Health Center,Southcentral Foundation,1043632037,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",11495 N Callison St,,Sutton,AK,99674-8116,Matanuska Susitna,4501 DIPLOMACY DRIVE,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5225,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000194,SUNSHINE COMMUNITY HEALTH CENTER INCORPORATED,Sunshine Community Health Center,1790802486,Dental Providers,34300 Talkeetna Spur Rd,,Talkeetna,AK,99676,Matanuska Susitna,34300 Talkeetna Spur Road,,Talkeetna,AK,99676,Matanuska Susitna,Melody West,Executive Director,907-733-2273,,mwest@sunshineclinic.org,Valera Brickel,Finance Director,907-733-9216,,vbrickel@sunshineclinic.org,www.sunshineclinic.org
AK-000195,SUNSHINE COMMUNITY HEALTH CENTER,SUNSHINE COMMUNITY HEALTH CENTER INCORPORATED,1922071117,"Dental Providers, Federally Qualified Health Centers - Medical Services",Mile 4.4 Talkeetna Spur Rd,,Talkeetna,AK,99676,Matanuska Susitna,Mile 4.4 Talkeetna Spur Rd,,Talkeetna,AK,99676,Matanuska Susitna,Melody West,Executive Director,907-733-2273,,mwest@sunshineclinic.org,Valera Brickel,Finance Directer,907-733-9216,,vbrickel@sunshineclinic.org,www.sunshineclinic.org
AK-000196,Tanacross Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1000 Tanacross Blvd.,,Tanacross,AK,99776,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacttanacross
AK-000197,Chugachmiut Tatitlek Clinic,Chugachmiut Association,1801067723,"Community Mental Health Centers, Indian Health Service",411 Old Village Rd,,Tatitlek,AK,99677,Valdez Cordova,1840 Bragaw St Ste 110,,Anchorage,AK,99508-3463,Anchorage,Kelley Baker,Health Service Division Director,907-444-8565,,jan@chugachmiut.org,Jan Vanderpool,Executive Director,907-562-4155,,jan@chugachmiut.org,www.chugachmiut.org
AK-000198,Thorne Bay Health Clinic,Southeast Alaska Regional Health Consortium (SEARHC),1376758037,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",120 Freeman Drive,,Thorne Bay,AK,99919,Prince Of Wales Hyder,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000199,BBAHC Togiak Clinic,Bristol Bay Area Health Corporation (BBAHC),1093877680,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",344 Main St,,Togiak,AK,99678,Dillingham,6000 Kanakanak Rd,,Dillingham,AK,99576,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Brandy Jensen,Revenue Cycle Manager,907-842-9394,6394,bjensen@bbahc.org,
AK-000200,Upper Tanana Health Center,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",123 Tok Cut-Off,,Tok,AK,99780,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacttok
AK-000201,Tetlin Health Clinic,DENA' NENA' HENASH,1821201278,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",303 Easton Rd,,Tok,AK,99780,Southeast Fairbanks,122 1st Ave Ste 600,,Fairbanks,AK,99701-4871,Fairbanks North Star,Crystal L Stordahl,Director,907-452-8251,,crystal.stordahl@tananachiefs.org,Victor Joseph,President/CEO,907-452-8251,,,https://www.tananachiefs.org/contact/village-contacts/#contacttetlin
AK-000202,TOOKSOOK BAY SUB-REGIONAL CLINIC,Yukon-Kuskokwim Health Corporation,1497938476,Federally Qualified Health Centers - Medical Services,101 Airport Rd,PO Box 37028,Toksook Bay,AK,99637-0028,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Susan Hoeldt,SRC Administrator,907-675-4556,,susan_hoeldt@ykhc.org,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,https://www.ykhc.org/
AK-000203,Yukon-Kuskokwim Health Corporation Tuluksak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",194 2nd St,PO Box 194,Tuluksak,AK,99679-0194,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000204,Yukon-Kuskokwim Health Corporation Tuntutuliak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",101 Army Way,PO Box 8017,Tuntutuliak,AK,99680-0017,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,,,,,,
AK-000205,YUKON-KUSKOKWIM HEALTH CORPORATION Tununak Clinic,Yukon-Kuskokwim Health Corporation,1447477815,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Washeteria Rd,PO Box 102,Tununak,AK,99681-0102,Bethel,700 Chief Eddie Hoffman Hwy,PO Box 528,Bethel,AK,99559,Bethel,Rahnia Boyer,VP of Village Health,907-543-6240,,rahnia_boyer@ykhc.org,Asela Calhoun,CHAP Director,907-543-6144,,asela_calhoun@ykhc.org,https://www.ykhc.org/elementor-popup/primary-care/
AK-000206,BBAHC Twin Hills Clinic,Bristol Bay Area Health Corporation (BBAHC),1487716825,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",521 Main St,,Twin Hills,AK,99576,Dillingham,6000 Kanakanak Rd,,Dillingham,AK,99576,Dillingham,Robert J. Clark,President/CEO,907-842-5201,6313,rclark@bbahc.org,Nat Hall,Chief Human Resources Officer,907-842-5201,6478,nhall@bbahc.org,https://www.bbahc.org/twin_hills
AK-000207,Indian Creek Health Center,Southcentral Foundation,1609232040,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",101 Indian Creek Rd,,Tyonek,AK,99682,Kenai Peninsula,4501 DIPLOMACY DRIVE,,Anchorage,AK,99508-5919,Anchorage,TAMARA BROWN,Director of Revenue Cycle,907-729-5525,,THBROWN@SCF.CC,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000208,"Iliuliuk Family and Health Services, Inc.","Iliuliuk Family and Health Services, Inc.",1376520692,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",34 Lavelle Ct,,Unalaska,AK,99685,Aleutians West,34 lavelle Court,,Unalaska,AK,99685,Aleutians West,Eileen Scott,Executive Director,907-581-1202,,escott@ifhs.org,,,,,,
AK-000209,Oonalaska Wellness Center,"Aleutian/Pribilof Islands Association, Inc. (APIAI)",1689610313,"Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",34 Lavelle Ct,,Unalaska,AK,99685,Aleutians West,1131 E International Airport Rd,,Anchorage,AK,99518-1408,Aleutians West,Dimitri Philemonof,President/CEO,907-276-2700,,dimitrip@apiai.org,Jessica Mata Rukovishnikoff,Primary Care Services Regional Director,907-276-2700,265,jmataruko@apiai.org,www.apiai.org
AK-000210,APIAI,"Aleutian Pribilof Islands Association, Inc. (APIAI)",1417992215,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",529 Biorka Drive,,Unalaska,AK,99685,Aleutians West,1131 E International Airport Rd,,Anchorage,AK,99518-1408,Aleutians West,Dimitri Philemonof,President/CEO,907-276-2700,,dimitrip@apiai.org,Tara Ford,Primary Care Services Regional Director,907-276-2700,265,taraf@apiai.org,www.apiai.org
AK-000211,MYRA ROBERTS CLINIC,COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS,1063602563,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",101 Main St,,Venetie,AK,99781,Yukon Koyukuk,3rd And Spruce St,,Fort Yukon,AK,99740,Yukon Koyukuk,Joyce W Hughes,Grants/Contracts Manager,907-662-7527,527,jhughes@catg.org,Melinda Peter,Health Director,907-662-2587,529,mlpeter@catg.org,www.catg.org
AK-000212,Valley Native Primary Care Center,Southcentral Foundation,1386680056,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1001 S Knik Goose Bay Rd,,Wasilla,AK,99654-8083,Matanuska Susitna,4501 Diplomacy DR,,Anchorage,AK,99508-5919,Anchorage,Jim Lamb,Director of Revenue Cycle,907-729-5453,,Jlamb@SouthcentralFoundation.com,Ronald L. Olson,VP Finance,907-729-4939,,lolson@SouthcentralFoundation.com,
AK-000213,"Mat-Su Health Services, Inc.",MAT SU HEALTH SERVICES INC,1184725210,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1363 W Spruce Ave,,Wasilla,AK,99654-5327,Matanuska Susitna,1363 W Spruce Ave,,Wasilla,AK,99654-5327,Matanuska Susitna,Kevin Munson,CEO,907-352-3210,,kmunson@matsuhealthservices.org,,,,,,
AK-000214,"Mat-Su Public Health Center State of Alaska, DHSS, DPH, SOPHN","State of Alaska Dept. of Health & Social Services, DPH/WCFH",1053447912,Other ECP Providers,3223 E Palmer Wasilla Hwy,State Of Alaska Dept. Of Health & Social Services,Wasilla,AK,99654-7277,Matanuska Susitna,3601 C St,PO Box 240249,Anchorage,AK,99503-5923,Matanuska Susitna,Sonja Engle,Nurse Manager,907-352-6600,,Sonja.engle@alaska.gov,Sheila Ohman,Team Leader,907-352-6626,,Sheila.ohman@alaska.gov,
AK-000215,TLCHC-WHALE PASS,ALASKA ISLAND COMMUNITY SERVICES,1881749430,Federally Qualified Health Centers - Medical Services,Community Building,,Whale Pass,AK,99927,Prince Of Wales Hyder,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000216,WHITTIER CLINIC,"EASTERN ALEUTIAN TRIBES, INC.",1467515148,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Tribal Health Program operated under P.L. 93-638",301 Kenai St,,Whittier,AK,99693,Valdez Cordova,3380 C St Ste 100,,Anchorage,AK,99503-3949,Aleutians East,Jennifer Harrison,Executive Director,907-277-1440,,jenniferh@eatribes.net,Edgar Smith,Director of Operations,907-277-1440,,edgars@eatribes.net,https://www.eatribes.org/communities/whittier/
AK-000217,Willow Community Health Center,SUNSHINE COMMUNITY HEALTH CENTER INCORPORATED,1699892307,"Dental Providers, Federally Qualified Health Centers - Medical Services",24091 Long Lake Rd,,Willow,AK,99688,Matanuska Susitna,Mile 4.4 Talkeetna Spur Rd,,Talkeetna,AK,99676,Matanuska Susitna,Melody West,Executive Director,907-733-2273,,mwest@sunshineclinic.org,Valera Brickel,Finance Director,907-733-9216,,vbrickel@sunshineclinic.org,www.sunshineclinic.org
AK-000218,Alaska Island Community Services,ALASKA ISLAND COMMUNITY SERVICES,1851649305,Federally Qualified Health Centers - Medical Services,232 Wood St,,Wrangell,AK,99929,Wrangell,232 Wood St,,Wrangell,AK,99929,Wrangell,Mark Walker,CEO,907-874-2373,,mark.walker@akics.org,Georgianna Buhler,CFO,907-874-2373,,,
AK-000219,Wrangell Medical Center,Southeast Alaska Regional Health Consortium (SEARHC),1487836391,Other ECP Providers,310 Bennett St.,,Wrangell,AK,99929,Wrangell,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AK-000220,Yakutat Tlingit Tribe,Yakutat Tlingit Tribe,1871529628,"Indian Health Service, Other ECP Providers",606 Forest Hwy #10,,Yakutat,AK,99689,Yakutat,PO Box 418,,Yakutat,AK,99689-0418,Yakutat,Rhoda Jensen,Health Director,907-784-3275,118,rjensen@y-chc.org,,,,,,https://yakutattlingittribe.org/contact-us/
AK-000221,YAKUTAT COMMUNITY HEALTH CENTER,YAKUTAT TLINGIT TRIBE,1871529628,Federally Qualified Health Centers - Medical Services,712 Ocean Cape Rd,,Yakutat,AK,99689,Yakutat,606 Forest Hwy #10,,Yakutat,AK,99689,Yakutat,Rhoda Jensen,Health Director,907-784-3275,118,rjensen@y-chc.org,Cathy Wassillie,YCHC Finance Manager,907-784-3275,120,cwassillie@y-chc.org,
AK-000222,Yakutat Health Center,Southeast Alaska Regional Health Consortium (SEARHC),1033323605,Other ECP Providers,712 Ocean Cape Rd,,Yakutat,AK,99689,Yakutat,3100 Channel Drive,Suite 300,Juneau,AK,99801,Juneau,Rachel Stauffer,Patient Finanical Services Manager,907-364-6644,,rachels@searhc.org,,,,,,www.searhc.org
AL-000223,Henry County Health Department Abbeville Branch,Alabama Department of Public Health,1639214901,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",505 Kirkland St,,Abbeville,AL,36310-2736,Henry,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000224,Abbeville Family Health Center,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1740580422,Federally Qualified Health Centers - Medical Services,615 Ozark Rd,,Abbeville,AL,36310-2629,Henry,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000225,Med-Assist Doctors Group,Med-Assist Doctors' Group,1245290154,Rural Health Clinics,3442 US Highway 431,,Albertville,AL,35950-0203,Marshall,3442 US Hwy 431 N,,Albertville,AL,35950,Marshall,Debbie Bonds,Office Manager,256-593-1234,112,debbiebonds@med-asst.com,Penny Davis,Credentialling Clerk,256-593-1234,111,pennydavis@med-asst.com,www.med-asst.com
AL-000226,Smart Start Pediatrics LLC,Smart Start Pediatrics LLC,1982020756,Rural Health Clinics,460 AL Highway 75 N,,Albertville,AL,35951-3838,Marshall,460 AL HWY 75 N,,Albertville,AL,35951,Marshall,LaShea Dalton,Office Manager,256-891-0300,,ldalton@smartstartpediatrics.com,Tracy Bell,Owner,256-891-0300,,tbell@fortpaynepeds.com,
AL-000227,Tallapoosa Co. Health Dept.,"State of Alabama Dept. of Public Health,",1295878643,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2078 Sportplex Blvd,,Alexander City,AL,35010-4472,Tallapoosa,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000228,Covington County Health Department,Alabama Department of Public Health,1134262330,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",23989 Alabama Hwy 55,,Andalusia,AL,36420,Covington,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000229,Andalusia Regional Hospital,LifePoint Health,1821078494,Inpatient Hospitals (other than children's hospitals),849 S Three Notch St,,Andalusia,AL,36420-5325,Covington,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Shirley Smith,CFO,334-428-7005,,,
AL-000230,ANNISTON QUALITY HEALTH CARE,QUALITY OF LIFE HEALTH SERVICES INC,1568412666,"Dental Providers, Federally Qualified Health Centers - Medical Services",1316 Noble St,,Anniston,AL,36201-4643,Calhoun,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000231,Calhoun County Health Department,Alabama Department of Public Health,1861535312,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3400 McClellan Blvd,,Anniston,AL,36201-2128,Calhoun,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000232,Calhoun Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1013339209,Federally Qualified Health Centers - Medical Services,601 Leighton Ave,,Anniston,AL,36207-5743,Calhoun,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000233,HEALTH SERVICES CENTER INC,"Health Services Center, Inc.",1477642601,"Ryan White Providers, Sexually Transmitted Disease Clinics",608 Martin Luther King Dr,,Anniston,AL,36201-7344,Calhoun,608 Martin Luther King Dr,,Anniston,AL,36201-7344,Calhoun,Sonia Preston,Clinical Director,256-832-0100,,spreston@hscal.org,Sean Holmes,Chief Information Officer,256-832-0100,,sholmes@hscal.org,http://www.hscal.org/
AL-000234,Clay Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1598187783,"Dental Providers, Federally Qualified Health Centers - Medical Services",40745 Highway 77,,Ashland,AL,36251-4807,Clay,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000235,Athens Family Health Center,"CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.",1881705994,Federally Qualified Health Centers - Medical Services,1005 W Market St,Suite B,Athens,AL,35611-2454,Limestone,110 Walker Ave NE,,Huntsville,AL,35801-4739,Madison,"Carleton H. A. Pyfrom, Sr.",President and CEO,256-534-8659,1403,cpyfrom@cnahsi.com,Kriska Gurley,Executive Assistant,256-534-8659,1403,kgurley@cnahsi.com,www.cnahsi.com
AL-000236,Limestone County Health Department,Alabama Department of Public Health,1467595892,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",20371 Clyde Mabry Dr,,Athens,AL,35611-6764,Limestone,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000237,Dr. John T. Cooper,Dr. John T. Cooper,1821032012,Other ECP Providers,212 S Main St,,Atmore,AL,36502-2448,Escambia,212 S. Main Street,,Atmore,AL,36502,Escambia,JOHN TAYLOR COOPER,Optometrist,251-391-0375,,JCOOPEROD@AOL.COM,John T. Cooper,Owner,251-391-0375,,jcooperod@aol.com,
AL-000238,ACH Primary Care,ACH Primary Care,1659510931,Rural Health Clinics,402 Medical Park Dr,,Atmore,AL,36502-3004,Escambia,402 Medical Park Dr,,Atmore,AL,36502-3004,Escambia,Brian G. Bruley,Clinic Director,251-368-6261,0,brian.bruley@infirmaryhealth.org,Dawn Luker,Patient Services Clerk II,251-368-6261,0,dawn.luker@infirmaryhealth.org,
AL-000239,West Escambia Family Medical Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1912327446,Federally Qualified Health Centers - Medical Services,408 Medical Park Dr,,Atmore,AL,36502-3016,Escambia,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000240,Buford L Rolin Health Clinic,Poarch Band of Creek Indians,1902916489,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",429 Buford L Rolin Dr,,Atmore,AL,36502-5190,Escambia,5811 Jack Springs Road,,Atmore,AL,36502,Escambia,Edith Tullis Jackson,Health & Elder Services Division Director,251-368-9136,2231,ejackson@pci-nsn.gov,Kelly Dirting,Revenue Cycle Director,251-368-9136,2351,kdirting@pci-nsn.gov,
AL-000241,ACH Family Physicians,ACH Family Physicians,1093994758,Rural Health Clinics,611 E Laurel St,,Atmore,AL,36502-3014,Escambia,611 E Laurel St,,Atmore,AL,36502-3014,Escambia,Brian G. Bruley,Clinic Director,251-368-6261,0,brian.bruley@infirmaryhealth.org,Dawn Luker,Patient Services Clerk,251-368-6261,0,dawn.luker@infirmaryhealth.org,
AL-000242,"Escambia County Health Department, Atmore Branch",Alabama Department of Public Health,1528101953,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",8600 Highway 31,Suite 17,Atmore,AL,36502-2686,Escambia,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000243,Autaugaville Family Health Center,"HEALTH SERVICES, (INC)",1992727853,Federally Qualified Health Centers - Medical Services,203 N Taylor St,,Autaugaville,AL,36003-2663,Autauga,PO Box 70365,,Montgomery,AL,36107-2613,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000244,North Baldwin Family Health Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1740536036,Federally Qualified Health Centers - Medical Services,201 Dolive St,,Bay Minette,AL,36507-3226,Baldwin,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000245,BALDWIN COUNTY DEPT BAY MINETTE BRANCH,BALDWIN CO HEALTH DEPT,1578606018,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",212 Courthouse Sq,,Bay Minette,AL,36507-4812,Baldwin,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000246,North Baldwin Rural HIV Clinic,"MOBILE, COUNTY BOARD OF HEALTH",1740543669,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",312 Courthouse Sq,,Bay Minette,AL,36507-4809,Baldwin,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,8833,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,8876,jfthomas@mchd.org,
AL-000247,Planned Parenthood Southeast--Birmingham Center,"Planned Parenthood Southeast, Inc.",1609829282,"Family Planning Providers, Sexually Transmitted Disease Clinics",1019 1st Ave N,,Birmingham,AL,35203-3011,Jefferson,"241 Peachtree Street NE, Suite 400",,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,,,,,,
AL-000248,NORTHSIDE DENTAL CLINIC,ALABAMA REGIONAL MEDICAL SERVICES,1417025917,Dental Providers,1333 19th St N,,Birmingham,AL,35234-2512,Jefferson,PO Box 11523,,Birmingham,AL,35202-1523,Jefferson,Pamela Weaver,Front Desk Supervisor,205-322-8288,,pweaver@arms.healthcare,Sharon Greenhill,ADMINISTRATIVE TO ASSISTANT to COO,205-322-8288,,sgreenhill@arms.healthcare,
AL-000249,Central Health Center,JEFFERSON COUNTY HEALTH DEPARTMENT,1497816565,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1400 6th Ave S,,Birmingham,AL,35233-1502,Jefferson,14006th Ave S,,Birmingham,AL,35233-1502,Jefferson,Toni Bellina,Clinic Administrator,205-933-1569,,toni.bellina@jcdh.org,,,334-206-5350,,,http://www.adph.org
AL-000251,CHILDREN'S HOSPITAL OF ALABAMA MAIN CAMPUS,CHILDREN'S HOSPITAL OF ALABAMA,1205935012,Children's Hospitals (inpatient only),1600 7th Ave S,,Birmingham,AL,35233-1711,Jefferson,1600 7th Ave S,,Birmingham,AL,35233-1711,Jefferson,Nancy Corona,Director of Reimbursement,205-638-9607,,nancy.corona@childrensal.org,Jenny Wakeford,Controller,205-638-6778,,jenny.wakeford@childrensal.org,www.childrensal.org
AL-000252,Children's Rehabilitation Service Birmingham Office,Alabama Department of Rehabilitation Services,1134273063,Hemophilia Treatment Centers,1600 7th Ave S,,Birmingham,AL,35233-1711,Jefferson,602 South Lawrence Street,,Montgomery,AL,36104,Montgomery,Kim McLaughlin,Hemophilia Program Coordinator/Specialist,334-293-7132,,kim.mclaughlin@rehab.alabama.gov,Melinda M Davis,CRS Director,334-293-7049,,melinda.davis@rehab.alabama.gov,
AL-000253,CHILDREN'S HOSPITAL OF ALABAMA SOUTH CAMPUS,CHILDREN'S HOSPITAL OF ALABAMA,1205935012,Outpatient Hospital Clinics,1940 Elmer J Bissell Rd,,Birmingham,AL,35243-2941,Jefferson,1600 7th Ave S,,Birmingham,AL,35233,Jefferson,Nancy Corona,Director of Reimbursement,205-638-9607,,nancy.corona@childrensal.org,Jenny Wakeford,Controller,205-638-6778,,jenny.wakeford@childrensal.org,www.childrensal.org
AL-000254,The Kirklin Clinic,"University of Alabama Health Services Foundation, P.C.",1093768723,Other ECP Providers,2000 6th Ave S,,Birmingham,AL,35233-2110,Jefferson,"500 22nd Street South, Suite 506",,Birmingham,AL,35233-3110,Jefferson,Raheel M. Farough,"VP, Managed Care & Venture Support",205-934-6230,,rfarough@uabmc.edu,,,,,,
AL-000255,"AIDS Alabama, Inc.",AIDS Alabama,1811014020,Ryan White Providers,3529 7th Ave S,,Birmingham,AL,35222-3210,Jefferson,3529 7th Avenur S.,3521 7th Avenue S.,Birmingham,AL,35222,Jefferson,Elaine M. Cottle,Executive Director,205-324-9822,8185,elaine@aidsalabama.org,Mitchell Tarver,Clinical Director,205-324-9822,8211,mitchell.tarver@aidsalabama.org,http://www.aidsalabama.org/
AL-000256,Ensley Health Center,ALABAMA REGIONAL MEDICAL SERVICES.,1699179440,Federally Qualified Health Centers - Medical Services,417 19th Street Ensley,,Birmingham,AL,35218-1601,Jefferson,PO Box 11523,,Birmingham,AL,35205-1523,Jefferson,Pamela Weaver,Front Desk Supervisor,205-783-9300,,pweaver@arms.healthcare,Sharon Greenhill,Administrative Assistant to COO,205-783-9300,,sgreenhill@arms.healthcare,
AL-000257,CHC - Woodlawn,"CHRIST HEALTH CENTER, INC.",1821234246,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5720 1st Ave S,,Birmingham,AL,35212-2522,Jefferson,5720 1st Ave S,,Birmingham,AL,35212-2522,Jefferson,Robert R Record,CEO,205-380-9455,157,rrecord@christhealthcenter.org,Mike Benedict,COO,205-380-9455,136,mbenedict@christhealthcenter.org,
AL-000258,Eastern Health Center,State of Alabama Department of Public Health,1306907472,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",601 West Blvd,,Birmingham,AL,35206-1300,Jefferson,601 West Blvd,,Birmingham,AL,35206-1300,Jefferson,Toni Bellina,Clinic Administrator,205-930-1549,,toni.bellina@jcdh.org,,,334-206-3530,,,http://www.adph.org
AL-000259,UNIVERSITY OF ALABAMA HOSPITAL (inpatient hospital),University of Alabama Hospital,1154435824,Inpatient Hospitals (other than children's hospitals),619 19th St S,,Birmingham,AL,35233-1900,Jefferson,"500 22nd Street South, Suite 506",,Birmingham,AL,35233-3110,Jefferson,RAHEEL FAROUGH,"VP, MANAGED CARE VENTURE SUPPORT",205-934-6230,,rfarough@uabmc.edu,,,,,,www.uab.edu
AL-000260,UNIVERSITY OF ALABAMA HOSPITAL (multiple outpatient ECP categories),University of Alabama Hospital,1154435824,"Dental Providers, Ryan White Providers",619 19th St S,,Birmingham,AL,35233-1900,Jefferson,619 19TH STREET SOUTH,,BIRMINGHAM,AL,35233,Jefferson,RAHEEL FAROUGH,DIRECTOR MANAGED CARE VENTURE SUPPORT,205-934-6230,,rfarough@uabmc.edu,,,,,,www.uab.edu
AL-000261,Birmingham Health Care Metro Facility,ALABAMA REGIONAL MEDICAL SERVICES,1780990473,Federally Qualified Health Centers - Medical Services,712 25th St N,,Birmingham,AL,35203-2400,Jefferson,PO Box 11523,,Birmingham,AL,35202-1523,Jefferson,Pamela Weaver,Front Desk Supervisor,205-407-6900,,pweaver@arms.healthcare,Sharon Greenhill,Administrative Assistant to COO,205-407-6900,,sgreenhill@arms.healthcare,
AL-000262,University of Alabama at Birmingham,UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION,1093768723,"Dental Providers, Ryan White Providers",908 20th St S,,Birmingham,AL,35205-2610,Jefferson,500 SOUTH 22ND ST,,BIRMINGHAM,AL,35294,Jefferson,RAHEEL FAROUGH,DIRECTOR MANAGED CARE VENTURE SUPPORT,205-934-1917,,rfarough@uabmc.edu,,,,,,www.uab.edu
AL-000263,SARDIS CITY MEDICAL CENTER,QUALITY OF LIFE HEALTH SERVICES INC,1225089675,Federally Qualified Health Centers - Medical Services,1989 Sardis Dr,,Boaz,AL,35956-2344,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000264,Brewton Family Dental Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1700206703,Dental Providers,1115 Azalea Pl,,Brewton,AL,36426-1318,Escambia,1303 Dr. Martin Luther King Jr. Ave,,Mobile,AL,36603,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000265,Escambia County Health Department,Alabama Department of Public Health,1437292869,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1115 Azalea Pl,,Brewton,AL,36426-1318,Escambia,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000266,Lower Alabama Family Medical Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1699194951,Federally Qualified Health Centers - Medical Services,1205 Belleville Ave,,Brewton,AL,36426-1304,Escambia,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,2514348188,charles.white@franklinprimary.org,,,,,,
AL-000267,Dr. John T. Cooper,Dr. John T. Cooper,1821032012,Other ECP Providers,301 Saint Joseph Ave,,Brewton,AL,36426-2025,Escambia,212 S. Main St,,Atmore,AL,36502,Escambia,JOHN TAYLOR COOPER,Optometrist,251-391-0375,,JCOOPEROD@AOL.COM,John T. Cooper,Owner,251-391-0375,,jcooperod@aol.com,
AL-000268,"NORTHEAST ALABAMA HEALTH SERVICES, INC. - NORTH SAND MOUNTAIN","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1356498505,Federally Qualified Health Centers - Medical Services,29810 AL Highway 71,,Bryant,AL,35958-5240,Jackson,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,369,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000269,Choctaw County Health Department,Alabama Department of Public Health,1699818179,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1001 S Mulberry Ave,,Butler,AL,36904-2813,Choctaw,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000270,Choctaw Urgent Care Center,"Rush Hospital/Butler, Inc.",1013355106,Rural Health Clinics,1404 E Pushmataha St,,Butler,AL,36904-2728,Choctaw,PO Box 908,,Meridian,MS,39302-0908,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,https://www.rushhealthsystems.org/clinics/choctaw-urgent-care-center/
AL-000271,Choctaw General Hospital,"Rush Hospital/Butler, Inc.",1184993727,Inpatient Hospitals (other than children's hospitals),401 Vanity Fair Ave,,Butler,AL,36904-3032,Choctaw,PO Box 908,,Meridian,MS,39302-0908,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,https://www.rushhealthsystems.org/hospitals/choctaw-general-hospital/
AL-000272,Wilcox County Health Department,Alabama Department of Public Health,1588707863,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",107 Union St,,Camden,AL,36726-1728,Wilcox,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000273,YELLOW BLUFF - CAMDEN HEALTH CENTER,"Rural Health Medical Program, Inc",1760561419,Federally Qualified Health Centers - Medical Services,2210 Highway 221,,Camden,AL,36726-4233,Wilcox,713 JL Chestnut Blvd,PO Box 2213,Selma,AL,36702-2213,Dallas,Keshee Smith,CEO,334-874-7428,122,smithk@rhmpi.com,Meneka Johnson,CCO,334-874-7428,125,johnsonm@rhmpi.com,
AL-000274,Pickens County Health Department,Alabama Department of Public Health,1083757280,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",80 William E Hill Dr,,Carrollton,AL,35447-3231,Pickens,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000275,Castleberry Medical Clinic,DW McMillan Memorial Hospital,1396125258,Rural Health Clinics,1674 Cleveland Ave,,Castleberry,AL,36432,Conecuh,PO Box 908,,Brewton,AL,36427,Escambia,Michael Myrick,CLINIC MANAGER,251-296-2456,1203,mmyrick@dwmmh.org,Stacy Hines,Director,251-867-8061,8429,shines@dwmmh.org,
AL-000276,Cherokee Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1851676605,"Dental Providers, Federally Qualified Health Centers - Medical Services",4055 AL Highway 9,Suite F,Cedar Bluff,AL,35959-5173,Cherokee,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000277,Cherokee Health Clinic,Centre RHC Corp,1225087422,Rural Health Clinics,395 Northwood Dr,,Centre,AL,35960-1045,Cherokee,395 Northwood Drive,,Centre,AL,35960,Cherokee,Amber Morris,Director of Physician Practices,256-927-9162,,amber_morris@quorumhealth.com,Sherry Walker,Office Manager,256-927-4600,230,sherry_walker@quorumhealth.com,
AL-000278,Cherokee County Health Department,Alabama Department of Public Health,1386787869,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",833 Cedar Bluff Rd,,Centre,AL,35960-1005,Cherokee,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,35960-0176,Montgomery,Mary Gomillion,Clinic Administrator,256-547-6311,,Laurie.gregory@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,http://www.adph.org
AL-000279,Bibb County Health Department,Alabama Department of Public Health,1295878734,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",281 Alexander Ave,,Centreville,AL,35042-2953,Bibb,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000280,Cahaba Medical Care,Cahaba Medical Care,1316201809,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",405 Belcher St,,Centreville,AL,35042-2946,Bibb,405 Belcher Street,,Centreville,AL,350422946,Bibb,"John B. Waits, MD",CEO,205-926-2992,,John.Waits@cahabamedicalcare.com,Lacy Smith,COO,205-926-2992,,lacy.smith@cahabamedicalcare.com,www.cahabamedicalcare.com
AL-000281,Washington County Health Department,Alabama Department of Public Health,1619010816,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",14900 Saint Stephens Ave,,Chatom,AL,36518-6715,Washington,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000282,Citronelle Clinic,"MOBILE, COUNTY OF",1053406280,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",19250 N Mobile St,,Citronelle,AL,36522-2122,Mobile,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,8833,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,8876,,http://www.adph.org
AL-000283,Clanton Family Health Center,"HEALTH SERVICES, (INC)",1700808664,Federally Qualified Health Centers - Medical Services,107 Medical Center Dr,,Clanton,AL,35045-2331,Chilton,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000284,Chilton County Health Department,Alabama Department of Public Health,1356484836,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 Health Center Dr,,Clanton,AL,35045-2349,Chilton,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000285,Barbour County Health Department - Clayton Branch,State of Alabama Department of Public Health,1770626194,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",39 Browder St,,Clayton,AL,36016-2079,Barbour,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Laurie.gregory@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000286,CLAYTON FAMILY HEALTH CENTER,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1710048053,Federally Qualified Health Centers - Medical Services,7 Western Byp,,Clayton,AL,36016-2013,Barbour,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000287,LAWRENCE RURAL HEALTH CLINIC-COURTLAND,"Attentus Moulton, LLC",1033155791,Rural Health Clinics,350 Tennessee St,,Courtland,AL,35618-3357,Lawrence,202 Hospital Street,,Moulton,AL,35650,Lawrence,Martha Everly,Clinic Manager,205-637-8033,,martha.everly@lawrencemedicalcenter.com,Connie Blankenship,Billing Credentialing Manager,256-522-2212,,connie.blankenship@lawrencemedicalcenter.com,
AL-000288,"South DeKalb Family Medical Assoc., PC","South DeKalb Family Medical Assoc., PC",1538487020,Rural Health Clinics,15239 AL Highway 68,,Crossville,AL,35962-3481,DeKalb,15239 AL Hwy 68W,,Crossville,AL,35962,DeKalb,Debbie Bonds,Office Manager,256-593-1234,112,debbiebonds@med-asst.com,Penny Davis,Credentialling Clerk,256-593-1234,111,pennydavis@med-asst.com,www.med-asst.com
AL-000289,CULLMAN QUALITY HEALTH CARE,QUALITY OF LIFE HEALTH SERVICES INC,1467402768,"Dental Providers, Federally Qualified Health Centers - Medical Services",2016 Main Ave SW,,Cullman,AL,35055-5239,Cullman,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000290,Cullman County Health Department,Alabama Department of Public Health,1891838223,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",601 Logan Ave SW,,Cullman,AL,35055-4520,Cullman,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000291,Tallapoosa County Health Department - Dadeville Clinic,Alabama Department of Public Health,1104969559,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",220 W Lafayette St,,Dadeville,AL,36853-1327,Tallapoosa,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000292,"Family Health Care Clinic, Inc., --Decatur","FAMILY HEALTH CARE CLINIC, INC.",1184857195,Federally Qualified Health Centers - Medical Services,1304 13th Ave SE,Suite A,Decatur,AL,35601-4316,Morgan,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
AL-000293,Medical East of Decatur,Medical East of Decatur,1659518553,Rural Health Clinics,2941 Point Mallard Pkwy SE,,Decatur,AL,35603-5716,Morgan,2941 Point Mallard Pkwy,,Decatur,AL,35603,Morgan,Jeanne Lindsay,Office Manager,256-432-2822,,jlindsay9253@gmail.com,,,,,,
AL-000294,Morgan County Health Department,Alabama Department of Public Health,1548303977,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3821 US Highway 31 S,,Decatur,AL,35603-1637,Morgan,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000295,Dothan Family Health Center,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1194087593,Federally Qualified Health Centers - Medical Services,1450 Ross Clark Cir,Suite 400,Dothan,AL,36301-4770,Houston,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000296,Houston County Health Department,Alabama Department of Public Health,1114060316,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1781 E Cottonwood Rd,,Dothan,AL,36301-5309,Houston,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-012435,Center for Vein Restoration,Center for Vein Restoration,1164897427,Other ECP Providers,3280 Ross Clark Cir,,Dothan,AL,36303-3040,Houston,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
AL-000297,Winston County Health Department,Alabama Department of Public Health,1164565370,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",110 Legion Rd,,Double Springs,AL,35553-2365,Winston,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000298,DOZIER FAMILY HEALTH CENTER,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1063573301,Federally Qualified Health Centers - Medical Services,18131 Dozier Hwy,,Dozier,AL,36028-2719,Crenshaw,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000299,Eclectic Family Health Center,"HEALTH SERVICES, (INC)",1982626842,Federally Qualified Health Centers - Medical Services,30 Main St,,Eclectic,AL,36024-5614,Elmore,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000300,ENTERPRISE CHILDREN'S CENTER AND FAMILY MEDICINE,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1891856134,Federally Qualified Health Centers - Medical Services,105 E Watts St,,Enterprise,AL,36330-2511,Coffee,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000301,Coffee County Health Department,Alabama Department of Public Health,1487797965,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2841 Neil Metcalf Rd,,Enterprise,AL,36330-8003,Coffee,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000302,Eufaula Internal Medicine,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1710933098,Federally Qualified Health Centers - Medical Services,23 Veteran Blvd,,Eufaula,AL,36027-4444,Barbour,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000303,Barbour County Health Department - Eufaula Clinic,State of Alabama Department of Public Health,1487797924,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",634 School St,,Eufaula,AL,36027-2430,Barbour,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000304,Medical Center Barbour,Medical Center Barbour Hospital,1548773450,Inpatient Hospitals (other than children's hospitals),820 W Washington St,,Eufaula,AL,36027-1822,Barbour,820 West Washington Street,,Eufaula,AL,36027,Barbour,Michele Waters,Director Senior Care Center,334-688-7185,,mwaters@medctrbarbour.org,Christy Moore,Director of Nursing,334-688-7274,,clmoore@medctrbarbour.org,
AL-000305,Eutaw Health Center,"Whatley Health Services, Inc",1831133958,Federally Qualified Health Centers - Medical Services,200 Morrow Ave,,Eutaw,AL,35462-1106,Greene,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,,205-614-6135,,dtucker@whatleyhealth.org,
AL-000306,Greene County Health Department,Alabama Department of Public Health,1205979408,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",412 Morrow Ave,,Eutaw,AL,35462-1109,Greene,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Tammy Yager,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000307,Greene County Hospital,Greene County Health Services,1043389398,Inpatient Hospitals (other than children's hospitals),607 Wilson Ave,,Eutaw,AL,35462-1136,Greene,509 WILSON AVENUE,,Eutaw,AL,35462,Greene,Alma Cole,CLINICAL MANAGER,205-535-9857,,alma.cole@gcheutaw.com,Elmore Patterson,CEO,205-372-3388,212,elmore.patterson@gcheutaw.com,
AL-000308,Greene County Physicians Clinic,Greene County Health Services,1043389398,"Family Planning Providers, Rural Health Clinics",607 Wilson Ave,,Eutaw,AL,35462-1064,Greene,509 WILSON AVENUE,,EUTAW,AL,35462,Greene,Alma Cole,CLINICAL MANAGER,205-535-9857,,alma.cole@gcheutaw.com,TIFFANY GRISBY,CFO,205-372-3388,302,TIFFANY.GRISBY@GCHEUTAW.COM,
AL-000309,Eva Family Health Center,"CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.",1972869931,Federally Qualified Health Centers - Medical Services,4208 Eva Rd,Suite B,Eva,AL,35621-7629,Morgan,110 Walker Ave NE,,Huntsville,AL,35801-4739,Madison,"Carleton H. A. Pyfrom, Sr.",President and CEO,256-534-8659,1403,cpyfrom@cnahsi.com,Kriska Gurley,Executive Assistant,256-534-8659,1403,kgurley@cnahsi.com,www.cnahsi.com
AL-000310,EVERGREEN PRIMARY CARE,EVERGREEN MEDICAL CENTER LLC,1427366871,Rural Health Clinics,100 Edwina St,,Evergreen,AL,36401-3319,Conecuh,101 CRESTVIEW AVE,,EVERGREEN,AL,36401-3333,Conecuh,SHARON JONES,CFO,251-578-2480,,SJONES@EVERGREENMEDICAL.ORG,TOM MCLENDON,CEO,251-578-2480,,TMCLENDON@EVERGREENMEDICAL.ORG,
AL-000311,Conecuh County Health Department,Alabama Department of Public Health,1164565586,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",102 Wild Ave,,Evergreen,AL,36401-2134,Conecuh,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000312,Evergreen Family Medical Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1912327479,Federally Qualified Health Centers - Medical Services,316 S Main St,,Evergreen,AL,36401-3325,Conecuh,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000313,"Falkville Medical Clinic, LLC","Falkville Medical Clinic, LLC",1518301837,Rural Health Clinics,434 E Pike Rd,,Falkville,AL,35622-5109,Morgan,434 E Pike Rd,,Falkville,AL,35622,Morgan,Jessica Flores,Operations Manager,256-784-2200,,jessica.familycarefirst@gmail.com,,,,,,
AL-000314,Fayette County Health Department,Alabama Department of Public Health,1588707780,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",215 1st Ave NW,,Fayette,AL,35555-2331,Fayette,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000315,Flomaton Medical Center,DW McMillan Memorial Hospital,1497852735,Rural Health Clinics,174 Highway 113,,Flomaton,AL,36441-4556,Escambia,PO Box 908,,Brerwton,AL,36427,Escambia,Michael Myrick,CLINIC MANAGER,251-296-2456,1203,mmyrick@dwmmh.org,Stacy Hines,Director of Physician Services,215-867-8061,8439,shines@dwmmh.org,
AL-000316,"Family Health Care Clinic, Inc. --Florence","FAMILY HEALTH CARE CLINIC, INC.",1730312745,Federally Qualified Health Centers - Medical Services,216 Marengo St,Suite A,Florence,AL,35630-6034,Lauderdale,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,
AL-000317,Lauderdale County Health Department,Alabama Department of Public Health,1588707913,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4112 Chisholm Rd,,Florence,AL,35630-7345,Lauderdale,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000318,South Baldwin Family Health Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1932416195,Federally Qualified Health Centers - Medical Services,1628 N McKenzie St,Suite 102,Foley,AL,36535-2275,Baldwin,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000319,FORT MITCHELL CLINIC PC,FORT MITCHELL CLINIC PC,1568748242,Rural Health Clinics,2 Gilmore Rd,,Fort Mitchell,AL,36856-4442,Russell,2 GILMORE RD,,FORT MITCHELL,AL,36856,Russell,RAJIV L SRIVASTAVA,ADMINISTRATOR,334-664-1960,3327,LSRAJIV@GMAIL.COM,RITU CHANDRA,MEDICAL DIRECTOR,334-664-1960,3312,DOCRITU@HOTMAIL.COM,
AL-000320,Fort Payne Pediatrics,"Fort Payne Pediatrics, LLC",1356746085,Rural Health Clinics,1359 Old Water Works Rd SW,,Fort Payne,AL,35968-3347,DeKalb,1359 Old Waterworks Road,,Fort Payne,AL,35968,DeKalb,Morgan Pinholster,HR Manager,256-997-5900,116,mpinholster@fortpaynepeds.com,Jessica Cushen,Office Manager,256-997-5900,113,jcushen@fortpaynepeds.com,
AL-000321,Fort Payne Pediatrics # 1,"Fort Payne Pediatrics, LLC",1033477393,Rural Health Clinics,1906 Glenn Blvd SW,Suite 100A,Fort Payne,AL,35968-3546,DeKalb,1906 Glenn Blvd. Suite 100-A,,Fort Payne,AL,35968,DeKalb,Morgan Pinholster,HR Manager,256-997-5900,116,mpinholster@fortpaynepeds.com,Jessica Cushen,Office Manager,256-997-5900,113,jcushen@fortpaynepeds.com,
AL-000322,Dekalb County Health Department,Alabama Department of Public Health,1679616874,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2401 Calvin Dr SW,,Fort Payne,AL,35967-1100,DeKalb,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000323,"VALLEYHEAD CLINIC, LLC","VALLEYHEAD CLINIC, LLC",1528467388,Rural Health Clinics,2605 Gault Ave N,Suite 200,Fort Payne,AL,35967-3700,DeKalb,"2605 GAULT AVE N, STE 200",,FORT PAYNE,AL,35967,DeKalb,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,MANAGER.CLINIC@HOTMAIL.COM,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000324,"NORTHEAST ALABAMA HEALTH SERVICES, INC. - FORT PAYNE","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1831346386,Federally Qualified Health Centers - Medical Services,3840 Gault Ave N,,Fort Payne,AL,35967-5211,DeKalb,309 Taylor St,,Scottsboro,AL,35768-2421,DeKalb,Deborah Culpepper,CEO,256-259-5313,221,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000325,DeKalb Clinic,Fort Payne RHC Corp,1184679938,Rural Health Clinics,415 Medical Center Dr SW,,Fort Payne,AL,35968-3421,DeKalb,415 Medical Center Drive SW,,Fort Payne,AL,35968,De Kalb,Amber Morris,Director of Physician Practices,256-927-9162,,amber_morris@quorumhealth.com,Karen Barnett,Practice Manager,256-997-2820,,karen_barnett@quorumhealth.com,
AL-000326,Frisco City Family Medical Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1982024402,Federally Qualified Health Centers - Medical Services,53 Mulberry St,,Frisco City,AL,36445-4484,Monroe,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000327,"NORTHEAST ALABAMA HEALTH SERVICES, INC. - FYFFE","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1104973353,Federally Qualified Health Centers - Medical Services,34617 AL Highway 75,,Fyffe,AL,35971-3488,DeKalb,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,221,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000328,ROBERTA O. WATTS MEDICAL CENTER,QUALITY OF LIFE HEALTH SERVICES INC,1366492597,Federally Qualified Health Centers - Medical Services,1020 Tuscaloosa Ave,,Gadsden,AL,35901-3005,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000329,GADSDEN FAMILY & STUDENT HEALTH SOLUTIONS,QUALITY OF LIFE HEALTH SERVICES INC,1184673535,"Dental Providers, Federally Qualified Health Centers - Medical Services",1216 Wilbanks Ave,,Gadsden,AL,35903-2024,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000330,J.W. STEWART NEIGHBORHOOD HEALTH CENTER,QUALITY OF LIFE HEALTH SERVICES INC,1750332243,Federally Qualified Health Centers - Medical Services,1409 Springfield Ave,,Gadsden,AL,35903-2819,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000331,Quality of Life Health Complex,"Quality of Life Health Services, Inc.",1447200977,"Dental Providers, Federally Qualified Health Centers - Medical Services",1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000332,PROCARE - COLLEY HOMES,QUALITY OF LIFE HEALTH SERVICES INC,1023069416,Federally Qualified Health Centers - Medical Services,420 N 6th St,,Gadsden,AL,35901-3244,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-439-6303,,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000333,Canterberry Family Practice,QUALITY OF LIFE HEALTH SERVICES INC,1902856214,Federally Qualified Health Centers - Medical Services,502 N 27th St,,Gadsden,AL,35904-1580,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Devlopment Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000334,Etowah County Health Department,Alabama Department of Public Health,1346383775,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",709 E Broad St,,Gadsden,AL,35903-2452,Etowah,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000335,Geneva Family Health Center,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1659658391,Federally Qualified Health Centers - Medical Services,100 W Lake Professional Park,Suite 1,Geneva,AL,36340-1200,Geneva,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000336,Ivy Creek Clinic,"Ivy Creek of Butler, LLC",1245372168,Rural Health Clinics,125 Church St,,Georgiana,AL,36033-4268,Butler,125 Church Street,,Georgiana,AL,36033-4519,Butler,Patti Cook,Administrator,334-376-2205,2207,pcook@georgianahospital.com,,,,,,
AL-000337,Butler Primary Care,"Ivy Creek of Butler, LLC",1477979672,Rural Health Clinics,138 Jones St,,Georgiana,AL,36033-4510,Butler,138 Jones Street,,Georgiana,AL,36033-4519,Butler,Patti Cook,Administrator,334-376-2205,2207,pcook@georgianahospital.com,,,,,,
AL-000338,Dekalb Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1417191594,"Dental Providers, Federally Qualified Health Centers - Medical Services",12062 AL Highway 227,,Geraldine,AL,35974-3562,DeKalb,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000339,GILBERTOWN MEDICAL/DENTAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1093775918,"Dental Providers, Federally Qualified Health Centers - Medical Services",140 Front St,Suite 4,Gilbertown,AL,36908-5510,Choctaw,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000340,Health Partners of Goodwater,Russell Medical Center,1174990626,Rural Health Clinics,21342 Alabama Hwy 9,,Goodwater,AL,35072,Coosa,3316 Highway 280,,Alexander City,AL,35010,Tallapoosa,Tammy V. Coker,CRNP-FNP,256-743-1300,,tcoker@russellmedcenter.com,Jim Peace,CEO Russell Medical,,,jpeace@russellmedicalcenter.com,
AL-000341,South Alabama Medical Clinic,South Alabama Medical Clinic,1811288038,Rural Health Clinics,10075 Grand Bay Wilmer Rd S,,Grand Bay,AL,36541-5003,Mobile,10075 Grand Bay Wilmer Rd. S.,,Grand Bay,AL,36541,Mobile,Cherri Bedwell,Office Manager,251-865-1852,,cbedwell@southalabamamedicalclinic.com,Lloyd Sean Stokes,Managing Partner,251-865-1852,,sstokes@southalabamamedicalclinic.com,
AL-000342,Hale County Health Department,State of Alabama Department of Public Health,1164565594,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",670 Hall St,,Greensboro,AL,36744-2516,Hale,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000343,Hale County Health Center,"Whatley Health Services, Inc",1285655936,"Dental Providers, Federally Qualified Health Centers - Medical Services",800 Hall St,,Greensboro,AL,36744-2517,Hale,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Rolling,CFO,205-777-8521,,jrolling9435@yahoo.com,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000344,Butler County Health Department,Alabama Department of Public Health,1043353592,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",350 Airport Rd,,Greenville,AL,36037-8822,Butler,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000345,Clarke County Health Department,Alabama Department of Public Health,1508909086,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",22600 Highway 84,,Grove Hill,AL,36451-5481,Clarke,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000346,Grove Hill Healthcare,Grove Hill Healthcare,1396796611,Rural Health Clinics,295B S Jackson St,,Grove Hill,AL,36451-3231,Clarke,295 South Jackson Street,,Grove Hill,AL,36451,Clarke,William Wiggins,Office Manager,251-275-3173,,williamwiggins.ghmh@gmail.com,Roxanne Smith,Administrative Assistant,251-275-3173,,rsmith@grovehillmemorial.org,
AL-000347,Marshall County Health Department,Alabama Department of Public Health,1265575468,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",150 Judy Smith Dr,,Guntersville,AL,35976-4500,Marshall,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000348,MORROW CLINICS INC,MORROW CLINIC'S INC,1992816185,Rural Health Clinics,34867 US Highway 43,PO Box 221,Hackleburg,AL,35564-4281,Marion,34867 us hwy 43,P.O.Box 221,Hackleburg,AL,35564,Marion,Jerita Whitehead,Office Manager,205-935-3744,,jerita10@yahoo.com,,,,,,
AL-000349,"Family Care First, Inc","Family Care First, Inc",1861765638,Rural Health Clinics,1023 Highway 13,,Haleyville,AL,35565-1638,Winston,1023 AL hwy 13,,Haleyville,AL,35565,Winston,Jessica Flores,Operations Manager,205-486-5050,,jessica.familycarefirst@gmail.com,,,,,,
AL-000350,Hamilton Primary Care Center,Marion Regional Medical Center,1205254356,Rural Health Clinics,1256 Military St S,,Hamilton,AL,35570-5003,Marion,1256 Military Street South,,Hamilton,AL,35570,Marion,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
AL-000351,Marion County Health Department,Alabama Department of Public Health,1356484554,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2448 Military St S,,Hamilton,AL,35570-6673,Marion,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000352,"SOUTHVIEW MEDICAL CLINIC, LLC","SOUTHVIEW MEDICAL CLINIC, LLC",1033554357,Rural Health Clinics,222 Arkadelphia Rd NE,,Hanceville,AL,35077-4700,Cullman,222 ARKADELPHIA RD NE,,HANCEVILLE,AL,35077-1210,Cullman,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,MANAGER.CLINIC@HOTMAIL.COM,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000353,Geneva Co. Health Dept.,Alabama Department of Public Health,1255474680,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 County Road 41,,Hartford,AL,36344-5177,Geneva,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000354,LOWNDES COUNTY HEALTH DEPARTMENT,Alabama Department of Public Health,1740323948,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",507 E Tuskeena St,,Hayneville,AL,36040-2666,Lowndes,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000355,Hayneville Family Health Center,"HEALTH SERVICES, (INC)",1598788218,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",511 E Tuskeena St,,Hayneville,AL,36040-2666,Lowndes,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-263-2301,,veronica.thompson@hservinc.org,George Waldrop,Chief Financial Officer,334-420-5029,,george.waldrop@hservinc.org,
AL-000356,Henry Co. Health Dept. Headland Branch,Alabama Department of Public Health,1760525190,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2 Cable St,,Headland,AL,36345-2136,Henry,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000357,Cleburne Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1467620989,"Dental Providers, Federally Qualified Health Centers - Medical Services",64 Giles St,,Heflin,AL,36264-1738,Cleburne,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000358,Cleburne Co. Health Dept.,Alabama Department of Public Health,1376686543,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",90 Brockford Rd,,Heflin,AL,36264-1677,Cleburne,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000359,"MIDWAY MEDICAL CLINIC, LLC","MIDWAY MEDICAL CLINIC, LLC",1386984649,Rural Health Clinics,111 Brooklyn Rd,,Holly Pond,AL,35083-6478,Cullman,111 BROOKLYN RF,,HOLLYPOND,AL,35083-6478,Cullman,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,manager.clinic@hotmail.com,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000360,Douglas Medical Center,QUALITY OF LIFE HEALTH SERVICES INC,1033371562,Federally Qualified Health Centers - Medical Services,8225 AL Highway 75,,Horton,AL,35980-8473,Marshall,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000361,Madison Co. Health Dept.,State of Alabama Dept. of Public Health,1285777615,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 Max Luther Dr NW,,Huntsville,AL,35811-1724,Madison,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000362,Thrive Alabama - The Davis Clinic,"AIDS Action Coalition of Huntsville, Inc d/b/a Thrive Alabama",1770635633,Ryan White Providers,600 Saint Clair Ave SW,Suite 3,Huntsville,AL,35801-5057,Madison,600 St Clair Ave,Bldg 3,Huntsville,AL,35801,Madison,Jitesh Parmar,Chief Operating Officer,256-536-4700,155,jparmar@thrivealabama.org,Mary Rozier-Hachen,Director of Clinical Services,256-536-4700,138,mhachen@thrivealabama.org,http://www.thrivealabama.org
AL-000363,Huntsville Family Health Center,"CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.",1407891336,"Dental Providers, Federally Qualified Health Centers - Medical Services",751 Pleasant Row NW,,Huntsville,AL,35816-2537,Madison,110 Walker Ave NE,,Huntsville,AL,35801-4739,Madison,"Carleton H. A. Pyfrom, Sr.",President and CEO,256-534-8659,1403,cpyfrom@cnahsi.com,Kriska Gurley,Executive Assistant,256-534-8659,1403,kgurley@cnahsi.com,www.cnahsi.com
AL-000364,Crestwood Medical Center,ALABAMA REGIONAL MEDICAL SERVICES,1093119109,Federally Qualified Health Centers - Medical Services,7001 Crestwood Blvd,Suite 822,Irondale,AL,35210-2344,Jefferson,PO Box 11523,,Birmingham,AL,35202-1523,Jefferson,Pamela Weaver,Front Desk Supervisor,205-421-9615,,pweaver@arms.healthcare,Sharon Greenhill,Administrative Assistant to COO,205-421-9615,,sgreenhill@arms.healthcare,
AL-000365,Mostellar Medical Center,"Bayou La Batre Area Health Development Board, Inc.",1396794426,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",12701 Padgett Switch Rd,,Irvington,AL,36544-4011,Mobile,12701 Padgett Switch Road,,Irvington,AL,36544-4011,Mobile,Judi L. Steiner,Risk Managemen/Credentialing Coordinator,251-824-2174,5251,jsteiner@mostellarmedical.org,Alice Elizabeth (Beth) Edwards,Director of Operations,251-824-2174,5275,bedwards@mostellarmedical.org,www.mostellarmedical.org
AL-000366,BHC - WALKER PRIMARY CARE,Baptist Health Centers,1033451992,Rural Health Clinics,3400 Highway 78 E Ste 321,East Medical Arts Tower,Jasper,AL,35501-8951,Walker,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000367,Walker Co. Health Dept.,Alabama Department of Public Health,1497898761,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",705 20th Ave E,,Jasper,AL,35501-4071,Walker,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000368,Capstone Rural Health Center- Jasper Cottage,"CAPSTONE RURAL HEALTH CENTER, THE",1821043837,Federally Qualified Health Centers - Medical Services,714 12th St W,,Jasper,AL,35501-4519,Walker,5947 Highway 269,,Parrish,AL,35580-3847,Walker,Foster D Jones,Executive Director,205-292-9929,,fdjones@capstoneclinic.org,Cheryl Schober,Billing Manager,205-724-9028,9028,cschober@capstoneclinic.org,
AL-000369,BHC Jemison,Baptist Health Centers,1760446876,Rural Health Clinics,25420 US Highway 31,,Jemison,AL,35085-7868,Chilton,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000370,BHC LINCOLN,Baptist Health Centers,1770547804,Rural Health Clinics,47344 US Highway 78,,Lincoln,AL,35096-6748,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000371,Marengo Co. Health Dept.,Alabama Department of Public Health,1093858425,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",303 Industrial Dr,,Linden,AL,36748-2002,Marengo,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000372,Clay Co. Health Dept.,Alabama Department of Public Health,1134262611,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",86892 Highway 9,,Lineville,AL,36266-6949,Clay,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000373,Sumter Co. Health Dept.,Alabama Department of Public Health,1700929908,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1121 N Washington St,,Livingston,AL,35470-5415,Sumter,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000374,Rush Medical Group/Livingston,"Kemper CAH, Inc.",1982040317,Rural Health Clinics,1221 N Washington St,,Livingston,AL,35470-5410,Sumter,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,https://www.rushhealthsystems.org/clinics/rush-medical-group-livingston/
AL-000375,LOXLEY FAMILY MEDICAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1447229208,Federally Qualified Health Centers - Medical Services,1083 E Relham Dr,,Loxley,AL,36551-2406,Baldwin,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000376,LOXLEY FAMILY DENTAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1982886727,Dental Providers,3147 1st Ave,,Loxley,AL,36551,Baldwin,1303 Dr. Martin Luther King jr. Avenue,,Mobile,AL,36603,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000377,Crenshaw Co. Health Dept.,Alabama Department of Public Health,1982747309,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",15 Hospital Dr,,Luverne,AL,36049-7341,Crenshaw,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000378,Maplesville Office,Cahaba Medical Care Foundation,1316201809,Federally Qualified Health Centers - Medical Services,9431 Highway 22,,Maplesville,AL,36750,Chilton,405 Belcher St,,Centreville,AL,35042,Bibb,Kay Cox,COO,205-277-2384,,kay.cox@cahabamedicalcare.com,Lacy Smith,CMO,205-926-2992,,lacy.smith@cahabamedicalcare.com,
AL-000379,MARION HEALTH CENTER,"RURAL HEALTH MEDICAL PROGRAM, INC.",1437238151,Federally Qualified Health Centers - Medical Services,1313 Washington St,,Marion,AL,36756,Perry,713 JL Chestnut Blvd,PO Box 2213,Selma,AL,36702-2213,Dallas,Keshee Smith,CEO,334-874-7428,122,smithk@rhmpi.com,Meneka Johnson,CCO,334-874-7428,125,johnsonm@rhmpi.com,
AL-000380,Perry County Health Department,Alabama Department of Public Health,1457494882,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1748 S Washington St,,Marion,AL,36756-3406,Perry,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000381,Marion Clinic,Vaughan Regional Medical Center - Marion Clinic,1770600066,Rural Health Clinics,1768 S Washington St,,Marion,AL,36756-3406,Perry,1015 Medical Center Pkwy,,Selma,AL,36701,Dallas,Malinda Stewart,Office Manager,334-683-9085,,sherpri.small@lpnt.net,Sherpri Small,Regional Director,615-509-5945,,sherpri.small@lpnt.net,
AL-000382,Southwest Alabama Health Services,"Bayou La Batre Area Health Development Board, Inc.",1396794426,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",7777 Highway 43,,McIntosh,AL,36553-6621,Washington,12701 Padgett Switch Road,,Irvington,AL,36544-4011,Mobile,Janet Eddings,Office Manager,251-944-2842,303,jeddings@mostellarmedical.org,Alice Elizabeth (Beth) Edwards,Director of Operations,251-824-2174,5275,bedwards@mostellarmedical.org,www.mostellarmedical.org
AL-000383,Western Health Center,State of Alabama Dept. of Public Health,1376603050,"Family Planning Providers, Sexually Transmitted Disease Clinics",631 Bessemer Super Hwy,,Midfield,AL,35228-3013,Jefferson,631 Bessemer Super Highway,,Midfield,AL,35233,Jefferson,Toni Bellina,Clinic Administrator,205-930-1569,,toni.bellina@jcdh.org,,,334-206-3530,,,http://www.adph.org
AL-000384,H.E. SAVAGE CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1104895952,Federally Qualified Health Centers - Medical Services,1201 Spring Hill Ave,,Mobile,AL,36604-2717,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000385,Medical Mall - Administrative Site,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1679532303,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",1303 Martin Luther King Jr Ave,,Mobile,AL,36603,Mobile,1303 Martin Luther King Jr. Ave.,,Mobile,AL,36603,Mobile,Charles White,Chief Executive Officer,251-432-4117,,charles.white@franklinprimary.org,Michelle Bernard,Ryan White Program Manager,251-436-7633,,michelle.bernard@franklinprimary.org,www.franklinprimary.org
AL-000386,"J.R. Thomas Wellness, Fitness, and Rehabilitation Center","FRANKLIN PRIMARY HEALTH CENTER, INC.",1710117213,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1361 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000387,Children's Rehabilitation Service Mobile Office,Alabama Department of Rehabilitation Services,1134273063,Hemophilia Treatment Centers,1610 Center St,Suite A,Mobile,AL,36604-1512,Mobile,602 South Lawrence Street,,Montgomery,AL,36104,Montgomery,Kim McLaughlin,Hemophilia Program Coordinator/Specialist,334-293-7132,,kim.mclaughlin@rehab.alabama.gov,Melinda M Davis,CRS Director,334-293-7049,,melinda.davis@rehab.alabama.gov,
AL-000388,USA Children's and Women's Hospital,USA Children's and Women's Hospital,1023055191,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1700 Center St,,Mobile,AL,36604-3301,Mobile,P.O. Box 2867,,Mobile,AL,36652-2867,Mobile,Angelia Lewis,"CEO, Director-Family Health",251-690-8833,,alewis@mchd.org,James Dixon,Health Services Administrator,251-445-8638,,jdixon@mchd.org,http://mchd.org/General/Home.aspx
AL-000389,MAYSVILLE MEDICAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1225006679,Federally Qualified Health Centers - Medical Services,1956 Duval St,,Mobile,AL,36606-1145,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000390,UNIVERSITY OF SOUTH ALABAMA FAMILY SPECIALTY CLINIC,UNIVERSITY OF SOUTH ALABAMA,1700241015,Ryan White Providers,2451 USA Medical Center Dr,"Mastin Building, Ste 102",Mobile,AL,36617-2300,Mobile,2451 USA Medical Center Drive,Mastin Building 400-G,Mobile,AL,36617,Mobile,"Theresa Miller, MHS, PA-C",Physician Assistant/Program Coordinator,251-471-7844,,tprovince@health.southalabama.edu,"John Vande Waa, DO",Physician/Program Director,251-471-7895,,jvandewa@health.southalabama.edu,
AL-000391,"Women's and Children's Health Center, Newburn","MOBILE, COUNTY OF",1124042718,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",248 Cox St,Suite A,Mobile,AL,36604-3303,Mobile,251 N Bayou St,,Mobile,AL,36603,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,jfthomas@mchd.org,
AL-000392,"Family Oriente Primary Health Care Clinic, LLC","Mobile County Health Department/Family Oriented Primary Health Care Clinic, LLC",1063439065,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",251 N Bayou St,,Mobile,AL,36603-5827,Mobile,251 North Bayou Street,,Mobile,AL,36603,Mobile,Angelia D. Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,jfthomas@mchd.org,
AL-000393,Dauphin Island Parkway Health Center,"MOBILE, COUNTY OF",1164846283,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2601 Dauphin Island Pkwy,,Mobile,AL,36605-3472,Mobile,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,8833,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,8876,jfthomas@mchd.org,
AL-000394,Central Plaza Towers Health Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1487988499,Federally Qualified Health Centers - Medical Services,300 Bay Shore Ave,Bldg 306,Mobile,AL,36607-2009,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-012436,Center for Vein Restoration,Center for Vein Restoration,1164897427,Other ECP Providers,32 Tacon St,Suite A,Mobile,AL,36607-3138,Mobile,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
AL-000395,EIGHT MILE CLINIC,"MOBILE, COUNTY OF",1083709521,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4009 Saint Stephens Rd,,Mobile,AL,36612-1231,Mobile,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,,http://www.adph.org
AL-000396,Southwest Mobile Health Center,"MOBILE, COUNTY OF",1649523432,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5580 Inn Rd,,Mobile,AL,36619-1904,Mobile,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,jfthomas@mchd.org,
AL-000397,THE HADLEY MEDICAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1497724256,Federally Qualified Health Centers - Medical Services,572 Stanton Rd,,Mobile,AL,36617-2324,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000398,Planned Parenthood Southeast - Mobile Center,"Planned Parenthood Southeast, Inc.",1609829282,"Family Planning Providers, Sexually Transmitted Disease Clinics",717 Downtowner Loop W,,Mobile,AL,36609-5503,Mobile,"241 Peachtree Street NE, Suite 400",,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,,,,,,
AL-000399,West Mobile Family Medical Center,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1154551703,Federally Qualified Health Centers - Medical Services,801 S University Blvd,Suite D,Mobile,AL,36609-2949,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000400,Monroe Co. Health Dept.,Alabama Department of Public Health,1720121155,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",416 Agriculture Dr,,Monroeville,AL,36460-8686,Monroe,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000401,Chisholm Family Health Center,"HEALTH SERVICES, (INC)",1538181490,Federally Qualified Health Centers - Medical Services,100 E Vandiver Blvd,,Montgomery,AL,36110-1812,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000402,River Region Health Center,"HEALTH SERVICES, (INC)",1205844719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1845 Cherry St,,Montgomery,AL,36107-2613,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thomspn,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000403,Capital Family Health Center,"HEALTH SERVICES, (INC)",1548538010,Federally Qualified Health Centers - Medical Services,2140 Upper Wetumpka Rd,,Montgomery,AL,36107-1342,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thompson,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000405,Montgomery AIDS Outreach Inc.,"Montgomery AIDS Outreach, Inc.",1689651408,Ryan White Providers,2900 McGehee Rd,Suite A,Montgomery,AL,36111-2146,Montgomery,2900 McGehee Road,,Montgomery,AL,36111,Montgomery,Ashley Tarrant,Chief Operations Officer,334-386-0854,,atarrant@maoi.org,Benita Hillis,Chief Finance Officer,334-386-0855,,bhollis@maoi.org,www.maoi.org
AL-000404,Gateway Family Health Center,"HEALTH SERVICES, (INC)",1063654341,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2905 E South Blvd,,Montgomery,AL,36116-2501,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Vicki Ingram,Credentialing Specialist,334-420-5001,135,vicki.ingram@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000406,Montgomery County Health Department,Alabama Department of Public Health,1639212061,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3060 Mobile Hwy,,Montgomery,AL,36108-4027,Montgomery,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000407,Montgomery Primary Healthcare Center,"HEALTH SERVICES, (INC)",1528082336,"Dental Providers, Federally Qualified Health Centers - Medical Services",3060 Mobile Hwy,,Montgomery,AL,36108-4027,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thomspn,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000408,Children's Rehabilitation Service,Alabama Department of Rehabilitation Services,1134273063,Hemophilia Treatment Centers,602 S Lawrence St,,Montgomery,AL,36104-4787,Montgomery,602 S Lawrence St,,Montgomery,AL,36104,Montgomery,Kimberly McLaughlin,Hemophilia Program Coordinator,334-293-7132,,kim.mclaughlin@rehab.alabama.gov,Melinda Davis,Children's Rehabilitation Service Director,334-293-7049,,melinda.davis@rehab.alabama.gov,
AL-000409,Morris Health Center,State of Alabama Department of Public Health,1033270103,Family Planning Providers,590 Morris Majestic Rd,,Morris,AL,35116-1245,Jefferson,590 Majestic Road,,Morris,AL,35116-1245,Jefferson,Toni Bellina,Clinic Administrator,205-930-1569,,toni.bellina@jcdh.org,,,334-206-3530,,,http://www.adph.org
AL-000410,"LAWRENCE RHC, MOULTON/LAWRENCE URGENT CARE CENTER","Attentus Moulton,LLC",1124062286,"Black Lung Clinics, Rural Health Clinics",10939 Alabama Highway 157,,Moulton,AL,35650,Lawrence,202 Hospital Street,,Moulton,AL,35650,Lawrence,Martha Everly,Clinic Manager,205-974-3390,,martha.everly@lawrencemedicalcenter.com,Connie Blankenship,Billing Credentialing,256-522-2212,,connie.blankenship@lawrencemedicalcenter.com,
AL-000411,"Family Care First, Inc","Family Care First, Inc",1568758274,Rural Health Clinics,11809 Alabama Highway 157,,Moulton,AL,35650,Lawrence,11809 Alabama Hwy 157,,Moulton,AL,35650,Lawrence,Jessica Flores,Operations Manager,256-905-0340,,jessica.familycarefirst@gmail.com,,,,,,
AL-000412,Lawrence Co. Health Dept.,Alabama Department of Public Health,1013050442,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",13299 Alabama Hwy 157,,Moulton,AL,35650,Lawrence,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000413,COMPLETE FAMILY CARE,"ATTENTUS MOULTON, LLC",1699194308,Rural Health Clinics,94 Medical Cir,,Moulton,AL,35650-1256,Lawrence,202 HOSPITAL STREET,,MOULTON,AL,35650,Lawrence,MARTHA EVERLY,CLINIC MANAGER,256-974-9216,0,MARTHA.EVERLY@LAWRENCEMEDICALCENTER.COM,CONNIE BLANKENSHIP,BILLING CREDENTIALING MANAGER,256-522-2212,0,CONNIE.BLANKENSHIP@LAWRENCEMEDICALCENTER.COM,
AL-000414,North Mobile Health Center,"MOBILE, COUNTY OF",1639474778,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",950 W Coy Smith Hwy,,Mount Vernon,AL,36560-3201,Mobile,251 N Bayou St,,Mobile,AL,36603-5827,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,jfthomas@mchd.org,
AL-000415,BHC MUNFORD HEALTH CLINIC,Baptist Health Centers,1427012566,Rural Health Clinics,48 Cedars Rd,,Munford,AL,36268-7191,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000416,"Family Health Care Clinic, Inc.--Muscle Shoals","FAMILY HEALTH CARE CLINIC, INC.",1003049016,Federally Qualified Health Centers - Medical Services,102 Physicians Dr,Suite B,Muscle Shoals,AL,35661-2149,Colbert,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
AL-000417,Capstone Rural Health Nauvoo,"CAPSTONE RURAL HEALTH CENTER, THE",1821043837,Federally Qualified Health Centers - Medical Services,156 3rd Ave,,Nauvoo,AL,35578-3238,Walker,5947 Hwy 269,,Parrish,AL,35580,Walker,Foster D Jones,Executive Director,205-724-9018,9018,fdjones@capstoneclinic.org,Cheryl Schober,Billing Manager,205-724-9028,9028,cschober@capstoneclinic.org,
AL-000418,New Market Clinic,"CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.",1417068545,Federally Qualified Health Centers - Medical Services,110 Clinic St,,New Market,AL,35761-8507,Madison,110 Walker Ave NE,,Huntsville,AL,35801-4739,Madison,"Carleton H.A. Pyfrom, Sr.",President and CEO,256-534-8659,1403,cpyfrom@cnahsi.com,Kriska Gurley,Executive Assistant,256-534-8659,1403,kgurley@cnahsi.com,www.cnahsi.com
AL-000419,NEWTON FAMILY HEALTH CENTER,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1780745034,Federally Qualified Health Centers - Medical Services,193 Oates Dr,,Newton,AL,36352-4312,Dale,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000420,Oakman Health Center,"Whatley Health Services, Inc",1184642720,Federally Qualified Health Centers - Medical Services,10290 Main St,,Oakman,AL,35579-5845,Walker,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000421,BLOUNT COUNTY QUALITY HEALTH CARE,QUALITY OF LIFE HEALTH SERVICES INC,1912191644,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 Lincoln Ave,,Oneonta,AL,35121-2537,Blount,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000422,BLOUNT COUNTY HEALTH DEPARTMENT,Alabama Department of Public Health,1104969641,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1001 Lincoln Ave,,Oneonta,AL,35121-2533,Blount,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000423,St. Vincent's Primary Care - Oneonta,Ascension,1013468727,Rural Health Clinics,150 Gilbreath Dr,Suite 201,Oneonta,AL,35121-2827,Blount,St. Vincent's Blount,150 Gilbreath Drive,Oneonta,AL,35121,Blount,Marilyn Oden,Multi-Clinic Manager,205-446-1860,,marilyn.oden@ascension.org,Ansley Averett,Practice Transformation Manager,205-930-2903,,ansley.averett@ascension.org,
AL-012437,Center for Vein Restoration,Center for Vein Restoration,1164897427,Other ECP Providers,107 24th St,,Opelika,AL,36801-6253,Lee,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
AL-000424,Unity Wellness Center,"East Alabama Health Services, LLC",1972729598,Ryan White Providers,122 N 20th St,Bldg 26,Opelika,AL,36801-5442,Lee,East Alabama Health Services LLC d/b/a Unity Wellness Center,2000 Pepperell Parkway,Opelika,AL,36801,Lee,Lee Wilkins,Funding Manager,334-749-3593,204,lee.wilkins@eamc.org,Tracy Wynne,Clinical Operations Manager,334-749-3593,205,tracy.wynne@eamc.org,www.unitywellnesscenter.org
AL-000425,Lee Co. Health Dept.,Alabama Department of Public Health,1922141357,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1801 Corporate Dr,,Opelika,AL,36801-6861,Lee,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000426,Dale Co. Health Dept.,Alabama Department of Public Health,1043353246,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",532 W Roy Parker Rd,,Ozark,AL,36360-1006,Dale,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000427,Capstone Rural Health Center,"CAPSTONE RURAL HEALTH CENTER, THE",1821043837,Federally Qualified Health Centers - Medical Services,5947 Highway 269,,Parrish,AL,35580-3847,Walker,5947 Highway 269,,Parrish,AL,35580-3847,Walker,Foster D Jones,Executive Director,205-724-9018,9018,fdjones@capstoneclinic.org,Cheryl Schober,Billing Manager,205-724-9028,9028,cschober@capstoneclinic.org,
AL-000428,Shelby Co. Health Dept.,Alabama Department of Public Health,1326181769,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2000 County Services Dr,,Pelham,AL,35124-6149,Shelby,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000429,St. Clair Co. Health Dept.,Alabama Department of Public Health,1235272675,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1175 23rd St N,,Pell City,AL,35125-9310,Saint Clair,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000430,MAIN STREET MEDICAL CLINIC LLC,MAIN STREET MEDICAL CLINIC LLC,1306145289,"Family Planning Providers, Rural Health Clinics",1508 Cogswell Ave,,Pell City,AL,35125-1243,Saint Clair,1508 Cogswell Ave,,Pell City,AL,35125,Saint Clair,"Sue Suggs, CRNP",CRNP,205-814-1598,,mainstmedical@centurytel.net,,,,,,
AL-000431,Susie E. Allen Health Center,"Quality of Life Health Services, Inc.",1831568237,"Dental Providers, Federally Qualified Health Centers - Medical Services",1500 11th Ave,,Phenix City,AL,36867-4915,Russell,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne Rowe,CEO,256-492-0131,6334,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000432,Russell Co. Health Dept.,State of Alabama Dept. of Public Health,1417090853,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1850 Crawford Rd,,Phenix City,AL,36867-4222,Russell,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000433,PHIL CAMPBELL MEDICAL CLINIC,"Morrow Clinics, Inc",1124138763,Rural Health Clinics,2930 Highway 237,,Phil Campbell,AL,35581-3529,Franklin,2930 Hwy 237,P O Box 817,Phil Campbell,AL,35581,Franklin,Patti Baker,Office Manager,205-993-5642,,morrowdo@centurytel.net,,,,,,
AL-000434,PINE APPLE HEALTH CENTER,"RURAL HEALTH MEDICAL PROGRAM, INC.",1295804391,Federally Qualified Health Centers - Medical Services,867 County Road 59,,Pine Apple,AL,36768-3525,Wilcox,713 JL Chestnut Blvd,PO Box 2213,Selma,AL,36702-2213,Dallas,Keshee Smith,CEO,334-874-7428,122,smithk@rhmpi.com,Meneka Johnson,CCO,334-874-7428,125,johnsonm@rhmpi.com,
AL-000435,"VALLEYHEAD CLINIC, LLC DBA PISGAH MEDICAL CLINIC","VALLEYHEAD CLINIC, LLC DBA PISGAH MEDICAL CLINIC",1679827497,Rural Health Clinics,6110 Co. Rd. 88,,Pisgah,AL,35765,Jackson,6110 CO. RD. 88,,PISGAH,AL,35765,Jackson,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,manager.clinic@hotmail.com,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000436,Autauga Co. Health Dept.,State of Alabama Dept. of Public Health,1043353584,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",219 N Court St,,Prattville,AL,36067-3003,Autauga,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000437,AIELLO/BUSKEY MEDICAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1144298597,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",424 S Wilson Ave,,Prichard,AL,36610-3910,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000438,DR. ALBERT THOMAS MEDICAL CENTER,"FRANKLIN PRIMARY HEALTH CENTER, INC.",1881015261,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",510 S Wilson Ave,,Prichard,AL,36610-3912,Mobile,1303 Dr Martin L King Jr Ave,,Mobile,AL,36603-5341,Mobile,Charles White,CEO,251-434-8188,,charles.white@franklinprimary.org,,,,,,
AL-000439,Ramer Family Health Center,"HEALTH SERVICES, (INC)",1932122652,Federally Qualified Health Centers - Medical Services,5422 State Highway 94,,Ramer,AL,36069-5008,Montgomery,PO Box 70365,,Montgomery,AL,36107-0365,Montgomery,Veronica R Johnson Thomspn,Provider Credentialing Specialist,334-420-5038,,veronica.thompson@hservinc.org,Susie Jones,Chief Financial Officer,334-420-5029,,susie.jones@hservinc.org,
AL-000440,ROANOKE RURAL HEALTH CLINIC,REGIONAL HEALTH MANAGEMENT CORP,1497041834,"Family Planning Providers, Rural Health Clinics",1950 Main St,,Roanoke,AL,36274-2512,Randolph,PO BOX 2345,,ANNISTON,AL,36202,Calhoun,DEBBIE SELLERS,MANAGER,334-863-2311,,dsellers@rmccares.org,,,,,,
AL-000441,Randolph Co. Health Dept.,Alabama Department of Public Health,1700929148,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",320 Main St,,Roanoke,AL,36274-1436,Randolph,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,Asst. Area Administrator,334-206-7065,,mark.johnson@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,http://www.adph.org
AL-000442,Baldwin Co. Health Department,State of Alabama Dept. of Public Health,1861535288,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",23280 Gilbert Dr,,Robertsdale,AL,36567,Baldwin,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000443,"Family Health Care Clinic, Inc. --Rogersville","FAMILY HEALTH CARE CLINIC, INC.",1588992333,Federally Qualified Health Centers - Medical Services,16410 Highway 72,,Rogersville,AL,35652-8117,Lauderdale,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
AL-000444,"Family Health Care Clinic, Inc. --Russellville","FAMILY HEALTH CARE CLINIC, INC.",1831322841,Federally Qualified Health Centers - Medical Services,318 Coffee Ave NE,,Russellville,AL,35653-2331,Franklin,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
AL-000445,Franklin Co. Health Dept.,Alabama Department of Public Health,1396888590,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",801 Highway 48,,Russellville,AL,35654-8330,Franklin,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000446,Jackson Co. Health Dept.,Alabama Department of Public Health,1679616007,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",204 Liberty Ln,,Scottsboro,AL,35769-4133,Jackson,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000447,"NORTHEAST ALABAMA HEALTH SERVICES, INC. - SKYLINE","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1093862237,Federally Qualified Health Centers - Medical Services,21680 AL Highway 79,,Scottsboro,AL,35768-5904,Jackson,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,369,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000448,Kids First Pediatrics,Kids First Pediatrics,1295964682,Rural Health Clinics,23800 John T Reid Pkwy,,Scottsboro,AL,35768-2841,Jackson,"1359 Old Water Works Rd SW,",,Fort Payne,AL,35968,De Kalb,BethWeldon,Practice Manager,256-999-0808,,beth.weldon@kidsfirst-peds.com,,,,,,
AL-000449,"PREMIER MEDICAL CLINIC, LLC","PREMIER MEDICAL CLINIC, LLC",1083955173,Rural Health Clinics,506 Harley St,,Scottsboro,AL,35768-4219,Jackson,506 HARLEY STREET,,SCOTTSBORO,AL,35768,Jackson,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,manager.clinic@HOTMAIL.COM,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000450,"NORTHEAST ALABAMA HEALTH SERVICES, INC. - SCOTTSBORO","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1528115607,Federally Qualified Health Centers - Medical Services,70 Freedom Ln,,Scottsboro,AL,35769-3763,Jackson,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,369,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000451,"Northeast Alabama Health Services, Inc. - Section","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1457418659,Federally Qualified Health Centers - Medical Services,60 Main St N,,Section,AL,35771-7168,Jackson,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,369,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000452,Dallas Co. Health Dept.,Alabama Department of Public Health,1700929130,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",100 Samuel O Moseley Dr,,Selma,AL,36701-6729,Dallas,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000453,Dallas County Health Center,"RURAL HEALTH MEDICAL PROGRAM, INC.",1992040950,Federally Qualified Health Centers - Medical Services,228 Selma Ave,,Selma,AL,36701-5825,Dallas,713 JL Chestnut Blvd,PO Box 2213,Selma,AL,36702-2213,Dallas,Keshee Smith,CEO,334-874-7428,122,smithk@rhmpi.com,Meneka Johnson,CCO,334-874-7428,125,johnsonm@rhmpi.com,
AL-000454,Semmes Clinic,Mobile County Board of Health,1083629661,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3810 Wulff Rd E,,Semmes,AL,36575-5256,Mobile,251 North Bayou St.,,Mobile,AL,36603-5287,Mobile,Angelia Lewis,Chief Executive Officer,251-690-8833,,alewis@mchd.org,Jacqueline F. Thomas,Chief Operations Officer,251-690-8876,,jfthomas@mchd.org,
AL-000455,Colbert Co. Health Dept.,Alabama Department of Public Health,1255474672,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1000 S Jackson Hwy,,Sheffield,AL,35660-5761,Colbert,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000456,Sipsey Health Center,"Whatley Health Services, Inc",1356369078,Federally Qualified Health Centers - Medical Services,3805 Sipsey Rd,,Sipsey,AL,35584,Walker,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000457,Slocomb Family Health Center,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1023290608,Federally Qualified Health Centers - Medical Services,162 S Dalton St,,Slocomb,AL,36375-5669,Geneva,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000458,St. Vincent's Primary Care - Snead,Ascension,1225585383,Rural Health Clinics,180 Medical St,,Snead,AL,35952-6468,Blount,150 Gilbreath Drive,,Oneonta,AL,35121,Blount,Marilyn Oden,Multi-Clinic Manager,205-446-1860,,marilyn.oden@ascension.org,Ansley Averett,Practice Transformation Specialist,205-930-2903,,ansley.averett@ascension.org,
AL-000459,SYLACAUGA PEDIATRIC CLINIC,SYLACAUGA PEDIATRIC CLINIC,1912948373,"Family Planning Providers, Rural Health Clinics",115 W Clay St,,Sylacauga,AL,35150-3413,Talladega,115 WEST CLAY ST,,Sylacauga,AL,35150,Talladega,KASAYA REYNOLDS,INS/OFFICE MANAGER,256-245-3267,,SYLAPEDS@GMAIL.COM,CYNTHIA DARK,ASSISTANT,256-245-3267,,SYLAPEDS@GMAIL.COM,
AL-000460,Talladega Co. Health Dept. Sylacauga Clinic,Alabama Department of Public Health,1659414092,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",311 N Elm Ave,,Sylacauga,AL,35150-1992,Talladega,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000461,Talladega Co. Health Dept.,Alabama Department of Public Health,1568505907,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1004 South St E,,Talladega,AL,35160-2621,Talladega,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000462,BHC TALLADEGA FAMILY MEDICINE,Baptist Health Centers,1861456923,Rural Health Clinics,101 Stephen J White Memorial Blvd,,Talladega,AL,35160-2106,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,Greg.Smith2@bhsala.com,,,,,,
AL-000463,TALLADEGA QUALITY HEALTH CARE,QUALITY OF LIFE HEALTH SERVICES INC,1740230945,"Dental Providers, Federally Qualified Health Centers - Medical Services",110 Spring St N,,Talladega,AL,35160-2040,Talladega,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000464,Pediatric Care Center,Pediatric Care Center,1932443868,Rural Health Clinics,200 Battle St E,,Talladega,AL,35160-2420,Talladega,200 East Battle Street,,Talladega,AL,35160,Talladega,"Angela M. Martin, M.D. F.A.A.P.",Doctor,256-237-4877,,michi4358@aol.com,Donnette Hollingsworth,Office Administrator,256-237-1184,,donnetteh2005@yahoo.com,
AL-000465,BHC Talladega,Baptist Health Centers,1184688244,Rural Health Clinics,320 Coosa St E,,Talladega,AL,35160-2276,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000466,BHC TALLADEGA PEDIATRICS,Baptist Health Centers,1669436721,Rural Health Clinics,722 Stone Ave,,Talladega,AL,35160-2219,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000467,BHC-TALLADEGA OB/GYN,Baptist Health Centers,1285808584,Rural Health Clinics,724 Stone Ave,,Talladega,AL,35160-2219,Talladega,"1130 22nd Street South, Suite 1000",,Birmingham,AL,35205,Jefferson,Greg Smith,Executive Director of Payor & Provider Relations,205-715-5213,,greg.smith2@bhsala.com,,,,,,
AL-000468,"Tanner Medical Clinic, LLC","Tanner Medical Clinic, LLC",1376881870,Rural Health Clinics,20104 Swanner Blvd,,Tanner,AL,35671-3651,Limestone,20104 Swanner Blvd,,Tanner,AL,35671,Limestone,Jessica Flores,Operations Manager,256-686-3334,2566863334,jessica.familycarefirst@gmail.com,Jessica Flores,operations Manager,256-686-3334,,jessica.familycarefirst@gmail.com,
AL-000469,"Family Health Care Clinic, Inc. --Town Creek","FAMILY HEALTH CARE CLINIC, INC.",1508099151,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1841 AL Highway 20,,Town Creek,AL,35672-2500,Lawrence,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
AL-000470,SARHA Doctors Center,SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES,1578625125,Federally Qualified Health Centers - Medical Services,1412 Elba Hwy,,Troy,AL,36079-6020,Pike,1414 Elba Hwy,,Troy,AL,36079-6020,Pike,Pamylon Bowers,Director of Operations,334-670-6726,,pbowers@sarhaonline.com,,,,,,
AL-000471,Pike Co. Health Dept.,Alabama Department of Public Health,1891838231,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",900 S Franklin Dr,,Troy,AL,36081-3812,Pike,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000472,Crescent East Health Center,"Whatley Health Services, Inc",1427078716,Federally Qualified Health Centers - Medical Services,120 51st Ave E Apt B,,Tuscaloosa,AL,35404-5380,Tuscaloosa,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000473,Tuscaloosa Co. Health Dept.,State of Alabama Dept. of Public Health,1689717951,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2350 Hargrove Rd E,,Tuscaloosa,AL,35405-2612,Tuscaloosa,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000474,"Whatley Health Services, Inc","Whatley Health Services, Inc",1063422756,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",2731 Martin Luther King Jr Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000475,James O. Ellis Health Center,"Whatley Health Services, Inc",1063606358,Federally Qualified Health Centers - Medical Services,3532 Greensboro Ave,,Tuscaloosa,AL,35401-7002,Tuscaloosa,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000476,Tuskegee Quality Health Care,QUALITY OF LIFE HEALTH SERVICES INC,1770929028,"Dental Providers, Federally Qualified Health Centers - Medical Services",1201 Notasulga Rd,,Tuskegee,AL,36083-7131,Macon,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,265-439-6306,,amelia.wofford@qolhs.com,
AL-000477,Macon Co. Health Dept.,Alabama Department of Public Health,1376686709,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",812 Hospital Rd,,Tuskegee,AL,36083-1541,Macon,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000478,"Family Health Clinic of Union Springs, Inc","Family Health Clinic of Union Springs, Inc",1871701482,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",309 Prairie St N,,Union Springs,AL,36089-1418,Bullock,309 Prairie Street North,,Union Springs,AL,36089,Bullock,Carol Holder,"CRNP, Administrator",334-473-8795,,cmholder2@gmail.com,,,,,,
AL-000479,Bullock Co. Health Dept.,Alabama Department of Public Health,1801939350,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",674 Hicks Industrial Blvd,,Union Springs,AL,36089,Bullock,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000480,UNIONTOWN HEALTH SERVICES,"RURAL HEALTH MEDICAL PROGRAM, INC.",1033298757,"Dental Providers, Federally Qualified Health Centers - Medical Services",330 Old Hamburg Rd,,Uniontown,AL,36786-2614,Perry,713 J L Chestnut Blvd,PO Box 2213,Selma,AL,36702-2213,Dallas,Keshee Smith,CEO,334-874-7428,122,smithk@rhmpi.com,Meneka Johnson,CCO,334-874-7428,125,meneka.johnson@rhmpi.com,
AL-000481,UNIONTOWN SATELLITE,PERRY COUNTY HEALTH DEPARTMENT,1174666374,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",54 Hamburg-Duncan Rd,,Uniontown,AL,36786,Perry,1748 S. Washington,,Livingston,AL,35470,Perry,Ricky Elliott,Acting Area Administrator,205-652-7972,,ricky.elliott@adph.state.al.us,,,334-206-5350,,,http://www.adph.org/
AL-000482,Chambers Co. Health Dept.,Alabama Department of Public Health,1184767501,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5 Medical Park N,,Valley,AL,36854-3607,Chambers,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000483,"HORIZON HEALTHCARE, LLC","HORIZON HEALTHCARE, LLC",1952659419,Rural Health Clinics,126 Commerce Ave,,Valley Head,AL,35989-4259,DeKalb,126 COMMERCE AVE,,VALLEYHEAD,AL,35989-4259,Jackson,KAYLA WORMSLEY,CLINIC COORDINATOR,256-451-1250,,MANAGER.CLINIC@HOTMAIL.COM,JANICE HUCKABEE,OFFICE MANAGER,256-451-1250,,JANICE.PMC@HOTMAIL.COM,
AL-000484,Vernon Health Center,"Whatley Health Services, Inc",1114101383,Federally Qualified Health Centers - Medical Services,230 Hospital Dr,,Vernon,AL,35592-5251,Lamar,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000485,Lamar Co. Health Dept.,Alabama Department of Public Health,1831232032,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 Springfield Rd,,Vernon,AL,35592-4648,Lamar,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000486,Wadley Cornerstone Clinic,QUALITY OF LIFE HEALTH SERVICES INC,1699919779,Federally Qualified Health Centers - Medical Services,203 Tallapoosa St,,Wadley,AL,36276,Randolph,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6303,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000487,W. T. SCRUGGS MEDICAL CENTER,QUALITY OF LIFE HEALTH SERVICES INC,1588615959,Federally Qualified Health Centers - Medical Services,4350 Cleveland Ave,,Walnut Grove,AL,35990,Etowah,1411 Piedmont Cutoff,,Gadsden,AL,35903-2708,Etowah,Wayne C Rowe,CEO,256-492-0131,6334,wayne.rowe@qolhs.com,Amelia Wofford,Planning & Development Officer,256-439-6306,,amelia.wofford@qolhs.com,
AL-000488,West Blocton Health Center,"Whatley Health Services, Inc",1275628836,Federally Qualified Health Centers - Medical Services,345 Magnolia St,,West Blocton,AL,35184,Bibb,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35184,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AL-000489,Elmore Co. Health Dept.,Alabama Department of Public Health,1619010048,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6501 US Highway 231,,Wetumpka,AL,36092-2837,Elmore,"201 Monroe Street, Suite 800",P.O. Box 303017,Montgomery,AL,36130-3017,Montgomery,Arnita L. Shepherd,"Director, Centralized Billing Unit",334-206-7065,,Arnita.shepherd@adph.state.al.us,Cindy Ashley,Medical Billing Analyst,334-206-9306,,Cindy.ashley@adph.state.al.us,www.alabamapublichealth.gov
AL-000490,Wilmer Medical Clinic,Wilmer Medical Clinic,1649667577,Rural Health Clinics,6353 2nd St,,Wilmer,AL,36587-4453,Mobile,6353 2nd street,,Wilmer,AL,36587,Mobile,Cherri Bedwell,Office Manager,251-865-1852,,cherribedwell@yahoo.com,Lloyd Sean Stokes,Managing Partner,251-865-1852,,sstokes@southalabamamedicalclinic.com,
AL-000491,Woodstock Office,Cahaba Medical Care Foundation,1316201809,Federally Qualified Health Centers - Medical Services,28921 Highway 5,,Woodstock,AL,35188-3613,Bibb,405 Belcher St,,Centreville,AL,35042,Bibb,Kay Cox,COO,205-277-2384,,kay.cox@cahabamedicalcare.com,Lacy Smith,CMO,205-926-2992,,lacy.smith@cahabamedicalcare.com,
AL-000492,"Northeast Alabama Health Services, Inc. - Woodville","NORTHEAST ALABAMA HEALTH SERVICES, INC.",1649327883,Federally Qualified Health Centers - Medical Services,13624 County Road 8,,Woodville,AL,35776-6162,Jackson,309 Taylor St,,Scottsboro,AL,35768-2421,Jackson,Deborah Culpepper,CEO,256-259-5313,369,dculpepper@neahsi.com,Lisa Day,Finance Assistant,256-259-5313,224,lday@neahsi.com,www.neahsi.com
AL-000493,Sumter County Health Center,"Whatley Health Services, Inc",1801817549,Federally Qualified Health Centers - Medical Services,415 Derby Dr,,York,AL,36925-2117,Sumter,2731 MLK Jr. Blvd,,Tuscaloosa,AL,35401,Tuscaloosa,Justin Ross Rolling,CFO,205-614-6061,,jrolling@whatleyhealth.org,Deborah Tucker,CEO,205-614-6135,,dtucker@whatleyhealth.org,
AR-000494,ALTHEIMER CLINIC,"JEFFERSON COMPREHENSIVE CARE SYSTEM, INC",1730385105,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",309 S Edline,,Altheimer,AR,72004-8559,Jefferson,PO BOX 1285-1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000495,Amity Community Health Center,"CABUN Rural Health Services, Inc",1629017405,Federally Qualified Health Centers - Medical Services,210 N Main St,PO Box 218,Amity,AR,71921-9733,Clark,402 Lee Street,PO Box 1196,Hampton,AR,71744,Calhoun,Melanie Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000496,Clark County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,605 S 10th St,,Arkadelphia,AR,71923-7013,Clark,605 South 10th Street,,Arkadelphia,AR,71923,Clark,Kathy Loden,Administrator,870-246-4471,,Kathy.Loden@arkansas.gov,,,,,,
AR-000497,1st Choice Healthcare Ash Flat,"1ST CHOICE HEALTHCARE, INC.",1962824672,Federally Qualified Health Centers - Medical Services,308 Highway 62 W,,Ash Flat,AR,72513-9415,Sharp,1001 N Missouri Avenue,,Corning,AR,72422-1716,Clay,Brigitte McDonald,CEO,870-857-3399,,bmcdonald@1stchoice-ar.org,Debra Finley,COO,870-857-3334,,dfinley@1stchoice-ar.org,
AR-000498,Sharp County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,724 Ash Flat Dr,,Ash Flat,AR,72513-9103,Sharp,724 Ash Flat Drive,,Ash Flat,AR,72513,Sharp,Renee Brink,Acting Administrator,870-994-7364,,Renee.Brink@arkansas.gov,,,,,,
AR-000499,Little River County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,150 Keller St,,Ashdown,AR,71822-2810,Little River,150 Keller Street,,Ashdown,AR,71822,Little River,Gayle Vermeer,Administrator,870-898-3831,,Linda.Vermeer@arkansas.gov,,,,,,
AR-000500,ARcare - 10,ARCARE,1497716062,Federally Qualified Health Centers - Medical Services,400 Highway 64 E,,Augusta,AR,72006-5150,Woodruff,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,STEVEN.COLLIER@ARCARE.NET,,,,,,www.arcare.net
AR-000501,Woodruff County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,623 N 9th St,,Augusta,AR,72006-2129,Woodruff,P.O. Box 542,,Augusta,AR,72006,Woodruff,Debra Neal,Administrator,870-347-5061,,Debra.Neal@arkansas.gov,,,,,,
AR-000502,ARcare - 29,ARCARE,1598023293,Federally Qualified Health Centers - Medical Services,800 Main St,,Augusta,AR,72006-2449,Woodruff,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,STEVEN.COLLIER@ARCARE.NET,,,,,,WWW.ARCARE.NET
AR-000503,ARcare-16,ARCARE,1710948419,Federally Qualified Health Centers - Medical Services,170 Highway 167 N,,Bald Knob,AR,72010-4058,White,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,PROSERVICES@ARCARE.NET,,,,,,WWW.ARCARE.NET
AR-000504,Barling Family Clinic,RIVER VALLEY PRIMARY CARE SERVICES,1619232295,Federally Qualified Health Centers - Medical Services,815 Fort St,Suite B,Barling,AR,72923-2180,Sebastian,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000505,ARcare - 35,ARCARE,1669662615,Federally Qualified Health Centers - Medical Services,1175 Vine St,,Batesville,AR,72501-3526,Independence,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000506,Independence County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,120 Weaver Ave,,Batesville,AR,72501-7314,Independence,120 Weaver Avenue,,Batesville,AR,72501,Independence,Sonia Nix,Administrator,870-793-8847,,Sonia.Nix@arkansas.gov,,,,,,
AR-000507,ARcare - 41,ARCARE,1053676718,Federally Qualified Health Centers - Medical Services,2450 Batesville Blvd,,Batesville,AR,72501-7782,Independence,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000508,ARcare - 48,ARCARE,1235542937,Federally Qualified Health Centers - Medical Services,4100 Harrison St,,Batesville,AR,72501-9419,Independence,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000509,Bearden Health Center,"CABUN Rural Health Services, Inc",1265476402,Federally Qualified Health Centers - Medical Services,150 N School St,PO Box 198,Bearden,AR,71720-9594,Ouachita,402 Lee Street,PO Box 1196,Hampton,AR,71744,Calhoun,Melanie Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000510,White County/Beebe Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,306 N Gum St,,Beebe,AR,72012-3230,White,306 Gum,,Beebe,AR,72012,White,Trudy Noble,Administrator,501-882-5128,,Trudy.Noble@arkansas.gov,,,,,,
AR-000511,Saline County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1612 Edison Ave,,Benton,AR,72015-4630,Saline,1612 Edison Avenue,,Benton,AR,72015,Saline,Karen Mays,Administrator,501-303-5650,,Karen.Mays@arkansas.gov,,,,,,
AR-000512,Carroll County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,402 Hailey Rd,,Berryville,AR,72616-5077,Carroll,402 Hailey Road,,Berryville,AR,72616,Carroll,Lisa Holt,Administrator,870-423-2923,,Lisa.Holt@arkansas.gov,,,,,,
AR-000513,Access Medical Clinic,"Bradley Bibb, MD PLLC",1437569837,Rural Health Clinics,3519 Highway 63,,Black Rock,AR,72415-9022,Lawrence,49 Hwy 62/412,,Ash Flat,AR,72513,Sharp,Malinda Goodman,Office Manager,870-994-7301,,malindagoodman@myaccessmedicalclinic.com,"Brad Bibb, MD",Owner,870-994-7301,,bibbbrad@gmail.com,www.myaccessmedicalclinic.com
AR-000514,Mississippi County/Blytheville Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1299 N 10th St,,Blytheville,AR,72315-1614,Mississippi,1299 North 10th Street,,Blytheville,AR,72315,Mississippi,Walter Holloway,Administrator,870-763-7064,,Walter.Holloway@arkansas.gov,,,,,,
AR-000515,Great River Medical Center,Mississippi County Hospital System,1316180748,Inpatient Hospitals (other than children's hospitals),1520 N Division St,,Blytheville,AR,72315-1448,Mississippi,PO Box 167,,Blytheville,AR,72315,Mississippi,Rhonda Cunningham,Revenue Cycle Director,870-868-7462,,Rhonda.Cunningham@mchsys.org,Chris Raymer,CEO,870-838-7000,,Chris.Raymer@mchsys.org,
AR-000516,Healthy Partners,"EAST ARKANSAS FAMILY HEALTH CENTER, INC.",1659506095,"Dental Providers, Federally Qualified Health Centers - Medical Services",605 N 2nd St,,Blytheville,AR,72315-2034,Mississippi,900 N. 7th St,,West Memphis,AR,72301-2001,Crittenden,Susan E Ward-Jones,CEO,870-733-6300,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,
AR-000517,Logan County/Booneville Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,721 W 1st St,,Booneville,AR,72927-4567,Logan,721 West 1st Street,,Booneville,AR,72927,Logan,Paula Beaty,Administrator,479-675-2593,,Paula.Beaty@arkansas.gov,,,,,,
AR-000518,Monroe County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,306 Martin Luther King Dr,,Brinkley,AR,72021,Monroe,306 W. Kings Drive,,Brinkley,AR,72021,Monroe,Misty Williams,Administrator,870-734-1461,,Misty.Williams@arkansas.gov,,,,,,
AR-000519,ARcare-70,ARCARE,1669433363,Federally Qualified Health Centers - Medical Services,615 N Main St,,Brinkley,AR,72021-2507,Monroe,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000520,Lonoke County/Cabot Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,118 S 1st St,,Cabot,AR,72023-3007,Lonoke,118 South First Street,,Cabot,AR,72023,Lonoke,Milton Garris,Administrator,501-843-7561,,Milton.Garris@arkansas.gov,,,,,,
AR-000521,ARcare - 46,ARCARE,1679994412,Federally Qualified Health Centers - Medical Services,5830 Highway 5,,Cabot,AR,72023-7328,Lonoke,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000522,ARCARE - 93,ARCARE,1255635496,Federally Qualified Health Centers - Medical Services,614 N Grant St,,Cabot,AR,72023-2656,Lonoke,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000523,OCMC ExpressCare Clinic,Ouachita County Medical Center,1780039206,Outpatient Hospital Clinics,638 California Ave SW,,Camden,AR,71701-4604,Ouachita,PO BOX 797,,Camden,AR,71711,Ouachita,Joe Michael Givens,Administrative Project Coordinator,870-836-1415,,jgivens@ouachitamedcenter.com,Peggy L. Abbott,President and CEO,870-836-1200,,pabbott@ouachitamedcenter.com,
AR-000524,Ouachita County Medical Center,Ouachita County Medical Center,1245284769,Inpatient Hospitals (other than children's hospitals),638 California Ave SW,,Camden,AR,71701-4604,Ouachita,PO BOX 797,,Camden,AR,71711,Ouachita,Joe Michael Givens,Administrative Project Coordinator,870-836-1415,,jgivens@ouachitamedcenter.com,Peggy L. Abbott,President and CEO,870-836-1200,,pabbott@ouachitamedcenter.com,
AR-000525,Ouachita County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,740 California Ave SW,,Camden,AR,71701-4606,Ouachita,740 California Avenue SW,,Camden,AR,71701,Ouachita,Rebecca Wright,Administrator,870-836-5033,,Rebecca.Wright2@arkansas.gov,,,,,,
AR-000526,ARcare - 17,ARCARE,1033170576,Federally Qualified Health Centers - Medical Services,821 E Park St,Hwy 70,Carlisle,AR,72024-9024,Lonoke,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,www.arcare.net
AR-000527,ARcare-26,ARCARE,1437436573,Federally Qualified Health Centers - Medical Services,2624 Highway 42,,Cherry Valley,AR,72324-8674,Cross,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000528,Mid Delta Health Center,MID-DELTA HEALTH SYSTEMS INC,1255346060,"Dental Providers, Federally Qualified Health Centers - Medical Services",245 Madison St,,Clarendon,AR,72029-2706,Monroe,245 Madison St,,Clarendon,AR,72029-2706,Monroe,Alvin J Sliger,Executive Director,870-747-3381,,asliger@mid-delta.org,Mary Scemons,Credentialist/Outreach Enrollment Assister,870-747-3381,,mscemons@mid-delta.org,
AR-000529,Johnson County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,6 Professional Park Dr,,Clarksville,AR,72830-4432,Johnson,6 Professional Park Drive,,Clarksville,AR,72830,Johnson,Holly Foster,Administrator,479-754-2949,,Holly.Foster@arkansas.gov,,,,,,
AR-000530,"HOPE MEDICAL CLINIC, INC","Hope Medical Clinic, Inc.",1013245471,Rural Health Clinics,145 Shake Rag Rd,,Clinton,AR,72031-6682,Van Buren,145 Shake Rag RD,,Clinton,AR,72031-6682,Van Buren,Stefanie Shaver,Office Manager,501-745-7161,,sshaver@hope-medical.com,Nichole Clark,APRN / Owner,501-745-7161,,nclark@hope-medical.com,
AR-000531,Clinton Medical Clinic,Conway Regional Medical Center,1265421861,Rural Health Clinics,2526 Highway 65 S,Suite 203,Clinton,AR,72031-6678,Van Buren,2302 College Avenue,,Conway,AR,72032,Faulkner,Stephanie Cothran,Business Office Manager PCSN,501-745-2122,,scothran@conwayregional.org,Billy Henry,PCSN Director,501-327-1325,,billy.henry@conwayregional.org,conwayregional.org
AR-000532,Ozark Medical Clinic,Ozark Medical Clinic,1366614935,Rural Health Clinics,2526 Highway 65 S,Suite 201,Clinton,AR,72031-6678,Van Buren,2526 Hwy 65 South,Ste 201,Clinton,AR,72031,Van Buren,Casey Branscum,Office Supervisor,501-745-3388,,cdbranscum@practice-plus.com,,,,,,
AR-000533,BMRHC-Clinton,"Boston Mtn Rural Health Center, Inc.",1376631846,Federally Qualified Health Centers - Medical Services,465 Medical Center Parkway,,Clinton,AR,72031,Van Buren,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000534,Van Buren County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,526 Quality Dr,,Clinton,AR,72031,Van Buren,P.O. Box 452,,Clinton,AR,72031,Van Buren,Donna Branscum,Administrator,501-745-2485,,Donna.Branscum@arkansas.gov,,,,,,
AR-000535,COLLEGE STATION CLINIC,"JEFFERSON COMPREHENSIVE CARE SYSTEM,INC",1932305737,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",4206 Frazier Pike,,College Station,AR,72206,Pulaski,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J. BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000536,ARcare 24,ARCARE,1831487404,Federally Qualified Health Centers - Medical Services,1500 Museum Rd,Suite 104,Conway,AR,72032-4761,Faulkner,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000537,Faulkner County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,811 N Creek Dr,,Conway,AR,72032-4712,Faulkner,811 North Creek Drive,,Conway,AR,72032,Faulkner,Monica Wilson,Administrator,501-450-4941,,Monica.Wilson@arkansas.gov,,,,,,
AR-000538,1st Choice Healthcare Corning,"1ST CHOICE HEALTHCARE, INC.",1942256508,Federally Qualified Health Centers - Medical Services,1300 Creason Rd,,Corning,AR,72422-1716,Clay,1001 N Missouri Avenue,,Corning,AR,72422-1716,Clay,Brigitte McDonald,CEO,870-857-3334,,bmcdonald@1stchoice-ar.org,Debra Finley,COO,870-857-3334,,dfinley@1stchoice-ar.org,
AR-000539,Clay County/Corning Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,301 N Missouri Ave,Suite 18,Corning,AR,72422-1603,Clay,301 North Missouri #18,,Corning,AR,72422,Clay,Linda Hutchison,Acting Administrator,870-857-6281,,Linda.Hutchison@arkansas.gov,,,,,,
AR-000540,ARcare - 20,ARCARE,1154382844,Federally Qualified Health Centers - Medical Services,125 Oak St,,Cotton Plant,AR,72036-5089,Woodruff,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000541,Ashley County/Crossett Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1300 W 5th Ave,,Crossett,AR,71635-2500,Ashley,1300 West 5th Street,,Crossett,AR,71635,Ashley,Tammy Cook,Administrator,870-364-2115,,tammy.cook@arkansas.gov,,,,,,
AR-000542,Yell County/Danville Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1309 E 8th St,,Danville,AR,72833-8012,Yell,1309 East 8th Street,,Danville,AR,72833,Yell,Elizabeth Case,Administrator,479-495-2741,,Elizabeth.Case@arkansas.gov,,,,,,
AR-000543,Yell County/Dardanelle Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,719 N 5th St,,Dardanelle,AR,72834-3415,Yell,719 North 5th Street,,Dardanelle,AR,72834,Yell,Elizabeth Case,Administrator,479-229-3509,,Elizabeth.Case@arkansas.gov,,,,,,
AR-000544,DQMC Family Clinic,DeQueen Medical Center,1124549316,Outpatient Hospital Clinics,1314 W Collin Raye Dr,,De Queen,AR,71832-2135,Sevier,1306 W Collin Raye Dr,,DeQueen,AR,71832,Sevier,Angela Martin,Nurse Practioner; Clinic Manager,870-642-2273,,angie.martin@dqmc.org,Gloria Machuca,Receptionist,870-642-2273,,,
AR-000545,Cossatot Community Health Clinic,HEALTHY CONNECTIONS INC,1871868703,Federally Qualified Health Centers - Medical Services,183 College Dr,,De Queen,AR,71832-3929,Sevier,136 Health Park Dr,,Mena,AR,71953-9072,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,
AR-000546,Sevier County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,304 N 4th St,,De Queen,AR,71832-2829,Sevier,304 North 4th Street,,DeQueen,AR,71832,Sevier,Deborah Hedge,Administrator,870-642-2535,,Deborah.Hedge@arkansas.gov,,,,,,
AR-000547,DECATUR MEDI-CLINIC,"Spavinaw Clinics, Inc",1023028016,Rural Health Clinics,346 N Main St,,Decatur,AR,72722-9732,Benton,346 N Main St,,Decatur,AR,72722,Benton,Peggy Beal,Office Manager,479-752-3233,,pbeal@cox-internet.com,,,,,,
AR-000548,Dermott Medical and Dental Clinic,MAINLINE HEALTH SYSTEMS INC,1386758043,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 S School St,,Dermott,AR,71638-2127,Chicot,233 N Main St,,Portland,AR,71663-9230,Chicot,Tafta McCain,Executive Director,870-538-5414,,tmccain@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,,
AR-000549,Prairie County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,204 Main St,,Des Arc,AR,72040-7902,Prairie,204 Main Street,,Des Arc,AR,72040,Prairie,Rose Knupp,Administrator,870-256-4430,,Rose.Knupp@arkansas.gov,,,,,,
AR-000550,ARCARE30,ARCARE,1871554576,Federally Qualified Health Centers - Medical Services,405 Highway 11 N,,Des Arc,AR,72040-3140,Prairie,117 S SECOND ST,,AUGUSTA,AR,72006,Woodruff,"STEVEN COLLIER, MD",CEO,870-347-3374,,PROSERVICES@ARCARE.NET,,,,,,WWW.ARCARE.NET
AR-000551,Arkansas County/DeWitt Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1616 S Madison St,,Dewitt,AR,72042-3003,Arkansas,1606 South Madison,,DeWitt,AR,72042,Arkansas,Lisa Roberson,Administrator,870-946-2934,,lisa.roberson@arkansas.gov,,,,,,
AR-000552,Ferguson Rural Health Clinic,Dewitt Hospital and Nursing Home,1043276942,Rural Health Clinics,1641 S Whitehead Dr,PO Box 32,Dewitt,AR,72042-2994,Arkansas,1641 South Whitehead Drive,p.o. box 32,DeWitt,AR,72042,Arkansas,Rhonda Reed,Clinic Director,870-233-2076,,rreed@dhnh.org,,,,,,
AR-000553,DePaul Health Center,Daughters of Charity Services of Arkansas,1366527145,Rural Health Clinics,145 W Waterman St,,Dumas,AR,71639-2139,Desha,161 South Main Street,,Dumas,AR,71639,Desha,Lisa Goodgame,CFO,870-382-3080,3804,LGoodgame@DCSARK.org,Angela Anderson,Clinical Coordinator,870-382-3080,3805,Angela.Anderson@DCSARK.org,
AR-000554,Desha County/Dumas Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,751 Highway 65 S,,Dumas,AR,71639-3003,Desha,751 Hwy 65 South,,Dumas,AR,71639,Desha,Carolyne Blissett,Administrator,870-382-2377,,Leslie.Blissett@arkansas.gov,,,,,,
AR-000555,Delta Health Services,Delta Memorial Hospital,1295767689,Rural Health Clinics,811 Highway 65 S,,Dumas,AR,71639-3006,Desha,P.O box 887,,Dumas,AR,71639,Desha,Ashley Anthony,CEO,870-382-4303,8126,agibson@deltamem.net,vicki allen,CFO,870-382-4303,8234,vallen@deltamem.net,
AR-000556,Earle Family Health Center,"East Arkansas Family Health Center, Inc",1912370198,Federally Qualified Health Centers - Medical Services,216 Arkansas St,,Earle,AR,72331-2217,Crittenden,900 N. 7th St,,West Memphis,AR,72301-2001,Crittenden,Susan Ward-Jones,CEO,870-733-6300,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,
AR-000557,Crittenden County/Earle Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,841 Ruth St,,Earle,AR,72331-1337,Crittenden,841 Ruth Street,,Earle,AR,72331,Crittenden,Crystal Moore,Administrator,870-792-7393,,Crystal.Moore@arkansas.gov,,,,,,
AR-000558,Union County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,301 American Rd,,El Dorado,AR,71730-6554,Union,301 American Road,,El Dorado,AR,71730,Union,Danna Taylor,Administrator,870-863-5101,,Danna.Taylor@arkansas.gov,,,,,,
AR-000559,ARcare - 18,ARCARE,1568602472,Federally Qualified Health Centers - Medical Services,227 Pine Bluff Hwy,,England,AR,72046-2234,Lonoke,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000560,EUDORA CLINIC,MAINLINE HEALTH SYSTEMS INC,1619082724,Federally Qualified Health Centers - Medical Services,579 E Beouff St,,Eudora,AR,71640-3090,Chicot,233 N Main St,,Portland,AR,71663-9230,Ashley,Gary A Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,,
AR-000561,Ozark Medical Clinic Fairfield Bay,Ozark Medical Clinic Fairfield Bay,1477960581,Rural Health Clinics,383 Dave Creek Pkwy,,Fairfield Bay,AR,72088-3631,Van Buren,383 Dave Creek Parkway,,Fairfield Bay,AR,72088,Van Buren,Casey Branscum,Office Supervisor,501-745-3388,,cdbranscum@practice-plus.com,,,,,,
AR-000562,Community Clinic Fayetteville Medical,"ST. FRANCIS HOUSE NWA, INC.",1013384288,Federally Qualified Health Centers - Medical Services,3162 W Martin Luther King Blvd,,Fayetteville,AR,72704-7684,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000563,Washington County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,3270 N Wimberly Dr,,Fayetteville,AR,72703-4032,Washington,3270 Wimberly Drive,,Fayetteville,AR,72703,Washington,Robin Thomas,Administrator,479-521-8181,,Robin.Thomas@arkansas.gov,,,,,,
AR-000564,Fayetteville Health Center,"Planned Parenthood of Arkansas and Eastern Oklahoma, Inc.",1831185412,Family Planning Providers,3729 N Crossover Rd,Suite 107,Fayetteville,AR,72703-5538,Washington,4401 W 109th St.,Suite 200,Overland Park,KS,66211,Johnson,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,4662,Shirish.malla@ppgreatplains.org,Amanda Addison,VP of Health Services,913-345-4659,4659,amanda.addison@ppgreatplains.org,http://www.ppgreatplains.org
AR-000565,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1740578897,Federally Qualified Health Centers - Medical Services,375 N Rupple Rd,Owl Creek School Based Health Center,Fayetteville,AR,72704-6110,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000566,Dallas County Medical Center,Board of Governor of Dallas County Medical Center,1306826029,Inpatient Hospitals (other than children's hospitals),201 N Clifton St,,Fordyce,AR,71742-3026,Dallas,201 North Clifton,,Fordyce,AR,71742,Dallas,Brittany Hobson,Accounting,870-352-6321,,bhobson@dallascountymedicalcenter.com,Tamara Dixon,Administrative Assistant,870-352-6363,,tdixon@dallascountymedicalcenter.com,
AR-000567,Dallas County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,201 N Spring St,,Fordyce,AR,71742-3315,Dallas,201 North Spring Street,,Fordyce,AR,71742,Dallas,Donna Ferguson,Administrator,870-352-7198,,Donna.Ferguson@arkansas.gov,,,,,,
AR-000568,St. Francis County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,413 N Division St,,Forrest City,AR,72335-3231,Saint Francis,413 North Division,,Forrest City,AR,72335,Saint Francis,Tracy Mathews,Administrator,870-633-1340,,Tracy.Mathews@arkansas.gov,,,,,,
AR-000569,Sebastion County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,3112 S 70th St,,Fort Smith,AR,72903-5068,Sebastian,3112 S. 70th Street,,Fort Smith,AR,72903,Sebastian,Jo Wester,Administrator,479-452-8600,,Jo.Wester@arkansas.gov,,,,,,
AR-000570,RVPCS - Northside Clinic,RIVER VALLEY PRIMARY CARE SERVICES,1023163193,Federally Qualified Health Centers - Medical Services,4900 Kelley Hwy,,Fort Smith,AR,72904-5000,Sebastian,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000571,St Elizabeth Health Center,Daughters of Charity Services of Arkansas,1689775231,"Dental Providers, Rural Health Clinics",407 S Gould Ave,,Gould,AR,71643-5041,Lincoln,161 South Main Street,,Dumas,AR,71639,Desha,Lisa Goodgame,CFO,870-382-3080,3804,LGoodgame@DCSARK.org,Angela Anderson,Clinical Coordinator,870-382-3080,3805,Angela.Anderson@DCSARK.org,
AR-000572,OCH GRAVETTE SPECIALTY CLINIC,"SGOH ACQUISITION, INC.",1568643005,Outpatient Hospital Clinics,1101 Jackson St SW,,Gravette,AR,72736-9121,Benton,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
AR-000573,OCH OF GRAVETTE HOSPITAL,"SGOH ACQUISITION, INC.",1568643005,Inpatient Hospitals (other than children's hospitals),1101 Jackson St SW,,Gravette,AR,72736-9121,Benton,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
AR-000574,BMRHC - Green Forest,"Boston Mtn Rural Health Center, Inc.",1174857825,Federally Qualified Health Centers - Medical Services,1103 W Main St,,Green Forest,AR,72638-2311,Carroll,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000575,Greenbrier Family Medicine,Conway Regional Medical Center,1548362437,Rural Health Clinics,110 N Broadview St,,Greenbrier,AR,72058-9475,Faulkner,Cownay Regional Medical Center,2302 College Avenue,Conway,AR,72032,Faulkner,Stephanie Cothran,Business Office Manager PCSN,501-745-2122,,scothran@conwayregional.org,Billy Henry,Director PCSN,501-327-1325,,billy.henry@conwayregional.org,conwayregional.org
AR-000576,"Mainline Health Systems, Inc.","Mainline Health Systems, Inc.",1033584586,Federally Qualified Health Centers - Medical Services,1119 S Main St,Hamburg High School Clinic,Hamburg,AR,71646-8983,Ashley,233 N. Main,,Portland,AR,71663,Ashley,G. Allan Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000577,Hamburg Elementary Clinic,"Mainline Health Systems, Inc.",1699130468,Federally Qualified Health Centers - Medical Services,206 S. Bartlett,,Hamburg,AR,71646,Ashley,233 N. Main St.,,Portland,AR,71663,Ashley,G. Allan Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000578,Ashley County/Hamburg Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,401 N Cherry St,,Hamburg,AR,71646-3003,Ashley,401 North Cherry,,Hamburg,AR,71646,Ashley,Tammy Cook,Administrator,870-853-5525,,tammy.cook@arkansas.gov,,,,,,
AR-000579,Calhoun County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1119 Prestress Dr,,Hampton,AR,71744-8811,Calhoun,1119 Prestress Drive,,Hampton,AR,71744,Calhoun,Arnell Washington,Administrator,870-798-2808,,arnell.washington@arkansas.gov,,,,,,
AR-000580,"CABUN Rural Health Services, Inc.","CABUN RURAL HEALTH SERVICES, INC.",1912946807,"Dental Providers, Federally Qualified Health Centers - Medical Services",402 S Lee St,PO Box 1196,Hampton,AR,71744-8615,Calhoun,402 S Lee St,PO Box 1196,Hampton,AR,71744-8615,Calhoun,Melanie J Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000581,PoinsettCounty/Harrisburg Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,119 N Main St,,Harrisburg,AR,72432-1929,Poinsett,119 North Main Street,,Harrisburg,AR,72432,Poinsett,Janice Mitchusson,Administrator,870-578-4480,,Janice.Mitchusson@arkansas.gov,,,,,,
AR-000582,Boone County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1622 Campus Ave,,Harrison,AR,72601-5524,Boone,1622 Campus,,Harrison,AR,72601,Boone,Tammi McCutchen,Administrator,870-743-5244,,tammi.mccutchen@arkansas.gov,,,,,,
AR-000583,ARcare - 40,ARCARE,1396706099,Federally Qualified Health Centers - Medical Services,100 E Front St,,Hazen,AR,72064,Prairie,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000584,ARcare - 85,ARCARE,1780645481,Federally Qualified Health Centers - Medical Services,1511 Highway 25B,,Heber Springs,AR,72543-1701,Cleburne,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000585,Cleburne County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2319 Highway 110 W Ste C,Judge Claude Dill Office Complex,Heber Springs,AR,72543-3464,Cleburne,"2319 Hwy 110 West, Suite C",Judge Claude Dill Office Complex,Heber Springs,AR,72543,Cleburne,Hazel Thompson,Administrator,501-362-7581,,Hazel.Thompson@arkansas.gov,,,,,,
AR-000586,Phillips County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,110 Shirley Hicks Dr,,Helena,AR,72342,Phillips,P.O. Box 2627,,Helena West Helena,AR,72390,Phillips,Karen Hopper,Administrator,870-572-9028,,Karen.Hopper@arkansas.gov,,,,,,
AR-000587,Helena Family Health Center,"EAST ARKANSAS FAMILY HEALTH CENTER, INC.",1518218668,Federally Qualified Health Centers - Medical Services,513 Porter St,,Helena,AR,72342-3217,Phillips,215 E Bond Ave,,West Memphis,AR,72301-3550,Crittenden,Susan E Ward-Jones,CEO,870-732-6520,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,
AR-000588,"Bell-Winston Clinic, P.A.","Bell-Winston Clinic, P.A.",1306832845,Rural Health Clinics,626 Poplar St,,Helena,AR,72342-3140,Phillips,626 Poplar Street,,Helena,AR,72342,Phillips,Donna Ryan,clinic administrator,870-338-8163,,bwc@suddenlinkmail.com,Eugenia Newsom,Billing Supervisor,870-338-8163,,eugenia@suddenlinkmail.com,
AR-000589,Wadley Regional Medical Center at Hope,Steward Healthcare System LLC,1922353754,Inpatient Hospitals (other than children's hospitals),2001 S Main St,,Hope,AR,71801-8124,Hempstead,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,Thomas Gilbert,CEO and President,903-798-8002,,thomas.gilbert@steward.org,,,,,,www.steward.org
AR-000590,Hope Migrant/Community Health Center,"CABUN RURAL HEALTH SERVICES, INC.",1376583757,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",205 Smith Road,PO Box 1654,Hope,AR,71802-1654,Hempstead,402 Lee Street,PO Box 1196,Hampton,AR,71744,Calhoun,Melanie Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000591,Hempstead County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,808 W 5th St,,Hope,AR,71801-5020,Hempstead,808 W. 5th Street,,Hope,AR,71801,Hempstead,Jeannine Wilson,Administrator,870-777-2191,,Jeannine.Wilson@arkansas.gov,,,,,,
AR-000592,Premier Central Pediatrics,Premier Central Inc,1265477582,Rural Health Clinics,900 S Main St,,Hope,AR,71801-6525,Hempstead,900 S Main St,,Hope,AR,71801,Hempstead,SANDRA SOOMAN,physician,870-703-2563,,DRSOOMA@OUTLOOK.COM,Lea Cearley,LPN,870-722-6567,,PREMIERCENTRAL@OUTLOOK.COM,
AR-000593,ARcare - 23,ARCARE,1619389244,Federally Qualified Health Centers - Medical Services,805 Third St,,Horseshoe Bend,AR,72512-3736,Izard,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000594,"Healthy Connections, Inc. Hot Springs","Healthy Connections, Inc",1881060853,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",102 Chippewa Ct,,Hot Springs,AR,71901-7109,Garland,136 Health Park Drive,,Mena,AR,71953,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,www.healthy-connections.org
AR-000595,Garland County Local Health Unit,Arkansas Department of Health,1497966808,"Family Planning Providers, Sexually Transmitted Disease Clinics",1425 Malvern Ave,,Hot Springs,AR,71901-6316,Garland,1425 Malvern Ave,,Hot springs,AR,71901,Garland,Chris Rowland,Administrator,501-624-3394,,chris.rowland@arkansas.gov,,,,,,http://www.healthy.arkansas.gov
AR-000596,Madison County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,709 N College St,,Huntsville,AR,72740-8838,Madison,709 North College Avenue,,Huntsville,AR,72740,Madison,Shana Villines,Administrator,479-738-2612,,Shana.Villines@arkansas.gov,,,,,,
AR-000597,BMRHC - Huntsville,"Boston Mtn Rural Health Center, Inc.",1467543892,Federally Qualified Health Centers - Medical Services,934 N Gaskill St,,Huntsville,AR,72740-8903,Madison,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000598,Pulaski County/Jacksonville Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,3000 N 1st St,,Jacksonville,AR,72076-1802,Pulaski,3000 North First Street,,Jacksonville,AR,72076,Pulaski,Patricia Henderson,Administrator,501-982-7477,,Patricia.Henderson@arkansas.gov,,,,,,
AR-000599,Newton County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,506 W Court St,,Jasper,AR,72641,Newton,P.O. Box 451,,Jasper,AR,72641,Newton,Erika Houston,Administrator,870-446-2216,,Erika.Houston@arkansas.gov,,,,,,
AR-000600,"Boston Mtn Rural Health Center, Inc.","Boston Mtn Rural Health Center, Inc.",1609243674,Federally Qualified Health Centers - Medical Services,609 West Clark St,BMRHC - Jasper School Based,Jasper,AR,72641,Newton,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000601,ARcare - 55,ARCARE,1760443469,Federally Qualified Health Centers - Medical Services,1530 N Church St,,Jonesboro,AR,72401-1515,Craighead,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000602,ARcare - 22,ARCARE,1326365776,Federally Qualified Health Centers - Medical Services,2816 Fox Meadow Ln,,Jonesboro,AR,72404-9346,Craighead,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000603,ARCARE59,ARCARE,1154776532,Federally Qualified Health Centers - Medical Services,416 E Washington Ave,,Jonesboro,AR,72401-3108,Craighead,PO BOX 497,,Augusta,AR,72006-0497,Woodruff,"STEVEN COLLIER, MD",CEO,870-347-3304,,STEVEN.COLLIER@ARCARE.NET,,,,,,www.arcare.net
AR-000604,Craighead County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,611 E Washington Ave,Suite B,Jonesboro,AR,72401-3001,Craighead,"611 E. Washington Avenue, Suite B",,Jonesboro,AR,72401,Craighead,Amy Howell,Administrator,870-933-4585,,Amy.Howell@arkansas.gov,,,,,,
AR-000605,ARcare - 80,ARCARE,1245291947,Federally Qualified Health Centers - Medical Services,606 W Wilbur Mills Ave,,Kensett,AR,72082-9051,White,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000606,ARcare - 65,ARCARE,1801081294,Federally Qualified Health Centers - Medical Services,1009 Highway 18,,Lake City,AR,72437-9622,Craighead,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000607,Chicot County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1740 Highway US-65,,Lake Village,AR,71653,Chicot,1740 Highways 65 & 82 South,,Lake Village,AR,71653,Chicot,"Yolanda ""Jill"" Porter",Administrator,870-265-2236,,Yolanda.Porter@arkansas.gov,,,,,,
AR-000608,Lake Village Clinic,Lake Village Clinic,1306801212,Rural Health Clinics,2918 Louis Sessions St,,Lake Village,AR,71653-9749,Chicot,2918 Louis Sessions St,,Lake Village,AR,71653,Chicot,Suzanne Wright,Office Manager,870-265-5343,114,showell@lakevillageclinic.com,Tom Bryant,Administrator,870-265-5343,111,tbryant@lakevillageclinic.com,
AR-000609,River Valley Primary Care Services Inc.,RIVER VALLEY PRIMARY CARE SERVICES,1699010991,Federally Qualified Health Centers - Medical Services,635 Childers Ave,Lamar School District Health Center,Lamar,AR,72846-8161,Johnson,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000610,EAST ARKANSAS FAMILY HEALTH CTR,"EAST ARKANSAS FAMILY HEALTH CENTER, INC.",1922139062,"Dental Providers, Federally Qualified Health Centers - Medical Services",102 W Broad St,,Lepanto,AR,72354-2200,Poinsett,900 N. 7th St,,West Memphis,AR,72301-2001,Crittenden,Susan E Ward-Jones,CEO,870-733-6300,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,
AR-000611,Lewisville Family Practice Center,"CABUN Rural Health Services, Inc",1437193646,Federally Qualified Health Centers - Medical Services,1117 Chestnut St,PO Box 1013,Lewisville,AR,71845-1013,Lafayette,402 Lee Street,PO Box 1196,Hampton,AR,71744,Calhoun,Melanie Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000612,Lafayette County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,113 Chestnut St,,Lewisville,AR,71845,Lafayette,113 Chestnut Street,,Lewisville,AR,71845,Lafayette,Melissa Ward,Administrator,870-921-5744,,Melissa.Ward@arkansas.gov,,,,,,
AR-000613,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1053714295,Federally Qualified Health Centers - Medical Services,201 E School St,Lincoln School Based Health Center,Lincoln,AR,72744-8885,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000614,Arkansas Children's Hospital,Arkansas Children's Inc.,1194776757,Children's Hospitals (inpatient only),1 Childrens Way,,Little Rock,AR,72202-3500,Pulaski,1 Children's Way,,Little Rock,AR,72202,Pulaski,Debbra Haislip,Managed Care Contracts Manager,501-364-4080,,Haislipdc@archildrens.org,Ginger Cheatham,Managed Care Manager,501-364-1128,,cheathamgb@archildrens.org,https://www.archildrens.org
AR-000615,"Arkansas Children's Hospital, Center for Bleeding Disorders",Arkansas Children's Inc.,1194776757,Hemophilia Treatment Centers,1 Childrens Way,,Little Rock,AR,72202-3500,Pulaski,1 Children's Way,,Little Rock,AR,72202,Pulaski,Debbra Haislip,Managed Care Contracts Manager,501-364-4080,,Haislipdc@archildrens.org,Cassandra O'Neal/Kimo Stine,Coordinator/Medical Director,501-364-1076,,cloneal@uams.edu,https://www.archildrens.org
AR-000616,Arkansas Children's Hospital Dental Clinic,Arkansas Children's Inc.,1194776757,Dental Providers,1 Childrens Way,,Little Rock,AR,72202-3500,Pulaski,"1 Children's Way, Slot 664",,Little Rock,AR,72202,Pulaski,Debbra Haislip,Managed Care Contracts Manager,501-364-4080,,haislipdc@archildrens.org,Ginger Cheatham,Managed Care Manager,501-364-1128,,cheathamgb@archilderens.org,https://www.archildrens.org
AR-000617,LITTLE ROCK CHC,"JEFFERSON COMPREHENSIVE CARE SYSTEM,INC",1194922849,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",1100 N University Ave,Suite 125,Little Rock,AR,72207-6356,Pulaski,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J. BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000618,ARCARE88,ARCARE,1770948663,Federally Qualified Health Centers - Medical Services,11219 Financial Centre Pkwy,,Little Rock,AR,72211-3800,Pulaski,PO BOX 497,,Augusta,AR,72006-0497,Woodruff,"STEVEN COLLIER, MD",CEO,870-347-3304,,PROSERVICES@ARCARE.NET,,,,,,www.arcare.net
AR-000619,OPEN HANDS CLINIC,"JEFFERSON COMPREHENSIVE CARE SYSTEM,INC",1689870065,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",1225 Dr Martin Luther King Dr,,Little Rock,AR,72202-4743,Pulaski,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J. BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000620,Pulaski County/Central Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,3915 W 8th St,,Little Rock,AR,72204-2028,Pulaski,3915 W. 8th Street,,Little Rock,AR,72204,Pulaski,Vickie Jones,Administrator,501-280-3100,,Vickie.Jones@arkansas.gov,,,,,,
AR-000621,Arkansas Department of Health Women's Health Section,Arkansas Department of Health,1497966808,Family Planning Providers,4815 W Markham St,Slot H-16,Little Rock,AR,72205,Pulaski,"4815 W. Markham Street, Slot H-16",,Little Rock,AR,72205,Pulaski,Bradley Planey,Family Health Branch Chief,501-661-2021,,Bradley.Planey@arkansas.gov,,,,,,
AR-000622,Little Rock Health Center,"Planned Parenthood of Arkansas and Eastern Oklahoma, Inc.",1831185412,Family Planning Providers,5921 W 12th St,Suite C,Little Rock,AR,72204-1623,Pulaski,4401 W 109th St,Suite 200,Overland Park,KS,66211,Johnson,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,4662,Shirish.malla@ppgreatplains.org,Amanda Addison,VP of Health Services,913-345-4662,4662,amanda.addison@ppgreatplains.org,http://www.ppgreatplains.org
AR-000623,Pulaski County/Southwest Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,8901 Dailey Dr,,Little Rock,AR,72209-6238,Pulaski,8901 Dailey Drive,,Little Rock,AR,72209,Pulaski,Carol Waller,Administrator,501-565-9311,,Carol.Waller@arkansas.gov,,,,,,
AR-000624,ARcare-47,ARCARE,1831510700,Federally Qualified Health Centers - Medical Services,1310 N Center St,,Lonoke,AR,72086-2011,Lonoke,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000625,Lonoke County/Lonoke Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,306 N Center St,,Lonoke,AR,72086-2849,Lonoke,306 N. Center,,Lonoke,AR,72086,Lonoke,Milton Garris,Admnistrator,501-676-2268,,Milton.Garris@arkansas.gov,,,,,,
AR-000626,UAMS FMC Magnolia,UAMS FMC Magnolia,1841557725,"Rural Health Clinics, Ryan White Providers",1617 N Washington,,Magnolia,AR,71753-2046,Columbia,1617 N. Washington St,,Magnolia,AR,71753-2046,Columbia,Maria Coday,Business Manager,870-562-2588,1207,mcoday@uams.edu,Janet Hicks,Director of Practice Management,501-686-7650,,jshicks@uams.edu,
AR-000627,Columbia County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,207 S Jefferson,,Magnolia,AR,71753-3901,Columbia,207 South Jefferson,,Magnolia,AR,71753,Columbia,Twana Hendricks,Acting Administrator,870-235-3798,,Twana.Hendricks@arkansas.gov,,,,,,
AR-000628,Hot Spring County Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2204 E Sullenberger Ave,,Malvern,AR,72104-4806,Hot Spring,2204 E. Sullenberger,,Malvern,AR,72104,Hot Spring,Suellen Simpson,Administrator,501-332-6972,,Suellen.Simpson@arkansas.gov,,,,,,
AR-000629,Lee County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,141 Hicky St,,Marianna,AR,72360,Lee,141 N. Hicky Street,,Marianna,AR,72360,Lee,Veronica Sellers,Administrator,870-295-2400,,Veronica.Sellers@arkansas.gov,,,,,,
AR-000630,Lee County Cooperative Clinic,Lee County Cooperative Clinic,1669480836,"Dental Providers, Federally Qualified Health Centers - Medical Services",530 Atkins Blvd,,Marianna,AR,72360-2198,Lee,530 West Atkins Blvd,,Marianna,AR,72360,Lee,April Peer,Chief Financial Officer,870-298-4266,,apeer@lccc.us.com,Clifton Collier,Chief Executive Officer,870-295-5225,103,ccollier@lccc.us.com,
AR-000631,Poinsett County/Marked Tree Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,102 Liberty St,,Marked Tree,AR,72365-2231,Poinsett,102 Liberty Street,,Marked Tree,AR,72365,Poinsett,Janice Mitchusson,Administrator,870-358-3615,,Janice.Mitchusson@arkansas.gov,,,,,,
AR-000632,Access Medical Clinic Marked Tree,"Bradley Bibb, MD PLLC",1831595057,Rural Health Clinics,202 Newsome Dr,,Marked Tree,AR,72365-2021,Poinsett,49 Hwy 62/412,,Ash Flat,AR,72513,Sharp,Malinda Goodman,Office Manager,870-994-7301,,malindagoodman@myaccessmedicalclinic.com,"Brad Bibb, MD",Owner,870-994-7301,,bibbbrad@gmail.com,www.myaccessmedicalclinic.com
AR-000633,Searcy County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,742 Airport Rd,,Marshall,AR,72650-7603,Searcy,742 Airport Road,,Marshall,AR,72650,Searcy,Elizabeth Seftar,Administrator,870-448-3374,,Elizabeth.Seftar@arkansas.gov,,,,,,
AR-000634,"Boston Mountain Rural Health Center, Inc. - Marshall","Boston Mtn Rural Health Center, Inc.",1720096027,Federally Qualified Health Centers - Medical Services,Hwy 65 North,,Marshall,AR,72650,Searcy,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000635,Mayflower Medical Clinic,Conway Regional Medical Center,1851389605,Rural Health Clinics,606 Highway 365,,Mayflower,AR,72106-9595,Faulkner,2302 College Avenue,,Conway,AR,72032,Faulkner,Stephanie Cothran,Business Office Manager PCSN,501-745-2122,,scothran@conwayregional.org,Billy Henry,Director PCSN,501-327-1325,,billy.henry@conwayregional.org,conwayregional.org
AR-000636,ARcare - 42,ARCARE,1558782888,Federally Qualified Health Centers - Medical Services,8 N Railroad Ave,,Mayflower,AR,72106-9430,Faulkner,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000637,ARcare - 50,ARCARE,1801857503,Federally Qualified Health Centers - Medical Services,801 N Edmonds Ave,,McCrory,AR,72101-8279,Woodruff,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000638,Desha County/McGehee Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,200 E Ash St,,McGehee,AR,71654-1737,Desha,200 East Ash,,McGehee,AR,71654,Desha,Carolyne Blissett,Administrator,870-222-3910,,Leslie.Blissett@arkansas.gov,,,,,,
AR-000639,Izard County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,149 Haley St,,Melbourne,AR,72556,Izard,149 Haley Street,,Melbourne,AR,72556,Izard,Sharon Arnold,Acting Administrator,870-368-7790,,Sharon.Arnold@arkansas.gov,,,,,,
AR-000640,ARCARE100,ARCARE,1831442938,Federally Qualified Health Centers - Medical Services,54 Tate Springs Rd,,Melbourne,AR,72556-8633,Izard,117 S SECOND ST,,AUGUSTA,AR,72006,Woodruff,"STEVEN COLLIER, MD",CEO,870-347-3374,,PROSERVICES@ARCARE.NET,,,,,,WWW.ARCARE.NET
AR-000641,"Healthy Connections, Inc. Mena Street Clinic",HEALTHY CONNECTIONS INC,1962822916,Federally Qualified Health Centers - Medical Services,1201 Mena St,,Mena,AR,71953-4280,Polk,136 Health Park Dr,,Mena,AR,71953-9072,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,
AR-000642,"Healthy Connections, Inc.",HEALTHY CONNECTIONS INC,1588646491,"Dental Providers, Federally Qualified Health Centers - Medical Services",136 Health Park Dr,,Mena,AR,71953-9072,Polk,136 Health Park Dr,,Mena,AR,71953-9072,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,www.healthy-connections.org
AR-000643,Ouachita River Health Center: Acorn Campus,HEALTHY CONNECTIONS INC,1437416658,Federally Qualified Health Centers - Medical Services,139 School Ln,,Mena,AR,71953-8432,Polk,136 Health Park Dr,,Mena,AR,71953-9072,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,
AR-000644,Polk County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,702 Hornbeck Ave,,Mena,AR,71953-4422,Polk,702 Hornbeck Avenue,,Mena,AR,71953,Polk,Brenda Huff,Administrator,479-394-2707,,Brenda.Huff@arkansas.gov,,,,,,
AR-000645,Monticello Community Health Center,MAINLINE HEALTH SYSTEMS INC,1205163540,Federally Qualified Health Centers - Medical Services,766 H L Ross Dr,,Monticello,AR,71655-5706,Drew,233 N Main St,,Portland,AR,71663-9230,Ashley,Gary A Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000646,Drew County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,940 Scogin Dr,,Monticello,AR,71655-5732,Drew,940 Scogin Drive,,Monticello,AR,71655,Drew,Karen Brown,Administrator,870-367-6234,,Karen.Brown@arkansas.gov,,,,,,
AR-000647,Conway County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,100 Hospital Dr,,Morrilton,AR,72110-4516,Conway,100 Hospital Drive,,Morrilton,AR,72110,Conway,Jaynie Jones,Administrator,501-354-4652,,Jaynie.Jones@arkansas.gov,,,,,,
AR-000648,Montgomery County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,346 Luzerne St,,Mount Ida,AR,71957,Montgomery,P.O. Box 695,,Mount Ida,AR,71957,Montgomery,Echo Donahou,Administrator,870-867-2331,,Echo.Donahou@arkansas.gov,,,,,,
AR-000649,Montgomery County Community Clinic,HEALTHY CONNECTIONS INC,1265627616,"Dental Providers, Federally Qualified Health Centers - Medical Services",534 Luzerne St,,Mount Ida,AR,71957-9449,Montgomery,136 Health Park Dr,,Mena,AR,71953-9072,Polk,Tony Calandro,CEO,479-437-3449,,t.calandro@healthy-connections.org,,,,,,
AR-000650,Baxter County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,206 Bucher Dr,,Mountain Home,AR,72653-3400,Baxter,206 Bucher Drive,,Mountain Home,AR,72653,Baxter,Lou Anne McLendon,Administrator,870-425-3072,,lou.mclendon@arkansas.gov,,,,,,
AR-000651,Stone County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,204 Whitfield Ave,,Mountain View,AR,72560-9160,Stone,204 Whitfield Avenue,,Mountain View,AR,72560,Stone,Rhonda White,Administrator,870-269-3308,,Rhonda.White@arkansas.gov,,,,,,
AR-000652,Mountainburg Family Clinic,RIVER VALLEY PRIMARY CARE SERVICES,1639302896,Federally Qualified Health Centers - Medical Services,4 Hwy 71 N.E.,,Mountainburg,AR,72946,Crawford,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000653,Mulberry Family Clinic,RIVER VALLEY PRIMARY CARE SERVICES,1275766909,Federally Qualified Health Centers - Medical Services,437 N Main St,,Mulberry,AR,72947-8574,Crawford,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000654,Pike County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,15 Caddo Dr,,Murfreesboro,AR,71958,Pike,P.O. Box 413,,Murfreesboro,AR,71958,Pike,Teresa Morris,Administrator,870-285-3154,,Teresa.Morris@arkansas.gov,,,,,,
AR-000655,Howard Memorial Hospital,Howard Memorial Hospital,1851484695,Inpatient Hospitals (other than children's hospitals),130 Medical Cir,,Nashville,AR,71852-8606,Howard,130 Medical Circle,,Nashville,AR,71852,Howard,Debra J. Wright,Chief Executive Officer,870-845-8004,,debraw@howardmemorial.com,William J. Craig,Chief Financial Officer,870-845-8003,,williamjc@howardmemorial.com,howardmemorial.com
AR-000656,Howard County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,201 E Hempstead St,Suite 2,Nashville,AR,71852-2518,Howard,"201 E. Hempstead, Suite 2",,Nashville,AR,71852,Howard,Donna Webb,Administrator,870-845-2208,,Donna.Webb@arkansas.gov,,,,,,
AR-000657,Jackson County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1505 N Pecan St,,Newport,AR,72112-2867,Jackson,1505 North Pecan,,Newport,AR,72112,Jackson,Sonia Nix,Acting Administrator,870-523-8968,,Sonia.Nix@arkansas.gov,,,,,,
AR-000658,ARcare - 45,ARCARE,1255392957,Federally Qualified Health Centers - Medical Services,2000 McLain St,,Newport,AR,72112-3661,Jackson,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000659,Pulaski County/North Little Rock Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2800 Willow St,,North Little Rock,AR,72114-2230,Pulaski,2800 North Willow,,North Little Rock,AR,72114,Pulaski,Carey Woods,Administrator,501-791-8551,,Carey.Woods@arkansas.gov,,,,,,
AR-000660,SMC Hospital,Mississippi County Hospital System,1366685992,Inpatient Hospitals (other than children's hospitals),611 W Lee Ave,,Osceola,AR,72370-3001,Mississippi,PO Box 108,,Blytheville,AR,72315,Mississippi,Rhonda Cunningham,Revenue Cycle Director,870-838-7462,,Rhonda.Cunningham@mchsys.org,Chris Raymer,CEO,870-838-7000,,Chris.Raymer@mchsys.org,
AR-000661,Mississippi County/Osceola Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,720 W Lee Ave,,Osceola,AR,72370-3004,Mississippi,720 West Lee,,Osceola,AR,72370,Mississippi,Walter Holloway,Administrator,870-563-2521,,Walter.Holloway@arkansas.gov,,,,,,
AR-000662,Franklin County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,799 W River St,,Ozark,AR,72949-3100,Franklin,799 West River Street,,Ozark,AR,72949,Franklin,Brandi Stricklin,Administrator,479-667-2555,,Brandi.Stricklin@arkansas.gov,,,,,,
AR-000663,1st Choice Healthcare Paragould,"1st Choice Healthcare, Inc.",1730568189,Federally Qualified Health Centers - Medical Services,1 Medical Dr,,Paragould,AR,72450-4017,Greene,1001 N Missouri Avenue,,Corning,AR,72422,Clay,Brigitte McDonald,CEO,870-857-3334,,bmcdonald@1stchoice-ar.org,Debra Finley,COO,870-857-3334,,dfinley@1stchoice-ar.org,
AR-000664,Paragould Doctors Clinic,"Doctors' Health Group, Inc.",1134246747,Rural Health Clinics,4000 Linwood Dr,Suite A,Paragould,AR,72450-7224,Greene,800 S. Main St.,,Paragould,AR,72403,Craighead,Chad Garrett,Administrative Assistant,870-239-8503,1241,cgarrett@drsclinic.net,Jakita Lell,Clinic Administrator,870-239-8503,1235,jlell@drsclinic.net,
AR-000665,Greene County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,801 Goldsmith Rd,,Paragould,AR,72450-9509,Greene,800 Goldsmith Road,,Paragould,AR,72450,Greene,Laura Thaxton,Acting Administrator,870-236-7782,,Laura.Thaxton@arkansas.gov,,,,,,
AR-000666,Logan County/Paris Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,150 S Lowder St,,Paris,AR,72855-4204,Logan,150 South Lowder Street,,Paris,AR,72855,Logan,Paula Beaty,Administrator,479-963-6126,,Paula.Beaty@arkansas.gov,,,,,,
AR-000667,COOPER CLINIC PA,"Cooper Clinic, PA",1891908166,Rural Health Clinics,303 S 5th St,,Paris,AR,72855-4501,Logan,303 S 5th St,,Paris,AR,72855,Sebastian,Melissa Astin,"Director, Business Services",479-274-2004,,melissa.astin@cooperclinic.com,Cathy Garner,Practice Manager,479-274-2201,,cathy.garner@cooperclinic.com,
AR-000668,ARcare - 25,ARCARE,1083675524,Federally Qualified Health Centers - Medical Services,5787 Highway 64,,Parkin,AR,72373-9003,Cross,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000669,Perry County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1039 N Fourche Ave,,Perryville,AR,72126-8545,Perry,1039 North Fourche Avenue,,Perryville,AR,72126,Perry,Willa Darlene Spinks,Administrator,501-889-5156,,Willa.Spinks@arkansas.gov,,,,,,
AR-000670,Clay County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1009 S Garfield Ave,,Piggott,AR,72454-7610,Clay,1009 South Garfield,,Piggott,AR,72454,Clay,Linda Hutchison,Acting Administrator,870-598-3390,,Linda.Hutchison@arkansas.gov,,,,,,
AR-000671,PINE BLUFF,"JEFFERSON COMPREHENSIVE CARE SYSTEM, INC",1154386597,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",1101 S Tennessee St,,Pine Bluff,AR,71601-5801,Jefferson,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000672,Jefferson County/University of Arkansas at Pine Bluff Satellite Clinic,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1200 University Dr,,Pine Bluff,AR,71601-2780,Jefferson,1200 N. University Drive,,PINE BLUFF,AR,71601,Jefferson,Angela Parker,Administrator,870-535-2142,,Angela.L.Parker@arkansas.gov,,,,,,
AR-000673,Jefferson County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2306 Rike Dr,,Pine Bluff,AR,71603-3933,Jefferson,2306 Rike Drive,,PINE BLUFF,AR,71603,Jefferson,Angela L. Parker,Administrator,870-535-2142,,Angela.L.Parker@arkansas.gov,,,,,,
AR-000674,Randolph County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1304 Pace Rd,,Pocahontas,AR,72455-4305,Randolph,1304 Pace Road,,Pocahontas,AR,72455,Randolph,Lori Bergman,Acting Administrator,870-892-5239,,Lori.Bergman@arkansas.gov,,,,,,
AR-000675,1st Choice Healthcare Pocahontas,"1ST CHOICE HEALTHCARE, INC.",1366498735,Federally Qualified Health Centers - Medical Services,141 Betty Dr,,Pocahontas,AR,72455-3602,Randolph,1001 N Missouri Avenue,,Corning,AR,72422-1716,Clay,Brigitte McDonald,CEO,870-857-3334,,bmcdonald@1stchoice-ar.org,Debra Finley,COO,870-857-3334,,dfinley@1stchoice-ar.org,
AR-000676,Portland Elementary Clinic,"Mainline Health Systems, Inc.",1649636986,Federally Qualified Health Centers - Medical Services,314 Highway 160 E,,Portland,AR,71663-9262,Ashley,233 N. Main,,Portland,AR,71663,Ashley,G. Allan Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000677,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1518389089,Federally Qualified Health Centers - Medical Services,801 Viney Grove Rd,Prairie Grove School Based Health Center,Prairie Grove,AR,72753-2623,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000678,Nevada County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1501 W 1st St N,,Prescott,AR,71857-3309,Nevada,1501 West First North,,Prescott,AR,71857,Nevada,Debbie Henderson,Administrator,870-887-2004,,Deborah.Henderson@arkansas.gov,,,,,,
AR-000679,RIVER VALLEY PRIMARY CARE SERVICES INC.,RIVER VALLEY PRIMARY CARE SERVICES,1952349003,"Dental Providers, Federally Qualified Health Centers - Medical Services",9755 W State Highway 22,PO Box 130,Ratcliff,AR,72951-9000,Logan,9755 W State Highway 22,P.O. Box 130,Ratcliff,AR,72951-9000,Logan,Nikki McKinney,Credentialing,479-790-5110,,nikkim@rvpcs.org,,,,,,
AR-000680,FAMILY CARE CLINIC OF RECTOR,PIGGOTT COMMUNITY HOSPITAL,1679564413,Rural Health Clinics,715 E 9th St,,Rector,AR,72461-2705,Clay,1206 GORDON DUCKWORTH DR,,Piggott,AR,724541911,Clay,JAMES MAGEE,Executive Director,870-598-3881,201,james.magee@pch-health.com,LINDA ORT,Finance Director,870-598-3881,209,linda.ort@pch-health.com,http://pch-health.com
AR-000681,Rector Medical Clinic,"Doctors Health Group, Inc.",1073575734,Rural Health Clinics,807 E 9th St,,Rector,AR,72461-2406,Clay,800 S. Main St.,,Jonesboro,AR,72403,Craighead,Chad Garrett,Administrative Assistant,870-239-8503,1241,cgarrett@drsclinic.net,Jakita Lell,Clinic Administrator,870-239-8503,1235,jlell@drsclinic.net,
AR-000682,REDFIELD CLINIC,"JEFFERSON COMPREHENSIVE CARE SYSTEM,INC",1124224928,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",1101 Evening Sunset Circle,,Redfield,AR,72132,Jefferson,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000683,Cleveland County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,409 E Magnolia St,,Rison,AR,71665-8395,Cleveland,409 East Magnolia,,Rison,AR,71665,Cleveland,Gwendolyn Paul,Administrator,870-325-6311,,Gwendolyn.Paul@arkansas.gov,,,,,,
AR-000684,RISON CLINIC,"JEFFERSON COMPREHENSIVE CARE SYSTEM,INC",1396941191,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",505 Sycamore St,,Rison,AR,71665,Cleveland,PO BOX 1285,,PINE BLUFF,AR,71613-1285,Jefferson,SANDRA J. BROWN,CEO,870-543-2380,1101,SBROWN@JCCSI.ORG,,,,,,
AR-000685,Benton County/Rogers Local Health Unit,Arkansas Department of Health Women's Health Services,1497966808,Family Planning Providers,1200 W Walnut St,Suite 2200,Rogers,AR,72756-3572,Benton,"1200 W. Walnut Street, Suite 2200",,Rogers,AR,72756,Benton,Loy Bailey,Administrator,479-986-1300,,james.bailey@arkansas.gov,,,,,,
AR-000686,Community Clinic Rogers Medical,"ST. FRANCIS HOUSE NWA, INC.",1710160098,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1233 W Poplar St,,Rogers,AR,72756-4245,Benton,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Benton,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000687,Community Clinic Rogers Dental,"ST. FRANCIS HOUSE NWA, INC.",1891980405,Dental Providers,3710 W Southern Hills Blvd,,Rogers,AR,72758-8041,Benton,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000688,Pope County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,203 Weir Rd,,Russellville,AR,72802-9405,Pope,203 Weir Road,,Russellville,AR,72808,Pope,Judy Bradley,Administrator,479-968-6004,,Judy.Bradley@arkansas.gov,,,,,,
AR-000689,Fulton County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,510 S Main St,,Salem,AR,72576-9422,Fulton,510 S. Main Street,,Salem,AR,72576,Fulton,Wanda Koelling,Administrator,870-895-3300,,Wanda.Koelling@arkansas.gov,,,,,,
AR-000690,White County/Searcy Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,112 Brantley Rd,,Searcy,AR,72143-8315,White,112 Brantly Road,,Searcy,AR,72143,White,Trudy Noble,Administrator,501-268-6102,,Trudy.Noble@arkansas.gov,,,,,,
AR-000691,ARcare - 75,ARCARE,1861642985,Federally Qualified Health Centers - Medical Services,406 Rodgers Dr,,Searcy,AR,72143-7433,White,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000692,Grant County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,700 E Center St,,Sheridan,AR,72150-2514,Grant,700 East Center,,Sheridan,AR,72150,Grant,Jessica Wells,Acting Administrator,870-942-3157,,Jessica.Wells@Arkansas.gov,,,,,,
AR-000693,Benton County/Siloam Springs Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,101 W University St,,Siloam Springs,AR,72761-2663,Benton,101 W. University,,Siloam Springs,AR,72761,Benton,Loy Bailey,Administrator,479-549-3794,,james.bailey@arkansas.gov,,,,,,
AR-000694,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1083034029,Federally Qualified Health Centers - Medical Services,1500 N Mount Olive St,Siloam Springs School Based Health Center,Siloam Springs,AR,72761-9509,Benton,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000695,Community Clinic Siloam Springs Medical,"ST. FRANCIS HOUSE NWA, INC.",1417197245,Federally Qualified Health Centers - Medical Services,500 S Mount Olive St,Suite 200,Siloam Springs,AR,72761-3602,Benton,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000696,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1609272640,Federally Qualified Health Centers - Medical Services,2878 Powell St,George School Based Health Center,Springdale,AR,72764-7333,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000697,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1891181848,Federally Qualified Health Centers - Medical Services,420 N West End St,Elmdale School Based Health Center,Springdale,AR,72764-3002,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000698,Community Clinic Springdale Dental,"ST. FRANCIS HOUSE NWA, INC.",1619083458,Dental Providers,610 E Emma Ave,,Springdale,AR,72764-4634,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000699,Community Clinic Springdale Medical - Family Practice,"ST. FRANCIS HOUSE NWA, INC.",1356759385,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",610 E Emma Ave,,Springdale,AR,72764-4634,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000700,Community Clinic Springdale Medical,"ST. FRANCIS HOUSE NWA, INC.",1699785089,Federally Qualified Health Centers - Medical Services,614 E Emma Ave,Suite 300,Springdale,AR,72764-4469,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000701,Washington County/Dr. Joseph Bates Outreach Clinic,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,614 E Emma Ave,Suite 247,Springdale,AR,72764-4459,Washington,"614 East Emma Avenue, Suite 247",,Springdale,AR,72764,Washington,Robin Thomas,Administrator,479-751-3630,,Robin.Thomas@arkansas.gov,,,,,,
AR-000702,Community Clinic: A Healthcare Ministry of St. Francis House NWA,"ST. FRANCIS HOUSE NWA, INC.",1023328002,Federally Qualified Health Centers - Medical Services,900 Powell St,Jones School Based Health Center,Springdale,AR,72764,Washington,614 E Emma Ave Ste 300,,Springdale,AR,72764-4469,Washington,Kathy Grisham,CEO,479-751-7417,6070,kgrisham@communityclinicnwa.org,Amanda Echegoyen,Patient Financial Services Manager,479-751-7417,6167,aechegoy@communityclinicnwa.org,www.communityclinicnwa.org
AR-000703,Star City Community Health Center,MAINLINE HEALTH SYSTEMS INC,1154757920,"Dental Providers, Federally Qualified Health Centers - Medical Services",110 N Drew St,,Star City,AR,71667-5704,Lincoln,233 N Main St,,Portland,AR,71663-9230,Ashley,Gary A Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000704,Lincoln County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,214 S Lincoln Ave,,Star City,AR,71667-5202,Lincoln,214 South Lincoln,,Star City,AR,71667,Lincoln,Amanda Bradshaw,Administrator,870-628-5121,,Amanda.Bradshaw@arkansas.gov,,,,,,
AR-000705,Stephens Community Clinic,Ouachita County Medical Center,1740227370,Rural Health Clinics,113 W Ruby St,,Stephens,AR,71764-8803,Ouachita,PO BOX 797,,Camden,AR,71711,Ouachita,Joe Michael Givens,Administrative Project Coordinator,870-836-1415,,jgivens@ouachitamedcenter.com,Peggy L. Abbott,President and CEO,870-836-1200,,pabbott@ouachitamedcenter.com,
AR-000706,Strong Clinic,"CABUN Rural Health Services, Inc",1821032046,Federally Qualified Health Centers - Medical Services,253 South Concord,PO Box 565,Strong,AR,71765-0565,Union,402 Lee Street,PO Box 1196,Hampton,AR,71744,Calhoun,Melanie Sheppard,CEO,870-798-4064,2227,melanies@cabun.org,Susan Johnston,CIO,870-798-4064,2245,susanj@cabun.org,
AR-000707,Arkansas County/Stuttgart Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1602 N Buerkle St,,Stuttgart,AR,72160,Arkansas,1602 Buerkle Road,,Stuttgart,AR,72160,Arkansas,Lisa Roberson,Administrator,870-673-1609,,lisa.roberson@arkansas.gov,,,,,,
AR-000708,ARcare - 90,ARCARE,1437110129,Federally Qualified Health Centers - Medical Services,300 Main St,,Swifton,AR,72471-8809,Jackson,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000709,East Texas Border Health Clinic dba Genesis Primecare-Arkansas,East Texas Border Health Clinic dba Genesis Primecare,1093186249,Federally Qualified Health Centers - Medical Services,1205 E 35th St,,Texarkana,AR,71854-2746,Miller,P. O. Box 1326,502 East Rusk Street,Marshall,TX,75671,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing Specialist,903-927-3782,20,leighann.richmond@genesisprimecare.org,
AR-000710,Miller County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,503 Walnut St,,Texarkana,AR,71854-5286,Miller,503 Walnut,,Texarkana,AR,71854,Miller,Julie Huntley,Administrator,870-773-2108,,Julie.Huntley@arkansas.gov,,,,,,
AR-000711,Poinsett County/Trumann Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1204 W Main St,,Trumann,AR,72472-2925,Poinsett,1204 West Main Street,,Trumann,AR,72472,Poinsett,Janice Mitchusson,Administrator,870-483-5761,,Janice.Mitchusson@arkansas.gov,,,,,,
AR-000712,Truman Family Health Center,"EAST ARKANSAS FAMILY HEALTH CENTER, INC.",1578889622,"Dental Providers, Federally Qualified Health Centers - Medical Services",417 W Main St,,Trumann,AR,72472-3116,Poinsett,900 N. 7th St,,West Memphis,AR,72301-2001,Crittenden,Susan E Ward-Jones,CEO,870-733-6300,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,
AR-000713,Crawford County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2040 Chestnut St,,Van Buren,AR,72956-5321,Crawford,2040 Chestnut Street,,Van Buren,AR,72956,Crawford,Michelle Hammer,Administrator,479-474-6391,,Ronna.Hammer@arkansas.gov,,,,,,
AR-000714,Conway Regional Medical Clinic-Vilonia,Conway Regional Medical Center,1063798858,Rural Health Clinics,1122 Main St,Suite 7,Vilonia,AR,72173-8902,Faulkner,2302 College Avenue,,Conway,AR,72032,Faulkner,Stephanie Cothran,Business Office Manager PCSN,501-745-2122,,scothran@conwayregional.org,Billy Henry,Director PCSN,501-327-1325,,billy.henry@conwayregional.org,
AR-000715,Scott County Local Health Unit,Arkansas Department of Health Local Health Unit,1497966808,Family Planning Providers,316 Featherston St,,Waldron,AR,72958,Scott,316 Featherston St,,Waldron,AR,72958,Scott,Darla Mortimore,Administrator,479-637-2165,,Darla.Mortimore@arkansas.gov,,,,,,
AR-000716,Lawrence County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,1050 W Free St,,Walnut Ridge,AR,72476-1752,Lawrence,1050 West Free Street,,Walnut Ridge,AR,72476,Lawrence,Karen Sagaskey,Acting Administrator,870-886-3201,,Karen.Sagaskey@arkansas.gov,,,,,,
AR-000717,"Lawrence County Family Clinic, P. A.","Lawrence County Family Clinic, P. A.",1740317452,Rural Health Clinics,1210 W Main St,,Walnut Ridge,AR,72476-1005,Lawrence,1210 West Main,,Walnut Ridge,AR,72476,Lawrence,Anita Marlin,Assistant Office Manager,870-886-3543,,cmklcfc@sbcglobal.net,Karen Patterson,Office Manager,870-886-3543,,kplcfc@sbcglobal.net,
AR-000718,1st Choice Healthcare Walnut Ridge,"1ST CHOICE HEALTHCARE, INC.",1598711152,Federally Qualified Health Centers - Medical Services,201 Colonial Dr,,Walnut Ridge,AR,72476-1410,Lawrence,1001 N Missouri Avenue,,Corning,AR,72422-1716,Clay,Brigitte McDonald,CEO,870-857-3399,,bmcdonald@1stchoice-ar.org,Debra Finley,COO,870-857-3334,,dfinley@1stchoice-ar.org,
AR-000719,Bradley County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,208 Bragg St,,Warren,AR,71671-2500,Bradley,P.O. Box 118,,Warren,AR,71671,Bradley,Alicia Outlaw,Administrator,870-226-8440,,robin.outlaw@arkansas.gov,,,,,,
AR-000720,Crittenden County/Mid-South Community College Satellite Clinic,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,2000 W Broadway St,,West Memphis,AR,72301-3829,Crittenden,2000 West Broadway,,West Memphis,AR,72301,Crittenden,Crystal Moore,Administrator,870-735-4334,,Crystal.Moore@arkansas.gov,,,,,,
AR-000721,"East Arkansas Family Health Center, Inc.","EAST ARKANSAS FAMILY HEALTH CENTER, INC.",1871599613,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",900 N 7th St,,West Memphis,AR,72301-2001,Crittenden,215 E Bond Ave,,West Memphis,AR,72301-3550,Crittenden,Susan Ward-Jones,CEO,870-733-6301,,swjones@eafhc.org,Jacqueline Bell,Administrative Assistant,870-733-6301,,jbell@eafhc.org,http://www.eafhc.org
AR-000722,Crittenden County/West Memphis Local Health Unit,Arkansas Department of Health Women's Health Services,1497966808,Family Planning Providers,901 N 7th St,,West Memphis,AR,72301-2001,Crittenden,901 North 7th Street,,West Memphis,AR,72301,Crittenden,Crystal Moore,Administrator,870-735-4334,,Crystal.Moore@arkansas.gov,,,,,,
AR-000723,Wilmot Elementary Clinic,"Mainline Health Systems, Inc.",1790140564,Federally Qualified Health Centers - Medical Services,2764 Hwy. 165 S,,Wilmot,AR,71676,Ashley,233 N. Main,,Portland,AR,71663,Ashley,G. Allan Nichols,Executive Director,870-538-5414,,gnichols@mainlinehealth.net,Tafta McCain,Chief Financial Officer,870-538-5414,,tmccain@mainlinehealth.net,
AR-000724,ARcare - 60,ARCARE,1487615183,Federally Qualified Health Centers - Medical Services,601 Julia Ave E,,Wynne,AR,72396-3506,Cross,117 S 2nd St,,Augusta,AR,72006-2309,Woodruff,Steven F Collier,CEO,870-347-3304,,proservices@arcare.net,,,,,,
AR-000725,Cross County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,701 Julia Ave E,,Wynne,AR,72396-3515,Cross,701 Julia Avenue East,,Wynne,AR,72396,Cross,Kitty Bingham,Administrator,870-238-2101,,Kitty.Bingham@arkansas.gov,,,,,,
AR-000726,BMRHC - Yellville,"Boston Mtn Rural Health Center, Inc.",1487909107,Federally Qualified Health Centers - Medical Services,358 East Valley St,,Yellville,AR,72687-9087,Marion,305 S. Glade Street,,Marshall,AR,72650,Searcy,Becky Blair,Chief Financial Officer,870-448-5733,2008,beckyblair@bmrhc.net,,,,,,
AR-000727,Marion County Local Health Unit,Arkansas Department of Health Women's Health Section,1497966808,Family Planning Providers,707 Highway 202 W,,Yellville,AR,72687-9333,Marion,707 Hwy 202 West,,Yellville,AR,72687,Marion,Valerie Shipman,Administrator,870-449-4259,,Valerie.Shipman@arkansas.gov,,,,,,
AZ-000728,DESERT SENITA COMMUNITY HEALTH AND DENTAL CENTER,AJO COMMUNITY HEALTH CENTER,1114037496,"Dental Providers, Federally Qualified Health Centers - Medical Services",410 N Malacate St,,Ajo,AZ,85321-2253,Pima,410 N Malacate St,,Ajo,AZ,85321-2253,Pima,Jonathan Leonard,CEO,520-387-5651,3007,jleonard@desertsenita.org,Sherry Henley,Finance Manager,520-387-5651,3453,shenley@desertsenita.org,
AZ-000729,United Community Health Center at Amado,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1063732675,"Dental Providers, Federally Qualified Health Centers - Medical Services",28720 S Nogales Hwy,,Amado,AZ,85645-9997,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000730,Apache Junction Satellite,"SUN LIFE FAMILY HEALTH CENTER, INC.",1508276940,Federally Qualified Health Centers - Medical Services,2080 W Southern Ave,,Apache Junction,AZ,85120-7455,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000731,Broadway FQHC,"Horizon Health and Wellness, Inc.",1619236478,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics",477 E Broadway Ave,Bldg B,Apache Junction,AZ,85119-5201,Pinal,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,61837,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,
AZ-000732,Pinal County Public Health Services District Apache Junction Clinic,Pinal County Public Health Services District Apache Junction,1427481175,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",575 N Idaho Rd,Suite 301,Apache Junction,AZ,85119-4000,Pinal,575 N Idaho Rd Ste 301,,Apache Junction,AZ,85119-4000,Pinal,Tom Schryer,Health Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000733,Plaza FQHC,"Horizon Health and Wellness, Inc.",1235560087,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics",625 N Plaza Dr,,Apache Junction,AZ,85120-5501,Pinal,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,61837,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,
AZ-000734,United Community Health Center at Arivaca,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1922050319,"Dental Providers, Federally Qualified Health Centers - Medical Services",17388 W 3rd St,,Arivaca,AZ,85601,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000735,NORTH COUNTRY HEALTHCARE - ASH FORK,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",112 Park Ave,,Ash Fork,AZ,86320,Yavapai,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000736,Adelante Healthcare Avondale,"ADELANTE HEALTHCARE, INC.",1467761809,Federally Qualified Health Centers - Medical Services,3400 N Dysart Rd,Suite F121,Avondale,AZ,85392-1009,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000737,MIHS - Avondale Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1982022133,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",950 E Van Buren St,,Avondale,AZ,85323-1506,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000738,Cochise Health and Social Services - Benson,Cochise Health and Social Services,1215968250,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",126 W 5th St,,Benson,AZ,85602-6550,Cochise,"1415 Melody Lane, Bldg A",,Bisbee,AZ,85603,Cochise,Jennifer Lakosil,Director,520-432-9468,,jlakosil@cochise.az.gov,,,,,,https://www.cochise.az.gov/health-and-social-services/clinic-schedules
AZ-000739,COPPER QUEEN COMMUNITY HOSPITAL,Bisbee Hospital Association,1518968767,Inpatient Hospitals (other than children's hospitals),101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,James Ehasz,CFO,520-432-2042,,jehasz@cqch.org,,,,,,
AZ-000740,Copper Queen Medical Assoiciates-Bisbee,Bisbee Hospital Association,1508137209,Rural Health Clinics,101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,James Ehasz,CFO,520-432-6450,,jehasz@cqch.org,,,,,,
AZ-000741,"Chiricahua Community Health Centers, Inc.","Chiricahua Community Health Centers, Inc.",1942241443,Federally Qualified Health Centers - Medical Services,108 Arizona St,,Bisbee,AZ,85603-1804,Cochise,1100 F Ave,,Douglas,AZ,85607-1920,Cochise,Samantha Tardibuono,Credentialing Specialist,520-459-3012,7519,credentials@cchci.org,,,,,,https://cchci.org/locations/?location_id=867
AZ-000742,Cochise Health and Social Services - Bisbee,Cochise Health and Social Services,1215968250,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1415 W Melody Ln,Bldg A,Bisbee,AZ,85603-3027,Cochise,"1415 Melody Lane, Bldg A",,Bisbee,AZ,85603,Cochise,Jennifer Lakosil,Director,520-432-9468,,jlakosil@cochise.az.gov,,,,,,https://www.cochise.az.gov/health-and-social-services/clinic-schedules
AZ-000743,BOUSE MEDICAL CLINIC,LA PAZ REGIONAL HOSPITAL,1235154147,Rural Health Clinics,440314 E Plomosa Rd,,Bouse,AZ,85325,La Paz,1200 MOHAVE ROAD,,PARKER,AZ,85344,La Paz,CARL FLANAGAN,CFO,928-669-7400,,CFLANAGAN@LAPAZHOSPITAL.ORG,YOLANDA M HOLT,BO DIRECTOR,928-669-7313,,YHOLT@LAPAZHOSPITAL.ORG,
AZ-000744,Adelante Healthcare Buckeye,"ADELANTE HEALTHCARE, INC.",1801954441,"Dental Providers, Federally Qualified Health Centers - Medical Services",306 E Monroe Ave,,Buckeye,AZ,85326-2706,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000745,NORTH COUNTRY HEALTHCARE - BULLHEAD CITY,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2585 Miracle Mile,Suite 116,Bullhead City,AZ,86442-7562,Mohave,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000746,Clarence Wesley Health Center,San Carlos Apache Health Care Corporation,1417330713,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",101 Medical Dr,,Bylas,AZ,85530,Graham,PO Box 787,,Peridot,AZ,85542-0787,Graham,Deven Parlikar,Chief Executive Officer,928-475-1200,,dparlikar@gmail.com,Victoria Began,Chief Nursing Office,928-475-1208,1208,victoria.began@scahealth.org,
AZ-000747,Cameron Dental,Tuba City Regional Health Care Corporation,1134382211,"Dental Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",25 Miles South of Tuba City AZ,,Cameron,AZ,86020,Coconino,167 N Main St,,Tuba City,AZ,86045-0600,Coconino,Lynette Bonar,Chief Executive Officer,928-283-2094,,lynette.bonar@tchealth.org,Alvina Tunney-Patterson,Chief Compliance Officer,928-283-2452,,alvina.tunney-patterson@tchealth.org,
AZ-000748,2nd Street Integrated Care,"Horizon Health and Wellness, Inc.",1043687775,"Community Mental Health Centers, Other ECP Providers, Rural Health Clinics",115 W 2nd St,,Casa Grande,AZ,85122-4406,Pinal,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,
AZ-000749,Sun Life Center for Children,Sun Life Family Health Center,1417286568,Federally Qualified Health Centers - Medical Services,1856 E Florence Blvd,,Casa Grande,AZ,85122-5303,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Kim Charles Collins,COO,520-381-0302,,kim.collins@slfhc.org,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,
AZ-000750,Center for Women,"SUN LIFE FAMILY HEALTH CENTER, INC.",1548690332,Federally Qualified Health Centers - Medical Services,1864 E Florence Blvd,,Casa Grande,AZ,85122-5457,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000751,Pinal County Public Health Services District Casa Grande,Pinal County Public Health Services District Casa Grande,1366875056,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",820 E Cottonwood Ln,Suite E,Casa Grande,AZ,85122-2758,Pinal,820 E Cottonwood Ln Ste E,,Casa Grande,AZ,85122-2758,Pinal,Tom Schryer,Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000752,SUN LIFE FAMILY HEALTH CENTER,"SUN LIFE FAMILY HEALTH CENTER, INC.",1891913166,"Dental Providers, Federally Qualified Health Centers - Medical Services",865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000753,MIHS - Chandler FHC WHH SWN San Tan,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1225456429,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1465 W Chandler Blvd,Bldg A Ste B,Chandler,AZ,85224-6237,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000754,MIHS - Chandler Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1427476670,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",811 S Hamilton St,,Chandler,AZ,85225-6308,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000755,Chinle Comprehensive Healthcare Facility (inpatient hospital),Chinle Indian Health Service,1508800129,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",Hwy 191 Hospital Turnoff,,Chinle,AZ,86503-8000,Apache,PO Drawer PH,,Chinle,AZ,86503,Apache,Eric Ritchie,Clinical Director,928-674-7001,9286747019,eric.ritchie@ihs.gov,Ron Tso,CEO,928-674-7001,9286747011,Ron.Tso@ihs.gov,
AZ-000756,Chinle Comprehensive Healthcare Facility (multiple outpatient ECP categories),Chinle Indian Health Service,1508800129,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",Hwy 191 Hospital Turnoff,,Chinle,AZ,86503-8000,Apache,PO Drawer PH,,Chinle,AZ,86503,Apache,Eric Ritchie,Clinical Director,928-674-7001,9286747019,eric.ritchie@ihs.gov,Ron Tso,CEO,928-674-7001,9286747011,Ron.Tso@ihs.gov,
AZ-000757,Cibecue Health Center,DHHS IHS Phoenix Area,1427335181,"Dental Providers, Indian Health Service, Other ECP Providers",North Cromwell Rd,,Cibecue,AZ,85911,Navajo,North Cromwell Road,,Cibecue,AZ,85911,Navajo,Racheal Allen,Revenue Manager,928-338-5509,,racheal.allen@ihs.gov,Mitzi Classay,Supervisor Billing Technician,928-338-3532,,mitzi.classay@ihs.gov,
AZ-000758,Canyonlands Healthcare - Clifton,Canyonlands Healthcare - Clifton,1134568660,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",10A Ward Canyon Rd,,Clifton,AZ,85533-8233,Greenlee,10A Ward Canyon Rd,,Clifton,AZ,85533-8233,Greenlee,Christopher Hansen,CEO,928-645-6600,,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000759,Congress Hospital Clinic,"Community Hospital Association, Inc.",1609144393,"Outpatient Hospital Clinics, Rural Health Clinics",26750 B Santa Fe Road,,Congress,AZ,85332,Yavapai,520 Rose Lane,,Wickenburg,AZ,85390,Maricopa,Michael V. Ellis,CFO,928-668-1805,,mike.ellis@wickhosp.com,James F. Tavary,CEO,928-684-4360,,jim.tavary@wickhosp.com,http://wickhosp.com/service/community-clinics/
AZ-000760,Pinal County Public Health Services District Coolidge Clinic,Pinal County Public Health Services District Coolidge,1528113859,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",119 W Central Ave,,Coolidge,AZ,85128-4405,Pinal,119 W Central Ave,,Coolidge,AZ,85128-4405,Pinal,Tom Schryer,Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000761,COOLIDGE SATELLITE,"SUN LIFE FAMILY HEALTH CENTER, INC.",1033321989,Federally Qualified Health Centers - Medical Services,1284 N Arizona Blvd,,Coolidge,AZ,85128-3206,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000762,Yavapai Co. Community Health Services Cottonwood Clinic,Yavapai County Community Health Services,1659317022,"Dental Providers, Federally Qualified Health Centers - Medical Services",51 S Brian Mickelsen Pkwy,,Cottonwood,AZ,86326-3610,Yavapai,51 S Brian Mickelsen Pkwy,,Cottonwood,AZ,86326-3610,Yavapai,Debbie Savoini,Interim Director,928-442-5281,,debbie.savoini@yavapai.us,Kevin Goss,Business Manager Clinical Services,928-777-7539,,Kevin.Goss@yavapai.us,http://www.chcy.info/?page_id=291
AZ-000764,COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS,Bisbee Hospital Association,1942217088,Rural Health Clinics,100 E 5th St,,Douglas,AZ,85607-2859,Cochise,101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,James Ehasz,CFO,520-432-6450,,jehasz@cqch.org,,,,,,
AZ-000765,Cochise Health and Social Services - Douglas,Cochise Health and Social Services,1215968250,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1012 N G Ave,Suite 101,Douglas,AZ,85607-2020,Cochise,"1415 Melody Lane, Bldg A",,Bisbee,AZ,85603,Cochise,Jennifer Lakosil,Director,520-432-9468,,jlakosil@cochise.az.gov,,,,,,https://www.cochise.az.gov/health-and-social-services/clinic-schedules
AZ-000766,"Chiricahua Community Health Centers, Inc.","Chiricahua Community Health Centers, Inc.",1942241443,"Dental Providers, Federally Qualified Health Centers - Medical Services",1100 F Ave,,Douglas,AZ,85607-1919,Cochise,1205 F Avenue,,Douglas,AZ,85607,Cochise,Jessica King,Chief Administrative Officer,520-364-1429,7522,jaking@cchci.org,,,,,,
AZ-000767,"Chiricahua Community Health Centers, Inc.","Chiricahua Community Health Centers, Inc.",1942241443,Federally Qualified Health Centers - Medical Services,815 E 15th St,,Douglas,AZ,85607-1631,Cochise,1100 F Ave,,Douglas,AZ,85607-1920,Cochise,Samantha Tardibuono,Credentialing Specialist,520-459-3012,7519,credentials@cchci.org,,,,,,https://cchci.org/locations/?location_id=866
AZ-000768,Canyonlands Healthcare - Duncan,Canyonlands Healthcare - Duncan,1033275706,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",227 Main St,,Duncan,AZ,85534-9790,Greenlee,227 Main St,,Duncan,AZ,85534-9790,Greenlee,Christopher Hansen,CEO,928-645-6600,,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000769,MIHS - El Mirage Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073931218,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",12428 W Thunderbird Rd,,El Mirage,AZ,85335-3113,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000770,Cliff Whetton Clinic,Chiricahua Community Health Centers,1457489890,"Dental Providers, Federally Qualified Health Centers - Medical Services",10566 N Highway 191,,Elfrida,AZ,85610-9021,Cochise,1205 F Avenuea,,Douglas,AZ,85607,Cochise,Gary McPherran,CFO,520-364-1429,3333,mmcpherran@cchci.org,,,,,,www.cchci.org
AZ-000771,Eloy Satellite,"SUN LIFE FAMILY HEALTH CENTER, INC.",1588876429,Federally Qualified Health Centers - Medical Services,205 N Stuart Blvd,,Eloy,AZ,85131-2507,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000772,Pinal County Public Health Services District Eloy Clinic,Pinal County Public Health Services District Eloy,1770916470,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",302 E 5th St,,Eloy,AZ,85131-2111,Pinal,302 E 5th St,,Eloy,AZ,85131-2111,Pinal,Tom Schryer,Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000773,NORTH COUNTRY HEALTHCARE - FLAGSTAFF WEST,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1120 W University Ave,Suite 101,Flagstaff,AZ,86001-2851,Coconino,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000774,Native American Cardiology Program,Native American Cardiology Program,1568739605,"Indian Health Service, Other ECP Providers",1215 N Beaver St,,Flagstaff,AZ,86001-3126,Coconino,1215 N Beaver St Ste 201,,Flagstaff,AZ,86001-3126,Coconino,"Henry Van Dyk, M.D.",Director,928-214-3920,,Henry.vandyk@tchealth.org,Diane Steuart,Business Office Manager,928-214-3870,,Diane.Steuart@ihs.gov,
AZ-000775,NACA Family Health Center,"Native Americans for Community Action (Flagstaff, AZ)",1053326751,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1500 E Cedar Ave,Suite 26,Flagstaff,AZ,86004-1642,Coconino,2717 N Steves Blvd Ste 11,,Flagstaff,AZ,86004-3959,Coconino,Dr. Curtis Randolph,Interim Chief Executive Officer,928-773-1245,260,crandolph@nacainc.org,Gerald Clark,Chief Financial Officer,928-526-2968,128,gclark@nacainc.org,www.nacainc.org
AZ-000776,NORTH COUNTRY HEALTHCARE - THE GUIDANCE CENTER INTEGRATION CLINIC,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2187 N Vickey St,Suite B,Flagstaff,AZ,86004-6121,Coconino,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000777,North Country Healthcare,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2384 N Steves Blvd Suite B,NORTH COUNTRY HEALTHCARE - PONDEROSA HIGH SCHOOL BASED HEALTHCARE,Flagstaff,AZ,86004-6105,Coconino,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000778,Planned Parenthood Flagstaff Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",2500 S Woodlands Village Blvd,Suite 12,Flagstaff,AZ,86001-6373,Coconino,4751 N 15th Street,,Phoenix,AZ,85014-2500,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,https://www.plannedparenthood.org/health-center/arizona/flagstaff/86001/flagstaff-health-center-2566-90030
AZ-000779,Coconino County Public Health Services District,Coconino County Public Health Services District,1962529610,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2625 N King St,,Flagstaff,AZ,86004-1884,Coconino,2625 N King Street,,Flagstaff,AZ,86004,Coconino,Marie Peoples,Chief Health Officer,928-679-7222,7330,mpeoples@coconino.az.gov,Mike Oxtoby,Assistant Chief Health Officer,928-679-7241,,moxtoby@coconino.az.gov,http://www.coconino.az.gov/index.aspx?NID=235
AZ-000781,Florence Satellite,Sun Life Family Health Center,1902278252,Federally Qualified Health Centers - Medical Services,150 S Main,,Florence,AZ,85132,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000782,Wassaja Memorial Health Center,Fort McDowell Yavapai Nation,1053418533,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",16240 N Fort McDowell Rd,,Fort McDowell,AZ,85264-3402,Maricopa,16240 N Ft McDowell Rd,,Ft McDowell,AZ,85264,Maricopa,Demetra Barr,Medical/Health Division Director,480-789-7890,7878,dbarr@ftmcdowell.org,"Cormelia ""Meya"" Castillo",Bsiness Administrator,480-789-7890,,ccastillo@ftmcdowell.org,www.fmyn.org/clinic
AZ-000783,Valley View Medical Center,LifePoint Health,1811086994,Inpatient Hospitals (other than children's hospitals),5330 S Highway 95,,Fort Mohave,AZ,86426-9225,Mohave,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7581,,Ian.Andes@LPNT.net,Emma Canlas,CFO,928-788-7004,,,
AZ-000784,Adelante Healthcare Gila Bend,"ADELANTE HEALTHCARE, INC.",1386702942,Federally Qualified Health Centers - Medical Services,100 N Gila Ave,,Gila Bend,AZ,85337,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000785,MIHS - Glendale Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1952720708,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",5141 W Lamar Rd,,Glendale,AZ,85301-3423,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000786,Planned Parenthood Glendale Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",5771 W Eugie Ave,,Glendale,AZ,85304-1241,Maricopa,4751 N 15th Street,,Phoenix,AZ,85014-2500,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-000787,Terros Glendale Care Clinic,Terros,1699173245,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",6153 W Olive Ave,Suite 1,Glendale,AZ,85302-4564,Maricopa,"3003 N Central Avenue, Suite 200",,Phoenix,AZ,85012,Maricopa,Jennifer Siozos,Health Center Administrator,480-628-7113,,jennifer.siozos@terros.org,TIARA CROUSE,Director of Operations and Contracts,602-685-6000,,TIARA.CROUSE@TERROS.ORG,
AZ-000789,Canyonlands Healthcare - Globe,Canyonlands Healthcare - Globe,1417218876,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5860 S Hospital Dr,Suite 102,Globe,AZ,85501-9449,Gila,827 Vista Ave,PO Box 3486,Page,AZ,86040,Coconino,Liz Latham,CEO,928-645-6600,,liz.latham@cchcaz.org,Christopher Hansen,CEO,928-645-9675,5507,c.hansen@cchcaz.org,
AZ-000790,Mountain Park Health Center - Goodyear,MOUNTAIN PARK HEALTH CENTER,1922105204,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",140 N Litchfield Rd,Suite 200,Goodyear,AZ,85338-1226,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000791,NORTH COUNTRY HEALTHCARE - GRAND CANYON,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1 Clinic Rd,,Grand Canyon,AZ,86023,Coconino,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000792,Continental Family Medical Center,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1093766867,"Dental Providers, Federally Qualified Health Centers - Medical Services",1260 S Campbell Ave,Bldg 2,Green Valley,AZ,85614-0503,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000793,United Community Health Center Continental Pediatrics,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1275715286,"Dental Providers, Federally Qualified Health Centers - Medical Services",1260 S Campbell Ave,Bldg 1,Green Valley,AZ,85614-0503,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000794,MIHS - Guadalupe Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1861811614,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",5825 E Calle Guadalupe,,Guadalupe,AZ,85283-2664,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000795,PALOMINAS / HEREFORD RURAL HEALTH CLINIC,Bisbee Hospital Association,1225438104,Rural Health Clinics,10524 E Highway 92,,Hereford,AZ,85615-8371,Cochise,101 Cole Ave,,Bisbee,AZ,85603-1327,Cochise,James Ehasz,CFO,520-432-6450,,jehasz@cqch.org,,,,,,
AZ-000796,NORTH COUNTRY HEALTHCARE - HOLBROOK,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2109 Navajo Blvd,,Holbrook,AZ,86025-1822,Navajo,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000797,Canyonlands Healthcare - Chilchinbeto,Canyonlands Healthcare,1154380392,"Black Lung Clinics, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",E Hwy 160 To Rte 59,,Kayenta,AZ,86033,Navajo,PO Box 1625,,Page,AZ,86040-1625,Coconino,Christopher Hansen,CEO,928-645-6600,,c.hansen@cchcaz.org,Holly Smith,COO,928-645-9675,5555,h.smith@cchcaz.org,http://www.canyonlandschc.org
AZ-000798,Kayenta Health Center,Kayenta Health Center,1174692529,"Dental Providers, Indian Health Service, Other ECP Providers",Highway 163 Phs/I.H.S. Dr,,Kayenta,AZ,86033,Navajo,PO Box 368,,Kayenta,AZ,86033-0368,Navajo,Ethelyn Bailey,HSA,928-697-4004,,ethelyn.bailey@ihs.gov,Frank Dayish,Chief Executive Officer,928-697-4235,,frank.dayish@ihs.gov,
AZ-000799,Dennehotso Health Clinic (Kayenta Service Unit),Indian Health Service-Navajo Area,1821167297,"Indian Health Service, Other ECP Providers",Hwy 160 Building 2000,,Kayenta,AZ,86033,Navajo,POB 368,,Kayenta,AZ,86033,Navajo,Ethelyn Bailey,HSA,928-697-4004,,ethelyn.bailey@ihs.gov,Frank Dayish,Chief Executive Officer,928-697-4235,,frank.dayish@ihs.gov,
AZ-000800,Kearny Clinic,Cobre Valley Regional Medical Center,1992967780,Rural Health Clinics,100 S Tilbury Dr,,Kearny,AZ,85137-1218,Pinal,Cobre Valley Regional Medical Center,,Globe,AZ,85501,Gila,Frank Stapleton,"Administration, Regional Clinics Director",928-402-1131,,fstapleton@cvrmc.org,,,,,,
AZ-000802,NORTH COUNTRY HEALTHCARE - KINGMAN,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1510 N Stockton Hill Rd,,Kingman,AZ,86401-5173,Mohave,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000803,NORTH COUNTRY HEALTHCARE - KINGMAN INTEGRATION,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3705 Western Ave,Suite B,Kingman,AZ,86409-3077,Mohave,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000804,Mohave County Department of Public Health,MOHAVE COUNTY DEPARTMENT OF PUBLIC HEALTH,1740326727,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",700 W Beale St,,Kingman,AZ,86401-5711,Mohave,700 W. Beale St.,,Kingman,AZ,86401,Mohave,Lynne Valentine-RN,Nursing Services Manager,928-753-0714,,Lynne.Valentine@mohavecounty.us,Jocelyn Fernandez RN,Immunization Program Coordinator,928-753-0714,4581,Jocelyn.Fernandez@mohavecounty.us,
AZ-000805,Havasu Regional Medical Center,LifePoint Health,1780761866,Inpatient Hospitals (other than children's hospitals),101 Civic Center Ln,,Lake Havasu City,AZ,86403-5607,Mohave,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Christina Dimambro,CFO,928-453-0422,,,
AZ-000806,NORTH COUNTRY HEALTHCARE - LAKE HAVASU CITY,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2090 Smoketree Ave N,,Lake Havasu City,AZ,86403-5806,Mohave,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000808,Canyonlands Healthcare - Beaver Dam,CANYONLANDS COMMUNITY HEALTH CARE,1780653741,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3272 E Rio Virgin Rd,,Littlefield,AZ,86432-3200,Mohave,827 Vista Ave,PO Box 1625,Page,AZ,86040,Coconino,Christopher Hansen,CEO,928-645-9675,5507,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000809,Pinal County Public Health Services District Mammoth,Pinal County Public Health Services District Mammoth,1720411424,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",110 N Main St,,Mammoth,AZ,85618,Pinal,110 N Main St,,Mammoth,AZ,85618,Pinal,Tom Schryer,Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000810,Many Farms Dental Clinic,Many Farms Dental Clinic,1942484910,Dental Providers,Highway 191 Lake Rd.,,Many Farms,AZ,86538,Apache,POB 397,,Many Farms,AZ,86538,Apache,Patrick Yazzie,Business Office Supervisor,928-674-7030,,patrick.yazzie@ihs.gov,Ron Tso,Chief Executive Officer,928-674-7011,,ron.tso@ihs.gov,
AZ-000811,Marana Health Center BH,"MARANA HEALTH CENTER, INC.",1689864597,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",13395 N Marana Main St,Bldg B,Marana,AZ,85653-7008,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000812,Pinal County Public Health Services District Maricopa Clinic,Pinal County Public Health Services District Maricopa,1972936946,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",41600 W Smith Enke Rd,Bldg 15,Maricopa,AZ,85138-2702,Pinal,"41600 W Smith Enke Rd, Bldg 15",,Maricopa,AZ,85138-2702,Pinal,Tom Schryer,Director,520-866-7301,,tom.schryer@pinalcountyaz.gov,Kore Redden,Assistant Director,520-866-7331,,kore.redden@pinalcountyaz.gov,http://pinalcountyaz.gov/Departments/PublicHealth/Pages/OfficeLocations.aspx
AZ-000813,Maricopa Family Practice,"SUN LIFE FAMILY HEALTH CENTER, INC.",1548472475,Federally Qualified Health Centers - Medical Services,44572 W Bowlin Rd,,Maricopa,AZ,85138-4558,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000814,MARICOPA SATELLITE,"SUN LIFE FAMILY HEALTH CENTER, INC.",1881073443,Federally Qualified Health Centers - Medical Services,44765 W. Hathaway Rd,,Maricopa,AZ,85139,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000815,Planned Parenthood Mesa Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",1235 S Gilbert Rd,Suite 7,Mesa,AZ,85204-6006,Maricopa,4751 N. 15th St.,,Phoenix,AZ,85014,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-012438,Center for Vein Restoration,Center for Vein Restoration,1215411970,Other ECP Providers,1500 S Dobson Rd,Suite 310,Mesa,AZ,85202-4751,Maricopa,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
AZ-000816,Adelante Healthcare Mesa,"ADELANTE HEALTHCARE, INC.",1891853446,"Dental Providers, Federally Qualified Health Centers - Medical Services",1705 W Main St,,Mesa,AZ,85201-6920,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000817,MIHS - Desert Vista Behavioral Health Center (inpatient hospital),"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073576740,Inpatient Hospitals (other than children's hospitals),570 W Brown Rd,,Mesa,AZ,85201-3227,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000818,MIHS - Desert Vista Behavioral Health Center (other ecp providers),"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073576740,Other ECP Providers,570 W Brown Rd,,Mesa,AZ,85201-3227,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000819,MIHS - Mesa Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1306265145,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",59 S Hibbert,,Mesa,AZ,85210-1414,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000820,MARIPOSA CHC-MESQUITE BUILDING,"MARIPOSA COMMUNITY HEALTH CENTER, INC.",1104122563,"Dental Providers, Federally Qualified Health Centers - Medical Services",1835 N Mastick Way,,Nogales,AZ,85621-1064,Santa Cruz,1852 N Mastick Way,,Nogales,AZ,85621-1063,Santa Cruz,Ed Sicurello,CEO,520-761-2128,,esicurello@mariposachc.net,Tia Duncan,Senior Director of Administrative Services,520-761-2128,,tduncan@mariposachc.net,www.mariposachc.net
AZ-000821,"MARIPOSA COMMUNITY HEALTH CENTER, INC.","MARIPOSA COMMUNITY HEALTH CENTER, INC.",1417985474,"Dental Providers, Federally Qualified Health Centers - Medical Services",1852 N Mastick Way,,Nogales,AZ,85621-1063,Santa Cruz,1852 N Mastick Way,,Nogales,AZ,85621-1063,Santa Cruz,Ed Sicurello,CEO,520-761-2128,,esicurello@mariposachc.net,Tia Duncan,Senior Director of Administrative Services,520-761-2128,,tduncan@mariposachc.net,www.mariposachc.net
AZ-000822,ORACLE SATELLITE,"SUN LIFE FAMILY HEALTH CENTER, INC.",1902018856,Federally Qualified Health Centers - Medical Services,1870 W American Ave,,Oracle,AZ,85623-6015,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000823,Oracle FQHC,"Horizon Health and Wellness, Inc.",1710366737,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics",980 E Mt Lemmon Hwy,,Oracle,AZ,85623,Pinal,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,61837,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,http://www.hhwaz.org/locations/
AZ-000824,Summit Healthcare Community Clinic,Summit Healthcare Regional Medical Center,1770700767,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2352 Quarter Horse Trail,PO Box 1013,Overgaard,AZ,85933-1013,Navajo,2200 E Show Low Lake Road,,Show Low,AZ,85901,Navajo,Kim Burlison,Clinic Manager,928-535-3616,7819,kburlison@summithealthcare.net,Brandy Spires,Director,928-537-6778,,bspires@summithealthcare.net,summithealthcare.net
AZ-000825,Canyonlands Healthcare - Urgent Care,CANYONLANDS COMMUNITY HEALTH CARE,1669441564,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",440 N Navajo Dr,,Page,AZ,86040,Coconino,827 Vista Ave,,Page,AZ,86040,Coconino,Christopher Hansen,CFO,928-645-9675,5507,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000826,Canyonlands Healthcare - Lake Powell,Canyonlands Healthcare,1619945904,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services",467 Vista Ave,,Page,AZ,86040,Coconino,827 Vista Ave,PO Box 1625,Page,AZ,86040,Coconino,Christopher Hansen,CEO,928-645-9675,5507,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-6600,5555,h.smith@cchcaz.org,http://www.canyonlandschc.org
AZ-000827,Canyonlands Healthcare,Canyonlands Healthcare,1932103462,"Black Lung Clinics, Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",827 Vista Ave,,Page,AZ,86040,Coconino,467 Vista Avenue,,Page,AZ,86040,Coconino,Christopher Hansen,Chief Executive Officer,928-645-9675,5555,c.hansen@cchcaz.org,Holly Smith,Chief Fiancial Officer,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000828,Colorado River Service Unit - Parker Hospital/ Peach Springs Health Center/Supai Clinic/Chemehuevi Clinic/Moapa Clinic,Colorado River Service Unit - Parker Hospital/ Peach Springs Health Center/Supai Clinic/Chemehuevi Clinic/Moapa Clinic,1851678585,"Dental Providers, Indian Health Service, Rural Health Clinics",12033 Agency Rd,,Parker,AZ,85344-7718,La Paz,12033 Agency Rd,,Parker,AZ,85344,La Paz,ELIZABETH HELSEL,Chief Executive Officer,928-669-2137,,ELIZABETH.HELSEL@IHS.GOV,,,,,,
AZ-000829,LA PAZ HEALTHCARE PARKER CLINIC,"LA PAZ REGIONAL HOSPITAL,INC DBA",1083639983,Rural Health Clinics,601 W Riverside Dr,Suite 3,Parker,AZ,85344-5119,La Paz,1200 MOHAVE ROAD,,PARKER,AZ,85344,La Paz,CARL FLANAGAN,CFO,928-669-7400,,CFLANAGAN@LAPAZHOSPITAL.ORG,YOLANDA M HOLT,BO DIRECTOR,928-669-7313,,YHOLT@LAPAZHOSPITAL.ORG,
AZ-000830,"Parker Medical Center, Ltd","Parker Medical Center, Ltd",1720433832,Rural Health Clinics,905 S Fiesta Ave,,Parker,AZ,85344-5152,La Paz,905 South Fiesta Avenue,,PARKER,AZ,85344,La Paz,Alicia Shillito,Manager,928-669-2225,,parkermedicalcenter@outlook.com,Robyn Anderson,biller,928-279-4802,,parkermedicalcenter@outlook.com,
AZ-000831,FAMILY HEALTH CENTER,"MARIPOSA COMMUNITY HEALTH CENTER, INC.",1003837618,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 N Taylor Ln,,Patagonia,AZ,85624-9600,Santa Cruz,1852 N Mastick Way,,Nogales,AZ,85621-1063,Santa Cruz,Ed Sicurello,CEO,520-761-2128,,esicurello@mariposachc.net,Tia Duncan,Senior Director of Administrative Services,520-761-2128,,tduncan@mariposachc.net,www.mariposachc.net
AZ-000832,NORTH COUNTRY HEALTHCARE - PAYSON,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",708 S Coeur D Alene Ln,,Payson,AZ,85541-5662,Gila,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000833,Peach Springs Health Center,Peach Springs Health Center (included in Colorado River Service Unit),1265719934,"Indian Health Service, Other ECP Providers",943 Hualapai Way,,Peach Springs,AZ,86434,Mohave,PO Box 129,,Peach Springs,AZ,86434-0129,Mohave,Jane Preston,Acting Director,928-769-2910,,leslie.preston@ihs.gov,Kathleen Nelson,HIM Director,928-669-3245,,kathleen.nelson@ihs.gov,
AZ-000834,SUNSITES MEDICAL CLINIC,Northern Cochise Community Hospital,1013060367,Rural Health Clinics,223 N Frontage Rd,,Pearce,AZ,85625,Cochise,901 W Rex Allen Dr,,Willcox,AZ,85643,Cochise,Robin Allen,Rural Health Clinic Manager,520-766-6516,,rallen@ncch.com,Jennifer Cochran,Director of Human Resources,520-766-6494,,jcochran@ncch.com,http://www.ncch.com/getpage.php?name=sunsite
AZ-000835,Adelante Healthcare Peoria,"ADELANTE HEALTHCARE, INC.",1770991291,Federally Qualified Health Centers - Medical Services,15525 N 83rd Ave,Suite 104,Peoria,AZ,85382-5820,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000836,San Carlos Apache Healthcare Corporation,San Carlos Apache Health Care Corporation,1265813075,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",103 Medicine Way Rd,,Peridot,AZ,85542,Gila,PO Box 787,,Peridot,AZ,85542-0787,Graham,Deven Parlikar,Chief Executive Officer,928-475-1200,,dparlikar@gmail.com,Victoria Began,Chief Nursing Office,928-475-1208,1208,victoria.began@scahealth.org,
AZ-000837,MIHS - Seventh Avenue FHC WHH POCN Comunidad,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1356760102,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1035 E Jefferson St,Suite B,Phoenix,AZ,85034-2295,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000838,MIHS - Pendergast Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073916896,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",10550 W Mariposa St,Suite 1,Phoenix,AZ,85037-5082,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000839,MIHS - McDowell Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1629497474,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",1101 N Central Ave,Suite 200,Phoenix,AZ,85004-1844,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000840,MIHS - 7th Avenue Walk-in Clinic,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1083033831,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1201 S 7th Ave,,Phoenix,AZ,85007-3917,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000841,MIHS - Seventh Avenue Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1336568187,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",1205 S 7th Ave,,Phoenix,AZ,85007-3913,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000842,Red Mountain Service Center,Valle del Sol,1225317944,Federally Qualified Health Centers - Medical Services,1209 S 1st Ave,,Phoenix,AZ,85003-2692,Maricopa,3807 N. 7th Street,,Phoenix,AZ,85014,Maricopa,Kurt R. Sheppard,President and CEO,602-258-6797,122,kurts@valledelsol.com,Carmen Heredia,Chief of Arizona Operations,602-258-6797,132,carmenh@valledelsol.com,www.valledelsol.com
AZ-000843,NOAH Balsz Health Center,Neighborhood Outreach Access to Health,1790189991,"Dental Providers, Federally Qualified Health Centers - Medical Services",1300 N 48th St,,Phoenix,AZ,85008-5803,Maricopa,3634 N Drinkwater Blvd,,Scottsdale,AZ,85251-5622,Maricopa,Wendy Armendariz,Chief Executive Officer,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000844,Wesley Health Center,Wesley Health Center,1396910436,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1300 S 10th St,,Phoenix,AZ,85034-4516,Maricopa,1300 S 10th Street,,Phoenix,AZ,85034,Maricopa,Jaree Chambers,COO,602-368-9603,,jchambers@wccphx.net,Sonya Wilkins,CFO,602-368-9888,,swilkins@wccphx.net,
AZ-000845,NOAH Palomino Health Center,Neighborhood Outreach Access to Health,1972907129,"Dental Providers, Federally Qualified Health Centers - Medical Services",15833 N 29th St,,Phoenix,AZ,85032-3704,Maricopa,3634 N Drinkwater Blvd,,Scottsdale,AZ,85251-5622,Maricopa,Wendy Armendariz,Chief Executive Officer,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000846,Wesley Health Center - Golden Gate,Wesley Health Center,1144696097,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1625 N 39th Ave,,Phoenix,AZ,85009-2149,Maricopa,1300 S 10th Street,,Phoenix,AZ,85034,Maricopa,Jaree Chambers,COO,602-368-9603,,jchambers@wccphx.net,Sonya Wilkins,CFO,602-368-9888,,swilkins@wccphx.net,
AZ-000847,MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH SERVICES,"MARICOPA, COUNTY OF",1881928760,"Dental Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1645 E Roosevelt St,,Phoenix,AZ,85006-3638,Maricopa,4041 N. Central Ave.,Suite 1400,Phoenix,AZ,85012,Maricopa,Bob England,Director,602-506-6601,,bobengland@mail.maricopa.gov,Corinne Velasquez,Clinic Administrator,602-506-6657,,CorinneVelasquez@mail.maricopa.gov,www.wearepublichealth.org
AZ-000848,Mountain Park Health Center - Sunrise,MOUNTAIN PARK HEALTH CENTER,1386027852,Federally Qualified Health Centers - Medical Services,17624 N 31st Ave,,Phoenix,AZ,85053-1935,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000849,St. Luke's Medical Center,Steward Healthcare System LLC,1427009026,Inpatient Hospitals (other than children's hospitals),1800 E Van Buren St,,Phoenix,AZ,85006-3742,Maricopa,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,James Flinn,President,602-251-8116,,james.flinn@steward.org,Christopher Flores,Chief Financial Officer,602-251-8622,,christopher.flores@steward.org,www.steward.org
AZ-000850,Phoenix Children's Hospital,Phoenix Children's Hospital,1760480503,Children's Hospitals (inpatient only),1919 E Thomas Rd,,Phoenix,AZ,85016-7710,Maricopa,1919 E. Thomas Road,,Phoenix,AZ,85016,Maricopa,Renee Clarke,"Executive Director, Managed Care",602-933-2600,32600,rclarke@phoenixchildrens.com,Tiffanie Oenning,"Director, Managed Care",602-933-4136,,toenning@phoenixchildrens.com,phoenixchildrens.org
AZ-012374,Phoenix Children's Hospital HTC,Phoenix Children's Hospital,1760480503,Hemophilia Treatment Centers,1919 E Thomas Rd,,Phoenix,AZ,85016-7710,Maricopa,1919 E Thomas Rd,,Phoenix,AZ,85016,Maricopa,Renee Clarke,"Vice President, Managed Care",602-933-2600,,rclarke@phoenixchildrens.com,Tiffanie Oenning,"Director, Managed Care",602-933-4136,,toenning@phoenixchildrens.com,phoenixchildrens.org
AZ-000851,Health Care for the Homeless,Maricopa County,1417204157,Federally Qualified Health Centers - Medical Services,220 S 12th Ave,,Phoenix,AZ,85007-3101,Maricopa,4041 N. Central Ave.,Suite 1400,Phoenix,AZ,85012,Maricopa,Corinne Velasquez,Division Administrator,602-506-6657,,corinnevelasquez@mail.maricopa.gov,Vicki Copeland,Physician,602-372-2102,,vickicopeland@mail.maricopa.gov,
AZ-000852,NHW Community Health Center,Native Health,1982830410,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",2423 W Dunlap Ave,Suite 140,Phoenix,AZ,85021-5818,Maricopa,4041 N Central Ave,Building C,Phoenix,AZ,85012,Maricopa,Patricia Patron,COO,602-279-5262,3134,ppatron@nachci.com,Deanna Sangster,Health Services Administrator,602-279-5262,3409,dsangster@nachci.com,nativehealthphoenix.org
AZ-000853,MIHS - Comprehensive Healthcare Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1164840302,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",2525 E Roosevelt St,,Phoenix,AZ,85008-4948,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000854,MIHS - Maricopa Medical Center (children's inpatient hospital),Maricopa County Special Health Care District dba Maricopa Integrated Health System,1073576740,Children's Hospitals (inpatient only),2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000855,MIHS - Maricopa Medical Center (inpatient hospital),Maricopa County Special Health Care District dba Maricopa Integrated Health System,1073576740,Inpatient Hospitals (other than children's hospitals),2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000856,MIHS - Maricopa Medical Center (other ecp providers),"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073576740,Other ECP Providers,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000857,MIHS - Maricopa Behavioral Health Annex (inpatient hospital),"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073576740,Inpatient Hospitals (other than children's hospitals),2619 E Pierce St,,Phoenix,AZ,85008-6092,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000858,MIHS - Maricopa Behavioral Health Annex (outpatient hospital clinics),"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1073576740,Outpatient Hospital Clinics,2619 E Pierce St,,Phoenix,AZ,85008-6092,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000859,MIHS - South Central Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1891114641,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",33 W Tamarisk St,,Phoenix,AZ,85041-2422,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000860,Circle the City Medical Respite Center,CIRCLE THE CITY,1932588795,Federally Qualified Health Centers - Medical Services,333 W Indian School Rd,,Phoenix,AZ,85013-3205,Maricopa,300 W Clarendon,Suite 200,Phoenix,AZ,85013-3205,Maricopa,Brandon Clark,Chief Executive Officer,602-776-9000,,bclark@circlethecity.org,,,,,,
AZ-000861,Parsons Family Health Center,Circle the City,1487033247,Federally Qualified Health Centers - Medical Services,3522 N 3rd Ave,,Phoenix,AZ,85013-3903,Maricopa,300 W Clarendon,Suite 200,Phoenix,AZ,85013,Maricopa,Brandon Clark,Chief Executive Officer,602-776-9000,,bclark@circlethecity.org,,,,,,
AZ-000862,NOAH Calavar Family Health Center,Neighborhood Outreach Access to Health,1275086191,Federally Qualified Health Centers - Medical Services,3525 W Calavar Rd,,Phoenix,AZ,85053-5512,Maricopa,3634 N. Drinkwater Blvd.,,Scottsdale,AZ,85251,Maricopa,Wendy Armendariz,Chief Executive Officer,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000863,Central City Phoenix,Valle del Sol,1255614079,Federally Qualified Health Centers - Medical Services,3807 N 7th St,,Phoenix,AZ,85014-5005,Maricopa,3807 N. 7th Street,,Phoenix,AZ,85014,Maricopa,Kurt R. Sheppard,President and CEO,602-258-6797,122,kurts@valledelsol.com,Carmen Heredia,Chief Of Arizona Operations,602-258-6797,132,carmenh@valledelsol.com,www.valledelsol.com
AZ-000864,Mountain Park Health Center - Gateway,MOUNTAIN PARK HEALTH CENTER,1386741668,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",3830 E Van Buren St,,Phoenix,AZ,85008-6920,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000865,MIHS - Maryvale Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1295154045,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",4011 N 51st Ave,,Phoenix,AZ,85031-2601,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000866,Native Health Central,Native Health,1700904075,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",4041 N Central Ave,Bldg C,Phoenix,AZ,85012-3313,Maricopa,4041 N Central Ave,Building C,Phoenix,AZ,85012,Maricopa,Patricia Patron,COO,602-279-5262,3134,ppatron@nachci.com,Deanna Sangster,Health Services Administrator,602-279-5262,3409,dsangster@nachci.com,nativehealthphoenix.org
AZ-000867,Phoenix Indian Medical Center,Phoenix Indian Medical Center,1083643738,"Dental Providers, Indian Health Service, Ryan White Providers",4212 N 16th St,,Phoenix,AZ,85016-5389,Maricopa,4212 N 16th St,,Phoenix,AZ,85016-5389,Maricopa,Michael Weahkee,Chief Executive Officer,602-263-1200,,michael.weahkee@ihs.gov,Ms. Deanna Dick,Chief Operations Officer,602-263-1200,,deanna.dick@ihs.gov,
AZ-000868,Mountain Park Health Center - Atkinson,MOUNTAIN PARK HEALTH CENTER,1740663210,Federally Qualified Health Centers - Medical Services,4222 N 51st Ave,,Phoenix,AZ,85031-1908,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000869,Planned Parenthood Maryvale Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",4616 N 51st Ave,Suite 210,Phoenix,AZ,85031-1721,Maricopa,4751 N 15th Street,,Phoenix,AZ,85014-2500,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-000870,MIHS - Sunnyslope FHC WHH SWN Highland,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1730508524,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",4707 N 12th St,Suite B,Phoenix,AZ,85014-4009,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000871,Planned Parenthood Central Phoenix,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",4751 N 15th St,,Phoenix,AZ,85014-3707,Maricopa,4751 N. 15th St.,,Phoenix,AZ,85014,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-000872,Adelante Healthcare - Central Phoenix,"ADELANTE HEALTHCARE, INC.",1205200565,Federally Qualified Health Centers - Medical Services,500 W Thomas Rd,Suite 870,Phoenix,AZ,85013-4218,Maricopa,9520 W. Palm Lane Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000873,Mountain Park Health Center - Christown,MOUNTAIN PARK HEALTH CENTER,1487037958,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",5517 N 17th Ave,,Phoenix,AZ,85015-2516,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000874,Mountain Park Health Center - Baseline,MOUNTAIN PARK HEALTH CENTER,1558308825,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",635 E Baseline Rd,,Phoenix,AZ,85042-6583,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000875,Mountain Park Health Center - Maryvale,MOUNTAIN PARK HEALTH CENTER,1740387018,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",6601 W Thomas Rd,Suite 4,Phoenix,AZ,85033-5742,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000876,Adelante Healthcare Phoenix,"ADELANTE HEALTHCARE, INC.",1144419284,Federally Qualified Health Centers - Medical Services,7725 N 43rd Ave,Suite 510,Phoenix,AZ,85051-5771,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000877,Desert Mission Community Health Center,Neighborhood Outreach Access to Health,1649659236,"Dental Providers, Federally Qualified Health Centers - Medical Services",9201 N 5th St,,Phoenix,AZ,85020-2532,Maricopa,3634 N. Drinkwater Blvd.,,Scottsdale,AZ,85251,Maricopa,Wendy Armendariz,Executive Director,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000878,MIHS - Sunnyslope Family Health Center,"Maricopa County Special Health Care District dba Maricopa Integrated Health System ""MIHS""",1114346962,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",934 W Hatcher Rd,,Phoenix,AZ,85021-3139,Maricopa,2601 E Roosevelt St,,Phoenix,AZ,85008-4973,Maricopa,Barbara Harding,Sr VP Ambulatory Services & CEO MHCGC,602-344-1129,,Barbara.Harding@mihs.org,,,,,,
AZ-000879,Pinon Health Center,Pinon Health Center,1396761565,"Dental Providers, Indian Health Service, Other ECP Providers",Navajo Route 4,2 Miles East of Pinon,Pinon,AZ,86510,Navajo,PO Box 10,,Pinon,AZ,86510-0010,Navajo,Cornelia Lapahe,Business Office Supervisor,928-725-9657,,cornelia.lapahe@ihs.gov,Darlene Chee,HSA,928-725-9532,,darlene.chee@ihs.gov,
AZ-000880,Hopi Health Care Center (Keams Canyon Service Unit),Hopi Health Care Center (Keams Canyon Service Unit),1356628028,"Dental Providers, Indian Health Service, Other ECP Providers",Hwy 264 Milepost 388,,Polacca,AZ,86042,Navajo,PO Box 4000,Hwy 264 Milepost 388,Polacca,AZ,86042-4000,Navajo,Daryl Melvin,Chief Executive Officer,928-737-6085,6085,daryl.melvin@ihs.gov,IsaBelle Grover,Supervisoroy Health Systems Specialist,928-737-6085,6085,isabelle.grover@ihs.gov,
AZ-000881,Yavapai Co. Community Health Services Prescott Clinic,Yavapai County Community Health Services,1659317022,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1090 Commerce Dr,,Prescott,AZ,86305-3700,Yavapai,1090 Commerce Dr,,Prescott,AZ,86305-3700,Yavapai,Debbie Savoini,Interim Director,928-442-5581,,debbie.savoini@yavapai.us,Kevin Goss,Business Manager Clinical Services,928-777-7539,,Kevin.Goss@yavapai.us,http://www.chcy.info/?page_id=291
AZ-000882,Northland Cares,Northland Cares,1033213053,"Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",3112 Clearwater Dr,Suite A,Prescott,AZ,86305-7187,Yavapai,3112 Clearwater Drive,Suite A,Prescott,AZ,86305,Yavapai,Donald Sadler,Board of Directors Member,928-776-4612,108,ncsupport@northlandcares.org,LAURIE SILVER,Executive Director,928-776-4612,106,director@northlandcares.org,www.northlandcares.org
AZ-000883,Yavapai Co. Community Health Services Prescott Valley Clinic,Yavapai County Community Health Services,1659317022,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3212 N Windsong Dr # 2,,Prescott Valley,AZ,86314-2255,Yavapai,3212 N Windsong Dr # 2,,Prescott Valley,AZ,86314-2255,Yavapai,Debbie Savoini,Interim Director,928-442-5581,,debbie.savoini@yavapai.us,Kevin Goss,Business Manager Clinical Services,928-777-7539,,Kevin.Goss@yavapai.us,http://www.chcy.info/?page_id=291
AZ-000884,LA PAZ MEDICAL SERVICES,LA PAZ REGIONAL HOSPITAL dba,1013932938,Rural Health Clinics,150 E Tyson Rd,,Quartzsite,AZ,85359,La Paz,1200 MOHAVE RD,,PARKER,AZ,85344,La Paz,CARL FLANAGAN,CFO,928-669-7400,,cflanagan@lapazhospital.org,YOLANDA M HOLT,BO DIRECTOR,928-669-7313,,yholt@lapazhospital.org,
AZ-000885,MARIPOSA CHC - RIO RICO,"MARIPOSA COMMUNITY HEALTH CENTER, INC.",1013213404,"Dental Providers, Federally Qualified Health Centers - Medical Services",1103 Circulo Mercado,Suite E,Rio Rico,AZ,85648-6249,Santa Cruz,1852 N Mastick Way,,Nogales,AZ,85621-1063,Santa Cruz,Ed Sicurello,CEO,520-761-2128,,esicurello@mariposachc.net,Tia Duncan,Senior Director of Administrative Services,520-761-2128,,tduncan@mariposachc.net,www.mariposachc.net
AZ-000887,DHHS IHS PHOENIX AREA DESERT VISIONS YOUTH WELLNESS CENTER,DESERT VISIONS YOUTH WELLNESS CENTER,1104195353,"Indian Health Service, Other ECP Providers",198 South Skill Center Rd,PO Box 458,Sacaton,AZ,85147-0008,Pinal,POB 458,198 SOUTH SKILL CENTER ROAD,SACATON,AZ,85147,Pinal,Eugena Crossland,CHIEF EXECUTIVE OFFICER,520-562-4205,4205,eugena.crossland@ihs.gov,Michelle McGinn,Deputy CEO,520-562-4239,4250,michelle.mcginn@ihs.gov,https://www.ihs.gov/phoenix/index.cfm/adolescenttreatmentcenters/
AZ-000888,MT GRAHAM REGIONAL MEDICAL CENTER,MT GRAHAM REGIONAL MEDICAL CENTER,1275588345,Inpatient Hospitals (other than children's hospitals),1600 S 20th Ave,,Safford,AZ,85546-4011,Graham,1600 S 20th Avenue,,Safford,AZ,85546,Graham,Debi Connolly,Director of Revenue Integrity,928-348-4019,,debrac@mtgraham.org,Angie Hernandez,Lead,928-348-4021,,angela@mtgraham.org,
AZ-000889,Canyonlands Healthcare - Safford Integrated,CANYONLANDS COMMUNITY HEALTH CARE,1144755182,Federally Qualified Health Centers - Medical Services,1615 S 1st Ave,,Safford,AZ,85546-2103,Graham,PO Box 1625,,Page,AZ,86040,Coconino,Mari Reed,Director of Operations,928-645-9675,5521,m.reed@cchcaz.org,Jeannie Whitehorse,Finance Assistant,928-645-9675,5524,j.whitehorse@cchcaz.org,
AZ-000890,Canyonlands Healthcare - Safford,Canyonlands Healthcare - Safford,1861558595,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2016 W 16th St,,Safford,AZ,85546-4026,Graham,827 Vista,PO Box 1625,Page,AZ,86040,Coconino,Christopher Hansen,CEO,928-645-6600,,c.hansen@cchcaz.org,Holly Smith,CFO,928-645-9675,5555,h.smith@cchcaz.org,
AZ-000891,United Community Health Center at Sahuarita Heights,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1487978201,"Dental Providers, Federally Qualified Health Centers - Medical Services",2875 E Sahuarita Rd,,Sahuarita,AZ,85629-9434,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5609,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000892,NORTH COUNTRY HEALTHCARE - ST JOHNS,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",625 N 13th W St,,Saint Johns,AZ,85936,Apache,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000893,TRI-VALLEY MEDICAL CENTER,"LA PAZ REGIONAL HOSPITAL, INC DBA",1629093539,Rural Health Clinics,39726 Harquahala Mine Rd,,Salome,AZ,85348,La Paz,1200 MOHAVE RD,,PARKER,AZ,85344,La Paz,CARL FLANAGAN,CFO,928-669-7400,,CFLANAGAN@LAPAZHOSPITAL.ORG,YOLANDA M HOLT,BO DIRECTOR,928-669-7313,,YHOLT@LAPAZHOSPITAL.ORG,
AZ-000894,Maternal Child Health,San Carlos Apache Tribe,1639519002,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tribal Health Program operated under P.L. 93-638, Tuberculosis Clinics",103 Medicine Way Rd,P.O Box 0 Dhhs Bldg 15,San Carlos,AZ,85550,Gila,"San Carlos avenue, bldg 3",,San Carlos,AZ,85550,Gila,Brena Kennedy,Manager,928-475-1530,1535,brena.kennedy@scat-nsn.gov,Lois James,Billing Supervisor,928-475-2798,1125,lois.james@scat-nsn.gov,
AZ-000895,San Carlos Apache Wellness Center,San Carlos Apache Tribe,1821218801,"Community Mental Health Centers, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",5 San Carlos Blvd.,,San Carlos,AZ,85550,Gila,3 San Carlos Blvd.,,San Carlos,AZ,85550,Gila,DAVID REEDE,"Executive Director, Department of Health and Human Services",928-475-2798,1104,DAVID.REEDE@SCAT-NSN.GOV,Leolani Ah Quin,Program Manager,928-475-1500,1502,leolani.ahquin@scatwellness.net,
AZ-000896,SUNSET CHC - SAN LUIS DENTAL,SUNSET COMMUNITY HEALTH CENTER,1508947946,Dental Providers,801 N 2nd Ave,,San Luis,AZ,85349,Yuma,2060 West 24th street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Officer,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,928-819-8803,,wsims@sunset-chc.org,
AZ-000897,SUNSET CHC- SAN LUIS,SUNSET COMMUNITY HEALTH CENTER,1043324932,"Dental Providers, Federally Qualified Health Centers - Medical Services",815 E Juan Sanchez Blvd,,San Luis,AZ,85349,Yuma,2060 West 24th Street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Officer,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,928-819-8803,,wsims@sunset-chc.org,
AZ-000898,SAN MANUEL SATELLITE,"SUN LIFE FAMILY HEALTH CENTER, INC.",1467666206,Federally Qualified Health Centers - Medical Services,23 S McNab Pkwy,,San Manuel,AZ,85631-1156,Pinal,865 N Arizola Rd,,Casa Grande,AZ,85122-6011,Pinal,Travis Robinette,CEO,520-381-0303,,travisr@slfhc.org,Kim Collins,COO,520-381-0302,,kim.collins@slfhc.org,slfhc.org
AZ-000899,Pinal County Public Health Services District San Tan Valley Clinic,Pinal County Public Health Services District San Tan Valley,1730512708,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",36375 N Gantzel Rd,,San Tan Valley,AZ,85140-7333,Pinal,36375 N Gantzel Rd,,San Tan Valley,AZ,85140-7333,Pinal,KANDI HARRIS,Director,520-866-7304,,KANDI.HARRIS@PINALCOUNTYAZ.GOV,AUDREE UNGER,Assistant Director,520-866-7331,,AUDREE.UNGER@PINALCOUNTYAZ.GOV,http://www.pinalcountyaz.gov/publichealth/Pages/Home.aspx
AZ-000900,Behavioral Health Services,Salt River Pima-Maricopa Indian Community,1497000293,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",10005 E Osborn Rd,Bldg 32,Scottsdale,AZ,85256-4019,Maricopa,10005 E. Osborn Rd,,Scottsdale,AZ,85256,Maricopa,John Godfrey,Assistant Director of Health and Human Services,480-362-2727,,john.godfrey@srpmic-nsn.gov,,,,,,
AZ-000901,Salt River Health Center,Salt River Health Center,1093739740,"Dental Providers, Family Planning Providers, Indian Health Service",10005 E Osborn Rd,,Scottsdale,AZ,85256-4019,Maricopa,10005 E Osborn Rd,,Scottsdale,AZ,85256-4019,Maricopa,CAPT Michael D. Weahkee,Chief Executive Officer,602-263-1200,1894,michael.weahkee@ihs.gov,Ms. Deanna Dick,Chief Operating Officer,602-263-1200,1567,deanna.dick@ihs.gov,
AZ-000902,Cholla Health Center,Neighborhood Outreach Access to Health,1477956290,"Dental Providers, Federally Qualified Health Centers - Medical Services",11130 E Cholla St,Bldg I,Scottsdale,AZ,85259-3922,Maricopa,3634 N Drinkwater Blvd,,Scottsdale,AZ,85251-5622,Maricopa,Wendy Armendariz,Chief Executive Officer,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000903,NOAH Heuser Family Health Center,Neighborhood Outreach Access to Health,1881098036,Federally Qualified Health Centers - Medical Services,7301 E 2nd St,Suite 210,Scottsdale,AZ,85251-5620,Maricopa,3634 N Drinkwater Blvd,,Scottsdale,AZ,85251-5622,Maricopa,Wendy Armendariz,Chief Executive Officer,480-882-6073,,wendy.armendariz@honorhealth.com,Julia Nierad,Chief Financial Officer,480-882-5917,,julia.nierad@honorhealth.com,www.noahhelps.org
AZ-000904,NORTH COUNTRY HEALTHCARE - SELIGMAN,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",22585 W Oak St,,Seligman,AZ,86337,Yavapai,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000905,Santa Rosa Health Center,Santa Rosa Health Center,1770581639,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",HC01,,Sells,AZ,85634-9802,Pima,Route 15,,Sells,AZ,85634,Pima,Priscilla Whitethorne,Service Unit Director (CEO),520-383-7251,,priscilla.whitethorne@ihs.gov,Diane Shanley,Deputy Service Unit Director,520-383-7285,,diane.shanley@ihs.gov,
AZ-000906,Sells Indian Hospital (inpatient hospital),Sells PHS Indian Hospital,1487652426,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",Hwy 86 & Topawa Rd,,Sells,AZ,85634,Pima,PO Box 548,,Sells,AZ,85634-0548,Pima,Priscilla Whitethorne,Service Unit Director (CEO),520-383-7251,,priscilla.whitethorne@ihs.gov,Diane Shanley,Deputy Service Unit Director,520-383-7285,,diane.shanley@ihs.gov,
AZ-000907,Sells Indian Hospital (multiple outpatient ECP categories),Sells PHS Indian Hospital,1487652426,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",Hwy 86 & Topawa Rd,,Sells,AZ,85634,Pima,PO Box 548,,Sells,AZ,85634-0548,Pima,Priscilla Whitethorne,Service Unit Director (CEO),520-383-7251,,priscilla.whitethorne@ihs.gov,Diane Shanley,Deputy Service Unit Director,520-383-7285,,diane.shanley@ihs.gov,
AZ-000908,San Simon Health Center,San Simon Health Center,1588834998,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",West Hwy 86 Mile Marker 74,,Sells,AZ,85634,Pima,Route HC01,PO Box 8150,Sells,AZ,85634,Pima,Priscilla Whitethorne,Service Unit Director (CEO),520-383-7251,,priscilla.whitethorne@ihs.gov,Diane Shanley,Deputy Service Unit Director,520-383-7285,,diane.shanley@ihs.gov,
AZ-000909,Inscription House Health Center,Inscription House Health Center,1740359108,"Dental Providers, Indian Health Service, Other ECP Providers",Hwy 98 & Navajo Rt 1,,Shonto,AZ,86054,Navajo,PO Box 7397,,Shonto,AZ,86054-7397,Navajo,Ellamae Dayzie,HSA,928-672-3000,,ellamae.daysie@ihs.gov,Frank Dayish,Chief Executive Officer,928-672-3117,,frank.dayish@ihs.gov,
AZ-000910,NORTH COUNTRY HEALTHCARE - SHOW LOW INTEGRATION,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2600 E Show Low Lake Rd,,Show Low,AZ,85901-7931,Navajo,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000911,Vista Pediatrics,Chiricahua Community Health Centers,1821309089,Federally Qualified Health Centers - Medical Services,155 Calle Portal,Suite 700,Sierra Vista,AZ,85635-2973,Cochise,1205 F Avenue,,Douglas,AZ,85607,Cochise,Gary McPherran,CFO,520-364-1429,3333,mmcpherran@cchci.org,,,,,,https://cchci.org/locations/?location_id=871
AZ-000912,Cochise Health and Social Services - Sierra Vista,Cochise Health and Social Services,1215968250,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4115 E Foothills Dr,,Sierra Vista,AZ,85635-6311,Cochise,"1415 Melody Lane, Bldg A",,Bisbee,AZ,85603,Cochise,Jennifer Lakosil,Director,520-432-9468,,jlakosil@cochise.az.gov,,,,,,https://www.cochise.az.gov/health-and-social-services/clinic-schedules
AZ-000913,Sierra Vista Dental,Chiricahua Community Health Centers,1629499397,Dental Providers,4525 Campus Dr,,Sierra Vista,AZ,85635-2232,Cochise,1205 F Avenue,,Douglas,AZ,85607,Cochise,Gary McPherran,CFO,520-364-1429,3333,mmcpherran@cchci.org,,,,,,www.cchci.org
AZ-000915,"SUNSET COMMUNITY HEALTH CENTER, INC.",SUNSET COMMUNITY HEALTH CENTER,1962507376,"Dental Providers, Federally Qualified Health Centers - Medical Services",115 N Somerton Ave.,,Somerton,AZ,85350,Yuma,2060 West 24th Street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Officer,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,928-819-8803,,wsims@sunset-chc.org,
AZ-000916,White Mountain Regional Medical Center,"White Mountain Communities Hospital, Inc. d/b/a White Mountain Regional Medical Center",1699766592,Inpatient Hospitals (other than children's hospitals),118 S Mountain Ave,,Springerville,AZ,85938-5104,Apache,118 South Mountain Avenue,,Springerville,AZ,85938,Apache,Gregory J. Was,Chief Executive Officer,928-333-7145,,greg.was@wmrmc.com,Sammie Finch,Chief Nursing Officer,928-333-7338,,sammie.finch@wmrmc.com,www.wmrmc.com
AZ-000917,NORTH COUNTRY HEALTHCARE - SPRINGERVILLE,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",488 S Mountain Ave,,Springerville,AZ,85938-5103,Apache,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000918,NORTH COUNTRY HEALTHCARE - ST JOHNS INTEGRATION,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",470 West Cleveland,,St Johns,AZ,85936,Apache,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000919,SUPAI HEALTH CLINIC,SUPAI HEALTH CLINIC,1942318654,"Indian Health Service, Rural Health Clinics",1 Main St,,Supai,AZ,86435,Coconino,PO Box 129,,Supai,AZ,86435-0129,Coconino,ELIZABETH HELSEL,CEO CRSU,928-669-2137,,ELIZABETH.HELSEL@IHS.GOV,,,,,,
AZ-000920,Supai Health Clinic,DHHS IHS Phoenix Area,1184901829,"Indian Health Service, Other ECP Providers",129 Main Streer,PO Box 129,Supai,AZ,86435-0129,Coconino,12033 Agency Road,,Parker,AZ,85344,La Paz,Jane Preston,Acting Director,928-769-2910,,leslie.preston@ihs.gov,Kathleen Nelson,HIM Director,928-669-3245,,kathleen.nelson@ihs.gov,
AZ-000921,Superior Clinic,Cobre Valley Regional Medical Center,1649245135,Rural Health Clinics,1134 W US Highway 60,,Superior,AZ,85173-3400,Pinal,5880 S Hospital Drive,,Globe,AZ,85501,Gila,Frank Stapleton,"Administration, Regional Clinics Director",928-402-1131,,fstapleton@cvrmc.org,,,,,,
AZ-000922,Adelante Healthcare Surprise,"ADELANTE HEALTHCARE, INC.",1205994761,"Dental Providers, Federally Qualified Health Centers - Medical Services",15351 W Bell Rd,Suite 100,Surprise,AZ,85374-4580,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000923,Four Corners Regional Health Center ( part of Shiprock Service Unit),Four Corners Regional Health Center (part of Shiprock Service Unit),1477615789,"Dental Providers, Indian Health Service, Other ECP Providers",Us Hwy 160 Navajo Rt 35,,Teec Nos Pos,AZ,86514,Apache,HC 61 Box 30,,Teec Nos Pos,AZ,86514,Apache,Marcita Lee,Business Office Supervisor,928-656-5253,,marcita.lee@ihs.gov,Virgina Daniels,HSA,928-656-5253,,virginia.daniels@ihs.gov,
AZ-000925,Tempe St. Luke's Hospital,Steward Healthcare System LLC,1225086028,Inpatient Hospitals (other than children's hospitals),1500 S Mill Ave,,Tempe,AZ,85281-6699,Maricopa,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,James Flinn,President,602-251-8116,,james.flinn@steward.org,Christopher Flores,Chief Financial Officer,602-251-8622,,christopher.flores@steward.org,www.steward.org
AZ-000926,Planned Parenthood Tempe Regional Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",1837 E Baseline Rd,,Tempe,AZ,85283-1501,Maricopa,4751 N 15th Street,,Phoenix,AZ,85014-2500,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-000924,Mountain Park Health Center - Tempe,MOUNTAIN PARK HEALTH CENTER,1376640656,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1840 E Broadway Rd,Suite 312,Tempe,AZ,85282-1614,Maricopa,2702 N 3rd St Ste 4020,,Phoenix,AZ,85004-4608,Maricopa,Beckie Brown,Credentialing Manager,602-586-3025,,bbrown@mphc-az.org,,,,,,https://mountainparkhealth.org/
AZ-000927,Tsaile Health Center (Chinle Service Unit),Indian Health Service-Navajo Area,1538185715,"Dental Providers, Indian Health Service, Other ECP Providers",Junction Navajo Route 12 & 64,,Tsaile,AZ,86556,Apache,Junction Navajo Route 12 & 64,,Tsaile,AZ,86556,Apache,Melissa Begay,Business Office Supervisor,928-724-3612,,melissa.begay@ihs.gov,Fawn Damon,HSA,928-724-3715,,fawn.damon@ihs.gov,
AZ-000928,Tuba City Regional Health Care Corporation,Tuba City Regional Health Care Corporation,1548294424,"Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",167 N Main St,,Tuba City,AZ,86045,Coconino,PO Box 600,,Tuba City,AZ,86045-0600,Coconino,Lynette Bonar,Chief Executive Officer,928-283-2797,,lynette.bonar@tchealth.org,Alvina Tunney-Patterson,Chief Compliance Officer,928-283-2452,,alvina.tunney-patterson@tchealth.org,
AZ-000929,EL PUEBLO HEALTH CENTER,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1104116029,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",101 W Irvington Rd,,Tucson,AZ,85714-3050,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000930,EL RIO BROADWAY HEALTH CENTER,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1386934214,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1101 E Broadway Blvd,,Tucson,AZ,85719-5807,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000931,ORTIZ COMMUNITY HEALTH CENTER,"MARANA HEALTH CENTER, INC.",1730248972,Federally Qualified Health Centers - Medical Services,12635 W Rudasill Rd,,Tucson,AZ,85743-9724,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000932,FLOWING WELLS FAMILY PRACTICE,"MARANA HEALTH CENTER, INC.",1245399468,Federally Qualified Health Centers - Medical Services,1323 W Prince Rd,,Tucson,AZ,85705-3114,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000933,"St. Elizabeth's Health Center, Inc.","St. Elizabeths Health Center, Inc.",1023409760,"Dental Providers, Federally Qualified Health Centers - Medical Services",140 W Speedway Blvd,Suite 100,Tucson,AZ,85705-7687,Pima,140 W. Speedway Ste 100,,Tucson,AZ,85705,Pima,Jane Bakos,CEO,520-628-7871,,JaneB@saintehc.org,Alex Wheeler,Administrative Assistant,520-628-7871,,AlexW@saintehc.org,www.saintehc.org
AZ-000934,Pima County Health Department - Theresa Lee Public Health Center,Pima County Health Department,1134425150,"Family Planning Providers, Sexually Transmitted Disease Clinics",1493 W Commerce Ct,,Tucson,AZ,85746-6016,Pima,"3950 S. Country Club Rd., STE 100",,Tucson,AZ,85714,Pima,"Francisco Garcia, MD",Health Department Director,520-724-7931,,francisco.garcia@pima.gov,"Shauna McIsaac, MD",Medical Officer,520-724-7857,,shauna.mcisaac@pima.gov,https://www.webcms.pima.gov/cms/One.aspx?portalId=169&pageId=19998
AZ-000935,EL RIO SOUTHWEST HEALTH CENTERS,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1750672929,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1500 W Commerce Ct,Bldg 1,Tucson,AZ,85746-6031,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000936,Arizona Hemophilia & Thrombosis Center,Arizona Cancer Center,1689879967,Hemophilia Treatment Centers,1515 N Campbell Ave,,Tucson,AZ,85724-1000,Pima,1515 N Campbell Ave,,Tucson,AZ,85724,Pima,Mary Lou Damiano,"Assistant Director, AzHTC",520-626-7584,,mdamiano@email.arizona.edu,,,,,,
AZ-000937,United Community Health Center at Three Points,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1316999790,"Dental Providers, Federally Qualified Health Centers - Medical Services",15921 W Ajo Hwy,,Tucson,AZ,85735-2032,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000938,Ellie Towne Health Center,"MARANA HEALTH CENTER, INC.",1497032460,"Dental Providers, Federally Qualified Health Centers - Medical Services",1670 W Ruthrauff Rd,,Tucson,AZ,85705-1253,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000939,Santa Catalina Health Center,"MARANA HEALTH CENTER, INC.",1750440905,Federally Qualified Health Centers - Medical Services,16701 N Oracle Rd,Suite 135,Tucson,AZ,85739-9102,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000940,EL RIO SPECIAL IMMUNOLOGY,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1700100948,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1701 W Saint Marys Rd,Suite 100,Tucson,AZ,85745-2621,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000941,MARANA HEALTH CENTER OBSTETRICS AND GYNECOLOGY,"MARANA HEALTH CENTER, INC.",1407915630,Federally Qualified Health Centers - Medical Services,2055 W Hospital Dr,Suite 115,Tucson,AZ,85704-7823,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000942,West Side Health Center,"MARANA HEALTH CENTER, INC.",1316104573,Federally Qualified Health Centers - Medical Services,2202 W Anklam Rd,,Tucson,AZ,85709-0002,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000943,EL RIO OB/GYN ASSOCIATES,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1932490109,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",225 W Irvington Rd,,Tucson,AZ,85714-3054,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000944,Planned Parenthood Southern Arizona Regional Health Center,Planned Parenthood Arizona,1083694160,"Family Planning Providers, Sexually Transmitted Disease Clinics",2255 N Wyatt Dr,,Tucson,AZ,85712-2150,Pima,4751 N 15th Street,,Phoenix,AZ,85014-2500,Maricopa,James Washington,Vice President of Patient Services,602-263-4276,,jwashington@ppaz.org,Catherine Pisani,Medical Operations Manager,602-200-2129,,cpisani@ppaz.org,http://www.plannedparenthood.org/ppaz/
AZ-000945,MHC Primary Care Health Center,"MARANA HEALTH CENTER, INC.",1679724124,Federally Qualified Health Centers - Medical Services,2355 N Wyatt Dr,Suite 101,Tucson,AZ,85712-2120,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000946,Pima County Health Department - TB Clinic,PIMA COUNTY HEALTH DEPARTMENT,1134425150,Tuberculosis Clinics,2980 E Ajo Way Unit B,,Tucson,AZ,85713-6268,Pima,"3950 S. Country Club Rd., STE 100",,Tucson,AZ,85714,Pima,"Francisco Garcia, MD",Health Department Director,520-724-7931,,francisco.garcia@pima.gov,"Shauna McIsaac, MD",Medical Officer,520-724-7857,,shauna.mcisaac@pima.gov,https://www.webcms.pima.gov/cms/One.aspx?portalId=169&pageId=19998
AZ-000947,EL RIO NORTH WEST MEDICAL,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1114218385,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",320 W Prince Rd,,Tucson,AZ,85705-3526,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000948,El Rio Northwest Dental,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1558780023,Dental Providers,340 W Prince Rd,,Tucson,AZ,85705-6168,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000949,Pima County Health Department -North Clinic,Pima County Health Department,1134425150,"Family Planning Providers, Sexually Transmitted Disease Clinics",3550 N 1st Ave,Suite 300,Tucson,AZ,85719-1722,Pima,"3950 S. Country Club Rd., STE 100",,Tucson,AZ,85714,Pima,"Francisco Garcia, MD",Health Department Director,520-724-7931,,francisco.garcia@pima.gov,Shauna McIsacc,Medical Officer,520-724-7857,,shauna.mcisaac@pima.gov,https://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=19986
AZ-000950,CLINICA DEL ALMA,"MARANA HEALTH CENTER, INC.",1972662294,Federally Qualified Health Centers - Medical Services,3690 S Park Ave,Suite 805,Tucson,AZ,85713-5042,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Jania Arnoldi,CFO,520-682-4111,,jarnoldi@mhchealthcare.org,,,,,,
AZ-000951,KEELING HEALTH CENTER,"MARANA HEALTH CENTER, INC.",1376603837,Federally Qualified Health Centers - Medical Services,435 E Glenn St,,Tucson,AZ,85705-4664,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000952,FREEDOM PARK HEALTH CENTER,"MARANA HEALTH CENTER, INC.",1023177250,Federally Qualified Health Centers - Medical Services,5000 E 29th St,,Tucson,AZ,85711-6401,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000953,TUCSON BIRTH AND WOMEN'S HEALTH CENTER,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1255518528,Federally Qualified Health Centers - Medical Services,5979 E Grant Rd,Suite 107,Tucson,AZ,85712-2368,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000954,EL RIO CLINIC AT CODAC BEHAVIORAL HEALTH EAST,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1023308962,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",630 N Alvernon Way,,Tucson,AZ,85711-1843,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000955,Pima County Health Department - East Clinic,Pima County Health Department,1134425150,"Family Planning Providers, Sexually Transmitted Disease Clinics",6920 E Broadway Blvd,,Tucson,AZ,85710-2839,Pima,"3950 S. Country Club Rd., STE 100",,Tucson,AZ,85714,Pima,"Francisco Garcia, MD",Health Department Director,520-724-7931,,francisco.garcia@pima.gov,"Shauna McIsaac, MD",Medical Officer,520-724-7857,,shauna.mcisaac@pima.gov,https://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=19974
AZ-000956,EL RIO SOUTHEAST HEALTH CENTER,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1033400205,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",6950 E Golf Links Rd,,Tucson,AZ,85730-1017,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000957,EL RIO PASCUA YAQUI HEALTH CENTER,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1962770370,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",7490 S Camino de Oeste,,Tucson,AZ,85746-9308,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN, PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia S. Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000958,Pascua Yaqui Tribe/Health Center,Pascua Yaqui Tribe/Health Center,1477868396,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",7490 S Camino de Oeste,,Tucson,AZ,85746-9308,Pima,7474 S. Camino De Oeste,,Tucson,AZ,85757,Pima,Rosa M. Rivera,Yoeme Health Program Administrator,520-879-6163,,rosa.rivera@pascuayaqui-nsn.gov,Rosa M. Rivera,Yoeme Health Program Administrato,520-879-6163,,rosa.rivera@pascuayaqui-nsn.gov,
AZ-000959,San Xavier Health Center,San Xavier Health Center,1437157302,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",7900 S J Stock Rd,,Tucson,AZ,85746-7012,Pima,7900 S.J. Stock Rd,,Tucson,AZ,85746,Pima,Priscilla Whitethorne,Service Unit Director (CEO),520-383-7251,,priscilla.whitethorne@ihs.gov,Diane Shanley,Deputy Service Unit Director,520-383-7285,,diane.shanley@ihs.gov,
AZ-000960,East Side Health Center,"MARANA HEALTH CENTER, INC.",1821324948,Federally Qualified Health Centers - Medical Services,8181 E Irvington Rd,,Tucson,AZ,85709-4001,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Jania Arnoldi,CFO,520-682-4111,,jarnoldi@mhchealthcare.org,,,,,,
AZ-000961,EL RIO SANTA CRUZ NEIGHBORHOOD,"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.",1487602736,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",839 W Congress St,,Tucson,AZ,85745-2819,Pima,P.O. Box 1231,,Tucson,AZ,85702,Pima,"Nancy Johnson, RN PhD",CEO,520-309-2012,,NancyJ@elrio.org,Celia Hightower,CFO,520-670-3705,,CeliaSH@elrio.org,www.elrio.org
AZ-000962,Wilmot Family Health Center,"MARANA HEALTH CENTER, INC.",1295986735,Federally Qualified Health Centers - Medical Services,899 N Wilmot Rd,Suite B,Tucson,AZ,85711-1712,Pima,13395 N Marana Main St,,Marana,AZ,85653-7008,Pima,Clint Kuntz,CEO,520-682-4111,6254,ckuntz@mhchealthcare.org,,,,,,
AZ-000963,United Community Health Center,"UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",1528311958,"Dental Providers, Federally Qualified Health Centers - Medical Services",13299 E Colossal Cave Rd,United Community Health Center at Old Vail Middle School,Vail,AZ,85641-9001,Pima,1260 S Campbell Ave Bldg 2,,Green Valley,AZ,85614-0503,Pima,Wendy Kibby,Chief Operations Officer,520-407-5606,,wkibby@uchcaz.org,Michelle J. Kitchell,,520-407-5604,,mjkitchell@uchcaz.org,
AZ-000964,"SUNSET CHC, INC. - WELLTON",SUNSET COMMUNITY HEALTH CENTER,1245344316,Federally Qualified Health Centers - Medical Services,10425 Williams St,,Wellton,AZ,85356,Yuma,2060 West 24th Street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Officer,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,928-819-8803,,wsims@sunset-chc.org,
AZ-000966,Whiteriver Indian Hospital,DHHS IHS PHOENIX AREA,1427335140,"Dental Providers, Indian Health Service, Other ECP Providers",200 West Hospital Dr,,Whiteriver,AZ,85941,Navajo,200 W Hospital Dr,PO Box 860,Whiteriver,AZ,85941-0860,Navajo,Racheal Allen,Revenue Manager,928-338-5509,,racheal.allen@ihs.gov,Mitzi Classay,"Supervisor, Billing Technician",928-338-3532,,mitzi.classay@ihs.gov,
AZ-000967,Wickenburg Community Hospital & Clinics,Community Hospital Association Inc.,1841282852,Inpatient Hospitals (other than children's hospitals),520 Rose Ln,,Wickenburg,AZ,85390-1447,Maricopa,520 Rose Lane,,Wickenburg,AZ,85390,Maricopa,Michael V. Ellis,C.F.O.,928-668-1805,,mike.ellis@wickhosp.com,James F. Tavary,C.E.O.,928-684-4360,,jim.tavary@wickhosp.com,http://wickhosp.com/
AZ-000968,Wickenburg Community Clinic,"Community Hospital Association, Inc.",1225274210,"Outpatient Hospital Clinics, Rural Health Clinics",523 Rose Ln,,Wickenburg,AZ,85390-1448,Maricopa,520 Rose Lane,,Wickenburg,AZ,85390,Maricopa,Michael Ellis,CFO,928-668-1805,,mike.ellis@wickhosp.com,James F. Tavary,CEO,928-684-4360,,jim.tavary@wickhosp.com,http://wickhosp.com/
AZ-000969,Adelante Healthcare Wickenburg,"ADELANTE HEALTHCARE, INC.",1083772545,Federally Qualified Health Centers - Medical Services,811 N Tegner St,Suite 113,Wickenburg,AZ,85390-5410,Maricopa,9520 W Palm Ln Ste 200,,Phoenix,AZ,85037-4403,Maricopa,Richard Miller,Chief Financial Officer,623-583-3001,1209,rmiller@adelantehealthcare.com,Eric Battis,Chief Operations Officer,623-583-3001,1222,ebattis@adelantehealthcare.com,www.adelantehealthcare.com
AZ-000970,Cochise Health and Social Services - Willcox,Cochise Health and Social Services,1215968250,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",450 S Haskell Ave,,Willcox,AZ,85643-2790,Cochise,"1415 Melody Lane, Bldg A",,Bisbee,AZ,85603,Cochise,Jennifer Lakosil,Director,520-432-9468,,jlakosil@cochise.az.gov,,,,,,https://www.cochise.az.gov/health-and-social-services/clinic-schedules
AZ-000971,SULPHUR SPRINGS MEDICAL CENTER,Northern Cochise Community Hospital,1013060367,Rural Health Clinics,900 W Scott St,,Willcox,AZ,85643-1017,Cochise,901 W Rex Allen Dr,,Willcox,AZ,85643,Cochise,Robin Allen,Rural Health Clinic Manager,520-766-6516,,rallen@ncch.com,Jennifer Cochran,Director of Human Resources,520-766-6494,,jcochran@ncch.com,http://www.ncch.com/getpage.php?name=sulphur
AZ-000972,NORTH COUNTRY HEALTHCARE - WILLIAMS,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",301 S 7th St,,Williams,AZ,86046-2324,Coconino,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000973,NORTH COUNTRY HEALTHCARE - WINSLOW,"NORTH COUNTRY HEALTHCARE, INC.",1053587261,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",620 Lee St,,Winslow,AZ,86047-2435,Navajo,2920 N 4th St,,Flagstaff,AZ,86004-1816,Coconino,Linc Pehrson,Business Office Manager,928-522-9400,9800,lpehrson@nchcaz.org,,,,,,www.northcountryhealthcare.org
AZ-000974,"SUNSET CHC, INC. Yuma SITE",SUNSET COMMUNITY HEALTH CENTER,1063433720,Federally Qualified Health Centers - Medical Services,2060 W 24th St,,Yuma,AZ,85364-6123,Yuma,2060 West 24th Street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Officer,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,928-819-8803,,wsims@sunset-chc.org,
AZ-000976,Yuma OP Facility,"Horizon Health and Wellness, Inc.",1609255488,Community Mental Health Centers,3180 E 40th St,,Yuma,AZ,85365-7772,Yuma,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,
AZ-000978,Sunset Community Health Center-North Yuma,Sunst Community Health Center,1366812166,Federally Qualified Health Centers - Medical Services,675 S Avenue B,,Yuma,AZ,85364-2749,Yuma,2060 West 24th Street,,Yuma,AZ,85364,Yuma,David Rogers,Chief Executive Office,928-819-8802,,drogers@sunset-chc.org,Whitney Sims,Chief Financial Officer,819-819-8803,,wsims@sunset-chc.org,
AZ-000979,4th Ave. Integrated Care,"Horizon Health and Wellness, Inc.",1770962466,"Community Mental Health Centers, Other ECP Providers, Rural Health Clinics",791 S 4th Ave,Suite B,Yuma,AZ,85364-3067,Yuma,625 N Plaza Dr,,Apache Junction,AZ,85120,Pinal,Morgan Rambach,Practice Director,480-474-5617,61837,morgan.rambach@hhwaz.org,Dawn Cottrell,Chief Program Officer,480-983-0065,,dawn.cottrell@hhwaz.org,
CA-000981,"Sean R. Thomas, M.D., Inc",American Desert Medical Clinic,1154336246,Rural Health Clinics,6186 Adobe Rd,,29 Palms,CA,92277-2652,San Bernardino,6186 Adobe Road,,29 palms,CA,92277,San Bernardino,Valerie Dobbins,Office Manager,760-228-3366,,vdobbins760@gmail.com,,,,,,
CA-000982,Alhambra Health Center,"Planned Parenthood Pasadena and San Gabriel Valley, Inc",1861636177,Family Planning Providers,330 S Garfield Ave,Suite 300,Alhambra,CA,91801-3893,Los Angeles,2333 Lake Ave.,2nd Floor,Altadena,CA,91001,Los Angeles,Bethany Eshleman,C.O.O.,626-794-5737,107,beshleman@pppsgv.org,Cheri Pogue,Sr. Director of Patient Services,626-794-5737,168,cpogue@pppsgv.org,plannedparenthood.org/pppsgv
CA-000983,"Southern Indian Health Council, Inc - Alpine Clinic","Southern Indian Health Council, Inc.",1346247947,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",4058 Willows Rd,,Alpine,CA,91901-1668,San Diego,4058 Willows Rd,,Alpine,CA,91901-1668,San Diego,Carolina Manzano,Chief Executive Officer,619-445-1188,,cmanzano@sihc.org,,,,,,
CA-000984,XL Clinic,Pit River Health Service,1891762985,"Dental Providers, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",150 BIA Route 76A,Box 6,Alturas,CA,96101-4502,Modoc,36977 Park Ave,,Burney,CA,96013,Shasta,Jeremy Wheeler,Financial Director,530-335-0333,,jeremyw@pitriverhealthservice.org,Glenna Moore,Executive Director,530-335-0330,,glenna.m@pitriverhealthservice.org,www.pitriverhealthservice.org
CA-000985,"AltaMed Medical and Dental Group - Anaheim, Lincoln",AltaMed Health Services Corporation,1538303516,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1814 W Lincoln Ave,,Anaheim,CA,92801-6730,Orange,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-000986,AltaMed Medical Group - Anaheim Lincoln West,AltaMed Health Services Corporation,1235376047,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1820 W Lincoln Ave,,Anaheim,CA,92801-6730,Orange,2040 Camfield Ave.,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-000987,Anaheim Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1710975727,"Family Planning Providers, Sexually Transmitted Disease Clinics",303 W Lincoln Ave,Suite No. 105,Anaheim,CA,92805-2936,Orange,700 S Tustin St,,Orange,CA,92866,Orange,"Jessica Chinen, CPA",Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-000988,Happy Valley Family Health Center,Shasta Community Health Center,1013931476,Federally Qualified Health Centers - Medical Services,16300 Cloverdale Rd,,Anderson,CA,96007-8209,Shasta,1035 Placer Street,,Redding,CA,96001-4245,Shasta,C. Dean Germano,CEO,530-246-5704,,dgermano@shastahealth.org,Robin Glasco,COO,530-246-5739,,rglasco@shastahealth.org,
CA-000989,Anderson Family Health Center,Shasta Community Health Center,1942225719,"Dental Providers, Federally Qualified Health Centers - Medical Services",2801 Silver St,,Anderson,CA,96007-4239,Shasta,1035 Placer Street,,Redding,CA,96001-1125,Shasta,Harold Carlson,Chief Planning and Development Officer,530-246-5817,,hcarlson@shastahealth.org,Robin Glasco,Chief Operating Officer,530-246-5739,,rglasco@shastahealth.org,shastahealth.org
CA-000990,Family Medical Center - Angels Camp,Mark Twain Medical Center,1942362561,Rural Health Clinics,222 S Main St,,Angels Camp,CA,95222-9359,Calaveras,768 Mountain Ranch Road,,San Andreas,CA,95249,Calaveras,Debbie Esparza,Director of Managed Care,209-467-6546,,Debbie.Esparza@DignityHealth.Org,Chris Roberts,CFO/VP of Finance,209-754-2614,,Chris.Roberts@DignityHealth.Org,
CA-000991,Planned Parenthood Antioch,Planned Parenthood Northern California,1215095575,"Family Planning Providers, Sexually Transmitted Disease Clinics",1104 Buchanan Rd,Suite C10,Antioch,CA,94509-4226,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-000992,Anza Indian Health - Outreach Office,"Riverside San-Bernardino County Indian Health, Inc. - Morongo Clinic",1659424885,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",39100 Contreras Rd,Suite C,Anza,CA,92539-8724,Riverside,11980 Mount Vernon Ave,,Grand Terrace,CA,92313-5172,San Bernardino,Jess Montoya,Director,909-864-1097,4702,jmontoya@rsbcihi.org,Charlen Taylor,Controller,909-864-1097,4737,ctaylor@rsbcihi.org,
CA-000993,Potawot Health Village (UIHS),"United Indian Health Service, Inc.",1497751572,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1600 Weeot Way,,Arcata,CA,95521-4734,Humboldt,1600 Weeot Way,,Arcata,CA,95521-4734,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David.Rosen,CEO,707-825-5000,,david.rosen@crihb.org,
CA-000994,Family Medical Center - Arnold,Mark Twain Medical Center,1790846301,Rural Health Clinics,2182 Highway 4,,Arnold,CA,95223-9908,Calaveras,768 Mountain Ranch Road,,San Andreas,CA,95249,Calaveras,Debbie Esparza,Director of Managed Care,209-467-6546,,Debbie.Esparza@DignityHealth.Org,Chris Roberts,CFO/Vice President of Finance,209-754-2614,,Chris.Roberts@DignityHealth.Org,
CA-000995,Arvin Community Health Center,Clinica Sierra Vista,1518969211,"Dental Providers, Federally Qualified Health Centers - Medical Services",1305 Bear Mountain Blvd,,Arvin,CA,93203-1231,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-000996,Chapa-De Indian Health,Chapa-De Indian Health,1114057163,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",11670 Atwood Rd,,Auburn,CA,95603-9522,Placer,11670 Atwood Road,,Auburn,CA,95603,Placer,Sierk Haitsma,Chief Financial Officer,530-887-2800,2841,shaitsma@chapa-de.org,Lisa Davies,Chief Executive officer,530-887-2800,3777,ldavies@chapa-de.org,
CA-000997,Avenal Community Health Center,Avenal Community Health Center,1932169240,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1000 Skyline Blvd,,Avenal,CA,93204-1850,Kings,1000 Skyline Blvd,,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-000998,Aria Community Health Center AMC,Avenal Community Health Center,1912312273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",148 E Kings St,,Avenal,CA,93204-1529,Kings,1000 Skyline Blvd,,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-000999,ADVENTIST HEALTH MEDICAL OFFICE AVENAL RHC,ADVENTIST HEALTH REEDLEY,1215110879,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",216 E Fresno St,,Avenal,CA,93204-1525,Kings,372 W. CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Madeline Andrade,Site Manager,559-386-5364,,AndradM3@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001000,ADVENTIST HEALTH MEDICAL OFFICE AVENAL WEST RHC,ADVENTIST HEALTH REEDLEY,1326384579,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",337 E Kings St,,Avenal,CA,93204-1630,Kings,372 W. CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Celeste Stoltz,Site Manager,559-386-5200,28746,StoltzCM@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001001,Baker Street Village Community Health Center,Clinica Sierra Vista,1205222544,Federally Qualified Health Centers - Medical Services,1015 Baker St # 4,,Bakersfield,CA,93305-4341,Kern,1430 Truxtun Ave Ste 400,,Bakersfield,CA,93301-5220,Kern,Stephen Schilling,Chief Executive Officer,661-635-3050,2152,Schilling@clinicasierravista.org,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,Cindy.Stewart@clinicasierravista.org,www.clinicasierravista.org
CA-001002,East Bakersfield Dental Center,Clinica Sierra Vista,1942508270,Dental Providers,1125 E California Ave,,Bakersfield,CA,93307-1201,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001003,FAMILY HEALTH CENTER,Clinica Sierra Vista,1245516301,"Dental Providers, Federally Qualified Health Centers - Medical Services",1611 1st St,,Bakersfield,CA,93304-2901,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001004,34th Street Community Health Center,Clinica Sierra Vista,1205222544,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2000 Physicians Plaza Blvd,,Bakersfield,CA,93301,Kern,1430 Truxtun Ave Ste 400,,Bakersfield,CA,93301-5220,Kern,Stephen Schilling,Chief Executive Officer,661-635-3050,2152,Schilling@clinicasierravista.org,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,Cindy.Stewart@clinicasierravista.org,www.clinicasierravista.org
CA-001005,Old Town Kern Community Health Center,Clinica Sierra Vista,1063414548,Federally Qualified Health Centers - Medical Services,234 Baker St,Suite 1 & 2,Bakersfield,CA,93305-5856,Kern,"1430 Truxtun Ave, suite 400",P. O. BOX 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001006,South Bakersfield Community Health Center,Clinica Sierra Vista,1073515425,Federally Qualified Health Centers - Medical Services,2400 Wible Rd,Suite 14,Bakersfield,CA,93304-4734,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001007,North of the River Community Health Center,Clinica Sierra Vista,1639171028,Federally Qualified Health Centers - Medical Services,2525 N Chester Ave,,Bakersfield,CA,93308-1770,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001008,Bakersfield Clinic,PLANNED PARENTHOOD MAR MONTE,1962456558,"Family Planning Providers, Sexually Transmitted Disease Clinics",2633 16th St,,Bakersfield,CA,93301-3348,Kern,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001009,Central Bakersfield Community Health Center,Clinica Sierra Vista,1659373017,Federally Qualified Health Centers - Medical Services,301 Brundage Ln,,Bakersfield,CA,93304-3248,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2148,mccred@clinicasierravista.org,,,,,,
CA-001010,East Niles Community Health Center,Clinica Sierra Vista,1992117071,"Dental Providers, Federally Qualified Health Centers - Medical Services",7800 Niles St,,Bakersfield,CA,93306-4922,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001011,East Bakersfield Community Health Center,Clinica Sierra Vista,1861494338,Federally Qualified Health Centers - Medical Services,815 Dr Martin Luther King Jr Blvd,,Bakersfield,CA,93307-1365,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001012,Greenfield Community Health Center,Clinica Sierra Vista,1790128536,"Dental Providers, Federally Qualified Health Centers - Medical Services",9001 S H St,,Bakersfield,CA,93307-5948,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001013,Morongo Indian Health Clinic,"Riverside-San Bernardino County Indian Health, Inc",1437202124,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",11555 1/2 Potrero Rd,,Banning,CA,92220-6946,Riverside,11980 Mount Vernon Ave,,Grand Terrace,CA,92313-5172,San Bernardino,Charlen Kay Taylor,Controller,909-864-1097,4737,ctaylor@rsbcihi.org,,,,,,
CA-001014,AltaMed Medical and Dental Group - Bell,AltaMed Health Services Corporation,1518171016,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6901 Atlantic Ave,,Bell,CA,90201-3646,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90201,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001015,Bellflower Health Center,"Los Angeles County, Department of Health Services",1932115375,Family Planning Providers,10005 Flower St,,Bellflower,CA,90706-5412,Los Angeles,10005 E. Flower Street,,Bellflower,CA,90706,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001016,LIFELONG DENTAL CARE,LifeLong Medical Care,1013913300,Dental Providers,1860 Alcatraz Ave,,Berkeley,CA,94703-2715,Alameda,2344 6th Street,,Berkeley,CA,94710,Alameda,Marty Lynch,CEO,510-532-1930,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001017,BERKELEY PRIMARY CARE,LIFELONG MEDICAL CARE,1518963693,Federally Qualified Health Centers - Medical Services,2001 Dwight Way,,Berkeley,CA,94704-2608,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001018,WEST BERKELEY FAMILY PRACTICE,LIFELONG MEDICAL CARE,1720084163,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2031 6th St,,Berkeley,CA,94710-2006,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001019,LifeLong Ashby Health Center,LIFELONG MEDICAL CARE,1457758724,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",3075 Adeline St,Suite 280,Berkeley,CA,94703-2580,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,Mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001020,LIFELONG CARE OVER 60 HLTH CTR,LifeLong Medical Care,1689670002,Federally Qualified Health Centers - Medical Services,3260 Sacramento St,,Berkeley,CA,94702-2739,Alameda,2344 6th Street,,Berkeley,CA,94710,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001021,PUBLIC HEALTH CLINIC,"CITY OF BERKELEY DEPARTMENT OF HEALTH, HOUSING, AND COMMUNITY SERVICES",1902944796,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",830 University Ave,,Berkeley,CA,94710-2044,Alameda,2180 Milvia Street,,Berkeley,CA,94704,Alameda,Ann Song,Director Public Health Clinic,510-981-5399,,asong@cityofberkeley.info,Lisa Sterner,Director BHSHC/BTA,510-644-6308,,lsterner@cityofberkeley.info,www.cityofberkeley.info/publichealth
CA-001022,AHF Healthcare Center - Westside,AIDS Healthcare Foundation,1104801034,"Other ECP Providers, Ryan White Providers",99 N LA Cienega Blvd,Suite 200,Beverly Hills,CA,90211-2285,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,Donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001023,Big Valley Health Center,Mountain Valleys Health Centers,1356438261,"Dental Providers, Federally Qualified Health Centers - Medical Services",554-850 Medical Center Dr,,Bieber,CA,96009,Lassen,P.O. Box 277,,Bieber,CA,96009,Lassen,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grants Management,530-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001024,RURAL HEALTH CLINIC,Bear Valley Community Healthcare District,1073553756,Rural Health Clinics,1028 W Big Bear Blvd,,Big Bear,CA,92314,San Bernardino,PO Bo 1649,,"Big Bear Lake, CA",CA,92315,San Bernardino,Shelly Egerer,Administraton Assistant,909-878-8214,,shelly.egerer@bvchd.com,Garth Hamblin,CFO,909-878-8276,,garth.hamblin@bvchd.com,
CA-001025,FAMILY HEALTH CENTER,Bear Valley Community Healthcare District,1073553756,Rural Health Clinics,41820 Garstin Dr,,Big Bear Lake,CA,92315,San Bernardino,PO Box 1649,,Big Bear Lake,CA,92315,San Bernardino,Shelly Egerer,Administrative Assistant,909-878-8214,,shelly.egerer@bvchd.com,Garth Hamblin,CFO,909-878-8276,,garth.hamblin@bvchd.com,
CA-001026,Bear Valley Community Healthcare District,Bear Valley Community Healthcare District,1073553756,Inpatient Hospitals (other than children's hospitals),41870 Garstin Dr,,Big Bear Lake,CA,92315,San Bernardino,PO Box 1649,,Big Bear Lake,CA,92315,San Bernardino,Shelly Egerer,Administration Assistant,909-878-8214,,shelly.egerer@bvchd.com,Garth Hamblin,CFO,909-878-8276,,garth.hamblin@bvchd.com,
CA-001027,Anderson Valley Health Center,Anderson Valley Health Center,1568449304,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",13500 Airport Rd,PO Box 338,Boonville,CA,95415-9133,Mendocino,13500 Airport Road,PO Box 338,Boonville,CA,95415,Mendocino,E. Chloe Guazzone-Rugebregt,Executive Director,707-895-3477,102,cguazzone@avhc.org,,,,,,
CA-001028,Burbank Health Center,Planned Parenthood Los Angeles,1255420436,Family Planning Providers,916 W Burbank Blvd,Suite M,Burbank,CA,91506-1450,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001029,Burney Dental Center,Mountain Valleys Health Centers,1184176257,Dental Providers,20615 Commerce Way,,Burney,CA,96013-4380,Shasta,P.O. Box 277,,Bieber,CA,96009,Lake,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grants Management,530-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001030,Burney Clinic,Pit River Health Service,1891762985,"Dental Providers, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",36977 Park Ave,,Burney,CA,96013-4067,Shasta,36977 Park Ave,,Burney,CA,96013,Shasta,Jeremy Wheeler,Financial Director,530-335-0333,,jeremyw@pitriverhealthservice.org,Glenna Moore,Executive Director,530-335-0330,,glenna.m@pitriverhealthservice.org,www.pitriverhealthservice.org
CA-001031,Burney Health Center,Mountain Valleys Health Centers,1245301308,Federally Qualified Health Centers - Medical Services,37491 Enterprise Dr,,Burney,CA,96013-4379,Shasta,P.O. Box 277,,Bieber,CA,96009,Lassen,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grant Management,530-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001032,Deanza Clinic,Deanza Clinic,1356524599,Rural Health Clinics,1001 Blair Ave,,Calexico,CA,92231-2308,Imperial,1001 blair ave,,Calexico,CA,92231,Imperial,Mervat Kelada MD,MD,760-562-6633,,deanzaclinic@msn.com,,,,,,
CA-001033,CAL CITY CLINIC,"ASHMEAD ALI, MD",1093898454,Rural Health Clinics,9300 N Loop Blvd,,California City,CA,93505-2269,Kern,9300 N Loop Blvd,,Calif City,CA,93505-2269,Kern,Haneefa Ali,Administrator,760-373-1266,,haneefaali@live.com,,,,,,
CA-001034,ADVENTIST HEALTH TEHACHAPI VALLEY CALIFORNIA CITY RHC,ADVENTIST HEALTH TEHACHAPI VALLEY,1699084525,Rural Health Clinics,9350 N Loop Blvd,,California City,CA,93505-2269,Kern,PO Box 1900,,Tehachapi,CA,93581-1900,Kern,Sarah Shelbourne,Ambulatory & Physicians Services Executive,661-241-6700,,shelbosj@ah.org,Bonnie Quinonez,Director Operations,661-771-8604,,QuinonBD@AH.org,https://www.adventisthealth.org/tehachapivalley/
CA-001035,WESTERN SIERRA MEDICAL CENTER,JUDITH BRANDT DO INC,1457557126,Rural Health Clinics,3070 Camino Heights Dr,Suite B,Camino,CA,95709-9508,El Dorado,3070 Camino Heights Dr,,Camino,CA,95709-9508,El Dorado,Alexander D. Giloff,Administrator,530-647-9762,,agiloff@wsmedicalcenter.com,,,,,,
CA-001036,Southern Indian Health Council - Campo Clinic,Southern Indian Health Council,1922090885,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",36350 Church Rd,,Campo,CA,91906-2715,San Diego,4058 Willows Rd,,Alpine,CA,91901,San Diego,Carolina Manzano,Chief Executive Officer,619-445-1188,302,cmanzano@sihc.org,,,,,,
CA-001037,Canby Family Practice Clinic,I SOT Inc.,1528063153,"Dental Providers, Family Planning Providers, Rural Health Clinics",670 County Road 83,,Canby,CA,96015-9722,Modoc,22416 Hwy 299 East,,Canby,CA,96015,Modoc,Greta Jaree Elliott,Administrator,530-708-8903,,gjelliott@canbyclinic.org,Jim Linden,Assistant Administrator,530-708-8925,,jilinden@canbyclinic.org,www.canbyclinic.org
CA-001038,Canoga Park Health Center,Planned Parenthood Los Angeles,1295824498,Family Planning Providers,21001 Sherman Way,Suite 9,Canoga Park,CA,91303-3683,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001039,Canoga Park Health Center,Northeast Valley Health Corporation,1740281120,Federally Qualified Health Centers - Medical Services,7107 Remmet Ave,,Canoga Park,CA,91303-2016,Los Angeles,7107 Remmet Ave,,Canoga Park,CA,91303-2016,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/
CA-001040,NEVHC Santa Clarita Health Center,NORTHEAST VALLEY HEALTH CORPORATION,1558693655,Federally Qualified Health Centers - Medical Services,18533 Soledad Canyon Rd,,Canyon Country,CA,91351-3722,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa NItescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001041,NEVHC Rainbow Dental Center,NORTHEAST VALLEY HEALTH CORPORATION,1689925729,Dental Providers,26974 Rainbow Glen Dr,,Canyon Country,CA,91351-4875,Los Angeles,26974 Rainbow Glen Drive,,Canyon Country,CA,91351,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001042,ADVENTIST HEALTH MEDICAL OFFICE CARUTHERS EAST RHC,ADVENTIST HEALTH REEDLEY,1881930964,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",2357 W Tahoe Ave,,CARUTHERS,CA,93609,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Mary Pat Chavez,Site Manager,559-864-5200,,ChavezMP01@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001043,ADVENTIST HEALTH MEDICAL OFFICE CARUTHERS RHC,ADVENTIST HEALTH REEDLEY,1285651745,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",2440 W Tahoe Ave,,Caruthers,CA,93609-9476,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Ana Leon,Site Manager,559-864-3213,,LeonAL@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001044,Castroville Clinic,Clinica de Salud del Valle de Salinas,1013058106,"Dental Providers, Federally Qualified Health Centers - Medical Services",10561 Merritt St,,Castroville,CA,95012-3310,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001045,GVHC - CERES,GOLDEN VALLEY HEALTH CENTERS,1881798288,Federally Qualified Health Centers - Medical Services,2760 3rd St,Suite B,Ceres,CA,95307-3235,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001046,Planned Parenthood Chico,Planned Parenthood Northern California,1558420695,"Family Planning Providers, Sexually Transmitted Disease Clinics",3100 Cohasset Rd,,Chico,CA,95973-0962,Butte,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001047,CHOWCHILLA MEDICAL CENTER,Madera Community Hospital,1720286750,Rural Health Clinics,285 Hospital Dr,,Chowchilla,CA,93610-2041,Madera,1250 E ALmond Ave,,Madera,CA,93637,Madera,Karen Paolinelli,Chief Operations Officer,559-675-5597,,kpaolinelli@maderahospital.org,Mark Foote,CFO,556-675-5505,,mfoote@maderahospital.org,maderahospital.org
CA-001048,Clinica de Salud del Valle de Salinas,Clinica de Salud del Valle de Salinas,1053452136,Federally Qualified Health Centers - Medical Services,24285 Lincoln St,Chualar School-Based Clinic,Chualar,CA,93925,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,
CA-001049,Mi Clinica,San Ysidro Health Center,1356750657,Federally Qualified Health Centers - Medical Services,1058 3rd Ave,,Chula Vista,CA,91911-2009,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Angelica McFall,Clinic Services Manager,619-662-4100,,carmen.rodriguez@syhc.org,,,,,,www.SYHC.org
CA-001050,Chula Vista Clinic,Planned Parenthood of the Pacific Southwest,1255366241,"Family Planning Providers, Sexually Transmitted Disease Clinics",1295 Broadway,Suite 201,Chula Vista,CA,91911-2982,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001051,OTAY FAMILY HEALTH CENTER,San Ysidro Health Center,1952364747,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1637 3rd Ave,,Chula Vista,CA,91911-5823,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Jose Montes,Clinic Services Manager,619-662-4100,,jose.montes@syhc.org,,,,,,www.SYHC.org
CA-001052,Chula Vista Family Counseling Center,Family Health Centers of San Diego,1023462066,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",248 Landis Ave,,Chula Vista,CA,91910-2609,San Diego,823 Gateway Center Way,,San Diego,CA,92102,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001053,Chula Vista Family Health Center,Family Health Centers of San Diego,1346480837,Federally Qualified Health Centers - Medical Services,251 Landis Ave,,Chula Vista,CA,91910-2628,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001054,Rice Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1083959464,Federally Qualified Health Centers - Medical Services,352 L St,,Chula Vista,CA,91911-1208,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001055,Chula Vista Medical Plaza,San Ysidro Health Center,1326486861,"Dental Providers, Federally Qualified Health Centers - Medical Services",678 3rd Ave,,Chula Vista,CA,91910-5736,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Angelica McFall,Clinic Services Manager,619-662-4100,,amcfall@syhc.org,,,,,,www.SYHC.org
CA-001056,Planned Parenthood Clearlake,Planned Parenthood Northern California,1801147707,"Family Planning Providers, Sexually Transmitted Disease Clinics",14671 Olympic Dr,,Clearlake,CA,95422-9516,Lake,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001057,ADVENTIST HEALTH CLEAR LAKE MEDICAL OFFICE LAKESHORE RHC,ADVENTIST HEALTH CLEAR LAKE,1316937121,"Dental Providers, Rural Health Clinics",15230 Lakeshore Dr,,Clearlake,CA,95422-8107,Lake,15630 18th Ave.,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director of RHC's,707-995-5798,,fuhrimgv@ah.org,Angelique Cole,Practice Administrator,707-995-4520,,ColeAV@AH.org,https://www.adventisthealth.org/clear-lake
CA-001058,"Central Valley Indian Health, Clovis Clinic","Central Valley Indian Health, Inc.",1275751257,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",2740 Herndon Ave,,Clovis,CA,93611-6813,Fresno,2740 Herndon Ave,,Clovis,CA,93611-6813,Fresno,Charles Fowler,Executive Director,559-299-2578,1115,cfowler@cvih.org,Julie Ramsey,Chief Operating Officer,559-299-2578,1117,jramsey@cvih.org,www.cvih.org
CA-001059,Coachella Valley Clinic,Planned Parenthood of the Pacific Southwest,1336174325,"Family Planning Providers, Sexually Transmitted Disease Clinics",49-111 Hwy 111,#6A,Coachella,CA,92236,Riverside,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001060,Coalinga Valley Health Clinics Inc.,Coalinga Valley Health Clinics Inc.,1396874558,Rural Health Clinics,1145 Phelps Ave,Suite 104,Coalinga,CA,93210-9443,Fresno,P. O. Box 495,,Coalinga,CA,93210,Fresno,Yesenia Arroyo,Supervisor,559-935-4374,312,cvhc@sbcglobal.net,Veronica Perez,biller,559-935-4374,311,cvhc@sbcglobal.net,
CA-001061,ADVENTIST HEALTH MEDICAL OFFICE COALINGA RHC,ADVENTIST HEALTH REEDLEY,1972586386,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",155 S 5th St,,Coalinga,CA,93210-1903,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Valerie Folks,Site Manager,559-935-4282,,FolksVL@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001062,Coarsegold Medical Clinic,Fresno Long Term Care Medical Group Inc.,1114341898,Rural Health Clinics,35324 Highway 41,Suite A,Coarsegold,CA,93614-8302,Madera,5771 N. Fresno St,Suite 109,Fresno,CA,93710-6091,Fresno,Shertao Vang,Director of Operations,559-222-6500,,shertao@fltcmg.com,Eve Arriaga,Office Manager,559-222-6500,,eve@fltcmg.com,
CA-001063,Coleville Clinic,"TOIYABE INDIAN HEALTH PROJECT, INC.",1659433191,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",73 Camp Antelope Rd,,Coleville,CA,96107-9502,Mono,52 N Tu Su Ln,,Bishop,CA,93514-8058,Inyo,Rick Frey,COO,760-873-8464,,rick.frey@toiyabe.us,David Lent,ceo,760-873-8464,,,
CA-001064,ROADS Community Care Clinic,"The ROADS Foundation, Inc",1508278359,"Dental Providers, Federally Qualified Health Centers - Medical Services",121 S Long Beach Blvd,,Compton,CA,90221-3423,Los Angeles,4525 E. Atherton Street,,Long Beach,CA,90815-3700,Los Angeles,Lee D. Yoseloff,CEO,310-627-5850,,lyoseloff@roadsfoundation.org,Jill Schmidt,Clinic Director,310-627-5850,,jschmidt@roadsclinic.org,
CA-001065,St. John's Dominguez Health Center,St. John's Well Child and Family Center,1801028303,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",15301 S San Jose Ave,,Compton,CA,90221-3131,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001066,St. John's East Compton Health Center,St. John's Well Child and Family Center,1043542111,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",15715 S Atlantic Ave # 2,,Compton,CA,90221-4242,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001067,St. John's W. M. Keck Compton Health Center,St. John's Well Child and Family Center,1932249596,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2115 N Wilmington Ave,,Compton,CA,90222-2030,Los Angeles,808 W 58th St.,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001068,"TONI D JOHNSON CHAVIS,. MD",TONI D JOHNSON CHAVIS,1083728190,"Family Planning Providers, Other ECP Providers",403 S Long Beach Blvd,,Compton,CA,90221-3449,Los Angeles,403 S LONG BEACH BLVD,,COMPTON,CA,90221,Los Angeles,TONI D JOHNSON CHAVIS,CEO/ PRESIDENT,323-774-6551,,DRCHAVIS403@GMAIL.COM,MARIA CARRILLO,Clinical Manager,323-774-6551,201,CARRILLO.MARIA@DNHCC.COM,DRTCHAVIS.COM
CA-001069,Planned Parenthood Concord,Planned Parenthood Northern California,1982763090,"Family Planning Providers, Sexually Transmitted Disease Clinics",2185 Pacheco St,,Concord,CA,94520-2309,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal..org
CA-001070,Copperopolis Family Medical Center,Mark Twain Medical Center,1588725196,Rural Health Clinics,3505 Spangler Ln,Suite 400,Copperopolis,CA,95228-9424,Calaveras,768 Mountain Ranch Road,,San Andreas,CA,95249,Calaveras,Debbie Esparza,Director of Managed Care,209-467-6546,,Debbie.Esparza@DignityHealth.Org,Chris Roberts,CFO/VP of Finance,209-754-2614,,Chris.Roberts@DignityHealth.Org,
CA-001072,ADVENTIST HEALTH MEDICAL OFFICE CORCORAN RHC,ADVENTIST HEALTH REEDLEY,1881677292,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1212 Hanna Ave,,Corcoran,CA,93212-2313,Kings,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Melissa Ramos,Site Manager,559-992-2800,,RamosMJ@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001073,ADVENTIST HEALTH MEDICAL OFFICE CORCORAN EAST RHC,ADVENTIST HEALTH REEDLEY,1235475484,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1310 Hanna Ave,,Corcoran,CA,93212-2314,Kings,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Daisy Atkinson,Site Manager,559-992-8200,,AtkinsD1@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001074,ADVENTIST HEALTH + RIDEOUT CORNING RHC,ADVENTIST HEALTH + RIDEOUT,1285054106,"Dental Providers, Rural Health Clinics",155 Solano St,,Corning,CA,96021-3511,Tehama,726 4th Street,,Marysville,CA,95901,Yuba,Tim Williams,Administrative Director,530-876-2509,207,williate01@ah.org,Ruby Rodriguez,Site Manager,530-824-4663,3418,Rodriqa22@ah.org,www.adventisthealth.org/feather-river
CA-001075,Solano Street Medical Clinic,St. Elizabeth Community Hospital,1609246461,Rural Health Clinics,2620 Solano St,,Corning,CA,96021,Tehama,2550 Sister Columba Drive,,Red Bluff,CA,96080,Tehama,Kristine Kuebli,Director of Rural Health Clinics,530-529-8202,,kristine.kuebli@dignityhealth.org,,,,,,
CA-001076,Costa Mesa Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1609845171,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1520 Nutmeg Pl,Suite 101,Costa Mesa,CA,92626-2501,Orange,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.chinen@PPOSBC.org,Betha Schnelle,Chief Operations Officer,714-633-6373,130,bschnelle@pposbc.org,http://www.plannedparenthood.org/orange-san-bernardino/
CA-001077,SOS Community Health Center,Share Our Selves Corporation,1508073685,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1550 Superior Ave,,Costa Mesa,CA,92627-3653,Orange,1550 Superior Avenue,,Costa Mesa,CA,92627,Orange,Kathleen Bruski,Federal Grants & Program Manager,949-270-2132,,kbruski@shareourselves.org,,,,,,www.shareourselves.org
CA-001078,John C Fremont Healthcare District Northside Clinic,John C Fremont Healthcare District,1124248901,"Outpatient Hospital Clinics, Rural Health Clinics",6386 Greeley Hill Rd,,Coulterville,CA,95311-9572,Mariposa,5189 Hospital Road,,Mariposa,CA,95338,Mariposa,Kym Brownell,Exec Asst to CEO,209-966-3631,271,jcfadm@jcf-hospital.com,Theresa Loya,Chief Nursing Officer,209-966-3631,290,theresa.loya@jcf-hospital.com,www.jcf-hospital.com
CA-001079,"East Valley Community Health Center, Inc. - Covina Health Center","East Valley Community Health Center, Inc.",1285046847,Federally Qualified Health Centers - Medical Services,276 W College St,,Covina,CA,91723-1902,Los Angeles,420 S Glendora Ave,,West Covina,CA,91790-3001,Los Angeles,Alicia Mardini,Chief Executive Officer,626-919-4333,2220,amardini@evchc.org,Lelenia Navarro,Director of Operations,909-620-8088,3407,lnavarro@evchc.org,www.evchc.org
CA-001080,UIHS - Crescent City Medical Center,"United Indian Health Service, Inc.",1043216021,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1675 Northcrest Dr,,Crescent City,CA,95531-8928,Del Norte,1600 Weeot Way,,Arcata,CA,95521,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,707-825-5000,,david.rosen@crihb.org,
CA-001081,UIHS - Crescent City Dental Clinic,"United Indian Health Services, Inc.",1316384639,Dental Providers,785 E Washington Blvd,Suite 8,Crescent City,CA,95531-8372,Del Norte,1600 Weeot Way,,Arcata,CA,95521,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,707-825-5000,,david.rosen@crihb.org,
CA-001082,The Achievable Foundation,ACHIEVABLE FOUNDATION THE,1164771747,Federally Qualified Health Centers - Medical Services,5901 Green Valley Cir,Suite 405,Culver City,CA,90230-6971,Los Angeles,5901 Green Valley Cir Ste 405,,Culver City,CA,90230-6953,Los Angeles,Carmen Ibarra,CEO,424-266-7476,,cibarra@achievable.org,"Michelle Catanzarite, MD",CMO,424-266-7474,,mcatanzarite@achievable.org,www.achievable.org
CA-001083,DAVIS COMMUNITY CLINIC,COMMUNICARE HEALTH CENTERS,1558366823,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",2051 John Jones Rd,,Davis,CA,95616-9701,Yolo,2051 John Jones Rd,,Davis,CA,95616-9701,Yolo,Robin Affrime,Executive Director,530-753-3498,,robina@communicarehc.org,,,,,,http://www.communicarehc.org
CA-001084,"Shyam Bhaskar, MD","Shyam Bhaskar, MD",1154679447,Rural Health Clinics,1425 Main St,,Delano,CA,93215-1726,Kern,231 W Noble,,Vislaia,CA,93277,Tulare,Martha Sepeda,Practice Admin,559-635-7100,,m_anaya@msn.com,,,,,,
CA-001085,Delano Community Health Center,Clinica Sierra Vista,1316949837,Federally Qualified Health Centers - Medical Services,1508 Garces Hwy,Suite 1,Delano,CA,93215-3687,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001086,West Delano Dental Center,Clinica Sierra Vista,1134318959,Dental Providers,441 Diaz Ave,,Delano,CA,93215-4121,Kern,"1430 Truxtun Avem, Suite400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001087,ADVENTIST HEALTH MEDICAL OFFICE DINUBA RHC,ADVENTIST HEALTH REEDLEY,1427025691,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1451 E El Monte Way,,Dinuba,CA,93618-1812,Tulare,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Rebecca Guillen,Site Manager,559-591-3342,,GuilleR1@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001088,ADVENTIST HEALTH MEDICAL OFFICE DINUBA WEST RHC,ADVENTIST HEALTH REEDLEY,1508881376,Rural Health Clinics,250 W El Monte Way,,Dinuba,CA,93618-1554,Tulare,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Jose Agabo,Site Manager,559-595-9890,,AgaboJ2@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001089,Kaweah Delta Dinuba Health Clinic,Kaweah Delta Health Care District,1841607801,Rural Health Clinics,355 Monte Vista Dr,,Dinuba,CA,93618-9228,Tulare,400 w. Mineral King,,Visalia,CA,93291,Tulare,David W. Garrett,Rural health clinic director,559-592-7300,7395,dgarrett@kdhcd.org,,,,,,
CA-001090,ADVENTIST HEALTH MEDICAL OFFICE DINUBA PLAZA RHC,ADVENTIST HEALTH REEDLEY,1235578444,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",444 W El Monte Way,,Dinuba,CA,93618-1500,Tulare,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Christina Singh,Site Manager,559-591-4166,,SinghC3@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001091,Mountain View Medical Clinic,Mountain View Medical Clinic,1427123496,"Family Planning Providers, Rural Health Clinics",468 N Vermont Ave,,Dinuba,CA,93618-1631,Tulare,468 Vermont Ave,,Dinuba,CA,93618,Tulare,Neil Narayan,Manager,559-591-6200,,neil.mvmc@gmail.com,,,,,,
CA-001092,"Community Medical Centers, Dixon","COMMUNITY MEDICAL CENTERS, INC.",1699766519,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",131 W A St,,Dixon,CA,95620-3437,Solano,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,
CA-001093,Butte Valley Health Center,Mountain Valleys Health Centers,1013088582,"Dental Providers, Federally Qualified Health Centers - Medical Services",610 W 3rd St,,Dorris,CA,96023,Siskiyou,P.O. Box 277,,Bieber,CA,96009,Lassen,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grants Management,520-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001094,GVHC - DOS PALOS,GOLDEN VALLEY HEALTH CENTERS,1770567778,Federally Qualified Health Centers - Medical Services,1405 California Ave,,Dos Palos,CA,93620-2300,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001095,Hope at Home,City of Hope,1346283140,Hemophilia Treatment Centers,1500 Duarte Rd,,Duarte,CA,91010-3012,Los Angeles,1500 East Duarte Road,,Duarte,CA,91010,Los Angeles,Dr. Ewing,Medical Director,626-256-4673,,newing@coh.org,Lisa Pullens,RN,626-256-4673,,lpullens@coh.org,
CA-001096,DE NOVO HEALTH CARE,"DE NOVO HEALTH CARE, INC",1972752368,"Family Planning Providers, Other ECP Providers",803 E Rosecrans Ave,,East Rancho Dominguez,CA,90221-2145,Los Angeles,803 E ROSECRANS AVE,,COMPTON,CA,90221,Los Angeles,HILARY CHAVIS,COO,310-900-4289,,CD@DNHCC.COM,NELLIE SMITH,Operation Manager,310-900-4280,,SMITH.NELLIE@DNHCC.COM,DNHCC.COM
CA-001097,La Maestra El Cajon Broadway Clinic,"La Maestra Family Clinic, Inc",1134590086,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1032 Broadway,,El Cajon,CA,92021-7416,San Diego,4060 Fairmount Avenue,,San Diego,CA,92105,San Diego,Alejandrina Areizaga,VP,619-280-4213,3019,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001098,Chase Avenue Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1104861681,Federally Qualified Health Centers - Medical Services,1111 W Chase Ave,,El Cajon,CA,92020-5710,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001099,El Cajon Clinic,Planned Parenthood of the Pacific Southwest,1154356145,"Family Planning Providers, Sexually Transmitted Disease Clinics",1685 E Main St,Suite 301,El Cajon,CA,92021-5292,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001100,La Maestra El Cajon Dental Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1306929443,Dental Providers,183 S 1st St,,El Cajon,CA,92019-4795,San Diego,4060 Fairmount Avenue,,San Diego,CA,92105,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001101,El Cajon Family Health Center,Family Health Centers of San Diego,1932561198,"Dental Providers, Federally Qualified Health Centers - Medical Services",525 E Main St,,El Cajon,CA,92020-4007,San Diego,823 Gateway Center Way,,San Diego,CA,92102,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001102,Sycuan Medical & Dental Center,Sycuan Band of Kumeyaay Nation,1427197078,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5442 Sycuan Rd,,El Cajon,CA,92019-1816,San Diego,2 Kwaaypaay Court,,El Cajon,CA,92019,San Diego,Salvatore J. Falco,Administrative Director,619-445-0707,114,salf@sycuanmed.org,Teresa Mogielnicki,Medical Director,619-445-0707,110,teresam@sycuanmed.org,
CA-001103,Neighborhood Healthcare - El Cajon,Neighborhood Healthcare,1760667950,Federally Qualified Health Centers - Medical Services,855 E Madison Ave,,El Cajon,CA,92020-3819,San Diego,425 N. Date Street,,Escondido,CA,92025,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,http://www.nhcare.org/
CA-001104,Imperial Valley Health Center,Planned Parenthood of the Pacific Southwest,1518361435,"Family Planning Providers, Sexually Transmitted Disease Clinics",1463 S 4th St,,El Centro,CA,92243-4749,Imperial,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,https://www.plannedparenthood.org/pacific-southwest
CA-001105,Planned Parenthood El Cerrito,Planned Parenthood Northern California,1740505262,"Family Planning Providers, Sexually Transmitted Disease Clinics",320 El Cerrito Plz,,El Cerrito,CA,94530-4004,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001106,ChapCare Garvey,Community Health Alliance of Pasadena,1922429349,Federally Qualified Health Centers - Medical Services,10127 Garvey Ave,,El Monte,CA,91733-2066,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1222,1222,Sbautista@chapcare.org,Margaret B. Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001107,AltaMed Medical Group - El Monte,AltaMed Health Services Corporation,1982814745,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",10418 Valley Blvd,Suite B,El Monte,CA,91731-3600,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001108,El Monte Comphrensive Health Center,"Los Angeles County, Department of Health Services",1881607547,Family Planning Providers,10953 Ramona Blvd,,El Monte,CA,91731-2629,Los Angeles,10953 Ramona Blvd.,,El Monte,CA,91731,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001109,AHF Healthcare Center - El Monte,AIDS Healthcare Foundation,1740264217,"Other ECP Providers, Ryan White Providers",3131 Santa Anita Ave,Suite 109,El Monte,CA,91733-1369,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001110,Chapcare Peck,Community Health Alliance of Pasadena,1477924520,Federally Qualified Health Centers - Medical Services,3703 Peck Rd,,El Monte,CA,91731-3543,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1222,1222,Sbautista@chapcare.org,Margaret B Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001111,El Monte Health Center,Planned Parenthood Los Angeles,1700975927,Family Planning Providers,4786 Peck Rd,Suite B,El Monte,CA,91732-1665,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001112,APHCV - El Monte/Rosemead Health Center,"ASIAN PACIFIC HEALTH CARE VENTURE, INC.",1609147743,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9960 Baldwin Pl,,El Monte,CA,91731-2204,Los Angeles,4216 Fountain Ave,,Los Angeles,CA,90029-2256,Los Angeles,Lorali Delos Reyes,Executive Assistant,323-644-3880,485,LDelosreyes@aphcv.org,Nardo Beltran,CFO,323-644-3880,249,NBeltran@aphcv.org,http://www.aphcv.org/
CA-001113,Neighborhood Healthcare - Grand Avenue,NEIGHBORHOOD HEALTHCARE,1487826772,Federally Qualified Health Centers - Medical Services,1001 E Grand Ave,,Escondido,CA,92025-4604,San Diego,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001114,Escondido Clinic,Planned Parenthood of the Pacific Southwest,1063447050,"Family Planning Providers, Sexually Transmitted Disease Clinics",347 W Mission Ave,,Escondido,CA,92025-1729,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001115,RAY M. DICKINSON WELLNESS CENTER,NEIGHBORHOOD HEALTHCARE,1437335353,"Dental Providers, Federally Qualified Health Centers - Medical Services",425 N Date St,Suite 203,Escondido,CA,92025-3413,San Diego,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6974,,lisad@nhcare.org,http://www.nhcare.org/
CA-001116,NEIGHBORHOOD HEALTHCARE ~ PEDIATRICS & PRENATAL,NEIGHBORHOOD HEALTHCARE,1265618185,Federally Qualified Health Centers - Medical Services,426 N Date St,,Escondido,CA,92025-3409,San Diego,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001117,NEIGHBORHOOD HEALTHCARE ~ ESCONDIDO,NEIGHBORHOOD HEALTHCARE,1598703647,Federally Qualified Health Centers - Medical Services,460 N Elm St,,Escondido,CA,92025-3002,San Diego,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001118,Neighborhood Healthcare ~ Valley Parkway,NEIGHBORHOOD HEALTHCARE,1720264641,Federally Qualified Health Centers - Medical Services,728 E Valley Pkwy,Suite A,Escondido,CA,92025-3052,San Diego,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001119,"Community Medical Centers, Esparto","COMMUNITY MEDICAL CENTERS, INC.",1588729180,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",17050 S. Grafton St,,Esparto,CA,95627,Yolo,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001120,SCOTT VALLEY RURAL HEALTH CLINIC,Fairchild Medical Center,1336330646,Rural Health Clinics,155 Diggles St,,Etna,CA,96027,Siskiyou,444 Bruce Street,,Yreka,CA,96097,Siskiyou,Paulette Adams,Director of Hospital Clinics,530-841-6316,,padams@fairchildmed.org,Cheryl Freckman,Financial Systems Manager,530-841-6306,,cfreckman@fairchildmed.org,
CA-001121,EUREKA PEDIATRICS,Eureka Pediatrics,1881706380,Rural Health Clinics,2800 Harris St,,Eureka,CA,95503-4809,Humboldt,2800 Harris St,,Eureka,CA,95503,Humboldt,Elesha Hernandez,Office Manager,707-445-8416,,ekapedselesha@gmail.com,Emily Dalton,MD/Partner,707-445-8416,,eurekapedsemily@gmail.com,www.eurekapeds.com
CA-001122,Planned Parenthood Eureka,Planned Parenthood Northern California,1609286418,"Family Planning Providers, Sexually Transmitted Disease Clinics",3225 Timber Fall Ct,Suite B,Eureka,CA,95503-4892,Humboldt,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001123,Kaweah Delta Exeter Clinic,Kaweah Delta Health Care District,1043272172,Rural Health Clinics,1014 San Juan Ave,,Exeter,CA,93221-1312,Tulare,400 w mineral king,,Visalia,CA,93291,Tulare,Dave W. Garrett,Rural health clinic director,559-592-7300,7395,Dgarrett@kdhcd.org,,,,,,
CA-001124,San Joaquin Prime Care Medical Group,San Joaquin Prime Care Medical Group,1265580500,Rural Health Clinics,330 E Pine St,,Exeter,CA,93221-1838,Tulare,330 E. Pine St.,,Exeter,CA,93221,Tulare,Ana Lee Tunac,Office Manager,559-592-2134,,analee_sjpcmc7@msn.com,Vickie Stillwell,Administrator,559-592-2134,,vickielynn52@aol.com,
CA-001125,Planned Parenthood Fairfield,Planned Parenthood Northern California,1932269644,"Family Planning Providers, Sexually Transmitted Disease Clinics",1325 Travis Blvd,Suite C,Fairfield,CA,94533-4611,Solano,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001126,Fall River Valley Health Center,Mountain Valleys Health Centers,1922179498,Federally Qualified Health Centers - Medical Services,43563 State Highway 299 E,,Fall River Mills,CA,96028-9787,Shasta,P.O. Box 277,,Bieber,CA,96009,Lassen,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grants Management,530-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001127,FALLBROOK FAMILY HEALTH CENTER,"COMMUNITY HEALTH SYSTEMS, INC.",1982756086,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1320 S Mission Rd,,Fallbrook,CA,92028-4006,San Diego,22675 Alessandro Blvd.,,Moreno Valley,CA,92553,Riverside,Vanessa Ortiz,Executive Assistant,951-571-2300,,v.ortiz@chsica.org,,,,,,
CA-001128,Family HealthCare Network - Farmersville Health Center,FAMILY HEALTHCARE NETWORK,1326317819,Federally Qualified Health Centers - Medical Services,730 N Farmersville Blvd,,Farmersville,CA,93223-1220,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001129,"Clinicas del Camino Real, Inc. Fillmore","Clinicas del Camino Real, Inc.",1912123431,"Dental Providers, Federally Qualified Health Centers - Medical Services",355 Central Ave,,Fillmore,CA,93015-1920,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001130,Sespe Medical Inc,Sespe Medical Inc,1336385244,Rural Health Clinics,552 Sespe Ave,,Fillmore,CA,93015-1957,Ventura,552 Sespe Ave,,Fillmore,CA,93015,Ventura,Estrella Silva,Office Manager,805-524-2559,,estrellas992@gmail.com,,,,,,
CA-001131,North Coast Family Health Center,Mendocino Coast District Hospital,1124220249,Rural Health Clinics,721 River Drive,,Fort Bragg,CA,95437,Mendocino,700 River Drive,,Fort Bragg,CA,95437,Mendocino,Ilona Horton,Practice Administrator,707-961-4615,,ihorton@mcdh.net,Wade Sturgeon,CFO,707-961-4611,,wsturgeon@mcdh.net,www.mcdh.org
CA-001132,ADVENTIST HEALTH UKIAH VALLEY FORT BRAGG RHC,ADVENTIST HEALTH UKIAH VALLEY,1588095848,Rural Health Clinics,850 Sequoia Cir,,Fort Bragg,CA,95437-5490,Mendocino,275 Hospital Drive,,Ukiah,CA,95482,Mendocino,Garin Fuhriman,Administrative Director,707-571-2891,,fuhrimgv@ah.org,Victoria Brittain,Practice Administrator,707-467-5203,,brittavm@ah.org,https://www.adventisthealth.org/ukiah-valley
CA-001133,Philip L Olkin MD & C Ray Jones MD,Philip L Olkin MD & C Ray Jones MD,1699836981,Rural Health Clinics,3302 Renner Dr,,Fortuna,CA,95540-7103,Humboldt,3302 Renner Dr,,Fortuna,CA,95540,Humboldt,MARY MORIARTY,Office Manager,707-725-3318,,mary.moriarty@sjhs.org,,,,,,
CA-001134,UIHS - Fortuna Health Center,"United Indian Health Service, Inc.",1588660104,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",3302 Renner Dr,Suite C,Fortuna,CA,95540-7103,Humboldt,1600 Weeot Way,,Arcata,CA,95521,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,,,david.rosen@crihb.org,
CA-001135,ADVENTIST HEALTH MEDICAL OFFICE FOWLER RHC,ADVENTIST HEALTH REEDLEY,1093732554,"Dental Providers, Rural Health Clinics",300 S Leon S. Peters Blvd,,Fowler,CA,93625-2538,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Charlotte Montelongo,Site Manager,559-834-1614,,MontelS1@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001136,Frazier Mountain Community Health Center,Clinica Sierra Vista,1457353831,Federally Qualified Health Centers - Medical Services,704 Lebec Road,PO Box 207,Frazier Park,CA,93225-0207,Kern,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001137,San Joaquin County Clinics,San Joaquin General Hospital,1578803425,Federally Qualified Health Centers - Medical Services,500 W Hospital Rd,,French Camp,CA,95231-9693,San Joaquin,PO Box 1439,,French Camp,CA,95231,San Joaquin,David Jomaoas,ACS Director,209-468-6160,,djomaoas@sjgh.org,Margaret Szczepaniak,Asst Director,209-468-5610,,margarets@sjgh.org,
CA-001138,San Joaquin General Hospital,San Joaquin General Hospital,1801830583,Inpatient Hospitals (other than children's hospitals),500 W Hospital Rd,,French Camp,CA,95231-9693,San Joaquin,500 West Hospital Road,,French Camp,CA,95231,San Joaquin,David K Culberson,Chief Executive Officer,209-468-6600,,dculberson@sjgh.org,,,,,,
CA-001139,Orange & Butler Community Health Center,Clinica Sierra Vista,1740439314,Federally Qualified Health Centers - Medical Services,1350 S Orange Ave,,Fresno,CA,93702-3463,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001140,Fresno American Indian Health Project,Fresno American Indian Health Project,1427317981,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1551 E Shaw Ave,Suite 139,Fresno,CA,93710-8025,Fresno,"1551 E Shaw Ave, Suite 139",,Fresno,CA,93710,Fresno,Jennifer Ruiz,Executive Director,559-320-0490,,jruiz@faihp.org,Dawn Batten,Program Development/ Billing Manager,553-320-0490,104,dbatten@faihp.org,
CA-001141,North Fine Community Health Center,Clinica Sierra Vista,1720347149,Federally Qualified Health Centers - Medical Services,1945 N Fine Ave,Ste 100,Fresno,CA,93727-1528,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001142,Regional Medical Community Health Center,Clinica Sierra Vista,1427207000,"Dental Providers, Federally Qualified Health Centers - Medical Services",2505 E Divisadero St,,Fresno,CA,93721-1401,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001143,Elm Community Health Center,Clinica Sierra Vista,1245489814,Federally Qualified Health Centers - Medical Services,2740 S Elm Ave,,Fresno,CA,93706-5435,Fresno,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001144,Elm Dental Center,Clinica Sierra Vista,1770895138,Dental Providers,2756 S Elm Ave,,Fresno,CA,93706-5435,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001145,Elm Women's and Pediatric Community Health Center,Clinica Sierra Vista,1669621447,Federally Qualified Health Centers - Medical Services,2760 S Elm Ave,,Fresno,CA,93706-5435,Fresno,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001146,West Fresno Community Health Center,Clinica Sierra Vista,1326297904,"Dental Providers, Federally Qualified Health Centers - Medical Services",302 Fresno St,Suite 101,Fresno,CA,93706-3641,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001147,Garland Community Health Center,Clinica Sierra Vista,1053560631,Federally Qualified Health Centers - Medical Services,3727 N 1st St,Suite 106,Fresno,CA,93726-5628,Fresno,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001148,Fresno Barrios Unidos,Planned Parenthood Mar Monte,1790739126,Family Planning Providers,4415 E Tulare St,,Fresno,CA,93702-3039,Fresno,1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3707,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001149,West Shaw Community Health Center,Clinica Sierra Vista,1033486048,Federally Qualified Health Centers - Medical Services,4739 W Shaw Ave,Suite 108,Fresno,CA,93722-6265,Fresno,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001150,Easton Community Health Center,Clinica Sierra Vista,1336398908,Federally Qualified Health Centers - Medical Services,5784 S Elm Ave,,Fresno,CA,93706-5813,Fresno,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001151,Family First Clinic,PLANNED PARENTHOOD MAR MONTE,1023062593,"Family Planning Providers, Sexually Transmitted Disease Clinics",6095 N 1st St,,Fresno,CA,93710-5444,Fresno,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001152,Fulton Clinic,PLANNED PARENTHOOD MAR MONTE,1790739126,"Family Planning Providers, Sexually Transmitted Disease Clinics",650 N Fulton St,,Fresno,CA,93728-3404,Fresno,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001153,St. Jude Neighborhood Health Center,St. Jude Neighborhood Health Centers,1316206592,"Dental Providers, Federally Qualified Health Centers - Medical Services",731 S Highland Ave,,Fullerton,CA,92832-2753,Orange,731 S. Highland Ave,,Fullerton,CA,92832,Orange,Timothy J. Brown,Executive Director,714-446-5100,,timothy.brown@stjoe.org,,,,,,
CA-001154,North Orange County Regional Health Foundation,North Orange County Regional Health Foundation,1194974402,Federally Qualified Health Centers - Medical Services,901 W Orangethorpe Ave,,Fullerton,CA,92832-2826,Orange,901 W Orangethorpe Ave.,,Fullerton,CA,92832-2826,Orange,Debbie Cardenas,Chief Executive Officer,714-441-0411,,debbiecardenas@nocrhf.org,Carolina Romo,Clinical Operations Manager,,,carolinaromo@nocrhf.org,
CA-001155,ADVENTIST HEALTH LODI MEMORIAL GALT RHC,ADVENTIST HEALTH LODI MEMORIAL,1164431383,Rural Health Clinics,387 Civic Dr,,Galt,CA,95632-2059,Sacramento,975 S Fairmont Ave,,Lodi,CA,95240,San Joaquin,Kristin Shinn,Pracice Manager,209-339-7546,,ShinnKD@AH.org,Becky Clinkenbeard,Executive Director,209-339-7835,,ClinkeRD@AH.org,https://www.adventisthealth.org/lodimemorial
CA-001156,Jerold Phelps Community Hospital,Southern Humboldt Community Healthcare District,1003819376,Rural Health Clinics,733 Cedar St,,Garberville,CA,95542-3201,Humboldt,733 Cedar Street,,Garberville,CA,95542,Humboldt,Susan Gardner,Administrative Assistant/Med Staff Coordinator,707-923-3921,276,sgardner@shchd.org,Matt Rees,CEO/Administrator,707-923-3921,260,mrees@shchd.org,
CA-001157,AltaMed Medical Group - Garden Grove Harbor,AltaMed Health Services Corporation,1083851992,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",12751 Harbor Blvd,,Garden Grove,CA,92840-5800,Orange,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001158,Gilroy Health Center,Planned Parenthood Mar Monte,1053364109,"Family Planning Providers, Sexually Transmitted Disease Clinics",760 Renz Ln,,Gilroy,CA,95020-9584,Santa Clara,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3707,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001159,Gilroy Neighborhood Health Clinic,School Health Clinics of Santa Clara County,1689620478,Federally Qualified Health Centers - Medical Services,7861 Murray Ave,,Gilroy,CA,95020-4604,Santa Clara,6840 Via Del Oro #210,,San Jose,CA,95119,Santa Clara,Stephanie Kleinheinz,CEO,408-284-2288,,StephanieK@schoolhealthclinics.org,Jocelyn Hart,CFO/COO,408-284-2289,,JocelynH@schoolhealthclinics.org,
CA-001160,Glendale Health Center,"Los Angeles County, Department of Health Services",1992713499,Family Planning Providers,501 N Glendale Ave,,Glendale,CA,91206-3312,Los Angeles,501 N. Glendale Avenue,,Glendale,CA,91206,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001161,Glendale Location,Comprehensive Community Health Center,1356362743,"Dental Providers, Federally Qualified Health Centers - Medical Services",801 S Chevy Chase Dr,Suite 250,Glendale,CA,91205-4433,Los Angeles,801 S. Chevy Chase Dr,Suite 20,Glendale,CA,91205,Los Angeles,David Lontok,EVP,818-265-2221,,davidlo@cchccenters.org,,,,,,
CA-001162,Glendora Health Center,"Planned Parenthood Pasadena and San Gabriel Valley, Inc.",1497094114,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",130 W Route 66,Suite 100,Glendora,CA,91740-6250,Los Angeles,2333 Lake Ave.,2nd Floor,Altadena,CA,91001,Los Angeles,Bethany Eshleman,COO,626-794-5737,107,beshleman@pppsgv.org,Cheri Pogue,Sr. Director of Patient Services,626-794-5737,168,cpogue@pppsgv.org,http://www.pppsgv.org
CA-001163,Gonzales Clinic,Clinica de Salud del Valle de Salinas,1689048241,"Dental Providers, Federally Qualified Health Centers - Medical Services",126 Fifth Street,,Gonzales,CA,93926,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001164,San Manual Health Clinic,"Riverside San-Bernardino County Indian Health, Inc.",1174676670,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",11980 Mount Vernon Ave,,Grand Terrace,CA,92313-5172,San Bernardino,11555 1/2 Potrero Rd,,Banning,CA,92220,Riverside,Jess Montoya,Director,909-864-1097,4702,jmontoya@rsbcihi.org,Charlen Taylor,Controller,909-864-1097,4737,ctaylor@rsbcihi.org,
CA-001165,Chapa-De Indian Health,Chapa-De Indian Health,1922138841,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",1350 E Main St,,Grass Valley,CA,95945-5208,Nevada,11670 Atwood Road,,Auburn,CA,95603,Placer,Sierk Haitsma,Chief Financial Officer,530-887-2800,2841,shaitsma@chapa-de.org,Lisa Davies,Chief Executive officer,530-887-2800,3777,ldavies@chapa-de.org,
CA-001166,Nevada County Health Department,NEVADA COUNTY PUBLIC HEALTH,1700959863,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",500 Crown Point Cir,Suite 110,Grass Valley,CA,95945-9561,Nevada,500 Crown Point Circle,Suite 110,Grass Valley,CA,95945,Nevada,Cynthia Wilson,Director of Nursing,530-265-7269,,Cynthia.Wilson@co.nevada.ca.us,Carol Smith,Administrative Assistant,530-265-1413,,Carol.Smith@co.nevada.ca.us,http://www.mynevadacounty.com
CA-001167,Greenfield Clinic,Clinica de Salud del Valle de Salinas,1043351133,"Dental Providers, Federally Qualified Health Centers - Medical Services",808 Oak Ave,,Greenfield,CA,93927-5648,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001168,INDIAN VALLEY MEDICAL CLINIC,Plumas District Hospital,1881068708,Rural Health Clinics,176 Hot Springs Rd,,Greenville,CA,95947-9747,Plumas,1065 Bucks Lake Road,,Quincy,CA,95971,Plumas,Andy Werking,Insurance Contracting Specialist,916-366-5763,,awerking@sbcglobal.net,Caleb Johnson,Chief Financial Officer,530-283-2121,7952,cjohnson@pdh.org,
CA-001169,County of San Luis Obispo Public Health Department,County of San Luis Obsipo,1518064948,"Dental Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",286 S 16th St,,Grover Beach,CA,93433-2245,San Luis Obispo,2191 Johnson Ave.,,San Luis Obispo,CA,93401-4534,San Luis Obispo,Penny Borenstein,Health Officer/Public Health Administrator,805-781-5519,,pborenstein@co.slo.ca.us,Jean White,Secretary I,805-781-5520,,jwhite@co.slo.ca.us,http://www.slocounty.ca.gov/health.htm
CA-001170,RCMS-Gualala Medical Health Center,"Redwood Coast Medical Services, Inc.",1962530725,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",46900 Ocean Drive,PO Box 1100,Gualala,CA,95445-1100,Mendocino,46900 Ocean Drive,P.O. Box 1100,Gualala,CA,95445,Mendocino,Deborah Lane,Resource Development,707-884-4005,107,dlane@rcms-healthcare.org,Diane Agee,CEO,707-884-4046,,ceo@rcms-healthcare.org,
CA-001171,Russian River Health Center,"West County Health Centers, Inc.",1356344758,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",16319 3rd St,,Guerneville,CA,954461449,Sonoma,14045 Mill St,,Guerneville,CA,954468303,Sonoma,Vikki Minnifield,Billing Manger,707-869-5977,3306,vminnifield@wchealth.org,,,,,,
CA-001172,Horisons Unlimited Healthcare Gustine,Horisons Unlimited,1679759872,"Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",554 5th St,,Gustine,CA,95322-1516,Merced,1208 Paseo Verde Dr,,Merced,CA,95348,Merced,Sandy Haar,ceo,209-201-2099,,sandy.haar@gmail.com,,,,,,
CA-001173,ADVENTIST HEALTH MEDICAL OFFICE HANFORD RHC,ADVENTIST HEALTH REEDLEY,1417930892,"Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1025 N Douty St,,Hanford,CA,93230-3722,Kings,372 W. CYPRESS STREET,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Rebecca Flores,Site Manager,559-537-0243,,FloresRL@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001174,ADVENTIST HEALTH MEDICAL OFFICE HOME GARDEN RHC,ADVENTIST HEALTH REEDLEY,1467678342,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",11899 Shaw Pl,,Hanford,CA,93230-6644,Kings,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Tom Champion,Site Manager,559-537-0192,,ChampiT@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001175,Family HealthCare Network - Hanford Health Center,FAMILY HEALTHCARE NETWORK,1467504530,"Dental Providers, Federally Qualified Health Centers - Medical Services",329 W 8th St,,Hanford,CA,93230-4533,Kings,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,4731,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001176,Karuk Happy Camp Clinic,Karuk Tribal Health,1952483406,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",64236 Second Avenue,PO Box 316,Happy Camp,CA,96039-0316,Siskiyou,64236 Second Avenue,PO Box 316,Happy Camp,CA,96039,Siskiyou,Kori Novak,"CEO, Health & Human Services",530-842-9200,6125,knovak@karuk.us,Lessie Aubrey,Grants Manager,530-493-1600,2042,laubrey@karuk.us,www.karuk.us
CA-001177,Chemehuevi Health Station,CHEMEHUEVI HEALTH CLINIC,1578691390,"Indian Health Service, Rural Health Clinics",1900 Palo Verde St,,Havasu Lake,CA,92363,San Bernardino,1900 PALO VERDE STREET,,HAVASU LAKE,CA,92363,San Bernardino,ELIZABETH HELSEL,Chief Executive Officer,928-669-2137,,ELIZABETH.HELSEL@IHS.GOV,,,,,,
CA-001178,Hayfork Community Health Clinic,Mountain Communities Healthcare District,1669617783,Rural Health Clinics,6961 Highway 3,,Hayfork,CA,96041-0220,Trinity,PO Box 1229,,Weaverville,CA,96093,Trinity,Kelly Simpson,Manager of Business Services,530-623-5541,3258,kellys@mcmedical.org,,,,,,
CA-001179,Hayward Clinic,PLANNED PARENTHOOD MAR MONTE,1174923684,Family Planning Providers,1032 A St,,Hayward,CA,94541-4106,Alameda,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001180,Hayward Medical Center,"Tiburcio Vasquez Health Center, Inc.",1073676243,"Dental Providers, Federally Qualified Health Centers - Medical Services",22331 Mission Blvd,,Hayward,CA,94541-3911,Alameda,33255 Ninth Street,,Union City,CA,94587,Alameda,David Vliet,Chief Executive Officer,510-690-6050,,dvliet@tvhc.org,Wilfredo Lacro,VP of Business Development,510-460-3846,,wlacro@tvhc.org,www.tvhc.org
CA-001181,Firehouse Clinic,Tiburcio Vasquez Health Center,1861860306,Federally Qualified Health Centers - Medical Services,28300 Huntwood Ave,,Hayward,CA,94544-5425,Alameda,33255 Ninth Street,,Union City,CA,94587,Alameda,David Vliet,Chief Executive Officer,510-690-6050,,dvliet@tvhc.org,Wilfredo Lacro,VP of Business Development,510-460-3846,,wlacro@tvhc.org,www.tvhc.org
CA-001182,Silva Pediatric Clinic,"Tiburcio Vasquez Health Center, Inc.",1144597477,"Dental Providers, Federally Qualified Health Centers - Medical Services",680 W Tennyson Rd,,Hayward,CA,94544-5236,Alameda,33255 Ninth Street,,Union City,CA,94587,Alameda,David Vliet,Chief Executive Officer,510-690-6050,,wlacro@tvhv.org,Wilfredo Lacro,VP of Business Development,510-460-3846,,wlacro@tvhc.org,www.tvhc.org
CA-001183,Alliance Medical Center - Healdsburg,Alliance Medical Center,1750399796,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1381 University St,,Healdsburg,CA,95448-3314,Sonoma,1381 University Ave,,Healdsburg,CA,95448,Sonoma,Alex Armstrong,CEO,707-385-2306,,aarmstrong@alliancemed.org,Alan Finnie,Project Manager,707-385-2310,,afinnie@alliancemed.org,alliancemed.org
CA-001184,Neighborhood Healthcare-Hemet Devonshire Avenue,Neighborhood Healthcare,1154786846,Federally Qualified Health Centers - Medical Services,903 E Devonshire Ave,,Hemet,CA,92543-3000,Riverside,425 N. Date Street,,Escondido,CA,92025,San Diego,Tracy L Ream,CEO,760-737-6901,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001185,Hesperia Clinic,San Bernardino County Public Health,1578535845,Federally Qualified Health Centers - Medical Services,16453 Bear Valley Rd,,Hesperia,CA,92345-1752,San Bernardino,351 North Mt View Avenue,,San Bernardino,CA,92415,San Bernardino,Winfred Kimani,Public Health Program Coordinator,760-956-4432,,wkimani@dph.sbcounty.gov,Melanie Bird,Nurse Manager,909-383-3013,,Melanie.Bird@dph.sbcounty.gov,http://www.sbcounty.gov/dph/publichealth/
CA-001186,ADVENTIST HEALTH CLEAR LAKE MEDICAL OFFICE HIDDEN VALLEY LAKE RHC,ADVENTIST HEALTH CLEAR LAKE,1558737486,Rural Health Clinics,18990 Coyote Valley Rd,,Hidden Valley Lake,CA,95467-8337,Lake,15630 18th Ave,PO Box 6710,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5621,,fuhrimgv@ah.org,Jennifer Fredrickson,Practice Administrator,707-995-5628,,fredrijl@ah.org,https://www.adventisthealth.org/clear-lake
CA-001187,San Benito Health Foundation Community Health Center,San Benito Health Center,1295810174,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",351 Felice Dr,,Hollister,CA,95023-3361,San Benito,351 Felice Dr,,Hollister,CA,92023,San Benito,Rosa Vivian Fernandez,President & CEO,831-637-5783,130,rvfernandez@sanbenitohealth.org,,,,,,www.sanbenitohealth.org
CA-001188,ADVENTIST HEALTH MEDICAL OFFICE HURON RHC,ADVENTIST HEALTH REEDLEY,1528041779,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",16916 5th St,,HURON,CA,93234,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Dulce Garcia-Melgoza,Site Manager,559-945-9090,,GarciaDM@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001189,Imperial Beach Health Center,Imperial Beach Community Clinic,1790718351,Federally Qualified Health Centers - Medical Services,949 Palm Ave,,Imperial Beach,CA,91932-1503,San Diego,2232 Verus St,Suite I,SAN DIEGO,CA,91932,San Diego,Constance Kirk,Executive Diretor,619-429-5387,,ckirk@ibclinic.org,Linda Cornwell,Administrative Assistant,619-429-5387,,lcornwell@ibclinic.org,
CA-001190,Family HealthCare Network - Ivanhoe Health Center,FAMILY HEALTHCARE NETWORK,1386670610,Federally Qualified Health Centers - Medical Services,33025 Road 159,,Ivanhoe,CA,93235-1234,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001191,"Jackson Rancheria Health Center - M.A.C.T. Health Board, Inc.","M.A.C.T. Health Board, Inc.",1295727287,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",12140 New York Ranch Rd,,Jackson,CA,95642-9407,Amador,52 S Main St,,Angels Camp,CA,95221,Calaveras,John Alexander,Executive Director,209-754-6262,,john.alexander@macthealth.org,Mariela Contreras,Finance Director,209-754-6262,,mariela.contreras@macthealth.org,www.macthealth.org
CA-001192,Family Health Center of Joshua Tree,Family Health Center of Joshua Tree,1255511630,"Family Planning Providers, Rural Health Clinics",63532 Twentynine Palms Hwy,Suite C,Joshua Tree,CA,92252,San Bernardino,P.O. Box 1220,,Joshua Tree,CA,92252,San Bernardino,Sandra Wekenman,Practice Manager,760-366-7555,,swekenman@akaskoobgyn.com,,,,,,
CA-001193,ADVENTIST HEALTH CLEAR LAKE MEDICAL OFFICE KELSEYVILLE RHC,ADVENTIST HEALTH CLEAR LAKE,1962492876,Rural Health Clinics,5290 State St,,Kelseyville,CA,95451-9450,Lake,15630 18th Ave,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5621,,fuhrimgv@ah.org,Jennifer Fredrickson,Practice Administrator,707-995-5628,,fredrijl@ah.org,https://www.adventisthealth.org/clear-lake
CA-001194,ADVENTIST HEALTH MEDICAL OFFICE KERMAN RHC,ADVENTIST HEALTH REEDLEY,1902823461,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1000 S Madera Ave,,Kerman,CA,93630-1750,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Sherry Pennington,Site Manager,559-846-9370,,PenninSD@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001195,ADVENTIST HEALTH MEDICAL OFFICE KERMAN CENTRAL RHC,ADVENTIST HEALTH REEDLEY,1871839027,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",275 S Madera Ave,Suite 201,Kerman,CA,93630-1401,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Liliana Madrigal,Site Manager,559-846-5240,,MadrigL1@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001196,Aria Community Health Center Kettleman City,Avenal Community Health Center,1275918674,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",304 Becky Pease St,,Kettleman City,CA,93239,Kings,1000 Skyline Blvd.,,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-001197,King City Clinic,Clinica de Salud del Valle de Salinas,1376684456,"Dental Providers, Federally Qualified Health Centers - Medical Services",122 E San Antonio Dr,,King City,CA,93930-2518,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001198,ADVENTIST HEALTH MEDICAL OFFICE KINGSBURG RHC,ADVENTIST HEALTH REEDLEY,1225364060,Rural Health Clinics,1251 Draper St,,Kingsburg,CA,93631-1934,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Claudia Salinas,Site Manager,559-897-6610,,Salinac3@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001199,UIHS - Klamath Health Center,"United Indian Health Service, Inc.",1881690758,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",241 Salmon Ave,,Klamath,CA,95548,Del Norte,1600 Weeot Way,,Arcata,CA,95521-4734,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,707-825-5000,,david.rosen@crihb.org,
CA-001200,La Puente Health Center,"Los Angeles County, Department of Health Services",1689687345,Family Planning Providers,15930 Central Ave,,La Puente,CA,91744-5410,Los Angeles,15930 Central Avenue,,La Puente,CA,91744,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001201,"East Valley Community Health Center, Inc.","East Valley Community Health Center, Inc.",1386912202,Federally Qualified Health Centers - Medical Services,17840 Villa Corta St,"East Valley Community Health Center, Inc. - Villacorta School Based Clinic",La Puente,CA,91744-5342,Los Angeles,420 S Glendora Ave,,West Covina,CA,91790-3001,Los Angeles,Alicia Mardini,Chief Executive Officer,626-919-4333,2220,amardini@evchc.org,Lelenia Navarro,Director of Operations,909-620-8088,3407,lnavarro@evchc.org,www.evchc.org
CA-001202,MARTIN ROCHA MD INC,MARTIN ROCHA MD INC,1962435586,Rural Health Clinics,251 N Hwy 173,,Lake Arrowhead,CA,92352,San Bernardino,251 N Hwy 173,,Lake Arrowhead,CA,92352,San Bernardino,"Martin Rocha, MD",CEO,909-336-3670,,martinrochamd@gmail.com,,,,,,
CA-001203,San Bernardino Mountains Community Hospital District Rural Health Clinic,San Bernardino Mountains Community Hospital District,1528172541,"Dental Providers, Rural Health Clinics",29099 Hospital Rd,,Lake Arrowhead,CA,92352,San Bernardino,29101 Hospital Road,,Lake Arrowhead,CA,92352,San Bernardino,Charles H. Harrison,CEO,909-436-3200,,charles.harrison@mchcares.com,Yvonne D. Waggener,CFO,909-436-3202,,yvonne.waggener@mchcares.com,mchcares.com
CA-001204,Kern Valley Medical Center,Clinica Sierra Vista,1356343735,Federally Qualified Health Centers - Medical Services,6310 Lake Isabella Blvd,PO Box 890,Lake Isabella,CA,93240-0890,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001205,ADVENTIST HEALTH UKIAH VALLEY LAKEPORT RHC,ADVENTIST HEALTH UKIAH VALLEY,1417027095,Rural Health Clinics,487 S Main St,,Lakeport,CA,95453-5315,Lake,275 Hospital Drive,,Ukiah,CA,95482,Mendocino,Catherine Stewart,Practice Manager,707-463-2400,,StewarCl@AH.org,Garin Fuhriman,Administrative Director,707-995-5621,,fuhrimgv@ah.org,https://www.adventisthealth.org/ukiah-valley
CA-012375,ADVENTIST HEALTH CLEARLAKE MEDICAL OFFICE LAKEPORT RHC,ADVENTIST HEALTH CLEAR LAKE,1124018031,Rural Health Clinics,801 11th St,,Lakeport,CA,95453-4100,Lake,15630 18th Ave,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5798,,fuhrimgv@ah.org,Jennifer Fredrickson,Practice Manager,707-995-5628,,fredrijl@ah.org,https://www.adventisthealth.org/clear-lake
CA-001206,Lake County Tribal Health Program,"Lake County Tribal Health Consortium, Inc.",1881697381,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",925 Bevins Ct,,Lakeport,CA,95453-9754,Lake,925 Bevins Ct,359 Lakes,Lakeport,CA,95453-9754,Lake,Ernesto Padilla,Director,707-263-8382,1101,epadilla@lcthc.org,LaNita Johnson,Lead Biller,707-263-8382,1204,ljohnson@lcthc.org,
CA-001207,Planned Parenthood Basics Lakewood,Planned Parenthood Los Angeles,1174759583,Family Planning Providers,5519 Del Amo Blvd,,Lakewood,CA,90713-2307,Los Angeles,400 West 30th Streel,,Los Angeles,CA,90007,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001208,Lakewood Health Center,Planned Parenthood Los Angeles,1992894125,Family Planning Providers,5525 Del Amo Blvd,,Lakewood,CA,90713-2307,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001209,Lamont Community Health Center,Clinica Sierra Vista,1629070461,"Dental Providers, Federally Qualified Health Centers - Medical Services",8787 Hall Rd,,Lamont,CA,93241-1953,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001210,AHF Healthcare Center - Antelope Valley,AIDS Healthcare Foundation,1497738397,"Other ECP Providers, Ryan White Providers",1669 W Avenue J,Suite 301,Lancaster,CA,93534-2870,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001211,High Desert Regional Health Center,"Los Angeles County, Department of Health Services",1154636793,Family Planning Providers,335 E Avenue I,,Lancaster,CA,93535-1916,Los Angeles,335 East Avenue I,,Lancaster,CA,93535,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,"Judith Dannelle Pietersz, NP",Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001212,Bartz-Altadonna Community Health Center,BARTZ-ALTADONNA COMMUNITY HEALTH CENTER,1811279763,Federally Qualified Health Centers - Medical Services,43322 Gingham Ave,Suite 105,Lancaster,CA,93535-4569,Los Angeles,43322 Gingham Ave Ste 105,,Lancaster,CA,93535-4569,Los Angeles,Emma Gutierrez,CEO,661-874-4355,,emma@bachc.org,Mary Cummings,CFO,661-874-4050,109,maryc@bachc.org,www.bachc.org
CA-001213,Antelope Valley Community Clinic,Antelope Valley Community Clinic,1730499872,"Dental Providers, Federally Qualified Health Centers - Medical Services",45104 10th St W,,Lancaster,CA,93534-2310,Los Angeles,45104 10th St West,,Lancaster,CA,93534,Los Angeles,James A Cook,Chief Executive Officer,661-942-2391,,jcook@avclinic.org,Sheila Dizon,Special Projects,661-942-2391,,sdizon@avclinic.org,
CA-001214,South Bay Health Center,Planned Parenthood Los Angeles,1548359730,Family Planning Providers,14623 Hawthorne Blvd,Suite 300,Lawndale,CA,90260-1590,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001215,GVHC - Le Grand Dental,GOLDEN VALLEY HEALTH CENTERS,1356325310,Dental Providers,13151 Jefferson St,,Le Grand,CA,95333-9766,Merced,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001216,GVHC - LE GRAND,GOLDEN VALLEY HEALTH CENTERS,1356325310,Federally Qualified Health Centers - Medical Services,13161 Jefferson St,,Le Grand,CA,95333-9766,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001217,Lemon Grove Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1427282466,Federally Qualified Health Centers - Medical Services,7592 Broadway,,Lemon Grove,CA,91945-1604,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001218,La Maestra Lemon Grove Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1891011599,Dental Providers,7967 Broadway,,Lemon Grove,CA,91945-1809,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001219,Aria Community Health Center Lemoore,Avenal Community Health Center,1073868527,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",140 C St,,Lemoore,CA,93245-2929,Kings,1000 Skyline Blvd,,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-001220,Tachi Medical Center,"Central Valley Indian Health, Inc.",1215157375,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",16835 Alkali Dr,Suite M,Lemoore,CA,93245-9463,Kings,2740 Herndon Ave,,Clovis,CA,93611-6813,Fresno,Charles Fowler,Executive Director,559-299-2578,1115,cfowler@cvih.org,Julie Ramsey,Chief Operating Officer,559-299-2578,1117,jramsey@cvih.org,www.cvih.org
CA-001221,Aria Community Health Center Lemoore 209,Avenal Community Health Center,1669929543,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",209 C St,,Lemoore,CA,93245-2930,Kings,1000 Skyline Blvd,,Avenal,CA,93245,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-001222,ADVENTIST HEALTH MEDICAL OFFICE LEMOORE RHC,ADVENTIST HEALTH REEDLEY,1699758003,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",810 E D St,,Lemoore,CA,93245-9545,Kings,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Tina Threadgill,Site Manager,559-537-0198,,ThreadTM@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001223,LINDSAY FAMILY AND PEDIATRIC CLINIC,Sequoia Family Medical Center DBA Lindsay Family and Pediatrics,1326167115,Rural Health Clinics,825 Sequoia Ave,,Lindsay,CA,93247-1424,Tulare,590 W Putnam Suite 2,,Porterville,CA,93257,Tulare,John Angell,CFO,559-781-4100,,john.angell@seqfam.com,John Angell,CFO,559-306-1352,,john.angell@seqfam.com,
CA-001224,Kaweah Delta Lindsay Clinic,Kaweah Delta Health Care District,1104067636,Rural Health Clinics,839 Sequoia Ave,,Lindsay,CA,93247-1424,Tulare,400 w. Mineral king,,Visalia,CA,93291,Tulare,David w. Garrett,Rural Health clinic director,559-592-7300,7395,Dgarrett@kdhcd.org,,,,,,
CA-001225,Horisons Unlimited Livingston,Horisons Unlimited,1184674582,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2275 F St,Suite 1 & 2,Livingston,CA,95334-1776,Merced,1208 Paseo Verde Drive,,Merced,CA,95348,Merced,Sandy Haar,CEO,209-201-2099,,sandy.haar@gmail.com,,,,,,www.huhc.org
CA-001226,"Community Medical Centers, Lodi","COMMUNITY MEDICAL CENTERS, INC.",1881685964,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2401 W Turner Rd,Suite 450,Lodi,CA,95242-2191,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenter.org
CA-001227,"Community Medical Centers, Lawrence","COMMUNITY MEDICAL CENTERS, INC.",1659435279,Federally Qualified Health Centers - Medical Services,721 Calaveras St,,Lodi,CA,95240-0628,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001228,Loma Linda University Children's Hospital,Loma Linda University Health,1366866345,Children's Hospitals (inpatient only),11234 Anderson St,Suite A,Loma Linda,CA,92354-2804,San Bernardino,11234 Anderson St.,Suite A,Loma Linda,CA,92354,San Bernardino,Gary Eusebio,Executive Director of Contracting,909-558-5643,5643,geusebio@llu.edu,Sondra Leno,VP of Finance,909-558-7650,7650,SLeno@llu.edu,
CA-001229,LOMA LINDA UNIVERSITY MEDICAL CENTER,Loma Linda University Health,1912914821,Inpatient Hospitals (other than children's hospitals),11234 Anderson St,,Loma Linda,CA,92354-2804,San Bernardino,11234 Anderson St.,,Loma Linda,CA,92354,San Bernardino,Gary Eusebio,Executive Director of Contracting,909-558-5643,5643,geusebio@llu.edu,Sondra Leno,VP of Finance,909-558-7650,7650,SLeno@llu.edu,
CA-001230,St. Mary Medical Center,Comprehensive AIDS Resource & Education (CARE),1194840421,"Community Mental Health Centers, Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1043 Elm Ave,Suite 300,Long Beach,CA,90813-3295,Los Angeles,St. Mary Medical Center,1050 Linden Ave,Long Beach,CA,90813,Los Angeles,Ace Robinson,Executive Director,562-624-4901,,ace.robinson@dignityhealth.org,,,,,,www.careprogram.org
CA-001231,Long Beach Comprehensive Health Center,"Los Angeles County, Department of Health Services",1063426898,Family Planning Providers,1333 Chestnut Ave,,Long Beach,CA,90813-2944,Los Angeles,1333 Chestnut Avenue,,Long Beach,CA,90813,Los Angeles,Delia Casarez,Progam Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001232,Long Beach Health Center,Planned Parenthood Los Angeles,1669561890,Family Planning Providers,2690 Pacific Ave,Suite 370,Long Beach,CA,90806-2661,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001233,Miller Children's & Women's Hospital Long Beach (children's inpatient hospital),MemorialCare,1477596583,Children's Hospitals (inpatient only),2801 Atlantic Ave,,Long Beach,CA,90806-1701,Los Angeles,2801 Atlantic Avenue,,Long Beach,CA,90806,Los Angeles,Mark Kroeger,Executive Director of Managed Care,562-933-1716,,mkroeger@memorialcare.org,Angela Donatoni,Senior Contract Manager,562-933-1718,,adonatoni@memorialcare.org,
CA-001234,Miller Children's & Women's Hospital Long Beach (multiple outpatient ECP categories),MemorialCare,1477596583,"Family Planning Providers, Hemophilia Treatment Centers",2801 Atlantic Ave,,Long Beach,CA,90806-1701,Los Angeles,2801 Atlantic Avenue,,Long Beach,CA,90806,Los Angeles,Mark Kroeger,Executive Director of Managed Care,562-933-1716,,mkroeger@memorialcare.org,Angela Donatoni,Senior Contract Manager,562-933-1718,,adonatoni@memorialcare.org,
CA-001235,AHF Healthcare Center - Long Beach,AIDS Healthcare Foundation,1023448800,Other ECP Providers,3500 E Pacific Coast Hwy,,Long Beach,CA,90804-1904,Los Angeles,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001236,Universal Community Health Center,Universal Community Health Center,1093023277,Federally Qualified Health Centers - Medical Services,1005 E Washington Blvd,,Los Angeles,CA,90021-3020,Los Angeles,E. Washington Blvd,,Los Angeles,CA,90021,Los Angeles,Agustin Lara,CEO,213-233-3100,,laraagustin@hotmail.com,,,,,,
CA-001237,Regents of UCLA Sexual and Reproductive Health Services,"California Family Health Council, Inc.",1073582888,"Family Planning Providers, Sexually Transmitted Disease Clinics",1010 Veteran Ave,West Medical Bldg.,Los Angeles,CA,90024-2704,Los Angeles,1010 Veteran Ave,West Medical Bldg.,Los Angeles,CA,90024-2704,Los Angeles,Angela Chen,Medical Director,310-267-4313,,angelachen@mednet.ucla.edu,Karen Roque,Title X Program Manager,310-825-6657,,kroque@mednet.ucla.edu,
CA-001238,Hollywood Health Center,Planned Parenthood Los Angeles,1861581043,Family Planning Providers,1014 1/2 N Vermont Ave,,Los Angeles,CA,90029-2620,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001239,WATTS HEALTHCARE CORPORATION,Watts Healthcare Corporation,1477649119,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",10300 Compton Ave,,Los Angeles,CA,90002-3628,Los Angeles,10300 Compton Ave,,Los Angeles,CA,90002-3628,Los Angeles,Dana Knoll,Vice President Administration,323-564-4331,3145,dana.knoll@wattshealth.org,Yvette Wells,HIV/AIDS Manager,323-564-4331,3311,yvette.wells@wattshealth.org,www.wattshealth.org
CA-001240,Bixby Health Center,Planned Parenthood Los Angeles,1801985049,Family Planning Providers,1057 Kingston Ave,,Los Angeles,CA,90033-1310,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001241,LAC USC/Medical Center Women's Clinic,"Los Angeles County, Department of Health Services",1528078573,Family Planning Providers,1100 N State St,,Los Angeles,CA,90033-5000,Los Angeles,1100 N. State Street,,Los Angeles,CA,90033,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001242,"United American Indian Involvement, Inc.","United American Indian Involvement, Inc.",1740335678,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1125 W 6th St,Suite 103,Los Angeles,CA,90017-1896,Los Angeles,"1125 W. 6th Street, Suite 103",,Los Angeles,CA,90017,Los Angeles,Eugene Martinez,Associate Executive Officer,213-202-3970,7131,gmartinez@uaii.org,Jerimy Billy,Chief Executive officer,213-202-3970,7204,jbilly@uaii.org,
CA-001243,AHF Healthcare Center - Hollywood,AIDS Healthcare Foundation,1902880479,"Other ECP Providers, Ryan White Providers",1300 N Vermont Ave,Suite 407,Los Angeles,CA,90027-6005,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001244,AltaMed Medical Group @ Hollywood Pres Med Ctr,AltaMed Health Services Corporation,1437414190,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1300 N Vermont Ave,,Los Angeles,CA,90027-6098,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001245,AHF Healthcare Center - Downtown,AIDS Healthcare Foundation,1821072943,"Other ECP Providers, Ryan White Providers",1400 S Grand Ave,Suite 801,Los Angeles,CA,90015-3068,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001246,APHCV-Los Feliz Health Center,"ASIAN PACIFIC HEALTH CARE VENTURE, INC.",1336208255,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1530 Hillhurst Ave,,Los Angeles,CA,90027-5516,Los Angeles,4216 Fountain Ave,,Los Angeles,CA,90029-2256,Los Angeles,Lorali Delos Reyes,Executive Assistant,323-644-3880,485,LDelosreyes@aphcv.org,Nardo Beltran,CFO,323-644-3880,249,NBeltran@aphcv.org,http://www.aphcv.org/
CA-001247,St. John's Washington Health Center,St. John's Well Child and Family Center,1972845113,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1555 W 110th St,,Los Angeles,CA,90047-4912,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001248,Eagle Rock Health Center,"Planned Parenthood Pasadena and San Gabriel Valley, Inc",1023164019,Family Planning Providers,1578 Colorado Blvd,Suite 13,Los Angeles,CA,90041-1452,Los Angeles,2333 Lake Ave.,2nd Floor,Altadena,CA,91001-2463,Los Angeles,Bethany Eshleman,C.O.O.,626-794-5737,107,beshleman@pppsgv.org,Cheri Pogue,Sr. Director of Patient Services,626-794-5737,168,cpogue@pppsgv.org,http://www.plannedparenthood.org/pppsgv
CA-001249,The Los Angeles LGBT Center,The Los Angeles LGBt Center,1548298532,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1625 Schrader Blvd,,Los Angeles,CA,90028-6213,Los Angeles,1625 N Schrader Blvd,,Los Angeles,CA,90028,Los Angeles,Tim Pusateri,Deputy Director of Health and Mental Health Services,323-993-7538,,tpusateri@lalgbtcenter.org,Darrel Cummings,Chief of Staff,323-993-7605,,dcummings@lalgbtcenter.org,lalgbtcenter.org
CA-001250,"Martin Luther King Jr., Outpatient Center","Los Angeles County, Department of Health Services",1063525871,Family Planning Providers,1670 E 120th St,,Los Angeles,CA,90059-3026,Los Angeles,1670 East 120th Street,,Los Angeles,CA,90059,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001251,Eagle Rock Location,Comprehensive Community Health Centers,1679553192,"Dental Providers, Federally Qualified Health Centers - Medical Services",1704 Colorado Blvd,,Los Angeles,CA,90041-1338,Los Angeles,801 S Chevy Chase Dr,Suite 20,Glendale,CA,91205,Los Angeles,David Lontok,EVP,818-265-2221,,davidlo@cchccenters.org,,,,,,
CA-001252,APHCV - Belmont Health Center,"ASIAN PACIFIC HEALTH CARE VENTURE, INC.",1811129091,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",180 Union Pl,,Los Angeles,CA,90026-5715,Los Angeles,4216 Fountain Ave,,Los Angeles,CA,90029-2256,Los Angeles,Lorali Delos Reyes,Executive Assistant,323-644-3880,485,LDelosreyes@aphcv.org,Nardo Beltran,CFO,323-644-3880,249,NBeltran@aphcv.org,http://www.aphcv.org
CA-001253,St. John's Magnolia Place Health Center,St. John's Well Child and Family Center,1073653630,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1910 Magnolia Ave,,Los Angeles,CA,90007-1220,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001254,AHF Healthcare Center - Carl Bean,AIDS Healthcare Foundation,1295718187,"Other ECP Providers, Ryan White Providers",2146 W Adams Blvd,,Los Angeles,CA,90018-2039,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001255,AltaMed Medical and Dental Group - ELA 1st Street,AltaMed Health Services Corporation,1134492937,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2219 E 1st St,,Los Angeles,CA,90033-3901,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001256,Roybal Comprehensive Health Center,"Los Angeles County, Department of Health Services",1083627749,Family Planning Providers,245 S Fetterly Ave,,Los Angeles,CA,90022-1605,Los Angeles,245 S. Fetterly Avenue,,Los Angeles,CA,90022,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,"Judith Dannelle Pietersz, NP",Clinical Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,
CA-001257,St. John's Well Child and Family Center,St. John's Well Child and Family Center,1932249505,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2512 Alta St,St. John's at Lincoln High School,Los Angeles,CA,90031-2457,Los Angeles,808 W 58th St.,,Los Angeles,CA,90037-4045,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001258,H. Claude Hudson Comprehensive Health Center,"Los Angeles County, Department of Health Services",1053324715,Family Planning Providers,2829 S Grand Ave,,Los Angeles,CA,90007-3304,Los Angeles,2829 S. Grand Avenue,,Los Angeles,CA,90007,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001259,St. John's Rev. Warner Traynham Health Center,St. John's Well Child and Family Center,1861893844,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",326 W 23rd St,,Los Angeles,CA,90007-2612,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001260,"Planned Parenthood Basics, Baldwin Hills/Crenshaw",Planned Parenthood Los Angeles,1568791390,Family Planning Providers,3637 S La Brea Ave,,Los Angeles,CA,90016-5311,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001261,T.H.E. Health and Wellness Centers,"THE Clinic, Inc.",1023287679,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3834 S Western Ave,,Los Angeles,CA,90062-1104,Los Angeles,714 W. Olympic Blvd.,Suite 1106,Los Angeles,CA,90015,Los Angeles,Clifford Shiepe,President and CEO,323-730-1920,3053,cshiepe@tohelpeveryone.org,Pat Johnson,Compliance Officer,323-730-1920,3073,pjohnson@tohelpeveryone.org,www.ToHelpEveryone.org
CA-001262,"Asian Pacific Health Care Venture, Inc.","ASIAN PACIFIC HEALTH CARE VENTURE, INC.",1003951708,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3939 Tracy St,APHCV - John Marshall High School Health Center,Los Angeles,CA,90027-3207,Los Angeles,4216 Fountain Ave,,Los Angeles,CA,90029-2256,Los Angeles,Lorali Delos Reyes,Executive Assistant,323-644-3880,485,LDelosreyes@aphcv.org,Nardo Beltran,CFO,323-644-3880,249,NBeltran@aphcv.org,http://www.aphcv.org/
CA-001263,AltaMed Medical and Dental Group - ELA/Boyle Heights,AltaMed Health Services Corporation,1255542601,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3945 Whittier Blvd,,Los Angeles,CA,90023-2440,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001264,S. Mark Taper Center,Planned Parenthood Los Angeles,1093969115,Family Planning Providers,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001265,St. John's Trade Tech Health Center,St. John's Well Child and Family Center,1649680588,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",400 W Washington Blvd,Bldg E0192,Los Angeles,CA,90015-4108,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001266,Orthopaedic Institute for Children Hemophilia Treatment Center,Orthopaedic Hospital dba Orthopaedic Institute for children,1689632374,Hemophilia Treatment Centers,403 W Adams Blvd,,Los Angeles,CA,90007-2664,Los Angeles,403 W. Adams Blvd,,Los Angeles,CA,90007,Los Angeles,"Doris Quon, MD",Medical Director Hemophilia Treatment Center,213-742-1402,,dquon@mednet.ucla.edu,Linda Osorio,Administrative Director Hemophilia Treatment Center,213-742-1133,,losorio@mednet.ucla.edu,http://ortho-htc.org
CA-001267,St. John's Mark Ridley-Thomas Wellness Center at Manual Arts,St. John's Well Child and Family Center,1396981700,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4085 S Vermont Ave,,Los Angeles,CA,90037-1942,Los Angeles,808 W 58th St.,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001268,South Central Family Health Center,South Central Family Health Center,1396891909,Federally Qualified Health Centers - Medical Services,4425 S Central Ave,,Los Angeles,CA,90011-3629,Los Angeles,4425 S. Central Avenue,,Los Angeles,CA,90011-3629,Los Angeles,Richard A. Veloz,Chief Executive Officer,323-908-4247,,Richardv@scfhc.org,Paul Ramos,Chief Financial Officer,323-908-4239,,Paulr@scfhc.org,www.scfhc.org
CA-001269,AltaMed @ CHLA,AltaMed Health Services Corporation,1629283197,Federally Qualified Health Centers - Medical Services,4650 W Sunset Blvd,,Los Angeles,CA,90027-6062,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,
CA-001270,Children's Hospital Los Angeles (children's inpatient hospital),CHILDREN'S HOSPITAL LOS ANGELES,1124073366,Children's Hospitals (inpatient only),4650 W Sunset Blvd,,Los Angeles,CA,90027-6062,Los Angeles,4650 W Sunset Blvd,,Los Angeles,CA,90027,Los Angeles,Denise Cavenah,"Director, Patient Business Services",323-361-2543,,dcavenah@chla.usc.edu,Guy Young,"Director, Hemostasis & Thrombosis Program",323-361-5507,,gyoung@chla.usc.edu,http://www.chla.org
CA-001271,Children's Hospital Los Angeles (multiple outpatient ECP categories),CHILDREN'S HOSPITAL LOS ANGELES,1124073366,"Dental Providers, Federally Qualified Health Centers - Medical Services, Hemophilia Treatment Centers, Ryan White Providers",4650 W Sunset Blvd,,Los Angeles,CA,90027-6062,Los Angeles,4650 W Sunset Blvd,,Los Angeles,CA,90027,Los Angeles,Denise Cavenah,"Director, Patient Business Services",323-361-2543,,dcavenah@chla.usc.edu,Guy Young,"Director, Hemostasis & Thrombosis Program",323-361-5507,,gyoung@chla.usc.edu,http://www.chla.org
CA-001272,Eagle Rock Location,Comprehensive Community Health Centers,1679553192,Federally Qualified Health Centers - Medical Services,5059 York Blvd,,Los Angeles,CA,90042-1713,Los Angeles,801 S Chevy Chase Dr,Suite 20,Glendale,CA,91205,Los Angeles,David Lontok,EVP,818-265-2221,,davidlo@cchccenters.org,,,,,,
CA-001273,East Los Angeles Health Center,Planned Parenthood Los Angeles,1720256647,Family Planning Providers,5068 Whittier Blvd,,Los Angeles,CA,90022-3128,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001274,Center for Community Health,JWCH Institute Inc,1407808058,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",522 S San Pedro St,,Los Angeles,CA,90013-2102,Los Angeles,5650 Jillson St.,,Commerce,CA,90040,Los Angeles,Al Ballesteros,Chief Executive Officer,323-201-4516,3009,aballesteros@jwchinstitute.org,Sergio Avina,Director of HIV Services,323-201-4516,3043,savina@jwchinstitute.org,www.jwchinstitute.org
CA-001275,AHF Healthcare Center - Bienstar East LA,AIDS Healthcare Foundation,1669856811,Other ECP Providers,5326 E Beverly Blvd,,Los Angeles,CA,90022-2104,Los Angeles,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001276,AltaMed Medical Group - ELA/Whittier,AltaMed Health Services Corporation,1255542601,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5427 Whittier Blvd,,Los Angeles,CA,90022-4101,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,
CA-001277,St. John's Louis C. Frayser Health Center,St. John's Well Child and Family Center,1013057371,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5701 S Hoover St,,Los Angeles,CA,90037-4045,Los Angeles,808 W 58th St.,,Los Angeles,CA,90037-4045,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001278,Hubert H. Humphrey Comprehensive Health Center,"Los Angeles County, Department of Health Services",1497761324,Family Planning Providers,5850 S Main St,,Los Angeles,CA,90003-1215,Los Angeles,5850 S. Main Street,,Los Angeles,CA,90003,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001279,Via Care Community Health Center,Via Care Community Health Center,1497001226,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",607 S Atlantic Blvd,,Los Angeles,CA,90022-3211,Los Angeles,607 S Atlantic Blvd,,Los Angeles,CA,90022-3211,Los Angeles,Deborah Villar,CEO,323-475-1535,,dvillar@viacarela.org,Joe Gotsill,CFO,323-268-9191,,jgotsill@viacarela.org,viacarela.org
CA-001280,St. John's Well Child and Family Center,St. John's Well Child and Family Center,1003068206,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6505 8th Ave,St. John's at Hyde Park Elementary School,Los Angeles,CA,90043-4313,Los Angeles,808 W 58th St.,,Los Angeles,CA,90037-4045,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001281,St. John's Kenneth Williams Health Center,St. John's Well Child and Family Center,1285874826,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",808 W 58th St,,Los Angeles,CA,90037-3632,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001282,West Hollywood Health Center,Planned Parenthood Los Angeles,1114322518,Family Planning Providers,825 N San Vicente Blvd,,Los Angeles,CA,90069-4505,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,
CA-001283,Dorothy Hecht Health Center,Planned Parenthood Los Angeles,1801985049,Family Planning Providers,8520 S Broadway,,Los Angeles,CA,90003-3335,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001284,Southern California Men's Medical Group,Anthony Mills MD Inc,1679683049,Ryan White Providers,9201 W Sunset Blvd,Suite 812,Los Angeles,CA,90069-3709,Los Angeles,9201 Sunset Blvd.,Suite 812,Los Angeles,CA,90069,Los Angeles,Anthony Mills MD,President/CEO,310-550-1010,2800,tony.mills@socalmenshealth.com,Christian Garcia,Administrator,310-550-1010,1800,christian.garcia@socalmenshealth.com,www.socalmenshealth.com
CA-001285,"APEX MEDICAL GROUP, INC","APEX MEDICAL GROUP, INC",1518089507,Rural Health Clinics,311 W I St,,Los Banos,CA,93635-3479,Merced,311 west I street,,Los Banos,CA,93635,Merced,Debbie Perry,Administrator,209-826-2222,249,debbiep@apexmedicalgroup.org,Karthikeya Devireddy,Medical director,209-489-9110,,karthikeyad@apexmedicalgroup.org,apexmedicalgroup.org
CA-001286,GVHC - LOS BANOS DENTAL,GOLDEN VALLEY HEALTH CENTERS,1508840562,Dental Providers,725 W I St,,Los Banos,CA,93635-3478,Merced,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001287,GVHC- LOS BANOS,GOLDEN VALLEY HEALTH CENTERS,1730163734,Federally Qualified Health Centers - Medical Services,821 Texas Ave,,Los Banos,CA,93635-3453,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001288,ADVENTIST HEALTH CLEAR LAKE MEDICAL OFFICE LOWER LAKE RHC,ADVENTIST HEALTH CLEAR LAKE,1841626587,"Dental Providers, Rural Health Clinics",9430 Lake St,Suite C,Lower Lake,CA,95457-8600,Lake,15630 18th Ave,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5621,,fuhrimgv@ah.org,Angelique Cole,Practice Administrator,707-995-4520,,ColeAV@AH.org,https://www.adventisthealth.org/clear-lake
CA-012377,ADVENTIST HEALTH CLEARLAKE MEDICAL OFFICE LUCERN RHC,ADVENTIST HEALTH CLEAR LAKE,1093274508,Rural Health Clinics,6300 E Hwy 20,,Lucerne,CA,95458,Lake,15630 18th Ave,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5798,,fuhrimgv@ah.org,Jennifer Fredrickson,Practice Manager,707-995-5628,,fredrijl@ah.org,https://www.adventisthealth.org/clear-lake
CA-001289,St. John's Leavey Health Center,St. John's Well Child and Family Center,1063836526,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3628 E Imperial Hwy,Suite 300,Lynwood,CA,90262-2646,Los Angeles,808 W. 58th Street,,Los Angeles,CA,90037,Los Angeles,James Mangia,President & CEO,323-541-1600,4000,jimmangia@wellchild.org,Maria Genie,Executive Assistant,323-541-1600,4001,mgenie@wellchild.org,www.wellchild.org
CA-001290,ADVENTIST HEALTH MEDICAL OFFICE MADERA RANCHOS RHC,ADVENTIST HEALTH REEDLEY,1720459514,Rural Health Clinics,11976 Road 37,,Madera,CA,93636-8612,Madera,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Veronica Guzman,Site Manager,559-645-4191,,guzmanv01@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001291,Family Health Services,Madera Community Hospital,1174503114,Rural Health Clinics,1210 E Almond Ave,,Madera,CA,93637-5606,Madera,1250 E Almond Ave,,Madera,CA,93637,Madera,Karen Paolinelli,Cheif operations Officer,559-675-5597,,kpaolinelli@maderahospital.org,Mark Foote,CFO,559-675-5505,,mfoote@maderahospital.org,maderahospital.org
CA-001292,MADERA COMMUNITY HOSPITAL,Madera Community Hospital,1669673646,Inpatient Hospitals (other than children's hospitals),1250 E Almond Ave,,Madera,CA,93637-5696,Madera,1250 E Almond Ave,,Madera,CA,93637,Madera,Karen Paolinelli,Cheif Operations Officer,559-675-5597,,kpaolinelli@maderahospital.org,Mark Foote,CFO,559-675-5505,,mfoote@maderahospital.org,maderahospital.org
CA-001293,Madera Clinic,PLANNED PARENTHOOD MAR MONTE,1003860446,"Family Planning Providers, Sexually Transmitted Disease Clinics",500 E Almond Ave,Suite 1,Madera,CA,93637-5600,Madera,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001294,VALLEY CHILDREN'S HOSPITAL (children's inpatient hospital),Valley Children's Hospital,1952312043,Children's Hospitals (inpatient only),9300 Valley Childrens Pl,,Madera,CA,93636-8762,Madera,9300 Valley Childrens Pl,,Madera,CA,93636-8761,Madera,Brian Smullin,Vice President Managed Care,559-353-8879,,bsmullin@valleychildrens.org,Michele Waldron,CFO and Senior Vice President,559-353-7090,,MWaldron@valleychildrens.org,www.valleychildrens.org
CA-001295,VALLEY CHILDREN'S HOSPITAL (multiple outpatient ECP categories),Valley Children's Hospital,1952312043,"Hemophilia Treatment Centers, Outpatient Hospital Clinics, Rural Health Clinics",9300 Valley Childrens Pl,,Madera,CA,93636-8762,Madera,9300 Valley Childrens Pl,,Madera,CA,93636-8761,Madera,Brian Smullin,Vice President Managed Care,559-353-8879,,bsmullin@valleychildrens.org,Michele Waldron,CFO and Senior Vice President,559-353-7090,,MWaldron@valleychildrens.org,www.valleychildrens.org
CA-001296,"Community Medical Centers, Manteca","COMMUNITY MEDICAL CENTERS, INC.",1710211214,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",200 Cottage Ave,Suite 103,Manteca,CA,95336-4935,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001297,Manteca Health Center,Planned Parenthood Mar Monte,1487607222,"Family Planning Providers, Sexually Transmitted Disease Clinics",965 E Yosemite Ave,Suite 2,Manteca,CA,95336-5943,San Joaquin,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001298,Marin City Health and Wellness Center,Marin City Health and Wellness Center,1285804948,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",630 Drake Ave,,Marin City,CA,94965-1107,Marin,630 Drake Avenue,,Marin City,CA,94965-1107,Marin,JayVon Muhammad,Chief Executive Officer,415-339-8813,,jayvon@marincityclinic.org,Martina Devine,Billing Lead,415-579-0074,,martina@marincityclinic.org,www.MarinCityClinic.org
CA-001299,Monterey County Clinic at Marina,County of Monterey,1588617955,Federally Qualified Health Centers - Medical Services,3155 De Forest Rd,,Marina,CA,93933-2702,Monterey,1615 Bunker Hill Way STE 100,,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001300,John C Fremont Healthcare District RHC II,John C Fremont Healthcare District,1043433568,"Outpatient Hospital Clinics, Rural Health Clinics, Ryan White Providers",5186 Hospital Rd,,Mariposa,CA,95338-9524,Mariposa,5189 Hospital Road,,Mariposa,CA,95338,Mariposa,Kym Brownell,Exec Asst to CEO,209-966-3631,271,jcfadm@jcf-hospital.com,Theresa Loya,Chief Nursing Officer,209-966-3631,290,theresa.loya@jcf-hospital.com,www.jcf-hospital.com
CA-001301,John C Fremont Healthcare District,John C Fremont Healthcare District,1184662652,Inpatient Hospitals (other than children's hospitals),5189 Hospital Rd,,Mariposa,CA,95338-9524,Mariposa,5189 Hospital Road,,Mariposa,CA,95338,Mariposa,Kym Brownell,Exec Asst to CEO,209-966-3631,271,jcfadm@jcf-hospital.com,Theresa Loya,Chief Nursing Officer,209-966-3631,290,theresa.loya@jcf-hospital.com,www.jcf-hospital.com
CA-001302,John C Fremont Healthcare District RHC I,John C Fremont Healthcare District,1134342652,"Outpatient Hospital Clinics, Rural Health Clinics",5189 Hospital Rd,,Mariposa,CA,95338-9524,Mariposa,5189 Hospital Road,,Mariposa,CA,95338,Mariposa,Kym Brownell,Exec Asst to CEO,209-966-3631,271,jcfadm@jcf-hospital.com,Theresa Loya,Chief Nursing Officer,209-966-3631,290,theresa.loya@jcf-hospital.com,www.jcf-hospital.com
CA-001303,"Mariposa Indian Health Center - M.A.C.T. Health Board, Inc.","M.A.C.T. Health Board, Inc.",1740272731,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5192 Hospital Rd,,Mariposa,CA,95338-9524,Mariposa,52 S Main St,,Angels Camp,CA,95221,Calaveras,John Alexander,Executive Director,209-754-6262,,john.alexander@macthealth.org,Mariela Contreras,Finance Director,209-754-6262,,mariela.contreras@macthealth.org,www.macthealth.org
CA-001304,Horisons Unlimited Mariposa,Horisons Unlimited,1477893915,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5320 State Highway 49 N,,Mariposa,CA,95338-9588,Mariposa,1208 Paseo Verde Dr,,Merced,CA,95348,Merced,Sandy Haar,ceo,209-201-2099,,sandy.haar@gmail.com,,,,,,huhc.org
CA-001305,McFarland Community Health Center,Clinica Sierra Vista,1003818444,Federally Qualified Health Centers - Medical Services,217 W Kern Ave,,Mc Farland,CA,93250-1360,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001306,"McFarland Singh Medical Clinic, Inc","McFarland Singh Medical Clinic, Inc",1497052278,Rural Health Clinics,733 3rd St,,Mc Farland,CA,93250-1008,Kern,733 3rd Street,,McFarland,CA,93250,Kern,Balmeet Singh,Ast Admin,661-717-8383,,admin@singhmeds.com,Taran K Singh,Administrator,661-792-3097,,admin@singhmeds.com,
CA-001307,EUREKA PEDIATRICS MCKINLEYVILLE CLINIC,Eureka Pediatrics,1669775730,Rural Health Clinics,2192 Central Ave,Suite A,McKinleyville,CA,95519-3610,Humboldt,2800 Harris St,,Eureka,CA,95503,Humboldt,Elesha Hernnandez,Office Manager,707-445-8416,,ekapedselesha@gmail.com,Emily Dalton,MD/Partner,707-445-8416,,eurekapedsemily@gmail.com,www.eurekapeds.com
CA-001308,Neighborhood Healthcare ~ Menifee Valley,NEIGHBORHOOD HEALTHCARE,1841617958,Federally Qualified Health Centers - Medical Services,26926 Cherry Hills Blvd,Suite B,Menifee,CA,92586-2500,Riverside,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001309,GVHC - NORTH MERCED,GOLDEN VALLEY HEALTH CENTERS,1487639027,Federally Qualified Health Centers - Medical Services,127 W El Portal Dr,Suite B,Merced,CA,95348-2854,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001310,Merced Health Center,Planned Parenthood Mar Monte,1598719189,"Family Planning Providers, Sexually Transmitted Disease Clinics",3166 Collins Dr,,Merced,CA,95348-3132,Merced,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001311,GVHC - O'BANION,GOLDEN VALLEY HEALTH CENTERS,1114901121,Federally Qualified Health Centers - Medical Services,401 Lesher Dr,,Merced,CA,95341-6572,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001312,GVHC - Merced Dental,GOLDEN VALLEY HEALTH CENTERS,1255339644,Dental Providers,747 W Childs Ave,,Merced,CA,95341-6805,Merced,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001313,GVHC - MERCED WOMEN'S CLINIC,GOLDEN VALLEY HEALTH CENTERS,1528042512,Federally Qualified Health Centers - Medical Services,797 W Childs Ave,,Merced,CA,95341-6805,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Mono,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001314,GVHC - Merced Suites,GOLDEN VALLEY HEALTH CENTERS,1255339644,Federally Qualified Health Centers - Medical Services,847 W Childs Ave,,Merced,CA,95341-6862,Merced,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001315,Horisons Unlimited Merced,Horisons Unlimited,1174890511,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",936 W Main St,,Merced,CA,95340-4519,Merced,1208 Paseo Verde Drive,,Merced,CA,95348,Merced,Sandy Haar,CEO,209-201-2099,,sandy.haar@gmail.com,,,,,,www.huhc.org
CA-001316,ADVENTIST HEALTH CLEAR LAKE MEDICAL OFFICE MIDDLETOWN RHC,ADVENTIST HEALTH CLEAR LAKE,1972593788,Rural Health Clinics,21337 Bush St,PO Box 1519,Middletown,CA,95461-1519,Lake,15630 18th Ave,,Clearlake,CA,95422,Lake,Garin Fuhriman,Administrative Director,707-995-5621,,fuhrimgv@ah.org,Jennifer Fredrickson,Practice Administrator,707-995-5628,,fredrijl@ah.org,https://www.adventisthealth.org/clear-lake
CA-001317,Mission Viejo Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1235108713,"Family Planning Providers, Sexually Transmitted Disease Clinics",26137 La Paz Rd,Suite 200,Mission Viejo,CA,92691-5321,Orange,700 S Tustin St,,Orange,CA,92866-3425,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-001318,GVHC - WEST MODESTO,GOLDEN VALLEY HEALTH CENTERS,1346224417,Federally Qualified Health Centers - Medical Services,1114 6th St,,Modesto,CA,95354-2203,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001319,GVHC- Modesto Robertson Road Dental,GOLDEN VALLEY HEALTH CENTERS,1205810389,Dental Providers,1121 Hammond St,,Modesto,CA,95351-3509,Stanislaus,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001320,GVHC - ROBERTSON ROAD,GOLDEN VALLEY HEALTH CENTERS,1205810389,Federally Qualified Health Centers - Medical Services,1121 Hammond St,,Modesto,CA,95351-3509,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001321,GVHC - MODESTO CORNER OF HOPE,GOLDEN VALLEY HEALTH CENTERS,1295719813,Federally Qualified Health Centers - Medical Services,1130 6th St,,Modesto,CA,95354-2203,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001322,Modesto Health Center,PLANNED PARENTHOOD MAR MONTE,1154375624,"Family Planning Providers, Sexually Transmitted Disease Clinics",1431 McHenry Ave,Suite 100,Modesto,CA,95350-4534,Stanislaus,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001323,GVHC - Modesto Womens,GOLDEN VALLEY HEALTH CENTERS,1518298306,Federally Qualified Health Centers - Medical Services,1500 Florida Ave,,Modesto,CA,95350-4408,Stanislaus,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001324,GHVC - MODESTO FLORIDA SUITES,GOLDEN VALLEY HEALTH CENTERS,1033193610,Federally Qualified Health Centers - Medical Services,1510 Florida Ave,Suite B,Modesto,CA,95350-4437,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001325,GVHC-Florida North,GOLDEN VALLEY HEALTH CENTERS,1518298306,Federally Qualified Health Centers - Medical Services,1540 Florida Ave,,Modesto,CA,95350-4430,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001326,GVHC - HANSHAW,GOLDEN VALLEY HEALTH CENTERS,1780668863,Federally Qualified Health Centers - Medical Services,1717 Las Vegas St,,Modesto,CA,95358-5500,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001327,GVHC - Hanshaw Dental,GOLDEN VALLEY HEALTH CENTERS,1780668863,Dental Providers,1717 Las Vegas St,,Modesto,CA,95358-5500,Stanislaus,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001328,GVHC - TENAYA,GOLDEN VALLEY HEALTH CENTERS,1962680421,Federally Qualified Health Centers - Medical Services,2101 Tenaya Dr,,Modesto,CA,95354-3930,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001329,ADVENTIST HEALTH TEHACHAPI VALLEY MOJAVE RHC,ADVENTIST HEALTH TEHACHAPI VALLEY,1508175431,Rural Health Clinics,2041 Belshaw St,,Mojave,CA,93501-1601,Kern,PO Box 1900,,Tehachapi,CA,93581-1900,Kern,Sarah Shelbourne,Clinic Manager,661-241-6700,,shelbosj@ah.org,Bonnie Quinonez,Director Operations,661-771-8604,,QuinonBD@AH.org,https://www.adventisthealth.org/tehachapivalley/
CA-001330,AltaMed Medical Group - Montebello,AltaMed Health Services Corporation,1457617755,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2321 W Whittier Blvd,,Montebello,CA,90640-3006,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001331,"Clinicas del Camino Real, Inc. Moorpark","Clinicas del Camino Real, Inc.",1841556404,"Dental Providers, Federally Qualified Health Centers - Medical Services",4279 Tierra Rejada Rd,,Moorpark,CA,93021-3775,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001332,Moreno Valley Clinic,Planned Parenthood of the Pacific Southwest,1033144027,"Family Planning Providers, Sexually Transmitted Disease Clinics",12900 Frederick St,Suite C,Moreno Valley,CA,92553-5266,Riverside,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001333,County of San Luis Obispo Public Health Department,County of San Luis Obispo,1518064948,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",760 Morro Bay Blvd,,Morro Bay,CA,93442-1918,San Luis Obispo,2191 Johnson Ave.,,San Luis Obispo,CA,93401-4534,San Luis Obispo,Penny Borenstein,Health Officer/Public Health Administrator,805-781-5519,,pborenstein@co.slo.ca.us,Jean White,Secretary I,805-781-5520,,jwhite@co.slo.ca.us,http://www.slocounty.ca.gov/health.htm
CA-001334,SHASTA FAMILY CARE,DEBORAH A HIGER,1902183098,Rural Health Clinics,725 Pine St,,Mount Shasta,CA,96067-2133,Siskiyou,725 Pine Street,,Ount Shasta,CA,96067-2133,Siskiyou,"Deborah Higer, MD",CEO,530-926-4308,,docdeb@snowcrest.net,,,,,,
CA-001335,SISKIYOU MEDICAL GROUP,SISKIYOU MEDICAL GROUP,1508903584,Rural Health Clinics,824 Pine St,,Mount Shasta,CA,96067-2137,Siskiyou,824 PINE ST,,MOUNT SHASTA,CA,96067,Siskiyou,Tere Birdwell,Practice Administrator,530-926-4528,,tbirdwell@siskiyoumedical.org,,,,,,
CA-001336,Mountain View Clinic,Planned Parenthood Mar Monte,1417900531,"Family Planning Providers, Sexually Transmitted Disease Clinics",225 San Antonio Rd,,Mountain View,CA,94040-1209,Santa Clara,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001337,Planned Parenthood Napa,Planned Parenthood Northern California,1972662039,"Family Planning Providers, Sexually Transmitted Disease Clinics",1735 Jefferson St,,Napa,CA,94559-1702,Napa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001338,National City Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1417409228,Federally Qualified Health Centers - Medical Services,1000 Euclid Ave,,National City,CA,91950-3856,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,4456,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,2561,marthao@fhcsd.org,www.fhcsd.org
CA-001339,NATIONAL CITY FAMILY CLINIC,San Ysidro Health Center,1003869363,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1136 D Ave,,National City,CA,91950-3412,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Claudia Islas,Clinic Services Manager,619-662-4100,,claudia.islas@syhc.org,,,,,,www.SYHC.org
CA-001340,"Operation Samahan, Inc.","Operation Samahan, Inc.",1205134517,Federally Qualified Health Centers - Medical Services,2101 Granger Ave,Granger School-based Health Clinic,National City,CA,91950-6208,San Diego,1428 Highland Avenue,,National City,CA,91950,San Diego,Fe Seligman,Grants Director,619-471-5433,,feseligman@operationsamahan.org,Dirk Zirbel,Interim CEO,310-699-0998,,dzirbel@operationsamahan.org,www.operationsamahan.org
CA-001341,La Maestra National City Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1508949645,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",217 Highland Ave,,National City,CA,91950-1518,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-280-4213,3019,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001342,Paradise Hills Family Clinic,San Ysidro Health Center,1598907487,Federally Qualified Health Centers - Medical Services,2400 E 8th St,Suite A,National City,CA,91950-2956,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Martha Favela,Clinic Services Manager,619-662-4100,,mfavela@syhc.org,,,,,,www.SYHC.org
CA-001343,Operation Samahan,"Operation Samahan, Inc.",1801907449,Federally Qualified Health Centers - Medical Services,2743 Highland Ave,,National City,CA,91950-7410,San Diego,1428 Highland Avenue,,National City,CA,91950,San Diego,Fe Seligman,Grants Director,619-471-5433,,feseligman@operationsamahan.org,Dirk Zirbel,Interim CEO,310-699-0998,,dzirbel@operationsamahan.org,www.operationsamahan.org
CA-001344,Operation Samahan Community Health Center,"Operation Samahan, Inc.",1275617169,"Dental Providers, Federally Qualified Health Centers - Medical Services",2835 Highland Ave,,National City,CA,91950-7404,San Diego,1428 Highland Avenue,,National City,CA,91950,San Diego,Fe Seligman,Grants Director,619-471-5433,,feseligman@operationsamahan.org,Dirk Zirbel,Interim CEO,310-699-0998,,dzirbel@operationsamahan.org,www.operationsamahan.org
CA-001345,Needles Health Center,San Bernardino Co. Dept. of Public Health,1558531707,Family Planning Providers,1406 Bailey Ave,Suite D,Needles,CA,92363-3115,San Bernardino,351 N Mtn View,,San Bernardino,CA,92415-0010,San Bernardino,Melanie Bird,Nurse Manager,909-383-3016,,Melanie.Bird@dph.sbcounty.gov,,,,,,http://www.sbcounty.gov/dph/publichealth/default.aspx
CA-001346,"Sierra Family Medical Clinic, Inc.","Sierra Family Medical Clinic, Inc.",1316169618,Federally Qualified Health Centers - Medical Services,15301 Tyler Foote Rd,,Nevada City,CA,95959-9318,Nevada,15301 Tyler Foote Rd.,,Nevada City,CA,95959,Nevada,Victoria Knoll,CFO,530-292-3478,230,vknoll@sierraclinic.org,Terry Strom,CEO,530-292-3478,207,tstrom@sierraclinic.org,www.sierraclinic.org
CA-001347,"Clinicas del Camino Real, Inc. Newbury Park","Clinicas del Camino Real, Inc.",1982820221,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 Newbury Rd,Suite 150,Newbury Park,CA,91320-6438,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001348,Horisons Unlimited Newman,Horisons Unlimited,1013301548,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1221 Main St,,Newman,CA,95360-1324,Stanislaus,1208 Paseo Verde Dr,,Merced,CA,95348,Merced,Sandy Haar,ceo,209-201-2099,,sandy.haar@gmail.com,,,,,,huhc.org
CA-001349,GVHC - Newman Dental,GOLDEN VALLEY HEALTH CENTERS,1689658668,Dental Providers,637 Merced St,,Newman,CA,95360-1070,Stanislaus,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001350,GVHC-NEWMAN SITE,GOLDEN VALLEY HEALTH CENTERS,1689658668,Federally Qualified Health Centers - Medical Services,637 Merced St,,Newman,CA,95360-1070,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001351,North Fork Indian & Community Health Center,"Central Valley Indian Health, Inc.",1932329091,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",32938 Road 222,Suite 2,North Fork,CA,93643-9562,Madera,2740 Herndon Ave,,Clovis,CA,93611-6813,Fresno,Chuck Fowler,Executive Director,559-299-2578,1115,cfowler@cvih.org,Julie Ramsey,Chief Operating Officer,559-299-2578,1117,jramsey@cvih.org,www.cvih.org
CA-001352,North Highland Health Center,Planned Parenthood Mar Monte,1184677163,"Family Planning Providers, Sexually Transmitted Disease Clinics",5700 Watt Ave,,North Highlands,CA,95660-4752,Sacramento,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3707,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001353,North Hollywood,Comprehensive Community Health Centers,1871573360,Federally Qualified Health Centers - Medical Services,12157 Victory Blvd,,North Hollywood,CA,91606-3204,Los Angeles,801 S Chevy Chase Dr,Suite 20,Glendale,CA,91205,Los Angeles,David Lontok,EVP,818-265-2221,,davidlo@cchccenters.org,,,,,,
CA-001354,VALLEY COMMUNITY HEALTHCARE,VALLEY COMMUNITY HEALTHCARE,1588740989,"Dental Providers, Federally Qualified Health Centers - Medical Services",6801 Coldwater Canyon Ave,Suite 1B,North Hollywood,CA,91605-5164,Los Angeles,6801 Coldwater Canyon Ave Ste 1B,,North Hollywood,CA,91605-5164,Los Angeles,Irina Pogosyan,Director of Human Resources,818-301-6370,,ipogosyan@vchcare.org,Tina Hovsepian,HR Assistant,818-301-6396,,thovsepian@vchcare.org,http://valleycommunityhealthcare.org/
CA-001355,HOMELESS HEALTH CARE PROJECT,NORTHEAST VALLEY HEALTH CORPORATION,1184625568,Federally Qualified Health Centers - Medical Services,7843 Lankershim Blvd,,North Hollywood,CA,91605-2523,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/programs-a-services/health-centers/special-programs-health-centers.html
CA-001356,Marin County Adult Day Health Center,LIFELONG MEDICAL CARE,1528194339,Other ECP Providers,1905 Novato Blvd,,Novato,CA,94947-2912,Marin,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001357,Pathway Healthcare,Pathway Healthcare,1982797239,Rural Health Clinics,190 S Oak Ave,Suite 2-1,Oakdale,CA,95361-3540,Stanislaus,"190 S Oak Ave., Bldg 2",Ste 1,Oakdale,CA,95361-3528,Stanislaus,Dayna Iverson Stoner,Chief Operating Manager,209-848-8410,,daynalive@gmail.com,Gregory Briscoe,,916-479-0883,,gbriscoe@gjbbs.net,
CA-001358,ADVENTIST HEALTH MEDICAL OFFICE OAKHURST RHC,ADVENTIST HEALTH REEDLEY,1205253374,"Dental Providers, Rural Health Clinics",48677 Victoria Ln,Suite 104,Oakhurst,CA,93644-9217,Madera,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Genna Parker,Site Manager,559-683-2711,,parkerga@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001359,ADVENTIST HEALTH MEDICAL OFFICE OAKHURST EAST RHC,ADVENTIST HEALTH REEDLEY,1730550526,Rural Health Clinics,49063 Rd 426,Suite C&D,Oakhurst,CA,93644,Madera,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Krystal Balestier,Site Manager,559-642-1500,,Balestkl@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001360,LMC - EAST OAKLAND CLINIC,LIFELONG MEDICAL CARE,1154327138,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",10700 MacArthur Blvd,,Oakland,CA,94605-5298,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001361,AIDS Project of the East Bay,AIDS Project of the East Bay,1881795896,"Ryan White Providers, Sexually Transmitted Disease Clinics",1320 Webster St,,Oakland,CA,94612-3204,Alameda,1320 Webster Street,,Oakland,CA,94612,Alameda,Robert Newells,Executive Director,510-663-7979,150,rnewells@apeb.org,Jillian Young,Finance & Administration Manager,510-663-7979,,jyoung@apeb.org,www.apeb.org
CA-001362,Alameda Health System (inpatient hospital),Alameda Health System,1083815872,Inpatient Hospitals (other than children's hospitals),1411 E 31st St,,Oakland,CA,94602-1018,Alameda,1411 East 31st Street,,Oakland,CA,94602,Alameda,Garvey Golden,"Manager, Grants & Special Projects",510-437-4056,44056,gagolden@alamedahealthsystem.org,Heather Macdonald-Fine,Health Services Manager,510-437-5086,45086,gagolden@alamedahealthsystem.org,
CA-001363,Alameda Health System (multiple outpatient ECP categories),Alameda Health System,1083815872,"Black Lung Clinics, Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Freestanding Cancer Centers, Hemophilia Treatment Centers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1411 E 31st St,,Oakland,CA,94602-1018,Alameda,1411 East 31st Street,,Oakland,CA,94602,Alameda,Garvey Golden,"Manager, Grants & Special Projects",510-437-4056,44056,gagolden@alamedahealthsystem.org,Heather Macdonald-Fine,Health Services Manager,510-437-5086,45086,gagolden@alamedahealthsystem.org,
CA-001364,West Oakland Health Center,Planned Parenthood Mar Monte,1861731523,Family Planning Providers,1682 7th St,,Oakland,CA,94607-1351,Alameda,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001365,Frank Kiang Medical Center,ASIAN HEALTH SERVICES,1003134545,Federally Qualified Health Centers - Medical Services,250 E 18th St,,Oakland,CA,94606-1729,Alameda,818 Webster St,,Oakland,CA,94607-4220,Alameda,Sherry Hirota,CEO,510-986-6837,,shirota@ahschc.org,Dong Suh,COO,510-986-6836,,dsuh@ahschc.org,www.asianhealthservices.org
CA-001366,Native American Health Center,"Native American Health Center, Inc.",1689863516,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Urban Indian Health Program",2950 International Blvd,,Oakland,CA,94601-2228,Alameda,3124 International Blvd.,,Oakland,CA,94601,Alameda,Esmeralda Tuttle,Credentialing & Licensing Associate,510-747-3038,,EsmeraldaT@nativehealth.org,Anola Small,"Director - Registration, Billing, Collections",510-434-5379,,AnolaS@nativehealth.org,www.nativehealth.org
CA-001367,ASIAN HEALTH SERV DENTAL CLINIC,ASIAN HEALTH SERVICES,1447391719,Dental Providers,345 9th St,Suite 302,Oakland,CA,94607-6523,Alameda,818 Webster Street,,Oakland,CA,94607,Alameda,Sherry Hirota,CEO,510-986-6837,,shirota@ahschc.org,Dong Suh,COO,510-986-6836,,dsuh@ahschc.org,www.asianhealthservices.org
CA-001368,AHF Healthcare Center - Oakland,AIDS Healthcare Foundation,1568446037,"Other ECP Providers, Ryan White Providers",400 30th St,Suite 300,Oakland,CA,94609-3318,Alameda,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,3234365025,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001369,Children's Hospital Oakland Claremont Clinic,UCSF Benioff Children's Hospital Oakland,1003961251,Federally Qualified Health Centers - Medical Services,5220 Claremont Ave,,Oakland,CA,94618-1033,Alameda,747 52nd Street,,Oakland,CA,94609-1809,Alameda,Doris Lopez,Interim FQHC Executive Director,510-428-3788,,PCRCDLo@mail.cho.org,"Kelley Meade, MD","Medical Director, FQHC Services",510-428-3885,2793,kmeade@mail.cho.org,
CA-001370,LifeLong Medical Care - Downtown Oakland Clinic,LIFELONG MEDICAL CARE,1568598829,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",616 16th St,,Oakland,CA,94612-1205,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001371,Children's Hospital Oakland (children's inpatient hospital),UCSF Benioff Children's Hospital Oakland,1003961251,Children's Hospitals (inpatient only),747 52nd St,,Oakland,CA,94609-1809,Alameda,747 52nd Street,,Oakland,CA,94609,Alameda,"Ann Margaret Petru, MD","Director, Pediatric HIV/AIDS Program",510-428-3337,,APetru@mail.CHO.org,Teresa Courville,"Clinic Coordinator, Pediatric HIV/AIDS Program",510-428-3885,2827,TCourville@mail.CHO.org,
CA-001372,Children's Hospital Oakland (ryan white providers),UCSF Benioff Children's Hospital Oakland,1003961251,Ryan White Providers,747 52nd St,,Oakland,CA,94609-1809,Alameda,747 52nd Street,,Oakland,CA,94609,Alameda,"Ann Margaret Petru, MD","Director, Pediatric HIV/AIDS Program",510-428-3337,,APetru@mail.CHO.org,Teresa Courville,"Clinic Coordinator, Pediatric HIV/AIDS Program",510-428-3885,2827,TCourville@mail.CHO.org,
CA-001373,Hemophilia Treatment Center - Oakland,UCSF Benioff Children's Hospital Oakland,1003961251,Hemophilia Treatment Centers,747 52nd St,,Oakland,CA,94609-1809,Alameda,747 52nd Street,,Oakland,CA,94609,Alameda,"Alison Matsunaga, MD","Director, Hemophilia Treatment Center",510-428-3286,,amatsunaga@mail.cho.org,Patrick D. Fleming Jr. Pharm.D.,Director of Pharmacy Services,510-428-3851,,pfleming@mail.cho.org,
CA-001374,Asian Health Services,ASIAN HEALTH SERVICES,1447391719,Federally Qualified Health Centers - Medical Services,818 Webster St,,Oakland,CA,94607-4220,Alameda,818 Webster St,,Oakland,CA,94607-4220,Alameda,Sherry Hirota,CEO,510-986-6837,,shirota@ahschc.org,Dong Suh,COO,510-986-6836,,dsuh@ahschc.org,www.asianhealthservices.org
CA-001375,Rolland & Kathryn Lowe Medical Center,ASIAN HEALTH SERVICES,1225179641,Federally Qualified Health Centers - Medical Services,835 Webster St,,Oakland,CA,94607-4219,Alameda,818 Webster St,,Oakland,CA,94607-4220,Alameda,Sherry Hirota,CEO,510-986-6837,,shirota@ahschc.org,Dong Suh,COO,510-986-6836,,dsuh@ahschc.org,www.asianhealthservices.org
CA-001376,Coliseum Clinic,PLANNED PARENTHOOD MAR MONTE,1225426588,Family Planning Providers,8480 Enterprise Way,,Oakland,CA,94621-1318,Alameda,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001377,LifeLong Medical Care - Howard J Daniel Clinic,LIFELONG MEDICAL CARE,1619145307,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",9933 MacArthur Blvd,,Oakland,CA,94605-4853,Alameda,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001378,Occidental Area Health Center,"West County Health Centers, Inc",1598768962,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3802 Main St,,Occidental,CA,95465-0100,Sonoma,14045 Mill St,,Guerneville,CA,954468303,Sonoma,Vikki Minnifield,Billing Manager,707-869-5977,3306,vminnifield@wchealth.org,,,,,,
CA-001379,"Clinicas del Camino Real, Inc. Ojai","Clinicas del Camino Real, Inc.",1316163736,Federally Qualified Health Centers - Medical Services,1200 Maricopa Hwy,,Ojai,CA,93023-3129,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001380,Ontario Health Center,San Bernardino Co. Dept. of Public Health,1588834451,Federally Qualified Health Centers - Medical Services,150 E Holt Blvd,,Ontario,CA,91761-1613,San Bernardino,351 N Mtn View,,San Bernardino,CA,91761-2107,San Bernardino,Winfred Kimani,Public Health Program Coordinator,760-956-4432,,wkimani@dph.sbcounty.gov,Melanie Bird,Nurse Manager,909-383-3016,,Melanie.Bird@dph.sbcounty.gov,http://www.sbcounty.gov/pubhlth/Default.aspx
CA-001381,"UNICARE COMMUNITY HEALTH CENTER, INC.","UNICARE COMMUNITY HEALTH CENTER, INC.",1710309513,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",437 N Euclid Ave,,Ontario,CA,91762-3456,San Bernardino,437 N. EUCLID AVE.,,ONTARIO,CA,91762,San Bernardino,Kelly Hong Vo,VICE PRESIDENT,909-988-2555,107,k.vo@unicarechc.org,ANA DIAZ,OFFICE MANAGER,909-988-2555,,a.diaz@unicarechc.org,unicarechc.org
CA-001382,Center for Inherited Blood Disorders (CIBD),The Center for Comprehensive Care & Diagnosis of Inherited Blood Disorders,1679875942,Hemophilia Treatment Centers,1010 W La Veta Ave,Suite 670,Orange,CA,92868-4306,Orange,2670 N. Main St. Suite 150,,Santa Ana,CA,92705,Orange,"Diane Nugent, MD",Medical Director,714-221-1200,,dnugent@c3dibd.org,Matthew Cianciulli,Director,714-586-5369,,mcianciulli@c3dibd.org,www.cibd-ca.org
CA-001383,CHOC CHILDREN'S HOSPITAL (children's inpatient hospital),CHILDREN'S HOSPITAL ORANGE COUNTY,1811080526,Children's Hospitals (inpatient only),1201 W La Veta Ave,,Orange,CA,92868-4203,Orange,1201 W LA VETA AVE,,Orange,CA,92868,Orange,JENA JENSEN,CHIEF GOVERNMENT RELATIONS OFFICER,714-509-4206,4206,jjensen@choc.org,PREMLA MALIK,DIRECTOR CONTRACTS MANAGEMENT,714-509-7914,7914,pmalik@choc.org,
CA-001384,CHOC CHILDREN'S HOSPITAL (outpatient hospital clinics),Children's Hospital,1811080526,Outpatient Hospital Clinics,1201 W La Veta Ave,,Orange,CA,92868-4203,Orange,1201 W LA VETA AVE,,Orange,CA,92868,Orange,JENA JENSEN,CHIEF GOVERNMENT RELATIONS OFFICER,714-509-4206,4206,jjensen@choc.org,PREMLA MALIK,DIRECTOR CONTRACTS MANAGEMENT,714-509-7914,7914,pmalik@choc.org,
CA-001385,La Amistad Health Center,St. Jude Neighborhood Health Centers,1821494535,"Dental Providers, Federally Qualified Health Centers - Medical Services",353 S Main St,,Orange,CA,92868-3833,Orange,731 S. Highland Ave,,Fullerton,CA,92832,Orange,Timothy Brown,Executive Director,714-446-5100,,timothy.brown@stjoe.org,,,,,,
CA-001386,Orange Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1912976408,"Family Planning Providers, Sexually Transmitted Disease Clinics",700 S Tustin St,,Orange,CA,92866-3425,Orange,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-001387,ADVENTIST HEALTH MEDICAL OFFICE ORANGE COVE RHC,ADVENTIST HEALTH REEDLEY,1235154006,Rural Health Clinics,1455 Park Blvd,,Orange Cove,CA,93646-9322,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Vicki Beard,Site Manager,559-626-0882,28845,Beardva01@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001388,Karuk Orleans Clinic,Karuk Tribe Health and Human Services,1386726032,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",325 Asip,PO Box 141,Orleans,CA,95556-0141,Humboldt,1519 South Oregon St.,,Yreka,CA,96097,Siskiyou,Kori Novak,CEO,530-842-9200,6125,knovak@karuk.us,Lessie Aubrey,Grants Manager,530-493-1600,2042,laubrey@karuk.us,www.karuk.us
CA-001389,Family HealthCare Network - Cutler / Orosi Health Center,FAMILY HEALTHCARE NETWORK,1912093451,"Dental Providers, Federally Qualified Health Centers - Medical Services",12586 Avenue 408,,Orosi,CA,93647-9454,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001390,ADVENTIST HEALTH MEDICAL OFFICE OROSI RHC,ADVENTIST HEALTH REEDLEY,1427497866,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",41696 Road 128,,Orosi,CA,93647-2059,Tulare,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Shane Jimenez,Site Manager,559-528-6966,,JimeneS1@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001391,Family Practice Associates,Oroville Hospital,1871697102,Rural Health Clinics,1611 Feather River Blvd,Suite 10,Oroville,CA,95965-4548,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001392,"Feather River Tribal Health, Inc","Feather River Tribal Health, Inc",1629130240,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",2145 5th Ave,,Oroville,CA,95965-5870,Butte,2145 5th Ave,,Oroville,CA,95965,Butte,Maria Hunzeker,Executive Director,530-534-5394,265,maria.hunzeker@frth.org,Erik C. Lyon,Deputy Director,530-534-5394,264,erik.lyon@frth.org,
CA-001393,Family Medicine Practice,Oroville Hospital,1740583095,Rural Health Clinics,2721 Olive Hwy,Suite 1/4/5/9,Oroville,CA,95966,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001394,Primary Care Practice,Oroville Hospital,1063750297,Rural Health Clinics,2721 Olive Hwy,Suite 10/12/12b,Oroville,CA,95966,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001395,MEDICAL CLINIC,Oroville Hospital,1679581557,Rural Health Clinics,2767 Olive Hwy,,Oroville,CA,95966-6118,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001396,Oroville Hospital,Oroville Hospital,1871606269,Inpatient Hospitals (other than children's hospitals),2767 Olive Hwy,,Oroville,CA,95966-6118,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001397,Oroville Family Practice,Oroville Hospital,1962506295,Rural Health Clinics,2809 Olive Hwy,"Suite 260, 350, 320",Oroville,CA,95966,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001398,Oroville Womens Health,Oroville Hospital,1538437355,Rural Health Clinics,2809 Olive Hwy,Suite 320,Oroville,CA,95966-6135,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001399,Pediatrics Associates,Oroville Hospital,1598869828,Rural Health Clinics,2809 Olive Hwy,Suite 330,Oroville,CA,95966-6135,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001400,Pediatrics Practice,Oroville Hospital,1215031554,Rural Health Clinics,2809 Olive Hwy,Suite 270,Oroville,CA,95966-6135,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8506,,akhanchandani@orohosp.com,
CA-001401,Premier Health Center,Oroville Hospital,1780788018,Rural Health Clinics,900 Oro Dam Blvd E,,Oroville,CA,95965-5832,Butte,2767 Olive Highway,,Oroville,CA,95966,Butte,Jo L. Dilbeck,Chief Reimbursement Officer,530-712-2102,,jdilbeck@orohosp.com,Ashok P. Khanchandani,VP of Finance,530-532-8509,,akhanchandani@orohosp.com,
CA-001402,"Clinicas del Camino Real, Inc. North Oxnard","Clinicas del Camino Real, Inc.",1093933194,"Dental Providers, Federally Qualified Health Centers - Medical Services",1200 N Ventura Rd,Suite E,Oxnard,CA,93030-3827,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001403,"Clinicas del Camino Real, Inc. El Rio","Clinicas del Camino Real, Inc.",1134369366,"Dental Providers, Federally Qualified Health Centers - Medical Services",221 E Ventura Blvd,Suite 126,Oxnard,CA,93036-0277,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001404,"Clinicas del Camino Real, Inc. Ocean View","Clinicas del Camino Real, Inc.",1427276278,"Dental Providers, Federally Qualified Health Centers - Medical Services",4400 Olds Rd,,Oxnard,CA,93033-8061,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001405,"Clinicas del Camino Real, Inc. Maravilla","Clinicas del Camino Real, Inc.",1518183904,Federally Qualified Health Centers - Medical Services,450 W Clara St,,Oxnard,CA,93033-8363,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001406,"Clinicas del Camino Real, Inc. Oxnard","Clinicas del Camino Real, Inc.",1396961884,"Dental Providers, Federally Qualified Health Centers - Medical Services",650 Meta St,,Oxnard,CA,93030-7182,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001407,MACLAY Health Center for Children,NORTHEAST VALLEY HEALTH CORPORATION,1053312587,Federally Qualified Health Centers - Medical Services,12540 Pierce St,,Pacoima,CA,91331-1701,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001408,PACOIMA HEALTH CENTER,NORTHEAST VALLEY HEALTH CORPORATION,1114928595,Federally Qualified Health Centers - Medical Services,12756 Van Nuys Blvd,,Pacoima,CA,91331-1696,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41650,KimWyard@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/
CA-001409,"Desert AIDS Project, Inc.","Desert AIDS Project, Inc.",1568439081,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1695 N Sunrise Way,,Palm Springs,CA,92262-3701,Riverside,P.O. Box 2890,,Palm Springs,CA,92263,Riverside,Brande K. Orr,CEO,760-992-0437,,borr@desertaidsproject.org,David J. Benjamin,CFO,760-656-8418,,benjamindavid@desertaidsproject.org,www.desertaidsproject.org
CA-001410,Antelope Valley Health Center,Planned Parenthood Los Angeles,1902109580,Family Planning Providers,533 E Palmdale Blvd,Suite A1,Palmdale,CA,93550-2375,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001411,LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD (children's inpatient hospital),Lucile Salter Packard Children's Hospital at Stanford,1467442749,Children's Hospitals (inpatient only),725 Welch Rd,,Palo Alto,CA,94304-1601,Santa Clara,Lucile Packard Children's Hospital Stanford,725 Welch Road,Palo Alto,CA,94304,Santa Clara,Sherri Sager,Chief Government and Community Relations Officer,650-497-8277,,SSager@stanfordchildrens.org,Shawn Tienken,Director Revenue Cycle Operations,650-498-5965,,STienken@stanfordchildrens.org,www.stanfordchildrens.org
CA-001412,LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD (hemophilia treatment centers),Lucile Salter Packard Children's Hospital at Stanford,1467442749,Hemophilia Treatment Centers,725 Welch Rd,,Palo Alto,CA,94304-1601,Santa Clara,Lucile Packard Children's Hospital,725 Welch Road,Palo Alto,CA,94304,Santa Clara,Sherri Sager,Chief Government and Community Relations Officer,650-497-8277,,SSager@stanfordchildrens.org,Shawn Tienken,Director Revenue Cycle Operations,650-498-5965,,STienken@stanfordchildrens.org,www.stanfordchildrens.org
CA-001413,"Center for Family Health and Education, Inc.","Center for Family Health and Education, Inc.",1871853481,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",8727 Van Nuys Blvd,,Panorama City,CA,91402-2451,Los Angeles,8727 Van Nuys Boulevard,,Panorama City,CA,91402,Los Angeles,Daryoush Kashani,CEO,818-899-5555,110,dkashani@cffhae.org,Daryoush Kashani,CEO,818-899-5555,110,dkashani@cffhae.org,www.cffhae.org
CA-001414,ADVENTIST HEALTH + RIDEOUT PARADISE SKYWAY RHC,ADVENTIST HEALTH + RIDEOUT,1912092792,"Dental Providers, Rural Health Clinics",5125 Skyway,,Paradise,CA,95969-5624,Butte,726 4th Street,,Marysville,CA,95901,Yuba,Tim Williams,Administrative Director,530-876-2509,207,williate01@ah.org,Jamie Gagon,Practice Manager,530-877-9361,,gagonjc@ah.org,www.adventisthealth.org/feather-river
CA-001415,ADVENTIST HEALTH FEATHER RIVER RHC,ADVENTIST HEALTH FEATHER RIVER,1952402844,"Other ECP Providers, Rural Health Clinics",5730 Canyon View Dr,,Paradise,CA,95969-5534,Butte,5974 Pentz Rd,,Paradise,CA,95969-5509,Butte,Carlie Adams,Practice Manager,530-876-3168,,AdamsCR@AH.org,Jamie Gagon,Lead Medical Assistant Operations,530-877-9361,7010,GagonJC@AH.org,www.adventisthealth.org/feather-river
CA-001416,ADVENTIST HEALTH FEATHER RIVER CANYON VIEW RHC,ADVENTIST HEALTH FEATHER RIVER,1700972676,"Dental Providers, Other ECP Providers, Rural Health Clinics",5734 Canyon View Dr,,Paradise,CA,95969-5503,Butte,5974 Pentz Rd,,Paradise,CA,95969-5509,Butte,Carlie Adams,Practice Manager,530-876-3168,,AdamsCR@AH.org,Jamie Gagon,Lead Medical Assistant Operations,530-877-9361,7010,GagonJC@AH.org,www.adventisthealth.org/feather-river
CA-001417,FEATHER RIVER HOSPITAL,Feather River Hospital,1518940667,Inpatient Hospitals (other than children's hospitals),5974 Pentz Rd,,Paradise,CA,95969-5593,Butte,5974 Pentz Rd,,Paradise,CA,95969-5509,Butte,Shirley Young,Director Patient Financial Services,530-876-7911,,youngsm@ah.org,,,,,,www.adventisthealth.org/feather-river/pages/default.aspx
CA-001418,ADVENTIST HEALTH MEDICAL OFFICE PARLIER RHC,ADVENTIST HEALTH REEDLEY,1417972282,Rural Health Clinics,155 S Newmark Ave,,Parlier,CA,93648-2531,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Mirella Mendoza,Site Manager,559-646-1200,,mendozam2@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001419,Pasadena Health Center,"Planned Parenthood Pasadena and San Gabriel Valley, Inc",1073669040,Family Planning Providers,1045 N Lake Ave,,Pasadena,CA,91104-4521,Los Angeles,2333 Lake Ave.,2nd Floor,Altadena,CA,91001,Los Angeles,Bethany Eshleman,C.O.O.,626-794-5737,107,beshleman@pppsgv.org,Cheri Pogue,Sr. Director of Patient Services,626-794-5737,168,cpogue@pppsgv.org,http://www.plannedparenthood.org/pppsgv
CA-001420,ChapCare Lake,Community Health Alliance of Pasadena,1063748242,Federally Qualified Health Centers - Medical Services,1800 N Lake Ave,,Pasadena,CA,91104-1228,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1222,1222,Sbautista@chapcare.org,Margaret B. Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001421,Adrew Escajeda & Michael Antonovich Clinic,Wesley Health Clinics/JWCH Institute,1407808058,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Freestanding Cancer Centers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1845 N Fair Oaks Ave,,Pasadena,CA,91103-1620,Los Angeles,5650 Jillson Street,,Commerce,CA,90040,Los Angeles,Al Ballesteros,Chief Executive Officer,323-201-4516,3009,aballesteros@jwchinstitute.org,Sergio Avina,Division Director,323-201-4516,3043,savina@jwchinstitute.org,http://jwchinstitute.org/
CA-001422,ChapCare Fair Oaks,Community Health Alliance of Pasadena,1871689315,"Dental Providers, Federally Qualified Health Centers - Medical Services",1855 N Fair Oaks Ave,,Pasadena,CA,91103-1620,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1227,1227,Sbautista@chapcare.org,Margaret B. Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001423,ChapCare Lincoln,Community Health Alliance of Pasadena,1366856098,"Dental Providers, Federally Qualified Health Centers - Medical Services",2055 Lincoln Ave,,Pasadena,CA,91103-1324,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1222,1222,Sbautista@chapcare.org,Margaret B. Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001424,ChapCare Del Mar,Community Health Alliance of Pasadena,1720395874,Federally Qualified Health Centers - Medical Services,3160 E Del Mar Blvd,Suite 100,Pasadena,CA,91107-4649,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1227,1227,Sbautista@chapcare.org,Margaret B. Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001425,County of San Luis Obispo Public Health Department,County of San Luis Obispo,1518064948,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",723 Walnut Dr,,Paso Robles,CA,93446-2315,San Luis Obispo,2191 Johnson Ave.,,San Luis Obispo,CA,93401-4534,San Luis Obispo,Penny Borenstein,Health Officer/ Public Health Administrator,805-781-5519,,pborenstein@co.slo.ca.us,Jean White,Secretary I,805-781-5520,,jwhite@co.slo.ca.us,http://www.slocounty.ca.gov/health.htm
CA-001426,Wahid Medical Corporation,Wahid Medical Corp,1679767925,Rural Health Clinics,1108 Ward Ave,Bldg A Set 1,Patterson,CA,95363-8529,Stanislaus,1108 ward avenue,Bldg A ste 1,Patterson,CA,95363,Stanislaus,Ali Abdul Wahid,Md,209-892-1300,,Wahid@wahidmedical.com,,,,,,
CA-001427,Del Puerto Health Center,Del Puerto Health Care District,1063430916,Rural Health Clinics,1700 Keystone Pacific Pkwy Unit B,,Patterson,CA,95363-8874,Stanislaus,PO Box 187,,Patterson,CA,95363,Stanislaus,Yumi Edwards,District Office Manager,209-892-8781,,yumi.edwards@dphealth.org,Suzie Talamantes,RHC Office Manager,209-892-9100,,suzie.talamantes@dphealth.org,
CA-001428,GVHC - PATTERSON,GOLDEN VALLEY HEALTH CENTERS,1922082007,Federally Qualified Health Centers - Medical Services,200 C St,,Patterson,CA,95363-2701,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001429,GVHC - Patterson Dental,GOLDEN VALLEY HEALTH CENTERS,1922082007,Dental Providers,200 C St,,Patterson,CA,95363-2701,Stanislaus,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001430,Horisons Unlimited Patterson,Horisons Unlimited,1104218171,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",55 N Salado Ave,,Patterson,CA,95363-2522,Stanislaus,1208 Paseo Verde Dr,,Merced,CA,95348,Merced,Sandy Haar,ceo,209-201-2099,,sandy.haar@gmail.com,,,,,,huhc.org
CA-001431,Neighborhood Healthcare - Pauma Valley,Neighborhood Healthcare,1407031693,"Dental Providers, Federally Qualified Health Centers - Medical Services",16650 Highway 76,,Pauma Valley,CA,92061-9524,San Diego,425 N. Date Street,,Escondido,CA,92061-9524,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,http://www.nhcare.org/
CA-001432,Petaluma Health Center,"Petaluma Health Center, Inc",1588656268,"Dental Providers, Federally Qualified Health Centers - Medical Services",1179 N McDowell Blvd,,Petaluma,CA,94954-6559,Sonoma,1179 N McDowell Blvd,,Petaluma,CA,94954,Sonoma,Pedro Toledo,Chief Administrative Officer,707-326-7551,,pedrot@phealthcenter.org,Pedro Toledo,Chief Administrative Officer,707-326-7551,,Pedrot@phealthcenter.org,
CA-001433,AltaMed Medical Group - Pico Rivera Passons,AltaMed Health Services Corporation,1356775878,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6336 Passons Blvd,,Pico Rivera,CA,90660-3355,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001434,AltaMed Medical Group - Pico Rivera,AltaMed Health Services Corporation,1710191283,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",9436 Slauson Ave,,Pico Rivera,CA,90660-4748,Los Angeles,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001435,PIXLEY MEDICAL CLINIC,PIXLEY MEDICAL CLINIC,1578577490,Rural Health Clinics,205 E Davis,,Pixley,CA,93256,Tulare,205 E DAVIS,,PIXLEY,CA,93256,Tulare,Linda Roberts RN,CEO/OWNER,559-752-4147,,iarroyo@tiptonmedicalclinic.com,,,,,,
CA-001436,El Dorado Community Health Center,El Dorado County Community Health Center,1073981783,"Dental Providers, Federally Qualified Health Centers - Medical Services",4327 Golden Center Dr,,Placerville,CA,95667-6287,El Dorado,4340 Golden Center Drive,,Placerville,CA,95667,El Dorado,Terri Stratton,CEO,530-748-3105,,tstratton@edcchc.org,Judy Stein,CFO,530-350-8201,,jstein@edcchc.org,www.edcchc.org
CA-001437,GVHC - PLANADA,GOLDEN VALLEY HEALTH CENTERS,1235114745,Federally Qualified Health Centers - Medical Services,9235 W Broadway Ave,,Planada,CA,95365-8088,Merced,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001438,GVHC - Planada Dental,GOLDEN VALLEY HEALTH CENTERS,1235114745,Dental Providers,9235 W. Broadway Ave,,Planada,CA,95365,Merced,737 W Childs Ave,,Merced,CA,95341,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001439,Axis Community Health,Axis Community Health,1669403390,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4361 Railroad Ave,,Pleasanton,CA,94566-6611,Alameda,4361 Railroad Ave,,Pleasanton,CA,94566,Alameda,Sue Compton,Chief Executive Officer,925-201-6005,,scompton@axishealth.org,Alicia Pimentel,Contract Manager,925-201-6035,,apimentel@axishealth.org,
CA-001440,Plymouth Health Center,Sutter Medical Foundation,1801907308,Rural Health Clinics,9279 Locust St,,Plymouth,CA,95669,Amador,"2800 L. Street, 7th Floor",,Sacramento,CA,95816,Sacramento,April Abreu,Site Supervisor,209-304-8394,,abreua@sutterhealth.org,,,,,,
CA-001441,RCMS-Point Arena Dental,"Redwood Coast Medical Services, Inc.",1366688418,Dental Providers,175 Main St,PO Box 629,Point Arena,CA,95468-0629,Mendocino,46900 Ocean Drive,P.O. Box 1100,Gualala,CA,95445,Mendocino,Deborah Lane,Resource Development,707-884-4005,107,dlane@rcms-healthcare.org,Diane Agee,CEO,707-884-4046,,ceo@rcms-healthcare.org,
CA-001442,RCMS- Point Arena Medical,"Redwood Coast Medical Services, Inc.",1275778847,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",30 Mill St,PO Box 629,Point Arena,CA,95468-0629,Mendocino,46900 Ocean Drive,P.O. Box 1100,Gualala,CA,95445,Mendocino,Deborah Lane,Resource Development,707-884-4005,107,dlane@rcms-healthcare.org,Diane Agee,CEO,707-884-4046,,ceo@rcms-healthcare.org,
CA-001443,"UNICARE COMMUNITY HEALTH CENTER, INC.","UNICARE COMMUNITY HEALTH CENTER, INC.",1356763155,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1501 E Holt Ave,Suite A,Pomona,CA,91767-5823,Los Angeles,437 N. EUCLID AVE.,,ONTARIO,CA,91762,Los Angeles,Kelly Hong Vo,VICE PRESEDENT,909-623-3600,,k.vo@unicarechc.org,DAISY DEDIOS,OFFICE MANAGER,909-623-3600,,d.dedios@unicarechc.org,unicarechc.org
CA-001444,Pomona Health Center,Planned Parenthood Los Angeles,1710076997,Family Planning Providers,1550 N Garey Ave,,Pomona,CA,91767-3826,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001445,"East Valley Community Health Center, Inc. - Pomona Health Center","East Valley Community Health Center, Inc.",1649324443,Federally Qualified Health Centers - Medical Services,1555 S Garey Ave,,Pomona,CA,91766-5222,Los Angeles,420 S Glendora Ave,,West Covina,CA,91790-3001,Los Angeles,Alicia Mardini,Chief Executive Officer,626-919-4333,2220,amardini@evchc.org,Lelenia Navarro,Director of Operations,909-620-8088,3407,lnavarro@evchc.org,www.evchc.org
CA-001446,Family HealthCare Network - Porterville Health Center,FAMILY HEALTHCARE NETWORK,1083611156,Federally Qualified Health Centers - Medical Services,1107 W Poplar Ave,,Porterville,CA,93257-5839,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001447,Family HealthCare Network - Porterville Dental Center,FAMILY HEALTHCARE NETWORK,1558554519,Dental Providers,1133 W Poplar Ave,,Porterville,CA,93257-5839,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001448,Tule River Indian Health Clinic,"Tule River Indian Health Center, Inc.",1972586972,"Dental Providers, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",380 N Reservation Rd,,Porterville,CA,93257-9673,Tulare,380 N Reservation Rd,,Porterville,CA,93257-9673,Tulare,Zahid Shiekh,CHIEF EXECUTIVE OFFICER,559-784-2316,223,ZAHID.SHEIKH@CRIHB.ORG,FEDERICO HUERTA,DIRECTOR OF NURSES,559-784-2316,323,FEDERICO.HUERTA@CRIHB.ORG,
CA-001449,SEQUOIA FAMILY MEDICAL CENTER,SEQUOIA FAMILY MEDICAL CENTER,1528016987,Rural Health Clinics,590 W Putnam Ave,,Porterville,CA,93257-3257,Tulare,590 W Putnam Suite 2,,Porterville,CA,93257,Tulare,John Angell,CFO,559-781-4100,1060,john.angell@seqfam.com,John Angell,CFO,559-306-1352,,,
CA-001450,Eastern Plumas Health Care,Eastern Plumas Health Care,1982600920,"Dental Providers, Rural Health Clinics",480 1st Ave,,Portola,CA,96122-9405,Plumas,500 First Avenue,,Portola,CA,96122,Plumas,Alanna Collier-Wilson,Administrative Assistant,530-832-6564,,alanna.wilson@ephc.org,Jeri Nelson,CFO,530-832-6578,,jnelson@ephc.org,
CA-001451,Eastern Plumas Health Care,Eastern Plumas Health Care,1982600920,Inpatient Hospitals (other than children's hospitals),500 1st Ave,,Portola,CA,96122-9406,Plumas,500 First Avenue,,Portola,CA,96122,Plumas,Jeri Nelson,Chief Financial Officer,530-832-6578,,jnelson@ephc.org,,,,,,www.ephc.org
CA-001452,"Central Valley Indian Health, Prather Clinic","Central Valley Indian Health, Inc.",1902025059,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",29369 Auberry Rd,Suite 102,Prather,CA,93651-9784,Fresno,2740 Herndon Ave,,Clovis,CA,93611-6813,Fresno,Charles Fowler,Executive Director,559-299-2578,1115,cfowler@cvih.org,Julie Ramsey,Chief Operating Officer,559-299-2578,1117,jramsey@cvih.org,www.cvih.org
CA-001453,PLUMAS DISTRICT HOSPITAL,Plumas District Hospital,1326094269,Inpatient Hospitals (other than children's hospitals),1065 Bucks Lake Rd,,Quincy,CA,95971-9599,Plumas,1065 Bucks Lake Road,,Quincy,CA,95971,Plumas,Andy Werking,Insurance Contracting Specialist,916-366-5763,,awerking@sbcglobal.net,Caleb Johnson,Chief Financial Officer,530-283-2121,7952,cjohnson@pdh.org,
CA-001454,PLUMAS RURAL HEALTH CENTERS,Plumas Rural Health Center,1043348543,"Dental Providers, Rural Health Clinics, Ryan White Providers",1065 Bucks Lake Rd,,Quincy,CA,95971-9507,Plumas,1065 Bucks Lake Road,,Quincy,CA,95971,Plumas,Andy Werking,Insurance Contracting Specialist,916-366-5763,,awerking@sbcglobal.net,Caleb Johnson,Chief Financial Officer,530-283-2121,7952,cjohnson@pdh.org,
CA-001455,AHF Healthcare Center - Upland,AIDS Healthcare Foundation,1447233358,"Other ECP Providers, Ryan White Providers",8263 Grove Ave,Suite 201,Rancho Cucamonga,CA,91730-3107,San Bernardino,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001456,Rancho Mirage Clinic,Planned Parenthood of the Pacific Southwest,1669407656,"Family Planning Providers, Sexually Transmitted Disease Clinics",71777 San Jacinto Dr,Suite 202,Rancho Mirage,CA,92270-4457,Riverside,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001457,TEHAMA COUNTY HEALTH CENTER CL,Tehama County Health Services Agency,1043427388,"Family Planning Providers, Rural Health Clinics",1850 Walnut St,Bldg E,Red Bluff,CA,96080-3611,Tehama,1850 Walnut St,Building E,Red Bluff,CA,96080-3611,Tehama,Vicky Reilly,Clinic Director,916-527-0350,3563,Vicky.Reilly@tchsa.net,Jayme Bottke,Asstistant Executive Director,530-527-8491,3175,Jayme.Bottke@tchsa.net,
CA-001458,Shasta Community Health Center,Shasta Community Health Center,1891710638,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1035 Placer St,,Redding,CA,96001-1125,Shasta,1035 Placer Street,,Redding,CA,96001-1125,Shasta,Harold Carlson,Chief Planning and Develoopment Officer,530-246-5817,,hcarlson@shastahealth.org,Robin Glasco,Chief Operating Officer,530-246-5739,,rglasco@shastahealth.org,shastahealth.org
CA-001459,"Shasta Community Health Center, Redding Dental Center",Shasta Community Health Center,1538181557,Dental Providers,1400 Market St,,Redding,CA,96001-1052,Shasta,1035 Placer Street,,Redding,CA,96001-1125,Shasta,Harold Carlson,Chief Planning and Development Officer,530-246-5817,,hcarlson@shastahealth.org,Robin Glasco,Chief Operating Officer,530-246-5739,,rglasco@shastahealth.org,shastahealth.org
CA-001460,Redding Rancheria Tribal Health Center,Redding Rancheria,1104859354,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",1441 Liberty St,,Redding,CA,96001-0811,Shasta,2000 Redding Rancheria Road,,Redding,CA,96001,Shasta,Kathryn Waurig,Health Operations Director,530-224-2700,1740,kathyw@redding-rancheria.com,Kathryn Waurig,Health Operations Director,530-224-2700,1740,kathyw@redding-rancheria.com,
CA-001461,Planned Parenthood Redding,Planned Parenthood Northern California,1407044175,"Family Planning Providers, Sexually Transmitted Disease Clinics",2935 Bechelli Ln,Suite C,Redding,CA,96002-1905,Shasta,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001462,AHF Healthcare Center - Redondo Beach,AIDS Healthcare Foundation,1427032903,"Other ECP Providers, Ryan White Providers",520 N Prospect Ave,Suite 209,Redondo Beach,CA,90277-3042,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001463,"Redwoods Rural Health Center, Inc.","Redwoods Rural Health Center, Inc.",1235206087,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 West Coast Rd,,Redway,CA,95560-0769,Humboldt,Po Box 769,,Redway,CA,95560-0769,Humboldt,Tina Tvedt,Executive Director,707-923-2783,336,ttvedt@rrhc.org,Sandra Wageman,Lead Biller,707-923-2783,313,swageman@rrhc.org,
CA-001464,Redwood City Clinic,PLANNED PARENTHOOD MAR MONTE,1477977973,Family Planning Providers,2907 El Camino Real,,Redwood City,CA,94061-4003,San Mateo,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001465,"Consolidated Tribal Health Project, Inc.","Consolidated Tribal Health Project, Inc.",1003826009,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",6991 N State St,,Redwood Valley,CA,95470-9629,Mendocino,PO Box 387,Attn: Billing,Calpella,CA,95418,Mendocino,Randall Barnoskie,Executive Director,707-485-5115,5616,rbarnoskie@cthp.org,Preston Pete,Finance Director,707-485-5115,4617,ppete@cthp.org,www.cthp.org
CA-001466,ADVENTIST HEALTH MEDICAL OFFICE JEFFERSON RHC,ADVENTIST HEALTH REEDLEY,1497006126,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1150 E Washington Ave,,Reedley,CA,93654-4239,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Mari Marceleno,Site Manager,559-391-3125,,MarcelM3@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001467,ADVENTIST HEALTH MEDICAL OFFICE PEDIATRICS RHC,ADVENTIST HEALTH REEDLEY,1083647036,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1433 N Acacia Ave,,Reedley,CA,93654-2102,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Robert Vasquez,Site Manager,559-391-3100,,VasqueRM@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001468,ADVENTIST HEALTH MEDICAL OFFICE CYPRESS RHC,ADVENTIST HEALTH REEDLEY,1326063199,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",372 W Cypress Ave,,Reedley,CA,93654-2113,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Dora Sanchez,Site Manager,559-391-3110,,SancheDA@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001469,ADVENTIST HEALTH REEDLEY,ADVENTIST HEALTH REEDLEY,1326063199,Inpatient Hospitals (other than children's hospitals),372 W Cypress Ave,,Reedley,CA,93654-2113,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,DERRICK.GRUEN@AH.ORG,WAYNE FERCH,PRESIDENT,559-537-0050,,FERCHW@AH.ORG,https://www.adventisthealth.org/reedley/
CA-001470,ADVENTIST HEALTH MEDICAL OFFICE WOMEN'S HEALTH RHC,ADVENTIST HEALTH REEDLEY,1962805283,Rural Health Clinics,550 W Cypress Ave,,Reedley,CA,93654-2096,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Katie Rockwell,Site Manager,559-891-2611,,rockwekl@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001471,ADVENTIST HEALTH MEDICAL OFFICE REEDLEY RHC,ADVENTIST HEALTH REEDLEY,1598941825,Rural Health Clinics,811 E 11th St,,Reedley,CA,93654-2527,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Miriam Garcia,Site Manager,559-391-3125,29340,garcia86@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001472,LifeLong Brookside Community Health Center Richmond,LIFELONG MEDICAL CARE,1407973043,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1030 Nevin Ave,,Richmond,CA,94801-3122,Contra Costa,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,mlynch@lifelongmedical.org,Marie Loverde,Executive Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001473,Planned Parenthood Hilltop Richmond,Planned Parenthood Northern California,1770641482,"Family Planning Providers, Sexually Transmitted Disease Clinics",2970 Hilltop Mall Rd,Suite 307,Richmond,CA,94806-5204,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001474,Ridgecrest Rural Health Clinic,Ridgecrest Regional Hospital,1972813087,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1111 N China Lake Blvd,,Ridgecrest,CA,93555-3131,Kern,1081 N. China Lake Blvd.,,Ridgecrest,CA,93555,Kern,Clayton Griffin,Business Analyst,760-499-3254,,clayton.griffin@rrh.org,Zachary McDonough,Safety and Compliance Officer,760-499-3775,,zachary.mcdonough@rrh.org,
CA-001475,Riverbank Primary Care Medical Clinic Inc,Riverbank Primary Care Medical Clinic Inc,1043372618,Rural Health Clinics,3227 Stanislaus St,Suite A,Riverbank,CA,95367-2464,Stanislaus,3227 Stanislaus Street,Suite A,Riverbank,CA,95367,Stanislaus,Naomi Reynolds,Physician/Owner,209-869-0131,,nreynoldsmd@comcast.net,,,,,,
CA-001476,Golden Valley Health Center-Riverbank,GOLDEN VALLEY HEALTH CENTERS,1548568421,Federally Qualified Health Centers - Medical Services,4150 Patterson Rd,,Riverbank,CA,95367,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001477,Aria Community Health Center Riverdale,Avenal Community Health Center,1154736429,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",3554 W Mt Whitney Ave,,Riverdale,CA,93656,Fresno,Avenal Community Health Center,1000 Skyline Blvd,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-001478,ADVENTIST HEALTH MEDICAL OFFICE RIVERDALE RHC,ADVENTIST HEALTH REEDLEY,1679819742,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",3567 W Mt Whitney Ave,,Riverdale,CA,93656,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Irma Hernandez,Site Manager,559-867-7200,,HernanI2@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001479,Riverside Clinic,Planned Parenthood of the Pacific Southwest,1750316741,"Family Planning Providers, Sexually Transmitted Disease Clinics",3772 Tibbetts St,,Riverside,CA,92506-2605,Riverside,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001480,DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM,DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM,1619377942,"Indian Health Service, Other ECP Providers",9010 Magnolia Ave,Sherman Indian School Clinic,Riverside,CA,92503-4431,Riverside,9010 Magnolia Avenue,,Riverside,CA,92503-4431,Riverside,CAPT Michael D. Weahkee,Chief Executive Officer,602-263-1200,1567,michael.weahkee@ihs.gov,Ms. Deanna Dick,Chief Operating Officer,602-263-1200,1567,deanna.dick@ihs.gov,
CA-001481,Rohnert Park Health Center,Petaluma Health Center,1669870739,Federally Qualified Health Centers - Medical Services,5900 State Farm Dr Fl 2,,Rohnert Park,CA,94928-2149,Sonoma,1179 North McDowell Blvd,,Petaluma,CA,94954,Sonoma,Pedro Toledo,Chief Administrative Officer,707-326-7551,,pedrot@phealthcenter.org,,,,,,www.phealthcenter.org
CA-001482,Herald Christian Health Center,Herald Christian Health Center,1386000248,"Dental Providers, Federally Qualified Health Centers - Medical Services",8841 Garvey Ave,,Rosemead,CA,91770-3358,Los Angeles,8841 Garvey Ave,,Rosemead,CA,91770,Los Angeles,Cherry Lee,Operation Manager,626-286-8700,308,clee@hchcla.org,Alice Wang,Administrative Assistant,626-286-8700,305,awang@hchcla.org,
CA-001483,Roseville Health Center,PLANNED PARENTHOOD MAR MONTE,1447206321,"Family Planning Providers, Sexually Transmitted Disease Clinics",729 Sunrise Ave,Suite 900,Roseville,CA,95661-4525,Placer,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001484,Pajaro Clinic,Clinica de Salud del Valle de Salinas,1003173279,"Dental Providers, Federally Qualified Health Centers - Medical Services",29 Bishop St,Suite A,Royal Oaks,CA,95076-5266,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001485,San Bernardino Mountains Community Hospital District Rural Health Clinic,San Bernardino Mountains Community Hospital District,1881703957,Rural Health Clinics,31900 Hilltop Blvd.,,Running Springs,CA,92382,San Bernardino,29101 Hospital Road,,Lake Arrowhead,CA,92352,San Bernardino,Charles H. Harrison,,909-436-3200,,charles.harrison@mchcares.com,Yvonne D. Waggener,CFO,909-436-3202,,yvonne.waggener@mchcares.com,
CA-001486,Capital Plaza Health Center,Planned Parenthood Mar Monte,1316991714,"Family Planning Providers, Sexually Transmitted Disease Clinics",1125 10th St,,Sacramento,CA,95814-3503,Sacramento,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001487,Health For All - North,Health For All,1891705596,Federally Qualified Health Centers - Medical Services,1281 North Ave,,Sacramento,CA,95838-3661,Sacramento,420 I Street,Suite 7,Sacramento,CA,95814,Sacramento,Chuck Wiesen,CEO,916-441-2811,301,cwiesen@health-forall.org,Khou Vue,Billing Manager,916-441-2811,303,khou@health-forall.org,www.health-forall.org
CA-001488,Cares Community Health,Cares Community Health,1447297379,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1500 21st St,,Sacramento,CA,95811-5216,Sacramento,1500 21st Street,,Sacramento,CA,95811,Sacramento,Christy Ward,CEO,916-443-3299,,cward@carescommunityhealth.org,"Paolo Troia, MD",Chief Medical Officer,916-443-3299,,ptroia@carescommunityhealth.org,www.carescommunityhealth.org
CA-001489,B Street Health Center,PLANNED PARENTHOOD MAR MONTE,1679526693,"Family Planning Providers, Sexually Transmitted Disease Clinics",201 29th St,Suite B,Sacramento,CA,95816-3288,Sacramento,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001490,Sacramento Native American Health Center,Sacramento Native American Health Center,1588756530,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",2020 J St,,Sacramento,CA,95811-3120,Sacramento,2020 J St,,Sacramento,CA,95811-3120,Sacramento,Britta Guerrero,CEO,916-341-0576,2205,britta.guerrero@snahc.org,Doreen Franke,CFO,916-341-0576,2296,doreen.franke@snahc.org,www.snahc.org
CA-001491,Health For All - Meadowview,Health For All,1700896404,Federally Qualified Health Centers - Medical Services,2118 Meadowview Rd,,Sacramento,CA,95832-1212,Sacramento,420 I Street,Suite 7,Sacramento,CA,95814,Sacramento,Chuck Wiesen,CEO,916-441-2811,301,cwiesen@health-forall.org,Khou Vue,Billing Manager,916-441-2811,303,khou@health-forall.org,www.health-forall.org
CA-001492,UC Davis Medical Center,UC Davis Hemophilia Program,1548454713,Hemophilia Treatment Centers,2360 Stockton Blvd,Suite 1100,Sacramento,CA,95817-2283,Sacramento,2315 Stockton Blvd.,,Sacramento,CA,95817,Sacramento,Damia Dillard,Program Manager,916-734-7398,,djdillard@ucdavis.edu,Amanda Boyd,Financial Analyst,916-734-3461,,amboyd@ucdavis.edu,
CA-001493,SHC - Northern California,Shriners Hospitals for Children,1962530451,Children's Hospitals (inpatient only),2425 Stockton Blvd,,Sacramento,CA,95817-2215,Sacramento,2425 Stockton Blvd,,Sacramento,CA,95817,Sacramento,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
CA-001494,Sacramento County Health Center,Sacramento County Department of Health and Human Services,1366513061,Federally Qualified Health Centers - Medical Services,4600 Broadway,,Sacramento,CA,95820-1527,Sacramento,4600 Broadway,Suite 2500,Sacramento,CA,95820,Sacramento,Marcia Jo,Health Program Manager,916-875-5911,,jom@saccounty.net,Marie Ketcheshawno,Administrative Services Manager,916-875-1985,,ketcheshawnom@saccounty.net,
CA-001495,Fruitridge Clinic,PLANNED PARENTHOOD MAR MONTE,1679526610,"Family Planning Providers, Sexually Transmitted Disease Clinics",5385 Franklin Blvd,Suites A-D,Sacramento,CA,95820-4717,Sacramento,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3707,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001496,Health For All - Franklin,Health For All,1841209087,Federally Qualified Health Centers - Medical Services,5385 Franklin Blvd,Suite K,Sacramento,CA,95820-4717,Sacramento,420 I Street,Suite 7,Sacramento,CA,95814,Sacramento,Chuck Wiesen,CEO,916-441-2811,301,cwiesen@health-forall.org,Khou Vue,Billing Manager,916-441-2811,303,khou@health-forall.org,www.health-forall.org
CA-001497,Sacramento Community Clinic - Assembly Court,"Health and Life Organization, Inc.",1295044832,"Dental Providers, Federally Qualified Health Centers - Medical Services",5524 Assembly Ct,,Sacramento,CA,95823-2625,Sacramento,3030 Explorer Drive,,Sacramento,CA,95827,Sacramento,Albert Moua,Program Specialist,916-642-1880,,amoua@halocares.org,Jerry Bliatout,CEO,916-642-1867,,jbliatout@sbcglobal.net,
CA-001498,Sacramento Community Clinic - Southgate,"Health and Life Organization, Inc.",1740336734,"Dental Providers, Federally Qualified Health Centers - Medical Services",7275 E Southgate Dr,Suite 204,Sacramento,CA,95823-2629,Sacramento,3030 Explorer Drive,,Sacramento,CA,95827,Sacramento,Albert Moua,Program Specialist,916-642-1880,,amoua@halocares.org,Jerry Bliatout,CEO,916-642-1867,,jbliatout@sbcglobal.net,
CA-001499,Steven M.Thompson Community Health Clinic,Health For All,1841209087,Federally Qualified Health Centers - Medical Services,752 Revere St Unit B,,Sacramento,CA,95818-2073,Sacramento,420 I Street,Suite 7,Sacramento,CA,95814,Sacramento,Chuck Wiesen,CEO,916-441-2811,301,cwiesen@health-forall.org,Khou Vue,Billing Manager,916-441-2811,303,khou@health-forall.org,www.health-forall.org
CA-001500,Health For All - V Street,Health For All,1841209087,Federally Qualified Health Centers - Medical Services,923 V St,,Sacramento,CA,95818-1331,Sacramento,420 I Street,Suite 7,Sacramento,CA,95814,Sacramento,Chuck Wiesen,CEO,916-441-2811,301,cwiesen@health-forall.org,Khou Vue,Billing Manager,916-441-2811,303,khou@health-forall.org,www.health-forall.org
CA-001501,Laurel Family Practice,County of Monterey,1740232644,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1441 Constitution Blvd,Suite 300 Bldg 400,Salinas,CA,93906-3134,Monterey,"1615 Bunker Hill Way, STE 100",,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001502,Laurel Internal Medicine,County of Monterey,1043262959,Federally Qualified Health Centers - Medical Services,1441 Constitution Blvd,Bldg 151,Salinas,CA,93906-3100,Monterey,"1615 Bunker Hill Way, STE 100",,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001503,Laurel Pediatric Clinic,County of Monterey,1457303356,Federally Qualified Health Centers - Medical Services,1441 Constitution Blvd,Suite 101 Bldg 200,Salinas,CA,93906-3196,Monterey,"1615 Bunker Hill Way, STE 100",,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001504,Laurel Vista,County of Monterey,1033596911,Federally Qualified Health Centers - Medical Services,1441 Constitution Blvd,Suite 301 Bldg 400,Salinas,CA,93906-3134,Monterey,"1615 Bunker Hill Way, STE 100",,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001505,Sanborn Road Clinic,Clinica de Salud del Valle de Salinas,1477694263,Federally Qualified Health Centers - Medical Services,219 N Sanborn Rd,,Salinas,CA,93905-2218,Monterey,Clinica de Salud del Valle de Salinas,440 Airport Boulevard,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001506,Salinas Health Center,Planned Parenthood Mar Monte,1053364034,"Family Planning Providers, Sexually Transmitted Disease Clinics",316 N Main St,Suite 200,Salinas,CA,93901-2872,Monterey,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001507,Alisal Health Center,County of Monterey,1699726786,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",599 E Alisal St,,Salinas,CA,93905-2503,Monterey,Clinic Services Bureau,1615 Bunker Hill Way Ste 100,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,Julie Edgcomb,Bureu Chief,831-796-1386,,edgcombj@co.monterey.ca.us,http://www.montereycountyclinicservices.org/
CA-001508,Alvin Drive Clinic,Clinica de Salud del Valle de Salinas,1508994930,"Dental Providers, Federally Qualified Health Centers - Medical Services",620 E Alvin Dr,Suite G,Salinas,CA,93906-3054,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001509,Circle Drive Clinic,Clinica de Salud del Valle de Salinas,1023159811,Federally Qualified Health Centers - Medical Services,950 Circle Dr,,Salinas,CA,93905-2150,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8698,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001510,"San Andreas Community Clinic - M.A.C.T. Health Board, Inc.","M.A.C.T. Health Board, Inc.",1346410255,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1113 Highway 49,,San Andreas,CA,95249-9583,Calaveras,52 S Main St,,Angels Camp,CA,95221,Calaveras,John Alexander,Executive Director,209-754-6262,,john.alexander@macthealth.org,Mariela Contreras,Finance Director,209-754-6262,,mariela.contreras@macthealth.org,www.macthealth.org
CA-001511,Family Medical Center - San Andreas,Mark Twain Medical Center,1205002938,Rural Health Clinics,704 Mountain Ranch Rd,,San Andreas,CA,95249-9813,Calaveras,768 Mountain Ranch Road,,San Andreas,CA,95249,Calaveras,Debbie Esparza,Director of Managed Care,209-467-6546,,Eric.Carino@DignityHealth.org,Chris Roberts,CFO/VP of Finance,209-754-2614,,Chris.Roberts@DignityHealth.Org,
CA-001512,San Bernardino Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1003885518,"Family Planning Providers, Sexually Transmitted Disease Clinics",1873 Commercenter W,,San Bernardino,CA,92408-3303,San Bernardino,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-001514,Pediatric Specialty Team Centers,Loma Linda Children's Hospital,1366866345,"Dental Providers, Outpatient Hospital Clinics",2195 Club Center Dr,Suite G,San Bernardino,CA,92408-4162,San Bernardino,11234 Anderson St.,Suite A,Loma Linda,CA,92354,San Bernardino,Gary Eusebio,Executive Director of Contracting,909-558-5643,5643,geusebio@llu.edu,Sondra Leno,VP Finance,909-558-7650,7650,SLeno@llu.edu,
CA-001515,Pediatric Hematology/Oncology Clinic,Loma Linda Children's Hospital,1366866345,Outpatient Hospital Clinics,250 E Caroline St,,San Bernardino,CA,92408-3747,San Bernardino,11234 Anderson St.,Suite A,Loma Linda,CA,92354,San Bernardino,Gary Eusebio,Executive Director of Contracting,909-558-5643,5643,geusebio@llu.edu,Sondra Leno,VP Finance,909-558-7650,7650,SLeno@llu.edu,
CA-001516,"UNICARE COMMUNITY HEALTH CENTER, INC.","UNICARE COMMUNITY HEALTH CENTER, INC.",1265854061,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",570 S Mount Vernon Ave,Suite G,San Bernardino,CA,92410-2737,San Bernardino,437 N. EUCLID AVE.,,ONTARIO,CA,91762,San Bernardino,Kelly Hong Vo,Vice President,909-884-6700,,k.vo@unicarechc.org,,,,,,unicarechc.org
CA-001517,San Bernardino Health Center,SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH,1578535845,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",606 E Mill St,,San Bernardino,CA,92415-0011,San Bernardino,351 N Mtn View,,San Bernardino,CA,92415-0010,San Bernardino,Winfred Kimani,Public Health Program Coordinator,760-956-4432,,wkimani@dph.sbcounty.gov,Melanie Bird,Nurse Manager,909-383-3016,,Melanie.Bird@dph.sbcounty.gov,http://www.sbcounty.gov/pubhlth/
CA-001518,Inland Family Community Health Center,"Inland Behavioral and Health Services, Inc.",1275562969,"Dental Providers, Federally Qualified Health Centers - Medical Services",665 N D St,,San Bernardino,CA,92401-1109,San Bernardino,1963 North E Street,,San Bernardino,CA,92405-3919,San Bernardino,Dr. Temetry A. Lindsey,CEO/President,909-708-8158,164,Tlindsey@ibhealth.org,Mr. Lawrence Yang,Chief Counsel,909-708-8158,138,Lyang@ibhealth.org,
CA-001519,FAP,Foothill AIDS Project,1356629083,Ryan White Providers,670 N Arrowhead Ave,Suite A,San Bernardino,CA,92401-1102,San Bernardino,233 W Harrison Ave,,Claremont,CA,91711,Los Angeles,Maritza Tona,Executive Director,909-482-2066,310,mtona@fapinfo.org,Camila Cristiani,Grants Manager,909-482-2066,302,camila@fapinfo.org,
CA-001520,Mira Mesa,OPERATION SAMAHAN,1871680397,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",10737 Camino Ruiz,Suite 235,San Diego,CA,92126-2375,San Diego,2835 Highland Ave Ste C,,National City,CA,91950-7406,San Diego,Carl Walters,CEO,844-200-2426,1020,cwalters@operationsamahan.org,Dirk Zirbel,COO,844-200-2426,1019,dzirbel@operationsamahan.org,http://www.operationsamahan.org
CA-001521,Mira Mesa Clinic,Planned Parenthood of the Pacific Southwest,1124053111,"Family Planning Providers, Sexually Transmitted Disease Clinics",10737 Camino Ruiz,Medical Mall Suite No. 220,San Diego,CA,92126-2359,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001522,Nestor Community Health Center,Imperial Beach Community Clinic,1215246996,Federally Qualified Health Centers - Medical Services,1216 Outer Rd,,San Diego,CA,92154,San Diego,2232 Verus St,Suite I,SAN DIEGO,CA,92154,San Diego,Constance Kirk,Executive Diretor,619-429-5387,,ckirk@ibclinic.org,Linda Cornwell,Administrative Assistant,619-429-5387,,lcornwell@ibclinic.org,
CA-001523,Downtown Family Health Center at Connections,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1588901045,Federally Qualified Health Centers - Medical Services,1250 6th Ave,Suite 100,San Diego,CA,92101-4368,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001524,Elm Street Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1528331287,"Dental Providers, Federally Qualified Health Centers - Medical Services",140 Elm St,,San Diego,CA,92101-2602,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001525,FamilyHealth at City College,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1952729303,Federally Qualified Health Centers - Medical Services,1550 Broadway,Suite 2,San Diego,CA,92101-5713,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director -Billing and Compliance,619-515-2651,,marthao@fhcsd.org,www.fhcsd.org
CA-001526,Logan Heights Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1447281936,"Dental Providers, Federally Qualified Health Centers - Medical Services",1809 National Ave,,San Diego,CA,92113-2113,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-5361,,marthao@fhcsd.org,www.fhcsd.org
CA-001527,First Avenue Family Planning,Planned Parenthood of the Pacific Southwest,1689609679,"Family Planning Providers, Sexually Transmitted Disease Clinics",2017 1st Ave,Suite 301,San Diego,CA,92101-2033,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,https://www.plannedparenthood.org/pacific-southwest
CA-001528,First Avenue Specialty Services,Planned Parenthood of the Pacific Southwest,1497780480,"Family Planning Providers, Sexually Transmitted Disease Clinics",2017 1st Ave,Suite 100,San Diego,CA,92101-9001,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,https://www.plannedparenthood.org/pacific-southwest
CA-001529,FamilyHealth - Youth Counseling Center,"Family Health Centers of San Diego, Inc",1437678364,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2130 National Ave,,San Diego,CA,92113-2209,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,4456,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,2561,marthao@fhcsd.org,www.fhcsd.org
CA-001530,Euclid Avenue Clinic,Planned Parenthood of the Pacific Southwest,1245265230,"Family Planning Providers, Sexually Transmitted Disease Clinics",220 Euclid Ave,Suite 30,San Diego,CA,92114-3644,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001531,Logan Heights Family Counseling Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1013952597,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2204 National Ave,,San Diego,CA,92113-3615,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001532,FamilyHealth on Commercial,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1235521782,Federally Qualified Health Centers - Medical Services,2325 Commercial St,Suite 1400,San Diego,CA,92113-1195,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001533,Sherman Heights Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1174549232,Federally Qualified Health Centers - Medical Services,2391 Island Ave,,San Diego,CA,92102-2941,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001534,"San Diego American Indian Health Center (San Diego, CA)",San Diego American Indian Health Center,1003902917,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Urban Indian Health Program",2630 1st Ave,,San Diego,CA,92103-6599,San Diego,2602 1st Ave Ste 105,,San Diego,CA,92103-6529,San Diego,Joe Bulfer,Executive Director,619-234-2158,,joe.bulfer@sdaihc.com,Douglas Flaker,Chief Administrative Officer,619-234-1515,,douglas.flaker@sdaihc.com,www.sdaihc.com
CA-001535,RADY CHILDREN'S HOSPITAL - SAN DIEGO,Rady Children's Hospital - San Diego,1710065933,Children's Hospitals (inpatient only),3020 Childrens Way,,San Diego,CA,92123-4223,San Diego,3020 Childrens Way,,San Diego,CA,92123-4223,San Diego,Chris Abe,Senior Director Ancillary and Support Services,858-576-5968,5962,cabe@rchsd.org,Amanda Spivey,340B Program Manager,858-966-1700,5024,aspivey@rchsd.org,
CA-001536,Rady Children's Hospital San Diego HTC,Rady Children's Hospital San Diego,1710065933,Hemophilia Treatment Centers,3020 Childrens Way,,San Diego,CA,92123-4223,San Diego,3020 Children's Way,,San Diego,CA,92123,San Diego,Farah Ziai,"Director, Billing and Follow-up",858-966-8943,8943,fziai@rchsd.org,,,,,,
CA-001537,Comprehensive Health Center-Ocean View,San Ysidro Health Center,1326225632,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3177 Ocean View Blvd,,San Diego,CA,92113-1432,San Diego,4004 Beyer Blvd.,,San Ysidro,CA,92173,San Diego,Joanna Rodriguez,Clinic Services Manager,619-662-4100,,joanna.rodriguez@syhc.org,,,,,,www.SYHC.org
CA-001538,North Park Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1700821303,"Dental Providers, Federally Qualified Health Centers - Medical Services",3544 30th St,,San Diego,CA,92104-4120,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001539,Beach Area Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1386689701,Federally Qualified Health Centers - Medical Services,3705 Mission Blvd,,San Diego,CA,92109-7104,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director of Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001540,Stepping Stone Alcohol and Drug Treatment Program,"Stepping Stone of San Diego, Inc",1750408464,Other ECP Providers,3767 Central Ave,,San Diego,CA,92105-2506,San Diego,3767 Central Avenue,,San diego,CA,92015,San Diego,Cheryl Houk,Executive Director,619-584-4010,114,cheryl@steppingstonesd.org,Chris mueller,program Manager,619-584-4010,105,chris@steppingstonesd.org,
CA-001541,AHF Healthcare Center - San Diego,AIDS Healthcare Foundation,1881024669,Other ECP Providers,3940 4th Ave,Suite 140,San Diego,CA,92103-3193,San Diego,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001542,La Maestra Family Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1609849074,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001543,San Diego Family Care,San Diego Family Care,1962483040,Federally Qualified Health Centers - Medical Services,4063 Polk Ave,Central Elementary School,San Diego,CA,92105-1436,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,
CA-001544,Hillcrest Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1629456900,Federally Qualified Health Centers - Medical Services,4094 4th Ave,,San Diego,CA,92103-2143,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001545,La Maestra Hope Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1609849074,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4171 Fairmount Ave,,San Diego,CA,92105-1609,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001546,Mid-City Community Clinic-Adults,San Diego Family Care,1306827332,Federally Qualified Health Centers - Medical Services,4290 Polk Ave,,San Diego,CA,92105-1524,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,sdfamilycare.org
CA-001547,City Heights Clinic,Planned Parenthood of the Pacific Southwest,1831383637,"Family Planning Providers, Sexually Transmitted Disease Clinics",4305 University Ave,Suite 350,San Diego,CA,92105-8602,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001548,Mid-City Community Clinic-Pediatrics,San Diego Family Care,1962483040,Federally Qualified Health Centers - Medical Services,4305 University Ave,Suite 150,San Diego,CA,92105-1690,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,sdfamilycare.org
CA-001549,Monroe Clark Health Center - La Maestra Family Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1609849074,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4388 Thorn St,Monroe Clark Middle School,San Diego,CA,92105-4238,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001550,Monroe Clark Health Center - San Diego Family Care,San Diego Family Care,1962483040,Federally Qualified Health Centers - Medical Services,4388 Thorn St,Monroe Clark Middle School,San Diego,CA,92105-4238,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,www.sdfamilycare.org
CA-001551,La Maestra Hoover High Family Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1609849074,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4474 El Cajon Blvd,La Maestra Hoover High School Medical and Dental Clinic,San Diego,CA,92115-4312,San Diego,4060 Fairmount Avenue,,San Diego,CA,92105,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001552,Mission Bay Clinic,Planned Parenthood of the Pacific Southwest,1215962204,"Family Planning Providers, Sexually Transmitted Disease Clinics",4501 Mission Bay Dr,Suite No. 1C & D,San Diego,CA,92109-4923,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001553,Rosa Parks Clinic - La Maestra Family Clinic,"LA MAESTRA FAMILY CLINIC, INC.",1609849074,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4510 Landis St,Rosa Parks Elementary School,San Diego,CA,92105-2822,San Diego,4060 Fairmount Ave,,San Diego,CA,92105-1608,San Diego,Alejandrina Areizaga,VP,619-961-0819,,aareizaga@lamaestra.org,Michael Dew,Director of Contracts,619-269-1302,3131,mdew@lamaestra.org,www.lamaestra.org
CA-001554,Rosa Parks Clinic - San Diego Family Care,San Diego Family Care,1962483040,Federally Qualified Health Centers - Medical Services,4510 Landis St,Rosa Parks Elementary School,San Diego,CA,92105-2822,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,www.sdfamilycare.org
CA-001555,College Avenue Clinic,Planned Parenthood of the Pacific Southwest,1427081652,"Family Planning Providers, Sexually Transmitted Disease Clinics",4575 College Ave,,San Diego,CA,92115-4011,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001556,Diamond Neighborhoods Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1982747671,"Dental Providers, Federally Qualified Health Centers - Medical Services",4725 Market St,,San Diego,CA,92102-4715,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001557,Ibarra Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1477953933,Federally Qualified Health Centers - Medical Services,4874 Polk Ave,,San Diego,CA,92105-2026,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001558,Oak Park Family Health Center,Family Health Centers of San Diego,1336525906,Federally Qualified Health Centers - Medical Services,5160 Federal Blvd,,San Diego,CA,92105-5429,San Diego,823 Gateway Center Way,,San Diego,CA,92102,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director of Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001559,City Heights Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1023054004,"Dental Providers, Federally Qualified Health Centers - Medical Services",5454 El Cajon Blvd,,San Diego,CA,92115-3621,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director - Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001560,Linda Vista Health Care Center,San Diego Family Care,1780665877,Federally Qualified Health Centers - Medical Services,6973 Linda Vista Rd,,San Diego,CA,92111-6342,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,sdfamilycare.org
CA-001561,San Diego Family Care,San Diego Family Care,1457724858,Federally Qualified Health Centers - Medical Services,7011 Linda Vista Rd,,San Diego,CA,92111-6307,San Diego,6973 Linda Vista Road,,San Diego,CA,92111,San Diego,Roberta L. Feinberg,CEO,858-279-9676,,feinberg@lvhcc.com,,,,,,www.sdfamilycare.org
CA-001562,Kearny Mesa Clinic,Planned Parenthood of the Pacific Southwest,1306871397,"Family Planning Providers, Sexually Transmitted Disease Clinics",7526 Clairemont Mesa Blvd,,San Diego,CA,92111-1504,San Diego,1075 Camino del Rio South,,San Diego,CA,92108,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001563,San Diego Children's Dental Clinic,San Ysidro Health Center,1477730737,Dental Providers,8110 Birmingham Way,,San Diego,CA,92123-2758,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173,San Diego,Kevin Mattson,CEO,619-662-4100,,kmattson@syhc.org,,,,,,www.SYHC.org
CA-001564,Hemophilia & Thrombosis Treatment Center at UC San Diego Health,University of California San Diego Health,1376607036,Hemophilia Treatment Centers,8929 University Center Ln,Suite 201,San Diego,CA,92122-1008,San Diego,9500 Gilman Drive,MC0878,San Diego,CA,92093-0878,San Diego,Moniqa Diaz,Program Coordinator,858-657-6301,,m6diaz@ucsd.edu,Jane Kim,Financial Manager,858-657-6328,,jak039@ucsd.edu,health.ucsd.edu/hemophilia
CA-001565,King-Chavez Health Center,San Ysidro Health Center,1538262092,"Dental Providers, Family Planning Providers, Ryan White Providers",950 S Euclid Ave,,San Diego,CA,92114-6201,San Diego,950 S Euclid Ave,,San Diego,CA,92114,San Diego,Steven Perez,Clinic Services Manager,619-662-4100,,sperez@syhc.org,,,,,,WWW.SYHC.org
CA-001566,Northeast Valley Health Corporation,NORTHEAST VALLEY HEALTH CORPORATION,1417958943,"Dental Providers, Federally Qualified Health Centers - Medical Services",11051 N. O'Melveny Avenue,San Fernando High School - Teen Health Center,San Fernando,CA,91340-4424,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001567,SAN FERNANDO HEALTH CENTER,"Los Angeles County, Department of Health Services",1376556555,Family Planning Providers,1212 Pico St,,San Fernando,CA,91340-3503,Los Angeles,1212 Pico Street,,San Fernando,CA,91340,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001568,SAN FERNANDO HEALTH CENTER,NORTHEAST VALLEY HEALTH CORPORATION,1235130600,"Dental Providers, Federally Qualified Health Centers - Medical Services",1600 San Fernando Rd,,San Fernando,CA,91340-3115,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive,818-898-1388,41620,VilmaChampion@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/
CA-001569,BALBOA TEEN HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1538101126,Federally Qualified Health Centers - Medical Services,1000 Cayuga Ave,,San Francisco,CA,94112-3236,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org
CA-001570,Childrens Health Clinic,City and Co. of San Francisco Dept. of Public Health,1417023243,Federally Qualified Health Centers - Medical Services,1001 Potrero Ave,,San Francisco,CA,94110-3518,San Francisco,1001 Potrero Avenue,,San Francisco,CA,94110,San Francisco,James A Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001571,SAN FRANCISCO GENERAL HOSPITAL,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1508932336,Federally Qualified Health Centers - Medical Services,1001 Potrero Ave,,San Francisco,CA,94110-3518,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org
CA-001572,Womens Health Center,City and Co. of San Francisco Dept. of Public Health,1326114158,Federally Qualified Health Centers - Medical Services,1001 Potrero Ave,,San Francisco,CA,94110-3518,San Francisco,1001 Potrero Avenue,,San Francisco,CA,94110,San Francisco,James A Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001573,POTRERO HILL HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1386686087,Federally Qualified Health Centers - Medical Services,1050 Wisconsin St,,San Francisco,CA,94107-3328,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001574,Larkin Street Youth Center,City and Co. of San Francisco Dept. of Public Health,1356381214,Federally Qualified Health Centers - Medical Services,1138 Sutter St,,San Francisco,CA,94109-5608,San Francisco,1138 Sutter St,,San Francisco,CA,94109-5608,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/LarkinStYouthClin.asp
CA-001575,MAXINE HALL HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1932140795,Federally Qualified Health Centers - Medical Services,1301 Pierce St,,San Francisco,CA,94115-4005,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/MaxineHlthCtr.asp
CA-001576,OCEAN PARK HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1598705451,Federally Qualified Health Centers - Medical Services,1351 24th Ave,,San Francisco,CA,94122-1616,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001577,CHINATOWN PUBLIC HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1144263518,Federally Qualified Health Centers - Medical Services,1490 Mason St,,San Francisco,CA,94133-4222,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001578,SILVER AVENUE HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1477593259,Federally Qualified Health Centers - Medical Services,1525 Silver Ave,,San Francisco,CA,94134-1229,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org
CA-001579,Planned Parenthood San Francisco,Planned Parenthood Northern California,1851692560,"Family Planning Providers, Sexually Transmitted Disease Clinics",1650 Valencia St,,San Francisco,CA,94110-5013,San Francisco,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,,,,,,
CA-001580,Women's Community Clinic,Women's Community Clinic,1629498118,Family Planning Providers,1833 Fillmore St Fl 3,,San Francisco,CA,94115-3181,San Francisco,1833 Fillmore St.,3rd Floor,San Francisco,CA,94115,San Francisco,Elizabeth Steinfield,Clinic Director,415-820-7308,,liz@womenscommunityclinic.org,Carlina Hansen,Executive Director,415-820-7304,,carlina@womenscommunityclinic.org,
CA-001581,Tom Waddell Urban Health Clinic,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1053351916,Federally Qualified Health Centers - Medical Services,220 Golden Gate Ave,,San Francisco,CA,94102-3795,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001582,South of Market Health Center,"San Francisco Medical Center Outpatient Improvement Programs, Inc",1184913956,"Dental Providers, Federally Qualified Health Centers - Medical Services",229 7th St,,San Francisco,CA,94103-4003,San Francisco,229 7th Street,,San Francisco,CA,94103-4003,San Francisco,Asa Satariano,CCO/HR Manager,415-503-6055,,asa.satariano@smhcsf.org,Charles Range,Chief Executive officer,415-503-6054,,charles.range@smhcsf.org,
CA-001583,SOUTHEAST HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1437191087,Federally Qualified Health Centers - Medical Services,2401 Keith St,,San Francisco,CA,94124-3231,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,,http://www.sfdph.org
CA-001584,South of Market Senior Health Clinic,"San Francisco Medical Center Outpatient Improvement Programs, Inc",1255648929,Federally Qualified Health Centers - Medical Services,317 Clementina St,,San Francisco,CA,94103-4104,San Francisco,229 7th Street,,San Francisco,CA,94103-4003,San Francisco,Asa Satariano,CCO/HR Manager,415-503-6055,,asa.satariano@smhcsf.org,Charles Range,Chief Executive officer,415-503-6054,,charles.range@smhcsf.org,
CA-001585,CURRY SENIOR CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1851332167,Federally Qualified Health Centers - Medical Services,333 Turk St,,San Francisco,CA,94102-3703,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001586,Bayview Child Health Center,"San Francisco Medical Center Outpatient Improvement Programs, Inc",1487055562,Federally Qualified Health Centers - Medical Services,3450 3rd St,Suite 2A,San Francisco,CA,94124-1444,San Francisco,229 7th Street,,San Francisco,CA,94103-4003,San Francisco,Asa Satariano,CCO/HR Manager,415-503-6055,,asa.satariano@smhcsf.org,Charles Range,Chief Executive officer,415-503-6054,,charles.range@smhcsf.org,
CA-001587,CASTRO-MISSION HEALTH CENTER,SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM,1588606206,Federally Qualified Health Centers - Medical Services,3580 17th St,,San Francisco,CA,94110-1005,San Francisco,1550 Bryant St Ste 450,,San Francisco,CA,94103-4869,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001588,UCSF Hemophilia Treatment Center,UCSF Medical Center,1285818112,Hemophilia Treatment Centers,400 Parnassus Ave Fl 4,,San Francisco,CA,94143-2202,San Francisco,550 16th Street 4th Floor,,San Francisco,CA,94143,San Francisco,Sachiko Suzuki,Program Manager,415-476-0708,,sachiko.suzuki@ucsf.edu,Peggy Weix,Division Administrator,415-502-7062,,cynthia.weix@ucsf.edu,
CA-001589,AHF Healthcare Center - San Francisco,AIDS Healthcare Foundation,1457334344,Other ECP Providers,518A Castro St,,San Francisco,CA,94114-2512,San Francisco,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"AHF Chief, Managed Care",323-436-5025,,Donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001590,LoPrest Health Center,"San Francisco Medical Center Outpatient Improvement Programs, Inc",1528143401,Federally Qualified Health Centers - Medical Services,551 Minna St # 555,,San Francisco,CA,94103-2831,San Francisco,229 7th Street,,San Francisco,CA,94103,San Francisco,Asa Satariano,CCO/HR Manager,415-503-6055,,asa.satariano@smhcsf.org,Charles Range,Chief Executive officer,415-503-6054,,charles.range@smhcsf.org,
CA-001591,San Francisco General Hospital Ward 86,UCSF HIV AIDS Division at SFGH,1144396979,"Outpatient Hospital Clinics, Ryan White Providers",995 Potrero Ave,Ward 86,San Francisco,CA,94110-2859,San Francisco,"995 Potrero Ave, Ward 86",,San Francisco,CA,94110,San Francisco,James Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,Shivaun Nestor,Family Planning Coordinator,415-575-5677,,shivaun.nestor@sfdph.org,http://www.sfdph.org
CA-001592,Urgent Care Clinic,City and Co. of San Francisco Dept. of Public Health,1518033349,Federally Qualified Health Centers - Medical Services,995 Potrero Ave,,San Francisco,CA,94110-2859,San Francisco,"995 Potrero Ave, Ward 86",,San Francisco,CA,94110,San Francisco,James A Parker,Director Patient Accounts,415-759-4064,,james.parker@sfdph.org,,,,,,
CA-001593,Washington Neighborhood Health Clinic,School Health Clinics of Santa Clara County,1851431647,Federally Qualified Health Centers - Medical Services,100 Oak St,Room F-3,San Jose,CA,95110-2817,Santa Clara,6840 Via Del Oro #210,,San Jose,CA,95119,Santa Clara,Stephanie Kleinheinz,CEO,408-284-2288,,StephanieK@schoolhealthclinics.org,Jocelyn Hart,CFO/COO,408-284-2289,,JocelynH@schoolhealthclinics.org,
CA-001594,San Jose Neighborhood Health Clinic,School Health Clinics of Santa Clara County,1447390265,Federally Qualified Health Centers - Medical Services,1149 E Julian St,Bldg H,San Jose,CA,95116-1005,Santa Clara,6840 Via Del Oro #210,,San Jose,CA,95119,Santa Clara,Stephanie Kleinheinz,CEO,408-284-2288,,StephanieK@schoolhealthclinics.org,Jocelyn Hart,CFO/COO,408-284-2289,,JocelynH@schoolhealthclinics.org,
CA-001595,Indian Health Center - Main Campus,Indian Health Center of Santa Clara Valley,1164643862,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1333 Meridian Ave,,San Jose,CA,95125-5212,Santa Clara,1333 Meridian Ave,,San Jose,CA,95125,Santa Clara,Aldon Wayne Scott,Director of Operations/Compliance Officer,408-445-3400,3730,awscott@ihcsccv.org,Ira Singh,Chief Operations Officer,408-445-3400,5003,isingh@ihcscv.org,
CA-001596,San Jose Clinic,Planned Parenthood Mar Monte,1043263189,"Family Planning Providers, Sexually Transmitted Disease Clinics",1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001597,Overfelt Neighborhood Health Clinic,School Health Clinics of Santa Clara County,1083755631,Federally Qualified Health Centers - Medical Services,1835 Cunningham Ave,,San Jose,CA,95122-1712,Santa Clara,6840 Via Del Oro #210,,San Jose,CA,95119,Santa Clara,Stephanie Kleinheinz,CEO,408-284-2288,,StephanieK@schoolhealthclinics.org,Jocelyn Hart,CFO/COO,408-284-2289,,JocelynH@schoolhealthclinics.org,
CA-001598,AACI,"ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA, INC, THE",1750490363,Federally Qualified Health Centers - Medical Services,2400 Moorpark Ave,Suite 300,San Jose,CA,95128-2680,Santa Clara,2400 Moorpark Ave Ste 300,,San Jose,CA,95128-2680,Santa Clara,Michele Lew,CEO,408-975-2730,103,michele.lew@aaci.org,,,,,,www.aaci.org
CA-001599,Ira Greene PACE Clinic,Santa Clara Valley Health and Hospital System,1063406551,"Family Planning Providers, Ryan White Providers",2400 Moorpark Ave,Suite 316,San Jose,CA,95128-2625,Santa Clara,751 S. Bascom Ave.,,San Jose,CA,95128,Santa Clara,"Romida Magnampo, RN",Health Center Manager,408-885-5703,,Romida.Magnampo@hhs.sccgov.org,,,,,,
CA-001600,East Valley Community Clinic,Planned Parenthood Mar Monte,1700830296,Family Planning Providers,2470 Alvin Ave,Suite 60,San Jose,CA,95121-1664,Santa Clara,1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3610,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001601,Foothill Community Health Center,San Jose Foothill Family Community Clinic,1063658029,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2880 Story Rd,,San Jose,CA,95127-3942,Santa Clara,"2670 S. White Road, Suite 200",,San Jose,CA,95148,Santa Clara,Neil Kozuma,Director of Public Affairs & Agency Relations,408-729-4290,3179,nkozuma@sjffcc.org,,,,,,www.sjffcc.org
CA-001602,East Side Clinic,PLANNED PARENTHOOD MAR MONTE,1780637645,"Family Planning Providers, Sexually Transmitted Disease Clinics",3131 Alum Rock Ave,,San Jose,CA,95127-2902,Santa Clara,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3707,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001603,Blossom Hill Health Center,PLANNED PARENTHOOD MAR MONTE,1558314609,"Family Planning Providers, Sexually Transmitted Disease Clinics",5440 Thornwood Dr,Suite G,San Jose,CA,95123-1217,Santa Clara,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001604,Franklin McKinley Neighborhood Health Clinic,School Health Clinics of Santa Clara County,1376683151,Federally Qualified Health Centers - Medical Services,645 Wool Creek Dr,,San Jose,CA,95112-2617,Santa Clara,6840 Via Del Oro #210,,San Jose,CA,95119,Santa Clara,Stephanie Kleinheinz,CEO,408-284-2288,,StephanieK@schoolhealthclinics.org,Jocelyn Hart,CFO/COO,408-284-2289,,JocelynH@schoolhealthclinics.org,
CA-001605,AACI Story Road Clinic,"ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA, INC, THE",1316338775,Federally Qualified Health Centers - Medical Services,749 Story Rd,Suite 50,San Jose,CA,95122-2600,Santa Clara,2400 Moorpark Ave Ste 300,,San Jose,CA,95128-2680,Santa Clara,Michele Lew,CEO,408-975-2730,103,michele.lew@aaci.org,,,,,,www.aaci.org
CA-001606,Ashland Community Clinic,"Tiburcio Vasquez Health Center, Inc.",1720405491,"Dental Providers, Federally Qualified Health Centers - Medical Services",16110 E 14th St,,San Leandro,CA,94578-3002,Alameda,33255 Ninth Street,,Union City,CA,94587,Alameda,David Vliet,Chief Executive Officer,510-690-6050,,dvliet@tvhc.org,Wilfredo Lacro,VP of Business Development,510-460-3846,,wlacro@tvhc.org,www.tvhc.org
CA-001607,County of San Luis Obispo Public Health Department,County of San Luis Obispo,1518064948,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",2180 Johnson Ave,,San Luis Obispo,CA,93401-4513,San Luis Obispo,2191 Johnson Ave.,,San Luis Obispo,CA,93401-4534,San Luis Obispo,Penny Borenstein,Health Officer/Public Health Administrator,805-781-5519,,pborenstein@co.slo.ca.us,Jean White,Secretary I,805-781-5520,,jwhite@co.slo.ca.us,http://slocounty.ca.gov/health.htm
CA-001608,"Community Action Partnership of San Luis Obispo County, Inc.","California Family Health Council, Inc.",1447321120,Family Planning Providers,705 Grand Ave,,San Luis Obispo,CA,93401-2639,San Luis Obispo,1030 Southwood Drive,,San Luis Obispo,CA,93401-5813,San Luis Obispo,Kayla Wilburn,Family Planning Coordinator,805-544-2498,21,kwilburn@capslo.org,Raye Fleming,Health & Prevention Division Director,805-544-2498,11,rfleming@capslo.org,http://www.capslo.org/
CA-001609,San Luis Obispo Clinic,Planned Parenthood California Central Coast,1700803285,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",743 Pismo St,,San Luis Obispo,CA,93401-3921,San Luis Obispo,518 Garden St,,SANTA BARBARA,CA,93101,Santa Barbara,Yolanda Robles,VP of Clinical Operations,805-722-1512,,yolanda.robles@ppcentralcoast.org,,,805-963-2445,,,https://www.plannedparenthood.org/planned-parenthood-california-central-coast
CA-001610,San Marcos Health Center,"North County Health Project, Inc.",1669509824,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",150 Valpreda Rd Frnt,,San Marcos,CA,92069-2944,San Diego,150 Valpreda Road,,San Marcos,CA,92069,San Diego,Hector Orozco,Planning & Grants Specialist,760-736-6709,,hector.orozco@nchs-health.org,Briana Cardoza,Sr. Director of Program Planning and Grants,760-736-8738,,briana.cardoza@nchs-health.org,
CA-001611,San Mateo Health Center,Planned Parenthood Mar Monte,1316221617,"Family Planning Providers, Sexually Transmitted Disease Clinics",29 Baywood Ave,,San Mateo,CA,94402-1516,San Mateo,1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte
CA-001612,LifeLong Brookside Community Health Center San Pablo,LIFELONG MEDICAL CARE,1487696191,Federally Qualified Health Centers - Medical Services,2023 Vale Rd,Suite 107,San Pablo,CA,94806-3891,Contra Costa,2344 6th St,,Berkeley,CA,94710-2412,Alameda,Marty Lynch,CEO,510-981-4123,,Mlynch@lifelongmedical.org,Marie Loverde,Execuitve Assistant,510-981-4100,,mloverde@lifelongmedical.org,www.lifelongmedical.org
CA-001613,Harbor Community Clinic,Harbor Community Clinic INC,1467490425,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",593 W 6th St,,San Pedro,CA,90731-2521,Los Angeles,593 W 6th Street,,San Pedro,CA,90731,Los Angeles,Tamra King,EXECUTIVE DIRECTOR/CEO,310-547-0202,106,tking@pickharbor.org,Dahina Hernandez,Director of Operations,310-547-0202,102,dhernandez@pickharbor.org,harborcommunityclinic.com
CA-001614,Harbor Community Clinic Don Knabe Pediatric Center,Harbor Community Clinic INC,1467653873,Federally Qualified Health Centers - Medical Services,731 S Beacon St,,San Pedro,CA,90731-3738,Los Angeles,593 W 6th Street,,San Pedro,CA,90731,Los Angeles,Tamra King,EXECUTIVE DIRECTOR/CEO,310-547-0202,106,tking@pickharbor.org,Dahina Hernandez,Director of Operations,310-547-0202,102,dhernandez@pickharbor.org,harborcommunityclinic.com
CA-001615,Planned Parenthood San Rafael,Planned Parenthood Northern California,1902108541,"Family Planning Providers, Sexually Transmitted Disease Clinics",2 H St,,San Rafael,CA,94901-1700,Marin,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001616,Planned Parenthood San Ramon,Planned Parenthood Northern California,1295893550,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 Porter Dr,Suite 200,San Ramon,CA,94583-1524,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001617,San Ysidro Senior Health Center,San Ysidro Health Center,1265843122,Federally Qualified Health Centers - Medical Services,3364 Beyer Blvd,,San Ysidro,CA,92173-1322,San Diego,4004 Beyer Blvd.,,San Ysidro,CA,92173,San Diego,Jose Montes,Clinic Services Manager,619-662-4100,,jose.montes@syhc.org,,,,,,www.SYHC.org
CA-001618,SAN YSIDRO HEALTH CENTER,San Ysidro Health Center,1952364747,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4004 Beyer Blvd,,San Ysidro,CA,92173-2099,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Elizabeth Ramos,Clinic Services Manager,619-662-4100,,eramos@syhc.org,,,,,,www.SYHC.org
CA-001619,Maternal and Child Health Center,San Ysidro Health Center,1952364747,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4050 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,4004 Beyer Blvd,,San Ysidro,CA,92173-2007,San Diego,Elizabeth Ramos,Clinic Services Manager,619-662-4100,,eramos@syhc.org,,,,,,www.SYHC.org
CA-001620,ADVENTIST HEALTH MEDICAL OFFICE SANGER RHC,ADVENTIST HEALTH REEDLEY,1093980823,"Dental Providers, Rural Health Clinics",1939 Academy Ave,,Sanger,CA,93657-3737,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Saxon Hanwacker,Site Manager,559-537-1001,29281,hanwacss@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001621,Serve the People Community Health Center,"Serve the People, Inc",1770803462,"Dental Providers, Federally Qualified Health Centers - Medical Services",1206 E 17th St,Suite 101,Santa Ana,CA,92701-2641,Orange,"1206 East 17th Street, Suite 101",,Santa Ana,CA,92701,Orange,Rocio Magdaleno,Executive Director,714-392-6626,114,rmagdaleno@servethepeoplechc.org,,,,,,
CA-001622,C Medical Group - Santa Ana Main,AltaMed Health Services Corporation,1740427657,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1400 N Main St,,Santa Ana,CA,92701-2304,Orange,2040 Camfield Ave,,Los Angeles,CA,92701,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001623,Santa Ana Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1063481562,"Family Planning Providers, Sexually Transmitted Disease Clinics",1421 E 17th St,,Santa Ana,CA,92705-8505,Orange,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino/
CA-001624,AltaMed Medical Group - Santa Ana Bristol,AltaMed Health Services Corporation,1760651814,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2720 S Bristol St,Suite 110,Santa Ana,CA,92704-6210,Orange,2040 Camfield Ave,,Los Angeles,CA,90040,Los Angeles,Nena Davis,"Vice President, Development",323-889-7343,,ndavis@la.altamed.org,,,,,,www.altamed.org
CA-001625,UCI Family Health Centers,UCI Family Health Centers,1851325906,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",800 N Main St,,Santa Ana,CA,92701-3576,Orange,800 North Main St,,Santa Ana,CA,92701,Orange,Ivan Coziahr,Executive Director,714-480-2411,7144803518,icoziahr@uci.edu,Diana Crook,Analyst,714-480-3518,7144803518,dvcrook@Uci.edu,http://www.ucirvinehealth.org/locations/santa-ana/family-health-center-santa-ana/
CA-001626,Cottage Children's Medical Center,SANTA BARBARA COTTAGE HOSPITAL,1477554152,Children's Hospitals (inpatient only),400 W Pueblo St,,Santa Barbara,CA,93105-4353,Santa Barbara,400 W. Pueblo Street,,SANTA BARBARA,CA,93105,Santa Barbara,Lisa Dominguez,Contracting Manager,805-879-8965,48965,l1doming@sbch.org,,,,,,www.cottagehealth.org
CA-001627,SANTA BARBARA COTTAGE HOSPITAL,SANTA BARBARA COTTAGE HOSPITAL,1477554152,Inpatient Hospitals (other than children's hospitals),400 W Pueblo St,,Santa Barbara,CA,93105-4353,Santa Barbara,400 W. Pueblo St.,,SANTA BARBARA,CA,93105,Santa Barbara,Lisa Dominguez,Contracting Manager,805-879-8965,48965,l1doming@sbch.org,,,,,,www.cottagehealth.org
CA-001628,"American Indian Health & Services Corporation (Santa Barbara, CA)",American Indian Health & Services Corporation,1740222934,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",4141 State St,Suite B11,Santa Barbara,CA,93110-1898,Santa Barbara,4141 State St Ste B11,,Santa Barbara,CA,93110-1898,Santa Barbara,Scott Black,Executive Director,805-681-7356,222,fiscal@AIHSCORP.ORG,Deonna,Perez,805-681-4356,240,dperez@aihscorp.org,WWW.AIHSCORP.ORG
CA-001629,Santa Barbara Clinic,Planned Parenthood California Central Coast,1811926058,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",518 Garden St,,Santa Barbara,CA,93101-1606,Santa Barbara,518 Garden St,,SANTA BARBARA,CA,93101-1606,Santa Barbara,Yolanda Robles,VP of Clinical Operations,805-722-1512,,yolanda.robles@ppcentralcoast.org,,,,,,https://www.plannedparenthood.org/planned-parenthood-california-central-coast
CA-001630,Santa Cruz Health Center,County of Santa Cruz,1578680310,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1080 Emeline Ave,,Santa Cruz,CA,95060-1966,Santa Cruz,1080 Emeline Avenue,,Santa Cruz,CA,95060,Santa Cruz,Jeanette Garcia,Administrative Services Manager,831-454-4858,,jeanette.garcia@santacruzcounty.us,Amy Peeler,Chief of Clinic Services,831-454-4764,,amy.peeler@santacruzcounty.us,http://santacruzhealth.org/HSAHome/HSADivisions/ClinicServices.aspx
CA-001631,Westside Clinic,PLANNED PARENTHOOD MAR MONTE,1225081227,"Family Planning Providers, Sexually Transmitted Disease Clinics",1119 Pacific Ave,Suite 200,Santa Cruz,CA,95060-4464,Santa Cruz,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
CA-001632,Homeless Persons Health Project Coral Street Clinic,County of Santa Cruz,1285033514,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115A Coral St,,Santa Cruz,CA,95060-2131,Santa Cruz,1080 Emeline Avenue,,Santa Cruz,CA,95060,Santa Cruz,Jeanette Garcia,Administrative Services Manager,831-454-4858,,jeanette.garcia@santacruzcounty.us,Amy Peeler,Chief of Clinic Services,831-454-4764,,amy.peeler@santacruzcounty.us,http://www.santacruzhealth.org/HSAHome/HSADivisions/ClinicServices.aspx
CA-001633,East Cliff Family Health Center,Santa Cruz Community Health Centers,1952749541,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",21507 E Cliff Dr,,Santa Cruz,CA,95062-4844,Santa Cruz,PO Box 542,,Santa Cruz,CA,95061,Santa Cruz,Ruth Jasso,Revenue Cycle Manager,831-427-3500,142,rjasso@schealthcenters.org,,,,,,
CA-001634,Santa Cruz Women's Health Center,Santa Cruz Community Health Centers,1902923329,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",250 Locust St,,Santa Cruz,CA,95060-3813,Santa Cruz,PO Box 542,,Santa Cruz,CA,95061,Santa Cruz,Ruth Jasso,Revenue Cycle Manager,831-427-3500,142,rjasso@schealthcenters.org,,,,,,
CA-001635,Santa Maria Center,Planned Parenthood California Central Coast,1811914674,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",415 E Chapel St,,Santa Maria,CA,93454-4517,Santa Barbara,518 Garden St,,SANTA BARBARA,CA,93101,Santa Barbara,Yolanda Robles,VP of Clinical Operations,805-722-1512,,yolanda.robles@ppcentralcoast.org,,,805-963-2445,,,https://www.plannedparenthood.org/planned-parenthood-california-central-coast
CA-001636,Santa Monica Health Center,Planned Parenthood Los Angeles,1407945629,Family Planning Providers,1316 3rd Street Promenade,Suite 201,Santa Monica,CA,90401-1382,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001637,Westside Family Health Center,WESTSIDE FAMILY HEALTH CENTER,1831287978,Federally Qualified Health Centers - Medical Services,1711 Ocean Park Blvd,,Santa Monica,CA,90405-4901,Los Angeles,1711 Ocean Park Blvd,,Santa Monica,CA,90405-4901,Los Angeles,Debra A Farmer,President and Chief Executive Officer,310-450-4773,,dfarmer@wfhcenter.org,,,,,,http://www.wfhcenter.org/
CA-001638,"Clinicas del Camino Real, Inc. Santa Paula","Clinicas del Camino Real, Inc.",1023234465,Federally Qualified Health Centers - Medical Services,500 E Main St,,Santa Paula,CA,93060-2607,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001639,Santa Rosa Community Dental Center,SANTA ROSA COMMUNITY HEALTH CENTERS,1023439759,Dental Providers,1110 N Dutton Ave,,Santa Rosa,CA,95401-4606,Sonoma,Santa Rosa Community Health Centers,3569 Round Barn Circle,Santa Rosa,CA,95403,Sonoma,Noeleen Farrell,Director of Corp Compliance and Assurance,707-387-3265,,noeleenf@srhealthcenters.org,Kai Nissley,Chief Operations Officer,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001640,Planned Parenthood Santa Rosa,Planned Parenthood Northern California,1659671600,"Family Planning Providers, Sexually Transmitted Disease Clinics",1140 Sonoma Ave # Buidling,,Santa Rosa,CA,95405-4817,Sonoma,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001641,Sonoma County Indian Health,Sonoma County Indian Health Clinic,1265457980,"Dental Providers, Indian Health Service, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",144 Stony Point Rd,,Santa Rosa,CA,95401-4122,Sonoma,144 Stony Point Rd,24 Maime Laiwa Drive,Santa Rosa,CA,95401-4122,Sonoma,"Leroy Jackson, Jr.",CEO,707-521-4650,,leroy.jackson@scihp.org,Betty J. Arterberry,COO,707-521-4660,,betty.arterberry@scihp.org,www.scihp.org
CA-001642,Vista Family Health Center,SANTA ROSA COMMUNITY HEALTH CENTERS,1578631172,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3569 Round Barn Cir,,Santa Rosa,CA,95403-5781,Sonoma,3569 Round Barn Circle,,Santa Rosa,CA,94503,Sonoma,Noeleen Farrell,Director of Corp Compliance and Assurance,707-387-3265,,noeleenf@srhealthcenters.org,Kai Nissley,Chief Operations Officer,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001643,Elsie Allen Health Center,SANTA ROSA COMMUNITY HEALTH CENTERS,1568665073,Federally Qualified Health Centers - Medical Services,599 Bellevue Ave,,Santa Rosa,CA,95407-7713,Sonoma,Santa Rosa Community Health Centers,3569 Round Barn Circle,Santa Rosa,CA,95403,Sonoma,Noeleen Farrell,Director of Corp Compliance and Assurance,707-387-3265,,noeleenf@srhealthcenters.org,Kai Nissley,Chief Operations Officer,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001644,Sonoma County Health Department TB Program,Sonoma County Health Department,1235211954,Tuberculosis Clinics,625 5th St,,Santa Rosa,CA,95404-4428,Sonoma,3313 Chanate Road,,Santa Rosa,CA,95404,Sonoma,Karen Holbrook,Deputy Health Officer,707-565-4599,,karen.holbrook@sonoma-county.org,Mary Miller,Supervising Public Health Nurse,707-565-4569,,mary.miller@sonoma-county.org,
CA-001645,Roseland Pediatrics,SANTA ROSA COMMUNITY HEALTH CENTERS,1558512624,Federally Qualified Health Centers - Medical Services,711 Stony Point Rd,Suite 17,Santa Rosa,CA,95407-6848,Sonoma,Santa Rosa Community Health Centers,3569 Round Barn Circle,Santa Rosa,CA,95403,Sonoma,Noeleen Farrell,Director of Corp Compliance and Assurance,707-387-3265,,noeleenf@srhealthcenters.org,Kai Nissley,Chief Operations Officer,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001646,Sonoma County Health Department STD Clinic,Sonoma County Health Department,1235211954,Sexually Transmitted Disease Clinics,7425 Rancho Los Guilicos Rd,,Santa Rosa,CA,95409-6519,Sonoma,3313 Chanate Road,,Santa Rosa,CA,95404,Sonoma,Karen Holbrook,Deputy Health Officer,707-565-4599,,karen.holbrook@sonoma-county.org,Kristen Vela,Health Program Manager,707-565-6388,,kristen.vela@sonoma-county.org,
CA-001647,Southwest Community Health Center,SANTA ROSA COMMUNITY HEALTH CENTERS,1487857991,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",751 Lombardi Ct,Suite B,Santa Rosa,CA,95407-5454,Sonoma,Santa Rosa Community Health Centers,3569 Round Barn Cir,Santa Rosa,CA,95403-5781,Sonoma,Naomi Fuchs,CEO,707-303-3091,,naomif@srhealthcenters.org,Kai Nissley,COO,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001648,Brookwood Health Center,SANTA ROSA COMMUNITY HEALTH CENTERS,1184909103,Federally Qualified Health Centers - Medical Services,983 Sonoma Ave,,Santa Rosa,CA,95404-4818,Sonoma,Santa Rosa Community Health Centers,3569 Round Barn Circle,Santa Rosa,CA,95403,Sonoma,Noeleen Farrell,Director of Corp Compliance and Assurance,707-303-3265,,noeleenf@srhealthcenters.org,Kai Nissley,Chief Operations Officer,707-303-3600,3430,kain@srhealthcenters.org,www.srhealthcenters.org
CA-001649,Santa Ynez Tribal Health Center,Santa Ynez Tribal Health Program,1992779417,"Dental Providers, Federally Qualified Health Centers - Medical Services",90 Via Juana Rd,,Santa Ynez,CA,93460-9679,Santa Barbara,90 Via Juana Rd,,Santa Ynez,CA,93460-9679,Santa Barbara,Tonia L Archuleta,Administration Manager,805-694-2666,,tarchuleta@sythc.org,Ron G Sisson,Executive Director,805-694-2650,,rsisson@sythc.org,www.sythc.org
CA-001650,Seaside Family Health Center,County of Monterey,1881645158,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1150 Fremont Blvd,,Seaside,CA,93955,Monterey,1615 Bunker Hill Way STE 100,,Salinas,CA,93906-0000,Monterey,Nan Kyung Kim,Finance Manager,831-796-1308,,kimnk@co.monterey.ca.us,,,,,,
CA-001651,Seaside Health Center,Planned Parenthood Mar Monte,1972556967,"Family Planning Providers, Sexually Transmitted Disease Clinics",625 Hilby Ave,,Seaside,CA,93955-5720,Monterey,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001652,Gravenstein Community Health Center,"West County Health Centers, Inc",1861809501,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",652 Petaluma Ave,Suite H,Sebastopol,CA,95472-4266,Sonoma,14045 Mill St,,Guerneville,CA,954468303,Sonoma,Vikki Minnifield,Billing Manager,707-869-5977,3306,vminnifield@wchealth.org,,,,,,
CA-001653,Sebastopol Community Health Center,"West County Health Centers, Inc",1538334065,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",6800 Palm Ave,Suite C2,Sebastopol,CA,95472-4251,Sonoma,14045 Mill St,,Guerneville,CA,954468303,Sonoma,Vikki Minnifield,Billing Manager,707-869-5977,3306,vminnifield@wchealth.org,,,,,,
CA-001654,ADVENTIST HEALTH MEDICAL OFFICE SELMA CAMPUS RHC,ADVENTIST HEALTH REEDLEY,1265530018,Rural Health Clinics,1041 Rose Ave,,Selma,CA,93662-3240,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Teresa Escamilla,Site Manager,559-856-6099,,escamitl@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001655,Selma Rural Health,"Virender S. Kaleka, M.D.",1124241930,Rural Health Clinics,2057 High St,,Selma,CA,93662-3512,Fresno,2057 High St,,Selma,CA,93662,Fresno,Isela Haro,Office Manage,559-449-1370,,vskbusoff@yahoo.com,,,,,,
CA-001656,ADVENTIST HEALTH MEDICAL OFFICE SELMA CENTRAL RHC,ADVENTIST HEALTH REEDLEY,1811914377,Rural Health Clinics,2141 High St,Suite E,Selma,CA,93662-3065,Fresno,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Altalie Rosales,Site Manager,559-856-6110,,RosaleAG@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001657,Komin Medical Group,Michael L Komin MD Medical Corporation,1164696449,Rural Health Clinics,1150 E Lerdo Hwy Unit C,,Shafter,CA,93263-9420,Kern,1150 E Lerdo Hwy,Suite C,Shafter,CA,93263,Kern,Roxann Komin,admin,661-630-5890,,roxann@kominmedicalgroup.com,,,,,,
CA-001658,ADVENTIST HEALTH MEDICAL OFFICE SHAFTER RHC,ADVENTIST HEALTH REEDLEY,1689037533,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",406 James St,,Shafter,CA,93263-2035,Kern,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,,derrick.gruen@ah.org,Wendy Galland,Site Manager,661-746-5788,,GallanWJ@AH.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001659,Shasta Lake Family Health Center,Shasta Community Health Center,1013932797,"Dental Providers, Federally Qualified Health Centers - Medical Services",4215 Front St,,Shasta Lake,CA,96019-9430,Shasta,1035 Placer Street,,Redding,CA,96001-1125,Shasta,Harold Carlson,Chief Planning and Development Officer,530-246-5817,,hcarlson@shastahealth.org,Robin Glasco,Chief Operating Officer,530-246-5739,,rglasco@shastahealth.org,shastahealth.org
CA-001660,AHF Healthcare Center - Valley,AIDS Healthcare Foundation,1598740177,"Other ECP Providers, Ryan White Providers",4835 Van Nuys Blvd,Suite 200,Sherman Oaks,CA,91403-2139,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001661,Shingletown Medical Center,Shingletown Medical Center,1750387072,Federally Qualified Health Centers - Medical Services,31292 Alpine Meadows Rd,,Shingletown,CA,96088-9462,Shasta,31292 Alpine Meadows Road,,Shingletown,CA,96088-9462,Shasta,Tami Fraser,CEO,530-474-3390,307,tfraser@shingletownmedcenter.org,,,,,,
CA-001662,Death Valley Health Center,Clinica Sierra Vista,1972505469,Federally Qualified Health Centers - Medical Services,140 N State Highway 127,PO Box 158,Shoshone,CA,92384-0158,Inyo,1430 Truxtun Ave,P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,
CA-001663,"Clinicas del Camino Real, Inc. Simi Valley Madera","Clinicas del Camino Real, Inc.",1720362056,"Dental Providers, Federally Qualified Health Centers - Medical Services",1424 Madera Rd,,Simi Valley,CA,93065-3053,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001664,"Clinicas del Camino Real, Inc. East Simi Valley","Clinicas del Camino Real, Inc.",1609291996,"Dental Providers, Federally Qualified Health Centers - Medical Services",4370 Eve Rd,,Simi Valley,CA,93063-2323,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001665,UIHS - Howonquet Health Center,"United Indian Health Service, Inc.",1043216021,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",501 N Indian Rd,,Smith River,CA,95567-9509,Del Norte,1600 Weeot Way,,Arcata,CA,95521-4734,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,707-825-5000,,david.rosen@crihb.org,
CA-001666,SOLEDAD MEDICAL CLINIC,SOLEDAD COMMUNITY HEALTH CARE DISTRICT,1003822453,Rural Health Clinics,600 Main St,,Soledad,CA,93960-2533,Monterey,600 MAIN STREET,,SOLEDAD,CA,93960,Monterey,STEVEN PRITT,CHIEF EXECUTIVE OFFICER,831-678-2462,,stevenpritt@hotmail.com,SOPHIE PINA,EXECUTIVE ASSISTANT,831-678-2462,,spina@schcd.com,
CA-001667,Soledad Clinic,Clinica de Salud del Valle de Salinas,1053452136,"Dental Providers, Federally Qualified Health Centers - Medical Services",799 Front St,,Soledad,CA,93960-3017,Monterey,440 Airport Boulevard,,Salinas,CA,93905,Monterey,Maximiliano Cuevas,Chief Executive Officer,831-757-8689,,mcuevas@csvs.org,,,,,,www.csvs.org
CA-001668,SANTA YNEZ VALLEY COTTAGE HOSPITAL,SANTA YNEZ VALLEY COTTAGE HOSPITAL,1952301863,Inpatient Hospitals (other than children's hospitals),2050 Viborg Rd,,Solvang,CA,93463-2220,Santa Barbara,400 W. Pueblo Street,,SANTA BARBARA,CA,93105,Santa Barbara,Lisa Dominguez,Contracting Manager,805-879-8965,48965,l1doming@sbch.org,,,,,,cottagehealth.org
CA-001669,"Sonora Indian Health Center - M.A.C.T. Health Board, Inc.","M.A.C.T. Health Board, Inc.",1467444364,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",13975 Mono Way,Suite G,Sonora,CA,95370-2824,Tuolumne,52 S Main St,,Angels Camp,CA,95221,Calaveras,John Alexander,Executive Director,209-754-6262,,john.alexander@macthealth.org,Mariela Contreras,Finance Director,209-754-6262,,mariela.contreras@macthealth.org,www.macthealth.org
CA-001670,ADVENTIST HEALTH SONORA RHC,ADVENTIST HEALTH SONORA,1003014952,Rural Health Clinics,193 Fairview Ln,,Sonora,CA,95370-4828,Tuolumne,1000 Greenley Road,,Sonora,CA,95370-5200,Tuolumne,Toni Emerald,Executive Director Clinic Services,209-536-5050,,Toni.Emerald@ah.org,Jasmin Rice,"Director, Operations Outpatient",209-536-5050,,RiceJ3@ah.org,https://www.adventisthealth.org/sonora
CA-001671,Tuolumne MeWuk Health and Wellness Center,"Tuolumne MeWuk Indian Health Center, Inc.",1124286885,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",22044 Cedar Rd,,Sonora,CA,95370,Tuolumne,18880 Cherry Valley Blvd,,Tuolumne,CA,95379,Tuolumne,Chris Gorsky,Executive Director,209-928-5470,,cgorsky@tmwihc.org,Carol Anderson,Billing Supervisor,209-928-5452,,candeson@tmwihc.org,www.tmwhc.org
CA-001672,ChapCare Vacco,Community Health Alliance of Pasadena,1578808200,Federally Qualified Health Centers - Medical Services,10408 Vacco St,,South El Monte,CA,91733-3328,Los Angeles,455 W Montana St,,Pasadena,CA,91103,Los Angeles,Sergio Bautista,COO/CFO,626-993-1222,1222,Sbautista@chapcare.org,Margaret B Martinez,CEO,626-993-1227,1227,mmartinez@chapcare.org,
CA-001673,South San Francisco,PLANNED PARENTHOOD MAR MONTE,1699129403,Family Planning Providers,435 Grand Ave,,South San Francisco,CA,94080-3635,San Mateo,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,,,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001674,Grossmont Spring Valley Family Health Center,"FAMILY HEALTH CENTERS OF SAN DIEGO, INC.",1508801069,"Dental Providers, Federally Qualified Health Centers - Medical Services",8788 Jamacha Rd,,Spring Valley,CA,91977-4035,San Diego,823 Gateway Center Way,,San Diego,CA,92102-4541,San Diego,Felipe Garcia-Bigley,Director - Care Coordination Services,619-876-4456,,felipegb@fhcsd.org,Martha Ontiveros,Director- Billing and Compliance,619-515-2561,,marthao@fhcsd.org,www.fhcsd.org
CA-001675,Family HealthCare Network - Springville Health Center,FAMILY HEALTHCARE NETWORK,1386738177,Federally Qualified Health Centers - Medical Services,35800 Highway 190,,Springville,CA,93265-9116,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Director of Managed Care,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001676,Stanford Health Care,Stanford Health Care,1871543215,Inpatient Hospitals (other than children's hospitals),300 Pasteur Dr,,Stanford,CA,94305-2200,Santa Clara,300 Pasteur Dr MC5555,,Stanford,CA,94305,Santa Clara,Day Hsu,"Director, Revenue and Reimbursement",650-723-8307,,dhsu@stanfordhealthcare.org,Gary May,VP- Managed Care and Payer Relations,650-736-0928,,GMay@stanfordhealthcare.org,
CA-001677,"Community Medical Centers, Waterloo","COMMUNITY MEDICAL CENTERS, INC.",1285059923,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1031 Waterloo Rd,,Stockton,CA,95205-4256,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenter.ort
CA-001678,San Joaquin County Department of Public Health Services,San Joaquin County Department of Public Health Services,1083955801,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1601 E Hazelton Ave,,Stockton,CA,95205-6229,San Joaquin,1601 E. Hazelton Ave,,Stockton,CA,95205,San Joaquin,Tammy Evans,Director,209-468-3410,,tevans1@sjcphs.org,Julie Vaishampayan,Assistant Health Officer,209-468-3859,,jvaishampayan@sjcphs.org,www.sjcphs.org
CA-001679,"Community Medical Centers, Hammer Lane","COMMUNITY MEDICAL CENTERS, INC.",1538223375,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1721 E Hammer Ln,Suite A,Stockton,CA,95210-4124,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001680,"Community Medical Centers, E. March Lane","Community Medical Centers, Inc.",1356723936,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1801 E March Ln,Suite D470,Stockton,CA,95210-6677,San Joaquin,7210 Murray Drive,,Stockton,CA,95210,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001681,"Community Medical Centers, Mariposa","Community Medical Centers, Inc.",1669720157,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2015 E Mariposa Rd,,Stockton,CA,95205-7735,San Joaquin,7210 Murray Drive,,Stockton,CA,95210-0779,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001682,"Community Medical Centers, King","COMMUNITY MEDICAL CENTERS, INC.",1164586772,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2640 E Lafayette St,,Stockton,CA,95205-5713,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001683,"Community Medical Centers, Gleason House","COMMUNITY MEDICAL CENTERS, INC.",1649525544,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",423 S San Joaquin St,,Stockton,CA,95203-3537,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001684,North Clinic Health Center,Planned Parenthood Mar Monte,1366496838,"Family Planning Providers, Sexually Transmitted Disease Clinics",4555 Precissi Ln,,Stockton,CA,95207-6239,San Joaquin,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001685,Eastland Plaza Health Center,PLANNED PARENTHOOD MAR MONTE,1174579957,"Family Planning Providers, Sexually Transmitted Disease Clinics",678 N Wilson Way # G,,Stockton,CA,95205-4272,San Joaquin,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,3618,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001686,"Community Medical Centers, Channel","COMMUNITY MEDICAL CENTERS, INC.",1578552543,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",701 E Channel St,,Stockton,CA,95202-2628,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001687,Aria Community Health Center Stratford,Avenal Community Health Center,1992176267,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",20326 Main St,,Stratford,CA,93266-9742,Kings,1000 Skyline Blvd,,Avenal,CA,93204,Kings,Christine Ehda,Billing Manager,559-386-4500,1014,cehda@ariachc.org,Hemanta Mungur,CFO,559-386-4500,1030,hmungur@ariachc.org,
CA-001688,Sun Valley Health Center,NORTHEAST VALLEY HEALTH CORPORATION,1013199264,"Dental Providers, Federally Qualified Health Centers - Medical Services",7223 Fair Ave,,Sun Valley,CA,91352-4964,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/
CA-001689,Lassen Indian Health Center,Susanville Indian Rancheria,1770564049,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",795 Joaquin St,,Susanville,CA,96130-3628,Lassen,795 Joaquin Street,,Susanville,CA,96130,Lassen,Jacqueline J. Bae,CEO/COO,530-251-5184,,jbae888@yahoo.com,JJ Bae,,530-257-2542,,,
CA-001690,LOS ANGELES MISSION COLLEGE,NORTHEAST VALLEY HEALTH CORPORATION,1154322642,Federally Qualified Health Centers - Medical Services,13356 Eldridge Ave,,Sylmar,CA,91342-3200,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa NItescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001691,West Side Family Health Care,West Side Health Care District,1992142277,Rural Health Clinics,100 E North St,,Taft,CA,93268-3606,Kern,119 Adkisson Way,,Taft,CA,93268,Kern,Gerald A.Starr,Executive Director,661-765-7234,,gstarr@wshcd.org,Robyn Melton,District Manager,661-765-7234,,rmelton@wshcd.org,
CA-001692,ADVENTIST HEALTH MEDICAL OFFICE TAFT RHC,ADVENTIST HEALTH REEDLEY,1528324167,Rural Health Clinics,501 6th St,,Taft,CA,93268-2704,Kern,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,37,derrick.gruen@ah.org,Jason Harris,Site Manager,661-763-5131,,Harrisj02@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001693,ADVENTIST HEALTH TEHACHAPI VALLEY RHC,ADVENTIST HEALTH TEHACHAPI VALLEY,1275841629,Rural Health Clinics,105 W E St,,Tehachapi,CA,93561-1607,Kern,PO Box 1900,,Tehachapi,CA,93581-1900,Kern,Sarah Shelbourne,Ambulatory & Physician Services Executive,661-823-7070,,shelbosj@ah.org,Bonnie Quinonez,Director Operations,661-771-8604,,QuinonBD@AH.org,https://www.adventisthealth.org/tehachapivalley/
CA-001694,Pechanga Indian Health Center,"Riverside San-Bernardino County Indian Health, Inc. - Morongo Clinic",1316090798,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",12784 Pechanga Rd,,Temecula,CA,92592,Riverside,11980 Mount Vernon Ave,,Grand Terrace,CA,92313-5172,San Bernardino,Jess Montoya,Director,909-864-1097,4702,jmontoya@rsbcihi.org,Charlen Taylor,Controller,909-864-1097,4737,ctaylor@rsbcihi.org,
CA-001695,Neighborhood Healthcare ~ Temecula Enterprise,NEIGHBORHOOD HEALTHCARE,1437335148,Federally Qualified Health Centers - Medical Services,41840 Enterprise Cir N,,Temecula,CA,92590-5654,Riverside,425 N Date St Ste 203,,Escondido,CA,92025-3413,San Diego,Tracy L Ream,CEO,760-520-8375,,tracyr@nhcare.org,Lisa Daigle,CFO,760-737-6901,,lisad@nhcare.org,
CA-001696,Family HealthCare Network - Terra Bella Health Center,FAMILY HEALTHCARE NETWORK,1831520048,"Dental Providers, Federally Qualified Health Centers - Medical Services",9416 Road 238,,Terra Bella,CA,93270-9416,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001697,Torres-Martinez Health Clinic,"Riverside San-Bernardino County Indian Health, Inc. - Morongo Clinic",1043363641,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",66735 Martinez Rd,,Thermal,CA,92274-9007,Riverside,11980 Mount Vernon Ave,,Grand Terrace,CA,92313-5172,San Bernardino,Jess Montoya,Director,909-864-1097,4702,jmontoya@rsbcihi.org,Charlen Taylor,Controller,909-864-1097,4737,ctaylor@rsbcihi.org,
CA-001698,Thousand Oaks Clinic,Planned Parenthood California Central Coast,1619994191,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1200 W Hillcrest Dr,,Thousand Oaks,CA,91320-2734,Ventura,518 Garden St,,SANTA BARBARA,CA,93101,Santa Barbara,Yolanda Robles,VP of Clinical Operations,805-963-2445,1712,yolanda.robles@ppcentralcoast.org,,,805-963-2445,,,https://www.plannedparenthood.org/planned-parenthood-california-central-coast
CA-001699,Family HealthCare Network - Three Rivers Health Center,FAMILY HEALTHCARE NETWORK,1558454256,Federally Qualified Health Centers - Medical Services,41651 Sierra Dr,,Three Rivers,CA,93271-9678,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001700,Tipton Medical Clinic,Tipton Medical Clinic,1528072527,Rural Health Clinics,575 N Thompson Rd,,Tipton,CA,93272-9756,Tulare,575 N. Thompson,,Tipton,CA,93272,Tulare,"Linda Roberts, RN",CEO/OWNER,559-752-4147,,lroberts@tiptonmedicalclinic.com,,,,,,
CA-001701,Tracy Health Center,Planned Parenthood Mar Monte,1245493097,Family Planning Providers,1441 N Tracy Blvd,,Tracy,CA,95376-3445,San Joaquin,1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001702,"Community Medical Centers, Tracy","COMMUNITY MEDICAL CENTERS, INC.",1609867787,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",730 N Central Ave,,Tracy,CA,95376-4104,San Joaquin,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001703,Family HealthCare Network - Traver Health Center,FAMILY HEALTHCARE NETWORK,1790154862,Federally Qualified Health Centers - Medical Services,4177 Ave 368,,Traver,CA,93673,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001704,Nevada County Health Department,Nevada County Health Department,1700959863,"Family Planning Providers, Sexually Transmitted Disease Clinics",10075 Levone Ave,Suite 207,Truckee,CA,96161-4804,Nevada,10075 Levon Ave,Suite 207,Truckee,CA,96161-0443,Nevada,Cynthia Wilson,Director of Nursing,530-265-7269,,Cynthia.Wilson@co.nevada.ca.us,Carol Smith,Administrative Assistant,530-265-1413,,Carol.Smith@co.nevada.ca.us,http://www.mynevadacounty.com
CA-001705,Family HealthCare Network - Tulare Pediatrics,FAMILY HEALTHCARE NETWORK,1043664766,Federally Qualified Health Centers - Medical Services,1008 N Cherry St,,Tulare,CA,93274-2212,Tulare,305 E. Center Ave.,,Visalia,CA,93291,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001706,Family HealthCare Network - Tulare Health Center,FAMILY HEALTHCARE NETWORK,1073997201,"Dental Providers, Federally Qualified Health Centers - Medical Services",263 S West St,,Tulare,CA,93274-3411,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001707,Tulelake Health Center,Mountain Valleys Health Centers,1679645121,Federally Qualified Health Centers - Medical Services,498 Main St,,Tulelake,CA,96134,Siskiyou,P.O. Box 277,,Bieber,CA,96009,Lassen,Dave Jones,CEO,530-294-5114,,djones@mtnvalleyhc.org,Eileen Tremaine,Grants Management,530-524-5420,,etremaine@mtnvalleyhc.org,www.mtnvalleyhc.org
CA-001708,Tuolumne MeWuk Indian Health Center,"Tuolumne MeWuk Indian Health Center, Inc.",1619952397,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638, Urban Indian Health Program",18880 Cherry Valley Blvd,,Tuolumne,CA,95379-9506,Tuolumne,18880 Cherry ValleyBlvd,,Tuolumne,CA,95379,Tuolumne,Chris Gorsky,Executive Director,209-928-5470,,cgorsky@tmwihc.org,Carol Anderson,Billing Supervisor,209-928-5452,,canderson@tmwihc.org,www.tmwhc.org
CA-001709,GVHC - TURLOCK HEALTH CENTER,GOLDEN VALLEY HEALTH CENTERS,1356445753,Federally Qualified Health Centers - Medical Services,1141 N Olive Ave,,Turlock,CA,95380-3365,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001710,GVHC- Turlock West,GOLDEN VALLEY HEALTH CENTERS,1922249077,Federally Qualified Health Centers - Medical Services,1200 W Main St,,Turlock,CA,95380-5107,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001711,Hurtt Family Health Clinic,"HURTT FAMILY HEALTH CLINIC, INC.",1306965587,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Hope Dr,,Tustin,CA,92782-0221,Orange,1 Hope Dr,,Tustin,CA,92782-0221,Orange,Jewel Loff,CEO,714-247-4309,,daniel.davis@hurttclinic.org,Daniel Davis,COO,714-247-4309,,daniel.davis@hurttclinic.org,www.hurttclinic.org
CA-001712,ADVENTIST HEALTH UKIAH VALLEY N STATE ST RHC,ADVENTIST HEALTH UKIAH VALLEY,1770653362,Rural Health Clinics,1050 N State St,,Ukiah,CA,95482-3414,Mendocino,275 Hospital Drive,,Ukiah,CA,95482,Mendocino,Victoria Brittain,Practice Manager,707-467-5203,,BrittaVM@AH.org,Tamra Sams,Practice Administrator,707-463-7585,,SamsTL@AH.org,https://www.adventisthealth.org/ukiah-valley
CA-001713,Planned Parenthood Ukiah,Planned Parenthood Northern California,1962796268,"Family Planning Providers, Sexually Transmitted Disease Clinics",242 Hospital Dr,Suite A,Ukiah,CA,95482-4556,Mendocino,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,5233,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001714,ADVENTIST HEALTH UKIAH VALLEY UKIAH RHC,ADVENTIST HEALTH UKIAH VALLEY,1952471542,Rural Health Clinics,260 Hospital Dr,,Ukiah,CA,95482-4568,Mendocino,275 Hospital Drive,,Ukiah,CA,95482,Mendocino,Pravin Shende,Practice Manager,707-463-7378,,ShendePH@AH.org,Tamra Sams,Practice Administrator,707-463-7585,,SamsTL@AH.org,https://www.adventisthealth.org/ukiah-valley
CA-001715,Mendocino Community Health Clinic,Mendocino Community Health Clinic,1497961106,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",333 Laws Ave,,Ukiah,CA,95482-6540,Mendocino,333 Laws Avenue,,Ukiah,CA,95482,Mendocino,Carole Press,Chief Executive Officer,707-472-4511,,ceo@mchcinc.org,Anne McAfee,Ryan White Program Director,707-262-3232,,amcafee@mchcinc.org,mchcinc.org
CA-001716,Union City Health Center,Tiburcio Vasquez Health Center,1851389696,"Dental Providers, Federally Qualified Health Centers - Medical Services",33255 9th St,,Union City,CA,94587-2137,Alameda,33255 Ninth Street,,Union City,CA,94587,Alameda,David Vliet,Cheif Executive Officer,510-690-6050,,dvliet@tvhc.org,Wilfredo Lacro,VP of Business Development,510-460-3846,,wlacro@tvhc.org,www.tvhc.org
CA-001717,Upland Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1528037041,"Family Planning Providers, Sexually Transmitted Disease Clinics",918 W Foothill Blvd,Suite No. A,Upland,CA,91786-3772,San Bernardino,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-001718,"Community Medical Centers, Vacaville","COMMUNITY MEDICAL CENTERS, INC.",1417012329,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",600 Nut Tree Rd,Suite 310,Vacaville,CA,95687-4686,Solano,7210 Murray Dr,,Stockton,CA,95210-3339,San Joaquin,Christine Noguera,CEO,209-373-2826,,cnoguera@cmcenters.org,Art Feagles,CFO,209-373-2803,,afeagles@cmcenters.org,www.communitymedicalcenters.org
CA-001719,Valencia Health Center,Northeast Valley Health Corporation,1730180118,Federally Qualified Health Centers - Medical Services,23763 Valencia Blvd,,Valencia,CA,91355-2105,Los Angeles,23763 Valencia Blvd,,Valencia,CA,91355-2105,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa (Missy) Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/
CA-001720,Planned Parenthood Vallejo,Planned Parenthood Northern California,1942369012,"Family Planning Providers, Sexually Transmitted Disease Clinics",303 Sacramento St,,Vallejo,CA,94590-5901,Solano,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,5233,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001721,Family Medical Center - Valley Springs,Mark Twain Medical Center,1821159443,Rural Health Clinics,1919 Vista del Lago Dr,,Valley Springs,CA,95252-9294,Calaveras,768 Mountain Ranch Road,,San Andreas,CA,95249,Calaveras,Debbie Esparza,Director of Managed Care,209-467-6546,,Debbie.Esparza@DignityHealth.Org,Chris Roberts,CFO/VP of Finance,209-754-2614,,Chris.Roberts@DignityHealth.Org,
CA-001722,Van Nuys Adult Health Center,NORTHEAST VALLEY HEALTH CORPORATION,1629079009,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",6551 Van Nuys Blvd,Suite 201,Van Nuys,CA,91401-1490,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Eexecutive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,http://www.nevhc.org/programs-a-services/primary-and-preventive-care/hiv-testing-and-treatment.html
CA-001723,Van Nuys Health Center,Planned Parenthood Los Angeles,1588753701,Family Planning Providers,7100 Van Nuys Blvd,Suite 108,Van Nuys,CA,91405-3063,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001724,PEDIATRIC HEALTH & CENTER,NORTHEAST VALLEY HEALTH CORPORATION,1093716474,Federally Qualified Health Centers - Medical Services,7138 Van Nuys Blvd,,Van Nuys,CA,91405-3005,Los Angeles,1172 N Maclay Ave,,San Fernando,CA,91340-1328,Los Angeles,Kimberly Wyard,Chief Executive Officer,818-898-1388,41620,KimWyard@nevhc.org,Theresa Nitescu,Chief Operations Officer,818-898-1388,41624,MissyNitescu@nevhc.org,
CA-001725,Mid-Valley Comphrehensive Health Center,Mid-Valley Comphrehensive Health Center,1265440010,Family Planning Providers,7515 Van Nuys Blvd,,Van Nuys,CA,91405-1949,Los Angeles,7515 Van Nuys Blvd.,,Van Nuys,CA,91405,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001726,"Clinicas del Camino Real, Inc. Ventura","Clinicas del Camino Real, Inc.",1679631907,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 S Wells Rd,,Ventura,CA,93004-1377,Ventura,P.O. Box 1270,,Camarillo,CA,93011,Ventura,Antonio Alatorre,Chief Business Development Officer,805-659-1740,,talatorre@clinicas.org,Christina Velasco,Chief Financial Officer,805-659-1740,,cvelasco@clinicas.org,
CA-001727,Ventura Clinic,Planned Parenthood California Central Coast,1184641664,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",5400 Ralston St,,Ventura,CA,93003-6002,Ventura,518 Garden St,,SANTA BARBARA,CA,93101,Santa Barbara,Yolanda Robles,VP of Clinical Operations,805-722-1512,,yolanda.robles@ppcentralcoast.org,,,,,,https://www.plannedparenthood.org/planned-parenthood-california-central-coast
CA-001728,County of Ventura Health Care Agency,County of Ventura,1427118868,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Ryan White Providers",800 S Victoria Ave,,Ventura,CA,93009-0001,Ventura,5851 Thille,Suite 2,Vetnura,CA,93003,Ventura,Susan White Wood,Grants Manager,805-339-1103,,susan.whitewood@ventura.org,"Renee Higgins, MD",Chief Operations Officer,805-339-1112,,renee.higgins@ventura.org,
CA-001729,Victorville Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1225376809,"Family Planning Providers, Sexually Transmitted Disease Clinics",15403 Park Ave E,,Victorville,CA,92392-2482,San Bernardino,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino
CA-001730,Visalia,PLANNED PARENTHOOD MAR MONTE,1790739126,Family Planning Providers,211 N Stevenson St,,Visalia,CA,93291-6023,Tulare,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Dominique Lee,VP Patient Services,408-795-3688,,dominique_lee@ppmarmonte.org,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,www.ppmarmonte.org
CA-001731,Family HealthCare Network - Goshen Health Center,FAMILY HEALTHCARE NETWORK,1336237072,"Dental Providers, Federally Qualified Health Centers - Medical Services",31180 Rd 72,,Visalia,CA,93291,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001732,Family HealthCare Network - Visalia Oak Health Center,FAMILY HEALTHCARE NETWORK,1821186727,Federally Qualified Health Centers - Medical Services,400 E Oak Ave,,Visalia,CA,93291-5034,Tulare,305 E. Center Ave.,,Visalia,CA,93291,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001733,Family HealthCare Network - Visalia Bridge Health Center,FAMILY HEALTHCARE NETWORK,1588699151,"Dental Providers, Federally Qualified Health Centers - Medical Services",501 N Bridge St,,Visalia,CA,93291-5014,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001734,Vista Community Clinic,Vista Community Clinic,1295822658,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 Vale Terrace Dr,,Vista,CA,92084-5218,San Diego,1000 Vale Terrace,,Vista,CA,92084,San Diego,Fernando Sanudo,CEO,760-631-5000,1131,pgupta@vcc.clinic,Payal Gupta,Admin Manager,760-631-5000,1131,pgupta@vcc.clinic,
CA-001735,Vista Isabella Clinic,Planned Parenthood of the Pacific Southwest,1245257708,"Family Planning Providers, Sexually Transmitted Disease Clinics",1964 Via Ctr,,Vista,CA,92081-6056,San Diego,1075 Camino del Rio South,,San Diego,CA,92108-3538,San Diego,Francis Pickford,Vice President of Finance,619-881-4535,,fpickford@planned.org,,,,,,http://www.plannedparenthood.org/pacific-southwest/
CA-001736,Planned Parenthood Walnut Creek,Planned Parenthood Northern California,1003974064,"Family Planning Providers, Sexually Transmitted Disease Clinics",1357 Oakland Ct,,Walnut Creek,CA,94596-4337,Contra Costa,2185 Pacheco Street,,Concord,CA,94520,Contra Costa,Reyna Navarro,Medical Client Services Administrative Coordinator,925-887-5233,,rnavarro@ppnorcal.org,Erin Harr Yee,Sr. Vice President of Client Services,925-887-5386,,eharryee@ppnorcal.org,www.ppnorcal.org
CA-001737,ADVENTIST HEALTH MEDICAL OFFICE WASCO RHC,ADVENTIST HEALTH REEDLEY,1245694306,Rural Health Clinics,1040 7th St,,Wasco,CA,93280-1934,Kern,372 W CYPRESS AVENUE,,REEDLEY,CA,93654,Fresno,DERRICK GRUEN,VICE PRESIDENT,559-537-0037,,derrick.gruen@ah.org,Julsemina Belo,Site Manager,661-758-7801,,BeloguJ1@ah.org,https://www.adventisthealth.org/central-valley/Pages/OHAM/OrgUnitDetails.aspx?OrganizationalUnitId=2847
CA-001738,Watsonville Health Center,County of Santa Cruz,1770709149,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1430 Freedom Blvd,,Watsonville,CA,95076-2780,Santa Cruz,1080 Emeline Avenue,,Santa Cruz,CA,95060,Santa Cruz,Jeanette Garcia,Administrative Services Manager,831-454-5492,,jeanette.garcia@santacruzcounty.us,Amy Peeler,Chief of Clinic Services,831-454-4764,,amy.peeler@santacruzcounty.us,http://santacruzhealth.org/HSAHome/HSADivisions/ClinicServices.aspx
CA-001739,Watsonville Health Center,Planned Parenthood Mar Monte,1083667323,"Family Planning Providers, Sexually Transmitted Disease Clinics",398 S Green Valley Rd,,Watsonville,CA,95076-3099,Santa Cruz,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Jennifer Stork,Director of Payor Development & Management,408-795-3618,3618,jennifer_stork@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001740,Trinity Community Health Clinic,Mountain Communities Healthcare District,1356422307,Rural Health Clinics,31 Easter Ave,,Weaverville,CA,96093-1229,Trinity,PO Box 1229,,Weaverville,CA,96093,Trinity,Kelly Simpson,Manager of Business Services,530-623-5541,3258,kellys@mcmedical.org,,,,,,
CA-001741,Trinity Hospital,Mountain Communities Healthcare District,1750462271,Other ECP Providers,60 Easter Ave,,Weaverville,CA,96093-1229,Trinity,PO Box 1229,,Weaverville,CA,96093,Trinity,Kelly Simpson,Manager of Business Services,530-623-5541,3258,kellys@mcmedical.org,,,,,,
CA-001742,"EAST VALLEY COMMUNITY HEALTH CENTER, INC. - WEST COVINA HEALTH CENTER","EAST VALLEY COMMUNITY HEALTH CENTER, INC.",1831243625,Federally Qualified Health Centers - Medical Services,420 S Glendora Ave,,West Covina,CA,91790-3001,Los Angeles,420 S Glendora Ave,,West Covina,CA,91790-3001,Los Angeles,Alicia Mardini,Chief Executive Officer,626-919-4333,2220,amardini@evchc.org,Lelenia Navarro,Director of Operations,909-620-8088,3407,lnavarro@evchc.org,www.evchc.org
CA-001743,SALUD CLINIC,COMMUNICARE HEALTH CENTERS,1710087515,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",500 Jefferson Blvd,Suite B180,West Sacramento,CA,95605-2394,Yolo,2051 John Jones Rd,,Davis,CA,95616-9701,Yolo,Robin Affrime,CEO,530-753-3498,,robina@communicarehc.org,,,,,,
CA-001744,GVHC - WESTLEY,GOLDEN VALLEY HEALTH CENTERS,1770568347,Federally Qualified Health Centers - Medical Services,301 Howard Rd,,Westley,CA,95387,Stanislaus,737 W Childs Ave,,Merced,CA,95341-6805,Merced,Tony Weber,CEO,209-385-5551,,tweber@gvhc.org,,,,,,
CA-001745,Westminster Clinic,Planned Parenthood of Orange and San Bernardino Cos.,1316916836,"Family Planning Providers, Sexually Transmitted Disease Clinics",14372 Beach Blvd,,Westminster,CA,92683-4578,Orange,700 S Tustin St,,Orange,CA,92866,Orange,Jessica Chinen,Director of Financial Services,714-633-6373,137,jessica.wu@PPOSBC.org,,,,,,http://www.plannedparenthood.org/orange-san-bernardino/
CA-001746,UIHS - Weitchpec Health Center,"United Indian Health Service, Inc.",1265438154,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",Weitchpec Route Libby Nix Community Center,Highway 96,Wetchpec,CA,95546,Humboldt,1600 Weeot Way,,Arcata,CA,95521-4734,Humboldt,Sherri Provolt,CEO,707-825-5000,,sherri.provolt@crihb.org,David Rosen,CFO,707-825-5000,,david.rosen@crihb.org,
CA-001747,Whittier Health Center,Planned Parenthood Los Angeles,1245329440,Family Planning Providers,7655 Greenleaf Ave,,Whittier,CA,90602-1626,Los Angeles,400 W 30th St,,Los Angeles,CA,90007-3320,Los Angeles,Linda Pahl,Chief Financial Officer,213-284-3200,3210,Linda.Pahl@pp-la.org,Margie Slater,Director of Revenue Cycle,213-284-3200,3218,Margie.Slater@pp-la.org,http://www.plannedparenthood.org/los-angeles/
CA-001748,AHF Healthcare Center - Whittier,AIDS Healthcare Foundation,1316922347,"Other ECP Providers, Ryan White Providers",9200 Colima Rd,Suite 106,Whittier,CA,90605-1814,Los Angeles,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
CA-001749,Baechtel Creek Medical Clinic,Jihn R Glyer D Mills Matheson & Margaret Arner MDS PTR,1568525400,Rural Health Clinics,1245 S Main St,,Willits,CA,95490-4305,Mendocino,1245 S Main St,,Willits,CA,95490,Mendocino,Tracy Evans,Administrator,707-459-6861,,baechtelclinic@yahoo.com,,,,,,
CA-001750,ADVENTIST HEALTH HOWARD MEMORIAL RHC,ADVENTIST HEALTH HOWARD MEMORIAL,1437551652,Rural Health Clinics,3 Marcela Dr,Suite C,Willits,CA,95490-5769,Mendocino,1 Marcela Dr,,Willits,CA,95490,Mendocino,Shauna deMarquez,Practice Manager,707-456-3187,,deMarqSL@AH.org,Garin Fuhriman,Administrative Director,707-994-6486,,FuhrimGV@AH.org,https://www.adventisthealth.org/howard-memorial
CA-001751,Wilmington Health Center,"Los Angeles County, Department of Health Services",1225044662,Family Planning Providers,1325 Broad Ave,,Wilmington,CA,90744-2604,Los Angeles,1325 Broad Avenue,,Wilmington,CA,90744,Los Angeles,Delia Casarez,Program Manager,323-869-8579,,dcasarez@dhs.lacounty.gov,Judith Dannelle Pietersz,Clinical Program Manager,323-869-8579,,jpietersz@dhs.lacounty.gov,
CA-001752,Alliance Medical Center - Windsor,Alliance Medical Center,1710218409,Federally Qualified Health Centers - Medical Services,8465 Old Redwood Hwy,Suite 320,Windsor,CA,95492-9244,Sonoma,1381 University Ave,,Healdsburg,CA,95448,Sonoma,Alex Armstrong,CEO,707-385-2306,,aarmstrong@alliancemed.org,Alan Finnie,Project Manager,707-385-2310,,afinnie@alliancemed.org,alliancemed.org
CA-001753,Fort Yuma Health Center,Fort Yuma Health Center,1265719918,"Dental Providers, Indian Health Service, Other ECP Providers",One Indian Hill Rd,,Winterhaven,CA,92283,Imperial,PO Box 1368,,Yuma,AZ,85366-2361,Yuma,Yvonne Galvan,"Acting AO, Business Office Supervisor",760-572-4104,,yvonne.galvan@ihs.gov,,,,,,
CA-001754,Kern River Health Centre,Clinica Sierra Vista,1437151800,Federally Qualified Health Centers - Medical Services,67 Evans Road,PO Box 1150,Wofford Heights,CA,93285-1150,Kern,"1430 Truxtun Ave, suite 400",P.O. Box 1559,Bakersfield,CA,93302-1559,Kern,Cindy Stewart,Chief of Managed Care/Credentialing,661-635-3050,2169,mccred@clinicasierravista.org,,,,,,www.clinicasierravista.org
CA-001755,"Clinica El Lago, Inc.","Clinica El Lago, Inc.",1386077857,Rural Health Clinics,101 N Palm St,,Woodlake,CA,93286-1422,Tulare,101 N. Palm,,Woodlake,CA,93286,Tulare,Benjamin Cordova,Administrator,559-564-1100,,benclinicaellago@gmail.com,Socorro Jimenez,Clinic Manager,559-564-1100,,socorroclinicaellago@gmail.com,
CA-001756,Kaweah Delta Woodlake Health Clinic,Kaweah Delta Health Care District,1154614097,Rural Health Clinics,180 E Antelope Ave,,Woodlake,CA,93286-1506,Tulare,400 W. Mineral king,,Visalia,CA,93291,Tulare,David W. Garrett,Rural health clinic director,559-592-7300,7395,dgarrett@kdhcd.org,,,,,,
CA-001757,Family HealthCare Network - Woodlake Health Center,FAMILY HEALTHCARE NETWORK,1164517744,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 E Lakeview Ave,,Woodlake,CA,93286-1301,Tulare,305 E Center Ave,,Visalia,CA,93291-6331,Tulare,Kerry Hydash,President & CEO,559-737-4700,,khydash@fhcn.org,Chad Vawter,Chief Financial Officer,559-737-4700,,cvawter@fhcn.org,www.fhcn.org
CA-001758,Hansen Family Health Center,COMMUNICARE HEALTH CENTERS,1558469064,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",215 W Beamer St,,Woodland,CA,95695-2510,Yolo,2051 John Jones Rd,,Davis,CA,95616-9701,Yolo,Robin Affrime,CEO,530-758-1510,,robina@communicarehc.org,,,,,,
CA-001759,Woodland Health Center,PLANNED PARENTHOOD MAR MONTE,1568415495,"Family Planning Providers, Sexually Transmitted Disease Clinics",520 Cottonwood St,Suite 10,Woodland,CA,95695-3603,Yolo,1691 The Alameda,,San Jose,CA,95125,Santa Clara,Dominique Lee,Director of Payor Development & Management,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001760,Yreka Community Health Clinic,Karuk Tribe,1730279423,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1519 S Oregon St,,Yreka,CA,96097-3425,Siskiyou,1519 South Oregon St.,,Yreka,CA,96097,Siskiyou,Kori Novak,CEO,530-842-9200,6125,knovak@karuk.us,Lessie Aubrey,HRSA Grant Manager,530-493-1440,6003,laubrey@karuk.us,www.karuk.us
CA-001761,FAIRCHILD MEDICAL CLINIC,FAIRCHILD MEDICAL CENTER,1093892275,"Dental Providers, Rural Health Clinics",475 Bruce St,Suite 500,Yreka,CA,96097-3463,Siskiyou,444 Bruce Street,,Yreka,CA,96097,Siskiyou,Paulette Adams,Director of Hospital Clinics,530-841-6316,,padams@fairchildmed.org,Cheryl Freckman,Financial Systems Manager,530-841-6306,,cfreckman@fairchildmed.org,
CA-001762,Yuba City Health Center,PLANNED PARENTHOOD MAR MONTE,1255387106,"Family Planning Providers, Sexually Transmitted Disease Clinics",430 N Palora Ave,Suite G,Yuba City,CA,95991-4729,Sutter,1691 The Alameda,,San Jose,CA,95126-2203,Santa Clara,Dominique Lee,Director of Payor Development & Mgmt,408-795-3688,,dominique_lee@ppmarmonte.org,Dominique Lee,Vice President of Patient Services,408-795-3688,3688,dominique_lee@ppmarmonte.org,www.ppmarmonte.org
CA-001763,"Feather River Tribal Health, Inc.","Feather River Tribal Health, Inc.",1588826374,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",555 W Onstott Rd,,Yuba City,CA,95993-5654,Sutter,2145 5th Ave,,Oroville,CA,95965,Butte,Maria Hunzeker,Executive Director,530-534-5394,265,maria.hunzeker@frth.org,Erik C. Lyon,Deputy Director,530-534-5394,264,erik.lyon@frth.org,
CA-001764,"Sean R. Thomas, M.D., Inc.","Sean R. Thomas, M.D., Inc.",1447476312,Rural Health Clinics,55585 29 Palms Hwy,,Yucca Valley,CA,92284-2505,San Bernardino,55585 29 Palms Hwy,,Yucca Valley,CA,92284,San Bernardino,Valerie Dobbins,Office Manager,760-228-3366,,vdobbins760@gmail.com,,,,,,
CA-001765,"Yucca Family Medical Care, Inc.","Yucca Family Medical Care, Inc.",1942640511,Rural Health Clinics,57675 29 Palms Hwy,Suite 111,Yucca Valley,CA,92284-3099,San Bernardino,57675 29 Palms Hwy.,Ste. #111,Yucca Valley,CA,92284,San Bernardino,Pablo Sobero,MD,760-365-8500,,yfmc2008@gmail.com,Jenifer Batin,Office Manager,760-365-8500,,yfmc2008@gmail.com,
CO-001766,Northeast Colorado Health Department,Northeast Colorado Health Department,1013911437,Family Planning Providers,77 Main Ave,,Akron,CO,80720-1439,Washington,700 Columbine Street,,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CO-001767,Akron Clinic,Yuma District Hospital,1730185323,Rural Health Clinics,82 Main Ave,,Akron,CO,80720-1440,Washington,1000 West 8th Ave,,Yuma,CO,80759,Yuma,E Beth Saxton,CEO,970-848-4676,,bsaxton@yumahospital.org,Cindy Killip,,970-848-4792,,ckillip@yumahospital.org,www.yumahospital.org
CO-001768,Sierra Blanca Medical Center or Alamosa Physical Therapy and Rehabilitation,"VALLEY WIDE HEALTH SYSTEMS, INC.",1154377356,Federally Qualified Health Centers - Medical Services,106 Blanca Ave,Suite 300,Alamosa,CO,81101-2340,Alamosa,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001769,Convenient Care Community Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1568627941,Federally Qualified Health Centers - Medical Services,1131 Main St,,Alamosa,CO,81101-2446,Alamosa,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,
CO-001770,Alamosa Dental Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1154318236,Dental Providers,128 Market St,,Alamosa,CO,81101-2290,Alamosa,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001771,Planned Parenthood of the Rocky Mountains - Alamosa,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1560 12th St,Suite 7,Alamosa,CO,81101-3709,Alamosa,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001772,Alamosa Family Medical Center,"VALLEY WIDE HEALTH SYSTEMS, INC.",1801883459,Federally Qualified Health Centers - Medical Services,1710 1st St,,Alamosa,CO,81101-2302,Alamosa,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,
CO-001774,SAN LUIS VALLEY HEALTH ANTONITO CLINIC,"Lutheran Hospital Association of the San Luis Valley, DBA San Luis Valley Health",1821057860,Rural Health Clinics,115 Main St,,Antonito,CO,81120,Conejos,106 Blanca Avenue,,Alamosa,CO,81101,Alamosa,Kelly Gallegos,San Luis Valley Health CCH Administrator,719-274-5000,,Kelly.Gallegos@slvrmc.org,,,,,,www.sanluisvalleyhealth.org
CO-001775,Guadalupe Health Center or Physical Therapy Services,"VALLEY WIDE HEALTH SYSTEMS, INC.",1508853813,Federally Qualified Health Centers - Medical Services,W 10th Ave & Dahlia St,,Antonito,CO,81120,Conejos,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001776,ARVADA HEALTH CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1376701300,"Dental Providers, Federally Qualified Health Centers - Medical Services",11005 Ralston Rd,Suite 100G,Arvada,CO,80004-4551,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001777,Planned Parenthood of the Rocky Mountains -- Arvada,Planned Parenthood of the Rocky Mountains,1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",7735 Wadsworth Blvd Unit D,,Arvada,CO,80003-2131,Jefferson,7155 East 38th Avenue,,Denver,CO,80207,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,Kate Hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,www.pprm.org
CO-001778,Community Health Services Inc. Family Planning Program,Community Health Services Inc.,1205957032,Family Planning Providers,405 Castle Creek Rd,Suite 201,Aspen,CO,81611-3125,Pitkin,405 Castle Creek Rd Ste 6,,Aspen,CO,81611-3125,Pitkin,Liz Stark,Executive Director,970-920-5010,,liz.stark@pitkincounty.com,,,970-920-5010,,,ww.aspencommunityhealth.org
CO-001779,MCPN Aurora Health and Wellness Plaza,"METRO COMMUNITY PROVIDER NETWORK, INC",1558727883,"Dental Providers, Federally Qualified Health Centers - Medical Services",10680 Del Mar Pkwy,,Aurora,CO,80010-4011,Arapahoe,3701 S BROADWAY,,ENGLEWOOD,CO,80113,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001780,Planned Parenthood of the Rocky Mountains--Aurora,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",1284 S Abilene St,,Aurora,CO,80012-4629,Arapahoe,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001781,"Children's Hospital Colorado Anschutz Medical Campus, Aurora",Children's Hospital Colorado,1336245828,Children's Hospitals (inpatient only),13123 E 16th Ave,,Aurora,CO,80045-7106,Adams,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001782,"Children's Hospital Colorado Anschutz Medical Campus, Aurora",Children's Hospital Colorado,1336245828,"Dental Providers, Family Planning Providers, Outpatient Hospital Clinics",13123 E 16th Ave,,Aurora,CO,80045-7106,Adams,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,Elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001783,University of Colorado Hemophilia Center,University of Colorado Hemophilia Center,1588766968,Hemophilia Treatment Centers,13199 E Montview Blvd,Suite 100,Aurora,CO,80045-7202,Adams,"13199 E. Montview Blvd, #100",,Aurora,CO,80045,Adams,Paul Limberis,Pharmacy Manager of 340B Program,303-724-0172,,paul.limberis@ucdenver.edu,Candice Murchison,Reimbursement Coordinator,303-724-0173,,candice.murchison@ucdenver.edu,http://www.ucdenver.edu/academics/colleges/medicalschool/centers/HemophiliaThrombosis/Pages/home.aspx
CO-001784,Rocky Mountain Youth Clinics - Laredo,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,1350 Laredo St,,Aurora,CO,80011-7455,Arapahoe,"9197 S. Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,barb@rmyclinics.org,www.rmyclinics.org
CO-001785,SOUTH AURORA FAMILY HEALTH SERVICES CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1144489675,"Dental Providers, Federally Qualified Health Centers - Medical Services",15132 E Hampden Ave,Suite G,Aurora,CO,80014-5038,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001786,MCPN - Health &Wellness Center at the Asian Pacific Development Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1649605536,Federally Qualified Health Centers - Medical Services,1537 Alton St,,Aurora,CO,80010-1712,Adams,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001787,Rocky Mountain Youth Clinics - Aurora,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,1550 S Potomac St,Suite 130,Aurora,CO,80012-5442,Arapahoe,"9197 Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,btafoya@rmyclinics.org,www.rmyclinics.org
CO-001788,HELENA Health Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1568707776,Federally Qualified Health Centers - Medical Services,15501 E 13th Ave,,Aurora,CO,80011-7203,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001789,Rocky Mountain Youth Clinics - Crawford,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,1600 Florence St,,Aurora,CO,80010-2130,Adams,"9197 Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,btafoya@rmyclinics.org,www.rmyclinics.org
CO-001790,University of Colorados HIV/AIDS Clinical Program,University of Colorado Hospital,1144346800,Ryan White Providers,1635 Aurora Ct,,Aurora,CO,80045,Adams,1635 Aurora Court,,Aurora,CO,80045,Adams,Steven Johnson MD,Director of HIV/AIDS Prorgram,303-724-2401,,steven.johnson@ucdenver.edu,,,,,,
CO-001791,Elmira Refugee Health Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1811333842,Federally Qualified Health Centers - Medical Services,1666 Elmira St,,Aurora,CO,80010-2122,Adams,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001792,NORTH AURORA FAMILY HEALTH SERIVCES CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1205098340,"Dental Providers, Federally Qualified Health Centers - Medical Services",3292 Peoria St,,Aurora,CO,80010-1517,Adams,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001793,POTOMAC STREET HEALTH CLINIC,"METRO COMMUNITY PROVIDER NETWORK, INC.",1649430174,Federally Qualified Health Centers - Medical Services,700 Potomac St,Suite A,Aurora,CO,80011-6845,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001794,Chambers Clinic at AuMHC,"METRO COMMUNITY PROVIDER NETWORK, INC.",1558657312,Federally Qualified Health Centers - Medical Services,791 Chambers Rd,,Aurora,CO,80011-7112,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001795,Mountain Family Health Centers,MOUNTAIN FAMILY HEALTH CENTERS,1548613409,"Dental Providers, Federally Qualified Health Centers - Medical Services",850 W Beaver Creek Blvd,Avon Elementary School,Avon,CO,81620,Eagle,Attn: Shiela Kendall,"2700 Gilstrap Court, Ste 230",Glenwood Springs,CO,81601,Garfield,Ross Brooks,Chief Executive Officer,970-945-2840,7209,rbrooks@mountainfamily.org,Art Fernandez,Chief Operations Officer,970-945-2840,7205,afernandez@mountainfamily.org,www.mountainfamily.org
CO-001796,AVONDALE CLINIC,PUEBLO COMMUNITY HEALTH CENTER,1821010448,Federally Qualified Health Centers - Medical Services,328 Avondale Blvd,,Avondale,CO,81022-8700,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-001797,MOUNTAIN FAMILY HEALTH CENTERS BASALT,MOUNTAIN FAMILY HEALTH CENTERS,1548569924,Federally Qualified Health Centers - Medical Services,234 Cody Ln,,Basalt,CO,81621-9106,Pitkin,2700 Gilstrap Ct,Suite 230,Glenwood Springs,CO,81601-4206,Garfield,Ross Brooks,CEO,970-945-2840,7209,rbrooks@mountainfamily.org,Art Fernandez,COO,970-945-2840,7205,afernandez@mountainfamily.org,
CO-001798,Clinica Family Health - MHP Alpine,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1659649135,Federally Qualified Health Centers - Medical Services,1000 Alpine Ave,,Boulder,CO,80304-3406,Boulder,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-001799,Clinica Family Health - People's Clinic,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1184613234,Federally Qualified Health Centers - Medical Services,2525 13th St,,Boulder,CO,80304-4104,Boulder,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-001800,Planned Parenthood of the Rocky Mountains--Boulder,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",2525 Arapahoe Ave,Suite 200,Boulder,CO,80302-6720,Boulder,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001801,Boulder Valley Women's Health Center,Boulder Valley Women's Health Center,1679784342,Family Planning Providers,2855 Valmont Rd,,Boulder,CO,80301-1374,Boulder,2855 Valmont Rd,,Boulder,CO,80301-1309,Boulder,Susan Levy,Chief Executive Officer,303-440-9320,24,susan@bvwhc.org,Heidi Halpern,Chief Financial Officer,303-442-5160,21,heidi@bvwhc.org,www.boulderwomenshealth.org
CO-001802,Beacon Center for Infectious Diseases,Boulder Community Health (Hospital),1487803383,Ryan White Providers,4800 Riverbend Rd,Suite 200,Boulder,CO,80301-2636,Boulder,4865 Riverbend Rd,STE 200,Boulder,CO,80301,Boulder,"Guy Lively, MPH",Program Manager,303-415-8855,,glively@bch.org,Carol Quesenbery,Financial Manager,303-415-7849,,cquesenbery@bch.org,https://www.bch.org/beacon-center/beaconcenter.aspx
CO-001803,"Summit Community Care Clinic, Inc.","Summit Community Care Clinic, Inc.",1639595986,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",16201 Hwy 9,Roaring Fork High School,Breckenridge,CO,80424,Summit,PO Box 4337,,Frisco,CO,80443,Summit,Lori Bowman,Data Coordinator/Billing,970-423-8831,,lbowman@summitclinic.org,Erin Major,School Based Health Center Program Director,970-423-8831,,emajor@summitclinic.org,
CO-001804,Brighton Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1780717579,"Dental Providers, Federally Qualified Health Centers - Medical Services",1860 E Egbert St,,Brighton,CO,80601-2475,Adams,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,Rosario Morales,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001805,Brighton's Women Center,"PLAN DE SALUD DEL VALLE, INC.",1801298070,Federally Qualified Health Centers - Medical Services,30 S 20th Ave,,Brighton,CO,80601-3705,Adams,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001806,"Children's Hospital Colorado North Campus, Broomfield",Children's Hospital Colorado,1710348214,Outpatient Hospital Clinics,469 State Highway 7,,Broomfield,CO,80023-8965,Broomfield,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001807,"Children's Hospital Colorado North Campus, Broomfield Urgent and Outpatient Specialty Care (children's inpatient hospital)",Children's Hospital Colorado,1336245828,Children's Hospitals (inpatient only),469 State Highway 7,,Broomfield,CO,80023-8965,Broomfield,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001808,Broomfield Public Health and Environment Division of Health and Human Services,Broomfield Public Health and Environment Division of Health and Human Services Department,1215935978,"Family Planning Providers, Sexually Transmitted Disease Clinics",6 Garden Ctr,,Broomfield,CO,80020-1730,Broomfield,6 Garden Ctr,,Broomfield,CO,80020-1730,Broomfield,Kathleen Brown,Reproductive Health Administrator,720-887-2291,,kbrown@broomfield.org,Jason Vahling,Public Health Director,720-887-2218,,jvahling@broomfield.org,http://www.broomfield.org/
CO-012483,Valley-Wide Buena Vista,"VALLEY WIDE HEALTH SYSTEMS, INC.",1972111953,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",707 US Highway 24 N,,Buena Vista,CO,81211-9863,Chaffee,128 Market Street,,"Alamosa, CO",CO,81101,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,Javier Martinez,Chief Financial Officer,719-587-1083,,martinezj@vwhs.org,vwhs.org
CO-001809,Parke Health Center,Kit Carson County Health Service District,1932211596,Rural Health Clinics,182 16th St,,Burlington,CO,80807-1649,Kit Carson,286 16th Street,,Burlington,CO,80807,Kit Carson,Brenda Briegel,Manager,719-346-4898,3010,bbriegel@kcchsd.org,Marty Gaither,Director,719-346-0366,3501,mgaiter@kcchsd.org,
CO-001810,Farmworker Health Services - Kit Carson County Health & Human Services,"VALLEY WIDE HEALTH SYSTEMS, INC.",1790998953,Federally Qualified Health Centers - Medical Services,252 S 14th St,,Burlington,CO,80807-2321,Kit Carson,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001811,Valley Wide Canon City,"VALLEY WIDE HEALTH SYSTEMS, INC.",1215383500,Federally Qualified Health Centers - Medical Services,121 N 6th St,,Canon City,CO,81212-3329,Fremont,128 Market Street,,Alamosa,CO,81101,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,Javier Martinez,CFO,719-587-1083,,martinezj@vwhs.org,www.vwhs.org
CO-001812,Solvista Health,West Central Mental Health Center Inc. dba Solvista Health,1265565824,Community Mental Health Centers,3225 Independence Rd,,Canon City,CO,81212-9380,Fremont,3225 Independence Rd,,Canon City,CO,81212,Fremont,Rhonda Ducommun,Business Assistant,719-204-2090,2229,Rhondad@Solvistahealth.org,Kay Martin,COO,719-275-2351,2202,KayM@solvistahealth.org,www.Solvistahealth.org
CO-001813,"Button Family Practice, P.C.","Button Family Practice, P.C.",1144269739,Rural Health Clinics,715 S 9th St,,Canon City,CO,81212-4911,Fremont,715 S. 9th Street,,Canon City,CO,81212,Fremont,Dennis Johnson,Office Manager,719-269-8820,,djohnson.bfp@live.com,,,,,,
CO-001814,Rocky Mountain Youth Clinics,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,2270 Highway 133,Roaring Fork School Health Centers - Basalt High School,Carbondale,CO,81623-9271,Garfield,"9197 S. Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,barb@rmyclinics.org,www.rmyclinics.org
CO-001815,SURFACE CREEK FAMILY PRACTICE,"Surface Creek Family Practice, PC",1558309005,Rural Health Clinics,255 SW 8th Ave,,Cedaredge,CO,81413-3902,Delta,255 SW 8th Ave,,Cedaredge,CO,81413,Delta,Sheryl Hieber,Administrator,970-856-3146,,shieber@scfp.co,Richard Seiferd,Billing Office Manager,970-856-3146,,rseiferd@scfp.co,
CO-001816,"Children's Hospital Colorado Orthopedic Care, Centennial",Children's Hospital Colorado,1700247301,Outpatient Hospital Clinics,9094 E Mineral Cir,Suite 110,Centennial,CO,80112-7201,Arapahoe,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,Elizabeth.Nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001817,Cesar E. Chavez Medical Center,"VALLEY WIDE HEALTH SYSTEMS, INC.",1407843576,Federally Qualified Health Centers - Medical Services,186 Hurt St,,Center,CO,81125-9002,Saguache,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001818,Center Dental Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1649267741,Dental Providers,220 S Worth St,,Center,CO,81125,Rio Grande,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001820,Homeless Health Center,PEAK VISTA COMMUNITY HEALTH CENTERS,1043512023,Federally Qualified Health Centers - Medical Services,117 W Rio Grande St,,Colorado Springs,CO,80903-4013,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001821,El Paso County Public Health,El Paso County Public Health,1144388182,"Family Planning Providers, Sexually Transmitted Disease Clinics",1675 Garden of the Gods Rd,Suite No. 2044,Colorado Springs,CO,80907-9444,El Paso,1675 Garden of the Gods Rd,Suite No. 2044,Colorado Springs,CO,80907-9444,El Paso,Ingrid Silva,Clinical Services Program Manager,719-578-4068,3238,ingridsilva@elpasoco.com,Brenda Heimbach,Health Services Division Director,719-578-3195,3195,brendaheimbach@elpasoco.com,www.elpasocountyhealth.org
CO-001822,Peak Vista Community Health Centers,PEAK VISTA COMMUNITY HEALTH CENTERS,1164752812,Federally Qualified Health Centers - Medical Services,1740 Pepperwood Dr,Entrada School Based Health Center - Carmel Middle School,Colorado Springs,CO,80910-1525,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001823,Health Center at Union,PEAK VISTA COMMUNITY HEALTH CENTERS,1841593225,Federally Qualified Health Centers - Medical Services,225 S Union Blvd,,Colorado Springs,CO,80910-3184,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001824,Dental Health Center,Peak Vista Community Health Centers,1497787535,Dental Providers,2828 International Cir,Suite 100,Colorado Springs,CO,80910-3127,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J. McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,,christi.garriott@peakvista.org,
CO-001825,Health Center at International Circle,Peak Vista Community Health Centers,1780982058,Federally Qualified Health Centers - Medical Services,2828 International Cir,Suite 160,Colorado Springs,CO,80910-3127,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001826,Pediatric Health Center,Peak Vista Community Health Centers,1124321880,Federally Qualified Health Centers - Medical Services,2828 International Circle,Suite 140,Colorado Springs,CO,80910-3127,El Paso,3205 N. Academy,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J. McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence & Development,719-344-6454,,christi.garriott@peakvista.org,
CO-001827,Convenient Care Center,PEAK VISTA COMMUNITY HEALTH CENTERS,1689977365,Federally Qualified Health Centers - Medical Services,3205 N Academy Blvd,Suite 100,Colorado Springs,CO,80917-5147,El Paso,3205 N. Academy Blvd,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence and Revenue,719-344-6454,,christi.garriott@peakvista.org,www.peakvista.org
CO-001828,Developmental Disabilities Health Center,Peak Vista Community Health Centers,1679877138,Federally Qualified Health Centers - Medical Services,3207 N Academy Blvd,Suite 3300,Colorado Springs,CO,80917-5100,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J. McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6453,,christi.garriott@peakvista.org,
CO-001829,Health Center at Academy - South,Peak Vista Community Health Centers,1164769782,Federally Qualified Health Centers - Medical Services,3207 N Academy Blvd,Suite 3100,Colorado Springs,CO,80917-5100,El Paso,3205 N. Academy Blvd,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J. McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,,christi.garriott@peakvista.org,www.peakvista.org
CO-001830,Health Center at Academy Suite 3500,Peak Vista Community Health Centers,1962740381,Federally Qualified Health Centers - Medical Services,3207 N Academy Blvd,Suite 3500,Colorado Springs,CO,80917-5100,El Paso,3205 N. Academy,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J. McManus,President & CEO,719-344-6453,,pam.mcmanus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,,christi.garriott@peakvista.org,
CO-001831,Planned Parenthood of the Rocky Mountains--Colorado Springs,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",3480 Centennial Blvd,,Colorado Springs,CO,80907-4087,El Paso,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-012378,"Children's Hospital Colorado, Colorado Springs",Children's Hospital Colorado,1336637438,Children's Hospitals (inpatient only),4090 Briargate Pkwy,,Colorado Springs,CO,80920-7815,El Paso,13124 East 16th Avenue,,Aurora,CO,80046,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6069,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6556,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-012379,"Children's Hospital Colorado, Colorado Springs",Children's Hospital Colorado,1336637438,"Family Planning Providers, Outpatient Hospital Clinics",4090 Briargate Pkwy,,Colorado Springs,CO,80920-7815,El Paso,13124 East 16th Avenue,,Aurora,CO,80046,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6069,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6556,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001832,Health Center at Myron Stratton,PEAK VISTA COMMUNITY HEALTH CENTERS,1659674034,Federally Qualified Health Centers - Medical Services,410 Gold Pass Hts,,Colorado Springs,CO,80906-3882,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001833,"Children's Colorado Outpatient Care at Briargate, Colorado Springs",Children's Hospital Colorado,1336637438,"Family Planning Providers, Outpatient Hospital Clinics",4125 Briargate Pkwy,,Colorado Springs,CO,80920-7804,El Paso,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,Elizabeth.Nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001834,Logan Health Center at Myron Stratton,PEAK VISTA COMMUNITY HEALTH CENTERS,1396048054,Federally Qualified Health Centers - Medical Services,430 Gold Pass Hts,,Colorado Springs,CO,80906-3501,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001835,Lane Family Health Center,PEAK VISTA COMMUNITY HEALTH CENTERS,1851693832,Federally Qualified Health Centers - Medical Services,4863 N Nevada Ave,,Colorado Springs,CO,80918-3951,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001836,Health Center at Wahsatch,PEAK VISTA COMMUNITY HEALTH CENTERS,1033412796,Federally Qualified Health Centers - Medical Services,722 S Wahsatch Ave,,Colorado Springs,CO,80903-4035,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001837,Moreno Health Center,PEAK VISTA COMMUNITY HEALTH CENTERS,1407150121,Federally Qualified Health Centers - Medical Services,875 W Moreno Ave,,Colorado Springs,CO,80905-1731,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001838,Community Reach Center Salud,"PLAN DE SALUD DEL VALLE, INC.",1801297593,Federally Qualified Health Centers - Medical Services,4371 E 72nd Ave,,Commerce City,CO,80022-1471,Adams,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001839,Kids First Health Care at ACMS,Kids First Health Care,1639200702,Other ECP Providers,4451 E 72nd Ave,,Commerce City,CO,80022-1405,Adams,4675 E. 69th Avenue,,Commerce City,CO,80026,Adams,Devra Fregin,Director of Practice Management,303-853-3282,,dafregin@adams14.org,Amber Picinic,Associate Director,303-853-3293,,apicinic@adams14.org,www.kidsfirsthealthcare.org
CO-001840,Kids First Health Care at Commerce City,Kids First Health Care,1639200702,Other ECP Providers,4675 E 69th Ave,,Commerce City,CO,80022-2343,Adams,4675 E. 69th Avenue,,Commerce City,CO,80022,Adams,Devra Fregin,Director of Practice Management,303-853-3282,,dafregin@adams14.org,Amber Picinic,Associate Director,303-853-3293,,apicinic@adams14.org,www.kidsfirsthealthcare.org
CO-001841,Kids First Health Care at Kearney,Kids First Health Care,1639200702,Other ECP Providers,6160 Kearney St,,Commerce City,CO,80022-3434,Adams,4675 E. 69th Avenue,,Commerce City,CO,80022,Adams,Devra Fregin,Director of Practice Management,303-853-3282,,dafregin@adams14.org,Amber Picinic,Associate Director,303-853-3293,,apicinic@adams14.org,www.kidsfirsthealthcare.org
CO-001842,Commerce City Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1598898389,"Dental Providers, Federally Qualified Health Centers - Medical Services",6255 Quebec Pkwy,,Commerce City,CO,80022-4812,Adams,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,rmorales@saludclinic.org,,,,,,
CO-001843,Kids First Health Care at Lester Arnold,Kids First Health Care,1639200702,Other ECP Providers,6500 E 72nd Ave,,Commerce City,CO,80022-2006,Adams,4675 E. 69th Avenue,,Commerce City,CO,80022,Adams,Devra Fregin,Director of Practice Management,303-853-3282,,dafregin@adams14.org,Amber Picinic,Associate Director,303-853-3293,,apicinic@adams14.org,www.kidsfirsthealthcare.org
CO-001844,Kids First Health Care at ACHS,Kids First Health Care,1639200702,Other ECP Providers,7200 Quebec Pkwy,,Commerce City,CO,80022-4824,Adams,4675 E. 69th Avenue,,Commerce City,CO,80022,Adams,Devra Fregin,Director of Practice Management,303-853-3282,,dafregin@adams14.org,Amber Picinic,Associate Director,303-853-3293,,apicinic@adams14.org,www.kidsfirsthealthcare.org
CO-001845,Planned Parenthood of the Rocky Mountains--Cortez,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",20 W North St,,Cortez,CO,81321-3117,Montezuma,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001846,Rocky Mountain Youth Clinics,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,401 N Dolores Rd,Southwest Open School,Cortez,CO,81321-4213,Montezuma,"9197 S. Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,barb@rmyclinics.org,www.rmyclinics.org
CO-001847,Cortez Integrated Healthcare,Axis Health System,1376827998,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",691 E Empire St,,Cortez,CO,81321-2802,Montezuma,185 Suttle Street,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Operations,970-403-6067,,mpayne@axishealthsystem.org,Don Mooney,Director of Revenue Cycle Operations,970-335-2244,,dmooney@axishealthsystem.org,www.axishealthsystem.org
CO-001848,Craig Office,Northwest Colorado Visiting Nurse A,1063663292,Federally Qualified Health Centers - Medical Services,745 Russell St,,Craig,CO,81625-2019,Moffat,745 Russell Street,,Craig,CO,81625,Moffat,Stephanie Anderson,Chief Operating Officer,970-871-7636,,sanderso@nwcovna.org,Gisela Garrison,Health Center Director,970-871-7669,,ggarrison@nwcovna.org,www.nwcovna.org
CO-001849,Crestone Behavioral Health,"B. Lynn Wadelton, Ph.D. aka First Coast Therapy Group",1083764039,"Community Mental Health Centers, Rural Health Clinics",275 W Iron Ave,,Crestone,CO,81131,Saguache,P.O. Box 984,,Crestone,CO,81131,Saguache,"B. Lynn Wadelton, Ph.d.",sole owner/psychologist,904-280-8555,,crestonebehavioralhealth@gmail.com,,,,,,
CO-001850,Teller County Public Health Department,Teller County Public Health Department,1578720918,"Family Planning Providers, Sexually Transmitted Disease Clinics",166 E Bennett Ave,,Cripple Creek,CO,80813,Teller,11115 W. Hwy 24 Unit 2C,P.O. Box 928,Divide,CO,80814,Teller,Darlyn Miller,"RN, Family Planning Coordinator",719-687-6416,,millerd@co.teller.co.us,Martha Hubbard,Public Health Director,719-687-6416,,hubbardm@co.teller.co.us,
CO-001851,Rio Grande Hospital,"Valley Citizens' Foundation for Health Care, Inc.",1396783981,Inpatient Hospitals (other than children's hospitals),310 County Road 14,,Del Norte,CO,81132-8758,Rio Grande,310 County Rd. 14,,Del Norte,CO,81132,Rio Grande,Arlene Harms,CEO,719-657-4104,,arleneh@riograndehospital.net,,,,,,www.rio-grande-hospital.org
CO-001852,Surface Creek Family Practice,"Surface Creek Family Practice, PC",1558309005,Other ECP Providers,233 Cottonwood St,,Delta,CO,81416-4400,Delta,255 SW 8th Ave,,Cedaredge,CO,81413,Delta,Sheryl Hieber,Administrator,970-856-3146,,shieber@scfp.co,Richard Seiferd,Billing Office Manager,970-856-3146,,rseiferd@scfp.co,
CO-001853,Delta County Health Department,Delta County Health Department,1770512964,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",255 W 6th St,,Delta,CO,81416-1626,Delta,255 W 6th St,,Delta,CO,81416-1626,Delta,"Pat Sullivan, NP",Nurse Manager,970-874-2183,,psullivn@deltacounty.com,,,,,,
CO-001854,Stout Street Clinic at St Francis Center,Colorado Coalition for the Homeless,1144469578,Federally Qualified Health Centers - Medical Services,1001 Park Ave W,,Denver,CO,80205-2605,Denver,2111 Champa Street,,Denver,CO,80205,Denver,Stanley R. Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001855,LOWRY FAMILY HEALTH CENTER,DENVER HEALTH AND HOSPITALS AUTHORITY,1316988413,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1001 Yosemite St,,Denver,CO,80230-6003,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Carolyn Kitzman,Family Planning Coordinator,303-602-5129,,Carolyn.Kitzman@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001856,Westside Community Health Center and Teen Clinic,Denver Health and Hospital Authority,1801837810,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1100 Federal Blvd,,Denver,CO,80204-3219,Denver,1100 Federal Blvd,,Denver,CO,80204-3219,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001857,Montbello Family Health Center,DENVER HEALTH AND HOSPITALS AUTHORITY,1194766428,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",12600 Albrook Dr,,Denver,CO,80239-4604,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001858,Federico F. Pena Family Health Center,Denver Health,1992161780,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics",1339 S Federal Blvd,,Denver,CO,80219-4235,Denver,777 Bannock St,,Denver,CO,80204,Denver,Kim Carrol,Nurse Manager,303-602-0012,,kim.carroll@dhha.org,,,,,,
CO-001859,Rocky Mountain Youth Clinics - Denver,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,1601 E 19th Ave,Suite 6600,Denver,CO,80218-1292,Denver,"9197 Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,btafoya@rmyclinics.org,www.rmyclinics.org
CO-001860,Denver Indian Health and Family Services,Denver Indian Health and Family Services,1073561270,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1633 Fillmore St,Suite GL1,Denver,CO,80206-1546,Denver,1633 Fillmore St,GL1,Denver,CO,80206,Denver,Chris Barrientos,Biller,303-953-6600,605,cbarrientos@dihfs.org,Adrianne Maddux,Chief Financial Officer,303-953-6605,618,amaddux@dihfs.org,
CO-001861,Manual Campus SBHC,DENVER HEALTH AND HOSPITALS AUTHORITY,1366760498,Federally Qualified Health Centers - Medical Services,1700 E 28th Ave,,Denver,CO,80205-4502,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001862,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1184794893,Federally Qualified Health Centers - Medical Services,1700 E Louisiana Ave,South High School,Denver,CO,80210-1810,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001863,Clinica Family Health Services - Pecos Clinic,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1548256522,"Dental Providers, Federally Qualified Health Centers - Medical Services",1701 W 72nd Ave,Suite 300,Denver,CO,80221-2727,Adams,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-001864,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1144242900,Federally Qualified Health Centers - Medical Services,1820 Lowell Blvd,Lake Middle School,Denver,CO,80204-1549,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001865,"Children's Colorado Outpatient and Urgent Care at Uptown, Denver",Children's Hospital Colorado,1053774638,Outpatient Hospital Clinics,1830 N Franklin St,Suite 150,Denver,CO,80218-1128,Denver,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001866,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1811196959,Federally Qualified Health Centers - Medical Services,19535 E 46th Ave,MLK Middle School,Denver,CO,80249-6637,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001867,Colorado Coalition for the Homeless,Colorado Coalition for the Homeless,1346621208,Federally Qualified Health Centers - Medical Services,2100 N Broadway,,Denver,CO,80205-2526,Denver,2111 Champa Street,,Denver,CO,80205-2529,Denver,Stanley R. Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,www.anhc.org
CO-001868,CCH-Administrative/Clinical & Support Services,Colorado Coalition for the Homeless,1538557889,"Dental Providers, Federally Qualified Health Centers - Medical Services",2111 Champa St,,Denver,CO,80205-2529,Denver,2111 Champa St,,Denver,CO,80205-2529,Denver,Stanley R. Eilert,Chief Admihnistrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001869,Stout Street Health Center,Colorado Coalition for the Homeless,1396793030,"Dental Providers, Federally Qualified Health Centers - Medical Services",2130 Stout St,,Denver,CO,80205-2827,Denver,2111 Champa Street,,Denver,CO,80205,Denver,Stanley R. Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001870,DENVER HEALTH AND HOSPITALS AUTHORITY,DENVER HEALTH AND HOSPITALS AUTHORITY,1386714095,Federally Qualified Health Centers - Medical Services,2250 S Quitman Way,Kunsmiller Creative Arts Academy,Denver,CO,80219-5139,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001871,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1255353025,Federally Qualified Health Centers - Medical Services,2285 S Federal Blvd,Lincoln High School,Denver,CO,80219-5433,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001872,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1982626750,Federally Qualified Health Centers - Medical Services,2855 S Lamar St,JFK High School,Denver,CO,80227-3809,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001873,FAMILY CRISIS CENTER,DENVER HEALTH AND HOSPITALS AUTHORITY,1104973338,Federally Qualified Health Centers - Medical Services,2929 W 10th Ave,,Denver,CO,80204-3363,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Peggy Baikie,Program Manager,720-944-3745,,Peggy.Baikie@dhha.org,,,,,,http://www.denverhealth.org
CO-001874,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1093737868,Federally Qualified Health Centers - Medical Services,2960 N Speer Blvd,North High School,Denver,CO,80211-3795,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001875,"Webb Center for Primary Care, Denver Health",Denver Health and Hospital Authority,1922049014,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 W 6th Ave,,Denver,CO,80204-5182,Denver,301 W 6th Ave,,Denver,CO,80204,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001876,Sheridan Health Services,"REGENTS OF THE UNIVERSITY OF COLORADO, Sheridan Health Services",1750657722,"Dental Providers, Federally Qualified Health Centers - Medical Services",3525 W Oxford Ave Unit G3,,Denver,CO,80236-3106,Denver,3525 West Oxford Ave,Unit G3,Denver,CO,80236-3106,Denver,Terry Dargevics,Finance Manager,303-315-6172,,terry.dargevics@ucdenver.edu,Tracey Phillips,Billing and Finance Coordinator,303-315-6176,,tracey.phillips@ucdenver.edu,http://www.ucdenver.edu/academics/colleges/nursing/Sheridan/services/Pages/Adults.aspx
CO-001877,DENVER HEALTH AND HOSPITALS AUTHORITY,DENVER HEALTH AND HOSPITALS AUTHORITY,1114341963,Federally Qualified Health Centers - Medical Services,3950 S Holly St,Thomas Jefferson High School,Denver,CO,80237-1117,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001878,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1336252287,Federally Qualified Health Centers - Medical Services,3955 N Steele St,Bruce Randolf High School,Denver,CO,80205-3613,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001879,WESTWOOD FAMILY HEALTH CENTER,DENVER HEALTH AND HOSPITALS AUTHORITY,1619918794,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4320 W Alaska Pl,,Denver,CO,80219-2454,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001880,Rocky Mountain Cares,AIDS Resource Center of Wisconsin,1982654091,Ryan White Providers,4545 E 9th Ave,Suite 120,Denver,CO,80220-3902,Denver,820 N. Plankinton Avenue,,Milwaukee,WI,53203,Milwaukee,JoAnn Berk,Director of Revenue Cycle Management,414-225-1568,,joann.berk@arcw.org,Nichole Tiefenbacker,Billing Specialist,414-225-1573,,nichole.tiefenbacher@arcw.org,
CO-001881,La Casa Quigg Newton Family Health Center,Denver Health and Hospital Authority,1467877126,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4545 Navajo St,,Denver,CO,80211-2440,Denver,777 Bannock Street,,Denver,CO,80204,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,
CO-001882,Quigg Newton Family Counseling Center,Colorado Coalition for the Homeless,1477866184,Federally Qualified Health Centers - Medical Services,4545 Navajo St,,Denver,CO,80211-2440,Denver,2111 Champa Street,,Denver,CO,80205-2529,Denver,Stanley R. Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001883,Evie Garrett Dennis Campus,DENVER HEALTH AND HOSPITALS AUTHORITY,1528337755,Federally Qualified Health Centers - Medical Services,4800 Telluride St,,Denver,CO,80249-6803,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001884,PARK HILL FAMILY HEALTH CENTER,DENVER HEALTH AND HOSPITALS AUTHORITY,1326089400,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4995 E 33rd Ave,,Denver,CO,80207-1902,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001885,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1376565143,Federally Qualified Health Centers - Medical Services,5000 Crown Blvd,Montbello High School,Denver,CO,80239-4329,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001886,EAST SIDE FAMILY HEALTH CENTER,Denver Health and Hospital Authority,1285675371,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",501 28th St,,Denver,CO,80205-3003,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Family Planning Coordinator,303-436-4182,,Tara.Thomas-Gale@dhha.org,,,,,,http://denverhealth.org/MedicalServices/PrimaryCare/OurServices/FamilyPlanning.aspx
CO-001887,HIV Primary Care Clinic,Denver Health and Hospital Authority,1770526881,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",501 28th St,,Denver,CO,80205-3003,Denver,777 Bannock Street,,Denver,CO,80204,Denver,Joshua Blum,Team Leader,303-602-6551,,jblum@dhha.org,Joshua Blum,Team Leader,303-602-6551,,jblum@dhha.org,www.denverhealth.org
CO-001888,West End Health Center,Colorado Coalition for the Homeless,1477819506,Federally Qualified Health Centers - Medical Services,5050 W Colfax Ave,,Denver,CO,80204-1015,Denver,2111 Champa St,,Denver,CO,80205-2529,Denver,Stanley R Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001889,Clinica Tepeyac,"La Clinica Tepeyac, INC",1336516178,Federally Qualified Health Centers - Medical Services,5075 Lincoln St,,Denver,CO,80216-2015,Denver,5075 Lincoln Street,,Denver,CO,80216,Denver,Jim Garcia,Executive Director,720-274-2941,2941,jgarcia@clinicatepeyac.org,Matt Dyer,Finance Director,720-274-2926,2926,mdyer@clinicatepeyac.org,
CO-001890,DENVER HEALTH AND HOSPITALS AUTHORITY,DENVER HEALTH AND HOSPITALS AUTHORITY,1437171204,Federally Qualified Health Centers - Medical Services,5290 Kittredge St,RACHEL NOEL MIDDLE SCHOOL-BASED,Denver,CO,80239-5628,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001891,Denver Health,Denver Health and Hospital Authority,1467830778,Federally Qualified Health Centers - Medical Services,55 S Zuni St,Florence Crittenton High School,Denver,CO,80223-1208,Denver,777 Bannock Street,,Denver,CO,80204,Denver,Sonja O'Leary,Team Lead School Based Health Centers,303-602-8968,,Sonja.O'Leary@dhha.org,,,,,,
CO-001892,Colorado Health Network,Colorado Health Network,1316353485,"Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",6260 E Colfax Ave,,Denver,CO,80220-1515,Denver,6260 E Colfax Ave,,Denver,CO,80220,Denver,Lili Carrillo,"Director, OHCS",303-945-2381,,Lili.Carrillo@coloradohealthnetwork.org,Darrell Vigil,Chief Executive officer,303-962-5310,,Darrell.Vigil@coloradohealthnetwork.org,
CO-001893,Planned Parenthood of the Rocky Mountains--Glendale,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",6310 E Exposition Ave,,Denver,CO,80224-1260,Denver,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001894,Place Bridge Academy SBHC and Pediatric Clinic,DENVER HEALTH AND HOSPITALS AUTHORITY,1326311655,Federally Qualified Health Centers - Medical Services,7125 Cherry Creek North Dr,,Denver,CO,80224-2044,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001895,Planned Parenthood of the Rocky Mountains--Denver Stapleton,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",7155 E 38th Ave,,Denver,CO,80207-1630,Denver,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001896,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1427161371,Federally Qualified Health Centers - Medical Services,911 S Hazel Ct,KEPNER MIDDLE SCHOOL,Denver,CO,80219-3418,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001897,Planned Parenthood of the Rocky Mountains--Denver Central,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",921 E 14th Ave,,Denver,CO,80218-1903,Denver,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001898,Denver Health,DENVER HEALTH AND HOSPITALS AUTHORITY,1538181318,Federally Qualified Health Centers - Medical Services,951 Elati St,West High School,Denver,CO,80204-3939,Denver,777 Bannock St,,Denver,CO,80204-4507,Denver,Tara Thomas-Gale,Practice Administrator,303-602-6767,,Tara.Thomas-Gale@dhha.org,,,,,,http://www.denverhealth.org
CO-001899,"Summit Community Care Clinic, Inc.","Summit Community Care Clinic, Inc.",1588080956,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",108 Deerpath Rd,School Based Health Center - Dillon Valley Elementary,Dillon,CO,80435,Summit,PO Box 4337,,Frisco,CO,80443,Summit,Lori Bowman,Data Coordinator/Billing,970-423-8831,,lbowman@summitclinic.org,Erin Major,School Based Health Center Program Director,970-423-8831,,emajor@summitclinic.org,
CO-001900,Health Center at Divide,PEAK VISTA COMMUNITY HEALTH CENTERS,1609178524,Federally Qualified Health Centers - Medical Services,34 Hybrook Rd S,,Divide,CO,80814-9219,Teller,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001901,COMMUNITY HEALTH CLINIC,DOLORES COUNTY HEALTH ASSOCIATION,1710954433,"Dental Providers, Federally Qualified Health Centers - Medical Services",495 W 4th St,,Dove Creek,CO,81324,Dolores,495 W 4th,,Dove Creek,CO,81324,Dolores,Dianne Smith,Executive Director,970-677-3628,,dianne.smith@dovecreekclinic.org,James W Waschke,Operations Director,970-677-3645,,bill.waschke@dovecreekclinic.org,
CO-001902,Crossroads at Grandview,Axis Health System,1417295783,Community Mental Health Centers,1125 Three Springs Blvd,,Durango,CO,81301-9033,La Plata,185 Suttle St.,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001903,La Plata Integrated Healthcare,Axis Health System,1316374283,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1970 E 3rd Ave Ste 1 Lowr Level,,Durango,CO,81301-5049,La Plata,185 Suttle St.,,Durango,CO,81303-3409,La Plata,Don Mooney,Director of Revenue Cycle Management,970-335-2244,,dmooney@axishealthsystem.org,Matt Payne,Senior Director of Operations,,,mpayne@axishealthsystem.org,
CO-001904,Axis Health System,Axis Health System,1417295783,"Community Mental Health Centers, Other ECP Providers",216 Highway 172,School-Based Integrated Healthcare at Florida Mesa Elementary School,Durango,CO,81303-8295,La Plata,185 Suttle St.,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001905,Axis Health System,Axis Health System,1417295783,"Community Mental Health Centers, Other ECP Providers",2390 Main Ave,School-Based Integrated Healthcare at Durango High School,Durango,CO,81301-4638,La Plata,185 Suttle St.,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001906,Columbine Center Behavioral Health,Axis Health System,1417295783,Community Mental Health Centers,281 Sawyer Dr,Suite 100,Durango,CO,81303-3409,La Plata,185 Suttle St.,,Durango,CO,80303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001907,Planned Parenthood of the Rocky Mountains--Durango,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",46 Suttle St,,Durango,CO,81303-7947,La Plata,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001908,Oral Health Clinic,Axis Health System,1417295783,Dental Providers,701 Camino del Rio,Suite 316,Durango,CO,81301-5443,La Plata,185 Suttle St.,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001909,Eagle County Public Health,Eagle County Health and Human Services,1376754259,Family Planning Providers,551 Broadway,,Eagle,CO,81631,Eagle,551 Broadway,POB 660,Eagle,CO,81631,Eagle,Jennie Wahrer,"MCH Manager, PH",970-328-2604,,jennie.wahrer@eaglecounty.us,Denise Matthews,"Fiscal Manager, PH",970-328-8816,,denise.matthews@eaglecounty.us,
CO-001910,Metro Community Provider Network,"METRO COMMUNITY PROVIDER NETWORK, INC.",1699930651,Federally Qualified Health Centers - Medical Services,2305 Pierce St,JEFFERSON HIGH SCHOOL KIDS & TEENS HEALTH CENTER,Edgewater,CO,80214-1031,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org
CO-001911,MOUNTAIN FAMILY HEALTH CENTERS EDWARDS,MOUNTAIN FAMILY HEALTH CENTERS,1972933992,Federally Qualified Health Centers - Medical Services,320 Beard Creek Rd,,Edwards,CO,81632-6426,Eagle,2700 Gilstrap Ct,Suite 230,Glenwood Springs,CO,81601-4206,Garfield,Ross Brooks,CEO,970-945-2840,7209,rbrooks@mountainfamily.org,Art Fernandez,COO,970-945-2840,7205,afernandez@mountainfamily.org,
CO-001912,ENGLEWOOD HEALTH CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1841458882,Federally Qualified Health Centers - Medical Services,3515 S Delaware St,,Englewood,CO,80110-3529,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001913,Sheridan Health Services,"REGENTS OF THE UNIVERSITY OF COLORADO, Sheridan Health Services",1194921411,Federally Qualified Health Centers - Medical Services,4107B S Federal Blvd,,Englewood,CO,80110-4316,Arapahoe,3525 West Oxford Ave,Unit G3,Denver,CO,80236,Denver,Terry Dargevics,Finance Manager,303-315-6172,,terry.dargevics@ucdenver.edu,Tracey Phillips,Billing and Finance Coordinator,303-315-6176,,tracey.phillips@ucdenver.edu,http://www.ucdenver.edu/academics/colleges/nursing/Sheridan/services/youth/Pages/Kids.aspx
CO-001914,Larimer County Health Department Family Planning Program-Estes Park,Larimer County Health Department,1003092131,Family Planning Providers,1601 Brodie Ave,,Estes Park,CO,80517-7486,Larimer,1525 Blue Spruce Drive,,Fort Collins,CO,80524-2004,Larimer,Mike Keller,Sr Accountant,970-498-6751,,mkeller@larimer.org,Marie Macpherson,Director of Administrative Services,970-498-6714,,mmacpherson@larimer.org,
CO-001915,Estes Park Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1720111677,"Dental Providers, Federally Qualified Health Centers - Medical Services",1950 Redtail Hawk Dr,,Estes Park,CO,80517-9780,Larimer,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001916,KIDS CARE CLINIC,SUNRISE COMMUNITY HEALTH,1811295264,Federally Qualified Health Centers - Medical Services,1400 37th St,,Evans,CO,80620-1906,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,Chief Workforce Officer,970-350-4672,,srios.sunrise@nocoha.org,
CO-001917,MONFORT FAMILY CLINIC,SUNRISE COMMUNITY HEALTH,1295732048,Federally Qualified Health Centers - Medical Services,2930 11th Ave,,Evans,CO,80620-1011,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,Chief Workforce Officer,970-350-4672,,srios.sunrise@nocoha.org,
CO-001918,SCCC Fairplay SBHC,SCCC Fairplay SBHC,1215422720,Federally Qualified Health Centers - Medical Services,640 Hathaway St,,Fairplay,CO,80440,Park,PO BOX 4337,,Frisco,CO,80443,Summit,Raquel Santos,Credentialing Specialist,970-423-8866,,rsantos@summitclinic.org,Edna Roberts,Billing Supervisor,970-668-6892,,ednac@summitclinic.org,www.summitclinic.org
CO-001919,Lincoln Community Hospital Flagler Clinic,Lincoln Community Hospital & Nursing Home,1720107519,Outpatient Hospital Clinics,305 Pawnee Ave,,Flagler,CO,80815-9286,Kit Carson,PO Box 248,,Hugo,CO,80821,Lincoln,Kevin Stansbury,CEO,719-743-2421,3230,kstansbury@lchnh.com,Kathy Richie,Compliance Office,719-743-2421,3243,krichie@lchnh.com,http://www.hugohospital.com
CO-001920,Dental Center at Flagler,PEAK VISTA COMMUNITY HEALTH CENTERS,1386063485,Dental Providers,309 Pawnee Ave,,Flagler,CO,80815-9286,Kit Carson,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001921,Larimer County Health Department Family Planning Program-Fort Collins,Larimer County Health Department,1003092131,Family Planning Providers,1525 Blue Spruce Dr,,Fort Collins,CO,80524-2004,Larimer,1525 Blue Spruce Dr,,Fort Collins,CO,80524-2004,Larimer,Mike Keller,Sr Accountant,970-498-6751,,mkeller@larimer.org,Marie Macpherson,Director of Administrative Services,970-498-6714,,mmacpherson@larimer.org,
CO-001922,Fort Collins Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1114050903,"Dental Providers, Federally Qualified Health Centers - Medical Services",1635 Blue Spruce Dr,,Fort Collins,CO,80524-5427,Larimer,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001923,Fort Collins West Salud Family Health Centers,Salud Family Health Centers,1477926046,Federally Qualified Health Centers - Medical Services,1830 Laporte Ave,,Fort Collins,CO,80521-2341,Larimer,203 S Rollie Avenue,,Fort Lupton,CO,80621,Weld,Kandace Buckland,Chief Operations Officer,303-892-6401,2067,kbuckland@saludclinic.org,Rachel Foster,Vice President of Operations,303-892-6401,2089,rfoster@saludclinic.org,www.saludclinic.org
CO-001924,Planned Parenthood of the Rocky Mountains--Fort Collins,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",825 S Shields St,Ste 6&7,Fort Collins,CO,80521,Larimer,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001925,Fort Lupton Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1386777266,"Dental Providers, Federally Qualified Health Centers - Medical Services",1115 2nd St,,Fort Lupton,CO,80621-1745,Weld,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6041,2066,jsantistevan@saludclinic.org,,,,,,
CO-001926,Colorado Plains Medical Center,LifePoint Health,1477638971,Inpatient Hospitals (other than children's hospitals),1000 Lincoln St,,Fort Morgan,CO,80701-3290,Morgan,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Summer Owen,CFO,970-542-3303,,,
CO-001927,Northeast Colorado Health Department,Northeast Colorado Health Department,1013911437,Family Planning Providers,228 W Railroad Ave,,Fort Morgan,CO,80701-2324,Morgan,700 Columbine Street,,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CO-001928,Fort Morgan Salud Family Health Centers,"PLAN DE SALUD DEL VALLE, INC.",1841323565,"Dental Providers, Federally Qualified Health Centers - Medical Services",729 E Railroad Ave,,Fort Morgan,CO,80701-3340,Morgan,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-289-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001929,Health Center at Fountain,PEAK VISTA COMMUNITY HEALTH CENTERS,1124320106,Federally Qualified Health Centers - Medical Services,350 Lyckman Pl,,Fountain,CO,80817-2861,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001930,Frederick Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1972636504,"Dental Providers, Federally Qualified Health Centers - Medical Services",5995 Iris Pkwy,,Frederick,CO,80504-6412,Weld,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001931,"Summit Community Care Clinic, Inc.","Summit Community Care Clinic, Inc.",1437575792,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",158 School Rd,Summit Middle School,Frisco,CO,80443,Summit,PO Box 4337,,Frisco,CO,80443,Summit,Lori Bowman,Data Coordinator/Billing,970-423-8831,,lbowman@summitclinic.org,Erin Major,School Based Health Center Program Director,970-423-8831,,emajor@summitclinic.org,
CO-001932,"Summit Community Care Clinic, Inc.",SUMMIT COMMUNITY CARE CLINIC,1831219328,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",360 Peak One Drive,Suite 100,Frisco,CO,80443,Summit,360 Peak Dr 1st,,Frisco,CO,80443,Summit,Molly Lee,Family Planning Coordinator,970-668-4047,,mlee@summitclinic.org,Sarah E Vaine,CEO,970-668-4049,,svaine@summitclinic.org,http://www.summitclinic.org/your-healthcare-needs/family-planning/
CO-001933,FAMILY HEALTH WEST HOSPITAL,Lower Valley Hospital Association,1861496697,Inpatient Hospitals (other than children's hospitals),300 W Ottley Ave,,Fruita,CO,81521-2118,Mesa,300 W Ottley,,Fruita,CO,81521,Mesa,Diane Miller,CFO,970-858-2228,,dmiller@fhw.org,Mark Francis,CEO,970-858-2106,,mfrancis@fhw.org,
CO-001934,MOUNTAIN FAMILY HEALTH CENTERS GLENWOOD SPRINGS,MOUNTAIN FAMILY HEALTH CENTERS,1114088762,Federally Qualified Health Centers - Medical Services,1905 Blake Ave,Suite 101,Glenwood Springs,CO,81601-4206,Garfield,2700 Gilstrap Ct,Suite 230,Glenwood Springs,CO,81601-4206,Garfield,Ross Brooks,CEO,970-945-2840,7209,rbrooks@mountainfamily.org,Art Fernandez,COO,970-945-2840,7205,afernandez@mountainfamily.org,
CO-001935,Planned Parenthood of the Rocky Mountains--Glenwood Springs,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",50923 Highway 6,,Glenwood Springs,CO,81601-2537,Garfield,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,Kate Hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,www.pprm.org
CO-001936,Planned Parenthood of the Rocky Mountains - Granby,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",236 Agate Ave,PO Box 88,Granby,CO,80446-0088,Grand,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001937,Farmworker Health Services Clinic - Grand Junction,"VALLEY WIDE HEALTH SYSTEMS, INC.",1790998953,Federally Qualified Health Centers - Medical Services,2333 N 6th St,,Grand Junction,CO,81501-2001,Mesa,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001938,Marillac Clinic Grand Junction,Marillac Clinic Inc.,1518239219,"Dental Providers, Federally Qualified Health Centers - Medical Services",2333 N 6th St,,Grand Junction,CO,81501-2001,Mesa,Marillac Clinic,2333 N 6th St,Grand Junction,CO,81501,Mesa,Mark Mancuso,Finance Director,970-298-1799,,mark.mancuso@sclhs.net,Debbie Rowley,,970-298-1710,,deborah.rowley@sclhs.net,www.marillacclinic.org
CO-001939,St. Mary's Family Medicine,St. Mary's Hospital and Medical Center,1699716027,Ryan White Providers,2698 Patterson Rd,,Grand Junction,CO,81506-8818,Mesa,2635 North 7th Street,,Grand Junction,CO,81501,Mesa,"Kristy Watkins, RN, MPH",Program Coordinator,970-298-1702,,kristy.watkins@sclhs.net,Robin Rose,Contracts Coordinator,970-298-7134,,robin.rose@sclhs.net,
CO-001940,Marillac Clinic - Health Department,Marillac Clinic Inc,1518239219,Federally Qualified Health Centers - Medical Services,510 29 1/2 Rd,,Grand Junction,CO,81504-5383,Mesa,2333 N 6th St,,Grand Junction,CO,81501,Mesa,Mark Mancuso,Finance Director,970-298-1799,,mark.mancuso@sclhs.net,Debbie Rowley,,970-298-1710,,deborah.rowley@sclhs.net,www.marillacclinic.org
CO-001941,MONFORT CHILDREN'S CLINIC,SUNRISE COMMUNITY HEALTH,1871890152,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 N 11th Ave,,Greeley,CO,80631-2011,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001942,SUNRISE FAMILY DENTAL CLINIC,SUNRISE COMMUNITY HEALTH,1699073395,Dental Providers,1006 A St,,Greeley,CO,80631-2021,Weld,2930 11th Ave,,Evans,CO,80620,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001943,SUNRISE ADELANTE CLINIC,SUNRISE COMMUNITY HEALTH,1205236072,Federally Qualified Health Centers - Medical Services,1010 A St,,Greeley,CO,80631-2021,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001944,SUNRISE NORTH RANGE CLINIC,SUNRISE COMMUNITY HEALTH,1295041598,Federally Qualified Health Centers - Medical Services,1300 N 17th Ave,,Greeley,CO,80631-9584,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001945,WELD COUNTY HEALTH DEPT. PRENATAL CLINIC,SUNRISE COMMUNITY HEALTH,1316244692,Federally Qualified Health Centers - Medical Services,1551 N 17th Ave,,Greeley,CO,80631-9400,Weld,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001946,Weld County Department of Public Health and Environment Family Planning Program,Weld County Department of Public Health and Environment,1174515258,"Family Planning Providers, Sexually Transmitted Disease Clinics",1555 N 17th Ave,,Greeley,CO,80631-9117,Weld,1555 N 17th Ave,,Greeley,CO,80631-9117,Weld,Mark Wallace,Executive Director,970-304-6410,2104,mwallace@co.weld.co.us,Cynthia Horn,Nurse Practitioner Supervisor,970-304-6420,2433,chorn@co.weld.co.us,www.weldhealth.org
CO-001947,Planned Parenthood of the Rocky Mountains--Greeley,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics",3487 W 10th St,Suite B,Greeley,CO,80634-5361,Weld,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001948,Gunnison County Family Planning,Gunnsison County Public Health,1942366612,"Family Planning Providers, Sexually Transmitted Disease Clinics",225 N Pine St,Suite E,Gunnison,CO,81230-2648,Gunnison,225 N Pine St Ste E,,Gunnison,CO,81230-2648,Gunnison,Randy Morgan,Administrative Services Supervisor,970-641-0209,7907,rmorgan@gunnisoncounty.org,Emily Fitzgerald,Family Planning Coordinator,970-641-0209,7910,efitzgerald@gunnisoncounty.org,www.gunnisoncounty.org
CO-001949,Planned Parenthood of the Rocky Mountains--Littleton,"Planned Parenthood of the Rocky Mountains, Inc",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",131 W County Line Rd,,Highlands Ranch,CO,80129-1931,Arapahoe,7155 East 38th Avenue,,Denver,CO,80207,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001950,"Children's Hospital Colorado South Campus, Highlands Ranch",Children's Hospital Colorado,1730540238,Children's Hospitals (inpatient only),1811 Plaza Dr,,Highlands Ranch,CO,80129-2450,Douglas,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,Elizabeth.Nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001951,"Children's Hospital Colorado South Campus, Highlands Ranch",Children's Hospital Colorado,1730540238,"Family Planning Providers, Outpatient Hospital Clinics",1811 Plaza Dr,,Highlands Ranch,CO,80129-2450,Douglas,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,Elizabeth.Nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001952,High Plains Holly Clinic,"HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED",1932596350,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",410 W. Colorado,,Holly,CO,81047,Prowers,201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Human Resources,719-336-0261,146,shae.emick@highplainschc.net,
CO-001953,Family Practice of Holyoke,East Phillips County Hospital District,1073520375,"Community Mental Health Centers, Family Planning Providers, Rural Health Clinics",1001 E Johnson St,,Holyoke,CO,80734-1854,Phillips,1001 E Johnson St,,Holyoke,CO,80734,Phillips,Sheila Robinson,Clinic Director,970-854-2500,2184,sheila.robinson@bannerhealth.com,Trampas Hutches,CEO,970-854-2241,2026,trampas.hutches@bannerhealth.com,
CO-001954,Northeast Colorado Health Department,Northeast Colorado Health Department,1013911437,Family Planning Providers,127 E Denver St,Suite C,Holyoke,CO,80734-1553,Phillips,700 Columbine Street,,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CO-001955,Lincoln Community Hospital,Lincoln Community Hospital & Nursing Home,1720107519,Inpatient Hospitals (other than children's hospitals),111 6th St,,Hugo,CO,80821-2002,Lincoln,PO Box 248,,Hugo,CO,80821,Lincoln,Kevin Stansbury,CEO,719-743-2421,3230,kstansbury@lchnh.com,Kathy Richie,Compliance Officer,719-743-2421,3243,krichie@lchnh.com,http://www.hugohospital.com/
CO-001956,Lincoln Community Hospital Same Day Clinic,Lincoln Community Hospital & Nursing Home,1720107519,Outpatient Hospital Clinics,111 6th St,,Hugo,CO,80821-2002,Lincoln,PO Box 248,,Hugo,CO,80821,Lincoln,Kevin Stansbury,CEO,719-743-2421,3230,kstansbury@lchnh.com,Kathy Richie,Compliance Officer,719-743-2421,3243,krichie@lchnh.com,http://www.hugohospital.com
CO-001957,Northeast Colorado Health Department,Northeast Colorado Health Department,1013911437,Family Planning Providers,118 W 3rd St,,Julesburg,CO,80737-1542,Sedgwick,700 Columbine Street,,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CO-001958,Health Center at Kiowa,PEAK VISTA COMMUNITY HEALTH CENTERS,1205255304,"Dental Providers, Federally Qualified Health Centers - Medical Services",320 Comanche St,,Kiowa,CO,80117,Elbert,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001959,La Jara Dental Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1295724797,Dental Providers,421 Walnut St,,La Jara,CO,81140,Conejos,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001960,San Luis Valley Health La Jara Clinic,"Lutheran Hospital Association of the San Luis Valley, DBA San Luis Valley Health",1942511019,Rural Health Clinics,509 Main St,,La Jara,CO,81140,Conejos,106 Blanca Avenue,,Alamosa,CO,81101,Alamosa,Kelly Gallegos,SLV Health CCH Administrator,719-274-6004,,Kelly.Gallegos@slvrmc.org,,,,,,
CO-001961,La Junta Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1225025703,Federally Qualified Health Centers - Medical Services,1012 Belmont Ave,,La Junta,CO,81050-2101,Otero,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001962,"Arkansas Valley Family Practice, LLC","Arkansas Valley Family Practice, LLC",1497938351,Rural Health Clinics,2317 San Juan Ave,,La Junta,CO,81050-3340,Otero,2317 San Juan Ave.,,La Junta,CO,81050,Otero,Casey Phillips,Administrator,719-383-2325,,caseyphillipsavfp@gmail.com,Dr. Richard Book,Owner/Provider,719-383-2325,,bookdo@hotmail.com,
CO-001963,Clinica Family Health - Lafayette,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1831186915,Federally Qualified Health Centers - Medical Services,2000 W South Boulder Rd,,Lafayette,CO,80026-1318,Boulder,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-001964,Union Plaza Health Home at JCMH,"METRO COMMUNITY PROVIDER NETWORK, INC.",1114213972,Federally Qualified Health Centers - Medical Services,12055 W 2nd Pl,,Lakewood,CO,80228-1506,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001965,Metro Community Provider Network,Metro Community Provider Network,1437314481,Federally Qualified Health Centers - Medical Services,1255 S Wadsworth Blvd,Alameda High School Kids and Teens Health Center,Lakewood,CO,80232-5406,Jefferson,3701 S BROADWAY,,ENGLEWOOD,CO,80113,Arapahoe,Bob Cunningham,Vice President of Finance,303-761-1977,1156,bob.cunningham@mcpn.org,Janet Pinkul,Controller,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org
CO-001966,Planned Parenthood of the Rocky Mountains--Southwest,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Sexually Transmitted Disease Clinics",1400 S Wadsworth Blvd,,Lakewood,CO,80232-5441,Jefferson,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-001967,Jefferson County Public Health,Jefferson County Public Health,1790843787,"Family Planning Providers, Sexually Transmitted Disease Clinics",645 Parfet St,,Lakewood,CO,80215-5574,Jefferson,645 Parfet Street,,Lakewood,CO,80215,Jefferson,Jody Denver Erwin,Administrative Services Director,303-271-5717,5717,jerwin@jeffco.us,Joseph Badalpour,Accounting Supervisor,303-271-5721,,jbadalpo@jeffco.us,
CO-001968,STEIN KIDS HEALTH CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1326203399,Federally Qualified Health Centers - Medical Services,80 S Teller St,,Lakewood,CO,80226-2044,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org
CO-001969,MCPN Lakewood Health Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1992965420,Federally Qualified Health Centers - Medical Services,8500 W Colfax Ave,,Lakewood,CO,80215-4011,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001970,ESTES STREET COMMUNITY HEALTH CENTER,"METRO COMMUNITY PROVIDER NETWORK, INC.",1558526418,Federally Qualified Health Centers - Medical Services,8755 W 14th Ave,,Lakewood,CO,80215-4863,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001971,Colfax Health Center at JCMH,"METRO COMMUNITY PROVIDER NETWORK, INC.",1013203876,Federally Qualified Health Centers - Medical Services,9485 W Colfax Ave,,Lakewood,CO,80215-3918,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001972,High Plains Dental/Pediatric Building,High Plains Community Health Center,1609240894,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",200 Kendall Dr,,Lamar,CO,81052-3940,Prowers,201 Kendall Drive,,Lamar,CO,81052,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Operations,719-336-0261,140,shae.emick@highplainschc.net,
CO-001973,HIGH PLAINS COMMUNITY HEALTH CENTER,"HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED",1700889151,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Operations,719-336-0261,146,shae.emick@highplainschc.net,
CO-001974,High Plains Adult Community Health Center,"HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED",1770865644,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2221 Wellness Way,,Lamar,CO,81052-3867,Prowers,201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Operations,719-336-0261,146,shae.emick@highplainschc.net,
CO-001975,LCC CAMPUS HEALTH CLINIC,"HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED",1275813982,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2401 S Main St,,Lamar,CO,81052-3912,Prowers,201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Operations,719-336-0261,146,shae.emick@highplainschc.net,
CO-001976,Las Animas Clinic and Las Animas Dental Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1124015607,"Dental Providers, Federally Qualified Health Centers - Medical Services",245 Vine Ave,,Las Animas,CO,81054-1039,Bent,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001977,Fort Lyon Health Center for the Homeless,Colorado Coalition for the Homeless,1336563014,Federally Qualified Health Centers - Medical Services,30999 County Road 15,,Las Animas,CO,81054-9499,Bent,2111 Champa St,,Denver,CO,80205,Denver,Stanley R. Eilert,Chief Administrative Officer,303-312-9605,,seilert@coloradocoalition.org,Mary Lea Forington,Director of Health Services,303-312-9798,,mforington@coloradocoalition.org,
CO-001978,Lake County Public Health Agency,Lake County Public Health Agency,1851411458,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",112 W 5th St,PO Box 626,Leadville,CO,80461-3510,Lake,112 W. 5th St.,PO Box 626,Leadville,CO,80461,Lake,Jane Cole,RN,719-486-4143,,jcole@co.lake.co.us,Julie Gonzales,Financial Manager,719-486-4149,,jgonzales@co.lake.co.us,
CO-001979,SCCC Lake County Dental,SCCC Lake County Dental,1821450008,"Dental Providers, Federally Qualified Health Centers - Dental Services",223 Harrison Ave,,Leadville,CO,80461-3392,Lake,PO BOX 4337,,Frisco,CO,80443,Summit,Raquel Santos,Credentialing Specialist,970-423-8866,,rsantos@summitclinic.org,Edna Roberts,Billing Supervisor,970-668-6892,,ednac@summitclinic.org,www.summitclinic.org
CO-001980,Solvista Health,"West Central Mental Health Center, Inc dba Solvista Health",1265565824,Community Mental Health Centers,714 Front St,,Leadville,CO,80461-3921,Lake,3225 Independence,,Canon City,CO,81212,Fremont,Rhonda Ducommun,Business Assistant,719-204-2090,2229,Rhondad@Solvistahealth.org,Kay Martin,COO,719-275-2351,2202,KayM@solvistahealth.org,SolvistaHealth.org
CO-001981,Lincoln Community Hospital Limon Clinic,Lincoln Community Hospital & Nursing Home,1720107519,Outpatient Hospital Clinics,2110 6th St,,Limon,CO,80828,Lincoln,PO Box 248,,Hugo,CO,80821,Lincoln,Kevin Stansbury,CEO,719-743-2421,3230,kstansbury@lchnh.com,Kathy Richie,Compliance Officer,719-743-2421,3243,krichie@lchnh.com,http://www.hugohospital.com
CO-001982,Health Center at Limon,PEAK VISTA COMMUNITY HEALTH CENTERS,1568881688,"Dental Providers, Federally Qualified Health Centers - Medical Services",820 1st St,,Limon,CO,80828,Lincoln,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-001983,MCPN Arapahoe Douglas Health Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1205122066,Federally Qualified Health Centers - Medical Services,61 W Davies Ave N,,Littleton,CO,80120-5252,Arapahoe,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,Bob Cunningham,Vice President of Finance,303-761-1977,1156,bob.cunningham@mcpn.org,Janet Pinkul,Controller,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001984,Longmont Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1871626267,"Dental Providers, Federally Qualified Health Centers - Medical Services",220 E Rogers Rd,,Longmont,CO,80501-6027,Boulder,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-001985,Women's Health at Longmont,Boulder Valley Women's Health Center,1740654508,"Family Planning Providers, Sexually Transmitted Disease Clinics",82 21st Ave,Suite C,Longmont,CO,80501-1254,Boulder,2855 Valmont Rd,,Boulder,CO,80301,Boulder,Susan Levy,Chief Executive Officer,303-440-9320,24,susan@bvwhc.org,Heidi Halpern,Chief Financial Officer,303-442-5160,21,heidi@bvwhc.org,www.boulderwomenshealth.org
CO-001986,SUNRISE SUMMITSTONE CLINIC,SUNRISE COMMUNITY HEALTH,1750660726,Federally Qualified Health Centers - Medical Services,1250 N Wilson Ave,,Loveland,CO,80537-4461,Larimer,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4672,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001987,Larimer County Health Department Family Planning Program-Loveland,Larimer County Health Department,1003092131,Family Planning Providers,205 E 6th St,Suite 3,Loveland,CO,80537-5682,Larimer,1525 Blue Spruce Drive,,Fort Collins,CO,80537-5681,Larimer,Mike Keller,Sr Accountant,970-498-6751,,mkeller@larimer.org,Marie Macpherson,Director of Administrative Services,970-498-6714,,mmacpherson@larimer.org,
CO-001988,LOVELAND COMMUNITY HEALTH CENTER/DENTAL,SUNRISE COMMUNITY HEALTH,1902005382,"Dental Providers, Federally Qualified Health Centers - Medical Services",302 3rd St SE,Suite 150,Loveland,CO,80537-6419,Larimer,2930 11th Ave,,Evans,CO,80620-1011,Weld,Janie Newhard,Credentialing Specialist,970-350-4602,,jnewhard.sunrise@nocoha.org,Shelly Rios,CWO,970-350-4672,,srios.sunrise@nocoha.org,
CO-001989,Moffat Family Health Center,"VALLEY WIDE HEALTH SYSTEMS, INC.",1881681104,Federally Qualified Health Centers - Medical Services,545 Moffat Way,,Moffat,CO,81143,Saguache,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001990,Monte Vista Community Clinic,San Luis Valley Health,1083012504,Rural Health Clinics,103 Chico Ct,,Monte Vista,CO,81144-1065,Rio Grande,106 Blanca Avenue,,Alamosa,CO,81101,Alamosa,Edwin Cruz,CLINIC MANAGER,719-852-6406,6406,edwin.cruz@slvrmc.org,Andrea Garcia,RN,719-852-9400,6402,Andrea.Garcia@slvrmc.org,www.sanluisvalleyhealth.org
CO-001991,Edward M. Kennedy Health Clinic or Dental Services or Physical Therapy Services,"VALLEY WIDE HEALTH SYSTEMS, INC.",1821085994,"Dental Providers, Federally Qualified Health Centers - Medical Services",925 2nd Ave,,Monte Vista,CO,81144-1432,Rio Grande,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-001992,Olathe Community Clinic - Montrose,"Olathe Community Clinic, Inc",1245600493,Federally Qualified Health Centers - Medical Services,100 Tessitore Ct Unit B,,Montrose,CO,81401-5689,Montrose,PO Box 529,,Olathe,CO,81425,Montrose,Jeremy Carroll,CEO,970-252-4692,,jcarroll@rivervalleyfhc.com,Debby Harrison-Zarkis,COO,970-252-4689,,dzarkis@rivervalleyfhc.com,www.rivervalleyfhc.com
CO-001993,UNCOMPAHGRE COMBINED CLINICS,UNCOMPAHGRE COMBINED CLINICS,1982774816,"Dental Providers, Federally Qualified Health Centers - Medical Services",1350 Aspen St,,Norwood,CO,81423,San Miguel,1350 S Aspen St,,Norwood,CO,81423,San Miguel,Sarah Franklin,HR Director & Outreach & Enrollment Manager,970-327-4233,506,sfranklin@umclinic.org,Nichole Long,Nursing Director,970-327-4233,525,nlong@umclinic.org,
CO-001994,"OLATHE COMMUNITY CLINIC, INC.","Olathe Community Clinic, Inc.",1770834244,Federally Qualified Health Centers - Medical Services,308 Main St,,Olathe,CO,81425,Montrose,308 Main Street,,Olathe,CO,81425,Montrose,Jeremy Carroll,CEO,970-252-4692,,jcarroll@rivervalleyfhc.com,Debby Harrison-Zarkis,COO,970-252-4689,,dzarkis@rivervalleyfhc.com,
CO-012439,Valley-Wide Ordway,"VALLEY WIDE HEALTH SYSTEMS, INC.",1902448186,Federally Qualified Health Centers - Medical Services,319 Main St,,Ordway,CO,81063-1302,Crowley,128 Market Street,,Alamosa,CO,81101,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,Javier Martinez,Chief Financial Officer,719-587-1083,,martinezj@vwhs.org,www.vwhs.org
CO-001995,Archuleta Integrated Healthcare,Axis Health System,1417295783,"Community Mental Health Centers, Dental Providers",52 Village Dr,,Pagosa Springs,CO,81147-8368,Archuleta,185 Suttle St.,,Durango,CO,81303,La Plata,Matt Payne,Senior Director of Integration,970-335-2421,,mpayne@axishealthsystem.org,Debbie White,Senior Director of Finance,,,dwhite@axishealthsystem.org,www.axishealthsystem.org
CO-001996,MCPN Pine Tree Health Center,"METRO COMMUNITY PROVIDER NETWORK, INC.",1205098340,"Dental Providers, Federally Qualified Health Centers - Medical Services",17866 Cottonwood Dr,,Parker,CO,80134-3924,Douglas,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-001997,"Children's Colorado Emergency Care at Parker Adventist Hospital, Parker",Children's Hospital Colorado,1144683723,Children's Hospitals (inpatient only),9395 Crown Crest Blvd,,Parker,CO,80138-8573,Douglas,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001998,"Children's Colorado Emergency Care at Parker Adventist Hospital, Parker",Children's Hospital Colorado,1750742359,Outpatient Hospital Clinics,9399 Crown Crest Blvd,"Sierra Medical Office Building, Ste 300",Parker,CO,80138,Douglas,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-001999,Peak Vista Community Health Centers,PEAK VISTA COMMUNITY HEALTH CENTERS,1619224987,Federally Qualified Health Centers - Medical Services,12050 Falcon Hwy,Falcon Peak School,Peyton,CO,80831-8076,El Paso,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917-5101,El Paso,Pamela McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-002000,GRAND AVENUE HOMELESS CLINIC,PUEBLO COMMUNITY HEALTH CENTER,1144589425,Federally Qualified Health Centers - Medical Services,1008 N Grand Ave,,Pueblo,CO,81003-2916,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002001,Pueblo City and County Health Department,Pueblo City and County Health Department,1245228022,"Family Planning Providers, Sexually Transmitted Disease Clinics",101 W 9th St,,Pueblo,CO,81003-4103,Pueblo,101 W 9th St,,Pueblo,CO,81003-4103,Pueblo,"Stacy Herrera, RN, BSN",Clinic Program Manager,719-583-4380,,herrerast@co.pueblo.co.us,,,,,,
CO-002002,Pueblo Community Health Center,PUEBLO COMMUNITY HEALTH CENTER,1396098828,Federally Qualified Health Centers - Medical Services,1050 35th Ln,Pueblo County High School,Pueblo,CO,81006-9426,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002003,PARK HILL CLINIC,PUEBLO COMMUNITY HEALTH CENTER,1164468336,Federally Qualified Health Centers - Medical Services,1302 E 5th St,,Pueblo,CO,81001-3702,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002004,O'ROURKE DENTAL CLINIC,PUEBLO COMMUNITY HEALTH CENTER,1245275932,Dental Providers,2030 Lake Ave,,Pueblo,CO,81004-3536,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002005,Pueblo Community Health Center,PUEBLO COMMUNITY HEALTH CENTER,1700139813,Federally Qualified Health Centers - Medical Services,216 E Orman Ave,Central High School SBWC,Pueblo,CO,81004-2144,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002006,Centennial HS SBWC,PUEBLO COMMUNITY HEALTH CENTER,1720432610,Federally Qualified Health Centers - Medical Services,2525 Mountview Dr,,Pueblo,CO,81008-1431,Pueblo,110 E Routt Ave,,Pueblo,CO,81004,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,
CO-002007,Pueblo Community Health Center,PUEBLO COMMUNITY HEALTH CENTER,1770529950,Federally Qualified Health Centers - Medical Services,300 Colorado Ave,,Pueblo,CO,81004-2006,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,http://www.pueblochc.org/
CO-002008,Pueblo Community Health Center,PUEBLO COMMUNITY HEALTH CENTER,1013261023,Federally Qualified Health Centers - Medical Services,625 N Monument Ave,Risley Middle School SBWC,Pueblo,CO,81001-5706,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002009,Pueblo Community Health Center,PUEBLO COMMUNITY HEALTH CENTER,1649524653,Federally Qualified Health Centers - Medical Services,9 Macneil Rd,East High School SBWC,Pueblo,CO,81001-1931,Pueblo,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8718,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002010,Pueblo Community College Health Clinic,PUEBLO COMMUNITY HEALTH CENTER,1316466816,Federally Qualified Health Centers - Medical Services,900 W Orman Ave,Room MT118,Pueblo,CO,81004-1430,Pueblo,110 E Routt Ave,,Pueblo,CO,81004,Pueblo,Catie Shannon,Director Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Chief Financial Officer,719-543-8711,295,cpratt@pueblochc.org,
CO-002011,Rangely District Hospital,Rangely Hospital District,1063430346,Inpatient Hospitals (other than children's hospitals),225 Eagle Crest St,,Rangely,CO,81648-3105,Rio Blanco,225 Eagle Crest Dr.,,Rangely,CO,81648,Rio Blanco,Tammy Dunker,CLINIC MANAGER,970-675-2237,162,tdunker@rdhosp.org,Jim Dillon,CFO,970-675-5011,233,jdillon@rdhosp.org,
CO-002012,Rangely Family Medicine,Rangely District Hospital,1730108747,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Outpatient Hospital Clinics",225 Eagle Crest St,,Rangely,CO,81648-3105,Rio Blanco,225 Eagle Crest Dr.,,Rangely,CO,81648,Rio Blanco,Tammy Dunker,CLINIC MANAGER,970-675-2237,162,tdunker@rdhosp.org,Jim Dillon,CFO,970-675-5011,233,jdillon@rdhosp.org,
CO-002013,MOUNTAIN FAMILY HEALTH CENTERS RIFLE,MOUNTAIN FAMILY HEALTH CENTERS,1578862983,"Dental Providers, Federally Qualified Health Centers - Medical Services",195 W 14th,Bldg C,Rifle,CO,81650-4700,Garfield,2700 Gilstrap Ct,Suite 230,Glenwood Springs,CO,81601-4206,Garfield,Ross A Brooks,CEO,970-945-2840,7209,rbrooks@mountainfamily.org,Art Fernandez,COO,970-945-2840,7205,afernandez@mountainfamily.org,
CO-002014,Grand River Health,Grand River Health,1649218991,Inpatient Hospitals (other than children's hospitals),501 Airport Rd,,Rifle,CO,81650-8510,Garfield,PO Box 912,,Rifle,CO,81650,Garfield,Lee Canterbury,PFS Director,970-625-6610,,lcanterbury@grhd.org,Cris Bolin,CFO,970-625-6462,,cbolin@grhd.org,www.grandriverhealth.org
CO-002015,Grand River Primary Care,Grand River Health Primary Care,1124074042,Rural Health Clinics,501 Airport Rd,,Rifle,CO,81650-8510,Garfield,PO Box 912,,Rifle,CO,81650,Garfield,Vickie Schauster,Practice Director,970-625-6204,,vschauster@grhd.org,Lee Canterbury,PFS Director,970-625-6610,,lcanterbury@grhd.org,www.grandriverhealth.org
CO-002016,"Rocky Ford Family Health Center, LLC","Rocky Ford Family Health Center, LLC",1508932757,Rural Health Clinics,1014 Elm Ave,,Rocky Ford,CO,81067-1328,Otero,1014 Elm Ave,,Rocky Ford,CO,81067,Otero,Terry L Miller,Business Manager,719-254-7421,,terrymiller_rffhc@hotmail.com,Douglas D Miller,FNP-C/Clinic Owner,719-254-7421,,dougmiller@rffhc.com,
CO-002017,Rocky Ford Clinic or Rocky Ford Dental Clinic,"VALLEY WIDE HEALTH SYSTEMS, INC.",1104813682,"Dental Providers, Federally Qualified Health Centers - Medical Services",903 S 12th St,,Rocky Ford,CO,81067-2127,Otero,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-002018,Solvista Health,"West Central Mental Health Center, Inc dba Solvista Health",1265565824,Community Mental Health Centers,111 Vesta Rd,,Salida,CO,81201-9327,Chaffee,3225 Independence Rd,,Canon City,CO,81212,Fremont,Rhonda Ducommun,Business Assistant,719-204-2090,2229,Rhondad@Solvistahealth.org,Kay Martin,COO,719-275-2351,2202,KayMartin@SolvistaHealth.org,SolvistaHealth.org
CO-002019,Planned Parenthood of the Rocky Mountains--Salida,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",233 E 2nd St,,Salida,CO,81201-2116,Chaffee,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-002020,"San Luis Health Center, Ernesto Pacheco Dental Clinic, or San Luis Physical Therapy and Rehabilitation","VALLEY WIDE HEALTH SYSTEMS, INC.",1417944729,"Dental Providers, Federally Qualified Health Centers - Medical Services",233 Main St,Suite B,San Luis,CO,81152,Costilla,128 Market St,,Alamosa,CO,81101-2290,Alamosa,Suzanne DeVore,Decision Support Analyst,719-587-1022,,devores@vwhs.org,,,,,,www.vwhs.org
CO-002021,"Summit Community Care Clinic, Inc.","Summit Community Care Clinic, Inc.",1821414293,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",101 Hamilton Creek Rd,School Based Health Center - Silverthorne Elementary,Silverthorne,CO,80498,Summit,PO Box 4337,,Frisco,CO,80443,Summit,Lori Bowman,Data Coordinator/Billing,970-423-8831,,lbowman@summitclinic.org,Erin Major,School Based Health Center Program Director,970-423-8831,,emajor@summitclinic.org,
CO-002022,Southeast Colorado Hospital Medical Clinic,Southeast Colorado Hospital District,1669565677,Rural Health Clinics,900 Church St,,Springfield,CO,81073-1636,Baca,373 East 10th Ave.,,Springfield,CO,81073,Baca,Staci Bishop PA-C,Practice Manager,719-523-6628,222,sbishop@sechosp.org,David Engel,Chief Executive officer,719-523-4501,130,dengel@sechosp.org,
CO-002023,Planned Parenthood of the Rocky Mountains - Steamboat Springs,"Planned Parenthood of the Rocky Mountains, Inc.",1881743631,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",111 11th St Unit 102,PO Box 772865,Steamboat Springs,CO,80477-2865,Routt,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
CO-002024,Steamboat Springs,Northwest Colorado Visiting Nurse A,1265787857,Federally Qualified Health Centers - Medical Services,940 Central Park Dr,Suite 101,Steamboat Springs,CO,80487-8853,Routt,940 Central Park Drive,Suite 101,Steamboat Springs,CO,80487,Routt,Stephanie Anderson,Chief Operating Officer,970-871-7636,,sanderso@nwcovna.org,Gisela Garrison,Health Center Director,970-871-7669,,ggarrison@nwcovna.org,www.nwcovna.org
CO-002025,Sterling Salud Family Health Center,"PLAN DE SALUD DEL VALLE, INC.",1437282829,"Dental Providers, Federally Qualified Health Centers - Medical Services",1410 S 7th Ave,,Sterling,CO,80751-4557,Logan,203 S Rollie Ave,,Fort Lupton,CO,80621-1508,Weld,John Santistevan,President/CEO,303-892-6401,2066,jsantistevan@saludclinic.org,,,,,,
CO-002026,"Centennial Mental Health Center, Inc.","Centennial Mental Health Center, Inc.",1861479677,Community Mental Health Centers,211 W Main St,,Sterling,CO,80751-3168,Logan,211 West Main Street,,Sterling,CO,80751,Logan,Lorie Hessler,Executive Assistant,970-522-4549,,lorieh@centennialmhc.org,"Elizabeth L. Hickman, Ph.D.",Executive Director,970-522-4549,,LizH@CentennialMHC.org,CentennialMHC.org
CO-002027,Northeast Colorado Health Department,Northeast Colorado Health Dept,1013911437,Family Planning Providers,700 Columbine St,,Sterling,CO,80751-3728,Logan,Northeast Colorado Health Department,700 Columbine Street,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CO-002028,Health Center at Strasburg,PEAK VISTA COMMUNITY HEALTH CENTERS,1851710065,"Dental Providers, Federally Qualified Health Centers - Medical Services",55981 E Colfax Ave,,Strasburg,CO,80136-8014,Arapahoe,3205 N. Academy Blvd.,Suite 130,Colorado Springs,CO,80917,El Paso,Pamela J McManus,President & CEO,719-344-6453,7193446453,Pam.McManus@peakvista.org,Christi Garriott,VP of Business Intelligence & Revenue,719-344-6454,7193446454,Christi.Garriott@peakvista.org,www.peakvista.org
CO-002029,Clinica Family Health - Thornton,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1093702177,"Dental Providers, Federally Qualified Health Centers - Medical Services",8990 Washington St,,Thornton,CO,80229-4537,Adams,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-002030,Rocky Mountain Youth Clinics - Thornton,Rocky Mountain Youth Clinics,1730295296,Other ECP Providers,9197 Grant St,Suite 200,Thornton,CO,80229-4337,Adams,"9197 Grant St., Suite 100",,Thornton,CO,80229,Adams,Paul Eschen,Director of Finance,303-450-3690,1122,peschen@rmyclinics.org,Barb Tafoya,Finance Administrator,303-450-3690,1121,btafoya@rmyclinics.org,www.rmyclinics.org
CO-002031,Mt San Rafael Hospital Clinic,Trinidad Area Health Association,1467400309,Rural Health Clinics,400 Benedicta Ave,,Trinidad,CO,81082-2099,Las Animas,410 Benedicta Ave,,Trinidad,CO,81082,Las Animas,David Rollins,Chief Financial Officer,719-846-8042,,cfo@msrhc.org,Barry McLean,Director of Patient Financial Services,719-845-4207,,bmclean@msrhc.org,www.msrhc.org
CO-002032,Mt San Rafael Hospital,Trinidad Area Health Association,1184616740,Inpatient Hospitals (other than children's hospitals),410 Benedicta Ave,,Trinidad,CO,81082-2005,Las Animas,410 Benedicta Ave,,Trinidad,CO,81082,Las Animas,David Rollins,Chief Financial Officer,719-846-8042,,cfo@msrhc.org,Barry McLean,Director of Patient Financial Services,719-845-4207,,bmclean@msrhc.org,www.msrhc.org
CO-002033,Salud Family Health Center at Mt Carmel,"PLAN DE SALUD DEL VALLE, INC.",1851805709,Federally Qualified Health Centers - Medical Services,911 Robinson Ave,,Trinidad,CO,81082-2811,Las Animas,203 South Rollie Ave,,Fort Lupton,CO,80621,Weld,David Madsen,CFO,720-322-9405,,dmadsen@saludclinic.org,,,,,,
CO-002034,Walsenburg Clinic,Pueblo Community Health Center,1790966174,Federally Qualified Health Centers - Medical Services,129 Kansas Ave,,Walsenburg,CO,81089-1818,Huerfano,110 E Routt Ave,,Pueblo,CO,81004-2006,Pueblo,Catie Shannon,Director of Revenue Cycle,719-543-8711,156,cshannon@pueblochc.org,Cindy Pratt,Cheif Financial Officer,719-543-8711,295,cpratt@pueblochc.org,www.pueblochc.org
CO-002035,Walsh Medical Clinic,Walsh Medical Clinic,1588803050,Rural Health Clinics,137 S Kansas St,,Walsh,CO,81090,Baca,PO Box 608,,Walsh,CO,81090,Baca,Sissie Hutches,Administrative Assistant,719-324-5253,,sishutches@gmail.com,Cathy Irwin,Billing/ Receptionist,719-324-5253,,walshmedclinic@gmail.com,
CO-002036,Custer County Medical Center,West Custer County Hospital District,1689672255,Rural Health Clinics,704 Edwards Ave,,Westcliffe,CO,81252-8588,Custer,704 Edwards Ave,,Westcliffe,CO,81252,Custer,Delwin Lester,Executive Director,719-783-2380,15,delwin@custercoclinic.org,Theresa Kennedy,CFO,719-783-2380,,theresa@custercoclinic.org,
CO-002037,Solvista Health,"West Central Mental Health Center, Inc dba Solvista Health",1265565824,Community Mental Health Centers,704 Edwards Ave,,Westcliffe,CO,81252-8588,Custer,3225 Independence Rd,,Canon City,CO,81212,Fremont,Rhonda Ducommun,Business Assistant,719-275-2351,2229,Rhondad@Solvistahealth.org,Kay Martin,COO,719-275-2351,2202,KayM@solvistahealth.org,SolvistaHealth.org
CO-002038,Clinica Family Health - Federal Heights,CLINICA CAMPESINA FAMILY HEALTH SERVICES,1811279136,Federally Qualified Health Centers - Medical Services,8300 Alcott St,Suite 205,Westminster,CO,80031-4029,Adams,1345 Plaza Ct N Ste 1A,,Lafayette,CO,80026-2832,Boulder,Simon Smith,President and CEO,303-665-2599,,simon.smith@clinica.org,Betsy David,Chief Financial Officer,303-665-3036,1120,bdavid@clinica.org,clinica.org
CO-002039,"Children's Colorado Outpatient and Urgent Care, Wheat Ridge",Children's Hospital Colorado,1487015988,"Family Planning Providers, Outpatient Hospital Clinics",3455 Lutheran Pkwy,,Wheat Ridge,CO,80033-6028,Jefferson,13123 East 16th Avenue,,Aurora,CO,80045,Adams,Elizabeth Nowak,"Executive Director, Payer Strategy & Network Development",720-777-6068,,elizabeth.nowak@childrenscolorado.org,Zach Zaslow,Government Affairs Manager,720-777-6555,,zach.zaslow@childrenscolorado.org,www.childrenscolorado.org
CO-002040,Independence Health Center at JCMH,"METRO COMMUNITY PROVIDER NETWORK, INC.",1316233174,Federally Qualified Health Centers - Medical Services,4851 Independence St,,Wheat Ridge,CO,80033-6715,Jefferson,3701 S Broadway,,Englewood,CO,80113-3611,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-002041,Jeffco Family Health Services Center,METRO COMMUNITY PROVIDER NETWORK,1184961492,"Dental Providers, Federally Qualified Health Centers - Medical Services",7495 W 29th Ave,,Wheat Ridge,CO,80033-8002,Jefferson,3701 S BROADWAY,,ENGLEWOOD,CO,80113,Arapahoe,BOB CUNNINGHAM,VICE PRESIDENT OF FINANCE,303-761-1977,1156,bob.cunningham@mcpn.org,JANET PINKUL,CONTROLLER,303-761-1977,1159,janet.pinkul@mcpn.org,http://mcpn.org/
CO-002042,High Plains Wiley Clinic,"HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED",1912349465,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",302 Main St,,Wiley,CO,81092,Prowers,201 Kendall Dr,,Lamar,CO,81052-3939,Prowers,Laurie Larrick,Vice President of Human Resources,719-336-0261,140,laurie.larrick@highplainschc.net,Shae Emick,Vice President of Operations,719-336-0261,140,shae.emick@highplainschc.net,
CO-002043,Northeast Colorado Health Department,Northeast Colorado Health Department,1013911437,Family Planning Providers,529 N Albany St,Suite 1120,Yuma,CO,80759-1526,Yuma,700 Columbine Street,,Sterling,CO,80751,Logan,Tamera Hort,Public Health Nursing Manager,970-522-3741,1241,tammyh@nchd.org,Trish McClain,Deputy Director,970-867-4918,2248,trishm@nchd.org,
CT-002044,CS-HHC Ansonia Health Center,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",121 Wakelee Ave,,Ansonia,CT,06401-1198,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1123,New Haven,Michael R. Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002045,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",141 Prindle Ave,O'Brien Technical High School SBHC,Ansonia,CT,06401,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002046,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Lincoln Blvd,"Central High School, School Based Health Clinic",Bridgeport,CT,06606-5502,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002047,Southwest Community Health Center,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,1046 Fairfield Ave,,Bridgeport,CT,06605-1116,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002048,Casa Recovery,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,1124 Iranistan Ave,,Bridgeport,CT,06605-1121,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002049,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,"Dental Providers, Federally Qualified Health Centers - Medical Services",1181 Fairfield Ave,"Bassick High School, School Based Health Clinic",Bridgeport,CT,06605-1183,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002050,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,"Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",130 Ezra St,"Read School, School Based Health Clinic",Bridgeport,CT,06606-5061,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002051,"Optimus Health Care, Inc.","Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1734 Central Ave,Warren Harding High School Based Health Center,Bridgeport,CT,06610-2763,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002052,"Optimus Health Care, Inc.","Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services",275 George St,Columbus School Based Health Center,Bridgeport,CT,06604-3320,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002053,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,300 Laurel Ave,"James J. Curiale School, School Based Health Clinic",Bridgeport,CT,06605-1103,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002054,Main Street Pediatric,"Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services",3715 Main St,,Bridgeport,CT,06606-3618,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002055,Prospect House,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,392 Prospect St,,Bridgeport,CT,06604-4625,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002056,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,"Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",425 Thorme St,"Blackham School, School Based Health Center",Bridgeport,CT,06606-3418,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002057,Southwest Community Health Center,"Southwest Community Health Center, Inc.",1699703686,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",46 Albion St,,Bridgeport,CT,06605-2602,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,Lynn Sosa,TB Program Director,860-509-7723,,,
CT-002058,PPSNE BRIDGEPORT CENTER,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",4697 Main St,,Bridgeport,CT,06606-1869,Fairfield,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002059,Pivot Ministries,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,495 Jane St,,Bridgeport,CT,06608-1707,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002060,"Optimus Health Care, Inc.","Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",500 Palisade Ave,Bullard Havens School Based Health Center,Bridgeport,CT,06610-3458,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002061,Southwest Community Health Center,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,510 Clinton Ave,,Bridgeport,CT,06605-1701,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002062,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,606 Howard Ave,Cesar Batalla School Based Health Center,Bridgeport,CT,06605-2016,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,Lynn Sosa,TB Program Director,860-509-7723,,,
CT-002063,Park City Primary Care,"Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",64 Black Rock Ave,,Bridgeport,CT,06605-1200,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002064,Harrison Apartments,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,651 State St,,Bridgeport,CT,06604-4507,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002065,"Southwest Community Health Center, Inc.","Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,680 Park Ave,"Roosevelt School, School Based Health Clinic",Bridgeport,CT,06604-4610,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002066,CASA,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,690 Arctic St,,Bridgeport,CT,06608-2008,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002067,"Optimus Health Care, Inc.","Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",700 Palisade Ave,John F Kennedy School Based Health Center,Bridgeport,CT,06610-3457,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002068,Southwest Community Health Center,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,743 South Ave,,Bridgeport,CT,06604-5810,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002069,Southwest Community Health Center,"Southwest Community Health Center, Inc.",1699703686,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",968 Fairfield Ave,,Bridgeport,CT,06605-1116,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,Lynn Sosa,TB/STD Program Director,860-509-7723,,,http://www.swchc.org/id20.html
CT-002070,"Optimus Health Care, Inc.","Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",982 E Main St # 988,,Bridgeport,CT,06608-1913,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002071,Wheeler Health and Wellness Center,"WHEELER CLINIC, INC. THE",1396750840,Federally Qualified Health Centers - Medical Services,10 N Main St,,Bristol,CT,06010-8122,Hartford,91 Northwest Dr,,Plainville,CT,06062-1534,Hartford,Susan Walkama,CEO,860-793-3568,,swalkama@wheelerclinic.org,Athena Dellas,Vice President of Finance/Controller,860-793-4235,,adellas@wheelerclinic.org,www.wheelerclinic.org
CT-002072,UCFS Behavioral Health Center - Colchester,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",212 Upton Rd,,Colchester,CT,06415-2712,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002073,GDCHC HATS Satellite Site,"CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.",1780918045,Federally Qualified Health Centers - Medical Services,21 Hayestown Ave,,Danbury,CT,06811-4819,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002074,"CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.","CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.",1780918045,Federally Qualified Health Centers - Medical Services,21 Memorial Dr,Rogers Park Middle School,Danbury,CT,06810-8005,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002075,City of Danbury Emergency Shelter WYA,Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,41 New St,,Danbury,CT,06810-6512,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002076,"Connecticut Institute For Communities, Inc.","CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.",1780918045,Federally Qualified Health Centers - Medical Services,43 Clapboard Ridge Rd,Danbury High School- School Based Health Center,Danbury,CT,06811-4529,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002077,PPSNE-Danbury Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",44 Main St,,Danbury,CT,06810-8047,Fairfield,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-752-2821,2038655158,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002078,Greater Danbury Community Health Center,"Connecticut Institute For Communities, Inc.",1780918045,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",57 North St,,Danbury,CT,06810-5660,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002079,"CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.","CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.",1780918045,Federally Qualified Health Centers - Medical Services,72 Hospital Ave,Broadview Middle School,Danbury,CT,06810-6021,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002080,Community Health Center of Danbury,Community Health Center Inc,1518139500,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",8 Delay St,,Danbury,CT,06810-6654,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002081,"Generations Family Health Center, Inc.","GENERATIONS FAMILY HEALTH CENTER, INC.",1346228905,Federally Qualified Health Centers - Medical Services,42 Reynolds St,,Danielson,CT,06239-2917,Windham,40 Mansfield Ave,,Willimantic,CT,06226-2018,Windham,Arvind Shaw,Chief Executive Officer,860-456-6200,,ashaw@genhealth.org,"Debra Daviau Savoie, MBA",Chief Financial Officer,860-456-6271,,dsavoie@genhealth.org,www.genhealth.org
CT-002082,PPSNE-Danielson Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND,INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",87 Westcott Rd,,Danielson,CT,06239-2929,Windham,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002083,CS-HHC Richrd O. Belden Dental Clinic,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Dental Providers,30 Elizabeth St,,Derby,CT,06418-1802,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002084,FCHC@110 Connecticut Blvd.,"FIRST CHOICE HEALTH CENTERS, INC.",1215923131,Federally Qualified Health Centers - Medical Services,110 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002085,FCHC@265 Ellington Rd.,"FIRST CHOICE HEALTH CENTERS, INC.",1891101473,Federally Qualified Health Centers - Medical Services,265 Ellington Rd,,East Hartford,CT,06108-1176,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002086,InterCommunity,InterCommunity,1962896548,Federally Qualified Health Centers - Medical Services,281 Main St,,East Hartford,CT,06118-1823,Hartford,281 Main St,,East Hartford,CT,06118,Hartford,Tracey Decker,Director of Integrated Services,860-569-5900,158,traceydecker@intercommunityct.org,Kim Beauregard,CEO,860-291-1340,,,
CT-002087,First Choice Health Centers @ 92 CT BLVD,"FIRST CHOICE HEALTH CENTERS, INC.",1770932642,Federally Qualified Health Centers - Medical Services,92 Connecticut Blvd,,East Hartford,CT,06108,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108,Hartford,Eugene Market,CEO,860-610-6131,,emarket@firstchc.org,,,,,,www.firstchc.org
CT-002088,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",35 Wheelbarrow Ln,East Haven High School SBHC,East Haven,CT,06513-2003,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002089,PPSNE-Enfield Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",111 Hazard Ave,Suite D,Enfield,CT,06082-4570,Hartford,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,860-509-7920,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002090,Operation Hope,"Southwest Community Health Center, Inc.",1699703686,Federally Qualified Health Centers - Medical Services,50 Nichols Ave,,Fairfield,CT,06825-1928,Fairfield,46 Albion St.,,Bridgeport,CT,06605-2602,Fairfield,Katherine S. Yacavone,CEO,203-332-3501,,kyacavone@swchc.org,,,,,,
CT-002091,John Dempsey Hospital-Hemophilia Center,State of Connecticut,1972857282,Hemophilia Treatment Centers,263 Farmington Ave,,Farmington,CT,06030-5355,Hartford,263 Farmington Ave.,,Farmington,CT,06030-1614,Hartford,Roseann roux,Assistant Director,860-679-3152,,roux@uchc.edu,Wanita thorpe,Academic Administrative Manager,860-679-3248,,wthorpe@uchc.edu,
CT-002092,PPSNE-Hartford Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",1229 Albany Ave,,Hartford,CT,06112-2132,Hartford,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002093,"YWCA Shelter, Transitional Housing","CHARTER OAK HEALTH CENTER, INC.",1992750855,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",135 Broad St,,Hartford,CT,06105-3718,Hartford,21 Grand St Ste 1,,Hartford,CT,06106-1541,Hartford,"Nichelle Mullins, Esq.",President & CEO,860-550-7500,,nmullins@thecharteroak.org,Tami M. Cyr,Director of Administrative Operations,860-550-7500,,tamicyr@thecharteroak.org,
CT-002094,InterCommunity,InterCommunity,1962896548,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",16 Coventry St,,Hartford,CT,06112-1524,Hartford,18 Founders Plaza,,East Hartford,CT,06118,Hartford,Tracey Decker,Vice President Integrated Health Services,860-569-5900,158,traceydecker@intercommunityct.org,,,,,,
CT-002095,Connecticut Children's Medical Center (children's inpatient hospital),Connecticut Department of Public Health,1215947387,Children's Hospitals (inpatient only),282 Washington St,Infectious Diseases,Hartford,CT,06106-3322,Hartford,282 Washington St,,Hartford,CT,06106,Hartford,David Croke,"Director, Managed Care",860-837-5294,,dcroke@connecticutchildrens.org,Patrick Garvey,"Senior VP, CFO",860-545-8557,,pgarvey@connecticutchildrens.org,http://www.connecticutchildrens.org/index.php/healthinfo/teens/sexual-health/stds-and-other-infections/hiv-testing-resources/
CT-002096,Connecticut Children's Medical Center (multiple outpatient ECP categories),Connecticut Department of Public Health,1215947387,"Ryan White Providers, Tuberculosis Clinics",282 Washington St,Infectious Diseases,Hartford,CT,06106-3322,Hartford,282 Washington St,,Hartford,CT,06106,Hartford,David Croke,"Director, Managed Care",860-837-5294,,dcroke@connecticutchildrens.org,Patrick Garvey,"Senior VP, CFO",860-545-8557,,pgarvey@connecticutchildrens.org,http://www.connecticutchildrens.org/index.php/healthinfo/teens/sexual-health/stds-and-other-infections/hiv-testing-resources/
CT-002097,Community Health Services Inc,Community Health Services Inc,1730284605,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",500 Albany Ave,,Hartford,CT,06120-2508,Hartford,500 Albany Avenue,,Hartford,CT,06120-2508,Hartford,Judy Tallman,Director Grants & Outreach,860-808-8748,,judy.tallman@chshartford.org,Gregory Stanton,Chief Executive officer,860-808-8701,,gregory.stanton@chshartford.org,www.chshartford.org
CT-002098,CHC at CT Children's,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",76 New Britain Ave,,Hartford,CT,06106-3305,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002099,Wheeler Health & Wellness Center - Hartford,Wheeler Clinic,1396750840,Federally Qualified Health Centers - Medical Services,999 Asylum Ave,,Hartford,CT,06105-2416,Hartford,91 Northwest Drive,,Plainville,CT,06062,Hartford,Susan Walkama,President and CEO,860-793-3568,,swalkama@wheelerclinic.org,Athena Dellas,Vice President of Finance/Controller,860-793-4235,,adellas@wheelerclinic.org,www.wheelerclinic.org
CT-002100,UCFS Health Center - Griswold,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",76 Main St,,Jewett City,CT,06351-2226,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002101,Mashantucket Pequot Health Center,Mashantucket Pequot Health Center,1508140922,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",75 Rt 2,,Ledyard,CT,06339-1128,New London,PO Box 3260,,Mashantucket,CT,06338-3060,New London,"Shanna Reels, LCSW",Health Director,860-312-8000,,sreels@mptn.org,Jennifer Vital,Administrative Assistant,860-312-8025,,jvital@mptn.org,
CT-002102,FCHC@150 N.Main St.,"FIRST CHOICE HEALTH CENTERS, INC.",1699732206,"Dental Providers, Federally Qualified Health Centers - Medical Services",150 N Main St,,Manchester,CT,06042-2086,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002103,PPSNE-Manchester,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",319 Main St,,Manchester,CT,06040-4128,Hartford,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002104,"First Choice Health Centers, Inc.","FIRST CHOICE HEALTH CENTERS, INC.",1992111579,Federally Qualified Health Centers - Medical Services,791 Middle Tpke W,First Choice @ Howell Cheney Technical High School,Manchester,CT,06040-1819,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002105,FCHC @ CHR Manchester,"FIRST CHOICE HEALTH CENTERS, INC.",1962884395,Federally Qualified Health Centers - Medical Services,Chr 587 Middle Turnpike E,,Manchester,CT,06040,Hartford,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-610-6131,,emarket@firstchc.org,,,,,,
CT-002106,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",100 Clearview Ave,Casimir Pulaski Elementary School SBHC,Meriden,CT,06450-6492,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002107,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,121 Gravel St,Maloney High School School Based Health Center,Meriden,CT,06450-4611,New Haven,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002108,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1225 N Broad St,Washington Middle School SBHC,Meriden,CT,06450-2479,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002109,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",124 Columbia St,John Barry Elementary School SBHC,Meriden,CT,06451-3171,New Haven,635 Main Street,,Middletown,CT,06457,New London,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002110,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",133 Parker Ave,Israel Putnam Elementary School SBHC,Meriden,CT,06450-5925,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002111,Community Health Center of Meriden,Community Health Center Inc,1720263148,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",134 State St,Suite 1B,Meriden,CT,06450-3293,New Haven,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002112,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1355 N Broad St,Thomas Edison Magnet Middle School SBHC,Meriden,CT,06450-2438,New Haven,635 Main Street,,Middletown,CT,06450,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002113,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",164 Centennial Ave,Lincoln Middle School SBHC,Meriden,CT,06451-3707,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002114,Meri-Care Dental Clinic,Community Health Center Inc.,1720263148,Dental Providers,165 Miller St,,Meriden,CT,06450-4256,New Haven,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002115,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",208 Main St,Hanover Elementary School SBHC,Meriden,CT,06451-5149,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002116,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",220 Coe Ave,Platt High School SBHC,Meriden,CT,06451-3812,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002117,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",23 Oregon Rd,Wilcox Technical High School SBHC,Meriden,CT,06451-3716,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002118,PPSNE-Meriden Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",26 Womens Way,,Meriden,CT,06451-3237,New Haven,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002119,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",277 Atkins Street Ext,Nathan Hale Elementary School SBHC,Meriden,CT,06450-3405,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002120,Meriden Head Start SBHC,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",398 Liberty St,,Meriden,CT,06450-4529,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002121,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",426 W Main St,Benjamin Franklin Elementary School SBHC,Meriden,CT,06451-3802,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002122,W.Y.A. at Shelter Now,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",43 Saint Casimir Dr,,Meriden,CT,06450-5729,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002123,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",64 N Pearl St,Roger Sherman Elementary School SBHC,Meriden,CT,06450-4419,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002124,Venture Academy SBHC,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",883 Paddock Ave,,Meriden,CT,06450-7044,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002125,Wherever You Are Eddy Shelter,Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,1 Labella Cir,,Middletown,CT,06457-3938,Middlesex,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002126,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,200 LA Rosa Ln,Middletown High School School School Based Health Center,Middletown,CT,06457-2148,Middlesex,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002127,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,207 Westfield St,Spencer Elementary School School Based Health Center,Middletown,CT,06457-2042,Middlesex,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002128,UCFS Health Center - Plainfield,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",120 Plainfield Rd # 122,,Moosup,CT,06354-1632,Windham,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002129,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,110 Mill St,New Britain High School School Based Health Center,New Britain,CT,06051-3413,Hartford,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002130,Smalley Academy SBHC,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",175 West St,,New Britain,CT,06051-1415,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002131,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",183 Steele St,Slade Middle School SBHC,New Britain,CT,06052-1555,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002132,Friendship Service Center of New Britain,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",241 Arch St,,New Britain,CT,06051-2518,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002133,"Community Health Center, Inc.",Community Health Center In,1952591851,Federally Qualified Health Centers - Medical Services,322 Slater Rd,Gaffney Elementary School Based Health Center,New Britain,CT,06053-3458,Hartford,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002134,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",40 Goodwin St,Roosevelt Middle School SBHC,New Britain,CT,06051-2814,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002135,Wherever You Are Prudence Crandall,Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,594 Burritt St,,New Britain,CT,06053-4803,Hartford,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002136,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",735 Slater Rd,Goodwin Technical High School SBHC,New Britain,CT,06053-2200,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002137,Wheeler Health & Wellness Center - New Britain,Wheeler Clinic,1396750840,Federally Qualified Health Centers - Medical Services,75 N Mountain Rd,,New Britain,CT,06053-3468,Hartford,91 Northwest Drive,,Plainville,CT,06062,Hartford,Susan Walkama,President and CEO,860-793-3568,,swalkama@wheelerclinic.org,Athena Dellas,Vice President of Finance/Controller,860-793-4235,,adellas@wheelerclinic.org,www.wheelerclinic.org
CT-002138,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",757 Farmington Ave,Pulaski Middle School SBHC,New Britain,CT,06053-1364,Hartford,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002139,Community Health Center of New Britain,Community Health Center Inc,1912182338,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",85 Lafayette St,,New Britain,CT,06051-1803,Hartford,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002140,Yale-New Haven Children's Hospital,Yale-New Haven Hospital,1336139500,Children's Hospitals (inpatient only),1 Park St,,New Haven,CT,06504-8901,New Haven,20 York Street,,New Haven,CT,06510,New Haven,Michael Loftus,"Vice President, Finance",203-688-6364,,michael.loftus@ynhh.org,,,,,,
CT-002141,Fair Haven Community Health Clinic Inc,FAIR HAVEN COMMUNITY HEALTH CLINIC INC,1104803444,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 James St,John Martinez K-8 School Based Health Center,New Haven,CT,06513-4222,New Haven,374 Grand Ave,,New Haven,CT,06513-3733,New Haven,Suzanne Lagarde,CEO,203-752-5129,,s.lagarde@fhchc.org,Jeannette DeJesus,COO,203-752-5134,,j.dejesus@fhchc.org,
CT-002142,Cornell Scott-Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,114 Truman St,TRUMAN SCHOOL BASED HEALTH CTR,New Haven,CT,06519-2022,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002143,Wilmont Crossing Health Center,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",120 Wilmot Rd,Suite 1030,New Haven,CT,06515-1007,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R. Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002144,AIDS Project New Haven,AIDS Project New Haven,1184993081,Ryan White Providers,1302 Chapel St,,New Haven,CT,06511-4515,New Haven,1302 Chapel Street,,New Haven,CT,06511,New Haven,Christopher A. Cole,Executive Director,475-441-7017,,chris.cole@apnh.org,"Nicholas Boshnack, MSW",Director of Client Services,475-441-7027,,nick.boshnack@apnh.org,apnh.org
CT-002145,Cornell Scott-Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,140 Dewitt St,HILL CENTRAL SCHOOL CLINIC,New Haven,CT,06519-2133,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002146,KING ROBINSON SBHC,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,150 Fournier St,,New Haven,CT,06511-1763,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002147,Fair Haven Community Health Clinic Inc,FAIR HAVEN COMMUNITY HEALTH CLINIC INC,1104803444,"Dental Providers, Federally Qualified Health Centers - Medical Services",164 Grand Ave,Fair Haven K-8 School Based Health Center,New Haven,CT,06513-3938,New Haven,374 Grand Ave,,New Haven,CT,06513-3733,New Haven,Suzanne Lagarde,CEO,203-752-5129,,s.lagarde@fhchc.org,Jeannette DeJesus,COO,203-752-5134,,j.dejesus@fhchc.org,
CT-002148,DIXWELL HEALTH CENTER,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",226 Dixwell Ave,,New Haven,CT,06511-3456,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R. Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002149,South Central Rehabilitation Center,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Tuberculosis Clinics",232 Cedar St,,New Haven,CT,06519-1610,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R. Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002150,Cornell Scott-Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,259 Edgewood Ave,CS-HHC at Augusta Lewis Troup School,New Haven,CT,06511-4106,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002151,Fair Haven Community Health Clinic Inc,FAIR HAVEN COMMUNITY HEALTH CLINIC INC,1104803444,"Dental Providers, Federally Qualified Health Centers - Medical Services",293 Clinton Ave,Clinton Avenue School Based Health Center,New Haven,CT,06513-2814,New Haven,374 Grand Ave,,New Haven,CT,06513-3733,New Haven,Suzanne Lagarde,CEO,203-752-5129,,s.lagarde@fhchc.org,Jeannette DeJesus,COO,203-752-5134,,j.dejesus@fhchc.org,
CT-002152,Yale Hemophilia Treatment Center,Yale Hemophilia Treatment Center,1295039675,Hemophilia Treatment Centers,333 Cedar St,,New Haven,CT,06510-3206,New Haven,333 Cedar Street,,New Haven,CT,06520,New Haven,"Gary Kupfer, MD",Medical Director,203-785-4011,,Gary.kupfer@yale.edu,Susan Marino,Program Manager,203-785-4011,,susan.marino@yale.edu,
CT-002153,Fair Haven Medical Group at Bella Vista,FAIR HAVEN COMMUNITY HEALTH CLINIC INC,1871770768,"Dental Providers, Federally Qualified Health Centers - Medical Services",339 Eastern St,,New Haven,CT,06513-2463,New Haven,374 Grand Ave,,New Haven,CT,06513-3733,New Haven,Suzanne Lagarde,CEO,203-752-5129,,s.lagarde@fhchc.org,Jeannette DeJesus,COO,203-752-5134,,j.dejesus@fhchc.org,
CT-002154,CS-HHC at CMHC,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,34 Park St,,New Haven,CT,06519-1109,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002155,PPSNE-New Haven Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,Family Planning Coordinator,203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522821,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002156,Cornell Scott-Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,35 Davis St,DAVIS STREET SCHOOL CLINIC,New Haven,CT,06515-1601,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002157,Cornell Scott-Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,360 Columbus Ave,ROBERTO CLEMENTE SCHOOL CLINIC,New Haven,CT,06519-1516,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002158,Fair Haven Community Clinic,Fair Haven Community Clinic,1104803444,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",374 Grand Ave,,New Haven,CT,06513-3733,New Haven,374 Grand Ave,,New Haven,CT,06513,New Haven,Dorothy L Smith,Director of Finance,203-777-7411,5499,d.smith@fhchc.org,Pat Moro,VP of Finance,203-777-7411,5127,p.moro@fhchc.org,
CT-002159,Cornell Scott Hill Health Corporation,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002160,CORNELL SCOTT-HILL HEALTH CENTER,Cornell Scott Hill Health Corporation,1902921380,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",428 Columbus Ave,,New Haven,CT,06519-1233,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R. Taylor,CEO,203-503-3280,2035033280,mmckinna@cornellscott.org,,,,,,
CT-002161,FELLOWSHIP PLACE HOMELESS OUTREACH,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,441 Elm St,,New Haven,CT,06511-4523,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002162,LIFE HAVEN SHELTER HOMELESS OUTREACH,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,447 Ferry St,,New Haven,CT,06513-3617,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002163,Fair Haven Community Health Center at 50 Grand,Fair Haven Community Health Center,1811372469,"Dental Providers, Federally Qualified Health Centers - Medical Services",50 Grand Ave,,New Haven,CT,06513-3949,New Haven,374 Grand Avenue,,New Haven,CT,06513,New Haven,Rose Pudlin,Director of Community Outreach,203-752-5111,,r.pudlin@fhchc.org,Suzanne Lagarde,CEO,203-752-5129,,s.lagarde@fhchc.org,
CT-002164,TAKING INITIATIVE CENTER/MARRAKECH,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,514 Whalley Ave,,New Haven,CT,06511-2907,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002165,Martha's Place,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,559 Howard Ave,,New Haven,CT,06519-2139,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002166,Fair Haven Community Health Clinic Inc,FAIR HAVEN COMMUNITY HEALTH CLINIC INC,1104803444,"Dental Providers, Federally Qualified Health Centers - Medical Services",560 Ella T Grasso Blvd,Riverside Academy School Based Health Center,New Haven,CT,06519-1827,New Haven,374 Grand Ave,,New Haven,CT,06513-3733,New Haven,Suzanne Lagarde,Ceo,203-752-5129,,s.lagarde@fhchc.org,Jeannette DeJesus,COO,203-752-5134,,j.dejesus@fhchc.org,
CT-002167,COLUMBUS HOUSE SHELTER CLINIC,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,586 Ella T Grasso Blvd,,New Haven,CT,06519-1806,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002168,GRANT STREET PARTNERSHIP,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,62 Grant St,,New Haven,CT,06519-2514,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002169,Emergency Shelter Management Service,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,645 Grand Ave,,New Haven,CT,06511-5011,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002170,COMMUNITY SOUP KITCHEN-BROADWAY,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,84 Broadway,,New Haven,CT,06511-3412,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002171,State Street Health & Counseling Services,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,911 State St # 913,,New Haven,CT,06511-3926,New Haven,400 Columbus Ave,,New Haven,CT,06519-1233,New Haven,Michael R Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,
CT-002172,Community Health Center of New London,Community Health Center Inc,1982889309,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1 Shaws Cv,,New London,CT,06320-4902,New London,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002173,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",190 Governor Winthrop Blvd,The Interdistrict School for Arts and Communication (ISAAC),New London,CT,06320-6612,New London,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002174,W.Y.A. New London Homeless Hospitality Center,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",327 Huntington St,,New London,CT,06320-6214,New London,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002175,UCFS Behavioral Health Center - New London,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",351 N Frontage Rd,Suite B4,New London,CT,06320-2628,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002176,PPSNE-New London Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",45 Franklin St,,New London,CT,06320-5920,New London,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2937522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002177,"CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.","CONNECTICUT INSTITUTE FOR COMMUNITIES, INC.",1780918045,Federally Qualified Health Centers - Medical Services,11 Queen St,Newtown Middle School,Newtown,CT,06470-2121,Fairfield,7 Old Sherman Tpke Ste 200,,Danbury,CT,06810-4174,Fairfield,Diana Trumbley,Practice Administrator,203-743-0100,305,TrumbleyD@ct-institute.org,Katie Curran,COO,203-743-9760,121,CurranK@ct-institute.org,
CT-002178,Norwalk Smiles At Nathaniel Ely Head Start SBHC,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",11 Ingalls Ave,,Norwalk,CT,06854-4605,Fairfield,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002179,Norwalk Community Health Center,Connecticut Department of Public Health,1841226347,Federally Qualified Health Centers - Medical Services,120 Connecticut Ave,,Norwalk,CT,06854-1525,Fairfield,120 Connecticut Ave,,Norwalk,CT,06854-1525,Fairfield,Craig Glover,CEO,203-899-1770,8010,cglover@norwalkchc.org,,,,,,www.norwalkchc.org
CT-002180,Norwalk Smiles at Ben Franklin,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",165 Flax Hill Rd,,Norwalk,CT,06854-2837,Fairfield,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002181,Day Street Community Health Center,Community Health Center Inc,1972788321,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",49 Day St,,Norwalk,CT,06854-4901,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002182,PPSNE-Norwich Health Center,"Planned Parenthood of Southern New England, Inc.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",12 Case St,,Norwich,CT,06360-2222,New London,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002183,"Generations Family Health Center, Inc.","GENERATIONS FAMILY HEALTH CENTER, INC.",1346228905,Federally Qualified Health Centers - Medical Services,330 Washington St,Suite 510,Norwich,CT,06360-2733,New London,40 Mansfield Avenue,,Willimantic,CT,06226-2018,Windham,Arvind Shaw,Chief Executive Officer,860-456-6200,,ashaw@genhealth.org,"Debra Daviau Savoie, MBA",Chief Financial Officer,860-456-6271,,dsavoie@genhealth.org,www.genhealth.org
CT-002184,Edward & Mary Lord Family Health Center,United Community & Family Services,1467482539,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",47 Town St,,Norwich,CT,06360,New London,34 East Twon Street,,Norwich,CT,06360,New London,Karen Eichstaedt,VP People,860-822-4144,1211,keichstaedt@ucfs.org,,,,,,https://www.ucfs.org
CT-002185,United Community Services Inc,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7 Mahan Dr,Norwich Technical High School - School Based Health Center,Norwich,CT,06360-2425,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002186,United Community Services Inc,UNITED COMMUNITY SERVICES INC,1467482539,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",800 Old Colchester Rd,Montville High School - School Based Health Center,Oakdale,CT,06370-2608,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002187,PPSNE-Old Saybrook Health Center,"Planned Parenthood of Southern New England, Inc.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",263 Main St,,Old Saybrook,CT,06475-2326,Middlesex,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,20037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002188,"Generations Family Health Center, Inc.","GENERATIONS FAMILY HEALTH CENTER, INC.",1346228905,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",202 Pomfret St,,Putnam,CT,06260-1833,Windham,40 Mansfield Ave,,Willimantic,CT,06226-2018,Windham,Arvind Shaw,Chief Executive Officer,860-456-6200,,ashaw@genhealth.org,"Debra Daviau Savoie, MBA",Chief Financial Officer,860-456-6271,,dsavoie@genhealth.org,www.genhealth.org
CT-002189,"Generations Family Health Center, Inc.","GENERATIONS FAMILY HEALTH CENTER, INC.",1346228905,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",35 Wicker St,,Putnam,CT,06260-1443,Windham,40 Mansfield Ave,,Willimantic,CT,06226-2018,Windham,Arvind Shaw,Chief Executive Officer,860-456-6200,,ashaw@genhealth.org,"Debra Daviau Savoie, MBA",Chief Financial Officer,860-456-6271,,dsavoie@genhealth.org,www.genhealth.org
CT-002190,United Community Services Inc,UNITED COMMUNITY SERVICES INC,1467482539,Federally Qualified Health Centers - Medical Services,78 Hunts Brook Rd,UCFS at Waterford Country School,Quaker Hill,CT,06375-1009,New London,34 E Town St,,Norwich,CT,06360-2326,New London,Beth A. Mullin,CFO,860-889-2375,1226,bmullin@ucfs.org,Allison Keefe,Director of Outpatient Revenue,860-889-2375,1260,akeefe@ucfs.org,ucfs.org
CT-002191,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,1127 Hope St,Springdale Elementary School Based Health Center,Stamford,CT,06907-1825,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002192,Fairgate Community Health Center,"Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services",138 Stillwater Ave,,Stamford,CT,06902-4843,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002193,Franklin Street Community Health Center,Community Health Center Inc,1730311143,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",141 Franklin St,,Stamford,CT,06901-1014,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002194,Stamford Academy SBHC,"Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",229 North St,,Stamford,CT,06901-1112,Fairfield,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-002195,PPSNE-Stamford Health Center,"Planned Parenthood of Southern New England, Inc.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",35 Sixth St,,Stamford,CT,06905-4603,Fairfield,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002196,"Community Health Center, Inc.",Community Health Center Inc,1952591851,Federally Qualified Health Centers - Medical Services,398 Glenbrook Rd,Julia Stark Elementary School School Based Health Center,Stamford,CT,06906-2122,Fairfield,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002197,Stamford Community Health Center,"Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",805 Atlantic St,,Stamford,CT,06902-6805,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002198,"Community Health Center, Inc.",Community Health Center Inc,1952591851,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",83 Lockwood Ave,DOMUS School Health Services at Trailblazers Academy,Stamford,CT,06902-4201,Fairfield,675 Main Street,,Middletown,CT,06457,Fairfield,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002199,Stratford Community Health Center,"Optimus Health Care, Inc.",1669445946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",727 Honeyspot Rd,,Stratford,CT,06615-7172,Fairfield,982 East Main Street,,Bridgeport,CT,06608,Fairfield,Elena Reyes,Admin Assistant,203-696-3260,3885,ereyes@opthc.org,Linda Ugarte,Admin Assistant,203-696-3260,3357,lugarte@opthc.org,www.optimushealthcare.org
CT-002200,PPSNE-Torrington Health Center,Planned Parenthood of Southern New England,1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",249 Winsted Rd,,Torrington,CT,06790-2958,Litchfield,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002201,Community Health and Wellness Center,Connecticut Department of Public Health,1356318091,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",469 Migeon Ave,,Torrington,CT,06790-4643,Litchfield,469 Migeon Ave,,Torrington,CT,06790-4643,Litchfield,Lawrence Nolan,CFO /COO,860-482-3038,109,lnolan@chwctorr.org,Joanne Borduas,CEO,860-482-3038,125,jborduas@chwctorr.org,http://www.chwctorr.org/
CT-002202,"First Choice Health Centers, Inc.","FIRST CHOICE HEALTH CENTERS, INC.",1669874855,Federally Qualified Health Centers - Medical Services,20 Maple St,First Choice @ Maple Street School,Vernon,CT,06066-3026,Tolland,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002203,FCHC@3 Prospect St,"FIRST CHOICE HEALTH CENTERS, INC.",1396930459,Federally Qualified Health Centers - Medical Services,3 Prospect St,,Vernon Rockville,CT,06066-3215,Tolland,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,CEO,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002204,"First Choice Health Centers, Inc.","FIRST CHOICE HEALTH CENTERS, INC.",1669874087,Federally Qualified Health Centers - Medical Services,70 Loveland Hill Rd,First Choice @ Rockville High School,Vernon Rockville,CT,06066-6836,Tolland,94 Connecticut Blvd,,East Hartford,CT,06108-3013,Hartford,Eugene Market,Chief Executive Officer,860-289-6413,,emarket@firstchc.org,,,,,,
CT-002205,"Community Health Center, Inc.","Community Health Center, Inc.",1952591851,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",43 Tompkins St,Kaynor Technical High School SBHC,Waterbury,CT,06708-1416,New Haven,635 Main Street,,Middletown,CT,06457,Middlesex,"Margaret Flinter, APRN, PhD",SVP/Clinical Director,860-347-6971,3622,Margaret@chc1.com,"Robert Block, CPA",CFO,860-347-6971,3676,BlockR@chc1.com,www.chc1.com
CT-012440,Center for Vein Restoration,Center for Vein Restoration,1306282926,Other ECP Providers,475 Chase Pkwy,,Waterbury,CT,06708-3339,New Haven,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
CT-002206,Community Health Center of Waterbury,Community Health Center Inc.,1972866556,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",51 N Elm St,Suite 2,Waterbury,CT,06702-1545,New Haven,675 Main Street,,Middletown,CT,06457,Middlesex,Margaret Flinter,SVP/Clinical Director,860-347-6971,3622,flintem@chc1.com,,,,,,www.chc1.com
CT-002207,Staywell Health Center,Connecticut Department of Public Health,1154342335,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",80 Phoenix Ave,,Waterbury,CT,06702-1418,New Haven,80 Phoenix Avenue,Suite 201,Waterbury,CT,06702-1418,New Haven,Donald Thompson,President / CEO,203-756-8021,3016,dthompson@staywellhealth.org,,,,,,www.staywellhealth.org
CT-002208,PPSNE-Waterbury Health Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, Inc.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",969 W Main St,,Waterbury,CT,06708-2653,New Haven,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002209,PPSNE-West Hartford Health Center,"Planned Parenthood of Southern New England, Inc.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",1030 New Britain Ave,,West Hartford,CT,06110-2261,Hartford,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,www.ppsne.org
CT-002210,West Haven Health Center,CORNELL SCOTT-HILL HEALTH CORPORATION,1902921380,Federally Qualified Health Centers - Medical Services,285 Main St,,West Haven,CT,06516-7307,New Haven,400 Columbus Avenue,,New Haven,CT,06519-1233,New Haven,Michael R. Taylor,CEO,203-503-3280,,mmckinna@cornellscott.org,,,,,,www.cornellscott.org
CT-002211,PPSNE-Willimantic Health Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",1548 Main St,,Willimantic,CT,06226-1142,Windham,345 Whitney Avenue,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
CT-002212,"Generations Family Health Center, Inc.","GENERATIONS FAMILY HEALTH CENTER, INC.",1346228905,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",40 Mansfield Ave,,Willimantic,CT,06226-2018,Windham,40 Mansfield Avenue,,Willimantic,CT,06226-2018,Windham,Arvind Shaw,Chief Financial Officer,860-456-6200,,ashaw@genhealth.org,"Debra Daviau Savoie, MBA",Chief Financial Officer,860-456-6271,,dsavoie@genhealth.org,www.genhealth.org
CT-002213,Community Health and Wellness Center,Community Health and Wellness Center,1356318091,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",115 Spencer St,,Winsted,CT,06098-1140,Litchfield,115 Spencer Street,,Winsted,CT,06098,Litchfield,Joanne Borduas,CEO,860-387-0425,,jborduas@chwctorr.org,Francine Bondos,Senior Accounting Analyst,860-489-0931,177,fbondos@chwctorr.org,
DC-002214,Pathways to Housing Health Center,"Unity Health Care, Inc.",1427353002,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",101 Q St NE,Suite G,Washington,DC,20002-2166,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002215,Metro Health Inc.,MetroHealth,1710193438,Ryan White Providers,1012 14th St NW,Suite 700,Washington,DC,20005-3477,District of Columbia,1012 14th St NW,Suite 700,Washington,DC,20005,District of Columbia,Khalil Hassam,Deputy Chief Operating Officer,202-838-9266,,khassam@metrohealthdc.org,Tommy Zarembka,Chief Operating Officer,202-838-9268,,tzarembka@metrohealthdc.org,www.metrohealthdc.org
DC-002216,Children's Adolescent Medicine Clinic,Children's National Medical Center,1912939703,Outpatient Hospital Clinics,111 Michigan Ave NW,,Washington,DC,20010-2916,District of Columbia,111 Michigan Ave NW,,Washington,DC,20010,District of Columbia,Aldwin Lindsay,Executive Director,301-572-6277,,aclindsay@childrensnational.org,Nasima Hossain,Executive Director,202-476-3114,,nhossain@childrensnational.org,www.childrensnational.org
DC-002217,Children's Health Center,Children's National Medical Center,1912939703,Outpatient Hospital Clinics,111 Michigan Ave NW,,Washington,DC,20010-2916,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,Aldwin Lindsay,Executive Director,301-572-6277,,aclindsay@childrensnational.org,Nasima Hossain,Execute Director,202-476-3114,,nhossain@childrensnational.org,www.childrensnational.org
DC-002218,Children's Health Center at Sheikh Zayed (children's inpatient hospital),Children's National Medical Center,1912939703,Children's Hospitals (inpatient only),111 Michigan Ave NW,,Washington,DC,20010-2916,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,Nasima Hossain,Executive Director,202-476-3114,3114,nhossain@childrensnational.org,Nancy Nguy,Business Manager,301-572-8753,8753,nnguy@childrensnational.org,www.childrenshopsital.org
DC-002219,Children's Health Center at Sheikh Zayed (multiple outpatient ECP categories),Children's National Medical Center,1912939703,"Dental Providers, Ryan White Providers",111 Michigan Ave NW,,Washington,DC,20010-2916,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,Nasima Hossain,Executive Director,202-476-3114,3114,nhossain@childrensnational.org,Nancy Nguy,Business Manager,301-572-8753,8753,nnguy@childrensnational.org,www.childrenshopsital.org
DC-002220,Children's HTC,Children's National Medical Center,1912939703,Hemophilia Treatment Centers,111 Michigan Ave NW,,Washington,DC,20010-2916,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,George Fredrick Francois,Center Director,202-476-5153,,Gfrancoi@cnmc.org,Christine Guelcher,APNP Team Lead,202-476-3622,,Cguelche@cnmc.org,
DC-012441,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,1160 Varnum St NE,Suite 212,Washington,DC,20017-2106,District of Columbia,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
DC-002221,Cardozo Student Health Center,"UNITY HEALTH CARE, INC.",1477973428,Federally Qualified Health Centers - Medical Services,1200 Clifton St NW,Cardozo School-based Health Center,Washington,DC,20009,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002222,Washington DC Health Center,"Planned Parenthood of Metropolitan Washington, DC",1538253786,"Family Planning Providers, Sexually Transmitted Disease Clinics",1225 4th St NE,,Washington,DC,20002-3431,District of Columbia,"1225 4th St, NE",,Washington,DC,20002,District of Columbia,Tasha Joyner,Director of Operations,804-641-4480,,tasha.joyner@ppmw.org,Takina Wilson,VP of Patient Services,202-497-4169,,takina.wilson@ppmw.org,
DC-002223,East of the River Health Center,"UNITY HEALTH CARE, INC.",1386782563,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",123 45th St NE,,Washington,DC,20019-4632,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002224,Brentwood Health Center,"UNITY HEALTH CARE, INC.",1154469336,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1251 Saratoga Ave NE # B,,Washington,DC,20018-1025,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,
DC-002225,UNITED MEDICAL CENTER,NOT FOR PROFIT HOSPITAL DBA UNITED MEDICAL CENTER,1184932014,"Outpatient Hospital Clinics, Ryan White Providers",1310 Southern Ave SE,,Washington,DC,20032-4623,District of Columbia,1310 SOUTHERN AVENUE SE,,Washington,DC,20032,District of Columbia,BILLY GREEN,DIRECTOR OF OUTPATIENT CLINICS,202-688-4677,,BDGREEN@UNITED-MEDICALCENTER.COM,CHARLETTA WASHINGTON,C.O.O,202-574-5432,,CWASHINGTON@UNITED-MEDICALCENTER.COM,WWW.UNITEDMEDICALCENTER.COM
DC-002226,N Street Village,"UNITY HEALTH CARE, INC.",1093915357,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1333 N St NW,,Washington,DC,20005-3601,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002227,New York Avenue Homeless Shelter Health Center,"Unity Health Care, Inc.",1023157104,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1355 New York Ave NE,,Washington,DC,20002-1620,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002228,Andromeda Transcultural Health,Andromeda Transcultural Health,1669549192,"Community Mental Health Centers, Ryan White Providers",1400 Decatur St NW,,Washington,DC,20011-4343,District of Columbia,1400 Decatur St NW,,Washington,DC,20011,District of Columbia,Alfred McGugin,Administrator,202-291-4707,111,amcgugin@andromedadc.org,Alvaro,Guzman,202-291-4707,128,aguzman@andromedadc.org,www.andromedadc.org
DC-002229,Anacostia Health Center,"UNITY HEALTH CARE, INC.",1972641132,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1500 Galen St SE,,Washington,DC,20020-4913,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Camille Dixon,,202-715-7900,,,http://www.unityhealthcare.org
DC-002230,Whitman-Walker Health,"WHITMAN-WALKER CLINIC, INC.",1184616617,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1525 14th St NW,,Washington,DC,20005-3706,District of Columbia,1701 14th St NW,,Washington,DC,20009-4308,District of Columbia,Naseema Shafi,Deputy Executive Director,202-797-3572,,nshafi@whitman-walker.org,Erin Loubier,Senior Director for Health and Legal Integration and Payment Innovation,202-939-7662,,eloubier@whitman-walker.org,
DC-002231,BREAD FOR THE CITY,Bread for the City,1699950311,"Dental Providers, Federally Qualified Health Centers - Medical Services",1525 7th St NW,,Washington,DC,20001-3201,District of Columbia,1525 7th St NW,,Washington,DC,20001,District of Columbia,Norma Amador,Medical Billing,202-386-7087,7087,namador@breadforthecity.org,RANDI ABRAMSON,Medical Director,202-386-7020,,RABRAMSON@BREADFORTHECITY.ORG,https://breadforthecity.org
DC-002232,Elaine Ellis Center of Health,ELAINE ELLIS CENTER OF HEALTH,1427331461,Federally Qualified Health Centers - Medical Services,1605 Kenilworth Ave NE,,Washington,DC,20019-2010,District of Columbia,"1605 Kenilworth Avenue, NE",,Washington,DC,20019-2010,District of Columbia,Jacquelyn Walker,Chief Executive Officer,202-803-2340,112,jwalker@eechealth.com,Timothy Walker,Chief Operating Officer,202-803-2340,112,tw@eechealth.com,
DC-002233,AHF Healthcare Center - Benning Rd. Maryland,AIDS Healthcare Foundation,1033517024,Other ECP Providers,1647 Benning Rd NE,Suite 303,Washington,DC,20002-4572,District of Columbia,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
DC-002234,Columbia Road Health Center,"UNITY HEALTH CARE, INC.",1215257571,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1660 Columbia Rd NW,,Washington,DC,20009-3602,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,,202-715-7950,,kwerner@unityhealthcare.org,http://www.unityhealthcare.org
DC-002235,Elizabeth Taylor Medical Center,"WHITMAN-WALKER CLINIC, INC.",1184616617,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1701 14th St NW,,Washington,DC,20009-4308,District of Columbia,1701 14th St NW,,Washington,DC,20009-4308,District of Columbia,Naseema Shafi,Deputy Executive Director,202-797-3572,,nshafi@whitman-walker.org,Erin Loubier,Senior Director for Health and Legal Integration and Payment Innovation,202-939-7662,,eloubier@whitman-walker.org,
DC-002236,Christ House,"Unity Health Care, Inc.",1942329909,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1717 Columbia Rd NW,,Washington,DC,20009-2803,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7930,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002237,HSC Pediatric Center,HSC Health Care System,1689656183,Children's Hospitals (inpatient only),1731 Bunker Hill Rd NE,,Washington,DC,20017-3026,District of Columbia,"1731 Bunker Hill Road, NE",,Washington,DC,20017,District of Columbia,Donna Anthony,"Executive Vice President, Clinical Strategy",202-768-0831,,danthony@hschealth.org,Debbie Holson,"Chief Operating Officer, Pediatric Center",202-635-6125,,dholson@hschealth.org,http://www.hschealth.org
DC-002238,The Arc,Children's National Medical Center,1912939703,Outpatient Hospital Clinics,1901 Mississippi Ave SE,,Washington,DC,20020-6117,District of Columbia,111 Michigan Ave NW,,Washington,DC,20010,District of Columbia,Aldwin Lindsay,Executive Director,301-572-6277,,phnelson@childrennational.org,Nasima Hossain,Executive Director,202-476-3114,,nhossain@childrensnational.org,www.childrensnational.org
DC-002239,"Family and Medical Counseling Service, Inc.",FAMILY AND MEDICAL COUNSELING SERVICE INC,1124363072,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2041 Martin Luther King Jr Ave SE,Suite 303,Washington,DC,20020-7036,District of Columbia,2041 Martin Luther King Jr Ave SE Ste 303,,Washington,DC,20020-7036,District of Columbia,Flora Terrell Hamilton,CEO,202-889-7900,217,fhamilton@fmcsinc.org,Angela Fulwood Wood,COO,202-889-7900,213,afulwood@fmcsinc.org,www.fmcsinc.org
DC-002240,Harbor Light Homeless Health Center,"Unity Health Care, Inc.",1396864369,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2100 New York Ave NE,,Washington,DC,20002-1826,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002241,Center for Infectious Disease Management and Research,Howard University Hospital,1033163597,"Outpatient Hospital Clinics, Sexually Transmitted Disease Clinics",2139 Georgia Ave NW,Suite 3D,Washington,DC,20001-3006,District of Columbia,2041 Georgia Ave. NW,,Washington,DC,20060,District of Columbia,Celia Maxwell,Program Director,202-806-7264,,cmaxwell@howard.edu,Cedrina Calder,Program Manager,202-806-9477,,cedrina.calder@howard.edu,
DC-002242,AHF Healthcare Center - Washington DC (K Street-Blair Underwood),AIDS Healthcare Foundation,1689806556,"Other ECP Providers, Ryan White Providers",2141 K St NW,Suite 606,Washington,DC,20037-1810,District of Columbia,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
DC-002243,Shaw/Comp,Children's National Medical Center,1912939703,Outpatient Hospital Clinics,2220 11th St NW,,Washington,DC,20001-4018,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,Aldwin Lindsay,Executive Director,301-572-6277,,aclindsay@childrensnational.org,Nasima Hossain,Executive Director,202-476-3114,,nhossain@childrensnational.org,www.childrensnational.org
DC-002244,Community of Hope Marie Reed Health Center,Community of Hope,1881639714,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2250 Champlain St NW,,Washington,DC,20009-2618,District of Columbia,Conway Health and Resource Center,"4 Atlantic Street, NW",Washington,DC,20032,District of Columbia,Kelly Sweeney McShane,President and Chief Executive Officer,202-407-7746,,kmcshane@cohdc.org,Victoria Roberts,"Vice President, Health Services",202-407-7748,,vroberts@cohdc.org,www.communityofhopedc.org
DC-002245,Max Robinson Center,"WHITMAN-WALKER CLINIC, INC.",1821113341,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2301 Martin Luther King Jr Ave SE,,Washington,DC,20020-5813,District of Columbia,1701 14th St NW,,Washington,DC,20009-4308,District of Columbia,Naseema Shafi,Deputy Executive Director,202-797-3572,,nshafi@whitman-walker.org,Erin Loubier,Senior Director for Health and Legal Integration and Payment Innovation,202-939-7662,,eloubier@whitman-walker.org,
DC-002246,Good Hope Road,Children's National Medical Center,1912939703,Outpatient Hospital Clinics,2501 Good Hope Rd SE,,Washington,DC,20020-3011,District of Columbia,111 Michigan Avenue NW,,Washington,DC,20010,District of Columbia,Aldwin Lindsay,Executive Director,301-572-6277,,aclindsay@childrensnational.org,Nasima Hossain,Executive Director,202-476-3114,,nhossain@childrensnational.org,www.childrensnational.org
DC-002247,801 East Building Shelter,"Unity Health Care, Inc",1861686776,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2700 Martin Luther King Jr Ave SE,,Washington,DC,20032-2601,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002248,LA CLINICA DEL PUEBLO,"LA CLINICA DEL PUEBLO, INC.",1124227590,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2831 15th St NW,,Washington,DC,20009-4607,District of Columbia,2831 15th St NW,,Washington,DC,20009-4607,District of Columbia,Alicia Wilson,Executive Director,202-448-2810,,awilson@lcdp.org,Sam Calvit,Asst. to the CFO,202-448-2811,,scalvit@lcdp.org,
DC-002249,Upper Cardozo Health Center,"UNITY HEALTH CARE, INC.",1093894172,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3020 14th St NW,,Washington,DC,20009-6865,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002250,HIV Prevention Site,"LA CLINICA DEL PUEBLO, INC.",1124227590,Federally Qualified Health Centers - Medical Services,3055 Mount Pleasant St NW,,Washington,DC,20009-4209,District of Columbia,2831 15th St NW,,Washington,DC,20009-4607,District of Columbia,Alicia Wilson,Executive Director,202-448-2810,,awilson@lcdp.org,Sam Calvit,Asst. to the CFO,202-448-2811,,scalvit@lcdp.org,
DC-002251,Stanton Road Health Center,"UNITY HEALTH CARE, INC.",1467591602,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3240 Stanton Rd SE,,Washington,DC,20020-2910,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002252,Mary's Center for Maternal & Child Care,Mary's Center for Maternal & Child Care,1962520288,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3912 Georgia Ave NW,,Washington,DC,20011-5861,District of Columbia,"3912 Georgia Ave, NW",,Washingtn,DC,20011,District of Columbia,Marangely Nazario,Credentialing Specialist,202-420-7175,7175,MNazario@maryscenter.org,,,,,,
DC-002253,Minnesota Avenue Health Center,"UNITY HEALTH CARE, INC.",1376847061,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3924 Minnesota Ave NE,,Washington,DC,20019-2661,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFo,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002254,Community of Hope Conway Health and Resource Center,COMMUNITY OF HOPE INC,1649601154,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4 Atlantic St SW,,Washington,DC,20032-2350,District of Columbia,4 Atlantic Street SW,,Washington,DC,20032,District of Columbia,Kelly Sweeney McShane,President and CEO,202-232-7356,,kmcshane@cohdc.org,Victoria Roberts,"Vice President, Health Services",202-407-7748,,vroberts@cohdc.org,https://www.communityofhopedc.org/healthcare/conway-health-and-resource-center
DC-002255,Walker-Jones Health Center,"UNITY HEALTH CARE, INC.",1801935234,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",40 Patterson St NE,,Washington,DC,20002-3334,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7930,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002256,CCNV Shelter,"UNITY HEALTH CARE, INC.",1114066297,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",425 2nd St NW,,Washington,DC,20001-2003,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,
DC-002257,Friendship Place,"Unity Health Care, Inc.",1386763654,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4713 Wisconsin Ave NW,,Washington,DC,20016-4609,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002258,H.D. Woodson Student Health Center,"UNITY HEALTH CARE, INC.",1124309984,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",540 55th St NE,,Washington,DC,20019,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002259,So Others Might Eat (SOME),"UNITY HEALTH CARE, INC.",1295803856,"Dental Providers, Federally Qualified Health Centers - Medical Services",60 O St NW,,Washington,DC,20001-1259,District of Columbia,1220 12th St SE Ste 120,,Washington,DC,20003-3733,District of Columbia,Vincent A. Keane,CEO,202-518-6409,,KWerner@UnityHealthCare.org,Anne Loiret,"Director, Billing and Reporting",202-797-8806,1133,aloiret@some.org,
DC-002260,Central Union Mission,"Unity Health Care, Inc.",1376662262,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",65 Massachusetts Ave NW,,Washington,DC,20001-1431,District of Columbia,"1220 12th St., SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002261,Parkside Health Center,"Unity Health Care, Inc.",1790823797,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",765 Kenilworth Ter NE,,Washington,DC,20019-1898,District of Columbia,"1220 12th Street, SE, Suite 120",,Washington,DC,20003,District of Columbia,Ardell W. Butler,CFO,202-715-7930,,abutler@unityhealthcare.org,Karin Werner,VP,202-715-7950,,kwerner@unityhealthcare.org,www.unityhealthcare.org
DC-002262,Community of Hope Family Health and Birth Center,COMMUNITY OF HOPE INC,1487931465,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",801 17th St NE,,Washington,DC,20002-7200,District of Columbia,4 Atlantic Street SW,,Washington,DC,20032,District of Columbia,Kelly Sweeney McShane,President and CEO,202-407-7746,,kmcshane@cohdc.org,Victoria Roberts,"Vice President, Health Services",202-407-7748,,vroberts@cohdc.org,https://www.communityofhopedc.org/healthcare/family-health-and-birth-center
DC-002263,Pat Handy Place,"UNITY HEALTH CARE, INC.",1073976387,Federally Qualified Health Centers - Medical Services,810 5th St NW,,Washington,DC,20001-2622,District of Columbia,1220 12th St. SE,Suite 120,Washington,DC,20003,District of Columbia,Karin Werner,VP for Strategic Development,202-715-7950,7950,KWerner@UnityHealthCare.org,Ardell Butler,,202-715-7930,7930,abutler@unityhealthcare.org,www.unityhealthcare.org
DE-002264,Westside Family Healthcare - Bear / New Castle,"Westside Family Healthcare, Inc.",1821232869,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",404 Fox Hunt Dr,,Bear,DE,19701-2538,New Castle,300 Water Street,Suite 200,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
DE-002265,Henrietta Johnson Medical Center Claymont,Henrietta Johnson Medical Center,1760874549,Federally Qualified Health Centers - Medical Services,3301 Green St,,Claymont,DE,19703-2052,New Castle,601 New Castle Avenue,,Wilmington,DE,19801,New Castle,Ephraim Kaba,CEO,302-655-6187,232,ekaba@hjmc.org,shay scott,Director of Fund Development,302-655-6187,230,sscott@hjmc.org,www.hjmc.org
DE-002266,Westside Family Healthcare - Dover,"Westside Family Healthcare, Inc.",1588952618,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1020 Forrest Ave,,Dover,DE,19904-2799,Kent,300 Water Street,Suite 200,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
DE-002267,Administrative Offices,"Kent Sussex Community Services, Inc.",1396723078,"Other ECP Providers, Ryan White Providers",1241 College Park Dr,,Dover,DE,19904-8713,Kent,1241 College Park Drive,,Dover,DE,19904-8713,Kent,Miranda Tsyganov,Director Community Services,302-604-8843,,mtsyganov@kscs.org,David Parcher,Executive Director,302-270-4124,,dparcher@kscs.org,
DE-002268,WILLIAMS STATE SERVICE CENTER,Delaware Division of Public Health,1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",805 River Rd,,Dover,DE,19901-3753,Kent,417 Federal Street,,Dover,DE,19901,Kent,Andrea Keen,Clinic Manager,302-857-5150,,andrea.keen@state.de.us,,,302-857-5100,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002269,Planned Parenthood of Delaware,Planned Parenthood of Delaware,1124033865,"Family Planning Providers, Sexually Transmitted Disease Clinics",805 S Governors Ave,,Dover,DE,19904-4158,Kent,625 N Shipley St.,,Wilmington,DE,19801,New Castle,Ruth Lytle-Barnaby,President/CEO,302-655-7296,1028,rlytle-barnaby@ppde.org,Cheri Lebel-Boyer,VP of Operations,302-655-7296,1044,clebel-boyer@ppde.org,http://www.plannedparenthood.org/delaware/
DE-002270,Pyle State Service Center FP Clinic,"Delaware Dept. of Health and Social Services, Div. of Pub. Health FP Proj.",1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics",34314 Pyle Center Rd,,Frankford,DE,19945-3277,Sussex,34314 Pyle Center Rd,,Frankford,DE,19945-3277,Sussex,ROBIN MCGINNIS,Clinic Manager,302-732-9512,,ROBIN.MCGINNIS@PRIMECARECHI.ORG,,,,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002271,Georgetown Office,"Kent Sussex Community Services, Inc.",1396723078,"Other ECP Providers, Ryan White Providers",20728 DuPont Blvd Unit 315,,Georgetown,DE,19947-3199,Sussex,1241 College Park Drive,,Dover,DE,19904-8713,Kent,David Parcher,Executive Director,302-270-4124,,dparcher@kscs.org,Miranda Tsyganov,Director Community Services,302-604-8843,,mtsyganov@kscs.org,
DE-002272,"La Red Health Center, Inc",La Red Health Center,1700832185,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",21444 Carmean Way,,Georgetown,DE,19947-4572,Sussex,21444 Carmean Way,,Georgetown,DE,19947,Sussex,Brian Olsen,Chief Executive Officer,302-855-1233,1116,bolson@laredhealthcenter.org,,,,,,http://laredhealthcenter.org
DE-002273,ADAMS STATE SERVICE CENTER,DELAWARE DIVISION OF PUBLIC HEALTH,1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",546 S Bedford St,,Georgetown,DE,19947-1852,Sussex,417 FEDERAL STREET,,DOVER,DE,19901,Kent,Anna Short,CLINIC MANAGER,302-856-5225,,ANNA.SHORT@STATE.DE.US,,,302-856-5136,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002274,Laurel Office,"Kent Sussex Community Services, Inc.",1396723078,"Other ECP Providers, Ryan White Providers",31039 N Poplar St,,Laurel,DE,19956-3992,Sussex,1241 College Park Drive,,Dover,DE,19904-8713,Kent,David Parcher,Executive Director,302-270-4124,,dparcher@kscs.org,Miranda Tsyganov,Director Community Services,302-604-8843,,mtsyganov@kscs.org,
DE-002275,Westside Family Healthcare - Middletown,"Westside Family Healthcare, Inc.",1235493933,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",306 E Main St,,Middletown,DE,19709-1482,New Castle,300 Water Street,Suite 200,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
DE-002276,La Red Health Center,La Red Health Center,1750762126,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1 Sussex Ave,,Milford,DE,19963-1853,Sussex,21444 Carmean Way,,Georgetown,DE,19947,Sussex,Brian S. Olson,Chief Executive Officer,302-855-1233,1116,bolson@laredhealthcenter.org,,,,,,www.laredhealthcenter.org
DE-002277,Milford State Service Center FP Clinic,"Delaware Dept. of Health and Social Services, Div. of Pub. Health FP Proj.",1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics",253 NE Front St,,Milford,DE,19963-1431,Sussex,253 NE Front St,,Milford,DE,19963,Sussex,Shontesha Quail,Clinic Manager,302-424-7126,,shotesha.quail@state.de.us,,,,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002278,Planned Parenthood of Delaware,Planned Parenthood of Delaware,1124033865,"Family Planning Providers, Sexually Transmitted Disease Clinics",140 E Delaware Ave,,Newark,DE,19711-4605,New Castle,625 N Shipley St.,,Wilmington,DE,19801,New Castle,Ruth Lytle-Barnaby,President/CEO,302-655-7296,1028,rlytle-barnaby@ppde.org,Cheri Lebel-Boyer,VP of Operations,302-655-7296,1044,clebel-boyer@ppde.org,http://www.plannedparenthood.org/delaware/
DE-002279,Westside Family Healthcare - Newark,"Westside Family Healthcare, Inc.",1801898556,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",27 Marrows Rd,,Newark,DE,19713-3701,New Castle,300 Water Street,Suite 200,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
DE-002280,Hudson State Service Center,"Delaware Dept. of Health and Social Services, Div. of Pub. Health FP Proj.",1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",501 Ogletown Rd,,Newark,DE,19711-5403,New Castle,501 Ogletown Rd,,Newark,DE,19711-5403,New Castle,Susan Keegan,Clinic Director,302-283-7587,,susan.keegan@state.de.us,,,,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002281,La Red Health Center,La Red Health Center,1497071161,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",300 High St,,Seaford,DE,19973-3940,Sussex,21444 Carmean Way,,Georgetown,DE,19973,New Castle,Brian S. Olson,Chief Executive Officer,302-855-1233,1116,bolson@laredhealthcenter.org,,,,,,www.laredhealthcenter.org
DE-002282,Shipley State Service Center Family Planning,"Delaware Dept. of Health and Social Services, Div. of Pub. Health FP Proj.",1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics",350 Virginia Ave,,Seaford,DE,19973-1516,Sussex,350 Virginia Ave,,Seaford,DE,19973-1516,Sussex,Shirley Hitchens,Clinic Manager,302-628-2006,,shirley.hitches@state.de.us,,,,,,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002283,AIDS Delaware,"AIDS Delaware, Inc",1164575569,Ryan White Providers,100 W 10th St,Suite 315,Wilmington,DE,19801-1642,New Castle,100 West 10th Street,Suite #315,Wilmington,DE,19801,New Castle,John Gardner,Executive Director,302-652-6776,206,jgardner@aidsdelaware.org,Lori Campbell,Director of Client Services,302-652-6776,207,campbell@aidsdelaware.org,www.aidsdelaware.org
DE-002284,Alfred I duPont Hospital for Children,The Nemours Foundation,1467505073,Children's Hospitals (inpatient only),1600 Rockland Rd,,Wilmington,DE,19803-3607,New Castle,1801 Rockland Rd,Suite 204,Wilmington,DE,19803,New Castle,Ryan Forman,Sr Director of Payer Relations,302-298-7806,,ryan.forman@nemours.org,,,,,,
DE-002285,Westside Family Healthcare - Wilmington,"Westside Family Healthcare, Inc.",1669479929,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1802 W 4th St,,Wilmington,DE,19805-3420,New Castle,"300 Water Street, Suite 200",,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
DE-002286,Porter State Service Center,"Delaware Dept. of Health and Social Services, Div. of Pub. Health FP Proj.",1013089895,"Family Planning Providers, Sexually Transmitted Disease Clinics",511 W 8th St,,Wilmington,DE,19801-1449,New Castle,511 W 8th St,,Wilmington,DE,19801-1449,New Castle,Javar Simpson,Clinic Manager,302-777-2860,,javar.simpson@state.de.us,JOHN COOK,,302-777-2814,,JOHN.P.COOK@STATE.DE.US,http://dhss.delaware.gov/dhss/dph/chs/chsfamilyplanning.html
DE-002287,Henrietta Johnson Medical Center @ Eastside,SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC,1639417280,"Dental Providers, Federally Qualified Health Centers - Medical Services",600 N Lombard St,,Wilmington,DE,19801-4429,New Castle,601 New Castle Ave,,Wilmington,DE,19801-5821,New Castle,Ephraim Kaba,CEO,302-655-6187,232,ekaba@hjmc.org,Shay Scott,Director of Fund Development,302-655-6187,230,sscott@hjmc.org,www.hjmc.org
DE-002288,HENRIETTA JOHNSON MEDICAL CENTER,SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC,1770699621,"Dental Providers, Federally Qualified Health Centers - Medical Services",601 New Castle Ave,,Wilmington,DE,19801-5821,New Castle,601 New Castle Ave,,Wilmington,DE,19801-5821,New Castle,Ephraim Kaba,CEO,302-655-6187,232,ekaba@hjmc.org,Shay Scott,Director of Fund Development,302-655-6187,230,sscott@hjmc.org,www.hjmc.org
DE-002289,Planned Parenthood of Delaware,Planned Parenthood of Delaware,1124033865,"Family Planning Providers, Sexually Transmitted Disease Clinics",625 N Shipley St,,Wilmington,DE,19801-2228,New Castle,625 Shipley St,,Wilmington,DE,19801,New Castle,Ruth Lytle-Barnaby,President/CEO,302-655-7296,1028,rlytle-barnaby@ppde.org,Cheri Lebel-Boyer,VP of Operations,302-655-7296,1044,clebel-boyer@ppde.org,http://www.plannedparenthood.org/delaware/
DE-002290,Westside Family Healthcare - Northeast,"Westside Family Healthcare, Inc.",1952303695,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",908 E 16th St,Suite B,Wilmington,DE,19802-5145,New Castle,"300 Water Street, Suite 200",,Wilmington,DE,19801-5043,New Castle,Donna M. Goodman,VP & CFO/COO,302-656-8292,,donna.goodman@westsidehealth.org,Lolita A. Lopez,President & CEO,302-656-8292,,lolita.lopez@westsidehealth.org,http://www.westsidehealth.org/en-US
FL-002291,Sacred Heart Medical Group at Apalachicola,Sacred Heart Medical Group on the Gulf,1982963344,Rural Health Clinics,55 Avenue E,,Apalachicola,FL,32320-1763,Franklin,55 Ave E,,Apalachicola,FL,32320-1763,Franklin,"Ryan P. Pharr, DO",Director,850-370-1000,,Ryan.Pharr@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002292,COMMUNITY HEALTH CENTER-APOPKA DENTAL CARE,"COMMUNITY HEALTH CENTERS, INC.",1972800563,Dental Providers,210 E 7th St,,Apopka,FL,32703-5328,Orange,110 S WOODLAND ST,,WINTER GARDEN,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002293,COMMUNITY HEALTH CENTERS-APOPKA FAMILY & OB CARE,"COMMUNITY HEALTH CENTERS, INC.",1740364009,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",225 E 7th St,,Apopka,FL,32703-5327,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002294,COMMUNITY HEALTH CENTER - APOPKA PEDIATRIC CARE,"COMMUNITY HEALTH CENTERS, INC.",1427132794,Federally Qualified Health Centers - Medical Services,618 S Forest Ave,,Apopka,FL,32703-5338,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002295,Community Care Family Healthcare Center,"MCR Health, Inc",1780093229,Federally Qualified Health Centers - Medical Services,1110 E Gibson St,Bldg A,Arcadia,FL,34266-5011,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002296,Community Care Family Clinic,"MCR Health, Inc.",1578594107,Federally Qualified Health Centers - Medical Services,1148 E Gibson St,Bldg C,Arcadia,FL,34266-5011,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002297,Arcadia Children's Health Care Center,"MCR Health, Inc",1174870927,Federally Qualified Health Centers - Medical Services,250 N Brevard Ave,,Arcadia,FL,34266-4406,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8832,,jmcneal@mcr.health,https://mcr.health/
FL-012473,AMA Health,"MCR Health, Inc.",1669952156,Federally Qualified Health Centers - Medical Services,425 Nursing Home Dr,,Arcadia,FL,34266-3839,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002298,Community Care Family Clinic Counseling Services,"MCR Health, Inc.",1770989683,Federally Qualified Health Centers - Medical Services,725 N 12th Ave,Bldg B,Arcadia,FL,34266-8752,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"VP, Government Affairs and Policy",941-304-7975,,Lsnyder@mcr.health,Lovepreet Kaur,Program Operations Manager,941-776-4008,,lkaur@mcr.health,https://mcr.health/
FL-002299,Twin Rivers Medical Center,"MCR Health, Inc.",1578949038,Federally Qualified Health Centers - Medical Services,888 N Robert Ave,,Arcadia,FL,34266-9580,DeSoto,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8834,,jmcneal@mcr.health,https://mcr.health/
FL-002300,Archer Family Health Care,Archer Family Health Care,1578554572,Rural Health Clinics,16939 SW 134th Ave,,Archer,FL,32618-5413,Alachua,16939 SW 134th Ave,,Archer,FL,32618-5413,Alachua,Joan Newell-Walker,Manager Health Care Administration,352-495-2550,223,jowalker@ufl.edu,Denise Schentrup,Associate Dean for Clinical Affairs,352-495-2550,229,dschen@ufl.edu,
FL-002301,Tuberculosis Control Clinic,FDOH-POLK,1720273865,Tuberculosis Clinics,1749 Holt Rd,,Auburndale,FL,33823-4635,Polk,1290 Golfview Ave,,Bartow,FL,33830,Polk,Michael Aul,APRN,863-837-1638,,Michael.Aul@flhealth.gov,Tammy Durden,Director of Nursing,863-578-2113,,Tammy.Durden@flhealth.gov,
FL-002302,Avon Park Pediatrics PA,Avon Park Pediatrics PA,1811135502,Rural Health Clinics,1571 US Highway 27 N,,Avon Park,FL,33825-2150,Highlands,1571 US Highway 27 North,,Avon Park,FL,33825,Highlands,Dennis Valentin,Practice Administrator,863-382-0566,,cfmvalentin@gmail.com,,,,,,
FL-002303,"Central Florida Health Care, Inc., -Avon Park","CENTRAL FLORIDA HEALTH CARE, INC.",1063409290,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",950 County Road 17A W,,Avon Park,FL,33825-2164,Highlands,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002304,SPECIALTY CARE CLINIC,FDOH-POLK,1720273865,Ryan White Providers,1255 Brice Blvd,,Bartow,FL,33830-6735,Polk,1290 Golfview Ave,,Bartow,FL,33830,Polk,LEROY DUX,HEALTH CENTER ADMINISTRATOR,863-578-2243,,LEROY.DUX@FLHEALTH.GOV,MELINDA BERRIEN,RN Supervisor,863-578-2220,,MELINDA.BERRIEN@FLHEALTH.GOV,
FL-002305,C. L. Brumback Primary Care Clinic - Belle Glade (Dental),Health Care District of Palm Beach County,1720474075,Dental Providers,38754 State Road 80,,Belle Glade,FL,33430-5615,Palm Beach,1515 North Flager Drive Suite 101,Suite 138,West Palm Beach,FL,33401,Palm Beach,Damaris Lopez,Director Practice Operations,561-804-5772,1005,dlopez@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002306,C. L. Brumback Primary Care Clinic - Belle Glade (Medical),Health Care District of Palm Beach County,1124373113,Federally Qualified Health Centers - Medical Services,941 SE 1st St,,Belle Glade,FL,33430-4353,Palm Beach,1515 North Flager Drive Suite 101,Suite 138,West Palm Beach,FL,33401,Palm Beach,Damaris Lopez,Director Practice Operations,561-804-5772,1005,dlopez@hcdpbc.org,Marcia Young,Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002307,Heart of Florida Health Center-Belleview,"HEART OF FLORIDA HEALTH CENTER, INC.",1326442930,Federally Qualified Health Centers - Medical Services,7055 SE 110th Street Rd,,Belleview,FL,34420-3525,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002308,Beverly Hills Medical Center,Beverly Hills Medical Center,1417059056,Rural Health Clinics,3737 N Lecanto Hwy,,Beverly Hills,FL,34465-3504,Citrus,3737 N Lecanto Hwy,,Beverly Hills,FL,34465,Citrus,Venkatreddy Alugubelli,MD,352-746-1515,,alugubelli2000@yahoo.com,,,,,,
FL-002309,Langley Health Services - Beverly Hills,"Project Health, In.",1952756371,Federally Qualified Health Centers - Medical Services,3775 N Lecanto Hwy,Suite B,Beverly Hills,FL,34465-3559,Citrus,1425 S US Highwat 310,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002310,PanCare - Blountstown,PANCARE OF FLORIDA INC,1366456287,Federally Qualified Health Centers - Medical Services,16875 NE Cayson St,,Blountstown,FL,32424-2209,Calhoun,403 E. 11th Street,,Panama City,FL,32401-2737,Bay,Robert M Hill,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,,,,,,
FL-002311,"CALHOUN-LIBERTY HOSPITAL ASSOCIAITON, INC (inpatient hospital)","CALHOUN-LIBERTY HOSPITAL ASSOCITION, INC",1437253085,Inpatient Hospitals (other than children's hospitals),20370 NE Burns Ave,,Blountstown,FL,32424-1045,Calhoun,20370 NE Burns Ave.,,Blountstown,FL,32424,Calhoun,Nathan Ebersole,CFO,850-674-5411,219,nathanebersole@calhounlibertyhospital.com,,,,,,www.calhounlibertyhospital.com
FL-002312,"CALHOUN-LIBERTY HOSPITAL ASSOCIAITON, INC (rural health clinics)","CALHOUN-LIBERTY HOSPITAL ASSOCITION, INC",1437253085,Rural Health Clinics,20370 NE Burns Ave,,Blountstown,FL,32424-1045,Calhoun,20370 NE Burns Ave.,,Blountstown,FL,32424,Calhoun,Nathan Ebersole,CFO,850-674-5411,219,nathanebersole@calhounlibertyhospital.com,,,,,,www.calhounlibertyhospital.com
FL-002313,Boca Raton Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1508110560,Family Planning Providers,8177 Glades Rd,Bay 25,Boca Raton,FL,33434-4071,Palm Beach,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002314,PanCare - Bonifay,PANCARE OF FLORIDA INC,1366456287,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",495 Saint Johns Rd,,Bonifay,FL,32425-4237,Holmes,403 E. 11th Street,,Panama City,FL,32401-2737,Bay,Robert M Hill,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,,,,,,
FL-002315,Bonita Springs Health Center,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",11921 Saradrienne Ln,,Bonita Springs,FL,34135-5911,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,,2338,bwalker@hcnetwork.org,
FL-002316,Bethesda Hospital,"Bethesda Hospital, Inc.",1417952748,Inpatient Hospitals (other than children's hospitals),2815 S Seacrest Blvd,,Boynton Beach,FL,33435-7969,Palm Beach,2815 South Seacrest Boulevard,,Boynton Beach,FL,33435,Palm Beach,Tom Magri,"Director, Payor Analysis & Decision Support",561-737-7733,84927,tmagri@bhinc.org,Crystal Ruzkowski,Contract Manager,561-364-3100,,cruzkowski@bhinc.org,
FL-002317,Genesis Community Health,"GENESIS COMMUNITY HEALTH, INC.",1447578125,"Dental Providers, Federally Qualified Health Centers - Medical Services",2815 S Seacrest Blvd,,Boynton Beach,FL,33435-7969,Palm Beach,2623 S. Seacrest Blvd,Suite 65,Boynton Beach,FL,33435-6033,Palm Beach,DeAnna Warren,CEO,561-810-8790,201,dwarren@gencomhealth.org,Eric Chiyembekeza,Operations Director,561-735-6553,105,echiyembekeza@gencomhealth.org,www.gencomhealth.org
FL-002318,Manatee Health Center,Planned Parenthood of Southwest and Central Florida,1851664544,"Family Planning Providers, Sexually Transmitted Disease Clinics",1105 53rd Ave E,Suite 201,Bradenton,FL,34203-4897,Manatee,736 Central Ave,,Sarasota,FL,34236-4042,Manatee,Stephanie Fraim,President and CEO,941-365-3913,1106,Stephanie.Fraim@ppswcf.org,Sara Parrott,Manager Revenue Cycle,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002319,East Manatee Health and Wellness Center,"MCR Health, Inc.",1689600330,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1312 Manatee Ave E,,Bradenton,FL,34208-1358,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8835,,jmcneal@mcr.health,https://mcr.health/
FL-002320,Lawton Chiles Children and Family Healthcare Center,"MCR Health, Inc.",1467481960,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1515 26th Ave E,,Bradenton,FL,34208-7707,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8836,,jmcneal@mcr.health,https://mcr.health/
FL-002321,West Manatee Health Center,"MCR Health, Inc.",1275829970,Federally Qualified Health Centers - Medical Services,2318 Manatee Ave W,,Bradenton,FL,34205-5432,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8837,,jmcneal@mcr.health,https://mcr.health/
FL-002322,Riverside Medical Services,"MCR Health, Inc.",1912316217,Federally Qualified Health Centers - Medical Services,300 Riverside Dr E,Suite 2010,Bradenton,FL,34208-1023,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8838,,jmcneal@mcr.health,https://mcr.health/
FL-002323,Riverview Foot and Ankle,"MCR Health, Inc.",1740393073,Federally Qualified Health Centers - Medical Services,300 Riverside Dr E,Suite 1500,Bradenton,FL,34208-1031,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8839,,jmcneal@mcr.health,https://mcr.health/
FL-002324,Bradenton Family Medical Center,"MCR Health, Inc.",1083984587,Federally Qualified Health Centers - Medical Services,4805 26th St W,,Bradenton,FL,34207-1706,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-012474,AMA Health,"MCR Health, Inc.",1528620671,Federally Qualified Health Centers - Medical Services,5305 E State Road 64,,Bradenton,FL,34208-5534,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-012475,AMA Health,"MCR Health, Inc.",1326600487,Federally Qualified Health Centers - Medical Services,5309 E State Road 64,,Bradenton,FL,34208-5534,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002325,Southwest Healthcare Center,"MCR Health, Inc.",1376565945,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",5325 26th St W,,Bradenton,FL,34207-3012,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-012476,AMA Health Heart & Vascular,"MCR Health, Inc.",1356972533,Federally Qualified Health Centers - Medical Services,6001 21st Ave W,,Bradenton,FL,34209-7847,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002327,Whole Child Pediatrics & River Landing OB/GYN,"MCR Health, Inc.",1881873347,Federally Qualified Health Centers - Medical Services,6040 State Road 70 E Unit B,,Bradenton,FL,34203-9720,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002328,Florida Surgical Clinic,Florida Surgical Clinic LLC,1932550373,Other ECP Providers,701 Manatee Ave W,Suite 105,Bradenton,FL,34205-8624,Manatee,701 Manatee Ave. W.,Suite 105,Bradenton,FL,34205,Manatee,Peter Kazil,CEO,727-787-4379,3,floridasurgicalclinic@hotmail.com,Leanne Munger,Front Office Coordinator,727-787-4379,2,floridasurgicalclinicbiller@outlook.com,www.floridasurgicalclinic.com
FL-012477,AMA Health,"MCR Health, Inc.",1437639788,Federally Qualified Health Centers - Medical Services,701 Manatee Ave West,Suite 101,Bradenton,FL,34205,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002329,Manatee Pediatrics,"MCR Health, Inc.",1871523795,Federally Qualified Health Centers - Medical Services,712 39th St W,,Bradenton,FL,34205-2454,Manatee,700 8th Avenue W,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002330,Southeast Family Healthcare Center,"MCR Health, Inc.",1396775219,Federally Qualified Health Centers - Medical Services,919 53rd Ave E,,Bradenton,FL,34203-4801,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002331,Brandon Community Health Centers,"Suncoast Community Health Centers, Inc",1265548200,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",313 S Lakewood Dr,,Brandon,FL,33511-2815,Hillsborough,13110 Elk Moutain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002332,Palms Medical Group - Branford,TRENTON MEDICAL CENTER,1801826268,Federally Qualified Health Centers - Medical Services,109 Savannah St SW,,Branford,FL,32008,Suwannee,911 S Main St,,Trenton,FL,32693-3239,Suwannee,Anita Riels,CEO,352-463-4501,,ariels@palmsmg.org,,,,,,https://palmsmg.org/locations/20-office-locations/3-branford
FL-002333,PanCare-Liberty,PANCARE OF FLORIDA INC,1366456287,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",11033 NW State Road 20,,Bristol,FL,32321-6406,Liberty,403 E. 11th Street,,Panama City,FL,32401-2737,Bay,Robert M Hill,PRESIDENT/CEO,850-747-5599,,mikehill@nwbbhc.org,,,,,,
FL-002334,A.C.O.R.N. Clinic,Alachua County Organization for Rural Needs,1487772216,"Dental Providers, Rural Health Clinics",23320 N State Road 235,,Brooker,FL,32622-5266,Alachua,23320 North State Road 235,,Brooker,FL,32622,Bradford,Candice King,Executive Director,352-485-1961,20,cking@acornclinic.org,,,,,,
FL-002335,Muscogee Creek Indian Tribal Health Center,PANCARE OF FLORIDA INC,1366456287,Federally Qualified Health Centers - Medical Services,278 Church Rd,,Bruce,FL,32455-4769,Walton,403 E. 11th Street,,Panama City,FL,32401-2737,Bay,Robert M Hill,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,Kadey Purvis,Billing Specialist,850-747-5599,,kpurvis@pancarefl.org,PanCareFL.org
FL-002336,CLARK CLINIC INC,Clark Clinic Inc,1376733857,Rural Health Clinics,212 S Florida St,,Bushnell,FL,33513-6703,Sumter,212 S Florida St,,Bushnell,FL,33513,Sumter,Amber Espericueta,COO,352-793-2441,,clarkclinicamber@gmail.com,BETSY CLARK,,352-793-2441,,CLARKCLINICBETSY@GMAIL.COM,
FL-002337,SACRED HEART MEDICAL GROUP - MILESTONE,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,400 Milestone Blvd,,Cantonment,FL,32533-6579,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002338,Cape Coral Medical Office,Lee Memorial Health System,1417342163,Federally Qualified Health Centers - Medical Services,1435 SE 8th Ter,,Cape Coral,FL,33990-3289,Lee,2776 Cleveland Avenue,,Fort Myers,FL,33901-5855,Lee,Robert Johns,Executive Director,239-343-4806,,robert.johns@leememorial.org,Marlon Tyson,Syastem Director for Business Development and Contracting,239-343-4822,,marlon.tyson@leememorial.org,www.WeCareForLee.org
FL-002339,CAPE CORAL PEDIATRIC OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,305 SW 2nd Ter,,Cape Coral,FL,33991-1958,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002340,Cape Coral Health Center,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",316 Del Prado Blvd S,,Cape Coral,FL,33990-1710,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,239-278-3600,2338,bwalker@hcnetwork.org,
FL-002341,Chiefland Medical Center,"Chiefland Medical Center, LLC",1184674384,Rural Health Clinics,1113 NW 23rd Ave,,Chiefland,FL,32626-1911,Levy,1113 NW 23rd Ave,,Chiefland,FL,32626,Levy,Marie S. Minton,President,703-203-2422,,mintontfs@gmail.com,Jennifer Baumann,Office Manager,352-493-9500,,jbaumann@chiefmed.com,chieflandmedicalcenter.com
FL-002342,PanCare - Chipley,PANCARE OF FLORIDA INC,1366456287,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1414 Main St,Suite 4,Chipley,FL,32428-6951,Washington,403 E. 11th Street,,Panama City,FL,32401-2737,Bay,Robert M Hill,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,,,,,,
FL-002343,Citra Family Health,S & C Holding Company,1881800936,Rural Health Clinics,17805 N US Highway 301,,Citra,FL,32113-2459,Marion,1300 SW 42nd St,,Ocala,FL,34471,Marion,Frederick C. Spogen III,Administrator,352-595-7777,,fspogen@aol.com,Teresa Spogen,Administrator,352-207-9505,,tspogen59@gmail.com,WWW.CITRAFAMILYHEALTH.COM
FL-002344,Langley Health Services - Citrus Springs Family Practice,"Project Health, Inc.",1831544261,Federally Qualified Health Centers - Medical Services,10489 N Florida Ave,Suite B,Citrus Springs,FL,34434-3268,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COOI,352-569-2955,,vwynns@telmedical.com,
FL-002345,Langley Health Services - Citrus Springs Pediatrics,"Project Health, Inc.",1881041028,Federally Qualified Health Centers - Medical Services,10495 N Florida Ave,Suite B,Citrus Springs,FL,34434-3268,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002346,Community Health Centers at Suncoast,"Community Health Centers of Pinellas, Inc",1467873315,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5523 Roosevelt Blvd,,Clearwater,FL,33760-3425,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002347,Community Health Centers at Clearwater Dental,"Community Health Centers of Pinellas, Inc",1760807218,Dental Providers,702 Jasmine Way,,Clearwater,FL,33756-4086,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002348,Community Health Centers at Clearwater,"Community Health Centers of Pinellas, Inc",1568440287,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",707 Druid Rd E,,Clearwater,FL,33756-3951,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joe Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002349,CLEWISTON COMMUNITY HEALTH CTR,FLORIDA COMMUNITY HEALTH CENTER INC,1124078571,"Dental Providers, Federally Qualified Health Centers - Medical Services",315 S W C Owen Ave,,Clewiston,FL,33440-3637,Hendry,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Hendry,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002350,"Crossroads Behavioral Health Center, Inc.","Crossroads Behavioral Health Center, Inc.",1285775460,Community Mental Health Centers,626 W Sugarland Hwy,,Clewiston,FL,33440-3022,Hendry,483 E. Cowboy Way,,Labelle,FL,33935,Hendry,Gregory Finer,CEO,863-674-5012,,crossroadsbhc1@gmail.com,,,,,,crossroadsflorida.org
FL-002351,Wakulla Urgent Care & Diagnostic Center,Wakulla Urgent Care & Diagnostic Center PLC,1538349469,Rural Health Clinics,41 Feli Way,,Crawfordville,FL,32327-2368,Wakulla,41 Feli Way,,Crawfordville,FL,32327-2368,Wakulla,Michelle keen,Billing Administrator,850-879-7831,,michellekeen2@hotmail.com,Vickie Brown,Office Manager,850-926-3140,8,vickiebrown@wakullaurgentcare.com,www.wakullaurgentcare.com
FL-002352,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1235106618,Federally Qualified Health Centers - Medical Services,306 Union Ave,,Crescent City,FL,32112-4432,Putnam,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002353,Crestview Multi-Providers,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,550 W Redstone Ave,Suite 200,Crestview,FL,32536-6429,Okaloosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002354,Crestview Health/Dental Center,"North Florida Medical Centers, Inc.",1194908954,"Dental Providers, Federally Qualified Health Centers - Medical Services",800 Hospital Dr,,Crestview,FL,32539-7385,Okaloosa,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002355,Okaloosa County Health Dept.-Crestview Family Planning Clinic,Okaloosa County Health Dept.,1376502088,"Family Planning Providers, Ryan White Providers",810 E James Lee Blvd,,Crestview,FL,32539-3118,Okaloosa,221 Hospital Drive NE,,Fort Walton Beach,FL,32548-5066,Okaloosa,Lin Schwader,AR Manager,850-833-9233,2151,lin.schwader@flhealth.gov,Lynn Wadsworth,Nursing Director,850-833-9240,2253,lynn.wadsworth@flhealth.gov,
FL-002356,Tri-County Primary Care,"Tri-County Primary Care, Inc",1437225067,Rural Health Clinics,306 NE Highway 351,,Cross City,FL,32628-3105,Dixie,306 NE Highway 351,,Cross City,FL,32628,Dixie,Wanda Liddell,ARNP,352-498-3372,,wanda1930@cox.net,Kerrie Huff,Office Manager,352-498-3372,,kerrietcpc@cox.net,
FL-002357,Family Medical Center,"North Florida Medical Centers, Inc.",1053315564,Federally Qualified Health Centers - Medical Services,412 SW Highway 351,,Cross City,FL,32628-3827,Dixie,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002358,Crystal River Medical Center,"West Florida Medical Associate, Pa",1144355587,Rural Health Clinics,7647 W Gulf To Lake Hwy,,Crystal River,FL,34429-7962,Citrus,7647 W Gulf To Lake Hwy,,Crystal River,FL,34429,Citrus,Sujan Li,Office Manager,352-795-1718,,sujanli@yahoo.com,,,,,,
FL-002359,DORIS ISON HEALTH CENTER,"COMMUNITY HEALTH OF SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,10300 SW 216th St,,Miami,FL,33190,Miami,"BRODES H. HARTLEY, JR",President/CEO,305-252-4853,,CHARTLEY@CHISOUTHFL.ORG,BLAKE HALL,COO,305-252-4853,,ABHALL@CHISOUTHFL.ORG,WWW.CHISOUTHFL.ORG
FL-002360,Dade City Family Health Center,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1841263399,Federally Qualified Health Centers - Medical Services,14027 5th St,,Dade City,FL,33525-4302,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph D Resnick,CEO,352-518-2000,,jresnick@hcnetwork.org,,,,,,
FL-002361,Dade City Behavioral Health and Dental Center,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1881928869,"Dental Providers, Federally Qualified Health Centers - Medical Services",37944 Pasco Ave,Suite B,Dade City,FL,33525-4202,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph D Resnick,CEO,352-518-2000,,jresnick@hcnetwork.org,,,,,,
FL-002362,Lacoochee Family Health Center,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1255738977,Federally Qualified Health Centers - Medical Services,38724 Mudcat Grant Blvd,,Dade City,FL,33523-6792,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph Resnick,CEO,352-518-2000,9004,jresnick@hcnetwork.org,,,,,,
FL-002363,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1811429806,Federally Qualified Health Centers - Medical Services,1455 Dunn Ave,,Daytona Beach,FL,32114-1437,Volusia,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002364,Volusia County Health Department/Daytona Beach,Florida Department of Health/Volusia County Health Department,1831158039,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1845 Holsonback Dr,,Daytona Beach,FL,32117-5114,Volusia,1845 Holsonback Dr.,,Daytona Beach,FL,32117,Volusia,Patricia Boswell,County Health Department Administrator,386-274-0799,0817,Patricia.Boswell@flhealth.gov,Gregory Ballard,Asst. County Health Department Director,386-274-0500,0785,Gregory.Ballard@flhealth.gov,
FL-002365,Florida Hospital Memorial Medical Center,Adventist Health System/Sunbelt Inc.,1063426823,Inpatient Hospitals (other than children's hospitals),301 Memorial Medical Pkwy,,Daytona Beach,FL,32117-5167,Volusia,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002366,DOCTORS MEDICAL CENTER OF WALTON COUNTY,DOCTORS MEDICAL CENTER OF WALTON COUNTY,1437271509,Rural Health Clinics,21 W Main Ave,,Defuniak Springs,FL,32435-2529,Walton,21 W MAIN AVE,,DEFUNIAK SPRINGS,FL,32435,Walton,NORMA PRICE,Billing Manager,850-892-2888,,nprice@docatdmc.com,GWYN THOMAS,Office Manager,850-892-2888,,gthomas@docatdmc.com,
FL-002367,Walton County Health Department,"HEALTH, FLORIDA DEPARTMENT OF",1164775870,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",362 State Highway 83,,Defuniak Springs,FL,32433-3800,Walton,4052 Bald Cypress Way,,Tallahassee,FL,32399-0001,Walton,PATTY ROBERTS,Administrator,850-892-8040,1118,PATRICIA.ROBERTS@FLHEALTH.GOV,,,,,,http://walton.floridahealth.gov/
FL-002368,"Garcia Medical Clinic, LLC","Garcia Medical Clinic, LLC",1407971922,Rural Health Clinics,411 E Nelson Ave,,Defuniak Springs,FL,32433-7444,Walton,411 east nelson avenue,,DEFUNIAK SPRINGS,FL,32433,Walton,RUBEN GARCIA,Owner,850-892-4791,,RUBENGMD@YAHOO.COM,sherri bell,Office Manager,850-892-4791,,rubengmd@yahoo.com,
FL-002369,Florida Hospital Deland,Adventist Health System/Sunbelt Inc.,1649367269,Inpatient Hospitals (other than children's hospitals),701 W Plymouth Ave,,Deland,FL,32720-3236,Volusia,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002370,C. L. Brumback Primary Care Clinic - Delray Beach,Health Care District of Palm Beach County,1477890267,"Dental Providers, Federally Qualified Health Centers - Medical Services",225 S Congress Ave,,Delray Beach,FL,33445-4616,Palm Beach,1515 North Flager Drive Suite 101,Suite 138,West Palm Beach,FL,33401,Palm Beach,Damaris Lopez,Director Practice Operations,561-804-5772,1005,dlopez@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002371,"AHF Healthcare Center -Lake Ida (Palm Beach, Delray Beach)",AIDS Healthcare Foundation,1760757009,"Other ECP Providers, Ryan White Providers",2605 W Atlantic Ave,Suite D101,Delray Beach,FL,33445-4414,Palm Beach,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002372,Destin Medical Park (PCP),SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,36500 Emerald Coast Pkwy,,Destin,FL,32541-4713,Okaloosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002373,Tom Lee Community Health Center,"Suncoast Community Health Centers, Inc",1992817498,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",14254 Dr Martin Luther King Jr Blvd,,Dover,FL,33527-4414,Hillsborough,13110 Elk Mountain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,3645,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002374,"Central Florida Health Care, Inc., -Dundee Pediatrics","CENTRAL FLORIDA HEALTH CARE, INC.",1699134924,Federally Qualified Health Centers - Medical Services,1023 Dundee Rd,,Dundee,FL,33838-3101,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002375,"Central Florida Health Care, Inc., -Dundee","CENTRAL FLORIDA HEALTH CARE, INC.",1063408813,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",916 Dundee Rd,,Dundee,FL,33838-4198,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002376,Community Health Centers at Dunedin,"Community Health Centers of Pinellas, Inc",1427438043,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1721 Main St,,Dunedin,FL,34698-6402,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002377,Deven Medical Center,West Florida Medical Associates / Deven Medical Center,1235120338,Rural Health Clinics,11707 N Williams St,,Dunnellon,FL,34432-5855,Marion,3404 N Lecanto Hwy,,Lecanto,FL,34465,Citrus,Sri Deven,Practice Manager,352-464-0762,,srideven@yahoo.com,Ulhas deven,Medical Doctor,,,ulhasdeven@yahoo.com,
FL-002378,Heart of Florida Health Center-Dunnellon,"HEART OF FLORIDA HEALTH CENTER, INC.",1790157584,Federally Qualified Health Centers - Medical Services,19204 E Pennsylvania Ave,,Dunnellon,FL,34432-6168,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002379,Bellam Medical Clinic,"West Florida Medical Associates, PA",1053392969,Rural Health Clinics,20021 SW 111th Pl,,Dunnellon,FL,34432-4786,Marion,3404 N Lecanto Hwy,,Lecanto,FL,34465,Citrus,Radha Bellam,Administrator,352-465-1199,,radha@bellammedical.com,Angela Le Roy,Co-Ordinator,352-465-1199,,aleroy@bellammedical.com,
FL-002380,Eastpoint Medical Center,"North Florida Medical Centers, Inc.",1538163043,Federally Qualified Health Centers - Medical Services,158 US Highway 98,,Eastpoint,FL,32328-3304,Franklin,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002381,South County Medical Center,"MCR Health, Inc.",1144692674,Federally Qualified Health Centers - Medical Services,579 S Indiana Ave,Suite A,Englewood,FL,34223-3751,Sarasota,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002382,"TREASURE COAST COMMUNITY HEALTH, INC.","TREASURE COAST COMMUNITY HEALTH, INC.",1891740916,"Dental Providers, Federally Qualified Health Centers - Medical Services",12196 County Road 512,,Fellsmere,FL,32948-5463,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Vicki L Soule,Chief Executive Officer,772-571-1986,,vsoule@tcchinc.org,Christine Hyde,Credentialing Manager,772-257-8224,1908,chyde@tcchinc.org,www.tcchinc.org
FL-002383,Treasure Coast Community Health - Pine Street,"TREASURE COAST COMMUNITY HEALTH, INC.",1891740916,Federally Qualified Health Centers - Medical Services,44 N Pine St,,Fellsmere,FL,32948-5944,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Vicki L Soule,Chief Executive Officer,772-571-1986,,vsoule@tcchinc.org,Christine Hyde,Credentialing Manager,772-257-8224,339,chyde@tcchinc.org,www.tcchinc.org
FL-002384,EVERGLADES HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,Federally Qualified Health Centers - Medical Services,19300 SW 376th St,,Florida City,FL,33034-6300,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Management,305-278-6434,6434,amadden@chisouthfl.org,
FL-002385,Clinica de las Americas,"North Broward Hospital District, dba Broward Health",1134157100,Federally Qualified Health Centers - Medical Services,1101 NW 1st St,,Fort Lauderdale,FL,33311-8905,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,,,,,,www.browardhealth.org
FL-002386,Specialty Care Center,"North Broward Hospital District, dba Broward Health",1689692246,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1111 W Broward Blvd,,Fort Lauderdale,FL,33312-1638,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,www.browardhealth.org
FL-002387,Children's Diagnostic and Treatment Center,"North Broward Hospital District, dba Broward Health",1437245529,"Dental Providers, Family Planning Providers, Ryan White Providers",1401 S Federal Hwy,,Fort Lauderdale,FL,33316-2619,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Renae Sales,Business Office Manager,954-712-5057,,rsales@browardhealth.org,Stewart Wechsler,Director of Finance and Operations,954-728-1020,,swechsler@browardhealth.org,www.childrensdiagnostic.org
FL-002388,Comprehensive Care Center,"North Broward Hospital District, dba Broward Health",1134157100,Ryan White Providers,1726 SE 3rd Ave,,Fort Lauderdale,FL,33316-2514,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,,,,,,www.browardhealth.org
FL-002389,Cora E. Braynon Family Health Center,"North Broward Hospital District, dba Broward Health",1972531945,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",200 NW 7th Ave,,Fort Lauderdale,FL,33311-9026,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Tiana Blout,Vice President Community Health Services,954-217-3512,,tblount@browardhealth.org,www.browardhealth.org
FL-002390,AHF Healthcare Center - One River Plaza (Broward Co),AIDS Healthcare Foundation,1952645905,"Other ECP Providers, Ryan White Providers",305 S Andrews Ave,Suite 601,Fort Lauderdale,FL,33301-1851,Broward,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002391,AHF Healthcare Center - Northpoint,AIDS Healthcare Foundation,1922244250,"Other ECP Providers, Ryan White Providers",6405 N Federal,Hwy Ste 205,Fort Lauderdale,FL,33308-1414,Broward,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002392,Metro Women's Health Center,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,13195 Metro Pkwy,Suite 8,Fort Myers,FL,33966-4810,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002393,The Heights Medical Clinic,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,15570 Hagie Dr,,Fort Myers,FL,33908-2890,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002394,Estero Health Center,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",19701 S Tamiami Trl,,Fort Myers,FL,33908-4818,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,,2338,bwalker@hcnetwork.org,
FL-002395,AHF Healthcare Center -Fort Myers,AIDS Healthcare Foundation,1720324411,"Other ECP Providers, Ryan White Providers",2231 McGregor Blvd,,Fort Myers,FL,33901-3311,Lee,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002396,Downtown Ft. Myers Center,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2232 Grand Ave,,Fort Myers,FL,33901-3717,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,239-278-3600,2338,bwalker@hcnetwork.org,www.fhcswf.org
FL-002397,SALVATION ARMY,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,2400 Edison Ave,,Fort Myers,FL,33901-5106,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002398,"The McGregor Clinic, Inc.",McGregor Clinic,1518065440,Ryan White Providers,3487 Broadway,,Fort Myers,FL,33901-7213,Lee,3487 Broadway,,Fort Myers,FL,33901,Lee,"Sharon Murphy, RN, ACRN","CEO, Director",239-334-9555,8018,sharon@mcgregorclinic.org,Susan Gerald,CFO,239-334-9555,8019,susan@mcgregorclinic.org,www.mcgregorclinic.org
FL-002399,P.L. Dunbar Medical Office,LEE MEMORIAL HEALTH SYSTEM,1417342163,Federally Qualified Health Centers - Medical Services,3511 Dr Martin Luther King Blvd,,Fort Myers,FL,33916-4651,Lee,2776 Cleveland Ave,,Fort Myers,FL,33901-5855,Lee,Robert Johns,Executive Director,239-343-4806,,robert.johns@leememorial.org,Marlon Tyson,System Director for Business Development and Contracting,239-343-4822,,marlon.tyson@leememorial.org,www.WeCareForLee.org
FL-002400,BROADWAY DENTAL OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Dental Providers,3600 Broadway,,Fort Myers,FL,33901-8002,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,,2338,bwalker@hcnetwork.org,
FL-002401,EAST FORT MYERS MEDICAL OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,4040 Palm Beach Blvd,,Fort Myers,FL,33916-3470,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002402,Renaissance Preserve Office,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,4211 Romeo Ln,,Fort Myers,FL,33916-4810,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002403,Fort Myers Health Center,Planned Parenthood of Southwest and Central Florida,1033482724,"Family Planning Providers, Sexually Transmitted Disease Clinics",8595 College Pkwy,Suite 250,Fort Myers,FL,33919-5161,Lee,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002404,SOUTH FORT MYERS PEDIATRICS OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,9800 S Healthpark Dr,Suite 110,Fort Myers,FL,33908-3630,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002405,FT. PIERCE COMMUNITY HEALTH CTR,FLORIDA COMMUNITY HEALTH CENTER INC,1104875095,"Dental Providers, Federally Qualified Health Centers - Medical Services",1505 Delaware Ave,,Fort Pierce,FL,34950-3975,Saint Lucie,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,"Wilhelmina Lewis, M.D.",President and CEO,561-844-9443,335,wlewis@fchcinc.org,"Michael F Gervasi, M.D.",Practicing Physician,561-844-9443,335,mgervasi@fchcinc.org,www.fchcinc.org
FL-002406,Grace Women's Health Center,FLORIDA COMMUNITY HEALTH CENTER INC,1104250786,Federally Qualified Health Centers - Medical Services,2402 Frist Blvd,Suite 202,Fort Pierce,FL,34950-4838,Saint Lucie,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002407,Midway Specialty Care Center Inc,Midway Specialty Care Center Inc,1376970814,Tuberculosis Clinics,356 E Midway Rd,,Fort Pierce,FL,34982-7148,Saint Lucie,356 E Midway Road,,Ft Pierce,FL,34982,Saint Lucie,Anand Sukhram,Office Manager,772-464-9746,,anansukh@yahoo.com,,,,,,
FL-002408,ST. LUCIE County Health Department,Florida Department of Health,1649329236,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",714 Avenue C,,Fort Pierce,FL,34950-4189,Saint Lucie,5150 NW Milner Drive,,Port Saint Lucie,FL,34983-3392,Saint Lucie,Lens Lezeau,Contracting and Billing Consultant,772-462-3830,2311,Lens.Lezeau@flhealth.gov,Maribel Still,Operations and Management Consulting,772-462-3874,3945,Maribel.Still@flhealth.gov,
FL-002409,"Whole Family Health Center, Inc.","Whole Family Health Center, Inc.",1578612883,Ryan White Providers,725 N US Highway 1,,Fort Pierce,FL,34950-9125,Saint Lucie,725 North US Highway 1,,Fort Pierce,FL,34950,Saint Lucie,Lorri Chambers,Credentialing Specialist,772-468-9900,226,lchambers@wfhcfl.org,,,,,,
FL-002410,Okaloosa County Health Department,OKALOOSA COUNTY HEALTH DEPARTMENT,1376502088,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",221 Hospital Dr NE,,Fort Walton Beach,FL,32548-5066,Okaloosa,221 Hospital Drive NE,,Fort Walton Beach,FL,32548-5066,Okaloosa,Lin Schwader,AR Manager,850-833-9233,2151,lin.schwader@flhealth.gov,Lynn Wadsworth,Nursing Director,850-833-9240,2253,lynn.wadsworth@flhealth.gov,
FL-002411,Freeport Clinic,PANCARE OF FLORIDA INC,1366456287,"Dental Providers, Federally Qualified Health Centers - Medical Services",479 State Highway 20 E,,Freeport,FL,32439-3931,Walton,403 E. 11th Street,,Panama City,FL,32401-3409,Bay,R. MICHAEL HILL,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,KADEY PURVIS,BILLING SPECIALIST,850-747-5599,5,KPURVIS@PANCAREFL.ORG,
FL-002412,CFHC FROSTPROOF CLINIC,"CENTRAL FLORIDA HEALTH CARE, INC.",1467449660,"Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",109 W Wall St,,Frostproof,FL,33843-2043,Polk,47 5th St NW,,Winter Haven,FL,33881,Polk,Jennifer Birge,Managed Care Coordinator,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002413,Care Resource Community Health Center at Ft. Lauderdale,Care Resource,1093717464,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",871 W Oakland Park Blvd,,Ft. Lauderdale,FL,33311-1731,Broward,3510 Biscayne Blvd.,,Miami,FL,33137,Miami-Dade,Hudes Desrameaux,"Director of Grants, Contracts and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,Hudes Desrameaux,"Director of Grants, Contracts and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,www.careresource.org
FL-002414,UF HEALTH SHANDS HOSPITAL,University of Florida Hemophilia Treatment Center,1063463768,Hemophilia Treatment Centers,1600 SW Archer Rd,,Gainesville,FL,32610-3003,Alachua,1600 SW Archer Rd,,Gainesville,FL,32610,Alachua,Tung Wynn,"Director, Hemophilia Treatment Center",352-273-9120,,twynn@pediatrics.ufl.edu,Anita Rajasekhar,"Adult Director, Hemophilia Treatment Center",352-273-7830,,Anita.Rajasekhar@medicine.ufl.edu,
FL-002415,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1740594050,Dental Providers,410 NE Waldo Rd,,Gainesville,FL,32641-5685,Alachua,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002416,Gainesville Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1154713816,Family Planning Providers,914 NW 13th St,,Gainesville,FL,32601-4140,Alachua,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002417,Graceville Family Medicine Inc,Graceville Family Medicine Inc,1083688311,Rural Health Clinics,5239 Brown St,,Graceville,FL,32440-2513,Jackson,5239 Brown Street,,Graceville,FL,32440,Jackson,"Lucinda Collins, ARNP","Provider, Owner",850-360-4909,,lucy@gracevillefamilymedicine.com,Barbara Barfield,Office manager,850-360-4909,,barbara@gracevillefamilymedicine.com,
FL-002418,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1700135522,Federally Qualified Health Centers - Medical Services,1305 N Orange Ave,Suite 120,Green Cove Springs,FL,32043-2553,Clay,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002419,"COMMUNITY HEALTH CENTER - SOUTH LAKE FAMILY, PEDIATRIC & DENTAL CARE","COMMUNITY HEALTH CENTERS, INC.",1922197243,"Dental Providers, Federally Qualified Health Centers - Medical Services",1296 W Broad St,,Groveland,FL,34736-2012,Lake,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002420,SACRED HEART MEDICAL GROUP - TIGER POINT,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,1395 El Rito Dr,,Gulf Breeze,FL,32563-6707,Santa Rosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002421,Tiger Point II / Family Medicine,SACRED HEART HOSPITAL,1922032424,Other ECP Providers,1399 Country Club Rd,,Gulf Breeze,FL,32563-3451,Santa Rosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002422,"Central Florida Health Care, Inc., -Haines City Pediatrics","CENTRAL FLORIDA HEALTH CARE, INC.",1780194928,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1011 E Main St,,Haines City,FL,33844-4239,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002423,"Central Florida Health Care, Inc., -Haines City","CENTRAL FLORIDA HEALTH CARE, INC.",1396282299,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",705 Ingraham Ave,,Haines City,FL,33844-4327,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representaive,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002424,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1679822993,Federally Qualified Health Centers - Medical Services,201 W Lattin St,,Hastings,FL,32145,Saint Johns,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002425,NEIGHBORHOOD MEDICAL CENTER INC.,NEIGHBORHOOD MEDICAL CENTER INC.,1487869467,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1210 Kemp Rd,Neighborhood Medical Center Havana Middle School,Havana,FL,32333-1938,Gadsden,438 W Brevard St,,Tallahassee,FL,32301-1004,Gadsden,Nellie Graham,human resources,850-577-0045,,ngraham@neighborhoodmedicalcenter.org,jeanne Freeman,Interm CEO,850-284-5183,,jfreeman@neighborhoodmedicalcenter.org,http://nhsclinic.org
FL-002426,Neighborhood Medical Center Inc.,NEIGHBORHOOD MEDICAL CENTER INC.,1487869467,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",604 E 5th Ave,,Havana,FL,32333,Gadsden,438 W Brevard St,,Tallahassee,FL,32301-1004,Leon,Nellie Graham,Human Resources,850-577-0045,,ngraham@neighborhoodmedicalcenter.org,Jeanne Freeman,Interm CEO,850-284-5182,,jfreeman@neighborhoodmedicalcenter.org,
FL-002427,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1114994944,Federally Qualified Health Centers - Medical Services,22066 SE 71st Ave,,Hawthorne,FL,32640-3969,Alachua,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002428,Langely Health Services - Hernando,"Project Health, Inc.",1457706889,Federally Qualified Health Centers - Medical Services,2601 N Forest Ridge Blvd,Suite B,Hernando,FL,34442-5123,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002429,"Citrus Health Network, Inc.","Citrus Health Network, Inc.",1275647752,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4125 W 20th Ave,,Hialeah,FL,33012-5874,Miami-Dade,4175 West 20 Ave,,Hialeah,FL,33012,Miami,Olga Golik,In-House Counsel,305-424-3010,3010,olgag@citrushealth.com,Maria Alonso,Chief Operating Officer,305-424-3100,3058250300,maria@citrushealth.com,
FL-002430,JTCHC-Hialeah Women's Wellness Center,"Jessie Trice Community Health Center, Inc.",1023486735,Federally Qualified Health Centers - Medical Services,777 E 25th St,Suite 316,Hialeah,FL,33013-3849,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002431,JTCHC-Flamingo Medical Center,"Jessie Trice Community Health Center, Inc.",1740442375,Federally Qualified Health Centers - Medical Services,901 E 10th Ave,Bay 39,Hialeah,FL,33010-3762,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Karen Alteaga,Accreditation Coordinator,305-835-1608,23154,kaarteaga@jtchc.org,http://www.jtchc.org
FL-002432,Joe DiMaggio Children's Hospital,South Broward Hospital District,1780667923,Children's Hospitals (inpatient only),3501 Johnson St,Joe Dimaggio Childrens Hospital Pavilion,Hollywood,FL,33021-5421,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Veronica Bautista,Chief Financial Officer,954-265-0503,503,vbautista@mhs.net,Sandra Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002433,MEMORIAL REGIONAL HOSPITAL,South Broward Hospital District,1780667923,Inpatient Hospitals (other than children's hospitals),3501 Johnson St,,Hollywood,FL,33021-5421,Broward,3501 Johnson Street,MHS Administration,Hollywood,FL,33021,Broward,Walter Bussell,Chief Financial Officer,954-265-5812,3550,wbussell@mhs.net,Sandy Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002434,Memorial Regional Hospital South,South Broward Hospital District,1780667923,Inpatient Hospitals (other than children's hospitals),3600 Washington St,,Hollywood,FL,33021-8216,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Joseph Stuczynski,Chief Finanical Officer,954-518-5001,5008,jstuczynski@mhs.net,Sandar Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002435,South Broward Community Health Services - Hollywood,South Broward Hospital District,1780667923,Ryan White Providers,4105 Pembroke Rd,,Hollywood,FL,33021-8103,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Walter Bussell,Chief Financial Officer,954-265-5812,5204,wbussell@mhs.net,Sandra Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002436,"BROWARD COMMUNITY & FAMILY HEALTH CENTER, INC.","BROWARD COMMUNITY AND FAMILY HEALTH CENTERS, INC",1710134135,Federally Qualified Health Centers - Medical Services,5010 Hollywood Blvd,Suite 100B,Hollywood,FL,33021-6557,Broward,5010 Hollywood Blvd,Suite 100B,Hollywood,FL,33021-6557,Broward,Edwens Belizaire,Director of Managed Care,954-266-2999,,ebelizaire@bcfhc.org,Felicia Hart,COO,954-266-2999,,fhart@bcfhc.org,Www.bcfhc.org
FL-002437,SOUTH DADE HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",13600 SW 312th St,,Homestead,FL,33033-5500,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002438,NARANJA HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,Federally Qualified Health Centers - Medical Services,13805 SW 264th St,,Homestead,FL,33032-7602,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002439,MARTIN LUTHER KING JR. CLINICA CAMPESINA,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",810 W Mowry Dr,,Homestead,FL,33030-5746,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002440,AHF Healthcare Center - Homestead,AIDS Healthcare Foundation,1114344561,"Other ECP Providers, Ryan White Providers",925 NE 30th Ter,Suite 310,Homestead,FL,33033-7614,Miami-Dade,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002441,Langley Medical Services - Homassassa #1,"Project Health, Inc.",1588019905,Federally Qualified Health Centers - Medical Services,4363 S Suncoast Blvd,Suite B,Homosassa,FL,34446-1182,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@temedical.com,
FL-002442,Langley Health Services - Homassassa #2,"Project Health, Inc.",1326495565,Federally Qualified Health Centers - Medical Services,7991 S Suncoast Blvd,Suite B,Homosassa,FL,34446-5005,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002443,Hudson Family Health Center,"Premier Community HealthCare Group, Inc.",1710288766,Federally Qualified Health Centers - Medical Services,11611 Denton Ave,,Hudson,FL,34667,Pasco,PO Box 232,,Dade City,FL,33526,Pasco,Jennfier Maffett,Health Data Analyst,352-518-2000,9004,jmaffett@hcnetwork.org,,,,,,www.premierhc.org
FL-002444,Children's Care FSU,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1441 Heritage Blvd,,Immokalee,FL,34142-2260,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002445,Women's Care FSU (Immokalee),"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1441 Heritage Blvd,,Immokalee,FL,34142-2260,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002446,Dental Care Immokalee,"Collier Health Services, INC",1609827211,Dental Providers,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002447,Family Care Immokalee,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,http://www.healthcareswfl.org/
FL-002448,Marion E. Fether Specialty,Healthcare Network of Southwest Florida,1609827211,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1454 Madison Ave W,,Immokalee,FL,34142,Collier,1454 Madison Avenue N.,,Immokalee,FL,34142,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director of Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002449,Family Care iTech,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,508 N 9th St Unit 142,,Immokalee,FL,34142-2948,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002450,INDIANTOWN COMMUNITY HEALTH CTR,FLORIDA COMMUNITY HEALTH CENTER INC,1205886223,"Dental Providers, Federally Qualified Health Centers - Medical Services",15858 SW Warfield Blvd,,Indiantown,FL,34956-3513,Martin,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,"Wilhelmina Lewis, M.D.",President and CEO,561-844-9443,335,wlewis@fchcinc.org,"Michael F Gervasi, M.D.",Practicing Physician,561-844-9443,335,mgervasi@fchcinc.org,www.fchcinc.org
FL-002451,WFMA/Bellam Medical Clinic,"West Florida Medical Associates, PA",1053392969,Rural Health Clinics,41 N Inglis Ave,,Inglis,FL,34449-9463,Levy,3404 N Lecanto Hwy,,Lecanto,FL,34465,Citrus,Radha Bellam,Administrator,352-465-1199,,radha@bellammedical.com,Angela Le Roy,Co-Ordinator,352-447-3031,,aleroy@bellammedical.com,
FL-002452,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1477529311,Federally Qualified Health Centers - Medical Services,1213 State Road 20,,Interlachen,FL,32148-2737,Putnam,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002453,DOH-Citrus - Inverness,Florida Department of Health,1164493664,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",120 N Montgomery Ave,,Inverness,FL,34450-2439,Citrus,3700 West Sovereign Path,,Lecanto,FL,34461-8071,Citrus,"Janora Wade, RN",COO FDOH-Citrus,352-527-0068,,Janora.Wade@flhealth.gov,Tito Rubio,Director FDOH-Citrus,352-527-0068,,Tito.Rubio@flhealth.gov,
FL-002454,Langley Health Services - Inverness,"Project Health, Inc.",1972959302,"Dental Providers, Federally Qualified Health Centers - Medical Services",120 N Montgomery Ave,Suite B,Inverness,FL,34450-2439,Citrus,"Project Health, Inc.",1425 S US Highway 301,Sumterville,FL,33585,Sumter,Thomas G. Chase,Chief Executive Officer,352-569-2941,,tchase@telmedical.com,Vicki Wynns,Chief Operating Officer,352-569-2955,,vwynns@telmedical.com,
FL-002455,Langley Health Services - Inverness #2,"Project Health, Inc.",1669827085,Federally Qualified Health Centers - Medical Services,213 S Pine Ave,Suite B,Inverness,FL,34452-4830,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002456,Langley Health Services - Inverness Family Practice #3,"Project Health, Inc.",1912352345,Federally Qualified Health Centers - Medical Services,3733 E Gulf To Lake Hwy,Suite C,Inverness,FL,34453-3206,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,CEO,352-569-2941,,tchase@telmedical.com,Vicki Wynns,COO,352-569-2955,,vwynns@telmedical.com,
FL-002457,AHF Healthcare Center - Jacksonville,AIDS Healthcare Foundation,1679557201,"Other ECP Providers, Ryan White Providers",2 Shircliff Way,Depaul Building Suite 900,Jacksonville,FL,32204,Duval,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,Charity Chandler-Cole,Director of Contract Administration,323-860-5384,,charity.chandler@aidshealth.org,www.aidshealth.org
FL-002458,Jacksonville Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1528450285,Family Planning Providers,5978 Powers Ave,,Jacksonville,FL,32217-2210,Duval,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002459,I.M. SULZBACHER CENTER FOR THE HOMELESS,"SULZBACHER, I M CENTER FOR THE HOMELESS INC, THE",1710051354,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",611 E Adams St,,Jacksonville,FL,32202-2847,Duval,611 E Adams St,,Jacksonville,FL,32202-2847,Duval,LETA WASHINGTON,BILLING/OUTREACH COORDINATOR,904-394-8055,,letawashington@tscjax.org,TABATHA BALL,MEDICAL CLINIC DIRECTOR,904-394-8065,,tabathaball@tscjax.org,
FL-002460,"University of Florida Center for HIV/AIDS Research, Education and Service (UF CARES)",University of Florida,1245299320,"Outpatient Hospital Clinics, Ryan White Providers",655 8th St W Fl 3,,Jacksonville,FL,32209,Duval,655 West Eighth Street,3rd Floor Clinical Center,Jacksonville,FL,32209,Duval,Kendall Guthrie,Assistant Director of Healthcare Administration,904-244-4424,,Kendall.Guthrie@jax.ufl.edu,"Mobeen Rathore, MD",Principal Investigator and Division Chief,904-798-4179,,Mobeen.Rathore@jax.ufl.edu,
FL-002461,Wolfson Children's Hospital,Baptist Medical Center/Wolfson Children's Hospital,1578620449,Children's Hospitals (inpatient only),800 Prudential Dr,,Jacksonville,FL,32207-8202,Duval,800 Prudential Dr,,Jacksonville,FL,32207,Duval,Philip Boyce,Chief Revenue Officer,904-376-3760,,philip.boyce@bmcjax.com,Jennifer Leach,"Director, Managed Care",904-202-4028,,jennifer.leach@bmcjax.com,https://www.wolfsonchildrens.com/
FL-002462,Nemours Specialty Children's Care,The Nemours Foundation,1699014415,Hemophilia Treatment Centers,807 Childrens Way,,Jacksonville,FL,32207-8426,Duval,10140 Centurion Parkway North,,Jacksonville,FL,32256,Duval,Ray Hejmanowski,Practice Administrator,904-697-3528,,ray.hejmanowski@nemours.org,Gina McCarter,,850-473-4501,,gina.mccarter@nemours.org,
FL-002463,BEACHES MEDICAL CLINIC - Sulzbacher Center Clinic,"SULZBACHER, I M CENTER FOR THE HOMELESS INC, THE",1710051354,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",850 6th Ave S,,Jacksonville Beach,FL,32250-4253,Duval,611 E Adams St,,Jacksonville,FL,32202-2847,Duval,LETA WASHINGTON,BILLING/OUTREACH COORDINATOR,904-394-8055,,letawashington@tscjax.org,TABATHA BALL,MEDICAL CLINIC DIRECTOR,904-394-8065,,tabathaball@tscjax.org,
FL-002464,MONROE County Health Department - KEY WEST - Olivia,Florida Department of Health,1639148919,Family Planning Providers,105 Olivia St,,Key West,FL,33040-7379,Monroe,105 Olivia St,,Key West,FL,33040-7379,Monroe,Kathy Rogers,Business Manager,205-293-7500,5615,kathy.rogers@flhealth.gov,,,,,,
FL-002465,MONROE County Health Department - KEY WEST,Florida Department of Health,1639148919,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1100 Simonton St,,Key West,FL,33040-3110,Monroe,1100 Simonton St,,Key West,FL,33040-3110,Monroe,Kathy Rogers,Business Manager,205-293-7500,5615,kathy.rogers@flhealth.gov,,,,,,
FL-002466,Womankind,Subsidiary of Florida Department of Health,1639148919,"Family Planning Providers, Sexually Transmitted Disease Clinics",1511 Truman Ave,,Key West,FL,33040-7252,Monroe,1511 Truman Ave,,Key West,FL,33040-7252,Monroe,Cali Roberts,Executive Director,305-294-4004,,croberts@womankindkeywest.org,,,,,,http://womankindkeywest.com/
FL-002467,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1073589065,Federally Qualified Health Centers - Medical Services,100 Commercial Dr,,Keystone Heights,FL,32656-6802,Clay,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002468,Primary Care Medical Services,Department of Health In Osceola County,1710375456,Federally Qualified Health Centers - Medical Services,1875 Fortune Rd,,Kissimmee,FL,34744-4428,Osceola,1875 Fortune Road,,Kissimmee,FL,34744,Osceola,Belinda Johnson-Cornett,CEO,407-343-2016,,belinda.johnson-cornett@flhealth.gov,Daniella Sullivan,FQHC Operations Director,407-343-2014,,daniella.sullivan@flhealth.gov,
FL-002469,Kissimmee Health Center,Planned Parenthood of Southwest and Central Florida,1740604149,"Family Planning Providers, Sexually Transmitted Disease Clinics",610 Oak Commons Blvd,,Kissimmee,FL,34741-4198,Osceola,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002470,"Gulf Coast Healthcare Systems, Inc. dba Urgent and Convenient Care Center","Gulf Coast Healthcare Systems, Inc. dba Urgent and Convenient Care Center",1134497167,"Rural Health Clinics, Sexually Transmitted Disease Clinics",700 S Main St,,Labelle,FL,33935-4440,Hendry,2718 Lee Blvd Ste B,,Lehigh Acres,FL,33971,Lee,Rudolph Jones,CEO,239-694-9102,,DRMICKEYJONES@GMAIL.COM,Rudolph Jones,CEO,239-694-9102,,drmickeyjones@gmail.com,
FL-002471,LABELLE MEDICAL & DENTAL OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",930 S Main St,,Labelle,FL,33935-4448,Hendry,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002472,"Milla Pediatrics and Associates, Inc","Milla Pediatrics and Associates, Inc",1982775128,Rural Health Clinics,426 SW Commerce Dr,Suite 101,Lake City,FL,32025-1506,Columbia,426 SW Commerce Dr.,Suite 101,Lake City,FL,32025,Columbia,Pamela S. Carlisle,Administrator,386-755-2240,,millapeds@hotmail.com,,,,,,
FL-002473,Heartland Pediatrics of Lake Placid PA,Heartland Pediatrics of Lake Placid PA,1265453203,Rural Health Clinics,344 E Royal Palm St,,Lake Placid,FL,33852-5020,Highlands,344 East Royal Palm St,,Lake Placid,FL,33852,Highlands,Dennis Valentin,Practice Administrator,863-382-0566,,cfmvalentin@gmail.com,,,,,,
FL-002474,Heartland Pediatrics of Lake Wales LLC,Heartland Pediatrics of Lake Wales LLC,1104989680,Rural Health Clinics,1354 State Road 60 E,,Lake Wales,FL,33853-4322,Polk,1354 State Road 60 East,,Lake Wales,FL,33853,Highlands,Dennis Valentin,Practice Administrator,863-382-0566,,cfmvalentin@gmail.com,,,,,,
FL-002475,"Central Florida Health Care, Inc.,-Lake Wales","CENTRAL FLORIDA HEALTH CARE, INC.",1225337819,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",305 W Central Ave,,Lake Wales,FL,33853-4015,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002476,C. L. Brumback Primary Care Clinic - Lake Worth,Health Care District of Palm Beach County,1184004590,Federally Qualified Health Centers - Medical Services,7408 Lake Worth Rd,Suite 700,Lake Worth,FL,33467-2502,Palm Beach,902 Clint Moore Rd.,Suite 138,Boca Raton,FL,33487,Palm Beach,"Christopher F. Irizarry, MPA",Vice President and Executive Director of Clinic Services,561-642-1005,1005,cirizarr@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002477,"Central Florida Health Care, Inc., -Lakeland Primary Care","CENTRAL FLORIDA HEALTH CARE, INC.",1386835064,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1129 N Missouri Ave,,Lakeland,FL,33805-4411,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002478,SCHC Womens Care Of Lakeland,"Suncoast Community Health Centers, Inc",1487621314,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1729 Lakeland Hills Blvd,,Lakeland,FL,33805-3016,Polk,13110 Elk Mountain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002479,Lakeland Health Center,Planned Parenthood of Southwest and Central Florida,1578842266,"Family Planning Providers, Sexually Transmitted Disease Clinics",2250 E Edgewood Dr,,Lakeland,FL,33803-3643,Polk,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002480,"Central Florida Health Care, Inc., -Lakeland Pediatrics","CENTRAL FLORIDA HEALTH CARE, INC.",1851751549,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",601 S Florida Ave,Suite 6,Lakeland,FL,33801-5237,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002481,C. L. Brumback Primary Care Clinic - Lantana,Health Care District of Palm Beach County,1720325517,"Dental Providers, Federally Qualified Health Centers - Medical Services",1250 Southwinds Dr,,Lantana,FL,33462-1459,Palm Beach,1515 North Flager Drive Suite 101,Suite 138,West Palm Beach,FL,33401,Palm Beach,Damaris Lopez,Director Practice Operations,561-804-5772,1005,dlopez@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002482,Community Health Centers at Largo,"Community Health Centers of Pinellas, Inc.",1255319976,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12420 130th Ave,,Largo,FL,33774-1919,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joeseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002483,Lauderdale Lakes,"North Broward Hospital District, dba Broward Health",1669884854,Federally Qualified Health Centers - Medical Services,3716 W Oakland Park Blvd,,Lauderdale Lakes,FL,33311-1134,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,www.browardhealth.org
FL-002484,"Central Broward Community Health Centers, Inc.","Broward Community & Family Health Centers, Inc.",1083859789,Federally Qualified Health Centers - Medical Services,1229 NW 40th Ave,,Lauderhill,FL,33313,Broward,6015 Washington Street,,Hollywood,FL,33023,Broward,Brenda colon,Director of Managed Care,954-266-2999,242,Bcolon@bcfhc.org,Felicia Hart,CHEIF OPERATING OFFICER,954-266-2999,,fhart@bcfhc.org,Www.bcfhc.org
FL-002485,FDOH-Citrus,FDOH-Citrus,1164493664,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3700 W Sovereign Path,,Lecanto,FL,34461-8071,Citrus,3700 West Sovereign Path,,Lecanto,FL,34461,Citrus,"Janora Wade, RN",COO FDOH-Citrus,352-527-0068,,Janora.Wade@flhealth.gov,"Tito Rubio, MPH",Director FDOH-Citrus,352-527-0068,,Tito.Rubio@flhealth.gov,
FL-002486,Langley Health Services - Lecanto Pediatric,Project Health Inc.,1598270555,Federally Qualified Health Centers - Medical Services,512 N Lecanto Hwy,,Lecanto,FL,34461-8547,Citrus,1425 S US Highway 301,,Sumterville,FL,33585,Sumter,Thomas G. Chase,Chief Executive Officer,352-569-2941,,tchase@telmedical.com,Vicki Wynns,Chief Operating Officer,352-569-2955,,vwynns@telmedical.com,
FL-002487,LifeStream Behavioral Center,LifeStream Behavioral Center,1902802002,Community Mental Health Centers,215 N 3rd St,,Leesburg,FL,34748-5105,Lake,P.O. Box 491000,,Leesburg,FL,34749-1000,Lake,Vickie Anderson,Billing/Credentioaling mgr,352-315-7537,,vmilliner@lsbc.net,David Braughton,SR VP,352-315-7500,,dbraughton@lsbc.net,
FL-002488,"COMMUNITY HEALTH CENTER - LEESBURG FAMILY, PEDIATRIC & WOMEN'S CARE","COMMUNITY HEALTH CENTERS, INC.",1881783124,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",225 N 1st St,,Leesburg,FL,34748-5150,Lake,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002489,LEHIGH ACRES PEDIATRIC & DENTAL OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",3400 Lee Blvd,Suite 101-104,Lehigh Acres,FL,33971-1309,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002490,Lehigh Acres Adult Medical Office,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,5220 Lee Blvd,,Lehigh Acres,FL,33971-1021,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002491,Palms Medical Group - Live Oak,TRENTON MEDICAL CENTER,1801826268,Federally Qualified Health Centers - Medical Services,915 Nobles Ferry Rd,,Live Oak,FL,32064-8463,Suwannee,911 S Main St,,Trenton,FL,32693-3239,Suwannee,Candace Naughon,Credentialing/Administration,386-454-0698,3021,cnaughton@palmsmg.org,,,,,,https://palmsmg.org/index.php/locations/20-office-locations/8-live-oak
FL-002492,BAKER RURAL HEALTH CLINIC,"Baker County Medical Services, Inc",1386082220,Rural Health Clinics,155 N 3rd St,,Macclenny,FL,32063-2103,Baker,159 North 3rd Street,,Macclenny,FL,32063,Baker,WILLIAM STEVE DUDLEY,CFO,904-653-4698,,sdudley@bcmedsvcs.com,,,,,,
FL-002493,Ed Fraser Memorial Hospital,"Baker County Medical Services, Inc",1104926401,Inpatient Hospitals (other than children's hospitals),159 N 3rd St,,Macclenny,FL,32063-2103,Baker,159 North 3rd Street,,Macclenny,FL,32063,Baker,WILLIAM STEVE DUDLEY,CFO,904-653-4698,,sdudley@bcmedsvcs.com,,,,,,
FL-002494,Madison Medical Center,"North Florida Medical Centers, Inc.",1144637109,Federally Qualified Health Centers - Medical Services,235 SW Dade St,Suite A,Madison,FL,32340-2363,Madison,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO,850-298-6001,,llunn@nfmc.org,https://www.nfmc.org/
FL-002495,MARATHON HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2855 Overseas Hwy,,Marathon,FL,33050-2239,Monroe,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Management,305-278-6434,6434,amadden@chisouthfl.org,
FL-002496,Monroe County Health Dept.-Ruth Ivins Center Marathon Family Planning Clinic,Florida Department of Health,1639148919,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",3333 Overseas Hwy,,Marathon,FL,33050-2329,Monroe,3333 Overseas Hwy,,Marathon,FL,33050-2329,Monroe,Kathy Rogers,Business Manager,205-293-7500,5615,kathy.rogers@flhealth.gov,,,,,,https://opa-fpclinicdb.hhs.gov/service-site/monroe-county-health-dept-ruth-ivins-center-marathon-family-planning-clinic
FL-002497,Margate Health Center,"North Broward Hospital District, dba Broward Health",1124430319,Federally Qualified Health Centers - Medical Services,5109 Coconut Creek Pkwy,,Margate,FL,33063-3914,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,www.browardhealth.org
FL-002498,River Valley Medical Center,"North Florida Medical Centers, Inc.",1235133745,Federally Qualified Health Centers - Medical Services,710 W Main St,,Mayo,FL,32066-4127,Lafayette,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002499,Stingl Eye Clinic,The Stingl Family Foundation Inc,1548629108,Other ECP Providers,1304 Oak St,,Melbourne,FL,32901-3111,Brevard,The Stingl Family Foundation Inc,1304 Oak Street,Melbourne,FL,32901,Brevard,"Daniel M. Stingl, M.D.",Ophthalmologist,321-345-4002,,info@stingleyeclinic.com,,,,,,www.stingleyeclinic.com
FL-002500,Comprehensive Health Care,"Unconditional Love, Incorporated",1902067630,Ryan White Providers,1495 N Harbor City Blvd,Suite F,Melbourne,FL,32935-6572,Brevard,1495 N. Harbor City Blvd.,Suite F,Melbourne,FL,32935,Brevard,Marcia E. King,"CEO, Director of Clinical Services",321-253-0846,,mking@chcfl.net,"Jessica Seidita, RN","Deputy CEO, Clinical Services Supervisor",321-253-0846,,jseidita@chcfl.net,
FL-002501,"Jessie Trice Community Health Center, Inc.","Jessie Trice Community Health Center, Inc.",1609247329,Federally Qualified Health Centers - Medical Services,1100 NW 71st St,JTCHC - John H. Peavy Health Center at Miami Northwestern Senior High School,Miami,FL,33150-3894,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002502,MBCHC North Suite 309,Miami Beach Community Health Center,1255752853,"Dental Providers, Federally Qualified Health Centers - Medical Services",11645 Biscayne Blvd,"Suites 103, 104, 301, 302, 304, 305, 307, 308, 309, 401, 403, 405",Miami,FL,33181-3139,Miami-Dade,710 Alton Road,,Miami Beach,FL,33139,Miami,Mark Delvaux,CFO,305-538-8835,1713,mdelvaux@mbchc.com,Sorangely Menjivar,COO,305-538-8835,1409,sorangelym@mbchc.com,miamibeachhealth.org
FL-002503,JTCHC - Children's Wellness Center,"Jessie Trice Community Health Center, Inc.",1467614099,Federally Qualified Health Centers - Medical Services,1190 NW 95th St,Suite 304,Miami,FL,33150-2066,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002504,JTCHC - Women's Health Center,"Jessie Trice Community Health Center, Inc.",1831352624,Federally Qualified Health Centers - Medical Services,1190 NW 95th St,Suite 101,Miami,FL,33150-2064,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002505,Marjorie Stoneman Douglas 3-5,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,Federally Qualified Health Centers - Medical Services,11901 SW 2nd St,,Miami,FL,33184-1601,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Allison Madden,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,amadden@chisouthfl.org,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,
FL-002506,West Kendall Health Center,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",13540 SW 135th Ave,,Miami,FL,33186-6184,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002507,Jean Shehan Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1841544822,Family Planning Providers,1378 Coral Way,4th Floor,Miami,FL,33145,Miami-Dade,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,www.ppsenfl.org
FL-002508,"COMMUNITY HEALTH SOUTH FLORIDA, INC.","COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",15625 SW 80th St,Dante B Fascell Elementary School,Miami,FL,33193-2628,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Allison Madden,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,amadden@chisouthfl.org,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,http://www.chisouthfl.org/locations/school-based-services/
FL-002509,University of Miami Hemophilia Treatment Center,Pediatrics,1932434636,Hemophilia Treatment Centers,1601 NW 12 Th Ave,5th Flr,Miami,FL,33136,Miami-Dade,1601 NW 12th Ave,5th Flr,Miami,FL,33136,Miami-Dade,Maggie Gonzalez,Clinical Program Coordinator,305-243-7167,,mgonzalez28@med.miami.edu,,,,,,
FL-002510,Jackson Memorial Hospital (inpatient hospital),Jackson Health System,1225033020,Inpatient Hospitals (other than children's hospitals),1611 NW 12th Ave,,Miami,FL,33136-1005,Miami-Dade,1611 NW 12 Ave,,Miami,FL,33136,Miami-Dade,Alejandro Contreras,SVP Operations,305-585-4073,,alejandro.contreras@jhsmiami.org,Gino Santorio,COO,,,gino.santorio@jhmimai.org,
FL-002511,Jackson Memorial Hospital (multiple outpatient ECP categories),Jackson Health System,1225033020,Ryan White Providers,1611 NW 12th Ave,,Miami,FL,33136-1005,Miami-Dade,1611 NW 12 Ave,,Miami,FL,33136,Miami-Dade,Alejandro Contreras,SVP Operations,305-585-4073,,alejandro.contreras@jhsmiami.org,Gino Santorio,COO,,,gino.santorio@jhmimai.org,
FL-002512,JTCHC-Dental Center Miami Gardens,"Jessie Trice Community Health Center, Inc.",1750543393,Dental Providers,18360 NW 7th Ave,,Miami,FL,33169-4410,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Karen Alteaga,Accreditation Coordinator,305-835-1608,23154,kaarteaga@jtchc.org,http://www.jtchc.org
FL-002513,Care Resource Community Health Center at Little Havana,Care Resource,1891102224,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1901 SW 1st St,3rd Floor,Miami,FL,33135-1601,Miami-Dade,3510 Biscayne Blvd.,,Miami,FL,33137,Miami-Dade,Kathleen Calienes,Grants & Data Analysis Manager,305-576-1234,295,kcalienes@careresource.org,Hudes Desrameaux,"Director of Grants, Programs and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,www.careresource.org
FL-002514,JTCHC-Frederica Wilson / Juanita Mann,"Jessie Trice Community Health Center, Inc.",1821498999,Federally Qualified Health Centers - Medical Services,2520 NW 75th St,,Miami,FL,33147-6025,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002515,AHF Wellness Center - Midtown Miami,AIDS Healthcare Foundation,1801026711,Other ECP Providers,2900 Biscayne Blvd,,Miami,FL,33137-4122,Miami-Dade,6255 W. Sunset Blvd.,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002516,Nicklaus Children's Hospital,Miami Children's Health System,1871540237,Children's Hospitals (inpatient only),3100 SW 62nd Ave,,Miami,FL,33155-3009,Miami-Dade,3100 S.W. 62nd Avenue,,Miami,FL,33155,Miami,Michael Sisti,Director of Managed Care & Pricing Strategy,305-662-8336,8336,michael.sisti@mch.com,Michael Durr,Admin Director of Accounting/Interim CFO,786-624-5750,5750,michael.durr@mch.com,https://www.miamichildrens.com
FL-002517,AHF Kinder Medical Group Healthcare Center,AIDS Healthcare Foundation,1942579503,"Other ECP Providers, Ryan White Providers",3661 S Miami Ave,Suite 806,Miami,FL,33133-4214,Miami-Dade,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,Donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002518,Care Resource Community Health Center at Midtown Miami,Care Resource,1053311373,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3801 Biscayne Blvd Fl 2,,Miami,FL,33137-9800,Miami-Dade,3510 Biscayne Blvd.,,Miami,FL,33137,Miami-Dade,Hudes Desrameaux,"Director of Grants, Contracts and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,Hudes Desrameaux,"Director of Grants, Programs and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,www.careresource.org
FL-002519,COCONUT GROVE HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,Federally Qualified Health Centers - Medical Services,3831 Grand Ave,,Miami,FL,33133-4862,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002520,Jessie Trice Center for Community Health,"Jessie Trice Community Health Center, Inc.",1689605362,"Dental Providers, Federally Qualified Health Centers - Medical Services",5361 NW 22nd Ave,,Miami,FL,33142-8035,Miami-Dade,5607 NW 27th Ave Suite 1,,Miami,FL,33142-2826,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Karen Alteaga,Accreditation Coordinator,305-835-1608,23154,kaarteaga@jtchc.org,www.jtchc.org
FL-002521,JTCHC-Dental Health Center,"Jessie Trice Community Health Center, Inc.",1760645550,Dental Providers,5607 NW 27th Ave,Suite 2,Miami,FL,33142-2826,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Karen Alteaga,Accreditation Coordinator,305-835-1608,23154,kaarteaga@jtchc.org,http://www.jtchc.org
FL-002522,Golden Glades-Miami Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1265822142,Family Planning Providers,585 NW 161st St,,Miami,FL,33169-6314,Miami-Dade,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002523,SOUTH MIAMI HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6350 Sunset Dr,,Miami,FL,33143-4836,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002524,"COMMUNITY HEALTH SOUTH FLORIDA, INC.","COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6401 SW 152nd Ave,Bowman Ashe/Doolin Pre-k-5,Miami,FL,33193-2169,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,ALLISON MADDEN,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,AMADDEN@CHISOUTHFL.ORG,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,http://www.chisouthfl.org/locations/school-based-services/
FL-002525,"COMMUNITY HEALTH SOUTH FLORIDA, INC.","COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",650 NW 132nd Ave,Marjorie Stoneman Douglas Elementary K,Miami,FL,33182-1155,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Allison Madden,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,amadden@chisouthfl.org,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,http://www.chisouthfl.org/locations/school-based-services/
FL-002526,"COMMUNITY HEALTH SOUTH FLORIDA, INC.","COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6601 SW 152nd Ave,Bowman Ashe/Doolin 6-8,Miami,FL,33193-2152,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,ALLISON MADDEN,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,AMADDEN@CHISOUTHFL.ORG,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,http://www.chisouthfl.org/locations/school-based-services/
FL-002527,"Empower U, Inc.","Empower U, Inc.",1205194883,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",7900 NW 27th Ave,Suite E12,Miami,FL,33147-4909,Miami-Dade,7900 NW 27th Avenue,Suite E 12,Miami,FL,33147,Miami,"Vanessa Mills, CEO",Cheif Executive Officer,786-318-2337,127,vmills@empower-u-miami.org,Christine Stroy Martin,Cheif Financial Officer,786-318-2337,116,cstroymartin@empower-u-miami.org,
FL-002528,Kendall Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1831443811,Family Planning Providers,8900 SW 117th Ave,Ste 207-B,Miami,FL,33186,Miami-Dade,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,www.ppsenfl.org
FL-002529,Beverly Press Health Center,Miami Beach Community Health Center,1821251612,Federally Qualified Health Centers - Medical Services,1221 71st St,,Miami Beach,FL,33141-3647,Miami-Dade,710 Alton Road,,Miami Beach,FL,33139,Miami,Mark Delvaux,CFO,305-538-8835,1713,mdelvaux@mbchc.com,Sorangely Menjivar,COO,305-538-8835,1409,sorangelym@mbchc.com,miamibeachhealth.org
FL-002530,AHF Healthcare Center- South Beach,AIDS Healthcare Foundation,1386926574,"Other ECP Providers, Ryan White Providers",1613 Alton Rd,,Miami Beach,FL,33139-2420,Miami-Dade,6255 W Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,
FL-002531,Care Resource Community Health Center at Miami Beach,Care Resource,1831438803,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1701 Meridian Ave,Suite 400,Miami Beach,FL,33139-1890,Miami-Dade,3510 Biscayne Blvd.,,Miami,FL,33137,Miami-Dade,Kathleen Calienes,Grants & Data Analysis Manager,305-576-1234,295,kcalienes@careresource.org,Hudes Desrameaux,"Director of Grants, Programs and Pharmacy",305-576-1234,230,hdesrameaux@careresource.org,www.careresource.org
FL-002532,"Miami Beach Community Health Center, Inc",Miami Beach Community Health Center,1063411874,"Dental Providers, Federally Qualified Health Centers - Medical Services",710 Alton Rd,,Miami Beach,FL,33139-5504,Miami-Dade,710 Alton Road,,Miami Beach,FL,33139,Miami,Mark Delvaux,Chief Financial Officer,305-538-8835,1713,mdelvaux@mbchc.com,Sorangely Menjivar,Chief Operating Officer,305-538-8835,1409,sorangelym@mbchc.com,miamibeachhealth.org
FL-002533,Pediatric & Family Health & Wellness Center,"Center for Family and Child Enrichment, Inc.",1891859575,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1825 NW 167th St,,Miami Gardens,FL,33056-4838,Miami-Dade,1825 N.W. 167 Street,Suite 102,Miami Gardens,FL,33056,Miami,T. Delores Dunn,President/CEO,305-624-7450,1794,ddunn@cfceinc.org,Wanda Brantley,Operations Administrator,305-624-1794,1741,wbrantley@cfceinc.org,
FL-002534,"Jessie Trice Community Health Center, Inc.","Jessie Trice Community Health Center, Inc.",1861863458,Federally Qualified Health Centers - Medical Services,3301 Miami Gardens Drive,JTCHC - Health Center at Miami Carol City Senior High School,Miami Gardens,FL,33056,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002535,JTCHC-Miami Gardens Health Center,"Jessie Trice Community Health Center, Inc.",1639518798,Federally Qualified Health Centers - Medical Services,4692 NW 183rd St,,Miami Gardens,FL,33055-3054,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Eleace Sawyers,"VP, Planning & Business Development",305-805-1700,23154,ESawyers@jtchc.org,http://www.jtchc.org
FL-002536,SACRED HEART MEDICAL ONCOLOGY GROUP AT MILTON,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,5992 Berryhill Road,Suite 302,Milton,FL,32570-1017,Santa Rosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002537,MEMORIAL HOSPITAL MIRAMAR,South Broward Hospital District,1326021197,Inpatient Hospitals (other than children's hospitals),1901 SW 172nd Ave,,Miramar,FL,33029-5592,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Judy Sada,Chief Financial Officer,954-538-4812,4807,jsada@mhs.net,Sandra Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002538,ENT - Dr. McWilliams,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,7720 Hwy 98 W,Suite 370,Miramar Beach,FL,32550-7232,Walton,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002539,"Florida Community Health Center, Moore Haven",FLORIDA COMMUNITY HEALTH CENTER INC,1194071944,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",1021 Health Park Dr,,Moore Haven,FL,33471-6206,Glades,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002540,"Central Florida Health Care, Inc., -Mulberry","CENTRAL FLORIDA HEALTH CARE, INC.",1154746899,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",106 NW 9th Ave,,Mulberry,FL,33860-2922,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002541,Myakka Family Healthcare Center,"MCR Health, Inc.",1124056759,Federally Qualified Health Centers - Medical Services,37220 Glenwood Ave,,Myakka City,FL,34251-2310,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002542,Children's Care North,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1265 Creekside Pkwy,Suite 208,Naples,FL,34108-1954,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002543,Family Care North,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1284 Creekside St,Suite 101,Naples,FL,34108-1949,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002544,Naples Health Center,Planned Parenthood of Southwest and Central Florida,1770606477,"Family Planning Providers, Sexually Transmitted Disease Clinics",1425 Creech Rd,,Naples,FL,34103-4207,Collier,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002545,Dental Care East,"Collier Health Services, INC",1609827211,Dental Providers,1749 Heritage Trl # 801,,Naples,FL,34112-7591,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Susan Melican,Director Revenue Cycle,239-658-3134,,smelican@healthcareswfl.org,Thomas Van Pelt,Director Adminsistrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002546,Family Care East,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1755 Heritage Trl,Suite 604,Naples,FL,34112-7600,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002547,Total Women's Care,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,1890 SW Health Pkwy,Suite 203,Naples,FL,34109-0473,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002548,Friendship Health Center,"Collier Health Services, INC",1609827211,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2355 Stanford Ct,Suite 701,Naples,FL,34112-4813,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Tom Van Pelt,,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002549,Women's Care Naples,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,3339 Tamiami Trl E,Suite 146,Naples,FL,34112-5361,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002550,CHILDREN'S CARE CENTRAL,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,3425 10th St N,Suite 1,Naples,FL,34103-3866,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Y Lopez,Director of Clinical Operations,239-658-3002,,smelican@healthcareswfl.org,Thoma Van Pelt,Director of Admistrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002551,Dental Care Central,"COLLIER HEALTH SERVICES, INC.",1609827211,Dental Providers,4077 Tamiami Trl N,Suite D203,Naples,FL,34103-3594,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002552,Children's Care Golden Gate,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,5262 Golden Gate Pkwy,,Naples,FL,34116-7635,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002553,Nichols Pediatric Center,"Collier Health Services, INC",1609827211,Federally Qualified Health Centers - Medical Services,5450 Ymca Rd,,Naples,FL,34109-5944,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Tom Van Pelt,,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002554,Family Care David Lawrence Center,Healthcare Network of Southwest Florida,1609827211,Federally Qualified Health Centers - Medical Services,6075 Bathey Ln,Bldg D1,Naples,FL,34116-7536,Collier,1454 Madison Avenue N.,,Immokalee,FL,34142,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas VanPelt,Director of Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002555,Children's Care East,"COLLIER HEALTH SERVICES, INC.",1609827211,Federally Qualified Health Centers - Medical Services,6350 Davis Blvd,Suite 1001,Naples,FL,34104-5323,Collier,1454 Madison Ave W,,Immokalee,FL,34142-2200,Collier,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002556,Dental Care FSW (V),"COLLIER HEALTH SERVICES, INC.",1609827211,Dental Providers,7507 Grand Lely Dr,,Naples,FL,34113-1753,Collier,1454 Madison Ave,,Immokalee,FL,34142,Clay,Yerania Lopez,Director of Clinical Operations,239-658-3002,,ylopez@healthcareswfl.org,Thomas Van Pelt,Director Administrative Operations,239-658-3027,,tvanpelt@healthcareswfl.org,www.healthcareswfl.org
FL-002557,Volusia County Health Department/New Smyrna Beach,Florida Department of Health/Volusia County Health Department,1831158039,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",717 Canal St,,New Smyrna,FL,32168-6973,Volusia,1845 Holsonback Dr,,Daytona Beach,FL,32117,Volusia,Patricia Boswell,County Health Department Administrator,386-274-0500,0817,Patricia.Boswell@flhealth.gov,Gregory Ballard,Asst. County Health Department Director,386-274-0500,0785,Gregory.Ballard@flhealth.gov,
FL-002558,OB/GYN - Dr. Hood,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4586 Hwy 20,Suite A,Niceville,FL,32578-9724,Okaloosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002559,North Fort Myers Medical Office,LEE MEMORIAL HEALTH SYSTEM,1417342163,Federally Qualified Health Centers - Medical Services,13279 N Cleveland Ave,,North Fort Myers,FL,33903-4818,Lee,2776 Cleveland Ave,,Fort Myers,FL,33901-5855,Lee,Robert Johns,Executive Director,239-834-9998,,robert.johns@leememorial.org,Marlon Tyson,System Director for Business Development and Contracting,239-343-4822,,marlon.tyson@leememorial.org,www.WeCareForLee.org
FL-002560,Florida Department of Health in Lee County,Florida Department of Health,1154392686,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",83 Pondella Rd,Suite 1,North Fort Myers,FL,33903-4411,Lee,83 Pondella Road,,North Fort Myers,FL,33903,Lee,ANGELA SMITH,Administrator,239-461-6150,,ANGELA.SMITH2@FLHEALTH.GOV,DOT SINGLETON,Business Manager,239-461-6136,,DOT.SINGLETON@FLHEALTH.GOV,http://lee.floridahealth.gov/
FL-002561,AHF Healthcare Center - Jackson North,AIDS Healthcare Foundation,1427218874,"Other ECP Providers, Ryan White Providers",100 NW 170th St,Suite 208,North Miami Beach,FL,33169-5510,Miami-Dade,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,
FL-002562,North Port Health Center,Center Place Health,1861715906,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",6950 Outreach Way,,North Port,FL,34287-3405,Sarasota,2200 Ringling Boulevard,,Sarasota,FL,34237,Sarasota,"Linda L. Stone, Ph.D.",CEO,941-861-2954,,linda.stone@flhealth.gov,Patricia Egan,Chief Operating Officer,941-861-2992,,patricia.egan@flhealth.gov,
FL-002563,AHF Healthcare Center - Oakland Park,AIDS Healthcare Foundation,1376886002,"Other ECP Providers, Ryan White Providers",1164 E Oakland Park Blvd Fl 3,,Oakland Park,FL,33334-2707,Broward,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
FL-002564,Heart of Florida Health Center-Southwest,"HEART OF FLORIDA HEALTH CENTER, INC.",1144624750,Federally Qualified Health Centers - Medical Services,100 Marion Oaks Blvd,,Ocala,FL,34473-2209,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002565,Heart of Florida Health Center-Central,"HEART OF FLORIDA HEALTH CENTER, INC.",1710923727,Federally Qualified Health Centers - Medical Services,1025 SW 1st Ave,,Ocala,FL,34471-0900,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002566,FDOH-Marion,FDOH-Marion,1447296389,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1801 SE 32nd Ave,,Ocala,FL,34471-5532,Marion,1801 S.E. 32 Avenue,,Ocala,FL,34471-5532,Marion,DIANIA SPADLMUELLER,DON,352-629-0137,2735,D.SPADLMUELLER@FLHEALTH.GOV,SHERRY DUNCAN,Administrative Services Director,352-629-0137,2626,Sherry.Duncan@flhealth.gov,
FL-002567,Heart of Florida Health Center-East,"HEART OF FLORIDA HEALTH CENTER, INC.",1912301557,Federally Qualified Health Centers - Medical Services,1801 SE 32nd Ave,,Ocala,FL,34471-5532,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002568,Heart of Florida Health Care-Children's Dental,"HEART OF FLORIDA HEALTH CARE, INC.",1710923727,Dental Providers,255 SE 17th St,,Ocala,FL,34471-5138,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002569,Heart of Florida Health Center-West,"HEART OF FLORIDA HEALTH CENTER, INC.",1457755951,Federally Qualified Health Centers - Medical Services,6041 SW 54th St,Suite 100,Ocala,FL,34474-5521,Marion,203 E. Silver Springs Blvd. Ste101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002570,Langley Health Services Ocala,PROJECT HEALTH INC,1942487186,"Dental Providers, Federally Qualified Health Centers - Medical Services",7205 SE Maricamp Rd,,Ocala,FL,34472-2105,Marion,1425 S US 301,,Sumterville,FL,33585-5141,Sumter,Thomas G. Chase,Chief Executive Officer,352-793-5900,2941,tchase@telmedical.com,Vicki Wynns,Chief Operating Officer,352-793-5900,2955,vwynns@telmedical.com,
FL-002571,Health Central Hospital,"Orlando Health Central, Inc.",1033475959,Inpatient Hospitals (other than children's hospitals),10000 W Colonial Dr,,Ocoee,FL,34761-3400,Orange,1414 Kuhl Avenue,,Orlando,FL,32806-2008,Orange,Michael Stubee,"Chief Operating Officer, Managed Care",407-481-7156,,Michael.Stubee@orlandohealth.com,Enisa Baltic,Sr. Managed Care Specialist,407-481-7133,,Enisa.Baltic@orlandohealth.com,
FL-002572,Lakeshore Medical Adults,FLORIDA COMMUNITY HEALTH CENTER INC,1952351306,Federally Qualified Health Centers - Medical Services,1100 N Parrott Ave,,Okeechobee,FL,34972-2129,Okeechobee,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002573,Dr. Fred Brown Children's Health Center,FLORIDA COMMUNITY HEALTH CENTER INC,1831148741,"Dental Providers, Federally Qualified Health Centers - Medical Services",2015 US Highway 441 N,,Okeechobee,FL,34972-1901,Okeechobee,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002574,JTCHC-Opa-Locka Children and Youth Wellness Center,"Jessie Trice Community Health Center, Inc.",1518337880,Federally Qualified Health Centers - Medical Services,490 Opa Locka Blvd,Suite 100,Opa Locka,FL,33054-3563,Miami-Dade,5607 N.W. 27 Avenue,Suite 1,Miami,FL,33142,Miami-Dade,Ana L. Garcia,Managed Care Administrator,305-637-6400,15185,algarcia@jtchc.org,Karen Alteaga,Accreditation Coordinator,305-835-1608,23154,kaarteaga@jtchc.org,http://www.jtchc.org
FL-002575,Volusia County Health Department/Orange City,Florida Department of Health/Volusia County Health Department,1831158039,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",775 Harley Strickland Blvd,Suite 110,Orange City,FL,32763-7963,Volusia,1875 Holsonback Dr.,,Daytona Beach,FL,32117,Volusia,Patricia Boswell,County Health Department Administrator,386-274-0799,0817,Patricia.Boswell@flhealth.gov,Gregory Ballard,Asst. County Health Department Director,386-274-0500,0785,Gregory.Ballard@flhealth.gov,
FL-002576,East Orlando Health Center,Planned Parenthood of Southwest and Central Florida,1053597484,"Family Planning Providers, Sexually Transmitted Disease Clinics",11500 University Blvd,Suite B,Orlando,FL,32817-2197,Orange,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002577,NEMOURS CHILDREN'S HOSPITAL,The Nemours Foundation,1245520386,Children's Hospitals (inpatient only),13535 Nemours Pkwy,,Orlando,FL,32827-7402,Orange,10140 Centurion Parkway N,,Jacksonville,FL,32256,Duval,Barry Brennan,"Senior Director, Managed Care",904-697-5601,,barry.brennan@nemours.org,Angela Strowbridge,Contracting Supervisor,904-697-5272,,angela.strowbridge@nemours.org,www.nemours.org
FL-002578,Orlando Regional Medical Center,Orlando Health,1184709057,Inpatient Hospitals (other than children's hospitals),1414 Kuhl Ave,,Orlando,FL,32806-2008,Orange,1414 Kuhl Avenue,,Orlando,FL,32806-2008,Orange,Michael Stubee,"Chief Operating Officer, Managed Care",407-481-7156,,Michael.Stubee@orlandohealth.com,Enisa Baltic,Sr. Managed Care Specialist,407-481-7133,,Enisa.Baltic@orlandohealth.com,
FL-002579,COMMUNITY HEALTH CENTER - BITHLO FAMILY CARE,"COMMUNITY HEALTH CENTERS, INC.",1033409123,Federally Qualified Health Centers - Medical Services,19108 E Colonial Dr,,Orlando,FL,32820-3701,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002580,FLORIDA HOSPITAL,"Adventist Health System/Sunbelt, Inc.",1306938071,Inpatient Hospitals (other than children's hospitals),601 E Rollins St,,Orlando,FL,32803-1248,Orange,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,VP,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002581,FLORIDA HOSPITAL FOR CHILDREN,"Adventist Health System/Sunbelt, Inc.",1306938071,Children's Hospitals (inpatient only),601 E Rollins St,,Orlando,FL,32803-1248,Orange,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,VP,407-357-1900,,Kevin.Lay@AHSS.org,Meg Heaton,Clinical Healthcare Outcomes Manager,407-303-9972,,meg.heaton@flhosp.org,
FL-002582,COMMUNITY HEALTH CENTER-LAKE ELLENOR PEDIATRIC DENTAL & ADULT EMERGENCY DENTAL CARE,"COMMUNITY HEALTH CENTERS, INC.",1831261445,Dental Providers,6101 Lake Ellenor Dr,Suite 106,Orlando,FL,32809-4616,Orange,110 S WOODLAND ST,,WINTER GARDEN,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002583,Downtown Orlando Health Center,Planned Parenthood of Southwest and Central Florida,1295873248,"Family Planning Providers, Sexually Transmitted Disease Clinics",726 S Tampa Ave,,Orlando,FL,32805-3646,Orange,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002584,"FOREST CITY CHILD, ADULT MEDICAL & DENTAL CARE","Community Health Centers, Inc.",1790874956,"Dental Providers, Federally Qualified Health Centers - Medical Services",7900 Forest City Rd # 7912,,Orlando,FL,32810-3002,Orange,110 S WOODLAND STREET,,Winter Garden,FL,34787,Orange,MARGARET BRENNAN,President/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002585,"COMMUNITY HEALTH CENTER - PINE HILLS FAMILY, PEDIATRIC, OB/GYN & DENTAL CARE","Community Health Centers, Inc.",1366531618,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",840 Mercy Dr,,Orlando,FL,32808-7850,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,President/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002586,COMMUNITY HEALTH CENTER - MEADOW WOODS PEDIATRIC & DENTAL CARE,"COMMUNITY HEALTH CENTERS, INC.",1710259965,"Dental Providers, Federally Qualified Health Centers - Medical Services",849 Greenway Professional Ct,Suite 101,Orlando,FL,32824-9482,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002587,Arnold Palmer Hospital for Children,"Orlando Health, Inc.",1184709057,Children's Hospitals (inpatient only),92 W Miller St,,Orlando,FL,32806-2032,Orange,1414 Kuhl Avenue,,Orlando,FL,32806-2008,Orange,Michael Stubee,"Chief Operating Officer, Managed Care",407-481-7156,,Michael.Stubee@orlandohealth.com,Enisa Baltic,Sr. Managed Care Specialist,407-481-7133,,Enisa.Baltic@orlandohealth.com,
FL-002588,SACRED HEART MEDICAL GROUP-PACE,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,3754 Highway 90,Suite 200,Pace,FL,32571-1098,Santa Rosa,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002589,PAHOKEE COMMUNITY HEALTH CENTER,FLORIDA COMMUNITY HEALTH CENTER INC,1851518211,Federally Qualified Health Centers - Medical Services,170 S Barfield Hwy,Suite 103,Pahokee,FL,33476-1868,Palm Beach,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002590,"ACUTE CARE PEDIATRICS, PA","ACUTE CARE PEDIATRICS, PA",1003866732,Rural Health Clinics,1301 Reid St,,Palatka,FL,32177-3237,Putnam,1301 REID ST PO BOX 797,,PALATKA,FL,32177,Putnam,CHRISTINE TIU,SECRETARY,386-328-5437,,CTMD@YAHOO.COM,ELIZABETH ROSARIO,OFFICE MANAGER,386-328-5437,,lizrosario1975@hotmail.com,
FL-002591,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1871569061,Federally Qualified Health Centers - Medical Services,1302 River St,,Palatka,FL,32177-5042,Putnam,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002592,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1891762613,Dental Providers,2503 President St,,Palatka,FL,32177-5433,Putnam,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002593,"ACUTE CARE PEDIATRICS OF PALM COAST, PA","ACUTE CARE PEDIATRICS OF PALM COAST, PA",1225065717,Rural Health Clinics,397 Palm Coast Pkwy SW Unit 3,,Palm Coast,FL,32137-4777,Flagler,397 SW PALM COAST PKWY,UNIT 3,PALM COAST,FL,32137,Flagler,CHRISTINE TIU,SECRETARY,386-447-7337,,ctmd@yahoo.com,ELIZABETH ROSARIO,OFFICE MANAGER,386-328-5437,,lizrosario1975@hotmail.com,
FL-002594,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1780064808,Federally Qualified Health Centers - Medical Services,460 Palm Coast Pkwy SW,Suite 5,Palm Coast,FL,32137-4786,Flagler,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002595,Florida Hospital Flagler,Adventist Health System/Sunbelt,1679678486,Inpatient Hospitals (other than children's hospitals),60 Memorial Medical Pkwy,,Palm Coast,FL,32164,Flagler,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,386-586-4200,,cory.domayer@ahss.org,,,,,,
FL-002596,Palmetto Family Healthcare Center,"MCR Health, Inc.",1124059753,Federally Qualified Health Centers - Medical Services,404 7th St W,,Palmetto,FL,34221-5209,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002597,North Manatee Family Healthcare Center,"MCR Health, Inc.",1841236247,Federally Qualified Health Centers - Medical Services,5600 Bayshore Rd,,Palmetto,FL,34221-9352,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002598,"COMMUNITY HEALTH SOUTH FLORIDA, INC.","COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",8851 SW 168th St,Dr Henry E. Perrine Academy of the Arts,Palmetto Bay,FL,33157-4549,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,ALLISON MADDEN,ASSISTANT VP OF CARE MANAGEMENT,305-278-6434,,AMADDEN@CHISOUTHFL.ORG,NILDA GONZALEZ,CONTRACT COORDINATOR,305-252-4827,,NGONZALEZ@CHISOUTHFL.ORG,http://www.chisouthfl.org/locations/school-based-services/
FL-002599,Wakulla Medical Center,"North Florida Medical Centers, Inc.",1447254958,Federally Qualified Health Centers - Medical Services,1328 Coastal Hwy,,Panacea,FL,32346-2151,Wakulla,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator / Privacy Officer,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002600,COMMUNITY HEALTH CENTER-BAY CO,PANCARE OF FLORIDA INC,1366456287,Federally Qualified Health Centers - Medical Services,2309 E 15th St,,Panama City,FL,32405-6345,Bay,403 E. 11th Street,,Panama City,FL,32401-3409,Bay,R. MICHAEL HILL,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,KADEY PURVIS,BILLING SPECIALIST,850-747-5599,5,KPURVIS@PANCAREFL.ORG,
FL-002601,PANCARE DENTAL,PANCARE OF FLORIDA INC,1366456287,Dental Providers,403 E 11th St,,Panama City,FL,32401-3409,Bay,403 E. 11th Street,,Panama City,FL,32401-3409,Bay,R. MICHAEL HILL,PRESIDENT/CEO,850-747-5599,,MHILL@PANCAREFL.ORG,KADEY PURVIS,BILLING SPECIALIST,850-747-5599,5,KPURVIS@PANCAREFL.ORG,
FL-002602,Dr. Yauch Clinic,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,120 N Richard Jackson Blvd,,Panama City Beach,FL,32407-2521,Bay,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002603,Edgar H. Price Jr. Children And Family Healthcare Center,"MCR Health, Inc.",1255376000,Federally Qualified Health Centers - Medical Services,12271 US Highway 301 N,,Parrish,FL,34219-8410,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002604,Pembroke Pines Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1548514508,Family Planning Providers,263 N University Dr,,Pembroke Pines,FL,33024-6715,Broward,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002605,MEMORIAL HOSPITAL WEST,South Broward Hospital District,1134102080,Inpatient Hospitals (other than children's hospitals),703 N Flamingo Rd,,Pembroke Pines,FL,33028-1006,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Kevin Corcoran,Chief Financial Officer,954-844-7109,7109,kcorcoran@mhs.net,Sandra Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002606,MEMORIAL HOSPITAL PEMBROKE,South Broward Hospital District,1063495836,Inpatient Hospitals (other than children's hospitals),7800 Sheridan St,,Pembroke Pines,FL,33024-2536,Broward,3501 Johnson Street,Administration,Hollywood,FL,33021,Broward,Patrick Connor,Chief Financial Officer,954-883-8482,8407,pconnor@mhs.net,Sandra Dilts,Vice President of Managed Care,954-265-7732,7732,sdilts@mhs.net,www.mhs.net
FL-002607,SACRED HEART MEDICAL GROUP-PERDIDO,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,13139 Sorrento Rd,,Pensacola,FL,32507-8777,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002608,SACRED HEART MEDICAL ONCOLOGY GROUP - 002,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,1545 Airport Blvd,Suite 2000,Pensacola,FL,32504-8615,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Terri Smith,"VP, Cancer Services",850-416-2770,,tdsmith@shhpens.org,
FL-002609,Airport CT,SACRED HEART HOSPITAL,1922032424,Other ECP Providers,1547 Airport Blvd,,Pensacola,FL,32504-8615,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Amy Wilson,COO/CNO Sacred Heart Hospital Pensacola,850-416-2573,,Amy.Wilson@shhpens.org,
FL-002610,SACRED HEART MEDICAL GROUP - GORTON,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,1549 Airport Blvd,Suite 200D,Pensacola,FL,32504-8634,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002611,SACRED HEART MEDICAL GROUP - RAMOS,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4313 Spanish Trl,,Pensacola,FL,32504-4942,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002612,SHMG Primary Care Davis HWY,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4501 N Davis Hwy,Suite A,Pensacola,FL,32503-2724,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002613,Pain Management - Davis Hwy.,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4521 N Davis Hwy,,Pensacola,FL,32503-2770,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002614,Orthopedics,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4541 N Davis Hwy,Suite A,Pensacola,FL,32503-2733,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002615,Orthopedics Hand Center,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4551 N Davis Hwy,Suite A,Pensacola,FL,32503-2782,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002616,SACRED HEART MEDICAL GROUP - MOBILE HWY.,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,4929 Mobile Hwy,,Pensacola,FL,32506-3229,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002617,Ann Baroco Center,SACRED HEART HOSPITAL,1922032424,Other ECP Providers,5147 N Ninth Ave,Suite G03,Pensacola,FL,32504-8732,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Amy Wilson,COO/CNO Sacred Heart Hospital Pensacola,850-416-2573,,Amy.Wilson@shhpens.org,
FL-002618,SACRED HEART MEDICAL GROUP - GUTIERREZ,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,5149 N 9th Ave,Suite 256,Pensacola,FL,32504-8755,Escambia,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, Sacred Heart Medical Group",850-475-4736,,jlabrato@shhpens.org,
FL-002619,Sacred Heart Hospital (inpatient hospital),SACRED HEART HEALTH SYSTEM,1922032424,Inpatient Hospitals (other than children's hospitals),5151 N 9th Ave,,Pensacola,FL,32504-8795,Escambia,5151 N 9th Ave,,Pensacola,FL,32504-8721,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Henry Stovall,"President, Sacred Heart Hospital",850-416-7681,,Henry.Stovall@shhpens.org,
FL-002620,Sacred Heart Hospital (multiple outpatient ECP categories),SACRED HEART HEALTH SYSTEM,1922032424,"Dental Providers, Other ECP Providers, Rural Health Clinics, Ryan White Providers",5151 N 9th Ave,,Pensacola,FL,32504-8795,Escambia,5151 N 9th Ave,,Pensacola,FL,32504-8721,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Henry Stovall,"President, Sacred Heart Hospital",850-416-7681,,Henry.Stovall@shhpens.org,
FL-002621,WEST PERRINE HEALTH CENTER,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",18255 Homestead Ave,,Perrine,FL,33157-5564,Miami-Dade,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Coordination,305-278-6434,6434,amadden@chisouthfl.org,
FL-002622,Premier Medical Pediatric Clinic,Premier Medical Pediatric Clinic,1831342880,Rural Health Clinics,315 E Ash St,,Perry,FL,32347-2029,Taylor,315 E Ash Street,,Perry,FL,32347,Taylor,Victoria Marbas,Clinic Administrator,850-584-3278,,vickym1275@fairpoint.net,,,,,,
FL-002623,DOCTORS' MEMORIAL HOSPITAL INC (inpatient hospital),"DOCTORS' MEMORIAL HOSPITAL, INC.",1427092006,Inpatient Hospitals (other than children's hospitals),333 N Byron Butler Pkwy,,Perry,FL,32347-2300,Taylor,333 N. BYRON BUTLER PKWY,,PERRY,FL,32347,Taylor,Mary Lescher,Interim CEO,850-584-0800,643,mlescher@doctorsmemorial.com,,,,,,https://www.tmh.org/doctors-memorial-hospital
FL-002624,DOCTORS' MEMORIAL HOSPITAL INC (rural health clinics),"DOCTORS' MEMORIAL HOSPITAL, INC.",1427092006,Rural Health Clinics,333 N Byron Butler Pkwy,,Perry,FL,32347-2300,Taylor,333 N. BYRON BUTLER PKWY,,PERRY,FL,32347,Taylor,Mary Lescher,Interim CEO,850-584-0800,643,mlescher@doctorsmemorial.com,,,,,,https://www.tmh.org/doctors-memorial-hospital
FL-002625,Taylor Medical/Dental Center,"North Florida Medical Centers, Inc.",1255526638,"Dental Providers, Federally Qualified Health Centers - Medical Services",616 S Jefferson St,,Perry,FL,32347-4115,Taylor,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002626,Community Health Centers at Pinellas Park,"Community Health Centers of Pinellas, Inc.",1811975535,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7550 43rd St N,,Pinellas Park,FL,33781-3601,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joe Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002627,SCHC Pediatrics,"Suncoast Community Health Centers, Inc",1770511024,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",502 N Mobley St,,Plant City,FL,33563-2904,Hillsborough,13110 Elk Mountain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002628,Plant City Family Care,"Suncoast Community Health Centers, Inc",1003176322,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",508 N Maryland Ave,,Plant City,FL,33563-3820,Hillsborough,13110 Elk Mountain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002629,Broward Community & Family Dental,"Broward Community & Family Health Centers, Inc",1639550056,"Dental Providers, Federally Qualified Health Centers - Medical Services",162 N Powerline Rd,,Pompano Beach,FL,33069-2514,Broward,6015 Washington Street,,Hollywood,FL,33023,Broward,Brenda colon,Director of Managed Care,954-266-2999,242,Bcolon@bcfhc.org,Felicia Hart,Chief Operating Officer,954-266-2999,,fhart@bcfhc.org,Www.bcfhc.org
FL-002630,"Broward Community & Family Health Centers, Inc.","Broward Community & Family Health Centers, Inc.",1467635482,Federally Qualified Health Centers - Medical Services,168 N Powerline Rd,,Pompano Beach,FL,33069-5713,Broward,6015 Washington Street,,Hollywood,FL,33023,Broward,Brenda colon,Director of Managed Care,954-266-2999,242,Bcolon@bcfhc.org,Felicia Hart,Chief Operating Officer,954-266-2999,,fhart@bcfhc.org,Www.bcfhc.org
FL-002631,Annie L. Weaver Health Center,"North Broward Hospital District, dba Broward Health",1497773055,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2011 NW 3rd Ave,,Pompano Beach,FL,33060-4800,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A. DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,www.browardhealth.org
FL-002632,Pompano Pediatrics and Prenatal Care Center,"North Broward Hospital District, dba Broward Health",1255376067,Federally Qualified Health Centers - Medical Services,601 W Atlantic Blvd # 2,,Pompano Beach,FL,33060-5916,Broward,1800 NW 49th St.,,Fort Lauderdale,FL,33309,Broward,Scott A DiMarzo,Director,954-355-4953,,sdimarzo@browardhealth.org,Jasmin Shirley,Vice President Community Health Services,954-355-5903,,jshirley@browardhealth.org,www.browardhealth.org
FL-002633,Port Charlotte Family Practice Medical Office,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,Federally Qualified Health Centers - Medical Services,4300 Kings Hwy,Suite 210,Port Charlotte,FL,33980-2922,Charlotte,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Frank Mazzeo,President / CEO,239-278-3600,,fmazzeo@hcnetwork.org,,,,,,
FL-002634,Port Charlotte Pediatric & Dental Office,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",4300 Kings Hwy,Suite 500,Port Charlotte,FL,33980-2953,Charlotte,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,239-278-3600,2338,bwalker@hcnetwork.org,
FL-002635,PORT ST. LUCIE CHILDRENS HC,FLORIDA COMMUNITY HEALTH CENTER INC,1215986872,Federally Qualified Health Centers - Medical Services,1701 SE Hillmoor Dr,Suite D19,Port Saint Lucie,FL,34952-7541,Saint Lucie,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002636,St. Lucie Women & Children Center,FLORIDA COMMUNITY HEALTH CENTER INC,1811947245,Federally Qualified Health Centers - Medical Services,1871 SE Tiffany Ave,Suite 200,Port Saint Lucie,FL,34952-7585,Saint Lucie,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,Michael F Gervasi,Chief Executive Officer,561-844-9443,335,mgervasi@fchcinc.org,Kathy Amato,Chief Financial Officer,561-844-9443,311,kamato@fchcinc.org,www.fchcinc.org
FL-002637,St. Lucie County Health Department,Florida Department of Health,1649329236,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",5150 NW Milner Dr,,Port Saint Lucie,FL,34983-3392,Saint Lucie,5150 NW Milner Drive,,Port Saint Lucie,FL,34983-3392,Saint Lucie,Robbie Fiore,Family Planning Coordinator,850-245-4465,,Robbie.Fiore@flhealth.gov,Angela Roberson,Community Nursing Director,772-462-3800,3945,Angela.Roberson@flhealth.gov,www.floridahealth.gov
FL-002638,Sacred Heart Hospital on the Gulf,Sacred Heart Hospital on the Gulf,1083941678,Inpatient Hospitals (other than children's hospitals),3801 E Highway 98,,Port St Joe,FL,32456-5318,Gulf,3801 E. Hwy 98,,Port St. Joe,FL,32456,Gulf,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Roger Hall,"President, Sacred Heart Hospital on the Gulf",850-229-5601,,rhall@shhpens.org,
FL-002639,Florida Community Health Center- Darwin Square,FLORIDA COMMUNITY HEALTH CENTER INC,1346619244,Federally Qualified Health Centers - Medical Services,3235 SW Port St Lucie Blvd,,Port St Lucie,FL,34953-3405,Saint Lucie,5827 Corporate Way,,West Palm Beach,FL,33407,Palm Beach,"Michael F. Gervasi, DO",CEO,561-844-9443,1000,mgervasi@fchcinc.org,,,,,,
FL-002640,Jessie Furlow Medical Center,"North Florida Medical Centers, Inc.",1356345862,Federally Qualified Health Centers - Medical Services,1249 Strong Rd,,Quincy,FL,32351-5248,Gadsden,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002641,Gadsden County Health Department,FDOH-Gadsden,1346446895,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",278 Lasalle Lefall Dr,,Quincy,FL,32351-5324,Gadsden,278 LaSalle Leffall Dr,,Quincy,FL,32351,Gadsden,Jana Barfield,Nursing Consultant,850-875-7200,319,jana.barfield@flhealth.gov,Adrian Cooksey,Admininstrator,850-875-7200,398,Adrian.Cooksey2@flhealth.gov,
FL-002642,Heart of Florida Health Center-Reddick,"HEART OF FLORIDA HEALTH CENTER, INC.",1235533845,Federally Qualified Health Centers - Medical Services,4500 NW 152nd Ln,,Reddick,FL,32686-3200,Marion,203 E. Silver Springs Blvd. Ste 101,,Ocala,FL,34470-5813,Marion,Richard Mutarelli,Chief Executive Officer,352-732-6599,204,Richard.Mutarelli@myhfhc.org,Sherri Lewis,Chief Operating Officer,352-732-6599,209,Sherri.Lewis@myhfhc.org,www.myhfhc.org
FL-002643,Ruskin Health Center,"Suncoast Community Health Centers, Inc",1891925061,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2814 14th Ave SE,,Ruskin,FL,33570-5471,Hillsborough,13110 Elk Mountain,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002644,AHF Healthcare Center- Tampa,AIDS Healthcare Foundation,1194035675,"Other ECP Providers, Ryan White Providers",3135 State Road 580,Suite 1,Safety Harbor,FL,34695-4917,Pinellas,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,
FL-002645,PINE ISLAND MEDICAL AND DENTAL OFFICE,"FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",1326090390,"Dental Providers, Federally Qualified Health Centers - Medical Services",8359 Stringfellow Rd,,Saint James City,FL,33956-2910,Lee,2256 Heitman St,,Fort Myers,FL,33901-3744,Lee,Melinda Black,Supervisor of Administrative Services,239-931-3873,,mblack@hcnetwork.org,Barbara Walker,Director of Credentialing,,2338,bwalker@hcnetwork.org,
FL-002646,"Metropolitan Charities, Inc.","Metropolitan Charities, Inc.",1013277060,"Community Mental Health Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",3251 3rd Ave N,,Saint Petersburg,FL,33713-8506,Pinellas,3251 3rd Ave North,,Saint Petersburg,FL,33713,Pinellas,Jacob Hamm,Credentialing Agent,727-800-2332,,jacob.hamm@pmcbh.com,,,,,,www.metrotampabay.org
FL-002647,St. Petersburg Health Center,Planned Parenthood of Southwest and Central Florida,1679846364,"Family Planning Providers, Sexually Transmitted Disease Clinics",33 6th St S,Suite 110,Saint Petersburg,FL,33701-4163,Pinellas,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002648,"ALL CHILDREN'S HOSPITAL, INC (children's inpatient hospital)","All Children's Hospital, Inc",1063877181,Children's Hospitals (inpatient only),501 6th Ave S,,Saint Petersburg,FL,33701-4634,Pinellas,501 6th Ave S,,Saint Petersburg,FL,33701-4631,Pinellas,Jayne Behlau,Managed Care Director,727-767-8490,,jbehlau1@jhmi.edu,,,,,,
FL-002649,"ALL CHILDREN'S HOSPITAL, INC (hemophilia treatment centers)","All Children's Hospital, Inc",1063877181,Hemophilia Treatment Centers,501 6th Ave S,,Saint Petersburg,FL,33701-4634,Pinellas,501 6th Ave S,,Saint Petersburg,FL,33701-4631,Pinellas,Jayne Behlau,Managed Care Director,727-767-8490,,jbehlau1@jhmi.edu,,,,,,
FL-002650,Pediatrics - Destin,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,23 Mack Bayou Loop,Suite 200,Santa Rosa Beach,FL,32459-2606,Walton,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Justin Labrato,"VP, SHMG",850-475-4736,,jlabrato@shhpens.org,
FL-002651,SACRED HEART MEDICAL ONCOLOGY GROUP AT DESTIN,SACRED HEART HEALTH SYSTEM,1922032424,Other ECP Providers,27 Mack Bayou Loop,Suite 1000,Santa Rosa Beach,FL,32459-2613,Walton,5151 N 9th Ave,,Pensacola,FL,32504,Escambia,Becky McQueen,"Director, Managed Care",850-416-7024,,Rebecca.McQueen@shhpens.org,Terri Smith,"VP, Cancer Services",850-416-2770,,tdsmith@shhpens.org,
FL-002652,Sally and Sam Shapiro Babies and Children's Medical Center,Center Place Health,1861715906,"Dental Providers, Federally Qualified Health Centers - Medical Services",1750 17th St,,Sarasota,FL,34234-8632,Sarasota,1750 17th St,,Sarasota,FL,34234,Sarasota,"Linda L. Stone, Ph.D.",CEO,941-861-2954,,linda.stone@flhealth.gov,Patricia Egan,Chief Operating Officer,941-861-2992,,patricia.egan@flhealth.gov,
FL-002653,North Sarasota Walk-in,"MCR Health, Inc.",1982929709,Federally Qualified Health Centers - Medical Services,1945 Northgate Blvd,,Sarasota,FL,34234-2143,Sarasota,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002654,North County Healthcare Center,"MCR Health, Inc.",1215963335,Federally Qualified Health Centers - Medical Services,1949 Northgate Blvd,,Sarasota,FL,34234-2143,Sarasota,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002655,North Tuttle Pediatrics,"MCR Health, Inc.",1396105300,Federally Qualified Health Centers - Medical Services,220 N Tuttle Ave,,Sarasota,FL,34237-5229,Sarasota,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002656,William L. Little Health and Human Services Center,Center Place Health,1861715906,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2200 Ringling Blvd,,Sarasota,FL,34237-6102,Sarasota,2200 Ringling Boulevard,,Sarasota,FL,34237,Sarasota,"Linda L. Stone, Ph.D.",CEO,941-861-2954,,linda.stone@flhealth.gov,Patricia Egan,Chief Operating Officer,941-861-2992,,patricia.egan@flhealth.gov,Sarasotahealth.org
FL-012478,AMA Health,"MCR Health, Inc.",1801376306,Federally Qualified Health Centers - Medical Services,2415 University Pkwy,Suite 111 Bldg 3,Sarasota,FL,34243-2809,Manatee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-012479,SOUTH MANATEE PEDIATRICS,"MCR Health, Inc.",1386157584,Federally Qualified Health Centers - Medical Services,6326 15th St E,,Sarasota,FL,34243-3201,Manatee,700 8th Avenue,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002657,Sarasota Health Center,Planned Parenthood of Southwest and Central Florida,1710264411,"Family Planning Providers, Sexually Transmitted Disease Clinics",736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002658,"TREASURE COAST COMMUNITY HEALTH, INC.","TREASURE COAST COMMUNITY HEALTH, INC.",1194274720,Federally Qualified Health Centers - Medical Services,13507 US Highway 1,,Sebastian,FL,32958-3759,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Christine Hyde,Credentialing Manager,772-257-8224,339,chyde@tcchinc.org,Vicki Soule,Chief Executive officer,772-571-1986,,vsoule@tcchinc.org,http://www.tcchinc.org
FL-002659,Sebring Pediatrics LLC,Sebring Pediatrics LLC,1255492096,Rural Health Clinics,3201 Medical Way,Suite 101,Sebring,FL,33870-5412,Highlands,3201 Medical Way,Suite 101,Sebring,FL,33870,Highlands,Dennis Valentin,Practice Administrator,863-382-0566,,cfmvalentin@gmail.com,,,,,,
FL-002660,Florida Hospital Heartland Medical Center,Adventist Health System/Sunbelt Inc.,1083692594,Inpatient Hospitals (other than children's hospitals),4200 Sun N Lake Blvd,,Sebring,FL,33872-1986,Highlands,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002661,Forest Family Health,Marion Rural Health Inc.,1033160684,Rural Health Clinics,15932 E Highway 40,,Silver Springs,FL,34488-5144,Marion,15932 E. HWY 40,,Silver Springs,FL,34488,Marion,Teresa Spogen,Administrator,352-625-7777,307,tspogen59@gmail.com,Tina Northrup,Office Manager,352-625-7777,307,northt111@gmail.com,www.forestfamilyhealth.com
FL-002662,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1629324751,Federally Qualified Health Centers - Medical Services,105 Whitehall Dr,Suite 109,St Augustine,FL,32086-5269,Saint Johns,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002663,St. Johns County Health Department,Florida Department of Health St. Johns County,1154392686,"Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 San Sebastian Vw,Suite 1100,St Augustine,FL,32084-8695,Saint Johns,4042 Bald Cypress Way,,Tallahassee,FL,32399,Leon,Christie Mathews,Medical Case Manager,904-209-3250,1068,Christie.Mathews@flhealth.gov,Comelia Brown,Community Health Nurse,904-209-3250,1017,Comelia.Brown@flhealth.gov,www.floridahealth.gov/chdStJohns
FL-002664,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1821533175,Dental Providers,250 State Road 207,,St Augustine,FL,32084-0997,Saint Johns,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002665,Johnnie Ruth Clarke Health Center,"Community Health Center of Pinellas, Inc",1902884620,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1344 22nd St S,,St Petersburg,FL,33712-2744,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002666,Johns Hopkins All Children's Hospital (children's inpatient hospital),"Johns Hopkins All Children's Hospital, Inc.",1427114099,Children's Hospitals (inpatient only),501 6th Ave S,,St Petersburg,FL,33701-4634,Pinellas,501 Sixth Street South,,St. Petersburg,FL,33701,Pinellas,Jayne C Behlau,"Director, Managed Care",727-767-8490,,jbehlau1@jhmi.edu,Christopher Whitby,Chief Financial Officer,727-767-4703,,cwhitby3@jhmi.edu,hopkinsallchildrens.org
FL-002667,Johns Hopkins All Children's Hospital (hemophilia treatment centers),"Johns Hopkins All Children's Hospital, Inc.",1427114099,Hemophilia Treatment Centers,501 6th Ave S,,St Petersburg,FL,33701-4634,Pinellas,501 Sixth Street South,,St. Petersburg,FL,33701,Pinellas,Jayne C Behlau,"Director, Managed Care",727-767-8490,,jbehlau1@jhmi.edu,,,,,,hopkinsallchildrens.org
FL-002668,Community Health Centers at St. Petersburg,"Community Health Centers of Pinellas, Inc.",1437550084,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",612 Dr Martin Luther King Jr St N,,St Petersburg,FL,33705-1403,Pinellas,PO Box 10549,,St Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002669,Community Health Centers at Bayfront,"Community Health Centers of Pinellas, Inc.",1396094017,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",701 6th St S,,St Petersburg,FL,33701-4814,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002670,Palms Medical Group - Starke,TRENTON MEDICAL CENTER,1801826268,Federally Qualified Health Centers - Medical Services,550 Georgia St,,Starke,FL,32091-1816,Bradford,911 S Main St,,Trenton,FL,32693-3239,Gilchrist,Anita Riels,CEO,352-463-4501,,ariels@palmsmg.org,,,,,,
FL-002671,Martin County Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1679827448,Family Planning Providers,1322 NW Federal Hwy,,Stuart,FL,34994-1004,Martin,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002672,Florida Community Health Center - Stuart,FLORIDA COMMUNITY HEALTH CENTER INC,1659621654,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3441 SE Willoughby Blvd,,Stuart,FL,34994-5060,Martin,4450 S Tiffany Dr,,West Palm Beach,FL,33407-3241,Palm Beach,"Wilhelmina Lewis, M.D.",President and CEO,561-844-9443,335,wlewis@fchcinc.org,"Michael F Gervasi, M.D.",Practicing Physician,561-844-9443,335,mgervasi@fchcinc.org,www.fchcinc.org
FL-002673,Langley Health Services,PROJECT HEALTH INC,1437180239,"Dental Providers, Federally Qualified Health Centers - Medical Services",1389 S US 301,,Sumterville,FL,33585-5143,Sumter,1425 S US 301,,Sumterville,FL,33585-5141,Sumter,Thomas G. Chase,Chief Executive Officer,352-793-5900,2941,tchase@telmedical.com,Vicki Wynns,Chief Operating Officer,352-793-5900,2955,vwynns@telmedical.com,
FL-002674,Robert & Stevens Clinic,FDOH-Leon,1568428837,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1515 Old Bainbridge Rd,,Tallahassee,FL,32303-5340,Leon,2965 Municipal Way,,Tallahassee,FL,32304,Leon,RoseAnn Scheck,Program Administrator,850-606-8065,,RoseAnn.Scheck@flhealth.gov,,,,,,http://leon.floridahealth.gov/locations/roberts-stevens.html
FL-002675,Bond Specialty & Community Wellness Center,"Bond Community Health Center, Inc.",1407109812,Federally Qualified Health Centers - Medical Services,1549 S Monroe St,,Tallahassee,FL,32301-4312,Leon,1720 South Gadsden Street,,Tallahassee,FL,32301-5506,Leon,Temple Robinson MD,Chief Executive Officer,850-576-4073,207,trobinson@bondchc.com,Marshun Deane,Chief Operating Officer,850-576-4073,248,mdeane@bondchc.com,http://www.bondchc.com/
FL-002676,Bond Community Health Center Inc.,"BOND COMMUNITY HEALTH CENTER, INC.",1396718409,"Dental Providers, Federally Qualified Health Centers - Medical Services",1720 S Gadsden St,,Tallahassee,FL,32301-5506,Leon,1720 S Gadsden St,,Tallahassee,FL,32301-5506,Leon,Temple Robinson MD,Chief Executive Officer,850-576-4073,207,trobinson@bondchc.com,Marshun Deane,Chief Operating Officer,850-576-4073,248,mdeane@bondchc.com,http://www.bondchc.com/
FL-002677,Neighborhood Medical Center Smith Williams Center,NEIGHBORHOOD MEDICAL CENTER INC.,1487869467,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",2295 Pasco St,,Tallahassee,FL,32310-0908,Leon,438 W Brevard St,,Tallahassee,FL,32301-1004,Leon,Nellie Graham,Human resources,850-577-0045,,ngraham@neighborhoodmedicalcenter.org,jeanne Freeman,Interm CEO,850-284-5183,,jfreeman@neighborhoodmedicalcenter.org,
FL-002678,The Sally Bellamy Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1417349184,Family Planning Providers,2618 W Tennessee St,,Tallahassee,FL,32304-2512,Leon,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,www.ppsenfl.org
FL-002679,KAY FREEMAN HEALTH CENTER,"BOND COMMUNITY HEALTH CENTER, INC.",1639309842,"Dental Providers, Federally Qualified Health Centers - Medical Services",2729-8 Municipal Way,,Tallahassee,FL,32304-3805,Leon,1720 SOUTH GADSDEN,,Tallahassee,FL,32301,Leon,DEIRDRE VICKERS,Billing Specialist,850-576-4073,301,dvickers@bondchc.com,John Grayson,CFO,850-576-4073,273,jgrayson@bondchc.com,http://www.bondchc.com/services/the-kay-freeman-center
FL-002680,Neighborhood Medical Center,Neighborhood Medical Center,1487869467,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",438 W Brevard St,,Tallahassee,FL,32301-1004,Leon,438 West Brevard Street,,Tallahassee,FL,32301,Leon,Nellie Graham,Human Resources,850-577-0045,,ngraham@neighborhoodmedicalcenter.org,Jeanne Freeman,Interm CEO,850-284-5183,,jfreeman@neighborhoodmedicalcenter.org,
FL-002681,Neighborhood Medical Center,Neighborhood Medical Center,1487869467,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",872 W Orange Ave,,Tallahassee,FL,32310-6123,Leon,438 west brevard street,,Tallahassee,FL,32301,Leon,Nellie Graham,human resources,850-577-0045,,ngraham@neighborhoodmedicalcenter.org,jeanne freeman,Interm CEO,850-284-5183,,jfreeman@neighborhoodmedicalcenter.org,
FL-002682,Tampa General Hospital,Tampa General Hospital,1235196510,Inpatient Hospitals (other than children's hospitals),1 Tampa General Cir,,Tampa,FL,33606-3571,Hillsborough,P.O.Box 1289,,Tampa,FL,33601-1289,Hillsborough,Tammy Uhl,"Director, Managed Care",813-844-4801,,tuhl@tgh.org,,,,,,
FL-002683,SHC - Tampa,Shriners Hospitals for Children,1376748160,Children's Hospitals (inpatient only),12502 USF Pine Dr,,Tampa,FL,33612-9411,Hillsborough,12502 USF Pine Dr.,,Tampa,FL,33612,Hillsborough,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
FL-002684,University of South Florida Hemophilia Treatment Center,University of South Florida,1033214325,Hemophilia Treatment Centers,13330 USF Laurel Dr,,Tampa,FL,33612-6601,Hillsborough,13220 USF Laurel Drive,,Tampa,FL,33612,Hillsborough,Tony Brown,Medical Social Worker/Program Planner,813-974-3725,,abrown134@health.usf.edu,Ruhksana Azam,Clinical Coordinator,813-974-7074,,razam@health.usf.edu,http://health.usf.edu/medicine/internalmedicine/hematology
FL-002685,University Avenue Health Center,Tampa Family Health Centers,1578857140,Federally Qualified Health Centers - Medical Services,13601 N 22nd St,,Tampa,FL,33613-4427,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Edward Kucher,Chief Operating Officer,813-866-0930,1311,EKucher@HCNetwork.org,Joseph G. Giacomo,Chief Financial Officer,813-866-0930,1316,JGGiacomo@HCNetwork.org,http://www.tampachc.com/
FL-002686,North Tampa Health Center,Tampa Family Health Centers,1417953571,"Dental Providers, Federally Qualified Health Centers - Medical Services",1502 E Fowler Ave,,Tampa,FL,33612-5416,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002687,West Tampa Health Center,Tampa Family Health Centers Inc,1104866870,Federally Qualified Health Centers - Medical Services,2103 N Rome Ave,,Tampa,FL,33607-3509,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Edward Kucher,Chief Operating Officer,813-866-0930,1311,EKucher@HCNetwork.org,Joseph G. Giacomo,Chief Financial Officer,813-866-0930,1316,JGGiacomo@HCNetwork.org,http://www.tampachc.com/
FL-002688,North Tampa Health Center - Planned Parenthood,Planned Parenthood of Southwest and Central Florida,1053597484,"Family Planning Providers, Sexually Transmitted Disease Clinics",236 E Bearss Ave,,Tampa,FL,33613-1625,Hillsborough,736 Central Ave.,,Sarasota,FL,34236,Sarasota,Stephanie Fraim,President & CEO,941-365-3913,,stephanie.fraim@ppswcf.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002689,St. Joseph's Hospitals (children's inpatient hospital),BayCare,1881632818,Children's Hospitals (inpatient only),3001 W Dr Martin Luther King Jr Blvd,,Tampa,FL,33607-6307,Hillsborough,2985 Drew Street,,Clearwater,FL,33759,Pinellas,Keri Eisenbeis,Director of Government Relations,727-519-1884,,keri.eisenbeis@baycare.org,Kimberly Guy,President,813-872-2951,,kimberly.guy@baycare.org,
FL-002690,St. Joseph's Hospitals (multiple outpatient ECP categories),BayCare,1881632818,"Hemophilia Treatment Centers, Ryan White Providers",3001 W Dr Martin Luther King Jr Blvd,,Tampa,FL,33607-6307,Hillsborough,2985 Drew Street,,Clearwater,FL,33759,Pinellas,Keri Eisenbeis,Director of Government Relations,727-519-1884,,keri.eisenbeis@baycare.org,Kimberly Guy,President,813-872-2951,,kimberly.guy@baycare.org,
FL-002691,Fletcher Avenue Health Center,Tampa Family Health Centers,1447544010,"Dental Providers, Federally Qualified Health Centers - Medical Services",302 W Fletcher Ave,,Tampa,FL,33612-3415,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002692,Florida Hospital Health Center,Tampa Family Health Centers,1952779050,Federally Qualified Health Centers - Medical Services,3100 E Fletcher Ave,,Tampa,FL,33613-4613,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Edward Kucher,Chief Operating Officer,813-866-0930,1311,EKucher@HCNetwork.org,Joseph G. Giacomo,Chief Financial Officer,813-866-0930,1316,JGGiacomo@HCNetwork.org,http://www.tampachc.com/
FL-002693,Florida Hospital Tampa,Adventist Health System/Sunbelt Inc.,1538403753,Inpatient Hospitals (other than children's hospitals),3100 E Fletcher Ave,,Tampa,FL,33613-4613,Hillsborough,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002694,Westshore Health Center,Tampa Family Health Centers,1356347413,"Dental Providers, Federally Qualified Health Centers - Medical Services",3901 S West Shore Blvd,,Tampa,FL,33611-1003,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002695,DACCO,Tampa Family Health Centers,1104056209,Federally Qualified Health Centers - Medical Services,4422 E Columbus Dr,,Tampa,FL,33605-3233,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Edward Kucher,Chief Operating Officer,813-866-0930,1311,EKucher@HCNetwork.org,Joseph G. Giacomo,Chief Financial Officer,813-866-0930,1316,JGGiacomo@HCNetwork.org,http://www.tampachc.com/
FL-002696,Osborne Health Center,Tampa Family Health Centers,1316942840,"Dental Providers, Federally Qualified Health Centers - Medical Services",4620 N 22nd St,,Tampa,FL,33610-6205,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com
FL-002697,Charles Bottoms Health Center,Tampa Family Health Centers,1811281488,"Dental Providers, Federally Qualified Health Centers - Medical Services",5611 Sheldon Rd,,Tampa,FL,33615-3532,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002698,Gracepoint Health Center,Tampa Family Health Centers,1417325515,Federally Qualified Health Centers - Medical Services,5707 N 22nd St,,Tampa,FL,33610-4350,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Edward Kucher,Chief Operating Officer,813-866-0930,1311,EKucher@HCNetwork.org,Joseph G. Giacomo,Chief Financial Officer,813-866-0930,1316,JGGiacomo@HCNetwork.org,http://www.tampachc.com/
FL-002699,Sligh Health Center,Tampa Family Health Centers,1851562367,"Dental Providers, Federally Qualified Health Centers - Medical Services",6216 E Sligh Ave,,Tampa,FL,33617-9105,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002700,Florida Hospital Carrollwood,Florida Hospital Carrollwood,1427068345,Inpatient Hospitals (other than children's hospitals),7171 N Dale Mabry Hwy,,Tampa,FL,33614-2665,Hillsborough,7171 N Dale Mabry Hwy,,Tampa,FL,33614,Hillsborough,Kevin Lay,FH Division Vice President Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002701,Causeway Health Center,Tampa Family Health Center,1255675682,"Dental Providers, Federally Qualified Health Centers - Medical Services",7608 Causeway Blvd,,Tampa,FL,33619-5912,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002702,Palm River Community Health Center,"Suncoast Community Health Centers, Inc",1205859592,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7728 Palm River Rd,,Tampa,FL,33619-4215,Hillsborough,13110 Elk Mountain Drive,,Riverview,FL,33579,Hillsborough,Robert Rodriguez,"CPA, Chief Financial Officer",813-349-7563,7563,rrodriguez@suncoast-chc.org,Sonia Goodwin,Chief Operations Officer,813-653-6264,6264,sgoodwin@suncoast-chc.org,www.suncoast-chc.org
FL-002703,Dale Mabry Health Center,Tampa Family Health Centers,1164754701,"Dental Providers, Federally Qualified Health Centers - Medical Services",7814 N Dale Mabry Hwy,,Tampa,FL,33614-3220,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002704,Tampa Health Center,Planned Parenthood of Southwest and Central Florida,1760755458,"Family Planning Providers, Sexually Transmitted Disease Clinics",8068 N 56th St,,Tampa,FL,33617-7620,Hillsborough,736 Central Ave,,Sarasota,FL,34236-4042,Sarasota,Stephanie Fraim,President and CEO,941-365-3913,1106,stephanie.fraim@myplannedparenthood.org,Sara Parrott,Revenue Cycle Manager,941-365-3913,1119,sara.parrott@ppswcf.org,www.ppswcf.org
FL-002705,North Nebraska Health Center,Tampa Family Health Centers,1649548017,"Dental Providers, Federally Qualified Health Centers - Medical Services",8108 N Nebraska Ave,,Tampa,FL,33604-3103,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002706,West Waters Health Center,Tampa Family Health Centers,1396891016,Federally Qualified Health Centers - Medical Services,8213 W Waters Ave,,Tampa,FL,33615-1822,Hillsborough,PO Box 82969,,Tampa,FL,33682,Hillsborough,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,Courtney Leech,Director of Performance Outcomes,813-866-0930,1368,cgleech@hcnetwork.org,http://www.tampachc.com/
FL-002707,Florida Hospital North Pinellas,Florida Hospital North Pinellas,1568473015,Inpatient Hospitals (other than children's hospitals),1395 S Pinellas Ave,,Tarpon Springs,FL,34689-3790,Pinellas,1395 S Pinellas Ave,,Tarpon Springs,FL,34689,Pinellas,Kevin Lay,Florida Hospital Division Vice President Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002708,Community Health Centers at Tarpon Springs,"Community Health Centers of Pinellas, Inc",1346228061,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",247 S Huey Ave,,Tarpon Springs,FL,34689-4205,Pinellas,PO Box 10549,,St. Petersburg,FL,33733-0549,Pinellas,Lorraine Travis,Billing Manager,727-824-8126,,lftravis@hcnetwork.org,Joseph Santini,Director of Business Development,727-824-8129,,jsantini@hcnetwork.org,
FL-002709,"Florida Hospital Waterman, Inc.",Adventist Health System,1821019571,Inpatient Hospitals (other than children's hospitals),1000 Waterman Way,,Tavares,FL,32778-5266,Lake,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002710,Community Health Centers-Tavares Family Medical and Dental,"COMMUNITY HEALTH CENTERS, INC.",1801284906,"Dental Providers, Federally Qualified Health Centers - Medical Services",212 E Main St,,Tavares,FL,32778-3808,Lake,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,Margaret Brennan,PRESIDENT/CEO,407-905-8827,,m.brennan@chcfl.org,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002711,MONROE County Health Department - TAVERNIER,Florida Department of Health,1639148919,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",50 High Point Rd,Suite 104,Tavernier,FL,33070-2022,Monroe,50 High Point Rd,,Tavernier,FL,33070-2022,Monroe,Kathy Rogers,Business Manager,205-293-7500,5615,kathy.rogers@flhealth.gov,,,,,,
FL-002712,Tavernier Health Center,"COMMUNITY HEALTH SOUTH FLORIDA, INC.",1336152347,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",91200 Overseas Hwy,,Tavernier,FL,33070-2500,Monroe,10300 SW 216th St,,Cutler Bay,FL,33190-1003,Miami-Dade,Nilda Gonzalez,Contract Coordinator,305-252-4827,4827,ngonzalez@chisouthfl.org,Allison Madden,AVP Care Management,305-278-6434,6434,amadden@chisouthfl.org,
FL-002713,New Port Richey Family Health Center,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1881836195,Federally Qualified Health Centers - Medical Services,2114 Seven Springs Blvd,,Trinity,FL,34655-3908,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph D Resnick,CEO,352-518-2000,,jresnick@hcnetwork.org,,,,,,
FL-002714,LOUIS J RADNOTHY DO PA,LOUIS J RADNOTHY DO PA DBA UMATILLA FAMILY PRACTICE,1578639209,Rural Health Clinics,390 S Central Ave,,Umatilla,FL,32784-9602,Lake,390 S CENTRAL AVE,,UMATILLA,FL,32487-9602,Lake,DHARTI BISHT,OFFICE ADMINISTRATOR,352-669-3175,,DHARTIBISHT@GMAIL.COM,,,,,,
FL-012480,VENICE PEDIATRICS,"MCR Health, Inc.",1083246359,Federally Qualified Health Centers - Medical Services,119 Shamrock Blvd,,Venice,FL,34293-1630,Sarasota,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002715,"TREASURE COAST COMMUNITY HEALTH, INC. South County","TREASURE COAST COMMUNITY HEALTH, INC.",1891740916,"Dental Providers, Federally Qualified Health Centers - Medical Services",1545 9th St SW,,Vero Beach,FL,32962-4312,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Vicki L Soule,Chief Executive Officer,772-571-1986,,vsoule@tcchinc.org,Christine Hyde,Credentialing Manager,772-257-8224,1908,chyde@tcchinc.org,www.tcchinc.org
FL-002716,"TREASURE COAST COMMUNITY HEALTH, INC. Central Vero Beach","TREASURE COAST COMMUNITY HEALTH, INC.",1891740916,Federally Qualified Health Centers - Medical Services,1553 US Highway 1,,Vero Beach,FL,32960-5735,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Vicki L Soule,Chief Executive Officer,772-571-1986,,vsoule@tcchinc.org,Christine Hyde,Credentialing Manager,772-257-8224,339,chyde@tcchinc.org,www.tcchinc.org
FL-002717,"TREASURE COAST COMMUNITY HEALTH, INC.","TREASURE COAST COMMUNITY HEALTH, INC.",1205385838,Dental Providers,1955 21st Ave,,Vero Beach,FL,32960-3091,Indian River,2182 Ponce de Leon Circle,,Vero Beach,FL,32960-5338,Indian River,Christine Hyde,Credentialing Manager,772-257-8224,1908,chyde@tcchinc.org,Vicki Soule,Chief Executive officer,772-571-1986,,vsoule@tcchinc.org,http://www.tcchinc.org
FL-002718,"Whole Family Health Center, Inc.","Whole Family Health Center, Inc.",1578612883,Ryan White Providers,981 37th Pl,,Vero Beach,FL,32960-6541,Indian River,725 North US Highway 1,,Fort Pierce,FL,34950,Saint Lucie,Lorri Chambers,Credentialing Specialist,772-468-9900,226,lchambers@wfhcfl.org,,,,,,
FL-002719,Sonni's Pediatrics PA,Sonni's Pediatrics PA,1760776900,Rural Health Clinics,1125 S 6th Ave,,Wauchula,FL,33873-3350,Hardee,1125 South 6th Ave,,Wauchula,FL,33873,Hardee,Dennis Valentin,Practice Administrator,863-382-0566,,cfmvalentin@gmail.com,,,,,,
FL-002720,"Central Florida Health Care, Inc., -Hardee","CENTRAL FLORIDA HEALTH CARE, INC.",1790116911,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",121 K D Revell Rd,,Wauchula,FL,33873-2051,Hardee,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002721,"Central Florida Health Care, Inc., -Wauchula","CENTRAL FLORIDA HEALTH CARE, INC.",1750378956,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",204 E Palmetto St,,Wauchula,FL,33873-2732,Hardee,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-012481,AMA Health,"MCR Health, Inc.",1417437872,Federally Qualified Health Centers - Medical Services,508 S 6th Ave,,Wauchula,FL,33873-3211,Hardee,700 8th Avenue West,Suite 101,Palmetto,FL,34221,Manatee,Linda Snyder,"Vice President, Government Affairs & Policy",941-304-7975,,lsnyder@mcr.health,Jeffery McNeal,Vice President of Business Development,941-201-8831,,jmcneal@mcr.health,https://mcr.health/
FL-002722,Florida Hospital Wauchula,Adventist Health System/Sunbelt Inc.,1457458986,Inpatient Hospitals (other than children's hospitals),533 Carlton St,,Wauchula,FL,33873-3407,Hardee,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
FL-002723,WEIRSDALE FAMILY HEALTH CENTER INC,WEIRSDALE FAMILY HEALTH CENTER INC,1669548392,Rural Health Clinics,16400 S Highway 25,,Weirsdale,FL,32195-2442,Marion,16400 S HWY 25,,WEIRSDALE,FL,32195-2442,Marion,DHARTI BISHT,OFFICE ADMINISTRATOR,516-305-9805,,DHARTIBISHT@GMAIL.COM,,,,,,
FL-002724,Azalea Health,"Rural Health Care, Inc. d/b/a Azalea Health",1164621744,Federally Qualified Health Centers - Medical Services,405 Elm St,,Welaka,FL,32193-2125,Putnam,P.O. Drawer 817,,PALATKA,FL,32178-0817,Putnam,Laura M Spencer,President & CEO,386-326-7340,,LSpencer@azahealth.org,Jim Reid,Vice President & CFO,386-326-7341,,JReid@azahealth.org,www.azahealth.org
FL-002725,Wellington Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1578817342,Family Planning Providers,10111 Forest Hill Blvd,Room 340,Wellington,FL,33414-6142,Palm Beach,2300 N florida mango rd,,West palm beach,FL,33409,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002726,C. L. Brumback Primary Care Clinic - Lewis Center,Health Care District of Palm Beach County,1427442136,Federally Qualified Health Centers - Medical Services,1000 45th St,,West Palm Beach,FL,33407-2416,Palm Beach,902 Clint Moore Rd.,Suite 138,Boca Raton,FL,33487,Palm Beach,"Christopher F. Irizarry, MPA",Vice President and Executive Director of Clinic Services,561-642-1005,1005,cirizarr@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002727,C. L. Brumback Primary Care Clinic - Jerome Golden Center,Health Care District of Palm Beach County,1376934521,Federally Qualified Health Centers - Medical Services,1041 45th St,,West Palm Beach,FL,33407-2402,Palm Beach,902 Clint Moore Rd.,Suite 138,Boca Raton,FL,33487,Palm Beach,"Christopher F. Irizarry, MPA",Vice President and Executive Director of Clinic Services,561-642-1005,1005,cirizarr@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002728,C. L. Brumback Primary Care Clinic - West Palm Beach,Health Care District of Palm Beach County,1679810469,"Dental Providers, Federally Qualified Health Centers - Medical Services",1150 45th St,,West Palm Beach,FL,33407-2361,Palm Beach,1515 North Flager Drive Suite 101,Suite 138,West Palm Beach,FL,33401,Palm Beach,Damaris Lopez,Director Practice Operations,561-804-5772,1005,bandric@hcdpbc.org,"Marcia Young, MHA, BA",Director of Operations,561-642-1015,1015,mayoung@hcdpbc.org,clbrumbackprimarycareclinics.org
FL-002729,Foundcare Inc.,FOUNDCARE INC.,1215182712,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2330 S Congress Ave,,West Palm Beach,FL,33406-7608,Palm Beach,2330 S Congress Ave,,West Palm Beach,FL,33406-7608,Palm Beach,Yolette Bonnet,Chief Executive Officer,561-432-7900,,ybonnet@foundcare.org,Rik Pavlescak,Chief Operating Officer,561-432-7902,,rikp@foundcare.org,www.foundcare.org
FL-002730,West Palm Beach Health Center,"Planned Parenthood of South, East and North Florida, Inc.",1285898445,Family Planning Providers,931 Village Blvd,Suite 904,West Palm Beach,FL,33409-1939,Palm Beach,2300 N Florida Mango Rd,,West Palm Beach,FL,33409-6416,Palm Beach,Compliance Officer,Compliance Officer,561-472-9975,,public_affairs@ppsenfl.org,Administrative Assistant to COO,Admin Asst,561-472-9975,,public_affairs@ppsenfl.org,
FL-002731,"West Park Community Health Centers, Inc.","Broward Community & Family Health Centers, Inc.",1437473980,Federally Qualified Health Centers - Medical Services,5801 Hallandale Beach Blvd,,West Park,FL,33023-5243,Broward,6015 Washington Street,,Hollywood,FL,33023,Broward,Brenda colon,Director of Managed Care,954-266-2999,242,Bcolon@bcfhc.org,Felicia Hart,Cheif Operation Officer,954-266-2999,,fhart@bcfhc.org,Www.bcfhc.org
FL-002732,Wewahitchka Medical Center,"North Florida Medical Centers, Inc.",1598769192,Federally Qualified Health Centers - Medical Services,255 W River Rd,,Wewahitchka,FL,32465-4533,Gulf,2804 Remington Green Circle,Suite 2,Tallahassee,FL,32308,Leon,Matthew R. Mayo,Grants & Compliance Coordinator,850-298-6009,,mmayo@nfmc.org,Lane Lunn,CEO in waiting,850-298-6007,,llunn@nfmc.org,https://www.nfmc.org/
FL-002733,"Nature Coast Medical Group, P.A.","Nature Coast Medical Group, P.A.",1275683682,Rural Health Clinics,130 SW 7th St,,Williston,FL,32696-2404,Levy,130 SW 7th Street,,Williston,FL,32696,Levy,"Donald L. McCoy, D.O.","President, NCMG",352-528-5801,,ncmg@atlantic.net,Julie Thornton,Office Manager,352-528-5801,,ncmg@atlantic.net,
FL-002734,Williston Rural Health and Wellness,C&S Holding Company LLC,1952712713,Rural Health Clinics,300A NW 1st Ave,,Williston,FL,32696-2006,Levy,1300 SW 42nd St,,Ocala,FL,34471,Marion,Frederick C. Spogen III,Administrator,352-573-0666,,fspogen@aol.com,,,,,,
FL-002735,Palms Medical Group,"Trenton Medical Center, Inc.",1255577631,Federally Qualified Health Centers - Medical Services,630 N Main St,,Williston,FL,32696-1705,Levy,23343 NW CR 236,,High Springs,FL,32643-9669,Alachua,Candace Naughton,Credentialing/Administration,386-454-0698,3021,cnaughton@palmsmg.org,,,,,,
FL-002736,Community Health Centers-Winter Garden Family and Dental Care,"COMMUNITY HEALTH CENTERS, INC.",1790851640,"Dental Providers, Federally Qualified Health Centers - Medical Services",13275 W Colonial Dr,,Winter Garden,FL,34787-3984,Orange,110 S Woodland St,,Winter Garden,FL,34787-3546,Orange,MARGARET BRENNAN,PRESIDENT/CEO,407-905-8827,,M.BRENNAN@CHCFL.ORG,MARK DICKINSON,EXEC VP/CFO,407-905-8827,,M.DICKINSON@CHCFL.ORG,WWW.CHCFL.ORG
FL-002737,"Central Florida Health Care, Inc., -Winter Haven","CENTRAL FLORIDA HEALTH CARE, INC.",1467752998,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1514 1st St N,,Winter Haven,FL,33881-2476,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5110,,aclaussen@cfhconline.org,
FL-002738,"Central Florida Health Care, Inc., -Magnolia","CENTRAL FLORIDA HEALTH CARE, INC.",1134586043,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",201 Magnolia Ave SW,,Winter Haven,FL,33880-2943,Polk,47 NW 5th St,,Winter Haven,FL,33881,Polk,Jennifer Birge,Patient Account Representative,863-268-7850,4301,jbirge@cfhconline.org,Ann Claussen,CEO,863-291-5115,,aclaussen@cfhconline.org,
FL-002739,ZEPHYRHILLS FAMILY HEALTH CENTER,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1225000318,Federally Qualified Health Centers - Medical Services,37920 Medical Arts Ct,,Zephyrhills,FL,33541-4323,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph D Resnick,CEO,352-518-2000,,jresnick@hcnetwork.org,,,,,,
FL-002740,Women's Health Center,"PREMIER COMMUNITY HEALTHCARE GROUP, INC.",1366882573,Federally Qualified Health Centers - Medical Services,38030 Daughtery Rd,,Zephyrhills,FL,33540-1375,Pasco,37912 Church Ave,,Dade City,FL,33525-4207,Pasco,Joseph D Resnick,CEO,352-518-2000,,jresnick@hcnetwork.org,,,,,,
FL-002741,Florida Hospital Zephyrhills,Adventist Health Systems/Sunbelt,1346354677,Inpatient Hospitals (other than children's hospitals),7050 Gall Blvd,,Zephyrhills,FL,33541-1347,Pasco,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Kevin Lay,FH Division VP Managed Care,407-357-1900,,Kevin.Lay@AHSS.org,,,,,,
GA-002742,South Albany Medical Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1023043692,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1300 Newton Rd,,Albany,GA,31701-3424,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelly Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Tony Gray,Operations Manager,229-431-3120,,,
GA-002743,West Albany Dental and Medical Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1578795894,Dental Providers,1412 W Oakridge Dr,,Albany,GA,31707-5307,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Steven Ramsey,Operations Manager,229-435-2424,,,
GA-002744,"Albany Area Primary Health Care, Inc.","Albany Area Primary Health Care, Inc.",1003287731,Federally Qualified Health Centers - Medical Services,1425 W Oakridge Dr,Alice Coachman Elementary School-Based Health Center,Albany,GA,31707-5306,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002745,"Albany Area Primary Health Care, Inc.","Albany Area Primary Health Center, Inc.",1902277635,Dental Providers,1700 Cordell Ave,Albany Middle School-Based Health Center,Albany,GA,31705-1497,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002746,Albany Area Laboratory,"ALBANY AREA PRIMARY HEALTH CARE, INC",1568784056,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1711 E Broad Ave,,Albany,GA,31705-2311,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002747,AAPHC Behavioral Wellness Center,"Albany Area Primary Health Care, Inc.",1164888491,Federally Qualified Health Centers - Medical Services,1712 E Broad Ave,Suite B,Albany,GA,31705-2611,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002748,East Albany Medical Center,"Albany Area Primary Health Care, Inc.",1780608992,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1712 E Broad Ave,Suite A,Albany,GA,31705-2611,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,David Morris,Operations Manager,229-639-3100,,,
GA-002749,East Albany Pediatric & Adolescent Center,"Albany Area Primary Health Care, Inc.",1346265550,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1712 E Broad Ave,Suite C,Albany,GA,31705-2611,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,David Morris,Operations Manager,229-639-3103,,,
GA-002750,"Albany Area Primary Health Care, Inc.","ALBANY AREA PRIMARY HEALTH CARE, INC",1487999124,"Dental Providers, Federally Qualified Health Centers - Medical Services",2001 Leonard Ave,Turner Elementary School-Based Health Center,Albany,GA,31705-2341,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Clifton Bush,COO,229-435-9934,,,
GA-002751,"Albany Area Primary Health Care, Inc","Albany Area Primary Health Care, Inc.",1174558746,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,,Shelley.Spires@aaphc.org,,,,,,https://aaphc.org
GA-002752,Rural HIV Model,"Albany Area Primary Health Care, Inc.",1841225315,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2202 E Oglethorpe Blvd,,Albany,GA,31705-2940,Dougherty,204 N Westover Blvd.,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-431-1423,,Shelley.Spires@aaphc.org,Jocelyn Cooper,Opeartions Manager,229-431-1423,,,
GA-002753,AAPHC Glover Dental Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1841543402,Dental Providers,2607 Gillionville Rd,,Albany,GA,31707-3003,Dougherty,204 N Westover Blvd,,Albany,GA,31707,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Lateefah Lowe,Operations Manager,229-883-9001,,,
GA-002754,Mirian Worthy Women's Health Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1134366834,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",401 S Madison St,,Albany,GA,31701-3111,Dougherty,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Clifton Bush,Operations Manager,229-888-3636,,,
GA-002755,"McKinney Community Health Center in Alma, Bacon County, Georgia","MCKINNEY COMMUNITY HEALTH CENTER, INC.",1134454911,Dental Providers,501 N Pierce St,,Alma,GA,31510-2445,Bacon,218 Quarterman St,,Waycross,GA,31501-3547,Ware,Ola A Smith,CEO,912-287-0301,108,bwilson@mckinneyhealth.com,Stephanie Gill,A/R Billing Supervisor,912-287-9140,126,sgill@mckinneyhealth.com,http://www.mckinneymedicalcenter.com/
GA-002756,Americus Urgent Care,"SOUTHWEST GEORGIA HEALTH CARE, INC",1134362916,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",101 Mayo St,Suite B,Americus,GA,31709-3696,Sumter,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002757,Americus OBGYN,"SOUTHWEST GEORGIA HEALTH CARE, INC",1447669668,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",205 Rees St,,Americus,GA,31709-3756,Sumter,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002758,Southwest Pediatrics,"SOUTHWEST GEORGIA HEALTH CARE, INC",1497921167,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",609 E Lamar St,,Americus,GA,31709-3737,Sumter,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002759,Sumter Convenient Care,"SOUTHWEST GEORGIA HEALTH CARE, INC",1225228307,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",618 E Lamar St,,Americus,GA,31709-3738,Sumter,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002760,Athens Neighborhood Health Center - West,ATHENS NEIGHBORHOOD HEALTH CENTER,1457725152,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3320 Old Jefferson Rd,Bldg 300,Athens,GA,30607-1400,Clarke,3320 Old Jefferson Road,Building 300,Athens,GA,30607,Clarke,Harold Weber,Navigator and Outreach Coordinator,706-255-4292,,hweber@aneighbor.org,Cshanyse Allen,Chief Operating Officer,706-850-9041,102,callen@aneighbor.org,athensneighborhoodhealth.org
GA-002761,Athens Neighborhood Health Center - East,ATHENS NEIGHBORHOOD HEALTH CENTER,1275751448,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",402 McKinley Dr,,Athens,GA,30601-3261,Clarke,3320 Old Jefferson Road,Building 300,Athens,GA,30607,Clarke,Harold Weber,Navigator and Outreach Coordinator,706-255-4292,,hweber@aneighbor.org,Cshanyse Allen,Chief Operation Officer,706-850-9041,102,callen@aneighbor.org,athensneighborhoodhealth.org
GA-002762,Athens Neighborhood Health Center - Central,ATHENS NEIGHBORHOOD HEALTH CENTER,1093932683,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",675 College Ave,,Athens,GA,30601-2635,Clarke,3320 Old Jefferson Road,Building 300,Athens,GA,30607,Clarke,Harold Weber,Navigator and Outreach Coordinator,706-255-4292,,hweber@aneighbor.org,Cshanyse Allen,Chief Operating Officer,706-850-9041,102,callen@aneighbor.org,athensneighborhoodhealth.org
GA-002763,Comprehensive Intervention Clinic,Empowerment Resource Center,1235469875,Sexually Transmitted Disease Clinics,100 Edgewood Ave NE,Suite 1020,Atlanta,GA,30303-3065,Fulton,100 Edgewood Avenue,Suite 1020,Atlanta,GA,30303,Fulton,Jacqueline Brown,Executive Director,404-526-1145,101,jbrown@erc-inc.org,Karla Porch,Office Adminstrator,404-526-1145,100,kporch@erc-inc.org,www.erc-inc.org
GA-002764,CHILDRENS HEALTHCARE OF ATLANTA AT SCOTTISH RITE,CHILDRENS HEALTHCARE OF ATLANTA AT SCOTTISH RITE,1922178789,Children's Hospitals (inpatient only),1001 Johnson Ferry Rd,,Atlanta,GA,30342-1605,Fulton,1001 Johnson Ferry Rd,,Atlanta,GA,30342-1605,Fulton,Tom Brems,VP Corporate Finance,404-785-7944,,tom.brems@choa.org,,,,,,
GA-002765,"Southside Medical Center, Inc.","SOUTHSIDE MEDICAL CENTER, INC.",1235123993,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,Dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002766,SOUTHSIDE MEDICAL CENTER - East Point Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1174641658,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1100 Cleveland Ave,,Atlanta,GA,30344-3602,Fulton,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002767,Mercy Care at City of Refuge,SAINT JOSEPHS MERCY CARE SVCS,1689921306,"Dental Providers, Federally Qualified Health Centers - Medical Services",1300 Joseph E Boone Blvd NW,,Atlanta,GA,30314-2032,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002768,CHILDREN'S HEALTHCARE OF ATLANTA AT EGLESTON,CHILDREN'S HEALTHCARE OF ATLANTA AT EGLESTON,1689744450,Children's Hospitals (inpatient only),1405 Clifton Rd NE,,Atlanta,GA,30322-1060,DeKalb,1405 Clifton Rd NE,,Atlanta,GA,30322-1060,DeKalb,Tom Brems,VP Corporate Finance,404-785-7944,4047857944,tom.brems@choa.org,,,,,,
GA-002769,"Meridian Education Resource Group, Inc.","MERIDIAN EDUCATION RESOURCE GROUP, INC.",1730305004,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1550 Hosea L Williams Dr NE,King Middle School Clinic,Atlanta,GA,30317-1902,DeKalb,1353 George W Brumley Way SE,,Atlanta,GA,30317-1743,DeKalb,Yvette J Hagins,CEO / Executive Director,404-523-2500,,yhagins@whitefoord.org,Michael Bekele,CFO,404-523-2500,,mbekele@whitefoord.org,www.whitefoord.org
GA-002770,AID Atlanta-Midtown,"AID Atlanta, Inc",1144646340,Ryan White Providers,1605 Peachtree St NE,,Atlanta,GA,30309-2433,Fulton,1605 Peachtree St NE,,Atlanta,GA,30309-2433,Fulton,Nicole Roebuck,Acting Executive Director,404-870-7720,,nicole.roebuck@aidatlanta.org,Alexis Howell,Executive Assistant,404-870-7711,,alexis.howell@aidatlanta.org,www.aidatlanta.org
GA-002771,Mercy Care at Mary Hall Freedom House,SAINT JOSEPHS MERCY CARE SVCS,1003058967,Federally Qualified Health Centers - Medical Services,200 Hannover Park Rd,,Atlanta,GA,30350-1899,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002772,SOUTHSIDE MEDICAL CENTER - Gresham Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1831217488,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2578 Gresham Rd SE,,Atlanta,GA,30316-4138,DeKalb,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,DeKalb,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002773,HEALing Community Center,Health Education Assessment and Leadership,1831476399,"Dental Providers, Federally Qualified Health Centers - Medical Services",2600 Martin Luther King Jr Dr SW,Suite 100,Atlanta,GA,30311-1636,Fulton,2600 Martin Luther King Jr. Dr. SW,,Atlanta,GA,30311,Fulton,karen williams,CEO,678-704-4336,,kwilliams@healingourcommunities.org,,,,,,
GA-002774,Mercy Care at Gateway Center,SAINT JOSEPHS MERCY CARE SVCS,1821239708,Federally Qualified Health Centers - Medical Services,275 Pryor St SW,,Atlanta,GA,30303-3638,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002775,Whitefoord Family Medical Center,"MERIDIAN EDUCATION RESOURCE GROUP, INC.",1730305004,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",30 Warren St SE,,Atlanta,GA,30317-2267,DeKalb,1353 George W Brumley Way SE,,Atlanta,GA,30317-1743,DeKalb,Yvette J Hagins,CEO / Executive Director,404-523-2500,,yhagins@whitefoord.org,Michael Bekele,CFO,404-523-2500,,mbekele@whitefoord.org,www.whitefoord.org
GA-002776,Mercy Care North,"Mercy Care, Inc.",1588663421,"Dental Providers, Federally Qualified Health Centers - Medical Services",3367 Buford Hwy NE,Suite 910,Atlanta,GA,30329-1833,DeKalb,424 Decatur St.,,Atlanta,GA,30312,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002777,Ponce De Leon Center,Grady Memorial Hospital Corporation,1992799050,Ryan White Providers,341 Ponce de Leon Ave NE,,Atlanta,GA,30308-2012,Fulton,80 Jesse Hill Jr Dr SE,Box 26019,Atlanta,GA,30303,Fulton,Melinda St George,Director Managed Care,404-616-6695,,mstgeorge@gmh.edu,Melissa Beaupierre,Policy and Contract Manager,404-616-6230,,mbeaupierre@gmh.edu,
GA-002778,WHITEFOORD ELEM SCHL HLTH CLINIC,"MERIDIAN EDUCATION RESOURCE GROUP, INC.",1730305004,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",35 Whitefoord Ave SE,,Atlanta,GA,30317-1727,DeKalb,1353 George W Brumley Way SE,,Atlanta,GA,30317-1743,DeKalb,Yvette J Hagins,CEO/Executive Director,404-523-2500,,yhagins@whitefoord.org,Michael Bekele,CFO,404-523-2500,,mbekele@whitefoord.org,www.whitefoord.org
GA-002779,Mercy Care at the Imperial,SAINT JOSEPHS MERCY CARE SVCS,1689090896,Federally Qualified Health Centers - Medical Services,355 Peachtree St NE,,Atlanta,GA,30308-3256,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002780,The Family Health Center at Adamsville Regional Health,"The Family Health Centers of Georgia, Inc.",1760741102,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3700 Martin Luther King Jr Dr SW,,Atlanta,GA,30331-3674,Fulton,"868 York Avenue, S.W.",,Atlanta,GA,30310,Fulton,Dr. Michael W. Brooks,President and CEO,404-756-8732,,mwbrooksmd@mindspring.com,Linda G. Abbott,Vice President of Operations/HR,404-756-6866,,lgabbott@mindspring.com,www.fhcga.org
GA-002781,Mercy Care at St. Luke's,SAINT JOSEPHS MERCY CARE SVCS,1598906448,Federally Qualified Health Centers - Medical Services,420 Courtland St NE,,Atlanta,GA,30308-3405,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002782,Planned Parenthood East Atlanta Health Center,"Planned Parenthood Southeast, Inc.",1609829282,Family Planning Providers,440 Moreland Ave SE,,Atlanta,GA,30316-1926,DeKalb,"241 Peachtree Street NE, Suite 400",,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,Staci Fox,CEO,404-688-9300,,staci.fox@ppse.org,www.ppse.org
GA-002783,Emory Comprehensive Bleeding Disorders Clinic,Emory Healthcare,1144203563,Hemophilia Treatment Centers,5565 Peachtree Dunwoody Rd,1st Floor,Atlanta,GA,30342,Fulton,2015 Uppergate Drive,Suite 426F,Atlanta,GA,30322,DeKalb,Pamela Bryant,Associate Director,404-727-3706,,pamela.bryant@emory.edu,Nicole Buford,"Senior Manager, Contract & Provider Services",404-778-1961,,nicole.buford@emoryhealthcare.org,http://www.emoryhealthcare.org/connecting/contact-us.html
GA-002784,Mercy Care at Atlanta Day Shelter,SAINT JOSEPHS MERCY CARE SVCS,1477794360,Federally Qualified Health Centers - Medical Services,655 Ethel St NW,,Atlanta,GA,30318-5410,Fulton,424 Decatur St SE,,Atlanta,GA,30312-1848,Fulton,Alan Bradford,VP Operations,678-843-8646,,abradford@mercyatlanta.org,Erica Stokes,VP Finance,678-843-8530,,estokes@mercyatlanta.org,
GA-002785,AHF Healthcare Center - Midtown Atlanta,AIDS Healthcare Foundation,1356729164,"Other ECP Providers, Ryan White Providers",735 Piedmont Ave NE,,Atlanta,GA,30308-1416,Fulton,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,
GA-002786,Grady Memorial Hospital (inpatient hospital),Grady Memorial Hospital Corporation,1992799050,Inpatient Hospitals (other than children's hospitals),80 Jesse Hill Jr Dr SE,,Atlanta,GA,30303-3031,Fulton,80 Jesse Hill Jr Dr SE,Box 26019,Atlanta,GA,30303,Fulton,Melinda St George,Director Managed Care,404-616-6695,,mstgeorge@gmh.edu,Melissa Beaupierre,Policy and Contract Manager,404-616-6230,,mbeaupierre@gmh.edu,
GA-002787,Grady Memorial Hospital (multiple outpatient ECP categories),Grady Memorial Hospital Corporation,1992799050,"Community Mental Health Centers, Family Planning Providers",80 Jesse Hill Jr Dr SE,,Atlanta,GA,30303-3031,Fulton,80 Jesse Hill Jr Dr SE,Box 26019,Atlanta,GA,30303,Fulton,Melinda St George,Director Managed Care,404-616-6695,,mstgeorge@gmh.edu,Melissa Beaupierre,Policy and Contract Manager,404-616-6230,,mbeaupierre@gmh.edu,
GA-002788,"The Family Health Centers of Georgia, at West End",The Family Health Centers of Georgia Inc,1720080989,Federally Qualified Health Centers - Medical Services,868 York Ave SW,,Atlanta,GA,30310-2750,Fulton,868 York Ave,,Atlanta,GA,30310,Fulton,MICHAEL BROOKS MD,CEO,404-756-8732,,mwbrooksmd@mindspring.com,Linda,Director of Operation,404-756-8732,,lgabbott@fhcga.org,www.fhcga.org
GA-002790,Augusta University Medical Center Adult Hemophilia Clinic,Hemophilia of Georgia,1265541403,Hemophilia Treatment Centers,1120 15th St,Suite 2015,Augusta,GA,30912-0004,Richmond,"8800 Roswell Rd, Suite 170",,Atlanta,GA,30350,Fulton,Joetta Smith,"RN, MSN",706-721-3626,15,joesmith@gru.edu,Afshin Ameri,MD,706-721-3626,11,aameri@gru.edu,http://www.hog.org/
GA-002791,Augusta University Ryan White Program,Augusta University,1437135902,"Rural Health Clinics, Ryan White Providers",1120 15th St,,Augusta,GA,30912-0004,Richmond,1120 15th Street,,Augusta,GA,30912,Richmond,Karen Denny,Ryan White Program Manager,706-721-9512,,kdenny@augusta.edu,Peter Rissing,Ryan White Program Director,706-721-2236,,,
GA-002792,Christ Community Health Services Augusta: Laney Walker,"CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.",1174716989,"Dental Providers, Federally Qualified Health Centers - Medical Services",1226 Dantignac St,,Augusta,GA,30901-2788,Richmond,PO Box 2344,,Augusta,GA,30903-2344,Richmond,Patti Davis,Billing Manager,706-922-0607,,billing@christcommunityaugusta.org,Jeff Drake,Executive Director,706-922-3017,,,
GA-002793,Christ Community Health Services Augusta: Olde Town,"CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.",1174716989,"Dental Providers, Federally Qualified Health Centers - Medical Services",127 Telfair St,,Augusta,GA,30901-2590,Richmond,1226 Dantignac St,,Augusta,GA,30901-2788,Richmond,Patti Davis,Billing Manager,706-922-0607,,billing@christcommunityaugusta.org,Jeff Drake,Executive Director,706-922-3017,,,
GA-002794,Medical Associates Plus,"Neighborhood Improvement Project, Inc.",1700900867,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2467 Golden Camp Rd,,Augusta,GA,30906-5515,Richmond,2467 Golden Camp Rd,,Augusta,GA,30906-5515,Richmond,J.R. Richards,CEO,706-790-4440,105,jrrichards@mapbt.com,Wesley Wood,CFO,706-790-4440,100,wwood@mapbt.com,www.mapbt.com
GA-002795,PCSG - Bainbridge,"PRIMARY CARE OF SOUTHWEST GEORGIA, INC.",1821471277,Federally Qualified Health Centers - Medical Services,509 Wheat Ave,,Bainbridge,GA,39819-4321,Decatur,360 College St,,Blakely,GA,39823-2554,Early,Ann Addison,CEO,229-723-2660,,aaddison@pcswga.org,Edwin James,CFO,229-723-2660,7131,ejames@pcswga.org,www.pcswga.org
GA-002796,YourTown Health,"PALMETTO HEALTH COUNCIL, INC",1164682662,Federally Qualified Health Centers - Medical Services,101 Commerce Pl,Suite 1,Barnesville,GA,30204-1680,Lamar,643 Main St,,Palmetto,GA,30268-1138,Fulton,"Jon W. Wollenzien, Jr.",CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
GA-002797,"East Georgia HealthCare Center, Inc.","EAST GEORGIA HEALTHCARE CENTER, INC.",1801239389,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1636 Hatch Pkwy S,,Baxley,GA,31513-4376,Appling,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Bea Payne,Office Coordinator,912-557-3300,,bpayne@eghc.org,www.eghc.org
GA-002798,Pioneer Family Medical of Early,"Pioneer Health Services of Early County, LLC",1720393895,Rural Health Clinics,11045 Columbia St,,Blakely,GA,39823-3447,Early,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
GA-002799,Pioneer Community Hospital of Early,"Pioneer Health Services, INC",1104131267,Inpatient Hospitals (other than children's hospitals),11740 Columbia St,,Blakely,GA,39823-2574,Early,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Lauren Williams,Director of Strategic Alignment & Network Development,601-849-6440,385,laurenwilliams@phscorporate.com,
GA-002800,"PRIMARY CARE OF SW GEORGIA, INC.","PRIMARY CARE OF SOUTHWEST GEORGIA, INC.",1780607754,Federally Qualified Health Centers - Medical Services,360 College St,,Blakely,GA,39823-2554,Early,360 College St,,Blakely,GA,39823-2554,Early,"Ann Addison, PhD",CFO,229-723-2660,,aaddison@pcswga.org,Edwin James,CFO,229-723-2660,7131,ejames@pcswga.org,www.pcswga.org
GA-002801,Blue Ridge Health Center,"Georgia Mountains Health Services, Inc",1538123666,Federally Qualified Health Centers - Medical Services,165 Blue Ridge Overlook,,Blue Ridge,GA,30513-4431,Fannin,165 Blue Ridge Overlook,,Blue Ridge,GA,30513-4431,Fannin,Steven Miracle,CEO,706-946-5610,,smiracle@gamtnhealth.org,Lisa Allen,Office Manager,706-946-4647,,,
GA-002802,Georgia Mountains Health-Dental Services,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1467428250,Dental Providers,990 E Main St,,Blue Ridge,GA,30513-4565,Fannin,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Joan Patterson,Office Manager,706-258-3384,,,
GA-002803,"The Medical Clinics of Georgia, LLC","The Medical Clinics of Georgia, LLC",1619943255,Rural Health Clinics,425 W College St,,Bowdon,GA,30108-1311,Carroll,425 West College Street,,Bowdon,GA,30108,Carroll,"JAMES K. BAILEY, MD",Medical Doctor,770-378-3798,,jkeithbailey@aol.com,,,,,,
GA-002804,MEDLINK BOWMAN,"MEDLINK GEORGIA, INC",1235249236,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",206 E Church St,,Bowman,GA,30624-2109,Elbert,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002805,Coastal Community Health Services Inc.,"COASTAL COMMUNITY HEALTH SERVICES, INC.",1609298751,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",106 Shoppers Way,Suite 1,Brunswick,GA,31525-0511,Glynn,106 Shoppers Way Ste 1,,Brunswick,GA,31525-0511,Glynn,Barbara J Meyers,Executive Director,912-275-8028,100,bmeyers@coastalchs.org,Martina Senol,Finance Director,912-275-8028,110,msenol@coastalchs.org,www.coastalchs.org
GA-002806,Glynn CARE Center,Chatham County Health Department,1164429692,Ryan White Providers,2747 4th St,,Brunswick,GA,31520-3714,Glynn,1395 Eisenhower Drive,,Savannah,GA,31406,Chatham,Susan Alt,"Director, HIV Services",912-651-0995,,Susan.Alt@dph.ga.gov,Delores Cooper,Ryan White Grants Manager,912-651-2293,,Delores.Cooper@dph.ga.gov,gachd.org
GA-002807,Butler Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1104255934,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",80 W Main St,,Butler,GA,31006-5156,Taylor,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002808,Byron Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1538422977,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",218 GA Highway 49 N,Suite A,Byron,GA,31008-4051,Peach,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002809,Gordon Hospital,Adventist Health System/Sunbelt Inc.,1760402424,Inpatient Hospitals (other than children's hospitals),1035 Red Bud Rd NE,,Calhoun,GA,30701-6010,Gordon,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Cory Reeves,CFO,706-879-4710,,Cory.Reeves@ahss.org,,,,,,
GA-002810,GEORGIA HIGHLANDS MEDICAL SVCS - CANTON,GEORGIA HIGHLANDS MEDICAL SERVICE INC,1063419422,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",220 Oakside Ln,,Canton,GA,30114-6413,Cherokee,260 Elm St,,Cumming,GA,30040-2467,Forsyth,Todd Shifflet,CEO,770-887-1668,1102,todd.shifflet@ghms-inc.org,Linda P. Howell,COO/CFO,678-807-1030,,linda.howell@ghms-inc.org,
GA-002811,YourTown Health,"PALMETTO HEALTH COUNCIL, INC",1467612952,Federally Qualified Health Centers - Medical Services,202 Croft St,,Carrollton,GA,30117-3803,Carroll,643 Main St,,Palmetto,GA,30268-1138,Fulton,"Jon W. Wollenzien, Jr.",CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
GA-002812,GHMS-Bartow Family Health Center,GEORGIA HIGHLANDS MEDICAL SERVICE INC,1407281058,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",775 West Ave,Suite A,Cartersville,GA,30120-3482,Bartow,260 Elm St,,Cumming,GA,30040-2467,Forsyth,Todd Shifflet,CEO,770-887-1668,1102,todd.shifflet@ghms-inc.org,Linda P. Howell,COO/CFO,678-807-1030,,linda.howell@ghms-inc.org,
GA-002813,Primary Health Care Center Cedartown,"PRIMARY HEALTH CARE CENTER OF DADE, INC.",1952723298,Federally Qualified Health Centers - Medical Services,118 E Girard Ave,,Cedartown,GA,30125-2778,Polk,13570 N Main St,,Trenton,GA,30752-2012,Dade,Diana Allen,CEO,706-996-8251,8549,allend@primaryhealthcarecenter.org,Amy Buffington,Administrative Services Manager/Credentialing,706-620-4494,8542,BUFFINGTONA@PRIMARYHEALTHCARECENTER.ORG,
GA-002814,Georgia Mountains Health-Chatsworth,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1144419813,Federally Qualified Health Centers - Medical Services,1008 N 3rd Ave,,Chatsworth,GA,30705-2118,Murray,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Lourdes Seda,Office Manager,706-517-2273,,,
GA-002815,Murray Medical Center,Adventist Health System/Sunbelt Inc.,1750776571,Inpatient Hospitals (other than children's hospitals),707 Old Dalton Ellijay Rd,,Chatsworth,GA,30705-2029,Murray,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Cory Reeves,CFO,706-879-4710,,Cory.Reeves@ahss.org,,,,,,
GA-002816,MEDLINK RABUN,"MEDLINK GEORGIA, INC",1346299807,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",896 Highway 441 S,,Clayton,GA,30525-5423,Rabun,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002817,MEDLINK WHITE,MEDLINK GEORGIA INC,1578942363,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",105 N Main St,,Cleveland,GA,30528-1123,White,11 CHARLIE MORRIS RD,,COLBERT,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002818,Optim Primary Care Cobbtown,Optim Healthcare,1023253408,Rural Health Clinics,36671 GA Highway 23,,Cobbtown,GA,30420-6042,Tattnall,Tattnall Hospital LLC,247 Main Street,Reidsville,GA,30453,Tattnall,Pam Swicord,RHC Director,912-557-1000,1237,pswicord@optimhealth.com,Rob Snipes,CEO,912-557-1000,1237,rsnipes@optimhealth.com,
GA-002819,Cochran Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1598089658,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",148 E Peacock St,,Cochran,GA,31014-7847,Bleckley,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002820,MedLink Colbert,"MEDLINK GEORGIA, INC",1427156264,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002821,The Family Health Centers at North Clayton,"the Family Health Centers of Georgia, Inc.",1952717357,Federally Qualified Health Centers - Medical Services,1525 Norman Dr,,College Park,GA,30349-5403,Clayton,"868 York Avenue, S.W.",,Atlanta,GA,30310-2750,Fulton,Dr. Michael W. Brooks,President and CEO,404-756-8732,,mwbrooksmd@mindspring.com,Linda G. Abbott,Vice President of Operations/HR,404-756-6866,,lgabbott@mindspring.com,www.fhcga.org
GA-002822,Miller County Medical Center,The Hospital Authority of Miller County,1528110103,Rural Health Clinics,208 N Cuthbert St,,Colquitt,GA,39837-3517,Miller,The Hospital Authority of Miller County,209 N Cuthbert St,Colquitt,GA,39837-3518,Miller,Catherine B Worthy,Director of Internal Compliance,229-758-5950,,cworthy@millercountyhospital.com,Robin Rau,CEO,229-758-4949,,rrau@millercountyhospital.com,
GA-002823,Fort Benning Road Health Center,"VALLEY HEALTHCARE SYSTEM, INC.",1609814219,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1600 Fort Benning Rd,,Columbus,GA,31903-2834,Muscogee,1600 Fort Benning Rd,,Columbus,GA,31903-2834,Muscogee,Sarah E Lang,Chief Executive Officer,706-987-8330,1011,SBankslang@aol.com,Jennifer Melvin,CFO,706-987-8250,1005,JMelvin@valleyhealthcolumbus.com,http://www.valleyhealthcolumbus.com
GA-002824,Columbus Department of Public Health,Columbus Department of Public Health,1427017201,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2100 Comer Ave,,Columbus,GA,31904-8725,Muscogee,2100 Comer Avenue,,Columbus,GA,31904,Muscogee,Sherrie Martin,Billing Specialist,706-321-6206,,Sherrie.Martin@dph.ga.gov,Loretta Willis,Public Health Nurse Coordinator,706-321-6420,,Loretta.Willis@dph.ga.gov,
GA-002825,St. Francis Hospital,LifePoint Health,1033228168,Inpatient Hospitals (other than children's hospitals),2122 Manchester Expy,,Columbus,GA,31904-6878,Muscogee,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Greg Hembree,CFO,706-320-3751,,,
GA-002826,Rockdale Medical Center,LifePoint Health,1275788762,Inpatient Hospitals (other than children's hospitals),1412 Milstead Ave NE,,Conyers,GA,30012-3877,Rockdale,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Diane Roth,CFO,770-918-3101,,,
GA-002827,"Oakhurst Medical Centers, Inc.","Oakhurst Medical Centers, Inc.",1811333859,"Dental Providers, Federally Qualified Health Centers - Medical Services",977 Taylor St SW,Suite A,Conyers,GA,30012-5357,Rockdale,977 Taylor Street,Suite A,Conyers,GA,30012,Rockdale,Billie Inclan,Director of HR,404-564-9345,,Billie.Inclan@oakmed.org,Jeff Taylor,CEO,404-298-8998,,Jeff.Taylor@oakmed.org,
GA-002828,Crisp Regional Convenient Care,"Crisp Regional Hospital, Inc.",1376750976,Rural Health Clinics,216 Hospital Dr,,Cordele,GA,31015-3275,Crisp,902 North 7th Street,,Cordele,GA,31015,Crisp,Lynn Renee Bearden,Director Revenue Integrity,229-276-3146,3146,rbearden@crispregional.org,,,,,,
GA-002829,"Albany Area Primary Health Care, Inc.","Albany Area Primary Health Center, Inc.",1699131920,Federally Qualified Health Centers - Medical Services,330 Old Hatley Rd,Crisp County Primary School-Based Health Center,Cordele,GA,31015-5104,Crisp,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002830,Crisp Urgent Care and Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1124266499,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",602 E 16th Ave,Suite B,Cordele,GA,31015-1782,Crisp,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002831,Cordele Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1457581738,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",712 N 7th St,,Cordele,GA,31015-3271,Crisp,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002832,"Crisp Regional Hospital, Inc. (inpatient hospital)","Crisp Regional Hospital, Inc.",1700851649,Inpatient Hospitals (other than children's hospitals),902 N 7th St,,Cordele,GA,31015-3234,Crisp,902 N 7th St,,Cordele,GA,31015,Crisp,Lynn Renee Bearden,Director Revenue Integrity,229-276-3146,3146,rbearden@crispregional.org,,,,,,
GA-002833,"Crisp Regional Hospital, Inc. (outpatient hospital clinics)","Crisp Regional Hospital, Inc.",1700851649,Outpatient Hospital Clinics,902 N 7th St,,Cordele,GA,31015-3234,Crisp,902 North 7th Street,,Cordele,GA,31015,Crisp,Lynn Renee Bearden,Director Revenue Integrity,229-276-3146,3146,rbearden@crispregional.org,,,,,,
GA-002834,"GEORGIA HIGHLANDS MEDICAL SERVICES, INC.",GEORGIA HIGHLANDS MEDICAL SERVICE INC,1174529192,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",260 Elm St,,Cumming,GA,30040-2467,Forsyth,260 Elm St,,Cumming,GA,30040-2467,Forsyth,Todd Shifflet,CEO,770-887-1668,1102,todd.shifflet@ghms-inc.org,Linda P. Howell,COO/CFO,678-807-1030,,linda.howell@ghms-inc.org,
GA-002835,Chattahoochee Education Center Clinic,"SOUTHWEST GEORGIA HEALTH CARE, INC",1619357860,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",140 Merrell St,,Cusseta,GA,31805-3022,Chattahoochee,220 Alston St,,Richland,GA,31825-6012,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002836,Cusseta Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1679689558,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",298 US Highway 520,,Cusseta,GA,31805-3602,Chattahoochee,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002837,Georgia Mountains Health-Dahlonega,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1285057281,Federally Qualified Health Centers - Medical Services,134 Ansley Dr,Suite 200,Dahlonega,GA,30533-1640,Lumpkin,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Sherry Simmons,Office Manager,706-864-2155,,,
GA-002838,The Living Bridge Center - Whitefield County Health Department,Whitfield County Board of Health,1093789075,Ryan White Providers,1200 W Waugh St,Suite A,Dalton,GA,30720-8918,Whitfield,800 Professional Blvd.,,Dalton,GA,30720,Whitfield,Cynthia Mann,BILLING SUPERVISOR,706-529-5741,3281,cynthia.mann@dph.ga.gov,Steve Tonya,Administrator,706-529-5741,3251,,
GA-002839,Dalton Health Center,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1225399041,Federally Qualified Health Centers - Medical Services,218 N Fredrick St,,Dalton,GA,30721-3242,Whitfield,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Michelle Bradford,Office Manager,706-529-3643,,,
GA-002840,The Living Bridge Center -Whitefield County Health Department,Whitfield County Board of Health,1093789075,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",800 Professional Blvd,,Dalton,GA,30720-2536,Whitfield,800 Professional Blvd.,,Dalton,GA,30720,Whitfield,Cynthia Mann,Billing Supervisor,706-529-5741,3281,cynthia.mann@dph.ga.gov,Steve Tonya,Administrator,706-529-5741,3251,,
GA-002841,Appalachian Integrated Care and Wellness Program,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1821332495,Federally Qualified Health Centers - Medical Services,900 Shugart Rd,,Dalton,GA,30720-2467,Whitfield,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Lourdes Seda,Office Manager,706-517-2273,,,
GA-002842,Dawson Medical Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1730114208,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",420 Johnson St SE,,Dawson,GA,39842-1523,Terrell,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Karen Hilliary,Operations Manger,229-995-2990,,,
GA-002843,"Albany Area Primary Health Care, Inc.","Albany Area Primary Health Care, Inc.",1326404658,Federally Qualified Health Centers - Medical Services,455 Greenwave Blvd,Terrell County School-Based Health Center,Dawson,GA,39842-2908,Terrell,204 N Westover Blvd,,Albany,GA,31707-2983,Early,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002844,"Oakhurst Medical Centers, Inc.","Oakhurst Medical Centers, Inc.",1790821023,"Dental Providers, Federally Qualified Health Centers - Medical Services",1760 Candler Rd,,Decatur,GA,30032-3254,DeKalb,1760 Candler Road,,Decatur,GA,30032,DeKalb,Billie Inclan,Director of HR,404-564-9345,,Billie.Inclan@oakmed.org,Jeff Taylor,CEO,404-298-8998,,Jeff.Taylor@oakmed.org,
GA-002845,CLIFTON SPRINGS HEALTH CENTER,DEKALB COUNTY BOARD OF HEALTH,1356447411,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3110 Clifton Springs Rd,,Decatur,GA,30034-4600,DeKalb,"445 WINN WAY, SUITE 598",,Decatur,GA,30030,DeKalb,PARECIA A. BENSON,Billing Manager,404-294-3830,,Parecia.Benson@dph.ga.gov,TA-TANISHA INGRAM,Medical Records Administrator/Privacy Compliance,404-294-3275,,Ta-Tanisha.Ingram@dph.ga.gov,
GA-002846,Recovery Consultants of Atlanta,Recovery Consultants of Atlanta,1851482376,Federally Qualified Health Centers - Medical Services,3423 Covington Dr,Suite B,Decatur,GA,30032-1837,DeKalb,3423 Covington Drive,Suite B,Decatur,GA,30032,DeKalb,Cassandra Collins,CEO,404-289-0313,222,cassandra@recoveryconsultants.org,,,,,,
GA-002847,Community Health Center,Recovery Consultants of Atlanta,1851482376,Federally Qualified Health Centers - Medical Services,4229 Snapfinger Woods Dr,,Decatur,GA,30035-3440,DeKalb,3423 Covington Drive,Suite B,Decatur,GA,30032,DeKalb,Cassandra Collins,CEO,404-289-0313,222,cassandra@recoveryconsultants.org,,,,,,www.recoveryconsultants.org
GA-002848,Positive Impact Health Centers - Decatur,"Positive Impact Health Centers, INC",1790861995,"Ryan White Providers, Sexually Transmitted Disease Clinics",523 Church St,,Decatur,GA,30030-2515,DeKalb,523 Church St,,Decatur,GA,30030,Fulton,Quinton Rasberry,"Director of Marketing, Pharmacy, & Clinical Care",678-990-6454,454,quinton.rasberry@pihcga.org,Joey Helton,COO,678-990-6453,453,joey.helton@pichga.org,https://www.positiveimpacthealthcenters.org
GA-002849,MedLink Habersham,"MEDLINK GEORGIA, INC",1851722524,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",396 Historic Hwy 441 N,,Demorest,GA,30535,Habersham,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002850,Doerun Family Medicine Clinic,Doerun Family Medicine Clinic,1992147573,Rural Health Clinics,128 West Broad,,Doerun,GA,31744,Colquitt,128 West Broad,,Doerun,GA,31744,Colquitt,Denise Romanowski,"Director, Practice Mgmt",229-891-9559,,dromanowski@colquittregional.com,,,,,,
GA-002851,Coffee Wellness Center,Southeast Health District/Ware County Board of Health,1316976699,Ryan White Providers,1003 Shirley Ave,,Douglas,GA,31533-2123,Coffee,Southeast Health District,1101 Church St,Waycross,GA,31501,Ware,AMANDA COFFEE,Program Coordinator,912-764-2402,,AMANDA.COFFEE@DPH.GA.GOV,SHELBY FREEMAN,Nurse Manager,912-764-2402,,SHELBY.FREEMAN@DPH.GA.GOV,
GA-002852,Douglas Family Health,SOUTH CENTRAL PRIMARY CARE CENTER,1831273028,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1309 Ocilla Rd,,Douglas,GA,31533-2209,Coffee,406 W 5th St,,Ocilla,GA,31774-1421,Irwin,Robert B Tucker,CEO,229-468-9166,,rtucker@scpccga.org,SANDRA CHAUNCEY,OFFICE COORDINATOR,912-384-2252,,,
GA-002853,Kid's Health,SOUTH CENTRAL PRIMARY CARE CENTER,1063840296,Federally Qualified Health Centers - Medical Services,303 Shirley Ave,Suite B,Douglas,GA,31533-2373,Coffee,406 W 5th St,,Ocilla,GA,31774-1421,Irwin,ROBERT B. TUCKER JR.,CEO,229-468-9166,,RTUCKER@SCPCCGA.ORG,Christy Johnson,MA,912-384-2474,,,
GA-002854,The Family Health Centers of Georgia Inc,The Family Health Centers of Georgia Inc,1306399977,Federally Qualified Health Centers - Medical Services,8277 Connally Dr,The Family Health Center at Burnett School,Douglasville,GA,30134-3840,Douglas,868 York Ave,,Atlanta,GA,30310,Fulton,Michael Brooks,CEO,404-756-8732,,mwbrooksmd@mindspring.com,linda abbott,,404-756-8732,,lgabbott@fhcga.org,
GA-002855,Laurens County Board of Health Specialty Clinic,South Central Health District 5-1,1689740045,Ryan White Providers,103 Mercer Dr,Suite B,Dublin,GA,31021-4257,Laurens,2121 B Bellvue Avenue,,Dublin,GA,31021,Laurens,MALELA ROZIER,Program Coordinator,478-274-3012,,MALELA.ROZIER@DPH.GA.GOV,Kelly Knight,District Nursing Director,478-275-6564,,kelly.knight@dph.ga.gov,
GA-002856,"Community Health Care Systems, Inc.- Laurens County",COMMUNITY HEALTH CARE SYSTEMS INC,1336378892,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",107 Fairview Park Dr,,Dublin,GA,31021-2501,Laurens,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN PRICE,Site Coordinator,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002857,Duluth Center--Ric Crawford Clinic,Positive Impact Health Centers,1790861995,Ryan White Providers,3075 Breckinridge Blvd,Suite 415,Duluth,GA,30096-4981,Gwinnett,3075 Breckinridge Blvd.,,Duluth,GA,30096,Gwinnett,KAREN CROSS,Director of Client Services,678-990-6415,,KAREN.CROSS@PIHCGA.ORG,Rosemary Donnelly,Director of Clinical Care,678-990-6426,,rosemary.donnelly@pihcga.org,www.pihcga.org
GA-007613,Decatur,Positive Impact Health Centers,1790861995,"Other ECP Providers, Ryan White Providers",3350 Breckinridge Blvd,Suite 200,Duluth,GA,30096-4959,Gwinnett,3350 Breckinridge Boulevard,Suite 200,Duluth,GA,30096,Gwinnett,KAREN CROSS,Director of Client Services,678-990-6415,,KAREN.CROSS@PIHCGA.ORG,Rosemary Donnelly,Director of Clinical Care,678-990-6426,,rosemary.donnelly@pihcga.org,www.pihcga.org
GA-002858,Georgia Mountains Health-Ellijay,"GEORGIA MOUNTAINS HEALTH SERVICES, INC.",1396940029,Federally Qualified Health Centers - Medical Services,772 Maddox Dr,Suite 120,East Ellijay,GA,30540-8196,Gilmer,165 Blue Ridge Overlook,,Blue Ridge,GA,30513-4431,Fannin,Steven Miracle,CEO,706-946-5610,,SMiracle@gamtnhealth.org,Rosa Trevino,Office Manager,706-635-6898,,,
GA-002859,Eastman Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1124272869,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1111 Griffin Ave,Suite A,Eastman,GA,31023-9104,Dodge,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002860,Middle Georgia Pediatrics,"SOUTHWEST GEORGIA HEALTH CARE, INC",1043440340,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",817 Griffin Ave,,Eastman,GA,31023-6718,Dodge,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002861,Edison Medical Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1366477838,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",19519 Hartford St,,Edison,GA,39846-5803,Calhoun,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Omega Reid,CEO,229-888-6559,6248,Omega.Reid@aaphc.org,Carla Moseley,Operations Manager,229-835-2238,,,
GA-002862,Ellaville Convenient Care,"SOUTHWEST GEORGIA HEALTH CARE, INC",1487036075,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",93 S Broad St,,Ellaville,GA,31806-3456,Schley,220 Alston St,,Richland,GA,31825-6012,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002863,Georgia Mountains Health AIM Ellijay,"Georgia Mountains Health Services, Inc",1184035057,Federally Qualified Health Centers - Medical Services,1197 Progress Rd,,Ellijay,GA,30540-5504,Gilmer,165 Blue Ridge Overlook,,Blue Ridge,GA,30513,Fannin,Steven Miracle,CEO,706-946-5610,,Smiracle@gamtnhealth.org,Rosa Trevino,Office Manager,706-635-6898,,,
GA-002864,DMC INTERNAL MEDICINE AND FAMILY HEALTH RHC,DMC PHYSICIAN GROUP LLC,1124430020,Rural Health Clinics,118 Norman Dorminy Dr,,Fitzgerald,GA,31750-8858,Ben Hill,117 Kite Rd,ATTN DEBORAH DRIGGERS,Swainsboro,GA,30401,Emanuel,CAREY SHIMADA,REGIONAL CREDENTIALING SPECIALIST,801-628-8260,,CSHIMADA@ERHOSPITAL.COM,DEBORAH DRIGGERS,,478-289-1303,,DDRIGGERS@EMANUELMEDICAL.ORG,
GA-002865,KID'S HEALTH,SOUTH CENTRAL PRIMARY CARE CENTER,1295094340,Federally Qualified Health Centers - Medical Services,119 Norman Dorminy Dr,Suite A,Fitzgerald,GA,31750-8855,Ben Hill,406 W 5TH ST,,OCILLA,GA,31774,Irwin,"ROBERT B. TUCKER, JR.",CEO,229-468-9166,1,RTUCKER@SCPCCGA.ORG,ANTHONY FRAZIER,LPN,229-423-5437,,,
GA-002866,South Central WOMEN'S HEALTH,SOUTH CENTRAL PRIMARY CARE CENTER,1982019253,Federally Qualified Health Centers - Medical Services,119 Norman Dorminy Dr,Suite B,Fitzgerald,GA,31750-8855,Ben Hill,406 W 5TH ST,,Ocilla,GA,31774,Irwin,Robert B Tucker Jr.,CEO,229-468-9166,2104,RTUCKER@SCPCCGA.ORG,Cathy McGill,CFO,229-468-9166,2105,cmcgill@scpccga.org,http://scpccga.org
GA-002867,MCKINNEY COMMUNITY HEALTH CENTER,"MCKINNEY COMMUNITY HEALTH CENTER, INC.",1801057690,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3919 Main St,,Folkston,GA,31537-7545,Charlton,218 Quarterman St,,Waycross,GA,31501-3547,Ware,Ola A Smith,CEO,912-287-0301,108,bwilson@mckinneyhealth.com,Stephanie Gill,A/R Billing Supervisor,912-287-9140,126,sgill@mckinneyhealth.com,http://www.mckinneymedicalcenter.com/
GA-002868,SOUTHSIDE MEDICAL CENTER - Forest Park Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1730207663,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4140 Jonesboro Rd,Suite D1,Forest Park,GA,30297-1071,Clayton,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002869,Clay County Medical Center,"Clay County Medical Center, Inc.",1750464855,Other ECP Providers,305 Washington St S,Pob 281,Fort Gaines,GA,39851-4315,Clay,305 Washington Street South,POB 281,Fort Gaines,GA,39851,Clay,Karen Kinsell,Owner,229-942-9496,,susie4797@gmail.com,,,,,,
GA-002870,Fortson Medical,"Valley Healthcare System, Inc",1952599623,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",94 McCrary Rd,,Fortson,GA,31808-4558,Harris,1600 Fort Benning Road,,Columbus,GA,31903-2834,Muscogee,Sarah E. Lang,Chief Executive Officer,706-987-8330,1101,SBankslang@aol.com,Jennifer Melvin,Chief Financial Officer,706-987-8250,1005,JMelvin@valleyhealthcolumbus.com,www.valleyhealthcolumbus.com
GA-002871,Hall County Health Department,Hall County Health Department,1326427261,"Ryan White Providers, Tuberculosis Clinics",1290 Athens St,,Gainesville,GA,30507-7000,Hall,1290 Athens Street,,Gainesville,GA,30507,Hall,Beverly Robertson,Ryan White Program Coordinator,770-535-5872,,beverly.robertson@dph.ga.gov,Karla Henriquez,Ryan White Program Associate,770-535-5801,,karla.henriquez@dph.ga.gov,
GA-002872,MedLink Gainesville,"MEDLINK GEORGIA, INC",1245340264,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",528 Broad St SE,,Gainesville,GA,30501-3728,Hall,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002873,Northeast Georgia Medical Center,Northeast Georgia Medical Center,1427055821,Inpatient Hospitals (other than children's hospitals),743 Spring St NE,,Gainesville,GA,30501-3715,Hall,743 Spring ST NE,,Gainesville,GA,30501,Hall,Linda D. Nicholson,Vice President Finance Operatiions,770-219-6646,,linda.nicholson@nghs.com,,,,,,
GA-002874,Quitman Health Care,"SOUTHWEST GEORGIA HEALTH CARE, INC",1962410613,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",23 Old School Rd,,Georgetown,GA,39854-4627,Quitman,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002875,TriCounty Health System - Gibson,COMMUNITY HEALTH CARE SYSTEMS INC,1245400969,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",437 E Main St,,Gibson,GA,30810-4135,Glascock,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002876,Optim Primary Care Glennville,Optim Healthcare,1972762508,Rural Health Clinics,1000b Veterans Blvd,,Glennville,GA,30427,Tattnall,"Tattnall Hospital, LLC",247 Main Street,Reidsville,GA,30453,Tattnall,Pam Swicord,RHC Director,912-557-1000,1237,pswicord@optimhealth.com,Rob Snipes,CEO,912-557-1000,1237,rsnipes@optimhealth.com,
GA-002877,"Community Health Care Systems, Inc.- Jones County",COMMUNITY HEALTH CARE SYSTEMS INC,1518265818,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4292 Gray Hwy,,Gray,GA,31032-5900,Jones,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002878,Tendercare Women's Center,"Tendercare Clinic, Inc.",1255433736,Federally Qualified Health Centers - Medical Services,1040 Park Dr,,Greensboro,GA,30642-3466,Greene,803 S. Main St.,,Greensboro,GA,30642,Greene,Lisa Brown,CEO,706-454-5118,,lbrown@tendercarega.org,Jean Aycock,CFO,706-454-5110,,jaycock@tendercarega.org,
GA-002879,"TENDERCARE CLINIC, INC.","Tendercare Clinic, Inc.",1255433736,"Dental Providers, Federally Qualified Health Centers - Medical Services",803 S Main St,,Greensboro,GA,30642-1211,Greene,803 S Main St,,Greensboro,GA,30642-1211,Greene,Lisa Brown,CEO,706-453-1201,,lbrown@tendercarega.org,Karen Post,CFO,706-454-5127,,,
GA-002880,YourTown Health Dental,"PALMETTO HEALTH COUNCIL, INC",1053540328,Dental Providers,51 Gay Connector,,Greenville,GA,30222-3339,Meriwether,643 Main St,,Palmetto,GA,30268-1138,Fulton,"Jon W. Wollenzien, Jr.",CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
GA-002881,Southside Medical Center Spalding,Southside Medical Center,1053789511,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",409 W Solomon St,,Griffin,GA,30223-2831,Spalding,"1046 Ridge Ave., SW",,Atlanta,GA,30315-1640,Fulton,David Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002882,SOUTHSIDE MEDICAL CENTER - Lovejoy Medical Center,"SOUTHSIDE MEDICAL CENTER, INC.",1962529529,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2201 Talmadge Rd,,Hampton,GA,30228-1608,Clayton,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,69209,qhuguley@smcmed.com,www.southsidemedical.net
GA-002883,MEDLINK HARTWELL,"MEDLINK GEORGIA, INC",1275643272,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",63 W Gibson St,,Hartwell,GA,30643-1845,Hart,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002884,Hiawassee Family Practice P C,Hiawassee Family Practice P C,1285706879,Rural Health Clinics,56 Hospital St,,Hiawassee,GA,30546-3251,Towns,PO Box 409,,Hiawassee,GA,30546,Towns,Cheryl Bleckley,Office Manager,706-896-2289,6,hfp@brmemc.net,,,,,,
GA-002885,Diversity Health Center Hinesville,"DIVERSITY HEALTH CENTER, INC.",1720108590,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",303 Fraser Dr,,Hinesville,GA,31313-3712,Liberty,301 Fairhope Ln,,Hinesville,GA,31313-4101,Liberty,Stephanie Jones-Theaker,CEO,912-318-3971,,stephanie.jones-theaker@diversityhc.org,Cathy Atkins,Executive Assistant,912-318-3947,,,
GA-002886,MedLink Banks,"MEDLINK GEORGIA, INC",1033304274,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1244 Historic Homer Hwy,,Homer,GA,30547-2737,Banks,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002887,COMMUNITY HEALTH CARE SYSTEMS-WILKINSON,COMMUNITY HEALTH CARE SYSTEMS INC,1063683332,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",144 E Main St,,Irwinton,GA,31042-2602,Wilkinson,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002888,SOUTHSIDE MEDICAL CENTER - Jackson Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1588088025,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",176 Lyons St,,Jackson,GA,30233-2134,Butts,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002889,Good Samaritan Health & Wellness Center,"GOOD SAMARITAN HEALTH & WELLNESS CENTER, INC.",1407174675,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",175 Samaritan Dr,,Jasper,GA,30143-1964,Pickens,175 Samaritan Dr,,Jasper,GA,30143-1964,Pickens,Carole Maddux,CEO,706-253-4673,,executivedirector@goodsamhwc.org,Tammi Sorrells,CFO,706-253-4673,243,cfo@goodsamhwc.org,www.goodsamhwc.org
GA-002890,"Community Health Care Systems, Inc.",COMMUNITY HEALTH CARE SYSTEMS INC,1194996421,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",101 Watson Dr,,Jeffersonville,GA,31044-5508,Twiggs,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,LPRICE@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002891,DISTRICT 3-3,CLAYTON COUNTY BOARD OF HEALTH,1104911924,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1117 Battlecreek Rd,,Jonesboro,GA,30236-2407,Clayton,1117 Battle Creek Road,,Jonesboro,GA,30236-2407,Clayton,Olatanwa Adewale,"Program Manger, Office of Infectious Diseases",678-610-7193,,olatanwa.adewale@dph.ga.gov,Caroline Hawkins,District Nursing and Clinical Director,678-610-7196,,caroline.hawkins@dph.ga.gov,
GA-002892,"Neighborhood Improvement Project, Inc. d.b.a. as Medical Associates Plus @Keysville","Neighborhood Improvement Project, Inc.",1609248996,Federally Qualified Health Centers - Medical Services,480B Martin Luther King Rd,,Keysville,GA,30816-4444,Burke,2467 Golden Camp Road,,Augusta,GA,30816-4444,Burke,J.R. RICHARDS,CEO,706-790-4440,105,JRRICHARDS@MAPBT.COM,Wesley Wood,CCFO,706-790-4440,100,wwood@mapbt.com,www.mapbt.com
GA-002893,"McKinney Community Health Center, Inc.","MCKINNEY COMMUNITY HEALTH CENTER, INC.",1821476193,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services",711 Charles Gilman Jr Ave,Suite B,Kingsland,GA,31548-5664,Camden,218 Quarterman St,,Waycross,GA,31501-3547,Ware,Ola A Smith,CEO,912-287-0301,108,bwilson@mckinneyhealth.com,Stephanie Gill,A/R Billing Supervisor,912-287-9140,126,sgill@mckinneyhealth.com,http://www.mckinneymedicalcenter.com/
GA-002894,"Primary Health Care Center Of Dade, Inc.","PRIMARY HEALTH CARE CENTER OF DADE, INC.",1235505678,"Dental Providers, Federally Qualified Health Centers - Medical Services",87 S Burnt Mill Rd,Gilbert School Based Health Center,Lafayette,GA,30728,Walker,13570 N Main Street,,Trenton,GA,30752,Dade,Amy Buffington,Administrative Services Manager,706-620-4494,8542,buffingtona@primaryhealthcarecenter.org,Diana Allen,CEO,706-620-4494,8549,allend@primaryhealthcarecenter.org,www.primaryhealthcarecenter.org
GA-002895,Four Corners Primary Care Center at VPH,FOUR CORNERS PRIMARY CARE CENTER,1265624548,Federally Qualified Health Centers - Medical Services,175 Gwinnett Dr,Suite 213,Lawrenceville,GA,30046-8457,Gwinnett,5030 Georgia Belle Ct Ste 2066,,Norcross,GA,30093-2667,Gwinnett,Brian Williams,Chief Executive Officer,770-279-3140,,bwilliams@fcpchealth.org,,,,,,
GA-002896,Planned Parenthood Gwinnett Health Center,"Planned Parenthood Southeast, Inc.",1609829282,Family Planning Providers,798 Lawrenceville Suwanee Rd Ste 300,Cross Creek Village,Lawrenceville,GA,30043-7350,Gwinnett,241 Peachtree Street NE Ste 400,,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,Staci Fox,CEO,404-688-9300,,staci.fox@ppse.org,www.ppse.org
GA-002897,Lee Medical Arts Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1568497030,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",235 Walnut Ave S,,Leesburg,GA,31763-4367,Lee,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Erica Robinson,Operations Manager,229-759-6508,,,
GA-002898,MEDLINK OGLETHORPE,"MEDLINK GEORGIA, INC",1083724082,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",247 Union Point St,,Lexington,GA,30648-2303,Oglethorpe,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002899,AHF Healthcare Center - Lithonia,AIDS Healthcare Foundation,1750656906,"Other ECP Providers, Ryan White Providers",5700 Hillandale Dr,Suite 100,Lithonia,GA,30058-4104,DeKalb,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
GA-002900,JEFFERSON HOSPITAL,Jefferson Hospital,1710992433,Inpatient Hospitals (other than children's hospitals),1067 Peachtree St,,Louisville,GA,30434-1599,Jefferson,1067 Peachtree Street,,Louisville,GA,30434,Jefferson,Jessica Guy,Administrative Manager,478-625-7000,205,jguy@jeffersonhosp.com,,,,,,
GA-002901,PHYSICIANS' HEALTH GROUP,Jefferson Hospital,1215943915,Rural Health Clinics,1067 Peachtree St,,Louisville,GA,30434-1599,Jefferson,1067 Peachtree Street,,Louisville,GA,30434,Jefferson,Jessica Guy,Administrative Manager,478-625-7000,205,jguy@jeffersonhosp.com,,,,,,
GA-002902,"Diversity Health Center, Inc.- Long County","DIVERSITY HEALTH CENTER, INC.",1952584708,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",213 N McDonald St,,Ludowici,GA,31316-6075,Long,301 Fairhope Ln,,Hinesville,GA,31313-4101,Liberty,Stephanie Jones-Theaker,CEO,912-318-3971,,stephanie.jones-theaker@diversityhc.org,Cathy Atkins,Executive Assistant,912-318-3947,,cathy.atkins@diversityhc.org,
GA-002903,Toombs County Health Department,Southeast Health District/Ware County Board of Health,1831112879,"Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",714 NW Broad St,,Lyons,GA,30436-5648,Toombs,1101 Church Street,,Waycross,GA,31501,Ware,Shelby Freeman,Program Coordinator,912-764-2402,,Shelby.Freeman@dph.ga.gov,AMANDA COFFEE,,912-764-2402,,AMANDA.COFFEE@DPH.GA.GOV,
GA-002904,The HOPE Center,Houston County Board of Health,1164464756,Ryan White Providers,135 Macon West Dr,,Macon,GA,31210-5652,Bibb,98 Cohen Walker Drive,,Warner Robins,GA,31088,Houston,Terri Smith,Program Manager,478-405-7220,,terri.smith@dph.ga.gov,,,,,,http://dph.georgia.gov/sites/dph.georgia.gov/files/related_files/site_page/Georgia%20Ryan%20White%20Part%20B%20Primary%20Care%20Clinics.pdf
GA-002905,"First Choice Primary Care, Inc.","First Choice Primary Care, Inc.",1023492162,Federally Qualified Health Centers - Medical Services,171 Emery Hwy,,Macon,GA,31217-3666,Bibb,PO Box 4363,,Macon,GA,31208,Bibb,Katherine McLeod,CEO,478-787-4266,104,kmcleod@firstchoiceprimarycare.org,Dawn Janes,Billing Supervisor,478-787-4266,104,djanes@firstchoiceprimarycare.org,
GA-002906,"First Choice Primary Care, Inc.","First Choice Primary Care, Inc.",1558714329,Federally Qualified Health Centers - Medical Services,174 Walnut St,,Macon,GA,31201-3440,Bibb,PO Box 4363,,Macon,GA,31208,Bibb,LaKita Stewart,BILLING SUPERVISOR,478-787-4266,138,lstewart@firstchoiceprimarycare.org,Katherine McLeod,CEO,478-787-4266,104,cslade@firstchoiceprimarycare.org,
GA-002907,"First Choice Primary Care, Inc.","First Choice Primary Care, Inc.",1083145981,Federally Qualified Health Centers - Medical Services,3741 Houston Ave,,Macon,GA,31206-2415,Bibb,PO Box 4363,,Macon,GA,31208,Bibb,LaKita Stewart,BILLING SUPERVISOR,478-787-4266,138,lstewart@firstchoiceprimarycare.org,Katherine McLeod,CEO,478-787-4266,104,kmcleod@firstchoiceprimarycare.org,
GA-002908,"FIRST CHOICE PRIMARY CARE, INC.","FIRST CHOICE PRIMARY CARE, INC.",1336332857,Federally Qualified Health Centers - Medical Services,770 Walnut St,,Macon,GA,31201-7307,Bibb,PO Box 4363,,Macon,GA,31208,Bibb,Katherine McLeod,CEO,478-787-4266,104,kmcleod@firstchoiceprimarycare.org,Dawn Janes,Billng Supervisor,478-787-4266,104,djanes@firstchoiceprimarycare.org,
GA-002909,"First Choice Primary Care, Inc. DBA Ingram-Pye Health Center","First Choice Primary Care, Inc. DBA Ingram-Pye Health Center",1740666767,Federally Qualified Health Centers - Medical Services,855 Anthony Rd,,Macon,GA,31204-6266,Bibb,PO Box 4363,,Macon,GA,31208,Bibb,Katherine McLeod,CEO,478-787-4266,104,kmcleod@firstchoiceprimarycare.org,Dawn Janes,Billing Supervisor,478-787-4266,104,djanes@firstchoiceprimarycare.org,
GA-002910,Good Samaritan Health Center,"Good Samaritan Health Center of Cobb, Inc.",1881923126,"Dental Providers, Federally Qualified Health Centers - Medical Services",1605 Roberta Dr SW,,Marietta,GA,30008-3855,Cobb,1605 Roberta Drive,1605 Roberta Drive,Marietta,GA,30008,Cobb,Randy Cook,CEO,404-803-2502,,Randy.Cook@goodsamhc.org,Erin Hiers,Director of Operations,,,,
GA-002911,"Someone Cares, Inc. of Atlanta","Someone Cares, Inc. of Atlanta",1215251640,"Community Mental Health Centers, Sexually Transmitted Disease Clinics",1950 Spectrum Cir SE,Suite 145,Marietta,GA,30067-8470,Cobb,1950 Spectrum Circle,Ste. 145,Marietta,GA,30067,Cobb,Ronnie E. Bass,Executive Director,678-921-2706,100,ronniebass@s1catl.org,WINSTON LIBURD,CFO,678-921-2706,104,winstonliburd@s1catl.org,www.s1catl.org
GA-002912,Planned Parenthood Cobb Health Center,"Planned Parenthood Southeast, Inc.",1609829282,Family Planning Providers,220 Cobb Pkwy N,Suite 500,Marietta,GA,30062-3580,Cobb,241 Peachtree Street NE Ste 400,,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,Staci Fox,CEO,404-688-9300,,staci.fox@ppse.org,www.ppse.org
GA-002913,The Family Health Center at Cobb,"The Family Health Centers of Georgia, Inc.",1285727396,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",805 Campbell Hill St NW,,Marietta,GA,30060-1144,Cobb,1650 County Services Pkwy SW,,Marietta,GA,30008-4010,Cobb,Dr. MIchael W. Brooks,President and CEO,404-756-8732,,mwbrooksmd@mindspring.com,Linda G. Abbott,Vice President of Operations/HR,404-756-6866,,lgabbott@mindspring.com,www.fhcga.org
GA-002914,"Community Health Care Systems, Inc.- Telfair County",COMMUNITY HEALTH CARE SYSTEMS INC,1568806297,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",280 E Willow Creek Ln,,Mc Rae,GA,31055-5126,Telfair,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002915,East Georgia Healthcare Center,"EAST GEORGIA HEALTHCARE CENTER, INC.",1821270323,Federally Qualified Health Centers - Medical Services,34 NW Broad St,,Metter,GA,30439-4025,Candler,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Kim Mincey,OFFICE COORDINATOR,912-685-4040,,kmincey@eghc.org,www.eghc.org
GA-002916,CANDLER COUNTY FAMILY MEDICAL CLINIC RHC,HOSPITAL AUTHORITY OF CANDLER COUNTY,1790888089,Rural Health Clinics,380 Cedar St,,Metter,GA,30439-4042,Candler,PO BOX 597,,METTER,GA,30439,Candler,CAREY SHIMADA,REGIONAL CREDENTIALING SPECIALIST,801-628-8260,,CSHIMADA@ERHOSPITAL.COM,DEBORAH DRIGGERS,,478-289-1303,,DDRIGGERS@EMANUELMEDICAL.ORG,
GA-002917,Tendercare Clinic dba Family Medical of Milledgeville,"TENDERCARE CLINIC, INC",1770822496,Federally Qualified Health Centers - Medical Services,111 Fieldstone Dr,Suite 114,Milledgeville,GA,31061-7108,Baldwin,803 S Main St,,Greensboro,GA,30642-1211,Greene,Lisa Brown,CEO,706-453-1201,,lbrown@tendercarega.org,,,,,,
GA-002918,TenderCare Clinic dba Family Medical of Milledgeville - River Edge Service Site,"TENDERCARE CLINIC, INC",1790106623,Federally Qualified Health Centers - Medical Services,60 GA Highway 22 W,,Milledgeville,GA,31061-6606,Baldwin,803 S Main St,,Greensboro,GA,30642-1211,Greene,Lisa Brown,CEO,706-453-1201,,lbrown@tendercarega.org,,,,,,
GA-002919,"COMMUNITY HEALTH CARE SYSTEMS, INC-BALDWIN","COMMUNITY HEALTH CARE SYSTEMS,INC",1790153997,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",102a Airport Road NE,,Millegeville,GA,31061,Baldwin,2251 WEST ELM STREET,,WRIGHTSVILLE,GA,31096,Johnson,CARLA W BELCHER,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002920,East Georgia HealthCare Center Inc,East Georgia Healthcare Center Inc,1194258327,Federally Qualified Health Centers - Medical Services,1075 E Winthrope Ave,,Millen,GA,30442-6766,Jenkins,215 N Coleman St,,Swainsboro,GA,30401,Emanuel,Linda K. Braswell,Business Manager,478-299-6992,,lbraswell@eghc.org,Jill R Sorrells,CFO,478-237-6262,1514,jsorrells@eghc.org,
GA-002921,Optim Primary Care Millen,National Surgical Healthcare,1033428214,Rural Health Clinics,961 E Winthrope Ave,,Millen,GA,30442-1839,Jenkins,210 E Derenne Ave,,Savannnah,GA,31405,Chatham,Jill Bazemore,Lpn/Office Manager,478-982-0120,,jibazemore@optimhealth.com,Sylvia Hutcheson,Administrative Assistant,912-564-5290,,shutcheson@optimhealth.com,
GA-002922,MedLink Monroe,"MEDLINK GEORGIA, INC",1669833364,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",924 W Spring St,,Monroe,GA,30655-1751,Walton,PO Box 459,,Colbert,GA,30628,Madison,DAVID WARD,President and CEO,706-788-3234,1042,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,1007,SBARBER@MEDLINKGA.ORG,
GA-002923,Southwest Pediatrics,"SOUTHWEST GEORGIA HEALTH CARE, INC",1407252638,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",512 Sumter St,Suite B,Montezuma,GA,31063-1758,Macon,220 Alston St,,Richland,GA,31825-6012,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002924,Moultrie Convenient Care,"Southwest Georgia Health Care, Inc.",1518347418,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1401 S Main St,,Moultrie,GA,31768-5811,Colquitt,220 Alston Street,,Richland,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002925,Colquitt Regional Medical Center Primary Care Clinic,Colquitt Regional Medical Center Primary Care Clinic,1881758753,Rural Health Clinics,6 Hospital Park,,Moultrie,GA,31768-6700,Colquitt,6 Hospital Park,,Moultrie,GA,31768,Colquitt,Denise Romanowski,"Director, Practice Mgmt",229-891-9559,,dromanowski@colquittregional.com,,,,,,
GA-002926,Kirk Clinic,Kirk Clinic,1083816128,Rural Health Clinics,8 Laurel Ct,,Moultrie,GA,31768-6889,Colquitt,8 Laurel Court,,Moultrie,GA,31768,Colquitt,Denise Romanowski,"Director, Practice Mgmt",229-891-9559,,dromanowski@colquittregional.com,,,,,,
GA-002927,East Georgia HealthCare Center Inc,"EAST GEORGIA HEALTHCARE CENTER, INC.",1487892857,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",118 E Broad St,,Mount Vernon,GA,30445-3018,Montgomery,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Jean Marie Hunter,Office Coordinator,912-537-6565,,jmhunter@eghc.org,www.eghc.org
GA-002928,MCHC Nahunta,"MCKINNEY COMMUNITY HEALTH CENTER, INC.",1871756049,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9355 Main St S,,Nahunta,GA,31553-6159,Brantley,218 Quarterman St,,Waycross,GA,31501-3547,Ware,Ola A Smith,CEO,912-287-0301,108,bwilson@mckinneyhealth.com,Stephanie Gill,A/R Billing Supervisor,912-287-9140,126,sgill@mckinneyhealth.com,http://www.mckinneymedicalcenter.com/
GA-002929,Betty Dupree Health Care Center,SOUTH CENTRAL PRIMARY CARE CENTER,1568844991,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",201 N Bartow St,,Nashville,GA,31639-1435,Berrien,406 W 5th St,,Ocilla,GA,31774-1421,Irwin,Robert B Tucker,CEO,229-468-9166,,rtucker@scpccga.org,WINNIE MOORE,OFFICE MANAGER,229-686-2774,,,
GA-002930,AID Atlanta-Newnan,AID Atlanta Inc.,1144646340,Ryan White Providers,770 Greison Trl,Suite H,Newnan,GA,30263-6401,Coweta,1605 Peachtree St NE,,Atlanta,GA,30309-2433,Fulton,Nicole Roebuck,Acting Executive Director,404-870-7720,,nicole.roebuck@aidatlanta.org,Alexis Howell,Eexcutive Assistant,404-870-7711,,alexis.howell@aidatlanta.org,www.aidatlanta.org
GA-002931,Baker County Primary Health Care,"ALBANY AREA PRIMARY HEALTH CARE, INC",1184649329,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",327 Sunset Ave SW,Suite 3,Newton,GA,39870-7343,Baker,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Marie Hughes,Operations Manager,229-734-5250,,,
GA-002932,FOUR CORNERS PRIMARY CARE CENTERS,FOUR CORNERS PRIMARY CARE CENTERS,1265624548,Federally Qualified Health Centers - Medical Services,5030 Georgia Belle Ct,Suite 2066,Norcross,GA,30093-2667,Gwinnett,5030 GEORGIA BELLE COURT,SUITE 2066,NORCROSS,GA,30093,Gwinnett,Brian Williams,CHIEF EXECUTIVE OFFICER,770-279-3141,,bwilliams@fcpchealth.org,,,,,,
GA-002933,SOUTHSIDE MEDICAL CENTER - Norcross Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1922125574,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5127 Jimmy Carter Blvd,Suite 205,Norcross,GA,30093-1619,Gwinnett,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002934,CPACS Cosmo Health Center,"Center for Pan Asian Community Services, Inc. (CPACS)",1336493311,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",6185 Buford Hwy,Bldg G,Norcross,GA,30071-2350,Gwinnett,3510 Shallowford Road NE,,Atlanta,GA,30341-2909,DeKalb,Chaiwon Kim,CEO/President,770-936-0969,117,Chaiwon.kim@cpacs.org,Victoria Huynh,Vice President,770-936-0969,137,victoria.huynh@cpacs.org,
GA-002935,Norman Park Family Medicine Clinic,Norman Park Family Medicine Clinic,1518398049,Rural Health Clinics,139 E Broad,,Norman Park,GA,31771-5085,Colquitt,Norman Park Family Clinic,139 East Broad Street,Norman Park,GA,31771,Colquitt,Denise Romanowski,"Director, Practice Mgmt",229-891-9559,,dromanowski@colquittregional.com,,,,,,
GA-002936,Kid's Health,SOUTH CENTRAL PRIMARY CARE CENTER,1356709646,Federally Qualified Health Centers - Medical Services,602 N Irwin Ave,Suite B,Ocilla,GA,31774-5040,Irwin,406 W. 5th St.,,Ocilla,GA,31774,Irwin,Robert B Tucker Jr.,CEO,229-468-9166,2104,RTUCKER@SCPCCGA.ORG,Cathy McGill,CFO,229-468-9166,2105,cmcgill@scpccga.org,http://scpccga.org
GA-002937,South Central Family Medicine,SOUTH CENTRAL PRIMARY CARE CENTER,1558447896,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",607C N Irwin Ave,,Ocilla,GA,31774-5009,Irwin,406 W 5th St,,Ocilla,GA,31774-1421,Irwin,Robert B Tucker,CEO,229-468-9166,,rtucker@scpccga.org,SHANNON SMITH,MA,229-468-7762,,,
GA-002938,Southwest Family Practice,"SOUTHWEST GEORGIA HEALTH CARE, INC",1497019194,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",300 Medical Ct,,Oglethorpe,GA,31068,Macon,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002939,YourTown Health,"PALMETTO HEALTH COUNCIL, INC",1184884678,"Dental Providers, Federally Qualified Health Centers - Medical Services",643 Main St,,Palmetto,GA,30268-1138,Fulton,643 Main St,,Palmetto,GA,30268-1138,Fulton,Jon Wollenzien,CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
GA-002940,South Central Family Medicine,SOUTH CENTRAL PRIMARY CARE CENTER,1558445742,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",664 Main St N,,Pearson,GA,31642-7549,Atkinson,406 W 5th St,,Ocilla,GA,31774-1421,Irwin,Robert B Tucker,CEO,229-468-9166,,RTUCKER@SCPCCGA.ORG,LUCY PEDRAZA,LPN,912-422-3131,,,
GA-002941,"Albany Area Primary Health Care, Inc.","Albany Area Primary Health Care, Inc.",1427413137,Federally Qualified Health Centers - Medical Services,11949 US Highway 41,Dooly County Elementary and Middle School-Based Health Center,Pinehurst,GA,31070-7467,Dooly,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,,,,,,
GA-002942,Plains Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1225046998,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",107 Main St,,Plains,GA,31780-5570,Sumter,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002943,East Georgia Healthcare Center,"EAST GEORGIA HEALTHCARE CENTER, INC.",1093754905,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",117 Memorial Dr,,Reidsville,GA,30453-4641,Tattnall,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Bea Payne,Office Coordinator,912-705-5656,,bpayne@eghc.org,www.eghc.org
GA-002944,Optim Primary Care Reidsville,Optim Healthcare,1285893818,Rural Health Clinics,125 Memorial Dr,,Reidsville,GA,30453-4641,Tattnall,"Tattnall Hospital, LLC",247 South Main Street,Reidsville,GA,30453,Tattnall,Pam Swicord,RHC Director,912-557-1000,1237,pswicord@optimhealth.com,Rob Snipes,CEO,912-557-1000,1237,rsnipes@optimhealth.com,
GA-002945,Stewart Webster Rural Health Clinic,"SOUTHWEST GEORGIA HEALTH CARE, INC",1063422038,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",510 Alston St,,Richland,GA,31825-6012,Stewart,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002946,North Georgia Healthcare Center,North Georgia Healthcare Center,1356596399,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",6120 Alabama Hwy,,Ringgold,GA,30736-2804,Catoosa,6120 Alabama Hwy,,Ringgold,GA,30736-2804,Catoosa,Delaine Hunter,CEO,706-935-6442,,dhunter@nghcc.com,Craig Durante,COO/CFO,706-935-6442,,crdurante@nghcc.com,
GA-002947,SOUTHSIDE MEDICAL CENTER - Riverdale Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1427175090,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",275 Upper Riverdale Rd SW,Suite D,Riverdale,GA,30274-2556,Clayton,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quentin Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002948,Rochelle Medical Center,"SOUTHWEST GEORGIA HEALTH CARE, INC",1144401787,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",636 2nd Ave,,Rochelle,GA,31079-2046,Wilcox,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002949,Northwest Georgia Specialty Clinic,Floyd County Health Department,1851432173,Ryan White Providers,16 E 12th St SW,,Rome,GA,30161-4720,Floyd,16 East 12th Street,,Rome,GA,30161,Floyd,Janet Eberhart,Program Coordinator,706-802-5623,,Janet.eberhart@dph.ga.gov,Nichole Crick,Program Manager,706-295-6647,,nichole.crick@dph.ga.gov,
GA-002950,Primary Health Care Center Rossville,"PRIMARY HEALTH CARE CENTER OF DADE, INC.",1255512182,Federally Qualified Health Centers - Medical Services,1430 Suggs St,,Rossville,GA,30741-2223,Walker,13570 N Main St,,Trenton,GA,30752-2012,Dade,Diana Allen,CEO,706-620-4494,8549,allend@primaryhealthcarecenter.org,Amy Buffington,Administrative Services Manager/Credentialing,706-620-4494,8542,buffingtona@primaryhealthcarecenter.org,
GA-002951,MedLink Royston,"MEDLINK GEORGIA, INC",1336259340,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",930 Franklin Springs St,Suite A,Royston,GA,30662-3908,Franklin,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-002952,SANDERSVILLE COMMUNITY HLTH CTR,COMMUNITY HEALTH CARE SYSTEMS INC,1861666455,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",616 Ferncrest Dr,,Sandersville,GA,31082-1863,Washington,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002789,Hemophilia of Georgia,Hemophilia of Georgia,1699778563,Hemophilia Treatment Centers,8607 Robertsl Dr,Suite 150,Sandy Springs,GA,30350-2237,Fulton,8607 Roberts Dr,Suite 150,Sandy Springs,GA,30350-2237,Fulton,Edith Rosato,CEO,770-518-8272,233,earosato@hog.org,Mark O. Jolly,"VP, Payer Relations and Network Development",770-518-8272,204,mojolly@hog.org,www.hog.org
GA-002953,"CURTIS V. COOPER PRIMARY HEALTH CARE, INC",CURTIS V COOPER PRIMARY HEALTH CARE INC,1750314183,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",106 E Broad St,,Savannah,GA,31401-2917,Chatham,106 E Broad St,,Savannah,GA,31401-2917,Chatham,Albert B Grandy,CEO,912-527-1117,,agrandy@cvcphc.com,Cynthia Washington,Credentialing Coordinator,912-527-1097,,cwashington@cvcphc.com,
GA-002954,Chatham CARE Center,Chatham County Health Department,1164503124,Ryan White Providers,107 Fahm St,,Savannah,GA,31401-2391,Chatham,107 Fahm St,,Savannah,GA,31401,Chatham,Susan Alt,"Director, HIV Services",912-651-0995,,Susan.Alt@dph.ga.gov,Delores Cooper,Grants Manager,912-651-2293,,Delores.Cooper@dph.ga.gov,gachd.org
GA-002955,J C LEWIS DENTAL CENTER,"J C LEWIS PRIMARY HEALTH CARE CENTER, INC",1922301472,Dental Providers,107 Fahm St,,Savannah,GA,31401-2391,Chatham,125 FAHM STREET,,SAVANNAH,GA,31401,Chatham,SUPRENA JOINER,MEDICAL BILLER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002956,The J.C. Lewis Primary Health Care Center @ West Broad YMCA,"The J.C. Lewis Primary Health Care Center, Inc.",1922301472,Federally Qualified Health Centers - Medical Services,1110 May St,,Savannah,GA,31415-5470,Chatham,1110 May St,,Savannah,GA,31415-5470,Chatham,KADESIA GOLDEN,MEDICAL BILLER,912-721-6758,,KGOLDEN@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002957,"J C Lewis Primary Health Care Center, Inc.",J C LEWIS HEALTH CENTER,1922301472,Federally Qualified Health Centers - Medical Services,125 Fahm St,,Savannah,GA,31401-2391,Chatham,125 Fahm St,,Savannah,GA,31401-2391,Chatham,KADESIA GOLDEN,MEDICAL BILLER,912-721-6751,,KGOLDEN@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002958,CURTIS V. COOPER PRI HLTH CARE,CURTIS V COOPER PRIMARY HEALTH CARE INC,1316972599,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2 Roberts St,,Savannah,GA,31408-3524,Chatham,106 E Broad St,,Savannah,GA,31401-2917,Chatham,Albert B Grandy,CEO,912-527-1117,,agrandy@cvcphc.com,Cynthia Washington,Credentialing Coordinator,912-527-1097,,cwashington@cvcphc.com,
GA-002959,The J.C. Primary Health Care Center @Old Savannah City Mission,"The J.C. Lewis Primary Health Care Center, Inc.",1922301472,Federally Qualified Health Centers - Medical Services,2414 Bull St,,Savannah,GA,31401-9113,Chatham,2414 Bull St,,Savannah,GA,31405,Chatham,KADESIA GOLDEN,MEDICAL BILLER,912-721-6758,,KGOLDEN@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002960,The Salvation Army Homeless Shelter & Services Agency,J C LEWIS PRIMARY HEALTH CENTER,1922301472,Federally Qualified Health Centers - Medical Services,3100 Montgomery St,,Savannah,GA,31405-3212,Chatham,125 Fahm St,,Savannah,GA,31401-2391,Chatham,KADESIA GOLDEN,MEDICAL BILLER,912-721-6758,,KGOLDEN@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002961,Curtis V. Cooper Primary Health Care,CURTIS V COOPER PRIMARY HEALTH CARE INC,1659668010,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",349 W Bryan St,,Savannah,GA,31401-2356,Chatham,106 E Broad St,,Savannah,GA,31401-2917,Chatham,Albert B Grandy,CEO,912-527-1117,,agrandy@cvcphc.com,Cynthia Washington,Credentialing Coordinator,912-527-1097,,cwashington@cvcphc.com,
GA-002962,J C LEWIS HEALTH PEDIATRICS,"J C LEWIS PRIMARY HEALTH CARE CENTER, INC.",1922301472,Federally Qualified Health Centers - Medical Services,3802 Waters Ave,,Savannah,GA,31404-6210,Chatham,125 FAHM STREET,,SAVANNAH,GA,31401,Chatham,KADESIA GOLDEN,MEDICAL BILLER,912-721-6758,,KGOLDEN@JCLEWISHEALTH.ORG,SUPRENA JOINER,FRONT DESK MANAGER,912-721-6751,,SJOINER@JCLEWISHEALTH.ORG,
GA-002963,"MEMORIAL HEALTH UNIV MED CEN, INC (children's inpatient hospital)",Children's Hospital,1528177367,Children's Hospitals (inpatient only),4700 Waters Ave,,Savannah,GA,31404-6220,Chatham,4700 Waters Avenue,,Savannah,GA,31404,Chatham,James Martin Johnston,"Director, Ped Hem/Onc",912-350-8016,,martinjohnston@memorialhealth.com,,,,,,
GA-002964,"MEMORIAL HEALTH UNIV MED CEN, INC (hemophilia treatment centers)",Children's Hospital,1528177367,Hemophilia Treatment Centers,4700 Waters Ave,,Savannah,GA,31404-6220,Chatham,4700 Waters Avenue,,Savannah,GA,31404,Chatham,James Martin Johnston,"Director, Ped Hem/Onc",912-350-8016,,martinjohnston@memorialhealth.com,,,,,,
GA-002965,Curtis V. Cooper Women's Health Care Center,CURTIS V COOPER PRIMARY HEALTH CARE INC,1841683067,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5354 Reynolds St,Suite 420,Savannah,GA,31405-6011,Chatham,106 E Broad St,,Savannah,GA,31401-2917,Chatham,Albert B Grandy,CEO,912-527-1117,,agrandy@cvcphc.com,Cynthia Washington,Credentialing Coordinator,912-527-1097,,cwashington@cvcphc.com,
GA-002966,Planned Parenthood Savannah Health Center,"Planned Parenthood Southeast, Inc.",1609829282,Family Planning Providers,720 E 71st St,,Savannah,GA,31405-4907,Chatham,"241 Peachtree Street NE, Suite 400",,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,Staci Fox,CEO,404-688-9300,,staci.fox@ppse.org,www.ppse.org
GA-002967,YourTown Health Senoia,"Palmetto Health Council, Inc.",1235517343,Federally Qualified Health Centers - Medical Services,48 Main St,Suite 3A,Senoia,GA,30276-1895,Coweta,643 Main Street,,Palmetto,GA,30268,Fulton,"Jon W. Wollenzien, Jr.",,404-929-8824,222,wollenzi@aol.com,,,,,,www.yourtownhealth.com
GA-002968,SOUTHSIDE MEDICAL CENTER - Windy Hill Clinic,"SOUTHSIDE MEDICAL CENTER, INC.",1881711414,Federally Qualified Health Centers - Medical Services,578 Windy Hill Rd SE,,Smyrna,GA,30080-1367,Cobb,1046 Ridge Ave SW,,Atlanta,GA,30315-1640,Fulton,David M Williams,President/CEO,404-456-0245,,dwilliams@smcmed.com,Quention Huguley,Revenue Manager,404-688-1350,6929,qhuguley@smcmed.com,www.southsidemedical.net
GA-002969,"East Georgia Healthcare Center, Inc.","EAST GEORGIA HEALTHCARE CENTER, INC.",1700820917,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",452 Second St,,Soperton,GA,30457-3004,Treutlen,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Kim Mincey,Office Coordinator,912-685-4040,,kmincey@eghc.org,www.eghc.org
GA-002970,TriCounty Health System - Sparta,COMMUNITY HEALTH CARE SYSTEMS INC,1245417435,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",675 Hamilton St,,Sparta,GA,31087-1837,Hancock,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002971,Statesboro Pediatrics and Family Healthcare,"EAST GEORGIA HEALTHCARE CENTER, INC.",1821126400,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1570 Brampton Ave,,Statesboro,GA,30458-0855,Bulloch,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Pat Galletti,Office Coordinator,912-764-9196,,pgalletti@eghc.org,www.eghc.org
GA-002972,Bulloch Wellness Center,Southeast Health District,1043243876,Ryan White Providers,3 W Altman St,,Statesboro,GA,30458-5212,Bulloch,1101 Church St.,,Waycross,GA,31501,Ware,Shelby Freeman,Program Coordinator,912-764-2402,,Shelby.Freeman@dph.ga.gov,Amanda Coffee,Nurse Manager,912-389-4586,,Amanda.Coffee@dph.ga.gov,
GA-002973,"Oakhurst Medical Centers, Inc.","Oakhurst Medical Centers, Inc.",1417011487,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5582 Memorial Dr,,Stone Mountain,GA,30083-3215,DeKalb,5582 Memorial Drive,,Stone Mountain,GA,30083,DeKalb,Billie Inclan,Director of HR,404-564-9345,,Billie.Inclan@oakmed.org,Jeff Taylor,CEO,404-298-8998,,Jeff.Taylor@oakmed.org,
GA-002974,Primary Health Care Center Summerville,"PRIMARY HEALTH CARE CENTER OF DADE, INC.",1457770612,Federally Qualified Health Centers - Medical Services,11638 Highway 27,Suite 8,Summerville,GA,30747-8515,Chattooga,13570 N Main St,,Trenton,GA,30752-2012,Dade,Diana Allen,CEO,706-620-4494,8549,ALLEND@PRIMARYHEALTHCARECENTER.ORG,Amy Buffington,Administrative Services Manager/Credentialing,706-620-4494,8542,BUFFINGTONA@PRIMARYHEALTHCARECENTER.ORG,
GA-002975,Emanuel County Hospital Authority dba Smith Clinic,Emanuel Medical Center,1932531258,Rural Health Clinics,114 S Jefferson St,,Swainsboro,GA,30401-3146,Emanuel,117 Kite Road,,Swainsboro,GA,30401,Emanuel,Lindsay Smith,Practice Manager,478-237-7517,106,lsmith@emanuelmedical.org,,,,,,
GA-002976,PORTER FAMILY MEDICAL CLINIC RHC,EMANUEL COUNTY HOSPITAL AUTHORITY,1538586243,Rural Health Clinics,124 Victory Dr,,Swainsboro,GA,30401-3235,Emanuel,117 Kite Rd,ATTN DEBORAH DRIGGERS,Swainsboro,GA,30401,Emanuel,CAREY SHIMADA,REGIONAL CREDENTIALING SPECIALIST,801-628-8260,,CSHIMADA@ERHOSPITAL.COM,DEBORAH DRIGGERS,,478-289-1303,,DDRIGGERS@EMANUELMEDICAL.ORG,
GA-002977,SWAINSBORO INTERNAL MEDICINE RHC,EMANUEL COUNTY HOSPITAL AUTHORITY,1366784415,Rural Health Clinics,131A Victory Dr,,Swainsboro,GA,30401-3234,Emanuel,117 Kite Rd,ATTN DEBORAH DRIGGERS,Swainsboro,GA,30401,Emanuel,CAREY SHIMADA,REGIONAL CREDENTIALING SPECIALIST,801-628-8260,,CSHIMADA@ERHOSPITAL.COM,DEBORAH DRIGGERS,,478-289-1303,,DDRIGGERS@EMANUELMEDICAL.ORG,
GA-002978,"East Georgia Healthcare Center, Inc.","EAST GEORGIA HEALTHCARE CENTER, INC.",1831144971,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Andrea Martinez,Office Coordinator,478-237-2638,,amartinez@eghc.org,www.eghc.org
GA-002979,Ray Medical Clinic,Emanuel Medical Center,1679523419,Rural Health Clinics,401 W Main St,,Swainsboro,GA,30401-3110,Emanuel,117 Kite Rd,,Swainsboro,GA,30401,Emanuel,Beth Smith,Office Manager,478-237-9928,102,bsmith@emanuelmedical.org,,,,,,
GA-002980,Screven County Family Health Center,Screven County Hospital,1205879301,Rural Health Clinics,105 Rocky Ford Rd,,Sylvania,GA,30467-2027,Screven,215 Mims Road,,Sylvania,GA,30467,Screven,Darlette Perkins,Office Manager,912-564-7133,,dperkins@optimhealth.com,,,,,,
GA-002981,Optim Primary Care - Screven,Optim Healthcare,1518127687,Rural Health Clinics,213 Mims Rd,,Sylvania,GA,30467-1994,Screven,215 Mims Rd,,Sylvania,GA,30467,Screven,Kelli Luckey,Office Manager,912-564-2779,2435,kluckey@optimhealth.com,,,,,,
GA-002982,Talbotton Medical/Dental Clinic,"Valley Healthcare System, Inc.",1013951706,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",341 N Washington Ave,,Talbotton,GA,31827-2037,Talbot,1600 Fort Benning Roard,,Columbus,GA,31903-2834,Muscogee,Sarah Lang,Chief Executive Officer,706-987-8330,1011,SBankslang@aol.com,Jennifer Melvin,Chief Finance Officer,706-987-8330,1005,JMelvin@valleyhealthcolumbus.com,http://www.valleyhealthcolumbus.com
GA-002983,TENNILLE COMMUNITY HLTH CENTER,COMMUNITY HEALTH CARE SYSTEMS INC,1104876390,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",116 Smith St,,Tennille,GA,31089-1465,Washington,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-002984,Thomaston Convenient Care,"Southwest Georgia Health Care, Inc.",1093190670,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",101 Deluxe Cir,Suite B,Thomaston,GA,30286-3030,Upson,220 Alston Street,,Richland,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002985,Rural HIV Model Thomasville,"ALBANY AREA PRIMARY HEALTH CARE, INC",1235489683,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",14540 US Highway 19 S,Suite 1,Thomasville,GA,31757-4811,Thomas,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6209,Shelley.Spires@aaphc.org,Jocelyn Cooper,Operations Manager,229-431-1423,,,
GA-002986,PCSG - Thomasville,"PRIMARY CARE OF SOUTHWEST GEORGIA, INC.",1366641318,Federally Qualified Health Centers - Medical Services,454 Smith Ave,,Thomasville,GA,31792-5535,Thomas,360 College St,,Blakely,GA,39823-2554,Early,Ann Addison,CEO,229-723-2660,,aaddison@pcswga.org,Angie McVey,COO,229-723-2660,,amcvey@pcswga.org,
GA-002987,Primary Care of Southwest Georgia Midwifery Center,"PRIMARY CARE OF SOUTHWEST GEORGIA, INC.",1992102073,Federally Qualified Health Centers - Medical Services,916 S Broad St,,Thomasville,GA,31792-6113,Thomas,360 College St,,Blakely,GA,39823-2554,Early,Ann Addison,CEO,229-723-2660,,aaddison@pcswga.org,Angie McVey,COO,229-723-2660,,amcvey@pcswga.org,
GA-002988,Tifton Urgent Care,"SOUTHWEST GEORGIA HEALTH CARE, INC",1265720668,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1401 Tift Ave N,Suite B,Tifton,GA,31794-3577,Tift,220 ALSTON ST,,RICHLAND,GA,31825,Stewart,Linda Young,Administrative Secretary,229-273-8881,10,lyoung@swghc.org,,,,,,
GA-002989,Primary Health Care Center Trenton,"PRIMARY HEALTH CARE CENTER OF DADE, INC.",1437102449,"Dental Providers, Federally Qualified Health Centers - Medical Services",13570 N Main St,,Trenton,GA,30752-2012,Dade,13570 N Main St,,Trenton,GA,30752-2012,Dade,Diana Allen,CEO,706-620-4494,8549,allend@primaryhealthcarecenter.org,Amy Buffington,Administrative Services Manager/Credentialing,706-620-4494,8542,BUFFINGTONA@PRIMARYHEALTHCARECENTER.ORG,
GA-002990,"PRIMARY HEALTH CARE CENTER OF DADE, INC.","PRIMARY HEALTH CARE CENTER OF DADE, INC.",1699016527,"Dental Providers, Federally Qualified Health Centers - Medical Services",134 Rhea McClanahan Dr,Tiger Creek Elementary School,Tunnel Hill,GA,30755-7328,Catoosa,13570 N Main St,,Trenton,GA,30752-2012,Dade,Diana Allen,CEO,706-620-4494,8549,allend@primaryhealthcarecenter.org,Amy Buffington,Administrative Services Manager/Credentialing,706-620-4494,8542,BUFFINGTONA@PRIMARYHEALTHCARECENTER.ORG,http://www.primaryhealthcarecenter.org/locations/tiger-care-clinic
GA-002991,Twin City Family Medical Clinic,Emanuel Medical Center,1568750636,Rural Health Clinics,115 Gillikin St,,Twin City,GA,30471-3989,Emanuel,117 Kite Rd,,Swainsboro,GA,30401,Emanuel,Beth Smith,Office Manager,478-763-3036,,bsmith@emanuelmedical.org,,,,,,
GA-002992,Adult Health Promotion Clinic (South Health District) - Lowndes Co. Board of Health,GEORGIA PUBLIC HEALTH DISTRICT 8-1,1780749028,Ryan White Providers,601 N Lee St,,Valdosta,GA,31601-4725,Lowndes,601 N Lee St,,Valdosta,GA,31601-4725,Lowndes,SUSAN GREEN,BILLING SUPERVISOR,229-333-7587,,susan.green@dph.ga.gov,,,229-245-8711,,,http://dph.georgia.gov/sites/dph.georgia.gov/files/related_files/site_page/Georgia%20Ryan%20White%20Part%20B%20Primary%20Care%20Clinics.pdf
GA-002993,"East Georgia Healthcare Center, Inc.","EAST GEORGIA HEALTHCARE CENTER, INC.",1790924918,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",118 Alice Coleman Dr,,Vidalia,GA,30474-8860,Toombs,215 N Coleman St,,Swainsboro,GA,30401-3530,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Jean Marie Hunter,Office Coordinator,912-583-2277,,jmhunter@eghc.org,www.eghc.org
GA-002994,Dooly County Community Health Center,"ALBANY AREA PRIMARY HEALTH CARE, INC",1306164082,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1212 E Union St,,Vienna,GA,31092-7545,Dooly,204 N Westover Blvd,,Albany,GA,31707-2983,Dougherty,Shelley Spires,CEO,229-888-6559,6248,Shelley.Spires@aaphc.org,Carolyn Maddox,Operations Manager,229-268-8865,,,
GA-002995,PHYSICIANS' HEALTH GROUP- WADLEY,Jefferson Hospital,1699782037,Rural Health Clinics,162 N Main St,,Wadley,GA,30477-4951,Jefferson,1067 Peachtree Street,,Louisville,GA,30434,Jefferson,Jessica Guy,Administrative Manager,478-625-7000,205,jguy@jeffersonhosp.com,,,,,,
GA-002996,"East Georgia Healthcare Center, Inc.","East Georgia Healthcare Center,Inc.",1346625928,Federally Qualified Health Centers - Medical Services,257 N Main St,,Wadley,GA,30477-4962,Jefferson,215 N Coleman St,,Swainsboro,GA,30401,Emanuel,Jennie Wren Denmark,CEO,478-237-6262,,jwdenmark@eghc.org,Andrea Martinez,Office Coordinator,478-252-0027,,amartinez@eghc.org,www.eghc.org
GA-002997,YourTown Health,"PALMETTO HEALTH COUNCIL, INC",1497984769,Federally Qualified Health Centers - Medical Services,3939 White House Pkwy,,Warm Springs,GA,31830-2455,Meriwether,643 Main St,,Palmetto,GA,30268-1138,Fulton,"Jon W. Wollenzien, Jr.",CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
GA-002998,"First Choice Primary Care, Inc.","First Choice Primary Care, Inc.",1154747590,Federally Qualified Health Centers - Medical Services,207 Green St,,Warner Robins,GA,31093-2727,Houston,PO Box 4363,,Macon,GA,31208,Bibb,Katherine McLeod,CEO,478-787-4266,104,kmcleod@firstchoiceprimarycare.org,Dawn Janes,Billing Supervisor,478-787-4266,104,djanes@hotmail.com,
GA-002999,TriCounty Health System - Warrenton,COMMUNITY HEALTH CARE SYSTEMS INC,1376535278,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1008 Atlanta Hwy,,Warrenton,GA,30828-9109,Warren,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,CARLA W BELCHER,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-003000,"MCKINNEY COMMUNITY HEALTH CENTER, INC.","MCKINNEY COMMUNITY HEALTH CENTER, INC.",1487665733,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",218 Quarterman St,,Waycross,GA,31501-3547,Ware,218 Quarterman St,,Waycross,GA,31501-3547,Ware,Ola A Smith,CEO,912-287-0301,108,bwilson@mckinneyhealth.com,Stephanie Gill,A/R Billing Supervisor,912-287-9140,126,sgill@mckinneyhealth.com,http://www.mckinneymedicalcenter.com/
GA-003001,Medical Specialists,"Medical Specialists, Inc",1063459899,Rural Health Clinics,305 Jones Ave,,Waynesboro,GA,30830-1510,Burke,305 Jones Avenue,,Waynesboro,GA,30830,Burke,Debbie Metz,Practice Administrator,706-554-5147,221,metzd@msincga.com,,,,,,
GA-003002,Burke Medical Center Health Clinic,Burke Medical Center,1013933944,Rural Health Clinics,311 W 4th St,,Waynesboro,GA,30830-1511,Burke,351 S. Liberty Street,,Waynesboro,GA,30830,Burke,Allison T. Clark,Administrator,706-554-2176,206,aclark@burkemedical.net,Jerry Pickett,CFO,706-437-2683,,jlpickett@burkemedical.net,
GA-003003,MedLink Winder,"MEDLINK GEORGIA, INC",1033229059,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",133 W Athens St,,Winder,GA,30680-1786,Barrow,11 Charlie Morris Rd,,Colbert,GA,30628-2445,Madison,DAVID WARD,PRESIDENT AND CEO,706-788-3234,,DWARD@MEDLINKGA.ORG,STEVE BARBER,VP OF ADMINISTRATIVE SERVICES,706-788-3234,,SBARBER@MEDLINKGA.ORG,
GA-003004,WRENS PHYSICIANS' HEALTH GROUP,Jefferson Hospital,1801801543,Rural Health Clinics,400 Canterbury Dr,,Wrens,GA,30833-4072,Jefferson,1067 Peachtree Street,,Louisville,GA,30434,Jefferson,Jessica Guy,Administrative Manager,478-625-7000,205,jguy@jeffersonhosp.com,,,,,,
GA-003005,North Jefferson Medical Center,Medical Associates,1851334015,Rural Health Clinics,406 E Broad St,,Wrens,GA,30833-1113,Jefferson,305 Jones Avenue,,Waynesboro,GA,30815,Burke,Debbie Metz,Practice Administrator,706-554-5147,221,metzd@msincga.com,,,,,,
GA-003006,"Neighborhood Improvement Project, Inc. dba Medical Associates Plus @ Wrens","NEIGHBORHOOD IMPROVEMENT PROJECT, INC.",1760815773,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",501 E Broad St,,Wrens,GA,30833-1185,Jefferson,2467 Golden Camp Rd,,Augusta,GA,30906-5515,Richmond,J.R. Richards,CEO,706-790-4440,105,jrrichards@mapbt.com,Wesley Wood,CFO,706-790-4440,,wwood@mapbt.com,www.mapbt.com
GA-003007,"Community Health Care Systems Inc.- Wrens, GA",COMMUNITY HEALTH CARE SYSTEMS INC,1952712689,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",623 N Main St,,Wrens,GA,30833-1178,Jefferson,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,CBELCHER@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-003008,Johnson County Center for Community Health,"Community Health Care Systems, Inc.",1932150422,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,2251 W Elm St,,Wrightsville,GA,31096-2017,Johnson,Carla Belcher,CEO,478-552-7384,1211,LPRICE@CHCSGA.ORG,LYNN W PRICE,INSURANCE/BILLING,478-864-3448,2204,LPRICE@CHCSGA.ORG,
GA-003009,YourTown Health Milby Medical Center,"PALMETTO HEALTH COUNCIL, INC",1134344732,Federally Qualified Health Centers - Medical Services,16201 Barnesville St,,Zebulon,GA,30295-3380,Pike,643 Main St,,Palmetto,GA,30268-1138,Fulton,"Jon W. Wollenzien, Jr.",CEO,404-929-8824,222,wollenzi@aol.com,,,,,,
HI-003010,HANA COMMUNITY HEALTH CENTER,HANA COMMUNITY HEALTH CENTER,1992811954,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4590 Hana Hwy,,Hana,HI,96713,Maui,4590 Hana Hwy,,Hana,HI,96713,Hawaii,cheryl vasconcellos,EXECUTIVE DIRECTOR,808-248-7515,26,cvasconcellos@hanahealth.org,PETER METZ,OPERATIONS DIRECTOR,808-248-7515,27,pmetz@hanahealth.org,
HI-003011,Ko`olauloa Health Center,Ko`olauloa Health Center,1578508602,"Black Lung Clinics, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",54-316 Kamehameha Hwy # 6,,Hauula,HI,96717-9539,Honolulu,56-119 Pualalea Street,,Kahuku,HI,96731,Honolulu,Bryan L. Talisayan,COO,808-594-7250,,btalisayan@koolauloachc.org,,,,,,www.koolauloachc.org
HI-003012,Hilo Family Health Center,"Bay Clinic, Inc.",1225086887,Federally Qualified Health Centers - Medical Services,1178 Kinoole St,,Hilo,HI,96720-7206,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003013,Hilo Family Dental Center,"Bay Clinic, Inc.",1851676746,"Dental Providers, Federally Qualified Health Centers - Dental Services",1257 Kilauea Ave,Suite 100,Hilo,HI,96720-4205,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003014,Hawaii Family Dental Centers - Hilo,"Hawaii Dental Group, Inc.",1205992922,Dental Providers,400 Hualani St,Suite 192,Hilo,HI,96720-4339,Hawaii,500 Ala Moana Blvd,Suite 7-220,Honolulu,HI,96813,Honolulu,Diane McCawley,Billing Team Lead,808-523-3104,,dmccawley@hawaiifamilydental.com,Melanie Baji,Controller,808-523-3113,,mbaji@hawaiifamilydental.com,www.hawaiifamilydental.com
HI-003015,Hilo Women's Health Center,"Bay Clinic, Inc.",1568784304,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",73 Puuhonu Pl,Suite 204,Hilo,HI,96720-2060,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003016,Hamakua Health Center,"HAMAKUA HEALTH CENTER, INC.",1013993146,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",45-549 Plumeria St,,Honokaa,HI,96727-6902,Hawaii,45-549 Plumeria St,,Honokaa,HI,96727-6902,Hawaii,Irene Carpenter,CEO,808-930-2721,,icarpenter@hamakua-health.org,Milton Cortez,COO,808-775-7204,,mcortez@hamakua-health.org,
HI-003017,SHC - Honolulu,Shriners Hospitals for Children,1316065360,Children's Hospitals (inpatient only),1310 Punahou St,,Honolulu,HI,96826-1027,Honolulu,1310 Punahou St.,,Honolulu,HI,96826,Honolulu,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
HI-003018,Hemophilia and Thrombosis Treatment Center of Hawaii,Kapiolani Medical Center for Women and Children,1346315652,Hemophilia Treatment Centers,1319 Punahou St,,Honolulu,HI,96826-1080,Honolulu,1319 Punahou Street,,Honolulu,HI,96826,Honolulu,Desiree Medeiros,Medical Director,808-983-8551,,desireem@kapiolani.org,Gail Tashima,Nurse Coordinator,808-983-8551,,gailt@kapiolani.org,
HI-003019,Kapiolani Medical Center for Women and Children,Kapiolani Medical Center for Women and Children,1043263080,Children's Hospitals (inpatient only),1319 Punahou St,,Honolulu,HI,96826-1080,Honolulu,1319 Punahou St,,Honolulu,HI,96826,Honolulu,Jamie Ota,Contract Manager,808-535-7258,,jamie.ota@hawaiipacifichealth.org,Lorrie Luke,"VP, Contacting",808-535-7360,,lorrie-ann.luke@hawaiipacifichealth.org,
HI-003020,Honolulu Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1558424473,"Family Planning Providers, Sexually Transmitted Disease Clinics",1350 S King St,Number 310,Honolulu,HI,96814-2009,Honolulu,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/health-center/hawaii/honolulu/96814/honolulu-health-center-2951-91810
HI-003021,KUHIO PARK TERRACE PUB. HOUSING,KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES,1558583856,Federally Qualified Health Centers - Medical Services,1475 Linapuni St Bldg A # 115,,Honolulu,HI,96819-3569,Honolulu,2239 N School St,,Honolulu,HI,96819-2539,Honolulu,David D Derauf,Executive Director,808-791-9400,,Dderauf@kkv.net,Jo Ayers,COO,808-791-9413,,Jayers@kkv.net,www.kkv.net
HI-003022,Kokua Kalihi Valley Gulick Elder Center,KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES,1689896953,Federally Qualified Health Centers - Medical Services,1846 Gulick Ave,,Honolulu,HI,96819-4212,Honolulu,2239 N School St,,Honolulu,HI,96819-2539,Honolulu,David D Derauf,Executive Director,808-791-9400,316,Dderauf@kkv.net,Jo Ayers,COO,808-791-9413,,Jayers@kkv.net,www.kkv.net
HI-003023,KOKUA KALIHI VALLEY MAIN CLINIC,KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES,1114074622,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",2239 N School St,,Honolulu,HI,96819-2539,Honolulu,2239 N School St,,Honolulu,HI,96819-2539,Honolulu,David D Derauf,Executive Director,808-791-9400,316,david@kkv.net,Jo Ayers,COO,808-791-9413,,Jayers@kkv.net,www.kkv.net
HI-003024,Ohua Clinic,Waikiki Health Center,1679646509,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",277 Ohua Ave,,Honolulu,HI,96815-3695,Honolulu,Waikiki Health,277 Ohua Ave,Honolulu,HI,96815,Honolulu,Sheila Beckham,CEO,808-791-9302,,sbeckham@waikikihealth.org,Todd Okamoto,CFO,808-791-9319,,tokamoto@waikikihealth.org,www.waikikihealth.org
HI-003025,Youth Outreach,Waikiki Health,1063668473,Federally Qualified Health Centers - Medical Services,415 Keoniana St,,Honolulu,HI,96815-2018,Honolulu,277 Ohua Ave.,,Honolulu Ave.,HI,96815,Honolulu,Sheila Beckham,CEO,808-791-9302,,sbeckham@waikikihealth.org,Todd Okamoto,CFO,808-791-9319,,tokamoto@waikikihealth.org,
HI-003026,PATH Clinic,Waikiki Health,1528359791,Federally Qualified Health Centers - Medical Services,845 22nd Ave,Bldg 5,Honolulu,HI,96816-4521,Honolulu,277 Ohua Ave,,Honolulu,HI,96815,Honolulu,Sheila Beckham,CEO,808-791-9302,,sbeckham@waikikihealth.org,Todd Okamoto,CFO,808-791-9319,,tokamoto@waikikihealth.org,
HI-003027,KPHC Downtown Family Medical and Dental Center,Kalihi-Palama Health Center,1669644068,"Dental Providers, Federally Qualified Health Centers - Medical Services",89 S King St,,Honolulu,HI,96813-4315,Honolulu,915 North King Street,,Honolulu,HI,96817,Honolulu,Emmanuel Kintu,CEO/Executive Director,808-791-6315,,ekintu@kphc.org,Liane Sugimoto,CFO,808-843-7238,,lsugimoto@kphc.org,www.kphc.org
HI-003028,Kalihi-Palama Health Center,Kalihi-Palama Health Center,1457304966,"Dental Providers, Federally Qualified Health Centers - Medical Services",915 N King St,,Honolulu,HI,96817-4544,Honolulu,915 North King Street,,Honolulu,HI,96817,Honolulu,Emmanuel Kintu,CEO/Executive Director,808-791-6315,,ekintu@kphc.org,Liane Sugimoto,CFO,808-843-7238,,lsugimoto@kphc.org,www.kphc.org
HI-003029,Makahiki Clinic,Waikiki Health,1093156119,"Dental Providers, Federally Qualified Health Centers - Medical Services",935 Makahiki Way Fl 2,,Honolulu,HI,96826-2896,Honolulu,277 Ohua Ave,,Honolulu,HI,96815,Honolulu,Sheila Beckham,CEO,808-791-9302,,sbeckham@waikikihealth.org,Todd Okamoto,CFO,808-791-9319,,tokamoto@waikikihealth.org,
HI-003030,Next Step,Waikiki Health,1629330550,Federally Qualified Health Centers - Medical Services,Pier 1,Forrest Ave.,Honolulu,HI,96813,Honolulu,277 Ohua Ave,,Honolulu,HI,96815,Honolulu,Sheila Beckham,CEO,808-791-9302,,sbeckham@waikikihealth.org,Todd Okamoto,CFO,808-791-9319,,tokamoto@waikikihealth.org,
HI-003031,Ko`olauloa Health Center,Ko`olauloa Health Center,1578508602,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",56-119 Pualalea St,,Kahuku,HI,96731-2052,Honolulu,56-119 Pualalea Street,,Kahuku,HI,96731,Honolulu,Isabella K. Gary,COO,808-792-4600,,igary@koolauloachc.org,Terrence Aratani,CEO,808-293-9216,,taratani@koolauloachc.org,www.koolauloachc.org
HI-003032,Ko`olauloa Health Center,Ko`olauloa Health Center,1578508602,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",56-490 Kamehameha Hwy,Rm R-104,Kahuku,HI,96731-2200,Honolulu,PO Box 395,,Kahuku,HI,96731-0395,Honolulu,Isabella K. Gary,COO,808-792-4600,,igary@koolauloachc.org,Terrence Aratani,CEO,808-293-9216,,taratani@koolauloachc.org,www.koolauloachc.org
HI-003033,Kahului Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1558424473,"Family Planning Providers, Sexually Transmitted Disease Clinics",140 Hoohana St,Number 303,Kahului,HI,96732-2467,Maui,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/health-center/hawaii/kahului/96732/maui-health-center-2950-91810
HI-003034,WHCHC -- Kealakehe,WEST HAWAII COMMUNITY HEALTH CENTER INC,1053703066,"Dental Providers, Federally Qualified Health Centers - Medical Services",74-5214 Keanalehu Dr,,Kailua Kona,HI,96740,Hawaii,75-5751 Kuakini Hwy Ste 203,,Kailua Kona,HI,96740-1753,Hawaii,Richard J Taaffe,CEO,808-326-3884,,rtaaffe@westhawaiichc.org,,,,,,
HI-003035,Hawaii Family Dental - Kona,"Hawaii Dental Group, Inc.",1205992922,Dental Providers,75-1028 Henry St,Suite 102,Kailua Kona,HI,96740-1693,Hawaii,500 Ala Moana Blvd,Suite 7-220,Honolulu,HI,96813,Honolulu,Diane McCawley,Patient Advocate Manager,808-523-3104,,dmccawley@hawaiifamilydental.com,Melanie Baji,Controller,808-523-3113,,mbaji@hawaiifamilydental.com,www.hawaiifamilydental.com
HI-003036,WHCHC -- Kuakini,WEST HAWAII COMMUNITY HEALTH CENTER INC,1952335630,Federally Qualified Health Centers - Medical Services,75-5751 Kuakini Hwy,Suite 101A,Kailua Kona,HI,96740-1705,Hawaii,75-5751 Kuakini Hwy Ste 203,,Kailua Kona,HI,96740-1753,Hawaii,Richard J Taaffe,CEO,808-326-3884,,rtaaffe@westhawaiichc.org,,,,,,
HI-003037,HO'OLA LAHUI HAWAI'I,HO-OLA LAHUI HAWAII INC,1891098513,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",4800 Kawaihau Rd,Suite D,Kapaa,HI,96746-1964,Kauai,4491 Rice St Ste 106,,Lihue,HI,96766-1805,Kauai,David J Peters,CEO,808-240-0113,,dpkauai@hoolalahui.org,,,,,,www.hoolalahui.org
HI-003038,Kapolei Health Care Center,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1356416986,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",599 Farrington Hwy,Suite 100,Kapolei,HI,96707-2028,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,http://www.wcchc.com/Kapolei
HI-003039,"Molokai Ohana Health Care, Inc. dba Molokai Community Health Center","Molokai Ohana Health Care, Inc. dba Molokai Community Health Center",1770570780,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 Oki Pl,PO Box 2040,Kaunakakai,HI,96748-2040,Maui,30 Oki Place,PO 2040,Kaunakakai,HI,96748,Hawaii,Andrea Trenner,CEO,808-660-2601,,atrenner@molokaichc.org,,,,,,
HI-003040,Keaau Family Health & Dental Center,"Bay Clinic, Inc.",1104874619,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",16-192 Pili Mua St,,Keaau,HI,96749-8134,Hawaii,PO Box 69,16-192 Pili Mua St,Keaau,HI,96749-0069,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003041,WHCHC -- Kealakekua Keiki Health,WEST HAWAII COMMUNITY HEALTH CENTER INC,1841463080,"Dental Providers, Federally Qualified Health Centers - Medical Services",81-6627 Mamalahoa Hwy,Suite 106,Kealakekua,HI,96750-8180,Hawaii,75-5751 Kuakini Hwy Ste 203,,Kailua Kona,HI,96740-1753,Hawaii,Richard J Taaffe,CEO,808-326-3884,,rtaaffe@westhawaiichc.org,,,,,,
HI-003042,WHCHC -- Kealakekua Adult Health,WEST HAWAII COMMUNITY HEALTH CENTER INC,1346656311,Federally Qualified Health Centers - Medical Services,81-980 Halekii St,Suite 107,Kealakekua,HI,96750-8177,Hawaii,75-5751 Kuakini Hwy Ste 203,,Kailua Kona,HI,96740-1753,Hawaii,Richard J Taaffe,CEO,808-326-3884,,rtaaffe@westhawaiichc.org,,,,,,https://www.westhawaiichc.org/locations/kealakekua/
HI-003043,Hawaii Family Dental - Kihei,Hawaii Dental Group. Inc,1205992922,Dental Providers,1847 S Kihei Rd,Suite 101,Kihei,HI,96753-7939,Maui,500 Ala Moana Blvd,Suite 7-220,Honolulu,HI,96813,Honolulu,Diane McCawley,Patient Advocate Manager,808-523-3104,,dmccawley@hawaiifamilydental.com,Melanie Baji,Controller,808-523-3113,,mbaji@hawaiifamilydental.com,www.hawaiifamilydental.com
HI-003044,ADVENTIST HEALTH CASTLE LAIE RHC,ADVENTIST HEALTH CASTLE,1578948519,Rural Health Clinics,55-510 Kamehameha Hwy Laie,Suite 5,Laie,HI,96762,Honolulu,640 Ulukahiki St,,Kailua,HI,96734-4454,Honolulu,Derek Dickard,"Director, Operations Outpatient",808-263-5011,,DickarDA@AH.org,Travis Clegg,VP Operations,808-263-5142,,CleggTL@AH.org,https://www.adventisthealth.org/castle
HI-003045,Lana'i Community Health Center,LANA'I COMMUNITY HEALTH CENTER,1679754097,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",333 6th Street,,Lanai City,HI,96763,Maui,333 Sixth Street,,Lanai City,HI,96763,Maui,Diana M Shaw,Executive Director,808-565-6919,,dshaw@lanaicommunityhealthcenter.org,Cindy Figuerres,Chief Financial Officer,808-565-6919,,cfiguerres@lanaicommunityhealthcenter.org,www.lanaicommunityhealthcenter.org
HI-003046,Lana'i Community Health Center,LANA'I COMMUNITY HEALTH CENTER,1679754097,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",478 Lauhala Pl,,Lanai City,HI,96763,Maui,333 Sixth Street,,Lanai City,HI,96763,Maui,Diana M Shaw,Executive Director,808-565-6919,114,dshaw@lanaicommunityhealthcenter.org,Cindy Santiago,Chief Financial Officer,808-565-6919,123,csantiago@lanaicommunityhealthcenter.org,www.lanaicommunityhealthcenter.org
HI-003047,Campus Wellness Center,University of Hawaii -Kauai Community College,1467889295,Family Planning Providers,3-1901 Kaumualii Hwy,,Lihue,HI,96766-9500,Kauai,Kauai Community College,3-1901 Kaumualii Hwy,Lihue,HI,96766,Kauai,Charlene K Ono,Wellness Center Director,808-245-8307,,onoc@hawaii.edu,Diane Higa,,808-245-8307,,dahiga@hawaii.edu,https://sites.google.com/a/hawaii.edu/wellness/
HI-003048,Hawaii Family Dental - Kukui Grove,"Hawaii Dental Group, Inc.",1205992922,Dental Providers,4473 Pahee St,Suite K,Lihue,HI,96766-2037,Kauai,500 Ala Moana Blvd,Suite 7-220,Honolulu,HI,96813,Honolulu,Diane McCawley,Patient Advocate Manager,808-523-3104,,dmccawley@hawaiifamilydental.com,Melanie Baji,Controller,808-523-3113,,mbaji@hawaiifamilydental.com,www.hawaiifamilydental.com
HI-003049,HO'OLA LAHUI-HAWAII,HO-OLA LAHUI HAWAII INC,1952302770,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",4491 Rice St,Suite 106,Lihue,HI,96766-1805,Kauai,4491 Rice St Ste 106,,Lihue,HI,96766-1805,Kauai,David Peters,CEO,808-240-0113,,dpkauai@hoolalahui.org,,,,,,www.hoolalahui.org
HI-003050,Ka'u Family Health and Dental Center,"Bay Clinic, Inc.",1487602918,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",95-5583 Mamalahoa Hwy,,Na'alehu,HI,96772-8900,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720-2975,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003051,Pahoa Family Health Center,"Bay Clinic, Inc.",1265482624,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",15-2866 Pahoa Village Rd,Bldg C,Pahoa,HI,96778-7720,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003052,Pahoa Women and Children's Health Center,"Bay Clinic, Inc.",1689814022,"Black Lung Clinics, Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",15-2866 Pahoa Village Rd,Bldg F,Pahoa,HI,96778-7720,Hawaii,"450 Kilauea Avenue, Suite 105",,Hilo,HI,96720,Hawaii,Youlsau Bells,Interim Chief Executive Officer,808-930-0499,,ybells@bayclinic.org,Tess Spencer,Credentialing Coordinator,808-961-4082,,tspencer@bayclinic.org,bayclinic.org
HI-003053,Kamaile Olakino Maikai Health Center,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1285066985,Dental Providers,85-180 Ala Akau St,,Waianae,HI,96792-2323,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
HI-003054,"Waianae District Comprehensive Health and Hospital Board, Incorporated","Waianae District Comprehensive Health and Hospital Board, Incorporated",1942673264,Federally Qualified Health Centers - Medical Services,85-251 Farrington Hwy,Waianae High School School-based Health Center,Waianae,HI,96792-2113,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,http://www.wcchc.com/Contact/Waianae-High-School-Based-Health-Center
HI-003055,"Waianae District Comprehensive Health and Hospital Board, Incorporated","Waianae District Comprehensive Health and Hospital Board, Incorporated",1851764179,Federally Qualified Health Centers - Medical Services,85-626 Farrington Hwy,Waianae Intermediate School School-based Health Center,Waianae,HI,96792-2419,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,http://www.wcchc.com/Contact/Waianae-Intermediate-School-Based-Health-Center
HI-003056,Waianae Vision Care,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1902288830,Federally Qualified Health Centers - Medical Services,86-120 Farrington Hwy,Suite C-301,Waianae,HI,96792-3072,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
HI-003057,Waiola Clinic,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1164597795,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",86-120 Farrington Hwy,Suite C-305A,Waianae,HI,96792-3068,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
HI-003058,Waianae Coast Comprehensive Health Center,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1992730956,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",86-260 Farrington Hwy,,Waianae,HI,96792-3128,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
HI-003059,Leeward Pediatrics,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1295928497,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",87-2070 Farrington Hwy,Suite N,Waianae,HI,96792-3756,Honolulu,86-260 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
HI-003060,WHCHC - Waikoloa,WEST HAWAII COMMUNITY HEALTH CENTER INC,1649520644,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",68-1845 Waikoloa Rd,Suite 207,Waikoloa,HI,96738-5581,Hawaii,75-5751 Kuakini Hwy Ste 203,,Kailua Kona,HI,96740-1753,Hawaii,Richard J Taaffe,CEO,808-326-3884,,rtaaffe@westhawaiichc.org,Victoria Hanes,Director of Behavioral Health / Interim Chief Operating Officer,808-327-5170,,vkhanes@westhawaiichc.org,www.westhawaiichc.org
HI-012380,Hui No Ke Ola Pono,Hui No Ke Ola Pono,1881701357,Dental Providers,95 Mahalani St,Room 21,Wailuku,HI,96793-2521,Maui,"95 Mahalani St, Rm 21",,Wailuku,HI,96793,Maui,Emi Orikasa,Dental Director,808-244-4647,6854,eeorikasa@hnkop.org,Holly Ho,Finance Director,808-244-4647,6835,hho@hnkop.org,hnkop.org
HI-003061,WAIMANALO HEALTH CENTER,WAIMANALO HEALTH CENTER,1780738005,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",41-1347 Kalanianaole Hwy,,Waimanalo,HI,96795-1297,Honolulu,41-1347 Kalanianaole Hwy,,Waimanalo,HI,96795-1297,Honolulu,Mary Oneha,Chief Executive Officer,808-954-7107,,moneha@waimanalohealth.org,Christina Lee,Chief Medical Officer,808-954-7151,,clee@waimanalohealth.org,www.waimanalohealth.org
HI-003062,HO'OLA LAHUI HAWAI'I WEST,HO-OLA LAHUI HAWAII INC,1245269976,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",4643 Waimea Canyon Dr,,Waimea,HI,96796,Kauai,4491 Rice St Ste 106,,Lihue,HI,96766-1805,Kauai,David J Peters,CEO,808-240-0113,,dpkauai@hoolalahui.org,,,,,,www.hoolalahui.org
HI-003063,Waipahu Family Health Center,"Waianae District Comprehensive Health and Hospital Board, Incorporated",1730253626,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",94-428 Mokuola St,Suite 108B,Waipahu,HI,96797-3396,Honolulu,86-280 Farrington Hwy.,,Waianae,HI,96792,Honolulu,James Z. Chen,CFO,808-697-3300,,jchen@wcchc.com,Richard P. Bettini,President & CEO,808-697-3300,,wcchc@wcchc.com,
IA-003064,AKRON FAMILY PRACTICE CLINIC,Mercy Medical Services,1902840671,Rural Health Clinics,321 Mill St,,Akron,IA,51001-7712,Plymouth,"801 5th St., Suite 310",,Sioux City,IA,51101,Iowa,Lori Heeren,Office Manager,712-568-2411,2411,heerenl@mercyhealth.com,Jerry French,Supervisor Clinic Business Operations,712-279-5808,5808,frencj@mercyhealth.com,http://www.mercysiouxcity.com/akron-mercy-medical-clinic
IA-003065,Ames Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,2530 Chamberlain St,,Ames,IA,50014-7272,Story,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003066,Primary Health Care-Story County Clinic,"Primary Health Care, Inc.",1932539608,Federally Qualified Health Centers - Medical Services,3510 Lincoln Way,,Ames,IA,50014-7533,Story,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003067,Anthon Mercy Medical Clinic,Mercy Medical Services,1255379400,Rural Health Clinics,307 E Main St,,Anthon,IA,51004-7705,Woodbury,801 5th St Suite 310,,Sioux City,IA,51101,Woodbury,Denise White,Office Manager,712-378-2921,7183,whitedr@mercyhealth.com,Jerry French,Supervisor Clinic Business Operations,712-279-5808,5808,frencj@mercyhealth.com,http://www.mercysiouxcity.com/anthon-mercy-medical-clinic
IA-003068,Atkins Family Medical Clinic,Atkins Family Medical Clinic,1295099141,Rural Health Clinics,401 Cardinal Ave,,Atkins,IA,52206-4700,Benton,401 Cardinal Avenue,,Atkins,IA,52206,Benton,Taylor Frank,Credentialing,319-472-6300,,tfrank@vghinc.com,,,,,,
IA-003069,Atlantic Medical Center,Cass County Health System,1699976696,Rural Health Clinics,1501 E 10th St,,Atlantic,IA,50022-1936,Cass,1501 E 10th Street,,Atlantic,IA,50022,Cass,Beth Spieker,Chief Clinic Administrator,712-250-8121,,spibe@casshealth.org,,,,,,
IA-003070,Audubon County Memorial Hospital,Audubon County Memorial Hospital,1710951686,Inpatient Hospitals (other than children's hospitals),515 Pacific Ave,,Audubon,IA,50025-1056,Audubon,515 Pacific Ave,,Audubon,IA,50025,Audubon,Cristie Lynn Knudsen,Business Office Manager,712-563-5303,,knudsenc@acmhhosp.org,Melinda Alt,Chief Financial Officer,712-563-5305,,altm@acmhhosp.org,
IA-003071,CHI HEALTH BEDFORD CLINIC,Payer Strategy and Operations,1942381538,Rural Health Clinics,1502 Madison St,,Bedford,IA,50833-1043,Taylor,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003072,BELMOND CLINIC,Belmond Community Hospital dba Iowa Specialty Hospital Belmond,1841536745,Rural Health Clinics,403 1st St SE,,Belmond,IA,50421-1201,Wright,403 1st St SE,,Belmond,IA,50421,Wright,Kelly Leu,Business Office Leader,515-532-9231,9231,kelly.leu@iaspecialty.com,Greg Polzin,CFO,641-444-5623,5623,greg.polzin@iaspecialty.com,
IA-003073,Birmingham Medical Clinic,Van Buren County Hospital,1790854503,Rural Health Clinics,735 N Highway 1,,Birmingham,IA,52535-9004,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003074,Bonaparte Medical Clinic,Van Buren County Hospital,1962580944,Rural Health Clinics,604 1st St,,Bonaparte,IA,52620-1012,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003075,Gundersen Calmar Clinic,Gundersen Calmar Clinic,1306890959,Rural Health Clinics,106 E Main,PO Box 538,Calmar,IA,52132-0538,Winneshiek,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
IA-003076,Fox River Medical Clinic,Van Buren County Hospital,1578641593,Rural Health Clinics,14983 275th St,,Cantril,IA,52542-8087,Van Buren,Van Buren County Hospital,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003077,Health Services,"New Opportunities, Inc.",1083832455,Family Planning Providers,23751 Highway 30,,Carroll,IA,51401-8505,Carroll,PO Box 427,,Carroll,IA,51401,Carroll,Paula Klocke,Health Services Director,712-792-9266,201,pklocke@newopp.org,Vickie Steffes,Nurse Educator,712-792-9266,209,vsteffes@newopp.org,newopp.org
IA-003078,Cedar Falls Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,2520 Melrose Dr,Suite L,Cedar Falls,IA,50613-5248,Black Hawk,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003079,Eastern Iowa Health Center,Eastern Iowa Health Center,1578753703,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1201 3rd Ave SE,,Cedar Rapids,IA,52403-4009,Linn,1201 3rd Avenue SE,1201 3rd Avenue SE,Cedar Rapids,IA,52403,Linn,Joe Lock,Chief Executive Officer,319-730-7300,7326,jlock@eihc.co,Tim Goody,Chief Operating Officer,319-730-7300,7300,tgoody@eihc.co,www.easterniowahealthcenter.com
IA-003080,Cedar Rapids Health Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,3425 1st Ave SE,Suite 100,Cedar Rapids,IA,52402-6155,Linn,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003081,St. Luke's Family Health Center,Family Health Center,1578658738,"Family Planning Providers, Sexually Transmitted Disease Clinics",4251 River Center Ct NE,,Cedar Rapids,IA,52402-7549,Linn,4251 River Center Court NE,,Cedar Rapids,IA,52402,Linn,Valerie Campbell,Manager,319-369-7416,,valerie.campbell@unitypoint.org,,,,,,
IA-003082,Linn County Public Health,Linn County Public Health,1972873073,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",501 13th St NW,Linn County Public Health,Cedar Rapids,IA,52405-3747,Linn,Linn County Public Health,501 13th Street NW,Cedar Rapids,IA,52405,Linn,Barbara Chadwick,Community Health Division Director,319-892-6060,,Barbara.chadwick@linncounty.org,Heather Meador,Sr. Public Health Nurse,319-892-6061,,heather.meador@linncounty.org,http://www.linncounty.org/health
IA-003083,"River Hills Community Health Center, Centerville","RIVER HILLS COMMUNITY HEALTH CENTER, INC.",1912952367,"Dental Providers, Federally Qualified Health Centers - Medical Services",1015 N 18th St,Suite A,Centerville,IA,52544-1170,Appanoose,201 S Market St,,Ottumwa,IA,52501-2924,Wapello,Rick Johnson,CEO,641-683-5773,,rjohnson@riverhillshealth.org,Kim Grove,Billing Manager,641-684-6896,109,kgrove@riverhillshealth.org,
IA-003084,"Community Health Centers of Southern Iowa, Inc.","COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC.",1710102132,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",221 E State St,,Centerville,IA,52544-1813,Appanoose,302 NE 14th Street,,Leon,IA,50144,Decatur,Samantha Cannon,CEO/CFO,641-446-2383,1250,scannon@chcsi.org,Janeen Eddy,COO,641-446-2383,1234,jeddy@chcsi.org,www.chcsi.org
IA-003085,"Community Health Centers of Southern Iowa, Inc.","COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC.",1568672939,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1711 Osceola Ave,,Chariton,IA,50049-1516,Lucas,302 NE 14th Street,,Leon,IA,50144,Decatur,Samantha Cannon,CEO/CFO,641-446-2383,1250,scannon@chcsi.org,Janeen Eddy,COO,641-446-2383,1234,jeddy@chcsi.org,www.chcsi.org
IA-003086,Iowa Specialty Hospital and Clinic (inpatient hospital),Webster County Health Department,1710305636,Inpatient Hospitals (other than children's hospitals),1316 S Main St,,Clarion,IA,50525-2019,Wright,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Executive Director,515-573-4107,,kprescott@webstercountyia.org,Jennifer Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003087,Iowa Specialty Hospital and Clinic (multiple outpatient ECP categories),Webster County Health Department,1710305636,"Family Planning Providers, Sexually Transmitted Disease Clinics",1316 S Main St,,Clarion,IA,50525-2019,Wright,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Executive Director,515-573-4107,,kprescott@webstercountyia.org,Jennifer Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003088,CLarion Clinic,Iowa Specialty Hospital-Clarion,1497791511,"Family Planning Providers, Rural Health Clinics",215 13th Ave SW,,Clarion,IA,50525-2078,Wright,1316 South Main St,,Clarion,IA,50525,Wright,Kelly Leu,Business Office Leader,515-532-9231,9231,kelly.leu@iaspecialty.com,Greg Polzin,CFO,641-444-5623,5623,greg.polzin@iaspecialty.com,
IA-003089,Women's Health Services,"Women's Health Services of Eastern Iowa, Inc",1720056492,"Family Planning Providers, Sexually Transmitted Disease Clinics",2635 Lincoln Way,Suite A,Clinton,IA,52732-7229,Clinton,2635 Lincoln Way,Suite A,Clinton,IA,52732-7203,Clinton,Joanne Hermiston,CEO,563-241-1316,,jhermiston@gmtel.net,Diane McVey,Patient Service Representative,563-241-1314,,whsadminasst@gmtel.net,http://www.womenshealthservices.org
IA-003090,"Community Health Care, Inc. Clinton","Community Health Care, Inc.",1598152019,"Dental Providers, Federally Qualified Health Centers - Medical Services",925 S 4th St,,Clinton,IA,52732-5726,Clinton,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IA-003091,Primary Health Care-West Side Clinic,"Primary Health Care, Inc.",1396270831,Federally Qualified Health Centers - Medical Services,1601 NW 114th St,Suite 334,Clive,IA,50325-7035,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,HR Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003092,"Community Health Centers of Southeastern Iowa, Inc.","Community Health Centers of Southeastern Iowa, Inc.",1558340968,"Dental Providers, Federally Qualified Health Centers - Medical Services",2409 Spring St,,Columbus City,IA,52737-9302,Louisa,1706 W. Agency Rd,,West Burlington,IA,52655,Des Moines,Ronald W. Kemp,ceo,319-753-2300,100,rkemp@chcseia.com,Diane Rouse,CFO,319-753-2300,105,drouse@chcseia.com,
IA-003093,CHI Health Alegent Creighton Clinic Family Medicine Corning,"Catholic Health Initiatives, Payer Strategy",1952486433,Rural Health Clinics,601 Rosary Dr,,Corning,IA,50841-1683,Adams,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,"Director, Payer Strategy and Operations",402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
IA-003094,ALEGENT CREIGHTON HEALTH MERCY HOSPITAL,Payer Strategy and Operations,1699856260,Inpatient Hospitals (other than children's hospitals),603 Rosary Dr,,Corning,IA,50841-1683,Adams,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Directory Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003095,Correctionville Mercy Medical Clinic,Mercy Medical Services,1336187277,Rural Health Clinics,1120 Highway 20,,Correctionville,IA,51016-8055,Woodbury,801 5th St Suite 310,,Sioux City,IA,51101,Woodbury,Denise White,Office Manager,712-378-2921,7183,whitedr@mercyhealth.com,Jerry French,Supervisor Clinic Business Operations,712-279-5808,5808,frencj@mercyhealth.com,http://www.mercysiouxcity.com/correctionville-mercy-medical-clinic
IA-003096,Council Bluffs,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,1604 2nd Ave,,Council Bluffs,IA,51501-3801,Pottawattamie,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003097,ALEGENT HEALTH MERCY HOSPITAL,"Catholic Health Initiatives, Payer Strategy",1265517759,Inpatient Hospitals (other than children's hospitals),800 Mercy Dr,,Council Bluffs,IA,51503-3128,Pottawattamie,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,"Directory, Payer Strategy and Operations",402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003098,All Care Health Center,All Care Health Center,1114906906,"Dental Providers, Federally Qualified Health Centers - Medical Services",902 S 6th St,,Council Bluffs,IA,51501-6441,Pottawattamie,902 South 6th Street,,Council Bluffs,IA,51501,Pottawattamie,"William M. Wypyski, Jr.",Executive Director,207-951-6889,,bwypyski@allcarehealthcenter.org,,,,,,
IA-003099,Methodist Jennie Edmundson Hospital,Methodist Jennie Edmundson Hospital,1457448755,Inpatient Hospitals (other than children's hospitals),933 E Pierce St,,Council Bluffs,IA,51503-4626,Pottawattamie,933 E Pierce Street,,Council Bluffs,IA,51503,Pottawattamie,Jeff Francis,VP of Finance and CFO,402-354-5438,4023545438,jeff.francis@nmhs.org,Matt Edwards,Chief Network Development Officer,402-354-6588,4023546588,matt.edwards@nmhs.org,www.bestcare.org
IA-003100,Cresco Medical Clinic,Regional Health Services of Howard County,1669560199,Rural Health Clinics,321 8th Ave W,,Cresco,IA,52136-1064,Howard,321 8th Avenue West,,Cresco,IA,52136,Howard,Jessica McCabe,Director of Business Office,563-547-2101,,mccabejl@mercyhealth.com,,,,,,
IA-003101,Community Health Care Inc. Dental Clinic,"COMMUNITY HEALTH CARE, INC.",1598759029,Dental Providers,125 Scott St,,Davenport,IA,52801-1130,Scott,500 W River Dr,,Davenport,IA,52801-1014,Scott,Tom Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IA-003102,CHC Edgerton,"Community Health Care, Inc.",1427418276,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1510 E Rusholme St,,Davenport,IA,52803-2463,Scott,"Community Health Care, Inc.",500 W. River Drive,Davenport,IA,52801,Scott,Mateo Tiry-Ortiz,Outreach & Enrollment Coordinator,563-336-3202,,mtiryortiz@chcqca.org,Tom Bowman,CEO,563-336-3112,,tboman@chcqca.org,
IA-003103,"Community Health Care, Inc. Iowa Homeless Drop-In Clinic","Community Health Care, Inc.",1124008214,"Dental Providers, Federally Qualified Health Centers - Medical Services",303 W 6th St,,Davenport,IA,52803-5101,Scott,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IA-003104,"Community Health Care, Inc. River Dr Clinic","Community Health Care, Inc.",1932193224,"Dental Providers, Federally Qualified Health Centers - Medical Services",500 W River Dr,,Davenport,IA,52801-1014,Scott,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IA-003105,Gundersen Decorah Clinic,Gundersen Decorah Clinic,1982657458,"Community Mental Health Centers, Dental Providers, Rural Health Clinics",1830 State Highway 9,,Decorah,IA,52101-7301,Winneshiek,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
IA-003106,NEICAC Health Services,Northeast Iowa Community Action Corpor,1700953874,"Family Planning Providers, Other ECP Providers",305 Montgomery St,Suite 7,Decorah,IA,52101-2721,Winneshiek,Northeast Iowa Community Action Corporation,305 Montgomery,Decorah,IA,52101,Winneshiek,Courtney Adam,NEICAC Health Programs Coordinator,563-387-4934,,cadam@neicac.org,,,,,,http://www.neicac.org/
IA-003107,WINNESHIEK MEDICAL CENTER,WINNESHIEK MEDICAL CENTER,1619922051,Inpatient Hospitals (other than children's hospitals),901 Montgomery St,,Decorah,IA,52101-2325,Winneshiek,901 Montgomery St,,Decorah,IA,52101-2325,Winneshiek,Lynn Luloff,Chief Financial Officer,563-387-3109,,luloffl@winmedical.org,,,,,,www.winmedical.org
IA-003108,CCMH Medical Clinic-Main Campus,Crawford County Memorial Hospital,1104893700,Rural Health Clinics,100 Medical Pkwy,Suite A,Denison,IA,51442-2614,Crawford,100 Medical Parkway,,Denison,IA,51442,Crawford,Christine Marie Weber,Director of Provider Services,712-265-2701,2701,cweber@ccmhia.com,Staci Neumann,Clinic Supervisor,712-265-2802,2802,sneumann@ccmhia.com,
IA-003109,CCMH Medical Clinic--City Center,Crawford County Memorial Hospital,1134586811,Rural Health Clinics,115 N 14th St,,Denison,IA,51442-1452,Crawford,100 Medical Parkway,,Denison,IA,51442,Crawford,Christine Marie Weber,Director of Provider Services,712-265-2701,2701,cweber@ccmhia.com,Staci Neumann,Clinic Supervisor,712-265-2802,2802,sneumann@ccmhia.com,
IA-003110,Rosenfield Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,1000 E Army Post Rd,,Des Moines,IA,50315-5939,Polk,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003111,Mercy Children's Hospital and Clinics,Mercy Medical Center - Des Moines,1508964883,Children's Hospitals (inpatient only),1111 6th Ave,,Des Moines,IA,50314-2610,Polk,1111 6th Avenue,,Des Moines,IA,50314,Polk,Katy Little,Network Pricing Analyst Sr,515-643-7416,,KatyLittle@catholichealth.net,Bart Berg,Reimbursement Manager - Financial Services,515-643-7251,,bberg@mercydesmoines.org,
IA-003112,Blank Children's Hospital,Iowa Methodist Medical Center,1396837951,Children's Hospitals (inpatient only),1200 Pleasant St,,Des Moines,IA,50309-1453,Polk,1200 Pleasant St.,,Des Moines,IA,50309,Polk,Timothy McCulley,Director of Payor Contracting,515-241-3754,,timothy.mcculley@unitypoint.org,Crystal Estabrook,Director of Reimbursement,515-362-5103,,crystal.estabrook@unitypoint.org,
IA-003113,Primary Health Care-University Clinic,"Primary Health Care, Inc.",1417005919,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1200 University Ave,Suite 120,Des Moines,IA,50314-2355,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003114,Primary Health Care-University Dental Clinic,"Primary Health Care, Inc.",1720539091,Dental Providers,1200 University Ave,Suite 100,Des Moines,IA,50314-2355,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,HR Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003115,Primary Health Care at Central Iowa Shelter & Services,"Primary Health Care, Inc.",1871716498,"Dental Providers, Federally Qualified Health Centers - Medical Services",1420 Mulberry St,,Des Moines,IA,50309-3618,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003116,Primary Health Care at Scavo,"Primary Health Care, Inc.",1083086359,Federally Qualified Health Centers - Medical Services,1800 Grand Ave,,Des Moines,IA,50309-3310,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,HR/Credentialing Specialist,515-248-1490,,rmiller@phcinc.net,
IA-003117,Susan Knapp Health Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,2304 University Ave,,Des Moines,IA,50311-4316,Polk,818 5th Ave,Suite 200,Des Moines,IA,50309,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0462,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003118,Primary Health Care - Bery Engebretsen Clinic,PRIMARY HEALTH CARE INC,1588692487,"Dental Providers, Family Planning Providers",2353 SE 14th St,,Des Moines,IA,50320-1109,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,Chief Executive Officer,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003119,Primary Health Care at Mercy,"Primary Health Care, Inc.",1316379845,Federally Qualified Health Centers - Medical Services,250 Laurel St,,Des Moines,IA,50314-3024,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003120,Primary Health Care-East Side Clinic,"Primary Health Care, Inc.",1124177407,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3509 E 29th St,,Des Moines,IA,50317-4253,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Sepcialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003121,Primary Health Care at Hoover/Meredith,"Primary Health Care, Inc.",1598204182,Federally Qualified Health Centers - Medical Services,4800 Aurora Ave,,Des Moines,IA,50310-2903,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,HR Specialist,515-249-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003122,Primary Health Care at Youth Emergency Shelter Services,"Primary Health Care, Inc.",1275656787,Federally Qualified Health Centers - Medical Services,918 SE 11th St,,Des Moines,IA,50309-5324,Polk,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003123,"Genesis Medical Center, DeWitt",Genesis Health System,1649368523,Inpatient Hospitals (other than children's hospitals),1118 11th St,,DeWitt,IA,52742-1353,Clinton,1227 East Rusholme,,Davenport,IA,52803,Scott,Jill M. Mundt,Revenue Cycle Coordinator,563-421-1986,,mundtj@genesishealth.com,Kurt Coleman,Administrator,563-652-4020,,colemanc@genesishealth.com,
IA-003124,Douds Medical Clinic,Van Buren County Hospital,1801966585,Rural Health Clinics,14204 Highway 98,,Douds,IA,52551-8158,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003125,Crescent Community Health Center,Crescent Community Health Center,1720146319,"Dental Providers, Federally Qualified Health Centers - Medical Services",1789 Elm St,Suite A,Dubuque,IA,52001-2256,Dubuque,1789 Elm St.,Suite A,Dubuque,IA,52001-2256,Dubuque,Julie Woodyard,Executive Director,563-690-2860,,jwoodyard@crescentchc.org,Mary Brimeyer,Finance Director,563-690-2862,,mbrimeyer@crescentchc.org,
IA-003126,Hillcrest Community Mental Health Center,Hillcrest Family Services,1326096116,Community Mental Health Centers,2005 Asbury Rd,,Dubuque,IA,52001-3042,Dubuque,2005 Asbury Road,,Dubuque,IA,52001,Dubuque,Julie Ann Heiderscheit,Chief Operating Officer,563-583-7357,209,julie.heiderscheit@hillcrest-fs.org,Erica Borgerding,VP of Health,563-583-7357,,erica.borgerding@hillcrest-fs.org,www.hillcrest-fs.org
IA-003127,Hillcrest Family Services Clinic,Hillcrest Family Services Clinic,1063678936,Family Planning Providers,220 W 7th St,,Dubuque,IA,52001-2375,Dubuque,2005 Asbusry Rd,,Dubuque,IA,52001,Dubuque,GISELE CARBONE KRUGER,COO,563-583-6431,305,gisele.carbone-kruger@hillcrest-fs.org,Gisele Carbone Kruger,Clinic Manager,563-583-6431,,erica.borgerding@hillcrest-fs.org,http://www.hillcrest-fs.org
IA-003128,Burgess Family Clinic - Dunlap,Burgess Health Center,1780637678,Rural Health Clinics,612 Iowa Ave,,Dunlap,IA,51529-1334,Harrison,1600 Diamond,,Onawa,IA,51040,Monona,Teresa Butler,VP Clinical Services,712-423-9373,,tbutler@burgesshc.org,,,,,,www.burgesshc.org
IA-003129,ALEGENT HEALTH DUNLAP RURAL HEALTH CLINIC,Payer Strategy and Operations,1316028020,Rural Health Clinics,707 Iowa Ave,,Dunlap,IA,51529-1335,Harrison,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Directory Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003130,UnityPoint Family Medicine Eagle Grove,UnityPoint Clinic,1861761009,Rural Health Clinics,115 S Park Ave,,Eagle Grove,IA,50533-2219,Wright,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,715-660-1423,,Doris.Hott@unitypoint.org,Carolyn Matteson,Clinic Administrator,575-448-5185,,Carolyn.Matteson@unitypoint.org,
IA-003131,Earlham Medical Clinic,Madison County Memorial Hospital,1497810097,Rural Health Clinics,125 W 1st St,PO Box 516,Earlham,IA,50072-7705,Madison,300 W. Hutchings Street,,Winterset,IA,50273,Madison,Shelley Weeks,Clinic Director,515-462-2950,541,sweeks@madisonhealth.com,,,,,,
IA-003132,Cornerstone Family Practice - Edgewood,Guttenberg Municipal Hospital,1831441096,Rural Health Clinics,101 S Washington St,,Edgewood,IA,52042-8512,Delaware,PO Box 550,,Guttenberg,IA,52052,Crawford,Lisa Manson,Clinic Operations Officer,563-252-5526,,lisa.manson@guttenberghospital.org,,,,,,
IA-003133,Regional Family Health-Edgewood,Regional Family Health,1871662163,Rural Health Clinics,702 W Union St,,Edgewood,IA,52042-8187,Delaware,709 W Main Street,PO Box 359,Manchester,IA,52057-0359,Delaware,Lori Weber,Business Services Manager,563-927-7533,,lweber@regmedctr.org,Michelle Paris,Provider Support Coordinator,563-927-7904,,mparis@regmedctr.org,
IA-003134,Family Practice Clinic Emmetsburg,Palo Alto County Health System,1326051574,Rural Health Clinics,3201 1st St,,Emmetsburg,IA,50536-2516,Palo Alto,3201 1st St.,,Emmetsburg,IA,50536,Palo Alto,Jordan Bragg,Administrative Secretary,712-852-5500,55746,Jordan.J.Bragg@mercyhealth.com,,,,,,
IA-003135,Farmington Medical Clinic,Van Buren County Hospital,1992875678,Rural Health Clinics,206 S 4th St,,Farmington,IA,52626-9235,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownswoth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003136,Gundersen Palmer Lutheran Hospital and Clinics-Fayette,Gundersen Palmer Lutheran Hospital and Clinics,1053366518,Federally Qualified Health Centers - Medical Services,110 King St,,Fayette,IA,52142-9735,Fayette,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Kari Adank,CCO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
IA-003137,UnityPoint Clinic Family Medicine Fonda,UnityPoint Clinic,1831468073,Rural Health Clinics,101 N Main St,,Fonda,IA,50540-7729,Pocahontas,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Justin Wieck,Clinic Administrator,712-662-6301,,Justin.Wieck@unitypoint.org,
IA-003138,Forest City Clinic NICAO,North Iowa Community Action Organization,1568519676,Family Planning Providers,135 School St,,Forest City,IA,50436-1644,Winnebago,100 1st St NW,,Mason City,IA,50401-3130,Cerro Gordo,Lisa Koppin,Health Services Coordinator,641-423-5044,17,lkoppin@nicao-online.org,Stacy Parcher,Medical Billing Coordinator,641-423-5044,25,spartcher@nicao-online.org,www.nicao-online.org
IA-003139,Webster County Health Department,Webster County Health Department,1710305636,Family Planning Providers,110 N 12th St,,Fort Dodge,IA,50501-4023,Webster,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Director,515-573-4107,,kprescott@webstercountyia.org,Jennife Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003140,Community Health Center of Fort Dodge,"Community Health Center of Fort Dodge, Inc",1225083728,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Sexually Transmitted Disease Clinics",126 N 10th St,,Fort Dodge,IA,50501-3915,Webster,126 N 10th St,,Fort Dodge,IA,50501,Webster,Renae Kruckenberg,CEO,515-576-6500,1021,rkruckenberg@chcfortdodge.com,Colleen Koester,COO,515-576-6500,1025,ckoester@chcfortdodge.com,http://www.chcfd.com
IA-003141,UnityPoint Clinic Family Medicine Second Ave North,UnityPoint Clinic,1770991853,Rural Health Clinics,1428 2nd Ave N,,Fort Dodge,IA,50501-4119,Webster,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Dena Sheffield,Clinic Administrator,515-574-6004,,Dena.Sheffield@unitypoint.org,
IA-003142,Webster County Health Department,Webster County Health Department,1710305636,"Family Planning Providers, Sexually Transmitted Disease Clinics",723 1st Ave S,Suite 220,Fort Dodge,IA,50501-4633,Webster,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Executive Director,515-573-4107,,kprescott@webstercountyia.org,Jennifer Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003143,UnityPoint Clinic Family Medicine Kenyon Road,UnityPoint Clinic,1861800948,Rural Health Clinics,800 Kenyon Rd,Suite S,Fort Dodge,IA,50501-5776,Webster,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Linda.Schafer,Clinic Administrator,515-574-6816,,Linda.Schafer@unitypoint.org,
IA-003144,UnityPoint Clinic Pediatrics Fort Dodge,UnityPoint Clinic,1033527114,Rural Health Clinics,804 Kenyon Rd,Suite D,Fort Dodge,IA,50501-5744,Webster,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Julie Bass,Clinic Administrator,515-574-6896,,Julie.Bass@unitypoint.org,
IA-003145,Fort Madison Physicians & Surgeons,Fort Madison Community Hospital,1629024286,Outpatient Hospital Clinics,5409 Avenue O,Suite 1,Fort Madison,IA,52627-9673,Lee,5445 Avenue O,,Fort Madison,IA,52627,Lee,Jeremy Alexander,Controller,319-376-2015,,jalexander@fmchosp.com,Cheryl Albin,Revenue Cycle Specialist,319-376-2415,,calbin@fmchosp.com,
IA-003146,Fort Madison Community Hospital,Fort Madison Community Hospital,1902810856,Inpatient Hospitals (other than children's hospitals),5445 Avenue O,,Fort Madison,IA,52627-9611,Lee,5445 Avenue O,,Fort Madison,IA,52627,Lee,Jeremy Alexander,Controller,319-376-2015,,jalexander@fmchosp.com,Cheryl Albin,Revenue Cycle Specialist,319-376-2415,,calbin@fmchosp.com,
IA-003147,Cornerstone Family Practice - Garnavillo,Guttenberg Municipal Hospital,1386996544,Rural Health Clinics,101 E Watson St,,Garnavillo,IA,52049-9718,Clayton,PO Box 550,,Guttenberg,IA,52052,Clayton,Lisa Manson,Clinic Operations Officer,563-252-5526,,lisa.manson@guttenberghospital.org,,,,,,
IA-003148,Sanford Rock Rapids George Clinic,Sanford Health,1972785723,Rural Health Clinics,101 N Main St,,George,IA,51237-7741,Lyon,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,701-234-2076,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
IA-003149,MCCRARY ROST CLINIC,Stewart Memorial Community Hospital,1588690267,Rural Health Clinics,1800 Main St,,Gowrie,IA,50543-7438,Webster,1301 West Main,,Lake City,IA,51449,Calhoun,Jim Henkenius,CFO,712-464-4200,,jihenkenius@stewartmemorial.org,Cynthia Carstens,COO,712-464-4218,,ccarstens@stewartmemorial.org,
IA-003150,Adair County Medical clinic Greenfield (inpatient hospital),Adair County Health System,1457398414,Inpatient Hospitals (other than children's hospitals),609 SE Kent St,,Greenfield,IA,50849-9454,Adair,609 SE Kent,,Greenfield,IA,50849,Adair,Emily Simmons,Clinic Manager,641-743-7285,,esimmons@adaircountyhealthsystem.org,,,,,,
IA-003151,Adair County Medical clinic Greenfield (rural health clinics),Adair County Health System,1457398414,Rural Health Clinics,609 SE Kent St,,Greenfield,IA,50849-9454,Adair,609 SE Kent,,Greenfield,IA,50849,Adair,Emily Simmons,Clinic Manager,641-743-7285,,esimmons@adaircountyhealthsystem.org,,,,,,
IA-003152,Central Iowa Family Planning - Grinnell,Central Iowa Family Planning,1407921554,Family Planning Providers,717 5th Ave,Suite 4,Grinnell,IA,50112-1600,Poweshiek,717 5th Ave Ste 4,Po Box 146,Grinnell,IA,50112-1600,Poweshiek,Cindy Krull,LPN,641-236-7787,,ckrull@cifp.org,Mandi Beeghly,Executive Director,641-752-7159,,mbeeghly@cifp.org,http://www.cifp.org
IA-003153,"Griswold Medical Center, RHC",Cass County Health System,1316148307,Rural Health Clinics,1109 Morningside Dr,,Griswold,IA,51535-8067,Cass,1109 Morningside Drive,,Griswold,IA,51535,Cass,Beth Spieker,Chief Clinic Administrator,712-250-8121,,spibe@casshealth.org,,,,,,
IA-003154,Cornerstone Family Practice- Guttenberg,Guttenberg Municipal Hospital,1972855286,Rural Health Clinics,200 Main St,,Guttenberg,IA,52052-9108,Clayton,PO Box 550,,Guttenberg,IA,52052,Clayton,Lisa Manson,Clinic Operations Officer,563-252-5526,,lisa.manson@guttenberghospital.org,,,,,,
IA-003155,MEDICAL CLINIC,"Medical Clinic, P.C.",1972575595,Rural Health Clinics,1219 Main St,,Hamburg,IA,51640-1300,Fremont,1219 Main St,,Hamburg,IA,51640-1300,Fremont,Nancy A Buckalew,Administrator,712-382-2626,,clinic@hamburgia.net,,,,,,https://medclinicpc.com
IA-003156,Hampton Clinic NICAO,North Iowa Community Action Organization,1568519676,Family Planning Providers,114 1st Ave NW,,Hampton,IA,50441-1705,Franklin,100 1st St NW,,Mason City,IA,50401-3130,Cerro Gordo,Lisa Koppin,Health Services Coordinator,641-423-5044,17,lkoppin@nicao-online.org,Stacy Parcher,Medical Billing Coordinator,641-423-5044,25,sparcher@nicao-online.org,www.nicao-online.org
IA-003157,Hampton Clinic,Bemond Community Hospital dba Iowa Specialty Hospital Belmond,1114269339,Rural Health Clinics,700 2nd St SE,,Hampton,IA,50441-2655,Franklin,403 1st St SE,,Belmond,IA,50421,Wright,Kelly Leu,Business Office Leader,515-532-9231,9231,kelly.leu@iaspecialty.com,Greg Polzin,CFO,641-444-5623,5623,greg.polzin@iaspecialty.com,
IA-003158,Hartley Mercy Medical Clinic,Baum Harmon Mercy Hospital,1518901107,Rural Health Clinics,231 N 8th Ave W,,Hartley,IA,51346-1077,O'Brien,255 N Welch Ave,,Primghar,IA,51245,O'Brien,Debra Prins,Clinic Office Manager,712-957-2312,,prinsd@mercyhealth.com,,,,,,
IA-003159,Regional Family Health-Hopkinton,Regional Family Health,1497824353,Rural Health Clinics,122 1st St SW,,Hopkinton,IA,52237-7769,Delaware,709 W Main Street,PO Box 359,Manchester,IA,52057-0359,Delaware,Lori Weber,Business Services Manager,563-927-7533,,lweber@regmedctr.org,Michelle Paris,Provider Support Coordinator,563-927-7904,,mparis@regmedctr.org,
IA-003160,HUMBOLDT COUNTY MEMORIAL HOSPITAL,Webster County Health Department,1710305636,"Family Planning Providers, Sexually Transmitted Disease Clinics",1000 15th St N,,Humboldt,IA,50548-1008,Humboldt,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Executive Director,515-573-4107,,kprescott@webstercountyia.org,Jennifer Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003161,UnityPoint Clinic Family Medicine Humboldt,UnityPoint Clinic,1619246899,Rural Health Clinics,1010 15th St N,,Humboldt,IA,50548-1008,Humboldt,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,D'Etta Lester,Clinic Administrator,515-332-3385,,DEtta.Lester@unitypoint.org,
IA-003162,Horn Memorial Hospital,Ida County Iowa Community Hospital dba Horn Memorial Hospital,1326271073,Inpatient Hospitals (other than children's hospitals),700 E 2nd St,,Ida Grove,IA,51445-1601,Ida,701 E 2nd Street,,Ida Grove,IA,51445,Ida,Marcia Fehring,CFO,712-364-3311,,mfehring@hornmemorialhospital.org,Michelle Weber,Director of Clinics,712-364-2514,7213,mweber@hornmemorialhospital.org,
IA-003163,Horn Physicians Clinic,Ida County Iowa Community Hospital dba Horn Memorial Hospital,1326271073,Rural Health Clinics,700 E 2nd St,,Ida Grove,IA,51445-1601,Ida,701 E 2nd Street,,Ida Grove,IA,51445,Ida,Marcia Fehring,CFO,712-364-3311,,mfehring@hornmemorialhospital.org,Michelle Weber,Director of Clinics,712-364-2514,7213,mweber@hornmemorialhospital.org,
IA-003164,UNIVERSITY OF IOWA HOSPITAL & CLINICS (inpatient hospital),University of Iowa Health Care,1376544320,Inpatient Hospitals (other than children's hospitals),200 Hawkins Dr,,Iowa City,IA,52242-1009,Johnson,200 Hawkins Dr,,Iowa City,IA,52242-1009,Johnson,Megan Threlkeld (Fee for Service contact),"Director, Payor Relations",319-467-8983,,megan-threlkeld@uiowa.edu,Jennifer Vermeer (Value-based contact),AVP for Health Policy and Population Health,319-467-7092,,jennifer-vermeer@uiowa.edu,https://www.uihealthcare.org/
IA-003165,UNIVERSITY OF IOWA HOSPITAL & CLINICS (multiple outpatient ECP categories),University of Iowa Health Care,1376544320,"Dental Providers, Family Planning Providers, Hemophilia Treatment Centers, Other ECP Providers, Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 Hawkins Dr,,Iowa City,IA,52242-1009,Johnson,200 Hawkins Dr,,Iowa City,IA,52242-1009,Johnson,Megan Threlkeld (Fee for Service contact),"Director, Payor Relations",319-467-8983,,megan-threlkeld@uiowa.edu,Jennifer Vermeer (Value-based contact),AVP for Health Policy and Population Health,319-467-7092,,jennifer-vermeer@uiowa.edu,https://www.uihealthcare.org/
IA-003166,Iowa City,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,850 Orchard St,,Iowa City,IA,52246-5412,Johnson,818 5th Ave,Suite 200,Des Moines,IA,50309,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
IA-003167,VAN DIEST FAMILY HEALTH CLINIC OF JEWELL,Hamilton County Public Hospital dba Van Diest Medical Center,1851308423,Outpatient Hospital Clinics,731 Main St,,Jewell,IA,50130-2040,Hamilton,2350 HOSPITAL DRIVE,,Webster City,IA,50595,Hamilton,ALICE HEINRICHS,CFO,515-832-7751,,AHEINRICHS@VANDIESTMC.ORG,ASHLEY ALLERS,Revenue Cycle Director,515-832-7715,,AGRITTERS@VANDIESTMC.ORG,WWW.VANDIESTMC.ORG
IA-003168,WCHC Kalona Clinic,Washington County Hospital and Clinics,1598134090,Rural Health Clinics,207 1st St,,Kalona,IA,52247-9729,Washington,400 E Polk St,,Washington,IA,52353,Washington,Brett Antczak,Chief Clinic Officer,319-863-3904,,bantczak@wchc.org,Shelli Cleverley,Finance Director,319-863-3919,,scleverley@wchc.org,www.wchc.org
IA-003169,CHC/SEIA Keokuk Clinic,"Community Health Centers of Southeastern Iowa, Inc.",1558340968,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",400 N 17th St,,Keokuk,IA,52632-3452,Lee,1706 W. Agency Rd.,,West Burlington,IA,52655,Des Moines,Ronald W. Kemp,CEO,319-753-2300,100,rkemp@chcseia.com,Diane Rouse,CFO,319-753-2300,105,drouse@chcseia.com,
IA-003170,Keosauqua Medical Clinic,Van Buren County Hospital,1831260280,Rural Health Clinics,304 Franklin St,,Keosauqua,IA,52565-1164,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003171,Van Buren County Hospital,Van Buren County Hospital,1508810714,Inpatient Hospitals (other than children's hospitals),304 Franklin St,,Keosauqua,IA,52565-1164,Van Buren,304 Franklin Street,,Keosauqua,IA,52565,Van Buren,Kara McEntee,CFO,319-293-8722,,kara.mcentee@vbch.org,Ray Brownsworth,CEO,319-293-8725,,ray.brownsworth@vbch.org,
IA-003172,Kingsley Mercy Medical Clinic,Mercy Medical Services,1790723633,Rural Health Clinics,111 Main St,,Kingsley,IA,51028-7725,Plymouth,801 5th St Suite 310,,Sioux City,IA,51101,Woodbury,Denise White,Office Manager,712-378-2921,7183,whitedr@mercyhealth.com,Jerry French,Supervisor Clinic Business Operations,712-279-5808,5808,frencj@mercyhealth.com,http://www.mercysiouxcity.com/kingsley-mercy-medical-clinic
IA-003173,STEWART MEMORIAL COMMUNITY HOSPITAL,Stewart Memorial Community Hospital,1063497188,Rural Health Clinics,1301 W Main St,,Lake City,IA,51449-1585,Calhoun,1301 West Main,,Lake City,IA,51449,Calhoun,Jim Henkenius,CFO,712-464-4200,,jihenkenius@stewartmemorial.org,Cynthia Carstens,COO,712-464-4218,,ccarstens@stewartmemorial.org,
IA-003174,MCCRARY-ROST CLINIC,Stewart Memorial Community Hospital,1285652909,Rural Health Clinics,1351 W Main St,,Lake City,IA,51449-1585,Calhoun,1301 West Main,,Lake City,IA,51449,Calhoun,Jim Henkenius,CFO,712-464-3194,,jihenkenius@stewartmemorial.org,Cynthia Carstens,COO,712-464-4218,,ccarstens@stewartmemorial.org,
IA-003175,MCCRARY ROST CLINIC,Stewart Memorial Community Hospital,1073549853,Rural Health Clinics,1160 3rd St,,Lake View,IA,51450-7612,Sac,1301 West Main,,Lake City,IA,51449,Calhoun,Jim Henkenius,CFO,712-657-8555,,jihenkenius@stewartmemorial.org,Cynthia Carstens,COO,712-464-4218,,ccarstens@stewartmemorial.org,
IA-003176,UnityPoint Clinic Family Medicine Lake View,UnityPoint Clinic,1437428612,Rural Health Clinics,208 Main St,,Lake View,IA,51450-7717,Sac,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Justin Wieck,Clinic Administrator,712-662-6301,,Justin.Wieck@unitypoint.org,
IA-003177,"Community Health Centers of Southern Iowa, Inc.","COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC.",1922294362,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",802 Ackerly St,,Lamoni,IA,50140-1544,Decatur,802 E Ackerly St,,Lamoni,IA,50140,Decatur,Samantha Cannon,CEO/CFO,641-446-2383,1250,scannon@chcsi.org,Janeen Eddy,COO,641-446-2383,1234,jeddy@chcsi.org,www.chcsi.org
IA-003178,GUNDERSEN LANSING CLINIC,Gundersen Lansing Clinic,1417902933,Rural Health Clinics,50 N 4th St,,Lansing,IA,52151-7729,Allamakee,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Kari Adank,CCO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
IA-003179,UnityPoint Clinic Family Medicine Laurens,UnityPoint Clinic,1346519527,Rural Health Clinics,307 Highway 10,,Laurens,IA,50554-1307,Pocahontas,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Ann Wise,Clinic Administrator,712-335-5632,,Ann.Wise@unitypoint.org,
IA-003180,CHI HEALTH LENOX CLINIC,Payer Strategy and Operations,1285715870,Rural Health Clinics,210 S Main St,,Lenox,IA,50851-1242,Taylor,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003181,"Community Health Centers of Southern Iowa, Inc.","COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC.",1770521981,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",302 NE 14th St,,Leon,IA,50144-1206,Decatur,302 NE 14th Street,,Leon,IA,50144,Decatur,Samantha Cannon,CEO/CFO,641-446-2383,1250,scannon@chcsi.org,Janeen Eddy,COO,641-446-2383,1234,jeddy@chcsi.org,www.chcsi.org
IA-003182,Lime Springs Medical Clinic,Regional Health Services of Howard County,1295818524,Rural Health Clinics,101 West Main,,Lime Springs,IA,52155,Howard,235 8th Avenue West,,Cresco,IA,52136,Howard,Jessica McCabe,Director of Business Office,563-547-2101,,mccabejl@mercyhealth.com,,,,,,
IA-003183,CHI HEALTH LOGAN CLINIC,"Catholic Health Initiatives, Payer Strategy",1558442269,Rural Health Clinics,122 W 8th St,,Logan,IA,51546-1416,Harrison,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003184,Regional Family Health-Manchester,Regional Family Health,1699707257,Rural Health Clinics,709 W Main St,PO Box 359,Manchester,IA,52057-1526,Delaware,709 W Main Street,PO Box 359,Manchester,IA,52057-0359,Delaware,Lori Weber,Business Services Manager,563-927-7533,,lweber@regmedctr.org,Michelle Paris,Provider Support Coordinator,563-927-7904,,mparis@regmedctr.org,
IA-003185,UnityPoint Clinic Family Medicine Manson,UnityPoint Clinic,1790161255,Rural Health Clinics,1303 11th Ave,,Manson,IA,50563-5065,Calhoun,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Ann Wise,Clinic Administrator,712-335-5632,,Ann.Wise@unitypoint.org,
IA-003186,BURGESS FAMILY CLINIC - MAPLE VALLEY,Burgess Health Center,1588991962,Rural Health Clinics,513 S Muckey St,,Mapleton,IA,51034-1055,Monona,1600 Diamond,,Onawa,IA,51040,Monona,Teresa Butler,VP Clinical Services,712-423-9373,,tbutler@burgesshc.org,,,,,,www.burgesshc.org
IA-003187,HORN PHYSICIANS CLINIC MAPLETON,Ida County Iowa Community Hospital dba Horn Memorial Hospital,1003157603,Rural Health Clinics,520 Main St,PO Box 236,Mapleton,IA,51034-1215,Monona,701 E 2nd Street,,Ida Grove,IA,51445,Ida,Marcia Fehring,CFO,712-364-3311,,mfehring@hornmemorialhospital.org,Michelle Weber,Director of Clinics,712-881-4676,102,mweber@hornmemorialhospital.org,
IA-003188,Women's Health Services,"Women's Health Services of Eastern Iowa, Inc",1720056492,"Family Planning Providers, Sexually Transmitted Disease Clinics",229 S Main St,,Maquoketa,IA,52060-3056,Jackson,229 S Main St,,Maquoketa,IA,52060-3056,Jackson,Joanne Hermiston,CEO,563-241-1316,,jhermiston@gmtel.net,Diane McVey,Patient Service Representative,563-241-1314,,whsadminasst@gmtel.net,http://www.womenshealthservices.org
IA-003189,Primary Health Care - Marshalltown Dental Clinic,"Primary Health Care, Inc.",1003293317,Dental Providers,112 E Linn St,,Marshalltown,IA,50158-2901,Marshall,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003190,Primary Health Care-Marshalltown Clinic,"Primary Health Care, Inc.",1982753273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",412 E Church St,,Marshalltown,IA,50158-2947,Marshall,1200 University Ave,STE 200,Des Moines,IA,50314-2355,Polk,Kelly Huntsman,CEO,515-248-1441,,khuntsman@phcinc.net,Rachael Miller,Human Resources Specialist,515-248-1490,,rmiller@phcinc.net,http://www.phciowa.org/
IA-003191,Central Iowa Family Planning,Central Iowa Family Planning,1407921554,Family Planning Providers,704 May St,PO Box 1146,Marshalltown,IA,50158-3437,Marshall,704 May Street,,Marshalltown,IA,50158,Marshall,Mandi Beeghly,Executive Director,641-752-7159,,mbeeghly@cifp.org,,,,,,http://www.cifp.org
IA-003192,North Iowa Community Action Organization,North Iowa Community Action Organization,1568519676,Family Planning Providers,100 1st St NW,Suite 200,Mason City,IA,50401-3172,Cerro Gordo,100 1st St NW,,Mason City,IA,50401-3130,Cerro Gordo,Lisa Koppin,Health Services Coordinator,641-423-5044,17,lkoppin@nicao-online.org,Stacy Parcher,Medical Billing Coordinator,641-423-5044,25,sparcher@nicao-online.org,http://www.nicao-online.org/services
IA-003193,"Massena Medical Center, RHC",Cass County Health System,1447451331,Rural Health Clinics,92 Main St,,Massena,IA,50853-1016,Cass,1501 E 10th Street,,Atlantic,IA,50022,Cass,Beth Spieker,Chief Clinic Administrator,712-250-8121,,spibe@casshealth.org,,,,,,
IA-003194,ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL,Payer Strategy and Operations,1508964123,Inpatient Hospitals (other than children's hospitals),631 N 8th St,,Missouri Valley,IA,51555-1102,Harrison,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003195,CHI HEALTH MISSOURI VALLEY CLINIC,"Catholic Health Initiatives, Payer Strategy",1700961273,Rural Health Clinics,809 Elm St,,Missouri Valley,IA,51555-1140,Harrison,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003196,Trinity Muscatine Public Health,UnityHealth Care dba Trinity Muscatine,1952440455,"Family Planning Providers, Sexually Transmitted Disease Clinics",1609 Cedar St,,Muscatine,IA,52761-3426,Muscatine,1609 Cedar Street,,Muscatine,IA,52761,Muscatine,Christy Roby Williams,Director of Public Health,563-263-0122,,Christy.RobyWilliams@unitypoint.org,Holly Barrett,Fiscal Manager,563-263-0122,,Holly.Barrett2@unitypoint.org,
IA-003197,Story County Hospital (inpatient hospital),Story County Hospital,1215054713,Inpatient Hospitals (other than children's hospitals),640 S 19th St,,Nevada,IA,50201-2902,Story,640 South 19th Street,,Nevada,IA,50201,Story,Lisa Hemesath,Senior Accountant,515-382-7707,,lhemesath@storymedical.org,Kemberlee Packer,Credentialing Specialist,515-382-7101,,kpacker@storymedical.org,
IA-003198,Story County Hospital (outpatient hospital clinics),Story County Hospital,1215054713,Outpatient Hospital Clinics,640 S 19th St,,Nevada,IA,50201-2902,Story,640 South 19th Street,,Nevada,IA,50201,Story,Lisa Hemesath,Senior Accountant,515-382-7707,,lhemesath@storymedical.org,Kem Packer,Credentialing Specialist,515-382-7101,,kpacker@storymedical.org,
IA-003199,HORN PHYSICIANS CLINIC ODEBOLT,Ida County Iowa Community Hospital dba Horn Physicians Clinic,1982006359,Rural Health Clinics,300 S Maple St,,Odebolt,IA,51458-7714,Sac,701 E 2nd Street,,Ida Grove,IA,51445,Ida,Marcia Fehring,CFO,712-364-3311,,mfehring@hornmemorialhospital.org,Michelle Weber,Director of Clinics,712-668-2233,,mweber@hornmemorialhospital.org,
IA-003200,"Family Medicine Clinic, PC","Family Medicine Clinic, PC",1063418820,Rural Health Clinics,1614 Diamond Street Pl,,Onawa,IA,51040-1554,Monona,1614 Diamond Street Place,,Onawa,IA,51040,Monona,Jennifer Moore,Office Manager,712-423-1525,,jmoore@longlines.com,,,,,,
IA-003201,MITCHELL COUNTY REGIONAL HEALTH,Mitchell County Regional Health Center,1033291927,Inpatient Hospitals (other than children's hospitals),616 N 8th St,,Osage,IA,50461-1456,Mitchell,616 North Eighth Street,,Osage,IA,50461,Mitchell,Gregory J Burkel,CFO,641-732-6003,,burkelgj@mercyhealth.com,,,,,,
IA-003202,OSAGE CLINIC,Mitchell County Regional Health Center,1588756191,Rural Health Clinics,620 N 8th St,,Osage,IA,50461-1456,Mitchell,620 North Eighth Street,,Osage,IA,50461,Mitchell,Gregory J Burkel,CFO,641-732-6003,,burkelgj@mercyhealth.com,,,,,,
IA-003203,Clarke County Public Hospital,Clarke County Public Hospital,1114954997,Inpatient Hospitals (other than children's hospitals),800 S Fillmore St,,Osceola,IA,50213-1694,Clarke,800 S Fillmore St,,Osceola,IA,50213-1694,Clarke,Michael T Thilges,Chief Financial Officer,641-342-5327,,mthilges@clarkehosp.org,Brian G Evans,Chief Executive officer,641-342-5342,,bevans@clarkehosp.org,www.clarkehosp.org
IA-003204,RIVER HILLS COMMUNITY HEALTH CENTER,"RIVER HILLS COMMUNITY HEALTH CENTER, INC.",1912952367,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 S Market St,,Ottumwa,IA,52501-2924,Wapello,201 S Market St,,Ottumwa,IA,52501-2924,Wapello,Rick Johnson,CEO,641-683-5773,,rjohnson@riverhillshealth.org,Kim Grove,Billing Manager,641-684-6896,109,kgrove@riverhillshealth.org,
IA-003205,River Hills Pediatric Clinic,"RIVER HILLS COMMUNITY HEALTH CENTER, INC.",1912952367,Federally Qualified Health Centers - Medical Services,931 Pennsylvania Ave,,Ottumwa,IA,52501-2138,Wapello,201 S Market St,,Ottumwa,IA,52501-2924,Wapello,Rick Johnson,CEO,641-683-5773,,rjohnson@riverhillshealth.org,Kim Grove,Billing Manager,641-684-6896,109,kgrove@riverhillshealth.org,
IA-003206,Paullina Mercy Medical Clinic,Baum Harmon Mercy Hospital,1306880968,Rural Health Clinics,108 E Groesbeck St,,Paullina,IA,51046-7748,O'Brien,255 N Welch AVe,,Primghar,IA,51245,O'Brien,Debra Prins,Clinic OFfice Manager,712-957-2312,,prinsd@mercyhealth.com,,,,,,
IA-003207,Mill Creek Family Practice,Orange City Municipal Hospital,1518932821,Rural Health Clinics,5616 460th St,,Paullina,IA,51046-7516,O'Brien,1000 Lincoln Circle SE,,Orange City,IA,51041,Sioux,Lonna Boltjes,Clinic Manager,712-448-2000,,boltjesl@ochealthsystem.org,Steve Walhof,,712-737-5267,,walhofs@ochealthsystem.org,
IA-003208,UnityPoint Clinic Family Medicine Pocahontas,UnityPoint Clinic,1255600433,Rural Health Clinics,608 NW 7th St,,Pocahontas,IA,50574-1000,Pocahontas,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Ann Wise,Clinic Administrator,712-335-5632,,Ann.Wise@unitypoint.org,
IA-003209,Gundersen Palmer Lutheran Hospital and Clinics-Postville,Gundersen Palmer Lutheran Hospital and Clinics,1508227539,Rural Health Clinics,111 S Reynolds St,,Postville,IA,52162-7737,Allamakee,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Kari Adank,CCO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
IA-003210,Primghar Mercy Medical Clinic,Baum Harmon Mercy Hospital,1306880570,Rural Health Clinics,240 N Rerick Ave,,Primghar,IA,51245-7786,O'Brien,255 N Welch Ave,,Primghar,IA,51245,O'Brien,Debra Prins,Clinic Office Manager,712-957-2312,,prinsd@mercyhealth.com,,,,,,
IA-003211,REDFIELD MEDICAL CLINIC,Redfield Medical Clinic,1821006990,Rural Health Clinics,1013 1st St.,,Redfield,IA,50233,Dallas,"1013 1st St., Box C",,Redfield,IA,50233-1007,Dallas,Edward Friedmann,PA,515-833-2301,,edfriedman@aol.com,,,,,,
IA-003212,RICEVILLE CLINIC,Mitchell County Regional Health Center,1689766206,Rural Health Clinics,109 Westward Dr,,Riceville,IA,50466-7550,Howard,109 Westward Drive 6,,Riceville,IA,50466,Mitchell,Gregory J Burkel,CFO,641-732-6003,,burkelgj@mercyhealth.com,,,,,,
IA-003213,"River Hills Community Health Center, Keokuk Co Clinic","River Hills Community Health Center, INC",1912952367,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 W Main St,,Richland,IA,52585-9212,Keokuk,201 S. Market St,,Ottumwa,IA,52501-2924,Wapello,Rick Johnson,CEO,641-954-9971,,rjohnson@riverhillshealth.org,Kim grove,Billing Manager,641-684-6896,109,kgrove@riverhillshealth.org,
IA-003214,Sanford Rock Rapids Medical Center,Sanford,1609806280,Inpatient Hospitals (other than children's hospitals),801 S Greene St,,Rock Rapids,IA,51246-1948,Lyon,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
IA-003215,Sanford Clinic Rock Rapids,Sanford Health,1235218215,Rural Health Clinics,803 S Greene St,,Rock Rapids,IA,51246-1948,Lyon,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
IA-003216,MCCRARY-ROST CLINIC,Stewart Memorial Community Hospital,1316240104,Rural Health Clinics,505 E Lake St,,Rockwell City,IA,50579-1711,Calhoun,1301 West Main,,Lake City,IA,51449,Calhoun,Jim Henkenius,CFO,712-297-8989,,jihenkenius@stewartmemorial.org,Cynthia Carstens,COO,712-464-4218,,ccarstens@stewartmemorial.org,
IA-003217,UnityPoint Clinic Family Medicine Sac City,UnityPoint Clinic,1073882254,Rural Health Clinics,301 Highland Ave,,Sac City,IA,50583-2411,Sac,800 Kenyon Road,,Fort Dodge,IA,50501,Webster,Doris J Hott,Director of Operations,712-660-1423,,Doris.Hott@unitypoint.org,Justin Wieck,Clinic Administrator,712-662-6301,,Justin.Wieck@unitypoint.org,
IA-003218,ST ANSGAR CLINIC,Mitchell County Regional Health Center,1518059138,Rural Health Clinics,140 W 4th St,Suite 1,Saint Ansgar,IA,50472-1352,Mitchell,140 West Fourth Street Suite 1,,St Ansgar,IA,50472,Mitchell,Gregory J Burkel,CFO,641-732-6003,,burkelgj@mercyhealth.com,,,,,,
IA-003219,Sanford Clinic Sanborn,Sanford Clinic,1831372077,Rural Health Clinics,321 Main St,,Sanborn,IA,51248-7731,O'Brien,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Exec Dir Corporate Contracting and Payor Analytics,605-328-9587,,torrey.sundall@sanfordhealth.org,,,,,,
IA-003220,Sanford Sheldon Medical Center,Sanford,1841200623,Inpatient Hospitals (other than children's hospitals),118 N 7th Ave,,Sheldon,IA,51201-1235,O'Brien,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
IA-003221,Sanford Clinic Sheldon,Sanford Health,1831281047,Rural Health Clinics,800 Oak St,,Sheldon,IA,51201-1242,O'Brien,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
IA-003222,Medical Clinic-Sidney,"Medical Clinic, P.C.",1871566265,Rural Health Clinics,313 Main St,,Sidney,IA,51652-8036,Fremont,1219 Main ST,,Hamburg,IA,51640-1300,Fremont,Nancy A Buckalew,Administrator,712-382-2626,,clinic@hamburgia.net,,,,,,https://medclinicpc.com
IA-003223,Promise Community Health Center,Promise Community Health Center,1053582098,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",338 1st Ave NW,,Sioux Center,IA,51250-1875,Sioux,338 1st Ave NW,,Sioux Center,IA,51250,Sioux,Stephanie Michelle Aguilar,Family Planning Coordinator,712-722-1700,670,stephaniea@promisechc.org,Nancy Dykstra,Executive Director,712-722-1700,110,ndykstra@promisechc.org,promisechc.org
IA-003224,Siouxland Community Health Center,Siouxland Community Health Center,1558355305,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1021 Nebraska St,,Sioux City,IA,51105-1436,Woodbury,1021 Nebraska Street,,Sioux City,IA,51105,Woodbury,Mari Kaptain-Dahlen,Chief Executive Officer,712-202-1011,,mkaptaindahlen@slandchc.com,Jan Anderson,Chief Financial Officer,712-202-1002,,janderson@slandchc.com,slandchc.com
IA-003225,Burgess Family Clinic - Sloan,Burgess Health Center,1013243633,Rural Health Clinics,409 Evans St,,Sloan,IA,51055-7748,Woodbury,1600 Diamond,,Onawa,IA,51040,Monona,Teresa Butler,VP Clinical Services,712-423-9373,,tbutler@burgesshc.org,,,,,,www.burgesshc.org
IA-003226,United Community Health Center,United Community Health Center,1043268659,"Dental Providers, Federally Qualified Health Centers - Medical Services",715 W Milwaukee Ave,,Storm Lake,IA,50588-1564,Buena Vista,715 W Milwaukee Ave,,Storm Lake,IA,50583,Buena Vista,Richard Gehrig,Chief Executive Officer,712-213-0109,1106,rich@uchcsl.com,Maria Ramos,Human Resource Manager,712-213-0109,1102,mariar@uchcsl.com,
IA-003227,VAN DIEST FAMILY HEALTH CLINIC OF STRATFORD,Hamilton County Public Hospital dba Van Diest Medical Center,1497957351,Outpatient Hospital Clinics,817 Shakespeare Ave,,Stratford,IA,50249-7774,Hamilton,2350 HOSPITAL DRIVE,PO BOX 430,Webster City,IA,50595,Hamilton,ALICE HEINRICHS,CFO,515-832-7751,,AHEINRICHS@VANDIESTMC.ORG,ASHLEY ALLERS,Revenue Cycle Director,515-832-7705,,AGRITTERS@VANDIESTMC.ORG,WWW.VANDIESTMC.ORG
IA-003228,Regional Family Health-Strawberry Point,Regional Family Health,1811039886,Rural Health Clinics,111 E Mission St,,Strawberry Point,IA,52076,Clayton,709 W Main Street,PO Box 359,Manchester,IA,52057-0359,Delaware,Lori Weber,Business Services Manager,563-927-7533,,lweber@regmedctr.org,Michelle Paris,Provider Support Coordinator,563-927-7904,,mparis@regmedctr.org,
IA-003229,Stuart Medical Clinic,Stuart Medical Clinic,1396726105,Rural Health Clinics,106 NE 2nd St,,Stuart,IA,50250-7706,Guthrie,PO Box 196,,Stuart,IA,50250,Guthrie,"Wilda Orewiler, PA",Owner,515-523-2283,,williestuartmedical@msn.com,,,,,,williestuartmedicalmsn.com
IA-003230,Adair County Medical Clinic Stuart,Adair County Health System,1932440146,Rural Health Clinics,303 SW 7th St,Suite B,Stuart,IA,50250-2164,Guthrie,609 SE Kent,,Greenfield,IA,50849,Adair,Shelley Weeks,Interim Clinic Manager,641-743-6189,285,sweeks@adaircountyhealthsystem.org,,,,,,
IA-003231,Sutherland Mercy Medical Clinic,Baum Harmon Mercy Hospital,1548209984,Rural Health Clinics,108 W 2nd St,,Sutherland,IA,51058-7672,O'Brien,255 N Welch AVe,,Primghar,IA,51245,O'Brien,Debra Prins,Clinic Office Manager,712-957-2312,,prinsd@mercyhealth.com,,,,,,
IA-003232,MEDICAL CLINIC-TABOR,"Medical Clinic, P.C.",1841263233,Rural Health Clinics,710 Center St,,Tabor,IA,51653-2069,Fremont,1219 Main ST,,Hamburg,IA,51640-1300,Fremont,Nancy A Buckalew,Administrator,712-629-2975,,clinic@hamburgia.net,,,,,,https://medclinicpc.com
IA-003233,Meskwaki Tribal Health Center,Meskwaki Tribal Health Clinic,1962618355,"Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tribal Health Program operated under P.L. 93-638",1646 305th St,,Tama,IA,52339-9698,Tama,1646 305th St,,Tama,IA,52339-9629,Tama,Cindy Nielsen,DO,641-484-4094,2465,cd.mhc@meskwaki-nsn.gov,Rudy Papakee,Health Administrator,641-484-4094,2445,director.mhc@meskwaki-nsn.gov,http://www.meskwaki.org/HealthServices.html
IA-003234,Urbana Family Medical Clinic,Urbana Family Medical Clinic,1003859620,Rural Health Clinics,1002 W Main St,,Urbana,IA,52345-9099,Benton,1002 W Main Street,,Urbana,IA,52345,Benton,Taylor Frank,Credentialing,319-472-6300,,tfrank@vghinc.com,,,,,,
IA-003235,West Health Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,3303 109th St,,Urbandale,IA,50322-8105,Polk,PO Box 4557,,Des Moines,IA,50309,Polk,Jennifer Warren Ulrick,Director of Health Services Business Operations,515-235-0452,,jennifer.warren-ulrick@ppheartland.org,Paula Farnen,Credentialing Specialist,720-450-8524,,pfarnen@bridgehcp.com,ppheartland.org
IA-003236,Van Horne Family Medical Clinic,Van Horne Family Medical Clinic,1821031436,Rural Health Clinics,205 Main St,,Van Horne,IA,52346-9713,Benton,205 Main Street,,Van Horne,IA,52346,Benton,Taylor Frank,Credentialing,319-472-6300,,tfrank@vghinc.com,,,,,,
IA-003237,Vinton Family Medical Clinic,Vinton Family Medical Clinic,1447293063,Rural Health Clinics,504 N 9th Ave,,Vinton,IA,52349-2254,Benton,504 N 9th Avenue,,Vinton,IA,52349,Benton,Taylor Frank,Credentialing,319-472-6300,,tfrank@vghinc.com,,,,,,
IA-003238,WCHC Family Medicine,Washington County Hospital and Clinics,1669802955,Rural Health Clinics,1230 S Iowa Ave,,Washington,IA,52353-1144,Washington,400 E Polk St,,Washington,IA,52353,Washington,Brett Antczak,Chief Clinic Officer,319-863-3904,,bantczak@wchc.org,Shelli Cleverley,Finance Director,319-863-3919,,scleverley@wchc.org,www.wchc.org
IA-003239,WCHC Medical Clinic,Washington County Hospital and Clinics,1699167866,Rural Health Clinics,444 E Polk St,,Washington,IA,52353-1237,Washington,400 E Polk St,,Washington,IA,52353,Washington,Brett Antczak,Chief Clinic Officer,319-863-3904,,bantczak@wchc.org,Shelli Cleverley,Finance Director,319-863-3919,,scleverley@wchc.org,www.wchc.org
IA-003240,Allen Women's Health Dept.,Allen Women's Health,1891772927,"Family Planning Providers, Sexually Transmitted Disease Clinics",233 Vold Dr,,Waterloo,IA,50703-1256,Black Hawk,233 Vold Dr,,Waterloo,IA,50703-1256,Black Hawk,Sandy Kahler,Clinic Manager,319-235-5095,,Sandy.kahler@unitypoint.org,,,,,,http://www.allenwomenshealth.org
IA-003241,PEOPLES COMMUNITY HEALTH CLINIC,"PEOPLES COMMUNITY HEALTH CLINIC, INC.",1093703639,"Dental Providers, Federally Qualified Health Centers - Medical Services",905 Franklin St,,Waterloo,IA,50703-4407,Black Hawk,905 Franklin St,,Waterloo,IA,50703-4407,Black Hawk,Jennifer Lightbody,Chief Executive Officer,319-272-4311,,jlightbody@peoples-clinic.com,Christine Kemp,Chief Operating Officer,319-272-4476,,ckemp@peoples-clinic.com,www.peoples-clinic.com
IA-003242,Gundersen Waukon Clinic,Gundersen Waukon Clinic,1831144302,Rural Health Clinics,102 2nd Avenue SE,,Waukon,IA,52172,Allamakee,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
IA-003243,Mayo Clinic Health System-Franciscan Healthcare in Waukon,"Mayo Clinic Health System-Franciscan Medical Center, Inc.",1639156987,Rural Health Clinics,105 E Main St,,Waukon,IA,52172-1735,Allamakee,700 West Avenue South,,La Crosse,WI,54601,La Crosse,Justin Offord,Regulatory Specialist,507-266-4850,,offord.justin@mayo.edu,Kim Hawthorne,Administrator,608-366-5223,,hawthorne.kimberly@mayo.edu,
IA-003244,VAN DIEST FAMILY HEALTH CLINIC OF WEBSTER CITY,Hamilton County Public Hospital dba Van Diest Medical Center,1174968697,Outpatient Hospital Clinics,2350 Hospital Dr,,Webster City,IA,50595-6600,Hamilton,2350 HOSPITAL DRIVE,PO BOX 430,Webster City,IA,50595,Hamilton,ALICE HEINRICHS,CFO,515-832-7751,,AHEINRICHS@VANDIESTMC.ORG,ASHLEY ALLERS,Revenue Cycle Director,515-832-7705,,AGRITTERS@VANDIESTMC.ORG,WWW.VANDIESTMC.ORG
IA-003245,Van Diest Medical Center,Hamilton County Public Hospital dba Van Diest Medical Center,1295702397,Inpatient Hospitals (other than children's hospitals),2350 Hospital Dr,,Webster City,IA,50595-6600,Hamilton,PO Box 430,,Webster City,IA,50595,Hamilton,ALICE HEINRICHS,CFO,515-832-7705,,AHEINRICHS@VANDIESTMC.ORG,ASHLEY ALLERS,Revenue Cycle Director,515-832-7705,,AGRITTERS@VANDIESTMC.ORG,WWW.VANDIESTMC.ORG
IA-003246,Hamilton County Public Health,Webster County Health Department,1710305636,"Family Planning Providers, Sexually Transmitted Disease Clinics",820 James St,,Webster City,IA,50595-1317,Hamilton,723 1st Ave S Ste 220,,Fort Dodge,IA,50501-4633,Webster,Kari Prescott,Executive Director,515-573-4107,,kprescott@webstercountyia.org,Jennifer Chance,Admin Assistant,515-573-4107,,jchance@webstercountyia.org,
IA-003247,"Community Health Centers of Southeastern Iowa, Inc.","Community Health Centers of Southeastern Iowa, Inc.",1255339750,"Dental Providers, Federally Qualified Health Centers - Medical Services",1706 W Agency Rd,,West Burlington,IA,52655-1667,Des Moines,1706 W. Agency Rd,,West Burlington,IA,52655,Des Moines,Ronald W Kemp,Chief Executive Officer,319-753-2300,100,rkemp@chcseia.com,Diane Rouse,CFO,319-753-2300,105,drouse@chcseia.com,
IA-003248,Gundersen Palmer Lutheran Hospital and Clinics-West Union,Gundersen Palmer Lutheran Hospital and Clinics,1639533763,Rural Health Clinics,110 Jefferson St,,West Union,IA,52175-1022,Fayette,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Kari Adank,CCO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
IA-003249,Gundersen Palmer Lutheran Hospital and Clinics,Gundersen Palmer Lutheran Hospital and Clinics,1598765398,Inpatient Hospitals (other than children's hospitals),112 Jefferson St,,West Union,IA,52175-1022,Fayette,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Leila Hutchens,CCO,608-775-8714,27300,lnhutche@gundersenhealth.org,,,,,,
IA-003250,Health Trust Physicians Clinic (inpatient hospital),Madison County Memorial Hospital,1962567990,Inpatient Hospitals (other than children's hospitals),300 W Hutchings St,,Winterset,IA,50273-2109,Madison,300 W. Hutchings Street,,Winterset,IA,50273,Madison,Shelley Weeks,Clinic Director,515-462-2950,541,sweeks@madisonhealth.com,,,,,,
IA-003251,Health Trust Physicians Clinic (rural health clinics),Madison County Memorial Hospital,1962567990,Rural Health Clinics,300 W Hutchings St,,Winterset,IA,50273-2109,Madison,300 W. Hutchings Street,,Winterset,IA,50273,Madison,Shelley Weeks,Clinic Director,515-462-2950,541,sweeks@madisonhealth.com,,,,,,
IA-003252,Regional Family Health-Winthrop,Regional Family Health,1154474609,Rural Health Clinics,345 1st St S,,Winthrop,IA,50682-9759,Buchanan,709 W Main Street,PO Box 359,Manchester,IA,52057-0359,Delaware,Lori Weber,Business Services Manager,563-927-7533,,lweber@regmedctr.org,Michelle Paris,Provider Support Coordinator,563-927-7904,,mparis@regmedctr.org,
IA-003253,Alegent Health-Woodbine Clinic,"Catholic Health Initiatives, Payer Strategy",1073694774,Rural Health Clinics,518 Lincolnway St,,Woodbine,IA,51579-1238,Harrison,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
IA-003254,Zearing Medical Clinic,Story County Hospital,1134192750,Rural Health Clinics,112 W Main St,,Zearing,IA,50278-7728,Story,640 South 19th Street,,Nevada,IA,50201,Story,Lisa Hemesath,Senior Accountant,515-382-7707,,lhemesath@storymedical.org,Kem Packer,Credentialing Specialist,515-382-7101,,kpacker@storymedical.org,
ID-003255,HEALTH WEST - ABERDEEN CHC,Health West Inc.,1295734796,Federally Qualified Health Centers - Medical Services,330 N Main,,Aberdeen,ID,83210-4928,Bingham,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003256,HEALTH WEST - AMERICAN FALLS CHC,Health West Inc.,1629077235,Federally Qualified Health Centers - Medical Services,823 Reed St,,American Falls,ID,83211-1336,Power,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003257,Lost Rivers Medical Center,Lost Rivers District Hospital,1427062181,Rural Health Clinics,551 Highland Dr,,Arco,ID,83213-5003,Butte,551 Highland Dr,,Arco,ID,83213,Butte,LeeAn Betzer,CFO,208-527-8206,105,lbetzer@lrmctr.org,Kevin Nelson,Clinic Manager,208-527-8206,128,knelson@lrmctr.org,
ID-003258,1st Choice Urgent Care,"BMH, Inc",1922243088,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1350 Parkway Dr,,Blackfoot,ID,83221-1657,Bingham,98 Poplar Street,,Blackfoot,ID,83221,Bingham,Emily Milton,Director of Physician Services,208-785-3855,,emilton@binghammemorial.org,Jeff Daniels,CEO,208-785-4100,,jdaniels@binghammemorial.org,binghammemorial.org
ID-003259,Community Family Clinic,Community Council of Idaho,1710925250,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",625 W Pacific St,Suite 3A,Blackfoot,ID,83221-2034,Bingham,317 Happy Day Blvd.,Suite 250,Caldwell,ID,83607,Ada,Arnold Cantu,Clinic Administrator,208-528-7655,3519,acantu@ccimail.org,Shawn Blue,Administrative Specialist,208-528-7655,3511,sblue@ccimail.org,
ID-003260,Bingham Memorial Hospital,"BMH, Inc",1982805271,Inpatient Hospitals (other than children's hospitals),98 Poplar St,,Blackfoot,ID,83221-1758,Bingham,98 Poplar Street,,Blackfoot,ID,83221,Bingham,Jake Erickson,COO,208-782-3762,,jerickson@binghammemorial.org,Jeff Daniels,CEO,208-785-4100,,jdaniels@binghammemorial.org,binghammemorial.org
ID-003261,Bingham Memorial Medical Clinic,"BMH, Inc",1982805271,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",98 Poplar St,,Blackfoot,ID,83221-1758,Bingham,98 Poplar Street,,Blackfoot,ID,83221,Bingham,Emily Milton,Director of Physician Services,208-785-3855,,emilton@binghammemorial.org,Jeff Daniels,CEO,208-785-4100,,jdaniels@binghammemorial.org,binghammemorial.org
ID-003262,St. Luke's Hemophilia Center,St. Luke's Regional Medical Center,1770586794,Hemophilia Treatment Centers,190 E Bannock St,,Boise,ID,83712-6241,Ada,100 E. Idaho St.,,Boise,ID,83712,Ada,Bob Mueller,VP Revenue Cycle,208-706-7310,,muellerr@slhs.org,,,,,,
ID-003263,Terry Reilly Boise 23rd Street Clinic,Community Health Clinics Inc,1477560654,Federally Qualified Health Centers - Medical Services,300 S 23rd St,,Boise,ID,83702-9100,Ada,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Executive Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003264,Boise Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",3668 N Harbor Ln,,Boise,ID,83703-6914,Ada,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/health-center/idaho/boise/83703/boise-health-center-2939-91810
ID-003265,Central District Health Dept.,CENTRAL DISTRICT HEALTH DEPARTMENT,1326009648,"Family Planning Providers, Sexually Transmitted Disease Clinics",707 N Armstrong Pl,,Boise,ID,83704-0825,Ada,707 N. Armstrong Pl,,Boise,ID,83704,Ada,Lorraine Fortunati,Preventive Health Services Division Director,208-327-8618,,lfortuna@cdhd.idaho.gov,Heather Gagliano,Clinic Nurse Manager,208-327-8534,,hgagliano@cdhd.idaho.gov,http://cdhd.idaho.gov/
ID-003266,Family Medicine Health Center,"The Family Medicine Residency of Idaho, Inc.",1841490075,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Tuberculosis Clinics",777 N Raymond St,,Boise,ID,83704-9251,Ada,777 N Raymond,,Boise,ID,83704,Ada,Michelle Robin,Director of Compliance and Federal Grants,208-954-8744,,michelle.robin@fmridaho.org,Anne Rieber,Compliance and Federal Grants Manager,208-514-2500,7002,anne.rieber@fmridaho.org,www.fmridaho.org
ID-003267,Kootenai Tribal Health Clinic,Kootenai Tribal Health Clinic,1669594057,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",100 Circle Dr,,Bonners Ferry,ID,83805-5483,Boundary,PO Box T,,Bonners Ferry,ID,83805-1279,Boundary,Karen Hanson,Director,208-267-3519,528,karen@kootenai.org,Peggy Maas,Administrative Assistant,208-267-5223,565,peggy@kootenai.org,
ID-003268,BONNERS FERRY FAMILY MEDICINE,Bonners Ferry Family Medicine RHC,1922152537,Rural Health Clinics,6488 Chinook St,,Bonners Ferry,ID,83805-7515,Boundary,PO BOX 208,,Bonners Ferry,ID,83805-7515,Idaho,Laurel Martin,Office Manager,208-267-8710,,BFFMTG@Frontier.com,"Troy Geyman, M.D.",Executive Director,208-267-8710,,twgeyman@yahoo.com,
ID-003269,BRCHC dba Kaniksu Health Services,KANIKSU HEALTH SERVICES,1306883244,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",6615 Comanche St,,Bonners Ferry,ID,83805-7523,Boundary,301 Cedar St. Suite 206,,Sandpoint,ID,83864,Bonner,Victoria J McClellan King,CEO,208-610-6990,,vicki@kaniksuhealthservices.org,Kevin Knepper,CFO,208-263-3410,,kknepper@kaniksuhealthservices.org,
ID-003270,Boundary Community Hospital,Boundary Community Hospital,1801896683,Inpatient Hospitals (other than children's hospitals),6640 Kaniksu St,,Bonners Ferry,ID,83805-7532,Boundary,6640 Kaniksu Street,,Bonners Ferry,ID,83860,Boundary,Holly McDonald,CEO,208-267-3141,4352,holly.m@bcch.org,Holly McDonald,Controller,208-267-3141,4352,holly.m@bcch.org,
ID-003271,Boundary Community Clinics,Boundary Community Hospital,1801273552,Rural Health Clinics,6641 Kaniksu St,,Bonners Ferry,ID,83805-7532,Boundary,6640 Kaniksu St,,Bonners Ferry,ID,83805,Boundary,Jan Baird,PFS Manager,208-267-3141,4310,jan.b@bcch.org,Craig Johnson,CEO,208-267-3141,4850,cjohnson@bcch.org,
ID-003272,FAMILY HEALTH SERVICES - BUHL MEDICAL AND DENTAL CLINIC,FAMILY HEALTH SERVICES CORPORATION,1003862525,Federally Qualified Health Centers - Medical Services,725 Fair St,,Buhl,ID,83316-6442,Twin Falls,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-734-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003273,"FHS - BURLEY MEDICAL, DENTAL & BEHAVIORAL HEALTH CLINIC",FAMILY HEALTH SERVICES CORPORATION,1033165550,"Dental Providers, Federally Qualified Health Centers - Medical Services",1309 Bennett Ave,,Burley,ID,83318-2676,Cassia,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-734-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003274,Southwest District Health District Family Planning Program,Southwest District Health,1598748337,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",13307 Miami Ln,,Caldwell,ID,83607-4701,Canyon,1155 3rd Ave N,,Payette,ID,83661,Payette,Cheryl Thibault,Family Planning Coordinator,208-642-9321,,cheryl.thibault@swdh.idaho.gov,TAMARA MARTINEZ,PROGRAM INFORMATION COORDINATOR,208-455-5305,,Tamara.Martinez@phd3.idaho.gov,
ID-003275,Terry Reilly Caldwell Elgin,Community Health Clinics Inc,1477560654,"Dental Providers, Federally Qualified Health Centers - Medical Services",1508 Hope Ln,,Caldwell,ID,83605-4775,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003276,Terry Reilly Caldwell Arlington,Community Health Clinics Inc,1477560654,Federally Qualified Health Centers - Medical Services,2005 Arlington Ave,,Caldwell,ID,83605-4808,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003277,Eastern Idaho Public Health - Challis,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",1050 N Clinic Rd,Suite A,Challis,ID,83226-9376,Custer,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Amy Shaw,,208-879-2504,,ashaw@eiph.idaho.gov,www.eiph.idaho.gov
ID-003278,HEALTH WEST - CHUBBUCK CHC,Health West Inc.,1629499751,Federally Qualified Health Centers - Medical Services,880 W Quinn Rd,,Chubbuck,ID,83202-2454,Bannock,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003279,HEALTH WEST - DENTAL CHC,Health West Inc.,1346658515,Dental Providers,880 W Quinn Rd,,Chubbuck,ID,83202-2454,Bannock,500 S 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003280,Restored Paths,Heritage Health,1235503426,Community Mental Health Centers,109 E Harrison Ave,,Coeur D Alene,ID,83814-3238,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003281,Heritage Dental Coeur d'Alene,Heritage Health,1447305610,Dental Providers,1090 W Park Pl,,Coeur D Alene,ID,83814-2785,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003282,Heritage Health,Heritage Health,1285686477,Federally Qualified Health Centers - Medical Services,1090 W Park Pl,,Coeur D Alene,ID,83814-2785,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003283,Union Gospel Mission,Heritage Health,1992044077,Federally Qualified Health Centers - Medical Services,196 W Haycraft Ave,,Coeur D Alene,ID,83815-9317,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003284,Heritage Health Behavioral Health,Heritage Health,1174860894,Community Mental Health Centers,2025 W Park Pl,,Coeur D Alene,ID,83814-2787,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003285,Family Support Services,Heritage Health,1255756730,Community Mental Health Centers,2201 Ironwood Pl,,Coeur D Alene,ID,83814-2670,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003286,St. Mary's Hospital - Cottonwood Medical Clinic (inpatient hospital),St. Mary's Hospital,1174577100,Inpatient Hospitals (other than children's hospitals),701 Lewiston St,,Cottonwood,ID,83522-9750,Idaho,701 Lewiston St.,,Cottonwood,ID,83522-0137,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,www.smh-cvhc.org
ID-003287,St. Mary's Hospital - Cottonwood Medical Clinic (other ecp providers),St. Mary's Hospital,1174577100,Other ECP Providers,701 Lewiston St,,Cottonwood,ID,83522-9750,Idaho,701 Lewiston St.,,Cottonwood,ID,83522-0137,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,www.smh-cvhc.org
ID-003288,"ADAMS COUNTY HEALTH CENTER, INC.",ADAMS COUNTY HEALTH CENTER INC,1710915897,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",205 N Berkley St,,Council,ID,83612-5015,Adams,205 N Berkley Ave,,Council,ID,83612,Adams,Denise Langston-Groves,Executive Director/CFO,208-253-4242,1005,deniseg@ctcweb.net,Cindy Miller,Billing Clerk,208-253-4242,1027,achc@ctcweb.net,achcid.org
ID-003289,St. Marys Hospital - Craigmont Medical Clinic,St. Mary's Hospital,1841292307,Outpatient Hospital Clinics,320 Division Ave,,Craigmont,ID,83523-9700,Lewis,P O Box 137,,Cottonwood,ID,83522,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,
ID-003290,HEALTH WEST - DOWNEY CHC,Health West Inc.,1588666945,Federally Qualified Health Centers - Medical Services,79 N. Main St,,Downey,ID,83234,Bannock,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003291,TETON VALLEY HOSPITAL,"Teton Valley Healthcare, Inc",1477809622,Inpatient Hospitals (other than children's hospitals),120 E Howard St,,Driggs,ID,83422-5112,Teton,120 East Howard St,,Driggs,ID,83422,Teton,Keith Gnagey,CEO,208-354-6355,,kgnagey@tvhcare.org,Wes White,CFO,208-354-6340,,wwhite@tvhcare.org,
ID-003292,Driggs Health Clinic,"Teton Valley Healthcare, Inc",1013264183,Rural Health Clinics,283 N 1st E,,Driggs,ID,83422-5109,Teton,120 East Howard St,,Driggs,ID,83422,Teton,Keith Gnagey,CEO,208-354-6355,,kgnagey@tvhcare.org,Wes White,CFO,208-354-6340,,wwhite@tvhcare.org,
ID-003293,Eastern Idaho Public Health - Driggs,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",820 Valley Centre Dr,,Driggs,ID,83422-5005,Teton,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Cammie Durbin,"Registered Nurse, Senior",208-354-2220,,cdurbin@eiph.idaho.gov,www.eiph.idaho.gov
ID-003294,Eastern Idaho Public Health - Dubois,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",332 W Main,,Dubois,ID,83423,Clark,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Brenda Bloom,"Registered Nurse, Sr",208-374-5216,,bbloom@eiph.idaho.gov,www.eiph.idaho.gov
ID-003295,St. Mary's Hospital - Elk City Medical Clinic,St. Mary's Hospital,1841292307,Outpatient Hospital Clinics,133 Highway 14,,Elk City,ID,83525,Idaho,P O Box 137,,Cottonwood,ID,83522,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,
ID-003296,Emmett Medical Center,EMMETT MEDICAL CENTER,1821091083,Rural Health Clinics,1102 E Locust St,,Emmett,ID,83617-2713,Gem,1202 E Locust St,,Emmett,ID,83617,Gem,Lisa Foruria,Clinic Administrator,208-365-6004,,lisa.foruria@valorhealth.org,,,,,,
ID-003297,Valley Family Health Care,Valley Family Health Care,1932139995,Federally Qualified Health Centers - Medical Services,207 E 12th St,,Emmett,ID,83617-3626,Gem,207 E 12th Street,,Emmett,ID,83617,Gem,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
ID-003298,FAMILY HEALTH SERVICES - FAIRFIELD MEDICAL AND DENTAL CLINIC,FAMILY HEALTH SERVICES CORPORATION,1316984529,"Dental Providers, Federally Qualified Health Centers - Medical Services",401 W Camas,,Fairfield,ID,83327,Camas,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,Chief Financial Officer,208-734-3312,6708,ahouston@fhsid.org,,,,,,www.fhsid.org
ID-003299,FORT HALL INDIAN HEALTH SERVICE,FORT HALL INDIAN HEALTH SERVICE,1558441139,"Dental Providers, Family Planning Providers, Indian Health Service, Outpatient Hospital Clinics, Rural Health Clinics",717 Mission Rd,,Fort Hall,ID,83203,Bingham,PO BOX 717,,Fort Hall,ID,83203,Bingham,MORIONNA WASHAKIE,Business Office Manager,208-238-5403,,MORIONNA.WASHAKIE@IHS.GOV,SHIRLEY ALVAREZ,Chief Executive officer,208-238-5493,,SHIRLEY.ALVAREZ@IHS.GOV,
ID-003300,Shoshone-Bannock Community Health Center,Shoshone-Bannock Tribes,1225414519,Federally Qualified Health Centers - Medical Services,Building 70 Navajo Drive,PO Box 306,Fort Hall,ID,83203-0306,Bingham,PO Box 306,,Fort Hall,ID,83203,Bannock,Chris Waterhouse,Administrator,208-478-3995,,cwaterhouse@sbth.nsn.us,,,,,,
ID-003301,GLENNS FERRY HEALTH CENTER,"GLENNS FERRY HEALTH CENTER, INC.",1376673137,"Community Mental Health Centers, Other ECP Providers",486 W 1st Ave,,Glenns Ferry,ID,83623-2701,Elmore,486 W 1st Ave,,Glenns Ferry,ID,83623-2701,Elmore,Leslyn K Phelps,CEO,208-366-7416,,lphelps@gfhcid.org,Jesus Blanco,Director of Policy and Operations,208-366-7416,,jblanco@gfhcid.org,http://www.gfhcid.org/
ID-003302,GOODING FAMILY PHYSICIANS,Gooding Family Physicians,1518377019,Rural Health Clinics,134 4th Ave W,,Gooding,ID,83330-1018,Gooding,North Canyon Medical Center,267 N Canyon Dr,Gooding,ID,83330,Gooding,joyce Astle,Revenue Cycle Director,208-934-4433,1199,joyce.astle@ncm-c.org,,,,,,
ID-003303,Associates in Family Practice,Associates in Family Practice,1326002650,Rural Health Clinics,425 Idaho St,,Gooding,ID,83330-1258,Gooding,425 Idaho Street,,Gooding,ID,83330,Gooding,Dana Gies,CEO,208-934-5900,,afpg@cableone.net,Karen Rosa,Office Manager,208-934-5900,,afpg@cableone.net,
ID-003304,VALLEY HEALTH CENTER,"GLENNS FERRY HEALTH CENTER, INC.",1972633949,Community Mental Health Centers,350 Main St,,Grand View,ID,83624,Owyhee,486 W 1st Ave,,Glenns Ferry,ID,83623-2701,Elmore,Leslyn K Phelps,CEO,208-366-7416,,lphelps@gfhcid.org,Jesus Blanco,Director of Policy and Operations,208-366-7416,,jblanco@gfhcid.org,http://www.gfhcid.org/
ID-003305,St. Mary's Hospital - Grangeville Clinic,St. Mary's Hospital,1710203237,Outpatient Hospital Clinics,617 W North St,,Grangeville,ID,83530-1239,Idaho,701 Lewiston St.,,Cottonwood,ID,83522-0137,Idaho,Pam MdBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,
ID-003306,Public Health - Idaho North Central District-Grangeville Office,Public Health - Idaho North Central District,1225057813,"Family Planning Providers, Sexually Transmitted Disease Clinics",903 W Main St,,Grangeville,ID,83530-5192,Idaho,215 10th Street,,Lewiston,ID,83501,Nez Perce,Mike Larson,Division Administrator,208-799-3100,1381,mlarson@phd2.idaho.gov,Anna Olson,Clinic Nurse Manager,208-799-3100,1387,aolson@phd2.idaho.gov,http://idahopublichealth.com/
ID-003307,Panhandle Health District,PANHANDLE PUBLIC HEALTH DISTRICT,1841212933,"Family Planning Providers, Sexually Transmitted Disease Clinics",8500 N Atlas Rd,,Hayden,ID,83835-8332,Kootenai,8500 N Atlas Rd,,Hayden,ID,83835,Kootenai,Tina Ghirarduzzi,Family Planning Coordinator,208-415-5140,,tghirarduzzi@phd1.idaho.gov,Nick Swope,Program Manager,208-415-5295,,sswope@phd1.idaho.gov,http://www.phd1.idaho.gov/
ID-003308,Terry Reilly Homedale Clinic,Community Health Clinics Inc,1477560654,"Dental Providers, Federally Qualified Health Centers - Medical Services",108 E Idaho Ave,,Homedale,ID,83628-3229,Owyhee,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003309,Eastern Idaho Public Health,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",1250 Hollipark Dr,,Idaho Falls,ID,83401-6217,Bonneville,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Rachel Mugleston,Reproductive Health Coordinator,208-533-3198,,rmugleston@eiph.idaho.gov,www.eiph.idaho.gov
ID-003310,Community Family Clinic,Community Council of Idaho,1710925250,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2088 E 25th St,,Idaho Falls,ID,83404-6490,Bonneville,317 Happy Day Blvd.,Suite 250,Caldwell,ID,83607,Ada,Arnold Cantu,Clinic Administrator,208-528-7655,3519,acantu@ccimail.org,Shawn Blue,Administrative Specalist,208-528-7655,3511,sblue@ccimail.org,
ID-003311,FAMILY HEALTH SERVICES - JEROME MEDICAL/DENTAL/BEHAVIORAL HEALTH CLINIC,FAMILY HEALTH SERVICES CORPORATION,1730135310,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",114 Pioneer Ct,,Jerome,ID,83338-5193,Jerome,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-734-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003312,Public Health-Idaho North Central District-Kamiah Office,Public Health-Idaho North Central District,1225057813,"Family Planning Providers, Sexually Transmitted Disease Clinics",132 North Hill St,PO Box 277,Kamiah,ID,83536-0277,Lewis,215 10th Street,,Lewiston,ID,83501,Nez Perce,Mike Larson,Division Administrator,208-799-3100,1381,mlarson@phd2.idaho.gov,Anna Olson,Clinic Nurse Manager,208-799-3100,1387,aolson@phd2.idaho.gov,http://idahopublichealth.com/
ID-003313,St. Marys Hospital - Kamiah Medical Clinic,St. Mary's Hospital,1568400562,Outpatient Hospital Clinics,518 Oak St,,Kamiah,ID,83536,Lewis,701 Lewiston St.,,Cottonwood,ID,83522-0137,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,
ID-003314,Mountain Health,Heritage Health,1487076048,Federally Qualified Health Centers - Medical Services,740 McKinley Ave,,Kellogg,ID,83837-2693,Shoshone,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003315,Kendrick Family Care,Gritman Medical Center,1750475380,Rural Health Clinics,606 E Main St,,Kendrick,ID,83537-5002,Latah,700 S Main St,,Moscow,ID,83843,Latah,Dani Lynas,Director of Finance,208-883-6456,,lynasd@gritman.org,Preston Becker,CFO,208-883-2220,,preston.becker@gritman.org,
ID-003316,FAMILY HEALTH SERVICES - KIMBERLY MEDICAL AND DENTAL CLINIC,FAMILY HEALTH SERVICES CORPORATION,1538405410,"Dental Providers, Federally Qualified Health Centers - Medical Services",132 Main St N,,Kimberly,ID,83341,Twin Falls,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,Chief Financial Officer,208-734-3312,6705,satkinson@fhsid.org,,,,,,www.fhsid.org
ID-003317,CLEARWATER VALLEY HOSPITAL - KOOSKIA MEDICAL CLINIC,"Clearwater Valley Hospital and Clinics, Inc.",1891733747,Outpatient Hospital Clinics,201 Thenon St,,Kooskia,ID,83539-6010,Idaho,301 Cedar St.,,Orofino,ID,83544-9029,Clearwater,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Lenne Bonner,President,208-476-8008,,lenne.bonner@smh-cvhc.org,
ID-003318,Nimiipuu Health,Nimiipuu Health,1790795888,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",111 Beaver Grade Rd,,Lapwai,ID,83540,Nez Perce,111 Beaver Grade RD,,Lapwai,ID,83540,Nez Perce,Artrette Felicia Sampson,Benefits Coordinator,208-843-2271,2871,artrettes@nimiipuu.org,Vesta Moe,Interim Business Office Manager,208-843-2271,2830,vestam@nimiipuu.org,
ID-003319,HEALTH WEST - LAVA CHC,Health West Inc.,1427057926,Federally Qualified Health Centers - Medical Services,85 S 5th W,,Lava Hot Springs,ID,83246-1603,Bannock,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003320,Public Health-Idaho North Central District-Lewiston Office,PUBLIC HEALTH - IDAHO NORTH CENTRAL DISTRICT,1225057813,"Family Planning Providers, Sexually Transmitted Disease Clinics",215 10th St,,Lewiston,ID,83501-1910,Nez Perce,215 10th Street,,Lewiston,ID,83501,Nez Perce,Mike Larson,Division Administrator,208-799-3100,1381,mlarson@phd2.idaho.gov,Anna Olson,Clinic Nurse Manager,208-799-3100,1387,aolson@phd2.idaho.gov,http://idahopublichealth.com/
ID-003321,Lewis and Clark Health Center,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1235372707,Federally Qualified Health Centers - Medical Services,338 6th St,,Lewiston,ID,83501-2420,Nez Perce,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Lindsey Ruivivar,CEO,509-444-8888,,lruivivar@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
ID-003322,Terry Reilly Marsing Clinic,Community Health Clinics Inc,1477560654,Federally Qualified Health Centers - Medical Services,201 Main St,,Marsing,ID,83639,Owyhee,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003323,Central District Health Family Planning Program,Central District Health Dept.,1326009648,"Family Planning Providers, Sexually Transmitted Disease Clinics",703 N 1st St,PO Box 1448,McCall,ID,83638-3851,Valley,703 N 1st St,PO Box 1448,McCall,ID,83638-3851,Valley,Lorranine Fortunati,Preventive Health Services Division Director,208-327-8618,,lfortuna@cdhd.idaho.gov,Heather Gagliano,Clinic Nurse Manager,208-327-8534,,hgagliano@cdhd.idaho.gov,http://cdhd.idaho.gov/
ID-003324,Terry Reilly Melba Clinic,Community Health Clinics Inc,1477560654,"Dental Providers, Federally Qualified Health Centers - Medical Services",150 2nd St,,Melba,ID,83641-5199,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003325,Meridian Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",2112 E Franklin Rd,,Meridian,ID,83642-9024,Ada,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/health-center/idaho/meridian/83642/meridian-health-center-4105-91810
ID-003326,Terry Reilly Middleton Clinic,Community Health Clinics Inc,1477560654,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 S 1st Ave E,,Middleton,ID,83644-5809,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003327,Bear Lake Community Health Center Montpelier,"Bear Lake Community Health Center, Inc.",1689754475,"Dental Providers, Federally Qualified Health Centers - Medical Services",152 S 4th St,,Montpelier,ID,83254-1538,Bear Lake,325 W Logan Hwy,,Garden City,UT,84028,Rich,Becky Lowee,Finance Director,435-881-0973,,blowe@cvchc.org,Nikki Oldham,Business Operations Director,435-755-6061,,noldham@cvchc.org,
ID-003328,BEAR LAKE MEMORIAL HOSPITAL,Bear Lake Memorial Hospital,1336125533,Inpatient Hospitals (other than children's hospitals),164 S 5th St,,Montpelier,ID,83254-1597,Bear Lake,164 South 5th Street,,Montpelier,ID,83254,Bear Lake,Patsy Boehme,PFS Director,208-847-4410,,patsy.boehme@blmhospital.com,Jory Hunter,Assistant PFS Director,208-847-4378,,jory.hunter@blmhospital.com,
ID-003329,Bear Lake Internal Medicine,Bear Lake County Memorial Hospital,1174741441,Rural Health Clinics,166 S 5th St,,Montpelier,ID,83254-4959,Bear Lake,164 S 5th Street,,Montpelier,ID,83254,Bear Lake,Leslie Crane,CFO,208-847-1630,,leslie.crane@blmhospital.com,Patsy Boehme,PFS Director,208-847-4410,,patsy.boehme@blmhospital.com,
ID-003330,BEAR LAKE FAMILY CARE & OB/GYN,Bear Lake Memorial Hospital,1699057166,Rural Health Clinics,465 Washington St,,Montpelier,ID,83254-1544,Bear Lake,164 South 5th Street,,Montpelier,ID,83254,Bear Lake,Patsy Boehme,PFS Director,208-847-1630,,patsy.boehme@blmhospital.com,,,,,,
ID-003331,"MOSCOW MEDICAL, P A","Moscow Medical, PA",1871646976,Rural Health Clinics,213 N Main St,,Moscow,ID,83843-2700,Latah,213 N Main,,Moscow,ID,83843,Latah,Tracy Paz,Adminstrator,208-882-7565,,tpaz@moscowmedical.com,Emily Valencia,Billing Specialist,208-882-7565,,evalencia@moscowmedical.com,www.moscowmedical.com
ID-003332,Public Health - Idaho North Central District-Moscow Office,Public Health - Idaho North Central District,1225057813,"Family Planning Providers, Sexually Transmitted Disease Clinics",333 E Palouse River Dr,,Moscow,ID,83843-8916,Latah,215 10th Street,,Lewiston,ID,83501,Nez Perce,Mike Larson,Division Administrator,208-799-3100,1381,mlarson@phd2.idaho.gov,Anna Olson,Clinic Nurse Manager,208-799-3100,1387,aolson@phd2.idaho.gov,http://idahopublichealth.com/
ID-003333,Latah Community Health,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1285077230,"Dental Providers, Federally Qualified Health Centers - Medical Services",803 S Main St,Suite 120,Moscow,ID,83843-3043,Latah,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
ID-003334,DESERT SAGE HEALTH CENTER,"GLENNS FERRY HEALTH CENTER, INC.",1518097047,"Community Mental Health Centers, Dental Providers",2280 American Legion Blvd,,Mountain Home,ID,83647-3142,Elmore,486 W 1st Ave,,Glenns Ferry,ID,83623-2701,Elmore,Leslyn K Phelps,CEO,208-366-7416,,lphelps@gfhcid.org,Jesus Blanco,Director of Policy and Operations,208-366-7416,,jblanco@gfhcid.org,http://www.gfhcid.org/
ID-003335,Central District Health Family Planning Program,Central District Health Dept.,1326009648,"Family Planning Providers, Sexually Transmitted Disease Clinics",520 E 8th N,,Mountain Home,ID,83647-2111,Elmore,520 E 8th N,,Mountain Home,ID,83647-2111,Elmore,Lorranine Fortunati,Preventive Health Services Division Director,208-327-8618,,lfortuna@cdhd.idaho.gov,Heather Gagliano,Clinic Nurse Manager,208-327-8534,,hgagliano@cdhd.idaho.gov,http://cdhd.idaho.gov/
ID-003336,Eastern Idaho Public Health -Terreton,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",1078 E 1500 N,,Mud Lake,ID,83450-5022,Jefferson,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Brenda Bloom,Registered Nurse Senior,208-663-4860,,nsayer@eiph.idaho.gov,www.eiph.idaho.gov
ID-003337,Heritage Health - Mullan,Heritage Health,1689068413,Federally Qualified Health Centers - Medical Services,117 Terrill Loop,,Mullan,ID,83846,Shoshone,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003338,Terry Reilly Nampa 1st Street Clinic,Community Health Clinics Inc,1477560654,Federally Qualified Health Centers - Medical Services,207 1st St S,,Nampa,ID,83651-3703,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003339,Terry Reilly Nampa 16th Street Clinic,Community Health Clinics Inc,1477560654,Federally Qualified Health Centers - Medical Services,223 16th Ave N,,Nampa,ID,83687-4058,Canyon,PO Box 9,,Nampa,ID,83653,Canyon,Heidi Traylor,Chief Executive Officer,208-318-1255,1255,hhart@trhs.org,Brian Baldwin,Chief Financial Officer,208-318-1255,1255,bbaldwin@trhs.org,www.trhs.org
ID-003340,Valley Family Health Care,Valley Family Health Care,1467482455,Federally Qualified Health Centers - Medical Services,300 S Plymouth Rd,,New Plymouth,ID,83655,Payette,300 N. Plymouth,,New Plymouth,ID,83655,Payette,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
ID-003341,St. Mary's Hospital - Nezperce Medical Clinic,St. Mary's Hospital,1366480394,Outpatient Hospital Clinics,501 Oak St,,Nezperce,ID,83543-5066,Lewis,701 Lewiston St.,,Cottonwood,ID,83522-0137,Idaho,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Matthew Forge,Chief Administrative Officer,208-962-2316,,matthew.forge@smh-cvhc.org,www.smh-cvhc.org
ID-003342,Public Health - Idaho North Central District-Orofino Office,Public Health - Idaho North Central District,1225057813,"Family Planning Providers, Sexually Transmitted Disease Clinics",105 115th St,,Orofino,ID,83544-9346,Clearwater,215 10th Street,,Lewiston,ID,83501,Nez Perce,Mike Larson,Division Administrator,208-799-3100,1381,mlarson@phd2.idaho.gov,Anna Olson,Clinic Nurse Manager,208-799-3100,1387,aolson@phd2.idaho.gov,http://idahopublichealth.com/
ID-003343,Orofino Health Clinic,"Clearwater Valley Hospital and Clinics, Inc.",1285018754,Outpatient Hospital Clinics,1055 Riverside Ave,,Orofino,ID,83544,Clearwater,301 Cedar St.,,Orofino,ID,83544-9029,Clearwater,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Lenne Bonner,President,208-476-8008,,lenne.bonner@smh-cvhc.org,
ID-003344,CLEARWATER VALLEY HOSPITAL & CLINICS,"Clearwater Valley Hospital and Clinics, Inc.",1255449013,Inpatient Hospitals (other than children's hospitals),301 Cedar St,,Orofino,ID,83544-9029,Clearwater,301 Cedar St.,,Orofino,ID,83544-9029,Clearwater,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Lenne Bonner,President,208-476-8008,,lenne.bonner@smh-cvhc.org,
ID-003345,Valley Family Health Care,Valley Family Health Care,1407886484,"Dental Providers, Federally Qualified Health Centers - Medical Services",1441 NE 10th Ave,,Payette,ID,83661-5420,Payette,1441 NE 10th Avenue,,Payette,ID,83661,Payette,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,Julie Warden,Admin,208-642-9376,4133,jwardent@vfhc.org,
ID-003346,Clearwater Valley Hospital - Pioneer Medical Clinic,"Clearwater Valley Hospital and Clinics, Inc.",1033153739,Outpatient Hospital Clinics,105 W Carle St,,Pierce,ID,83546,Clearwater,301 Cedar St.,,Orofino,ID,83544-9029,Clearwater,Pam McBride,Chief Grants Officer,208-816-0794,,pam.mcbride@smh-cvhc.org,Lenne Bonner,President,208-476-8008,,lenne.bonner@smh-cvhc.org,
ID-003347,Benewah Medical Center,BENEWAH MEDICAL CENTER,1336135136,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",427 North 12th St,,Plummer,ID,83851,Benewah,427 N 12th Street,,Plummer,ID,83851,Benewah,John Rowland,Revenue Manager,208-686-1931,270,jrowland@bmc.portland.ihs.gov,Charlene Way,Billing Lead,208-686-1931,277,cway@bmc.portland.ihs.gov,
ID-003348,HEALTH WEST - DENTAL CHC,Health West Inc.,1346658515,Dental Providers,1000 N 8th Ave,,Pocatello,ID,83201-5757,Bannock,500 S 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1763,jeremy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003349,HEALTH WEST - POCATELLO CHC,Health West Inc.,1154320752,Federally Qualified Health Centers - Medical Services,1000 N 8th Ave,,Pocatello,ID,83201-5757,Bannock,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003350,HEALTH WEST - ISU CHC,Health West Inc.,1912261413,Federally Qualified Health Centers - Medical Services,465 Memorial Dr,,Pocatello,ID,83201-4008,Bannock,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003351,BRCHC dba Kaniksu Health Services,KANIKSU HEALTH SERVICES,1811054877,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",30410 Highway 200,,Ponderay,ID,83852-9601,Bonner,301 Cedar St. Suite 206,,Sandpoint,ID,83864,Bonner,Victoria J McClellan King,CEO,208-610-6990,,vicki@kaniksuhealthservices.org,Kevin Knepper,CFO,208-263-3410,,kknepper@kaniksuhealthservices.org,
ID-003352,Heritage Health Post Falls,Heritage Health,1841696952,Federally Qualified Health Centers - Medical Services,925 E Polston Ave,,Post Falls,ID,83854-9049,Kootenai,6795 N Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003353,Potltach Family Care,Gritman Medical Center,1356438816,Rural Health Clinics,156 6th St,,Potlatch,ID,83855-5008,Latah,700 S Main Street,,Moscow,ID,83843,Latah,Dani Lynas,Director of Finance,208-883-6456,,lynasd@gritman.org,Preston Becker,CFO,208-883-2220,,preston.becker@gritman.org,
ID-003354,HEALTH WEST - PRESTON CHC,Health West Inc.,1033595541,Federally Qualified Health Centers - Medical Services,655 S 4th E,Suite 600,Preston,ID,83263-1624,Franklin,500 S. 11th Ave,Ste. 400,Pocatello,ID,83201-4880,Bannock,Mindy Benedetti,CEO,208-232-7862,1120,mindy@healthwestinc.org,Amy Tovey,DOO,208-232-7862,1107,atovey@healthwestinc.org,www.healthwestinc.org
ID-003355,BRCHC dba Kaniksu Health Services,KANIKSU HEALTH SERVICES,1538447727,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",6509 Highway 2,Suite 101,Priest River,ID,83856-6609,Bonner,301 Cedar St. Suite 206,,Sandpoint,ID,83864,Bonner,Victoria J McClellan King,CEO,208-610-6990,,vicki@kaniksuhealthservices.org,Kevin Knepper,CFO,208-263-3410,,kknepper@kaniksuhealthservices.org,
ID-003356,Family Support Services - Rathdrum,Heritage Health,1689039448,Community Mental Health Centers,14775 N Kimo Ct,,Rathdrum,ID,83858-8762,Kootenai,6795 N Mineral Ave,,Coeur d'Alene,ID,83815,Latah,Casey Hamilton,Revenue Cycle Manager,208-620-5223,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003357,Heritage Health Rathdrum,Heritage Health,1760736334,Federally Qualified Health Centers - Medical Services,16760 N Highway 41,,Rathdrum,ID,83858-8715,Kootenai,6795 Mineral Drive,,Coeur d'Alene,ID,83815,Kootenai,Casey Hamilton,Revenue Cycle Manager,208-620-5523,1029,chamilton@myheritagehealth.org,Ben Gaby,COO,208-292-0240,,bgaby@myheritagehealth.org,
ID-003358,Eastern Idaho Public Health - Rexburg,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",314 N 3rd E,,Rexburg,ID,83440-1661,Madison,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Rachel Mugleston,"Registered Nurse, Senior",208-533-3198,,rmugleston@eiph.idaho.gov,www.eiph.idaho.gov
ID-003359,Eastern Idaho Public Health - Rigby,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",380 Community Ln,,Rigby,ID,83442-1266,Jefferson,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Teresa Stucki,"Registered Nurse, Senior",208-745-7297,,tstucki@eiph.idaho.gov,www.eiph.idaho.gov
ID-003360,Community Family Clinic,Community Council of Idaho,1710925250,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",651 North 2858 East,,Roberts,ID,83444-5070,Jefferson,317 Happy Day Blvd.,Suite 250,Caldwell,ID,83607,Ada,Arnold Cantu,Clinic Administrator,208-528-7655,3519,acantu@ccimail.org,Shawn Blue,Administrative Specailist,208-528-7655,3511,sblue@ccimail.org,
ID-003361,FAMILY HEALTH SERVICES - RUPERT MEDICAL CLINIC,FAMILY HEALTH SERVICES CORPORATION,1093761694,Federally Qualified Health Centers - Medical Services,1024 8th St,,Rupert,ID,83350-1306,Minidoka,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-737-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003362,Miinidoka Medical Center RHC,Minidoka Medical Center RHC,1043387426,Rural Health Clinics,1308 8th St,Suite 1,Rupert,ID,83350-1535,Minidoka,1308 8th St Ste 1,,Rupert,ID,83350-1535,Minidoka,Brenda Broner,RN/Clinic Manager,208-436-4322,,brenda@minidokamemorial.com,Dennis Merrell,Business office Manager,208-436-8266,,dmerrell@minidokamemorial.com,
ID-003363,Grand Peaks Medical,"UPPER VALLEY COMMUNITY HEALTH SERVICES, INC.",1972792489,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",20 N 3rd E,,Saint Anthony,ID,83445-1521,Fremont,20 N 3rd E,,Saint Anthony,ID,83445-1521,Fremont,Heidi L Cureton,Billing,208-624-4100,108,heidi@grandpeaks.org,,,,,,
ID-003364,UPPER VALLEY COMMUNITY HEALTH SERVICES,Grand Peaks Dental,1679738397,Dental Providers,325 E Main St,,Saint Anthony,ID,83445-1546,Fremont,325 E. Main,72 S. 1st E.,Rexburg,ID,83445,Madison,Susette Brizzee,Office Manager,208-356-0100,2083728006,susette@grandpeaks.org,,,,,,
ID-003365,ST MARIES FAMILY MEDICINE,Benewah Community Hospital,1386632180,Rural Health Clinics,229 S 8th St,,Saint Maries,ID,83861-1813,Benewah,229 South 7th Street,,St. Maries,ID,83861,Benewah,Lori Stoltz,CFO,208-245-7614,7609,lstoltz@bchmed.org,Kathy Tweedy,Revenue Cycle Director,208-245-7600,7600,ktweedy@bchmed.org,
ID-003366,Eastern Idaho Public Health - Salmon,Eastern Idaho Public Health,1154426104,"Family Planning Providers, Sexually Transmitted Disease Clinics",801 Monroe St,,Salmon,ID,83467-3316,Lemhi,1250 Hollipark,,Idaho Falls,ID,83401,Bonneville,Nikki Sayer,Nurse Manager,208-533-3208,,nsayer@eiph.idaho.gov,Cari Whitson,"Registered Nurse, Senior",208-756-2123,,cwhitson@eiph.idaho.gov,www.eiph.idaho.gov
ID-003367,Steele Memorial Medical Clinic,Steele Memorial Medical Center,1922182278,Rural Health Clinics,805 Main St,,Salmon,ID,83467-4316,Lemhi,203 S. Daisy St.,,Salmon,ID,83467,Lemhi,Judith B. Washbon,Administrative Assistant,208-756-5600,5728,judith.washbon@steelemed.org,Tina Still,Business Office Manager,208-756-5600,5606,Tina.Still@steelememorial.org,
ID-003368,Sandpoint Pediatrics - Kaniksu Health Services,"BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.",1316343320,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",420 N Second Ave,,Sandpoint,ID,83864-1565,Bonner,301 Cedar Street Suite 206,,Sandpoint,ID,83864,Bonner,Victoria J McClellan King,CEO,208-610-6990,,vicki@kaniksuhealthservices.org,Kevin Knepper,CFO,208-263-3410,,kknepper@kaniksuhealthservices.org,
ID-003369,Physicians and Surgeons Clinic of Shelley,"BMH, Inc",1508989765,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",275 W Locust St,,Shelley,ID,83274-1230,Bingham,98 Poplar Street,,Blackfoot,ID,83221,Bingham,Emily Milton,Director of Physician Services,208-785-3855,,emilton@binghammemorial.org,Jeff Daniels,CEO,208-785-4100,,jdaniels@binghammemorial.org,binghammemorial.org
ID-003370,Shoshone Family Medical Center,Shoshone Family Medical Center,1972673218,Rural Health Clinics,113 S Apple St,,Shoshone,ID,83352-5287,Lincoln,113 S. Apple Street,,Shoshone,ID,83352,Lincoln,Pam Lowder,Clinic Manager,208-886-2224,,manager@shoshone.net,Keith E. Davis,Owner,208-886-2224,,docdavis4l@hotmail.com,
ID-003371,Salmon River Clinic,Salmon River Clinic Hospital District,1083796569,Rural Health Clinics,110 Niece Avenue,PO Box 129,Stanley,ID,83278-0129,Custer,PO Box 129,,Stanley,ID,83278,Custer,Amy Klingler,Administrator,208-774-3565,,amy@salmonriverclinic.org,Cassandra Brown,Front Office Manager,208-774-3565,,cassie@mtecom.net,www.salmonriverclinic.org
ID-003372,FAMILY HEALTH SERVICES - TWIN FALLS BEHAVIORAL HEALTH,FAMILY HEALTH SERVICES CORPORATION,1538485685,Community Mental Health Centers,1102 Eastland Dr N,Suite A,Twin Falls,ID,83301-8941,Twin Falls,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-734-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003373,Twin Falls Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 2nd Ave N,,Twin Falls,ID,83301-6158,Twin Falls,2001 East Madison Avenue,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/health-center/idaho/twin-falls/83301/twin-falls-health-center-2938-91810
ID-003374,Family Health Services - 325 Martin,FAMILY HEALTH SERVICES CORPORATION,1750566386,"Dental Providers, Federally Qualified Health Centers - Medical Services",325 Martin St,Suite B,Twin Falls,ID,83301-4563,Twin Falls,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,Chief Financial Officer,208-734-3312,6708,ahouston@fhsid.org,,,,,,www.fhsid.org
ID-003375,FAMILY HEALTH SERVICES - TWIN FALLS,FAMILY HEALTH SERVICES CORPORATION,1669449450,Federally Qualified Health Centers - Medical Services,388 Martin St,,Twin Falls,ID,83301-4544,Twin Falls,794 Eastland Dr,,Twin Falls,ID,83301-6856,Twin Falls,Aaron Houston,CEO,208-734-3312,,sescalante@fhsid.org,,,,,,www.fhsid.org
ID-003376,VICTOR HEALTH CLINIC,"Teton Valley Healthcare, Inc",1801143029,Rural Health Clinics,252 S Main St,,Victor,ID,83455,Teton,120 East Howard Avenue,,Driggs,ID,83422,Teton,Keith Gnagey,CEO,208-354-6355,,kgnagey@tvhcare.org,Wes White,CFO,208-354-6340,,wwhite@tvhcare.org,
ID-003377,Heritage Health Dental,"HERITAGE HEALTH CENTERS, INC.",1043603160,Dental Providers,413 Pine St,,Wallace,ID,83873-2256,Shoshone,1090 W Park Pl,,Coeur D Alene,ID,83814,Kootenai,Ben Gaby,Chief Financial Officer,208-292-0240,,bgaby@myheritagehealth.org,,,,,,
ID-003378,Family Medical Center,Weiser Memorial Hospital,1255364030,Rural Health Clinics,360 E Liberty St,,Weiser,ID,83672-2261,Washington,645 E. 5th Street,,Weiser,ID,83672,Washington,Triss Thulander,Office Administrator,208-549-4424,,tthulander@weiserhospital.org,Shaun Kunz,Out Patient Services,208-549-4419,,skunz@weiserhospital.org,weisermemorialhospital.org
ID-003379,"Two Rivers Medical Clinic, PA","Two Rivers Medical Clinic, PA",1376662486,Rural Health Clinics,683 E 3rd St,,Weiser,ID,83672-2248,Washington,683 E. Third St.,,Weiser,ID,83672,Washington,Anthony L. Edmondson,Clinic Admin.,208-549-0211,,tony10@ruralnetwork.net,Anthony L. Edmondson,Clinic Admin.,208-549-0211,,tony10@ruralnetwork.net,www.tworiversmedicalclinic.com
IL-003380,ACCESS Addison Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1033304373,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1111 W Lake St,,Addison,IL,60101-1101,Dupage,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003381,Hamdard-Addison,HAMDARD CENTER FOR HEALTH & HUMAN SERVICES NFP,1609875053,Federally Qualified Health Centers - Medical Services,228 E Lake St,,Addison,IL,60101-2889,Dupage,228 E Lake St Ste 300,,Addison,IL,60101-2872,Dupage,kiran siddiqui,COO,773-465-4600,227,ksidd@hamdardcenter.org,Shawn Bailey,Manager,630-835-1430,29,sbailey@hamdardcenter.org,www.hamdardcenter.org
IL-003382,Albion Community Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1437423167,Federally Qualified Health Centers - Medical Services,33 W Main St,,Albion,IL,62806-1006,Edwards,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-1037,Franklin,"Kim Mitroka, CEO",CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,www.crhpc.org
IL-003383,"GENESIS HEALTH GROUP, ALEDO",Genesis Health System dba Genesis Health Group,1053664938,Rural Health Clinics,1007 NW 3rd St,,Aledo,IL,61231-1317,Mercer,409 NW 9th Ave,,Aledo,IL,61231-1258,Mercer,Jill Mundt,Revenue Cycle Coordinator,563-421-1986,,mundtj@genesishealth.com,Ted Rogalski,Administrator,309-582-9250,,rogalski@genesishealth.com,
IL-003384,"Genesis Medical Center, Aledo",Genesis Health System,1225380967,Inpatient Hospitals (other than children's hospitals),409 NW 9th Ave,,Aledo,IL,61231-1258,Mercer,1227 East Rusholme,,Davenport,IA,52803,Scott,Jill M. Mundt,Revenue Cycle Coordinator,563-421-1986,,mundtj@genesishealth.com,Ted Rogalski,Administrator,309-582-9250,,rogalski@genesishealth.com,
IL-003385,OSF Saint Anthony's Health Center,OSF Healthcare System,1710396932,Inpatient Hospitals (other than children's hospitals),1 Saint Anthonys Way,,Alton,IL,62002-4568,Madison,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003386,ALTON WOMEN'S HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1356377568,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2 Memorial Dr,Suite 122,Alton,IL,62002-6723,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003387,JCH Medical Group-Alton OB,Jersey Community Hospital,1922403096,Other ECP Providers,2 Saint Anthonys Way,Suite 105,Alton,IL,62002-4580,Madison,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003388,Central Alton Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1235430323,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2615 Edwards St,Suite 171,Alton,IL,62002-3915,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003389,ALTON HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1376589226,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",550 Landmarks Blvd,,Alton,IL,62002-6321,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003390,Good Samaritan Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1346402062,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",815 E 5th St,Suite 202,Alton,IL,62002-6471,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003391,JCH Medical Group-Alton Pysch,Jersey Community Hospital,1730584806,Other ECP Providers,815 E 5th St,Suite 205,Alton,IL,62002-6471,Madison,390 Maple Summit Road,,Jerseyville,IL,62002,Madison,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003392,ANNA MEDICAl CLINIC,RURAL HEALTH INC,1982666384,"Dental Providers, Federally Qualified Health Centers - Medical Services",513 N Main St,,Anna,IL,62906-1697,Union,513 N Main St,,Anna,IL,62906-1697,Union,Cynthia Flamm,CEO,618-833-4471,116,cflamm@ruralhealthinc.org,,,,,,
IL-003393,RURAL HEALTH INC,RURAL HEALTH INC,1043497548,Federally Qualified Health Centers - Medical Services,608 S Main St,A-j SCHOOL HEALTH CENTER,Anna,IL,62906-1247,Union,513 N Main St,,Anna,IL,62906-1697,Union,Cynthia Flamm,CEO,618-833-4471,,cflamm@ruralhealthinc.org,,,,,,
IL-003395,ACCESS Northwest Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1780879023,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1120 N Arlington Heights Rd,,Arlington Heights,IL,60004-4767,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003397,Atwood Rural Health Clinic,Kirby Medical Center,1740271667,Rural Health Clinics,108 N Main St,,Atwood,IL,61913-7103,Piatt,108 N. Main St,,Atwood,IL,61913,Douglas,Sara Wells,Clinic Director,217-762-1701,,swells@kirbyhealth.org,Dr. Narain Mandhan,Chief Medical Officer,217-762-6241,,nmandhan@kirbyhealth.org,www.kirbyhealth.org
IL-003398,Memorial Medical Clinic Augusta,Memorial Medical Hospital,1275979031,Other ECP Providers,204 Center St,,Augusta,IL,62311-1228,Hancock,Memorial Hospital Association,1454 North County Road 2050,Carthage,IL,62321,Hancock,Stephanie Meyers,Director of Clinic Operations,217-357-2173,,smeyers@mhtlc.org,,,,,,
IL-003399,Aunt Martha's Aurora Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1356481899,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",101 S Broadway,,Aurora,IL,60505-4276,Kane,19990 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003400,VNA Health Care,VNA Health Care,1891136149,Federally Qualified Health Centers - Medical Services,1400 Indian Ave,,Aurora,IL,60505-3137,Kane,400 N. Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003401,Aurora Dental Clinic,Community Health Partnership of Illinois,1962525691,Dental Providers,157 S Lincoln Ave,Suite C,Aurora,IL,60505-4291,Kane,205 West Randolph Street,Suite 2222,Chicago,IL,60606-1814,Cook,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,www.chpofil.org
IL-003402,Community Health Partnership of Illinois - Aurora,Community Health Partnership of Illinois,1932375169,Federally Qualified Health Centers - Medical Services,157 S Lincoln Ave,Suite D,Aurora,IL,60505-4291,Kane,205 W Randolph St Ste 2222,,Chicago,IL,60606-1814,Cook,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,https://www.chpofil.org/aurora.html
IL-003403,Open Door Clinic of Greater Elgin,Open Door Clinic of Greater Elgin,1174902555,"Community Mental Health Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",157 S Lincoln Ave,Suite K,Aurora,IL,60505-4291,Kane,157 S Lincoln Ave,Suite K,Aurora,IL,60505,Kane,Barbara Cox,Director of Finance,847-695-1093,218,BarbC@odhcil.org,Margaret Dunteman,Practice Manager,630-264-1819,335,PegD@odhcil.org,www.opendoorclinic.org
IL-003404,Aurora Health Center,Planned Parenthood of Illinois,1831506773,Family Planning Providers,3051 E New York St,,Aurora,IL,60504-5160,Dupage,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3200,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003405,VNA Health Care,VNA Health Care,1700910981,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",400 N Highland Ave,,Aurora,IL,60506-3814,Kane,400 N. Highland Ave.,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003406,VNA Health Care,VNA Health Care,1043334139,Federally Qualified Health Centers - Medical Services,500 Tomcat Ln,,Aurora,IL,60505-5006,Kane,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003407,Aunt Martha's Aurora Health and Outreach Center,"Aunt Martha's Youth Service Center, Inc.",1629118161,Federally Qualified Health Centers - Medical Services,680 S River St,,Aurora,IL,60506-5552,Kane,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003408,Cass County Community Health Clinic-Beardstown,COUNTY OF CASS,1942439310,Federally Qualified Health Centers - Medical Services,8570 Saint Lukes Dr,,Beardstown,IL,62618-9200,Cass,331 S Main St,,Virginia,IL,62691-1571,Cass,Teresa Armstrong,Administrator,217-452-3057,301,tarmstrong@casscohealth.org,Sarah Fanning,Billing,217-452-3057,323,sfanning@casscohealth.org,
IL-003409,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1760602593,Community Mental Health Centers,12 N 64th St,,Belleville,IL,62223-3809,Saint Clair,50 Northgate Industrial Drive,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003410,Chestnut Health Systems-Belleville,Chestnut Health Systems,1700154911,Other ECP Providers,12 N 64th St,,Belleville,IL,62223-3809,Saint Clair,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003411,Belleville Family Health Center,"SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.",1780609578,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",180 S 3rd St,,Belleville,IL,62220-1952,Saint Clair,2041 Goose Lake Road,,Sauget,IL,62206,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator and Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003412,Prime Time of Belleville,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1487882775,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",211 S 3rd St,Suite 2304,Belleville,IL,62220-1915,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003413,Childrens Medical Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1699066985,Federally Qualified Health Centers - Medical Services,2810 Frank Scott Pkwy W,Suite 828,Belleville,IL,62223-5007,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003414,BELLEVILLE PEDIATRIC & ADOLESCENT HEALTH CENTER,Southern Illinois Healthcare Foundation,1376588871,Federally Qualified Health Centers - Medical Services,2900 Frank Scott Pkwy W,Suite 950,Belleville,IL,62223-5010,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003415,ILLINI FAMILY MEDICINE,Southern Illinois Healthcare Foundation,1881793578,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2900 Frank Scott Pkwy W,Suite 980,Belleville,IL,62223-5000,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206,Saint Clair,LARRY MCCULLEY,President and CEO,618-332-0694,19208,lmcculley@sihf.org,Patrice Howard,VP of Administration,618-332-0694,19204,phoward@sihf.org,
IL-003416,WEST BELLEVILLE HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1275561797,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7210 W Main St,,Belleville,IL,62223-3038,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003417,Crusader Clinic - Belvidere,CRUSADERS CENTRAL CLINIC ASSOCIATION,1780852244,"Dental Providers, Federally Qualified Health Centers - Medical Services",1050 Logan Ave,,Belvidere,IL,61008-3966,Boone,1200 W State St,,Rockford,IL,61102-2112,Boone,Gordon Eggers,CEO,815-490-1604,,geggers@crusaderhealth.org,Sam Miller,CFO,815-490-1737,,smiller@crusaderhealth.org,
IL-003418,VNA Health Care,VNA Health Care,1205188448,Federally Qualified Health Centers - Medical Services,28 N York Rd,,Bensenville,IL,60106-2141,Dupage,400 N. Highland Ave.,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003419,FRANKLIN HOSPITAL - FRANKLIN HEALTHCARE CLINIC,Franklin Hospital,1033140488,Rural Health Clinics,201 Bailey Ln,,Benton,IL,62812-1999,Franklin,201 Bailey Lane,,Benton,IL,628121969,Franklin,Kimberly Grob,Dir of Pt Fin Srvcs,618-439-3161,323,kimberly.grob@franklinhospital.net,,,,,,
IL-003420,Benton Community Healthcare,Southern Illinois Medical Group,1518920073,Rural Health Clinics,203 Bailey Ln,,Benton,IL,62812-2266,Franklin,1239 E Main St,,Carbondale,IL,62901,Jackson,Petra Massetto,Practice Manager,618-457-5200,68085,petra.massetto@sih.net,,,,,,
IL-003421,PCC SOUTH FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1174549786,"Dental Providers, Federally Qualified Health Centers - Medical Services",6201 Roosevelt Rd,,Berwyn,IL,60402-1108,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003422,ACCESS Martin T. Russo Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1881773232,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",245 S Gary Ave Lowr Level,,Bloomingdale,IL,60108-2228,Dupage,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003423,Chestnut Health Systems - MLK,Chestnut Health Systems,1366431686,Other ECP Providers,1003 Martin Luther King Dr,,Bloomington,IL,61701-1429,McLean,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003424,Bloomington,Planned Parenthood of Illinois,1033526967,Family Planning Providers,1319 N Veterans Pkwy,,Bloomington,IL,61704-6426,McLean,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003425,St Joseph Medical Center,OSF Healthcare System,1619916806,Inpatient Hospitals (other than children's hospitals),2200 E Washington St,,Bloomington,IL,61701-4364,McLean,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003426,Chestnut Health Systems - Men's Health,Chestnut Health Systems,1316068471,Other ECP Providers,702 W Chestnut St,,Bloomington,IL,61701-2814,McLean,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003427,Chestnut Health Systems - Women's Health,Chestnut Health Systems,1609021997,Other ECP Providers,702 W Chestnut St,,Bloomington,IL,61701-2814,McLean,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003428,Chestnut Family Health Center,"CHESTNUT HEALTH SYSTEMS, INC.",1790055952,Federally Qualified Health Centers - Medical Services,720 W Chestnut St,,Bloomington,IL,61701-2814,McLean,1003 Martin Luther King Drive,,Bloomington,IL,61701,Mclean,Dietra Kulicke,Executive Director,309-557-1400,1437,dkulicke@chestnut.org,Stephanie Paxton,Clinic Coordinator,309-557-1400,1418,sjpaxton@chestnut.org,www.chestnut.org
IL-003429,ACCESS Blue Island Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1114005337,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",13000 Maple Ave,,Blue Island,IL,60406-2318,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003430,VNA Health Care,VNA Health Care,1811249972,Federally Qualified Health Centers - Medical Services,396 Remington Blvd,Suite 230,Bolingbrook,IL,60440-4304,Will,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003431,Memorial Medical Clinic Bowen,Memorial Hospital Association,1508831520,Rural Health Clinics,209 E 5th St,,Bowen,IL,62316-1130,Hancock,1454 N County Road 2050,,Carthage,IL,62321,Hancock,Stephanie Meyers,Practice Manager,217-357-6810,,smeyers@mhtlc.org,Valerie Bostic,OFFICE COORDINATOR,217-357-6808,,vbostic@mhtlc.org,
IL-003432,Bunker Hill Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1659506939,Federally Qualified Health Centers - Medical Services,144 N Washington St,,Bunker Hill,IL,62014,Macoupin,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003433,CCHC Calumet City Health Center,Christian Community Health Center,1780857219,"Dental Providers, Federally Qualified Health Centers - Medical Services",364 Torrence Ave,,Calumet City,IL,60409-1902,Cook,9718 S Halsted Street,,Chicago,IL,60628-1007,Cook,Kenneth Burnett,CEO,773-298-2070,2070,kenneth.burnett@cchc-rchm.org,Samantha Mitchell,COO,773-298-2070,2070,samantha.mitchell@cchc-rchm.org,
IL-003434,Graham Medical Group,Graham Hospital Association,1780692087,Rural Health Clinics,180 S Main St,,Canton,IL,61520-2608,Fulton,180 South Main St,,Canton,IL,61520,Fulton,Elicia D Munson,"Director, Business Services",309-647-0201,8527,emunson@grahamhospital.org,Holly Henline,"Senior Director, Revenue Cycle",309-647-5240,2709,hhenline@grahamhospital.org,
IL-003435,Graham Hospital,Graham Hospital Association,1780692087,Inpatient Hospitals (other than children's hospitals),210 W Walnut St,,Canton,IL,61520-2444,Fulton,210 W Walnut St,,Canton,IL,61520,Fulton,Elicia D Munson,"Director, Business Services",309-647-5240,8527,emunson@grahamhospital.org,Holly Henline,"Senior Director, Revenue Cycle",309-647-5240,2709,hhenline@grahamhospital.org,
IL-003436,Fulton Co. Health Dept.,FULTON COUNTY HEALTH DEPARTMENT,1245216241,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",700 E Oak St,,Canton,IL,61520-3168,Fulton,700 E Oak St,,Canton,IL,61520,Fulton,Damon Roberson,Administrator,309-647-1134,232,droberson@fultonco.org,Amy Edwards,Family Planning Coordinator,,,,
IL-003437,"Shawnee Health Care, Psychiatry",SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1457381774,Federally Qualified Health Centers - Medical Services,101 S Wall St,,Carbondale,IL,62901-3021,Jackson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003438,Terrier Care,SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1326079245,Federally Qualified Health Centers - Medical Services,1301 E Walnut St,,Carbondale,IL,62901-5004,Jackson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003439,"Shawnee Health Care, Carbondale OB/GYN",SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1578656682,Federally Qualified Health Centers - Medical Services,202 W Jackson St,,Carbondale,IL,62901-1409,Jackson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003440,"Shawnee Health Care, Carbondale",Shawnee Health Service and Development Corp,1073745345,Federally Qualified Health Centers - Medical Services,400 S Lewis Ln,,Carbondale,IL,62901-3547,Jackson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003441,Shawnee Health Care Carbondale Dental,Shawnee Health Service and Development Corp,1174859870,Dental Providers,402 S Lewis Ln,,Carbondale,IL,62901-3547,Jackson,109 California Street,PO Box 577,Carterville,IL,62918,Williamson,Patsy Jensen,CEO,618-985-8221,,shsinfo@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003442,Carlinville Family Practice Center,Macoupin Family Practice Centers LLP,1649460510,Rural Health Clinics,15574 Route 108,,Carlinville,IL,62626-4091,Macoupin,715 West Broadway,,Gillespie,IL,62033,Macoupin,Jennifer Henrichs,Administrator,217-839-4491,,jhenrichs@mfpc.net,,,,,,
IL-003443,Carlinville Family Health Care,Carlinville Area Hospital,1992020499,Rural Health Clinics,20613 N Broad St,Suite B,Carlinville,IL,62626-3721,Macoupin,20733 North Broad Street,,Carlinivlle,IL,62626,Macoupin,Kathi McCaherty,RHC Business Manager,217-854-3881,,kmccaherty@cahcare.com,Michael Brown,CFO,217-854-3141,357,mbrown@cahcare.com,www.cahcare.com
IL-003444,Carlinville Area Hospital Association,Carlinville Area Hospital Association,1053425124,Rural Health Clinics,20733 N Broad St,,Carlinville,IL,62626-3710,Macoupin,20733 North Broad Street,,Carlinville,IL,62626,Macoupin,Michael J. Brown,Chief Financial Officer,217-854-3857,,mbrown@cahcare.com,,,,,,
IL-003445,Macoupin County Public Health Clinic Site,"MACOUPIN, COUNTY OF",1861800526,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",805 N Broad St,,Carlinville,IL,62626-1075,Macoupin,805 N Broad St,,Carlinville,IL,62626-1075,Macoupin,Kent A Tarro,CEO,217-854-3223,,ktarro@mcphd.net,Amanda Brandenberg,Health Plan Educator,217-782-2016,,abrandenberg@mcphd.net,
IL-003446,CRHPC-Carmi Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1871867507,Federally Qualified Health Centers - Medical Services,103 Commerce St,,Carmi,IL,62821-2223,White,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003447,VNA Health Care,VNA Health Care,1265784417,Federally Qualified Health Centers - Medical Services,350 S Schmale Rd,Suite 150,Carol Stream,IL,60188-2778,Dupage,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003448,Aunt Martha's Carpentersville Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1538209077,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3003 Wakefield Dr,,Carpentersville,IL,60110-2422,Kane,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003449,JCH Medical Group-Carrollton,Jersey Community Hospital,1689079642,Rural Health Clinics,523 S Main St,,Carrollton,IL,62016-1256,Greene,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003450,Thomas H. Boyd Memorial Hospital,Thomas H. Boyd Memorial Hospital,1811096811,Inpatient Hospitals (other than children's hospitals),800 School St,,Carrollton,IL,62016-1436,Greene,800 School Street,,Carrollton,IL,62016,Greene,Deborah Campbell,CEO,217-942-6946,1200,dcampbell@boydhcs.org,Jim Johnson,CFO,217-942-6946,1303,jjohnson@boydhcs.org,
IL-003451,Thomas H. Boyd Rural Health Clinic,Thomas H. Boyd Memorial Hospital,1164507604,Rural Health Clinics,800 School St,,Carrollton,IL,62016-1436,Greene,800 School St,,Carrollton,IL,62016,Greene,Deborah Campbell,CEO,217-942-6946,1200,dcampbell@boydhcs.org,Jim Johnson,CFO,217-942-6946,1303,jjohnson@boydhcs.org,
IL-003452,"Shawnee Health Care, Carterville",SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1811928732,Federally Qualified Health Centers - Medical Services,1006 S Division St,,Carterville,IL,62918-1539,Williamson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003453,Memorial Hospital,Memorial Hospital Association,1730139031,Inpatient Hospitals (other than children's hospitals),1454 N County Road 2050,,Carthage,IL,62321-3551,Hancock,PO Box 160,,Carthage,IL,62321-0160,Hancock,Teresa Smith,Chief Financial Officer,217-357-6512,,tsmith@mhtlc.org,Portia G. Anderson,Credentialing & Enrollment,217-357-6512,,panderson@mhtlc.org,
IL-003454,Women & Family Medical Group,Memorial Hospital Association,1205887742,Rural Health Clinics,630 Locust St,,Carthage,IL,62321-1459,Hancock,1454 North County Road 2050,,Carthage,IL,62321,Hancock,Stephanie Meyers,Practice Manager,217-357-2173,,smeyers@mhtlc.org,Nornil,Villaflores,217-357-2173,,nvillaflores@mhtlc.org,
IL-003456,CENTREVILLE HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1609813500,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6000 Bond Ave,,Centreville,IL,62207-2328,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003457,Champaign-Urbana Public Health District (CUPHD),Champaign-Urbana Public Health District,1073666996,"Dental Providers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 W Kenyon Rd,,Champaign,IL,61820-7892,Champaign,201 W. Kenyon Road,,Champaign,IL,61820,Champaign,Julie A. Pryde,Administrator,217-531-5369,,jpryde@c-uphd.org,Avais Vaid,Director of Planning and Research,217-531-5360,,avaid@c-uphd.org,www.c-uphd.org
IL-003458,Champaign,Planned Parenthood of Illinois,1134536063,Family Planning Providers,302 E Stoughton St,,Champaign,IL,61820-5414,Champaign,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003459,Promise Healthcare at Community Elements,Promise Healthcare NFP,1578821005,Federally Qualified Health Centers - Medical Services,801 N Walnut St,,Champaign,IL,61820-3055,Champaign,819 Bloomington Road,,Champaign,IL,61820,Champaign,Nancy Greenwalt,CEO,217-403-5401,,ngreenwalt@promisehealth.org,Pat Owens,Director of Finance and Information,217-403-5473,,powens@promisehealth.org,
IL-003460,Frances Nelson Health Center,Promise Healthcare NFP,1578821005,"Dental Providers, Federally Qualified Health Centers - Medical Services",819 Bloomington Rd,,Champaign,IL,61820-2101,Champaign,819 Bloomington Road,,Champaign,IL,61820,Champaign,Nancy Greenwalt,CEO,217-403-5401,,ngreenwalt@promisehealth.org,Pat Owens,Director of Finance and Information,217-403-5473,,powens@promisehealth.org,
IL-003461,Charleston Medical Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1487070835,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",626 W Lincoln Ave,,Charleston,IL,61920-2444,Coles,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003462,Coles County Health Department,Coles County Health Department,1356543060,"Family Planning Providers, Sexually Transmitted Disease Clinics",825 18th St,Suite 1,Charleston,IL,61920-2995,Coles,825 18th St,,Charleston,IL,61920,Coles,Shan Brown,,217-348-0547,,sbrown@co.coles.il.us,,,,,,
IL-003463,"HEARTLAND HEALTH OUTREACH, INC.","HEARTLAND HEALTH OUTREACH, INC.",1538294483,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1015 W Lawrence Ave # 2,,Chicago,IL,60640-5017,Cook,208 S La Salle St,Ste 1300,Chicago,IL,60604-1286,Cook,Ed Stellon,Executive Director,773-751-4104,,estellon@heartlandalliance.org,Randi Tolliver,Chief Operations Officer,773-334-7117,1003,rtolliver@heartlandalliance.org,www.heartlandhealthoutreach.org
IL-003464,TCA Health,"TCA HEALTH, INC. NFP",1184757353,"Dental Providers, Federally Qualified Health Centers - Medical Services",1029 E 130th St,,Chicago,IL,60628-6908,Cook,1029 E 130th St,,Chicago,IL,60628-6908,Cook,VERONICA CLARKE,CEO,773-995-6300,213,VCLARKE@TCAHEALTH.ORG,Samantha Mitchell,Chief Operating Officer,773-995-6300,238,somitchell@tcahealth.org,http://www.tcahealth.org/services/
IL-003465,PCC WALK-In WELLNESS CENTER at NORWEGIAN AMERICAN HOSPITAL,PCC COMMUNITY WELLNESS CENTER,1962633081,Federally Qualified Health Centers - Medical Services,1044 N Francisco Ave,,Chicago,IL,60622-2743,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003466,PCC WEST TOWN FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1164628012,Federally Qualified Health Centers - Medical Services,1044 N Mozart St,Suite 100,Chicago,IL,60622-3644,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003467,Chicago Family Health Center East Side,"CHICAGO FAMILY HEALTH CENTER, INC.",1992976419,"Dental Providers, Federally Qualified Health Centers - Medical Services",10536 S Ewing Ave,,Chicago,IL,60617-6219,Cook,9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,Brandon Taylor,Credentialing & Managed Care Specialist,773-768-5000,1112,btaylor@chicagofamilyhealth.org,J. Eric Boklage,CAO,773-768-5000,1092,eboklage@chicagofamilyhealth.org,
IL-003468,Roseland,Planned Parenthood of Illinois,1093121923,Family Planning Providers,11250 S Halsted St,,Chicago,IL,60628-4711,Cook,18 S. Michigan Avenue,6th Floor,Chicago,IL,60603,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60628/roseland-health-center-2263-90430
IL-003469,PrimeCare Wicker Park,PrimeCare Community Health,1700230398,Federally Qualified Health Centers - Medical Services,1127 N Oakley Blvd # 2,,Chicago,IL,60622-3507,Cook,1431 N. Western Ave.,Suite 401,Chicago,IL,60622,Cook,ROBIN MCGINNIS,CEO,312-491-5085,,ROBIN.MCGINNIS@PRIMECARECHI.ORG,Joseph Moldovan,CFO/COO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003470,Erie Clemente Wildcats Student Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1144461385,Federally Qualified Health Centers - Medical Services,1147 N Western Ave,,Chicago,IL,60622-2931,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003471,Parkside,Circle Family Healthcare Network,1649399106,Federally Qualified Health Centers - Medical Services,115 N Parkside Ave,,Chicago,IL,60644-3040,Cook,5002 W. Madison Street,,Chicago,IL,60644,Cook,Christopher Jackson,CFO,773-379-1000,3013,cjackson@cfhcn.org,Denise Moody,Administrator Assistant,773-379-1000,3030,dmoody@cfhcn.org,www.cfhcn.org
IL-003472,Wicker Park,Planned Parenthood of Illinois,1205242120,Family Planning Providers,1152 N Milwaukee Ave,,Chicago,IL,60642-4010,Cook,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60642/wicker-park-health-center-2267-90430
IL-003473,Chicago Family Health Center - Roseland,"CHICAGO FAMILY HEALTH CENTER, INC.",1770785644,Federally Qualified Health Centers - Medical Services,120 W 111th St,,Chicago,IL,60628-4215,Cook,9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,Brandon Taylor,Credentialing & Managed Care Specialist,773-768-5000,1112,btaylor@chicagofamilyhealth.org,J. Eric Boklage,CAO,773-768-5000,1092,eboklage@chicagofamilyhealth.org,
IL-003474,Near North,Planned Parenthood of Illinois,1215343140,Family Planning Providers,1200 N La Salle Dr,,Chicago,IL,60610-1913,Cook,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60610/near-north-health-center-2474-90430
IL-003475,UIH-Mile Square Health Center,The Board of Trustees of the University of Illinois,1669493466,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1220 S Wood St,,Chicago,IL,60608-1202,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/main-location
IL-003476,WINFIELD MOODY HEALTH CENTER,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003477,Heartland Health Center - Devon,Heartland International Health Center,1609289883,"Dental Providers, Federally Qualified Health Centers - Medical Services",1300 W Devon Ave,,Chicago,IL,60660-1302,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003478,TCA Health,"TCA HEALTH, INC. NFP",1053622043,Federally Qualified Health Centers - Medical Services,13100 S Doty Ave,"Carver Military Academy/TCA Health, Inc.",Chicago,IL,60827-1597,Cook,1029 E 130th St,,Chicago,IL,60628-6908,Cook,VERONICA CLARKE,CEO,773-995-6300,213,VCLARKE@TCAHEALTH.ORG,Samantha Mitchell,Chief Operating Officer,773-995-6300,238,somitchell@tcahealth.org,http://www.tcahealth.org/services/
IL-003479,Heartland Health Center Trilogy,Heartland International Health Center,1265726780,Federally Qualified Health Centers - Medical Services,1400 W Greenleaf Ave,,Chicago,IL,60626-2805,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003480,Michelini Center for Health,PrimeCare Community Health,1336692359,Federally Qualified Health Centers - Medical Services,1431 N Western Ave,Suite 209,Chicago,IL,60622-7712,Cook,1431 N Western Ave,Suite 401,Chicago,IL,60622,Cook,ROBIN MCGINNIS,CEO,312-491-5085,,ROBIN.MCGINNIS@PRIMECARECHI.ORG,Joseph Moldovan,CFO/COO,312-491-5034,,joseph.moldovan@primecarechi.org,https://primecarehealth.org/michael-michelini-center-for-health/
IL-003481,PRIMECARE WEST TOWN,PrimeCare Community Health,1225010911,Federally Qualified Health Centers - Medical Services,1431 N Western Ave,Suite 406,Chicago,IL,60622-1774,Cook,1431 N Western Ave,Suite 401,Chicago,IL,60622-1797,Cook,Stephen S. Stabile,CEO,312-491-5085,,stephen.stabile@primecarechi.org,Joseph Moldovan,CFO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003482,"ERIE FAMILY HEALTH CENTER, INC.","ERIE FAMILY HEALTH CENTER, INC.",1043407547,Federally Qualified Health Centers - Medical Services,1504 S Albany Ave,Erie Johnson School-Based Health Center,Chicago,IL,60623-2209,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003487,AHF Healthcare Center - Chicago (Hyde Park),AIDS Healthcare Foundation,1578920492,Other ECP Providers,1515 E 52nd Pl,,Chicago,IL,60615-4390,Cook,6255 W. Sunset Blvd.,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
IL-003483,North/Kostner Health Center,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",1520 N Kostner Ave,,Chicago,IL,60651-1610,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharfi2@nm.org,http://www.nearnorthhealth.org/
IL-003484,Friend Health - Woodlawn,"Friend Family Health Center, Inc",1215394895,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1522 E 63rd St,,Chicago,IL,60637-2921,Cook,800 East 55th Street,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003485,Howard Brown Health 55th Street,Howard Brown Health Center,1710437991,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1525 E 55th St,,Chicago,IL,60615-5512,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613-2010,Cook,Carla Hess,Director of Grants Management,773-388-8686,,carlah@howardbrown.org,,,,,,
IL-003486,Hamdard-Chicago,HAMDARD CENTER FOR HEALTH & HUMAN SERVICES NFP,1356772834,Federally Qualified Health Centers - Medical Services,1542 W Devon Ave,,Chicago,IL,60660-1344,Cook,228 E Lake St Ste 300,,Addison,IL,60101-2872,Cook,kiran siddiqui,COO,773-465-4600,227,ksidd@hamdardcenter.org,Shawn Bailey,Manager,630-835-1430,29,,www.hamdardcenter.org
IL-003488,ACCESS Evanston-Rogers Park Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1982783338,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1555 W Howard St,,Chicago,IL,60626-1707,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003489,UIC-South Side Field Station,University of Illinois at Chicago,1861431751,Ryan White Providers,1606 W 63rd St,,Chicago,IL,60636-2211,Cook,808 S Wood St,Rm 888 MC735,Chicago,IL,60612,Cook,Alissa Eugeni,Administrative Staff,312-996-8380,,eugeni@uic.edu,,,,,,https://coip.uic.edu/locations/
IL-003490,UIC -Northwest Side Field Station,University of Illinois at Chicago,1861431751,Ryan White Providers,1610 N Kedzie Ave # 12,,Chicago,IL,60647-4908,Cook,808 S Wood St,Rm 888 MC 735,Chicago,IL,60612,Cook,Alissa Eugeni,Administrative Staff,312-996-8380,,eugeni@uic.edu,,,,,,https://coip.uic.edu/locations/
IL-003491,The Board of Trustees of the University of Illinois,The Board of Trustees of the University of Illinois,1043510241,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1628 W Washington Blvd,UIH-Hope Institute Learning Academy,Chicago,IL,60612-2613,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60612-2613,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,http://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/school-based-clinics/hope-institute
IL-003492,Adolescent Family Center,Rush University Medical Center,1902922115,Family Planning Providers,1645 W Jackson Blvd,Suite 315A,Chicago,IL,60612-3227,Cook,1645 W Jackson Blvd,,Chicago,IL,60612-3276,Cook,Sally Lemke,Director,312-563-6830,,Sally_Lemke@rush.edu,Priank Patel,Senior Business Manager,312-942-2853,,priank_patel@rush.edu,www.rush.edu
IL-003493,PrimeCare Northwest,PRIMECARE COMMUNITY HEALTH INC,1730235870,Federally Qualified Health Centers - Medical Services,1649 N Pulaski Rd,,Chicago,IL,60639-5207,Cook,1431 N Western Ave Ste 401,,Chicago,IL,60622-1797,Cook,Stephen S. Stabile,CEO,312-491-5085,,stephen.stabile@primecarechi.org,Joseph Moldovan,CFO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003494,Rush University Hemophilia and Thrombophilia Center,Rush University Medical Center,1932213600,Hemophilia Treatment Centers,1650 W Harrison St,Jelke 1591,Chicago,IL,60612-3800,Cook,1650 W Harrison Street,Jelke 1591,Chicago,IL,60614,Cook,Lisa Boggio,Asst Professor,312-942-8114,,Lisa_Boggio@rush.edu,,,,,,https://www.rush.edu/services/hemophilia-and-thrombophilia-center
IL-003495,Erie West Town Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1760499545,Federally Qualified Health Centers - Medical Services,1701 W Superior St,,Chicago,IL,60622-5646,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003496,UNIVERSITY OF ILLINOIS HOSPITAL,The Board of Trustees of the University of Illinois,1861431751,Inpatient Hospitals (other than children's hospitals),1740 W Taylor St,Suite 1400,Chicago,IL,60612-7232,Cook,1740 W. Taylor St,Ste 1400,Chicago,IL,60612-7232,Cook,Michael Zenn,CEO,312-996-3900,,mbzenn@uic.edu,Marc DeVar,Associate Chief Financial Officer,312-996-9329,,wdevar@uic.edu,http://hospital.uillinois.edu
IL-003497,Loop,Planned Parenthood of Illinois,1467869230,Family Planning Providers,18 S Michigan Ave,Suite 600,Chicago,IL,60603-3206,Cook,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3200,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60603/loop-health-center-3286-90430
IL-003498,University of Illinois at Chicago (UIC),University of Illinois Family Planning Clinic,1003071812,Outpatient Hospital Clinics,1801 W Taylor St,4196 Occ Mc 650,Chicago,IL,60612-4795,Cook,820 S Wood St,MC 808,Chicago,IL,60612,Cook,Ankit Patel,Director of Administrative Operations,312-996-0533,,apatel62@uic.edu,Jeanine Turner,Family Planning Coordinator,312-996-7500,,,https://hospital.uillinois.edu/patients-and-visitors/locations-and-directions/outpatient-care-center
IL-003499,ACCESS Pilsen Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1790855187,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1817 S Loomis St,,Chicago,IL,60608-3018,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003500,Hektoen Institute/Stroger Hospital Agency,Illinois Dept. of Public Health Family Planning Program,1124149281,Family Planning Providers,1901 W Harrison St,Fantus 4th Floor Family Planning,Chicago,IL,60612-3714,Cook,1901 W Harrison St,,Chicago,IL,60612-3714,Cook,Kelly Stempinski,Family Planning Program Manager,312-864-5261,,kstempinski@cookcountyhhs.org,,,,,,
IL-003501,PrimeCare Hamlin,PRIMECARE COMMUNITY HEALTH INC,1356622500,Federally Qualified Health Centers - Medical Services,1920 N Hamlin Ave,,Chicago,IL,60647-3411,Cook,1431 N Western Ave Ste 401,,Chicago,IL,60622-1797,Cook,Stephen S. Stabile,CEO,312-491-5085,,stephen.stabile@primecarechi.org,Joseph Moldovan,CFO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003502,Aunt Martha's Roseland Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1780932061,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 E 115th St,,Chicago,IL,60628-5015,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,https://www.auntmarthas.org/am-finder/roseland-community-health-center-chicago/
IL-003503,Esperanza California,ESPERANZA HEALTH CENTERS,1124187125,Federally Qualified Health Centers - Medical Services,2001 S California Ave,Suite 1,Chicago,IL,60608-2884,Cook,2001 S California Ave Ste 1,,Chicago,IL,60608-2884,Cook,Jeffery McInnes,Revenue Cycle Manager,773-584-6200,,jmcinnes@esperanzachicago.org,Dan Fulwiler,CEO,773-584-6200,,dan@esperanzachicago.org,www.esperanzachicago.org
IL-003504,ACCESS at Anixter Center,ACCESS COMMUNITY HEALTH NETWORK,1184796609,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2020 N Clybourn Ave,,Chicago,IL,60614-4004,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-012442,Center for Vein Restoration,Center for Vein Restoration,1518504398,Other ECP Providers,2037 S Indiana Ave,,Chicago,IL,60616-1312,Cook,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
IL-003505,Heartland Health Outreach James West Clinic,"HEARTLAND HEALTH OUTREACH, INC.",1306279070,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",22 N Sangamon St,,Chicago,IL,60607-2640,Cook,208 S La Salle St.,Ste. 1300,Chicago,IL,60604-1286,Cook,Ed Stellon,Executive Director,773-751-4104,,estellon@heartlandalliance.org,Randi Tolliver,Chief Operations Officer,773-334-7117,,rtolliver@heartlandalliance.org,www.heartlandhealthoutreach.org
IL-003506,HEARTLAND HEALTH CENTER - ROGERS PARK,Heartland International Health Center,1871763375,Federally Qualified Health Centers - Medical Services,2200 W Touhy Ave,,Chicago,IL,60645-3412,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003507,SHC - Chicago,Shriners Hospitals for Children,1376656538,Children's Hospitals (inpatient only),2211 N Oak Park Ave,,Chicago,IL,60707-3351,Cook,2211 N Oak Park Ave,,Chicago,IL,60707,Cook,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,https://www.shrinershospitalsforchildren.org/chicago
IL-003508,ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO (children's inpatient hospital),ANN & ROBERT H LURIE CHILDRENS HOSP,1235234535,Children's Hospitals (inpatient only),225 E Chicago Ave,,Chicago,IL,60611-2991,Cook,225 E Chicago Ave,,Chicago,IL,60611-2991,Cook,Ron Blaustein,Sr VP/Chief Financial Officer,312-227-7133,,RBlaustein@luriechildrens.org,Jill Fraggos,Sr. Director Government Affairs,312-227-4267,,JFraggos@Luriechildrens.org,www.luriechildrens.org
IL-003509,ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO (ryan white providers),ANN & ROBERT H LURIE CHILDRENS HOSP,1235234535,Ryan White Providers,225 E Chicago Ave,,Chicago,IL,60611-2991,Cook,225 E Chicago Ave,,Chicago,IL,60611-2991,Cook,Ron Blaustein,Sr VP/Chief Financial Officer,312-227-7133,,RBlaustein@luriechildrens.org,Jill Fraggos,Sr. Director Government Affairs,312-227-4267,,JFraggos@Luriechildrens.org,www.luriechildrens.org
IL-003510,LCHC at Farragut Academy,LAWNDALE CHRISTIAN HEALTH CENTER,1154598282,Federally Qualified Health Centers - Medical Services,2345 S Christiana Ave,,Chicago,IL,60623-3217,Cook,3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003511,ACCESS Warren Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1528147824,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2409 W Warren Blvd,,Chicago,IL,60612-2115,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003512,Erie Division Street Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1700144243,Federally Qualified Health Centers - Medical Services,2418 W Division St,,Chicago,IL,60622-2940,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003513,Erie Teen and Young Adult Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1134316631,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2418 W Division St,,Chicago,IL,60622-2940,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003514,"Asian Human Services Family Health Center, Inc","Asian Human Services Family Health Center, Inc",1164439279,"Dental Providers, Federally Qualified Health Centers - Medical Services",2424 W Peterson Ave,Suite 1,Chicago,IL,60659-4128,Cook,2424 W. Peterson Ave,,Chicago,IL,60659,Cook,"Muhammad W. Paracha, MD., MPH.",Executive Director,773-761-0010,,mparacha@ahschicago.org,,,,,,
IL-003515,Friend Health -Beethoven,"FRIEND FAMILY HEALTH CENTER, INC.",1861667404,Federally Qualified Health Centers - Medical Services,25 W 47th St,,Chicago,IL,60609-4627,Cook,800 E 55th St,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc
IL-003516,"Asian Human Services Family Health Center, Inc","Asian Human Services Family Health Center, Inc",1609201060,"Dental Providers, Federally Qualified Health Centers - Medical Services",2501 W Peterson Ave,,Chicago,IL,60659-4108,Cook,2424 W. Peterson Ave,,Chicago,IL,60659,Cook,"Muhammad W. Paracha, MD., MPH.",Executive Director,773-761-0010,,mparacha@ahschicago.org,,,,,,
IL-003517,ACCESS Plaza Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1033289970,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2533 W Cermak Rd,,Chicago,IL,60608-3719,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003518,AHF Healthcare Center - Chicago,AIDS Healthcare Foundation,1629476635,"Other ECP Providers, Ryan White Providers",2600 S Michigan Ave,Suite Ll-D,Chicago,IL,60616-2857,Cook,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Suzanne Taylor,"Chief, Managed Care",323-436-5016,,suzanne.taylor@aidshealth.org,,,,,,www.aidshealth.org
IL-003519,UIH-Young Women Leadership,The Board of Trustees of the University of Illinois,1295751220,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2641 S Calumet Ave,,Chicago,IL,60616-2901,Cook,UIH-MIle Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,
IL-003520,Heartland Health Center-Lincoln Square,Heartland International Health Center,1629217161,"Dental Providers, Federally Qualified Health Centers - Medical Services",2645 W Lawrence Ave,,Chicago,IL,60625-2944,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003521,ACCESS at Sinai,ACCESS COMMUNITY HEALTH NETWORK,1912192253,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2653 W Ogden Ave Fl 3,,Chicago,IL,60608-1647,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003522,ACCESS Located at Holy Cross,ACCESS COMMUNITY HEALTH NETWORK,1467785782,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2701 W 68th St,3-South,Chicago,IL,60629-1813,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2064,,thea.kachorisflores@achn.net,,,,,,
IL-003523,Erie Humboldt Park Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1407043912,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2750 W North Ave,,Chicago,IL,60647-5247,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003524,Howard Brown Health Diversey,Howard Brown Health Center,1417473851,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2800 N Sheridan Rd,Suite 211,Chicago,IL,60657-6161,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613-2010,Cook,Carla Hess,Director of Grants Management,773-388-8686,,carlah@howardbrown.org,,,,,,
IL-003525,ACCESS Brandon Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1295813335,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2822 E 83rd St,,Chicago,IL,60617-2105,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003526,James and Catherine Denny Primary Care and Preventative Medicine Center,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 W Chicago Ave,,Chicago,IL,60654-3231,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003527,PCC Community Wellness Center at Steinmetz,PCC COMMUNITY WELLNESS CENTER,1255701942,Federally Qualified Health Centers - Medical Services,3030 N Mobile Ave,,Chicago,IL,60634-4041,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert J Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003528,Heartland Health Center - Pediatrics - Lakeview,Heartland International Health Center,1164751376,"Dental Providers, Federally Qualified Health Centers - Medical Services",3048 N Wilton Ave # 2,,Chicago,IL,60657-6710,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003529,UIH-Davis Health and Wellness Center,The Board of Trustees of the University of Illinois,1932450160,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3050 W 39th Pl,,Chicago,IL,60632-2402,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60632-2402,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/school-based-clinics/davis-health-wellness
IL-003530,Esperanza Little Village,ESPERANZA HEALTH CENTERS,1477812030,Federally Qualified Health Centers - Medical Services,3059 W 26th St,,Chicago,IL,60623-4131,Cook,2001 S California Ave Ste 1,,Chicago,IL,60608-2884,Cook,Jeffery McInnes,Revenue Cycle Manager,773-584-6200,,jmcinnes@esperanzachicago.org,Dan Fulwiler,CEO,773-584-6200,,dan@esperanzachicago.org,www.esperanzachicago.org
IL-003531,ACCESS Humboldt Park Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1760552541,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3202 W North Ave,,Chicago,IL,60647-4940,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003532,ACCESS Centro Medico San Rafael,ACCESS COMMUNITY HEALTH NETWORK,1972674315,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3204 W 26th St,,Chicago,IL,60623-4031,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003533,LCHC at Breakthrough,LAWNDALE CHRISTIAN HEALTH CENTER,1831590421,Federally Qualified Health Centers - Medical Services,3219 W Carroll Ave,,Chicago,IL,60624-2031,Cook,3860 W Ogden Ave,,Chicago,IL,60623,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003534,Chicago Family Health Center- Chicago Lawn,"CHICAGO FAMILY HEALTH CENTER, INC.",1629388756,"Dental Providers, Federally Qualified Health Centers - Medical Services",3223 W 63rd St,,Chicago,IL,60629-3333,Cook,9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,Brandon Taylor,Credentialing & Managed Care Specialist,773-768-5000,1112,btaylor@chicagofamilyhealth.org,J. Eric Boklage,CAO,773-768-5000,1092,eboklage@chicagofamilyhealth.org,
IL-003535,ACCESS Kedzie Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1598844268,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3229 W 47th Pl # 3243,,Chicago,IL,60632-3011,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003536,UIH-Mile Square IHC Humboldt Park(Integrated Health Care-AVIVA),UIH-Mile Square Health Center,1841614609,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3240 W Division St,,Chicago,IL,60651-2405,Cook,UIH-Mile Square Health,1220 S. Wood Street,Chicago,IL,60651-2405,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/humboldt-park
IL-003537,ACCESS at the Illinois Eye Institute,ACCESS COMMUNITY HEALTH NETWORK,1013086115,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3241 S Michigan Ave,,Chicago,IL,60616-4201,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003538,Heartland Health Center - Hibbard,Heartland International Health Center,1154640274,"Dental Providers, Federally Qualified Health Centers - Medical Services",3244 W Ainslie St,,Chicago,IL,60625-5018,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003539,Howard Brown Health Halsted,Howard Brown Health Center,1881913531,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3245 N Halsted St,,Chicago,IL,60657-3419,Cook,4025 N Sheridan Rd,,Chicago,IL,60613-2010,Cook,Joanna Mruz,Billing Manager,773-388-8991,,joannam@howardbrown.org,Erica Bertrand,Controller,773-388-1600,,ericab@howardbrown.org,www.howardbrown.org
IL-003540,ACCESS Servicios Medicos La Villita,ACCESS COMMUNITY HEALTH NETWORK,1205908720,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3303 W 26th St,,Chicago,IL,60623-4036,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003541,Heartland International Health Center,Heartland International Health Center,1700044039,"Dental Providers, Federally Qualified Health Centers - Medical Services",3436 W Wilson Ave,Heartland Health Center - Roosevelt High School,Chicago,IL,60625-5318,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003542,ACCESS Cabrini Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1780754523,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3450 S Archer Ave,,Chicago,IL,60608-6837,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003543,PCC CLINIC AT THE BOULEVARD,PCC COMMUNITY WELLNESS CENTER,1760630750,Federally Qualified Health Centers - Medical Services,3456 W Franklin Blvd,,Chicago,IL,60624-1308,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,https://www.pccwellness.org/pcc-clinic-at-the-boulevard
IL-003544,LCHC at Homan Square,LAWNDALE CHRISTIAN HEALTH CENTER,1326215450,Federally Qualified Health Centers - Medical Services,3517 W Arthington St,,Chicago,IL,60624-4165,Cook,3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003545,Aunt Martha's Southeast Side Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1811171143,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3528 E 118th St,,Chicago,IL,60617-7314,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003546,Infant Welfare Society of Chicago,Illinois Dept. of Public Health Family Planning Program,1497872543,"Community Mental Health Centers, Dental Providers, Family Planning Providers",3600 W Fullerton Ave,,Chicago,IL,60647-2319,Cook,3600 W Fullerton Ave,,Chicago,IL,60647-2319,Cook,Joanne Leck,Family Planning Coordinator,773-785-5022,,leckj@infantwelfare.org,,,,,,
IL-003547,ACCESS Centro Medico,ACCESS COMMUNITY HEALTH NETWORK,1194803213,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3700 W 26th St,,Chicago,IL,60623-3824,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003548,Heartland Health Center Albany Park,Heartland International Health Center,1548634991,"Dental Providers, Federally Qualified Health Centers - Medical Services",3737 W Lawrence Ave,,Chicago,IL,60625-5746,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003549,LCHC Health & Fitness - 3750,LAWNDALE CHRISTIAN HEALTH CENTER,1245289214,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3750 W Ogden Ave,,Chicago,IL,60623-2426,Cook,3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003550,ACCESS Paul and Mimi Francis Westside Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1447321898,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3752 W 16th St,,Chicago,IL,60623-2028,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003551,ACCESS Madison Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1922170349,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3800 W Madison St,,Chicago,IL,60624-2312,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003552,LCHC Ogden Main,LAWNDALE CHRISTIAN HEALTH CENTER,1245289214,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003553,PRIMECARE FULLERTON,PRIMECARE COMMUNITY HEALTH INC,1992851067,Federally Qualified Health Centers - Medical Services,3924 W Fullerton Ave,,Chicago,IL,60647-2228,Cook,1431 N Western Ave Ste 401,,Chicago,IL,60622-1797,Cook,Stephen S. Stabile,CEO,312-491-5085,,stephen.stabile@primecarechi.org,Joseph Moldovan,CFO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003554,Broadway Youth Center,Howard Brown Health Center,1699109546,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4009 N Broadway St,,Chicago,IL,60613-2110,Cook,4025 N Sheridan Rd,,Chicago,IL,60613-2010,Cook,Joanna Mruz,Billing Manager,773-388-8991,,joannam@howardbrown.org,,,,,,www.howardbrown.org
IL-003555,"Erie Family Health Center, Inc.","ERIE FAMILY HEALTH CENTER, INC.",1215228192,Federally Qualified Health Centers - Medical Services,4015 N Ashland Ave,Erie Lake View School Based Health Center,Chicago,IL,60613-2593,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003556,Howard Brown Health Sheridan,Howard Brown Health Center,1306048632,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4025 N Sheridan Rd,,Chicago,IL,60613-2010,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613,Cook,Joanna Mruz,Billing Manager,773-388-8991,,joannam@howardbrown.org,,,,,,www.howardbrown.org
IL-003557,American Indian Health Service-Chicago,American Indian Health Service-Chicago,1760572671,"Federally Qualified Health Centers - Medical Services, Indian Health Service",4081 N Broadway St,,Chicago,IL,60613-2117,Cook,4081 N Broadway St,,Chicago,IL,60613-2117,Cook,Kenneth Scott,Executive Director,773-883-9100,,krscott11@aol.com,Bobbie Bellinger,Administrative Director,773-883-9100,,bbellinger4@aol.com,www.aihschgo.org
IL-003558,UIH-Mile Square IHC North Center,The Board of Trustees of the University of Illinois,1932395233,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4221 N Lincoln Ave,,Chicago,IL,60618-2901,Cook,UIH-Mile Square Health,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,
IL-003559,KOMED/HOLMAN HEALTH CENTER,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4259 S Berkeley Ave,,Chicago,IL,60653-3030,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003560,Sunnyside Community Health Center,Near North Health Service Corporation,1821079088,Federally Qualified Health Centers - Medical Services,4501 N Sheridan Rd,,Chicago,IL,60640-5608,Cook,1276 N. Clybourn Avenue,,Chicago,IL,60610-2089,Cook,Berniece Mills-Thomas,Chief Executive Officer,312-337-1073,4200,bthomas@nm.org,Wahabi Tijani,Director of Finance and Accounting,312-337-1073,4212,wtijani@nm.org,www.nearnorthhealth.org
IL-003561,UIH-Mile Square Health Center at Back of the Yards,The Board of Trustees of the University of Illinois,1457523219,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4630 S Bishop St,,Chicago,IL,60609-3240,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/back-of-the-yards
IL-003602,UIH-Mile Square IHC New City,The Board of Trustees of the University of Illinois,1598879819,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4630 S Bishop St,,Chicago,IL,60609-3240,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/back-of-the-yards
IL-003562,Heartland Health Center - C4 - Clark,Heartland International Health Center,1407183734,Federally Qualified Health Centers - Medical Services,4740 N Clark St,,Chicago,IL,60640-4689,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003563,Erie Helping Hands Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1952598468,Federally Qualified Health Centers - Medical Services,4747 N Kedzie Ave,,Chicago,IL,60625-4420,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003564,UIC -West Side Field Station,University of Illinois at Chicago,1861431751,Ryan White Providers,4754 W Madison St,,Chicago,IL,60644-3615,Cook,808 S Wood St,Rm 888 MC735,Chicago,IL,60612,Cook,Alissa Eugeni,Administrative Staff,312-996-8380,,eugeni@uic.edu,,,,,,https://coip.uic.edu/locations/
IL-003565,Friend Health -Ashland,"FRIEND FAMILY HEALTH CENTER, INC.",1891921623,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4802 S Ashland Ave,,Chicago,IL,60609-4233,Cook,800 E 55th St,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003566,COTTAGE VIEW HEALTH CENTER,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",4829 S Cottage Grove Ave,,Chicago,IL,60615-1600,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003567,ACCESS Southwest Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1134290570,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4839 W 47th St,,Chicago,IL,60638-2039,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003568,ACCESS Austin Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1841661089,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4909 W Division St,Suite 508,Chicago,IL,60651-3161,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2064,,thea.kachorisflores@achn.net,,,,,,
IL-003569,Aunt Martha's- Children's Reception Center,"Aunt Martha's Youth Service Center, Inc.",1295863983,Federally Qualified Health Centers - Medical Services,5001 S Michigan Ave,,Chicago,IL,60615-2112,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003570,"Erie Family Health Center, Inc.","ERIE FAMILY HEALTH CENTER, INC.",1164713129,Federally Qualified Health Centers - Medical Services,5110 N Damen Ave,Erie Amundsen School Based Health Center,Chicago,IL,60625-1317,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003571,LCHC at Archer Avenue,LAWNDALE CHRISTIAN HEALTH CENTER,1396986147,Federally Qualified Health Centers - Medical Services,5122 S Archer Ave,,Chicago,IL,60632-4508,Cook,3860 W Ogden Ave,,Chicago,IL,60623-2460,Cook,Eric Kuhl,Director of Patient Accounting,872-588-3058,,erickuhl@lawndale.org,,,,,,
IL-003572,ACCESS Ashland Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1043398217,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5159 S Ashland Ave,,Chicago,IL,60609-4931,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003573,Erie Foster Avenue Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1396181590,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5215 N California Ave,Suite F700,Chicago,IL,60625-8562,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003574,PCC SALUD FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1487670097,Federally Qualified Health Centers - Medical Services,5359 W Fullerton Ave,,Chicago,IL,60639-1450,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003575,ACCESS Grand Boulevard Health and Specialty Center,ACCESS COMMUNITY HEALTH NETWORK,1275605792,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5401 S Wentworth Ave Spc 5,,Chicago,IL,60609-6300,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003576,PCC AUSTIN FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1609892223,"Dental Providers, Federally Qualified Health Centers - Medical Services",5425 W Lake St,,Chicago,IL,60644-2342,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003577,The Board of Trustees of the University of Illinois,The Board of Trustees of the University of Illinois,1356367304,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",55 W Cermak Rd,UIH-National Teachers Academy,Chicago,IL,60616-2001,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,http://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/school-based-clinics/national-teachers
IL-003578,Howard Brown Health at TPAN,Howard Brown Health Center,1356876387,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5537 N Broadway St,,Chicago,IL,60640-1405,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613-2010,Cook,Carla Hess,Director of Grants Management,773-388-8686,,carlah@howardbrown.org,,,,,,
IL-003579,Friend Health - Pulaski,"FRIEND FAMILY HEALTH CENTER, INC.",1457525792,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5635 S Pulaski Rd,,Chicago,IL,60629-4438,Cook,800 E 55th St,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003580,PrimeCare Portage Park,PRIMECARE COMMUNITY HEALTH INC,1437440229,Federally Qualified Health Centers - Medical Services,5645 W Addison St,,Chicago,IL,60634-4403,Cook,1431 N Western Ave Ste 401,,Chicago,IL,60622-1797,Cook,Stephen S. Stabile,CEO,312-491-5085,,stephen.stabile@primecarechi.org,Joseph Moldovan,CFO,312-491-5034,,joseph.moldovan@primecarechi.org,
IL-003581,Chicago Family Health Center- Pullman,"CHICAGO FAMILY HEALTH CENTER, INC.",1063614923,"Dental Providers, Federally Qualified Health Centers - Medical Services",570 E 115th St,,Chicago,IL,60628-5740,Cook,9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,Brandon Taylor,Credentialing & Managed Care Specialist,773-768-5000,1112,btaylor@chicagofamilyhealth.org,J. Eric Boklage,CAO,773-768-5000,1092,eboklage@chicagofamilyhealth.org,
IL-003582,Heartland Health Center - C4 - Broadway,Heartland International Health Center,1669713343,Federally Qualified Health Centers - Medical Services,5710 N Broadway St,,Chicago,IL,60660-4302,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003583,Rogers Park,Planned Parenthood of Illinois,1801202734,Family Planning Providers,5725 N Broadway St,,Chicago,IL,60660-4301,Cook,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60660/rogers-park-health-center-2266-90430
IL-003584,Friend Health - Western,"FRIEND FAMILY HEALTH CENTER, INC.",1457330870,"Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",5843 S Western Ave,,Chicago,IL,60636-1526,Cook,800 E 55th St,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003585,Heartland International Health Center,Heartland International Health Center,1932366408,"Dental Providers, Federally Qualified Health Centers - Medical Services",5900 N Glenwood Ave,HEARTLAND HEALTH CENTER - SENN HIGH SCHOOL,Chicago,IL,60660-3312,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003586,Austin,Planned Parenthood of Illinois,1841607785,Family Planning Providers,5937 W Chicago Ave,,Chicago,IL,60651-2524,Cook,18 S Michigan Ave Ste 600,6th Floor,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60651/austin-health-center-2265-90430
IL-003587,Englewood,Planned Parenthood of Illinois,1790192623,Family Planning Providers,6059 S Ashland Ave,,Chicago,IL,60636-2303,Cook,18 S Michigan Ave,6th Floor,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/chicago/60636/englewood-health-center-2264-90430
IL-003588,Friend Health - Burnham,"Friend Family Health Center, Inc",1740635663,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6134 S Cottage Grove Ave,,Chicago,IL,60637-2565,Cook,800 East 55th Street,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003589,ACCESS Doctors Medical Center,ACCESS COMMUNITY HEALTH NETWORK,1790863827,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6240 W 55th St,,Chicago,IL,60638-2531,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003590,Howard Brown Health 63rd Street,Howard Brown Health Center,1255791331,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",641 W 63rd St,,Chicago,IL,60621-2032,Cook,Howard Brown Health Center,4025 N. Sheridan Rd.,Chicago,IL,60613,Cook,Joanna Mruz,Billing Manager,773-388-8991,,joannam@howardbrown.org,,,,,,www.howardbrown.org
IL-003591,UIH-Mile Square Health Center at Englewood,The Board of Trustees of the University of Illinois,1346596327,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",641 W 63rd St,,Chicago,IL,60621-2032,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/englewood
IL-003592,PCC Community Wellness Center at Loretto Hospital,PCC COMMUNITY WELLNESS CENTER,1508287673,Federally Qualified Health Centers - Medical Services,645 S Central Ave,Suite 600,Chicago,IL,60644-5059,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003593,Erie Westside Health Center at Laura S. Ward Elementary,"ERIE FAMILY HEALTH CENTER, INC.",1770770273,Federally Qualified Health Centers - Medical Services,646 N Lawndale Ave,,Chicago,IL,60624-1254,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003594,Howard Brown Health Clark,Howard Brown Health Center,1912382227,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",6500 N Clark St,,Chicago,IL,60626-4097,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613,Cook,Joanna Mruz,Billing Manager,773-388-8991,,carlah@howardbrown.org,,,,,,
IL-003595,LARABIDA CHILDRENS HOSPITAL,LARABIDA CHILDRENS HOSPITAL,1427146430,Children's Hospitals (inpatient only),6501 S Promontory Dr,,Chicago,IL,60649-1003,Cook,6501 South Promontory Drive,,Chicago,IL,60649,Cook,Lucy Mayhugh,"Executive Director, Clinic Operations, Outpatient clinic",773-256-5953,,lmayhugh@larabida.org,Melanie Maeda,Business Analyst,773-256-5731,,mmaeda@larabida.org,www.larabida.org
IL-003596,ACCESS Booker Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1538247762,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",654 E 47th St,,Chicago,IL,60653-4224,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003597,Esperanza Marquette,ESPERANZA HEALTH CENTERS,1669812582,Federally Qualified Health Centers - Medical Services,6550 S Richmond St,,Chicago,IL,60629-2821,Cook,2001 S California Ave Ste 1,,Chicago,IL,60608-2884,Cook,Dan Fulwiler,Revenue Cycle Manager,773-584-6200,,dan@esperanzachicago.org,Dan Fulwiler,CEO,773-584-6200,,dan@esperanzachicago.org,www.esperanzachicago.org
IL-003598,Beloved Community Family Wellness Center,BELOVED COMMUNITY FAMILY WELLNESS CENTER,1144528167,Federally Qualified Health Centers - Medical Services,6821 S Halsted St,,Chicago,IL,60621-1833,Cook,6821 S Halsted St,,Chicago,IL,60621-1833,Cook,MARGIE JOHNSON,Executive Director,773-651-3828,,MJOHNSON@BCFWC.ORG,IQBAL HUSSAIN,Billing Specialist,773-651-3629,212,IHUSSAIN@BCFWC.ORG,
IL-003599,UIH-Mile Square Health Center at South Shore,The Board of Trustees of the University of Illinois,1760400170,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7131 S Jeffery Blvd,Suite A,Chicago,IL,60649-2176,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,
IL-003600,ACCESS at Gary Comer Youth Center,ACCESS COMMUNITY HEALTH NETWORK,1659691715,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",7200 S Ingleside Ave,,Chicago,IL,60619-1254,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003601,Howard Brown Health at Thresholds South,Howard Brown Health Center,1740708858,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",734 W 47th St,,Chicago,IL,60609-4411,Cook,4025 N. Sheridan Rd.,,Chicago,IL,60613-2010,Cook,Carla Hess,Director of Grants Management,773-388-8686,,carlah@howardbrown.org,,,,,,
IL-003603,Friend Health - Cottage Grove,"FRIEND FAMILY HEALTH CENTER, INC.",1578560090,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",800 E 55th St,,Chicago,IL,60615-4906,Cook,800 E 55th St,,Chicago,IL,60615-4906,Cook,Wendy Thompson,Chief Strategy and Development Officer,773-702-2193,,wthompson@bsd.uchicago.edu,Sabrina G. Moore,Chief Financial Officer,773-702-2193,,smoore@peds.bsd.uchicago.edu,www.friendfhc.org
IL-003604,Louise Landau Health Center,"NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",800 N Kedzie Ave,,Chicago,IL,60651-4100,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003605,UIH-Mile Square Auburn Gresham,The Board of Trustees of the University of Illinois,1952713323,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",8131 S May St,,Chicago,IL,60620-3007,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,
IL-003606,ACCESS Auburn-Gresham Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1629156807,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",8234 S Ashland Ave,,Chicago,IL,60620-4625,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003607,"Near North Health Service Corporation, The","NEAR NORTH HEALTH SERVICE CORPORATION, THE",1821079088,"Dental Providers, Federally Qualified Health Centers - Medical Services",834 E 50th St,Reavis School Based Health Center,Chicago,IL,60615-2620,Cook,1276 N Clybourn Ave,,Chicago,IL,60610-2089,Cook,Berneice Mills-Thomas,Executive Director,312-337-1073,4200,bthomas@nm.org,Ahmer Sharif,Controller,312-337-1073,4216,asharif2@nm.org,http://www.nearnorthhealth.org/
IL-003608,TCA Health - Chatham,"TCA HEALTH, INC. NFP",1578936696,"Dental Providers, Federally Qualified Health Centers - Medical Services",8425 S Cottage Grove Ave,,Chicago,IL,60619-6113,Cook,1029 E 130th St,,Chicago,IL,60628,Cook,VERONICA CLARKE,CEO,773-995-6300,213,VCLARKE@TCAHEALTH.ORG,Samantha Mitchell,Chief Operating Officer,773-995-6300,238,somitchell@tcahealth.org,http://www.tcahealth.org/services/
IL-003609,HEARTLAND HEALTH CENTER WILSON,Heartland International Health Center,1790090876,"Dental Providers, Federally Qualified Health Centers - Medical Services",845 W Wilson Ave,Suite 2,Chicago,IL,60640-8090,Cook,3048 N Wilton Ave Fl 2,,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003610,UIC-Uptown,University of Illinois at Chicago,1861431751,Ryan White Providers,845 W Wilson Ave,Suite 2,Chicago,IL,60640-8090,Cook,808 S Wood St,Rm 888 MC 735,Chicago,IL,60640,Cook,Alissa Eugeni,Administrative Staff,312-996-8380,,eugeni@uic.edu,,,,,,https://coip.uic.edu/locations/
IL-003611,UIC-Southeast Side Field Station,University of Illinois at Chicago,1861431751,Ryan White Providers,8910 S Commercial Ave,,Chicago,IL,60617-3201,Cook,808 S Wood St,Rm 888 MC 735,Chicago,IL,60612,Cook,Alissa Eugeni,Administrative Staff,312-996-8380,,eugeni@uic.edu,,,,,,https://coip.uic.edu/locations/
IL-003612,Heartland International Health Center,Heartland International Health Center,1932417615,Federally Qualified Health Centers - Medical Services,900 W Wilson Ave,Heartland Health Center - Uplift Community High School,Chicago,IL,60640-5707,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003613,"CHICAGO FAMILY HEALTH CENTER, INC.","CHICAGO FAMILY HEALTH CENTER, INC.",1245266337,"Dental Providers, Federally Qualified Health Centers - Medical Services",9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,9119 S Exchange Ave,,Chicago,IL,60617-4225,Cook,Brandon Taylor,Credentialing & Managed Care Specialist,773-768-5000,1112,btaylor@chicagofamilyhealth.org,J. Eric Boklage,CAO,773-768-5000,1092,eboklage@chicagofamilyhealth.org,
IL-003614,Halsted Health Center,Christian Community Health Center,1790888238,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",9718 S Halsted St,,Chicago,IL,60628-1007,Cook,9718 S Halsted Street,,Chicago,IL,60628-1007,Cook,Kenneth Burnett,CEO,773-298-2070,2070,kenneth.burnett@cchc-rchm.org,Samantha Mitchell,COO,773-298-2070,2070,samantha.mitchell@cchc-rchm.org,
IL-003615,ACCESS Family Health Society,ACCESS COMMUNITY HEALTH NETWORK,1366514887,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",152 W Lincoln Hwy,,Chicago Heights,IL,60411-2619,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003616,Aunt Martha's Chicago Heights Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1922148501,Federally Qualified Health Centers - Medical Services,1536 Vincennes Ave,,Chicago Heights,IL,60411-3458,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003617,Aunt Martha's- Women's Health Center,"Aunt Martha's Youth Service Center, Inc.",1831239490,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",233 W Joe Orr Rd,,Chicago Heights,IL,60411-1744,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003743,Grand Prairie Services,Grand Prairie Services,1447723564,Federally Qualified Health Centers - Medical Services,450 West 14th Street,,Chicago Heights,IL,60411,Cook,17746 Oak Park Ave,,Tinley Park,IL,60477,Cook,Sharronne Ward,President and CEO,708-444-1012,1501,sward@gpsbh.org,Michele Spell,Administrative Assistant,708-444-1012,,mspell@gpsbh.org,
IL-003618,Aunt Martha's Chicago Heights Pediatric and Wellness Center,"Aunt Martha's Youth Service Center, Inc.",1255778221,Federally Qualified Health Centers - Medical Services,500 Dixie Hwy,,Chicago Heights,IL,60411-1741,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003619,Family Medical Center-Chrisman,"Hospital & Medical Foundation of Paris, Inc.",1447314653,Rural Health Clinics,112 W Madison Ave,,Chrisman,IL,61924-1118,Edgar,727 E Court St.,,Paris,IL,61944,Edgar,Meagan Lewsader,Payer Cred. Coord,217-465-4141,257,mlewsader@pchfmc.com,Eunice Chaney,Office Manager,217-465-8411,512,echaney@pchfmc.com,
IL-003620,Christopher Greater Area Rural Health Planning Corporation & Clinic,CHRISTOPHER RURAL HEALTH PLANNING CORP,1437370400,"Dental Providers, Federally Qualified Health Centers - Medical Services",4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-1037,Franklin,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,KIMBERLY A MITROKA,CEO,618-724-2436,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003621,ACCESS Hawthorne Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1164501896,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3040 S Cicero Ave,,Cicero,IL,60804-3638,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003622,UIH-Mile Square Health Center at Cicero,The Board of Trustees of the University of Illinois,1407166671,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4747 W Cermak Rd # 51,,Cicero,IL,60804-2508,Cook,UIH-Mile Square Health Center,1220 S. Wood Street,Chicago,IL,60608-1202,Cook,Robert Maziarka,Chief Finance Officer,312-413-9854,,maziarka@uic.edu,,,,,,https://hospital.uillinois.edu/patients-and-visitors/mile-square-federally-qualified-health-center/locations/cicero
IL-003623,Hektoen Institute/Cicero Health Center,Hektoen Institute/Stroger Hospital Agency,1124149281,Family Planning Providers,5912 W Cermak Rd,,Cicero,IL,60804-2135,Cook,5912 W Cermak Rd,,Cicero,IL,60804-2135,Cook,Kelly Stempinski,Family Planning Program Manager,312-864-5261,,kstempinski@cookcountyhhs.org,,,,,,
IL-003624,Clay County Hospital Cisne Clinic,"County of Clay, d.b.a. Clay County Hospital",1215317995,Rural Health Clinics,413 Park St,,Cisne,IL,62823,Wayne,911 Stacy Burk Drive,,Flora,IL,62839,Clay,Michael L Hobbs,CFO,618-662-1623,,mike.hobbs@claycountyhospital.org,Micchael Zilm,CEO,618-662-1628,,michael.zilm@claycountyhospital.org,
IL-003625,Clay County Hospital Clay City Clinic,"County of Clay, d.b.a. Clay County Hospital",1871950550,Rural Health Clinics,800 Kelly Dr SW,,Clay City,IL,62824-1155,Clay,911 Stacy Burk Drive,,Flora,IL,62839,Clay,Michael L Hobbs,CFO,618-662-1623,,mike.hobbs@claycountyhospital.org,Michael Zilm,CEO,618-662-1628,,,
IL-003626,Warner Hospital and Health Services,Warner Hospital and Health Services,1235211301,Inpatient Hospitals (other than children's hospitals),422 W White St,,Clinton,IL,61727-2272,Dewitt,422 West White Street,,Clinton,IL,61727,Dewitt,Donna Wisner,CFO,217-935-9571,3204,donna.wisner@warnerhospital.org,Paul Skowron,CEO,217-935-9571,3201,paul.skowron@warnerhospital.org,
IL-003627,Warner Hospital and Health Services Family Medicine,Warner Hospital and Health Services Family Medicine,1366504565,Rural Health Clinics,422 W White St,,Clinton,IL,61727-2272,Dewitt,422 West White St.,,Clinton,IL,61727,Dewitt,Donna Wisner,CFO,217-935-9571,3204,donna.wisner@warnerhospital.org,,,,,,
IL-003628,Central Collinsville Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1750530424,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",80 Burlington Dr,,Collinsville,IL,62234-4931,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003629,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1346566445,Community Mental Health Centers,814 Saint Louis Rd,,Collinsville,IL,62234-2023,Madison,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003630,Henry County Health Department-Colona,Henry County Health Department,1851394829,"Family Planning Providers, Sexually Transmitted Disease Clinics",103 1st St,,Colona,IL,61241-9742,Henry,103 1st Street,,Colona,IL,61241,Henry,Sandra Sommer,Director of Clinic Services,309-852-0197,250,ssommer@henrystarkhealth.org,,,,,,
IL-003631,Hammond Henry Hospital Colona Clinic,Hammond Henry Hospital,1457344491,Outpatient Hospital Clinics,1604 Cleveland Rd,,Colona,IL,61241-8970,Henry,600 North College Ave,,Geneseo,IL,61254,Henry,Jodie Criswell,Vice President of Fiscal Services,309-944-9103,,jodiecriswell@hammondhenry.com,Rhonda Rice,Patiant Accounts Manager,309-944-9122,,rhondarice@hammondhenry.com,
IL-003632,Cowden Medical Clinic LLC,Cowden Medical Clinic LLC,1356410781,Rural Health Clinics,209 E Elm St,,Cowden,IL,62422-1041,Shelby,PO Box 154,,Cowden,IL,62422-0154,Shelby,Maria Barfield,Accounts Receivable,217-783-6565,225,cowdenmedical@consolidated.net,Cindy Rich,Owner,217-783-6565,224,cowdenmedical@consolidated.net,
IL-003633,Riverview Pediatrics,Riverview Pediatrics,1417033705,Rural Health Clinics,102 N Logan Ave,,Danville,IL,61832-8513,Vermilion,102 N Logan Avenue,,Danville,IL,61832,Vermilion,Patti Moore,Office Coordinatio,217-442-5863,,patti@riverviewpeds.com,Sabeeha Haque,Physician/owner,217-442-5863,,drhaque@riverviewpeds.com,
IL-003634,drgindi.com,Family Practice Medical Center,1477503472,Rural Health Clinics,511 W Fairchild St,,Danville,IL,61832-3801,Vermilion,511 W Fairchild St,,Danville,IL,61832,Vermilion,Melbo,Office Manager,217-431-2025,,gindimddanville@hotmail.com,,,,,,
IL-003635,Aunt Martha's Vermilion Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1447390984,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",614 Gilbert St.,,Danville,IL,61832,Vermilion,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003636,Crossing Healthcare at the Macon County Health Department,Community Health Improvement Center dba Crossing Healthcare,1467784090,"Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",1221 E Condit St,,Decatur,IL,62521-1405,Macon,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003637,Crossing Healthcare at Heritage Behavioral Health Center,Community Health Improvement Center dba Crossing Healthcare,1164778031,Federally Qualified Health Centers - Medical Services,151 N Main St,,Decatur,IL,62523-1206,Macon,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003638,Crossing Healthcare at Decatur Memorial Hospital,Community Health Improvement Center dba Crossing Healthcare,1518384213,Federally Qualified Health Centers - Medical Services,2300 N Edward St,,Decatur,IL,62526-4163,Macon,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003639,Crossing Healthcare at OASIS Drop In Center,Community Health Improvement Center dba Crossing Healthcare,1083884852,Federally Qualified Health Centers - Medical Services,243 W Cerro Gordo St,,Decatur,IL,62522-2101,Macon,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003640,Decatur,Planned Parenthood of Illinois,1144637075,Family Planning Providers,3021 N Oakland Ave,,Decatur,IL,62526-1607,Macon,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003641,Crossing Healthcare,Community Health Improvement Center dba Crossing Healthcare,1194794917,Federally Qualified Health Centers - Medical Services,320 E Central Ave,,Decatur,IL,62521-4665,Macon,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003642,Center for Family Health - DeKalb,GREATER ELGIN FAMILY CARE CENTER,1730517871,Federally Qualified Health Centers - Medical Services,2550 N Annie Glidden Rd,,Dekalb,IL,60115-1389,DeKalb,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003643,DeKalb Co. Health Dept.,DEKALB COUNTY HEALTH DEPARTMENT,1457334203,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2550 N Annie Glidden Rd,,Dekalb,IL,60115-1389,DeKalb,2550 N Annie Glidden Rd,,DeKalb,IL,60115-1389,DeKalb,Cindy Graves,"Director, Community Health & Prevention",815-748-2447,,cgraves@dekalbcounty.org,Deb Hall,Family Planning Coordinator,815-748-2418,,dhall@dekalbcounty.org,http://dekalbcounty.org/Health/
IL-003644,ACCESS Genesis Center for Health and Empowerment,ACCESS COMMUNITY HEALTH NETWORK,1982783692,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1 N Broadway St,,Des Plaines,IL,60016-2335,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003645,Family Christian Health Center,FAMILY CHRISTIAN HEALTH CENTER,1336433382,Federally Qualified Health Centers - Medical Services,713 E 142nd St,,Dolton,IL,60419-1062,Cook,31 W 155th St,,Harvey,IL,60426-3556,Cook,Lisa Green,CEO,708-339-5525,,lgreen@familychc.org,,,,,,
IL-003646,DONGOLA MEDICAL CLINIC,RURAL HEALTH INC,1366506628,Federally Qualified Health Centers - Medical Services,318 US Highway 51 N,,Dongola,IL,62926-1103,Union,513 N Main St,,Anna,IL,62906-1697,Union,Cynthia K Flamm,CEO,618-833-4471,116,cflamm@ruralhealthinc.org,,,,,,
IL-003647,REA CLINIC-DUQUOIN FACILITY,CHRISTOPHER RURAL HEALTH PLANNING CORP,1619957297,Federally Qualified Health Centers - Medical Services,119 Gas Plant Rd,,Du Quoin,IL,62832-3866,Perry,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-1037,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003648,BETHALTO HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1487719860,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2 Terminal Dr,Suite 8,East Alton,IL,62024-2294,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003649,"Community Health Care, Inc. East Moline Clinic","Community Health Care, Inc.",1477819886,"Dental Providers, Federally Qualified Health Centers - Medical Services",708 15th Ave,,East Moline,IL,61244-2134,Rock Island,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IL-003650,WINDSOR HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1770851875,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",100 N 8th St,,East Saint Louis,IL,62201-2989,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator and Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003651,STATE STREET CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1811054935,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2001 State St,,East Saint Louis,IL,62205-1803,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,CEO and President,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003652,FAIRMONT CITY HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1770648917,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2568 N 41st St,,East Saint Louis,IL,62201-2204,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003653,"Southern Illinois Health Care Foundation, Inc.","SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1831254234,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4901 State St,East St. Louis School Based Clinic,East Saint Louis,IL,62205-1356,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003654,"Southern Illinois Health Care Foundation, Inc.","SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1689739062,Federally Qualified Health Centers - Medical Services,800 Range Ln,CAHOKIA SCHOOL BASED CLINIC,East Saint Louis,IL,62206-2022,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003655,CAHOKIA HEALTH CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1689739062,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",818 Upper Cahokia Rd,,East Saint Louis,IL,62206-1212,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003656,Chestnut Health Systems - Edwardsville,Chestnut Health Systems,1992179642,Other ECP Providers,110 Rottingham Ct,Suite B,Edwardsville,IL,62025-3788,Madison,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003657,"FAMILY CARE ASSOCIATES OF EFFINGHAM, SC",Family Care Associates of Effingham S.C.,1649255266,Rural Health Clinics,1106 N Merchant St,,Effingham,IL,62401-2128,Effingham,1106 N Merchant St,,Effingham,IL,62401-0665,Effingham,Janice Westendorf,Practice Manager,217-342-7000,287,jwestendorf@familycareassociates.com,Taryn Rohr,Clinical Manager,217-342-7000,242,trohr@familycareassociates.com,www.familycareassociates.com
IL-003658,Effingham Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1154651776,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",900 W Temple Ave,Suite 208,Effingham,IL,62401-2187,Effingham,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003659,Eldorado Primary Care,Harrisburg Medical Center,1073646436,Rural Health Clinics,1007 US Highway 45 N,,Eldorado,IL,62930-3767,Saline,100 Dr. Warren Tuttle Drive,,Harrisburg,IL,62946,Saline,Cathy L Harte,Director Practice Administration,618-273-7723,23432,charte@harrisburgmc.com,,,,,,
IL-003660,Ferrell Hospital Community Foundation,Ferrell Hospital Community Foundation,1194713404,Inpatient Hospitals (other than children's hospitals),1201 Pine St,,Eldorado,IL,62930-1634,Saline,1201 Pine Street,,Eldorado,IL,62930,Saline,Jodie A Smith,PFS Director,618-273-3361,376,jasmith@ferrellhosp.org,,,,,,
IL-003661,Ferrell Hospital Family Practice,Ferrell Hospital Community Foundation,1457586620,Rural Health Clinics,1306 Maple St,,Eldorado,IL,62930-1662,Saline,1201 Pine Street,,Eldorado,IL,62930,Saline,Jodie A Smith,PFS Director,618-273-3361,376,jasmith@ferrellhosp.org,,,,,,
IL-003662,Eldorado Rural Health Clinic,CHRISTOPHER RURAL HEALTH PLANNING CORP,1144200825,Federally Qualified Health Centers - Medical Services,1401 Us 45 N,,Eldorado,IL,62930,Saline,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003663,Eldorado Family Medicine Clinic,Ferrell Hospital Community Foundation,1700011046,Rural Health Clinics,1407 Locust St,,Eldorado,IL,62930-1629,Saline,1201 Pine Street,,Eldorado,IL,62930,Saline,Jodie A Smith,PFS Director,618-273-3361,376,jasmith@ferrellhosp.org,,,,,,
IL-003664,Open Door Clinic of Greater Elgin,Open Door Clinic of Greater Elgin,1255354635,"Community Mental Health Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",1665 Larkin Ave,,Elgin,IL,60123-5977,Kane,1665 Larkin Ave,,Elgin,IL,60123,Kane,Barbara Cox,Director of Finance,847-695-1093,218,BarbC@odhcil.org,Margaret Dunteman,Practice Manager,630-264-1819,335,PegD@odhcil.org,www.opendoorclinic.org
IL-003665,Summit Health Center,GREATER ELGIN FAMILY CARE CENTER,1720142557,Federally Qualified Health Centers - Medical Services,370 Summit St,Suite 1A,Elgin,IL,60120-3843,Kane,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003666,Seneca Health Center,GREATER ELGIN FAMILY CARE CENTER,1447381074,"Dental Providers, Federally Qualified Health Centers - Medical Services",450 Dundee Ave,Suite 105,Elgin,IL,60120-4205,Kane,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003667,VNA Health Care,VNA Health Care,1629102819,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",620 Wing St,,Elgin,IL,60123-2800,Kane,400 N. Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003668,VNA Health Care,VNA Health Care,1740533546,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",801 Villa St,,Elgin,IL,60120-8001,Cook,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003669,Slade Health Center,GREATER ELGIN FAMILY CARE CENTER,1568606051,Federally Qualified Health Centers - Medical Services,901 Center St,,Elgin,IL,60120-2104,Kane,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003670,Equality Family Practice,Harrisburg Medical Center,1073646436,Rural Health Clinics,183 W Lane St,,Equality,IL,62934-1332,Gallatin,100 Dr. Warren Tuttle Drive,,Harrisburg,IL,62946,Saline,Cathy L Harte,Director Practice Administration,618-273-7723,23432,charte@harrisburgmc.com,,,,,,
IL-003671,Erie Evanston/Skokie Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1629328836,"Dental Providers, Federally Qualified Health Centers - Medical Services",1285 Hartrey Ave,,Evanston,IL,60202-1056,Cook,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003672,ACCESS Evanston Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1104139559,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1723 Howard St,,Evanston,IL,60202-3735,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,https://www.achn.net/locations/location-pages/access-evanston-family-health-center/
IL-003673,Fairfield Community Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1902170632,Federally Qualified Health Centers - Medical Services,209 NW 11th St,,Fairfield,IL,62837-1218,Wayne,4241 State Highway 14 W,P,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003674,HORIZON HEALTHCARE RHC,Fairfield Memorial Hospital,1295908853,Rural Health Clinics,213 NW 10th St,Suite A,Fairfield,IL,62837-1219,Wayne,303 NW 11th St,,Fairfield,IL,62837,Wayne,Melody Morgan,CFO,618-842-2611,260,mmorgan@fairfieldmemorial.org,Julie Aman,Director of Physician Practice,618-842-4617,4814,jaman@fairfieldmemorial.org,
IL-003675,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1558649608,Community Mental Health Centers,5109 N Illinois St,,Fairview Heights,IL,62208-3405,Saint Clair,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003676,FAMILY HEALTHCARE OF FARMER CITY,Gibson Community Hospital Association,1790913903,Rural Health Clinics,1230 George Rock Dr,,Farmer City,IL,61842-9488,Dewitt,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Jan Wilson,Office Manager,309-928-9192,,jan.wilson@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003677,CLAY MEDICAL CENTER,CHRISTOPHER RURAL HEALTH PLANNING CORP,1528048105,Federally Qualified Health Centers - Medical Services,201 E North Ave,P O Box 155,Flora,IL,62839-2030,Clay,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-1037,Franklin,KIMBERLY A MITROKA,CEO,618-724-2436,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003678,Clay County Hospital,"County of Clay, d.b.a. Clay County Hospital",1184655136,Inpatient Hospitals (other than children's hospitals),911 Stacey Burk Dr,,Flora,IL,62839-3241,Clay,911 Stacy Burk Drive,,Flora,IL,62839,Clay,Michael L Hobbs,CFO,618-662-1623,,mike.hobbs@claycountyhospital.org,Michael Zilm,CEO,618-662-1628,,michael.zilm@claycountyhospital.org,
IL-003679,CCH Medical Clinic,"County of Clay, d.b.a. Clay County Hospital",1811946411,Rural Health Clinics,929 Stacey Burk Dr,,Flora,IL,62839-3241,Clay,911 Stacy Burk Drive,,Flora,IL,62839,Clay,Michael L Hobbs,CFO,618-662-1623,,mike.hobbs@claycountyhospital.org,Michael Zilm,CEO,618-662-1628,,michael.zilm@claycountyhospital.org,
IL-003680,Flossmoor Health Center,Planned Parenthood of Illinois,1790754745,Family Planning Providers,19831 Governors Hwy,,Flossmoor,IL,60422-2001,Cook,18 S Michigan Ave,6th Floor,Chicago,IL,60603,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,plannedparenthood.org/illinois
IL-003681,PRAIRIE FAMILY MEDICINE & OBSTETRICS,Gibson Community Hospital Association,1063462976,Rural Health Clinics,122 E Wabash Ave,,Forrest,IL,61741-9369,Livingston,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Claudia Chase,Office Manager,815-657-8707,,Claudia.chase@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003682,Stephenson County Health Department,Stephenson County Health Department,1801959226,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",10 W Linden St,,Freeport,IL,61032-3310,Stephenson,10 West Linden,,Freeport,IL,61032,Stephenson,Melinda Hartman,"Director, Public Health Nursing",815-599-8429,,melinda.hartman@aeroinc.net,,,,,,
IL-003683,Galatia Primary Care,Harrisburg Medical Center,1023473956,Rural Health Clinics,124 E Main St,,Galatia,IL,62935-1300,Saline,100 Dr. Warren Tuttle Drive,,Harrisburg,IL,62946,Saline,Cathy L Harte,Director Practice Administration,618-273-7723,23432,charte@harrisburgmc.com,,,,,,
IL-003684,Knox Community Health Center,"KNOX, COUNTY OF",1649526773,"Dental Providers, Federally Qualified Health Centers - Medical Services",1361 W Fremont St,,Galesburg,IL,61401-2436,Knox,1361 W Fremont St,,Galesburg,IL,61401-2436,Knox,Michele Fishburn,CEO,309-344-2224,222,fishburn@knoxcountyhealth.org,Cathy Pearson,Billing Specialist,309-344-2225,283,cpearson@knoxcountyhealth.org,
IL-003685,"Family Planning Service of Western Illinois, Inc.","Family Planning Service of Western Illinois, Inc.",1558530691,"Family Planning Providers, Sexually Transmitted Disease Clinics",311 E Main St,Suite 409,Galesburg,IL,61401-4867,Knox,"311 East Main Street, Suite 409",,Galesburg,IL,61401,Knox,Ashley German,Executive Director,309-343-6162,,ashleycooper@familyplanningservice.net,,,,,,
IL-003686,St Mary Medical Center,OSF Healthcare System,1164485363,Inpatient Hospitals (other than children's hospitals),3333 N Seminary St,,Galesburg,IL,61401-1251,Knox,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003687,Hammond-Henry Hospital,Henry Hospital District,1457344491,Inpatient Hospitals (other than children's hospitals),600 N College Ave,,Geneseo,IL,61254-1091,Henry,600 North College,,Geneseo,IL,61254,Henry,Jodie Criswell,Vice President of Fisal Services,309-944-9103,,jodiecriswell@hammondhenry.com,Debbie Rowley,Accountant,309-944-9104,,debbieRowley@hammondhenry.com,
IL-003688,Gibson City Clinic,Gibson Community Hospital,1841390747,Rural Health Clinics,222 N Sangamon Ave,,Gibson City,IL,60936-1345,Ford,1120 N Melvini,,Gibson City,IL,60936,Ford,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003689,FAMILY HEALTHCARE OF GIBSON CITY,Gibson Community Hospital Association,1699922138,Rural Health Clinics,7 Doctors Park,,Gibson City,IL,60936-2000,Ford,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Claudia Chase,Office Manager,217-784-5500,,claudia.chase@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003690,Gibson Area Medical Clinic,Gibson Community Hospital Association,1154702181,Rural Health Clinics,8 Doctors Park,,Gibson City,IL,60936-2000,Ford,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,Claudia Chase,Office Manager,217-784-4086,,claudia.chase@gapho.org,
IL-003691,Macoupin County Maple Street Clinic,Macoupin County Public Health Department,1538444906,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",109 E Maple St,,Gillespie,IL,62033-1473,Macoupin,805 North Broad Street,,Carlinville,IL,62626-1075,Macoupin,Kent Tarro,CEO,217-854-3223,224,Ktarro@mcphd.net,Peggy Garrison,CFO,217-854-3223,223,pgarrison@mcphd.net,www.mcphd.net
IL-003692,Macoupin Family Practice Centers LLP,Macoupin Family Practice Centers LLP,1699899070,Rural Health Clinics,715 Broadway St,,Gillespie,IL,62033-1166,Macoupin,715 West Broadway,,Gillespie,IL,62033,Macoupin,Jennifer Henrichs,Administrator,217-839-4491,,jhenrichs@mfpc.net,Kim Bilbruck,Practice Coordinator,217-839-4491,,kbilbruck@mfpc.net,
IL-003693,IMH Gilman Clinic,IROQUOIS MEMORIAL HOSPITAL,1366469132,Rural Health Clinics,508 E Crescent St,,Gilman,IL,60938-1702,Iroquois,200 Fairman Ave,,WATSEKA,IL,60970,Iroquois,Michelle Fox,Director Medical Staff & Clinical Informatic Services,815-432-7775,,mdfox@iroquoismemorial.com,Julie Giroux,Director of Clinics,815-432-7778,,jagiroux@iroquoismemorial.com,
IL-003694,Girard Family Health Care,Carlinville Area Hospital,1447691571,Rural Health Clinics,205 S 3rd St,,Girard,IL,62640-1547,Macoupin,20733 North Broad,,Carlinville,IL,62626,Macoupin,Kathi McCaherty,RHC Business Manager,217-854-3881,,kmccaherty@cahcare.com,Mike Brown,CFO,217-854-3141,357,mbrown@cahcare.com,www.cahcare.com
IL-003695,East Adams County Rural Health Clinic,Blessing Corporate Services,1245392349,Rural Health Clinics,102 Prairie Mills Rd,,Golden,IL,62339-1055,Adams,927 Broadway,,Quincy,IL,62301,Adams,Cynthia Cassens,Clinic Office Supervisor,217-696-4446,5115,Cynthia.Cassens@blessinghealthsystem.org,Alane Goehl,Medical Assistant,217-696-4446,5112,Alane.Goehl@blessinghealthsystem.org,
IL-003696,Goreville Clinic,RURAL HEALTH INC,1962763045,Federally Qualified Health Centers - Medical Services,400 S Broadway,,Goreville,IL,62939-2484,Johnson,513 N Main St,,Anna,IL,62906-1697,Johnson,Cynthia K Flamm,CEO,618-833-4471,,cflamm@ruralhealthinc.org,,,,,,
IL-003697,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1386922433,Community Mental Health Centers,1218 19th St,,Granite City,IL,62040-4501,Madison,50 Northgate Industrial Drive,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003698,McKinley Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1326392747,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2166 Madison Ave,,Granite City,IL,62040-4700,Madison,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003699,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1003194150,Community Mental Health Centers,3924 Oakmont Dr,,Granite City,IL,62040-4395,Madison,50 Northgate Industrial Drive,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003700,Chestnut Family Health Center,"CHESTNUT HEALTH SYSTEMS, INC.",1326417080,Federally Qualified Health Centers - Medical Services,50 Northgate Industrial Dr,,Granite City,IL,62040-6805,Madison,50 Northgate Industrial Drive,,Granite City,IL,62040,Madison,Dietra Kulicke,Executive Director CFHC,309-557-1400,1437,dkulicke@chestnut.org,Chantel Riley,Clinic Coordinator,618-512-1919,1922,cmriley@chestnut.org,www.chestnut.org
IL-003701,Chestnut Health Systems - Granite City,Chestnut Health Systems,1609144815,Other ECP Providers,50 Northgate Industrial Dr,,Granite City,IL,62040-6805,Madison,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003702,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1619921665,Community Mental Health Centers,50 Northgate Industrial Dr,,Granite City,IL,62040-6805,Madison,50 Northgate Industrial Drive,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@charter.net,,,,,,
IL-003703,Boyd Fillager Clinic,Thomas H. Boyd Memorial Hospital,1912090960,Rural Health Clinics,712 College St,,Greenfield,IL,62044-1409,Greene,800 School Street,,Carrollton,IL,62016,Greene,Deborah Campbell,CEO,217-942-6946,1200,dcampbell@boydhcs.org,Jim Johnson,CFO,217-942-6946,1303,jjohnson@boydhcs.org,
IL-003704,Cumberland County Health Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1346423803,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",302 N Mill St,,Greenup,IL,62428-1062,Cumberland,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003705,CHC/SEIA KHS HAMILTON CLINIC,"COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC",1558340968,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",951 Broadway St,,Hamilton,IL,62341-1436,Hancock,1706 W Agency Rd,,West Burlington,IA,52655-1667,Des Moines,Ronald W Kemp,CEO,319-753-2300,100,rkemp@chcseia.com,Diane Rouse,CFO,319-753-2300,105,drouse@chcseia.com,
IL-003706,Lake Health Center,GREATER ELGIN FAMILY CARE CENTER,1861885949,Federally Qualified Health Centers - Medical Services,1515 E Lake St,Suite 202,Hanover Park,IL,60133-7152,Dupage,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003707,JCH Medical Group-Hardin,Jersey Community Hospital,1417352527,Rural Health Clinics,106 S Water St,,Hardin,IL,62047,Calhoun,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003708,Community Health Partnership of Illinois - Harvard,Community Health Partnership of Illinois,1770821670,Federally Qualified Health Centers - Medical Services,62 N Ayer St,Suite A B,Harvard,IL,60033-2870,McHenry,205 W Randolph St Ste 2222,,Chicago,IL,60606-1814,Cook,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,https://www.chpofil.org/harvard.html
IL-003709,Mercy Harvard Hospital,Mercy Health System Corporation,1427001445,Inpatient Hospitals (other than children's hospitals),901 Grant St,,Harvard,IL,60033-1821,McHenry,1000 Mineral Point Ave,,Janesville,WI,53548,Rock,DuWayne Severson,Director of Contracting,608-741-5626,,dseverson@mhsjvl.org,,,,,,https://mercyhealthsystem.org/location/mercyhealth-harvard-hospital-and-medical-center-campus/
IL-003710,Family Christian Health Center,Family Christian Health Center,1093855736,"Dental Providers, Federally Qualified Health Centers - Medical Services",31 W 155th St,,Harvey,IL,60426-3556,Cook,31 West 155th Street,,Harvey,IL,60426,Cook,Malikah Hodo,Revenue Cycle Manager,708-339-5505,5505,mhodo@familychc.org,Julius Talley,CFO,708-339-5508,,jtalley@familychc.org,
IL-003711,Aunt Martha's Hazel Crest Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1174716823,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",17850 Kedzie Ave,Suite 1150,Hazel Crest,IL,60429-2095,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,https://www.auntmarthas.org/locations/hazel-crest-community-health-center/
IL-003712,Aunt Martha's Hazel Crest Womens Health,"Aunt Martha's Youth Service Center, Inc.",1104054386,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",17850 Kedzie Ave,Suite 3200,Hazel Crest,IL,60429-2086,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,https://www.auntmarthas.org/am-finder/hazel-crest-community-health-center/
IL-003713,REA CLINIC - HERRIN,CHRISTOPHER RURAL HEALTH PLANNING CORP,1700866381,Federally Qualified Health Centers - Medical Services,3303 Logan Dr,,Herrin,IL,62948-3732,Williamson,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003714,"Shawnee Health Care, Herrin OB/GYN",Shawnee Health Service and Development Corp,1033567169,Federally Qualified Health Centers - Medical Services,3303 Logan Dr,,Herrin,IL,62948-3732,Williamson,109 California Street,,Carterville,IL,62918,Williamson,Patsy Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003715,NORTH SHORE HEALTH CENTER,Lake County Health Department/Community Health Center,1285663328,"Dental Providers, Federally Qualified Health Centers - Medical Services",1840 Green Bay Rd,,Highland Park,IL,60035-3110,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003716,Hillsboro Area Hospital,Hillsboro Area Hospital,1194705210,Inpatient Hospitals (other than children's hospitals),1200 E Tremont St,,Hillsboro,IL,62049-1912,Montgomery,1200 East Tremont Street,,Hillsboro,IL,62049,Montgomery,Stephanie Ellis,Financial Analyst,217-532-6111,213,stephanieellis@hillsboroareahospital.org,Terri Carroll,VP of Finance,217-532-6111,187,terricarroll@hillsboroareahospital.org,www.hillsboroareahospital.org
IL-003717,FAMILY HEALTHCARE OF HOOPESTON,Gibson Community Hospital Association,1881676005,Rural Health Clinics,705 S Dixie Hwy,,Hoopeston,IL,60942-1904,Vermilion,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Jan Wilson,Office Manager,217-283-5530,,Jan.Wilson@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003718,Central Counties Health Centers Jacksonville,Central Counties Health Centers,1205282936,"Dental Providers, Federally Qualified Health Centers - Medical Services",1440 W Walnut St,Suite 2,Jacksonville,IL,62650-1143,Morgan,2239 E Cook St,,Springfield,IL,62703,Sangamon,Brad Buzzard,COO,217-788-2300,,bbuzzard@centralcounties.org,,,,,,www.centralcounties.org
IL-003719,JCH Medical Group-Jacksonville,Jersey Community Hospital,1114322286,Other ECP Providers,1440 W Walnut St,Suite 2A,Jacksonville,IL,62650-1143,Morgan,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003720,JCH Medical Group- Jerseyville II,Jersey Community Hospital,1659750818,Rural Health Clinics,270 Maple Summit Rd,Mcdow Bldg,Jerseyville,IL,62052-2004,Jersey,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003721,JCH Medical Group-Jerseyville,Jersey Community Hospital,1811392970,Rural Health Clinics,390 Maple Summit Rd,Illini Building,Jerseyville,IL,62052-2000,Jersey,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003722,JCH Medical Group,Jersey Community Hospital,1134163827,Outpatient Hospital Clinics,400 Maple Summit Rd,,Jerseyville,IL,62052-2028,Jersey,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003723,Jersey Community Hospital,Jersey Community Hospital,1184630519,Inpatient Hospitals (other than children's hospitals),400 Maple Summit Rd,,Jerseyville,IL,62052-2028,Jersey,400 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003724,Johnston City Community Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1053593533,Federally Qualified Health Centers - Medical Services,14410 Route 37,,Johnston City,IL,62951-3166,Williamson,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003725,WILL COUNTY COMMUNITY HEALTH CENTER,WILL COUNTY COMMUNITY HEALTH CENTER,1902811714,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1106 Neal Ave,,Joliet,IL,60433-2548,Will,501 Ella Ave,,Joliet,IL,60433-2799,Will,Mary Maragos,Chief Executive Officer,815-740-7635,,mmaragos@willcountyhealth.org,Gayle Andrae,Managed Care Specialist,815-774-7353,,gandrae@willcountyhealth.org,www.willcountyhealth.org
IL-003726,Aunt Martha's Joliet East Community Health Center,Aunt Martha's Youth Service Center,1073950044,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1200 Eagle St,,Joliet,IL,60432-2010,Will,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003727,VNA Health Care,VNA Health Care,1295104958,Federally Qualified Health Centers - Medical Services,2400 Glenwood Ave,Suite 210,Joliet,IL,60435-5498,Will,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003728,Aunt Martha's Joliet West Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1154679116,Federally Qualified Health Centers - Medical Services,333 Madison St # 150,,Joliet,IL,60435-8200,Will,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003729,Chestnut Health Systems-Joliet,Chestnut Health Systems,1912371824,Other ECP Providers,829 Campus Dr,,Joliet,IL,60435-8573,Will,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003730,Aunt Martha's Kankakee Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1790825347,Federally Qualified Health Centers - Medical Services,1777 E Court St,,Kankakee,IL,60901-2670,Kankakee,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003731,Community Health Partnership of Illinois,Community Health Partnership of Illinois,1982870259,Federally Qualified Health Centers - Medical Services,202 N Schuyler Ave,Suite 206,Kankakee,IL,60901-3605,Kankakee,205 W Randolph St Ste 2222,,Chicago,IL,60606-1814,Cook,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,www.chpofil.org
IL-003732,OSF Saint Luke Medical Center,OSF Healthcare System,1871919381,Inpatient Hospitals (other than children's hospitals),1051 W South St,,Kewanee,IL,61443-8354,Henry,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003733,Regional Health Partners,"Regional Health Partners, LLC",1164764635,Rural Health Clinics,1258 W South St,Suite 2,Kewanee,IL,61443-8300,Henry,1258 W South St,Suite 2,Kewanee,IL,61443,Henry,Wendy S. Wiesbrook,Clinic Administrator,309-852-0032,,wwiesbrook@regionalhealthpartners.com,Jodie Criswell,VP Financial Services Hammond Henry Hospital,309-944-9103,,jodiecriswell@hammondhenry.com,
IL-003734,Henry and Stark County Health Department,HENRY COUNTY HEALTH DEPARTMENT,1851394829,"Family Planning Providers, Tuberculosis Clinics",4424 US Highway 34,,Kewanee,IL,61443-8377,Henry,4424 US Hwy 34,,Kewanee,IL,61443,Henry,Sandra Sommer,Director of Clinic Services,309-852-0197,250,ssommer@henrystarkhealth.org,,,,,,
IL-003735,Community Nurse Health Center,COMMUNITY NURSE HEALTH ASSOCIATION,1174878813,Federally Qualified Health Centers - Medical Services,110 W Calendar Ave,,La Grange,IL,60525-2325,Cook,23 Calendar Avenue,,LaGrange,IL,60525,Cook,Angela Curran,CEO,708-579-4781,,acurran@communitynurse.org,Gloria Torres,Financial Services Manager,708-617-9332,,gtorres@communitynurse.org,www.communitynurse.org
IL-003736,Community Nurse Health Association Dental Center,COMMUNITY NURSE HEALTH ASSOCIATION,1174878813,Dental Providers,27 W Calendar Ave,,La Grange,IL,60525-3141,Cook,23 W Calendar Ave Ste 207,,La Grange,IL,60525-6327,Cook,Angela Curran,CEO,708-579-4781,,acurran@communitynurse.org,Gloria Torres,Financial Services Manager,708-617-9332,,gtorres@communitynurse.org,www.communitynurse.org
IL-003737,Memorial Medical Clinic La Harpe,Memorial Hospital Association,1184027849,Rural Health Clinics,501 E Main St,,La Harpe,IL,61450-9461,Hancock,1454 North County Road 2050,,Carthage,IL,62321,Hancock,Stephanie Meyers,Director of Clinic Operations,217-357-2173,,smeyers@mhtlc.org,,,,,,
IL-003738,"HYGIENIC INSTITUTE FOR LASALLE, PERU & OGLESBY",Illinois Valley Community Hospital,1912944703,Rural Health Clinics,2970 Chartres St,,La Salle,IL,61301-1097,La Salle,925 West Street,,Peru,IL,61354,La Salle,Jane Fisher,Executive Assistant Finance & Managed Care,815-780-3544,,jane.fisher@ivch.org,Lorene Munson,Director,815-223-0196,,lorene.munson@ivch.org,ivch.org
IL-003739,Libertyville Health Center,Lake County Health Department/Community Health Center,1679900229,Federally Qualified Health Centers - Medical Services,18698 W Peterson Rd,,Libertyville,IL,60048-1052,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,https://www.lakecountyil.gov/2591/Community-Health-Center-Locations
IL-003740,Litchfield Family Practice Center,Litchfield Family Practice Center,1235189499,Rural Health Clinics,1285 Franciscan Dr,,Litchfield,IL,62056-1778,Montgomery,1285 Franciscan Drive,,Litchfield,IL,62056,Montgomery,Meghan Elizabeth Hyam,Administrator,217-324-1031,,mhyam@lfpc.net,Babs Binney,Insurance Manager,217-324-1032,,bbinney@lfpc.net,
IL-003741,Louisville Medical Clinic,"County of Clay, d.b.a. Clay County Hospital",1831120401,Rural Health Clinics,935 Bryant St,,Louisville,IL,62858-1053,Clay,911 Stacy Burk Drive,,Flora,IL,62839,Clay,Michael L Hobbs,CFO,618-662-1623,,mike.hobbs@claycountyhospital.org,Michael Zilm,CEO,618-662-1628,,michael.zilm@claycountyhospital.org,
IL-003742,Crusader Community Health Loves Park,CRUSADERS CENTRAL CLINIC ASSOCIATION,1205238623,"Dental Providers, Federally Qualified Health Centers - Medical Services",6115 N 2nd St,,Loves Park,IL,61111-4155,Winnebago,1200 W State St,,Rockford,IL,61102-2112,Winnebago,Gordon Eggers,CEO,815-490-1616,,geggers@crusaderhealth.org,Sam Miller,CFO,815-490-1737,,smiller@crusaderhealth.org,
IL-003744,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1790083095,Community Mental Health Centers,1425 6th St,,Madison,IL,62060-1417,Madison,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003745,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1902184054,Community Mental Health Centers,648A State St,,Madison,IL,62060-1420,Madison,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003746,"Chestnut Health Systems, Inc.","CHESTNUT HEALTH SYSTEMS, INC.",1770850075,Community Mental Health Centers,648B State St,,Madison,IL,62060-1420,Madison,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003747,Shawnee Health Care Marion,SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1649405150,Federally Qualified Health Centers - Medical Services,1506 Sioux Dr,,Marion,IL,62959-5209,Williamson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003748,Marion Wellness,SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION,1881624161,Federally Qualified Health Centers - Medical Services,1700 Wildcat Dr,,Marion,IL,62959-1506,Williamson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003749,"Shawnee Health Care, Marion Dental",Shawnee Health Service and Development Corp,1356677058,Dental Providers,3115 Williamson County Pkwy,,Marion,IL,62959-5235,Williamson,109 California Street,,Carterville,IL,62918,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003751,"Chestnut Health Systems, Inc.",Chestnut Health Systems,1043587348,Community Mental Health Centers,2148 Vadalabene Dr,,Maryville,IL,62062-5632,Madison,50 Northgate Industrial Dr,,Granite City,IL,62040,Madison,Becky Browning,Regional Accounts Receivable and Billing Manager,618-877-4420,1845,bbrowning@chestnut.org,,,,,,
IL-003752,Chestnut Health Systems-Maryville,Chestnut Health Systems,1801069059,Other ECP Providers,2148 Vadalabene Dr,,Maryville,IL,62062-5632,Madison,1003 Martin Luther King Dr.,,Bloomington,IL,61701,Mclean,Karen Rettick,CFO,309-820-3581,3581,krettick@chestnut.org,,,,,,
IL-003753,Mattoon Medical Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1023371143,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",700 Broadway Ave E,Suite 39,Mattoon,IL,61938-4662,Coles,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003754,McHenry Community Health Center,GREATER ELGIN FAMILY CARE CENTER,1295014116,Federally Qualified Health Centers - Medical Services,3901 Mercy Dr,,McHenry,IL,60050-3151,McHenry,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003755,PCC MELROSE PARK FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1720104573,Federally Qualified Health Centers - Medical Services,1111 Superior St,Suite 101,Melrose Park,IL,60160-4100,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003756,ACCESS Melrose Park Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1104905702,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",8321 W North Ave,,Melrose Park,IL,60160-1605,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003757,Community Health Partnership of Illinois,Community Health Partnership of Illinois,1093981367,"Dental Providers, Federally Qualified Health Centers - Medical Services",1009 Main St,,Mendota,IL,61342-1604,La Salle,205 W Randolph St Ste 2222,,Chicago,IL,60606-1814,Cook,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,www.chpofil.org
IL-003758,OSF Saint Paul Medical Center,OSF Healthcare System,1609803113,Inpatient Hospitals (other than children's hospitals),1401 E 12th St,,Mendota,IL,61342-9216,La Salle,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003759,Massac Memorial Medical Clinic,Massac Memorial Hospital,1740355809,Rural Health Clinics,1204 W 10th St,,Metropolis,IL,62960-2433,Massac,P O Box 850,,Metropolis,IL,62960,Massac,Randall Rushing,CFO,618-524-2176,257,rrushing@massachealth.org,Rick Goins,COO,618-524-2176,173,rgoins@massachealth.org,massachealth.org
IL-003760,Massac Memorial Hospital,Massac County Hospital District,1790788578,Inpatient Hospitals (other than children's hospitals),28 Chick St,,Metropolis,IL,62960-2467,Massac,P O Box 850,,Metropolis,IL,62960,Massac,Randall Rushing,CFO,618-524-2176,257,rrushing@massachealth.org,Rick Goins,COO,618-524-2176,173,rgoins@massachealth.org,massachealth.org
IL-003761,IMH MILFORD CLINIC,IROQUOIS MEMORIAL HOSPITAL,1578580346,Rural Health Clinics,34 E Jones St,,Milford,IL,60953-1046,Iroquois,200 FAIRMAN,,WATSEKA,IL,60970,Iroquois,ERIN GWALTNEY,MANAGED CARE,815-432-7966,,EMGWALTNEY@IROQUOISMEMORIAL.COM,,,,,,
IL-003762,Millstadt Medical Clinic,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1811236458,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",60 Regency Pl,,Millstadt,IL,62260-2210,Saint Clair,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003763,"Community Health Care, Inc. Moline","Community Health Care, Inc.",1710971486,"Dental Providers, Federally Qualified Health Centers - Medical Services",1106 4th Ave,,Moline,IL,61265-1231,Rock Island,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IL-003764,OSF Holy Family Medical Center,OSF Healthcare System,1548393184,Inpatient Hospitals (other than children's hospitals),1000 W Harlem Ave,,Monmouth,IL,61462-1007,Warren,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003765,Kirby Medical Group,Kirby Medical Center,1558527259,Rural Health Clinics,1000 Medical Center Dr,,Monticello,IL,61856-2116,Piatt,1000 Medical Center Dr.,,Monticello,IL,61856,Piatt,Sara Wells,Clinic Director,217-762-1701,,swells@kirbyhealth.org,Dr. Narain Mandhan,Chief Medical Officer,217-762-6241,,nmandhan@kirbyhealth.org,www.kirbyhealth.org
IL-003766,Morrison Family Care Clinic,Morrison Community Hospital,1174644629,Rural Health Clinics,303 N Jackson St,,Morrison,IL,61270-3042,Whiteside,303 North Jackson,,Morrison,IL,61270,Whiteside,Pam Pfister,CEO,815-772-5530,257,ppfister@mchstaff.com,Cami Megli,CFO,815-772-5533,284,cmegli@mchstaff.com,www.morrisonhospital.com
IL-003767,WABASH PRIMARY CARE ASSOCIATES,Wabash Primary Care Associates,1932224508,Rural Health Clinics,1123 Chestnut St,,Mount Carmel,IL,62863-1212,Wabash,1123 Chestnut Street,,Mount Carmel,IL,62863,Wabash,Karissa Turner,VP Hospital Operations,618-263-6280,,kturner@wabashgeneral.com,Raven Hart,Clinic Operations Manager,618-263-6276,,rhart@wabashgeneral.com,
IL-003768,Wabash County Health Department,Wabash County Health Department,1912906306,"Community Mental Health Centers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",130 W 7th St,,Mount Carmel,IL,62863-1439,Wabash,130 W 7th Street,,Mt. Carmel,IL,62863,Wabash,Kendra Grounds,DON,618-263-3873,240,kgrounds@wabashhealth.org,Audra Spray,Administrative Assistant,618-263-3873,223,aspray@wabashhealth.org,
IL-003769,WABASH GENERAL HOSPITAL (inpatient hospital),Wabash General Hospital,1295834208,Inpatient Hospitals (other than children's hospitals),1418 College Dr,,Mount Carmel,IL,62863-2638,Wabash,1418 College Drive,,Mount Carmel,IL,62863,Wabash,Karissa Turner,VP Hospital Operations,618-263-6280,,kturner@wabashgeneral.com,Susan Zeeb,Business Office Manager,618-263-6379,,szeeb@wabashgeneral.com,
IL-003770,WABASH GENERAL HOSPITAL (rural health clinics),Wabash General Hospital,1295834208,Rural Health Clinics,1418 College Dr,,Mount Carmel,IL,62863-2638,Wabash,1418 College Drive,,Mount Carmel,IL,62863,Wabash,Karissa Turner,VP Hospital Operations,618-263-6280,,kturner@wabashgeneral.com,Susan Zeeb,Business Office Manager,618-263-6379,,szeeb@wabashgeneral.com,
IL-003771,Mt Olive Family Practice Center,Macoupin Family Practice Centers LLP,1477743342,Rural Health Clinics,115 N Poplar St,,Mount Olive,IL,62069-1613,Macoupin,Macoupin Family Practice Centers LLP,715 West Broadway,Gillespie,IL,62033,Macoupin,JenniferHenrichs,Administrator,217-839-4491,,jhenrichs@mfpc.net,,,,,,
IL-003772,MT VERNON COMMUNITY HLTH CENTER,CHRISTOPHER RURAL HEALTH PLANNING CORP,1134161805,Federally Qualified Health Centers - Medical Services,2920 Veterans Memorial Dr,,Mount Vernon,IL,62864-5924,Jefferson,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,KIMBERLY A MITROKA,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003773,Physician Rural Health Clinic of Jefferson County,Physician Rural Health Clinic of Jefferson County,1790713899,Rural Health Clinics,3307 Broadway St,Suite 130,Mount Vernon,IL,62864-2387,Jefferson,3307 Broadway,Suite 130,Mt. Vernon,IL,62864,Jefferson,Pauline Annette Becker,Receptionist,618-244-2560,,cfmc1988@gmail.com,Dr. Veena Gupta,Medical Director,618-244-2560,,cfmc1988@gmail.com,
IL-003774,Murphysboro Family Medicine,Murphysboro Family MEDICINE,1952369902,Rural Health Clinics,628 N 14th St,,Murphysboro,IL,62966-1807,Jackson,628 North 14th Street,,Murphysboro,IL,62966,Jackson,Janet Austin,Office Manager,618-687-2353,33,janet.austin@sih.net,Cindy Hobbs,Billing,618-687-2353,27,cindy.hobbs@sih.net,
IL-003775,"Shawnee Health Care, Murphysboro",Shawnee Health Service and Development Corp,1245260645,Federally Qualified Health Centers - Medical Services,7 S Hospital Dr,,Murphysboro,IL,62966-3333,Jackson,109 California St,,Carterville,IL,62918-1923,Williamson,Patsy R Jensen,E.D.,618-985-8221,,pjensen@shsdc.org,Cassie Korando,In-House Legal Counsel,618-985-8221,,ckorando@shsdc.org,
IL-003776,Washington County Health Center,Washington County Hospital and Medical Group,1184671463,Rural Health Clinics,705 S Grand St,,Nashville,IL,62263-1534,Washington,705 South Grand Avenue,,Nashville,IL,62263,Washington,Nancy M. Newby,CEO,618-327-2200,,nnewby@washingtoncountyhospital.org,Elaine Matzenbacher,CFO,618-327-2207,,ematzenbacher@washingtoncountyhospital.org,
IL-003777,Memorial Medical Clinic Nauvoo,Memorial Hospital Association,1912175506,Rural Health Clinics,1370 Mulholland St,,Nauvoo,IL,62354-1010,Hancock,1454 N Count Rd 2050,,Carthage,IL,62321,Hancock,Stephanie Meyers,Practice Manager,217-357-6810,,smeyers@mhtlc.org,Nornil Villaflores,Clinic Admin Asst,217-357-6809,,nvillaflores@mhtlc.org,
IL-003780,"Asian Human Services Family Health Center, Inc","Asian Human Services Family Health Center, Inc",1891162962,Federally Qualified Health Centers - Medical Services,8565 W Dempster St,,Niles,IL,60714-1472,Cook,2424 W. Peterson Ave,,Chicago,IL,60659,Cook,"Muhammad W. Paracha, MD., MPH.",Executive Director,773-761-0010,,mparacha@ahschicago.org,,,,,,
IL-003781,North Chicago Health Center,Lake County Health Department/Community Health Center,1083643118,"Dental Providers, Federally Qualified Health Centers - Medical Services",2215 14th St,,North Chicago,IL,60064-1618,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003782,PCC ERIE COURT HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1558387167,Federally Qualified Health Centers - Medical Services,1 Erie Ct,Suite 6040,Oak Park,IL,60302-2510,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,https://www.pccwellness.org/pcc-erie-court-health-center
IL-003783,PCC LAKE STREET FAMILY HEALTH CENTER,PCC COMMUNITY WELLNESS CENTER,1073536991,Federally Qualified Health Centers - Medical Services,14 Lake St,,Oak Park,IL,60302-2606,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003784,PCC WALK-In WELLNESS CENTER at WEST SUBURBAN MEDICAL CENTER,PCC COMMUNITY WELLNESS CENTER,1750621769,Federally Qualified Health Centers - Medical Services,3 Erie Ct,Suite 1300,Oak Park,IL,60302-2519,Cook,14 Lake St,,Oak Park,IL,60302-2606,Cook,Robert Urso,President and CEO,708-524-7686,,rurso@pccwellness.org,Patrick Garrick,Chief Financial Officer,708-406-3927,,pgarrick@pccwellness.org,
IL-003785,CMH Rural Health-Oblong,Crawford Memorial Hospital,1790769073,Rural Health Clinics,1366 E 1050th Ave,,Oblong,IL,62449-2409,Crawford,1000 North Allen St,,Robinson,IL,62454,Crawford,Chris Bautista,Practice Management Officer,618-546-2460,,chris.bautista@crawfordmh.org,Ellen Maxwell,Director of Clinic Systems,618-546-2581,,ellen.maxwell@crawfordmh.org,
IL-003786,Weber Medical Clinic,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1679844468,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1200 N East St,,Olney,IL,62450-2432,Richland,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003787,"ONARGA CLINIC, THE",Gibson Community Hospital Association,1972509701,Rural Health Clinics,912 W Seminary Ave,,Onarga,IL,60955-1401,Iroquois,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Jan Wilson,Office Manager,815-268-4843,,jan.wilson@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003788,Eagle View Community Health System - Oquawka Location,"HENDERSON COUNTY RURAL HEALTH CENTER, INC.",1548314834,"Dental Providers, Federally Qualified Health Centers - Medical Services",1204 Hwy 164 E,,Oquawka,IL,61469,Henderson,1204 Hwy 164 E,,Oquawka,IL,61469,Henderson,Lori A. Sutton,Executive Director,309-867-2734,,lsutton@eagleviewhealth.org,Shannon Courson,Administrative Assistant,309-867-2735,,scourson@eagleviewhealth.org,www.eagleviewhealth.org
IL-003789,Orland Park,Planned Parenthood of Illinois,1962818898,Family Planning Providers,14470 S La Grange Rd,Suite 101,Orland Park,IL,60462-2690,Cook,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3200,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,https://www.plannedparenthood.org/health-center/illinois/orland-park/60462/orland-park-health-center-3102-90430
IL-003790,OSF Saint Elizabeth Medical Center,OSF Healthcare System,1588713440,Inpatient Hospitals (other than children's hospitals),1100 E Norris Dr,,Ottawa,IL,61350-1604,La Salle,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003791,Ottawa,Planned Parenthood of Illinois,1508272436,Family Planning Providers,612 Court St,,Ottawa,IL,61350-2915,La Salle,18 S Michigan Ave Ste 600,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003792,CMH Rural Health - Palestine,Crawford Memorial Hospital,1538105523,Rural Health Clinics,209 E Grand Prairie St,,Palestine,IL,62451-1254,Crawford,1000 North Allen Street,,Robinson,IL,62454,Crawford,Chris Bautista,Practice Management Officer,618-546-2460,,chris.bautista@crawfordmh.org,Ellen Maxwell,Director of Clinic Systems,618-546-2581,,ellen.maxwell@crawfordmh.org,
IL-003793,Pana Community Hospital (inpatient hospital),Pana Community Hospital,1942326970,Inpatient Hospitals (other than children's hospitals),101 E 9th St,,Pana,IL,62557-1716,Christian,101 E 9th St,,Pana,IL,62557,Christian,James E Moon,CFO,217-562-6409,409,jmoon@panahospital.com,,,,,,www.panahospital.com
IL-003794,Pana Community Hospital (outpatient hospital clinics),Pana Community Hospital,1942326970,Outpatient Hospital Clinics,101 E 9th St,,Pana,IL,62557-1716,Christian,101 E 9th St,,Pana,IL,62557,Christian,James E Moon,CFO,217-562-6409,409,jmoon@panahospital.com,,,,,,www.panahospital.com
IL-003795,Paris Community Hospital,"Hospital & Medical Foundation of Paris, Inc.",1679502322,Inpatient Hospitals (other than children's hospitals),721 E Court St,,Paris,IL,61944-2460,Edgar,721 E. Court St.,,Paris,IL,61944,Edgar,Meagan Lewsader,Payer Cred. Coord.,217-465-4141,257,mlewsader@pchfmc.com,Eunice Chaney,Office Manager,217-465-8411,512,echaney@pchfmc.com,
IL-003796,Family Medical Center,"Hospital & Medical Foundation of Paris, Inc.",1548334956,Rural Health Clinics,727 E Court St,,Paris,IL,61944-2460,Edgar,727 E Court St,,Paris,IL,61944,Edgar,Meagan Lewsader,Payer Cred Coord,217-465-4141,257,mlewsader@pchfmc.com,Eunice Chaney,Office Manager,217-465-8411,512,echaney@pchfmc.com,
IL-003797,"PAXTON CLINIC,THE",Gibson Community Hospital Association,1992700595,Rural Health Clinics,227 N Market St,,Paxton,IL,60957-1123,Ford,1120 N. Melvin St.,,Gibson City,IL,60936,Ford,Jan Wilson,Office Manager,217-379-4864,,jan.wilson@gapho.org,Jason Blackman,Managed Care Coordinator,217-784-2364,,jason_blackman@gibsonhospital.org,
IL-003798,Pekin,Planned Parenthood of Illinois,1346656279,Family Planning Providers,328 S 4th St,Suite D,Pekin,IL,61554-6805,Tazewell,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003799,HEARTLAND COMMUNITY HEALTH CLINIC - GARDEN,HEARTLAND COMMUNITY HEALTH CLINIC,1336193861,Federally Qualified Health Centers - Medical Services,1701 W Garden St,,Peoria,IL,61605-3531,Peoria,2214 N University Street,,Peoria,IL,61604,Peoria,Charles Bandoian,CEO,309-680-7657,,charlesbandoian@heartlandchc.org,,,,,,www.heartlandchc.org
IL-003800,HCHC @ HUMAN SRVC CTR,HEARTLAND COMMUNITY HEALTH CLINIC,1336193861,Federally Qualified Health Centers - Medical Services,228 NE Jefferson Ave,,Peoria,IL,61603-3802,Peoria,2214 N University Street,,Peoria,IL,61604,Peoria,Charles Bandoian,CEO,309-680-7657,,charlesbandoian@heartlandchc.org,,,,,,
IL-003801,HEARTLAND CHC - EAST BLUFF,HEARTLAND COMMUNITY HEALTH CLINIC,1336193861,Federally Qualified Health Centers - Medical Services,2321 N Wisconsin Ave,Suite 2,Peoria,IL,61603-5614,Peoria,2214 N University Street,,Peoria,IL,61604,Peoria,Charles Bandoian,CEO,309-680-7657,,charlesbandoian@heartlandchc.org,,,,,,www.heartlandchc.org
IL-003802,Peoria,Planned Parenthood of Illinois,1083020911,Family Planning Providers,2709 N Knoxville Ave,,Peoria,IL,61604-2867,Peoria,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003803,Heartland Community Health Clinic - Armstrong,HEARTLAND COMMUNITY HEALTH CLINIC,1336193861,Federally Qualified Health Centers - Medical Services,320 E Armstrong Ave,,Peoria,IL,61603-3172,Peoria,2214 N University,,Peoria,IL,61604,Peoria,Charles Bandoian,CEO,309-680-7657,,charlesbandoian@heartlandchc.org,,,,,,www.heartlandchc.org
IL-003804,Children's Hospital of Illinois,OSF Healthcare System,1043260482,Children's Hospitals (inpatient only),530 NE Glen Oak Ave,,Peoria,IL,61637-0002,Peoria,530 NE Glen Oak AVe,,Peoria,IL,61637,Peoria,Ken Harbaugh,CFO,309-624-5920,,ken.harbaugh@osfhealthcare.org,,,,,,
IL-003805,Saint Francis Medical Center,OSF Healthcare System,1043260482,Inpatient Hospitals (other than children's hospitals),530 NE Glen Oak Ave,,Peoria,IL,61637-0001,Peoria,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003806,HEARTLAND COMMUNITY HEALTH CLINIC AT CARVER,HEARTLAND COMMUNITY HEALTH CLINIC,1336193861,Federally Qualified Health Centers - Medical Services,711 W John H Gwynn Jr Ave,,Peoria,IL,61605-2270,Peoria,2214 N University Street,,Peoria,IL,61604,Peoria,Charles Bandoian,CEO,309-680-7657,,charlesbandoian@heartlandchc.org,,,,,,www.heartlandchc.org
IL-003807,The Bleeding and Clotting Disorders Institute,The Bleeding and Clotting Disorders Institute,1134424633,Hemophilia Treatment Centers,9128 N Lindbergh Dr,,Peoria,IL,61615-1422,Peoria,9128 N Lindbergh Dr,,Peoria,IL,61615,Peoria,Becky Burns,Finance Director,309-692-5337,115,becky@thebloodexperts.com,Dr. Michael Tarantino,Medical Director,309-692-5337,112,mtarantino@thebloodexperts.com,www.thebloodexperts.com
IL-003808,PINCKNEYVILLE COMMUNITY HOSPITAL,FAMILY MEDICAL CENTER,1306818844,Rural Health Clinics,5383 State Route 154,PO Box 437,Pinckneyville,IL,62274-3342,Perry,5383 STATE ROUTE 154,PO BOX 437,PINCKNEYVILLE,IL,62274,Perry,LISA HEPBURN,FMC OFFICE MANAGER,618-357-2131,,fmc@pvillehosp.org,KARA JO CARSON,CFO,618-357-2187,5902,kjcarson@pvillehosp.org,
IL-003809,Pike Co. Health Dept.,PIKE COUNTY HEALTH DEPARTMENT,1548335862,"Dental Providers, Family Planning Providers",606 W Adams St,,Pittsfield,IL,62363-1308,Pike,606 W Adams Street,,Pittsfield,IL,62363-1308,Pike,"Anita Andress, RN, BSN",Administrator,217-285-4407,126,administration@pikecoilhealth.org,"Beth Fencik, RN",Family Planning Coordinator,217-285-4407,113,bfencik@pikecoilhealth.org,
IL-003810,Saint James Hospital,OSF Healthcare System,1407808090,Inpatient Hospitals (other than children's hospitals),2500 W Reynolds St,,Pontiac,IL,61764-9774,Livingston,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003811,Livingston Co. Health Dept.,LIVINGSTON COUNTY HEALTH DEPARTMENT,1255398517,"Family Planning Providers, Tuberculosis Clinics",310 E Torrance Ave,,Pontiac,IL,61764-2748,Livingston,310 E. Torrance Ave.,,Pontiac,IL,61764-2748,Livingston,MaLinda Hillman,Administrator,815-844-7174,247,mhillman@lchd.us,Katie Oxarart,Family Planning Coordinator,815-844-7174,229,koxarart@lchd.us,
IL-003812,Perry Memorial Family Health Center,Perry Memorial Hospital,1922411602,Rural Health Clinics,530 Park Ave E,Suite 303,Princeton,IL,61356-3903,Bureau,530 Park Avenue East,,Princeton,IL,61356,Bureau,Stephen M Davis,Business Office Director,815-876-4419,,sdavis@perrymemorial.org,Michael DeFoe,Vice President Finance,815-876-4497,,mdefoe@perrymemorial.org,perrymemorial.org
IL-003813,Preferred Family Healthcare dba Clarity Healthcare,"PREFERRED FAMILY HEALTHCARE, INCORPORATED",1124499074,"Dental Providers, Federally Qualified Health Centers - Medical Services",540 Harrison St,,Quincy,IL,62301-7236,Adams,900 E. LaHarpe Street,,Kirksville,MO,63501-4520,Adair,Mark Conover,VP of Healthcare Services,573-603-1460,,mconover@clarity-healthcare.org,,,,,,www.clarity-healthcare.org
IL-003814,SIU Center for Family Medicine-Quincy,SOUTHERN ILLINOIS UNIVERSITY,1376921924,Federally Qualified Health Centers - Medical Services,612 N 11th St,,Quincy,IL,62301-2662,Adams,320 E. Carpenter,,Springfield,IL,62702,Sangamon,Iris Wesley,Cheif Executive Officer,217-757-8116,,iwesley@siumed.edu,Jeanne Hill,Site Administrator,217-224-9484,,jhill@siumed.edu,
IL-003815,"Family Planning, Inc. Quincy","Family Planning, Inc. - Quincy",1659427797,"Family Planning Providers, Sexually Transmitted Disease Clinics",636 Hampshire St,Suite 201,Quincy,IL,62301-3054,Adams,636 Hampshire St,,Quincy,IL,62301-3054,Adams,Beverly Simmons,Family Planning Coordinator,217-224-6877,202,Beverly@familyplanningquincy.org,Melisa James,Certified Medical Assistant- Insurance Biller,217-224-6877,205,Melisa@familyplanningquincy.org,
IL-003816,Preferred Family Healthcare dba Clarity Healthcare,"PREFERRED FAMILY HEALTHCARE, INCORPORATED",1871969964,"Dental Providers, Federally Qualified Health Centers - Medical Services",639 York St,Room 208,Quincy,IL,62301-3919,Adams,900 E. LaHarpe Street,,Kirksville,MO,63501-4520,Adair,Mark Conover,VP of Healthcare Services,573-603-1460,,mconover@clarity-healthcare.org,,,,,,http://www.clarity-healthcare.org/
IL-003817,Champaign-Urbana Public Health District WIC Clinic,Community Health Partnership of Illinois,1942619606,Federally Qualified Health Centers - Medical Services,520 E Wabash Ave,,Rantoul,IL,61866-3018,Champaign,205 W Randolph St Ste 2222,,Chicago,IL,60606-1814,Champaign,Nicolas Garcia,Director of Finance,312-795-0000,223,ngarcia@chpofil.org,,,,,,www.chpofil.org
IL-003818,CUPHD Rantoul Clinic,Champaign-Urbana Public Health District,1073666996,"Dental Providers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",520 E Wabash Ave,Suite 2,Rantoul,IL,61866-3019,Champaign,201 W. Kenyon Road,,Champaign,IL,61820,Champaign,Julie A. Pryde,Administrator,217-531-5369,,jpryde@c-uphd.org,Brandon Meline,Director of Maternal and Child Health,217-531-4308,,bmeline@c-uphd.org,www.c-uphd.org
IL-003819,RED BUD HEALTH CENTER,Southern Illinois Healthcare Foundation,1033573183,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",824 Locust St,,Red Bud,IL,62278-1209,Randolph,2041 Goose Lake Road,,Sauget,IL,62206,Saint Clair,LARRY MCCULLEY,President and CEO,618-332-0694,19208,lmcculley@sihf.org,Patrice Howard,VP of Administration,618-332-0694,19204,phoward@sihf.org,
IL-003820,Beloved Community Family Wellness Center Robbins,BELOVED COMMUNITY FAMILY WELLNESS CENTER,1114278009,Federally Qualified Health Centers - Medical Services,3518 W 139th St Fl 2,,Robbins,IL,60472-2002,Cook,6821 S Halsted St,,Chicago,IL,60621-1833,Cook,MARGIE JOHNSON,Executive Director,773-651-3828,,MJOHNSON@BCFWC.ORG,IQBAL HUSSAIN,Billing Specialist,773-651-3629,212,IQBQLHUSSAIN@BCFWC.ORG,
IL-003821,CMH Rural Health,Crawford Memorial Hospital,1356325633,Rural Health Clinics,1101 N Allen St,,Robinson,IL,62454-1168,Crawford,1000 North Allen Street,,Robinson,IL,62454,Crawford,Chris Bautista,Practice Management Officer,618-546-2460,,chris.bautista@crawfordmh.org,Ellen Maxwell,Director of Clinic Systems,618-546-2581,,ellen.maxwell@crawfordmh.org,
IL-003822,Whiteside County Community Health Clinic,Whiteside County Health Department,1851566236,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1300 W 2nd St,,Rock Falls,IL,61071-1005,Whiteside,1300 W 2nd St,,Rock Falls,IL,61071-1005,Whiteside,Beth Fiorini,CEO,815-626-2230,1206,bfiorini@whitesidehealth.org,Theresa Friel-Draper,COO,815-626-2230,1283,tdraper@whitesidehealth.org,
IL-003823,Rock Island Co. Health Dept.,ROCK ISLAND COUNTY HEALTH DEPARTMENT,1922252899,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2112 25th Ave,,Rock Island,IL,61201-5317,Rock Island,2112 25th Ave,,Rock Island,IL,61201,Rock Island,Nita Ludwig,Administrator,309-558-2802,,nludwig@co.rock-island.il.us,Linda Livengood,Chief Nurse Officer/Family Planning Coordinator,309-558-2901,,llivengood@co.rock-island.il.us,
IL-003824,"Community Health Care, Inc.- Robert Young Center","Community Health Care, Inc.",1114252012,"Dental Providers, Federally Qualified Health Centers - Medical Services",2200 3rd Ave,,Rock Island,IL,61201-8840,Rock Island,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,tbowman@chcqca.org,,,,,,
IL-003825,"Community Health Care, Inc. Rock Island Clinic","Community Health Care, Inc.",1598759292,"Dental Providers, Federally Qualified Health Centers - Medical Services",2750 11th St,,Rock Island,IL,61201-5216,Rock Island,500 W River Dr,,Davenport,IA,52801-1014,Scott,Thomas J Bowman,CEO,563-336-3112,,hbarnes@chcqca.org,,,,,,
IL-003826,Crusaders Central Clinic Association,CRUSADERS CENTRAL CLINIC ASSOCIATION,1205238623,"Dental Providers, Federally Qualified Health Centers - Medical Services",1002 N Pierpont Ave,Crusader Community Health Auburn Campus-A School Based Health Center,Rockford,IL,61101-5085,Winnebago,1200 W State St,,Rockford,IL,61102-2112,Winnebago,Gordon Eggers,CEO,815-490-1616,,geggers@crusaderhealth.org,Sam Miller,CFO,815-490-1737,,smiller@crusaderhealth.org,
IL-003827,Crusader Clinic on Broadway,CRUSADERS CENTRAL CLINIC ASSOCIATION,1265601488,"Dental Providers, Federally Qualified Health Centers - Medical Services",1100 Broadway,,Rockford,IL,61104-1429,Winnebago,1200 W State St,,Rockford,IL,61102-2112,Winnebago,Gordon Eggers,CEO,815-490-1604,,geggers@crusaderhealth.org,Sam Miller,CFO,815-490-1737,,smiller@crusaderhealth.org,
IL-003828,Crusader Clinic on West State Street,CRUSADERS CENTRAL CLINIC ASSOCIATION,1902972557,"Dental Providers, Federally Qualified Health Centers - Medical Services",1200 W State St,,Rockford,IL,61102-2112,Winnebago,1200 W State St,,Rockford,IL,61102-2112,Winnebago,Gordon Eggers,CEO,815-490-1616,,Geggers@crusaderhealth.org,Sam Miller,CFO,815-490-1737,,smiller@crusaderhealth.org,
IL-003829,SWEDISH AMERICAN HOSPITAL,Swedish American Hospital,1760542732,Inpatient Hospitals (other than children's hospitals),1401 E State St,,Rockford,IL,61104-2298,Winnebago,1401 E State St,,Rockford,IL,61104-2315,Winnebago,Patti Dewane,Vice President,779-696-4009,,pdewane@swedishamerican.org,,,,,,
IL-003830,"STI, Winnebago County Health Department",Winnebago County Health Department,1578666541,Sexually Transmitted Disease Clinics,401 Division St,,Rockford,IL,61104-2014,Winnebago,401 Division Street,,Rockford,IL,61104,Winnebago,Sandra L Martell,Administrator Public Health,815-720-4210,,smartell@wchd.org,Patrick T Madigan,Director Finance,815-720-4025,,PMadigan@wchd.org,
IL-003831,"TB, Winnebago County Health Department",Winnebago County Health Department,1578666541,Tuberculosis Clinics,555 N Court St,,Rockford,IL,61103-6862,Winnebago,401 Division Street,,Rockford,IL,61104,Winnebago,Sandra L Martell,Administrator Public Health,815-720-4210,,smartell@wchd.org,Patrick T Madigan,Director Finance,815-720-4025,,PMadigan@wchd.org,
IL-003832,Saint Anthony Medical Center,OSF Healthcare System,1790739977,Inpatient Hospitals (other than children's hospitals),5666 E State St,,Rockford,IL,61108-2425,Winnebago,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
IL-003833,VNA Health Care,VNA Health Care,1497175160,Federally Qualified Health Centers - Medical Services,160 N Independence Blvd,,Romeoville,IL,60446-1803,Will,400 N Highland Ave,,Aurora,IL,60506,Kane,Chrissie Howorth,VP of Philanthropy and Business Relations,630-482-8132,8132,choworth@vnahealth.com,,,,,,www.vnahealth.com
IL-003834,Rural Health Center of RoodhouseThomas H. Boyd Memorial Hospital,Thomas H. Boyd Memorial Hospital,1144313180,Rural Health Clinics,132 W Lorton St,,Roodhouse,IL,62082-1569,Greene,800 School Street,,Carrollton,IL,62016,Greene,Deborah Campbell,CEO,217-942-6946,1200,dcampbell@boydhcs.org,Jim Johnson,CFO,217-942-6946,1303,jjohnson@boydhcs.org,
IL-003835,JCH Medical Group-Roodhouse,Jersey Community Hospital,1770988735,Rural Health Clinics,205 S Morse St,,Roodhouse,IL,62082-1322,Greene,390 Maple Summit Road,,Jerseyville,IL,62052,Jersey,Beth KIng,CFO,618-498-6402,8350,bking@jch.org,Dawn Stumpf,Credentialing Coordinator,618-498-7518,232,dawnstumpf@jch.org,jch.org
IL-003836,Hardin County General Hospital and Clinic,Hardin County General Hospital and Clinic,1346323615,Rural Health Clinics,6 Ferrell Rd,,Rosiclare,IL,62982,Hardin,PO Box 2467,,Rosiclare,IL,62982,Hardin,Janie Parker,CFO,618-285-6634,309,janie.parker@ilhcgh.org,Doris Guarderas,Patient Account Manager,618-285-6634,333,doris.guarderas@ilhcgh.org,
IL-003837,Hardin County General Hospital and Clinic,Hardin County General Hospital and Clinic,1538165600,Inpatient Hospitals (other than children's hospitals),6 Ferrell Rd,,Rosiclare,IL,62982,Hardin,PO Box 2467,,Rosiclare,IL,62982,Hardin,Janie Parker,CFO,618-285-6634,309,janie.parker@ilhcgh.org,Doris Guarderas,Patient Account Manager,618-285-6634,333,doris.guaraderas@ilhcgh.org,
IL-003838,Round Lake District 116 Student Clinic,Lake County Health Department/Community Health Center,1639588254,Federally Qualified Health Centers - Medical Services,800 High School Dr,,Round Lake,IL,60073-2951,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,https://www.rlas-116.org/Page/6100
IL-003839,Midlakes Clinic,Lake County Health Department/Community Health Center,1750310884,"Dental Providers, Federally Qualified Health Centers - Medical Services",224 W Clarendon Dr,,Round Lake Beach,IL,60073-1896,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003840,HeadStart - Round Lake,Lake County Health Department/Community Health Center,1861857401,Dental Providers,420 Greenwood Dr,,Round Lake Park,IL,60073-3448,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003841,Children and Adolescent Behavioral Services,Lake County Health Department/Community Health Center,1902027147,Community Mental Health Centers,423 E Washington St,,Round Lake Park,IL,60073-3018,Lake,3010 Grand Ave.,,Waukegan IL,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003842,Salem Township Hospital,Salem Township Hospital,1295739548,Inpatient Hospitals (other than children's hospitals),1201 Ricker Rd,,Salem,IL,62881-4263,Marion,1201 Ricker Rd,,Salem,IL,62881,Marion,Teresa L Stroud,Chief Financial Officer,618-548-3194,8188,tstroud@sthcares.org,Willie Ray,Director of Revenue Cycle,618-548-3194,8145,wray@sthcares.org,
IL-003843,Salem Township Hospital Rural Health Clinic,Salem Township Hospital,1265467195,Rural Health Clinics,1201 Ricker Rd,,Salem,IL,62881-4263,Marion,1201 Ricker Rd,,Salem,IL,62881,Marion,Teresa L Stroud,Chief Financial Officer,618-548-3194,8188,tstroud@sthcares.org,Willie Ray,Director of Revenue Cycle,618-548-3194,8145,wray@sthcares.org,
IL-003844,SALEM MEDICAL CENTER,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1376588848,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1275 Hawthorn Rd,,Salem,IL,62881-1028,Marion,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003845,STH Family Health Care Center,Salem Township Hospital,1629433784,Outpatient Hospital Clinics,1321 W Whittaker St,,Salem,IL,62881-2013,Marion,1201 Ricker Rd,,Salem,IL,62881,Marion,Teresa L Stroud,Chief Financial Officer,618-548-3194,8188,tstroud@sthcares.org,Willie Ray,Director of Revenue Cycle,618-548-3194,8145,wray@sthcares.org,
IL-003846,ARCHVIEW MEDICAL CENTER,Southern Illinois Healthcare Foundation,1083162432,Federally Qualified Health Centers - Medical Services,2071 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,2041 Goose Lake Road,,Sauget,IL,62206,Saint Clair,LARRY MCCULLEY,President and CEO,618-332-0694,19208,lmcculley@sihf.org,Patrice Howard,VP of Administration,618-332-0694,19204,phoward@sihf.org,
IL-003847,Sesser Community Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1073816542,Federally Qualified Health Centers - Medical Services,6294 State Highway 154,,Sesser,IL,62884-2163,Franklin,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003848,Sesser Dental Clinic,Christopher Rural Health,1861547705,Dental Providers,6294 State Highway 154,P O Box 640,Sesser,IL,62884-2163,Franklin,4241 St Hwy 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003849,Shawneetown Community Health Center,CHRISTOPHER RURAL HEALTH PLANNING CORP,1285614867,Federally Qualified Health Centers - Medical Services,9525 Gold Hill Rd,,Shawneetown,IL,62984-3659,Gallatin,4241 State Highway 14 W,P O Box 155,Christopher,IL,62822-0155,Franklin,Kim Mitroka,CEO,618-724-1608,,kmitroka@crhpc.org,Brenda Spotanski,CIO,618-724-1608,,bspotanski@crhpc.org,
IL-003850,Family Healthcare Center,Shelby Memorial Hospital,1750350922,Rural Health Clinics,200 S Cedar St,,Shelbyville,IL,62565-1838,Shelby,200 S Cedar St,,Shelbyville,IL,62565,Shelby,Lisa Miller,Practice Manager,217-774-3961,4413,lmiller@mysmh.org,Jean Hudson,Administrative Assistant,217-774-3961,2661,jhudson@mysmh.org,
IL-003851,Shelby Memorial Hospital,Shelby Memorial Hospital,1053348532,Inpatient Hospitals (other than children's hospitals),200 S Cedar St,,Shelbyville,IL,62565-1838,Shelby,200 South Cedar Street,,Shelbyville,IL,62565-1838,Shelby,Kristin Cervi,Medical Biller,217-774-3961,2385,kcervi@mysmh.org,Tracie Helton,Director of Financial Services,217-774-3961,2612,thelton@mysmh.org,
IL-003853,Heartland Health Center Niles West,Heartland International Health Center,1881089720,Federally Qualified Health Centers - Medical Services,5701 Oakton St,,Skokie,IL,60077-2630,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003854,"Asian Human Services Family Health Center, Inc","Asian Human Services Family Health Center, Inc",1013334002,"Dental Providers, Federally Qualified Health Centers - Medical Services",8800 Lockwood Ave,,Skokie,IL,60077-1500,Cook,2424 W. Peterson Ave,,Chicago,IL,60659,Cook,"Muhammad W. Paracha, MD., MPH.",Executive Director,773-761-0010,,mparacha@ahschicago.org,,,,,,
IL-003855,Heartland Health Center Niles North,Heartland International Health Center,1083008585,Federally Qualified Health Centers - Medical Services,9800 Lawler Ave,,Skokie,IL,60077-1215,Cook,3048 N Wilton Ave,2nd Floor,Chicago,IL,60657-6710,Cook,Gwenn Rausch,CEO,773-296-7587,,grausch@heartlandhealthcenters.org,Huell Collier,Billing and Credentialing Manager,773-296-7544,,hcollier@heartlandhealthcenters.org,
IL-003856,Aunt Martha's South Holland Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1871724369,Federally Qualified Health Centers - Medical Services,52 W 162nd St,,South Holland,IL,60473-2061,Cook,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,https://www.auntmarthas.org/am-finder/south-holland-community-health-center/
IL-003857,CCHC South Holland Health Center,Christian Community Health Center,1912170457,Federally Qualified Health Centers - Medical Services,901 E Sibley Blvd,,South Holland,IL,60473-1166,Cook,9718 S Halsted Street,,Chicago,IL,60628-1007,Cook,Kenneth Burnett,CEO,773-298-4745,4745,kenneth.burnett@cchc-rchm.org,Samantha Mitchell,COO,773-298-2070,2070,samantha.mitchell@cchc-rchm.org,
IL-003858,Central Counties Health Centers Salvation Army,Central Counties Health Centers,1861480709,Federally Qualified Health Centers - Medical Services,221 N 11th St,,Springfield,IL,62703-1003,Sangamon,2239 E Cook St.,,Springfield,IL,62703,Sangamon,Brad Buzzard,COO,217-788-2300,,bbuzzard@centralcounties.org,,,,,,
IL-003859,Central Counties Health Centers,"Central Counties Health Centers, Inc.",1861480709,"Dental Providers, Federally Qualified Health Centers - Medical Services",2239 E Cook St,,Springfield,IL,62703-1944,Sangamon,2239 E Cook St,,Springfield,IL,62703-1944,Sangamon,Heather K Burton,CEO,217-788-2300,,hburton@centralcounties.org,Jason D. Jones,CFO,217-788-2317,,jjones@centralcounties.org,
IL-003860,SIU Center for Family Medicine-Springfield,SOUTHERN ILLINOIS UNIVERSITY,1497002182,Federally Qualified Health Centers - Medical Services,520 N 4th St,Suite 202,Springfield,IL,62702-5256,Sangamon,320 E. Carpenter,,Springfield,IL,62702,Sangamon,Iris Wesley,Cheif Executive Officer,217-757-8116,,iwesley@siumed.edu,Ellen King,Chief Financial Officer,217-757-8137,,eking24@siumed.edu,siucenterforfamilymedicine.org
IL-003861,Springfield,Planned Parenthood of Illinois,1922414846,Family Planning Providers,601 N Bruns Ln,,Springfield,IL,62702-3596,Sangamon,18 S Michigan Ave Fl 6,,Chicago,IL,60603-3206,Cook,Edward Mbewe,CFO,312-592-6878,,edwardm@ppil.org,Julie Uhal,Access Expansion Coordinator,314-531-7526,,julieu@ppil.org,
IL-003862,Central Counties Health Centers St. John's,Central Counties Health Centers,1225588387,Dental Providers,800 E Carpenter St,,Springfield,IL,62702-5324,Sangamon,2239 E Cook St,,Springfield,IL,62703,Sangamon,Brad Buzzard,COO,217-788-2300,,bbuzzard@centralcounties.org,,,,,,www.centralcounties.org
IL-003863,Streamwood Community Health Center,GREATER ELGIN FAMILY CARE CENTER,1588925804,Federally Qualified Health Centers - Medical Services,135 E Irving Park Rd,,Streamwood,IL,60107-2950,Cook,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003864,Eagle View Community Health System - Stronghurst Location,"HENDERSON COUNTY RURAL HEALTH CENTER, INC.",1972662658,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 S Division St,,Stronghurst,IL,61480-5033,Henderson,1204 Hwy 164 E,,Oquawka,IL,61469,Henderson,Lori A. Sutton,Executive Director,309-867-2734,,lsutton@eagleviewhealth.org,Shannon Courson,Administrative Assistant,309-867-2735,,scourson@eagleviewhealth.org,www.eagleviewhealth.org
IL-003865,"Rural Health Clinic Moultrie County, LLC","Rural Health Clinic Moultrie County, LLC",1831361344,"Rural Health Clinics, Tuberculosis Clinics",2 W Adams St,,Sullivan,IL,61951-1943,Moultrie,Same,,Sullivan,IL,61951,Moultrie,Karen Sims,Practice Manager,217-728-7353,,karen.sims@hshs.org,Faisal Bukhari,MD,217-728-7353,,karen.sims@hshs.org,
IL-003867,ACCESS Des Plaines Valley Health Center,ACCESS COMMUNITY HEALTH NETWORK,1871671990,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",7450 W 63rd St,,Summit Argo,IL,60501-1816,Cook,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003868,Fairview Heights Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1770904054,"Family Planning Providers, Sexually Transmitted Disease Clinics",4529 N Illinois St,,Swansea,IL,62226-1534,Saint Clair,4251 Forest Park Ave,,Saint Louis,MO,63108-2810,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,307,mary.kogut@ppslr.org,Tom Hemingway,Vice President of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,http://www.ppslr.org
IL-003869,Center for Family Health - Sycamore,GREATER ELGIN FAMILY CARE CENTER,1285061879,Federally Qualified Health Centers - Medical Services,165 E Plank Rd,,Sycamore,IL,60178-8757,DeKalb,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003870,C C Medical Clinic,C C Medical Clinic,1952427163,Rural Health Clinics,1141 N Cheney St,,Taylorville,IL,62568-2741,Christian,1141 N Cheney St,,Taylorville,IL,62568-2741,Christian,Laura Winans,Office Manager,217-287-7477,,ccmedicalclinic@ctitech.com,,,,,,
IL-003872,Douglas County Health Department,Douglas County Health Department,1659406163,"Dental Providers, Tuberculosis Clinics",1250 E US Highway 36,,Tuscola,IL,61953-8020,Douglas,1250 E. US Hwy 36,,Tuscola,IL,61953,Douglas,Amanda Minor,Administrator,217-253-4137,,amanda.minor@douglascountyil.com,April Kauffman,Office Manager,217-253-4137,,april.kauffman@douglascountyil.com,
IL-003873,Community Health Improvement Center Dba Crossing Healthcare,Community Health Improvement Center dba Crossing Healthcare,1023083227,Federally Qualified Health Centers - Medical Services,1002 S Race St,Urbana School Health Center,Urbana,IL,61801-4998,Champaign,320 East Central Ave,,Decatur,IL,62521-4665,Macon,Tanya Andricks,CEO,217-877-6111,,tandricks@crossinghealthcare.org,Karla Sparks,CFO,217-877-6127,,ksparks@crossinghealthcare.org,
IL-003874,Promise Healthcare at the Community Resource Center,Promise Healthcare NFP,1174932586,Federally Qualified Health Centers - Medical Services,1400 W Park St,Building 3,Urbana,IL,61801,Champaign,819 Bloomington Road,,Champaign,IL,61820,Champaign,Nancy Greenwalt,Executive Director,217-403-5401,,ngreenwalt@promisehealth.org,Pat Owens,Director of Finance and Information,217-403-5473,,powens@promisehealth.org,
IL-003875,Vandalia Healthcare Center,"SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",1326288143,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1510 Sunset Dr,,Vandalia,IL,62471-3228,Fayette,2041 Goose Lake Rd,,Sauget,IL,62206-2822,Saint Clair,Larry W McCulley,President and CEO,618-332-0694,,lmcculley@sihf.org,Patrice Howard,Family Planning Coordinator Vice President of Administration,618-332-0694,,phoward@sihf.org,
IL-003876,VIENNA MEDICAL CLINIC,RURAL HEALTH INC,1932263332,Federally Qualified Health Centers - Medical Services,803 N 1st St,,Vienna,IL,62995-1544,Johnson,513 N Main St,,Anna,IL,62906-1697,Johnson,Cynthia K Flamm,CEO,618-833-4471,,cflamm@ruralhealthinc.org,,,,,,
IL-003877,Cass County Health Department - Cass County Health Clinic,COUNTY OF CASS,1164596375,"Dental Providers, Federally Qualified Health Centers - Medical Services",331 S Main St,,Virginia,IL,62691-1571,Cass,331 S Main St Frnt,,Virginia,IL,62691-1571,Cass,"Teresa Armstrong RN, BSN",Administrator,217-452-3057,301,tarmstrong@casscohealth.org,Sarah Fanning,Billing,217-452-3057,323,,
IL-003878,IMH Multi Specialty Physicians,IROQUOIS MEMORIAL HOSPITAL,1447610472,Rural Health Clinics,200 E Fairman Ave,,Watseka,IL,60970-1644,Iroquois,200 Fairman Ave,,WATSEKA,IL,60970,Iroquois,Michelle Fox,Director Medical Staff & Clinical Informatics,815-432-7775,,mdfox@iroquoismemorial.com,Julie Giroux,Clinic Director,815-432-7778,,jagiroux@iroquoismemorial.com,
IL-003879,Iroquois Memorial Hospital,IROQUOIS MEMORIAL HOSPITAL,1629003470,Inpatient Hospitals (other than children's hospitals),200 E Fairman Ave,,Watseka,IL,60970-1644,Iroquois,200 Fairman Ave,,WATSEKA,IL,60970,Iroquois,Michelle Fox,Director Medical Staff & Clinical Informatic Services,815-432-7775,,mdfox@iroquoismemorial.com,Rebecca Wright,Vice President,815-432-7917,,rebecca.wright@iroquoismemorial.com,
IL-003880,Aunt Martha's Iroquois Community Health Center,"Aunt Martha's Youth Service Center, Inc.",1649417759,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 E Walnut St,,Watseka,IL,60970-1356,Iroquois,19900 Governors Highway,,Olympia Fields,IL,60461,Cook,Maria Borrayo,Manager of Healthcare Plans and Patient Access,708-825-7511,,mborrayo@auntmarthas.org,Audrey Pennington,Executive VP of Health,773-802-7645,,aapennington@auntmarthas.org,
IL-003881,Iroquois Women's Health,IROQUOIS MEMORIAL HOSPITAL,1740538958,Other ECP Providers,625 S 5th St,,Watseka,IL,60970-1835,Iroquois,200 Fairman Ave,,WATSEKA,IL,60970,Iroquois,Michelle Fox,Director Medical Staff & Clinical Informatic Services,815-432-7775,,mdfox@iroquoismemorial.com,Julie Giroux,Clinic Director,815-432-7778,,jagiroux@iroquoismemorial.com,
IL-003882,Erie Waukegan Health Center,"ERIE FAMILY HEALTH CENTER, INC.",1851712053,"Dental Providers, Federally Qualified Health Centers - Medical Services",2323 Grand Ave,,Waukegan,IL,60085-3312,Lake,1701 W Superior St,,Chicago,IL,60622-5646,Cook,Lee Francis,CEO,312-432-7394,,lfrancis@eriefamilyhealth.org,Scott Spencer,Controller,312-432-7389,,sspencer@eriefamilyhealth.org,
IL-003883,Belvidere Medical Clinic,Lake County Health Department/Community Health Center,1174552293,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2400 Belvidere Rd,,Waukegan,IL,60085-6165,Lake,3010 Grand Ave.,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003885,Crisis Care Program,Lake County Health Department/Community Health Center,1821200197,Community Mental Health Centers,3002 Grand Ave,,Waukegan,IL,60085-2321,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003886,Assertive Community Treatment (ACT),Lake County Health Department/Community Health Center,1174745160,Community Mental Health Centers,3010 Grand Ave,,Waukegan,IL,60085-2321,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003887,Children and Adolescent Behavioral Services,Lake County Health Department/Community Health Center,1568674836,Community Mental Health Centers,3010 Grand Ave,,Waukegan,IL,60085-2321,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,https://www.lakecountyil.gov/698/Child-Adolescent-Behavioral-Health-CABS
IL-003888,Community Support and Outpatient Services,Lake County Health Department/Community Health Center,1053623637,Community Mental Health Centers,3010 Grand Ave,,Waukegan,IL,60085-2321,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,https://www.lakecountyil.gov/701/Community-Support-Services-CSS
IL-003889,Community Support Services - Residential,Lake County Health Department,1659583920,Community Mental Health Centers,4118 Greenleaf Ct,,Waukegan,IL,60085-8509,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003890,Tuberculosis Clinic,Lake County Health Department/Community Health Center,1255342457,Tuberculosis Clinics,515 Keller Ave,,Waukegan,IL,60085-5008,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,https://www.lakecountyil.gov/
IL-003891,ACCESS West Chicago Family Health Center,ACCESS COMMUNITY HEALTH NETWORK,1710065164,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",245 W Roosevelt Rd,Bldg 14,West Chicago,IL,60185-3739,Dupage,600 W Fulton St Ste 200,,Chicago,IL,60661-1262,Cook,Thea Kachoris-Flores,"Director, Planning and Development",312-526-2071,,thea.kachorisflores@achn.net,,,,,,
IL-003892,MORTHLAND COLLEGE HEALTH SERVICES,Franklin Hospital District,1376861385,Rural Health Clinics,309 W Saint Louis St,,West Frankfort,IL,62896-2099,Franklin,Franklin Hospital,201 Bailey Lane,Benton,IL,628121969,Franklin,Kimberly Grob,Dir of Pt Fin Services,618-439-3161,323,kimberly.grob@franklinhospital.net,,,,,,
IL-003893,Creekside Health Center,GREATER ELGIN FAMILY CARE CENTER,1417336264,Federally Qualified Health Centers - Medical Services,300 McHenry Rd,,Wheeling,IL,60090-2696,Cook,370 Summit St Ste 1A,,Elgin,IL,60120-3843,Kane,Robert M Tanner,CEO,847-608-6068,,btanner@gefcc.org,Jason Carey,CFO,847-608-6053,,jcarey@gefcc.org,http://www.gefcc.org
IL-003894,Greene County Rural Health Clinic,Thomas H. Boyd Memorial Hospital,1366535304,Rural Health Clinics,116A N Main St,,White Hall,IL,62092-1054,Greene,800 School Street,,Carrollton,IL,62016,Greene,Deborah Campbell,CEO,217-942-6946,1200,dcampbell@boydhcs.org,Jim Johnson,CFO,217-942-6946,1303,jjohnson@boydhcs.org,
IL-003895,"NORTHEAST SATELLITE, ZION",COUNTY OF LAKE,1023047164,Federally Qualified Health Centers - Medical Services,1819 27th St,,Zion,IL,60099-2541,Lake,3010 Grand Ave,,Waukegan,IL,60085-6165,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IL-003896,Community Support Services - Residential,Lake County Health Department,1538380647,Community Mental Health Centers,2905 Willow Ln Apt C1,,Zion,IL,60099-1462,Lake,3010 Grand Ave.,,Waukegan,IL,60085,Lake,Kim Burke,"Director, Managed Care",847-377-8000,8758,KBurke@lakecountyil.gov,,,,,,
IN-003897,JPCHC at Anderson/Kids Plus,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,1210 Medical Arts Blvd,Suite 300,Anderson,IN,46011-3439,Madison,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003898,"Madison County Community Health Center, Inc.","Madison County Community Health Center, Inc.",1770668030,"Dental Providers, Federally Qualified Health Centers - Medical Services",1547 Ohio Ave,,Anderson,IN,46016-1917,Madison,"Madison County Community Health Center, Inc.",,Anderson,IN,46016,Madison,Sharon a. Foote,COO,765-641-0255,413,sharon.foote@mcchc.org,Edna Crawford,Fiscal Director,765-641-0255,244,ecrawford@mcchc.org,
IN-003899,Open Door Health Services - Anderson,"OPEN DOOR HEALTH SERVICES, INC.",1508811910,Federally Qualified Health Centers - Medical Services,2101 Jackson St,Suite 8,Anderson,IN,46016-4341,Madison,333 S Madison St,,Muncie,IN,47305,Delaware,Bryan Ayars,CEO,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants & Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,www.opendoorhs.org
IN-003900,Open Door Family Planning Clinic,"OPEN DOOR HEALTH SERVICES, INC.",1336279967,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2525 E 10th St,,Anderson,IN,46012-4409,Madison,333 S Madison St,,Muncie,IN,47305-2465,Delaware,Bryan Ayars,Cheif Executive Officer,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants & Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,http://www.opendoorhs.org/
IN-003901,"Robert E. Judge, M.D.",Adams Medical Group,1952405581,Rural Health Clinics,1521 W Main St,,Berne,IN,46711-1796,Adams,1521 West Main Street,Suite 1,Berne,IN,46711,Adams,Robert E. Judge,MD,260-589-2312,,rljudge1@gmail.com,,,,,,
IN-003902,Valley Professionals Community Health Center - Bloomingdale Clinic,"Valley Professionals Community Health Center, Inc.",1427306778,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 W Academy St,,Bloomingdale,IN,47832-8095,Parke,201 W ACADEMY,,BLOOMINGDALE,IN,47832,Parke,Terry Warren,CEO,765-832-3843,,twarren@vpchc.org,,,,,,
IN-003903,MCHD Futures Family Planning Clinic,Monroe County Health Department,1962697284,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",119 W 7th St,,Bloomington,IN,47404-3989,Monroe,119 W 7th St,,Bloomington,IN,47404-3926,Monroe,Penny Caudill,Clinic Administrator,812-349-2068,,pcaudill@co.monroe.in.us,,,,,,http://www.co.monroe.in.us/tsd/Community/Health/FuturesFamilyPlanningClinic.aspx
IN-003904,Bloomington Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,421 S College Ave,,Bloomington,IN,47403-1592,Monroe,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003905,TRI-CAP Family Health Services Boonville Clinic,TRI-CAP Family Health Services,1295800084,Family Planning Providers,499 W Sr 62,,Boonville,IN,47601,Warrick,607 Third Avenue,,Jasper,IN,47547-0729,Dubois,Joyce Fleck,Executive Director,812-482-2233,101,joyce@tri-cap.net,Deborah Capps,Health Services Director,812-482-2233,130,deb@tri-cap.net,http://www.tri-cap.net/
IN-003906,Brazil Family Medicine,"Providence Medical Group, LLC",1013087048,Rural Health Clinics,115 S Murphy Ave,Suite A,Brazil,IN,47834-8296,Clay,2723 S 7th Street Ste A,,Terre Haute,IN,47802-3558,Vigo,Babette Bolinger,Billing,812-238-1730,5622,bbolinger@provmed.net,Carol Lutes,Office Manager,812-442-2100,,clutes@provmed.net,
IN-003907,"Community Hospital of Bremen, Inc","Community Hospital of Bremen, Inc",1568417004,Inpatient Hospitals (other than children's hospitals),1020 High Rd,PO Box 8,Bremen,IN,46506-1093,Marshall,1020 High Rd,PO Box 8,Bremen,IN,46506,Marshall,Amy Lashbrook,CFO,574-546-2211,,alashbrook@bremenhospital.com,David Bailey,CEO,574-546-2211,,dbailey@bremenhospital.com,
IN-003908,"Joanne Guttman, MD","Reid Physician Hospital Organization, LLC",1902897366,Rural Health Clinics,11137 US Highway 52,Suite B,Brookville,IN,47012-7901,Franklin,1100 Reid Parkway,,Richmond,IN,47374,Wayne,Gwen McGill,Executive Assistant,765-983-3322,,Gwen.McGill@ReidHealth.org,,,,,,
IN-003909,Family Health Clinic of Burlington,Purdue North Central Nursing Clinics,1295104669,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",425 E 5th St,Suite B,Burlington,IN,46915-9700,Carroll,Family Health Clinic of Carroll County,901 Prince William Road,Delphi,IN,46923,Carroll,Jim Layman,Executive Director,765-564-3016,,laymand@purdue.edu,Barb Hickner,Outreach and Enrollment Coordinator,765-329-2232,,hickner@purdue.edu,
IN-003910,CARLISLE MEDICAL CLINIC,"MSO CLinics, INC",1699194704,Rural Health Clinics,8685 Old Hw 41 S,,Carlisle,IN,47838,Sullivan,PO BOx 230,,Sullivan,IN,47882-0230,Sullivan,Sam Roberts,Practice Manager,812-268-3318,,sam.roberts@schosp.com,,,,,,
IN-003911,Jane Pauley Community Health Center at Aspire Carmel,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,697 Pro-Med Ln,,Carmel,IN,46032-5323,Hamilton,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003912,Valley Professionals Community Health Center - Cayuga Clinic,"Valley Professionals Community Health Center, Inc.",1417284043,Federally Qualified Health Centers - Medical Services,114 N Division St,,Cayuga,IN,47928-8230,Vermillion,114 N DIVISION ST,,Cayuga,IN,47928,Vermillion,Terry Warren,CEO,765-832-3843,,twarren@vpchc.org,,,,,,
IN-003913,Family Health Centers of Southern Indiana Charlestown Satellite,FAMILY HEALTH CENTER OF CLARK COUNTY INC,1528125341,Federally Qualified Health Centers - Medical Services,11500 Highway 62,,Charlestown,IN,47111-8612,Clark,1319 Duncan Ave,,Jeffersonville,IN,47130-3759,Clark,Lori G Harris,CEO,812-283-2371,,lharris@fhcenters.org,Lori Harris,CEO,812-283-2371,,lharris@fhcenters.org,
IN-003914,NorthShore Chesterton Health Center,"NORTHSHORE HEALTH CENTERS, INC",1568856045,Federally Qualified Health Centers - Medical Services,407 W Indiana Ave,,Chesterton,IN,46304-2350,Porter,6450 US Highway 6,,Portage,IN,46368-5110,Porter,Janice E Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-003915,Valley Professionals Community Health Center - Clinton Site,"Valley Professionals Community Health Center, Inc.",1104006253,Federally Qualified Health Centers - Medical Services,777 S Main St,Suite 100,Clinton,IN,47842-2493,Vermillion,"777 South Main Street, STE 100",,Clinton,IN,47842,Vermillion,Terry Warren,CEO,765-832-3843,,twarren@vpchc.org,,,,,,
IN-003916,Columbus Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,3200 Sycamore Ct,Suite 2C,Columbus,IN,47203-1552,Bartholomew,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003917,Family Health Centers of Southern Indiana Harrison,FAMILY HEALTH CENTER OF CLARK COUNTY INC,1528125341,Federally Qualified Health Centers - Medical Services,290 N Harrison Dr,,Corydon,IN,47112-1725,Harrison,1319 Duncan Ave,,Jeffersonville,IN,47130-3759,Clark,Lori G Harris,CEO,812-283-2371,,lharris@fhcenters.org,Lori G. Harris,CEO,812-283-2371,,lharris@fhcenters.org,
IN-003918,Valley Professionals Community Health Center - Crawfordsville Clinic,"Valley Professionals Community Health Center, Inc.",1083009997,Federally Qualified Health Centers - Medical Services,1810 Lafayette Rd,,Crawfordsville,IN,47933-1035,Montgomery,1810 LAFAYETTE ROAD,,CRAWFORDSVILLE,IN,47933,Montgomery,Terry Warren,CEO,765-832-3843,,twarren@vpchc.org,,,,,,
IN-003919,Family Health Clinic of Carroll County,Purdue University North Central Nursing Clinics,1477549731,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",901 Prince William Rd,Family Health Clinic Of Carroll County,Delphi,IN,46923-1758,Carroll,Family Health Clinic,901 Prince William Road,Delphi,IN,46923,Carroll,Jim Layman,Executive Director,765-564-3016,,laymand@purdue.edu,Barb Hickner,Outreach and Enrollment Coordinator,765-329-2232,,hickner@purdue.edu,
IN-003920,HealthLinc - East Chicago,"HEALTHLINC, INC.",1184069569,Federally Qualified Health Centers - Medical Services,1313 W Chicago Ave,,East Chicago,IN,46312-3316,Lake,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E. Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-003921,Regional Health Clinic- Stark,Regional Mental Health,1376919217,Federally Qualified Health Centers - Medical Services,3903 Indianapolis Blvd,,East Chicago,IN,46312-2555,Lake,8555 Taft St,,Merrillville,IN,46410,Lake,Lynn Hall,Contract/Credentialing Coordinator,219-757-1928,,lynette.hall@geminus.org,Sherry Oman,Executive Director,219-937-3300,,sherry.oman@regionalmentalhealth.org,
IN-003922,Heart City Health Center SCENIC HEALTH,"HEART CITY HEALTH CENTER, INC.",1295143774,Federally Qualified Health Centers - Medical Services,148 W Hively Ave,Suite 1,Elkhart,IN,46517-2191,Elkhart,236 Simpson Ave,,Elkhart,IN,46516-4666,Elkhart,Vernita E Todd,Chief Executive Officer,574-293-0052,2233,vtodd@heartcityhealth.org,Omobola Olaniyan,Chief Medical Officer,574-294-3167,,oolaniyan@heartcityhealth.org,www.heartcityhealth.org
IN-003923,HEART CITY HEALTH CENTER,"HEART CITY HEALTH CENTER, INC.",1720033418,"Dental Providers, Federally Qualified Health Centers - Medical Services",236 Simpson Ave,,Elkhart,IN,46516-4666,Elkhart,236 Simpson Ave,,Elkhart,IN,46516-4666,Elkhart,Vernita E Todd,Chief Executive Officer,574-293-0052,,vtodd@heartcityhealth.org,"Omobola Olaniyan, MD",Chief Medical Officer,574-294-3167,,oolaniyan@heartcityhealth.org,www.heartcityhealth.org
IN-003924,Elkhart Planned Parenthood,Planned Parenthood of IN & KY,1891743092,Family Planning Providers,505 S 3rd St,Suite 160,Elkhart,IN,46516-3242,Elkhart,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003925,Evansville Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,125 N Weinbach Ave,Suite 120,Evansville,IN,47711-6091,Vanderburgh,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003926,ECHO COMMUNITY HEALTH CARE Division Street Clinic,"ECHO COMMUNITY HEALTH CARE, INC.",1467483255,Federally Qualified Health Centers - Medical Services,25 W Division St,,Evansville,IN,47710-1374,Vanderburgh,315 Mulberry St,,Evansville,IN,47713-1252,Vanderburgh,Sandee E Strader-McMillen,CEO,812-436-0215,,sstrader-mcmillen@echochc.org,Carla Acker,Billing Manager,812-602-2155,,cacker@echochc.org,
IN-003927,Echo Community Health Care Inc.,"ECHO COMMUNITY HEALTH CARE, INC.",1912906850,Federally Qualified Health Centers - Medical Services,315 Mulberry St,,Evansville,IN,47713-1252,Vanderburgh,315 Mulberry St,,Evansville,IN,47713-1252,Vanderburgh,Sandee E Strader-McMillen,CEO,812-436-0215,,sstrader-mcmillen@echochc.org,Carla Acker,Billing Manager,812-602-2155,2244,cacker@echochc.org,
IN-003928,ECHO Pediatric and Prenatal Clinic,"ECHO COMMUNITY HEALTH CARE, INC.",1063805216,Federally Qualified Health Centers - Medical Services,316 Chandler Ave,,Evansville,IN,47713-1147,Vanderburgh,315 Mulberry St,,Evansville,IN,47713-1252,Vanderburgh,Sandee E Strader-McMillen,CEO,812-436-0215,,sstrader-mcmillen@echochc.org,Carla Acker,Billing Manager,812-602-2155,,cacker@echochc.org,
IN-003929,"ECHO Community Health Care, Inc. John Street-Woodson Homeless Health Clinic","ECHO COMMUNITY HEALTH CARE, INC.",1700816683,Federally Qualified Health Centers - Medical Services,501 John St,Suite 12,Evansville,IN,47713-2705,Vanderburgh,315 Mulberry St,,Evansville,IN,47713-1252,Vanderburgh,Sandee E Strader-McMillen,CEO,812-436-0215,,sstrader-mcmillen@echochc.org,Carla Acker,Billing Manager,812-602-2155,,cacker@echochc.org,
IN-012443,Center for Vein Restoration,Center for Vein Restoration,1629437397,Other ECP Providers,6540 Logan Dr,Suite 2,Evansville,IN,47715-8271,Vanderburgh,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
IN-003930,TRI-CAP Family Health Services Evansville Clinic,TRI-CAP Family Health Services,1295800084,Family Planning Providers,727 John St,,Evansville,IN,47713-2754,Vanderburgh,607 Third Avenue,,Jasper,IN,47547-0729,Dubois,Joyce Fleck,Executive Director,812-482-2233,101,joyce@tri-cap.net,Deborah Capps,Health Services Director,812-482-2233,130,deb@tri-cap.net,http://www.tri-cap.net/
IN-003931,Tulip Tree Family Health Care,Tulip Tree Health Services of Gibson County Inc. dba Tulip Tree Family Health Care,1932225372,"Dental Providers, Other ECP Providers",123 N McCreary St,,Fort Branch,IN,47648-1313,Gibson,123 N McCreary Street,,Fort Branch,IN,476481313,Gibson,Maureen Shepherd,Executive Director,812-753-1039,,tulipadmin@tuliptreehealth.org,Allison Williams,Administrator,812-753-1039,,mshepherd@tuliptreehealth.org,www.tuliptreehealth.org
IN-003932,"Neighborhood Health Clinics, Inc.","Neighborhood Health Clinics, Inc.",1548291222,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1717 S Calhoun St,,Fort Wayne,IN,46802-5257,Allen,PO Box 11949,,Fort Wayne,IN,46862-1949,Allen,Richard Yergler,VP/CFO,260-458-2641,3623,ryergler@nhci.org,Angela M. Zaegel,President/CEO,260-458-2641,3634,azaegel@nhci.org,www.nhci.org
IN-003933,IPFW Lafayette Street Family Health Clinic,Indiana University - Purdue University Fort Wayne,1336351089,Family Planning Providers,2700 Lafayette St,Suite 200,Fort Wayne,IN,46806-1100,Allen,2101 East Coliseum Blvd.,,Fort Wayne,IN,46805,Allen,Linda M. Finke,Executive Director,260-481-6564,,finkel@ipfw.edu,,,,,,
IN-003934,Southeast Clinic,"Neighborhood Health Clinics, Inc.",1508262916,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3350 E Paulding Rd,,Fort Wayne,IN,46816-4513,Allen,PO Box 11949,,Fort Wayne,IN,46862,Allen,Richard Yergler,VP/CFO,260-458-2641,3623,ryergler@nhci.org,Angela M. Zaegel,President/CEO,260-458-2641,3634,azaegel@nhci.org,www.nhci.org
IN-003935,Community HealthNet Inc,Community HealthNet Inc,1497007876,Federally Qualified Health Centers - Medical Services,1015 N Shelby St,,Gary,IN,46403-1446,Lake,1021 West 5th Avenue,,Gary,IN,46402,Lake,Bonita Brown,Billing/Credentialing,219-979-2721,,bbrown@garychc.org,"Janet Seabrook, M.D.",Executive Director,219-484-2442,,jseabrook@garychc.org,
IN-003936,Community HealthNet Inc,COMMUNITY HEALTHNET,1952332298,Federally Qualified Health Centers - Medical Services,1021 W 5th Ave,,Gary,IN,46402-1703,Lake,1021 W 5th Ave,,Gary,IN,46402-1703,Lake,Janet Seabrook,Executive Director,219-880-1190,,jseabrook@garychc.org,Bonita Brown,Billing/Credentialing,219-979-2721,,bbrown@garychc.org,
IN-003937,Gary Health Center,Planned Parenthood of IN & KY,1891743092,Family Planning Providers,1124 Broadway,,Gary,IN,46407-1307,Lake,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003938,Marram Health Center,"Porter-Starke Services, Inc.",1023485356,Federally Qualified Health Centers - Medical Services,3229 Broadway,Suite 205,Gary,IN,46409-1038,Lake,601 Wall Street,,Valparaiso,IN,46383,Porter,Mary Idstein,Chief Financial Officer,219-476-4503,,midstein@porterstarke.org,Aileen Wehren,"Vice President, Administration",219-476-4567,,awehren@porterstarke.org,
IN-003939,Community HealthNet Inc,Community HealthNet Inc,1649539933,Federally Qualified Health Centers - Medical Services,3900 Calhoun St,Door R,Gary,IN,46408-1753,Lake,1021 West 5th Avenue,,Gary,IN,46402,Lake,Bonita Brown,Billing/Credentialing,219-979-2721,,bbrown@garychc.org,"Janet Seabrook, M.D.",Executive Director,219-484-2442,,jseabrook@garychc.org,
IN-003940,Maple City Health Care Center,"MAPLE CITY HEALTH CARE CENTER, INC.",1033166095,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",213 Middlebury St,,Goshen,IN,46528-2956,Elkhart,213 Middlebury St,,Goshen,IN,46528-2956,Elkhart,Donald Yost,Storyteller,574-534-3300,205,dyost@mchcc.org,James Nelson Gingerich,Guardian of Vision,574-526-8027,,jngingerich@mchcc.org,www.mchcc.org
IN-003941,Johnson Nichols Health Clinic-Greencastle,"Johnson Nichols Health Clinic, Inc.",1174571681,Family Planning Providers,1542 S Bloomington St,Suite 1300,Greencastle,IN,46135-2212,Putnam,P.O. Box 369,,Greencastle,IN,46135,Putnam,Stephanie LaFontaine,Executive Director,765-653-6171,,stephanie.lafontaine@centerstone.org,Misty Hall,Accounts Receivable Coordinator,812-829-0303,,misty.hall@centerstone.org,
IN-003942,Jane Pauley Community Health Center at Greenfield,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,1107 N State St,,Greenfield,IN,46140-1207,Hancock,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003943,Regional Health Clinic,Regional Mental Health,1609231927,Federally Qualified Health Centers - Medical Services,4022 Hohman Ave,,Hammond,IN,46327-1239,Lake,8555 Taft St,,Merrillville,IN,46410,Lake,Lynn Hall,Contract/Credentialing Coordinator,219-757-1928,,lynette.hall@geminus.org,Sherry Oman,Executive Director,219-937-3300,,sherry.oman@regionalmentalhealth.org,
IN-003944,Regional Health Clinic,SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER,1134543960,Federally Qualified Health Centers - Medical Services,559 State St,,Hammond,IN,46320-1533,Lake,8555 Taft St,,Merrillville,IN,46410-6123,Lake,Sherry Oman,Executive Director,219-937-3300,,sherry.oman@regionalmentalhealth.org,Lynn Hall,Contract/Credential Coordinator,219-757-1928,,lynette.hall@geminus.org,
IN-003945,Community HealthNet Inc,Community HealthNet Inc,1881946267,Federally Qualified Health Centers - Medical Services,5927 Columbia Ave,,Hammond,IN,46320-2611,Lake,1021 West 5th Avenue,,Gary,IN,46402,Lake,Bonita Brown,Billing/Credentialing,219-979-2721,,bbrown@garychc.org,"Janet Seabrook, M.D.",Executive Director,219-484-2442,,jseabrook@garychc.org,
IN-003946,NorthShore Hammond Health Center,"NORTHSHORE HEALTH CENTERS, INC",1023440526,"Dental Providers, Federally Qualified Health Centers - Medical Services",6920 Indianapolis Blvd,,Hammond,IN,46324-2206,Lake,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-003947,Hammond Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,7131 Indianapolis Blvd,,Hammond,IN,46324-2220,Lake,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-012444,Center for Vein Restoration,Center for Vein Restoration,1629437397,Other ECP Providers,105 S Raceway Rd,Suite 135,Indianapolis,IN,46231-1417,Marion,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
IN-003948,Eskenazi Health Center Cottage Corner,The Health & Hospital Corp of Marion County,1194077503,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1434 Shelby St,,Indianapolis,IN,46203-1945,Marion,1434 S. Shelby St,,Indianapolis,IN,46203-1945,Marion,Nancy A Buxser,COO,317-880-5101,,nancy.buxser@eskenazihealth.edu,Lisa Smitha,Family Planning Coordinator,317-880-5115,,,https://ehub.eskenazihealth.edu/
IN-003949,Tech Teen Clinic,"HEALTHNET, INC.",1780634964,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1500 E Michigan St,,Indianapolis,IN,46201-3079,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003950,"Healthnet, Inc.","HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1501 E 10th St,Harshman Middle School Clinic,Indianapolis,IN,46201-1909,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003951,Southwest Health Center,"HealthNet, Inc.",1780634964,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1522 W Morris St,,Indianapolis,IN,46221-1629,Marion,3403 E. Raymond Street,,Indianapolis,IN,46203,Marion,RACHEL BELL,CEO,317-957-2970,,RACHEL.BELL@INDYHEALTHNET.ORG,Rachel Bell,NP,317-957-2970,,RACHEL.BELL@INDYHEALTHNET.ORG,http://www.indyhealthnet.org/
IN-003952,Dayspring Center,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1537 Central Ave,,Indianapolis,IN,46202-2606,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C. Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003953,Care Center at the Towers,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1633 N Capitol Ave,Suite 500,Indianapolis,IN,46202-1453,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003954,IU Health Methodist Hospital,Indiana University Health,1144266024,Inpatient Hospitals (other than children's hospitals),1701 Senate Blvd,,Indianapolis,IN,46202-1239,Marion,340 West 10th Street,,Indianapolis,IN,46202,Marion,Frank Runion,Chief Financial Officer,317-948-4470,,frunion@iuhealth.org,Debra L Nystrom,Executive Director-Revenue and Reimbursement,317-963-1138,,dnystrom1@iuhealth.org,
IN-003955,"Healthnet, Inc.","HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1740 E 30th St,KIPP School Based Health Center,Indianapolis,IN,46218-2605,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003956,"Healthnet, Inc.","HEALTHNET, INC.",1780634964,Family Planning Providers,1751 E Riverside Dr,Vision Academy at Riverside School-Based Health Center,Indianapolis,IN,46202-2010,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003957,Homeless Initiative Program,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1835 N Meridian St,,Indianapolis,IN,46202-1411,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003958,Interfaith Hospitality Network,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,1850 N Arsenal Ave,,Indianapolis,IN,46218-4237,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003959,Jane Pauley Community Health Center at Shadeland,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,2040 N Shadeland Ave,Suite 300,Indianapolis,IN,46219-1712,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003960,"Healthnet, Inc.","HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,2215 W Washington St,George Washington Community School Clinic,Indianapolis,IN,46222-4279,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003961,Peoples Health Center,"HEALTHNET, INC.",1780634964,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2340 E 10th St,,Indianapolis,IN,46201-2008,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,Beth Pickens,Clinic Director,317-957-2972,,,http://www.indyhealthnet.org/
IN-003962,Salvation Army Harbor Light,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,2400 N Tibbs Ave,,Indianapolis,IN,46222-2458,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003963,Eskenazi Health Willowbrook,Eskenazi Health,1104027879,Family Planning Providers,2506 Willowbrook Pkwy,Suite 299,Indianapolis,IN,46205-1548,Marion,720 Eskenazi Avenue,,Indianapolis,IN,46202,Marion,Lisa Smitha,Program Director,317-880-5115,,lisa.smitha@eskenazihealth.edu,,,,,,
IN-003964,Damien Cares,Damien Cares,1649650235,Ryan White Providers,26 N Arsenal Ave,,Indianapolis,IN,46201-3808,Marion,26 N Arsenal Ave,,Indianapolis,IN,46201-3808,Marion,Jerry Parsons,Director of Compliance and Quality Assurance,317-632-0123,224,jparsons@damien.org,Melissa Pohlman,Director of Operations,317-632-0123,269,mpohlman@damien.org,www.damien.org/damien-cares-clinic
IN-003965,Martindale Brightwood Community Health Center,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,2855 N Keystone Ave,Suite 100,Indianapolis,IN,46218-2790,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003966,Wheeler Shelter for Women and Children,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,3208 E Michigan St,,Indianapolis,IN,46201-3318,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003967,SHALOM PRIMARY CARE CENTER,"SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,3400 Lafayette Rd,Suite 200,Indianapolis,IN,46222-1147,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo Ortega,CEO,317-291-7422,,mcarlson@shalomhealthcenter.org,,,,,,
IN-003968,Barrington Health Center,"HEALTHNET, INC.",1780634964,"Dental Providers, Federally Qualified Health Centers - Medical Services",3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2100,,jbrown54@iuhealth.org,,,,,,
IN-003969,Midtown Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,3750 N Meridian St,Suite 100,Indianapolis,IN,46208-4300,Marion,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003970,Northeast Health Center,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,3908 Meadows Dr,,Indianapolis,IN,46205-3114,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003971,"Healthnet, Inc.","HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,3980 Meadows Dr,Avondale Meadows Academy School-Based Health Center,Indianapolis,IN,46205-3114,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-803-3182,2013,jbrown54@iuhealth.org,,,,,,
IN-003972,RAPHAEL HEALTH CENTER,RAPHAEL HEALTH CLINIC,1487764759,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",401 E 34th St,Suite 1,Indianapolis,IN,46205-3790,Marion,401 E 34th St Ste 1,,Indianapolis,IN,46205-3790,Marion,Dee Roudebush,CEO,317-860-3961,3961,roudebush@raphaelhc.org,Sherry Gray,Grants/compliance manager,317-860-3963,3963,gray@raphaelhc.org,www.raphaelhc.org
IN-003973,Indiana College Preparatory,"SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,4050 E 38th St,,Indianapolis,IN,46218-1444,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo R Ortega,CEO,317-269-7199,,lortega@shalom-hcc.org,,,,,,
IN-003974,"SHALOM HEALTH CARE CENTER, INC.","SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,4326 Patricia St,FARRINGTON MIDDLE SCHOOL,Indianapolis,IN,46222-1543,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo R Ortega,CEO,317-269-7199,3172917422,mcarlson@shalomhealthcenter.org,,,,,,
IN-003975,"SHALOM HEALTH CARE CENTER, INC.","SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,4575 W 38th St,Indiana Math and Science Academy West,Indianapolis,IN,46254-3313,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo R Ortega,CEO,317-269-7199,,mcarlson@shalomhealthcenter.org,,,,,,https://www.shalomhealthcenter.org/home/school-based-clinics/
IN-003976,Jane Pauley Community Health Center at Howe,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,4900 Julian Ave,,Indianapolis,IN,46201-3755,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003977,Jane Pauley Community Health Center at Brook Park,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,5259 David St,,Indianapolis,IN,46226-1793,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003978,Jane Pauley Community Health Center at 16th Street,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,5317 E 16th St,,Indianapolis,IN,46218-4897,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003979,Salvation Army Family Service Center (for women),"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,540 N Alabama St,,Indianapolis,IN,46204-1536,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003980,Jane Pauley Community Health Center at Gallahue,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,5470 E 16th St,,Indianapolis,IN,46218-4861,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003981,Eskenazi Health W 38th Street,Health and Hospital Corporation of Marion County,1104027879,Dental Providers,5515 W 38th St,,Indianapolis,IN,46254-2919,Marion,3838 N Rural St,,Indianapolis,IN,46205,Monroe,Nancy A. Buxser,COO,317-880-5101,,nancy.buxser@eskenazihealth.edu,,,,,,eskenazihealth.edu
IN-003982,Eskenazi Health West 38th Street,Eskenazi Health,1730451063,Family Planning Providers,5515 W 38th St,,Indianapolis,IN,46254-2919,Marion,720 Eskenazi Avenue,,Indianapolis,IN,46202,Marion,Lisa Smitha,Program Director,317-880-5115,,lisa.smitha@eskenazihealth.edu,,,,,,
IN-003983,West Health Center,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,6029 W 10th St,,Indianapolis,IN,46224-6115,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003984,"SHALOM HEALTH CARE CENTER, INC.","SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,653 N Somerset Ave,Stephen Foster School #67,Indianapolis,IN,46222-3327,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo R Ortega,CEO,317-269-7199,,mcarlson@shalomhealthcenter.org,,,,,,
IN-003985,Eskenazi Health Center Pecar,Eskenazi Health,1093054447,Family Planning Providers,6940 N Michigan Rd,,Indianapolis,IN,46268-2800,Marion,720 Eskenazi Avenue,,Indianapolis,IN,46202,Marion,Lisa Smitha,Program Director,317-880-5115,,lisa.smitha@eskenazihealth.edu,,,,,,
IN-003986,Riley Hospital for Children,Indiana University Health,1144266024,Children's Hospitals (inpatient only),705 Riley Hospital Dr,,Indianapolis,IN,46202,Marion,340 West 10th Street,,Indianapolis,IN,46202,Marion,Frank Runion,Chief Financial Officer,317-948-4470,,frunion@iuhealth.org,Debra L Nystrom,Executive Director-Revenue and Reimbursement,317-963-1138,,dnystrom1@iuhealth.org,
IN-003987,Eskenazi Health Center Women's Center of Excellence,Health and Hospital Corporation of Marion County,1194077503,Federally Qualified Health Centers - Medical Services,720 Eskenazi Ave,Occ - 5th Floor,Indianapolis,IN,46202-5187,Marion,3838 N Rural St,,Indianapolis,IN,46205,Marion,Nancy A Buxser,COO,317-880-5101,,nancy.buxser@eskenazihealth.edu,,,,,,
IN-003988,Eskenazi Health (inpatient hospital),Eskenazi Health,1205906492,Inpatient Hospitals (other than children's hospitals),720 Eskenazi Ave,,Indianapolis,IN,46202-5189,Marion,720 Eskenazi Avenue,,Indianapolis,IN,46202,Marion,Lisa Smitha,Program Director,317-880-5115,,lisa.smitha@eskenazihealth.edu,,,,,,
IN-003989,Eskenazi Health (multiple outpatient ECP categories),Eskenazi Health,1205906492,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",720 Eskenazi Ave,,Indianapolis,IN,46202-5189,Marion,720 Eskenazi Avenue,,Indianapolis,IN,46202,Marion,Lisa Smitha,Program Director,317-880-5115,,lisa.smitha@eskenazihealth.edu,,,,,,
IN-003990,"SHALOM HEALTH CARE CENTER, INC.","SHALOM HEALTH CARE CENTER, INC.",1992924633,Federally Qualified Health Centers - Medical Services,7435 N Keystone Ave,Indiana Math and Science Academy North,Indianapolis,IN,46240-4367,Marion,3400 Lafayette Rd Ste 200,,Indianapolis,IN,46222-1147,Marion,Leonardo R Ortega,CEO,317-269-7199,,mcarlson@shalomhealthcenter.org,,,,,,https://www.shalomhealthcenter.org/home/school-based-clinics/
IN-003991,Jane Pauley Community Health Center at Hawthorne,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,8301 Rawles Ave,,Indianapolis,IN,46219-7730,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003992,Jane Pauley Community Health Center at Madison Avenue,Jane Pauley Community Health Center,1730488818,Federally Qualified Health Centers - Medical Services,8320 Madison Ave,,Indianapolis,IN,46227-6066,Marion,8931 E. 30th Street,,Indianapolis,IN,46219,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003993,"Indiana Hemophilia & Thrombosis Center, Inc.","Indiana Hemophilia & Thrombosis Center, Inc.",1659364800,Hemophilia Treatment Centers,8326 Naab Rd,,Indianapolis,IN,46260-1920,Marion,8326 Naab Road,,Indianapolis,IN,46260,Marion,Nancy Hoard,Executive Director,317-871-0011,258,nhoard@ihtc.org,Chris Roberson,"Director, Community Programs & Compliance",317-871-0011,243,croberson@ihtc.org,www.ihtc.org
IN-003994,Georgetown Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,8590 Georgetown Rd,,Indianapolis,IN,46268-1647,Marion,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl GAtzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-003995,Eastside Health Center,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,8902 E 38th St,,Indianapolis,IN,46226-6073,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003996,Jane Pauley Community Health Center at Post,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,8931 E 30th St,,Indianapolis,IN,46219-1501,Marion,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-003997,Southeast Health Center,"HEALTHNET, INC.",1780634964,"Dental Providers, Federally Qualified Health Centers - Medical Services",901 Shelby St,,Indianapolis,IN,46203-1151,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003998,Holy Family Shelter,"HEALTHNET, INC.",1780634964,Federally Qualified Health Centers - Medical Services,907 N Holmes Ave,,Indianapolis,IN,46222-3714,Marion,3403 E Raymond St,,Indianapolis,IN,46203-4744,Marion,Jimmy C Brown,CEO,317-957-2006,,jbrown54@iuhealth.org,,,,,,
IN-003999,Southside Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,935 E Hanna Ave,Suite A,Indianapolis,IN,46227-1396,Marion,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004000,Eastside Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,9385 E Washington St,,Indianapolis,IN,46229-3029,Marion,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004001,Eskenazi Health Center Grassy Creek,THE HEALTH & HOSPITAL CORP OF MARION COUNTY,1194077503,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",9443 E 38th St,,Indianapolis,IN,46235-2132,Marion,3838 N Rural St Fl 8,,Indianapolis,IN,46205-2930,Marion,Nancy A Buxser,COO,317-880-5101,,nancy.buxser@eskenazihealth.edu,Lisa Smitha,Dir. FP and Community Health Programs,317-880-5115,,,eskenazihealth.edu
IN-004002,Jane Pauley Community Health Center Dental Clinic,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Dental Providers,9651 E 21st St,,Indianapolis,IN,46229-1706,Marion,8931 E. 30th Street,,Indianapolis,IN,46219,Marion,Marc Hackett,Executive Director,317-355-9320,,mhackett@ecommunity.com,,,,,,
IN-004003,TRI-CAP Family Health Services Jasper Clinic,TRI-CAP Family Health Services,1295800084,Family Planning Providers,607 3rd Ave,Suite 2X,Jasper,IN,47546-3651,Dubois,607 3rd Ave.,,Jasper,IN,47547-0729,Dubois,Joyce Fleck,Executive Director,812-482-2233,101,joyce@tri-cap.net,Deborah Capps,Health Services Director,812-482-2233,130,deb@tri-cap.net,http://www.tri-cap.net/
IN-004004,LifeSpring Community Medical Services,LIFESPRING INC.,1982083564,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1036 Sharon Dr,,Jeffersonville,IN,47130-4522,Clark,460 Spring St,,Jeffersonville,IN,47130-3452,Clark,Beth Keeney,SR VP Community Health/ COO Primary Care,812-280-2080,1362,info@lifespringhealthsystems.org,,,,,,www.lifespringhealthsystems.org
IN-004005,HopeCare Clinic,New Hope Services,1699193904,Family Planning Providers,1302 Wall St,,Jeffersonville,IN,47130-3885,Clark,New Hope Services,,Jeffersonville,IN,47130,Clark,Jenny Ingle,Nurse Pracititoner,812-288-1223,353,Jenny_Ingle@newhopeservices.org,Elizabeth Boyd,Director of Family Services,812-288-4304,330,elizabeth_boyd@newhopeservices.org,http://hopecareclinic.org/
IN-004006,"Family Health Center of Clark County, Inc. DBA Family Health Centers of Southern Indiana",FAMILY HEALTH CENTER OF CLARK COUNTY INC,1528125341,"Dental Providers, Federally Qualified Health Centers - Medical Services",1319 Duncan Ave,,Jeffersonville,IN,47130-3759,Clark,1319 Duncan Ave,,Jeffersonville,IN,47130-3759,Clark,Lori G Harris,CEO,812-283-2371,,lharris@fhcenters.org,Lori Harris,CEO,812-283-2371,,lharris@fhcenters.org,
IN-004007,LifeSpring Health Systems,LifeSpring Inc.,1851489942,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",460 Spring St,,Jeffersonville,IN,47130-3452,Clark,460 Spring Street,,Jeffersonville,IN,47130,Clark,Beth Keeney,SR VP Community Health/ COO Primary Care,812-280-2080,1362,beth.keeney@lifespringhealthsystems.org,,,,,,www.lifespringhealthsystems.org
IN-004008,IMH Kentland Clinic,IROQUOIS MEMORIAL HOSPITAL,1467470906,Rural Health Clinics,303 N 7th,PO Box 86,Kentland,IN,47951-0086,Newton,200 Fairman Ave,,WATSEKA,IL,60970,Iroquois,Michelle Fox,Director Medical Staff & Clinical Informatic Services,815-432-7775,,mdfox@iroquoismemorial.com,Julie Giroux,Clinic Director,815-432-7778,,jagiroux@iroquoismemorial.com,
IN-004009,"Knox Winamac Community Health Centers, Inc.",Knox Winamac Community Health Centers,1629248919,Federally Qualified Health Centers - Medical Services,1002 S Edgewood Dr,,Knox,IN,46534-8226,Starke,1002 S. Edgewood Drive,,Knox,IN,46534,Starke,Kathy Robb,Executive Director,574-772-6030,24,k.robb@kwchc.net,Eileen Blanke,Chief Financial Officer,574-772-6030,27,e.blanke@kwchc.net,
IN-004010,HealthLinc Knox,"HEALTHLINC, INC.",1801063268,Federally Qualified Health Centers - Medical Services,104 E Culver Rd,Suite 106,Knox,IN,46534-2241,Starke,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E. Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004011,Primary Care Knox,IU Health LaPorte Physicians Network,1548277288,Rural Health Clinics,104 E Culver Rd,Suite 102,Knox,IN,46534-2241,Starke,1007 Lincolnway,Attn Paulette Means,La Porte,IN,46350,LaPorte,Crystal Eskew,Office Manager,574-772-7918,,c.eskew@lph.org,Thomas Browne,Medical Director,574-772-7918,,,
IN-004012,IHC Kokomo,"Indiana Health Centers, Inc.",1811007800,"Dental Providers, Federally Qualified Health Centers - Medical Services",3118 S Lafountain St,,Kokomo,IN,46902,Howard,8003 Castleway Drive,,Indianapolis,IN,46250-1946,Marion,Tracy Nagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004013,Riggs Community Health Center Annex,"RIGGS COMMUNITY HEALTH CENTER, INC.",1386660900,Dental Providers,1324 Tippecanoe St,,Lafayette,IN,47904-2051,Tippecanoe,1716 Hartford St,,Lafayette,IN,47904-2173,Tippecanoe,Bambi McQuade-Jones,CEO,765-742-1567,,BmcQuade@riggshealth.com,Steven M. Leszczynski,CFO,765-492-2772,,stevenl@riggshealth.com,
IN-004014,RIGGS COMMUNITY HEALTH CENTER,"RIGGS COMMUNITY HEALTH CENTER, INC.",1386660900,"Dental Providers, Federally Qualified Health Centers - Medical Services",1716 Hartford St,,Lafayette,IN,47904-2173,Tippecanoe,1716 Hartford St,,Lafayette,IN,47904-2173,Tippecanoe,Bambi McQuade-Jones,CEO,765-742-1567,,BmcQuade@riggshealth.com,Steven M. Leszczynski,CFO,765-492-2772,,stevenl@riggshealth.com,
IN-004015,Riggs Community Health Center South Street,"RIGGS COMMUNITY HEALTH CENTER, INC.",1386660900,Federally Qualified Health Centers - Medical Services,2316 South St,,Lafayette,IN,47904-2971,Tippecanoe,1716 Hartford St,,Lafayette,IN,47904-2173,Tippecanoe,Bambi McQuade-Jones,CEO,765-742-1567,,BmcQuade@riggshealth.com,Steven M. Leszczynski,CFO,765-492-2772,,stevenl@riggshealth.com,
IN-004016,Lafayette Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,964 Mezzanine Dr,,Lafayette,IN,47905-8631,Tippecanoe,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004017,"Redi-Care, Inc, PC","Redi-Care, Inc, PC",1790896611,Rural Health Clinics,2120 N Detroit St,,Lagrange,IN,46761-1147,Lagrange,2120 N Detroit St,,LaGrange,IN,46761-1147,Lagrange,Maria Brashear,Office Manager,260-463-2468,29,maria@redicare.co,Geraldine Hershberger,Administrative Assistant,260-463-2468,32,geri@redicare.co,
IN-004018,NorthShore Lake Station Health Center,"NORTHSHORE HEALTH CENTERS, INC",1861636664,Federally Qualified Health Centers - Medical Services,2490 Central Ave,,Lake Station,IN,46405-2122,Lake,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004019,NorthShore Dr. Fernando Rivera Dental Center,"NORTHSHORE HEALTH CENTERS, INC",1356530505,Dental Providers,3099 Central Ave,,Lake Station,IN,46405-2207,Lake,PO BOX 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004020,"NORTHSHORE HEALTH CENTERS, INC","NORTHSHORE HEALTH CENTERS, INC",1972895647,Other ECP Providers,3304 Parkside Ave,NorthShore Edison Senior High School,Lake Station,IN,46405-1143,Lake,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368-5110,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,http://www.northshorehealth.org/lake-station-edison-high-school/
IN-004021,Premier Healthcare Ridge Medical Center,Premier Healthcare LLC,1548580764,Rural Health Clinics,1043 N 1000 W,,Linton,IN,47441-5281,Greene,550 S Landmark Ave,,Bloomington,IN,47403,Monroe,Amanda Helms,Financial Analyst,812-355-6938,2076,ahelms@premierhealthcare.org,Casey Simmons,Office Assistant,812-847-4481,,csimmons@premierhealthcare.org,
IN-004022,Cass County Community Health Center,"Indiana Health Centers, Inc.",1669582664,Federally Qualified Health Centers - Medical Services,1700 Dividend Dr,,Logansport,IN,46947-1572,Cass,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Tracy Nagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004023,King's Daughters' Health,King's Daughters' Health,1518916048,Inpatient Hospitals (other than children's hospitals),1373 E SR 62,,Madison,IN,47250-7328,Jefferson,P.O. Box 159,,Madison,IN,47250,Jefferson,Anita Joy Yager,"Director, Patient Financial Services",812-801-0535,,yagerj@kdhmadison.org,Paula K. Lee,Insurance Enrollment,812-801-0715,,leep@kdhmadison.org,
IN-004024,Open Door Family Planning Clinic,"OPEN DOOR HEALTH SERVICES, INC.",1376865733,Family Planning Providers,319 E 2nd St,,Marion,IN,46952-3871,Grant,333 S. Madison St.,,Muncie,IN,47305-2465,Delaware,Bryan Ayars,Chief Executive Officer,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants and Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,http://www.opendoorhs.org/
IN-012445,Center for Vein Restoration,Center for Vein Restoration,1629437397,Other ECP Providers,330 N Wabash Ave,Suite 340,Marion,IN,46952-2678,Grant,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
IN-004025,IHC Marion,"Indiana Health Centers, Inc.",1619087624,Federally Qualified Health Centers - Medical Services,925 S Nebraska St,,Marion,IN,46953-1874,Grant,8003 Castleway Drive,,Indianapolis,IN,46250-1946,Marion,Tracy Nagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004026,"Northshore Health Centers, Inc","NORTHSHORE HEALTH CENTERS, INC",1598196933,Other ECP Providers,276 E 68th Pl,NorthShore Merrillville High School Clinic,Merrillville,IN,46410-3566,Lake,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004027,"NorthShore Health Center, Inc, Merrillville Health Center","NORTHSHORE HEALTH CENTERS, INC",1477810315,"Dental Providers, Federally Qualified Health Centers - Medical Services",6091 Broadway,,Merrillville,IN,46410-2619,Lake,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004028,Community HealthNet Merrillville,COMMUNITY HEALTHNET,1952660243,Federally Qualified Health Centers - Medical Services,6100 Broadway,,Merrillville,IN,46410-3002,Lake,1021 W 5th Ave,,Gary,IN,46402-1703,Lake,"Janet Seabrook, MD",Executive Director,219-880-1190,,jseabrook@garychc.org,Bonita Brown,Billing/Credentialing,219-979-2721,,bbrown@garychc.org,
IN-004029,Merrillville Health Center,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,8645 Connecticut St,,Merrillville,IN,46410-6222,Lake,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004030,Michigan City Center - Planned Parenthood,Planned Parenthood of IN & KY,1891743092,Family Planning Providers,2424 Franklin St,Suite 100,Michigan City,IN,46360-4562,LaPorte,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004031,HealthLinc - Michigan City,"HEALTHLINC, INC.",1013105568,"Dental Providers, Federally Qualified Health Centers - Medical Services",710 Franklin St,Suite 200,Michigan City,IN,46360-3564,LaPorte,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004032,Mishawaka Health Center - Planned Parenthood,"Planned Parenthood of Indiana and Kentucky, Inc.",1891743092,Family Planning Providers,3005 Grape Rd,Suite B,Mishawaka,IN,46545-2709,St. Joseph,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004033,HealthLinc - Mishawaka,"HEALTHLINC, INC.",1417244989,Federally Qualified Health Centers - Medical Services,420 W 4th St,,Mishawaka,IN,46544-1948,St. Joseph,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E. Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004034,Family Health Clinic of Monon,Purdue University North Central Nursing Clinics,1871794826,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",420 N Market St,,Monon,IN,47959-9799,White,901 Prince William Road,,Delphi,IN,46923,Carroll,Jim Layman,Executive Director,765-564-3016,,laymand@purdue.edu,Barb Hickner,Outreach and Enrollment Coordinator,765-329-2232,,hickner@purdue.edu,
IN-004035,MONTICELLO MEDICAL CENTER,"Franciscan Alliance, Inc. DBA Monticello Medical Center",1508153206,Rural Health Clinics,826 N 6th St,,Monticello,IN,47960-1752,White,1515 W Dragoon Trail,,Mishawaka,IN,46544,St. Joseph,John M. McGinley,Operations Manager,574-583-1935,,john.mcginley@franciscanalliance.org,Virginia Sue Wilson,Office Supervisor,574-583-1924,,sue.wilson2@franciscanalliance.org,
IN-004036,MeridianMD,Meridian Health Services,1770808362,Federally Qualified Health Centers - Medical Services,100 N Tillotson Ave,,Muncie,IN,47304-3987,Delaware,240 N. Tillotson,,Muncie,IN,47304,Delaware,Amelia Clark,VP Community Health,765-288-1928,,amelia.clark@meridianhs.org,,,,,,
IN-004037,"OPEN DOOR HEALTH SERVICES, INC.","OPEN DOOR HEALTH SERVICES, INC.",1902851082,"Dental Providers, Federally Qualified Health Centers - Medical Services",333 S Madison St,,Muncie,IN,47305-2465,Delaware,333 S Madison St,,Muncie,IN,47305-2465,Delaware,Bryan Ayars,Chief Executive Officer,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants & Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,www.opendoorhs.org
IN-004038,Southway Urgent Care,"OPEN DOOR HEALTH SERVICES, INC.",1770510240,Federally Qualified Health Centers - Medical Services,3807 S Madison St,,Muncie,IN,47302-5758,Delaware,333 S Madison St,,Muncie,IN,47305-2465,Delaware,Bryan Ayars,Chief Executive Officer,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants & Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,www.opendoorhs.org
IN-004039,Open Door Family Planning Clinic,"OPEN DOOR HEALTH SERVICES, INC.",1912080060,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",905 S Walnut St,,Muncie,IN,47302-2333,Delaware,333 S Madison St,,Muncie,IN,47305-2465,Delaware,Bryan Ayars,Chief Executive Officer,765-747-2971,,bayars@opendoorhs.org,Lori Mathis,Grants & Communications Manager,765-287-3001,,lsmathis@opendoorhs.org,http://www.opendoorhs.org/
IN-004040,Family Health Centers of Southern Indiana Floyd County,FAMILY HEALTH CENTER OF CLARK COUNTY INC,1528125341,Federally Qualified Health Centers - Medical Services,1000 E Spring St,,New Albany,IN,47150-2943,Floyd,1319 Duncan Ave,,Jeffersonville,IN,47130-3759,Clark,Lori G Harris,CEO,812-283-2371,,lharris@fhcenters.org,Lori G. Harris,CEO,812-283-2371,,lharris@fhcenters.org,
IN-004041,New Albany Health Center - Planned Parenthood,Planned Parenthood of IN & KY,1891743092,Family Planning Providers,2708 Paoli Pike,Suite J,New Albany,IN,47150-5100,Floyd,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004042,New Castle Family and Internal Medicine,Henry County Memorial Hospital,1518044692,Rural Health Clinics,2200 Forest Ridge Pkwy,Suite 310,New Castle,IN,47362-2943,Henry,PO Box 485,,New Castle,IN,47362-0485,Henry,Carissa Fuller,Credentialing Coordinator,765-599-3534,,cfuller@hcmhcares.org,,,,,,
IN-004043,Community Health Center of Miami County,"Indiana Health Centers, Inc.",1336373190,Federally Qualified Health Centers - Medical Services,661 E Main St,,Peru,IN,46970-2662,Miami,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,TracyNagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004044,DEACONESS CLINIC INC,"Deaconess Clinic, Inc.",1831345792,Rural Health Clinics,106 W Pike Ave,,Petersburg,IN,47567-8750,Pike,600 Mary Street,,Evansville,IN,47747-0001,Vanderburgh,Brenda Mattingly,Credentialing Specialist,812-450-6879,,brenda.mattingly@deaconess.com,Janet Frederick,Practice Manager,812-354-1052,,janet.frederick@deaconess.com,
IN-004045,TRI-CAP Family Health Services Petersburg Clinic,TRI-CAP Family Health Services,1295800084,Family Planning Providers,809 E Illinois St,,Petersburg,IN,47567-8026,Pike,607 Third Avenue,,Jasper,IN,47547-0729,Dubois,Joyce Fleck,Executive Director,812-482-2233,101,joyce@tri-cap.net,Deborah Capps,Health Services Director,812-482-2233,130,deb@tri-cap.net,http://www.tri-cap.net/
IN-004046,Scottsdale Health Center,"NORTHSHORE HEALTH CENTERS, INC",1407061336,Federally Qualified Health Centers - Medical Services,3564 Scottsdale St,,Portage,IN,46368-5420,Porter,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004047,Stacy McKay Health & Education Center,"NORTHSHORE HEALTH CENTERS, INC",1467490300,"Dental Providers, Federally Qualified Health Centers - Medical Services",6450 US Highway 6,,Portage,IN,46368-5110,Porter,PO Box 1430,3207 Willowcreek Rd.,Portage,IN,46368,Porter,Janice Wilson,CEO,219-764-6052,,jwilson@northshorehealth.org,,,,,,
IN-004048,Reid Health,Reid Health,1063457380,Inpatient Hospitals (other than children's hospitals),1100 Reid Pkwy,,Richmond,IN,47374-1157,Wayne,1100 Reid Parkway,Medical Staff Office,Richmond,IN,47374,Wayne,Misty Nash,CPCS,765-983-3127,,misty.nash@reidhealth.org,Christopher Knight,CFO,765-983-3127,,Christopher.Knight@Reidhealth.org,
IN-004049,Wayne County Community Health Center,Wayne County Health Department,1366518102,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",203 E Main St,,Richmond,IN,47374-4208,Wayne,203 East Main Street,,Richmond,IN,47374,Wayne,"Kimberly Flanigan, RN, BSN",Chief Operating Officer / Supervisor of Clinic Operations,765-973-9243,,kflanigan@co.wayne.in.us,Carol Stoker,Clinic Office Manager,765-973-9200,1748,cstoker@co.wayne.in.us,
IN-004050,Meridian Health Services Richmond,MERIDIAN SERVICES CORP,1467854661,Federally Qualified Health Centers - Medical Services,2300 Chester Blvd,,Richmond,IN,47374-1221,Wayne,240 N Tillotson Ave,,Muncie,IN,47304-3988,Delaware,Amelia Clark,VP of Community Health,765-254-5137,,amelia.clark@meridianhs.org,Scott Riggs,Director of Finance,765-254-5189,,scott.riggs@meridianhs.org,
IN-004051,Scott Memorial Hospital,LifePoint Health,1013251594,Inpatient Hospitals (other than children's hospitals),1451 N Gardner St,,Scottsburg,IN,47170-7751,Scott,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Angie Doan,CFO,812-752-8500,,,
IN-004052,Scottsburg Family Practice,"RHN Scott Physician Practices, LLC",1780004788,Rural Health Clinics,1465 N Gardner St,,Scottsburg,IN,47170-7751,Scott,PO Box 1025,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
IN-004053,Community Health Center of Jackson County,"Indiana Health Centers, Inc.",1134227689,"Dental Providers, Family Planning Providers",113 N Chestnut St,,Seymour,IN,47274-2176,Jackson,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Tracy Nagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004054,CHCJC Annex,"Indiana Health Centers, Inc.",1124434469,Federally Qualified Health Centers - Medical Services,120 Saint Louis Ave,,Seymour,IN,47274-2304,Jackson,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Tracy Nagel,CFO,317-576-1335,4128,tnagel@ihcinc.org,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,
IN-004055,Seymour Planned Parenthood,Planned Parenthood of IN & KY,1891743092,Family Planning Providers,357 Tanger Blvd,Suite 302,Seymour,IN,47274-1800,Jackson,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
IN-004056,Jane Pauley Community Health Center at Shelbyville,"JANE PAULEY COMMUNITY HEALTH CENTER, INC.",1730488818,Federally Qualified Health Centers - Medical Services,1200 W McKay Rd,,Shelbyville,IN,46176-3292,Shelby,8931 E 30th St Ste 100,,Indianapolis,IN,46219-1501,Marion,Marc Hackett,Executive Director,317-355-8696,,mhackett@ecommunity.com,,,,,,
IN-004057,HealthLinc - South Bend Dental,"HealthLinc, Inc.",1679954804,Dental Providers,1002 S Esther St,,South Bend,IN,46615-1440,St. Joseph,951 Transport Drive,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E Bondi,CEO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004058,IHC Bendix Community Health Center,"Indiana Health Centers, Inc.",1780065672,Federally Qualified Health Centers - Medical Services,1010 N Bendix Dr,,South Bend,IN,46628-1925,St. Joseph,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,Tracy Nagel,Chief Financial Officer,317-576-1335,4128,tnagel@ihcinc.org,
IN-004059,IHC South Bend,"Indiana Health Centers, Inc.",1174626014,"Dental Providers, Federally Qualified Health Centers - Medical Services",1900 W Western Ave # B,,South Bend,IN,46619-3521,St. Joseph,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,Tracy Nagel,Chief Financial Officer,317-576-1335,4128,tnagel@ihcinc.org,
IN-004060,Olive Street Health Center,Northern Indiana MCH Network,1528151602,Family Planning Providers,244 S Olive St,Suite E,South Bend,IN,46619-2107,St. Joseph,244 S. Olive Street,Suite E,South Bend,IN,466192107,St. Joseph,Melinda Konrath,Executive Director,574-282-3230,109,mkonrath@nimchn.com,,,,,,
IN-004061,IHC Project Homecoming,"Indiana Health Centers, Inc.",1306957311,Federally Qualified Health Centers - Medical Services,701 S Main St,Suite B,South Bend,IN,46601-3001,St. Joseph,8003 Castleway Drive,,Indianapolis,IN,46250,Marion,Elvin Plank,President/CEO,317-576-1335,4124,eplank@ihcinc.org,Tracy Nagel,Chief Financial Officer,317-576-1335,4128,tnagel@ihcinc.org,
IN-004062,HealthLinc - South Bend Medical,"HealthLinc, Inc.",1790158244,Federally Qualified Health Centers - Medical Services,941 S 20th St,,South Bend,IN,46615-1607,St. Joseph,951 Transport Drive,,Valparaiso,IN,46383-8434,Porter,Beth A. Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004063,JOHNSON NICHOLS HEALTH CLINIC INC-Spencer Integrated Health,JOHNSON NICHOLS HEALTH CLINIC INC,1174571681,Family Planning Providers,35 Bob Babbs Dr,,Spencer,IN,47460-6828,Owen,35 Bob Babbs Dr,,Spencer,IN,47460-1133,Owen,Stephanie LaFontaine,Executive Director,765-653-6171,,stephanie.lafontaine@centerstone.org,Misty Hall,Accounts Receivable Coordinator,812-829-0303,3779,misty.hall@centerstone.org,http://www.centerstone.org/indiana-facilities
IN-004064,Family Practice Associates of Sullivan County,"MSO Clinics, INC",1811317977,Rural Health Clinics,2229 Mary Sherman Dr,,Sullivan,IN,47882-7633,Sullivan,PO BOx 230,,Sullivan,IN,47882-0230,Sullivan,Sam Roberts,Practice Manager,812-268-3318,2606,sam.roberts@schosp.com,,,,,,
IN-004065,Wabash Valley Health Center Inc.,"WABASH VALLEY HEALTH CENTER, INC.",1376974527,"Dental Providers, Federally Qualified Health Centers - Medical Services",1436 Locust St,,Terre Haute,IN,47807-1648,Vigo,1436 Locust St,,Terre Haute,IN,47807-1648,Vigo,Brooke N Lockhart,COO,812-232-7447,,blockhart@wvhealthcenter.org,Davy R Montgomery,Revenue Cycle Director,812-232-7447,119,dmontgomery@wvhealthcenter.org,http://www.wabashvalleyhealthcenter.org
IN-004066,Valley Professionals Community Health Center - Terre Haute Clinic,"Valley Professionals Community Health Center, Inc.",1952795957,Federally Qualified Health Centers - Medical Services,1530 N 7th St,Suite 201,Terre Haute,IN,47807-1061,Vigo,1530 N 7TH ST SUITE 201,,Terre Haute,IN,47807,Vigo,Terry Warren,CEO,765-832-3843,,twarren@vpchc.org,,,,,,
IN-004067,"Union Hospital, Inc.",Union Hospital Terre Haute,1619975331,Rural Health Clinics,1606 N 7th St,,Terre Haute,IN,47804-2706,Vigo,1606 N. 7th Street,,Terre Haute,IN,47804-2706,Vigo,Lori A. Moon,Corporate Compliance Officer,812-238-7533,7533,LMoon@uhhg.org,John Royer,Managed Care,812-238-7000,7352,mcjer@uhhg.org,
IN-004068,Pace Health Connection - Terre Haute,PACE Health Connection,1962575423,Family Planning Providers,501 E Hospital Ln,Suite No. 101,Terre Haute,IN,47802-4230,Vigo,501 E Hospital Ln,,Terre Haute,IN,47802-4230,Vigo,Michelle Pitcher,Clinical Services Manager,812-882-7927,1224,mpitcher@pacecaa.org,Rebecca Skiver,Health Connection Supervisor,812-234-0707,,rskiver@pacecaa.org,http://www.pacecaa.org/home/
IN-004069,"John A. Egli, MD",John A. Egli MD PC,1841374618,Rural Health Clinics,315 Lehman Ave,,Topeka,IN,46571-9476,Lagrange,PO Box 698,,Topeka,IN,465710698,Lagrange,GAIL BOYER,Office Manager,260-593-2902,,egli208@embarqmail.com,,,,,,
IN-004070,HealthLinc - Valparaiso,"HEALTHLINC, INC.",1528262581,"Dental Providers, Federally Qualified Health Centers - Medical Services",1001 Sturdy Rd,,Valparaiso,IN,46383-4126,Porter,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004071,HealthLinc - Valparaiso/Porter-Starke Services,"HEALTHLINC, INC.",1023288032,Federally Qualified Health Centers - Medical Services,701 Wall St,,Valparaiso,IN,46383-2514,Porter,951 Transport Dr,,Valparaiso,IN,46383-8434,Porter,Beth A Wrobel,CEO,219-465-9500,,bwrobel@healthlincchc.org,Joan E Bondi,CFO,219-465-9514,,jbondi@healthlincchc.org,healthlincchc.org
IN-004072,PACE Health Connection- Vincennes,PACE Health Connection,1962575423,Family Planning Providers,525 N 4th St,,Vincennes,IN,47591-1444,Knox,525 N. 4th Street,,Vincennes,IN,47591,Knox,Michelle Pitcher,Clinicial Services Manager,812-882-7927,1224,mpitcher@pacecaa.org,Rebecca Skiver,Health Connection Supervisor,812-234-0707,,rskiver@pacecaa.org,http://www.pacecaa.org/home
IN-004073,Warsaw Family Health Center,Northern Indiana MCH Network,1528151602,Family Planning Providers,2307 E Center St,Suite A,Warsaw,IN,46580-3907,Kosciusko,244 S. Olive Street,Suite E,South Bend,IN,466192107,St. Joseph,Melinda Konrath,Executive Director,574-282-3230,109,mkonrath@nimchn.com,,,,,,
IN-004074,Daviess Community Hospital,Daviess County Hospital,1861465999,Rural Health Clinics,1314 E Walnut St,,Washington,IN,47501-2860,Daviess,1314 E Walnut Street,,Washington,IN,47501,Daviess,Catherine E Keck,Chief Financial Officer,812-254-2760,1103,ckeck@dchosp.org,Candis Posey,Director of Revenue Cycle,812-254-2760,1011,cposey@dchosp.org,dchosp.org
IN-004075,PACE Health Connection - Washington,PACE Health Connection,1962575423,Family Planning Providers,2 NE 21st St,,Washington,IN,47501-3134,Daviess,2 NE 21st St,,Washington,IN,47501-3134,Daviess,Michelle Pitcher,Clinical Services Manager,812-882-7927,1224,mpitcher@pacecaa.org,Rebecca Skiver,Health Connection Supervisor,812-234-0707,,rskiver@pacecaa.org,http://www.pacecaa.org/home/
IN-004076,PMH MEDICAL AND SURGICAL GROUP,Pulaski Memorial Hospital,1740403419,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Rural Health Clinics",540 Hospital Dr,,Winamac,IN,46996-1173,Pulaski,PO Box 279,,Winamac,IN,46996,Pulaski,Tashia Lindvall,Revenue Cycle Manager,574-946-2125,7,tlindvall@pmhnet.com,,,,,,
IN-004077,Pulaski Memorial Hospital,Pulaski Memorial Hospital,1306928213,Inpatient Hospitals (other than children's hospitals),616 E 13th St,,Winamac,IN,46996-1117,Pulaski,PO Box 279,,Winamac,IN,46996,Pulaski,Tashia Lindvall,Revenue Cycle Manager,574-946-2125,7,tlindvall@pmhnet.com,,,,,,
IN-004078,Kenneth D Watkins MD,Kenneth D Watkins MD,1972704013,Rural Health Clinics,108 E Hospital Dr,,Winchester,IN,47394-2223,Randolph,108 Hospital Drive,,Winchester,IN,47394-2223,Randolph,Kenneth Dale Watkins,MD Owner,765-584-1639,,kenoffice@watkins.comcastbiz.net,Watkins,,,,kenoffice@watkins.comcastbiz.net,
KS-004079,Memorial Hospital,MEMORIAL HOSPITAL,1992759633,Inpatient Hospitals (other than children's hospitals),511 NE 10th St,,Abilene,KS,67410-2153,Dickinson,511 NE 10TH ST,,Abilene,KS,67410,Dickinson,ELGIN GLANZER,CFO,785-263-6614,,EGLANZER@MHSKS.ORG,PAULA PEDERSEN,PFS Director,785-263-6644,,PPEDERSEN@MHSKS.ORG,
KS-004080,ARK CITY CLINIC PA,"Ark City Clinic, P.A.",1164464525,Rural Health Clinics,510 W Radio Ln,,Arkansas City,KS,67005-4098,Cowley,510 W. RADIO LANE,,ARKANSAS CITY,KS,67005,Cowley,Diann Bonifield,Administrator,620-442-2100,110,dbonifield@arkcityclinic.com,Tammy Vanderpool,Office Manager,620-442-2100,107,tvanderpool@arkcityclinic.com,arkcityclinic.com
KS-004081,Girard Medical Center of Arma,Girard Medical Center,1649597147,Other ECP Providers,417 E. Washington,PO Box 417,Arma,KS,66712-0417,Crawford,302 N Hospital Dr.,,Girard,KS,66743,Crawford,Ruth Duling,Director of Patient Financial Services,620-724-5152,,rduling@girardmedicalcenter.com,Michele L Hart,Director of Community Services,620-724-5117,,mhart@girardmedicalcenter.com,
KS-004082,Clark County Health Department,Clark County Health Department,1053336040,Other ECP Providers,913 N Highland St,,Ashland,KS,67831,Clark,913 N Highland St,,Ashland,KS,67831,Clark,Mary Ann Cunningham,RN Administrator,620-635-2624,,shotsrus@ucom.net,,,,,,
KS-004083,Atchison Community Health Clinic,Atchison Community Health Clinic,1407108335,"Dental Providers, Federally Qualified Health Centers - Medical Services",1412 N 2nd St,,Atchison,KS,66002-1203,Atchison,Po Box 27,,Atchison,KS,66002,Atchison,Kathleen Butler,Executive Director,913-367-4879,,director@achc-ks.org,,,,,,
KS-004084,Rawlins County Dental Clinic,Rawlins County Dental Clinic,1740423003,Dental Providers,515 State St,,Atwood,KS,67730-1930,Rawlins,PO Box 177,,Atwood,KS,67730,Rawlins,Debra Pochop,CEO,785-626-8290,,ceo@rcdentalclinic.com,Lisa Olson,Business Office Manager,785-626-8290,,lisa@rcdentalclinic.com,www.rcdentalclinic.com
KS-004085,Rawlins Clinic/Atwood RHC,Rawlins County Health Center,1144267881,Rural Health Clinics,707 Grant St,,Atwood,KS,67730-1598,Rawlins,707 Grant St,,Atwood,KS,67730,Rawlins,Heather Prideaux,CFO,785-626-3211,204,hprideaux@rchc.us,Destiny Schroeder,IS Director,785-626-3211,351,dschroeder@rchc.us,
KS-004086,Augusta Family Practice,"Augusta Family Practice, PA",1508060864,Rural Health Clinics,1306 State St,,Augusta,KS,67010-1126,Butler,1306 State Street,,Augusta,KS,67010,Butler,Connie Rausch,Administrative Assistant,316-775-9191,4,connie@augustafamilypractice.net,Lynette Scheid,CEO,316-775-9191,4,lynette@rauschclinics.com,
KS-004087,Community Health Center of Southeast Kansas/Baxter Springs,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1932414224,"Dental Providers, Federally Qualified Health Centers - Medical Services",2990 Military Ave,,Baxter Springs,KS,66713-2331,Cherokee,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004088,REPUBLIC COUNTY HOSPITAL,REPUBLIC COUNTY HOSPITAL,1396765145,Inpatient Hospitals (other than children's hospitals),2420 G St,,Belleville,KS,66935-2400,Republic,2420 G Street,,Belleville,KS,66935,Republic,Barry Bottger,CFO,785-527-2254,,bbottger@rphospital.org,Blaine K. Miller,CEO,785-527-2254,,bkmiller@rphospital.org,
KS-004089,Minneola District Hospital,Minneola District Hospital,1013009828,Inpatient Hospitals (other than children's hospitals),212 Main St,,Bloom,KS,67865-8511,Ford,212 S. Main,,Minneola,KS,67865,Clark,Marion Zirger,CFO,620-885-4264,1108,marionz@minneolahealthcare.com,,,,,,
KS-004090,COFFEY COUNTY HOSPITAL,COFFEY COUNTY HOSPITAL,1376548370,Inpatient Hospitals (other than children's hospitals),801 N 4th St,,Burlington,KS,66839-2602,Coffey,801 N 4th Street,,Burlington,KS,66839,Coffey,Leonard Hernandez,CEO,620-364-2121,4140,lhernandez@coffeyhealth.org,Terri Tweedy,Executive Assistant,620-364-2121,4222,ttweedy@coffeyhealth.org,
KS-004091,SUMNER COUNTY HOSPITAL DISTRICT #1,SUMNER COUNTY HOSPITAL DISTRICT #1,1215094438,Other ECP Providers,601 S Osage St,,Caldwell,KS,67022-1698,Sumner,601 S Osage,,Caldwell,KS,67022,Sumner,Tom Henton,CEO,620-845-6492,,tomh@schd1.com,,,,,,
KS-004092,GIRARD MEDICAL CENTER OF CHEROKEE,Girard Medical Center,1912935552,Rural Health Clinics,120 NW Highway 400,,Cherokee,KS,66724,Crawford,302 N Hospital Dr.,,Girard,KS,66743,Crawford,Ruth Duling,Director of Patient Financial Services,620-724-5152,,rduling@girardmedicalcenter.com,Michele L Hart,Director of Community Services,620-724-5117,,mhart@girardmedicalcenter.com,
KS-004093,Labette Health Cherryvale Clinic,Labette County Medical Center,1154787190,Rural Health Clinics,116 N Maple St,,Cherryvale,KS,67335-1729,Montgomery,1902 S Hwy 59 Bldg E,,Parsons,KS,67357,Labette,Missy Beasley,CLINIC MANAGER,620-820-5889,,mbeasley@labettehealth.com,Doug Stacy,CIO,620-820-5398,,dstacy@labettehealth.com,
KS-004094,Cherryvale Family Medicine,Wilson County Hospital,1598121790,Rural Health Clinics,203 W Main St,,Cherryvale,KS,67335-1332,Montgomery,P.O. 403,,Cherryvale,KS,67335,Montgomery,Sharon Shoop,CLINIC MANAGER,620-336-2131,,sshoop@wmcrc.org,John Gutschenritter,CFO,620-325-8388,,johng@wmcrc.org,
KS-004096,Clay Center Family Physicians,CLAY COUNTY MEDICAL CENTER,1396108213,Rural Health Clinics,609 Liberty St,,Clay Center,KS,67432-1564,Clay,609 Liberty St.,,Clay Center,KS,67432,Clay,Lance Haller,CLINIC MANAGER,785-632-2181,284,LHaller@ccmcks.org,Jim Brinkman,Controller,785-632-2144,466,jbrinkman@ccmcks.org,
KS-004097,Clay County Medical Center,CLAY COUNTY MEDICAL CENTER,1265485817,Inpatient Hospitals (other than children's hospitals),617 Liberty St,,Clay Center,KS,67432-1564,Clay,617 Liberty St,,Clay Center,KS,67432,Clay,Jim Brinkman,Controller,785-632-2144,466,jbrinkman@ccmcks.org,,,,,,www.ccmcks.org
KS-004098,Clay County Health Department,Clay County Health Department,1164429148,"Family Planning Providers, Sexually Transmitted Disease Clinics",820 Spellman Cir,Suite A,Clay Center,KS,67432-7492,Clay,820 Spellman Cir,Suite A,Clay Center,KS,67432,Clay,Dana Rickley,County Health Administrator,785-632-3193,104,drickley@claycountykansas.org,"Nancy Winter, RN",Women's Health Coordinator,785-632-3193,106,nwinter@claycountykansas.org,
KS-004099,Clyde Family Physicians,CLAY COUNTY MEDICAL CENTER,1801259783,Rural Health Clinics,815 Campbell Ave,,Clyde,KS,66938-9428,Cloud,Clay County Medical Center,,Clay Center,KS,67432,Clay,Lance Haller,CLINIC MANAGER,785-632-2181,284,LHaller@ccmcks.org,Jim Brinkman,Controller,785-632-2144,466,jbrinkman@ccmcks.org,
KS-004100,Community Health Center of Southeast Kansas/CES,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1487939773,Federally Qualified Health Centers - Medical Services,102 Cline Rd,,Coffeyville,KS,67337-3022,Montgomery,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,,www.chcsek.org
KS-004101,Community Health Center of Southeast Kansas- Field Kindley Clinic,Community Health Center of Southeast Kansas,1063844629,Federally Qualified Health Centers - Medical Services,1110 W 8th St,,Coffeyville,KS,67337-4116,Montgomery,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004102,Coffeyville Regional Medical Center,Coffeyville Regional Medical Center,1285600379,Inpatient Hospitals (other than children's hospitals),1400 W 4th St,,Coffeyville,KS,67337-3306,Montgomery,1400 W. 4th Street,,Coffeyville,KS,67337,Montgomery,Jessica McMahan,Director Patient Financial Services,620-252-1530,1530,jessicam@crmcinc.org,Dean Ohmart,CFO,620-252-1536,1536,DOhmart@crmcinc.org,
KS-004103,CRMC Medical Group,Coffeyville Regional Medical Center,1407147903,Rural Health Clinics,1400 W 4th St,,Coffeyville,KS,67337-3306,Montgomery,1400 W. 4th Street,,Coffeyville,KS,67337,Montgomery,Jessica McMahan,Director Patient Financial Services,620-252-1530,1530,jessicam@crmcinc.org,Becky McCune,Senior Director of Practice Management and New Business Development,620-688-6566,1610,beckym@crmcinc.org,
KS-004104,Community Health Center of Southeast Kansas/Coffeyville,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1649557281,"Dental Providers, Federally Qualified Health Centers - Medical Services",801 W 8th St,,Coffeyville,KS,67337-4109,Montgomery,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004105,"Citizens Medical Center, Inc","Citizens Medical Center, Inc",1386678431,Inpatient Hospitals (other than children's hospitals),100 E College Dr,,Colby,KS,67701-3702,Thomas,100 E College Dr,,Colby,KS,67701,Thomas,Heather Dixon,Medical Staff Services Coordinator,785-460-1713,,hdixon@cmciks.com,Scott Focke,Clinic Administrator,785-460-1745,,sfocke@cmciks.com,
KS-004106,FAMILY CENTER FOR HEALTH CARE,Citizens Medical Center dba Family Center for Health Care,1053406330,Rural Health Clinics,310 E College Dr,,Colby,KS,67701-3716,Thomas,310 E College Dr,,Colby,KS,67701,Thomas,Heather Dixon,Medical Staff Services Coordinator,785-460-1713,713,hdixon@cmciks.com,Scott Focke,Clinic Administrator,785-460-1745,,sfocke@cmciks.com,
KS-004107,Comanche County Hospital,Comanche County Hospital,1003845652,Inpatient Hospitals (other than children's hospitals),202 S Frisco St,,Coldwater,KS,67029-9101,Comanche,202 S. Frisco,,Coldwater,KS,67029,Comanche,Nancy Zimmerman,Administrator,620-582-2144,,nzimmerman@comanchech.com,Lisa Brooks,CFO,620-582-2144,,lbrooks@comanchech.com,
KS-004108,"Saint Lukes Hospital of Garnett, Inc. d/b/a Family Care Center South",Saint Luke's Health System,1487075586,Rural Health Clinics,309 N Pine St,,Colony,KS,66015-7279,Anderson,901 E 104th Street,,Kansas City,MO,64131,Jackson,Tina A Capeder,"Program Manager, Quality and Risk",785-204-4010,,tcapeder@saint-lukes.org,Vicki Mills,Chief Financial Officer,785-204-4043,,vmills@saint-lukes.org,
KS-004109,Community Health Center of Southeast Kansas/Columbus Clinic,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1972794402,Federally Qualified Health Centers - Medical Services,120 W Pine St,,Columbus,KS,66725-1705,Cherokee,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004110,CUNNINGHAM CLINIC,NINNESCAH VALLEY HEALTH SYSTEMS INC,1437542073,Rural Health Clinics,112 N Main St,,Cunningham,KS,67035-8802,Kingman,750 W D AVE,,Kingman,KS,67068,Kingman,LACY DROSSELMEYER,CLINICS OFFICE MANAGER,620-532-0295,,LACYD@KCHKS.COM,SHANNAN FLACH,CEO,620-532-3147,,SHANNANF@KCHKS.COM,
KS-004111,Ford County Health Department,Ford County Health Department,1104841196,"Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",106 E. Spruce,PO Box 79,Dodge City,KS,67801-0079,Ford,106 E. Spruce,PO Box 79,Dodge City,KS,67801,Ford,Angela Sowers,Administrator,620-227-4545,,asowers@fordcounty.net,Ronda Worden,Adm Ass't/Office Manager,620-227-4545,,rworden@fordcounty.net,
KS-004112,"Family Practice Associates of Western Kansas, LLC","Family Practice Associates of Western Kansas, LLC",1841255437,Rural Health Clinics,120 W Ross Blvd,,Dodge City,KS,67801-2131,Ford,120 W Ross Blvd,,Dodge City,KS,67801,Ford,Glenda Smith,Office Manager,620-225-1650,202,gsmithfpa1@hotmail.com,,,,,,
KS-004113,Genesis Family Health (Dodge City),"UNITED METHODIST WESTERN KANSAS MEXICAN- AMERICAN MINISTRIES, INC.",1528254463,Federally Qualified Health Centers - Medical Services,1700 Avenue F,,Dodge City,KS,67801-4541,Ford,122 W Laurel,,Garden City,KS,67846-5128,Finney,Laura Dykstra,COO,620-275-1766,242,ldykstra@genesisfh.org,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,
KS-004114,Genesis Family Health Dental Clinic (Dodge City),"UNITED METHODIST WESTERN KANSAS MEXICAN- AMERICAN MINISTRIES, INC.",1174669303,Dental Providers,2011 Central Ave,,Dodge City,KS,67801-6410,Ford,122 W Laurel,,Garden City,KS,67846,Finney,Laura Dykstra,COO,620-275-1766,242,ldykstra@genesisfh.org,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,
KS-004115,Morton County Medical Clinic,Morton County Hospital,1700831229,Other ECP Providers,411 Sunset St,,Elkhart,KS,67950-5001,Morton,Morton County Hospital,,Elkhart,KS,67950,Morton,Bridgette S. Horner,Credentialing Coordinator,620-697-2141,375,mrd@mchswecare.com,Barbara Andersonc,CFO,620-697-2141,252,banderson@mchswecare.com,
KS-004116,Morton County Hospital,Morton County Hospital,1770511297,Other ECP Providers,445 Hilltop St,,Elkhart,KS,67950,Morton,445 Hilltop,,Elkhart,KS,67950,Morton,Richard Bergling,CEO,620-697-5200,,rbergling@mchswecare.com,Barbara Anderson,CFO,620-697-5252,,banderson@mchswecare.com,
KS-004117,ELLINWOOD DISTRICT HOSPITAL,ELLINWOOD DISTRICT HOSPITAL,1578676409,Inpatient Hospitals (other than children's hospitals),605 N Main St,,Ellinwood,KS,67526-1440,Barton,605 N Main St,,Ellinwood,KS,67526,Barton,Kile N Magner,CEO,620-564-2548,,kmagner@gpoe.org,Summer Zink,CFO,620-564-2548,,szink@gpoe.org,
KS-004118,ELLINWOOD CLINIC,ELLINWOOD DISTRICT HOSPITAL,1578676409,Rural Health Clinics,611 N Main St,,Ellinwood,KS,67526-1440,Barton,605 N Main St,,Ellinwood,KS,67526,Barton,Kile N Magner,CEO,620-564-2548,,kmagner@gpoe.org,Summer Zink,CFO,620-564-2548,,szink@gpoe.org,
KS-004119,ELLIS FAMILY CARE CENTER,ELLIS FAMILY CARE CENTER,1194830679,Rural Health Clinics,1000 Washington St,,Ellis,KS,67637-1615,Ellis,320 N 13th,,WaKeeney,KS,67672,Trego,David Augustine,CEO,785-743-2182,175,daugustine@tclmh.org,,,,,,
KS-004120,"Flint Hills Community Health Center, Inc.",Flint Hills Community Health Center,1467413906,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",420 W 15th Ave,,Emporia,KS,66801-5367,Lyon,Flint HIlls Communty Health Center,420 W. 15th Avenue,Emporia,KS,66801,Lyon,Renee E. Hively,Clinic Operation Director,620-342-4864,3747,rhively@flinthillshealth.org,Betty Murrell,CFO,620-342-4864,3703,bmurrell@flinthillshealth.org,
KS-004121,Eureka Clinic,Greenwood County Hospital,1215045299,Rural Health Clinics,100 W 16th St,,Eureka,KS,67045-1064,Greenwood,100 W. 16th St,,Eureka,KS,67045,Greenwood,Jennifer A Larsen,"Physician Assistant, Practice Manager",620-583-5274,,jlarsen@gwch.org,,,,,,
KS-004122,Flint HIlls Community Health Center - Eureka,Flint Hills Community Health Center,1538580279,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1602 N Elm St,,Eureka,KS,67045-1090,Greenwood,420 W. 15th Avenue,,Emporia,KS,66801,Lyon,Renee E. Hively,Clinic Operations Director,620-342-4864,3747,rhively@flinthillshealth.org,Betty Murrell,CFO,620-342-4864,3703,bmurrell@flinthillshealth.org,
KS-004123,FREDONIA REGIONAL HOSPITAL,FREDONIA REGIONAL HOSPITAL,1285634006,Inpatient Hospitals (other than children's hospitals),1527 Madison St,,Fredonia,KS,66736-1751,Wilson,1527 Madison St,,Fredonia,KS,66736-1751,Wilson,Tracy Row,Business Office Manager,620-378-6204,323,tracyrow@frh1.org,John Hart,CEO,620-378-2121,201,jhart@frh1.org,
KS-004124,GIRARD MEDICAL CENTER OF FRONTENAC,Girard Medical Center,1992733539,Rural Health Clinics,1011 Us 69,,Frontenac,KS,66763,Crawford,302 N Hospital Dr.,,Girard,KS,66743,Crawford,Ruth Duling,Director of Patient Financial Services,620-724-5152,,rduling@girardmedicalcenter.com,Michele L Hart,Director of Community Services,620-724-5117,,mhart@girardmedicalcenter.com,
KS-004125,Compass Behavioral Health,Compass Behavioral Health,1922058510,Community Mental Health Centers,1111 E Spruce St,,Garden City,KS,67846-5958,Finney,1111 E Spruce Street,,Garden City,KS,67846,Finney,Tiffany Burrows,Quality Improvement Manager/Credentialing,620-275-0644,2115,tburrows@compassbh.org,Ric Dalke,Executive Director,620-275-0644,2105,rdalke@compassbh.org,
KS-004126,Genesis Family Health Dental Clinic (Garden City),"UNITED METHODIST WESTERN KANSAS MEXICAN- AMERICAN MINISTRIES, INC.",1083752935,Dental Providers,310 E Walnut St,Suite LL5,Garden City,KS,67846-5560,Finney,122 W Laurel,,Garden City,KS,67846,Finney,Laura Dykstra,COO,620-275-1766,242,ldykstra@genesisfh.org,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,
KS-004127,St Catherine Hospital,St Catherine Hospital,1659360196,Inpatient Hospitals (other than children's hospitals),401 E Spruce St,,Garden City,KS,67846-5679,Finney,401 E Spruce,,Garden City,KS,67846,Finney,Sara McKenna,Director of Revenue Cycle,620-272-2266,,saramckenna@centura.org,,,,,,
KS-004128,Genesis Family Health (Garden City),"UNITED METHODIST WESTERN KANSAS MEXICAN- AMERICAN MINISTRIES, INC.",1730174228,Federally Qualified Health Centers - Medical Services,712A Saint John St,,Garden City,KS,67846-5128,Finney,122 W Laurel,,Garden City,KS,67846-5128,Finney,Laura Dykstra,COO,620-275-1766,242,ldykstra@genesisfh.org,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,
KS-004129,Finney County Health Department,Finney County Health Department,1881668622,Rural Health Clinics,919 W Zerr Rd,,Garden City,KS,67846-2777,Finney,919 Zerr Rd,,Garden City,KS,67846,Finney,Colleen Drees,Assistant Director,620-272-3600,,cdrees@finneycounty.org,Sandy Carabajal,Business Manager,620-272-3600,,scarabajal@finneycounty.org,
KS-004130,"Saint Luke's Hospital of Garnett, Inc. d/b/a ANDERSON COUNTY HOSPITAL (inpatient hospital)",Anderson County Hospital,1316911878,Inpatient Hospitals (other than children's hospitals),421 S Maple St,,Garnett,KS,66032,Anderson,421 S Maple Street,,Garnett,KS,66032,Anderson,Tina A Capeder,"Program Manager, Quality & Risk",785-204-4010,,tcapeder@saint-lukes.org,Vicki Mills,Chief Financial Officer,785-204-4043,,vmills@saint-lukes.org,
KS-004131,"Saint Luke's Hospital of Garnett, Inc. d/b/a ANDERSON COUNTY HOSPITAL (rural health clinics)",Anderson County Hospital,1316911878,Rural Health Clinics,421 S Maple St,,Garnett,KS,66032,Anderson,421 S Maple Street,,Garnett,KS,66032,Anderson,Tina A Capeder,"Program Manager, Quality & Risk",785-204-4010,,tcapeder@saint-lukes.org,Vicki Mills,Chief Financial Officer,785-204-4043,,vmills@saint-lukes.org,
KS-004132,"Saint Lukes Hospital of Garnett, Inc. d/b/a Family Care Center",Saint Luke's Health System,1598739948,Rural Health Clinics,536 W 4th Ave,,Garnett,KS,66032-1355,Anderson,901 E 104th Street,,Kansas City,MO,64131,Jackson,Tina A Capeder,"Program Manager, Quality and Risk",785-204-4010,,tcapeder@saint-lukes.org,Vicki Mills,Chief Financial Officer,785-204-4043,,vmills@saint-lukes.org,
KS-004133,Girard Medical Center,Girard Medical Center,1578505095,Inpatient Hospitals (other than children's hospitals),302 N Hospital Dr,,Girard,KS,66743-2000,Crawford,302 N Hospital Dr.,,Girard,KS,66743,Crawford,Ruth Duling,Director of Patient Financial Services,620-724-5152,,rduling@girardmedicalcenter.com,Holly Koch,CFO,620-724-8291,,hkoch@girardmedicalcenter.com,
KS-004134,Girard Medical Center Orthopedics,Girard Medical Center,1588993232,Other ECP Providers,307 N Hospital Dr,Suite 3,Girard,KS,66743-2047,Crawford,302 N Hospital Dr.,,Girard,KS,66743,Crawford,Ruth Duling,Director of Patient Financial Services,620-724-5152,,rduling@girardmedicalcenter.com,Michele L Hart,Director of Community Services,620-724-5117,,mhart@girardmedicalcenter.com,
KS-004135,Sherman County Health Department,County of Sherman,1871527556,Family Planning Providers,1622 Broadway Ave,,Goodland,KS,67735-3053,Sherman,1622 Broadway,,Goodland,KS,67735,Sherman,Donna Terry,Administrator,785-890-4888,7858904894,shcounty@st-tel.net,,,,,,shermancountyhealthdepartment.org
KS-004136,Goodland Family Health Center,Goodland Regional Medical Center,1598839045,Rural Health Clinics,220 W 2nd St,,Goodland,KS,67735-1602,Sherman,220 W 2nd St,,Goodland,KS,67735,Sherman,Diana Slough,Business Office Manager,785-890-6012,,dslough@gmedctr.org,Jennie Klinge,Clinic Manager,785-890-4012,,jklinge@gmedctr.org,http://www.goodlandregional.com/
KS-004137,Goodland Regional Medical Center,Goodland Regional Medical Center,1598839045,Inpatient Hospitals (other than children's hospitals),220 W 2nd St,,Goodland,KS,67735-1602,Sherman,220 W 2nd St,,Goodland,KS,67735,Sherman,Diana Slough,Business Office Manager,785-890-6012,,dslough@gmedctr.org,Jennie Klinge,Clinic Manager,785-890-4012,,jklinge@gmedctr.org,http://www.goodlandregional.com/
KS-004138,Heart of Kansas Family Health Care,Heart of Kansas Family Health Care,1184739443,Federally Qualified Health Centers - Medical Services,1905 19th St,,Great Bend,KS,67530-2502,Barton,1905 19th St,,Great Bend,KS,67530-2502,Barton,William Middleton,CEO,620-792-5700,107,bmiddleton@heartofkansas.com,Jyl Nokes,COO,620-792-5700,106,jnokes@heartofkansas.com,
KS-004139,Health Ministries Clinic-Halstead,Health Ministries Clinic,1558741264,Federally Qualified Health Centers - Medical Services,126 Main St,,Halstead,KS,67056-1708,Harvey,215 South Pine St.,,Newton,KS,67114,Harvey,Matthew D. Schmidt,Executive Director,316-283-6103,309,mschmidt@hmcks.org,,,,,,
KS-004140,HANOVER HOSPITAL,HANOVER HOSPITAL,1285635425,Inpatient Hospitals (other than children's hospitals),205 S Hanover St,,Hanover,KS,66945-8924,Washington,205 S. Hanover Street,,Hanover,KS,66945-8924,Washington,Sheryl Adam,Office Manager,785-337-2214,166,hhshari@yahoo.com,Melissa Minge,Billing Clerk,785-337-2214,161,mminge22@hotmail.com,
KS-004141,Harper Clinic,"Hospital District #5 of Harper County, Kansas",1598726275,Rural Health Clinics,700 W 13th St,,Harper,KS,67058-1401,Harper,700 W 13th,,Harper,KS,67058,Harper,Michele Donoho,Patient Account Manager,620-896-7324,291,mdonoho@hh5.com,Sandra Owen,CEO/CFO,620-896-7324,6208967324,SOWEN@HHD5.COM,
KS-004142,Harper District Hospital,"Hospital District #5 of Harper County, Kansas",1598726275,Inpatient Hospitals (other than children's hospitals),700 W 13th St,,Harper,KS,67058-1401,Harper,700 W 13th,,Harper,KS,67058,Harper,Michele Donoho,Patient Account Manager,620-896-7324,291,mdonoho@hh5.com,Sandra Owen,CEO/CFO,620-896-7324,6208967324,SOWEN@HHD5.COM,
KS-004143,"First Care Clinic, Inc.","FIRST CARE CLINIC, INC.",1568634327,"Dental Providers, Federally Qualified Health Centers - Medical Services",105 W 13th St,,Hays,KS,67601-3613,Ellis,105 W 13th St,,Hays,KS,67601-3613,Ellis,Bryan Brady,CEO,785-621-4990,,bbrady@firstcareclinic.com,Danielle WIndholz,Operations Manager,785-621-4990,,daniellew@firstcareclinic.com,
KS-004144,"Hays Medical Center, Inc.","Hays Medical Center, Inc.",1881697043,Inpatient Hospitals (other than children's hospitals),2220 Canterbury Dr,,Hays,KS,67601-2370,Ellis,2220 Canterbury Drive,,Hays,KS,67601,Ellis,George Harms,CFO,785-623-5000,,george.harms@haysmed.com,Andy Beck,Controller,785-623-5599,,andy.beck@haysmed.com,www.haysmed.com
KS-004145,Ellis County Health Department,Ellis County Health Department,1376545384,Other ECP Providers,601 Main St,Suite B,Hays,KS,67601-4256,Ellis,601 Main Street,Suite B,Hays,KS,67601,Ellis,Robert Schlyer,Ellis County Health Administrator,785-628-9440,,butch@ellisco.net,Lynda Arnhold,Office Manager,785-628-9440,,lynda@ellisco.net,www.ellissco.net
KS-004146,Herington Municipal Hospital,Herington Municipal Hospital,1215908454,Inpatient Hospitals (other than children's hospitals),100 E Helen St,,Herington,KS,67449-1697,Dickinson,100 E Helen St,,Herington,KS,67449,Dickinson,Alan Meisinger,Administrator,785-258-2207,138,ameisinger@heringtonhospital.com,Dawn Scott,Revenue Cycle Manager,785-258-2207,,dscott@heringtonhospital.com,
KS-004147,HCH Family Practice,"Hiawatha Community Hospital Association, Inc.",1023175064,Rural Health Clinics,300 Utah St # 2,,Hiawatha,KS,66434-2314,Brown,300 Utah Street,2nd Floor,Hiawatha,KS,66434,Brown,Jennifer Ploeger,CLINIC MANAGER,785-742-2161,402,jploeger@hch-ks.org,Jeff Shelton,CEO,785-742-2131,,jshelton@hch-ks.org,
KS-004148,"Kanza Mental Health & Guidance Center, Inc.","Kanza Mental Health & Guidance Center, Inc.",1619909181,Community Mental Health Centers,909 S 2nd St,PO Box 319,Hiawatha,KS,66434-2774,Brown,909 S. 2nd Street,,Hiawatha,KS,66434-0319,Brown,Virginia Freese,Director of Business Operatio ns,785-742-7113,102,vfreese@kanzamhgc.org,David Elsbury,CEO,785-742-7113,122,delsbury@kanzamhgc.org,
KS-004149,Highland Clinic,"Hiawatha Community Hospital Association, Inc.",1700936440,Rural Health Clinics,415 W Main St,,Highland,KS,66035-4143,Doniphan,300 Utah,2nd Floor,Hiawatha,KS,66434,Brown,Jennifer Ploeger,CLINIC MANAGER,785-742-2161,402,jploeger@hch-ks.org,Jeff Shelton,CEO,785-742-2131,,jshelton@hch-ks.org,
KS-004150,Graham County Hospital Clinic,Graham County Hospital,1629165998,Rural Health Clinics,114 E Walnut St,,Hill City,KS,67642-1722,Graham,114 E. Walnut,,Hill City,KS,67642,Graham,Melissa Atkins,CEO,785-421-2121,,matkins@gchospital.org,Lindsey Thompson,Clinic Manager,785-421-2191,,lleonard@gchospital.org,http://www.grahamcountyhospital.org/
KS-004151,Graham County Hospital,Graham County Hospital,1588673297,Inpatient Hospitals (other than children's hospitals),304 W Prout St,,Hill City,KS,67642-1435,Graham,304 W Prout,,Hill City,KS,67642,Graham,Melissa Atkins,CEO,785-421-2121,1342,matkins@gchospital.org,Dan Irby,Director of Nursing,785-421-2121,1340,dirby@gchospital.org,http://www.grahamcountyhospital.org/
KS-004152,Hillsboro Clinic,Hillsboro Community Hospital,1063792919,Rural Health Clinics,101 Industrial Rd,,Hillsboro,KS,67063-9602,Marion,101 Industrial Rd,,Hillsboro,KS,67063,Marion,Marion Regier,CEO,620-877-4283,,mregier@hchks.com,Julie Gardner,Clinic Manager,620-947-1421,,jgardner@hchks.com,www.hchks.com
KS-004153,Hillsboro Community Hospital,Hillsboro Community Hospital,1063792919,Inpatient Hospitals (other than children's hospitals),701 S Main St,,Hillsboro,KS,67063-1553,Marion,704 S Main St,,Hillsboro,KS,67063,Marion,Marion Regier,CEO,620-947-3114,,mregier@hchks.com,,,,,,www.hchks.com
KS-004154,Family Practice Associates - Holton,Rural Health Resources of Jackson Co,1639145204,Rural Health Clinics,1100 Columbine Dr,,Holton,KS,66436-8841,Jackson,1110 Columbine Dr,,Holton,KS,66436,Jackson,Bart Kenton,CFO,785-364-2116,4111,bkenton@rhrjc.org,Carrie Saia,CEO,785-364-2116,4101,csaia@rhrjc.org,
KS-004155,Holton Community Hospital,Rural Health Resources of Jackson Co,1902805716,Inpatient Hospitals (other than children's hospitals),1110 Columbine Dr,,Holton,KS,66436-8824,Jackson,1110 Columbine Dr,,Holton,KS,66436,Jackson,Bart Kenton,CFO,785-364-2116,4111,bkenton@rhrjc.org,Carrie Saia,CEO,785-364-2116,4101,csaia@rhrjc.org,
KS-004156,"Kanza Mental Health & Guidance Center, Inc.","Kanza Mental Health & Guidance Center, Inc.",1619909181,Community Mental Health Centers,713 Idaho Ave,,Holton,KS,66436,Jackson,909 S 2nd St,,Hiawatha,KS,66434-0319,Brown,Virginia Freese,Director of Business Operations,785-742-7113,102,vfreese@kanzamhgc.org,David Elsbury,CEO,785-742-7113,122,delsbury@kanzamhgc.org,
KS-004157,Kickapoo Nation Health Center,Kickapoo Tribe in Kansas,1992806012,"Community Mental Health Centers, Dental Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",1117 Goldfinch Rd,,Horton,KS,66439-9537,Brown,1117 Goldfinch Road,,Horton,KS,66439,Brown,Allison Minshew,Credentialing Specialist,785-486-2154,,allison.minshew@ihs.gov,Jolene Walters,Director,785-486-2154,,jolene.walters@ihs.gov,
KS-004158,HORTON COMMUNITY HOSPITAL,HORTON COMMUNITY HOSPITAL,1518141373,Inpatient Hospitals (other than children's hospitals),240 W 18th St,,Horton,KS,66439-1245,Brown,240 W 18th St,,Horton,KS,66439-1245,Brown,James Noble,CEO,785-879-4357,2003,jnoble@horton-hospital.com,Sue Kidd,CFO,785-879-4357,2019,kidds@hhf-ks.org,www.horton-hospital.com
KS-004159,Howard Clinic,Greenwood County Hospital,1215045299,Rural Health Clinics,118 S Wabash,,Howard,KS,67349-9434,Elk,100 W. 16th St,,Eureka,KS,67045,Greenwood,Tracy Harrod,Practice Manager,620-583-7451,,tharrod@gwch.org,,,,,,
KS-004160,Elk County Health Department,Elk County Health Department,1396729380,Rural Health Clinics,127 S Pine St,,Howard,KS,67349,Elk,127 N Pine,,Howard,KS,67349,Elk,Beverly Signer,Billing Clerk,620-374-2277,,billinghealthems@elkcountyks.org,Kandy Dowell,RN Admin,620-374-2277,,healthadmin@elkcountyks.org,
KS-004161,SHERIDAN COUNTY HOSPITAL,Hoxie Medical Clinic,1942316799,Federally Qualified Health Centers - Medical Services,826 18th St,Suite A,Hoxie,KS,67740-4373,Sheridan,826 18th Street,,Hoxie,KS,67740,Sheridan,Pam Popp,,785-675-3018,203,ppopp@sheridan.hpmin.com,Niceta Farber,CEO,785-675-3281,127,nfarber@sheridan.hpmin.com,
KS-004162,Sheridan County Public Health Department,Sheridan County Public Health Department,1205899150,Other ECP Providers,940 8th St,,Hoxie,KS,67740,Sheridan,940 8th,,Hoxie,KS,67740,Sheridan,Melissa Wachendorfer,RN/Administrator,785-675-2101,,mw.sheridan@ruraltel.net,Crystal Smith,Office Manager,785-675-2101,,cs.sheridan@ruraltel.net,
KS-004163,FAMILY PRACTICE ASSOCIATES HOYT CLINIC,Rural Health Resources of Jackson County,1326147380,Rural Health Clinics,117 W 3rd St,,Hoyt,KS,66440-9671,Jackson,1110 Columbine Dr,,Holton,KS,66436,Jackson,Bart Kenton,CFO,785-364-2116,4111,bkenton@rhrjc.org,Carrie Saia,CEO,785-364-2116,4101,csaia@rhrjc.org,
KS-004164,Stevens County Health Department,Stevens County,1750489555,Other ECP Providers,505 S Polk St,,Hugoton,KS,67951-2137,Stevens,505 S Polk Street,,Hugoton,KS,67951,Stevens,"Paula M. Rowden, RN, MPH",Administrator,620-544-7177,16,svcohlth@pld.com,Shanna Flores,Billing Clerk,620-544-7177,20,sflores@pld.com,
KS-004165,"Hutchinson Clinic PA, Inc","Hutchinson Clinic, PA, Inc",1285926493,Rural Health Clinics,1100 N Main St,,Hutchinson,KS,67501-4406,Reno,2101 N Waldron St,,Hutchinson,KS,67502,Reno,Belinda Mahoney,Contract & Reimbursement Manager,620-669-2644,2644,mahoneyb@hutchclinic.com,Gary Golliher,CFO,620-694-2110,2110,golliherg@hutchclinic.com,www.hutchclinic.com
KS-004166,HUTCHINSON REGIONAL MEDICAL CENTER INC,HUTCHINSON REGIONAL MEDICAL CENTER INC,1922039320,Inpatient Hospitals (other than children's hospitals),1701 E 23rd Ave,,Hutchinson,KS,67502-1105,Reno,1701 E. 23rd Avenue,,Hutchinson,KS,67502,Reno,Cassie Dolen,CFO,620-513-4556,,dolenc@hutchregional.com,Peggy Tuxhorn,VP of Quality,620-513-4556,,tuxhornpr@hutchregional.com,
KS-004167,"Hutchinson Clinic, PA, Inc","Hutchinson Clinic, PA, Inc",1902871940,Rural Health Clinics,2101 N Waldron St,,Hutchinson,KS,67502-1131,Reno,2101 N Waldron St,,Hutchinson,KS,67502,Reno,Belinda Mahoney,Contract & Reimbursement Manager,620-669-2644,2644,mahoneyb@hutchclinic.com,Gary Golliher,CFO,620-694-2110,2110,golliherg@huthclinic.com,www.hutchclinic.com
KS-004168,PrairieStar Health Center,PRAIRIESTAR HEALTH CENTER INC,1871564534,"Dental Providers, Federally Qualified Health Centers - Medical Services",2700 E 30th Ave,,Hutchinson,KS,67502-1242,Reno,2700 E 30th Ave,,Hutchinson,KS,67502-1242,Reno,Shandi Stallman,CFO,620-663-8484,143,stallmans@prairiestarhealth.org,Bryant Anderson,CEO,620-663-8484,,andersonb@prairiestarhealth.org,www.prairiestarhealth.org
KS-004169,Independence Family Medicine,Wilson County Hospital,1003251802,Rural Health Clinics,1415 N Penn Ave,,Independence,KS,67301-2222,Montgomery,P.O. Box 314,,Independence,KS,67301,Montgomery,Jody Wright,CLINIC MANAGER,620-331-2400,,jwright@wmcrc.org,John Gutschenritter,CFO,620-325-8388,,johng@wmcrc.org,
KS-004170,Independence RHC,Labette County Medical Center,1154787190,Rural Health Clinics,209 E Laurel St,,Independence,KS,67301-3136,Montgomery,1902 S Hwy 59 Bldg E,,Parsons,KS,67357,Labette,Missy Beasley,CLINIC MANAGER,620-820-5889,,mbeasley@labettehealth.com,Doug Stacy,CIO,620-820-5398,,dstacy@labettehealth.com,
KS-004171,Independence Family Medicine,Wilson County Hospital,1003251802,Rural Health Clinics,209 N 6th Suite 103,PO Box 314,Independence,KS,67301-0314,Montgomery,2600 Ottawa Rd,PO Box 360,Neodesha,KS,66757,Wilson,Jody Wright,Office Manager,620-331-2400,,jwright@wmcrc.org,John Gutschenritter,CFO,620-325-8388,,jgutschenritter@wmcrc.org,
KS-004172,Community Health Center of Southeast Kansas,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1801208053,Federally Qualified Health Centers - Medical Services,3751 W Main St,,Independence,KS,67301-8446,Montgomery,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004173,Four County Mental Health Center,Four County Mental Health Center,1841290251,Community Mental Health Centers,3751 W Main St,,Independence,KS,67301-8446,Montgomery,3751 W Main,,Independence,KS,67301,Montgomery,Jodi L Hayse,COO,620-331-1748,1914,jhayse@fourcounty.com,,,,,,www.fourcounty.com
KS-004174,Community Health Center of Southeast Kansas / Iola,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1609025485,"Dental Providers, Federally Qualified Health Centers - Medical Services",1408 East St,Suite C,Iola,KS,66749-4403,Allen,3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004175,The Family Physicians,"The Family Physicians, PA",1851325773,Rural Health Clinics,1408 East St,Suite A,Iola,KS,66749-4403,Allen,1408 East Street,Suite A,Iola,KS,66749,Allen,Martha DeGrado,Office Administrator,620-365-3115,114,marthadegrado@gmail.com,Dr. Frank Porter,President,620-365-3115,,famphys@dr.kscoxmail.com,www.thefamilyphysiciansiola.com
KS-004176,Allen County Regional Hospital,Allen County Regional Hospital,1639185457,Inpatient Hospitals (other than children's hospitals),3066 N Kentucky St,,Iola,KS,66749-1951,Allen,3066 N Kentucky Street,,Iola,KS,66749,Allen,Marion Anthony Thompson,Chief Executive Officer,620-365-1021,,Tony.Thompson@HCAHealthcare.com,Larry R Peterson,Chief Financial Officer,620-365-1026,,Larry.Peterson@HCAHealthcare.com,
KS-004177,Allen County Regional Clinic,Allen County Regional Hospital,1639185457,Rural Health Clinics,401 S Washington Ave,,Iola,KS,66749,Allen,3066 N Kentucky Street,,Iola,KS,66749,Allen,Marion Anthony Thompson,Chief Executive Officer,620-365-1021,,Tony.Thompson@HCAHealthcare.com,Larry R Peterson,Chief Financial Officer,620-365-1026,,Larry.Peterson@HCAHealthcare.com,
KS-004178,Hodgeman County Health Dept,Hodgeman County Health Dept,1902853815,Other ECP Providers,500 Main St,,Jetmore,KS,67854,Hodgeman,500 Main St,,Jetmore,KS,67854-0086,Hodgeman,Ashley Burns,Billing Clerk,620-357-8736,,hghealthdept@hotmail.com,Jenette Schuette,Administrator. RN,620-357-8736,,hghealthdept@hotmail.com,
KS-004179,STANTON COUNTY FAMILY PRACTICE,Stanton County Hospital,1679880363,Rural Health Clinics,404 N Chestnut St,,Johnson City,KS,67855-5001,Stanton,404 N Chestnut St,,Johnson City,KS,67855,Stanton,Peggy Carrithers,Manager,620-492-1400,177,pcarrithers@stantoncountyhospital.com,,,,,,
KS-004180,GCH Rural Health Clinic,Geary Community Hospital,1699877555,Rural Health Clinics,1110 Saint Marys Rd,,Junction City,KS,66441-4176,Geary,1102 St. Mary's Rd.,,Junction City,KS,66441,Geary,Bradley Meier,"Director, Practice Management",785-762-3388,,bmeier@gchks.org,Denise LaForce,"Director, Revenue Cycle",785-762-5140,4403,dlaforce@gchks.org,www.gchks.org
KS-004181,KONZA PRAIRIE COMMUNITY HEALTH CENTER,Konza Prairie Community Health Center,1447247663,"Dental Providers, Federally Qualified Health Centers - Medical Services",361 Grant Ave,,Junction City,KS,66441-4201,Geary,361 Grant Ave,,Junction City,KS,66441-4201,Geary,Lee Wolf,Chief Executive Officer,785-238-4711,201,lwolf@konzaprairiechc.com,Linda Davies,Chief Operating Officer,785-238-4711,244,ldavies@konzaprairiechc.com,
KS-004182,SWOPE HEALTH SVCS - WYANDOTTE,SWOPE HEALTH SERVICES,1861587511,"Dental Providers, Federally Qualified Health Centers - Medical Services",21 N 12th St,Suite 400,Kansas City,KS,66102-5172,Wyandotte,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,Dave Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
KS-004183,Family Health Care,Southwest Boulevard Family Health Care,1609030311,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",340 Southwest Blvd,,Kansas City,KS,66103-2150,Wyandotte,340 Southwest Boulevard,,Kansas City,KS,66103,Wyandotte,Sharon Lee,CEO,913-722-3100,,slee2@kumc.edu,Kevin Dennis,CAO,913-722-3100,,kevindennis@swbfhcs.org,www.swbfhc.org
KS-004184,SWOPE HEALTH WEST,SWOPE HEALTH SERVICES,1013002765,Federally Qualified Health Centers - Medical Services,6013 Leavenworth Rd,Suite 1,Kansas City,KS,66104-1488,Wyandotte,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,David Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
KS-004185,DONLEY MEMORIAL CLINIC,NINNESCAH VALLEY HEALTH SYSTEMS INC,1396271516,Rural Health Clinics,437 Cedar St,,Kingman,KS,67068-1324,Kingman,750 W D AVE,,Kingman,KS,67068,Kingman,LACY DROSSELMEYER,CLINICS OFFICE MANAGER,620-532-0295,,LACYD@KCHKS.COM,SHANNAN FLACH,CEO,620-532-3147,,SHANNANF@KCHKS.COM,
KS-004186,MEDICAL ARTS CENTER,NINNESCAH VALLEY HEALTH SYSTEMS INC,1508253501,Rural Health Clinics,760 W D Ave,,Kingman,KS,67068-1222,Kingman,750 W D AVE,,Kingman,KS,67068,Kingman,LACY DROSSELMEYER,CLINICS OFFICE MANAGER,620-532-0295,,LACYD@KCHKS.COM,SHANNAN FLACH,CEO,620-532-3147,,,
KS-004188,Midway Clinic,Edwards County Hospital and Healthcare Center,1629587803,Rural Health Clinics,604 W 8th St,,Kinsley,KS,67547-2329,Edwards,620 West Eighth,,Kinsley,KS,67547,Edwards,Thyra Strate,CLINIC MANAGER,620-659-3621,920,tstrate@edcomed.com,,,,,,https://edcomed.com/ECH/main.aspx?tid=284
KS-004187,Midway Clinic,Edwards County Hospital and Healthcare Center,1649372012,Rural Health Clinics,604 W 8th St,,Kinsley,KS,67547-2329,Edwards,620 West Eighth,,Kinsley,KS,67547,Edwards,Thyra Strate,CLINIC MANAGER,620-659-3621,920,tstrate@edcomed.com,,,,,,
KS-004189,KINSLEY RURAL HEALTH CLINIC,Pratt Regional Medical Center Corporation,1467551069,Sexually Transmitted Disease Clinics,807 E 4th St,,Kinsley,KS,67547-1219,Edwards,200 Commodore,,Pratt,KS,67124,Pratt,Kelly McDermeit,V.P. Clinic Services,620-672-7451,1420,kmcdermeit@prmc.org,Susan Page,CEO,620-672-7451,,spage@prmc.org,prmc.org
KS-004190,Rush County Memorial Hospital,Rush County Medical Clinic,1699877050,Rural Health Clinics,801 Locust St,,La Crosse,KS,67548-9673,Rush,PO Box 520,,La Crosse,KS,67548,Rush,Brenda Legleiter,CEO,785-222-2545,319,blegleiter@rcmhosp.hpmin.com,,,,,,
KS-004191,Rush County Memorial Hospital,Rush County Memorial Hospital,1841240959,Inpatient Hospitals (other than children's hospitals),801 Locust St,,La Crosse,KS,67548-9673,Rush,PO Box 520,,La Crosse,KS,67548,Rush,Brenda Legleiter,CEO,785-222-2545,319,blegleiter@rcmhosp.hpmin.com,,,,,,
KS-004192,KEARNY COUNTY HOSPITAL (inpatient hospital),KEARNY COUNTY HOSPITAL,1821096322,Inpatient Hospitals (other than children's hospitals),500 E Thorpe St,,Lakin,KS,67860-9625,Kearny,500 E Thorpe St,,Lakin,KS,67860,Kearny,Travis Ward,Financial Counselor,620-355-7112,1541,tward@kearnycountyhospital.com,Kelly Ann Speckman,Cheif Financial Officer,620-355-7112,1380,kspeckman@kearnycountyhospital.com,
KS-004193,KEARNY COUNTY HOSPITAL (rural health clinics),KEARNY COUNTY HOSPITAL,1821096322,Rural Health Clinics,500 E Thorpe St,,Lakin,KS,67860-9625,Kearny,500 E Thorpe St,,Lakin,KS,67860,Kearny,Travis Ward,Financial Counselor,620-355-7112,1541,tward@kearnycountyhospital.com,Kelly Ann Speckman,Cheif Financial Officer,620-355-7112,1380,kspeckman@kearnycountyhospital.com,
KS-004194,Pawnee County Health Department,Pawnee County Health Department,1023006400,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",715 Broadway St,,Larned,KS,67550-3054,Pawnee,PO Box 150,,Larned,KS,67550,Pawnee,Robin Rziha,Administrator,620-285-6963,,rrziha@pawnee.kscoxmail.com,,,,,,
KS-004195,Pawnee Valley Community Hospital,Pawnee Valley Community Hospital,1568401206,Inpatient Hospitals (other than children's hospitals),923 Carroll Ave,,Larned,KS,67550-2429,Pawnee,923 Carroll Ave,,Larned,KS,67550,Pawnee,Eric Lybarger,Administrator,620-285-3161,,eric.lybarger@haysmed.com,Andy Beck,Controller,785-623-5599,,andy.beck@haysmed.com,www.pawneevalleyhospital.com
KS-004196,Haskell Indian Health Center,Haskell Indian Health Center,1700915782,"Dental Providers, Indian Health Service, Other ECP Providers",2415 Massachusetts St,,Lawrence,KS,66046-4808,Douglas,2415 Massachusetts St,,Lawrence,KS,66046-4808,Douglas,Kelly Battese,Chief Executive Officer,785-843-4824,,kelly.battese@ihs.gov,Chelsea Anglin,Administrative Officer,785-843-4828,,chelse.anglin@ihs.gov,
KS-004197,LAWRENCE MEMORIAL HOSPITAL (inpatient hospital),LAWRENCE MEMORIAL HOSPITAL,1508883422,Inpatient Hospitals (other than children's hospitals),325 Maine St,,Lawrence,KS,66044-1360,Douglas,325 Maine St,,Lawrence,KS,66044-1360,Douglas,Russell W. Johnson,CEO,785-505-6130,6130,Russell.Johnson@lmh.org,Joseph Pedley,CFO,785-505-6133,6133,Joseph.Pedley@lmh.org,
KS-004198,LAWRENCE MEMORIAL HOSPITAL (other ecp providers),LAWRENCE MEMORIAL HOSPITAL,1508883422,Other ECP Providers,325 Maine St,,Lawrence,KS,66044-1360,Douglas,325 Main Street,,Lawrence,KS,66044,Douglas,Julie Powell,Reimbursement Coordinator,785-505-2910,,Julie.Powell@lmh.org,Joseph Pedley,"Vice President, CFO",785-505-6133,,Joseph.Pedley@lmh.org,
KS-004199,Heartland Community Health Center,"HEARTLAND MEDICAL CLINIC, INC",1669657029,Federally Qualified Health Centers - Medical Services,346 Maine St,Suite 150,Lawrence,KS,66044-1393,Douglas,346 Maine Street,Suite 150,Lawrence,KS,66044-2294,Douglas,Jon Stewart,CEO,785-841-7297,,jstewart@heartlandhealth.org,,,785-296-6544,,,
KS-004200,SAINT LUKE'S CUSHING HOSPITAL,SAINT LUKE'S CUSHING HOSPITAL,1366486797,Inpatient Hospitals (other than children's hospitals),711 Marshall St,,Leavenworth,KS,66048-3235,Leavenworth,711 Marshall St,,Leavenworth,KS,66048-3235,Leavenworth,Adele Ducharme,CEO,913-684-1100,,aducharme@saint-lukes.org,Julie Murphy,CFO,913-684-1100,,jumurphy@saint-lukes.org,
KS-004201,Wichita County Health Center (inpatient hospital),Wichita County Health Center,1184615338,Inpatient Hospitals (other than children's hospitals),211 E Earl St,,Leoti,KS,67861-9620,Wichita,211 East Earl,,Leoti,KS,67861,Wichita,Teresa Clark RN CEO,CEO,620-375-2233,2013,tclark@wchosp.com,Janice Campas,CFO,620-375-2233,2007,jcampas@wchosp.com,
KS-004202,Wichita County Health Center (rural health clinics),Wichita County Health Center,1184615338,Rural Health Clinics,211 E Earl St,,Leoti,KS,67861-9620,Wichita,211 East Earl,,Leoti,KS,67861,Wichita,Teresa Clark,CEO,620-375-2233,2013,tclark@wchosp.com,Janice Campas,CFO,620-375-2233,2007,jcampas@wchosp.com,
KS-004203,Genesis Family Health (Liberal),"United Methodist Western Kansas Mexican American Ministries,Inc",1871789719,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",121 W 3rd St,,Liberal,KS,67901-3218,Seward,122 W Laurel,,Garden City,KS,67846,Finney,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,Laura Dykstra,COO,620-275-1766,242,ldykstra@genesisfh.org,
KS-004204,Linn Family Physicians,CLAY COUNTY MEDICAL CENTER,1710340690,Rural Health Clinics,706 3rd St,,Linn,KS,66953-9029,Washington,609 Liberty St.,,Clay Center,KS,67432,Clay,Lance Haller,CLINIC MANAGER,785-632-2181,284,LHaller@ccmcks.org,Jim Brinkman,Controller,785-632-2144,466,jbrinkman@ccmcks.org,
KS-004205,Lyons Medical Center,Hospital District #1 of Rice County,1588933352,Rural Health Clinics,1221 W Noble St,,Lyons,KS,67554-3026,Rice,619 S Clark Ave,,Lyons,KS,67554,Rice,George M. STover,CEO,620-257-5173,,gstover@rch-lyons.com,,,,,,
KS-004206,Hospital District #1 of Rice County,Hospital District #1 of Rice County,1710962014,Inpatient Hospitals (other than children's hospitals),619 S Clark Ave,,Lyons,KS,67554-3003,Rice,619 S Clark Ave,Box 828,Lyons,KS,67554,Rice,George M. STover,CEO,620-257-5173,,gstover@rch-lyons.com,Terry Pound,CFO,620-257-5173,,tpound@rch-lyons.com,
KS-004207,"Via Christi Hospital Manhattan, Inc.","Via Christi Health, Inc.",1760482517,Inpatient Hospitals (other than children's hospitals),1823 College Ave,,Manhattan,KS,66502-3381,Riley,1823 College Avenue,,Manhattan,KS,66502,Riley,Courtney Herrill,Manager Managed Care Operations,316-719-1403,,courtney.herrill@ascension.org,Michael McCullough,Chief Financial Officer,316-858-4933,,michael.mccullough@ascension.org,
KS-004208,Konza Prairie Community Health Center,KONZA PRAIRIE COMMUNITY HEALTH CENTER INC,1447247663,"Dental Providers, Federally Qualified Health Centers - Medical Services",2030 Tecumseh Rd,,Manhattan,KS,66502-3512,Riley,361 Grant Avenue,,Junction City,KS,66441,Geary,Lee Wolf,Chief Executive Officer,785-238-4711,201,lwolf@konzaprairiechc.com,Linda Davies,Chief Operating Officer,785-238-4711,244,ldavies@konzaprairiechc.com,
KS-004209,JEWELL COUNTY HOSPITAL,JEWELL COUNTY HOSPITAL,1336184647,Inpatient Hospitals (other than children's hospitals),100 Crestvue Ave,,Mankato,KS,66956-2407,Jewell,100 Crestvue,,Mankato,KS,66956,Jewell,Lori Slate,Admin Asst.,785-378-3137,,lslate@jewellcohosp.org,D'Ann Gardner,HIM,785-378-3137,,dgardner@jewellcohosp.org,www.jewellcohospital.org
KS-004210,Jewell County Rural Health Clinic,Jewell County Rural Health Clinic,1386689586,Rural Health Clinics,102 S Center St,,Mankato,KS,66956,Jewell,102 S Center St,,Mankato,KS,66956,Jewell,Lori Slate,Admin Asst.,785-378-3137,,lslate@jewellcohosp.org,Susan Newell,Clinic Manager,785-378-3511,,snewell@jewellcohosp.org,www.jewellcohospital.org
KS-004211,St. Luke Hospital,Hospital District NO 1 Marion CO,1326087966,Inpatient Hospitals (other than children's hospitals),535 S Freeborn St,,Marion,KS,66861-1256,Marion,535 S Freeborn,,Marion,KS,66861,Marion,DIANE KAHNS,Business Office Manager,620-382-2177,112,diane.kahns@slhmarion.org,Bev Reid,CFO,620-382-2177,197,bev.reid@slhmarion.org,
KS-004212,St. Luke Medical Clinic,St. Luke Medical Clinic,1265617526,Rural Health Clinics,537 S Freeborn St,,Marion,KS,66861-1243,Marion,537 S. Freeborn,,Marion,KS,66861,Marion,Tammy Snelling,CLINIC MANAGER,620-382-2033,503,tammy.snelling@slhmarion.org,,,,,,
KS-004213,Marshall County Health Department,Marshall County Health Department,1457393019,Rural Health Clinics,600 Broadway St,,Marysville,KS,66508-1840,Marshall,600 Broadway St,,Marysville,KS,66508-1840,Marshall,Sue Rhodes,Administrator,785-562-3485,,sue@marshallcohealth.org,Mary Weeks,Office Manager,785-562-3485,,mary@marshallcohealth.org,
KS-004214,MEADE RURAL HEALTH CLINIC,Meade Rural Health Clinic,1558367607,Rural Health Clinics,119 N Hart St,,Meade,KS,67864-6402,Meade,119 N Hart St,,Meade,KS,67864,Meade,Gaudelia T Feldmeyer,Clinic Manager,620-873-2112,5560,gfeldmeyer@meadehospital.com,Janet Gleason,Billing and Assistant Manager,620-873-5687,,jgleason@meadehospital.com,
KS-004215,MEADE DISTRICT HOSPITAL (inpatient hospital),MEADE DISTRICT HOSPITAL,1922004076,Inpatient Hospitals (other than children's hospitals),510 E Carthage St,,Meade,KS,67864-6401,Meade,510 E Carthage St,,Meade,KS,67864-6401,Meade,Steve Stewart,CEO,620-873-5500,,sstewart@meadehospital.com,,,,,,
KS-004216,MEADE DISTRICT HOSPITAL (rural health clinics),MEADE DISTRICT HOSPITAL,1922004076,Rural Health Clinics,510 E Carthage St,,Meade,KS,67864-6401,Meade,510 E Carthage St,,Meade,KS,67864-6401,Meade,Steve Stewart,CEO,620-873-5500,,sstewart@meadehospital.com,,,,,,
KS-004217,Barber Co. Health Dept.,Barber County Community Health Department,1871603712,"Family Planning Providers, Sexually Transmitted Disease Clinics",211 E Kansas Ave,,Medicine Lodge,KS,67104-1406,Barber,211 E Kansas Ave,,Medicine Lodge,KS,67104-1404,Barber,Pam Rickard,Administrative Assistant,620-886-3294,,prickard@barber.ks.gov,Anita Poland,RN,620-886-3294,,apoland@barber.ks.gov,
KS-004218,Medicine Lodge Memorial Hospital and Physicians Clinic,Lodge Memorial Hospital and Physicians Clinic,1083702369,Rural Health Clinics,710 N Walnut St,,Medicine Lodge,KS,67104-1019,Barber,710 N Walnut,,Medicine Lodge,KS,67104,Barber,Ashley Taylor,Clinic Director,620-930-3705,,ataylor@mlmh.net,Kevin White,CEO,620-930-3744,,kwhite@mlmh.net,
KS-004219,Wilson County Hospital,dba Wilson Medical Center,1669441176,Inpatient Hospitals (other than children's hospitals),2600 Ottawa Rd,,Neodesha,KS,66757-1897,Wilson,P.O. Box 360,,Neodesha,KS,66757,Wilson,Carolyn Eisenstein,PFS Director,620-325-8336,,ceisenstein@wmcrc.org,John Gutschenritter,CFO,620-325-8388,,johng@wmcrc.org,
KS-004220,NESS COUNTY HOSPITAL DISTRICT #2,NESS COUNTY HOSPITAL DISTRICT #2,1457452898,Inpatient Hospitals (other than children's hospitals),312 E Custer St,,Ness City,KS,67560-1654,Ness,312 Custer,,Ness City,KS,67560-1654,Ness,Debra Frank,CFO,785-798-2291,256,debbief@nchospital.org,,,,,,
KS-004221,Ness City Medical Clinic,Ness City Medical Clinic,1962439943,Rural Health Clinics,316 E Custer St,,Ness City,KS,67560-1654,Ness,316 East Custer,,Ness City,KS,67560,Ness,Tammy Pfannenstiel,CLINIC MANAGER,785-798-2233,,tammyp@nchospital.org,,,,,,
KS-004222,Mirror Inc.,Mirror Inc.,1053431676,Other ECP Providers,1309 N Duncan St,,Newton,KS,67114-5704,Harvey,130 E. 5th,P.O. Box 711,Newton,KS,67114-0711,Harvey,John F. Gilbert,Executive Vice President,316-283-6743,106,jgilbert@mirrorinc.org,Charles Applegate,Vice-President of Finance,316-283-6743,111,capplegate@mirrorinc.org,https://www.mirrorinc.org
KS-004223,Prairie View Inc,Prairie View Inc,1558426486,Community Mental Health Centers,1901 E 1st St,PO Box 467,Newton,KS,67114-5010,Harvey,1901 E. 1st Street,PO Box 467,Newton,KS,67114-0467,Harvey,Lisa Ramsey,CFO,316-284-6351,,ramseylr@pvi.org,Mary Lou Tate,Patient Accounts Director,800-992-6292,,tateml@pvi.org,
KS-004224,Primary Care Partners-HMC,Health Ministries Clinic,1003366758,Federally Qualified Health Centers - Medical Services,700 Medical Center Dr,,Newton,KS,67114-9013,Harvey,215 South Pine Street,,Newton,KS,67114,Harvey,Matthew Schmidt,Executive Director,316-281-7314,,mschmidt@hmcks.org,Dan Evans,Finance Director,316-281-7327,,devans@hmcks.org,
KS-004225,Health Ministries Clinic,"HEALTH MINISTRIES CLINIC, INC.",1346261930,"Dental Providers, Federally Qualified Health Centers - Medical Services",720 Medical Center Dr,,Newton,KS,67114-8778,Harvey,720 Medical Center Drive,,Newton,KS,67114,Harvey,Matthew Schmidt,Executive Director,316-281-7314,,mschmidt@hmcks.org,Dan Evans,Finance Director,316-281-7327,,devans@hmcks.org,
KS-004226,LOGAN COUNTY HOSPITAL (inpatient hospital),LOGAN COUNTY HOSPITAL,1821087230,Inpatient Hospitals (other than children's hospitals),211 Cherry Ave,,Oakley,KS,67748-1218,Logan,211 CHERRY,,OAKLEY,KS,67748-1218,Logan,MEL SNOW,CEO,785-672-3211,407,msnow@lchoakley.com,AIMEE ZIMMERMAN,COO,785-672-3211,333,azimmerman@lchoakley.com,
KS-004227,LOGAN COUNTY HOSPITAL (rural health clinics),LOGAN COUNTY HOSPITAL,1821087230,Rural Health Clinics,211 Cherry Ave,,Oakley,KS,67748-1218,Logan,211 CHERRY,,OAKLEY,KS,67748-1218,Logan,MEL SNOW,CEO,785-672-3211,407,msnow@lchoakley.com,AIMEE ZIMMERMAN,COO,785-672-3211,333,azimmerman@lchoakley.com,
KS-004228,Decatur Health Systems,Decatur Health Systems,1619973468,Outpatient Hospital Clinics,810 W Columbia St,,Oberlin,KS,67749-2450,Decatur,810 W Columbia,,Oberlin,KS,67749,Decatur,Natasha Weishapl,Business Office Manager,785-475-2208,226,nweishapl@decaturhealthsystems.org,Kris Mathews,Chief Operating Officer,785-475-2208,229,kmathews@chmccook.org,
KS-004229,Decatur Health Systems,Decatur Health Systems,1821019605,Inpatient Hospitals (other than children's hospitals),810 W Columbia St,,Oberlin,KS,67749-2450,Decatur,810 W Columbia,,Oberlin,KS,67749,Decatur,Natasha Weishapl,Business Office Manager,785-475-2208,226,nweishapl@decaturhealthsystems.org,Kris Mathews,Chief Operating Officer,785-475-2208,229,kmathews@chmccook.org,
KS-004230,Decatur Health Systems Family Practice Clinic,Decatur Health Systems,1013222629,Rural Health Clinics,902 W Columbia St,,Oberlin,KS,67749-2450,Decatur,810 W Columbia,,Oberlin,KS,67749,Decatur,Natasha Weishapl,Business Office Manager,785-475-2208,225,nweishapl@decaturhealthsystems.org,Kris Mathews,Chief Operating Officer,785-475-2208,229,kmathews@chmccook.org,
KS-004231,"Health Partnership Clinic, Inc.","HEALTH PARTNERSHIP CLINIC, INC",1265785232,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",407 S Clairborne Rd,Suite 104,Olathe,KS,66062-1744,Johnson,"407 S. Clairborne Rd., Suite 104",,Olathe,KS,66062,Johnson,Nathan Jackson,COO,816-865-6283,,njackson@hpcjc.org,,,,,,
KS-004232,Goad Medical Clinic,Osborne County Memorial Hospital,1639261811,Rural Health Clinics,431 W New Hampshire St,,Osborne,KS,67473-2313,Osborne,424 W New Hampshire,PO B,Osborne,KS,67473,Osborne,Linda Murphy,CFO,785-346-2121,140,lmurphy@ocmh.net,Linda Murphy,CFO,785-346-2121,140,lmurphy@ocmh.net,
KS-004233,Oswego Community Clinic,CAH Acquisition Company #2 LLC,1871823344,Rural Health Clinics,800 Barker Dr,Suite B,Oswego,KS,67356-9022,Labette,800 Barker Drive,,Oswego,KS,67356,Labette,Jacque Swanston,Director of Managed Care Contracting,816-802-6141,,JSwanston@ruralcommunityhospitals.com,Dan Hiben,CEO,620-795-2921,,dhiben@oswegomedical.com,
KS-004234,OSWEGO COMMUNITY HOSPITAL,OSWEGO COMMUNITY HOSPITAL,1083630164,Inpatient Hospitals (other than children's hospitals),800 Barker Dr,,Oswego,KS,67356-9022,Labette,800 Barker Drive,Suite B,Oswego,KS,67356,Labette,Daniel Hiben,CEO,620-795-2921,,dhiben@oswegocommunityhospital.com,Christina Schlatter,CFO,620-795-2921,,cshclatter@oswegocommunityhospital.com,
KS-004235,Health Partnership Clinic Ottawa,"HEALTH PARTNERSHIP CLINIC, Inc.",1851773709,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",107 S Main St,Suite 1,Ottawa,KS,66067-2327,Franklin,"407 S. Clairborne Rd., Suite 104",,Olathe,KS,66062,Johnson,Amy Falk,CEO,913-433-7583,8028,afalk@hpcjc.com,Billie Reese-Turner,Revenue Cycle Manager,913-730-3674,8057,bturner@hpcjc.com,http://www.hpcjc.org
KS-004236,"Elizabeth Layton Center, Inc.","Elizabeth Layton Center, Inc.",1649296757,Community Mental Health Centers,2537 Eisenhower Rd,,Ottawa,KS,66067-9482,Franklin,2537 Eisenhower Road,,Ottawa,KS,66067-9482,Franklin,Kiki Heck,Executive Integration Specialist,785-242-3780,109,kheck@laytoncenter.org,Leslie Bjork,Executive Director,785-242-3780,,lbjork@laytoncenter.org,www.laytoncenter.org
KS-004237,Overland Park Health Center,"Comprehensive Health of Planned Parenthood Great Plains, Inc.",1336282573,Family Planning Providers,4401 W 109th St # 100,,Overland Park,KS,66211-1303,Johnson,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Amanda Addison,VP of Health Services,913-345-4659,,Amanda.addison@ppgreatplains.org,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,,shirish.malla@ppgreatplains.org,http://www.ppgreatplains.org
KS-004238,Children's Mercy Hospital Kansas (children's inpatient hospital),Children's Mercy Hospital (The),1154400232,Children's Hospitals (inpatient only),5808 W 110th St,,Overland Park,KS,66211-2504,Johnson,2401 Gillham Road,,Kansas City,MO,64108,Jackson,Chad M. Moore,Sr. Director of Payor Relations,816-559-9374,,cmoore@cmpcn.org,,,,,,
KS-004239,Children's Mercy Hospital Kansas (dental provider),Children's Mercy Hospital (The),1154400232,Dental Providers,5808 W 110th St,,Overland Park,KS,66211-2504,Johnson,2401 Gillham Road,,Kansas City,MO,64108,Jackson,Chad M. Moore,Sr. Director of Payor Relations,816-559-9374,,cmoore@cmpcn.org,,,,,,
KS-004240,HEALTH PARTNERSHIP CLINIC Paola,"HEALTH PARTNERSHIP CLINIC, Inc.",1407109481,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1604 Industrial Park Dr,,Paola,KS,66071-9528,Miami,"407 S. Clairborne Rd., Suite 104",,Olathe,KS,66062,Johnson,Nathan Jackson,COO,816-865-6283,,njackson@hpcjc.org,,,,,,
KS-004241,Labette County Medical Center d/b/a Labette Health,Labette Health,1578560421,Inpatient Hospitals (other than children's hospitals),1902 S US Highway 59,,Parsons,KS,67357-4948,Labette,1902 S US Hwy 59,,Parsons,KS,67357,Labette,Thomas L. Macaronas,CFO/COO,620-820-5251,,tmac@labettehealth.com,Brian Williams,President,620-820-5372,,bwilliams@labettehealth.com,
KS-004242,Labette Health Family Practice Clinic,Labette County Medical Center,1861798753,Rural Health Clinics,1902 S US Highway 59,Bldg E,Parsons,KS,67357-4948,Labette,"1902 S Hwy 59, Bldg E",,Parsons,KS,67357,Labette,Missy Beasley,CLINIC MANAGER,620-820-5889,,mbeasley@labettehealth.com,Doug Stacy,CIO,620-820-5398,,dstacy@labettehealth.com,
KS-004243,Community Health Center of Southeast Kansas/Parsons Clinic,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1669858973,"Dental Providers, Federally Qualified Health Centers - Medical Services",2100 Commerce Dr,,Parsons,KS,67357-4951,Labette,3011 N Michigan,,Pittsburg,KS,66762,Crawford,Jason Wesco,Executive Vice President,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004244,PHILLIPS COUNTY HOSPITAL,PHILLIPS COUNTY HOSPITAL,1639268246,Inpatient Hospitals (other than children's hospitals),1150 State St,,Phillipsburg,KS,67661-1743,Phillips,1150 State St,,Phillipsburg,KS,67661,Phillips,Dave Engel,CEO,785-540-4924,,dengel@phillipshospital.org,Christi Driggs,CFO,785-540-4919,,cdriggs@phillipshospital.org,http://www.phillipshospital.org/
KS-004245,PHILLIPS COUNTY MEDICAL CLINIC,PHILLIPS COUNTY MEDICAL CLINIC,1366499717,Rural Health Clinics,1719 Highway 183,,Phillipsburg,KS,67661-2549,Phillips,1150 State St.,,Phillipsburg,KS,67661,Phillips,Rhonda Kellerman,Clinic Administrator,785-543-5211,,rkellerman@phillipshospital.org,Dave Engel,CEO,785-540-4924,,dengel@phillipshospital.org,http://www.phillipshospital.org/
KS-004246,VIA CHRISTI HOSPITAL PITTSBURG INC (dental provider),VIA CHRISTI HOSPITAL PITTSBURG INC,1831125087,Dental Providers,1 Mt Carmel Way,,Pittsburg,KS,66762-7587,Crawford,8200 E Thorn,,Wichita,KS,67226,Sedgwick,Courtney Herrill,Manager Managed Care Contracts,316-719-1403,,courtney.herrill@viachristi.org,Carol Karp,Chief Financial Officer,316-858-4933,,carol.karp@viachristi.org,
KS-004247,"Via Christi Hospital Pittsburg, Inc. (inpatient hospital)","Via Christi Health, Inc.",1831125087,Inpatient Hospitals (other than children's hospitals),1 Mt Carmel Way,,Pittsburg,KS,66762-7587,Crawford,8200 E Thorn,,Wichita,KS,67226,Sedgwick,Courtney Herrill,Manager Managed Care Operations,316-719-1403,,courtney.herrill@ascension.org,Michael McCullough,Chief Financial Officer,316-858-4933,,michael.mccullough@ascension.org,
KS-004248,Community Health Center of Southeast Kansas -,Community Health Center of Southeast Kansas,1669474425,"Dental Providers, Federally Qualified Health Centers - Medical Services",3011 N Michigan St,,Pittsburg,KS,66762-2546,Crawford,3011 N Michigan,,Pittsburg,KS,66762,Crawford,Jason Wesco,Executive Vice-President,620-240-5076,,jwesco@chcsek.org,Krista Postai,CEO and President,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004249,Vie Medical Clinic,Women's Resource CTR of SEK,1891746913,Sexually Transmitted Disease Clinics,613 N Broadway St,Suite C,Pittsburg,KS,66762-3935,Crawford,613 N. Broadway,Suite C,Pittsburg,KS,66762,Crawford,Hannah Larcom,Executive Director,620-235-0605,,hannah@viemedicalclinic.org,,,,,,www.viemedicalclinic.org
KS-004250,CHC OF SE KANSAS / DENTAL CLINIC,"COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",1174525943,Dental Providers,924 N Broadway St,,Pittsburg,KS,66762-3910,Crawford,3011 N Michigan,,Pittsburg,KS,66762,Crawford,Jason Wesco,Exec VP,620-240-5076,,jwesco@chcsek.org,Krista Postai,President & CEO,620-235-1867,,kpostai@chcsek.org,www.chcsek.org
KS-004251,Plains Rural Health Clinic,MEADE DISTRICT HOSPITAL,1285630327,Rural Health Clinics,402 Grand Ave,,Plains,KS,67869-9772,Meade,P O Box 820,,Meade,KS,67864,Meade,Gaudelia T Feldmeyer,CLINIC MANAGER,620-873-5560,,gfeldmeyer@meadehospital.com,Janet Gleason,Assistant Manager,620-873-5687,,jgleason@meadehospital.com,www.avhealthsystem.com
KS-004252,ROOKS COUNTY HEALTHCARE CENTER,ROOKS COUNTY HEALTHCARE CENTER,1649278854,Inpatient Hospitals (other than children's hospitals),1210 N Washington St,,Plainville,KS,67663-1632,Rooks,1210 N WASHINGTON,PO Box 389,Plainville,KS,67663,Rooks,FRANK RAJEWSKI,CFO,785-688-4444,444,frajewski@plainville.hpmin.com,MIKE SINCLAIR,CEO,785-688-4435,435,msinclair@plainville.hpmin.com,http://rookscountyhealthcenter.com/
KS-004253,PRATT REGIONAL MEDICAL CENTER,Pratt Regional Medical Center Corporation,1578596904,Rural Health Clinics,200 Commodore St,,Pratt,KS,67124-3099,Pratt,200 Commodore St,,Pratt,KS,67124,Pratt,Vincent S. Wilczek,CFO,620-450-1436,,vwilczek@prmc.org,Susan Page,CEO,620-450-1163,,spage@prmc.org,prmc.org
KS-004254,Pratt Family Practice LLC,Pratt Family Practice LLC,1740233204,Rural Health Clinics,203 Watson St,Suite 200,Pratt,KS,67124-3092,Pratt,PO Box 308,,Pratt,KS,67124,Pratt,Amy Schrag,Office Manager,620-672-7422,,aschrag@prmc.org,Dr. Gene Cannata,Physician/owner,620-672-7422,,gcannata@prmc.org,prmc.org
KS-004255,PRATT INTERNAL MEDICINE GROUP,Pratt Regional Medical Center Corporation,1881025393,Sexually Transmitted Disease Clinics,420 Country Club Rd,,Pratt,KS,67124-3125,Pratt,200 Commodore,,Pratt,KS,67124,Pratt,Kelly McDermeit,V.P. Clinic Services,620-672-7451,1420,kmcdermeit@prmc.org,Susan Page,CEO,620-672-7451,,spage@prmc.org,prmc.org
KS-004256,GOVE COUNTY MEDICAL CENTER,GOVE COUNTY MEDICAL CENTER,1932192465,Inpatient Hospitals (other than children's hospitals),520 W 5th St,,Quinter,KS,67752-9705,Gove,520 W 5th Street,,Quinter,KS,67752-9705,Gove,Coleen Tummons,CEO,785-754-3341,5155,ctummons@govecountymedicalcenter.org,Sheree Flax,CFO Assistant,785-754-3341,5132,sflax@govecountymedicalcenter.org,
KS-004257,Russell Regional Hospital Physicians Clinic (inpatient hospital),Russell Regional Hospital,1215907951,Inpatient Hospitals (other than children's hospitals),200 S Main St,,Russell,KS,67665-2920,Russell,222 South Kansas,200 South Main,Russell,KS,67665,Russell,Pamala S Blau,Clinic Manager,785-483-3333,,pamb@russellhospital.org,,,,,,
KS-004258,Russell Regional Hospital Physicians Clinic (rural health clinics),Russell Regional Hospital,1215907951,Rural Health Clinics,200 S Main St,,Russell,KS,67665-2920,Russell,222 South Kansas,200 South Main,Russell,KS,67665,Russell,Pamala S Blau,Clinic Manager,785-483-3333,,pamb@russellhospital.org,,,,,,
KS-004259,Sabetha Community Hospital,"GREAT PLAINS OF SABETHA, INC.",1306875745,Inpatient Hospitals (other than children's hospitals),14th And Oregon Streets,,Sabetha,KS,66534,Nemaha,14th and Oregon Streets,PO Box 229,SABETHA,KS,66534,Nemaha,Jianna Zahner,Administrative Assistant,785-284-1542,,jzahner@sabethahospital.com,Lora Key,CEO,785-284-2121,568,lkey@sabethahospital.com,
KS-004260,CHEYENNE COUNTY HOSPITAL,CHEYENNE COUNTY HOSPITAL,1992736458,Inpatient Hospitals (other than children's hospitals),210 W 1st St,,Saint Francis,KS,67756-3540,Cheyenne,210 West First Street,PO Box 547,Saint Francis,KS,67756,Cheyenne,Scott Jenkins,Administrator,785-332-2104,119,sjenkins@cheyennecountyhospital.com,Shawna Blanka,Director of Quality,785-332-2104,118,sblanka@cheyennecountyhospital.com,
KS-004261,Cheyenne County Clinic,Cheyenne County Clinic,1821389180,Rural Health Clinics,221 W 1st St,,Saint Francis,KS,67756-3540,Cheyenne,220 W 1st,,St. Francis,KS,67756,Cheyenne,Scott Jenkins,CEO Cheyenne County Hospital,785-332-2104,119,sjenkins@cheyennecountyhospital.com,,,,,,
KS-004262,Cheyenne County Health Department,Cheyenne County Health Department,1134150659,Other ECP Providers,221 W 1st St,,Saint Francis,KS,67756-3540,Cheyenne,221 W 1st St.,,Saint Francis,KS,67756,Cheyenne,Tia Sager,CEO,785-332-2104,,sjenkins@cheyennecountyhospital.com,Shawna Blanka,Quality,785-332-2104,,sblanka@cheyennecountyhospital.com,
KS-004263,ST JOHN RURAL HEALTH CLINIC,Pratt Regional Medical Center Corporation,1639278286,Sexually Transmitted Disease Clinics,609 E 1st Ave,,Saint John,KS,67576-2223,Stafford,200 Commodore,,Pratt,KS,67124,Pratt,Kelly McDermeit,V.P. Clinic Services,620-672-7451,1420,kmcdermeit@prmc.org,Susan Page,CEO,620-672-7451,,spage@prmc.org,https://www.prmc.org/our-clinics/farmer-clinic.html
KS-004264,St. Paul Clinic,Labette County Medical Center,1710985429,Rural Health Clinics,200 Carroll St,,Saint Paul,KS,66771-4044,Neosho,1902 S Hwy 59 Bldg E,,Parsons,KS,67357,Labette,Missy Beasley,CLINIC MANAGER,620-820-5889,,mbeasley@labettehealth.com,Doug Stacy,CIO,620-820-5398,,dstacy@labettehealth.com,
KS-004265,SALINA FAMILY HEALTHCARE CENTER,SALINA HEALTH EDUCATION FOUNDATION,1396836029,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",651 E Prescott Rd,,Salina,KS,67401-7408,Saline,651 E Prescott Rd,,Salina,KS,67401-7408,Saline,Robert S Freelove,CEO,785-825-7251,,rfreelove@salinahealth.org,Ann Feil,COO,785-825-7251,233,afeil@salinahealth.org,
KS-004266,Satanta District Hospital.,Satanta District Hospital,1740230549,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Rural Health Clinics",401 Cheyenne Ave,PO Box 159,Satanta,KS,67870-0159,Haskell,401 Cheyenne Ave,PO Box 159,Satanta,KS,67870,Haskell,Kim Leggett,Office Manager,620-649-2761,258,kleggett@satantahospital.org,,,,,,
KS-004267,Satanta District Hospital.,Satanta District Hospital,1740230549,Inpatient Hospitals (other than children's hospitals),401 Cheyenne Ave,,Satanta,KS,67870-8748,Haskell,401 Cheyenne Ave,,Satanta,KS,67870,Haskell,Kim Leggett,Office Manager,620-649-2761,258,kleggett@satantahospital.org,,,,,,
KS-004268,NEMAHA VALLEY COMMUNITY HOSPITAL,NEMAHA VALLEY COMMUNITY HOSPITAL,1669470712,Rural Health Clinics,1600 Community Dr,,Seneca,KS,66538-9739,Nemaha,1600 Community Drive,,Seneca,KS,66538,Nemaha,Kiley Floyd,CEO,785-336-6181,137,kfloyd@nemvch.org,,,,,,
KS-004269,"Kanza Mental Health & Guidance Center, Inc.","Kanza Mental Health & Guidance Center, Inc.",1619909181,Community Mental Health Centers,710 Pioneer St,Suite 3,Seneca,KS,66538-1614,Nemaha,909 S. 2nd Street,PO Box 319,Hiawatha,KS,66434-0319,Brown,Virginia Freese,Director of Business Operations,785-742-7113,102,vfreese@kanzamhgc.org,David Elsbury,CEO,785-742-7113,122,delsbury@kanzamhgc.org,
KS-004270,Wallace County Family Practice Clinic,GREELEY CO FAMILY PRACTICE CLINIC,1316054141,Rural Health Clinics,504 E 6th,,Sharon Springs,KS,67758-9707,Wallace,321 E Harper St,,Tribune,KS,67879,Greeley,John Kennedy,Quality and Compliance Manager,620-376-4221,152,jkennedy@mygchs.com,Luke Senden,Interim CFO,620-376-4221,501,cfo@mygchs.com,http://mygchs.com/
KS-004271,Smith County Family Practice,"Great Plains of Smith Co., Inc.",1396773180,Rural Health Clinics,119 E Parliament St,,Smith Center,KS,66967-3015,Smith,"Great Plains of Smith Co., Inc",614 S. Main,Smith Center,KS,66967,Smith,Allen Van Driel,Chief Executive Officer,785-282-6845,214,avandriel@smithcohosp.org,Viola Babcock,Chief Financial Officer,785-282-6845,246,vbabcock@smithcohosp.org,
KS-004272,Smith County Memorial Hospital,"Great Plains of Smith Co., Inc.",1700985116,Inpatient Hospitals (other than children's hospitals),614 S Main St,,Smith Center,KS,66967-3001,Smith,614 S. Main,P.O. Box 349,Smith Center,KS,66967,Smith,Allen Van Driel,Chief Executive Officer,785-282-6845,214,avandriel@smithcohosp.org,Viola Babcock,Chief Financial Officer,785-282-6845,246,vbabcock@smithcohosp.org,
KS-004273,Hutchinson Clinic Walk In Care,"Hutchinson Clinic, PA, Inc",1841530946,Rural Health Clinics,24 S Main St,,South Hutchinson,KS,67505-1508,Reno,2101 North Waldron St,,Hutchinson,KS,67502,Reno,Belinda Mahoney,Contract & Reimbursement Manager,620-669-2644,2644,mahoneyb@hutchclinic.com,Gary Golliher,CFO,620-694-2110,2110,golliherg@hutchclinic.com,www.hutchclinic.com
KS-004274,FARMER CLINIC,Pratt Regional Medical Center Corporation,1750472429,Sexually Transmitted Disease Clinics,802 W Broadway St,,Stafford,KS,67578-1402,Stafford,200 Commodore,,Pratt,KS,67124,Pratt,Kelly McDermeit,V.P. Clinic Services,620-672-7451,1420,kmcdermeit@prmc.org,Susan Page,CEO,620-672-7451,,spage@prmc.org,prmc.org
KS-004275,Sterling Medical Center,Hospital District #1 of Rice County,1689973372,Rural Health Clinics,239 N Broadway Ave,,Sterling,KS,67579-1916,Rice,619 S. Clark,,Lyons,KS,67554,Rice,George M. Stover,CEO,620-257-5173,,gstover@rch-lyons.com,,,,,,
KS-004276,SYLVIA RURAL HEALTH CLINIC,Pratt Regional Medical Center Corporation,1245321819,Sexually Transmitted Disease Clinics,200 S Main St,,Sylvia,KS,67581-9704,Reno,200 Commodre,,Pratt,KS,67124,Pratt,Kelly McDermeit,V.P. Clinic Services,620-672-7451,1420,kmcdermeit@prmc.org,Susan Page,CEO,620-672-7451,,spage@prmc.org,prmc.org
KS-004277,Stormont Vail Health,"Stormont-Vail HealthCare, Inc.",1194782409,Inpatient Hospitals (other than children's hospitals),1500 SW 10th Ave,,Topeka,KS,66604-1301,Shawnee,1500 SW 10th Ave,,Topeka,KS,66604,Shawnee,DeAnna King,Managed Care Contract Manager,785-354-6259,,deking@stormontvail.org,Todd Lutz,Director of Managed Care Services,785-354-5215,,tolutz@stormontvail.org,stormontvail.org
KS-004278,Community Health Center/Local Health Department,Shawnee County Health Agency,1104841907,Federally Qualified Health Centers - Medical Services,1615 SW 8th Ave,,Topeka,KS,66606-1633,Shawnee,200 SE 7th St,,Topeka,KS,66603-3922,Shawnee,Alice Weingartner,CHC Director,785-251-2039,,alice.weingartner@snco.us,,,785-233-8200,,,
KS-004279,GraceMed Capitol Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1194174482,Federally Qualified Health Centers - Medical Services,1615 SW 8th Ave,,Topeka,KS,66606-1633,Shawnee,1122 N Topeka,,Wichita,KS,67214,Sedgwick,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,David Sanford,CEO,316-866-2001,,dsanford@gracemed.org,
KS-004280,Sims-Kemper Clinical Counseling,Sims-Kemper Clinical Counseling,1437241536,Other ECP Providers,1701 SW Medford Ave,,Topeka,KS,66604-3147,Shawnee,1701 SW Medford Ave,,Topeka,KS,66604,Shawnee,Shirley Murray,Executive Director,785-233-0666,,shirley.simskemper@sbcglobal.net,Julie Brobst,Director of Operations,785-233-0666,,julie.simskemper@sbcglobal.net,
KS-004281,GraceMed Highland Park Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1285083469,Federally Qualified Health Centers - Medical Services,2025 SE California Ave,,Topeka,KS,66607-1443,Shawnee,1122 N Topeka,,Wichita,KS,67214,Sedgwick,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,David Sanford,CEO,316-866-2001,,dsanford@gracemed.org,
KS-004282,Shawnee County Health Agency/CHC - California Clinic,Shawnee County Health Agency/CHC,1104841907,Federally Qualified Health Centers - Medical Services,2025 SE California Ave,,Topeka,KS,66607-1443,Shawnee,200 SE 7th St,,Topeka,KS,66603-3922,Shawnee,Alice Weingartner,CHC Director,785-251-2000,,alice.weingartner@snco.us,,,,,,
KS-004283,Marian Dental Clinic,Marian Clinic Inc,1063577922,Dental Providers,3164 SE 6th Ave,,Topeka,KS,66607-2204,Shawnee,3164 SE 6th Ave,,Topeka,KS,66607,Shawnee,Krista M Hahn,Executive Director,785-233-2800,105,krista.hahn@mariandental.org,Patty Vasquez,Office Manager,785-233-2800,,patty.vasquez@mariandental.org,www.mariandental.org
KS-004284,Family Service and Guidance Center (Frazier),Family Service and Guidance Center,1235103755,Community Mental Health Centers,325 SW Frazier Ave,,Topeka,KS,66606-1999,Shawnee,325 SW Frazier,,Topeka,KS,66606,Shawnee,Ed Cullumber,Chief Operating Officer,785-270-8901,,ecullumber@fsgctopeka.com,Chris Hartman,Chief Financial Officer,785-232-7905,,chartman@fsgctopeka.com,http://www.fsgctopeka.com
KS-004285,Valeo Recovery Center,Valeo Recovery Center,1669597704,Community Mental Health Centers,330 SW Oakley Ave,,Topeka,KS,66606-1995,Shawnee,5401 SW 7th,,Topeka,KS,66606-1995,Shawnee,Rebecca Honaker,Billing Manager,785-273-2252,5230,beckyh@valeotopeka.org,Angela Haggard,CFO,785-273-2253,5204,angieh@valeotopeka.org,http://www.valeotopeka.org
KS-004286,Greeley County Hospital,Greeley County Health Services,1285742536,Inpatient Hospitals (other than children's hospitals),506 3rd St,,Tribune,KS,67879-9684,Greeley,PO Box 338,,Tribune,KS,67879,Greeley,John Kennedy,Quality and Compliance Manager,620-376-4221,152,jkennedy@mygchs.com,Luke Senden,CFO,620-376-4221,501,cfo@mygchs.com,www.mygchs.com
KS-004287,"Kanza Mental Health & Guidance Center, Inc.","Kanza Mental Health & Guidance Center, Inc.",1619909181,Community Mental Health Centers,134 E Walnut St,,Troy,KS,66087,Doniphan,909 S 2nd St,,Hiawatha,KS,66434-0319,Brown,Virginia Freese,Director of Business Operations,785-742-7113,102,vfreese@kanzamhgc.org,David Elsbury,CEO,785-742-7113,122,delsbury@kanzamhgc.org,
KS-004288,Genesis Family Health (Ulysses),"United Methodist Western Kansas Mexican American Ministries,Inc",1164619136,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",321 W Grant Ave,,Ulysses,KS,67880-2419,Grant,122 W Laurel,,Garden City,KS,67846,Finney,Laura Dykstra,COO,620-275-1766,,ldykstra@genesisfh.org,Connie Monzon,Billing Manager,620-271-7400,,cmonzon@genesisfh.org,
KS-004289,TREGO COUNTY LEMKE MEMORIAL HOSPITAL,TREGO COUNTY LEMKE MEMORIAL HOSPITAL,1922001015,Inpatient Hospitals (other than children's hospitals),320 N 13th St,,Wa Keeney,KS,67672-2002,Trego,320 N 13th,,WaKeeney,KS,67672,Trego,David Augustine,CEO,785-743-2182,175,daugustine@tclmh.org,,,,,,
KS-004290,WAKEENEY FAMILY CARE CENTER,WAKEENEY FAMILY CARE CENTER,1629186960,Rural Health Clinics,333 N 14th St,,Wa Keeney,KS,67672-3000,Trego,320 N 13th,,WaKeeney,KS,67672,Trego,David Augustine,CEO,785-743-2124,,daugustine@tclmh.org,,,,,,
KS-004291,Wamego Hospital Association dba Wamego Health Center,"Via Christi Health, Inc.",1588657928,Rural Health Clinics,711 Genn Dr,,Wamego,KS,66547-1179,Pottawatomie,8200 E Thorn,,Wichita,KS,67226,Sedgwick,Courtney Herrill,Manager Managed Care Contracts,316-719-1403,,courtney.herrill@ascension.org,Steve Land,Administrator,785-458-7201,,steve.land@ascension.org,
KS-004292,Washington County Hospital DBA Family Medicine of Washington County,Washington County Hospital DBA Family Medicine of Washington County,1790172377,Rural Health Clinics,302 E 2nd St,,Washington,KS,66968-2029,Washington,302 E. 2nd Street,,Washington,KS,66968,Washington,Jana Rollman,credentialing clerk,785-325-2211,144,jrollman@bluevalley.net,,,,,,
KS-004293,WASHINGTON COUNTY HOSPITAL,WASHINGTON COUNTY HOSPITAL,1962403584,Inpatient Hospitals (other than children's hospitals),304 E 3rd St,,Washington,KS,66968-2033,Washington,304 E 3rd St,,Washington,KS,66968-2033,Washington,Lana Schaaf,HIM/IT,785-325-2211,124,lschaaf@bluevalley.net,Roxanne Schottel,CEO,785-325-2211,102,rschottel@bluevalley.net,
KS-004294,Sumner Mental Health Center,Sumner Mental Health Center,1093735896,Community Mental Health Centers,1601 W 16th St,,Wellington,KS,67152-8125,Sumner,1601 W. 16th St,,Wellington,KS,67152,Sumner,Rhonda L. Fitzgerald,Patient Benefits Coordinator,620-326-7448,251,rhondalfitzgerald@hotmail.com,Lynette Turney,Patient Accounts Director,620-326-7448,250,lturney@sumnermentalhealth.org,
KS-004295,FAMILY PRACTICE ASSOCIATES (WETMORE),Rural Health Resources of Jackson County,1003152430,Rural Health Clinics,323 2nd St,,Wetmore,KS,66550-9618,Nemaha,1110 Columbine Dr,,Holton,KS,66436,Jackson,Bart Kenton,CFO,785-364-2116,4111,bkenton@rhrjc.org,Carrie Saia,CEO,785-364-2116,4101,csaia@rhrjc.org,
KS-004296,White Cloud Health Station,White Cloud Health Station,1538199724,"Dental Providers, Indian Health Service, Other ECP Providers",3313B Thrasher Rd,,White Cloud,KS,66094-4028,Doniphan,3313B Thrasher Rd,,White Cloud,KS,66094-4028,Doniphan,Kelly Battese,CEO,785-843-4824,,kelly.battese@ihs.gov,Brenda Griffin,PHN,785-595-3450,,brenda.griffin@ihs.gov,
KS-004297,KU Internal Medicine Midtown Clinic,University of Kansas School of Medicine-Wichita Medical Practice Association,1982679478,Ryan White Providers,1001 N Minneapolis St,,Wichita,KS,67214-3127,Sedgwick,1010 North Kansas,,Wichita,KS,67203,Sedgwick,Michael Roland Madecky,HIV Program Coodinator,316-293-3405,,mmadecky@kumc.edu,Dr. Donna Sweet,Medical Director,316-293-1840,,dsweet@kumc.edu,http://wichita.kumc.edu/
KS-004298,GraceMed Helen Galloway Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1184691693,"Dental Providers, Federally Qualified Health Centers - Medical Services",1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004299,GraceMed Evergreen Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1912333774,Federally Qualified Health Centers - Medical Services,1125 W 26th St N,,Wichita,KS,67204-5102,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004300,GraceMed Mother Mary Anne Clinic,"GRACEMED HEALTH CLINIC, INC.",1275893224,"Dental Providers, Federally Qualified Health Centers - Medical Services",1131 S Clifton Ave,,Wichita,KS,67218-2955,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004301,E C Tyree Health & Dental Clinic,E C Tyree Health & Dental Clinic,1295915841,"Dental Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1525 N Lorraine Ave,,Wichita,KS,67214-2444,Sedgwick,1525 N Lorraine,,Wichita,KS,67214,Sedgwick,Schaunta James-Boyd,ceo,316-681-2545,121,sjames-boyd@tyreeclinic.com,Trey Hightower,COO,316-681-2545,,fhightower@tyreeclinic.com,www.tyreeclinic.com
KS-004302,GraceMed Healthy Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1356777114,Federally Qualified Health Centers - Medical Services,1905 S Laura St,,Wichita,KS,67211-4422,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004303,GraceMed ComCare Clinic,"GRACEMED HEALTH CLINIC, INC.",1861859787,Federally Qualified Health Centers - Medical Services,1919 N Amidon Ave,Suite 100,Wichita,KS,67203-2118,Sedgwick,1122 N Topeka,,Wichita,KS,67214,Sedgwick,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,David Sanford,CEO,316-866-2001,,dsanford@gracemed.org,
KS-004304,GraceMed Downing Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1043646870,Federally Qualified Health Centers - Medical Services,2201 E 25th St N,Bldg 200,Wichita,KS,67219-4714,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004305,Wichita Health Center,Planned Parenthood Great Plains,1679614838,"Family Planning Providers, Sexually Transmitted Disease Clinics",2226 E Central Ave,,Wichita,KS,67214-4406,Sedgwick,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Amanda Addison,Vice President of Health Services,913-345-4659,,Amanda.addison@ppgreatplains.org,Shirish Malla,"Project Manager,Operations & Strategic Initiatives",913-345-4662,,shirish.malla@ppgreatplains.org,http://www.ppgreatplains.org
KS-004306,Hunter Health Clinic,Hunter Health Clinic,1376618348,"Dental Providers, Federally Qualified Health Centers - Medical Services",2318 E Central Ave,,Wichita,KS,67214-4436,Sedgwick,2318 E Central Ave,,Wichita,KS,67214-4436,Sedgwick,Erica Davis,Associate Executive Director,316-262-3611,1135,edavis@hunterhealthclinic.org,Liz Robledo,Accounts Receivable Manager,316-262-3611,1184,lrobledo@hunterhealthclinic.org,
KS-004307,HealthCore Clinic Inc,HEALTHCORE CLINIC INC,1033218565,Federally Qualified Health Centers - Medical Services,2707 E 21st St N,,Wichita,KS,67214-2249,Sedgwick,2707 E 21st St N,,Wichita,KS,67214-2249,Sedgwick,Teresa Lovelady,CEO,316-691-9404,,tlovelady@healthcoreclinic.org,Judy Ridder,Senior Staff Acct,316-612-6895,,jridder@healthcoreclinic.org,
KS-004308,BROOKSIDE SATELLITE OF HUNTER HEALTH,"HUNTER HEALTH CLINIC INC,",1376618348,Federally Qualified Health Centers - Medical Services,2750 S Roosevelt St,,Wichita,KS,67210-1304,Sedgwick,2318 E Central Ave,,Wichita,KS,67214-4436,Sedgwick,Erica Davis,Associate Executive Director,316-262-3611,1135,edavis@hunterhealthclinic.org,Liz Robledo,Accounts Receivable Manager,316-262-3611,1184,lrobledo@hunterhealthclinic.org,
KS-004309,GraceMed Jardine Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1730575069,Federally Qualified Health Centers - Medical Services,3610 E Ross Pkwy,,Wichita,KS,67210-1311,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004310,GraceMed Good Samaritan,"GRACEMED HEALTH CLINIC, INC.",1659631695,Federally Qualified Health Centers - Medical Services,3701 E 13th St N,Bldg 400,Wichita,KS,67208-2081,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004311,Recovery Unlimited,Recovery Unlimited,1174568398,Other ECP Providers,3835 W Douglas Ave,,Wichita,KS,67213-2408,Sedgwick,3835 West Douglas,,Wichita,KS,67213,Sedgwick,Wayne Simpson,Facility Director,316-941-9948,204,wayne@recovery-unlimited.com,Wayne Simpson,Facility Director,316-941-9948,,wayne@recovery-unlimited.com,
KS-004312,GraceMed Dodge Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1952651713,Federally Qualified Health Centers - Medical Services,4910 W 1st St N,,Wichita,KS,67212-2341,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004313,GraceMed Oaklawn Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1992113898,Federally Qualified Health Centers - Medical Services,5000 S Clifton Ave,Suite 200,Wichita,KS,67216-3408,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2001,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004314,GraceMed Meyer Family Clinic,"GRACEMED HEALTH CLINIC, INC.",1932579513,Federally Qualified Health Centers - Medical Services,755 W Lincoln St,,Wichita,KS,67213-4405,Sedgwick,1122 N Topeka St,,Wichita,KS,67214-2810,Sedgwick,David Sanford,Chief Executive Officer,316-866-2064,,dsanford@gracemed.org,Venus Lee,Associate Executive Officer,316-866-2064,,vlee@gracemed.org,www.gracemed.org
KS-004315,"Via Christi Hospitals Wichita, Inc. (inpatient hospital)","Via Christi Health, Inc.",1154314789,Inpatient Hospitals (other than children's hospitals),929 N Saint Francis St,,Wichita,KS,67214-3882,Sedgwick,929 N Saint Francis St,,Wichita,KS,67214-3821,Sedgwick,Courtney Herrill,Manager Managed Care Operations,316-719-1403,,courtney.herrill@ascension.org,Michael McCullough,Chief Financial Officer,316-858-4933,,michael.mccullough@ascension.org,
KS-004316,"VIA CHRISTI HOSPITALS WICHITA, INC (multiple outpatient ECP categories)","VIA CHRISTI HOSPITALS WICHITA, INC",1154314789,"Dental Providers, Freestanding Cancer Centers",929 N Saint Francis St,,Wichita,KS,67214-3882,Sedgwick,929 N Saint Francis St,,Wichita,KS,67214-3821,Sedgwick,Courtney Herrill,Manager Managed Care Contracts,316-719-1403,,courtney.herrill@viachristi.org,Carol Karp,Chief Financial Officer,316-858-4933,,carol.karp@viachristi.org,
KS-004317,Hunter Health Clinic at Inter-Faith Ministries,"HUNTER HEALTH CLINIC INC,",1376618348,Federally Qualified Health Centers - Medical Services,935 N Market St,,Wichita,KS,67214-3521,Sedgwick,2318 E Central Ave,,Wichita,KS,67214-4436,Sedgwick,Erica Davis,Associate Executive Director,316-262-3611,1135,edavis@hunterhealthclinic.org,Liz Robledo,Accounts Receivable Manager,316-262-3611,1184,lrobledo@hunterhealthclinic.org,
KS-004318,ABC Medical Clinic,Augusta Family Practice PA,1427491208,Rural Health Clinics,1230 E 6th Ave,Suite 2C,Winfield,KS,67156-3145,Cowley,1306 State Street,,Augusta,KS,67010,Butler,Amanda Johnson,Site Manager,620-402-6699,,amanda@rauschclinics.com,Lynette Scheid,CEO,316-775-9191,,lynette@rauschclinics.com,
KS-004319,WILLIAM NEWTON HOSPITAL (inpatient hospital),WILLIAM NEWTON HOSPITAL,1548229149,Inpatient Hospitals (other than children's hospitals),1300 E 5th Ave,,Winfield,KS,67156-2407,Cowley,1300 E th Ave,,Winfield,KS,67156,Cowley,Debbie Hockenbury,CFO,620-221-2300,104,debbie.hockenbury@wnmh.org,Megan Welty,Business Office Director,620-221-2300,107,megan.welty@wnmh.org,
KS-004320,WILLIAM NEWTON HOSPITAL (rural health clinics),WILLIAM NEWTON HOSPITAL,1548229149,Rural Health Clinics,1300 E 5th Ave,,Winfield,KS,67156-2407,Cowley,1300 E th Ave,,Winfield,KS,67156,Cowley,Debbie Hockenbury,CFO,620-221-2300,104,debbie.hockenbury@wnmh.org,Megan Welty,Business Office Director,620-221-2300,107,megan.welty@wnmh.org,
KS-004321,Community Health Center in Cowley County,"Community Health Center in Cowley County, Inc",1568843050,Federally Qualified Health Centers - Medical Services,221 W 8th Ave,,Winfield,KS,67156-2718,Cowley,221 W. 8th Avenue,,Winfield,KS,67156,Cowley,David E. Brazil,Chief Executive Officer,620-221-3350,,dbrazil@cowleyhealthcenter.org,Melody Vaden,Chief Operations Officer,620-221-3350,,mvaden@cowleyhealthcenter.org,http://www.cowleyhealthcenter.org
KS-004322,Cowley County Kansas,City-Cowley County Health Department,1497800684,Family Planning Providers,320 E 9th Ave,Suite B,Winfield,KS,67156-2867,Cowley,320 E 9th Street,Suite B,Winfield,KS,67156,Cowley,Thomas Langer,Administrator,620-221-1430,5551,tlanger@cowleycounty.org,,,,,,
KS-004323,WINFIELD MEDICAL ARTS PA,WINFIELD MEDICAL ARTS PA,1295720654,Rural Health Clinics,3625 Quail Ridge Rd,,Winfield,KS,67156-8881,Cowley,3625 QUAIL RIDGE DR,,WINFIELD,KS,67156,Cowley,J. KENT WINBLAD,PRESIDENT,620-221-6100,,DRKENT@WMARTS.COM,LORI ROOT,ADMINISTRATIVE ASSISTANT,620-221-6100,105,LROOT@WMARTS.COM,
KY-004324,Clinton County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1730561283,Federally Qualified Health Centers - Medical Services,169 Middle School Rd,,Albany,KY,42602-7931,Clinton,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004325,Early Childhood Center Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1043692643,Federally Qualified Health Centers - Medical Services,204 King Dr,,Albany,KY,42602-9630,Clinton,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004326,Clinton Family Medical Center,"Cumberland Family Medical Center, Inc.",1427218023,Federally Qualified Health Centers - Medical Services,606 Burkesville Rd,,Albany,KY,42602-1612,Clinton,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004327,Clinton County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1558743005,Federally Qualified Health Centers - Medical Services,65 High School Dr,,Albany,KY,42602-8986,Clinton,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Directory of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004328,Albany Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1942682547,Federally Qualified Health Centers - Medical Services,819 3rd St,,Albany,KY,42602-1635,Clinton,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004329,Annville Medical Clinic,East Bernstadt Medical Clinic,1336109644,Rural Health Clinics,78 Highway 3444,Suite 1,Annville,KY,40402-8245,Jackson,PO Box 398,,Annville,KY,40402,Jackson,Crissy Ward,Office Manager,606-287-5162,,dhmmc@prtcnet.org,Carla Johnson,Billing Manager,606-843-6195,,carla_ebmc@windstream.net,
KY-004330,Beechfork ARH Clinic,"Mary Breckinridge ARH Health Services, Inc.",1982989018,"Outpatient Hospital Clinics, Rural Health Clinics",805 Middle Fork Rd,,Asher,KY,40803,Leslie,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004331,Ashland Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,Federally Qualified Health Centers - Medical Services,2914 Holt St,,Ashland,KY,41101-4080,Boyd,211KY 59,,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004332,"Pathways, Inc.","Pathways, Inc.",1982615043,Community Mental Health Centers,3701 Landsdowne Dr,,Ashland,KY,41102,Boyd,1212 Bath Avenue,P.O. Box 790,Ashland,KY,41105-0790,Boyd,Kimberly Kay McClanahan,Chief Executive Officer,606-329-8588,4078,kmcclanahan@pathways-ky.org,Thomas Leach,Chief Financial Officer,606-329-8588,4059,tleach@pathways-ky.org,
KY-004333,AUBURN COMMUNITY HEALTH CLINIC,"Logan Physician Practice, LLC",1891031191,Rural Health Clinics,128 Sugar Maple Dr,,Auburn,KY,42206-5352,Logan,PO Box 1025,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004334,Bracken County Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,Federally Qualified Health Centers - Medical Services,1551 Augusta Chatham Rd,,Augusta,KY,41002-9224,Bracken,211 KY59,,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,MIchelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004335,PHYSICIANS FOR WOMEN,"BIG SANDY HEALTH CARE, INC.",1588606370,Federally Qualified Health Centers - Medical Services,23 Willow Dr,,Auxier,KY,41602-9259,Floyd,1709 KY Route 321 Ste 3,,Prestonsburg,KY,41653-9097,Floyd,Ancil W Lewis,CEO,606-886-8546,,A.LEWIS@BSHC.ORG,,,,,,WWW.BSHC.ORG
KY-004336,Barbourville Family Health Center,Barbourville Family Health Center,1801872882,Rural Health Clinics,215 N Allison Ave,PO Box 1150,Barbourville,KY,40906-1336,Knox,PO Box 1150,,Barbourville,KY,40906,Knox,Stephanie Wilson,Practice Manager,606-546-9287,304,bfhc1@windstream.net,,,,,,
KY-004337,Access Family Health Center,Access Family Health Center,1275786071,Rural Health Clinics,315 Hospital Dr,Suite 2,Barbourville,KY,40906-7917,Knox,PO Box 1150,,Barbourville,KY,40906,Knox,Stephanie Wilson,Practice Manager,606-546-9287,304,bfhc1@windstream.net,,,,,,
KY-004338,Carlisle County Health Center,Purchase District Health Center,1346277563,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",62 John Roberts Dr,,Bardwell,KY,42023-8000,Carlisle,P.O. Box 2357,,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-9625,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004339,KENTUCKYCARE112,ARCARE,1215318019,Federally Qualified Health Centers - Medical Services,120 N 4th St,,Barlow,KY,42024-9579,Ballard,117 S SECOND ST,,AUGUSTA,AR,72006,Woodruff,"STEVEN COLLIER, MD",CEO,870-347-3374,,PROSERVICES@ARCARE.NET,,,,,,WWW.ARCARE.NET
KY-004340,"JUNIPER HEALTH, Inc. DBA Lee County Family Medical Clinic","JUNIPER HEALTH, INC.",1407818628,"Dental Providers, Federally Qualified Health Centers - Medical Services",125 Main St,,Beattyville,KY,41311-7484,Lee,141 Main St,,Beattyville,KY,41311-7484,Lee,Karen Ditsch,CEO,606-464-0151,,karen.ditsch@juniperhealth.org,,,,,,www.juniperhealth.org
KY-004341,HEALTHPOINT FC BELLEVUE OFFICE,"HEALTH POINT FAMILY CARE, INC",1508889742,"Dental Providers, Federally Qualified Health Centers - Medical Services",103 Landmark Dr,Suite LL2,Bellevue,KY,41073-1399,Campbell,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004342,"Health Help, Incorporated","HEALTH HELP, INCORPORATED",1952733842,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Pirate Pkwy,White House Clinic - Berea Community School,Berea,KY,40403-1541,Madison,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004343,White House Clinic - Berea,"HEALTH HELP, INCORPORATED",1023094695,"Dental Providers, Federally Qualified Health Centers - Medical Services",104 Legacy Dr,,Berea,KY,40403-9594,Madison,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004344,Saint Joseph Berea,Saint Joseph Berea,1740488386,Inpatient Hospitals (other than children's hospitals),305 Estill St,,Berea,KY,40403-1742,Madison,250 East Liberty Street,,Louisville,KY,40205,Jefferson,Stephen Yates,Sr. Reimbursement Analyst,502-587-4748,,stephenyates@sjhlex.org,Christy Spitser,,606-330-6016,,clspitser@sj-london.org,
KY-004345,White House Clinic,Health Help Incorporated,1861477630,"Dental Providers, Federally Qualified Health Centers - Medical Services",305 Estill St,,Berea,KY,40403-1742,Madison,1010 Main Street South,,Mckee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004346,Big Creek ARH Clinic,"Mary Breckinridge ARH Health Services, Inc.",1790060820,"Outpatient Hospital Clinics, Rural Health Clinics",17644 S Highway 421,,Big Creek,KY,40914-8713,Clay,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Leslie,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004347,"ROYAL TREATMENT HEALTHCARE, INC","Royal Treatment Healthcare, Inc",1376889055,Rural Health Clinics,4671 S US Highway 25E,,Bimble,KY,40915-6112,Knox,4671 S US Hwy 25E,,Barbourville,KY,40915,Knox,Barbara Bargo,"Owner, president",606-546-2598,,Royaltx@aol.windstream.net,,,,,,
KY-004348,Owsley County Medical Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1043257827,"Dental Providers, Federally Qualified Health Centers - Medical Services",826 KY 11 N,,Booneville,KY,41314-9155,Owsley,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,"Teresa Fleming, MBA",Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004349,Fairview Community Health Center,"Bowling Green-Warren County Primary Care Center, Inc.",1336268234,Federally Qualified Health Centers - Medical Services,615 7th Ave,,Bowling Green,KY,42101-6921,Warren,615 7th Ave,PO BOX 1177,Bowling Green,KY,42101-6921,Warren,Chris Keyser,EXECUTIVE DIRECTOR/CEO,270-783-3573,1034,ckeyser@fairviewcommunityhealth.org,DAWN COLEMAN,DIRECTOR OF BUSINESS,270-783-3573,1033,dcoleman@fairviewcommunityhealth.org,www.fairviewcommunityhealth.org
KY-004350,Fairview Adult Health Care,"Bowling Green-Warren County Primary Care Center, Inc.",1336268234,Federally Qualified Health Centers - Medical Services,811 Fairview Ave,,Bowling Green,KY,42101-4969,Warren,615 7th Ave,,Bowling Green,KY,42101-6921,Warren,Chris Keyser,EXECUTIVE DIRECTOR/CEO,270-783-4251,,ckeyser@fairviewcommunityhealth.org,DAWN COLEMAN,DIRECTOR OF BUSINESS,270-783-3573,1033,dcoleman@fairviewcommunityhealth.org,
KY-004351,FAIRVIEW COMMUNITY HEALTH CENTER-ANNEX,"BOWLING GREEN-WARREN COUNTY PRIMARY CARE CENTER, INC.",1336268234,Federally Qualified Health Centers - Medical Services,825 4th Ave,,Bowling Green,KY,42101-1720,Warren,615 7th Ave,,Bowling Green,KY,42101-6921,Warren,Chris Keyser,EXECUTIVE DIRECTOR/CEO,270-783-4251,,ckeyser@fairviewcommunityhealth.org,DAWN COLEMAN,DIRECTOR OF BUSINESS,270-783-3573,1033,dcoleman@fairviewcommunityhealth.org,
KY-004352,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1063836898,Federally Qualified Health Centers - Medical Services,18392 KY Highway 28 Suite A,Buckhorn School Based Clinic,Buckhorn,KY,41721-8967,Perry,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004353,Buckhorn Medical Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1225082985,Federally Qualified Health Centers - Medical Services,72 Buckhorn Clinic Rd,,Buckhorn,KY,41721-8936,Perry,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004354,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1699019174,Federally Qualified Health Centers - Medical Services,11497 Hwy 805,Burdine Campus School Based Clinic,Burdine,KY,41517,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004355,Cumberland County Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1033591615,Federally Qualified Health Centers - Medical Services,150 Glasgow Rd,,Burkesville,KY,42717-9695,Cumberland,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004356,CUMBERLAND FAMILY MEDICAL CENTER,"Cumberland Family Medical Center, Inc.",1306873500,Federally Qualified Health Centers - Medical Services,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004357,Cumberland County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1205218880,Federally Qualified Health Centers - Medical Services,908 N Main St,,Burkesville,KY,42717-8955,Cumberland,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004358,Cumberland County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1346622933,Federally Qualified Health Centers - Medical Services,912 N Main St,,Burkesville,KY,42717-8955,Cumberland,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004359,"Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Calhoun","REGIONAL HEALTH CARE AFFILIATES, INC.",1144543349,Federally Qualified Health Centers - Medical Services,295 Main St,,Calhoun,KY,42327-2104,McLean,215 E Main St,,Providence,KY,42450-1261,Webster,William Smith,CEO,270-667-7017,,qstone@hfchc.net,,,,,,
KY-004360,"Juniper Health, Inc. DBA Wolfe County Family Medical Clinic","Juniper Health, Inc.",1962823393,Federally Qualified Health Centers - Medical Services,202 Plummer St,,Campton,KY,41301-9381,Wolfe,141 Main St,,Beattyville,KY,41311-7484,Wolfe,Karen Ditsch,CEO,606-464-0151,,karen.ditsch@juniperhealth.org,,,,,,www.juniperhealth.org
KY-004361,Carlisle Clinic,"Bourbon Physician Practices, LLC",1356689079,Rural Health Clinics,107 S Broadway St,,Carlisle,KY,40311-1150,Nicholas,PO Box 1025,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004362,Nicholas Family Health Services,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,2330 Concrete Rd,,Carlisle,KY,40311-9700,Nicholas,209 North Maysville Street,Suite 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004363,"Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Clay","REGIONAL HEALTH CARE AFFILIATES, INC.",1194020230,Federally Qualified Health Centers - Medical Services,9086 Sr 132 W,,Clay,KY,42404,Webster,215 E Main St,,Providence,KY,42450-1261,Webster,William Smith,CEO,270-667-7017,,bsmith@hfchc.net,,,,,,
KY-004364,FOOTHILLS HEALTH AND WELLNESS CENTER,KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL INC,1366713000,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",108 12th St,,Clay City,KY,40312-8979,Powell,309 Spangler Drive,,Richmond,KY,40475,Madison,Ruth Woolum,Project Director,606-663-9011,,rwoolum@foothillscap.org,Janice Rice,Billing Specialist,606-663-9011,,jrice@foothillscap.org,
KY-004365,Hickman County Health Center,Purchase District Health Department,1437186657,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",370 S Washington St,,Clinton,KY,42031-1325,Hickman,P.O. Box 2357,,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-6925,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004366,Family Medical Center,"Genesis Enterprises, Inc",1730243858,Rural Health Clinics,1463 Campbellsville Rd,,Columbia,KY,42728-2263,Adair,1463 Campbellsville Rd,,Columbia,KY,42728-2263,Adair,Kelly Bryant,Office Manager,270-384-9934,,kellybryant1@hotmail.com,,,,,,
KY-004367,Adair County Primary Center Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1164804720,Federally Qualified Health Centers - Medical Services,158 Colonel Casey Drive,,Columbia,KY,42728,Adair,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004368,First Choice Immediate Care Center,"Cumberland Family Medical Center, Inc.",1306873500,Federally Qualified Health Centers - Medical Services,197 Will Walker Rd,,Columbia,KY,42728,Adair,360 Keen St.,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,
KY-004369,Adair County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1831571751,Federally Qualified Health Centers - Medical Services,322 General John Adair Dr,,Columbia,KY,42728-1878,Adair,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004370,Adair County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1467834390,Federally Qualified Health Centers - Medical Services,526 Indian Dr,,Columbia,KY,42728-1879,Adair,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004371,Taylor Rural Health,Taylor Regional Hospital,1447581871,Rural Health Clinics,805 Burkesville St,,Columbia,KY,42728-1655,Adair,1700 Old Lebanon Road,,Campbellsville,KY,42718,Taylor,Sretta Clark,Office Manager,270-384-1110,115,stclark@trhosp.org,Cathy Settle,Clinical Services Administrator,270-789-6193,,crsettle@trhosp.org,
KY-004372,Westlake Primary Care,Adair County Hospital District,1932174968,Rural Health Clinics,810 Jamestown St,,Columbia,KY,42728-1010,Adair,901 Westlake Drive,,Columbia,KY,42728,Adair,Gidgett Warren,CNO/Clinic Director,270-384-4753,1111,gidgett.warren@wrhs-ky.com,Neal Gold,CEO,270-384-4753,1154,neal.gold@wrhs-ky.com,
KY-004373,Adair County Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1699157461,Federally Qualified Health Centers - Medical Services,870 Indian Dr,Adair County Elementary,Columbia,KY,42728-1813,Adair,360 Keen Street,,Burkesville,KY,427171080,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004374,Westlake Regional Hospital,Adair County Hospital District,1023083060,Inpatient Hospitals (other than children's hospitals),901 Westlake Dr,,Columbia,KY,42728-1123,Adair,761 Holmes Bend Road,,Columbia,KY,42728,Adair,Gidgett Warren,CNO/Clinic Director,270-384-4753,1111,gidgett.warren@wrhs-ky.com,Neal Gold,CEO,270-384-4753,1154,neal.gold@wrhs-ky.com,
KY-004375,Westlake Family Practice,Adair County Hospital District,1396992970,Rural Health Clinics,902 Westlake Dr,,Columbia,KY,42728-1149,Adair,901 Westlake Drive,Columb ia,KY,KY,42728,Adair,Gidgett Warren,CNO/Clinic Director,270-384-4753,1111,gidgett.warren@wrhs-ky.com,Neal Gold,CEO,270-384-4753,1154,neal.gold@wrhs-ky.com,
KY-004376,Adair Family Medical Center,"Cumberland Family Medical Center, Inc.",1003016882,Federally Qualified Health Centers - Medical Services,937 Campbellsville Rd,Suite 901,Columbia,KY,42728-2265,Adair,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004377,Grace Community Health Center Inc,Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,121 Bishop St,,Corbin,KY,40701-1702,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701-2735,Whitley,Kathy Brock,Credentialing Manager,606-545-4866,241,kathy@brickmountain.com,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.org,
KY-004378,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,1901 Snyder St,Corbin High School Based Health Clinic,Corbin,KY,40701-2451,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004379,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,3551 5th Street Rd,Corbin Primary School Based Health Clinic,Corbin,KY,40701-9650,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-545-4866,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004380,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,404 17th St,Corbin Intermediate School Based Health Clinic,Corbin,KY,40701-1922,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004381,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,614 Master St,Corbin Preschool Center School Based Health Clinic,Corbin,KY,40701-1058,Knox,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004382,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,706 S Kentucky Ave,Corbin Middle School Based Health Clinic,Corbin,KY,40701-1842,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004383,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,709 Roy Kidd Ave,Corbin Educational Center School Based Health Clinic,Corbin,KY,40701-1123,Knox,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004384,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,710 W 8th St,Corbin Elementary School Based Health Clinic,Corbin,KY,40701-2106,Whitley,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004385,Leatherwood/Blackey Medical Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1326092990,Federally Qualified Health Centers - Medical Services,464 KY Highway 699,,Cornettsville,KY,41731-8749,Perry,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004386,James E. Biggs ECE Center,"HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,1124 Scott St,,Covington,KY,41011-3168,Kenton,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004387,HealthPoint Covington Center,"HEALTH POINT FAMILY CARE, INC",1508889742,"Dental Providers, Federally Qualified Health Centers - Medical Services",1401 Madison Ave,,Covington,KY,41011-3313,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004388,"HealthPoint Family Care, Inc.","HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,1901 Maryland Ave,6th District Elementary,Covington,KY,41014-1442,Kenton,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004389,Holmes TLC,"HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,200 Home Rd,,Covington,KY,41011-1942,Kenton,1401 Madison Ave.,,Covington,KY,41011-3313,Kenton,Pamela Smallwood,Chief Operating Officer,859-655-6222,,psmallwood@healthpointfc.org,,,,,,
KY-004390,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,2500 Madison Ave,Holmes Middle School,Covington,KY,41014-1658,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004391,"HealthPoint Family Care, Inc.","HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,2800 Indiana Ave,9th District Elementary,Covington,KY,41015-1029,Kenton,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004392,"HealthPoint Family Care, Inc.","HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,3901 Huntington Ave,Latonia Elementary,Covington,KY,41015-1645,Kenton,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004393,"HealthPoint Family Care, Inc.","HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,501 W 19th St,Glenn O'Swing Elementary,Covington,KY,41014-1141,Kenton,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004394,JOHN G. CARLISLE ELEMENTARY SBHC,"HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,910 Holman Ave,,Covington,KY,41011-3013,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004395,Cumberland Medical/Dental Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1992251185,"Dental Providers, Federally Qualified Health Centers - Medical Services",1620 E Main St,,Cumberland,KY,40823-1837,Harlan,226 Medical Plaza Lane,,Whitesburg,KY,41858,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,"Teresa Fleming, MBA",Director of Financial Affairs,606-633-4823,1389,tfleming@mtncomp.org,www.mchcky.com
KY-004396,ARH Tri Cities Medical Center,"Appalachian Regional Healthcare, Inc.",1720112691,"Outpatient Hospital Clinics, Rural Health Clinics",18880 N US Highway 119,,Cumberland,KY,40823-8106,Harlan,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004397,Women's Care of the Commonwealth,"Cumberland Family Medical Center, Inc.",1548418494,Federally Qualified Health Centers - Medical Services,217 S 3rd St,,Danville,KY,40422-1823,Boyle,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,
KY-004398,Women's Care of the Commonwealth,"Cumberland Family Medical Center, Inc.",1700336864,Federally Qualified Health Centers - Medical Services,321 S 3rd St,Suite B,Danville,KY,40422-2090,Boyle,360 Keen St.,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,
KY-004399,Women's Care of the Commonwealth,"Cumberland Family Medical Center, Inc.",1215918917,Federally Qualified Health Centers - Medical Services,333 S 3rd St,,Danville,KY,40422-2016,Boyle,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,
KY-004400,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,701 5th Ave,Lincoln Elementary School,Dayton,KY,41074-1301,Campbell,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004401,Webster County Family Medicine,Methodist Hospital,1427035476,Outpatient Hospital Clinics,1355 US Highway 41A S,,Dixon,KY,42409-9447,Webster,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004402,Health First - Earlington,"Regional Health Care Affiliates, Inc.",1487020459,Federally Qualified Health Centers - Medical Services,107 E Main St,,Earlington,KY,42410-1333,Hopkins,"2251 Westerfield Drive, Ste B",,Providence,KY,42450,Webster,Shelley Gobin,COO,270-667-7017,,sgobin@hfchc.net,,,,,,
KY-004403,Eddyville Family Medical,"Livingston Hospital and Healthcare Services, Inc.",1386859908,Rural Health Clinics,209 W Main St,,Eddyville,KY,42038-7752,Lyon,131 Hospital Drive,,Salem,KY,42078,Livingston,Leah Tramble,Practice Administrator,270-988-7256,,ltramble@lhhs.org,Kent Giles,Interim CEO,270-988-7236,,kgiles@lhhs.org,www.lhhs.org
KY-004404,Edmonton Primary Care,Adair County Hospital District,1699740647,Rural Health Clinics,112 Sartin Dr Lot 1,,Edmonton,KY,42129-8170,Metcalfe,901 Westlake Drive,,Columbia,KY,42728,Adair,Gidgett Warren,CNO/Clinic Director,270-384-4753,1111,gidgett.warren@wrhs-ky.com,Neal Gold,CEO,270-384-4753,1154,neal.gold@wrhs-ky.com,
KY-004405,BLOUNT RURAL HEALTH CENTER,"Helping Hands Health Clinic, INC",1346670189,Rural Health Clinics,810 S Main St,,Elkton,KY,42220-8812,Todd,810 South Main,PO Box 277,Elkton,KY,42220,Todd,Anita Jo Powell,Executive Director,270-265-6504,,hhhc102@bellsouth.net,Angela Markham,Administrative Assistant,270-265-5600,202,angelahhhc@bellsouth.net,
KY-004406,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,459 Buckner St,Howell Elementary,Elsmere,KY,41018-2303,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004407,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1497002570,Federally Qualified Health Centers - Medical Services,1099 Highway 806,Arlie Boggs Elementary School Based Clinic,Eolia,KY,40826-6554,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004408,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,208 Sunset Ave,Miles Elementary School,Erlanger,KY,41018-1526,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004409,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,305 Bartlett Ave,Tichenor Middle School,Erlanger,KY,41018-1678,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004410,"HEALTH POINT FAMILY CARE, INC","HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,558 Erlanger Rd,Lindeman Elementary School,Erlanger,KY,41018-1305,Kenton,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,http://www.healthpointfc.org/service/school-based/
KY-004411,CLOVER FORK OUTPATIENT MEDICAL PROJECT,CLOVER FORK OUTPATIENT MEDICAL PROJECT INC,1811939366,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 Chad St,,Evarts,KY,40828-8200,Harlan,PO Box 39,,Evarts,KY,40828-0039,Harlan,Jack Miniard,CFO,606-837-2108,114,jminiard@cloverforkclinic.org,,,606-837-2108,,,www.cloverforkclinic.org
KY-004412,FAMILY HEALTH CENTER - FAIRDALE,"FAMILY HEALTH CENTERS, INC.",1871546119,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1000 Neighborhood Pl,,Fairdale,KY,40118-9697,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Julie Farmer,Clinic Director,502-774-8631,,,www.fhclouisville.org
KY-004413,ARH Family Health - Barbourville,"ARH Mary Breckinridge Health Services, Inc.",1770029126,"Outpatient Hospital Clinics, Rural Health Clinics",34 Mary Alice Dr,,Flat Lick,KY,40935-6164,Knox,100 Airport Gardens Roac,ATTN: Roy Milwee,Hazard,KY,41701,Knott,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004414,Fleming County Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,Federally Qualified Health Centers - Medical Services,520 Elizaville Ave,,Flemingsburg,KY,41041-1141,Fleming,211 KY 59,P.O. Box 550,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004415,Fleming County Hospital,LifePoint Health,1881726347,Inpatient Hospitals (other than children's hospitals),55 Foundation Dr,,Flemingsburg,KY,41041-9815,Fleming,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,THERESA FITE,CFO,606-759-3117,,THERESA.FITE@LPN.NET,
KY-004416,HealthPoint Florence,"HEALTH POINT FAMILY CARE, INC",1508889742,"Dental Providers, Federally Qualified Health Centers - Medical Services",7607 Dixie Hwy,Suite 1,Florence,KY,41042-2648,Boone,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004417,Women's Care of the Bluegrass/Family Care of the Bluegrass,"Cumberland Family Medical Center, Inc.",1255775755,Federally Qualified Health Centers - Medical Services,279 Kings Daughters Dr,,Frankfort,KY,40601-6561,Franklin,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004418,Women's Care of the Bluegrass/Family Care of the Bluegrass,"Cumberland Family Medical Center, Inc.",1861837270,Federally Qualified Health Centers - Medical Services,593 E Main St,,Frankfort,KY,40601-2332,Franklin,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004419,St. Claire Regional Family Medicine - Frenchburg,"St. Claire Medical Center, Inc.",1265493993,"Dental Providers, Rural Health Clinics",732 Highway 36,,Frenchburg,KY,40322-8123,Menifee,222 Medical Circle,,Morehead,KY,40351,Rowan,Charlotte Walker,"Co-Director, Patient Financial Services",606-783-6417,,Charlotte.Walker@st-claire.org,Chris McClurg,"Vice President, Finance",606-783-6587,,Chris.McClurg@st-claire.org,www.st-claire.org
KY-004420,"Community Family Clinic, PLLC","Community Family Clinic, PLLC",1427082338,Rural Health Clinics,784 Highway 36,,Frenchburg,KY,40322-8123,Menifee,784 Highway 36,,Frenchburg,KY,40322,Menifee,Kandi Hughes,Billing Manager,606-768-4549,,kandih73@yahoo.com,,,,,,
KY-004421,Fulton County Health Center,Purchase District Health Department,1427000454,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",350 Browder St,,Fulton,KY,42041-1410,Fulton,P.O. Box 2357,,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-9625,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004422,Gamaliel Family Medical Center,"Cumberland Family Medical Center, Inc.",1528464385,Federally Qualified Health Centers - Medical Services,102 Rhodes St,,Gamaliel,KY,42140-8942,Monroe,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004423,Glasgow Pediatric Healthcare,Cumberland Family Medical Center Inc.,1093159873,Federally Qualified Health Centers - Medical Services,301 Professional Park Dr,,Glasgow,KY,42141-3487,Barren,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004424,Grand Lakes Clinic,"Livingston Hospital and Healthcare Services, Inc.",1578549184,Rural Health Clinics,1860 Jh Obryan Ave,,Grand Rivers,KY,42045-9049,Livingston,131 Hospital Drive,,Salem,KY,42078,Livingston,Leah Tramble,Practice Administrator,270-988-7256,,ltramble@lhhs.org,SHANE WHITTINGTON,Interim CEO,270-988-7236,,SWHITTINGTON@LHHS.ORG,www.lhhs.org
KY-004425,Freeman Family Practice,Freeman Family Practice,1750557302,Rural Health Clinics,10755 N US Highway 25E,,Gray,KY,40734-6529,Knox,10755 N. US Highway 25E,,Gray,KY,40734,Knox,Tammy Freeman,"Owner, APRN",606-258-8050,,freeman_fp@bellsouth.net,Lori,Billing Manager,606-258-8050,,lorimullins@hotmail.com,
KY-004426,"Grace Community Health Center, Inc","GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,Federally Qualified Health Centers - Medical Services,39 Cumberland Gap Plz,,Gray,KY,40734-4536,Knox,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-258-1152,105,chad.stevens@gracechc.org,
KY-004427,Greensburg Health Care,"Cumberland Family Medical Center, Inc.",1922442391,Federally Qualified Health Centers - Medical Services,2751 Campbellsville Rd,,Greensburg,KY,42743-7749,Green,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004428,"Community Health Centers of Western Kentucky, Inc. Women's Health","COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.",1306848650,Federally Qualified Health Centers - Medical Services,226 Hopkinsville St,,Greenville,KY,42345-1214,Muhlenberg,480 Hopkinsville St,,Greenville,KY,42345-1124,Muhlenberg,Roger Arbuckle,CEO,270-338-5777,,chcwk@bellsouth.net,Joe Swab,CFO,270-338-5777,,chcwk.cfo@gmail.com,
KY-004429,"Community Health Centers of Western Kentucky, Inc.","COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.",1306848650,Federally Qualified Health Centers - Medical Services,480 Hopkinsville St,,Greenville,KY,42345-1124,Muhlenberg,480 Hopkinsville St,,Greenville,KY,42345-1124,Muhlenberg,Roger Arbuckle,CEO,270-338-5777,,chcwk@bellsouth.net,Joe Swab,CFO,270-338-5777,,chcwk.cfo@gmail.com,
KY-004430,Community Health Centers OF WESTERN KENTUCKY PEDIATRIC AND ADOLESCENT MEDICINE,"COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.",1306848650,Federally Qualified Health Centers - Medical Services,504 Hopkinsville St,,Greenville,KY,42345-1104,Muhlenberg,480 Hopkinsville St,,Greenville,KY,42345-1124,Muhlenberg,Roger Arbuckle,CEO,270-338-5777,,chcwk@bellsouth.net,Joe Swab,CFO,270-338-5777,,chcwk.cfo@gmail.com,
KY-004431,Eula Hall Health Center,"BIG SANDY HEALTH CARE, INC.",1154367191,"Dental Providers, Federally Qualified Health Centers - Medical Services",7629 Ky Route 979,,Grethel,KY,41631-6304,Floyd,1709 KY Route 321 Ste 3,,Prestonsburg,KY,41653-9097,Floyd,Ancil W Lewis,CEO,606-886-8546,,A.LEWIS@BSHC.ORG,,,,,,WWW.BSHC.ORG
KY-004432,"Community Health Centers of Western Kentucky, Inc","Community Health Centers of Western Kentucky, Inc",1306848650,Federally Qualified Health Centers - Medical Services,10220 Dixie Beeline Hwy,,Guthrie,KY,42234-9310,Todd,480 Hopkinsville Street,,Greenville,KY,42345,Muhlenberg,Roger Arbuckle,CEO,270-338-5777,1022,chcwk@bellsouth.net,,,,,,
KY-004433,Harlan Medical Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1316991979,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",132 Village Center Rd,,Harlan,KY,40831-1777,Harlan,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,"Teresa Fleming, MBA",Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004434,ARH Daniel Boone Clinic - Harlan,"Appalachian Regional Healthcare, Inc.",1861526709,"Outpatient Hospital Clinics, Rural Health Clinics",37 Ball Park Rd,,Harlan,KY,40831-1701,Harlan,100 Airport Gardens Road,,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004435,Harold Primary Care,Highlands Regional Medical Center,1306060975,Rural Health Clinics,24 Left Penhook Rd,,Harold,KY,41635-7064,Floyd,5000 KY ROUTE 321,,Prestonsburg,KY,41653,Floyd,HAROLD C WARMAN JR,CEO,606-886-7600,,bwarman@hrmc.org,HALEY BLAIR,Administrative Assistant,606-886-7600,,haleyb@hrmc.org,www.hrmc.org
KY-004436,Primary Care Centers of Eastern KY-Hazard,Primary Care Centers of Eastern KY,1942275805,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics",101 Town and Country Ln,Suite 100,Hazard,KY,41701-9524,Perry,PO Box 1988,,Hazard,KY,41702-1988,Perry,Shelia Bowling,BILLING SUPERVISOR,606-435-7643,,sbowling@pccek.com,Charla Napier,COO,606-439-1300,3229,cnapier@pccek.com,
KY-004437,Little Flower Clinic,"KENTUCKY MOUNTAIN HEALTH ALLIANCE, INC.",1407043979,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",421 Memorial Dr,,Hazard,KY,41701-1441,Perry,421 Memorial Dr,,Hazard,KY,41701-1441,Perry,Ellen Napier,CEO,606-487-9505,230,ellen@kymha.org,Mandie Wooton,"Business Officer, Biller",606-487-9505,262,mandie@kymha.org,www.kymha.com
KY-004438,Methodist Convenience Care,Methodist Hospital,1417264060,Outpatient Hospital Clinics,110 2nd St,,Henderson,KY,42420-3136,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004439,Methodist Family Medicine of Henderson,Methodist Hospital,1518127638,Outpatient Hospital Clinics,110 3rd St,Suite 250,Henderson,KY,42420-5802,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004440,Methodist Pediatrics -- Imperial,Methodist Hospital,1457784126,Outpatient Hospital Clinics,110 3rd St,Suite 180,Henderson,KY,42420-5808,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004441,Methodist Gastroenterology Services,Methodist Hospital,1457640898,Outpatient Hospital Clinics,1305 N Elm St,Suite G,Henderson,KY,42420-2783,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004442,Methodist Oncology and Hematology,Methodist Hospital,1861708653,Outpatient Hospital Clinics,1305 N Elm St,,Henderson,KY,42420-2783,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004443,Methodist Family Medicine -- Atkinson,Methodist Hospital,1609018951,Outpatient Hospital Clinics,1413 N Elm St,Suite 201,Henderson,KY,42420-2767,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004444,Methodist Surgical Services,Methodist Hospital,1245547892,Outpatient Hospital Clinics,1413 N Elm St,,Henderson,KY,42420-2768,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004445,Methodist Family Medicine -- North Elm,Methodist Hospital,1578997482,Outpatient Hospital Clinics,2000 N Elm St,Suite 1A,Henderson,KY,42420-2385,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004446,Methodist Pediatrics - North Elm,Methodist Hospital,1639334261,Outpatient Hospital Clinics,2000 N Elm St,Suite 1B,Henderson,KY,42420-2385,Henderson,1305 North Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004447,Methodist Family Medicine - 8th Street,Methodist Hospital,1427290774,Outpatient Hospital Clinics,319 8th St,Suite 1,Henderson,KY,42420-2963,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,,,,,,
KY-004448,Matthew 25 AIDS Services Inc.,Matthew 25 AIDS Services,1457355125,Ryan White Providers,452 Old Corydon Rd,,Henderson,KY,42420-4645,Henderson,452 Old Corydon Rd,,Henderson,KY,42420,Henderson,Cynthia Burton,Administrator,270-826-0200,,cburton@matthew25clinic.org,,,,,,www.matthew25clinic.org
KY-004449,Methodist Orthopedic Services,Methodist Hospital.net,1144412479,Outpatient Hospital Clinics,471 Klutey Park Plaza Dr,,Henderson,KY,42420-3347,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004450,"Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Henderson","REGIONAL HEALTH CARE AFFILIATES, INC.",1205258670,Federally Qualified Health Centers - Medical Services,472 Klutey Park Plaza Dr,,Henderson,KY,42420-3348,Henderson,215 E Main St,,Providence,KY,42450-1261,Webster,William Smith,CEO,270-667-7017,,bsmith@hfchc.net,,,,,,
KY-004451,Health First - Cabell Platt,"Regional Health Care Affiliates, Inc.",1851767461,Federally Qualified Health Centers - Medical Services,700 Martin Luther King Jr Ave,,Henderson,KY,42420-3663,Henderson,"2251 Westerfield Drive, Ste B",,Providence,KY,42450,Webster,Shelley Gobin,COO,270-667-7017,,sgobin@hfchc.net,,,,,,
KY-004452,Methodist Womens Services,Methodist Hospital,1821076415,Outpatient Hospital Clinics,736 N Elm St,,Henderson,KY,42420-2938,Henderson,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004453,Fulton County Health Center,Purchase District Health Department,1255368478,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",402 Troy Ave,,Hickman,KY,42050-1336,Fulton,P. O. Box 2357,,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-9625,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004454,Primary Care Centers of Eastern KY-Hindman,Primary Care Centers of Eastern KY,1356395198,"Community Mental Health Centers, Dental Providers, Other ECP Providers, Rural Health Clinics",58 Highway 80 W,Suite 2,Hindman,KY,41822-9159,Knott,PO Box 1988,,Hazard,KY,41702-1988,Perry,Shelia Bowling,BILLING SUPERVISOR,606-435-7643,,sbowling@pccek.com,Charla Napier,COO,606-439-1300,3229,cnapier@pccek.com,
KY-004455,KNOTT COUNTY FAMILY HEALTHCARE,Knott County Family Healthcare,1578578225,Rural Health Clinics,70 Holly Hills Mall Rd,,Hindman,KY,41822-9121,Knott,70 Holly Hills Mall Rd,,Hindman,KY,41822,Knott,Kevin Davis PA-C,Physican Assistant,606-785-9440,,kcfhdavis@yahoo.com,,,,,,
KY-004456,Community Medical Clinic,"Pennyroyal Healthcare Services, Inc.",1124319942,Federally Qualified Health Centers - Medical Services,739 North Dr,,Hopkinsville,KY,42240-2620,Christian,310 Hawthorne St,,Princeton,KY,42445,Caldwell,Kecia Fulcher,CEO,270-365-0227,,kfulcher@communitymedicalclinic.org,Casey Payne,CFO,270-365-0227,,,
KY-004457,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,12975 Highway 421,Stinnett Elementary School Based Health Clinic,Hoskinston,KY,40844,Leslie,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Leslie,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004458,Hyden ARH Clinic,"ARH Mary Breckinridge Health Services, Inc.",1073898102,"Outpatient Hospital Clinics, Rural Health Clinics",130 Kate Ireland Dr,,Hyden,KY,41749-9071,Leslie,100 Airport Gardens Road,,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004459,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,170 Bears Trl,Mountain View Elementary School Based Health Clinic,Hyden,KY,41749-8488,Leslie,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.sevens@gracechc.org,
KY-004460,Primary Care Centers of Eastern KY-Hyden,Primary Care Centers of Eastern KY,1891841961,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics",21992 Main St,,Hyden,KY,41749-8567,Leslie,PO Box 1988,,Hazard,KY,41702-1988,Perry,Shelia Bowling,BILLING SUPERVISOR,606-435-7643,,sbowling@pccek.com,Charla Napier,COO,606-439-1300,3229,cnapier@pccek.com,
KY-004461,Martin County After Hours Clinic,Ohio Valley Physicians Inc,1982961165,Rural Health Clinics,1238 Middle Fork Rd,,Inez,KY,41224,Martin,601 20th St,,Huntington,WV,25703,Cabell,JUSTIN BAUMGARDNER,Billing Manager,304-429-1088,113,JBAUMGARDNER@OHIOVALLEYPHYSICIANS.COM,Tara Landers,Executive Assistant,304-429-1088,112,tlanders@ohiovalleyphysicians.com,
KY-004462,Lafferty Medical Clinic,Lafferty Medical Clinic,1992992572,Rural Health Clinics,2160 Blacklog Rd,,Inez,KY,41224-9019,Martin,2160 Blacklog Rd.,,Inez,KY,41224,Martin,Lon Lafferty,M.D./Owner,606-298-7405,,lonlafferty@suddenlink.net,Colin Lafferty,Director of Quality,606-626-1987,,colinlafferty.lmc@gmail.com,
KY-004463,Martin County Rural Health Clinic,Martin County Rural Health Clinic,1316363112,Rural Health Clinics,428 E Main St,,Inez,KY,41224-8931,Martin,428 East Main Street,,Inez,KY,41224,Martin,Dianna Craft,Practice Manager,606-298-2520,,dcraft@frontiermedical.org,ANTOIN HANA,Owner,606-471-2434,,DR.HANA@FRONTIERMEDICAL.COM,
KY-004464,Martin County Community Health Center,"BIG SANDY HEALTH CARE, INC.",1104055805,Federally Qualified Health Centers - Medical Services,6500 Highway 645,,Inez,KY,41224,Martin,1709 KY Route 321 Ste 3,,Prestonsburg,KY,41653-9097,Floyd,Ancil W Lewis,CEO,606-886-8546,,A.LEWIS@BSHC.ORG,,,,,,WWW.BSHC.ORG
KY-004465,Mercy Primary Care - Irvine,Marcum & Wallace Memorial Hospital,1811132525,Rural Health Clinics,1100 Richmond Rd,,Irvine,KY,40336-7231,Estill,60 Mercy Ct,,Irvine,KY,40336,Estill,Morgan Fowler,Director of Operations - Primary Care,606-723-2115,8213,mlfowler@mercy.com,,,,,,
KY-004466,Children's Clinic,Children's Care PLLC,1740381441,Rural Health Clinics,223 River Dr,,Irvine,KY,40336-1142,Estill,223 River Dr.,,Irvine,KY,40336,Estill,Vivian Ong,Administrator,606-723-5142,,vong@kidscareclinic.com,Cynthia Townsend,Billing Manager,606-723-5142,,ctownsend@kidscareclinic.com,
KY-004467,ESTILL MEDICAL CLINIC PSC,ESTILL MEDICAL CLINIC PSC,1154500296,Rural Health Clinics,275 Court St,,Irvine,KY,40336-1077,Estill,275 N. Court St,,Irvine,KY,40336-1077,Estill,Donna Isfort,Owner,606-723-2167,,drisfort@gmail.com,John Isfort,,606-723-2167,,jwisfort@gmail.com,
KY-004468,White House Clinic - Irvine,"HEALTH HELP, INCORPORATED",1427283647,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 Stacy Lane Rd,,Irvine,KY,40336-7356,Estill,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004469,"JUNIPER HEALTH, Inc. DBA Breathitt County Family Health Center","JUNIPER HEALTH, INC.",1467417691,Federally Qualified Health Centers - Medical Services,265 Highway 15 S,Suite 3,Jackson,KY,41339-7370,Breathitt,141 Main St,,Beattyville,KY,41311-7484,Breathitt,Karen Ditsch,CEO,606-464-0151,,karen.ditsch@juniperhealth.org,,,,,,www.juniperhealth.org
KY-004470,AARON K JONAN MEMORIAL CLINIC,Aaron K Jonan Memorial Clinic,1477569226,Rural Health Clinics,832 Highway 15 N,,Jackson,KY,41339-8284,Breathitt,832 Highway 15 N,,Jackson,KY,41339,Breathitt,Judy Hankins,Credentialing Manager,606-432-0174,,jhankins@setel.com,Stephanie Warrix,Information Resources Manager,606-432-0174,,stephanie.warrix@aacenter.com,
KY-004471,Jamestown Family Medical Center,"Cumberland Family Medical Center, Inc.",1972862407,Federally Qualified Health Centers - Medical Services,1417 N Main St,,Jamestown,KY,42629-2411,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004472,Jamestown Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1780075143,Federally Qualified Health Centers - Medical Services,342 S Main St,,Jamestown,KY,42629-2199,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004473,"Grace Community Health Center, Inc.",MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1881938363,Federally Qualified Health Centers - Medical Services,269 Highway 3086,Jenkins Middle High School Based Clinic,Jenkins,KY,41537-9204,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004474,Isom Medical Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1821546573,Federally Qualified Health Centers - Medical Services,105 Isom Plz,,Jeremiah,KY,41826-9088,Letcher,226 Medical Plaza Lane,,Whitesburg,KY,41858,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,"Teresa Fleming, MBA",Director of Financial Affairs,606-633-4823,1389,tfleming@mtncomp.org,www.mchcky.com
KY-004475,Ballard County Health Center,Purchase District Health Department,1013971720,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",198 Bluegrass Dr,,La Center,KY,42056-9668,Ballard,Purchase District Health Department,P.O. Box 2357,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-9625,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004476,Oldham County Health Department,Oldham County Health Department,1144300294,"Family Planning Providers, Sexually Transmitted Disease Clinics",1786 Commerce Pkwy,,Lagrange,KY,40031-8786,Oldham,1786 Commerce Pkwy,,LaGrange,KY,40031,Oldham,Stacy A Nichter,SSAIII,502-222-3516,144,stacya.nichter@ky.gov,Deloris Yantz,Director of Admin Services,502-222-3516,124,delorisr.yantz@ky.gov,
KY-004477,White House Clinic- Lancaster,Health Help Incorporated,1588187504,Federally Qualified Health Centers - Medical Services,89 Farra Dr,,Lancaster,KY,40444-9598,Garrard,1010 Main Street South,,Mckee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004478,"Cumberland Family Medical Center, Inc.","Cumberland Family Medical Center, Inc.",1114472644,Federally Qualified Health Centers - Medical Services,1 Bearcat Dr,Anderson County High School,Lawrenceburg,KY,40342-1290,Anderson,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedicalcenter.com
KY-004479,Emma B. Ward Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1750837282,Federally Qualified Health Centers - Medical Services,1150 Bypass N,Emma B. Ward Elementary,Lawrenceburg,KY,40342-9453,Anderson,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Finanical Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,
KY-004480,Ezra Sparrow Early Childhood Center,"Cumberland Family Medical Center, Inc.",1952857310,Federally Qualified Health Centers - Medical Services,1154 Bypass N,,Lawrenceburg,KY,40342-9453,Anderson,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004481,Women's Care of the Bluegrass/Family Care of the Bluegrass,"Cumberland Family Medical Center, Inc.",1811304496,Federally Qualified Health Centers - Medical Services,1180 Glensboro Rd,,Lawrenceburg,KY,40342-9034,Anderson,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004482,Robert B. Turner,"Cumberland Family Medical Center, Inc.",1295281723,Federally Qualified Health Centers - Medical Services,1411 Fox Creek Rd,,Lawrenceburg,KY,40342-9742,Anderson,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004483,Saffell Street Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1740736271,Federally Qualified Health Centers - Medical Services,210 Saffell St,Saffell Street Elementary,Lawrenceburg,KY,40342-1287,Anderson,360 Keen Street,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004484,"Grace Community Health Center, Inc.",MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1790032720,Federally Qualified Health Centers - Medical Services,160 Lhs Dr,Letcher Elementary School Based Clinic,Letcher,KY,41832-8922,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004485,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1679821995,Federally Qualified Health Centers - Medical Services,162 Lhs Dr,Letcher Middle School Based Clinic,Letcher,KY,41832-8922,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004486,BLUEGRASS COMMUNITY HEALTH CENTER,EASTERN KENTUCKY UNIVERSITY,1164460051,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1306 Versailles Rd,Suite 120,Lexington,KY,40504-1795,Fayette,521 Lancaster Avenue,,Richmond,KY,40475-3102,Madison,C. Alex Smith,Chief Executive Officer,859-259-2635,156,alex.smith@eku.edu,Lauren Bishop,Associate Director,859-259-2635,120,lauren.bishop@eku.edu,http://bchc.eku.edu/
KY-004487,Lexington Medical,"HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,1401 Harrodsburg Rd,Suite A500,Lexington,KY,40504-1715,Fayette,1401 Madison Ave.,,Covington,KY,41011-3313,Kenton,Pamela Smallwood,Chief Operating Officer,859-655-6222,,psmallwood@healthpointfc.org,,,,,,
KY-004488,Bluegrass Community Health Center,EASTERN KENTUCKY UNIVERSITY,1831386192,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",151 N Eagle Creek Dr,Suite 220,Lexington,KY,40509-1892,Fayette,521 Lancaster Avenue,,Richmond,KY,40475-3102,Madison,C. Alex Smith,Chief Executive Officer,859-259-2635,156,alex.smith@eku.edu,Lauren Bishop,Associate Director,859-259-2635,120,lauren.bishop@eku.edu,http://bchc.edu.edu/
KY-004489,HealthFirst Bluegrass Bryan Station,HealthFirst Bluegrass,1114932514,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1640 Bryan Station Rd,,Lexington,KY,40505-2144,Fayette,1640 Bryan Station Road,,Lexington,KY,40505,Fayette,Brent Rafferty,Interim Executive Director,859-229-9368,,brafferty@healthfirstlex.com,Brent Rafferty,Interim Executive Director,859-288-2425,2411,brafferty@healthfirstlex.com,www.healthfirstlex.com
KY-004490,Lexington Health Center - Planned Parenthood,Planned Parenthood of Indiana & Kentucky,1891743092,Family Planning Providers,268 Southland Dr,Suite 120,Lexington,KY,40503-1938,Fayette,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
KY-004491,HealthFirst Bluegrass Hope Center,HealthFirst Bluegrass,1114932514,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",360 W Loudon Ave,,Lexington,KY,40508-3729,Fayette,1640 Bryan Station Road,,Lexington,KY,40505,Fayette,Brent Rafferty,Interim Executive Director,859-229-9368,,brafferty@healthfirstlex.com,,,,,,
KY-004492,HealthFirst Bluegrass Southland,HealthFirst Bluegrass,1114932514,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",496 Southland Dr,,Lexington,KY,40503-1827,Fayette,1640 Bryan Station Road,,Lexington,KY,40505,Fayette,Brent Rafferty,Interim Executive Director,859-229-9368,,brafferty@healthfirstlex.com,Brent Rafferty,Interim Executive Director,859-288-2425,2411,brafferty@healthfirstlex.com,www.healthfirstlex.com
KY-004493,HealthFirst Bluegrass Newtown Pike,HealthFirst Bluegrass,1114932514,"Dental Providers, Federally Qualified Health Centers - Medical Services",650 Newtown Pike,,Lexington,KY,40508-1113,Fayette,1640 Bryan Station Road,,Lexington,KY,40504,Fayette,Brent Rafferty,Interim Executive Director,859-229-9368,,brafferty@healthfirstlex.com,,,,,,
KY-004494,Hemophilia Treatment Center,University of Kentucky,1326091448,Hemophilia Treatment Centers,740 S Limestone St,Kentucky Clinic J453,Lexington,KY,40536-0001,Fayette,KY Medical Services Foundation,2333 Alumni Park PLaza Suite 200,Lexington,KY,40517,Fayette,Vlad C. Radulescu,Director,859-257-6033,,vlad.radulescu@uky.edu,,,,,,
KY-004495,Casey County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1881076487,Federally Qualified Health Centers - Medical Services,1643 E KY 70,,Liberty,KY,42539-6716,Casey,360 keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004496,Casey County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1437531035,Federally Qualified Health Centers - Medical Services,1841 E KY 70,,Liberty,KY,42539-6718,Casey,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004497,"Bluegrass Clinic Liberty, PLLC",Bluegrass Clinic,1457555146,Rural Health Clinics,19 Abes Plz,,Liberty,KY,42539-3398,Casey,19 Abes Plaza,,Liberty,KY,42539,Casey,Cristi Martin,Administrative Assistant,606-365-8338,309,cmartin@bluegrassclinic.com,Vanessa Haste,Billing Manager,606-365-8338,312,vhaste@bluegrassclinic.com,
KY-004498,Walnut Hill Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1356723951,Federally Qualified Health Centers - Medical Services,2834 S US 127,,Liberty,KY,42539-8350,Casey,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004499,Casey Family Medical Center,"Cumberland Family Medical Center, Inc.",1902228075,Federally Qualified Health Centers - Medical Services,376 Randolph St,,Liberty,KY,42539-3382,Casey,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004500,Jones Park Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1720460868,Federally Qualified Health Centers - Medical Services,6295 E KY 70,,Liberty,KY,42539-6762,Casey,360 Keen Street,,Burkesville,KY,42539-6762,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004501,Liberty Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1639551237,Federally Qualified Health Centers - Medical Services,75 College St,,Liberty,KY,42539-3271,Casey,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004502,"London Women's Care, PLLC","London Women's Care, PLLC",1063454650,Rural Health Clinics,803 Meyers Baker Rd,Suite 200,London,KY,40741-3040,Laurel,803 Meyers Baker Road,Suite 200,London,KY,40741,Laurel,Joann Nolan,Practice Administrator,606-878-3240,116,jnolan@londonwomenscare.com,Kacey Bolton,Clinical Director,606-878-3240,144,kbolton@londonwomenscare.com,www.londonwomenscare.com
KY-004503,LAWRENCE COUNTY HEALTH DEPARTMENT,LAWRENCE COUNTY HEALTH DEPARTMENT,1225008964,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1080 Meadowbrook Ln,,Louisa,KY,41230-9657,Lawrence,1080 MEADOWBROOK LANE,1080 MEADOWBROOK LANE,LOUISA,KY,41230,Lawrence,CINDY MAYNARD,ADMINISTRATIVE SPECIALIST,606-638-4389,,CINDYL.MAYNARD@KY.GOV,,,,,,
KY-004504,HomePlace Primary Care Clinic,"Mountain Comprehensive Care Center, Inc.",1578811774,Federally Qualified Health Centers - Medical Services,130 Town Hill Rd,,Louisa,KY,41230-6389,Lawrence,104 South Front Ave,,Prestonsburg,KY,41230,Floyd,Suzanne Daniels,Program Director,606-788-1345,335,suzanne.daniels@mtcomp.org,Carrie Hackworth,Billing Coordinator,606-788-1345,,carrie.hackworth@mtcomp.org,www.mtcomp.org
KY-004505,City View,"Park DuValle Community Health Center, Inc.",1255354361,"Dental Providers, Federally Qualified Health Centers - Medical Services",1015 W Chestnut St,,Louisville,KY,40203-2048,Jefferson,1015 W Chestnut St,,Louisville,KY,40203,Jefferson,Ann Hagan-Grigsby,Interim CEO,502-774-4401,1221,ahagan@pdchc.org,Jennifer Hendricks,Credentialing Specialist,502-774-4401,1247,jhendricks@pdchc.org,
KY-004506,Shawnee Christian Healthcare Center - Maupin Elementary,Shawnee Christian Healthcare Center,1376708438,Federally Qualified Health Centers - Medical Services,1312 Catalpa St,,Louisville,KY,40211-1731,Jefferson,234 Amy Ave,,Louisville,KY,40212,Jefferson,Phyllis Platt,CEO,502-778-0001,,phyllis.platt@shawneehealthcare.org,,,,,,
KY-004507,"FAMILY HEALTH CENTERS, INC./FAMILY HEALTH CENTER - PORTLAND","FAMILY HEALTH CENTERS, INC.",1518963230,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Sam Riddick,CFO,502-772-8561,,,www.fhclouisville.org
KY-004508,Newburg,"Park DuValle Community Health Center, Inc.",1780698506,"Dental Providers, Federally Qualified Health Centers - Medical Services",2237 Hikes Ln,,Louisville,KY,40218-2203,Jefferson,2237 Hikes Lane,,Louisville,KY,40218,Jefferson,Ann Hagan-Grigsby,Interim CEO,502-774-4401,1221,ahagan@pdchc.org,Jennifer Hendricks,Credentialing Specialist,502-774-4401,1247,jhendricks@pdchc.org,
KY-004509,Shawnee Christian Healthcare Center,"SHAWNEE CHRISTIAN HEALTHCARE CENTER, INC.",1225333743,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",234 Amy Ave,,Louisville,KY,40212-2522,Jefferson,234 Amy Ave,,Louisville,KY,40212-2522,Jefferson,Phyllis Platt,CEO,502-939-9515,,phyllis.platt@shawneehealthcare.org,Susan Maguire,,502-778-0001,,susan.maguire@shawneehealthcare.org,www.shawneechristianhealth.org
KY-004510,Family Health Center - West Market,"FAMILY HEALTH CENTERS, INC.",1427574862,Federally Qualified Health Centers - Medical Services,2500 W Market St,,Louisville,KY,40212-1541,Jefferson,2215 Portland Ave,,Louisville,KY,40212,Jefferson,William B. Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Samuel Riddick,CFO,502-772-8561,,sriddick@fhclouisville.org,www.fhclouisville.org
KY-004511,Shawnee Christian Healthcare Center - Atkinson Elementary,Shawnee Christian Healthcare Center,1225333743,Federally Qualified Health Centers - Medical Services,2811 Duncan St,,Louisville,KY,40212-1825,Jefferson,234 Amy Ave,,Louisville,KY,40212,Jefferson,Phyllis Platt,CEO,502-778-0001,,phyllis.platt@shawneehealthcare.org,,,,,,
KY-004512,"Park DuValle Community Health Center, Inc.","Park DuValle Community Health Center, Inc.",1245253160,"Dental Providers, Federally Qualified Health Centers - Medical Services",3015 Wilson Ave,,Louisville,KY,40211-1969,Jefferson,3015 Wilson Ave,,Louisville,KY,40211,Jefferson,Ann Hagan-Grigsby,Interim CEO,502-774-4401,1221,ahagan@pdchc.org,Jennifer Hendricks,Credentialing Specialist,502-774-4401,1247,jhendricks@pdchc.org,
KY-004513,Shawnee Christian Healthcare Center - Academy @ Shawnee,Shawnee Christian Healthcare Center,1225333743,Federally Qualified Health Centers - Medical Services,4001 Herman St,,Louisville,KY,40212-2588,Jefferson,234 Amy Ave,,Louisville,KY,40212,Jefferson,Phyllis Platt,CEO,502-778-0001,,phyllis.platt@shawneehealthcare.org,,,,,,
KY-004514,FAMILY HEALTH CENTER - IROQUOIS,"FAMILY HEALTH CENTERS, INC.",1356394670,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4100 Taylor Blvd,,Louisville,KY,40215-2342,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Sam Riddick,CFO,502-772-8561,,,www.fhclouisville.org
KY-004515,FAMILY HEALTH CENTER - AMERICANA,"FAMILY HEALTH CENTERS, INC.",1578774477,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4805 Southside Dr,,Louisville,KY,40214-2111,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Liz Edghill,Clinic Director,502-468-6589,,,www.fhclouisville.org
KY-004516,University of Louisville Adult HTC,University of Louisville Physicians,1073652533,Hemophilia Treatment Centers,529 S Jackson St,Room 416,Louisville,KY,40202-3229,Jefferson,"300 East Market Street, Suite 400",,Louisville,KY,40202,Jefferson,Jaimie Tomlinson,Payor Relations and Contract Manager,502-588-0342,,jaimie.tomlinson@ulp.org,Tracey Gaslin,Hemophilia NP and 340B Administrator,502-562-2902,,tracey.gaslin@ulp.org,https://www.uoflphysicians.com/hemophilia-treatment-center
KY-004517,PHOENIX HEALTH CENTER FOR THE HOMELESS,"FAMILY HEALTH CENTERS, INC.",1205889540,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",712 E Muhammad Ali Blvd,,Louisville,KY,40202-1643,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Sam Riddick,CFO,502-772-8561,,,www.fhclouisville.org
KY-004518,Family Health Center-East Broadway,"FAMILY HEALTH CENTERS, INC.",1134172489,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",834 E Broadway,,Louisville,KY,40204-1072,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Sam Riddick,CFO,502-772-8561,,,www.fhclouisville.org
KY-004519,Louisville Health Center - Planned Parenthood,Planned Parenthood of Indiana & Kentucky,1891743092,Family Planning Providers,842 S 7th St,,Louisville,KY,40203-2149,Jefferson,200 S Meridian St Ste 400,,Indianapolis,IN,46225-1076,Marion,Cheryl Gatzmer,CFO,317-637-4378,,cheryl.gatzmer@ppink.org,,,,,,http://www.plannedparenthood.org/planned-parenthood-indiana-kentucky/
KY-004520,FAMILY HEALTH CENTER - SOUTHWEST,"FAMILY HEALTH CENTERS, INC.",1104879469,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9702 Stonestreet Rd,Suite 220,Louisville,KY,40272-6814,Jefferson,2215 Portland Ave,,Louisville,KY,40212-1033,Jefferson,William B Wagner,CEO,502-778-4201,,bwagner@fhclouisville.org,Sam Riddick,CFO,502-772-8561,,,www.fhclouisville.org
KY-004521,Methodist Womens Services of Madisonville,Methodist Hospital,1639502966,Outpatient Hospital Clinics,44 McCoy Ave,,Madisonville,KY,42431-2867,Hopkins,1305 N. Elm Stree,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004522,Grace Community Health Center / Manchester,"GRACE COMMUNITY HEALTH CENTER, INC.",1902048481,Rural Health Clinics,108 Manchester Shopping Ctr,,Manchester,KY,40962-1401,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-258-1152,105,chad.stevens@gracechc.org,
KY-004523,Burning Springs Medical Clinic,East Bernstad Medical Clinic,1114986197,Rural Health Clinics,11901 N Highway 421,,Manchester,KY,40962-4859,Clay,11901 North Hwy 421,11901 North Hwy 421,Manchester,KY,40962,Clay,Carla Johnson,Ins/Billing Manger,606-843-6195,,carla_ebmc@windstream.net,Crissy Ward,Office Manager,606-287-5162,,dhmmc@prtcnet.org,
KY-004524,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",1908 N Highway 421,Manchester Elementary School Based Health Clinic,Manchester,KY,40962-7337,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004525,"Grace Community Health Center, Inc.","GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",1983 S Highway 421,Grace CHC School Based Health Paces Creek Elementary,Manchester,KY,40962-7514,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004526,Manchester Memorial Hospital,Adventist Health System/Sunbelt Inc.,1811922347,Inpatient Hospitals (other than children's hospitals),210 Marie Langdon Dr,,Manchester,KY,40962-6388,Clay,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,David Strosnider,Director Managed Care,828-684-8501,,David.Strosnider@ahss.org,,,,,,
KY-004527,GCHC SBHC Clay Middle,"GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",239 Richmond Rd,,Manchester,KY,40962-1208,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-258-1152,105,chad.stevens@gracechc.org,
KY-004528,Clay County Health Department,Cumberland Valley District Health Department,1669514923,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",330 Shamrock Rd,,Manchester,KY,40962-9201,Clay,P.O. Box 158,"470 Manchester Square, Ste 200",Manchester,KY,40962,Clay,Christie Green,Public Health Director,606-598-5564,116,christiel.green@ky.gov,Tammy Byrd,Administrative Specialist,606-598-5564,153,tammyf.byrd@ky.gov,
KY-004529,GCHC SBHC Goose Rock,"GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",364 Highway 1524,,Manchester,KY,40962-8936,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-258-1152,105,chad.stevens@gracechc.org,
KY-004530,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",415 Clay County High Rd,Clay County High School,Manchester,KY,40962-7010,Clay,1019 Cumberland Falls Hwy,B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004531,Grace SBHC Hacker Elem,"GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",84 Hooker Rd,,Manchester,KY,40962-8202,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-521-3942,105,chad.stevens@gracechc.org,
KY-004532,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",9847 N Highway 421,Burning Springs Elementary School Based Health Clinic,Manchester,KY,40962-6647,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004533,Marion Physicians Clinic,Tri-Rivers Healthcare PLLC,1699895003,Rural Health Clinics,308 S Main St,,Marion,KY,42064-1545,Crittenden,PO Box 347,,Salem,KY,42078-0347,Livingston,Michael Heneisen,Business Manager,270-988-3298,,mheneisen@tririvershc.com,,,,,,
KY-004534,Jackson Purchase Medical Center,LifePoint Health,1891892741,Inpatient Hospitals (other than children's hospitals),1099 Medical Center Cir,,Mayfield,KY,42066-1159,Graves,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,VICKI PARKS,CFO,270-251-4504,,VIKI.PARKS@LPN.NET,
KY-004535,MAYFIELD FAMILY MEDICINE,"Pinelake Physician Practice, LLC",1295960532,Rural Health Clinics,1111 Medical Center Cir,,Mayfield,KY,42066-1194,Graves,PO Box 2138,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004536,Graves County Health Department,Graves County Health Department,1659601755,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",416 Central Ave,,Mayfield,KY,42066-3115,Graves,416 Central Avenue,,Mayfield,KY,42066,Graves,Noel Coplen,Director,270-247-3553,,NOELT.COPLEN@KY.GOV,Leslie Nolin,SSSA III,270-247-3553,,LeslieN.Nolin@ky.gov,www.GravesCountyHealthDepartment.com
KY-004537,Maysville OB/GYN Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,"Dental Providers, Federally Qualified Health Centers - Medical Services",927 Kenton Station Dr,,Maysville,KY,41056-9617,Mason,211 KY 59,,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004538,Meadowview Regional Medical Center,LifePoint Health,1881785863,Inpatient Hospitals (other than children's hospitals),989 W Highway 10,,Maysville,KY,41056,Mason,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Theresa Fite,CFO,606-759-3117,,,
KY-004539,White House Clinic - McKee,"HEALTH HELP, INCORPORATED",1770569113,"Dental Providers, Federally Qualified Health Centers - Medical Services",1010 Main St S,,McKee,KY,40447-7089,Jackson,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004540,McKee Medical Clinic,East Bernstadt Clinic,1275592529,Rural Health Clinics,25 Highway 290,,McKee,KY,40447-7067,Jackson,PO Box 757,,Mckee,KY,40447,Jackson,Crissy Ward,Office Manager,606-287-5162,,dhmmc@prtcnet.org,Carla Johnson,Insurance Billing Manager,606-843-6195,,carla_ebmc@windstream.net,
KY-004541,Jackson County Health Department,Cumberland Valley District Health Department,1437291473,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",456 Main St S,,McKee,KY,40447-7083,Jackson,P.O. Box 158,"470 Manchester Square, Ste 200",Manchester,KY,40962,Clay,Christie Green,Public Health Director,606-598-5564,116,christiel.green@ky.gov,Tammy Byrd,Administrative Specialist,606-598-5564,153,tammyf.byrd@ky.gov,
KY-004542,MONTICELLO MEDICAL ASSOCIATES,"Phillips,Pratt & Mcfarland, PSC",1104963305,Rural Health Clinics,1 S Creek Dr,Suite 102,Monticello,KY,42633-9472,Wayne,1 South Creek Drive STE 102,,Monticello,KY,42633,Wayne,Robert Parmelee,Administrator,606-348-3365,240,rparmelee@monticellomedical.com,,,,,,www.monticellomedical.com
KY-004543,Walker Early Learning Center Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1295118750,Federally Qualified Health Centers - Medical Services,1080 S Main St,,Monticello,KY,42633-2762,Wayne,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004544,Monticello Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1487037941,Federally Qualified Health Centers - Medical Services,160 Cave St,,Monticello,KY,42633-1412,Wayne,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004545,Wayne County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1669855128,Federally Qualified Health Centers - Medical Services,2 Kenny Davis Blvd,,Monticello,KY,42633-9479,Wayne,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004546,Bell Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1649652579,Federally Qualified Health Centers - Medical Services,278 Kenny Davis Blvd,,Monticello,KY,42633-9479,Wayne,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004547,Women's Care of Lake Cumberland,"Cumberland Family Medical Center, Inc.",1073063418,Federally Qualified Health Centers - Medical Services,39 Jim Hill Service Rd,,Monticello,KY,42633-7900,Wayne,360 Keen St.,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,
KY-004548,Wayne County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1578946034,Federally Qualified Health Centers - Medical Services,95 Champion Dr,,Monticello,KY,42633-5364,Wayne,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,ken Kimsal,CFO,270-858-6644,,cgreen@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004549,Methodist Family Medicine,Methodist Hospital,1548248123,Rural Health Clinics,1284 US Highway 60 W,,Morganfield,KY,42437-6236,Union,1305 N. Elm Stree,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004550,MCIS Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,1040 Maysville Rd,,Mount Sterling,KY,40353-9337,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistance,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004551,Sterling Health Care,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,209 N Maysville St,Suite 200,Mount Sterling,KY,40353-1179,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353-1179,Montgomery,Harold Brown,CEO,859-404-7686,,hbrown@sterlinghealthky.org,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,www.sterlinghealthky.org
KY-004552,McNabb Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,3570 Indian Mound Dr,,Mount Sterling,KY,40353-1633,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004553,Camargo Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,4307 Camargo Rd,,Mount Sterling,KY,40353-8866,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004554,Montgomery Dental Center,"Sterling Health Solutions, Inc.",1730627001,Dental Providers,635 Maysville Rd,Suite B,Mount Sterling,KY,40353-9767,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004555,Sterling Women's Care,"Sterling Health Solutions, Inc.",1548511397,Federally Qualified Health Centers - Medical Services,635 Maysville Rd,Suite A,Mount Sterling,KY,40353-9767,Montgomery,209 N Maysville St Ste 200,,Mount Sterling,KY,40353-1179,Montgomery,Harold Brown,CEO,859-404-7686,,hbrown@sterlinghealthky.org,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,www.sterlinghealthky.org
KY-004556,Family Care Clinic Mount Sterling,"Clark Regional Physician Practices, LLC",1114282605,Rural Health Clinics,644 Maysville Rd,Suite 8,Mount Sterling,KY,40353-9464,Montgomery,PO Box 2138,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004557,MSE Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,6601 Indian Mound Rd,,Mount Sterling,KY,40353-8200,Montgomery,"209 N Maysville St, Ste 200",,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004558,Montgomery County Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,724 Woodford Dr,,Mount Sterling,KY,40353-9505,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004559,Mapleton Community Health Center,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,809 Indian Mound Dr,,Mount Sterling,KY,40353-1151,Montgomery,209 N Maysville St,STE 200,Mount Sterling,KY,40353,Montgomery,Lori Coffey,Administrative Assistant,859-404-7686,114,lcoffey@sterlinghealthky.org,Harold Brown,CEO,859-404-7686,104,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004560,White House Clinic - Mt. Vernon,"HEALTH HELP, INCORPORATED",1437407723,"Dental Providers, Federally Qualified Health Centers - Medical Services",116 Progress Dr,,Mount Vernon,KY,40456-8590,Rockcastle,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004561,Rockcastle County Health Department,Cumberland Valley District Health Department,1912049941,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",120 Richmond St,,Mount Vernon,KY,40456-2701,Rockcastle,P.O. Box 158,"470 Manchester Square, Ste 200",Manchester,KY,40962,Clay,Christie Green,Public Health Director,606-598-5564,116,christiel.green@ky.gov,Tammy Byrd,Administrative Specialist,606-598-5564,153,tammyf.byrd@ky.gov,
KY-004562,Family Medical Center of Hart County,Family Medical Center of Hart County,1881659951,Rural Health Clinics,117 W South St,,Munfordville,KY,42765-9084,Hart,117 W. South Street,PO Box 579,Munfordville,KY,42765,Hart,Sky Marrese,Practice Administrator,270-524-7231,,sky@munfordvillefmc.com,Brenda Caswell,Business Office Manager,270-524-7231,231,bcaswell@munfordvillefmc.com,
KY-004563,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1295082386,Federally Qualified Health Centers - Medical Services,50 2nd St,Fleming Neon Middle School,Neon,KY,41840-8994,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004564,HealthPoint Nicholasville,"HEALTH POINT FAMILY CARE, INC",1508889742,Federally Qualified Health Centers - Medical Services,101 Orchard Dr,,Nicholasville,KY,40356-2690,Jessamine,1401 Madison Ave,,Covington,KY,41011-3313,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004565,Jessamine Early Learning Village,"HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,851 Wilmore Rd,,Nicholasville,KY,40356-9462,Jessamine,1401 Madison Ave.,,Covington,KY,41011-3313,Kenton,Pamela Smallwood,Chief Operating Officer,859-655-6222,,psmallwood@healthpointfc.org,,,,,,
KY-004566,Community Medical Clinic,"Pennyroyal Healthcare Services, Inc.",1720454507,Federally Qualified Health Centers - Medical Services,15095 Fort Campbell Blvd,,Oak Grove,KY,42262-9301,Christian,310 Hawthorne St,,Princeton,KY,42445,Caldwell,Kecia Fulcher,CEO,270-365-0227,,kfulcher@communitymedicalclinic.org,Casey Payne,CFO,270-365-0227,,cpayne@communitymedicalclinic.org,
KY-004567,St. Claire Regional Family Medicine - Olive Hill,"St. Claire Medical Center, Inc.",1639131527,Rural Health Clinics,155 Bricklayer St,,Olive Hill,KY,41164,Carter,222 Medical Circle,,Morehead,KY,40351,Rowan,Charlotte Walker,"Co-Director, Patient Financial Services",606-783-6417,,Charlotte.Walker@st-claire.org,Chris McClurg,"Vice President, Finance",606-783-6587,,Chris.McClurg@st-claire.org,www.st-claire.org
KY-004568,"Grace Community Health Center, Inc.","GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,"Dental Providers, Federally Qualified Health Centers - Medical Services",523 N Highway 66,Grace CHC School Based Health Big Creek,Oneida,KY,40972-6607,Clay,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004569,"Regional Health Care Affiliates, Inc. Doing Business As Health First Community Health Center Owensboro","REGIONAL HEALTH CARE AFFILIATES, INC.",1558743740,Federally Qualified Health Centers - Medical Services,1600 Breckenridge St,,Owensboro,KY,42303-1055,Daviess,215 E Main St,,Providence,KY,42450-1261,Webster,Shelley Gobin,COO,270-667-7017,,sgobin@hfchc.net,,,,,,
KY-012446,Center for Vein Restoration,Center for Vein Restoration,1629437397,Other ECP Providers,2054 E Parrish Ave,Suite A,Owensboro,KY,42303-1448,Daviess,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
KY-004570,"Regional Health Care Affiliates, Inc. DBA The Neel Clinic - Health First Community Health Center","REGIONAL HEALTH CARE AFFILIATES, INC.",1588058069,Federally Qualified Health Centers - Medical Services,2816 Veach Rd,Suite 205,Owensboro,KY,42303-6299,Daviess,215 E Main St,,Providence,KY,42450-1261,Webster,Shelley Gobin,COO,270-667-7017,,qstone@hfchc.net,,,,,,
KY-004571,Audubon Area Community Care Clinics,Audubon Area Community Care Clinic,1114462272,Federally Qualified Health Centers - Medical Services,819 E 9th St,,Owensboro,KY,42303-3221,Daviess,819 East 9th Street,,Owensboro,KY,42303,Daviess,Phyllis Pfingston,Billing/Coding Specialist,270-686-6045,,ppfingston@audubon-area.com,Dana Wilson,Director,270-686-6044,,dwilson@audubon-area.com,
KY-004572,Triad Health Systems Owenton,Triad Health System Inc.,1831311299,Federally Qualified Health Centers - Medical Services,1005 Highway 22 E,,Owenton,KY,40359-9041,Owen,441 Hwy 42W,,Warsaw,KY,41095,Gallatin,Adam D Craft,CEO,859-567-1720,,acraft.triad@zoomtown.com,Jessica Wheeler,Manager,859-567-1723,111,jwheeler.triad@zoomtown.com,http://www.triadhealthsystems.com
KY-004573,Owen County,"HealthPoint Family Care, Inc.",1508889742,Federally Qualified Health Centers - Medical Services,120 Progress Way,,Owenton,KY,40359-6032,Owen,1401 Madison Ave,,Covington,KY,41011,Kenton,Sally Jordan,"Vice President, CFO",859-655-6138,,sjordan@healthpointfc.org,,,,,,
KY-004574,Women's Care of the Bluegrass/Family Care of the Bluegrass,"Cumberland Family Medical Center, Inc.",1104233691,Federally Qualified Health Centers - Medical Services,120 Progress Way,,Owenton,KY,40359-6032,Owen,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004575,"Community Family Clinic, PLLC","Community Family Clinic, PLLC",1518302892,Rural Health Clinics,17 Miller Dr,,Owingsville,KY,40360-2212,Bath,17 Miller Drive,,Owingsville,KY,40360,Bath,Kandi Hughes,Billing Manager,606-768-4549,,kandih73@yahoo.com,,,,,,
KY-004576,Bath Family Health Services,"Sterling Health Solutions, Inc.",1366790099,Federally Qualified Health Centers - Medical Services,44 Water St,,Owingsville,KY,40360-8944,Bath,209 N Maysville St,Suite 200,Mt. Sterling,KY,40350,Montgomery,Harold Brown,CEO,859-404-7686,,hbrown@sterlinghealthky.org,Tina Hall,CAO,859-404-7686,,hbrown@sterlinghealthky.org,www.sterlinghealthky.org
KY-004577,St. Claire Regional Family Medicine - Owingsville,"St. Claire Medical Center, Inc.",1134180920,Rural Health Clinics,632 Slate Ave,,Owingsville,KY,40360-2206,Bath,222 Medical Circle,,Morehead,KY,40351,Rowan,Charlotte Walker,"Co-Director, Patient Financial Services",606-783-6417,,Charlotte.Walker@st-claire.org,Chris McClurg,"Vice President, Finance",606-783-6587,,Chris.McClurg@st-claire.org,www.st-claire.org
KY-004578,"Heartland CARES, Inc.","Heartland CARES, Inc.",1740284348,Ryan White Providers,619 N 30th St,,Paducah,KY,42001-4047,McCracken,"Heartland CARES, Inc.",,Paducah,KY,42001,McCracken,Ashley Horn,Compliance Manager,270-444-8183,2144,ahorn@hcares.org,,,,,,
KY-004579,Paducah McCracken County Health Center,Purchase District Health Department,1619904836,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tuberculosis Clinics",916 Kentucky Ave,,Paducah,KY,42003-1977,McCracken,Purchase District Health Department,P.O. Box 2357,Paducah,KY,42002-2357,Mccracken,Joanie Allen,Account Clerk III,270-444-9625,102,jallen@purchasehealth.org,Ronald Kent Koster,Public Health Director,270-444-9625,111,kent.koster@ky.gov,
KY-004580,White House Clinic - Paint Lick,"HEALTH HELP, INCORPORATED",1013329945,Federally Qualified Health Centers - Medical Services,480 Main Street,,Paint Lick,KY,40461-8454,Garrard,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004581,HomePlace Clinic,"Mountain Comprehensive Care Center, Inc.",1578811774,Federally Qualified Health Centers - Medical Services,1110 S Mayo Trl,Suite A,Paintsville,KY,41240-1273,Johnson,104 South Front Ave,,Prestonsburg,KY,41653,Floyd,Rachel Willoughby,Program Director,606-886-8572,,rachel.willoughby@mtcomp.org,Carrie Hackworth,BILLING COORDINATOR,606-788-1345,,carrie.hackworth@mtcomp.org,www.mtcomp.org
KY-004582,Bourbon Community Hospital,LifePoint Health,1427132158,Inpatient Hospitals (other than children's hospitals),9 Linville Dr,,Paris,KY,40361-2129,Bourbon,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Amber Goodpaster,CFO,859-595-2597,,,
KY-004583,HomePlace Clinic,"Mountain Comprehensive Care Center, Inc.",1578811774,Federally Qualified Health Centers - Medical Services,118 S Front Ave,,Pikeville,KY,41501,Pike,104 South Front Ave.,,Prestonsburg,KY,41653,Floyd,Rachel Willoughby,Program Director,606-886-8572,,rachel.willoughby@mtcomp.org,Carrie Hackworth,BILLING COORDINATOR,606-788-1345,,carrie.hackworth@mtcomp.org,www.mtcomp.org
KY-004584,"Pediatric Associates of Pikeville, LLC","Pediatric Associates of Pikeville, LLC",1851348338,Rural Health Clinics,156 Island Creek Rd,,Pikeville,KY,41501-9340,Pike,156 Island Creek Rd,,Pikeville,KY,41501,Pike,Judy Hankins,Credentialing Manager,606-432-3221,,jhankins@setel.com,Stephanie Warrix,Information Resources Manager,606-432-0174,,stephanie.warrix@aacenter.com,
KY-004585,SHELBY VALLEY CLINIC,"BIG SANDY HEALTH CARE, INC.",1700828597,"Dental Providers, Federally Qualified Health Centers - Medical Services",178 Douglas Pkwy,,Pikeville,KY,41501-6970,Pike,1709 KY Route 321 Ste 3,,Prestonsburg,KY,41653-9097,Floyd,Ancil W Lewis,CEO,606-886-8546,,A.LEWIS@BSHC.ORG,,,,,,WWW.BSHC.ORG
KY-004586,"CUMBERLAND FAMILY CLINIC, PLLC","CUMBERLAND FAMILY CLINIC, PLLC",1366703159,Rural Health Clinics,57 Hogue Rd,,Pine Knot,KY,42635-7003,McCreary,57 Hogue Road,,Pine Knot,KY,42635,McCreary,Monica S Lawson,Managing Member,606-354-9444,,monica.lawson@kyrhc.com,William Singleton,CFO,606-310-9726,,bill.singleton@kyrhc.com,
KY-004587,Pineville Medical Clinic,Mountain Comprehensive Health Corporation,1932575784,Federally Qualified Health Centers - Medical Services,251 S Pine St,,Pineville,KY,40977-1646,Bell,226 Medical Plaza Ln,,Whitesburg,KY,41858,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004588,Grace Community Health Center Inc,Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,313 S Cherry St,,Pineville,KY,40977-1724,Bell,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701-2735,Whitley,Kathy Brock,Credentialing Manager,606-545-4866,241,kathy@brickmountain.com,Michael W. Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,
KY-004589,Eastern Kentucky Tender Care Pediatrics,Eastern Kentucky Tender Care Pediatrics,1043437254,Rural Health Clinics,4851 KY Route 321,,Prestonsburg,KY,41653-9113,Floyd,4851 KY Route 321,,Prestonsburg,KY,41653,Floyd,Dianna Craft,Practice Manager,606-886-1173,,dcraft@frontiermedical.org,"Antoin Hana, M.D.",Owner,606-471-2434,,drhana@ektcp.com,
KY-004590,Highlands Regional Medical Center,Highlands Regional Medical Center,1194818138,Inpatient Hospitals (other than children's hospitals),5000 KY Route 321,,Prestonsburg,KY,41653-9113,Floyd,5000 KY ROUTE 321,,Prestonsburg,KY,41653,Floyd,"HAROLD C. WARMAN, JR",CEO,606-886-7600,,bwarman@hrmc.org,HALEY BLAIR,Administrative Assistant,606-886-7600,,haleyb@hrmc.org,www.hrmc.org
KY-004591,Community Medical Clinic,PENNYROYAL HEALTHCARE SERVICE INC.,1124319942,Federally Qualified Health Centers - Medical Services,310 Hawthorne St,,Princeton,KY,42445-1622,Caldwell,310 Hawthorne Street,,Princeton,KY,42445,Caldwell,Kecia Fulcher,CEO,270-365-0227,000,kfulcher@communitymedicalclinic.org,Casey Payne,CFO,270-365-0227,,cpayne@pennyroyalcenter.org,
KY-004592,Regional Health Care Affiliates Inc.,"REGIONAL HEALTH CARE AFFILIATES, INC.",1558692558,Federally Qualified Health Centers - Medical Services,215 E Main St,,Providence,KY,42450-1261,Webster,215 E Main St,,Providence,KY,42450-1261,Webster,William C Smith,CEO,270-667-7017,,bsmith@hfchc.net,Quintin Stone,Chief Financial Officer,270-667-2397,,qstone@hfchc.net,
KY-004593,Madison Family Clinic,"Rose Bowling, LLC",1891799177,Rural Health Clinics,2161 Lexington Rd,Suite 5,Richmond,KY,40475-7952,Madison,2161 Lexington Road,"1st Floor, Suite 5",Richmond,KY,40475-7952,Madison,Reba Bowling,Owner/CEO,859-626-7794,2006,rbowling@madisonfamilyclinic.com,Kristina Fox,Business Manager,859-626-7794,2015,kfox@madisonfamilyclinic.com,madisonfamilyclinic.com
KY-004594,White House Clinic - Richmond,"HEALTH HELP, INCORPORATED",1659358398,"Dental Providers, Federally Qualified Health Centers - Medical Services",401 Highland Park Dr,,Richmond,KY,40475-3839,Madison,1010 Main St S,,Mc Kee,KY,40447-7089,Jackson,Stephanie Moore,CEO,859-626-7700,,stephanie.moore@whitehouseclinics.com,,,,,,
KY-004595,Family Practice Associates,Russell County Hospital,1073936902,Rural Health Clinics,124 Dowell Rd,,Russell Springs,KY,42642-4278,Russell,153 Dowell Rd,,Russell Springs,KY,42642,Russell,Janie Landis,CFO,270-866-4753,,jlandis@russellcohospital.org,Amy Thomas,Medical Office Manager,270-866-9359,,athomas@russellcohospital.org,
KY-004596,Salem Elementary Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1538550991,Federally Qualified Health Centers - Medical Services,1409 S Highway 76,,Russell Springs,KY,42642-9612,Russell,360 Keen Street,,Burkesville,KY,42717-1080,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cumberlandfamilymedical.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cumberlandfamilymedical.com,www.cumberlandfamilymedical.com
KY-004597,Russell Springs Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1932590395,Federally Qualified Health Centers - Medical Services,1554 N Highway 127,,Russell Springs,KY,42642-9502,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004598,Russell County High Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1356732713,Federally Qualified Health Centers - Medical Services,2166 S Highway 127,,Russell Springs,KY,42642-4010,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004599,Russell County Middle Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1801287263,Federally Qualified Health Centers - Medical Services,2258 S Highway 127,,Russell Springs,KY,42642-4010,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004600,Westlake Primary Care of Russell County,Adair County Hospital District,1831164789,Rural Health Clinics,2465 Lakeview Drive,,Russell Springs,KY,42642,Russell,901 Westlake Drive,,Columbia,KY,42728,Adair,Gidgett Warren,CNO/Clinic Director,270-384-4753,1111,gidgett.warren@wrhs-ky.com,Neal Gold,CEO,270-384-4753,1154,neal.gold@wrhs-ky.com,
KY-004601,Russell Family Medical Center,"Cumberland Family Medical Center, Inc.",1437483815,Federally Qualified Health Centers - Medical Services,404 Steve Dr,,Russell Springs,KY,42642-4622,Russell,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004602,"Community Health Centers of Western Kentucky, Inc. Logan County","COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.",1306848650,Federally Qualified Health Centers - Medical Services,1497 Nashville St,,Russellville,KY,42276-8850,Logan,480 Hopkinsville St,,Greenville,KY,42345,Muhlenberg,Roger Arbuckle,CEO,270-338-5777,,chcwk@bellsouth.net,Joe Swab,CFO,270-338-5777,,chcwk.cfo@gmail.com,
KY-004603,Logan Memorial Hospital,LifePoint Health,1992893416,Inpatient Hospitals (other than children's hospitals),1625 Nashville St,,Russellville,KY,42276-8853,Logan,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Chris Stewart,CFO,270-725-4554,,,
KY-004604,Burkhart Rural Health Clinic,Crittenden County Hospital,1265481022,Rural Health Clinics,117 E Main St,,Salem,KY,42078-9998,Livingston,520 West Gum Street,,Marion,KY,42064,Crittenden,Yvette Martin,Office Manager,270-988-3839,,yvettem@crittenden-health.org,Jim Bishop,CFO,270-965-1164,,jbishop@crittenden-health.org,
KY-004605,"Livingston Hospital and Healthcare Services, Inc.","Livingston Hospital and Healthcare Services, Inc.",1588640254,Inpatient Hospitals (other than children's hospitals),131 Hospital Dr,,Salem,KY,42078-8043,Livingston,131 Hospital Drive,,Salem,KY,42078,Livingston,Leah Tramble,Practice Administrator,270-988-7256,,ltramble@lhhs.org,Kent Giles,Interim CEO,270-988-7236,,kgiles@lhhs.org,www.lhhs.org
KY-004606,Salem Medical Clinic,Tri-Rivers Healthcare PLLC,1588644496,Rural Health Clinics,141 Hospital Dr,Suite 102,Salem,KY,42078-8043,Livingston,PO Box 347,,Salem,KY,42078-0347,Livingston,Michael Heneisen,Business Manager,270-988-3298,,mheneisen@tririvershc.com,,,,,,
KY-004607,Highlands Primary Care,Highlands Regional Medical Center,1447683958,Rural Health Clinics,100 Brianna Blvd,Suite 100,Salyersville,KY,41465-7510,Magoffin,HIGHLANDS REGIONAL MEDICAL CENTER,5000 KY ROUTE 321,Prestonsburg,KY,41653,Floyd,HAROLD C WARMAN JR,CEO,606-886-7600,,bwarman@hrmc.org,HALEY BLAIR,Administrative Assistant,606-886-7600,,haleyb@hrmc.org,www.hrmc.org
KY-004608,SALYERSVILLE MEDICAL CENTER,Salyersville Medical Center,1215984711,Rural Health Clinics,601 E Maple St,,Salyersville,KY,41465-9470,Magoffin,601 E Maple St,,Salyersville,KY,41465,Magoffin,Judy Hankins,Credentialing Manager,606-432-0174,,jhankins@setel.com,Stephanie Warrix,Information Resources Manager,606-432-0174,,stephanie.warrix@aacenter.com,
KY-004609,HOPE FAMILY MEDICAL CENTER,"BIG SANDY HEALTH CARE, INC.",1326080110,"Dental Providers, Federally Qualified Health Centers - Medical Services",835 Parkway Dr,,Salyersville,KY,41465-9250,Magoffin,1709 KY Route 321 Ste 3,,Prestonsburg,KY,41653-9097,Floyd,Ancil W Lewis,CEO,606-886-8546,,A.LEWIS@BSHC.ORG,,,,,,WWW.BSHC.ORG
KY-004610,Albaree Health Services,Albaree Health Services,1730232182,Rural Health Clinics,906 E Mountain Pkwy,,Salyersville,KY,41465-8379,Magoffin,906 East Mountain Parkway,,Salyersville,KY,41465,Magoffin,Dianna Craft,Practice Manager,606-349-0482,322,dcraft@frontiermedical.org,ANTOIN HANA,Owner,606-471-2434,,DR.HANA@FRONTIERMEDICAL.ORG,
KY-004611,St. Claire Regional Family Medicine - Sandy Hook,"St. Claire Medical Center, Inc.",1447212493,Rural Health Clinics,390 S KY 7,,Sandy Hook,KY,41171-6830,Elliott,222 Medical Circle,,Morehead,KY,40351,Rowan,Charlotte Walker,"Co-Director, Patient Financial Services",606-783-6417,,Charlotte.Walker@st-claire.org,Chris McClurg,"Vice President, Finance",606-783-6587,,Chris.McClurg@st-claire.org,www.st-claire.org
KY-004612,Primary Care Centers of Eastern KY-Vicco,Primary Care Centers of Eastern KY,1184676314,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics",10897 S KY Highway 15,,Scuddy,KY,41760-9033,Perry,PO Box 1988,,Hazard,KY,41702-1988,Perry,Shelia Bowling,BILLING SUPERVISOR,606-435-7643,,sbowling@pccek.com,Charla Napier,COO,606-439-1300,3229,cnpaier@pccek.com,
KY-004613,Methodist Family Medicine of Sebree,Methodist Hospital,1013192293,Outpatient Hospital Clinics,47 E Webster St,,Sebree,KY,42455,Webster,1305 N. Elm Street,,Henderson,KY,42420,Henderson,Carey Sue Ginn,Quality Improvement Specialist,270-830-4697,,cginn@methodisthospital.net,Sarah Wilson,Enrollment Specialist,270-631-2412,,swilson@methodisthospital.net,
KY-004614,Shepherdsville Family Health Clinic,Shepherdsville Family Health Clinic,1902856123,Rural Health Clinics,130 W Joe B Hall Ave,,Shepherdsville,KY,40165-6028,Bullitt,181 Hwy 44 East,Suite 1,Shepherdsville,KY,40165,Bullitt,Karen Marie Scheich,APRN/President,502-921-1231,,kmsaprn@gmail.com,Rebecca Houston,Office Manager,502-921-1231,,rjhouston@windstream.net,
KY-004615,Smithland Medical Clinic,Tri-Rivers Healthcare PLLC,1598885998,Rural Health Clinics,205 E Adair St,,Smithland,KY,42081-9164,Livingston,PO Box 347,,Salem,KY,42078-0347,Livingston,Michael Heneisen,Business Manager,270-988-3298,,mheneisen@tririvershc.com,,,,,,
KY-004616,"Eastern Pulaski Rural Health Clinic, PLLC","Eastern Pulaski Rural Health Clinic, PLLC",1841630654,Rural Health Clinics,31 Mark Shopville Rd,,Somerset,KY,42503-7533,Pulaski,7238 W Hwy 80,PO Box 100,Nancy,KY,42544,Pulaski,Diana L Williamson,APRN/Owner,606-485-4553,,eprhc@yahoo.com,Steward A Framer,Owner,606-636-4400,,stew.framer@hotmail.com,
KY-004617,DBA/Lake Cumberland Medical Associates,"Lake Cumberland Regional Hospital, LLC",1447330451,Rural Health Clinics,350 Hospital Way,Suite 100,Somerset,KY,42503-1872,Pulaski,305 Langdon Street,,Somerset,KY,42503,Pulaski,Lisa McKinney,Practice Manager,606-451-2619,,Lisa.McKinney@lpnt.net,Steve Sloan,CFO,606-678-3101,,Steve.Sloan@lpnt.net,
KY-004618,South Shore Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,Federally Qualified Health Centers - Medical Services,142 Depot St,,South Shore,KY,41175,Greenup,211 KY 59,P.O. box 550,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004619,ARH Tug Valley Medical Associates,"Appalachian Regional Healthcare, Inc.",1487762399,"Outpatient Hospital Clinics, Rural Health Clinics",306 Hospital Dr,,South Williamson,KY,41503-4095,Pike,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004620,SPRING VIEW CLINIC,"Spring View Hospital, LLC",1508141961,Rural Health Clinics,79 Bobolink Dr,,Springfield,KY,40069-1516,Washington,320 Loretto Road,,Lebanon,KY,40033,Marion,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Heather Lamkin,Market Manager,270-699-4603,,Heather.Lamkin@LPNT.net,
KY-004621,"Bates, Miller and Sims, PLLC","Bates, Miller and Sims, PLLC",1598869638,Rural Health Clinics,100 Jay St,,Stanford,KY,40484-7511,Lincoln,100 Jay Street,,Stanford,KY,40484,Lincoln,Ashley L. Bodner,Practice Administrator,606-365-1547,102,abodner.78@gmail.com,Jonelle Rutherford,Administrative Assistant,606-365-1547,103,jone.rutherford@yahoo.com,
KY-004622,Stanford Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1306873500,Family Planning Providers,101 Old Fort Rd,,Stanford,KY,40484-8540,Lincoln,360 Keen St.,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,
KY-004623,"Bluegrass Clinic Stanford, PLLC","Bluegrass Clinic Stanford, PLLC",1265571020,Rural Health Clinics,107 Metker Trl,Suite A,Stanford,KY,40484-1049,Lincoln,107 Metker Trail,Suite A,Stanford,KY,40484,Lincoln,Cristi Martin,Administrative Assistant,606-365-8338,309,cmartin@bluegrassclinic.com,Vanessa Haste,Billing Manager,606-365-8338,312,vhaste@bluegrassclinic.com,
KY-004624,RED RIVER PEDIATRICS,Red River Pediatrics,1013954510,Rural Health Clinics,321C E College Ave,,Stanton,KY,40380-2325,Powell,321C E College Ave,,Stanton,KY,40380,Powell,Judy Hankins,Credentialing Manager,606-663-9797,,jhankins@setel.com,Stephanie Warrix,Information Resources Manager,606-432-0174,,stephanie.warrix@aacenter.com,
KY-004625,Casa San Pio Medical Clinics of Appalachia,Casa San Pio Medical Clinics of Appalachia,1982976700,Rural Health Clinics,638 E College Ave,Suite B,Stanton,KY,40380-2363,Powell,638 East College Avenue,Suite B,Stanton,KY,40380,Powell,"Nancy Kukulinsky, Ph.D.",consultant,859-585-7900,,kukulinsky@yahoo.com,"Taufik Kassis, MD",Medical Director,859-585-8395,,cfclinic06@yahoo.com,
KY-004626,ERTEL MEDICINE & PEDIATRICS - STANTON,"Clark Regional Physician Practices, LLC",1114282605,Rural Health Clinics,68 E Elkins St,,Stanton,KY,40380-2311,Powell,PO Box 1537,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004627,Spencer County,"Park DuValle Community Health Center, Inc.",1942214663,"Dental Providers, Federally Qualified Health Centers - Medical Services",311 Reasor Ave,,Taylorsville,KY,40071-8120,Spencer,311 Reasor Ave,,Taylorsville,KY,40071,Spencer,Jennifer Hendricks,Credentialing Specialist,502-774-4401,1247,jhendricks@pdchc.org,Ann Hagan-Grigsby,CEO,502-774-4401,1221,ahagan@pdchc.org,
KY-004628,Tollesboro Family Health Center,"Lewis County Primary Care Center, Inc.",1457303802,Federally Qualified Health Centers - Medical Services,17521 W KY 9,,Tollesboro,KY,41189-8243,Lewis,211 KY 59,P.O. Box 550,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004629,Monroe Family Medical Center,"Cumberland Family Medical Center, Inc.",1649516287,Federally Qualified Health Centers - Medical Services,1515 Edmonton Rd,,Tompkinsville,KY,42167-9402,Monroe,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004630,Monroe County Medical Center,"Monroe Medical Foundation, Inc.",1053499350,Inpatient Hospitals (other than children's hospitals),529 Capp Harlan Rd,,Tompkinsville,KY,42167-1808,Monroe,529 Capp Harlan road,,Tompkinsville,KY,42167,Monroe,Vicky Lynn McFall,CEO,270-487-9231,1154,CEO@MCMCCARES.COM,Rickie F. Brown,CFO,270-487-9231,1156,cfo@mcmccares.com,mcmccares.com
KY-004631,Lewis County Primary Care Center,Lewis County Primary Care Center,1457303802,"Dental Providers, Federally Qualified Health Centers - Medical Services",211 KY 59,,Vanceburg,KY,41179-7647,Lewis,211 KY 59,,Vanceburg,KY,41179,Lewis,Jerry Ugrin,CEO,606-796-3029,,jugrin@lcpcc.org,Michelle McCane,Administrative Assistant,606-796-3029,,mccanem@primaryplus.net,
KY-004632,Women's Care of the Bluegrass/Family Care of the Bluegrass,"Cumberland Family Medical Center, Inc.",1487061982,Federally Qualified Health Centers - Medical Services,360 Amsden Ave,,Versailles,KY,40383-1851,Woodford,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004633,TRIAD HEALTH SYSTEMS,TRIAD HEALTH SYSTEM INC,1831311299,Federally Qualified Health Centers - Medical Services,441 Hwy 42 W,,Warsaw,KY,41095,Gallatin,441 Hwy 42W,,Warsaw,KY,41095,Gallatin,Adam D Craft,CEO,859-567-1720,,acraft.triad@zoomtown.com,Jessica Wheeler,Manager,859-567-1723,,jwheeler.triad@zoomtown.com,http://www.triadhealthsystems.com
KY-004634,Waynesburg Healthy Kids Clinic,"Cumberland Family Medical Center, Inc.",1306873500,Federally Qualified Health Centers - Medical Services,345 KY Highway 328 W,,Waynesburg,KY,40489-8205,Lincoln,360 Keen St.,,Burkesville,KY,42717,Cumberland,Cheryl Green,Director of Patient Financial Services,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6644,,kkimsal@cfmcky.com,
KY-004635,Morgan County ARH Family Health,"Appalachian Regional Healthcare, Inc.",1780043927,"Outpatient Hospital Clinics, Rural Health Clinics",1084 Highway 7,Suite 2,West Liberty,KY,41472-7146,Morgan,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004636,ARH Morgan County Clinic,"Appalachian Regional Healthcare, Inc.",1982648010,"Outpatient Hospital Clinics, Rural Health Clinics",476 Liberty Rd,,West Liberty,KY,41472-2049,Morgan,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004637,Juniper Health Morgan County,"JUNIPER HEALTH, INC.",1447791512,Federally Qualified Health Centers - Medical Services,905 Main St,,West Liberty,KY,41472-1023,Morgan,"Juniper Health, Inc.",PO Box 690,Beattyville,KY,41311,Lee,Brooke Johnson,CFO,606-464-0151,2002,brooke.johnson@juniperhealth.org,Karen Ditsch,CEO,606-464-0151,,karen.ditsch@juniperhealth.org,juniperhealth.org
KY-004638,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1003164203,Federally Qualified Health Centers - Medical Services,185 Circle Dr Suite A,Letcher County Alternative Education School,Whitesburg,KY,41858-7662,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004639,ARH Whitesburg Clinic,"Appalachian Regional Healthcare, Inc.",1336355601,"Outpatient Hospital Clinics, Rural Health Clinics",214 Hospital Rd,,Whitesburg,KY,41858-7627,Letcher,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
KY-004640,Whitesburg Medical/Dental Clinic,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1417900242,"Black Lung Clinics, Dental Providers, Federally Qualified Health Centers - Medical Services",226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,"Teresa Fleming, MBA",Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004641,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1568710762,Federally Qualified Health Centers - Medical Services,3125 Highway 931 S,Cowan Elementary School,Whitesburg,KY,41858-8966,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004642,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1710235916,Federally Qualified Health Centers - Medical Services,330 Parks St,West Whitesburg Elementary School,Whitesburg,KY,41858-7539,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004643,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1629326822,Federally Qualified Health Centers - Medical Services,366 Parks St,Whitesburg Middle School,Whitesburg,KY,41858-7539,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004644,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1649528845,Federally Qualified Health Centers - Medical Services,435 Cougar Dr,Letcher County Central High School,Whitesburg,KY,41858-7009,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004645,Mountain Comprehensive Health Clinics,MOUNTAIN COMPREHENSIVE HEALTH CORPORATION,1992053193,Federally Qualified Health Centers - Medical Services,55 Kona Dr,Martha Jane Potter Elementary School,Whitesburg,KY,41858-7854,Letcher,226 Medical Plaza Ln,,Whitesburg,KY,41858-7425,Letcher,L.M. (Mike) Caudill,Chief Executive Officer,606-633-4823,1389,lmcaudill@mtncomp.org,Teresa Fleming,Director of Financial Affairs,606-633-4823,1387,tfleming@mtncomp.org,www.mchcky.org
KY-004646,Whitley Family Medical Center,"Cumberland Family Medical Center, Inc.",1619360062,Federally Qualified Health Centers - Medical Services,19 Medical Loop # 3,,Whitley City,KY,42653-4382,McCreary,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004647,McCreary Family Medical Center,"Cumberland Family Medical Center, Inc.",1356679179,Federally Qualified Health Centers - Medical Services,69 S Main St,,Whitley City,KY,42653-6043,McCreary,360 Keen St,,Burkesville,KY,42717-7915,Cumberland,Cheryl Green,Director of Business Administration,270-858-6644,2320,cgreen@cfmcky.com,Ken Kimsal,CFO,270-858-6655,,kkimsal@cfmcky.com,www.cumberlandfamilymedical.com
KY-004648,"SOUTH FORK MEDICAL CLINIC, PLLC","SOUTH FORK MEDICAL CLINIC, PLLC",1295718757,Rural Health Clinics,71 Medical Ln,,Whitley City,KY,42653-4216,McCreary,71 Medical Lane,,Whitley City,KY,42653,McCreary,Monica S Lawson,Managing Member,606-376-7212,,monica.lawson@kyrhc.com,William Singleton,CFO,606-310-9726,,bill.singleton@kyrhc.com,
KY-004649,APPALACHIA HEALTH SERVICES,APPALACHIA HEALTH SERVICES,1427096551,Rural Health Clinics,3080 N Highway 25 W,,Williamsburg,KY,40769-8602,Whitley,3080 N Highway 25 W,,Williamsburg,KY,40769,Whitley,REGINA ESCALANTE,OFFICE MANAGER,423-784-3600,,reginadoctor5@gmail.com,DAVID ESCALANTE,DIRECTOR,423-784-3600,,descalante@bellsouth.net,
KY-004650,CUMBERLAND RIVER CLINIC,"DAYSPRING FAMILY HEALTH CENTER, INC.",1871631804,Federally Qualified Health Centers - Medical Services,402 Cumberland Ave,,Williamsburg,KY,40769-1238,Whitley,107 S Main St,,Jellico,TN,37762-2154,Campbell,Angelia Washam,HR/Credentialing Director,423-784-5771,146,angiew@dayspringfhc.com,Patsy Prater,AR Manager,423-784-8492,208,patp@dayspringfhc.com,dayspringfhc.com
KY-004651,Williamsburg Family Medicine Center,Williamsburg Family Medicine Center,1376689620,Rural Health Clinics,475 N Highway 25 W,Suite 100,Williamsburg,KY,40769-1576,Whitley,475 Hwy 25WN,Suite 100,Williamsburg,KY,40769,Whitley,Debra Sharp,Administrative Assistant,423-784-3667,,sharpdebra@bellsouth.net,Elsie Crawford,VP Operations,423-494-7155,,elsiejcrawford@aol.com,
KY-004652,Ertel Medicine & Pediatrics - Winchester,"Clark Regional Physician Practices, LLC",1114282605,Rural Health Clinics,1520 Boonesboro Rd,,Winchester,KY,40391-8816,Clark,PO Box 1537,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004653,Clark Regional Medical Center,LifePoint Health,1811213994,Inpatient Hospitals (other than children's hospitals),175 Hospital Dr,,Winchester,KY,40391-9591,Clark,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Amber Goodpaster,CFO,859-737-8555,,,
KY-004654,Clark Clinic Primary Care,"Clark Regional Physician Practices, LLC",1114282605,Rural Health Clinics,225 Hospital Dr,,Winchester,KY,40391-7604,Clark,PO Box 1537,,Georgetown,KY,40324,Scott,John Hickey,Senior Director - Physician Practices,615-584-9867,,John.Hickey@LPNT.net,Sarah Comley,Central Billing Office Director,502-868-5618,,Sarah.Comley1@LPNT.net,
KY-004655,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,142 Pirate Dr,W.B. Muncy Elementary School,Wooton,KY,41776-8889,Leslie,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
KY-004656,"Grace Community Health Center, Inc. - Leslie County","GRACE COMMUNITY HEALTH CENTER, INC.",1568625648,Federally Qualified Health Centers - Medical Services,5923 Highway 80,,Wooton,KY,41776-8840,Leslie,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,C.E.O.,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,C.F.O.,606-258-1152,105,chad.stevens@gracechc.org,
KY-004657,"Grace Community Health Center, Inc.",Grace Community Health Center Inc,1568625648,Federally Qualified Health Centers - Medical Services,10130 Cutshin Rd,Hayes Lewis Elementary School,Yeaddiss,KY,41777,Leslie,1019 Cumberland Falls Hwy,Suite B201,Corbin,KY,40701,Whitley,Michael Stanley,CEO,606-526-9005,208,mstanley@gracechc.com,Chad Stevens,CFO,606-526-9005,6002,chad.stevens@gracechc.org,
LA-004658,Abbeville General Hospital,Abbeville General Hospital,1255300414,Inpatient Hospitals (other than children's hospitals),118 N Hospital Dr,,Abbeville,LA,70510-4039,Vermilion,118 N Hospital Dr,,Abbeville,LA,70510,Vermilion,Ray A. Landry,Chief Executive Officer,337-898-6500,,ray.landry@abbgen.net,Troy Hair,Chief Financial Office,337-898-6377,,troy.hair@abbgen.net,www.abbgen.net
LA-004659,SouthCare Medical LLC,SouthCare Medical LLC,1215294830,Rural Health Clinics,1305 N State St,,Abbeville,LA,70510-2825,Vermilion,1305 N State St,,Abbeville,LA,70510,Vermilion,Cristyana Sugeng,Manager,337-591-3983,,yanasugeng@gmail.com,,,,,,
LA-004660,Abbeville General Hospital Clinic,Abbeville General,1790744506,Rural Health Clinics,2419 Alonzo St,,Abbeville,LA,70510-4008,Vermilion,118 North Hospital Dr,,Abbeville,LA,70510,Vermilion,Bruce Sonnier,Business office director,337-898-6525,,bruce.sonnier@abbgen.net,Troy Hair,CFO,337-898-6377,,troy.hair@abbgen.net,
LA-004661,Vermilion Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",2501 Charity St,,Abbeville,LA,70510-4022,Vermilion,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-5334,,Carolyn.Wise@LA.Gov,,,,,,
LA-004662,Abbeville Community Health Center,Iberia Comprehensive Community Health Center,1134166556,"Dental Providers, Federally Qualified Health Centers - Medical Services",800 Charity St,,Abbeville,LA,70510-5239,Vermilion,806 Jefferson Terrace Blvd.,,New Iberia,LA,70560-5727,Iberia,Monique Dumond,CFO,337-365-4945,112,monique@icchc.org,Roderick Campbell,CEO,337-365-4945,114,roderickcc@icchc.org,www.icchc.org
LA-004663,dba Malinda's Patient Care,Patient's First Care LLC,1760746069,Rural Health Clinics,19115 Florida Blvd,Suite A,Albany,LA,70711-3704,Livingston,19115 Florida Blvd. Suite A,,Albany,LA,70711,Livingston,Kayla Dickerson,Office Manager/ Registered Nurse,225-610-7054,,kbrkwomack@gmail.com,Malinda T. Balado,FNP-BC,225-567-7150,,mbpc68@gmail.com,
LA-004664,"Rapides Primary Health Care Center, Inc.",Rapides Primary Health Care Center,1568404838,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1217 Willow Glen River Rd,,Alexandria,LA,71302-5458,Rapides,1217 Willow Glen River Road,,Alexandria,LA,71302,Rapides,Patricia L. Lewis,Chief Executive Officer,318-487-4400,1001,plewis@rphcc.org,Vera L. Miles,Deputy Chief Executive Officer,318-487-4400,1002,vmiles@rphcc.org,www.rphcc.org
LA-004665,Rapides Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",5604A Coliseum Blvd,,Alexandria,LA,71303-3709,Rapides,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004666,Children's International Medical Group Amite,"Children's International, LLC",1073620498,Rural Health Clinics,106 Mimosa St,,Amite,LA,70422-2136,Tangipahoa,59101 Amber,,Slidell,LA,70461,Saint Tammany,Zach H. Allen,Div Sr Vice President,601-337-2464,1,zach.allen@cimgpeds.com,Lacey Sones,Area Director of Operations,985-646-1580,6,lacey.sones@cimgpeds.com,www.cimgpeds.com
LA-004667,Tangipahoa Parish Health Unit - Amite,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",330 W Oak St,,Amite,LA,70422-2720,Tangipahoa,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004668,AMITE RURAL HEALTH CLINIC,HOOD MEMORIAL HOSPITAL,1932246261,Rural Health Clinics,409 NW Central Ave,,Amite,LA,70422-2428,Tangipahoa,301 WALNUT ST,,AMITE,LA,70422,Tangipahoa,Gari Brant,Director of Revenue Cycle,985-248-2458,,gari@hoodmemorial.com,SANDRA HAWKINS,RURAL HEALTH CLINIC MANAGER,985-248-2502,,sandra@hoodmemorial.com,
LA-004669,Bienville Family Clinic,Bienville Family Clinic-Arcadia,1316038441,Rural Health Clinics,1175 Pine St,Suite 100,Arcadia,LA,71001-3122,Bienville,1175 Pine Street Suite 100,,Arcadia,LA,71001,Bienville,Crystal Rabo,Chief Operating Officer,318-263-7970,,crystal@bienvillefamilyclinic.com,Randy McKinney,Administrator,318-263-7970,,admin@bienvillefamilyclinic.com,
LA-004670,Bienville Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1285 Pine St,Suite 102,Arcadia,LA,71001-3120,Bienville,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004671,Teche Action Clinic,"TECHE ACTION BOARD, THE",1902082811,Federally Qualified Health Centers - Medical Services,18331 Highway 182,West St. Mary High School,Baldwin,LA,70514-1449,Saint Mary,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004672,Morehouse Jr. High SBHC,"MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1114252558,Federally Qualified Health Centers - Medical Services,1001 W Madison Ave,,Bastrop,LA,71220-4331,Morehouse,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004673,"Morehouse Community Medical Centers, Inc.","MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1245656412,Federally Qualified Health Centers - Medical Services,402 Highland Ave,Bastrop High School,Bastrop,LA,71220-2241,Morehouse,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004674,BASTROP OUTPATIENT RURAL HEALTH CLINIC,Sterlington Rehabilitation Hospital,1669658571,Rural Health Clinics,510 S Washington St,,Bastrop,LA,71220-5033,Morehouse,10374 Hwy 165 N,SUITE a,Sterlington,LA,71280,Ouachita,Terri Mcnemar,Insurance,318-665-9950,110,tmcnemar@sterlingtonrehab.com,Kathy Schroeder,CNO,318-665-9950,113,kschroeder@sterlingtonrehab.com,
LA-004675,"Morehouse Community Medical Centers, Inc.","MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1083802060,Federally Qualified Health Centers - Medical Services,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004676,MCMC Dental Center,"MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1760717102,Dental Providers,625 S Washington St,,Bastrop,LA,71220-5034,Morehouse,518 Durham Street,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004677,Morehouse Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",650 School St,,Bastrop,LA,71220-5048,Morehouse,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004678,One Stop Health Care for the Homeless Center,"BATON ROUGE PRIMARY CARE COLLABORATIVE, INC.",1255665832,Federally Qualified Health Centers - Medical Services,153 N 17th St,,Baton Rouge,LA,70802-3800,East Baton Rouge,220 Saint Vincent de Paul Dr,,Baton Rouge,LA,70802-3808,East Baton Rouge,Stacie Bland,CEO,225-354-1914,,sbland@brprimarycare.org,Joyce Boater,Officer Manager,225-354-1652,,jboatner@brprimarycare.org,
LA-004679,Jewel Newman Community Health Center,"BATON ROUGE PRIMARY CARE COLLABORATIVE, INC.",1689722431,Federally Qualified Health Centers - Medical Services,2013 Central Rd,,Baton Rouge,LA,70807-3942,East Baton Rouge,220 Saint Vincent de Paul Dr,,Baton Rouge,LA,70802-3808,East Baton Rouge,Stacie Bland,CEO,225-354-1914,,sbland@brprimarycare.org,Joyce Boatner,Office Manager,225-354-1652,,jboatner@brprimarycare.org,
LA-004680,"CAPITOL CITY FAMILY HEALTH CENTER, INC.",CAPITOL CITY FAMILY HEALTH CENTER INC,1265548614,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers",3140 Florida Blvd,,Baton Rouge,LA,70806-3757,East Baton Rouge,3140 Florida Blvd,,Baton Rouge,LA,70806-3757,East Baton Rouge,Matthew Valliere,Chief Executive Officer (CEO),225-650-2026,,mvalliere@ccfhc.org,Christina Claiborne,Chief Administrative Officer (CAO),225-650-2027,,cclaiborne@ccfhc.org,
LA-004681,East Baton Rouge Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",353 N 12th St,,Baton Rouge,LA,70802-4612,East Baton Rouge,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004682,Open Health Care Clinic,HIV-AIDS Alliance for Region Two,1437527900,"Dental Providers, Federally Qualified Health Centers - Medical Services",3801 North Blvd,,Baton Rouge,LA,70806-3825,East Baton Rouge,4550 North Blvd,Suite 250,Baton Rouge,LA,70806,East Baton Rouge,Tim Young,Chief Executive Officer,225-927-1269,,tim.young@ohcc.org,Kim Hood,Chief Operations Officer,225-927-1269,,kim.hood@ohcc.org,www.ohcc.org
LA-004683,Baton Rouge Health Center,"Planned Parenthood Gulf Coast, Inc.",1821372277,Family Planning Providers,3825 Government St,Suite 2,Baton Rouge,LA,70806-5725,East Baton Rouge,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,CFO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
LA-004684,Caring Clinic of Louisiana,HIV/AIDS Alliance for Region Two Inc,1679762421,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",4560 North Blvd,Suite 101,Baton Rouge,LA,70806-4043,East Baton Rouge,4550 North Blvd Ste 250,,Baton Rouge,LA,70806-4013,East Baton Rouge,Timothy Young,Chief Executive Officer,225-927-1269,,tyoung@haartinc.org,Kimberly Hood,Chief Operating/Compliance Officer,225-927-1269,,khood@haartinc.org,http://www.caringclinic.org
LA-004685,"EXCELth, Inc. FHC - BATON ROUGE","EXCELth, Inc.",1710914049,Federally Qualified Health Centers - Medical Services,4560 North Blvd,Suite 104,Baton Rouge,LA,70806-4043,East Baton Rouge,1515 Poydras Street,STE 1070,New Orleans,LA,70112,Orleans,MICHAEL A. ANDRY,CEO,504-524-1210,4123,mandry@excelth.com,Matilda Tennessee,Revenue Cycle Manager,504-524-1210,,mtennessee@excelth.com,
LA-004686,AHF Healthcare Center - Baton Rouge Azmeh Clinic,AIDS Healthcare Foundation,1548697865,Other ECP Providers,4890 Bluebonnet Blvd,,Baton Rouge,LA,70809-9644,East Baton Rouge,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
LA-004687,AHF Healthcare Center - Baton Rouge (Goodwood),AIDS Healthcare Foundation,1801143607,Other ECP Providers,8281 Goodwood Blvd,Suite D1,Baton Rouge,LA,70806-7742,East Baton Rouge,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
LA-004688,Belle Chasse Community Health Center,Access Health Louisiana,1619233814,"Dental Providers, Federally Qualified Health Centers - Medical Services",8200 Highway 23,,Belle Chasse,LA,70037-2607,Plaquemines,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004689,Washington Community Health Center,Access Health Louisiana,1427488352,"Dental Providers, Federally Qualified Health Centers - Medical Services",2807 S Columbia St,,Bogalusa,LA,70427-7915,Washington,843 Milling Ave,,Luling,LA,70427,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004690,"Family Health Care Clinic, Inc., --Bogalusa","FAMILY HEALTH CARE CLINIC, INC.",1457781486,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",609 Superior Ave,,Bogalusa,LA,70427-2630,Washington,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,VP and COO,601-825-7280,5003,cmayes@familyhealthcareclinic.com,familyhealthcareclinic.com
LA-004691,Washington Parish Health Unit - Bogalusa,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",626 Carolina Ave,,Bogalusa,LA,70427-3319,Washington,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004692,David Raines Community Health Centers - Bossier,"David Raines Community Health Center, Inc.",1891964789,Federally Qualified Health Centers - Medical Services,1514 Doctors Dr,,Bossier City,LA,71111-3379,Bossier,3041 Martin Luther King Jr. Drive,,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004693,Bossier Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Tuberculosis Clinics",3022 Old Minden Rd,,Bossier City,LA,71112-2477,Bossier,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004694,CHRISTUS Community Health Clinic,CHRISTUS Health,1417494758,Rural Health Clinics,415 Saint Clair Rd,Suite B,Boyce,LA,71409-9007,Rapides,1635 Marvel St,,Coushatta,LA,71019,Red River,Angela Shoemaker,Manager of Patient Financial Services,318-932-2085,,angela.shoemaker@christushealth.org,Jana Baldwin,Patient Representative,318-932-2244,,jana.baldwin@christushealth.org,
LA-004695,Avoyelles Primary Health and Wellness Center,"Rapides Primary Health Care Center, Inc.",1972961100,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1007 Shirley Rd,,Bunkie,LA,71322-1544,Avoyelles,1217 Willow Glen River Road,,Alexandria,LA,71302,Rapides,Patricia L. Lewis,Chief Executive Officer,318-487-4400,1001,plewis@rphcc.org,Vera L. Miles,Deputy Chief Executive Officer,318-487-4400,1002,vmiles@rphcc.org,www.rphcc.org
LA-004696,Bunkie General Hospital Rural Health Clinic (inpatient hospital),Bunkie General Hospital,1811942279,Inpatient Hospitals (other than children's hospitals),108 N Lexington Ave,,Bunkie,LA,71322-1620,Avoyelles,427 Evergreen st.,,Bunkie,LA,71322,Avoyelles,LindaF. Deville,CEO,318-346-6681,200,ldeville@bunkiegeneral.com,,,,,,
LA-004697,Bunkie General Hospital Rural Health Clinic (rural health clinics),Bunkie General Hospital,1811942279,Rural Health Clinics,108 N Lexington Ave,,Bunkie,LA,71322-1620,Avoyelles,427 Evergreen st.,,Bunkie,LA,71322,Avoyelles,LindaF. Deville,CEO,318-346-6681,200,ldeville@bunkiegeneral.com,,,,,,
LA-004698,Avoyelles Parish Health Unit - Bunkie,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",406 Walnut St,,Bunkie,LA,71322-1765,Avoyelles,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004699,Bunkie General Hospital Family Care Clinic,Bunkie General Hospital,1073568366,Rural Health Clinics,510 S Cottonwood St,,Bunkie,LA,71322-1135,Avoyelles,427 Evergreen st.,,Bunkie,LA,71322,Avoyelles,Linda F. Deville,CEO,318-346-6681,200,ldeville@bunkiegeneral.com,,,,,,
LA-004700,Cameron Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",107 Recreation Center Ln,PO Box 1430,Cameron,LA,70631-4717,Cameron,1450 Poydras Street,Ste 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004701,North Natchitoches Medical Clinic,North Natchitoches Medical Clinic,1093933897,Rural Health Clinics,3194 Highway 71,,Campti,LA,71411-4060,Natchitoches,3194 hwy 71,,Campti,LA,71411,Natchitoches,Holley irvin,Business Office Supervisor,318-214-4401,,holley.irvin@nrmchospital.org,,,,,,
LA-004702,St Bernard Community Health Center,Access Health Louisiana,1174828362,"Dental Providers, Federally Qualified Health Centers - Medical Services",8050 W Judge Perez Dr,Suite 1300,Chalmette,LA,70043-1736,Saint Bernard,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3712,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004703,Chitimacha Health Center,Chitimacha Health Center,1154477909,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",3231Chitimacha Trail,,Charenton,LA,70523,Saint Mary,PO Box 640,,Charenton,LA,70523-0640,Saint Mary,Karen Matthews,Health Director,337-923-9955,3037,karen@chitimacha.gov,,,,,,
LA-004704,East Feliciana Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",12080 Marston St,,Clinton,LA,70722-3217,East Feliciana,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004705,"Winn Community Health Center, Inc.",Winn Community Health Center,1952785040,Federally Qualified Health Centers - Medical Services,301 3rd St,Winnfield Primary School,Colfax,LA,71417-1813,Grant,427 W Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,Missy Hyman,CFO,318-648-0375,,mhyman@winnchc.org,www.winnchc.org
LA-004706,Grant Community Health Center,"Winn Community Health Center, Inc.",1740601418,"Dental Providers, Federally Qualified Health Centers - Medical Services",340 Webb Smith Dr,,Colfax,LA,71417-1910,Grant,427 Lafatyette Strret,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,David Adams,COO,318-648-0375,,dadams@winnchc.org,www.winnchc.org
LA-004707,Grant Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",340A Webb Smith Dr,,Colfax,LA,71417-1910,Grant,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,http://www.dhh.louisiana.gov/index.cfm/directory/detail/4802/catid/192
LA-004708,Caldwell Memorial Hospital,"Caldwell Memorial Hospital, Inc.",1134126659,Inpatient Hospitals (other than children's hospitals),411 Main St,,Columbia,LA,71418-6704,Caldwell,411 Main Street,PO Box 899,Columbia,LA,71418,Caldwell,Lisa Patrick,COO,318-649-6111,272,lisapatrick3@gmail.com,Danielle Williams,,318-649-6111,270,dhutto@caldwellmemorial.net,
LA-004709,Caldwell Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",501 East Collins Rd,,Columbia,LA,71418,Caldwell,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004710,Cottonport Family Clinic,"Louisiana Health Care Practitioners, LLC",1477724995,Rural Health Clinics,1007 Sycamore St,,Cottonport,LA,71327-3403,Avoyelles,1007 Sycamore Street,,Cottonport,LA,71327,Avoyelles,Alec Donovan Jeansonne,"COO, CFO, Practice Administrator",318-880-2144,,alecj@lhcpclinics.net,Herndon Martin Jeansonne II,"FNP-C, Owner, CEO",318-793-7927,,buzzjeansonne@gmail.com,
LA-004711,CHRISTUS Coushatta Rural Health Clinic,CHRISTUS Health,1871584722,Rural Health Clinics,1633 Marvel St,,Coushatta,LA,71019-9022,Red River,1635 Marvel St,,Coushatta,LA,71019,Red River,Angela Shoemaker,Manager of Patient Financial Services,318-932-2085,,angela.shoemaker@christushealth.org,,,,,,
LA-004712,Red River Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",2015 Red Oak Rd,,Coushatta,LA,71019-9403,Red River,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004713,St Tammany Community Health Center Covington,Access Health Louisiana,1720321169,"Dental Providers, Federally Qualified Health Centers - Medical Services",1301 N Florida St,,Covington,LA,70433-1595,Saint Tammany,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004714,Acadia Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1029 Capitol Ave,,Crowley,LA,70526-3227,Acadia,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004715,ACADIA FAMILY CLINIC,ACADIA FAMILY CLINIC,1174710685,Rural Health Clinics,1325 Wright Ave,Suite E,Crowley,LA,70526-2226,Acadia,1325 Wright Ave Suite E,,Crowley,LA,70526,Acadia,Kayla Dawn Wimberly,OFFICE MANAGER,337-788-1081,,Acadiafamilyclinic1081@gmail.com,Gina Miller,FNP Owner,337-788-1081,,acadiafamilyclinic1081@gmail.com,
LA-004716,SWLA Center for Health Services - Crowley,SWLA CENTER FOR HEALTH SERVICES,1336383033,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",613 John F Kennedy Dr,,Crowley,LA,70526-3264,Acadia,2000 Opelousas St,,Lake Charles,LA,70601-2641,Calcasieu,Tommie Anderson,CEO,337-439-9983,1115,tanderson@swlahealth.org,Erica Victorian,Director of Revenue Cycle Management,337-439-9983,1112,evictorian@swlahealth.org,
LA-004717,Lafourche Parish Health Unit - Galliano,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",133 W 112th St,,Cut Off,LA,70345-3629,Lafourche,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004718,Lady of the Sea Medical Clinic - Cut Off,Lafourche Parish Hospital Service District #1,1902846603,Rural Health Clinics,144 W 134th Pl,,Cut Off,LA,70345-4128,Lafourche,200 West 134th Place,,Cut Off,LA,70345,Lafourche,Tad Lafont,Chief Clinic Officer,985-325-9300,,tadl@losgh.org,Karen Collins,CEO,985-632-8286,,karenc@losgh.org,
LA-004719,Hospital Service District 1A Parish Of Richland State Of Louisiana,Hospital Service District 1A Parish of Richland State of Louisiana,1083967178,Federally Qualified Health Centers - Medical Services,106 Toombs St,Delhi Middle School,Delhi,LA,71232-2647,Richland,407 Cincinnati St,,Delhi,LA,71232-3007,Richland,Barbara Hutchinson,CEO,318-878-6430,,bhutchinson@delhihospital.com,Lisa Dixon,COO,318-878-6650,,ldixon@delhihospital.com,
LA-004720,Delhi Community Health Center,Hospital Service District 1A Parish of Richland State of Louisiana,1154686665,"Dental Providers, Federally Qualified Health Centers - Medical Services",109 Elm St,,Delhi,LA,71232-2844,Richland,407 Cincinnati St,,Delhi,LA,71232-3007,Richland,Barbara Hutchinson,CEO,318-878-6650,,bhutchinson@delhihospital.com,Lisa Dixon,COO,318-878-6650,,ldixon@delhihospital.com,
LA-004721,RICHLAND PARISH HOSPITAL-DELHI,Hospital Service District 1A Parish of Richland State of Louisiana,1336109768,Inpatient Hospitals (other than children's hospitals),407 Cincinnati St,,Delhi,LA,71232-3007,Richland,407 Cincinnati Street,,Delhi,LA,71232,Richland,Michael Carroll,Administrator,318-878-6323,,admin@delhihospital.com,Linda Goode,COO,318-878-6328,,admin@delhihospital.com,
LA-004722,DELHI RURAL HEALTH CLINIC,Hospital Service District 1A Parish of Richland State of Louisiana,1174586283,Rural Health Clinics,508 Broadway St,,Delhi,LA,71232-3002,Richland,407 Cincinnati Street,,Delhi,LA,71232,Richland,Michael Carroll,Administrator,318-878-6323,,mcarroll@delhihospital.com,Linda Goode,COO,318-878-6328,,lgoode@delhihospital.com,
LA-004723,Hospital Service District 1A Parish Of Richland State Of Louisiana,Hospital Service District 1A Parish of Richland State of Louisiana,1588917660,Federally Qualified Health Centers - Medical Services,509 Main St,Delhi Elementary School,Delhi,LA,71232-2537,Richland,407 Cincinnati St,,Delhi,LA,71232-3007,Richland,Barbara Hutchinson,CEO,318-878-6650,,bhutchinson@delhihospital.com,Lisa Dixon,COO,318-878-6650,,ldixon@delhihospital.com,
LA-004724,Hospital Service District 1A Parish Of Richland State Of Louisiana,Hospital Service District 1A Parish of Richland State of Louisiana,1780937896,Federally Qualified Health Centers - Medical Services,6940 Highway 17,Delhi Charter School,Delhi,LA,71232-7021,Richland,407 Cincinnati St,,Delhi,LA,71232-3007,Richland,Barbara Hutchinson,CEO,318-878-6650,,bhutchinson@delhihospital.com,Lisa Dixon,COO,318-878-6650,,ldixon@delhihospital.com,
LA-004725,Chadha Medical Clinic RHC,Chadha Medical Clinic,1134136708,"Family Planning Providers, Rural Health Clinics",140 W 4th St,,Dequincy,LA,70633-3508,Calcasieu,140 W 4th St,,Dequincy,LA,70633,Calcasieu,Jean Adams,Clinic Support Manager,337-786-5007,,jamcc@copper.net,"Nandita Chadha, MD",Medical Director,337-786-5007,,chadhaclinic@aol.com,
LA-004726,Beauregard Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",216 Evangeline St,,Deridder,LA,70634-4251,Beauregard,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004727,St Charles Community Health Center Destrehan,Access Health Louisiana,1326342064,"Dental Providers, Federally Qualified Health Centers - Medical Services",105 Plantation Rd,,Destrehan,LA,70047-3049,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004728,Reddy Family Medical Clinic,Reddy Family Medical Clinic,1073639084,Rural Health Clinics,217 Railroad Ave,,Donaldsonville,LA,70346-2527,Ascension,217 Rail Road Ave,,Donaldsonville,LA,70346,Ascension,Nagaratna Reddy,M.D,225-323-1949,,nagaratna@aol.com,Jammie Smith,,225-473-3931,,,
LA-004729,"CAPITOL CITY FAMILY HEALTH CENTER, INC.",CAPITOL CITY FAMILY HEALTH CENTER INC,1235486226,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",904 Catalpa St,,Donaldsonville,LA,70346-2946,Ascension,3140 Florida Blvd,,Baton Rouge,LA,70806-3757,East Baton Rouge,Matthew Valliere,Chief Executive Officer (CEO),225-650-2028,,mvalliere@ccfhc.org,Christina Claiborne,Chief Administrative Officer (CAO),225-650-2027,,cclaiborne@ccfhc.org,
LA-004730,"Winn Community Health Center, Inc.",Winn Community Health Center,1578947107,Federally Qualified Health Centers - Medical Services,1000 Highway 1241,South Grant Elementary School,Dry Prong,LA,71423-3632,Grant,427 W Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,Missy Hyman,CFO,318-648-0375,,mhyman@winnchc.org,www.winnchc.org
LA-004731,Duson Family Healthcare,"Tiffany Roy, FNP, LLC",1376986257,Rural Health Clinics,9023 Cameron St,,Duson,LA,70529,Lafayette,9023 Cameron St,,Duson,LA,70529,Lafayette,Tiffany Roy,Owner,337-873-8244,,tiffanynp@dusonhealth.com,Tiffany Roy,Owner,337-873-8244,,tiffanynp@dusonhealth.com,www.dusonhealth.com
LA-004732,TECHE ACTION CLINIC AT EDGARD,"TECHE ACTION BOARD, THE",1154368553,Federally Qualified Health Centers - Medical Services,159 E 3rd St,,Edgard,LA,70049-2450,St John the Baptist,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,www.tabhealth.org
LA-004733,Erath/Delcambre Community Care Clinic,Abbeville General,1700129749,Rural Health Clinics,220 North Rd,,Erath,LA,70533-3200,Vermilion,118 North Hospital Drive,,Abbeville,LA,70510,Vermilion,Bruce Sonnier,Business Office Director,337-898-6525,,bruce.sonnier@abbgen.net,Troy Hair,CFO,337-898-6377,,troy.hair@abbgen.net,
LA-004734,Acadian Medical Center,LifePoint Health,1407947336,Inpatient Hospitals (other than children's hospitals),3501 Highway 190,,Eunice,LA,70535-5129,Saint Landry,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Michael Fontenot,CFO,337-580-7505,,,
LA-004735,Union Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1002 Marion Hwy,,Farmerville,LA,71241-9315,Union,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004736,UNION GENERAL RURAL HEALTH CLINIC,UNION GENERAL HOSPITAL,1912973090,Rural Health Clinics,1025 Marion Hwy,,Farmerville,LA,71241-9314,Union,901 JAMES AVE,,FARMERVILLE,LA,71241,Union,WILLLIAM ADCOCK,CFO,318-368-9751,,wadcock@uniongen.org,,,,,,
LA-004737,Union General Hospital,UNION GENERAL HOSPITAL,1881678704,Inpatient Hospitals (other than children's hospitals),901 James Ave,,Farmerville,LA,71241-2234,Union,P.O. Box 398,,FARMERVILLE,LA,71241,Union,William Adcock,CFO,318-368-7096,,wadcock@uniongen.org,,,,,,
LA-004738,Ferriday Family Health Center,Catahoula Parish Hospital District #2,1861531014,Federally Qualified Health Centers - Medical Services,100 Serio Blvd,,Ferriday,LA,71334-2013,Concordia,PO Box 8,,Sicily Island,LA,71368,Catahoula,Debra Miesch,CEO,318-389-5727,1012,dmiesch@cphd2.org,Michelle Brown,Billing Manager,318-389-5727,1007,mbrown@cphd2.org,
LA-004739,Concordia Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",905 Mickey Gilley Ave,,Ferriday,LA,71334-2619,Concordia,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004740,TECHE ACTION CLINIC,"TECHE ACTION BOARD, THE",1174579262,"Dental Providers, Federally Qualified Health Centers - Medical Services",1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,www.tabhealth.org
LA-004741,Washington Parish Health Unit - Franklinton,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",120 11th Ave,,Franklinton,LA,70438-1161,Washington,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004742,Riverside Medical Center,Riverside Medical Center,1700874062,Inpatient Hospitals (other than children's hospitals),1900 Main St,,Franklinton,LA,70438-3688,Washington,1900 Main Street,,Franklinton,LA,70438,Washington,Lesia McQueen,CNO,985-795-4150,,lmcqueen@rmchospital.com,,,,,,
LA-004743,Children's International Medical Group Franklinton,"Children's International, LLC",1073620498,Rural Health Clinics,2401 Washington St,,Franklinton,LA,70438-2582,Washington,59101 Amber St.,,Slidell,LA,70461,Saint Tammany,Zach H Allen,Div Sr. Vice President,601-337-2464,1,zach.allen@cimgpeds.com,Lacey Sones,Regional Director of Operations,985-646-1580,6,lacey.sones@cimgpeds.com,www.cimgpeds.com
LA-004744,Teche Action Clinic @ Galliano,"TECHE ACTION BOARD, THE",1215354014,Federally Qualified Health Centers - Medical Services,121 W 134th Place,,Galliano,LA,70354,Lafourche,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,www.tabhealth.org
LA-004745,"Winn Community Health Center, Inc.",Winn Community Health Center,1972987105,Federally Qualified Health Centers - Medical Services,4528 Highway 500,Georgetown School-Based Clinic,Georgetown,LA,71432-3628,Grant,427 W Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,Missy Hyman,CFO,318-648-0375,,mhyman@winnchc.org,www.winnchc.org
LA-004746,David Raines Community Health Centers - Gilliam,"David Raines Community Health Center, Inc.",1598761496,Federally Qualified Health Centers - Medical Services,12763 Lay Street,,Gilliam,LA,71029,Caddo,3041 Martin Luther King Jr. Drive,,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004747,Ascension Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1024 E Ascension Complex Blvd,,Gonzales,LA,70737-4263,Ascension,1450 Poydras Street,Ste 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-9176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004748,Jefferson Community Health Care Center,Jefferson Community Health Care Center,1639321714,"Dental Providers, Federally Qualified Health Centers - Medical Services",3101 Highway 1,,Grand Isle,LA,70358-9753,Jefferson,4028 U S Hwy,,Avondale,LA,70094,Jefferson,Carmen Cummings,Corporate Executive Manager,504-388-1960,,ccummings@jchcc.org,Dr. Shondra Williams,CEO,504-452-3622,,swilliams@jchcc.org,
LA-004749,Southeast Community Health Systems,Southeast Community Health Systems,1619106663,Federally Qualified Health Centers - Medical Services,14340 Highway 37,SCHS - College and Career Academy,Greensburg,LA,70441-5213,Saint Helena,6351 Main Street,P O Box 770,Zachary,LA,70791,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance Officer,225-306-2017,955147008,gwdunn@shchc.org,http://www.shchc.org/main/contact
LA-004750,St Helena Parish Hospital,St Helena Parish Hospital,1588614036,Inpatient Hospitals (other than children's hospitals),16874 Highway 43,,Greensburg,LA,70441-4834,Saint Helena,16874 Highway 43 N,,Greensburg,LA,70441,Saint Helena,Naveed Awan,CEO,225-222-6111,,nawan@shhosp.org,Joel Landry,CFO,225-222-6111,,jlandry@shhosp.org,sthelenaparishhospital.org
LA-004751,Southeast Community Health Systems,Southeast Community Health Systems,1528297579,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1798 Highway 1042,SCHS - St. Helena Arts and Technology Academy,Greensburg,LA,70441-4241,Saint Helena,6351 Main Street,P O Box 770,Zachary,LA,70781,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance officer,225-306-2017,9855147008,gwdunn@shchc.org,http://www.shchc.org/main/contact
LA-004752,Southeast Community Health Systems - Greensburg,Southeast Community Health Systems,1023147113,"Dental Providers, Federally Qualified Health Centers - Medical Services",490 Sitman St,,Greensburg,LA,70441-4212,Saint Helena,6351 Main Street,P O Box 770,Zachary,LA,70791,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance Officer,225-306-2017,9855147008,gwdunn@shchc.org,
LA-004753,Tangipahoa Parish Health Unit - Hammond,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",15481 W Club Deluxe Rd,,Hammond,LA,70403-1466,Tangipahoa,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004754,Southeast Community Health Systems - Albany,Southeast Community Health Systems,1366617367,"Dental Providers, Federally Qualified Health Centers - Medical Services",30575 Old Baton Rouge Hwy,,Hammond,LA,70403-8350,Livingston,6351 Main Street,P O Box 770,Zachary,LA,70791,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance Officer,225-306-2017,9855147008,gwdunn@shchc.org,
LA-004755,Tangipahoa Community Health Center,Access Health Louisiana,1790163715,"Dental Providers, Federally Qualified Health Centers - Medical Services",42351 Phyllis Ann Dr,,Hammond,LA,70403-1254,Tangipahoa,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-012381,HARRISONBURG FAMILY HEALTH,CATAHOULA PARISH HOSPITAL DISTRICT NO 2,1821459835,"Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",302A Bushley St,,Harrisonburg,LA,71340-1656,Catahoula,PO BOX 8,,SICILY ISLAND,LA,71368,Catahoula,MICHELLE BROWN,BILLING MANAGER,318-389-5727,1007,MBROWN@CPHD2.ORG,DEBRA MIESCH,CEO,318-389-5727,1012,DMIESCH@CPHD2.ORG,WWW.CPHD2.ORG
LA-004756,Access Health Louisiana,Access Health Louisiana,1477805869,"Dental Providers, Federally Qualified Health Centers - Medical Services",2200 8th St,West Jefferson School Based HC,Harvey,LA,70058-4006,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004757,David Raines Community Health Centers - Haynesville,"David Raines Community Health Center, Inc.",1912903964,Federally Qualified Health Centers - Medical Services,1953 Main St,,Haynesville,LA,71038-4907,Claiborne,3041 Martin Luther King Jr. Drive,,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004758,"Butler-Abshire Medical Clinic, APMC","Butler-Abshire Medical Clinic, APMC",1609929785,Rural Health Clinics,926 Frances Dr,,Haynesville,LA,71038-6100,Claiborne,926 Frances Dr.,,Haynesville,LA,71038,Claiborne,Juanita Faulkner,Office Manager,318-624-0554,,jfaulkner@butlerabshire.com,Rebekah White,Medical Records,318-624-0554,,rwhite@butlerabshire.com,
LA-004759,Willis-Knighton Claiborne Regional Health Center,Willis-Knighton Medical Center,1588696371,Rural Health Clinics,104 Morris Cir,,Homer,LA,71040-2109,Claiborne,2600 Greenwood Road,,Shreveport,LA,71103,Caddo,Lisa Gantt,Office Manager,318-927-1110,,lgantt@wkhs.com,,,,,,
LA-004760,Claiborne Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Tuberculosis Clinics",624 W Main St,,Homer,LA,71040-3418,Claiborne,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004761,Pelican Pediatrics,Pelican Pediatrics,1184053340,Rural Health Clinics,911 W Main St,Suite C,Homer,LA,71040-3300,Claiborne,911 W. Main St.,Suite C,Homer,LA,71040,Claiborne,Leslie Brasher,Owner/Provider,318-927-3255,,lesliecouvillon@gmail.com,,,,,,
LA-004762,Teche Action Clinic @ Houma,"TECHE ACTION BOARD, THE",1215974019,"Dental Providers, Federally Qualified Health Centers - Medical Services",1014 W Tunnel Blvd,,Houma,LA,70360-4050,Terrebonne,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Paulette Lofton,CEO,337-828-2550,,plofton@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004763,TECHE ACTION CLINIC AT DULAC,"TECHE ACTION BOARD, THE",1659319135,Federally Qualified Health Centers - Medical Services,189 Mozart Dr,,Houma,LA,70363-7990,Terrebonne,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004764,Terrebonne Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",600 Polk St,,Houma,LA,70360-4154,Terrebonne,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004765,Southeast Community Health Systems - Independence,Southeast Community Health Systems,1053749739,"Dental Providers, Federally Qualified Health Centers - Medical Services",13318 Berry Bowl Rd,,Independence,LA,70443-2363,Tangipahoa,6351 Main Street,P O Box 770,Zachary,LA,70791,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance Officer,225-306-2017,9855147008,gwdunn@shchc.org,
LA-004766,INNIS COMMUNITY HEALTH CENTER,"INNIS COMMUNITY HEALTH CENTER, INC.",1205858388,"Dental Providers, Federally Qualified Health Centers - Medical Services",6450 La Highway 1,,Innis,LA,70747,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,Excutive Director,225-492-3775,201,cpeavy@inchc.org,Rachel Nelson,COO,225-492-3775,206,rachel@inchc.org,
LA-004767,Riverdale SBHC,Access Health Louisiana,1538411921,"Dental Providers, Federally Qualified Health Centers - Medical Services",240 Riverdale Dr,,Jefferson,LA,70121-3507,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004768,LaSalle Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1673 N 2nd St,,Jena,LA,71342,La Salle,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004769,LASALLE FAMILY MEDICINE CLINIC,LaSalle General Hospital,1912173352,Rural Health Clinics,180 9th St,,Jena,LA,71342-5101,La Salle,187 9th Street,,Jena,LA,71342,La Salle,Lana Francis,Chief Executive Officer,318-992-9200,2154,lfrancis@lgh-jena.org,Daphne Keene,Business Office,318-992-9200,2192,dkeene@lgh-jena.org,
LA-004770,Jefferson Davis Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",403 Baker St,,Jennings,LA,70546-6707,Jefferson Davis,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004771,Jackson Parish Hospital Family Care Clinic,Jackson Parish Hospital,1992845564,Rural Health Clinics,107 Watts St,,Jonesboro,LA,71251-2053,Jackson,165 Beech Springs Rd.,,Jonesboro,LA,71251,Jackson,Timothy Paige,Community Services Director,318-259-4435,,tpaige@jphmd.com,Edwina Diffey,Clinic Manager,318-395-2121,,ediffey@jphmd.com,
LA-004772,Jackson Parish Hospital,Jackson Parish Hospital,1326267204,Outpatient Hospital Clinics,225 Pershing Hwy,Jonesboro Hodge High School,Jonesboro,LA,71251-2427,Jackson,165 Beech Springs Rd.,,Jonesboro,LA,71251,Jackson,Timothy Paige,Community Service Director,318-259-4435,316,tpaige@jphmd.com,Sandy Donaldson,Administrative Tech,318-395-0049,,sdonaldson@jphmd.com,
LA-004773,Jackson Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",228 Bond St,,Jonesboro,LA,71251-5334,Jackson,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004774,Catahoula Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Tuberculosis Clinics",200 Third St,,Jonesville,LA,71343-2342,Catahoula,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004775,LASALLE PRIMARY HEALTHCARE CENTER,LaSalle General Hospital,1275640070,Rural Health Clinics,2801 Fourth St,,Jonesville,LA,71343-2026,Catahoula,187 9th Street,,Jena,LA,71343,Catahoula,Lana Francis,Chief Executive Officer,318-992-9200,2154,lfrancis@lgh-jena.org,Daphne Keene,Business Office,318-992-9200,2192,dkeene@lgh-jena.org,
LA-004776,Jonesville Medical Clinic,Catahoula Parish Hospital District #2,1245629260,Federally Qualified Health Centers - Medical Services,900 Foster St,,Jonesville,LA,71343-2781,Catahoula,PO Box 8,,Sicily Island,LA,71368,Catahoula,Debra Miesch,CEO,318-389-5727,1012,dmiesch@cphd2.org,Michelle Brown,Billing Manager,318-389-5727,1007,mbrown@cphd2.org,
LA-004777,Kenner Community Health Center,Access Health Louisiana,1801241773,"Dental Providers, Federally Qualified Health Centers - Medical Services",1401 W Esplanade Ave,Suite 108A,Kenner,LA,70065-2800,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004778,St Charles Community Health Center Kenner,Access Health Louisiana,1992800718,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 W Esplanade Ave,,Kenner,LA,70065-2489,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004779,Bonnabel HS SBHC,Access Health Louisiana,1275818908,"Dental Providers, Federally Qualified Health Centers - Medical Services",2801 Bruin Dr,,Kenner,LA,70065-4707,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004780,Access Health Louisiana Kenner,Access Health Louisiana,1821472879,"Dental Providers, Federally Qualified Health Centers - Medical Services",2900 Indiana Ave,,Kenner,LA,70065-4605,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,,,,,,
LA-004781,Southeast Community Health Systems - Kentwood,Southeast Community Health Systems,1558515676,"Dental Providers, Federally Qualified Health Centers - Medical Services",721 Avenue G,,Kentwood,LA,70444-2601,Tangipahoa,6351 Main Street,P O Box 770,Zachary,LA,70791,East Baton Rouge,Alecia Cyprian,Chief Executive Officer,225-306-2010,,acyprian@shchc.org,Gail Williams Dunn,Chief Operating and Compliance Officer,225-306-2017,9855147008,gwdunn@shchc.org,
LA-004782,Allen Parish Hospital,Allen Parish Hospital,1982601944,Inpatient Hospitals (other than children's hospitals),108 6th Ave,,Kinder,LA,70648-3187,Allen,108 6th Ave,,Kinder,LA,70648,Allen,Melissa Martin,Director of Finance,337-738-9424,424,MMartin@allenparishhospital.com,Heather Foster,Business Office Director,337-738-9405,405,HFoster@allenparishhospital.com,www.allenparishhospital.com
LA-004783,Allen Parish Hospital Rural Health Clinic,Allen Parish Hospital Rural Health Clinic,1285785089,Rural Health Clinics,108 6th Ave,,Kinder,LA,70648-3187,Allen,108 6th Ave,,Kinder,LA,70648,Allen,Melissa Martin,Director of Finance,337-738-9424,424,MMartin@allenparishhospital.com,Kandace Fontenot,RHC Director,337-738-4670,670,KFontenot@allenparishhospital.com,www.allenparishhospital.com
LA-004784,Surrey Street Community Health Center Extension Site,"Iberia Comprehensive Community Health Center, Inc.",1316244338,Federally Qualified Health Centers - Medical Services,1002 12th St,,Lafayette,LA,70501-6224,Lafayette,806 Jefferson Terrace Blvd,,New Iberia,LA,70560,Iberia,MoniqueDumond,Chief Financial Officer,337-365-4945,112,monique@icchc.org,Roderick Campbell,CEO,337-365-4945,,roderickcc@icchc.org,www.icchc.org
LA-004785,Surrey Street Community Health Center,"Iberia Comprehensive Community Health Center,Inc.",1568731602,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1004 Surrey St,,Lafayette,LA,70501-6143,Lafayette,806 Jefferson Terrace Blvd,,New Iberia,LA,70560,Iberia,Monique Dumond,Chief Financial Officer,337-365-4945,112,monique@icchc.org,Roderick Campbell,CEO,337-365-4945,,roderickcc@icchc.org,www.icchc.org
LA-004786,Lafayette Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",220 W Willow St,Bldg A,Lafayette,LA,70501-2837,Lafayette,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004787,SWLA Center for Health Services - Lafayette,SWLA CENTER FOR HEALTH SERVICES,1376725952,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",500 Patterson St,,Lafayette,LA,70501-1849,Lafayette,2000 Opelousas St,,Lake Charles,LA,70601-2641,Calcasieu,Erica Victorian,Director of Revenue Cycle Management,337-439-9983,1112,evictorian@swlahealth.org,Tommie Anderson,CEO,337-439-9983,1115,tanderson@swlahealth.org,
LA-004788,Lake Arthur Clinic Of JALH,Lake Arthur Clinic of JALH,1154779874,Rural Health Clinics,328 Kellogg Ave,,Lake Arthur,LA,70549-4116,Jefferson Davis,328 Kellogg Ave,,Lake Arthur,LA,70549,Jefferson Davis,Tina K Monlezun,"DNP, CFNP",337-774-0100,,tmonlezun@jalh.com,Amber Martin,Office Manager,337-774-0100,,amartin@jalh.com,
LA-004789,SWLA Center for Health Services - Lake Charles,SWLA CENTER FOR HEALTH SERVICES,1720014186,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2000 Opelousas St,,Lake Charles,LA,70601-2641,Calcasieu,2000 Opelousas St,,Lake Charles,LA,70601-2641,Calcasieu,Erica Victorian,Director of Revenue Cycle Management,337-439-9983,1112,evictorian@swlahealth.org,Tommie Anderson,CEO,337-439-9983,1115,tanderson@swlahealth.org,
LA-004790,Calcasieu Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Tuberculosis Clinics",3236 Kirkman St,,Lake Charles,LA,70601-8640,Calcasieu,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004791,Family Medical Clinic,East Carroll Parish Hospital,1710966478,Rural Health Clinics,300 Scarborough St,,Lake Providence,LA,71254-3018,East Carroll,336 North Hood,,Lake Providence,LA,71254,East Carroll,BeLynda Martin,Clinic Administrator,318-559-2814,203,bmartin@ecphosp.com,Ashley Cox,Administrative Assistant,318-559-3303,200,acox@ecphosp.com,
LA-004792,THE FAMILY PRACTICE CLINIC,East Carroll Parish Hospital,1902885650,Rural Health Clinics,320 N Hood St,,Lake Providence,LA,71254-2140,East Carroll,336 North Hood,,Lake Providence,LA,71254,East Carroll,Belynda Martin,Clinic Administrator,318-559-2404,203,bmartin@ecphosp.com,Ashley Cox,Administrative Assistant,318-559-3303,200,acox@ecphosp.com,
LA-004793,East Carroll Parish Hospital,East Carroll Parish Hospital,1982695441,Inpatient Hospitals (other than children's hospitals),336 N Hood St,,Lake Providence,LA,71254-2140,East Carroll,336 North Hood Street,,Lake Providence,LA,71254,East Carroll,LaDonna Englerth,Administrator,318-559-4023,103,lenglerth@ecphosp.com,Lisa Bradford,Administrative Assistant,318-559-4023,114,lbradford@ecphosp.com,
LA-004794,East Carroll Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",403 2nd St,,Lake Providence,LA,71254-2605,East Carroll,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004795,Lady of the Sea Medical Clinic - Larose,Lafourche Parish Hospital Service District #1,1932256542,Rural Health Clinics,13030 Highway 308,,Larose,LA,70373-2001,Lafourche,200 West 134th Place,,Cut Off,LA,70345,Lafourche,Tad Lafont,Chief Clinic Officer,985-325-9300,,tadl@losgh.org,Karen Collins,CEO,985-632-8286,,karenc@losgh.org,
LA-004796,Byrd Regional Hospital,Byrd Regional Hospital,1881665164,Inpatient Hospitals (other than children's hospitals),1020 W Fertitta Blvd,,Leesville,LA,71446-4645,Vernon,1020 West Fertitta Blvd,,Leesville,LA,71446,Vernon,Melody J Ward,Financial Counselor,337-239-9041,5460,Melody_Ward@chs.net,,,,,,www.byrdregionalhospital.com
LA-004797,Vernon Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",406 W Fertitta Blvd,,Leesville,LA,71446-4649,Vernon,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004798,"Outpatient Medical Center, Inc. @ Leesville","OUTPATIENT MEDICAL CENTER, INC.",1285664508,"Dental Providers, Federally Qualified Health Centers - Medical Services",908 S 10th St,,Leesville,LA,71446-4614,Vernon,1640 Breazeale Springs St,,Natchitoches,LA,71457-4278,Natchitoches,"Carl Walters, II",CEO,318-357-2071,,cwalters@outpatientmedical.org,Anedra Seawood,CFO,318-357-2062,,aseawood@outpatientmedical.org,
LA-004799,Livingston Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",20399 Government Blvd,,Livingston,LA,70754-5347,Livingston,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004800,RKM Primary Care Livingston,"Primary Care Providers for a Healthy Feliciana, Inc.",1861823379,"Dental Providers, Federally Qualified Health Centers - Medical Services",29437 Highway 63,,Livingston,LA,70754,Livingston,11990 Jackson Street,P.O. Box 395,Clinton,LA,70722,East Feliciana,Dawn Taylor,CIO,225-683-6725,,dtaylor@rkmcare.org,Ginger Hunt,CEO,225-683-5292,10201,ghunt@rkmcare.org,www.rkmcare.org
LA-004801,LIVONIA COMMUNITY HEALTH CENTER,"INNIS COMMUNITY HEALTH CENTER, INC.",1003910167,Federally Qualified Health Centers - Medical Services,3041 Fordoche Rd,,Livonia,LA,70755-3303,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,executive director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,
LA-004802,"INNIS COMMUNITY HEALTH CENTER, INC.","INNIS COMMUNITY HEALTH CENTER, INC.",1184099574,Federally Qualified Health Centers - Medical Services,3118 LA Highway 78,Livonia High School,Livonia,LA,70755-3400,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,executive director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,http://innishealth.com/site/school-based-health/
LA-004803,"Innis Community Health Center, Inc.","INNIS COMMUNITY HEALTH CENTER, INC.",1578986006,Federally Qualified Health Centers - Medical Services,8387 Newfield Dr,Livonia School Health Center,Livonia,LA,70755-3605,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,Excutive Director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,
LA-004804,DeSoto Regional Family Medicine- Logansport,Desoto Regional Health System,1457489593,Rural Health Clinics,808 Main St,,Logansport,LA,71049,De Soto,DeSoto Regional Health System,207 Jefferson St,Mansfield,LA,71052,De Soto,Christopher Davis,VP of Rural Clinics,318-872-2700,5124,Chrisdavis@desotoregional.com,Todd Eppler,CEO,318-872-4610,3132,toddeppler@desotoregional.com,http://www.desotoregional.com/
LA-004805,Family Healthcare of Loranger,Family Healthcare of Loranger,1851663306,Other ECP Providers,54033 Highway 1062,Suite B,Loranger,LA,70446-3538,Tangipahoa,54033 HWY 1062 Suite B,,Loranger,LA,70446,Tangipahoa,Kimberly Manina,FNP-C,985-606-2273,,kmanina@hotmail.com,,,,,,
LA-004806,St Charles Community Health Center Paul Maillard,Access Health Louisiana,1902214133,"Dental Providers, Federally Qualified Health Centers - Medical Services",1057 Paul Maillard Rd,Suite 240,Luling,LA,70070-4349,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004807,St. Charles Community Health Center Luling,Access Health Louisiana,1417999327,"Dental Providers, Federally Qualified Health Centers - Medical Services",843 Milling Ave,,Luling,LA,70070-4442,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3712,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004808,Desoto Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",113 Jefferson St,,Mansfield,LA,71052-2601,De Soto,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004809,DeSoto Regional Family Medicine Clinic,Desoto Regional Health System,1043580624,Rural Health Clinics,207 Jefferson St,,Mansfield,LA,71052-2603,De Soto,207 Jefferson St.,,Mansfield,LA,71052,De Soto,Christopher Davis,VP of Rural Clinics,318-872-2700,5124,Chrisdavis@desotoregional.com,Todd Eppler,CEO,318-872-4610,3132,toddeppler@desotoregional.com,http://www.desotoregional.com/
LA-004810,"DeSoto Healthcare Center, Inc.","DeSoto Healthcare Center, Inc.",1811209232,Rural Health Clinics,7356 Highway 509,,Mansfield,LA,71052-6443,De Soto,7356 Highway 509,,Mansfield,LA,71052,De Soto,Detries Morris,Chief Executive Officer,318-871-1633,,dmorrisdhc@att.net,Adrienne Jefferson,Office Manager,318-871-1633,,ajeffersondhc@att.net,
LA-004811,Sabine Community Health Center,"Iberia Comprehensive Community Health Center, Inc.",1114341666,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1050 N Robinson St,,Many,LA,71449-3536,Sabine,806 Jefferson Terrace Blvd,,New Iberia,LA,70560,Iberia,Monique Dumond,CFO,337-365-4945,112,moniquedumond@icchc.org,Roderick Campbell,CEO,337-365-4945,,roderickcc@icchc.org,www.icchc.org
LA-004812,Sabine Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1230 W Louisiana Ave,,Many,LA,71449-3682,Sabine,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004813,"INNIS COMMUNITY HEALTH CENTER, INC.","INNIS COMMUNITY HEALTH CENTER, INC.",1164897542,Federally Qualified Health Centers - Medical Services,1653 Valverda Rd,Valverda Elementary School,Maringouin,LA,70757-5118,Iberville,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,executive director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,http://innishealth.com/site/school-based-health/
LA-004814,Maringouin Community Health Center,"INNIS COMMUNITY HEALTH CENTER, INC.",1538538863,Federally Qualified Health Centers - Medical Services,77695 Wagley Rd,,Maringouin,LA,70757-3028,Iberville,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,Excutive Director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,
LA-004815,"Morehouse Community Medical Centers, Inc.","MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1649609843,"Dental Providers, Federally Qualified Health Centers - Medical Services",3150 Taylor St,,Marion,LA,71260-3653,Union,518 Durham Street,,Bastrop,LA,71220,Morehouse,Christy Merriweather,CLC,318-283-8887,101,christy.merriweather@mcmcinc.org,Katie Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,
LA-004816,"Hope's Children and Family Care Clinic, LLC","Hope's Children and Family Care Clinic, LLC",1104195536,Rural Health Clinics,338 Moreau St,,Marksville,LA,71351-2957,Avoyelles,338 Moreau Street Suite B,,Marksville,LA,71351,Avoyelles,Patricia Monk,Owner,318-253-2299,,hopemonk@gmail.com,,,,,,
LA-004817,Avoyelles Hospital Rural Health Clinic,CLHG-Avoyelles LLC,1962924928,Rural Health Clinics,597 Tunica Dr W,,Marksville,LA,71351-2628,Avoyelles,PO Box 249,,Marksville,LA,71351-2628,Avoyelles,Nell Madrigal,Practice Manager,318-253-0677,,nmadrigal@ahmgt.com,Frances Deglandon,Controller,318-253-8611,,fdeglandon@ahmgt.com,
LA-004818,Avoyelles Parish Health Unit - Marksville,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",657 Government St,,Marksville,LA,71351-2945,Avoyelles,1450 Poydras Street,Suite 2032,New orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004819,Jefferson Community Health Care Inc,Jefferson Community Health Care Inc,1811123664,"Dental Providers, Federally Qualified Health Centers - Medical Services",1855 Ames Blvd,,Marrero,LA,70072-3429,Jefferson,4028 U S Hwy 90,,Avondale,LA,70094,Jefferson,Carmen Cummings,Corporate Executive Manager,504-388-1960,,ccummings@jchcc.org,Dr. Shondra Williams,CEO,504-452-3622,,swilliams@jchcc.org,
LA-004820,Jefferson Parish Health Unit - Marrero,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1855 Ames Blvd,Suite B,Marrero,LA,70072-3429,Jefferson,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004821,Access Health Louisiana,Access Health Louisiana,1760734156,"Dental Providers, Federally Qualified Health Centers - Medical Services",4300 Patriot St,John Ehret School Base Health Center,Marrero,LA,70072-4305,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004822,JeffCare - West Jefferson,"JeffCare, a program of Jefferson Parish Human Services Authority",1154747327,Federally Qualified Health Centers - Medical Services,5001 Westbank Expy,Suite 100,Marrero,LA,70072-2954,Jefferson,3616 S. I-10 Service Road,Suite 100,Metairie,LA,70001,Jefferson,Karen Canales,Contracts Grants Administrator,504-838-5703,125,kcanales@jphsa.org,Julie M. Shaw,Chief Executive officer,504-838-5306,160,jshaw@jphsa.org,www.jphsa.org
LA-004823,Jefferson Community Health Care Centers at Lapalco,"Jefferson Community Health Care Centers, Inc.",1811123664,"Dental Providers, Federally Qualified Health Centers - Medical Services",7017 Lapalco Blvd,,Marrero,LA,70072-4503,Jefferson,4028 US Highway 90,,Avondale,LA,70094,Jefferson,Dr. Shondra Williams,CEO,504-452-3622,,swilliams@jchcc.org,Carmen Cummings,Corporate Executive Manager,504-388-1960,,ccummings@jchcc.org,www.jchcc.org
LA-004824,"RIVERSIDE FAMILY MEDICINE, LLC","Riverside Family Medicine, LLC",1134152630,Rural Health Clinics,18740 Highway 22,,Maurepas,LA,70449-3018,Livingston,18740 Hwy 22,,Maurepas,LA,70449-3018,Livingston,marty bennett,cfo,225-698-3435,,marty@riversidefamilymedicine.com,,,225-337-1942,,,
LA-004825,Maurice Community Care Clinic,Abbeville General,1447301437,Rural Health Clinics,207 Milton Rd,,Maurice,LA,70555-4448,Vermilion,118 North Hospital Dr,,Abbeville,LA,70510,Vermilion,Bruce Sonnier,Business Office Director,337-893-6525,,bruce.sonnier@abbgen.net,Troy Hair,CFO,337-898-6377,,troy.hair@abbgen.net,https://www.abbevillegeneral.com/maurice-community-care-clinic/
LA-004826,MCMC - Mer Rouge,"MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1235468349,Federally Qualified Health Centers - Medical Services,108 N 16th St,,Mer Rouge,LA,71261-9726,Morehouse,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004827,MER ROUGE OUTPATIENT RURAL HEALTH CLINIC,Sterlington Rehabilitation Hospital,1811171085,Rural Health Clinics,220 West Davenport Ave,,Mer Rouge,LA,71261,Morehouse,10374 Highway 165 N,Suite A,Sterlington,LA,71280,Ouachita,Terri Mcnemar,Insurance,318-665-9950,110,tmcnemar@sterlingtonrehab.com,Kathy Schroeder,CNO,318-665-9950,113,kschroeder@sterlingtonrehab.com,
LA-004828,Merryville Community Health Center,"Iberia Comprehensive Community Health Center, Inc.",1891020012,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",567 Walker St,,Merryville,LA,70653-3040,Beauregard,806 Jefferson Terrace Blvd.,,New Iberia,LA,70560,Iberia,Monique Dumond,Chief Financial Officer,337-365-4945,112,monique@icchc.org,Roderick Campbell,CEO,337-365-4945,,roderickcc@icchc.org,www.icchc.org
LA-004829,Daughters of Charity Health Center - Metairie,MARILLAC COMMUNITY HEALTH CENTERS,1629329735,Federally Qualified Health Centers - Medical Services,111 N Causeway Blvd,,Metairie,LA,70001-5450,Jefferson,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,,,,,,
LA-004830,Jefferson Parish Health Unit - Metairie,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",111 N Causeway Blvd,,Metairie,LA,70001-5450,Jefferson,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004831,JeffCare - East Jefferson,"JeffCare, a program of Jefferson Parish Human Services Authority",1518383785,Federally Qualified Health Centers - Medical Services,3616 S I 10 Service Rd W,Suite 100,Metairie,LA,70001-1874,Jefferson,3616 S. I-10 Service Road,Suite 100,Metairie,LA,70001,Jefferson,Karen V Canales,Contracts Grants Administrator,504-838-5703,125,kcanales@jphsa.org,Julie M. Shaw,Chief Executive officer,504-838-5306,160,jshaw@jphsa.org,www.jphsa.org
LA-004832,Minden Medical Center,LifePoint Health,1891873337,Inpatient Hospitals (other than children's hospitals),1 Medical Plaza Pl,,Minden,LA,71055-3330,Webster,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Jim Williams,CFO,318-371-5602,,,
LA-004833,"Family Medicine Associates of Minden, L.L.C","Family Medicine Associates of Minden, L.L.C.",1699834473,Rural Health Clinics,1111 Homer Rd,,Minden,LA,71055-3027,Webster,1111 Homer Rd.,,Minden,LA,71055,Webster,Shayla Thomas,Office Manager,318-377-7500,,familyassociates@bellsouth.net,,,,,,
LA-004834,Webster Parish Health Unit - Minden,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1200 Homer Rd,,Minden,LA,71055-3082,Webster,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004835,David Raines Community Health Centers - Minden,"David Raines Community Health Center, Inc.",1265438998,Federally Qualified Health Centers - Medical Services,128 Homer Rd,,Minden,LA,71055-2732,Webster,"3041 Martin Luther King Jr., Drive",,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004836,The Womens Clinic Rural Clinic,Minden Physician Practices LLC,1720360795,Rural Health Clinics,427 Homer Rd,,Minden,LA,71055-2933,Webster,427 Homer Road,,Minden,LA,71055,Webster,Vickie Golihar,Director of Minden Physician Practices,318-377-8855,,vickie.golihar@lpnt.net,Daphne Zeidan,Office Manager of Minden Physician Practices,318-377-8855,,daphne.baham@lpnt.net,mywomensclinic.com
LA-004837,Ouachita Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1650 Desiard St,,Monroe,LA,71201-7722,Ouachita,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004838,PHSC- Behavioral Health,Primary Health Services Center,1043315286,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2913 Desiard St,,Monroe,LA,71201-7207,Ouachita,2913 Betin Avenue,,Monroe,LA,71201,Ouachita,Catherine M. Tonore,CEO,318-388-1250,205,ctonore@phsccenter.org,Pamela Chisley,Grants Management Director,318-388-1250,203,pchisley@phsccenter.org,
LA-004839,PHSC Dental Clinic,Primary Health Services Center,1053604892,Dental Providers,2914 Betin Ave,,Monroe,LA,71201-7258,Ouachita,2913 Betin Avenue,,Monroe,LA,71201,Ouachita,Catheine M. Tonore,CEO,318-388-1250,205,ctonore@phsccenter.org,Pamela Chisley,Grants Management Director,318-388-1250,203,pchisley@phsccenter.org,
LA-004840,PHSC- Pediatrics/Kid-Med,Primary Health Services Center,1316291495,Federally Qualified Health Centers - Medical Services,2915 Betin Ave,,Monroe,LA,71201-7257,Ouachita,2913 Betin Avenue,,Monroe,LA,71201,Ouachita,Catherine M. Tonore,CEO,318-388-1250,205,ctonore@phsccenter.org,Pamela Chisley,Grants Management Director,318-388-1250,203,pchisley@phsccenter.org,
LA-004841,UNIVERSITY HEALTH CONWAY,"BRFHH MONROE, LLC",1215939210,Inpatient Hospitals (other than children's hospitals),4864 Jackson St,,Monroe,LA,71202-6400,Ouachita,4864 JACKSON ST,,Monroe,LA,71202-6400,Ouachita,AARON EICHORN,CFO,318-629-4760,,ADAM.MILLER@UHSYSTEM.COM,,,,,,
LA-004842,UNIVERSITY HEALTH CONWAY,"BRFHH MONROE, LLC",1215939210,Outpatient Hospital Clinics,4864 Jackson St,,Monroe,LA,71202-6400,Ouachita,4864 JACKSON ST,,Monroe,LA,71202-6400,Ouachita,AARON EICHORN,CFO,318-629-4760,,ADAM.MILLER@UHSYSTEM.COM,,,,,,
LA-004843,PHSC S D HILL CLINIC,PRIMARY HEALTH SERVICES CENTER,1629173869,Federally Qualified Health Centers - Medical Services,850 S 2nd St,,Monroe,LA,71202-2112,Ouachita,2913 Betin Ave,,Monroe,LA,71201-7257,Ouachita,Catherine M Tonore,CEO,318-388-1250,,ctonore@phsccenter.org,Pamela B. Chisley,Grants Management Director,318-388-1250,203,pchisley@phsccenter.org,
LA-004844,"Winn Community Health Center, Inc.",Winn Community Health Center,1083098610,Federally Qualified Health Centers - Medical Services,2580 Highway 122,Verda School-Based Clinic,Montgomery,LA,71454-5540,Grant,427 W Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,Missy Hyman,CFO,318-648-0375,,mhyman@winnchc.org,www.winnchc.org
LA-004845,"Winn Community Health Center, Inc.","Winn Community Health Center, Inc",1578947701,Federally Qualified Health Centers - Medical Services,900 Harrison Drive,Montgomery School Based Clinic,Montgomery,LA,71454,Grant,427 W. Lafayette St.,,Winnfield,LA,71483,Winn,Deano Thornton,Chief Executive Officer,318-648-0375,234,dthornton@winnchc.org,,,,,,
LA-004846,Teche Action Clinic @ Morgan City,"TECHE ACTION BOARD, THE",1124307566,"Dental Providers, Federally Qualified Health Centers - Medical Services",1124 7th St,,Morgan City,LA,70380-1951,Saint Mary,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,www.tabhealth.org
LA-004847,Teche Regional Medical Center,LifePoint Health,1093876997,Inpatient Hospitals (other than children's hospitals),1125 Marguerite St,,Morgan City,LA,70380-1855,Saint Mary,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Lynn Kliebert,CFO,985-380-4409,,,
LA-004848,St. Mary Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1200 David Dr,,Morgan City,LA,70380-1362,Saint Mary,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004849,"Innis Community Health Center, Inc.","INNIS COMMUNITY HEALTH CENTER, INC.",1821287202,Federally Qualified Health Centers - Medical Services,8434 Pointe Coupee Rd,Pointe Coupee Central School Based Clinic,Morganza,LA,70759-3320,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,Excutive Director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,
LA-004850,Assumption Rural Health,Our Lady of the Lake Assumption Community Hospital,1609860360,Rural Health Clinics,143 Highway 402,Suite 4,Napoleonville,LA,70390-2217,Assumption,135 Hwy 402,,Napoleonville,LA,70390,Assumption,Rachel Ford,Office Supervisor,985-369-3600,232,rachel.ford@ololrmc.com,,,,,,
LA-004851,Reddy Family Medical Clinic,Reddy Family Medical Clinic,1124144027,Rural Health Clinics,154 Highway 1008,,Napoleonville,LA,70390-2009,Assumption,154 hwy 1008,,Napoleonville,LA,70390,Assumption,nagaratna reddy,MD,225-323-1949,,nagaratna@aol.com,Jammie Smith,Offic eManager,225-473-3931,,,
LA-004852,Assumption Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",158 Highway 1008,,Napoleonville,LA,70390-2009,Assumption,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004853,"Outpatient Medical Center, Inc. @ Natchitoches","OUTPATIENT MEDICAL CENTER, INC.",1871523266,"Dental Providers, Federally Qualified Health Centers - Medical Services",1640 Breazeale Springs St,,Natchitoches,LA,71457-4278,Natchitoches,1640 Breazeale Springs St,,Natchitoches,LA,71457-4278,Natchitoches,"Carl Walters, II",CEO,318-357-2071,,cwalters@outpatientmedical.org,Anedra Seawood,CFO,318-357-2062,,aseawood@outpatientmedical.org,
LA-004854,Natchitoches Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",625 Bienville Cir,,Natchitoches,LA,71457-5744,Natchitoches,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004855,Iberia Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",715B Weldon St,,New Iberia,LA,70560-4861,Iberia,1450 Poydras St,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004856,Iberia Comprehensive Community Health Center,"Iberia Comprehensive Community Health Center, Inc.",1922046549,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",806 Jefferson Ter,,New Iberia,LA,70560-5727,Iberia,806 Jefferson Terrace Blvd,,New Iberia,LA,70560-5727,Iberia,Roderick C. Campbell,CEO,337-365-4945,127,roderickcc@icchc.org,Nicole Roberson,Deputy Director,337-365-4945,114,nicoler@icchc.org,www.icchc.org
LA-004857,Daughters of Charity Health Center - Gentilly,MARILLAC COMMUNITY HEALTH CENTERS,1346659927,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 Warrington Dr,,New Orleans,LA,70122-3000,Orleans,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,,,,,,
LA-004858,St. Thomas Community Health Center,"St. Thomas Community Health Center, Inc.",1295757326,Federally Qualified Health Centers - Medical Services,1020 Saint Andrew St,,New Orleans,LA,70130-5022,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Donald T Erwin,CEO,504-529-5558,440,dterwin@stthomaschc.org,Mary M Abell,Medical Director,504-529-5558,440,mabell@stthomaschc.org,www.stthomaschc.org
LA-004859,Daughters of Charity Health Center - St. Cecilia,MARILLAC COMMUNITY HEALTH CENTERS,1780935973,"Dental Providers, Federally Qualified Health Centers - Medical Services",1030 Lesseps St,,New Orleans,LA,70117-4736,Orleans,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,,,,,,
LA-004860,"EXCELth, Inc. Family Dental Clinic - Algiers","EXCELth, Inc.",1164792404,Dental Providers,1111 Newton St,,New Orleans,LA,70114-2500,Orleans,1515 Poydras Street,STE 1070,New Orleans,LA,70112,Orleans,MICHAEL A. ANDRY,CEO,504-524-1210,4123,mandry@excelth.com,Matilda Tennessee,Revenue Cycle Manager,504-524-1210,,mtennessee@excelth.com,
LA-004861,Odyssey House Louisiana,Odyssey House Louisiana Inc.,1932578408,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1125 N Tonti St,,New Orleans,LA,70119-3549,Orleans,1125 N. Tonti Street,,New Orleans,LA,70119,Orleans,Am'asa Baldwin,Practice Manager,504-821-9211,7852,abaldwin@ohlinc.org,Amy Bosworth,QA Director,504-821-9211,7401,abosworth@ohlinc.org,
LA-004862,L.B. Landry Community Clinic,"St. Thomas Community Health Center, Inc.",1851784235,Federally Qualified Health Centers - Medical Services,1200 L B Landry Ave,,New Orleans,LA,70114-2657,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Donald T. Erwin,CEO,504-529-5558,440,dterwin@stthomaschc.org,Mary M. Abell,Medical Director,504-529-5558,440,mabell@stthomaschc.org,www.stthomaschc.org
LA-004863,NOELA Community Health Center,MQVN COMMUNITY DEVELOPMENT CORP,1679875744,Federally Qualified Health Centers - Medical Services,13085 Chef Menteur Hwy,,New Orleans,LA,70129-1804,Orleans,4626 Alcee Fortier Blvd Ste E,,New Orleans,LA,70129-2130,Orleans,Diem Nguyen,Chief Executive Officer,504-254-2741,,diemnguyen.mqvncdc@gmail.com,Julie Hoang,Compliance Credentialing Officer,504-249-5834,,jhoang@noelachc.org,
LA-004864,Access Health Louisiana Primary Care,Access Health Louisiana,1760841738,"Dental Providers, Federally Qualified Health Centers - Medical Services",1415 Tulane Ave # 5,,New Orleans,LA,70112-2600,Orleans,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Durene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004865,Tulane University Health Sciences Center DBA Louisiana Comprehensive Hemophilia Treatment Center,The Administrators of the Tulane Educational Fund Tulane University,1528014164,Hemophilia Treatment Centers,1430 Tulane Ave,Campus Mailbox 8031,New Orleans,LA,70112-2632,Orleans,P.O. Box 54431,,New Orleans,LA,70154-4431,Orleans,"Jennifer L Borrillo, MSW, LCSW, MBA",Administrative Director,504-988-7719,,jborrill@tulane.edu,Jennifer Belteau,Accountant II,504-988-3757,,beltea@tulane.edu,
LA-004866,St Thomas CHC at 1936-1938 Magazine Street,"St. Thomas Community Health Center, Inc.",1003185125,Federally Qualified Health Centers - Medical Services,1936 Magazine St,,New Orleans,LA,70130-5016,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Donald T Erwin,CEO,504-529-5558,440,dterwin@stthomaschc.org,Mary M Abell,Medical Director,504-529-5558,440,mabell@stthomaschc.org,www.stthomaschc.org
LA-004867,CHILDRENS HOSPITAL,Children's Hospital,1104819366,Children's Hospitals (inpatient only),200 Henry Clay Ave,,New Orleans,LA,70118-5798,Orleans,200 Henry Clay Avenue,,New Orleans,LA,70118,Orleans,Courtney Garrett,Senior Vice President/CFO,504-899-9511,,courtney.garrett@lcmchealth.org,,,,,,
LA-004868,University Medical Center New Orleans - Infectious Disease Clinic,University Medical Center Management Corporation,1689977902,"Dental Providers, Outpatient Hospital Clinics, Ryan White Providers",2000 Canal St,Ambulatory Care Building,New Orleans,LA,70112-3018,Orleans,2000 Canal Street,Ambulatory Care Building,New Orleans,LA,70112,Orleans,David Little,Ambulatory Operations Manager,504-702-4151,,david.little@lcmchealth.org,Kirsten Darbyshire,Grants Coordinate,504-702-2863,,kirsten.darbyshire@lcmchealth.org,
LA-004869,St. Thomas Community Wellness Center,St. Thomas Community Health Center,1598215402,Federally Qualified Health Centers - Medical Services,2010 Magazine St,,New Orleans,LA,70130-5018,Orleans,1936 Magazine Street,,New Orleans,LA,701305016,Orleans,Gretchen Helmstetter,CPA,504-717-1168,,reneehelmstetter@hotmail.com,Amanda Champagne,Billing Manager,504-529-5558,,achampagne@stthomaschc.org,www.stthomaschc.org
LA-004870,EXCELTH Family Health Center - Gentilly,"EXCELTH, INCORPORATED",1134440977,Federally Qualified Health Centers - Medical Services,2050 Caton St,,New Orleans,LA,70122-3147,Orleans,1515 Poydras St Ste 1070,,New Orleans,LA,70112-4520,Orleans,Michael A Andry,CEO,504-524-1210,,mandry@excelth.com,Matilda A. Tennessee,,504-524-1210,,mtennessee@excelth.com,
LA-004871,Trinity Counseling and Training Center,St Thomas Community Health Center,1609256494,Federally Qualified Health Centers - Medical Services,2108 Coliseum St,,New Orleans,LA,70130-5116,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Amanda Champagne,Billing Director,504-592-3950,,achampagne@stthomaschc.org,Elisa Escoto,Credentialing Agent,504-529-5558,216,eescoto@stthomaschc.org,
LA-004872,Mahalia Jackson Health Service Center,"St. Thomas Community Health Center, Inc.",1053626598,Federally Qualified Health Centers - Medical Services,2405 Jackson Ave,,New Orleans,LA,70113-2400,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Donald T. Erwin,CEO,504-529-5558,440,dterwin@stthomaschc.org,Mary M Abell,Medical Director,504-529-5558,440,mabell@stthomaschc.org,www.stthomaschc.org
LA-004873,CrescentCare Specialty Center,NEW ORLEANS AIDS TASK FORCE (NO/AIDS Task Force),1811303803,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2601 Tulane Ave,Suite 500,New Orleans,LA,70119-7400,Orleans,2601 Tulane Ave Ste 500,,New Orleans,LA,70119,Orleans,Noel Twilbeck,CEO,504-821-2601,228,Noel.Twilbeck@crescentcarehealth.org,Ellie Tinto-Poitier,Compliance and Risk Specialist,504-821-2601,750,Ellie.TintoPoitier@CrescentCareHealth.org,http://www.noaidstaskforce.org
LA-004874,Access Health Louisiana,Access Health Louisiana,1386062677,"Dental Providers, Federally Qualified Health Centers - Medical Services",3036 Iberville St,Warren Easton High school SBHC,New Orleans,LA,70119-5420,Orleans,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004875,Daughters of Charity Health Center - Carrollton,MARILLAC COMMUNITY HEALTH CENTERS,1891046876,"Dental Providers, Federally Qualified Health Centers - Medical Services",3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,David McBride,Executive Director and General Counsel,504-231-7479,,dmcbride@dcsno.org,
LA-004876,South Broad Community Health Center,Access Health Louisiana,1891199766,"Dental Providers, Federally Qualified Health Centers - Medical Services",3300 S Broad St,,New Orleans,LA,70125-2942,Orleans,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004877,CrescentCare Health and Wellness Center,New Orleans AIDS TASK FORCE (NO/AIDS Task Force),1689081648,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",3308 Tulane Ave,,New Orleans,LA,70119-7100,Orleans,2601 Tulane Ave Ste 500,,New Orleans,LA,70119-7400,Orleans,Noel Twilbeck,CEO,504-821-2601,228,Noel.Twilbeck@crescentcarehealth.org,Ellie Tinto-Poitier,Compliance and Risk Specialist,504-821-2601,750,Ellie.TintoPoitier@CrescentCareHealth.org,www.crescentcarehealth.org
LA-004878,Daughters of Charity Health Center - Louisa,MARILLAC COMMUNITY HEALTH CENTERS,1861897274,Federally Qualified Health Centers - Medical Services,3512 Louisa St,,New Orleans,LA,70126-5807,Orleans,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,,,,,,
LA-004879,Cohen College Prep HS SBHC,Access Health Louisiana,1447638465,"Dental Providers, Federally Qualified Health Centers - Medical Services",3520 Dryades Streeet,,New Orleans,LA,70115,Orleans,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004880,Columbia Parc CHC,"St. Thomas Community Health Center, Inc.",1699115600,Federally Qualified Health Centers - Medical Services,3943 Saint Bernard Ave,,New Orleans,LA,70122-1147,Orleans,1936 Magazine St,,New Orleans,LA,70130,Orleans,Donald T Erwin,CEO,504-529-5558,440,dterwin@stthomaschc.org,Mary M Abell,Medical Director,504-529-5558,440,mabell@stthomaschc.org,www.stthomaschc.org
LA-004881,EXCELth Family Health Center - Algiers,"EXCELTH, INCORPORATED",1003101346,Federally Qualified Health Centers - Medical Services,4422 General Meyer Ave,Suite 103,New Orleans,LA,70131-4330,Orleans,1515 Poydras St Ste 1070,,New Orleans,LA,70112-4520,Orleans,Michael A Andry,CEO,504-524-1210,,mandry@excelth.com,Matilda A. Tennessee,,504-524-1210,,mtennessee@excelth.com,
LA-004882,New Orleans Health Center,"Planned Parenthood Gulf Coast, Inc.",1780901587,Family Planning Providers,4636 S Claiborne Ave,,New Orleans,LA,70125-5010,Orleans,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
LA-004883,CrescentCare Family Care Services Center,NEW ORLEANS AIDS TASK FORCE (NO/AIDS Task Force),1356767719,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4640 S Carrollton Ave,,New Orleans,LA,70119-6051,Orleans,2601 Tulane Ave Ste 500,,New Orleans,LA,70119-7400,Orleans,Noel Twilbeck,CEO,504-821-2601,228,Noel.Twilbeck@crescentcarehealth.org,Ellie Tinto-Poitier,Compliance and Risk Specialist,504-821-2601,228,Ellie.TintoPoitier@CrescentCareHealth.org,www.crescentcarehealth.org
LA-004884,Delgado Personal Health Center,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",517 N Rampart St,,New Orleans,LA,70112-3503,Orleans,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004885,Daughters of Charity Health Center - New Orleans East,MARILLAC COMMUNITY HEALTH CENTERS,1962823211,Federally Qualified Health Centers - Medical Services,5630 Read Blvd,,New Orleans,LA,70127-3106,Orleans,3201 S Carrollton Ave,,New Orleans,LA,70118-4307,Orleans,Michael G Griffin,President and CEO,504-307-1188,,mgriffin@dcsno.org,,,,,,
LA-004886,Drop-In Clinic @ Covenant House,Tulane Section of Adolescent Medicine,1801196563,"Family Planning Providers, Sexually Transmitted Disease Clinics",611 N Rampart St,,New Orleans,LA,70112-3505,Orleans,1440 Canal Street,TW8342,New Orleans,LA,70112,Orleans,Edward Bonin,NP,504-584-1112,,ebonin@tulane.edu,Carol Armour,Nurse Manager,504-584-1112,,,
LA-004887,Ruth U Fertel/Tulane CHC,Access Health Louisiana,1063759066,"Dental Providers, Federally Qualified Health Centers - Medical Services",711 N Broad St,,New Orleans,LA,70119-4206,Orleans,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manger,504-575-3717,,dscallan@accesshealthla.org,Tacie dufrene,credetialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004888,EXCELth Family Health Center - New Orleans East,"EXCELth, Inc",1699114991,"Dental Providers, Federally Qualified Health Centers - Medical Services",9900 Lake Forest Blvd,Suite F,New Orleans,LA,70127-2609,Orleans,1515 Poydras Street,STE 1070,New Orleans,LA,70112,Orleans,MICHAEL A. ANDRY,CEO,504-524-1210,4123,mandry@excelth.com,Matilda Tennessee,Revenue Cycle Manager,504-524-1210,,mtennessee@excelth.com,
LA-004889,"INNIS COMMUNITY HEALTH CENTER, INC.","INNIS COMMUNITY HEALTH CENTER, INC.",1992170385,Federally Qualified Health Centers - Medical Services,1100 New Roads St,Rosenwald Elementary School,New Roads,LA,70760-2300,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,Exectutive Director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,http://innishealth.com/site/school-based-health/
LA-004890,Pointe Coupee Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",282B Hospital Rd,,New Roads,LA,70760-2619,Pointe Coupee,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004891,OLOL Physician Group New Roads,"Our Lady of the Lake Physician Group, LLC",1447399308,Rural Health Clinics,310 Durel Dr,,New Roads,LA,70760-2973,Pointe Coupee,7777 Hennessy Blvd,STE 6002,Baton Rouge,LA,70808-4300,East Baton Rouge,Anna Rougeau,CVO Manager,225-490-6301,,anna.rougeau@ololrmc.com,,,,,,
LA-004892,Franklin Medical Rural Health-Tensas,Franklin Medical Center,1831144054,"Family Planning Providers, Rural Health Clinics",104 Verona St,,Newellton,LA,71357,Tensas,2016 Loop road,,Winnsboro,LA,71295,Franklin,Charlotte Merritt,Director,318-467-9949,,Cmerritt@fmc-cares.com,Amanda Jinks,office clerk,318-467-9949,,,
LA-004893,St Charles Community Health Center Norco,Access Health Louisiana,1376784868,"Dental Providers, Federally Qualified Health Centers - Medical Services",16004 River Rd,,Norco,LA,70079-2040,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004894,West Carroll Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",402 Beale St,,Oak Grove,LA,71263,West Carroll,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004895,Allen Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",145 Hospital Dr,,Oakdale,LA,71463-3034,Allen,1450 Poydras Street,Ste 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004896,SWLA Center For Health Services - Oberlin,SWLA CENTER FOR HEALTH SERVICES,1942645007,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",112 N Sixth St,,Oberlin,LA,70655-6109,Allen,2000 Opelousas St,,Lake Charles,LA,70601-2641,Calcasieu,Tommie Anderson,CEO,337-439-9983,1115,tanderson@swlahealth.org,Erica Victorian,Director of Revenue Cycle Management,337-439-9983,1112,evictorian@swlahealth.org,
LA-004897,Hardtner Medical Clinic,Hardtner Medical Center,1053415745,Rural Health Clinics,1049 North Pine Rd.,,Olla,LA,71465,La Salle,1102 North Pine Rd.,,Olla,LA,71465,La Salle,Paul Glenn Mathews,Administrator,318-495-3131,109,admin@hardtnermedical.com,Cherry Beth Salter,Director of Nursing,318-495-3131,130,csalter@hardtnermedical.com,www.hardtnermedical.com
LA-004898,St. Landry Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",308 W Bloch St,,Opelousas,LA,70570-5214,Saint Landry,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004899,Opelousas General Health System,Opelousas General Health System,1447230388,Inpatient Hospitals (other than children's hospitals),539 E Prudhomme St,,Opelousas,LA,70570-6499,Saint Landry,Opelousas General Health System,539 E Prudhomme St,Opelousas,LA,70570,Saint Landry,Kenneth Cochran,CEO,337-948-5101,,kennethcochran@opelousasgeneral.com,James Juneau,CFO,337-948-5113,,jimjuneau@opelousasgeneral.com,opelousasgeneral.com
LA-004900,Access Health Louisiana SBHC Paradis,Access Health Louisiana,1104239482,"Dental Providers, Federally Qualified Health Centers - Medical Services",434 South St,,Paradis,LA,70080-2244,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004901,Reddy Family Medical Clinic,Reddy Family Medical Clinic,1316063209,Rural Health Clinics,3407 Highway 70 S,,Pierre Part,LA,70339-4524,Assumption,3407 Hwy 70,,Pierre Part,LA,70339,Assumption,nagaratna reddy,MD,225-323-1949,,nagaratna@aol.com,Jammie Smith,Office Manager,225-473-3931,,,
LA-004902,Teche Action Clinic @ Pierre Part,"TECHE ACTION BOARD, THE",1972746964,Federally Qualified Health Centers - Medical Services,3617 Highway 70 S,,Pierre Part,LA,70339-4455,Assumption,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004903,Iberville Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",24705 Plaza Dr,Suite A,Plaquemine,LA,70764-6827,Iberville,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004904,Reddy Family Medical Clinic,Reddy Family Medical Clinic,1811013709,Rural Health Clinics,58725 Belleview Dr,Suite A-5,Plaquemine,LA,70764-3948,Iberville,58725 Belleview Dr,,Plaquemine,LA,70764,Iberville,nagaratna reddy,MD,225-323-1949,,nagaratna@aol.com,Jammie Smith,Offic eManager,225-473-3931,,,
LA-004905,"CAPITOL CITY FAMILY HEALTH CENTER, INC.",CAPITOL CITY FAMILY HEALTH CENTER INC,1801210133,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",59340 River West Dr,Suite A & B,Plaquemine,LA,70764-6553,Iberville,3140 Florida Blvd,,Baton Rouge,LA,70806-3757,East Baton Rouge,Matthew Valliere,Chief Executive Officer (CEO),225-650-2026,,mvalliere@ccfhc.org,Christina Claiborne,Chief Administrative Officer (CAO),225-650-2027,,cclaiborne@ccfhc.org,
LA-004906,Access Health Louisiana,Access Health Louisiana,1457704900,"Dental Providers, Federally Qualified Health Centers - Medical Services",59595 Belleview Dr,Plaquemines High School Base Center,Plaquemine,LA,70764-6500,Iberville,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,http://accesshealthla.org/locations/school-based-wellness-centers/
LA-004907,WBR Primary Care,"Primary Care Providers for a Healthy Feliciana,Inc.",1770760902,"Dental Providers, Federally Qualified Health Centers - Medical Services",203 Allendale Dr,,Port Allen,LA,70767-3219,West Baton Rouge,11990 Jackson Street,P.O. Box 395,Clinton,LA,70722,East Feliciana,Dawn Taylor,CIO,225-683-6725,,dtaylor@rkmcare.org,Christi Hunt,Controller,225-683-5292,10203,chunt@rkmcare.org,www.rkmcare.org
LA-004908,West Baton Rouge Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",685 Louisiana Ave,,Port Allen,LA,70767-2144,West Baton Rouge,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004909,Northeast Louisiana Health Center,Northeast Louisiana Health Center,1043368392,Rural Health Clinics,1012 Louisa St,,Rayville,LA,71269-2957,Richland,1012 Louisa St,,Rayville,LA,71269,Richland,"James Barrett, Jr.",CEO,318-728-8389,389,jamesb@richardsonmed.org,Dianne Donald,Assistant CEO,318-728-8315,315,dianned@richardsonmed.org,
LA-004910,RMC Surgery Clinic,RMC Surgery Clinic,1598944357,Other ECP Providers,129 Christian Dr,,Rayville,LA,71269-3658,Richland,129 Christian Drive,,Rayville,LA,71269,Richland,"James Barrett, Jr",CEO,318-728-8389,389,jamesb@richardsonmed.org,Dianne Donald,Assistant CEO,318-728-8315,315,dianned@richardsonmed.org,
LA-004911,Richland Parish Health Clinic - Rayville,Richland Parish Health Clinic,1093996969,Other ECP Providers,155 Highway 3048,Rayville School Based Health Clinic,Rayville,LA,71269-3622,Richland,155 Highway 3048,,Rayville,LA,71269,Richland,"James Barrett, Jr",CEO,318-728-8389,389,jamesb@richardsonmed.org,Dianne Donald,Assistant CEO,318-728-8315,315,dianned@richardsonmed.org,http://www.richland.k12.la.us/health/
LA-004912,RAYVILLE FAMILY CLINIC,RAYVILLE FAMILY CLINIC,1063782811,Rural Health Clinics,1962 Julia St,,Rayville,LA,71269-5527,Richland,1962 JULIA ST,,RAYVILLE,LA,71269-5527,Richland,TRACY MORRIS,ADMINISTRATOR,318-728-8833,,rayvillefamily@att.net,,,,,,
LA-004913,Richland Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",21 Lynn Gayle Robertson Rd,,Rayville,LA,71269-4068,Richland,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004914,Richardson Medical Center,RICHARDSON MEDICAL CENTER,1255370144,Inpatient Hospitals (other than children's hospitals),254 Highway 3048,,Rayville,LA,71269-3624,Richland,254 HWY 3048,,Rayville,LA,71269,Richland,MIKA ODOM,RHC Director,318-728-2046,,MIKAM@RICHARDSONMED.ORG,JAMES BARRETT,Administrator,318-728-4181,,JAMESB@RICHARDSONMED.ORG,
LA-004915,Richardson Medical Center,NORTHEAST LA HEALTH CENTER,1043368392,Rural Health Clinics,256 Highway 3048,,Rayville,LA,71269-3624,Richland,256 HWY 3048,,Rayville,LA,71269,Richland,MIKA ODOM,RHC Director,318-728-2046,,MIKAM@RICHARDSONMED.ORG,,,,,,
LA-004916,START COMMUNITY CLINIC,RICHARDSON MEDICAL CENTER,1538595749,Rural Health Clinics,5975 FED HWY 80,,Rayville,LA,71269,Richland,5975 FED HWY 80,,Rayville,LA,71269,Richland,MIKA ODOM,RHC Director,318-728-4368,,MIKAM@RICHARDSONMED.ORG,,,,,,
LA-004917,Teche Action Clinic @ Reserve,"TECHE ACTION BOARD, THE",1386880433,Federally Qualified Health Centers - Medical Services,471 Central Ave,,Reserve,LA,70084-5509,St John the Baptist,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004918,St. John Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",473 Central Ave,,Reserve,LA,70084-5509,St John the Baptist,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004919,Bienville Parish Health Unit - Ringgold,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",2145 Mill Street,,Ringgold,LA,71068,Bienville,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004920,Bienville Community Health Center,"Winn Community Health Center, Inc.",1740601418,"Dental Providers, Federally Qualified Health Centers - Medical Services",2826 Bienville Rd,,Ringgold,LA,71068-2588,Bienville,427 W. Lafayette Street,,Winnfield,LA,71483,Winn,Deano Thornton,Chief Executive Officer,318-648-0375,234,dthornton@winnchc.org,David Adams,COO,318-648-0375,238,dadams@winnchc.org,
LA-004921,CHRISTUS Coushatta Ringgold Rural Health Clinic,CHRISTUS Health,1205827151,Rural Health Clinics,3342 Bienville Rd,,Ringgold,LA,71068-3242,Bienville,1635 Marvel St,,Coushatta,LA,71019,Red River,Angela Shoemaker,Manager of Patient Fiancial Services,318-932-2085,,angela.shoemaker@christushealth.org,Jana Baldwin,Patient Representative,319322244,,jana.baldwin@christushealth.org,
LA-004922,TOTAL FAMILY MEDICAL LLC,Total Family Medical,1558791905,Rural Health Clinics,44354 Highway 445,Suite D,Robert,LA,70455-1999,Tangipahoa,40230 pelican point pkwy,,Gonzales,LA,70737,La Salle,Peggy Gautreau,Administrator,985-542-2466,,pgautreau11@cox.net,,,,,,
LA-004923,"INNIS COMMUNITY HEALTH CENTER, INC.","INNIS COMMUNITY HEALTH CENTER, INC.",1780059162,Federally Qualified Health Centers - Medical Services,13258 LA Highway 416,Rougon Elementary School,Rougon,LA,70773-3606,Pointe Coupee,6450 LA Highway 1 # B,,Batchelor,LA,70715-3212,Pointe Coupee,Cindy Peavy,executive director,225-492-3775,201,cpeavy@inchc.org,rachel nelson,coo,225-492-3775,206,rachel@inchc.org,http://innishealth.com/site/school-based-health/
LA-004924,Lincoln Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",405 E Georgia Ave,,Ruston,LA,71270-3926,Lincoln,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004925,WEST FELICIANA PARISH HOSPITAL (inpatient hospital),WEST FELICIANA PARISH HOSPITAL,1164497533,Inpatient Hospitals (other than children's hospitals),5266 Commerce St,,Saint Francisville,LA,70775-4409,West Feliciana,PO Box 368,,SAINT FRANCISVILLE,LA,70775,West Feliciana,Kathy Cheatham,Director of HIM,225-635-3811,482,kathyc@wfph.org,Lee Chastant,CEO,225-635-3811,441,chastantl@wfph.org,
LA-004926,WEST FELICIANA PARISH HOSPITAL (outpatient hospital clinics),WEST FELICIANA PARISH HOSPITAL,1164497533,Outpatient Hospital Clinics,5266 Commerce St,,Saint Francisville,LA,70775-4409,West Feliciana,PO Box 368,,SAINT FRANCISVILLE,LA,70775,West Feliciana,Kathy Cheatham,Director,225-635-3811,482,kathyc@wfph.org,,,,,,
LA-004927,"St. Gabriel Health Clinic, Inc/Gardere Center for Primary Care Services","St. Gabriel Health Clinic, Inc.",1093874000,"Dental Providers, Federally Qualified Health Centers - Medical Services",1707 Gardere Ln,,Saint Gabriel,LA,70776-4412,Iberville,5760 Monticello,"1707 Gardere Lane, Suite E.",St. Gabriel,LA,70776,Iberville,Victor C. Kirk,Chief Executive Officer,225-642-9676,104,vkirk@stgabrielchc.org,Marilyn Antwine,Dirfector of Reimbursements,225-642-9676,103,mantwine@stgabrielchc.org,
LA-004928,TENSAS COMMUNITY HEALTH CENTER,TENSAS COMMUNITY HEALTH CENTER,1720054075,Federally Qualified Health Centers - Medical Services,1115 Levee Rd,,Saint Joseph,LA,71366-6639,Tensas,1115 Levee St,,Saint Joseph,LA,71366,Tensas,Jackie Schauf,CEO/Executive Director,318-766-1967,,jschauf@tensashealth.org,Sandra Lode,CFO,985-687-6277,,sandra@lodecg.com,
LA-004929,TENSAS DENTAL CLINIC,TENSAS COMMUNITY HEALTH CENTER,1720054075,Dental Providers,406 Levee Rd,,Saint Joseph,LA,71366-6661,Tensas,402 LEVEE STREET,,ST. JOSEPH,LA,71366,Tensas,Jacqueline Schauf,CEO/EXECUTIVE DIRECTOR,318-766-1967,,jschauf@tensashealth.org,SANDRA LODE,CFO,985-687-6277,,SANDRA@LODECG.COM,
LA-004930,Franklin Medical Center Rural Health Clinic Saint Joseph Clinic,Franklin Medical Center Rural Health Clinic Saint Joseph Clinic,1063466753,Rural Health Clinics,448 Newton St,,Saint Joseph,LA,71366-4330,Tensas,P O Box 6,,Saint Joseph,LA,71366,Tensas,Danielle Hankins,Manager,318-766-8506,,Dhankins@fmc-cares.com,Betty Westmoreland,Receptionist,318-766-8506,,Bwestmoreland@fmc-cares.com,
LA-004931,ST MARTINVILLE MATERNAL-CHILD CLINIC,"Pediatric Group of Acadiana, LLC",1922283225,Rural Health Clinics,1119 N Main St,,Saint Martinville,LA,70582-3513,Saint Martin,"401 Youngsville Hwy, Suite 100",,Lafayette,LA,70508,Lafayette,Matthew Billiodeaux,Project & Contract Manager,337-418-9377,,mbilliodeaux@pgacadiana.com,Dwayne Gros,Office Manager,337-839-5533,,Manager@PGAcadiana.com,http://www.pgacadiana.com
LA-004932,St. Martin Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",303 W Port St,,Saint Martinville,LA,70582-3923,Saint Martin,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004933,St. Martin Parish Community Health Center,"Iberia Comprehensive Community Health Center, Inc.",1821286899,"Dental Providers, Federally Qualified Health Centers - Medical Services",317 Dernier St,,Saint Martinville,LA,70582-3809,Saint Martin,806 Jefferson Terrace Blvd,,New Iberia,LA,70560,Iberia,Roderick Charles Campbell,Chief Executive Officer,337-365-4945,127,roderickcc@icchc.org,Monique Dumond,Chief Financial Officer,337-365-4945,112,monique@icchc.org,www.icchc.org
LA-004934,North Webster Medical Clinic,"Springhill Medical Services, Inc.",1932173564,Rural Health Clinics,106 Tri State Dr,,Sarepta,LA,71071-2826,Webster,2001 Doctors Drive,,Springhill,LA,71075-4526,Webster,Vincent R. Sedminik,Chief Executive Officer,318-539-1001,,vincent.sedminik@emailsmc.com,Layla Chase,Chief Financial Officer,318-539-1056,,layla.chase@emailsmc.com,www.smccare.com
LA-004935,Caddo Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1035 Creswell Ave,,Shreveport,LA,71101-3917,Caddo,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004936,UNIVERSITY HEALTH SHREVEPORT (inpatient hospital),"BRFHH SHREVEPORT, LLC",1912909912,Inpatient Hospitals (other than children's hospitals),1541 Kings Hwy,,Shreveport,LA,71103-4228,Caddo,1541 KINGS HWY,,Shreveport,LA,71103-4228,Caddo,AARON EICHORN,CFO,318-629-4760,,ADAM.MILLER@UHSYSTEM.COM,,,,,,
LA-004937,UNIVERSITY HEALTH SHREVEPORT (multiple outpatient ECP categories),"BRFHH SHREVEPORT, LLC",1912909912,"Dental Providers, Outpatient Hospital Clinics",1541 Kings Hwy,,Shreveport,LA,71103-4228,Caddo,1541 KINGS HWY,,Shreveport,LA,71103-4228,Caddo,AARON EICHORN,CFO,318-629-4760,,ADAM.MILLER@UHSYSTEM.COM,,,,,,
LA-004938,David Raines Community Health Centers - Shreveport North,"David Raines Community Health Center, Inc.",1215933254,Federally Qualified Health Centers - Medical Services,1625 David Raines Rd,,Shreveport,LA,71107-5899,Caddo,"3041 Martin Luther King, Jr. Drive",,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004939,Casse Community Health Institute,Casse Community Health Institute,1134532062,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2120 Bert Kouns Industrial Loop,Suite A,Shreveport,LA,71118-3351,Caddo,2120 Bert Kouns Industrial Loop,Suite A,Shreveport,LA,71118,Caddo,Beth Chumley,CEO,318-688-3350,,bchumley@casseusa.com,Kimberly Jefferson,Care Gap Coordinator,318-688-3350,,kjefferson@casseusa.com,
LA-004940,David Raines Community Health Centers,David Raines Community Health Centers,1215933254,"Dental Providers, Federally Qualified Health Centers - Medical Services",3041 Martin Luther King Jr,,Shreveport,LA,71107,Bossier,3041 Martin Luther King Jr,,Shreveport,LA,71107,Bossier,Karla Bounds,CFO,318-841-6046,3165,kbounds@davidraineschc.org,,,,,,
LA-004941,SHC - Shreveport,Shriners Hospitals for Children,1679617849,Children's Hospitals (inpatient only),3100 Samford Ave,,Shreveport,LA,71103-4239,Caddo,3100 Samford Ave,,Shreveport,LA,71103,Caddo,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
LA-004942,David Raines Community Health Centers - Shreveport West,"David Raines Community Health Center, Inc.",1104249473,Federally Qualified Health Centers - Medical Services,3121 W 70th St,,Shreveport,LA,71108-4605,Caddo,3041 Martin Luther King Jr. Drive,,Shreveport,LA,71107,Caddo,"Willie C. White, III",Chief Executive Officer,318-227-3342,,wwhite@davidraineschc.org,Myrtis Edwards,Chief Operating Officer,318-227-3341,,medwards@davidraineschc.org,www.davidraineschc.org
LA-004943,Sicily Island Medical Center,Catahoula Parish Hospital District #2,1770622631,Federally Qualified Health Centers - Medical Services,307 Chisum St,,Sicily Island,LA,71368-4807,Catahoula,PO Box 8,,Sicily Island,LA,71368,Catahoula,Debra Miesch,CEO,318-389-5727,1012,dmiesch@cphd2.org,Michelle Brown,Billing Manager,318-389-5727,1007,mbrown@cphd2.org,
LA-004944,Medical Center Family Dentistry,Catahoula Parish Hospital District #2,1225183916,Dental Providers,710 Chisum Street,,Sicily Island,LA,71368,Catahoula,P. O. Box 8,,Sicily Island,LA,71368,Catahoula,Debra Miesch,CEO,318-389-5727,1012,dmiesch@cphd2.org,Michelle Brown,Billing Manager,318-389-5727,1007,mbrown@cphd2.org,
LA-004945,St Tammany Community Health Center,Access Health Louisiana,1487898946,"Dental Providers, Federally Qualified Health Centers - Medical Services",501 Robert Blvd,,Slidell,LA,70458-1667,Saint Tammany,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004946,RKM Primary Care Springfield,"Primary Care Providers for a Healthy Feliciana, Inc.",1639559958,"Dental Providers, Federally Qualified Health Centers - Medical Services",27124 Highway 42,,Springfield,LA,70462-7979,Livingston,11990 Jackson Street,P.O. Box 395,Clinton,LA,70722,East Feliciana,Dawn Taylor,CIO,225-638-6725,,dtaylor@rkmcare.org,Ginger Hunt,CEO,225-683-5292,10201,ghunt@rkmcare.org,www.rkmcare.org
LA-004947,SMC Doctors Clinic,"Springhill Medical Services, Inc.",1871507616,Rural Health Clinics,401 11th St NE,,Springhill,LA,71075-4503,Webster,2001 Doctors Drive,,Springhill,LA,71075,Webster,Barbara L. Taylor,Executive Assistant,318-539-1001,,barbara.taylo@emailsmc.com,Vincent Sedminik,CEO,318-539-1001,,vincent.sedminik@emailsmc.com,
LA-004948,Albert Cammon Wellness Center,Access Health Louisiana,1013239508,"Dental Providers, Federally Qualified Health Centers - Medical Services",232 Pirate Dr,,St. Rose,LA,70087,Saint Charles,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004949,Start Community Clinic,Start Community Clinic,1538595749,Rural Health Clinics,5975 Federal Hwy 80,,Start,LA,71279,Richland,5975 Federal Highway 80,,Start,LA,71279,Richland,"James Barrett, Jr",CEO,318-728-8389,389,jamesb@richardsonmed.org,Dianne Donald,Assistant CEO,318-728-8315,315,dianned@richardsonmed.org,
LA-004950,STERLINGTON OUTPATIENT RURAL HEALTH CLINIC,Sterlington Rehabilitation Hospital,1134243736,Rural Health Clinics,10374 Highway 165 N,Suite B,Sterlington,LA,71280-3320,Ouachita,10374 Hwy 165 N,Suite A,Sterlington,LA,71280,Ouachita,Terry Mcnemar,Insurance,318-665-9950,110,tmcnemar@sterlingtonrehab.com,kschroeder,CNO,318-665-9950,113,kschroeder@sterlingtonrehab.com,
LA-004951,Madison PHU LA FP Clinic,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",123 Bailey St,,Tallulah,LA,71282-2831,Madison,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-5334,,Carolyn.Wise@LA.Gov,,,,,,
LA-004952,"Outpatient Medical Center, Inc. @ Tallulah","OUTPATIENT MEDICAL CENTER, INC.",1750311064,"Dental Providers, Federally Qualified Health Centers - Medical Services",804 N Beech St,,Tallulah,LA,71282-3809,Madison,1640 Breazeale Springs St,,Natchitoches,LA,71457-4278,Natchitoches,Carl Walters,CEO,318-357-2071,,cwalters@outpatientmedical.org,Anedra Seawood,CFO,318-357-2062,,aseawood@outpatientmedical.org,
LA-004953,Madison Parish Hospital Rural Health Clinic,Madison Parish Hospital Service District,1053575043,Rural Health Clinics,808 Johnson St,,Tallulah,LA,71282-4535,Madison,900 Johnson Street,,Tallulah,LA,71282,Madison,Chasity Whitaker,Assistant Administrator,318-651-5601,,chasity@madisonparishhospital.com,Stacey Sandidge,Clinic Manager,318-574-1137,315,ssandidge@madisonparishhospital.com,
LA-004954,Madison Parish Hospital,Madison Parish Hospital Service District,1851393409,Inpatient Hospitals (other than children's hospitals),900 Johnson St,,Tallulah,LA,71282-4537,Madison,900 Johnson Street,,Tallulah,LA,71282,Madison,Chasity Whitaker,Compliance Officer,318-651-5601,,chasity@madisonparishhospital.com,Amanda McCool,Business Office Manager,318-651-5608,,amccool@madisonparishhospital.com,www.madisonparishhospital.com
LA-004955,Teche Action Clinic @ Thibodaux,"TECHE ACTION BOARD, THE",1356767420,Federally Qualified Health Centers - Medical Services,1709 Ridgefield Rd,,Thibodaux,LA,70301-4333,Lafourche,1115 Weber St,,Franklin,LA,70538-4124,Saint Mary,Gary Wiltz,CEO,337-828-2550,2117,gwiltz@tabhealth.org,Paulette Lofton,COO,337-828-2550,2104,plofton@tabhealth.org,
LA-004956,Lafourche Parish Health Unit - Thibodaux,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",2535 Veterans Blvd,,Thibodaux,LA,70301-4363,Lafourche,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004957,St. James Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",29170 Health Unit St,,Vacherie,LA,70090-4221,Saint James,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004958,Evangeline Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",1010 W Lasalle St,,Ville Platte,LA,70586-3004,Evangeline,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004959,Mercy Regional Medical Center,LifePoint Health,1407947336,Inpatient Hospitals (other than children's hospitals),800 E Main St,,Ville Platte,LA,70586-4618,Evangeline,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Michael Fontenot,CFO,337-363-9454,,,
LA-004960,St. Landry Family Healthcare,St. Landry Family Healthcare,1528481587,Rural Health Clinics,6633 Highway 10,,Washington,LA,70589-4313,Saint Landry,6633 Hwy 10,,Washington,LA,70589,Saint Landry,Amelia Lyons,Practice Manager,337-826-7702,,Amelia.Lyons@lhcgroup.com,Elliot Myers,Nurse Practitioner,337-826-7702,,Elliot.Myers@lhcgroup.com,
LA-004961,"Morehouse Community Medical Centers, Inc.","MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1073993580,Federally Qualified Health Centers - Medical Services,100 Price Dr,Riser Middle School Based Health Center,West Monroe,LA,71292-6315,Ouachita,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcinc.org
LA-004962,"Morehouse Community Medical Centers, Inc.","MOREHOUSE COMMUNITY MEDICAL CENTERS, INC.",1134509649,Federally Qualified Health Centers - Medical Services,201 Riggs St,West Monroe High School Based Health Center,West Monroe,LA,71291-2640,Ouachita,518 Durham St,,Bastrop,LA,71220-5013,Morehouse,Katie M Parnell,CEO,318-283-8887,107,katie.parnell@mcmcinc.org,Sandra Lode,CFO,318-283-8887,145,sandra.lode@mcmcinc.org,www.mcmcimc.org
LA-004963,Glenwood Regional Medical Center,Steward Healthcare System LLC,1487706214,Inpatient Hospitals (other than children's hospitals),503 McMillan Rd,,West Monroe,LA,71291-5327,Ouachita,"111 Huntington Avenue, Suite 1800",,Boston,MA,02199,Suffolk,Jeremy Tinnerello,President,318-329-4700,4776,jeremy.tinnerello@steward.org,Lisa S. Bradley,Chief Financial Officer,318-329-4700,4733,lisa.bradley@steward.org,www.steward.org
LA-012447,Premier Family Walk In Clinic,Premier Family Walk In Clinic,1366919748,Other ECP Providers,903 Warren Dr,Suite B,West Monroe,LA,71291-7158,Ouachita,903 Warren Dr,Suite B,West Monroe,LA,71291,Ouachita,"Kala Parks, FNP",FNP,318-680-2491,,Kparks91@aol.com,Joni Kicklighter,MA/Office Manager,318-537-9320,,Joni@premierfamilyclinic.com,
LA-004964,Joshua Butler SBHC,Access Health Louisiana,1164774550,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 Fourth St,,Westwego,LA,70094-4335,Jefferson,843 Milling Ave,,Luling,LA,70070,Saint Charles,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004965,Reddy Family Medical Clinic,Reddy Family Medical Clinic,1407972391,Rural Health Clinics,32985 Bowie St,,White Castle,LA,70788-2320,Iberville,32985 Bowie st,,Whitecastle,LA,70788,Iberville,nagaratna reddy,MD,225-545-3631,,nagaratna@aol.com,Jammie Smith,office manager,225-473-3931,,,
LA-004966,Winn Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",301 W Main St,,Winnfield,LA,71483-2786,Winn,1450 Poydras Street,Room 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004967,"Winn Community Health Center, Inc.",WINN COMMUNITY HEALTH CENTER,1659704880,Federally Qualified Health Centers - Medical Services,400 S Saint John St,Winnfield Primary School-Based Health Center,Winnfield,LA,71483-3418,Winn,427 W Lafayette Street,,Winnfield,LA,71483-3418,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,Missy Hyman,CFO,318-648-0375,,mhyman@winnchc.org,www.winnchc.org
LA-004968,WINN COMMUNITY DENTAL CENTER,"Winn Community Health Center, Inc.",1295175750,Dental Providers,425 W Lafayette St,,Winnfield,LA,71483-3463,Winn,427 West Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,David Adams,COO,318-648-0375,,dadams@winnchc.org,www.winnchc.org
LA-004969,"Winn Community Health Center, Inc.",WINN COMMUNITY HEALTH CENTER,1104025048,Federally Qualified Health Centers - Medical Services,431 W Lafayette St,,Winnfield,LA,71483-3463,Winn,427 W Lafayette Street,,Winnfield,LA,71483-3463,Winn,Deano Thornton,CEO,318-648-0375,,dthornton@winnchc.org,David Adams,COO,318-648-0375,238,dadams@winnchc.org,www.winnchc.org
LA-004970,Winnsboro Health Clinic,Franklin Medical Center,1902851124,Rural Health Clinics,2104 Loop Rd,Suite C,Winnsboro,LA,71295-3341,Franklin,2106 Loop Rd,PO box 1300,Winnsboro,LA,71295,Franklin,Keith Dewayne Butler,Director,318-435-4571,,dbutler@fmc-cares.com,,,,,,
LA-004971,CROWVILLE HEALTH CENTER,Franklin Medical Center,1497068951,Rural Health Clinics,5745 Highway 17,,Winnsboro,LA,71295-5688,Franklin,2016 Loop Rd,PO Box 1300,Winnsboro,LA,71295,Franklin,Keith Dewayne Butler,Director,318-435-4571,,dbutler@fmc-cares.com,,,,,,
LA-004972,Franklin Parish Health Unit,Louisiana Dept. of Health and Hospitals - Office of Public Health - Bureau of Family Health - Reproductive Health Program,1649355561,"Family Planning Providers, Sexually Transmitted Disease Clinics",6614 Main St,,Winnsboro,LA,71295-2762,Franklin,1450 Poydras Street,Suite 2032,New Orleans,LA,70112,Orleans,Carolyn Wise,Reproductive Health Program Manager,504-568-8176,,Carolyn.Wise@LA.Gov,,,,,,
LA-004973,Wisner Medical Center,Catahoula Parish Hospital District #2,1386784569,Federally Qualified Health Centers - Medical Services,126 Watson Rd,,Wisner,LA,71378-4660,Franklin,PO Box 8,,Sicily Island,LA,71368,Catahoula,Debra Miesch,CEO,318-389-5727,1012,dmiesch@cphd2.org,Michelle Brown,Billing Manager,318-389-5727,1007,mbrown@cphd2.org,
LA-004974,Woodworth Community Health Center,Access Health Louisiana,1578929105,"Dental Providers, Federally Qualified Health Centers - Medical Services",9372 Highway 165 S,,Woodworth,LA,71485-9786,Rapides,9372 Highway 165 South,,Woodworth,LA,71485,Rapides,Dana Scallan,Billing Manager,504-575-3717,,dscallan@accesshealthla.org,Tracie Dufrene,Credentialing,504-575-3712,,tdufrene@accesshealthla.org,
LA-004975,Desoto Regional Family Medicine-Zwolle,Desoto Regional Health System,1932246378,Rural Health Clinics,2026 Obrie St,,Zwolle,LA,71486,Sabine,207 Jefferson St,,Mansfield,LA,71052,De Soto,Christopher Davis,VP Of Rural Clinics/Practice Manager,318-872-2700,5124,Chrisdavis@desotoregional.com,Todd Eppler,CEO,318-872-4610,3132,toddeppler@desotoregional.com,http://www.desotoregional.com/
MA-004976,CHP Adams Internists,"Community Health Programs, Inc.",1912272899,Federally Qualified Health Centers - Medical Services,19 Depot St,,Adams,MA,01220-1856,Berkshire,444 Stockbridge Road,,Great Barrington,MA,01230,Berkshire,Philip B. Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,communityhealthprograms.org
MA-004977,"Charles River Community Health, Inc.","Charles River Community Health, Inc.",1134306368,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",30 Athol St,Charles River Community Health at Gardner School,Allston,MA,02134-1124,Suffolk,495 Western Ave,,Brighton,MA,02135,Suffolk,Elizabeth Browne,Executive Director,617-208-1511,,ebrowne@charlesriverhealth.org,Evelyn Torres,Associate Director of Patient Accounts and Practice Systems,617-870-7282,,etorres@charlesriverhealth.org,
MA-004978,"Charles River Community Health, Inc.","Charles River Community Health, INC.",1225215452,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",40 Armington St,Charles River Community Health at Jackson Mann School,Allston,MA,02134-2406,Suffolk,495 Western Ave,,Boston,MA,02135,Suffolk,Elizabeth Browne,Executive Director,617-208-1511,,ebrowne@charlesriverhealth.org,Evelyn Torres,Associate Director of Patient Accounts and Practice Systmes,617-208-1511,,etorres@charlesriverhealth.org,
MA-004979,Attleboro Family Planning,Health Imperatives,1871646448,Family Planning Providers,150 Emory St,,Attleboro,MA,02703-2439,Bristol,942 West Chestnut street,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jciternelli@healthimperatives.org,
MA-004980,Health Quarters: Beverly Office,"HealthQuarters, Inc.",1154459618,Family Planning Providers,100 Cummings Ctr,Suite 131Q,Beverly,MA,01915-6117,Essex,100 Cummings Center,Suite 220B,Beverly,MA,01915,Essex,Rachel Zamora,Administrative Assistant,978-522-5600,,rachelz@healthq.org,Renee LaForce,Director of Programs,978-522-5609,,reneel@healthq.org,
MA-004981,Greater Boston Health Center,Planned Parenthood League of Massachusetts,1821095779,"Family Planning Providers, Sexually Transmitted Disease Clinics",1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,Jordina Shanks,COO,617-616-1646,,jshanks@pplm.org,Jennifer Childs-Roshak,CEO,617-616-1651,,jchildsroshak@pplm.org,http://www.plannedparenthood.org/ma/
MA-004982,Fenway Community Health Center,"FENWAY COMMUNITY HEALTH CENTER, INC.",1003804725,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1340 Boylston St,,Boston,MA,02215-4302,Suffolk,1340 Boylston St,,Boston,MA,02215-4302,Suffolk,Rodney A. VanDerwarker,"VP Primary Care, Behavioral Health & Institute Operations",617-927-6034,,rvanderwarker@fenwayhealth.org,Robb Johnson,Assoc VP of Special Projects,857-313-6554,,rjohnson@fenwayhealth.org,www.fenwayhealth.org
MA-004983,Dothouse Health Inc.,"DOTHOUSE HEALTH, INC.",1578514733,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1353 Dorchester Ave,,Boston,MA,02122-2932,Suffolk,1353 Dorchester Avenue,,Dorchester,MA,02122,Suffolk,Michelle Nadow,CEO,617-740-2521,,michelle.nadow@dorchesterhouse.org,Huy Nguyen,CMO,617-740-2439,,huy.nguyen@dothousehealth.org,
MA-004984,Fenway: South End,"FENWAY COMMUNITY HEALTH CENTER, INC.",1982995197,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",142 Berkeley St,,Boston,MA,02116-5100,Suffolk,1340 Boylston St,,Boston,MA,02215-4302,Suffolk,Rodney A VanDerwarker,"VP Primary Care, Behavioral Health & Institute Operations",617-927-6034,,rvanderwarker@fenwayhealth.org,Robb Johnson,Assoc. VP of Special Projects,857-313-6554,,rjohnson@fenwayhealth.org,www.fenwayhealth.org
MA-004985,South Cove Community Health Center - 145 South Street,South Cove Community Health Center,1700801263,Dental Providers,145 South St Fl 4,,Boston,MA,02111-2826,Suffolk,145 South Street,,Boston,MA,02111,Suffolk,Eugene Welch,Executive Director,617-521-6703,6703,ewelch@scchc.org,,,,,,www.scchc.org
MA-004986,South End Community Health Center,South End Community Health Center,1558310052,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1601 Washington St,,Boston,MA,02118-1951,Suffolk,1601 Washington Street,,Boston,MA,02118,Suffolk,William Walczak,CEO,857-206-7601,,bwalczak@sechc.org,Janet Mulligan,COO,857-206-7510,,jmulligan@sechc.org,www.sechc.org
MA-004987,Action for Boston Community Development,Action for Boston Community Development,1205167459,Family Planning Providers,178 Tremont St,,Boston,MA,02111-1006,Suffolk,178 Tremont Street,,Boston,MA,02111,Suffolk,Joan Whitaker,Director,617-348-6260,,joan.whitker@bostonabcd.org,Denice Garrett,Coordinator For Clinical Billing,617-348-6256,,denice.garrett@bostonabcd.org,
MA-004988,BOSTON CHILDREN'S HOSPITAL (children's inpatient hospital),Children's Hospital,1710087127,Children's Hospitals (inpatient only),300 Longwood Ave,,Boston,MA,02115-5737,Suffolk,300 Longwood Ave,,Boston,MA,02115-5737,Suffolk,Jean Yang,"Executive Director, CHICO",617-919-6203,,jean.yang@childrens.harvard.edu,Randy Cook,"VP, Enterprise Contracting",857-218-3904,,randy.cook@childrens.harvard.edu,http://www.childrenshospital.org
MA-004989,BOSTON CHILDREN'S HOSPITAL (dental provider),Children's Hospital,1710087127,Dental Providers,300 Longwood Ave,,Boston,MA,02115-5737,Suffolk,300 Longwood Ave,,Boston,MA,02115-5737,Suffolk,Jean Yang,"Executive Director, CHICO",617-919-6203,,jean.yang@childrens.harvard.edu,Randy Cook,"VP, Enterprise Contracting",857-218-3904,,randy.cook@childrens.harvard.edu,http://www.childrenshospital.org
MA-004990,NORTH END WATERFRONT HEALTH,"North End Community Health Committee, Inc.",1780606608,"Dental Providers, Federally Qualified Health Centers - Medical Services",332 Hanover St,,Boston,MA,02113-1901,Suffolk,332 Hanover Street,,Boston,MA,02113,Suffolk,Vincenzo Scibelli,Chief Operating Officer,617-643-8082,8082,vscibelli@partners.org,Timothy Clifford,Compliance Officer,617-643-8007,8007,taclifford@partners.org,
MA-004991,SHC - Boston,Shriners Hospitals for Children,1114053782,Children's Hospitals (inpatient only),51 Blossom St,,Boston,MA,02114-2601,Suffolk,51 Blossom St,,Boston,MA,02114,Suffolk,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
MA-004992,"Dimock Community Health Center, Inc.",The Dimock Center,1588719488,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",55 Dimock St,,Boston,MA,02119-1029,Suffolk,55 DIMOCK ST.,,ROXBURY,MA,02118,Suffolk,Peter Gerondeau,CFO,617-442-8800,,pgeronde@dimock.org,,,,,,
MA-004993,Massachusetts General Comprehensive Hemophilia and Thrombosis Treatment Center,Massachusetts General Hospital,1801874573,Hemophilia Treatment Centers,55 Fruit St,Yawkey 7b & 8b,Boston,MA,02114-2696,Suffolk,55 Fruit St.,,Boston,MA,02114,Suffolk,Eric Cronin,Program Coordinator,617-643-2986,2986,ecronin5@partners.org,Eric F. Grabowski,Associate Professor of Pediatrics,617-726-2737,,egrabowski@partners.org,
MA-004994,Boston Hemophilia Center,Brigham and Women's Physicians Organization,1821205576,Hemophilia Treatment Centers,75 Francis St,,Boston,MA,02115-6110,Suffolk,1620 Tremont Street,,Boston,MA,02120,Suffolk,Debra McNamara,Division Administrator,617-525-7581,,dmcnamara2@partners.org,Sharon Greenstein,"Director, Managed Care",781-416-8476,,sgreenstein@partners.org,
MA-004995,"Sidney Borum, Jr. Health Center","FENWAY COMMUNITY HEALTH CENTER, INC.",1548589047,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",75 Kneeland St,Suite 201,Boston,MA,02111-1906,Suffolk,1340 Boylston St,,Boston,MA,02215-4302,Suffolk,Ralph Vetters,Site Medical Director,617-927-6370,,rvetters@fenwayhealth.org,Rebecca Henderson,Clinical Manager,617-927-6376,,rhenderson@fenwayhealth.org,www.sidneyborum.org
MA-004996,Floating Hospital for Children at Tufts Medical Center,Tufts Medical Center,1730132515,Children's Hospitals (inpatient only),755 Washington St,,Boston,MA,02111-1520,Suffolk,800 Washington Street,Box 17,Boston,MA,02111,Suffolk,Jeannette Spillane,Executive Director,617-636-5000,9099,jspillane@tuftsmedicalcenter.org,Malisa Schuyler,Director of Government Relations,617-636-5000,7209,mschuyler@tuftsmedicalcenter.org,https://www.floatinghospital.org
MA-004997,Boston Health Care for the Homeless Program / McInnis Health Group,Boston Health Care for the Homeless Program,1033157771,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers",780 Albany St,,Boston,MA,02118-2524,Suffolk,780 Albany Street,,Boston,MA,02118,Suffolk,Dirk Williams,Compliance Officer,857-654-1049,,diwilliams@bhchp.org,Barry Bock,CEO,857-654-1015,,bbock@bhchp.org,www.bhchp.org
MA-004998,South Cove Community Health Center - 885 Washington St,South Cove Community Health Center,1700801263,Federally Qualified Health Centers - Medical Services,885 Washington St,,Boston,MA,02111-1415,Suffolk,145 South Street,,Boston,MA,02111,Suffolk,Eugene Welch,Executive Director,617-521-6703,6703,ewelch@scchc.org,,,,,,www.scchc.org
MA-004999,Community Health Center of Cape Cod - Bourne,"COMMUNITY HEALTH CENTER OF CAPE COD, INC.",1710136999,"Dental Providers, Federally Qualified Health Centers - Medical Services",123 Waterhouse Rd,Suite 1,Bourne,MA,02532-3890,Barnstable,107 Commercial St,,Mashpee,MA,02649-6507,Barnstable,Karen L Gardner,CEO,508-477-7090,,kgardner@chcofcapecod.org,,,,,,www.chcofcapecod.org
MA-005000,Franciscan Children's,Franciscan Children's,1174542013,"Dental Providers, Outpatient Hospital Clinics",30 Warren St,,Brighton,MA,02135-3602,Suffolk,Jennifer Atlas,30 Warren Street,Brighton,MA,02135,Suffolk,Jennifer Atlas,Strategic Project Manager,617-779-1125,,jatlas@franciscanchildrens.org,,,,,,
MA-005001,Charles River Community Health,"Charles River Community Health, Inc.",1487664884,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",495 Western Ave,,Brighton,MA,02135-1007,Suffolk,495 Western Ave,,Brighton,MA,02135,Suffolk,Elizabeth Browne,Executive Director,617-208-1511,,ebrowne@charlesriverhealth.org,Kathy Kates,Family Planning Coordinator,,,,www.charlesriverhealth.org
MA-005002,Brockton Family Planning,"Health Imperatives, Inc Massachusetts",1760526420,Family Planning Providers,111 Torrey St,,Brockton,MA,02301-4800,Plymouth,111 Torrey St,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005003,BNHC At Vicente's,"BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.",1497148407,Federally Qualified Health Centers - Medical Services,158 Pleasant St,,Brockton,MA,02301-3842,Plymouth,63 Main St,,Brockton,MA,02301-4042,Plymouth,Melvin E. Benson,CFO,508-894-3642,,bensonm@bnhc.org,Susan G. Joss,CEO,508-894-3203,,josss@bnhc.org,www.bnhc.org
MA-005004,BNHC Main Spring House,"BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.",1548663875,Federally Qualified Health Centers - Medical Services,54 N Main St,,Brockton,MA,02301-3907,Plymouth,63 main Street,,Brockton,MA,02301-4042,Plymouth,Melvin E. Benson,CFO,508-894-3642,,bensonm@bnhc.org,Susan G. Joss,CEO,508-894-3203,,josss@bnhc.org,bnhc.org
MA-005005,Brockton Neighborhood Health Center--Main Site,Brockton Neighborhood Health Center,1225085319,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",63 Main St,,Brockton,MA,02301-4042,Plymouth,63 Main St,,Brockton,MA,02301-4042,Plymouth,Susan Joss,CEO,508-894-3203,,josss@bnhc.org,Melvin Benson,CFO,508-894-3642,,bensonm@bnhc.org,bnhc.org
MA-005006,CHA Birth Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",10 Camelia Ave,,Cambridge,MA,02139-1008,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005007,CHA Windsor Street Health Center,Cambridge Health Alliance,1306908405,"Dental Providers, Family Planning Providers, Outpatient Hospital Clinics",119 Windsor St,,Cambridge,MA,02139-3648,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005008,Cambridge Pediatrics,Cambridge Health Alliance,1487603585,Family Planning Providers,1493 Cambridge St,,Cambridge,MA,02139-1099,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,www.challiance.org
MA-005009,CHA East Cambridge Health Center,Cambridge Health Alliance Family Planning Program,1306908405,"Family Planning Providers, Outpatient Hospital Clinics",163 Gore St,,Cambridge,MA,02141-1119,Middlesex,1493 CAMBRIDGE ST,,CAMBRIDGE,MA,02139,Middlesex,GLOVER TAYLOR,Clinic Director,617-806-8701,8701,gtaylor@challiance.org,JILL BATTY,Chief Financial Officer,781-338-0301,301,JBATTY@CHALLIANCE.ORG,http://www.challiance.org/Main/Home.aspx
MA-005010,CHA Cambridge Family Health North,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",2067 Massachusetts Ave,Suite 20,Cambridge,MA,02140-1339,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005011,CHA Cambridge Family Health,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",237 Hampshire St,,Cambridge,MA,02139-1306,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005012,CHA Teen Health Center,Cambridge Health Alliance,1487603585,Family Planning Providers,459 Broadway,,Cambridge,MA,02138-4125,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005013,MGH Chelsea Pediatric & Adolescent Medicine,"Action for Boston Community Development, Inc., Boston Family Planning",1386839629,Family Planning Providers,151 Everett Ave,,Chelsea,MA,02150-1812,Suffolk,151 Everett Ave,,Chelsea,MA,02150-1812,Suffolk,Ming Sun,Clinic Administrator,781-485-6477,,msun@partners.org,,,,,,
MA-005014,Chicopee Health Center,Holyoke Health Center Inc,1518948595,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",505 Front St,,Chicopee,MA,01013-3140,Hampden,230 Maple Street,,Holyoke,MA,01040,Hampden,Jay Breines,CEO,413-420-2110,,jay.breines@hhcinc.org,Ann Poole,Director of Development,413-420-2127,,Ann.Poole@hhcinc.org,www.hhcinc.org
MA-005015,Geiger Gibson Community Health Center,"Harbor Health Services, Inc.",1659330496,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",250 Mount Vernon St,,Dorchester,MA,02125-3120,Suffolk,1135 Morton St.,,Mattapan,MA,02126-2834,Suffolk,Dan Driscoll,CEO,617-533-2300,,ddriscoll@hhsi.us,Paulette Shaw Querner,VP/Community Health Centers,617-533-2300,,pquerner@hhsi.us,www.hhsi.us
MA-005016,Neponset Health Center,"Harbor Health Services, Inc.",1881692366,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",398 Neponset Ave,,Dorchester,MA,02122-3134,Suffolk,1135 Morton St.,,Mattapan,MA,02126,Suffolk,Dan Driscoll,CEO,617-533-2300,,ddriscoll@hhsi.us,Paulette Shaw Querner,VP/Community Health Centers,617-533-2300,,pquerner@hhsi.us,www.hhsi.us
MA-005017,Upham's Corner Health Center,"Upham's Corner Health Committee, INC.",1780780486,Federally Qualified Health Centers - Medical Services,415 Columbia Rd,,Dorchester,MA,02125-2424,Suffolk,500 Columbia RD,,Dorchester,MA,02125,Suffolk,Jagdeep Trivedi,Executive Director/CEO,617-287-8000,8133,JTrivedi@uphams.org,Samantha Taylor,"Operations Manager, Division I",617-740-8128,,STaylor3@uphams.org,
MA-005018,Upham's Corner Health Center,Upham's Corner Health Center,1780780486,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",500 Columbia Rd,,Dorchester,MA,02125-2322,Suffolk,500 Columbia RD,,Dorchester,MA,02125,Suffolk,Jagdeep Trivedi,Executive Director/CEO,617-287-8000,8133,JTrivedi@uphams.org,Judy Welsh,"Operations Manager, Division 4",617-287-0786,8511,JWelsh@uphams.org,
MA-005019,"Harvard Street Neighborhood Health Center, Inc.",HARVARD STREET NEIGHBORHOOD HEALTH CENTER INC,1902954449,"Dental Providers, Federally Qualified Health Centers - Medical Services",632 Blue Hill Ave,,Dorchester,MA,02121-3293,Suffolk,632 Blue Hill Ave,,Dorchester,MA,02121-3293,Suffolk,Charles A Murphy,"President,CEO",617-825-3400,5510,charley.murphy@harvardstreet.org,Claudia Liranzo,Director of Operations,617-825-3400,5547,claudia.lirazno@harvardstreet.org,www.harvardstreet.org
MA-005020,Upham's Eye and Dental Clinic,"Upham's Corner Health Committee, INC.",1780780486,"Dental Providers, Federally Qualified Health Centers - Medical Services",636 Columbia Rd,,Dorchester,MA,02125-3416,Suffolk,500 Columbia RD,,Dorchester,MA,02125,Suffolk,Jagdeep Trivedi,Executive Director/CEO,617-287-8000,8133,JTrivedi@uphams.org,Judy Welsh,"Operation Manager, Division 4",617-825-9839,,JWelsh@uphams.org,
MA-005021,Codman Square Health Center,Codman Square Health Center,1396808309,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",637 Washington St,,Dorchester,MA,02124-3510,Suffolk,Codman Square Health Center,637 Washington Street,Dorchester,MA,02124-3510,Suffolk,Tarsha Weaver,Chief Operating Officer,617-822-8744,,Tarsha.Weaver@codman.org,Trudy Griffin,Credentialing Cordinator,617-822-8382,,Trudy.Griffin@codman.org,www.codman.org
MA-005022,Harvard Street Neighborhood Health Center,HARVARD STREET NEIGHBORHOOD HEALTH CENTER INC,1902954449,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",895 Blue Hill Ave,,Dorchester,MA,02124-2902,Suffolk,632 Blue Hill Ave,,Dorchester,MA,02121-3293,Suffolk,Charley A Murphy,"President,CEO",617-822-5510,,Charley.Murphy@harvardstreet.org,Claudia Liranzo,Director of Operations,617-825-3400,5547,claudia.liranzo@harvardstreet.org,www.harvardstreet.org
MA-005023,East Boston Neighborhood Health Center,East Boston Neighborhood Health Center,1316994411,"Dental Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Ryan White Providers",10 Gove St,,East Boston,MA,02128-1920,Suffolk,10 Gove Street,,East Boston,MA,02128,Suffolk,James Hazard,Chief Financial Officer,617-568-7244,,hazardj@ebnhc.org,,,,,,www.ebnhc.org
MA-005024,Island Health Care,Island Health Inc.,1316077464,Federally Qualified Health Centers - Medical Services,245 Vineyard Haven Edgartown Rd,,Edgartown,MA,02539,Dukes,PO Box 1619,,West Tisbury,MA,02575,Dukes,Cynthia Mitchell,Chief Executive Officer,508-627-5797,110,cmitchell@vineyard.net,Maryellen Nixon,Billing Manager,508-627-5797,112,mnixon@ihimv.org,www.ihimv.org
MA-005025,CHA Everett Teen Health Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",100 Elm St,,Everett,MA,02149-5128,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005026,CHA Whidden Hospital (family planning providers),Cambridge Health Alliance,1487603585,Family Planning Providers,103 Garland St,,Everett,MA,02149-5066,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005027,CHA Whidden Hospital (inpatient hospital),Cambridge Health Alliance,1487603585,Inpatient Hospitals (other than children's hospitals),103 Garland St,,Everett,MA,02149-5066,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005028,MGH Everett Family Care,The General Hospital Corporation,1982731006,Other ECP Providers,19 Norwood St,,Everett,MA,02149-2709,Middlesex,55 Fruit Street,,Boston,MA,02114,Suffolk,"Ann-Marie Duffy-Keane, MPH","Director, MGH Community Health Associates",781-485-6135,,aduffy@partners.org,,,,,,
MA-005029,CHA Anna May Powers Health Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",20 Nichols St,,Everett,MA,02149,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005030,CHA Everett Family Health Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",391 Broadway,,Everett,MA,02149-3470,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005031,CHA Whidden Women's Health,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",96 Garland St,,Everett,MA,02149-5067,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005032,Southcoast Center for Cancer Care in Fairhaven,Southcoast Health System,1447275037,Freestanding Cancer Centers,206 Mill Rd,,Fairhaven,MA,02719-5208,Bristol,363 Highland Ave.,,Fall River,MA,02720,Bristol,Keith Hovan,President and CEO,508-973-7013,,hovank@southcoast.org,Stephen Canessa,"Vice President, Marketing, Government Affairs, and Planning",508-973-5899,,canessas@southcoast.org,
MA-005033,SSTAR's South End Services,"HEALTHFIRST FAMILY CARE CENTER, INC.",1902176449,Federally Qualified Health Centers - Medical Services,1004 S Main St,,Fall River,MA,02724-2820,Bristol,387 Quarry St Ste 100,,Fall River,MA,02723-1026,Bristol,Julie M Almond,CEO,774-627-1205,,almondj@healthfirstfr.org,Tim Comeaux,Clinical Manager,508-324-3569,,tcomeaux@SSTAR.ORG,http://www.healthfirstfr.org
MA-005034,Citizens for Citizens Inc / Family Planning,Citizens for Citizens Inc / Family Planning,1295870673,Family Planning Providers,337 Hanover St,,Fall River,MA,02720-5421,Bristol,264 GRIFFIN ST,,Fall River,MA,02724,Bristol,Lynda A Sampson,Clinic Director,508-675-2882,,famplan@aol.com,,,,,,http://www.cfcinc.orgfp
MA-005035,Charlton Memorial Hospital,Southcoast Health System,1306871223,Inpatient Hospitals (other than children's hospitals),363 Highland Ave,,Fall River,MA,02720-3703,Bristol,363 Highland Ave.,,Fall River,MA,02720,Bristol,Keith Hovan,President and CEO,508-973-7013,,hovank@southcoast.org,Stephen Canessa,"Vice President, Marketing, Government Affairs, Planning",508-973-5899,,canessas@southcoast.org,
MA-005036,HealthFirst Family Care Center Inc.,"HEALTHFIRST FAMILY CARE CENTER, INC.",1962435933,"Dental Providers, Federally Qualified Health Centers - Medical Services",387 Quarry St,,Fall River,MA,02723-1025,Bristol,387 Quarry St Ste 100,,Fall River,MA,02723-1007,Bristol,Julie M Almond,CEO,774-627-1205,,almondj@healthfirstfr.org,,,,,,http://www.healthfirstfr.org
MA-005037,STANLEY ST TREATMENT & RESOURCES,"HEALTHFIRST FAMILY CARE CENTER, INC.",1063438133,Federally Qualified Health Centers - Medical Services,400 Stanley St,,Fall River,MA,02720-6009,Bristol,387 Quarry St Ste 100,,Fall River,MA,02723-1007,Bristol,Julie M Almond,CEO,774-627-1205,,almondj@healthfirstfr.org,Tim Comeaux,Clinic Manager,508-324-3569,,tcomeaux@SSTAR.ORG,http://www.healthfirstfr.org
MA-005038,Southcoast Center for Cancer Care in Fall River,Southcoast Health System,1447275037,Freestanding Cancer Centers,506 Prospect St,,Fall River,MA,02720-5239,Bristol,363 Highland Ave,,Fall River,MA,02720,Bristol,Keith Hovan,President and CEO,508-973-7013,,hovank@southcoast.org,Stephen Canessa,"Vice President, Marketing, Government Affairs, Planning",508-973-5899,,canessas@southcoast.org,
MA-005039,Community Health Center of Cape Cod - Falmouth,"COMMUNITY HEALTH CENTER OF CAPE COD, INC.",1285836080,"Dental Providers, Federally Qualified Health Centers - Medical Services",210 Jones Rd,,Falmouth,MA,02540-2974,Barnstable,107 Commercial St,,Mashpee,MA,02649-6507,Barnstable,Karen L Gardner,CEO,508-477-7090,,kgardner@chcofcapecod.org,Melonie Kelly,Director of Clinical Services,508-540-2949,,,http://www.cfcofcapecod.org
MA-005040,HealthAlliance Hospitals,HealthAlliance Hospitals,1013995133,Inpatient Hospitals (other than children's hospitals),275 Nichols Rd,,Fitchburg,MA,01420-1919,Worcester,Managed Care Department,306 Belmont Street,Worcester,MA,01604,Worcester,Lynn LeVecque,"Senior Director, Government Revenue",508-334-0569,,lynn.levecque@umassmemorial.org,,,,,,http://www.umassmemorialhealthcare.org/healthalliance-hospital
MA-005041,Community Health Connections Fitchburg Health Center,"COMMUNITY HEALTH CONNECTIONS, INC.",1477580827,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",326 Nichols Rd,Suite 11,Fitchburg,MA,01420-1914,Worcester,326 Nichols Rd,,Fitchburg,MA,01420-1914,Worcester,John DeMalia,CEO,978-878-8510,,jdemalia@chcfhc.org,Patrick Lavelle,CFO,978-878-8556,,plavelle@chcfhc.org,www.chcfhc.org
MA-005042,Fitchburg Health Center,Planned Parenthood League of Massachusetts,1821095779,"Family Planning Providers, Sexually Transmitted Disease Clinics",391 Main St,,Fitchburg,MA,01420-8006,Worcester,1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,Jordina Shanks,COO,617-616-1646,,jshanks@pplm.org,Jennifer Childs-Roshak,CEO,617-616-1651,,jchildsroshak@pplm.org,http://www.plannedparenthood.org/ma/
MA-005043,EMKCHC/Framingham Dental,Edward M Kennedy Community Health Center,1154600344,Dental Providers,32 Concord St,,Framingham,MA,01702-8302,Middlesex,650 Lincoln Street,,Worcester,MA,01605,Worcester,Antonia McGuire,President and CEO,508-854-2122,7311,toni.mcguire@kennedychc.org,Maria Coppenrath,Chief Financial Officer,508-854-2122,7324,maria.coppenrath@kennedychc.org,www.kennedychc.org
MA-005044,EMKCHC/Framigham/Waverly St,Edward M Kennedy Community Health Center,1154600344,Federally Qualified Health Centers - Medical Services,354 Waverly St,,Framingham,MA,01702-7079,Middlesex,650 Lincoln Street,,Worcester,MA,01605,Worcester,Antonia McGuire,President and CEO,508-854-2122,7311,toni.mcguire@kennedychc.org,Maria Coppenrath,Chief Financial Officer,508-854-2122,7324,maria.coppenrath@kennedychc.org,www.kennedychc.org
MA-005045,GREATER GARDNER COMMUNITY HEALTH CENTER,"COMMUNITY HEALTH CONNECTIONS, INC.",1285630533,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",175 Connors St,,Gardner,MA,01440-2637,Worcester,326 Nichols Rd,,Fitchburg,MA,01420-1914,Worcester,John DeMalia,CEO,978-878-8510,,jdemalia@chcfhc.org,Patrick Lavelle,CFO,978-878-8556,,plavelle@chcfhc.org,www.chcfhc.org
MA-005046,Gloucester Family Health Center,North Shore Community Health,1366582090,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",302 Washington St,,Gloucester,MA,01930-4836,Essex,27 Congress Stree,Suite 504,Salem,MA,01970-7308,Essex,Margaret A Brennan,CEO,978-825-1109,,margaret.brennan@nschi.org,,,,,,
MA-005047,FAIRVIEW HOSPITAL,"Berkshire Health Systems, Inc.",1730112251,Inpatient Hospitals (other than children's hospitals),29 Lewis Ave,,Great Barrington,MA,01230-1713,Berkshire,725 North Street,,Pittsfield,MA,01201,Berkshire,Darlene Rodowicz,Chief Financial Officer,413-447-2809,,drodowicz@bhs1.org,"Anthony Rinaldi, Jr.",Executive Vice President,413-528-9646,,AnthonyR@bhs1.org,
MA-005048,CHP DENTAL CENTER,"COMMUNITY HEALTH PROGRAMS, INCORPORATED",1912272899,Dental Providers,343 Main St,Suite 1,Great Barrington,MA,01230-1817,Berkshire,444 Stockbridge Road,,Great Barrington,MA,01230,Berkshire,Philip B Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,CommunityHealthPrograms.org
MA-005049,CHP Health Center,"COMMUNITY HEALTH PROGRAMS, INCORPORATED",1013953009,Federally Qualified Health Centers - Medical Services,444 Stockbridge Rd,,Great Barrington,MA,01230-1295,Berkshire,444 Stockbridge Rd,,Great Barrington,MA,01230-1295,Berkshire,Philip B Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,communityHealthprograms.org
MA-005050,BARRINGTON OB-GYN,"COMMUNITY HEALTH PROGRAMS, INCORPORATED",1447488358,Federally Qualified Health Centers - Medical Services,780 Main St,,Great Barrington,MA,01230-2148,Berkshire,444 Stockbridge Rd,,Great Barrington,MA,01230-1295,Berkshire,Philip B Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,CommunityHealthPrograms.org
MA-005051,Tapestry Health Greenfield,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",278 Main St,Suite 307,Greenfield,MA,01301-3230,Franklin,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Alyssa Valbona,Health Services Manager,413-773-5403,,avalbona@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005052,Community Health Center of Franklin County-Main Site,COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY,1033458203,"Dental Providers, Federally Qualified Health Centers - Medical Services",489 Bernardston Rd,Suite 108,Greenfield,MA,01301-1239,Franklin,489 Bernardston Rd Ste 108,,Greenfield,MA,01301-1239,Franklin,Edward J Sayer,CEO,413-325-8500,108,edward.sayer@chcfc.org,,,,,,www.chcfc.org
MA-005053,Harwich Health Center,Outer Cape Health Services,1255629747,Federally Qualified Health Centers - Medical Services,269 Chatham Rd,,Harwich,MA,02645-3309,Barnstable,P.O. Box 598,710 Route 28,Harwich Port,MA,02646,Barnstable,Andy Lowe,Chief Strategy Officer,508-905-2800,2217,alowe@outercape.org,Jayne Lowe,Director of Revenue Cycle,508-905-2800,2211,jlowe@outercape.org,outercape.org
MA-005054,Ellen Jones Community Dental Center,"Harbor Health Services, Inc.",1881715332,Dental Providers,351 Pleasant Lake Ave,,Harwich,MA,02645-1813,Barnstable,1135 Morton St.,,Mattapan,MA,02126,Suffolk,Dan Driscoll,CEO,617-533-2300,,ddriscoll@hhsi.us,Paulette Shaw Querner,VP/Community Health Centers,617-533-2300,,pquerner@hhsi.us,www.hhsi.us
MA-005055,Health Quarters: Haverhill Office,"HealthQuarters, Inc.",1154459618,Family Planning Providers,215 Summer St,Suite 16,Haverhill,MA,01830-6305,Essex,100 Cummings Center,Suite 220B,Beverly,MA,01915,Essex,Denise McIntosh,Regional Manager,978-522-5605,,denisem@healthq.org,Renee LaForce,Director of Programs,978-522-5609,,reneel@healthq.org,
MA-005056,Holyoke Health Center,"Holyoke Health Center, Inc.",1740271022,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",230 Maple St,Suite 1,Holyoke,MA,01040-5143,Hampden,230 Maple Street,,Holyoke,MA,01040,Hampden,Jay Breines,CEO,413-420-2110,,jay.breines@hhcinc.org,Michael Germani,CFO,413-420-2122,,michael.germani@hhcinc.org,www.hhcinc.org
MA-005057,Tapestry Health Holyoke,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",306 Race St,,Holyoke,MA,01040-5720,Hampden,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Cindy Miller,Health Services Manager,413-536-8777,,cmiller@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005058,Hyannis Family Planning,"Health Imperatives, Inc Massachusetts",1144364811,Family Planning Providers,1019 Iyannough Rd,Suite 7,Hyannis,MA,02601-1839,Barnstable,1019 Iyanough,,Hyannis,MA,02601,Barnstable,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005059,Harbor Community Health Center - Hyannis,"Harbor Health Services, Inc.",1376502070,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",735 Attucks Ln,,Hyannis,MA,02601-1867,Barnstable,1135 Morton St.,,Mattapan,MA,02126-2834,Suffolk,Dan Driscoll,CEO,617-533-2300,,ddriscoll@hhsi.us,Paulette Shaw Querner,VP/Community Health Centers,617-533-2300,,pquerner@hhsi.us,www.hhsi.us
MA-005060,Duffy Health Center,Duffy Health Center,1588616742,Federally Qualified Health Centers - Medical Services,94 Main St,,Hyannis,MA,02601-3147,Barnstable,94 Main Street,,Hyannis,MA,02601,Barnstable,David Burke,CFO,508-771-7517,102,dburke@duffyhealthcenter.org,Deb Naklicki,Billing Manager,508-771-9599,,dnaklicki@duffyhealthcenter.org,www.duffyhealthcenter.org
MA-005061,Lawrence General,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 General St # 4,,Lawrence,MA,01841-2961,Essex,1 Griffin Brook Dr.,SUITE 209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Director,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President of External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005062,North Clinical Site,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",150 Park St,,Lawrence,MA,01841-2517,Essex,1 Griffin Brook Park Dr.,SUITE 209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Director,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005063,Health Quarters: Lawrence Office,"HealthQuarters, Inc.",1154459618,Family Planning Providers,280 Merrimack St,Suite 501,Lawrence,MA,01843-1779,Essex,100 Cummings Center,Suite 220B,Beverly,MA,01915,Essex,Denise McIntosh,Regional Manager,978-552-5605,,denisem@healthq.org,Renee LaForce,Director of Programs,978-522-5609,,reneel@healthq.org,
MA-005064,Haverhill St.,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",34 Haverhill St,,Lawrence,MA,01841-2884,Essex,1 Griffin Brook Drive,SUITE 209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Manager,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President of External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005065,West Clinical Site,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",700 Essex St,,Lawrence,MA,01841-4396,Essex,1 Griffin Brook Drive,SUITE 209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Director,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President of External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005066,South Clinical Site,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",73D Winthrop Ave,,Lawrence,MA,01843-3716,Essex,1 Griffin Brook Dr.,SUITE 209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Director,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President of External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005067,CHP Lee Family Practice,"COMMUNITY HEALTH PROGRAMS, INCORPORATED",1689945784,Federally Qualified Health Centers - Medical Services,11 Quarry Hill Rd,,Lee,MA,01238-9645,Berkshire,444 Stockbridge Rd,,Great Barrington,MA,01230-1295,Berkshire,Philip B Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,communityhealthprograms.org
MA-005068,LEOMINSTER COMMUNITY HEALTH CENTER,"COMMUNITY HEALTH CONNECTIONS, INC.",1891953048,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",14 Manning Ave,,Leominster,MA,01453-5768,Worcester,326 Nichols Rd,,Fitchburg,MA,01420-1914,Worcester,John DeMalia,CEO,978-878-8510,,jdemalia@chcfhc.org,Patrick Lavelle,CFO,978-878-8556,,plavelle@chcfhc.org,www.chcfhc.org
MA-005069,METTA HEALTH CENTER,"LOWELL COMMUNITY HEALTH CENTER, INC.",1952307530,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",135 Jackson St,,Lowell,MA,01852-2103,Middlesex,161 Jackson St,,Lowell,MA,01852-2103,Middlesex,Dorcas C Grigg-Saito,CEO,978-746-7851,,dorcasgr@lchealth.org,Robert Ebersole,CFO,978-322-8596,,roberteb@lchealth.org,
MA-005070,Lowell Community Health Center,Lowell Community Health Center,1952307530,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",161 Jackson St,,Lowell,MA,01852-2103,Middlesex,161 Jackson St,,Lowell,MA,01852-2103,Middlesex,Dorcas C Grigg-Saito,CEO,978-746-7851,,dorcasgr@lchealth.org,Robert Ebersole,CFO,978-322-8596,,roberteb@lchealth.org,http://www.lchealth.org
MA-005071,"Lowell Community Health Center, Inc.","LOWELL COMMUNITY HEALTH CENTER, INC.",1952307530,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",50 Father Morissette Blvd,LOWELL HIGH SCHOOL HEALTH CTR,Lowell,MA,01852-1037,Middlesex,161 Jackson St,,Lowell,MA,01852-2103,Middlesex,Dorcas C Grigg-Saito,CEO,978-746-7851,,dorcasgr@lchealth.org,Robert Ebersole,CFO,978-322-8596,,roberteb@lchealth.org,
MA-005072,"LOWELL COMMUNITY HEALTH CENTER, INC.","LOWELL COMMUNITY HEALTH CENTER, INC.",1952307530,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",560 Broadway St,Kathyrn P. Stoklosa Middle School,Lowell,MA,01854-3305,Middlesex,161 Jackson St,,Lowell,MA,01852-2103,Middlesex,Dorcas C Grigg-Saito,CEO,978-746-7851,,dorcasgr@lchealth.org,Robert Ebersole,CFO,978-322-8596,,roberteb@lchealth.org,https://www.lchealth.org/patients/connect-services/adolescent-health-services/school-based-health-centers
MA-005073,Lynn Community Health Center Satellite,Lynn Community Health Center,1013997691,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",20 Central Ave,,Lynn,MA,01901-1201,Essex,269 Union Street,,Lynn,MA,01901,Essex,Lori Abrams Berry,Executive Director,781-596-2502,2702,lberry@lchcnet.org,Kim MacLeod,CFO,781-596-2502,2709,kimm@lchcnet.org,
MA-005074,Lynn Community Health Center,Lynn Community Health Center,1013997691,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",269 Union St,,Lynn,MA,01901-1314,Essex,269 Union Street,,Lynn,MA,01901-1314,Essex,Lori Abrams Berry,Executive Director,781-596-2502,2707,lberry@lchcnet.org,Kim MacLeod,CFO,781-596-2502,2709,kimm@lchcnet.org,
MA-005075,Lynn Community Health Center - Primary Care and Behavioral Health Services,Lynn Community Health Center,1013997691,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",280 Union St,,Lynn,MA,01901-1353,Essex,269 Union Street,,Lynn,MA,01901,Essex,Lori Abrams Berry,Executive Director,781-596-2502,2707,lberry@lchcnet.org,Kim MacLeod,CFO,781-596-2502,2709,kimm@lchcnet.org,
MA-005076,Market Square Family Health Services,Lynn Community Health Center,1013997691,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",29 Market St,,Lynn,MA,01901-1004,Essex,269 Union Street,,Lynn,MA,01901,Essex,Lori Abrams Berry,Executive Director,781-596-2502,2707,lberry@lchcnet.org,Kim MacLeod,CFO,781-596-2502,2709,kimm@lchcnet.org,
MA-005077,Market Square Family Health Services at Western Avenue,Lynn Community Health Center,1013997691,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",694 Western Ave,,Lynn,MA,01905-2229,Essex,269 Union Street,,Lynn,MA,01901,Essex,Lori Abrams Berry,Executive Director,781-596-2502,2707,lberry@lchcnet.org,Kim MacLeod,CFO,781-596-2502,2709,kimm@lchcnet.org,
MA-005078,CHA Malden Family Medicine,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",195 Canal St,,Malden,MA,02148-6701,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005079,Marlborough,Planned Parenthood League of Massachusetts,1821095779,"Family Planning Providers, Sexually Transmitted Disease Clinics",91 Main St,Suite 103,Marlborough,MA,01752-3845,Middlesex,1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,Jordina Shanks,COO,617-616-1646,,jshanks@pplm.org,Jennifer Childs-Roshak,CEO,617-616-1651,,jchildsroshak@pplm.org,http://www.plannedparenthood.org/ma/
MA-005080,"Community Health Center of Cape Cod, Mashpee","COMMUNITY HEALTH CENTER OF CAPE COD, INC.",1821193145,"Dental Providers, Federally Qualified Health Centers - Medical Services",107 Commercial St,,Mashpee,MA,02649-6507,Barnstable,107 Commercial St,,Mashpee,MA,02649-6507,Barnstable,Karen L Gardner,CEO,508-477-7090,,kgardner@chcofcapecod.org,,,,,,www.chcofcapecod.org
MA-005081,Mashpee Service Unit-Indian Health Service,Indian Health Service,1992001457,"Dental Providers, Indian Health Service, Other ECP Providers",483B Great Neck Rd S,,Mashpee,MA,02649-3707,Barnstable,483 B Great Neck Rd South,,Mashpee,MA,02649,Barnstable,Rita Gonsalves,CEO,508-477-6967,6913,rita.gonsalves@ihs.gov,Lorraine Reels Pearson,Supervisory Health System Specialist,508-477-6967,6916,lorraine.reels@ihs.gov,
MA-005082,Mattapan Community Health Center,Mattapan Community Health Center,1639240393,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1575 Blue Hill Ave,,Mattapan,MA,02126-2122,Suffolk,1575 Blue Hill Ave,,Mattapan,MA,02126,Suffolk,"Tarma Johnson, FNP",Director of Clininal Health Services/FNP,617-898-9057,,johnsont@matchc.org,"Azzie Young, PhD",President and CEO,617-898-9020,,younga@matchc.org,www.matchc.org
MA-005083,Methuen Family Health Center,Greater Lawrence Family Health Center,1699774646,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",147 Pelham St,,Methuen,MA,01844-2060,Essex,1 Griffin Brook Dr.,Ste.209,Methuen,MA,01844,Essex,Beth Short,Marketing and Development Director,978-722-2868,,bshort@glfhc.org,Richard J. Napolitano,Senior Vice President of External Relations,978-722-2870,,rnapolitano@glfhc.org,www.glfhc.org
MA-005084,Nantucket Family Planning,"Health Imperatives, Inc Massachusetts",1316081094,Family Planning Providers,20 Vesper Ln,,Nantucket,MA,02554-4394,Nantucket,942 West Chestnut St,,Brockton,MA,02031,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jesica Cisternelli,Director od Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005085,St. Luke's Hospital,Southcoast Health System,1447275037,Inpatient Hospitals (other than children's hospitals),101 Page St,,New Bedford,MA,02740-3464,Bristol,363 Highland Avenue,,Fall River,MA,02720,Bristol,Keith Hovan,President and CEO,508-973-7013,,hovank@southcoast.org,Stephen Canessa,"Vice President, Marketing, Government Affairs, Planning",508-973-5899,,canessas@southcoast.org,
MA-005086,New Bedford Family Planning,"Health Imperatives, Inc Massachusetts",1013051614,Family Planning Providers,651 Orchard St,,New Bedford,MA,02744-1008,Bristol,942 West Chestnut street,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005087,Greater New Bedford Community Health Center,Greater New Bedford Community Health Center,1982607537,"Dental Providers, Federally Qualified Health Centers - Medical Services",874 Purchase St,,New Bedford,MA,02740-6232,Bristol,874 Purchase Street,,New Bedford,MA,02740,Bristol,Jillian O'Connor,CFO,508-992-6553,241,Joconnor@gnbchc.org,Dawn Johnson,Executive Secretary,508-984-8401,219,djohnson@gnbchc.org,www.gnbchc.org
MA-005088,Tapestry Health North Adams,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",289 Church St,,North Adams,MA,01247-4154,Berkshire,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Katrina Mattson,Health Services Manager,413-443-2844,,kmattson@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005089,CHP North Adams Family Medicine,"Community Health Programs, Inc.",1194195206,Federally Qualified Health Centers - Medical Services,71 Hospital Ave # 3,Floor North Wing,North Adams,MA,01247-2504,Berkshire,444 Stockbridge Road,,Great Barrington,MA,01230,Berkshire,Philip B. Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,communityhealthprograms.org
MA-005090,Tapestry Health Northampton,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",16 Center St,Suite 415,Northampton,MA,01060-3031,Hampshire,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Lucy Hartry,Health Services Manager,413-586-2539,,lhartry@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005091,Martha's Vineyard Hospital,"Martha's Vineyard Hospital, Inc.",1134206386,Inpatient Hospitals (other than children's hospitals),1 Hospital Rd,,Oak Bluffs,MA,02557,Dukes,P.O. Box 1477,,Oak Bluffs,MA,02557,Dukes,Edward J. Olivier,CFO,508-957-9555,,eolivier@partners.org,,,,,,mvhospital.com
MA-005092,"Community Health Center of Franklin County, Inc. - Orange Site",COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY,1033458203,"Dental Providers, Federally Qualified Health Centers - Medical Services",450 W River St,,Orange,MA,01364-1435,Franklin,489 Bernardston Rd Ste 108,,Greenfield,MA,01301-1239,Franklin,Edward J Sayer,CEO,413-325-8500,108,edward.sayer@chcfc.org,,,,,,www.chcfc.org
MA-005093,North Shore Community Health,North Shore Community Health,1366582090,"Community Mental Health Centers, Family Planning Providers",485 Lowell St,Peabody Veteran Memorial High School Student Health Center,Peabody,MA,01960-1329,Essex,27 Congress Street,Suite 504,Salem,MA,01970-7308,Essex,Margaret A Brennan,CEO,978-825-1109,,margaret.brennan@nschi.org,,,,,,
MA-005094,Peabody Family Health Center,North Shore Community Health,1366582090,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",89 Foster St,,Peabody,MA,01960-8925,Essex,27 Congress Street,Suite 504,Salem,MA,01970-7308,Essex,Margaret A. Brennan,CEO,978-825-1109,,margaret.brennan@nschi.org,,,,,,
MA-005095,Tapestry Health Pittsfield,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",100 Wendell Ave,,Pittsfield,MA,01201-6999,Berkshire,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Katrina Mattson,Health Services Manager,413-443-2844,,kmattson@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005096,CHP Neighborhood Health Center,"COMMUNITY HEALTH PROGRAMS, INCORPORATED",1649408899,Federally Qualified Health Centers - Medical Services,510 North St,,Pittsfield,MA,01201-5493,Berkshire,444 Stockbridge Rd,,Great Barrington,MA,01230-1295,Berkshire,Philip B Morrison,Chief Financial Officer,413-528-9311,1167,pmorrison@chpberkshires.org,Cindy Duryea,Grants Manager,413-528-9311,1168,cduryea@chpberkshires.org,communityhealthprograms.org
MA-005097,BERKSHIRE MEDICAL CENTER INC (dental provider),"Berkshire Health Systems, Inc.",1295765261,Dental Providers,725 North St,,Pittsfield,MA,01201-4124,Berkshire,725 North Street,,Pittsfield,MA,01201,Berkshire,Darlene Rodowicz,Chief Financial Officer,413-447-2809,,drodowicz@bhs1.org,,,,,,
MA-005098,BERKSHIRE MEDICAL CENTER INC (inpatient hospital),"Berkshire Health Systems, Inc.",1295765261,Inpatient Hospitals (other than children's hospitals),725 North St,,Pittsfield,MA,01201-4124,Berkshire,725 North Street,,Pittsfield,MA,01201,Berkshire,Darlene Rodowicz,Chief Financial Officer,413-447-2809,,drodowicz@bhs1.org,,,,,,
MA-005099,Harbor Community Health Center - Plymouth,"Harbor Health Services, Inc.",1568892859,"Dental Providers, Federally Qualified Health Centers - Medical Services",10 Cordage Park Cir,Suite 115,Plymouth,MA,02360-7318,Plymouth,1135 Morton St.,,Mattapan,MA,02126-2834,Suffolk,Dan Driscoll,CEO,617-533-2300,,ddriscoll@hhsi.us,Paulette Shaw Querner,VP/Community Health Centers,617-533-2300,,pquerner@hhsi.us,www.hhsi.us
MA-005100,Plymouth Family Planning,"Health Imperatives, Inc Massachusetts",1861536906,Family Planning Providers,123 Camelot Dr,Suite 1,Plymouth,MA,02360-3038,Plymouth,942 West Chestnut street,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,"Director, Reproductive Health Services",508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005101,Provincetown Health Center,Outer Cape Health Services,1841384013,"Dental Providers, Federally Qualified Health Centers - Medical Services",49 Harry Kemp Way,,Provincetown,MA,02657-1618,Barnstable,P.O. Box 598,710 Route 28,Harwich Port,MA,02646,Barnstable,Andy Lowe,Chief Strategy Officer,508-905-2800,2217,alowe@outercape.org,Jayne Lowe,Director of Revenue Cycle,508-905-2800,2211,jlowe@outercape.org,outercape.org
MA-005102,South Cove Community Health Center - 435 Hancock St,South Cove Community Health Center,1700801263,Federally Qualified Health Centers - Medical Services,435 Hancock St,,Quincy,MA,02171-2428,Norfolk,145 South Street,,Boston,MA,02111,Norfolk,Eugene Welch,Executive Director,617-521-6703,6703,ewelch@scchc.org,,,,,,www.scchc.org
MA-005103,South Cove Community Health Center - 88 Holmes St,South Cove Community Health Center,1700801263,"Dental Providers, Federally Qualified Health Centers - Medical Services",88 Holmes St,,Quincy,MA,02171-2431,Norfolk,145 South Street,,Boston,MA,02111,Suffolk,Eugene Welch,Executive Director,617-521-6703,6703,ewelch@scchc.org,,,,,,www.scchc.org
MA-005104,MGH Adolescent Health Center,"Action for Boston Community Development, Inc., Boston Family Planning",1386839629,Family Planning Providers,300 Broadway,,Revere,MA,02151-5009,Suffolk,300 Broadway,,Revere,MA,02151,Suffolk,Ming Sun,Clinic Administrator,781-485-6477,,msun@partners.org,,,,,,
MA-005105,MGH Revere HealthCare Center,The General Hospital Corporation,1982731006,Other ECP Providers,300 Ocean Ave,,Revere,MA,02151-3675,Suffolk,55 Fruit Street,,Boston,MA,02114,Suffolk,"Ann-Marie Duffy-Keane, MPH","Director, MGH Community Health Associates",781-485-6135,,aduffy@partners.org,,,,,,
MA-005106,MGH Revere HealthCare Center Pediatrics,"Action for Boston Community Development, Inc., Boston Family Planning",1386839629,Family Planning Providers,300 Ocean Ave,,Revere,MA,02151-3675,Suffolk,300 Ocean Avenue,,Revere,MA,02151,Suffolk,Ming Sun,Family Planning Coordinator,781-485-6477,,msun@partners.org,,,,,,http://www.massgeneral.org/revere/contact/
MA-005107,CHA Revere Health Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",454 Broadway,,Revere,MA,02151-3034,Suffolk,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0325,325,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005108,Greater Roslindale Medical and Dental Center,Greater Roslindale Medical and Dental Center,1386718823,"Dental Providers, Family Planning Providers, Other ECP Providers",4199 Washington St,,Roslindale,MA,02131-1752,Suffolk,4199 Washington Street,,Roslindale,MA,02131-1733,Suffolk,Barbara Lottero,Executive Director,617-323-4440,118,Barbara.Lottero@bmc.org,Lysa Thompson,Billing Manager,617-323-4440,117,Lysa.Thompson@bmc.org,www.roslindale.org
MA-005109,Whittier Street Health Center,"Whittier Street Health Center Committee, Inc.",1457397986,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Freestanding Cancer Centers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1290 Tremont St,,Roxbury,MA,02120-3432,Suffolk,1290 TREMONT ST,,ROXBURY,MA,02120,Suffolk,Frederica M. Williams,President and CEO,617-989-3221,,Frederica.Williams@wshc.org,Jim Lee,VP of Finance and CFO,617-989-3230,,jimlee90@gmail.com,www.wshc.org
MA-005110,The Dimock Center,"DIMOCK COMMUNITY HEALTH CENTER, INC.",1326193269,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",40 Dimock St Bldg 3,Cheney Floor,Roxbury,MA,02119-1210,Suffolk,55 Dimock St,,Boston,MA,02119-1029,Suffolk,Peter Gerondeau,CFO,617-442-8800,,pgeronde@dimock.org,,,,,,
MA-005111,Dimock Community Health Center Pediatric and Women's Health Dept.,"Action for Boston Community Development, Inc., Boston Family Planning",1588719488,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",45 Dimock St,,Roxbury,MA,02119-1208,Suffolk,55 Dimock St,,Roxbury,MA,02119-1029,Suffolk,Nandini Sengupta,Clinic Director,617-442-8800,,nsengupta@dimock.org,,,,,,http://dimockcenter.org/news/page/Obstetrics-and-Gynecology-(OBGYN).aspx
MA-005112,Salem Family Health Center,North Shore Community Health,1366582090,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",47 Congress St,,Salem,MA,01970-5590,Essex,27 Congress Street,Suite 504,Salem,MA,01970-7308,Essex,Margaret A Brennan,CEO,978-825-1109,,margaret.brennan@nschi.org,,,,,,
MA-005113,North Shore Community Health,North Shore Community Health,1366582090,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",77 Willson St,Teen Health Center at Salem High School,Salem,MA,01970-2829,Essex,27 Congress Street,Suite 504,Salem,MA,01970-7308,Essex,Margaret A Brennan,CEO,978-925-1109,,margaret.brennan@nschi.org,,,,,,
MA-005114,CHA Somerville Hospital (family planning providers),Cambridge Health Alliance,1487603585,Family Planning Providers,230 Highland Ave,,Somerville,MA,02143-1408,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005115,CHA Somerville Hospital (inpatient hospital),Cambridge Health Alliance,1487603585,Inpatient Hospitals (other than children's hospitals),230 Highland Ave,,Somerville,MA,02143-1408,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005116,CHA Somerville Primary Care,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",236 Highland Ave,,Somerville,MA,02143-1495,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005117,CHA Central Street Health Center,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",26 Central St,,Somerville,MA,02143-2827,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005118,CHA Broadway Health Center (Adult),Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",300 Broadway,,Somerville,MA,02145-2935,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,GTaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005119,CHA Assembly Square,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",5 Middlesex Ave,Suite 102,Somerville,MA,02145-1110,Middlesex,1493 Cambridge St,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,gtaylor@challiance.org,Jill Batty,"SVP, CFO",781-338-0301,301,jbatty@challiance.org,http://challiance.org/Main/Home.aspx
MA-005120,CHA Somerville Teen Connection,Cambridge Health Alliance,1487603585,"Family Planning Providers, Outpatient Hospital Clinics",81 Highland Ave,,Somerville,MA,02143-1740,Middlesex,1493 Cambridge Street,,Cambridge,MA,02139,Middlesex,Glover Taylor,Chief Compliance Officer,617-806-8701,8701,Gtaylor@challiance.org,Jill Batty,CFO,781-338-0301,301,Jbatty@challiance.org,http://www.challiance.org/Main/Home.aspx
MA-005121,SOUTH BOSTON COMMUNITY HEALTH CT,"SOUTH BOSTON COMMUNITY HEALTH CENTER, INC.",1669447413,"Dental Providers, Federally Qualified Health Centers - Medical Services",409 W Broadway,,South Boston,MA,02127-2245,Suffolk,409 W Broadway,409 W Broadway,Boston,MA,02127-2245,Suffolk,William J Halpin,Chief Executive Officer,617-464-7509,7509,wihalpin@sbchc.org,,,,,,WWW.SBCHC.org
MA-005122,Family Health Center-Southbridge,"Family Health Center of Worcester, Inc.",1265858773,Federally Qualified Health Centers - Medical Services,29 Orchard St,,Southbridge,MA,01550-4003,Worcester,26 Queen Street,,Worcester,MA,01610,Worcester,Alyda Justiniano,Mgr. Provider Relations & Credentialing,508-860-7962,,alyda.justiniano@fhcw.org,"Frances M. Anthes, MSW, LICSW",President/CEO,508-860-7995,,frances.anthes@fhcw.org,
MA-005123,Caring Health Center,"Caring Health Center, Inc.",1659476356,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1049 Main St,,Springfield,MA,01103-2114,Hampden,1049 Main Street,,Springfield,MA,01103,Hampden,Jacqueline Johnson,COO,413-693-1016,1016,jjohnson@caringhealth.org,Jasmine Naylor,Executive Vice President,413-693-2171,2171,jnaylor@caringhealth.org,
MA-005124,Tapestry Health Springfield,Tapestry Health,1578664322,"Family Planning Providers, Sexually Transmitted Disease Clinics",1985 Main St,Suite I,Springfield,MA,01103-1016,Hampden,296 Nonotuck St.,,Florence,MA,01062,Hampshire,Cindy Miller,Health Services Manager,413-536-8777,,cmiller@tapestryhealth.org,,,,,,http://www.tapestryhealth.org
MA-005125,Western Massachusetts Health Center,Planned Parenthood League of Massachusetts,1821095779,"Family Planning Providers, Sexually Transmitted Disease Clinics",3550 Main St,Suite 201,Springfield,MA,01107-1078,Hampden,1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,Jordina Shanks,COO,617-616-1646,,jshanks@pplm.org,Jennifer Childs-Roshak,CEO,617-616-1651,,jchildsroshak@pplm.org,http://www.plannedparenthood.org/ma/
MA-005126,SHC - Springfield,Shriners Hospitals for Children,1528195724,Children's Hospitals (inpatient only),516 Carew St,,Springfield,MA,01104-2330,Hampden,516 Carew St.,,Springfield,MA,01104,Hampden,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
MA-005127,OPEN PANTRY TEEN LIVING,"SPRINGFIELD, CITY OF",1962531004,"Dental Providers, Federally Qualified Health Centers - Medical Services",95 Jefferson Ave,,Springfield,MA,01107-2027,Hampden,1145 Main Street Suite 208,,Springfield,MA,01103,Hampden,HELEN R CAULTON-HARRIS,Commissioner of Health,413-787-6456,,hcaulton@springfieldcityhall.com,Linda Franklin,Clinic Administrator,413-750-2067,,lfranklin@springfieldcityhall.com,
MA-005128,Citizens for Citizens / Family Planning,Citizens for Citizens / Family Planning,1528252954,Family Planning Providers,1 Taunton Grn,Suite 1,Taunton,MA,02780-3225,Bristol,264 GRIFFIN ST,,Fall River,MA,02724,Bristol,Lynda Sampson,Clinic Director,508-675-2882,,famplan@aol.com,,,,,,http://www.cfcinc.org/fp
MA-005129,Martha's Vineyard Family Planning,"Health Imperatives, Inc Massachusetts",1093859779,Family Planning Providers,517 State Rd,,Vineyard Haven,MA,02568-5622,Dukes,517 State,,Vineyard Haven,MA,02568,Dukes,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005130,Charles River Community Health,"Action for Boston Community Development, Inc., Boston Family Planning",1750486106,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",564 Main St,,Waltham,MA,02452-5516,Middlesex,564 Main St,,Waltham,MA,02452-5516,Middlesex,Elizabeth Browne,Executive Director,617-208-1511,,ebrowne@charlesriverhealth.org,"Kathy Kates, RN",Family Planning Coordinator,781-693-3800,,,http://www.charlesriverhealth.org/
MA-005131,Wareham Family Planning,"Health Imperatives, Inc Massachusetts",1164566758,Family Planning Providers,106 Main St,,Wareham,MA,02571-2122,Plymouth,942 West Chestnut street,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,http://www.healthimperatives.org/reprohealth
MA-005132,Tobey Hospital,Southcoast Health System,1922024835,Inpatient Hospitals (other than children's hospitals),43 High St,,Wareham,MA,02571-2097,Plymouth,363 Highland Ave,,Fall River,MA,02720,Bristol,Keith Hovan,President and CEO,508-973-7013,,hovank@southcoast.org,Stephen Canessa,"Vice President, Marketing, Government Affairs, Planning",508-973-5899,,canessas@southcoast.org,
MA-005133,Wellfleet Health Center,Outer Cape Health Services,1578726790,Federally Qualified Health Centers - Medical Services,3130 State Hwy Rte 6,,Wellfleet,MA,02667-7402,Barnstable,P.O. Box 598,710 Route 28,Harwich Port,MA,02646,Barnstable,Andy Lowe,Chief Strategy Officer,508-905-2800,2217,alowe@outercape.org,Jayne Lowe,Director of Revenue Cycle,508-905-2800,2211,jlowe@outercape.org,outercape.org
MA-005134,Weymouth Family Planning,"Health Imperatives, Inc Massachusetts",1093859761,Family Planning Providers,210 Winter St,Suite 204,Weymouth,MA,02188-3302,Norfolk,942 West Chestnut street,,Brockton,MA,02301,Plymouth,Emily Gold,"Director, Reproductive Health Services",508-274-6541,,egold@healthimperatives.org,Jessica Cisternelli,Director of Clinic Operations,508-367-1963,,jcisternelli@healthimperatives.org,
MA-005135,Ryan White Program at UMass Memorial Medical Center Memorial Campus,UMass Memorial Medical Center,1831151455,Ryan White Providers,119 Belmont St,,Worcester,MA,01605-2903,Worcester,Managed Care Department,306 Belmont Street,Worcester,MA,01604,Worcester,Lynn LeVecque,"Senior Director, Government Revenue",508-334-0569,,lynn.levecque@umassmemorial.org,,,,,,http://www.umassmemorialhealthcare.org/umass-memorial-medical-center/
MA-005136,EMKCHC-Worcester/Tacoma St.,Edward M Kennedy Community Health Center,1609842152,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",19 Tacoma St,,Worcester,MA,01605-3516,Worcester,650 Lincoln Street,,Worcester,MA,01605,Worcester,Antonia G. McGuire,President and Chief Executive Officer,508-854-2122,7311,toni.mcguire@kennedychc.org,Maria Coppenrath,Chief Financial Officer,508-854-2122,7324,maria.coppenrath@kennedychc.org,www.kennedychc.org
MA-005137,"Family Health Center of Worcester, Inc.","Family Health Center of Worcester, Inc.",1841200664,"Dental Providers, Federally Qualified Health Centers - Medical Services",26 Queen St,,Worcester,MA,01610-2473,Worcester,26 Queen Street,,Worcester,MA,01610-2473,Worcester,Alyda Justiniano,Provider Relations & Credentialing Manager,508-860-7962,7962,alyda.justiniano@fhcw.org,Frances M. Anthes,President/CEO,508-860-7975,,frances.anthes@fhcw.org,
MA-005138,Planned Parenthood - Central MA Health Center,Planned Parenthood League of Massachusetts,1821095779,"Family Planning Providers, Sexually Transmitted Disease Clinics",470 Pleasant St,,Worcester,MA,01609-1823,Worcester,1055 Commonwealth Ave,,Boston,MA,02215-1001,Suffolk,Jordina Shanks,COO,617-616-1646,,jshanks@pplm.org,Jennifer Childs-Roshak,CEO,617-616-1651,,jchildsroshak@pplm.org,http://www.plannedparenthood.org/ma/
MA-005139,New England Hemophilia Treatment Center,"UMass Memorial Medical Center, Inc.",1831151455,Hemophilia Treatment Centers,55 Lake Ave N,,Worcester,MA,01655-0002,Worcester,55 Lake Avenue North,,Worcester,MA,01655,Worcester,Terri Russo,Senior Director,774-442-6890,,Terri.Russo@umassmemorial.org,Doreen Brettler,MD,508-334-6093,,Doreen.Brettler@umassmemorial.org,
MA-005140,UMass Memorial Children's Medical Center,"UMass Memorial Medical Center, Inc.",1831151455,Children's Hospitals (inpatient only),55 Lake Ave N,,Worcester,MA,01655-0002,Worcester,55 Lake Avenue North,,Worcester,MA,01655,Worcester,Lynn LeVecque,"Senior Director, Government Revenue",508-334-0569,,lynn.levecque@umassmemorial.org,,,,,,http://www.umassmemorialhealthcare.org/umass-memorial-medical-center/services-treatments/childrens-medical-center
MA-005141,UMASS MEMORIAL MEDICAL CENTER (inpatient hospital),"UMass Memorial Medical Center, Inc.",1831151455,Inpatient Hospitals (other than children's hospitals),55 Lake Ave N,,Worcester,MA,01655-0002,Worcester,55 Lake Avenue North,,Worcester,MA,01655,Worcester,Lynn LeVecque,"Senior Director, Government Revenue",508-334-0569,,lynn.levecque@umassmemorial.org,,,,,,http://www.umassmemorialhealthcare.org/umass-memorial-medical-center/
MA-005142,UMASS MEMORIAL MEDICAL CENTER (multiple outpatient ECP categories),"UMass Memorial Medical Center, Inc.",1831151455,"Ryan White Providers, Tuberculosis Clinics",55 Lake Ave N,,Worcester,MA,01655-0002,Worcester,55 Lake Avenue North,,Worcester,MA,01655,Worcester,Lynn LeVecque,"Senior Director, Government Revenue",508-334-0569,,lynn.levecque@umassmemorial.org,,,,,,http://www.umassmemorialhealthcare.org/umass-memorial-medical-center/
MA-005143,EMKCHC/Spectrum,Edward M Kennedy Community Health Center,1700152758,Federally Qualified Health Centers - Medical Services,585 Lincoln St,,Worcester,MA,01605-1906,Worcester,650 Lincoln Street,,Worcester,MA,01605,Worcester,Antonia McGuire,President and CEO,508-854-2122,7311,toni.mcguire@kennedychc.org,Maria Coppenrath,Chief Financial Officer,508-854-2122,7324,maria.coppenrath@kennedychc.org,www.kennedychc.org
MA-005144,"Family Health Center of Worcester, Inc at Webster Square","Family Health Center of Worcester, Inc.",1780851600,Federally Qualified Health Centers - Medical Services,645 Park Ave,,Worcester,MA,01603-2034,Worcester,"Family Health Center of Worcester, Inc.",,Worcester,MA,01610,Worcester,Alyda Justiniano,Mgr. Provider Relations & Credentialing,508-860-7962,,alyda.justiniano@fhcw.org,"Frances M Anthes, MSW, LICSW",President/CEO,508-860-7995,,frances.anthes@fhcw.org,
MD-005145,Planned Parenthood at Annapolis,Planned Parenthood of Maryland,1235242082,Family Planning Providers,929 West St,Suite 305,Annapolis,MD,21401-3693,Anne Arundel,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005146,Baltimore Medical System,Baltimore Medical System,1346664562,Federally Qualified Health Centers - Medical Services,100 Kane St,Patterson High School,Baltimore,MD,21224-1726,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-012448,Center for Vascular Medicine,Center for Vascular Medicine,1386935781,Other ECP Providers,1001 Pine Heights Ave,Suite 202,Baltimore,MD,21229-5284,Baltimore City,7474 Greenway Center Drive,Suite 900,Greenbelt,MD,20770,Prince Georges,Richard Kennedy,CEO,954-801-2371,,rick.kennedy@cvm-usa.com,Jai Lakhanpal,Director of Development,310-982-2000,,jai.lakhanpal@cvm-usa.com,www.cvmus.com
MD-012449,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,1001 Pine Heights Ave,Suite 303,Baltimore,MD,21229-5202,Baltimore City,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
MD-005147,Native American Lifelines of Boston and Baltimore,Native American Lifelines of Boston and Baltimore,1679863344,"Dental Providers, Urban Indian Health Program",106 Clay St,,Baltimore,MD,21201-3501,Baltimore City,106 W Clay Street,,Baltimore,MD,21201,Baltimore City,"Kerry Hawk Lessard, MAA",Executive Director,410-837-2258,,kerry@nativelifelines.org,Jess McPherson,Fiscal Manager,410-837-2258,,jess@nativelifelines.org,
MD-005148,Baltimore City Health Department,Baltimore City Health Department,1528423597,Federally Qualified Health Centers - Medical Services,1101 E Fayette St,Baltimore City School-Based Health Centers,Baltimore,MD,21202-4731,Baltimore City,1101 E. Fayette Street,,Baltimore,MD,21202,Baltimore City,Paulette Williams,Clinical Director,410-396-5211,,paulette.williams@baltimorecity.gov,Sherry Adeyemi,Health Program Planning and Evaluation Director,410-396-4502,,sherry.adeyemi@baltimorecity.gov,baltimorecity.gov
MD-005149,Chase Brexton Health Care at Mount Vernon,"CHASE BREXTON HEALTH SERVICES, INC",1588606305,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1111 N Charles St,,Baltimore,MD,21201-5505,Baltimore City,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005150,University of Maryland School of Medicine Young Adult and Adolescent Community Health Services,"University of Maryland School of Medicine, Department of Pediatrics",1912002320,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",120 Penn St,University Of Maryland School Of Medicine,Baltimore,MD,21201-1082,Baltimore City,120 Penn St,University of Maryland School of Medicine,Baltimore,MD,21201-1082,Baltimore City,Vicki Tepper,Division Head,410-706-8931,,vtepper@peds.umaryland.edu,Sue Lovelace,NP,410-706-8732,,slovelac@peds.umaryland.edu,http://umm.edu/programs/childrens/services/adolescent-and-young-adult
MD-005151,Baltimore Medical System,Baltimore Medical System,1265856488,Federally Qualified Health Centers - Medical Services,1400 Orleans St,Paul Laurence Dunbar High School,Baltimore,MD,21231-1021,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-005152,Baltimore Medical System,Baltimore Medical System,1902802705,Federally Qualified Health Centers - Medical Services,1409 N Collington Ave,Canton Middle School-Friendship Academy,Baltimore,MD,21213-3418,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-005153,Maryland Institute College of Art Student Health Center,"CHASE BREXTON HEALTH SERVICES, INC",1962759647,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1501 W Mount Royal Ave,,Baltimore,MD,21217-4289,Baltimore City,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005154,Adolescent and Reproductive Health Clinic,Baltimore City Health Department,1376750216,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1515 W North Ave,,Baltimore,MD,21217-1797,Baltimore City,1101 E Fayette Street,,Baltimore,MD,21202,Baltimore City,Denise Parker,Health Program Administrator,410-396-0100,,denise.parker@baltimorecity.gov,Daphne Hicks,Health Program Administrator,410-396-0185,,daphne.hicks@baltimorecity.gov,www.baltimorecity.gov
MD-005155,DRUID DENTAL CLINIC,Baltimore City Health Department- Oral Health Services,1679628846,Dental Providers,1515 W North Ave,,Baltimore,MD,21217-1735,Baltimore City,BCHD-Oral Health Services,1001 E. FAYETTE STREET,Baltimore,MD,21202,Baltimore City,Dr. Patricia L. Bell-McDuffie,"DIRECTOR, ORAL HEALTH SERVICES",410-396-4501,,patricia.bell-mcduffie@baltimorecity.gov,Dr. Adena Greenbaum,"Assistant Commissioner, Div. of Clinical Services",410-396-1309,,adena.greenbaum@baltimorecity.gov,
MD-005156,"Mt. Washington Pediatric Hospital, Baltimore",Mt. Washington Pediatric Hospital,1093871329,Children's Hospitals (inpatient only),1708 W Rogers Ave,,Baltimore,MD,21209-4545,Baltimore City,1708 W. Rogers Avenue,,Baltimore,MD,21209,Baltimore City,Mary Miller,CFO,410-578-5163,,mmiller@mwph.org,Jeneba Fofana,Finance Operations Manager,410-578-5062,,jfofana@mwph.org,www.mwph.org
MD-005157,"Mt. Washington Pediatric Hospital Outpatient, Baltimore",Mt. Washington Pediatric Hospital,1639273337,Outpatient Hospital Clinics,1708 W Rogers Ave,,Baltimore,MD,21209-4545,Baltimore City,1708 W. Rogers Avenue,,Baltimore,MD,21209,Baltimore City,Mary Miller,CFO,410-578-5163,,mmiller@mwph.org,Jeneba Fofana,Outpatient Operations Manager,410-578-5062,,jfofana@mwph.org,www.mwph.org
MD-005158,Planned Parenthood at Towson,Planned Parenthood of Maryland,1235242082,Family Planning Providers,1714 Joan Ave,,Baltimore,MD,21234-3792,Baltimore,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005159,John G. Bartlett Specialty Practice,Johns Hopkins Hospital,1578597993,Outpatient Hospital Clinics,1717 E Monument St,,Baltimore,MD,21287-0027,Baltimore City,1717 E. Monument Street,,Baltimore,MD,21287,Baltimore City,Jeanne Keruly,"Director, Adult Ryan White Services",410-955-6479,,jkeruly@jhmi.edu,Dennis Rivera,"Director, Social Work, Bartlett Specialty Practice",410-502-6289,,divera4@jhmi.edu,
MD-005160,Woodlawn Health Center,Baltimore County Health Dept.,1952670804,"Family Planning Providers, Sexually Transmitted Disease Clinics",1811 Woodlawn Dr,,Baltimore,MD,21207-4043,Baltimore,1811 Woodlawn Dr,,Baltimore,MD,21207-4043,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005161,Baltimore Medical System,Baltimore Medical System,1184904443,Federally Qualified Health Centers - Medical Services,1919 N Broadway,Harford Heights Elementary School,Baltimore,MD,21213-1432,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-005162,Johns Hopkins - Harriet Lane,Johns Hopkins Hospitals,1649220260,"Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Sexually Transmitted Disease Clinics",200 N Wolfe St,,Baltimore,MD,21287-0011,Baltimore City,Johns Hopkins Hospital,1800 Orleans Street,Baltimore,MD,21287,Baltimore City,Arik Marcell,Associate Professor,410-955-5710,,amarcell@jhu.edu,Kathy Tomaszewski,Nurse Coordinator,443-287-8887,,ktomaszewski@jhu.edu,jhu.edu
MD-005163,Essex Health Center,Baltimore County Health Dept.,1982974069,Family Planning Providers,201 Back River Neck Rd,,Baltimore,MD,21221-3949,Baltimore,1538 Country Ridge Ln,,Baltimore,MD,21221-3906,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005164,Institute for Behavioral Resources/Reach,Institute for Behavioral Resources/Reach,1063891869,Federally Qualified Health Centers - Medical Services,2104 Maryland Ave,,Baltimore,MD,21218-5612,Baltimore City,2104 Maryland Ave,,Baltimore,MD,21218,Baltimore City,Yngvild Olsen,Medical Director,410-752-6850,106,vwalters@ibrinc.org,Vicki Walters,,410-752-6850,106,vwalters@ibrinc.org,ibrinc.org
MD-005165,Independent Living Foundation,Independent Living Foundation,1437127586,"Dental Providers, Ryan White Providers",2126 W Pratt St,,Baltimore,MD,21223-2243,Baltimore City,2126 west pratt street,,Baltimore,MD,21223,Baltimore City,Gail Kelly,Support Staff,410-233-3323,,larrybank@comcast.net,"Larry Bank, DDS",Program Director,410-233-3323,,larrybank@comcast.net,
MD-005166,BMS @ Orleans Square,Baltimore Medical System,1619973419,Federally Qualified Health Centers - Medical Services,2323 Orleans St,,Baltimore,MD,21224-1020,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,
MD-005167,POB,Family Health Centers of Baltimore,1417134321,Federally Qualified Health Centers - Medical Services,301 Saint Paul St,,Baltimore,MD,21202-2102,Baltimore City,631 Cherry Hill Road,,Baltimore,MD,21225,Baltimore City,Winnie McCray,Health Service Administrator,410-354-2000,11233,wmccray@fhcb.org,Paula McLellan,CEO,410-354-2000,11222,pmclella@fhcb.org,
MD-005168,Mead,Family Health Centers of Baltimore,1033395637,Federally Qualified Health Centers - Medical Services,315 N Calvert St,,Baltimore,MD,21202-3611,Baltimore City,631 Cherry Hill Road,,Baltimore,MD,21225,Baltimore City,Paula McLellan,CEO,410-354-2000,11222,pmclellan@fhcb.org,Winnie McCray,Health Service Administrator,410-354-2000,11233,wmccray@fhcb.org,
MD-005169,Planned Parenthood at Baltimore City,Planned Parenthood of Maryland,1235242082,Family Planning Providers,330 N Howard St,,Baltimore,MD,21201-3610,Baltimore City,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005170,Belvedere,Park West Health System,1205896719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3319 W Belvedere Ave,Suite 1,Baltimore,MD,21215-5143,Baltimore City,3319 West Belvedere Ave,,Baltimore,MD,21215,Baltimore City,"Allen J, Bennett",CEO,443-994-7501,,abennett@parkwestmed.org,Elizabeth Lee,CFO,443-884-7512,,elee@parkwestmed.org,
MD-005171,Baltimore Medical System,Baltimore Medical System,1700882503,Federally Qualified Health Centers - Medical Services,3501 Sinclair Ln,,Baltimore,MD,21213-2029,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Pamela Brown,Director of Maternal and Child Health and Multicultural Programs,410-558-4946,,pam.brown@bmsi.org,Michele Lagana,Chief Financial Officer,410-558-4965,,michele.lagana@bsmi.org,bsmi.org
MD-005172,Highlandtown Healthy Living Center,Baltimore Medical System,1548266547,Federally Qualified Health Centers - Medical Services,3700 Fleet St,Suite 200,Baltimore,MD,21224-4243,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,
MD-005173,Lansdowne Health Center,Baltimore County Health Dept.,1578832374,Family Planning Providers,3902 Annapolis Rd,Suite 1,Baltimore,MD,21227-2249,Baltimore,3902 Annapolis Rd,,Baltimore,MD,21227-2249,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005174,Reisterstown Road Plaza,Park West Health System,1497801153,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4120 Patterson Ave,,Baltimore,MD,21215-2254,Baltimore City,3319 West Belvedere Ave,,Baltimore,MD,21215,Baltimore City,Allen J. Bennett,CEO,443-884-7501,,abennett@parkwestmed.org,Elizabeth Lee,CFO,443-884-7512,,elee@parkwestmed.org,
MD-005175,Men and Family Health,Park West Health System,1255512638,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4151 Park Heights Ave,,Baltimore,MD,21215-6730,Baltimore City,3319 West Belvedere Ave,,Baltimore,MD,21215,Baltimore City,Allen J. Bennett,CEO,443-884-7501,,abennett@parkwestmed.org,E Lee,CFO,443-884-7512,,elee@parkwestmed.org,
MD-005176,QCare @ Shoprite - Howard Park,Park West Health System,1073914206,Federally Qualified Health Centers - Medical Services,4601 Liberty Heights Ave,,Baltimore,MD,21207-7553,Baltimore City,3319 West Belvedere Ave,,Baltimore,MD,21215,Baltimore City,Allen J. Bennett,CEO,443-884-7501,,abennett@parkwestmed.org,Elizabeth Lee,CFO,443-884-7512,,elee@parkwestmed.org,
MD-005177,Baltimore Medical System,Baltimore Medical System,1619248515,Federally Qualified Health Centers - Medical Services,600 N Patterson Park Ave,Tench Tilghman Elementary & Middle School,Baltimore,MD,21205-2447,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-005178,Baltimore City Health Department STD/HIV/TB Clinics,Baltimore City Health Department,1154690592,Sexually Transmitted Disease Clinics,620 N Caroline St,,Baltimore,MD,21205-1839,Baltimore City,1001 E. Fayette Street,,Baltimore,MD,21202,Baltimore City,Adena Greenbaum,Assistant Commissioner for Clinical Services,410-396-1309,,adena.greenbaum@baltimorecity.gov,Amanda Rosecrans,Medical Director for HIV/HCV,410-396-9410,,amanda.rosecrans@baltimorecity.gov,
MD-005179,EASTERN DENTAL CLINIC,Baltimore City Health Dept.-Oral Health Services,1679628846,Dental Providers,620 N Caroline St Bsmt Level,,Baltimore,MD,21205-1839,Baltimore City,Baltimore City Health Dept.- Oral Health Services,1001 E. FAYETTE STREET,Baltimore,MD,21202,Baltimore City,Dr. Patricia L. Bell-McDuffie,"DIRECTOR, ORAL HEALTH SERVICES",410-396-4501,,patricia.bell-mcduffie@baltimorecity.gov,Dr. Adena Greenbaum,Asst. Commissioner; Div. of Clinical Services,410-396-1309,,adena.greenbaum@baltimorecity.gov,
MD-005180,Family Health Center of Baltimore,Family Health Center of Baltimore,1346286713,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",631 Cherry Hill Rd,,Baltimore,MD,21225-1228,Baltimore City,631 Cherry Hill Rd,,Baltimore,MD,21225,Baltimore City,Paula McLellan,Chief Executive Officer,410-354-2000,,pmclellan@fhcb.org,Winnie McCray,Health Service Administrator,410-354-2001,,wmccray@fhcb.org,fhcb.org
MD-005181,Baltimore Medical System,Baltimore Medical System,1174803456,Federally Qualified Health Centers - Medical Services,6900 Park Heights Ave,Northwestern High School,Baltimore,MD,21215-1608,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,http://bmsi.org/our-programs/school-based-health-centers/
MD-005182,University of Maryland Adolescent and Young Adult Medicine,University of Maryland Hospital,1568491876,"Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics",737 W Lombard St,Suite 215,Baltimore,MD,21201-1009,Baltimore City,22 S Greene Street,,Baltimore,MD,21201,Baltimore City,Vicki Tepper,Division Head,410-706-8931,,vtepper@peds.umaryland.edu,Margie Burr,Director of Billing,410-706-5181,,moburr@peds.umaryland.edu,umaryland.edu
MD-005183,Dundalk Health Center,Baltimore County Health Dept.,1346510427,Family Planning Providers,7700 Dunmanway,,Baltimore,MD,21222-5436,Baltimore,7700 Dunmanway,,Baltimore,MD,21222-5436,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005184,BMS @ St. Agnes,Baltimore Medical System,1811993611,Federally Qualified Health Centers - Medical Services,900 Caton Ave,,Baltimore,MD,21229-5201,Baltimore City,3501 Sinclair Lane,,Baltimore,MD,21213,Baltimore City,Shirley Sutton,President & CEO,410-558-4891,,Shirley.Sutton@bmsi.org,Joe Martin,Executive Assistant,410-558-4973,,Joe.Martin@bmsi.org,
MD-005185,Eastern Family Resource Center,Baltimore County Health Dept.,1538439617,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",9100 Franklin Square Dr,Suite No. 306,Baltimore,MD,21237-3903,Baltimore,9100 Franklin Square Dr,,Baltimore,MD,21237-3903,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005186,Brooklyn,Family Health Centers of Baltimore,1336326248,"Dental Providers, Federally Qualified Health Centers - Medical Services",3540 S Hanover St,,Baltimore City,MD,21225-1732,Baltimore City,631 Cherry Hill Road,,Baltimore City,MD,21225,Baltimore City,Paula McLellan,CEO,410-354-2000,11222,pmclellan@fhcb.org,Winnie McCray,Health Service Administrator,410-354-2000,11233,wmccray@fhcb.org,
MD-005187,WORCESTER COUNTY HEALTH DEPARTMENT,WORCESTER COUNTY HEALTH DEPARTMENT,1003868076,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9730 Healthway Dr,,Berlin,MD,21811-1154,Worcester,6040 Public Landing,,Snow Hill,MD,21863,Worcester,Loren Sallah,Practice Manager,410-632-1100,1255,loren.sallah@maryland.gov,Heather Barton,Director of Administration,410-632-1100,1210,heather.barton@maryland.gov,worcesterhealth.org
MD-005188,"FAMILY HEALTH CENTERS OF BALTIMORE, INC.",FAMILY HEALTH CENTERS OF BALTIMORE,1205013539,"Dental Providers, Federally Qualified Health Centers - Medical Services",631 Cherry Hill Rd,,Brooklyn,MD,21225-1228,Baltimore City,631 Cherry Hill Road,,Baltimore,MD,21225-1228,Baltimore City,PAULA B. MCLELLAN,CEO,410-354-2000,11222,wmccray@fhcb.org,Winnie McCray,Health Service Administrator,410-354-2000,11233,wmccray@fhcb.org,
MD-005189,Dorchester County Health Department,Dorchester County Health Department,1144298290,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1101 Maces Ln,Maces Lane Middle School Wellness Center,Cambridge,MD,21613-2619,Dorchester,"3 Cedar St,.",,Cambridge,MD,21613,Dorchester,"Katie Tolley, CRNP",Nurse Practioner,410-228-8121,,katie.tolley@maryland.gov,"Carla Todd, BSN, RN",Community Health Nurse Program Supervisor,410-901-8175,,carla.todd@maryland.gov,
MD-005190,Dorchester County Health Department,Dorchester County Health Department,1144298290,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",2475 Cambridge Beltway,Cambridge South Dorchester High School Wellness Center,Cambridge,MD,21613-3680,Dorchester,Dorchester County Health Dept,3 Cedar St.,Cambridge,MD,21613,Dorchester,"Casey Scott, MD",Doctor,410-228-3825,,scottc@dcpsmd.org,"Carla Todd, BSN, RN",Community Health Nurse Program Supervisor,410-901-8175,,carla.todd@maryland.gov,
MD-005191,Dorchester County Health Department,Dorchester County Health Department,1144298290,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3 Cedar St,North Dorchester Middle School Wellness Center,Cambridge,MD,21613-2300,Dorchester,3 Cedar St.,,Cambridge,MD,21613,Dorchester,"Kristie Gauck, CRNP",Nurse Practioner,410-901-8175,,gauckk@dcpsmd.org,"Carla Todd, BSN, RN",Community Health Nurse Program Supervisor,410-901-8175,,carla.todd@maryland.gov,
MD-005192,FASSETT-MAGEE HEALTH CENTER and Cambridge Dental Center,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,"Dental Providers, Federally Qualified Health Centers - Medical Services",503 Muir St,Suite A,Cambridge,MD,21613-1848,Dorchester,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005193,"Women, Infants, and Children (WIC)","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Dental Providers,7 Cedar St,,Cambridge,MD,21613-2381,Dorchester,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005194,Greater Baden at Capitol Heights 2,Greater Baden Medical Service Inc,1093987729,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1442 Addison Rd S,,Capitol Heights,MD,20743-4413,Prince Georges,7450 Albert Road,,Brandywine,MD,20613-3035,Prince Georges,Colenthia Malloy,CEO,301-836-9652,,cmalloy@gbms.org,Sarah Leonhard,Consultant,301-518-2349,,sleonhard@gbms.org,www.gbms.org
MD-005195,QUEEN ANNE'S COUNTY HEALTH DEPARTMENT,QUEEN ANNE'S COUNTY HEALTH DEPARTMENT,1881781805,Family Planning Providers,206 N Commerce St,Suite 1,Centreville,MD,21617-1049,Queen Annes,206 N. Commerce st.,,Centreville,MD,21617-1049,Queen Annes,melissa aftoora,Family Planning supervisor,443-262-4430,,melissa.aftoora@maryland.gov,,,410-767-6686,,,http://www.qahealth.org/reproductive-health.html
MD-005196,"Mt. Washington Pediatric Hospital Outpatient, Prince Georges County",Mt. Washington Pediatric Hospital,1639273337,Outpatient Hospital Clinics,3001 Hospital Dr,,Cheverly,MD,20785-1189,Prince Georges,1708 W. Rogers Avenue,,Baltimore,MD,21208,Baltimore City,Mary Miller,CFO,410-578-5163,,mmiller@mwph.org,Jeneba Fofana,Finance Operations Manager,410-578-5062,,jfofana@mwph.org,www.mwph.org
MD-005197,"Mt. Washington Pediatric Hospital, Prince Georges County",Mt. Washington Pediatric Hospital,1093871329,Children's Hospitals (inpatient only),3001 Hospital Dr,,Cheverly,MD,20785-1189,Prince Georges,1708 Rogers Avenue,,Baltimore,MD,21209,Baltimore City,Mary Miller,CFO,410-578-5163,,mmiller@mwph.org,Jeneba Fofana,Finance Operations Manager,410-578-5062,,jfofana@mwph.org,www.mwph.org
MD-005198,Cheverly Health Center,Prince George's County Health Department,1083945125,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3003 Hospital Dr,,Cheverly,MD,20785-1194,Prince Georges,1701 McCormick Drive,Suite 100,Largo,MD,20774,Prince Georges,Diane J Young,Associate Director,301-883-7864,,DJYoung@co.pg.md.us,Debra Adams,Billing Manager,301-883-6125,,DSAdams@co.pg.md.us,
MD-005199,Dyer Health Center,Prince George's County Health Department,1083945125,"Community Mental Health Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",9314 Piscataway Rd,,Clinton,MD,20735-3630,Prince Georges,1701 McCormick Drive,Suite 100,Largo,MD,20774,Prince Georges,Diane J Young,Associate Director,301-883-7864,,DJYoung@co.pg.md.us,Debra Adams,Billing Manager,301-883-6125,,DSAdams@co.pg.md.us,
MD-005200,Chase Brexton Health Care at Columbia,"CHASE BREXTON HEALTH SERVICES, INC",1376589309,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5500 Knoll North Dr,Suite 370,Columbia,MD,21045-2393,Howard,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005201,Columbia Health Center,Howard County Health Department,1689941957,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",8930 Stanford Blvd,,Columbia,MD,21045-5805,Howard,8930 Stanford Blvd.,,Columbia,MD,21045,Howard,Robin Bounds,Program Supervisor,410-313-7223,,rbounds@howardcountymd.gov,Andrea Raid,Bureau Director,410-313-0825,,amraid@howardcountymd.gov,
MD-005202,"WayStation, Inc.","CHASE BREXTON HEALTH SERVICES, INC",1821336959,"Family Planning Providers, Other ECP Providers",9030 State Route 108,Suite A,Columbia,MD,21045-1990,Howard,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005203,West Cecil Health Center Inc,"WEST CECIL HEALTH CENTER, INC",1366625089,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",49 Rock Springs Rd,,Conowingo,MD,21918-1352,Cecil,49 Rock Springs Rd,,Conowingo,MD,21918-1352,Cecil,Danielle Cochran,Practice Manager,410-378-9696,1130,DCochran@westcecilhealth.org,Mark Rajkowski,President & CEO,410-378-9696,1114,MRajkowski@westcecilhealth.org,http://www.westcecilhealth.org
MD-005204,ALLEGANY COUNTY HEALTH DEPARTMENT,ALLEGANY COUNTY HEALTH DEPARTMENT,1770852675,Family Planning Providers,12501 Willowbrook Rd,,Cumberland,MD,21502-2569,Allegany,12501 Willowbrook Road,,Cumberland,MD,21502,Allegany,"Paula McKenzie, RN",Director of Reproductive Health Services,410-767-6686,,paula.mckenzie@maryland.gov,"Catherine Parish, RN",Community Health Nurse II,410-767-6696,,catherine.parish@maryland.gov,
MD-005205,Tri-State Community Health Center - OB/GYN,Tri-State Community Health Center,1467401372,Federally Qualified Health Centers - Medical Services,12502 Willowbrook Rd,Suite 550,Cumberland,MD,21502-6594,Allegany,109 Rayloc Drive,,Hancock,MD,21750,Washington,Sheila DeShong,COO,301-678-5187,226,sdeshong@tschc.com,,,,,,
MD-005206,Tri-State Community Health Center - Cumberland,Tri-State Community Health Center,1457301939,Federally Qualified Health Centers - Medical Services,621 Kelly Rd,,Cumberland,MD,21502-2878,Allegany,109 Rayloc Drive,,Hancock,MD,21750,Washington,Sheila DeShong,COO,301-678-5187,226,sdeshong@tschc.com,,,,,,
MD-005207,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,303 Sharp Rd,Denton Elementary School,Denton,MD,21629-1481,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005208,Caroline County Health Department,Reproductive Health Program,1316101827,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",403 S 7th St,,Denton,MD,21629-1327,Caroline,403 S. 7th Street,,Denton,MD,21629,Caroline,Pamela Eberhard,CRNP,410-479-8000,8016,pam.eberhard@maryland.gov,Valerie Laureska,Program Manager,410-479-8000,8021,valerie.laureska@maryland.gov,
MD-005209,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,410 Lockerman St,LOCKERMAN MIDDLE SCHOOL,Denton,MD,21629-1048,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VO of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005210,DENTON MEDICAL CENTER,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,"Dental Providers, Federally Qualified Health Centers - Medical Services",609 Daffin Ln,,Denton,MD,21629-1392,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005211,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,201 Peach Blossom Ln,Easton Middle School,Easton,MD,21601-2544,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations-talbot-county/
MD-005212,"Women, Infants, and Children (WIC) Talbot County","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Dental Providers,215 Bay St,,Easton,MD,21601-2782,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005213,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,307 Glenwood Ave,Easton Elementary School - Moton and Dobson Buildings,Easton,MD,21601-4104,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations-talbot-county/
MD-005214,Choptank Community Health Easton Pediatrics,"Choptank Community Health System, Inc",1356388599,Federally Qualified Health Centers - Medical Services,522 Cynwood Dr,,Easton,MD,21601-3876,Talbot,301 Randolph St,,Denton,MD,21629,Caroline,Joseph Sheehan,CEO,410-479-4306,5005,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality and Population Health,410-479-4306,5009,smjohnson@choptankhealth.org,
MD-005215,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,723 Mecklenburg Ave,Easton High School,Easton,MD,21601-3395,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations-talbot-county/
MD-005216,Chase Brexton Health Care at Easton,"CHASE BREXTON HEALTH SERVICES, INC",1801920939,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",8221 Teal Dr,Suite 202,Easton,MD,21601-7229,Talbot,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005217,Planned Parenthood at Easton,Planned Parenthood of Maryland,1235242082,Family Planning Providers,8579 Commerce Dr,Suite 102,Easton,MD,21601-7420,Talbot,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005218,Edgewood Clinic,Harford County Health Dept.,1942579073,"Family Planning Providers, Sexually Transmitted Disease Clinics",1321 Woodbridge Station Way,,Edgewood,MD,21040-3830,Harford,1321 Woodbridge Station Way,,Edgewood,MD,21040-3830,Harford,Jean Toth,Director of Clinical Services/CD,410-612-1769,,jean.toth@maryland.gov,Jennifer Mangold,Family Planning Nursing Supervisor,410-612-1782,,jennifer.mangold@maryland.gov,http://www.harfordcountyhealth.com/?p=70
MD-005219,JOHN M. BYERS HEALTH CENTER,CECIL COUNTY HEALTH DEPARTMENT,1215206446,"Ryan White Providers, Sexually Transmitted Disease Clinics",401 Bow St,,Elkton,MD,21921-5515,Cecil,401 Bow Street,,Elkton,MD,21921,Cecil,"Judith Rodemich, WHNP",Director of Nursing,410-996-5100,,judi.rodemich@maryland.gov,"Henry Taylor, MD, MPH","Deputy Health Officer, Clinical Operations",410-996-5550,,henry.taylor@maryland.gov,http://www.cecilcountyhealth.org
MD-005220,FEDERALSBURG MEDICAL and DENTAL CENTER,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,"Dental Providers, Federally Qualified Health Centers - Medical Services",215 Bloomingdale Ave,,Federalsburg,MD,21632-1012,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005221,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,25320 Richardson Rd,COL. RICHARDSON HIGH SCHOOL,Federalsburg,MD,21632-2403,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005222,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,25390 Richardson Rd,COLONEL RICHARDSON MIDDLE SCHOOL,Federalsburg,MD,21632-2403,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005223,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,302 S University Ave,FEDERALSBURG ELEMENTARY SCHOOL,Federalsburg,MD,21632-1437,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005224,Frederick Community Action Agency,City of Frederick,1831202902,Federally Qualified Health Centers - Medical Services,100 S Market St,,Frederick,MD,21701-5527,Frederick,100 S. Market Street,,Frederick,MD,21701,Frederick,Mike Spurrier,DIrector,301-600-3955,,mspurrier@cityoffrederick.com,Janet Jones,Supervisor,301-600-3967,,jjones@cityoffrederick.com,www.cityoffrederick.com/fcaa
MD-005225,Planned Parenthood at Frederick,Planned Parenthood of Maryland,1235242082,Family Planning Providers,170 Thomas Johnson Dr,Suite No. 100,Frederick,MD,21702-4354,Frederick,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005226,Gaithersburg Health Center,"Planned Parenthood of Metropolitan Washington, DC",1245663434,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",19650 Clubhouse Rd,Suite 104,Gaithersburg,MD,20886-3039,Montgomery,"1225 4th St, NE",,Washington,DC,20002,District of Columbia,Tasha Joyner,Director of Operations,804-641-4480,,tasha.joyner@gmail.com,Takina Wilson,VP of Patient Services,202-497-4169,,takina.wilson@ppmw.org,
MD-005227,Gaithersburg Health Center,"COMMUNITY CLINIC, INC., THE",1790730281,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 Girard St,Suite 212A,Gaithersburg,MD,20877-3465,Montgomery,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005228,Teen and Young Adult (TAYA) Health Connection,Montgomery County Dept. of Health and Human Services,1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",602 E Diamond Ave,,Gaithersburg,MD,20877-5324,Montgomery,8630 Fenton Street Suite 1204,,Silver Spring,MD,20910,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2613,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005229,CCI - Family Services Inc.,"COMMUNITY CLINIC, INC., THE",1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",610 E Diamond Ave,Suite 300,Gaithersburg,MD,20877-5321,Montgomery,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005230,Chase Brexton Health Care of Glen Burnie,"CHASE BREXTON HEALTH SERVICES, INC",1497161483,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",200 Hospital Dr,Suite 200,Glen Burnie,MD,21061-5877,Anne Arundel,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005231,GOLDSBORO MEDICAL and DENTAL CENTER,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,"Dental Providers, Federally Qualified Health Centers - Medical Services",316 Railroad Ave,,Goldsboro,MD,21636-1126,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005232,Mountain Laurel Medical Center Grantsville,WESTERN MARYLAND HEALTH CARE CORPORATION,1053727065,Federally Qualified Health Centers - Medical Services,104 Parkview Dr,,Grantsville,MD,21536-1086,Garrett,1027 Memorial Dr,,Oakland,MD,21550-4343,Garrett,Beth A Little-Terry,CEO,301-533-3300,3019,beth@mtnlaurel.org,Jeremy Wilson,CFO,301-533-3300,3018,jeremy@mtnlaurel.org,www.MountainLaurelMedicalCenter.com
MD-005233,Granstville Clinic,Garrett County Health Dept.,1255467346,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",28 Hershberger Ln,Addictions Bldg.,Grantsville,MD,21536-1004,Garrett,28 Hershberger Ln,Addictions Bldg.,Grantsville,MD,21536-1004,Garrett,Jennifer Lee-Steckman,Director of Personal Health,301-334-7772,,Jennifer.Lee-Steckman@Maryland.gov,Kara Taylor,Fiscal Accounts Clerk II,301-334-7743,,kara.taylor@maryland.gov,http://www.garretthealth.org/departments/Personal/Family.htm
MD-005234,CCI-Greenbelt,CCI-Greenbelt,1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9001 Edmonston Rd,Suite 40,Greenbelt,MD,20770-1004,Prince Georges,8630 Fenton Street Suite 1204,,Silver Spring,MD,20910,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005235,Franklin Park Health Center,"COMMUNITY CLINIC, INC., THE",1790730281,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",9220 Springhill Ln,,Greenbelt,MD,20770-1203,Prince Georges,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,,www.cciweb.org
MD-005236,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,625 N Main St,GREENSBORO ELEMENTRY SCHOOL,Greensboro,MD,21639-1469,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005237,Hagerstown Health Center,Washington County Health Dept.,1437428760,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1302 Pennsylvania Ave,,Hagerstown,MD,21742-3197,Washington,1302 Pennsylvania Ave,,Hagerstown,MD,21742-3108,Washington,Tammi Fuller,Family Planning Coordinator,240-313-3290,,susan.parks@maryland.gov,Susan Parks,Director of Community Health Nursing,240-313-3290,,,http://www.washhealth.org/html/maternal.htm
MD-012450,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,1401 Dual Hwy,,Hagerstown,MD,21740-6568,Washington,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
MD-005238,Family Healthcare of Hagerstown,"Walnut Street Community Health Center, Inc.",1366425266,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 S Cleveland Ave,,Hagerstown,MD,21740-5745,Washington,201 S Cleveland Avenue,,Hagerstown,MD,21740,Washington,David Becker,CFO,301-745-3777,,david.becker@familyhch.org,Kimberly Murdaugh,Executive Director,301-745-3777,,,www.familyhch.org
MD-005239,Family Healthcare Of Hagerstown - Way Station,"Walnut Street Community Health Center, Inc",1235498122,Federally Qualified Health Centers - Medical Services,328 N Potomac St,,Hagerstown,MD,21740-3820,Washington,201 S. Cleveland Avenue,,Hagerstown,MD,21740,Washington,David Becker,CFO,301-745-3777,,david.becker@familyhch.org,Kim Murdaugh,Executive Director,,,,www.familyhch.org
MD-005240,Tri-State Community Health Center - Hancock,Tri-State Community Health Center,1366491201,Federally Qualified Health Centers - Medical Services,130 W High St,,Hancock,MD,21750-1143,Washington,109 Rayloc Drive,,Hancock,MD,21750,Washington,Sheila DeShong,COO,301-678-5187,,sdeshong@tschc.com,,,,,,www.tschc.com
MD-005241,Dorchester County Health Department,Dorchester County Health Department,1144298290,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",5875 Cloverdale Rd,North Dorchester High School Wellness Center,Hurlock,MD,21643-3019,Dorchester,3 Cedar St.,,Cambridge,MD,21613,Dorchester,"Kristie Gauck, CRNP",Nurse Practioner,410-943-3316,,gauckk@dcpsmd.org,"Carla Todd, BSN, RN",Community Health Nurse Program Supervisor,410-901-8175,,carla.todd@maryland.gov,
MD-005242,Healthy Teens and Young Adults Center,Prince George's County Health Department,1083945125,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",7824 Central Ave,,Landover,MD,20785-4807,Prince Georges,1701 McCormick Drive,Suite 100,Largo,MD,20774,Prince Georges,Diane J Young,Associate Director,301-883-7864,,DJYoung@co.pg.md.us,Debra Adams,Billing Manager,301-883-6125,,DSAdams@co.pg.md.us,
MD-005243,La Union: Family Health Services,Prince George's County Health Department,1083945125,Family Planning Providers,1401 University Blvd E,,Langley Park,MD,20783-4029,Prince Georges,1701 McCormick Drive,Suite 100,Largo,MD,20774,Prince Georges,Diane J. Young,Associate Director,301-883-7864,,DJYoung@co.pg.md.us,Debra Adams,Billing Manager,301-883-6125,,DSAdams@co.pg.md.us,
MD-005244,Leonardtown Health Center,St. Mary's County Health Dept.,1063697936,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",21580 Peabody St,PO Box 316,Leonardtown,MD,20650-2962,Saint Marys,21580 Peabody St,PO Box 316,Leonardtown,MD,20650-2962,Saint Marys,Bella Dean,Director of Clinical Services,301-475-4079,,bella.dean@maryland.gov,Terry Prochnow,"Division Director, Public Health Preparedness & Response",301-475-4319,,terry.prochnow@maryland.gov,http://www.smchd.org/call-email-or-mail/
MD-005245,GARRETT COUNTY HEALTH DEPARTMENT,GARRETT COUNTY HEALTH DEPARTMENT,1568411619,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1025 Memorial Dr,,Oakland,MD,21550-4343,Garrett,1025 Memorial Dive,,Oakland,MD,21550-4343,Garrett,Jennifer Lee-Steckman,Family Planning Coordinator,301-334-7770,,Jennifer.Lee-Steckman@Maryland.gov,Tammy Skiles,Administrator,301-334-7703,,tammy.skiles@Maryland.gov,http://www.garretthealth.org/departments/Personal/Family.htm
MD-005246,Mountain Laurel Medical Center,WESTERN MARYLAND HEALTH CARE CORPORATION,1467427047,Federally Qualified Health Centers - Medical Services,1027 Memorial Dr,,Oakland,MD,21550-4343,Garrett,1027 Memorial Dr,,Oakland,MD,21550-4343,Garrett,Beth A Little-Terry,CEO,301-533-3300,3019,beth@mtnlaurel.org,Jeremy Wilson,CFO,301-533-3300,3018,jeremy@mtnlaurel.org,www.MountainLaurelMedicalCenter.com
MD-005247,Planned Parenthood at Owings Mills,Planned Parenthood of Maryland,1235242082,Family Planning Providers,9129 Reisterstown Rd,Valley Village Center,Owings Mills,MD,21117-4503,Baltimore,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005248,THREE LOWER COUNTIES COMMUNITY SVCS INC,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1982871034,Federally Qualified Health Centers - Medical Services,305 10th St,,Pocomoke City,MD,21851-1607,Worcester,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005249,WORCESTER COUNTY HEALTH DEPARTMENT,WORCESTER COUNTY HEALTH DEPARTMENT,1003868076,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",400 Walnut St,,Pocomoke City,MD,21851-1501,Worcester,6040 Public Landing,,Snow Hill,MD,21863,Worcester,Loren Sallah,Practice Manager,410-632-1100,1255,loren.sallah@maryland.gov,Heather Barton,Director of Administration,410-632-1100,1210,heather.barton@maryland.gov,worcesterhealth.org
MD-005250,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,225 Main St,Preston Elementary School,Preston,MD,21655-2215,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005251,CALVERT COUNTY HEALTH DEPARTMENT,CALVERT COUNTY HEALTH DEPARTMENT,1861761868,"Community Mental Health Centers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",975 Solomons Island Rd N,,Prince Frederick,MD,20678-3917,Calvert,P.O. Box 980,,Prince Frederick,MD,20678,Calvert,Michael Bridgett,CRNP,410-535-5400,414,michael.bridgett@maryland.gov,Betsy Bridgett,RN,410-535-5400,351,betsy.bridgett@maryland.gov,www.calverthealth.org
MD-005252,"Three Lower Counties Community Services, Inc.","THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1063758498,Federally Qualified Health Centers - Medical Services,10902 Old Princess Anne Rd,TLC - SBHC @ Washington High School,Princess Anne,MD,21853-2940,Somerset,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/Presient,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005253,THREE LOWER COUNTIES COMMUNITY SVCS INC,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1376710111,"Dental Providers, Federally Qualified Health Centers - Medical Services",12145 Elm St,,Princess Anne,MD,21853-1358,Somerset,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005254,Chase Brexton Health Care of Randallstown,"CHASE BREXTON HEALTH SERVICES, INC",1851320147,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3510 Brenbrook Dr,,Randallstown,MD,21133-4902,Baltimore,1111 North Charles Street,,Baltimore,MD,21201-5505,Baltimore City,Judy Shahan,VP of Population Health,410-837-2050,,jshahan@chasebrexton.org,,,,,,
MD-005255,Liberty Family Resource Center,Baltimore County Health Dept.,1174893259,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",3525 Resource Dr,,Randallstown,MD,21133-4733,Baltimore,3525 Resource Dr,,Randallstown,MD,21133-4733,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005256,Hannah More Academy Center Health Nursing Services,Baltimore County Health Dept.,1285904367,Family Planning Providers,12035 Reisterstown Rd,,Reisterstown,MD,21136-3042,Baltimore,12035 Reisterstown Rd,,Reisterstown,MD,21136-3042,Baltimore,Renee Youngfellow,Family Planning Coordinator,410-887-2708,,ryoungfellow@baltimorecountymd.gov,,,,,,http://www.baltimorecountymd.gov/Agencies/health/healthservices/familyplanning.html
MD-005257,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,10990 River Rd,NORTH CAROLINE HIGH SCHOOL,Ridgely,MD,21660-1815,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005258,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,118 N Central Ave,RIDGELY ELEMENTARY SCHOOL,Ridgely,MD,21660-1345,Caroline,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VO of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations/
MD-005259,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.","CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,Federally Qualified Health Centers - Medical Services,100 Seymour Ave,St. Michaels Elementary School,Saint Michaels,MD,21663-2930,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,https://choptankhealth.org/locations/school-based-locations-talbot-county/
MD-005260,Bay Hundred Health Center and Dental Center,"CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",1356388599,"Dental Providers, Federally Qualified Health Centers - Medical Services",933 S Talbot St,Suite 4,Saint Michaels,MD,21663-2605,Talbot,301 Randolph St,,Denton,MD,21629-1243,Caroline,JOSEPH M. SHEEHAN,CEO,410-479-4306,,jsheehan@choptankhealth.org,Susan Johnson,VP of Quality Assurance,410-479-8393,,smjohnson@choptankhealth.org,
MD-005261,TLC SALISBURY,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1699942748,Federally Qualified Health Centers - Medical Services,1104 Healthway Dr,,Salisbury,MD,21804-4469,Wicomico,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005262,TLC Internal Medicine @ Woodbrooke,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1518296250,Federally Qualified Health Centers - Medical Services,1665 Woodbrooke Dr,,Salisbury,MD,21804-8502,Wicomico,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005263,TLC Pediatrics @ Sweet Bay,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1780913426,Federally Qualified Health Centers - Medical Services,1813 Sweetbay Dr,,Salisbury,MD,21804-1663,Wicomico,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005264,EASTERN SHORE OB/GYN - DIVISION OF TLC,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1275700015,Federally Qualified Health Centers - Medical Services,223 Phillip Morris Dr,,Salisbury,MD,21804-1923,Wicomico,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005265,Wicomico County Health Department Community Health Services,Wicomico County Health Department,1013286111,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 W Carroll St,,Salisbury,MD,21801-5305,Wicomico,108 E Main St,,Salisbury,MD,21801,Wicomico,Brandy Wink,Director of Administrative Services,410-543-6930,14591,brandy.wink@maryland.gov,Lori Brewster,Health Officer,410-543-6930,14592,lori.brewster@maryland.gov,
MD-005266,TLC @ Riverside Drive,"THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",1548423478,Federally Qualified Health Centers - Medical Services,560 Riverside Dr,Suite A204,Salisbury,MD,21801-4704,Wicomico,32033 Beaver Run Dr,,Salisbury,MD,21804-1773,Wicomico,Susanne Gray,CEO/President,410-749-1015,1614,sgray@tlccs.org,Joshua Boston,Chief Development Officer,410-749-1015,1607,jboston@tlccs.org,www.tlccs.org
MD-005267,Kemp Mill Practice Site,CCI Health & Wellness Services,1790730281,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1398 Lamberton Dr Fl 2,,Silver Spring,MD,20902-3414,Montgomery,8630 Fenton Street Suite 1204,,Silver Spring,MD,20910,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2613,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005268,Community Clinic Inc. - TAYA,"COMMUNITY CLINIC, INC., THE",1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1400 Spring St,Suite 200,Silver Spring,MD,20910-2750,Montgomery,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005269,Dennis Avenue Health Center,Montgomery County Department of Health and Human Services,1629190756,"Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2000 Dennis Ave,,Silver Spring,MD,20902-4136,Montgomery,401 Hungerford Drive,,Rockville,MD,20850,Montgomery,Cindy Edwards,Senior Healthcare Administrator,240-777-1024,,cindy.edwards@montgomerycountymd.gov,Dale Schacherer,Administrator HIV/STD Services,240-777-1739,,dale.schacherer@montgomerycountymd.gov,
MD-012451,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,831 University Blvd E,Suite 25,Silver Spring,MD,20903-2920,Montgomery,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
MD-005270,WORCESTER COUNTY HEALTH DEPARTMENT,WORCESTER COUNTY HEALTH DEPARTMENT,1003868076,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6040 Public Landing Rd,,Snow Hill,MD,21863-2453,Worcester,6040 Public Landing,,Snow Hill,MD,21863,Worcester,Loren Sallah,Practice Manager,410-632-1100,1255,loren.sallah@maryland.gov,Heather Barton,Director of Administration,410-632-1100,1210,heather.barton@maryland.gov,worcesterhealth.org
MD-005271,Suitland Health Center,"Planned Parenthood of Metropolitan Washington, DC",1417320458,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",5001 Silver Hill Rd,Suite 103,Suitland,MD,20746-5208,Prince Georges,"1225 4th St, NE",,Washington,DC,20002,District of Columbia,Tasha Joyner,Director of Operations,804-641-4480,,tasha.joyner@gmail.com,Takina Wilson,VP of Patient Servies,202-497-4169,,takina.wilson@ppmw.org,
MD-005272,Community Clinic at WAH,"COMMUNITY CLINIC, INC., THE",1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7620 Carroll Ave,,Takoma Park,MD,20912-6387,Montgomery,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2613,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,CFO,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005273,Takoma Park Health Center,"COMMUNITY CLINIC, INC., THE",1790730281,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7676 New Hampshire Ave,Suite 220A,Takoma Park,MD,20912-7514,Montgomery,8630 Fenton St Ste 1200,,Silver Spring,MD,20910-3808,Montgomery,Kathleen Knolhoff,CEO & President,240-499-2609,,Kathleen.Knolhoff@cciweb.org,Sheldon Kronzek,,240-638-1271,,Sheldon.Kronzek@cciweb.org,www.cciweb.org
MD-005274,AHF Healthcare Center - Temple Hills,AIDS Healthcare Foundation,1629499017,"Other ECP Providers, Ryan White Providers",4302 Saint Barnabas Rd,Suite B,Temple Hills,MD,20748-1842,Prince Georges,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
MD-005275,Planned Parenthood at Waldorf,Planned Parenthood of Maryland,1235242082,Family Planning Providers,3975 Saint Charles Pkwy,,Waldorf,MD,20602-2683,Charles,330 N Howard Street,,Baltimore,MD,21201,Baltimore City,Ana Calo,Revenue Cycle Manager,410-576-2147,,ana.calo@ppm.care,Carlos Plazas,VP of Finance,410-576-1548,,carlos.plazas@ppm.care,http://www.plannedparenthood.org/maryland/
MD-005276,"Owensville Primary Care, Inc.",OWENSVILLE PRIMARY CARE INC,1225110067,Federally Qualified Health Centers - Medical Services,134 Owensville Rd,,West River,MD,20778-9998,Anne Arundel,134 Owensville Rd,,West River,MD,20778-9998,Anne Arundel,Sharon Widmann,COO,410-867-4700,113,swidmann@owensvillepc.com,Courtney Corcoran,CFO,410-867-4700,138,ccorcoran@owensvillepc.com,owensvillepc.com
MD-005277,CARROLL COUNTY HEALTH DEPARTMENT,CARROLL COUNTY HEALTH DEPARTMENT,1366711145,"Family Planning Providers, Sexually Transmitted Disease Clinics",290 S Center St,,Westminster,MD,21157-5222,Carroll,290 S Center St,,Westminster,MD,21157-5222,Carroll,"Lynn Dodge, RN",Reproductive Health Supervisor,410-876-4944,,lynn.dodge@maryland.gov,"Barbara McDonald, RN",Reproductive Health Supervisor,410-876-4998,,barbara.mcdonald@maryland.gov,www.cchd.maryland.gov
MD-005278,SOMERSET COUNTY HEALTH DEPARTMENT,SOMERSET COUNTY HEALTH DEPARTMENT,1205810777,"Family Planning Providers, Sexually Transmitted Disease Clinics",7920 Crisfield Hwy,,Westover,MD,21871-3922,Somerset,7920 Crisfield Highway,,Westover,MD,21871,Somerset,Lee Ann Ennis,"RN, Community Health Program Manager",443-523-1764,,leeann.ennis@maryland.gov,,,,,,
MD-005279,Charles County Department of Health - White Plains,Charles County Health Dept.,1841377728,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4545 Crain Hwy,,White Plains,MD,20695-3045,Charles,4545 Crain Hwy,,White Plains,MD,20695-3045,Charles,Edith Patten,Family Planning Coordinator,301-609-6900,6898,edith.patten@maryland.gov,,,,,,http://www.charlescountyhealth.org/AdultServices/FamilyPlanning/tabid/70/Default.aspx
ME-005280,Lovejoy Health Center,HealthReach Community Health Centers,1922071745,Federally Qualified Health Centers - Medical Services,7 School St,Ste. No. 1,Albion,ME,04910-6501,Kennebec,10 Water Street,,Waterville,ME,04901,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Nona Quirion,Clinic Practice Manager,207-437-9388,,,
ME-005281,Katahdin Valley Health Center Ashland,KATAHDIN VALLEY HEALTH CENTER,1962833624,"Dental Providers, Federally Qualified Health Centers - Medical Services",33 Walker St,,Ashland,ME,04732-3429,Aroostook,529 SOUTH PATTEN ROAD,,Patten,ME,04765,Penobscot,Jaime Stanley,Billing Manager,207-528-2285,370,jaime.stanley@kvhc.org,Claudette Humphrey,CEO,207-528-2285,,,KVHC.ORG
ME-005282,The Horizon Program,MaineGeneral Medical Center,1376749911,Outpatient Hospital Clinics,9 Green St # 2,,Augusta,ME,04330-7451,Kennebec,35 Medical Center Parkway,,Augusta,ME,04330,Kennebec,Jennifer Karcher,Program Manager,207-621-3733,,jennifer.karcher@mainegeneral.org,,,,,,
ME-005283,PENOBSCOT COMMUNITY HLTH CENTER,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1427169010,Federally Qualified Health Centers - Medical Services,1012 Union St,,Bangor,ME,04401-3060,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005284,Dental Center,Penobscot Community Health Center,1053404996,Dental Providers,1048 Union St,,Bangor,ME,04401-3016,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005285,Penobscot Pediatrics,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1568555498,Federally Qualified Health Centers - Medical Services,1068 Union St,,Bangor,ME,04401-3016,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005286,Hope House Health Center,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1174845697,Federally Qualified Health Centers - Medical Services,181 Corporate Dr,,Bangor,ME,04401-4314,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,ceo@pchcbangor.org,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005287,CAPEHART COMMUNITY HEALTH CENTER,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1740373679,Federally Qualified Health Centers - Medical Services,86 Davis Rd,,Bangor,ME,04401-2311,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005288,Seaport Community Health Center,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1093136871,Federally Qualified Health Centers - Medical Services,53 Schoodic Dr,,Belfast,ME,04915-7246,Waldo,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005289,BELGRADE REGIONAL HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1851364632,Federally Qualified Health Centers - Medical Services,4 Clement Way,,Belgrade,ME,04917-4370,Kennebec,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Wendi Wainer,Practice Manager,207-495-3323,,,
ME-005290,BETHEL FAMILY HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1568435345,Federally Qualified Health Centers - Medical Services,32 Railroad St,,Bethel,ME,04217-3819,Oxford,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Dianna Milot,Clinic Director,207-824-2193,,,
ME-005291,Planned Parenthood of Northern New England - Biddeford,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,275 Main St,Suite 102,Biddeford,ME,04005-2432,York,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
ME-005292,BINGHAM AREA HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1942273727,"Dental Providers, Federally Qualified Health Centers - Medical Services",237 Main St,,Bingham,ME,04920-4015,Somerset,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Rochelle Dumont,Clinic Director,207-672-4187,,,
ME-005293,Brewer Medical Center,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1841475712,Federally Qualified Health Centers - Medical Services,735 Wilson St,,Brewer,ME,04412-1000,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005294,"Penobscot Community Health Center, Inc","PENOBSCOT COMMUNITY HEALTH CENTER, INC",1013000942,"Dental Providers, Federally Qualified Health Centers - Medical Services",79 Parkway S,BREWER HIGH SCHOOL CLINIC,Brewer,ME,04412-1627,Penobscot,1012 Union St Ste A,,Bangor,ME,04401-3060,Penobscot,Kenneth Schmidt,CEO,207-992-9200,,kschmidt@pchc.com,Christine McGlaughlin,VP Finance,207-992-9200,1443,cmcglaughlin@pchc.com,
ME-005295,"PENOBSCOT COMMUNITY HEALTH CENTER, INC","PENOBSCOT COMMUNITY HEALTH CENTER, INC",1013000942,"Dental Providers, Federally Qualified Health Centers - Medical Services",92 Pendleton St,Brewer Community School,Brewer,ME,04412-1776,Penobscot,1012 Union St Ste A,,Bangor,ME,04401-3060,Penobscot,Kenneth Schmidt,CEO,207-992-9200,,kschmidt@pchc.com,Christine McGlaughlin,VP Finance,207-992-9200,,cmcglaughlin@pchc.com,https://pchc.com/locations/brewer-school-based-health-centers/
ME-005296,Katahdin Valley Health Center Brownville,KATAHDIN VALLEY HEALTH CENTER,1053787721,"Dental Providers, Federally Qualified Health Centers - Medical Services",180 Main Rd,,Brownville,ME,04414-3107,Piscataquis,529 SOUTH PATTEN ROAD,,Patten,ME,04765,Penobscot,Jaime Stanley,Billing Manager,207-528-2285,370,jaime.stanley@kvhc.org,Claudette Humphrey,CEO,207-528-2285,320,claudette.humphrey@kvhc.org,KVHC.ORG
ME-005297,BUCKSPORT REGIONAL HEALTH CENTER,BUCKSPORT REGIONAL HEALTH CENTER,1043271133,"Dental Providers, Federally Qualified Health Centers - Medical Services",110 Broadway,,Bucksport,ME,04416-4612,Hancock,110 Broadway,,Bucksport,ME,04416-4612,Hancock,Carol Carew,CEO,207-469-7371,,ccarew@brhc.info,Susan England,CFO,207-469-7371,,,
ME-005298,Eastport Health Care Calais,EASTPORT HEALTH CARE INC,1568757946,Federally Qualified Health Centers - Medical Services,10 Palmer St,,Calais,ME,04619-1386,Washington,30 Boynton St,,Eastport,ME,04631-1397,Washington,Holly M Gartmayer-DeYoung,CEO,207-853-6001,,hdeyoung@eastporthealth.org,Camela Deschene,CFO,207-853-6001,136,cdeschene@eastporthealth.org,
ME-005299,Calais Regional Hospital,Calais Regional Hospital,1922001049,Inpatient Hospitals (other than children's hospitals),24 Hospital Ln,,Calais,ME,04619-1329,Washington,24 Hospital Lane,,Calais,ME,04619,Washington,Mary Brown,Exec Assistant to CEO,207-454-9201,,mary.brown@calaishospital.org,Rodney C. Boula,CEO,207-454-9201,,rod.boula@calaishospital.org,
ME-005300,REGIONAL MEDICAL CENTER CALAIS,REGIONAL MEDICAL CENTER AT LUBEC ME INC,1740283977,Federally Qualified Health Centers - Medical Services,5 Lowell St,,Calais,ME,04619-1712,Washington,43 S Lubec Rd,,Lubec,ME,04652-3620,Washington,Marilyn F Hughes,Chief Executive Officer,207-733-1090,2196,mhughes@rmcl.org,Terry Rier,Executive Adminstrative Assistant,207-733-1090,2116,trier@rmcl.org,
ME-005301,EASTPORT HEALTH CARE,EASTPORT HEALTH CARE INC,1770878167,Federally Qualified Health Centers - Medical Services,55 Franklin St,,Calais,ME,04619-1301,Washington,30 Boynton St,,Eastport,ME,04631-1397,Washington,Holly M Gartmayer-DeYoung,CEO,207-853-6001,,hdeyoung@eastporthealth.org,Camela Deschene,CFO,207-853-6001,136,cdeschene@eastporthealth.org,
ME-005302,Sebasticook Family Doctors - Canaan,SEBASTICOOK FAMILY DOCTORS,1518293547,Federally Qualified Health Centers - Medical Services,333 Main St,,Canaan,ME,04924-3407,Somerset,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Somerset,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005303,Pines WOMEN & CHILDREN'S CENTER,PINES HEALTH SERVICES,1528383262,Federally Qualified Health Centers - Medical Services,163 Van Buren Rd,Suite 4,Caribou,ME,04736-3567,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005304,PINES Caribou Health Center,PINES HEALTH SERVICES,1942277819,Federally Qualified Health Centers - Medical Services,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005305,SHEEPSCOT VALLEY HEALTH CENTER,HealthReach Community Health Centers,1841263118,Federally Qualified Health Centers - Medical Services,47 Main St,,Coopers Mills,ME,04341,Lincoln,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Christina Clark,Practice Manager,207-549-7581,,,
ME-005306,Corinth Medical Associates,Hospital Administrative District 4,1891888657,Rural Health Clinics,492 Main St,,Corinth,ME,04427-3273,Penobscot,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice Relations Coordinator,207-564-4476,,skoscielny@mayohospital.com,,,,,,
ME-005307,EAST GRAND HEALTH CENTER,EAST GRAND HEALTH CENTER,1467489666,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",201 Houlton Rd,,Danforth,ME,04424-3140,Washington,201 Houlton Rd,,Danforth,ME,04424-3140,Washington,Adelaide Carter,Administrator,207-448-2347,,addie.carter@eastgrand.org,,,,,,www.eastgrand.org
ME-005308,Sebasticook Family Doctors - Dexter,SEBASTICOOK FAMILY DOCTORS,1811223837,"Dental Providers, Federally Qualified Health Centers - Medical Services",29 Church St,,Dexter,ME,04930-1320,Penobscot,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Penobscot,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005309,DEXTER INTERNAL MEDICINE,Hospital Administrative District 4,1174645931,Rural Health Clinics,41 High St,,Dexter,ME,04930-1311,Penobscot,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice RelationsCoordinator,207-564-4476,,skoscielny@mayohospital.com,,,,,,
ME-005310,Sebasticook Family Doctors - Dover,SEBASTICOOK FAMILY DOCTORS,1831426022,Federally Qualified Health Centers - Medical Services,1008 W Main St,,Dover Foxcroft,ME,04426-3745,Piscataquis,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Penobscot,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005311,DOVER-FOXCROFT FAMILY PRACTICE,Hospital Administrative District 4,1548382328,Rural Health Clinics,891 W Main St,,Dover Foxcroft,ME,04426-1059,Piscataquis,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice Relations Coordinator,207-564-4464,,skoscielny@mayohospital.com,,,,,,
ME-005312,MAYO REGIONAL HOSPITAL,Hospital Administrative District 4,1558319103,Inpatient Hospitals (other than children's hospitals),897 W Main St,,Dover Foxcroft,ME,04426-1029,Piscataquis,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice Relations Coordinator,207-564-8401,,skoscielny@mayohospital.com,,,,,,
ME-005313,EAGLE LAKE HEALTH CENTER,FISH RIVER RURAL HEALTH,1376761288,"Dental Providers, Federally Qualified Health Centers - Medical Services",10 Carter St,,Eagle Lake,ME,04739,Aroostook,10 Carter St,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing Manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005314,MERCY HOME,FISH RIVER RURAL HEALTH,1376761288,Federally Qualified Health Centers - Medical Services,3388 Aroostook Rd,,Eagle Lake,ME,04739-3239,Aroostook,10 Carter St,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing Manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005315,HEALTHWAYS/EAST MACHIAS CLINIC,REGIONAL MEDICAL CENTER AT LUBEC ME INC,1104967884,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",893 Main St,,East Machias,ME,04630-4051,Washington,43 S Lubec Rd,,Lubec,ME,04652-3620,Washington,Marilyn F Hughes,Chief Executive Officer,207-733-1090,2196,mhughes@rmcl.org,Terry Rier,Executive Administrative Assistant,207-233-1090,2116,trier@rmcl.org,www.rmcl.org
ME-005316,EASTPORT HEALTH CARE INC,"Eastport Health Care, Inc.",1093752917,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 Boynton St,,Eastport,ME,04631-1397,Washington,30 Boynton St,,Eastport,ME,04631,Washington,Holly Gartmayer-DeYoung,CEO,207-853-6001,,hdeyoung@eastporthealth.org,Camela Deschene,CFO,207-853-6001,136,cdeschene@eastporthealth.org,
ME-005317,Ellsworth Family Planning,Family Planning Association of Maine,1477768216,Family Planning Providers,248 State St,Suite 3A,Ellsworth,ME,04605-1850,Hancock,"248 State St, #3A",,Ellsworth,ME,04605,Hancock,Melissa Gray,Regional Manager,207-812-7030,,mgray@mainefamilyplanning.org,Sarah Bly,HIV/STD Surveillance Coordinator,207-287-3297,,,
ME-005318,Pines Kimball Community Health Center,PINES HEALTH SERVICES,1508291089,Federally Qualified Health Centers - Medical Services,11 Harmony Ln,,Fort Fairfield,ME,04742-3354,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005319,Bolduc Avenue Health Center,FISH RIVER RURAL HEALTH,1568838928,"Dental Providers, Federally Qualified Health Centers - Medical Services",12 Bolduc Ave,,Fort Kent,ME,04743-1602,Aroostook,10 Carter St,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005320,Fort Kent Family Planning,Family Planning Association of Maine,1477768216,Family Planning Providers,139 Market St,,Fort Kent,ME,04743-1410,Aroostook,139 Market St,,Fort Kent,ME,04743,Aroostook,Lynne Kaplowitz,Executive Associate,207-248-3927,3927,lkaplowitz@mainefamilyplanning.org,Melissa Gray,Regional Manager,207-402-3220,,mgray@mainefamilyplanning.org,
ME-005321,FOREST HILL MANOR,FISH RIVER RURAL HEALTH,1376761288,Federally Qualified Health Centers - Medical Services,25 Bolduc Ave,,Fort Kent,ME,04743-1601,Aroostook,10 Carter St,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing Manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005322,Fort Kent Health Center,FISH RIVER RURAL HEALTH,1174741094,Federally Qualified Health Centers - Medical Services,3 Mountainview Dr,,Fort Kent,ME,04743-1614,Aroostook,10 Carter St,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005323,Crosswinds Residential Care,Fish River Rural Health,1376761288,Federally Qualified Health Centers - Medical Services,40 Village Rd,,Fort Kent,ME,04743-1031,Aroostook,10 Carter Street,,Eagle Lake,ME,04739,Aroostook,Alyssa St.Peter,Billing Manager,207-444-5973,215,astpeter@frrh.org,,,,,,
ME-005324,GUILFORD MEDICAL ASSOCIATES,Hospital Administrative District 4,1508988627,Rural Health Clinics,3 Park St,,Guilford,ME,04443-6383,Piscataquis,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice Relations Coordinator,207-876-3547,,skoscielny@mayohospital.com,,,,,,
ME-005325,HARRINGTON FAMILY HEALTH CENTER,HARRINGTON FAMILY HEALTH CENTER,1255383972,"Dental Providers, Federally Qualified Health Centers - Medical Services",50 E Main St,,Harrington,ME,04643-3043,Washington,50 E Main St,,Harrington,ME,04643-3043,Washington,Lee Umphrey,CEO,207-483-4502,230,lee.umphrey@harringtonfamilyhealth.org,Sue Dalton,director of administration and finance,207-483-4502,223,sue.dalton@harringtonfamilyhealth.org,www.harringtonfamilyhealth.org
ME-005326,Houlton Band of Maliseet Indians,Maliseet Health & Wellness Center,1225124050,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",3 Clover Cir,,Houlton,ME,04730-3424,Aroostook,88 Bell Road,,Littleton,ME,04730,Aroostook,"Patti Sponzo-Bechard, RN, MSN",Health Director,207-532-2240,132,pbechard@maliseets.com,,,,,,
ME-005327,Katahdin Valley Health Center Houlton,KATAHDIN VALLEY HEALTH CENTER,1376618546,"Dental Providers, Federally Qualified Health Centers - Medical Services",59 Bangor St,,Houlton,ME,04730-1740,Aroostook,529 South Patten Rd,,Patten,ME,04765,Penobscot,Claudette Humphrey,CEO,207-528-2285,,claudette.humphrey@kvhc.org,Jaime Stanley,Billing Manager,207-528-2285,,jaime.stanley@kvhc.org,KVHC.ORG
ME-005328,Gardiner Health Care Facility,KATAHDIN VALLEY HEALTH CENTER,1184794299,Federally Qualified Health Centers - Medical Services,8 Holland St,,Houlton,ME,04730-1706,Aroostook,529 South Patten Rd,,Patten,ME,04765-3035,Penobscot,Claudette Humphrey,CEO,207-528-2285,,claudette.humphrey@kvhc.org,Jaime Stanley,Billing Manager,207-528-2285,370,jstanley@kvhc.org,KVHC.ORG
ME-005329,Penobscot Nation Health Department,Penobscot Nation,1639139140,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",23 Wabananki Way,,Indian Island,ME,04468,Penobscot,12 Wabanaki Way,,Indian Island,ME,04468,Penobscot,Candy Henderly,Director,207-817-7440,,candy.henderly@ihs.gov,Nicole Fields,Assistant Director,207-817-7404,,nicole.hines@ihs.gov,
ME-005330,Katahdin Valley Health Center Island Falls,KATAHDIN VALLEY HEALTH CENTER,1457421307,Federally Qualified Health Centers - Medical Services,1300 Crystal Rd,,Island Falls,ME,04747-4369,Aroostook,529 South Patten Rd,,Patten,ME,04765,Penobscot,CLAUDETTE HUMPHREY,CEO,207-528-2285,,claudette.humphrey@kvhc.org,Jaime Stanley,Billing Manager,207-528-2285,370,jaime.stanley@kvhc.org,KVHC.ORG
ME-005331,Jackman Community Health Center,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1669802849,Federally Qualified Health Centers - Medical Services,376 Main St,,Jackman,ME,04945-5214,Somerset,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005332,MT. ABRAM REGIONAL HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1023082385,Federally Qualified Health Centers - Medical Services,25 Depot St,,Kingfield,ME,04947-4208,Franklin,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Sherra Osgood,Clinic Administrator,207-265-4555,,,
ME-005333,DFD Russell Medical Center Inc - Leeds,DFD Russell Medical Center Inc,1952482804,Federally Qualified Health Centers - Medical Services,180 Church Hill Rd,Suite 1,Leeds,ME,04263-3418,Androscoggin,180 Church Hill Road,Ste 1,Leeds,ME,04263,Androscoggin,Laurie Davis,Director of Billing,207-524-3501,215,laurie.davis@dfdrussell.org,Laurie Kane-Lewis,CEO,207-524-3501,203,laurie.kane-lewis@dfdrussell.org,
ME-005334,CCS Family Health Center,Community Clinical Services,1568703791,Federally Qualified Health Centers - Medical Services,100 Campus Ave,,Lewiston,ME,04240-6040,Androscoggin,57 Birch Street,Suite 201,Lewiston,ME,04240,Androscoggin,Joan Churchill,Executive Director/CFO,207-513-3897,,jchurchill@stmarysmaine.com,Jessica Moulton,Director of Primary Care,,,jmoulton@stmarysmaine.com,www.communityclinicalservices.com
ME-005335,Western Maine Family Health Center,HealthReach Community Health Centers,1497728133,Federally Qualified Health Centers - Medical Services,16 Depot St,,Livermore Falls,ME,04254-1311,Androscoggin,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Michelle Berry,Practice Manager,207-897-4345,,,
ME-005336,"REGIONAL MEDICAL CENTER AT LUBEC, INC.",REGIONAL MEDICAL CENTER AT LUBEC ME INC,1740283977,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",43 S Lubec Rd,,Lubec,ME,04652-3620,Washington,43 S Lubec Rd,,Lubec,ME,04652-3620,Washington,Marilyn F Hughes,Chief Executive Officer,207-733-1090,2196,mhughes@rmcl.org,Terry Rier,Executive Office Assistant,207-733-1090,2116,trier@rmcl.org,www.rmcl.org
ME-005337,Eastport Health Care Machias,EASTPORT HEALTH CARE INC,1295020691,Federally Qualified Health Centers - Medical Services,53 Fremont St,,Machias,ME,04654-1320,Washington,30 Boynton St,,Eastport,ME,04631-1397,Washington,Holly M Gartmayer-DeYoung,CEO,207-853-6001,,hdeyoung@eastporthealth.org,Camela Deschene,CFO,207-853-6001,136,cdeschene@eastporthealth.org,
ME-005338,MADISON AREA HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1184698441,Federally Qualified Health Centers - Medical Services,8 S Main St,,Madison,ME,04950-4501,Somerset,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Colleen Cyr,Practice Manager,207-696-3992,,,
ME-005339,Katahdin Valley Health Center Millinocket,KATAHDIN VALLEY HEALTH CENTER,1003034406,"Dental Providers, Federally Qualified Health Centers - Medical Services",50 Summer St,,Millinocket,ME,04462-1400,Penobscot,529 South Patten Rd,,Patten,ME,04765,Penobscot,Claudette Humphrey,CEO,207-528-2285,,claudette.humphrey@kvhc.org,Jaime Stanley,BILLING MANGER,207-528-2285,370,jaime.stanley@kvhc.org,KVHC.ORG
ME-005340,MILO FAMILY PRACTICE,Hospital Administrative District 4,1033231154,Rural Health Clinics,135 Park St,,Milo,ME,04463-1729,Piscataquis,897 West Main Street,,Dover-Foxcroft,ME,04426,Piscataquis,Stephanie Koscielny,Practice Relations Coordinator,207-943-7752,,skoscielny@mayohospital.com,,,,,,
ME-005341,DFD Russell Medical Center - Monmouth,DFD Russell Medical Center,1528377454,Federally Qualified Health Centers - Medical Services,11 Academy Rd,,Monmouth,ME,04259-7035,Kennebec,180 Church Hill Road,Ste 1,Leeds,ME,04263-3418,Androscoggin,Laurie Davis,Director of Billing,207-524-3501,215,laurie.davis@dfdrussell.org,Laurie Kane-Lewis,CEO,207-524-3501,203,laurie.kane-lewis@dfdrussell.org,
ME-005342,Sebasticook Family Doctors,SEBASTICOOK FAMILY DOCTORS,1063464634,Federally Qualified Health Centers - Medical Services,118 Moosehead Trl,,Newport,ME,04953-4055,Penobscot,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Penobscot,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005343,HELEN HUNT HEALTH CENTER,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1629161559,Federally Qualified Health Centers - Medical Services,242 Brunswick St,,Old Town,ME,04468-1613,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005344,DIRIGO PINES RETIREMENT COMM.,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1356683981,Federally Qualified Health Centers - Medical Services,9 Alumni Dr,,Orono,ME,04473-3479,Penobscot,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1401,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
ME-005345,Katahdin Valley Health Center Patten,KATAHDIN VALLEY HEALTH CENTER,1669450524,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 Houlton St,,Patten,ME,04765-3035,Penobscot,529 South Patten Rd,,Patten,ME,04765,Penobscot,Claudette Humphrey,CEO,207-528-2285,,claudette.humphrey@kvhc.org,Jaime Stanley,Billing Manager,207-528-2285,370,jaime.stanley@kvhc.org,KVHC.ORG
ME-005346,Pleasant Point Health Center,Pleasant Point Health Center,1760474613,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",11 Back Rd,,Perry,ME,04667-4119,Washington,PO Box 351,,Perry,ME,04667-0351,Washington,Brian Altvater,Health Director,207-853-0644,,brian.altvater@ihs.gov,Kirk Altvater,Asst Health Director,207-853-5010,,kirk.altvater@ihs.gov,
ME-005347,Sebasticook Family Doctors - Pittsfield,SEBASTICOOK FAMILY DOCTORS,1952637985,Federally Qualified Health Centers - Medical Services,140 Chandler St,,Pittsfield,ME,04967-3711,Somerset,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Penobscot,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005348,Sebasticook Valley Health Professional Building,SEBASTICOOK FAMILY DOCTORS,1396026803,Dental Providers,453 Main St,,Pittsfield,ME,04967-5310,Somerset,118 Moosehead Trl Ste 5,,Newport,ME,04953-4056,Penobscot,Robin Winslow,CEO,207-368-4213,,rwinslow@sfdchc.org,Joshua Snowman,CFO,207-355-3501,,jsnowman@sfdchc.org,
ME-005349,Sacopee Valley Health Center,Sacopee Valley Health Center,1952470411,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",70 Main St,,Porter,ME,04068-3527,Oxford,70 Main Street,,Porter,ME,04068,Oxford,Nancy Buck,HR and Facilities Coordinator,207-625-2214,,nbuck@svhc.org,Michelle Eastman,Controller,207-625-2235,,meastman@svhc.org,www.svhc.org
ME-005350,Greater Portland Health,Portland Community Health Center,1609120856,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",180 Park Ave,,Portland,ME,04102-2957,Cumberland,180 Park Avenue,,Portland,ME,04101,Cumberland,Ann Tucker,CFO,207-874-2141,3886,atucker@greaterportlandhealth.org,,,,,,
ME-005351,Maine Hemophilia and Thrombosis Center,Maine Medical Center,1053647024,Hemophilia Treatment Centers,22 Bramhall St,,Portland,ME,04102-3175,Cumberland,22 Bramhall Street,,Portland,ME,04074,Cumberland,Glen Roy,Nurse Coordinator,207-396-7683,,royg@mmc.org,Eric Larsen,Medical Director,207-396-7565,,larsee1@mmc.org,
ME-005352,Planned Parenthood of Northern New England- Portland,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",443 Congress St,Suite 200,Portland,ME,04101-3581,Cumberland,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
ME-005353,PINES Presque Isle FAMILY HEALTH CENTER,PINES HEALTH SERVICES,1518283126,Federally Qualified Health Centers - Medical Services,66 Spruce St,Suite 4,Presque Isle,ME,04769-3241,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005354,Micmac Service Unit,Micmac Service Unit/Presque Isle Health Center,1316031016,"Dental Providers, Indian Health Service, Other ECP Providers",8 Northern Rd,,Presque Isle,ME,04769-2040,Aroostook,8 Northern Rd,,Presque Isle,ME,04769-2040,Aroostook,Dawn Schillinger,Administrative Officer,207-764-7219,2109,Dawn.Schillinger@ihs.gov,Theresa Cochran,Health Systems Administrator,207-764-7219,2100,Theresa.Cochran@ihs.gov,
ME-005355,ST. CROIX REGIONAL FAMILY HEALTH CENTER,SAINT CROIX REGIONAL FAMILY HEALTH CENTER,1831174614,"Dental Providers, Federally Qualified Health Centers - Medical Services",136 Mill St,,Princeton,ME,04668-3344,Washington,136 Mill St,,Princeton,ME,04668-3344,Washington,Corinne A. LaPlant,Executive Director,207-796-5503,320,scrfhc.cal@hotmail.com,C. Denise Harriman,Office Manager,207-796-5503,306,scrfhc@hotmail.com,
ME-005356,Rangeley Family Medicine,HealthReach Community Health Centers,1497729750,Federally Qualified Health Centers - Medical Services,42 Dallas Hill Rd,PO Box 569,Rangeley,ME,04970-4032,Franklin,10 Water Street,Suite 305,Waterville,ME,04901,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Kate Quimby,Clinic Practice Manager,207-864-3303,,,
ME-005357,RICHMOND AREA HEALTH CENTER,HEALTHREACH COMMUNITY HEALTH CENTERS,1164496410,Federally Qualified Health Centers - Medical Services,24 Gardiner St,,Richmond,ME,04357-1336,Sagadahoc,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Leslie Coombs,Clinic Administrator,207-737-4359,,,
ME-005358,Planned Parenthood of Northern New England- Sanford,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",886 Main St,Suite 302,Sanford,ME,04073-7009,York,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
ME-005359,Nasson Health Care,York County Community Action Corporation,1497923916,"Dental Providers, Federally Qualified Health Centers - Medical Services",15 Oak St,,Springvale,ME,04083-1926,York,6 Spruce Street,,Sanford,ME,04073,York,Martin Sabol,Director of Health Services,207-608-4470,,martin.sabol@nassonhealthcare.org,Sherri Jordan,Operations Manager,207-608-2615,,sherri.jordan@nassonhealthcare.org,nassonhealthcare.org
ME-005360,STRONG AREA HEALTH CENTER,HealthReach Community Health Centers,1417921776,"Dental Providers, Federally Qualified Health Centers - Medical Services",177 N Main St,,Strong,ME,04983-3005,Franklin,10 Water St Ste 305,,Waterville,ME,04901-6566,Kennebec,Constance R Coggins,President/CEO,207-872-5610,,constance.coggins@healthreach.org,Marguerite Willihan,Practice Manager,207-684-4010,,,
ME-005361,Planned Parenthood of Northern New England- Topsham,PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",4 Bowdoin Mill Is,Suite 101,Topsham,ME,04086-1276,Sagadahoc,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
ME-005362,Pines ST. JOHN VALLEY HEALTH CENTER,PINES HEALTH SERVICES,1629393327,Federally Qualified Health Centers - Medical Services,4 Main St,,Van Buren,ME,04785-1009,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005363,"Islands Community Medical Services, Inc.","Islands Community Medical Services, Inc.",1265460794,"Dental Providers, Federally Qualified Health Centers - Medical Services",15 Medical Center Loop,,Vinalhaven,ME,04863-4119,Knox,15 Medical Center Loop,,Vinalhaven,ME,04863,Knox,Dinah B. Moyer,Executive Director,207-863-4109,,dmoyer@icmsvh.org,Christina Quinlan,Director of Operations,207-863-4341,1111,cquinlan@icmsvh.org,
ME-005364,Pines Washburn Health Center,PINES HEALTH SERVICES,1922449834,Federally Qualified Health Centers - Medical Services,1260 Main St,,Washburn,ME,04786-3225,Aroostook,74 Access Hwy,,Caribou,ME,04736-3807,Aroostook,James M Davis,Chief Executive Officer,207-498-2359,2022,jdavis@pineshealth.org,Lisa Caron,Chief Operating Officer,207-498-2359,2015,lcaron@pineshealth.org,www.pineshealthservices.org
ME-005365,Winterport Community Health Center,"PENOBSCOT COMMUNITY HEALTH CENTER, INC",1093136871,Federally Qualified Health Centers - Medical Services,775 N Main St,,Winterport,ME,04496-3414,Waldo,103 Maine Ave.,PO Box 1358,Bangor,ME,04402-1358,Penobscot,Kenneth Schmidt,President & CEO,207-992-9200,1491,kschmidt@pchc.com,Christine Finn-McLaughlin,CFO,207-992-9200,1443,cmclaughlin@pchc.com,http://pchc.com/
MI-005366,Lenawee County Health Department,Michigan Department of Community Health,1619066495,Family Planning Providers,1040 S Winter St,Suite 2328,Adrian,MI,49221-3876,Lenawee,1040 S Winter St,Ste 2328,Adrian,MI,49221-3876,Lenawee,Lisa McConnell,Nurse Practitioner Clinical Supervisor,517-264-5231,,lmcconnell@hline.org,Deidre Reed,Nursing Director,517-264-5233,,dreed@hline.org,http://www.lenaweehealthdepartment.org
MI-005367,Family Medical Center of MI - Adrian,FAMILY MEDICAL CENTER OF MICHIGAN INC,1457640930,"Dental Providers, Federally Qualified Health Centers - Medical Services",1200 N Main St,,Adrian,MI,49221-1759,Lenawee,8765 Lewis Ave,,Temperance,MI,48182-9583,Monroe,Ed Louis Larkins,CEO,734-654-2169,,elarkins@familymedical.org,,,,,,
MI-005368,PEDIATRIC CENTER OF ADRIAN,Pediatric Center of Adrian,1700925039,Rural Health Clinics,770 Riverside Ave,Suite 17,Adrian,MI,49221-1465,Lenawee,770 Riverside Ave,Suite 17,Adrian,MI,49221,Lenawee,Amy Drake,Billing,419-697-4416,,pediatric.center@buckeye-express.com,,,,,,
MI-005369,Grace Health,"Grace Health, Inc.",1134160534,"Dental Providers, Federally Qualified Health Centers - Medical Services",115 Market Pl,,Albion,MI,49224-1767,Calhoun,181 W. Emmett Street,,Battle Creek,MI,49037,Calhoun,AJ Jones,President/CEO,269-966-2600,,aj.jones@gracehealthmi.org,Scott Hutchings,CFO,269-966-2600,,scott.hutchings@gracehealthmi.org,www.gracehealthmi.org
MI-005370,Sterling Dental Clinic,Sterling Area Health Center,1689659450,Dental Providers,5095 Rifle River Trl,,Alger,MI,48610-9327,Ogemaw,725 E State Street,,Sterling,MI,48659,Arenac,James J Balten Jr,President/Chief Executive Officer,989-524-3750,,JBalten@sterlinghealth.net,,,,,,
MI-005371,"DOWNRIVER COMMUNITY SERVICES, INC.",DOWNRIVER COMMUNITY SERVICES INC,1851399570,Federally Qualified Health Centers - Medical Services,555 Saint Clair River Dr,,Algonac,MI,48001-1802,Saint Clair,555 Saint Clair River Dr,,Algonac,MI,48001-1802,Saint Clair,Michael Baranowski,CEO,586-270-8055,251,mbaranowski@downrivercs.org,Janice Daugherty,Billing Supervisor,586-749-5197,234,jdaugherty@downrivercs.org,
MI-005372,Family Planning Assoc. of Allegan,Michigan Dept. of Community Health,1083694715,Family Planning Providers,3255 122nd Ave,Suite No. 200,Allegan,MI,49010-9511,Allegan,3255 122nd Ave,,Allegan,MI,49010-9511,Allegan,Julia Diaz,Family Planning Coordinator,269-686-4560,,jdiaz@allegancounty.org,,,,,,http://www.familyplanningofallegan.org
MI-005373,Allegan Medical Clinic,Allegan Professional Health Services,1134281223,Rural Health Clinics,551 Linn St,,Allegan,MI,49010-1595,Allegan,551 Linn Street,,Allegan,MI,49010,Allegan,David Beeson,Administrator,269-686-5801,,davidbeeson@aghosp.com,Lisa Striegle,Clinical Manager,269-686-5876,,lisastriegle@aghosp.com,http://alleganhealth.com/
MI-005374,Center for OB Alma,MidMichigan Medical Center - Gratiot,1912089350,Rural Health Clinics,315 E Warwick Dr,Suite D,Alma,MI,48801-1083,Gratiot,300 E Warwick Drive,,Alma,MI,48801,Gratiot,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Mark Santamaria,President,989-466-3258,,mark.santamaria@midmichigan.org,
MI-005375,Family Practice Center - Alma,MidMichigan Medical Center - Gratiot,1265596126,Rural Health Clinics,330 E Warwick Dr,,Alma,MI,48801-1014,Gratiot,300 E. Warwick Drive,,Alma,MI,48801,Gratiot,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Mark Santamaria,President,989-466-3258,,mark.santamaria@midmichigan.org,
MI-005376,District Health Department No. 4-Alpena,District Health Department No. 4,1760443584,"Family Planning Providers, Sexually Transmitted Disease Clinics",100 Woods Cir,Suite 200,Alpena,MI,49707-1443,Alpena,100 Woods Cir Ste 200,,Alpena,MI,49707-1443,Alpena,Karen Nowicki-Compeau RN BSN,Family Planning Coordinator,989-356-4507,7960,kcompeau@dhd4.org,Amy Fournier,Account Clerk,989-356-4507,7947,afournier@dhd4.org,http://www.dhd4.org
MI-005377,ALCONA HLTH CTR-ALPENA SERVICES,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,"Dental Providers, Federally Qualified Health Centers - Medical Services",1185 US Highway 23 N,,Alpena,MI,49707-8004,Alpena,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-3020,,cbaumgard@alconahc.org,,,,,,
MI-005378,AHC - Wildcat Health Extension,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,309 W Lake St,,Alpena,MI,49707-2216,Alpena,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005379,C.S. MOTT CHILDREN'S HOSPITAL (UNIVERSITY OF MICHIGAN HEALTH SYSTEM),REGENTS OF THE UNIVERSITY OF MICHIGAN,1003878539,Children's Hospitals (inpatient only),1500 E Medical Center Dr,,Ann Arbor,MI,48109-5002,Washtenaw,1500 E Medical Center Dr,,Ann Arbor,MI,48109,Washtenaw,Thomas Daly,Contracting Officer,734-764-1114,,tdaly@med.umich.edu,,,,,,http://www.med.umich.edu
MI-005380,UNIVERSITY HOSPITAL (UNIVERSITY OF MICHIGAN HEALTH SYSTEM),REGENTS OF THE UNIVERSITY OF MICHIGAN,1003878539,Inpatient Hospitals (other than children's hospitals),1500 E Medical Center Dr,,Ann Arbor,MI,48109-5002,Washtenaw,1500 E Medical Center Dr,,Ann Arbor,MI,48109,Washtenaw,Thomas Daly,Contracting Officer,734-764-1114,,tdaly@med.umich.edu,,,,,,http://www.med.umich.edu
MI-005381,UNIVERSITY OF MICHIGAN HEALTH SYSTEM,REGENTS OF THE UNIVERSITY OF MICHIGAN,1003878539,"Family Planning Providers, Hemophilia Treatment Centers, Other ECP Providers, Ryan White Providers, Tuberculosis Clinics",1500 E Medical Center Dr,,Ann Arbor,MI,48109-5002,Washtenaw,1500 E Medical Center Dr,,Ann Arbor,MI,48109,Washtenaw,Thomas Daly,Contracting Officer,734-764-1114,,tdaly@med.umich.edu,,,,,,http://www.med.umich.edu
MI-005382,Planned Parenthood of Michigan - Ann Arbor West Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",2370 W Stadium Blvd,,Ann Arbor,MI,48103-3843,Washtenaw,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005383,Planned Parenthood of Michigan - Ann Arbor Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",3100 Professional Dr,,Ann Arbor,MI,48104-5131,Washtenaw,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005384,Packard Main,"PACKARD HEALTH, INC.",1609988245,Federally Qualified Health Centers - Medical Services,3174 Packard St,,Ann Arbor,MI,48108-1947,Washtenaw,3174 Packard St,,Ann Arbor,MI,48108-1947,Washtenaw,Raymond Rion,Executive Director,734-971-1073,,rrion@packardhealth.org,,,,,,
MI-005385,Packard West,"PACKARD HEALTH, INC.",1609988245,Federally Qualified Health Centers - Medical Services,501 N Maple Rd,,Ann Arbor,MI,48103-2827,Washtenaw,3174 Packard St,,Ann Arbor,MI,48108-1947,Washtenaw,Raymond Rion,Executive Director,734-971-1073,,rrion@packardhealth.org,,,,,,
MI-005386,Cascade Hemophilia Consortium,Cascade Hemophilia Consortium,1922019561,Hemophilia Treatment Centers,517 W William St,,Ann Arbor,MI,48103-4943,Washtenaw,517 West William Street,,Ann Arbor,MI,48103,Washtenaw,Stephanie Raymond,Executive Director,734-996-3300,,sraymond@cascadehc.org,,,,,,cascadehc.org
MI-005387,Sparrow Medical Group Ashley,Sparrow Carson Hospital,1225008048,Rural Health Clinics,320 S Sterling St,,Ashley,MI,48806-5110,Gratiot,406 East Elm St.,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005388,THUNDER BAY COMM HEALTH SERVICE - ATLANTA,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1639123623,"Dental Providers, Federally Qualified Health Centers - Medical Services",11899 M 32,,Atlanta,MI,49709-9374,Montmorency,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,,mstyma@tbchs.org,,,,,,
MI-005389,District Health Department No. 4-Atlanta,District Health Department No. 4,1760443584,"Family Planning Providers, Sexually Transmitted Disease Clinics",12519 State St,PO Box 183,Atlanta,MI,49709-9622,Montmorency,100 Woods Circle Suite 200,,Alpena,MI,49707,Alpena,Karen Nowicki-Compeau RN BSN,Family Planning Coordinator,989-356-4507,7960,kcompeau@dhd4.org,Amy Fournier,Account Clerk,989-356-4507,7947,afournier@dhd4.org,http://www.dhd4.org
MI-005390,Huron County Health Department,Huron County Health Department,1073638219,"Family Planning Providers, Sexually Transmitted Disease Clinics",1142 S Van Dyke Rd Frnt,,Bad Axe,MI,48413-9806,Huron,1142 S. Van Dyke,,Bad Axe,MI,48413,Huron,Mitzi Koroleski,Health Services Director,989-269-3323,,mkoroleski@hchd.us,,,,,,
MI-005391,GLBHC Integrated Care Thumb Area,Great Lakes Bay Health Centers,1922421387,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1375 R Dale Wertz Dr,,Bad Axe,MI,48413-1365,Huron,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,www.greatlakesbayhealthcenters.org
MI-005392,GLBHC Thumb Area,Great Lakes Bay Health Centers,1386066959,"Dental Providers, Federally Qualified Health Centers - Medical Services",876 N Van Dyke Rd,,Bad Axe,MI,48413-9016,Huron,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005393,BALDWIN FAMILY HEALTH CARE,BALDWIN FAMILY HEALTH CARE,1689783698,"Dental Providers, Federally Qualified Health Centers - Medical Services",1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005394,BALDWIN TEEN HEALTH CENTER,BALDWIN FAMILY HEALTH CARE,1801016613,"Dental Providers, Federally Qualified Health Centers - Medical Services",525 4th St,,Baldwin,MI,49304-9518,Lake,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005395,District Health Department # 10,District Health Department #10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",5681 S M 37,,Baldwin,MI,49304-7983,Lake,1049 Newell St.,P.O. Box,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005396,INTERCARE BANGOR,INTERCARE COMMUNITY HEALTH NETWORK,1992818835,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",308 Charles St,Suite P,Bangor,MI,49013-1317,Van Buren,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,velma@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005397,Keweenaw Bay Indian Community Health Center,Keweenaw Bay Indian Community Health Center,1336232289,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",102 Superior Ave,,Baraga,MI,49908-9673,Baraga,102 Superior Ave,,Baraga,MI,49908-9673,Baraga,Carole LaPointe,Health Director,906-353-4553,,clapointe@kbic-nsn.gov,Kathy Mayo,Assistant Health Director,906-353-4519,,kmayo@kbic-nsn.gov,www.ojibwa.com
MI-005398,Grace Health,Grace Health Inc.,1518945278,"Dental Providers, Federally Qualified Health Centers - Medical Services",181 Emmett St W,,Battle Creek,MI,49037-2963,Calhoun,181 W. Emmett Street,,Battle Creek,MI,49037,Calhoun,AJ Jones,President/CEO,269-966-2600,,aj.jones@gracehealthmi.org,Scott Hutchings,CFO,269-966-2600,,scott.hutchings@gracehealthmi.org,www.gracehealthmi.org
MI-005399,Calhoun County Public Health Department,Calhoun County Public Health Department,1699868703,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",190 E Michigan Ave,Suite A100,Battle Creek,MI,49014-4019,Calhoun,190 E Michigan Ave,,Battle Creek,MI,49014,Calhoun,Michelle Thorne,Personal Health Manager,269-969-6334,,mthorne@calhouncountymi.gov,Lynn Corrigan,Fiscal Support Specialist,269-969-6376,,lcorrigan@calhouncountymi.gov,
MI-005400,Bay Co. Health Dept.,Michigan Dept. of Community Health,1568408128,"Family Planning Providers, Other ECP Providers",1200 Washington Ave,,Bay City,MI,48708-5756,Bay,1200 Washington Ave,,Bay City,MI,48708-5756,Bay,Kathleen Janer,Family Planning Coordinator,989-895-2077,,janerk@baycounty.net,Joel Strasz,Health Officer,989-895-2018,,straszj@baycounty.net,baycounty-mi.gov/health
MI-005401,GLBHC Women's Care Bay City,Great Lakes Bay Health Centers,1881712669,Federally Qualified Health Centers - Medical Services,3175 Professional Ct,,Bay City,MI,48706-2823,Bay,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005402,GLBHC Bayside,Great Lakes Bay Health Centers,1982722039,"Dental Providers, Federally Qualified Health Centers - Medical Services",3884 Monitor Rd,,Bay City,MI,48706-9298,Bay,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005403,"Family Health & Wellness,pc","Family Health & Wellness,pc",1952858987,Rural Health Clinics,129 W Brown St,,Beaverton,MI,48612-8119,Gladwin,129 W BROWN ST,,BEAVERTON,MI,48612-8119,Gladwin,William E. Berner,Clinic Administrator,989-892-7722,,Bernermedical@hotmail.com,,,,,,
MI-005404,MidMichigan Medical Offices - Beaverton,"MIDMICHIGAN HEALTH SERVICES, INC",1114278140,Federally Qualified Health Centers - Medical Services,439 S Ross St,,Beaverton,MI,48612-9101,Gladwin,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005405,Spectrum Health Belding Family Medicine,Spectrum Health United,1306289558,Rural Health Clinics,1227 W State St,,Belding,MI,48809-9246,Ionia,615 S Bower St,,Greenville,MI,48838,Montcalm,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,Analyst,231-832-8533,,Roxanne.Brower@spectrumhealth.org,
MI-005406,Charles R Barker Jr DO Family Practice,Charles R Barker Jr DO Family Practice,1962595546,Rural Health Clinics,1320 W State St,Suite 3A,Belding,MI,48809-9245,Ionia,1320 W State Street,Suite 3A,Belding,MI,48809-2272,Ionia,Charles R Barker Jr DO,Office Manager,616-794-1810,,drcharlesbarker@yahoo.com,Cynthia Geisen,Patient Accounting Manager,616-794-1810,,drcharlesbarker@yahoo.com,
MI-005407,Bellaire Family Health Center,EAST JORDAN FAMILY HEALTH CENTER,1376750091,Federally Qualified Health Centers - Medical Services,4955 S M 88 Hwy,,Bellaire,MI,49615-9082,Antrim,601 Bridge St,,East Jordan,MI,49727-9383,Charlevoix,Daniel McKinnon,Executive Director,231-536-2206,111,dmckinnon@ejfhc.org,Diane Hawley,DOO,231-536-2206,102,dhawley@ejfhc.org,
MI-005408,Planned Parenthood of Michigan - Benton Harbor Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",1161 E Napier Ave,,Benton Harbor,MI,49022-3958,Berrien,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005409,INTERCARE RIVERWOOD,INTERCARE COMMUNITY HEALTH NETWORK,1902235328,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1485 M 139,,Benton Harbor,MI,49022-5711,Berrien,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005410,Berrien County Health Department-Benton Harbor,Berrien County Health Department,1326005109,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2149 E Napier Ave,,Benton Harbor,MI,49022-1846,Berrien,2149 East Napier Avenue,,Benton Harbor,MI,49022,Berrien,Peggy Hamel,Clinical and Community Health Services Manager,269-926-7121,5663,phamel@bchdmi.org,Stephanie Schadler,Clinic Coordinator,269-926-7121,5289,sschadler@bchdmi.org,
MI-005411,INTERCARE BENTON HARBOR,INTERCARE COMMUNITY HEALTH NETWORK,1982614103,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",800 M 139,,Benton Harbor,MI,49022-3881,Berrien,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005412,INTERCARE CHILD AND ADOLESCENT HEALTH CENTER,INTERCARE COMMUNITY HEALTH NETWORK,1558506253,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",870 Colfax Ave,,Benton Harbor,MI,49022-7409,Berrien,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005413,Benzie-Leelanau Dist. Health Department #001,Benzie-Leelanau District Health Department,1881719086,Family Planning Providers,6051 Frankfort Hwy,,Benzonia,MI,49616-9657,Benzie,6051 Frankfort Hwy,,Benzonia,MI,49616,Benzie,Michelle Klein,Director of Personal Health,231-256-0210,,mklein@bldhd.org,,,,,,
MI-005414,Western Upper Peninsula Health Department,Michigan Department of Community Health,1275660995,"Family Planning Providers, Sexually Transmitted Disease Clinics",210 N Moore St,,Bessemer,MI,49911-1057,Gogebic,210 Moore St.,,Bessemer,MI,49911,Gogebic,Barbara Auten,Director of Public Health and Education,906-482-7382,,bauten@wuphd.org,,,,,,http://www.westernuphealth.org
MI-005415,Planned Parenthood of Michigan - Big Rapids Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",110 Sanborn Ave,Suite B,Big Rapids,MI,49307-1769,Mecosta,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005416,District Health Department No. 10,District Health Dept. No. 10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",14485 Northland Dr,,Big Rapids,MI,49307-2368,Mecosta,1049 Newell St,P.O. Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3054,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005417,Spectrum Health Big Rapids Hospital,Mecost County Medical Center,1316945991,Inpatient Hospitals (other than children's hospitals),605 Oak St,,Big Rapids,MI,49307-2048,Mecosta,605 Oak St,,Big Rapids,MI,49307,Mecosta,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005418,SPECTRUM HEALTH BIG RAPIDS HOSPITAL FAMILY MEDICINE,Spectrum Health Big Rapids Hospital,1184912396,Rural Health Clinics,650 Linden St,Suite 1,Big Rapids,MI,49307-1880,Mecosta,605 Oak St,,Big Rapids,MI,49307,Mecosta,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005419,Spectrum Health Big Rapids Hospital Obstetrics and Gynecology,Spectrum Health Big Rapids Hospital,1891109591,Rural Health Clinics,722 Locust St,,Big Rapids,MI,49307-2040,Mecosta,605 Oak St,,Big Rapids,MI,49307,Mecosta,Teresa Arlene Treiber,Manager Finance RH and CAH,231-832-8509,,Teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,Roxanne.brower@spectrumhealth.org,
MI-005420,MidMichigan Medical Offices - Breckenridge,MidMichigan Medical Center - Gratiot,1265596126,Rural Health Clinics,302 W Chestnut St,,Breckenridge,MI,48615-9579,Gratiot,300 E Warwick Drive,,Alma,MI,48801,Gratiot,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Mark Santamaria,President,989-466-3258,,mark.santamaria@midmichigan.org,
MI-005421,GLBHC Bridgeport,Great Lakes Bay Health Centers,1982722039,"Dental Providers, Federally Qualified Health Centers - Medical Services",6297 Dixie Hwy,,Bridgeport,MI,48722-9635,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005422,Bay Mills Health Center,Bay Mills Indian Community,1053592089,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service",12124 W Lakeshore Dr,,Brimley,MI,49715-9319,Chippewa,12124 W Lakeshore Dr,,Brimley,MI,49715-9319,Chippewa,Audrey Breakie,Health Director,906-248-8327,,abreakie@baymills.org,Abby Kaunisto,Clinic Coordinator,906-248-8315,,akaunisto@baymills.org,
MI-005423,Henry Ford Macomb Health Center-Bruce Township,Macomb County Health Department,1528159258,Family Planning Providers,80650 Van Dyke Rd,,Bruce Twp,MI,48065-1333,Macomb,43525 Elizabeth,,Mt. Clemens,MI,48043,Macomb,Patricia Detrick,Public Health Services Coordinator,586-469-2055,,patricia.detrick@macombgov.org,Lillian Schreiber,,586-469-5523,,lillian.schreiber@macombgov.org,
MI-005424,Northern Pines Health Center,Northern Pines Health Center,1578547071,Rural Health Clinics,11293 N M 37,Suite A,Buckley,MI,49620-9593,Wexford,11293 N M37 Suite A,,Buckley,MI,49620,Wexford,Keisha Sexton,Office Manager,231-269-4185,,keishasexton@northernpineshealthcenter.com,,,,,,
MI-005425,Planned Parenthood of Michigan - Burton Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",G-1235 S Center Rd,,Burton,MI,48509,Genesee,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005426,Genesee Co. Health Dept.,Genesee County Health Department,1154370344,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",G3373 S Saginaw St,,Burton,MI,48529-1244,Genesee,G3373 S Saginaw St,,Burton,MI,48529-1244,Genesee,Toni LaRocco,Director of Nursing,810-237-4544,,tlarocco@gchd.us,Dianna LaBonte,Family Planning Coordinator,810-237-4608,,dlabonte@gchd.us,http://www.gchd.us
MI-005427,HCHN - New Burton,"HAMILTON COMMUNITY HEALTH NETWORK, INC.",1720152275,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",G3375 S Saginaw St,,Burton,MI,48529-1277,Genesee,225 E. Fifth St Ste 300,,Flint,MI,48502-2045,Genesee,Clarence R Pierce,CEO,810-406-4951,4951,cpierce@hamiltonchn.org,,,,,,
MI-005428,GREAT LAKES FAMILY CARE,BALDWIN FAMILY HEALTH CARE,1982815932,"Dental Providers, Federally Qualified Health Centers - Medical Services",520 Cobb St,,Cadillac,MI,49601-2588,Wexford,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005429,District Health Department #10,District Health Department. #10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",521 Cobb St,,Cadillac,MI,49601-2599,Wexford,1049 Newell St.,P.O.Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005430,Cadillac Primary Care & OB/GYN,Munson Healthcare Cadillac,1912303728,Rural Health Clinics,7985 Mackinaw Trl,,Cadillac,MI,49601-8111,Wexford,400 Hobart Street,,Cadillac,MI,49601,Wexford,Trisha Teare,Billing Manager,231-876-7234,,tteare@mhc.net,,,,,,
MI-005431,CALUMET FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1114354479,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",56901 S 6th St,,Calumet,MI,49913-2946,Houghton,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005432,FAMILY MEDICAL CENTER,FAMILY MEDICAL CENTER OF MICHIGAN INC,1043501539,"Dental Providers, Federally Qualified Health Centers - Medical Services",130 Medical Center Dr,,Carleton,MI,48117-9461,Monroe,8765 Lewis Ave,,Temperance,MI,48182-9583,Monroe,Ed Larkins,CEO,734-850-6914,,elarkins@familymedical.org,,,,,,
MI-005433,Tuscola Co Health Department,Tuscola Co Health Department,1669497053,Family Planning Providers,1309 Cleaver Rd,Suite B,Caro,MI,48723-9114,Tuscola,1309 Cleaver Rd,Ste B,Caro,MI,48723,Tuscola,Kristi Villalobos,Department Coordinator,989-673-8114,147,kvillalobos@tchd.us,Ann Hepfer,Nursing Administrator,989-673-8114,117,ahepfer@tchd.us,www.tchd.us
MI-005434,"Caro Health Plaza, PLC","Caro Health Plaza, PLC",1689022469,Rural Health Clinics,1525 W Caro Rd,,Caro,MI,48723-9686,Tuscola,1525 W. Caro Rd.,,Caro,MI,48723,Tuscola,William E. Berner,consultant,989-892-7722,,Bernermedical@hotmail.com,Julie Hilborn,Office Manager,989-672-2100,,hilbornj10@hotmail.com,
MI-005435,Sparrow Medical Group Carson City,Sparrow Carson Hospital,1013987833,Rural Health Clinics,102 S 3rd St,,Carson City,MI,48811-5115,Gratiot,406 East Elm St,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005436,Sparrow Medical Group Pediatrics Carson City,Sparrow Carson Hospital,1629048491,Rural Health Clinics,245 S 2nd St,,Carson City,MI,48811-9650,Gratiot,406 East Elm Street,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005437,Cass City Medical Practice,Hills & Dales General Hospital,1487924221,Rural Health Clinics,4674 Hill St,,Cass City,MI,48726-1009,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,Director of Finance,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,
MI-005438,Family Healthcare of Cass City,Hills & Dales General Hospital,1225257348,Rural Health Clinics,4675 Hill St,,Cass City,MI,48726-1008,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,Director of Finance,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,
MI-005439,"Hills & Dales General Hospital, Inc (inpatient hospital)","Hills & Dales General Hospital, Inc",1154367001,Inpatient Hospitals (other than children's hospitals),4675 Hill St,,Cass City,MI,48726-1008,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,VP of Finance/CFO,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,www.hdghmi.org
MI-005440,"Hills & Dales General Hospital, Inc (multiple outpatient ECP categories)","Hills & Dales General Hospital, Inc",1154367001,"Outpatient Hospital Clinics, Rural Health Clinics",4675 Hill St,,Cass City,MI,48726-1008,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,VP of Finance/CFO,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,www.hdghmi.org
MI-005441,Cass City Family Practice,Hills & Dales General Hospital,1144665456,Rural Health Clinics,6190 Hospital Dr,,Cass City,MI,48726-1072,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,Director of Finance,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEP,989-912-6325,,janthony@hillsanddales.com,
MI-005442,Thumb Pediatrics,Hills & Dales General Hospital,1487873501,Rural Health Clinics,6190 Hospital Dr,Suite 103,Cass City,MI,48726-1072,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,Director of Finance,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,
MI-005443,Ranger Wellness Center,LAKELAND IMMEDIATE CARE CENTER,1982677548,Federally Qualified Health Centers - Medical Services,22721 Diamond Cove St,,Cassopolis,MI,49031-9711,Cass,261 M 62,,Cassopolis,MI,49031-1034,Cass,Mary Geegan Middleton,CEO,269-445-5244,,mmiddleton@cassfamilyclinic.org,Tammy Howard,Chief Operating Officer,269-445-3874,135,thoward@cassfamilyclinic.org,http://cassfamilyclinic.org
MI-005444,Cassopolis Family Clinic,LAKELAND IMMEDIATE CARE CENTER,1982677548,"Dental Providers, Federally Qualified Health Centers - Medical Services",261 M 62,,Cassopolis,MI,49031-1034,Cass,261 M 62,,Cassopolis,MI,49031-1034,Cass,Mary Geegan Middleton,CEO,269-445-5244,,mmiddleton@cassfamilyclinic.org,Tammy Howard,Chief Operating Officer,269-445-3874,135,thoward@cassfamilyclinic.org,http://cassfamilyclinic.org
MI-005445,Cherry Street Services Inc,"CHERRY STREET SERVICES, INC.",1184015539,Federally Qualified Health Centers - Medical Services,204 E Muskegon St,Cedar Springs School Health Center,Cedar Springs,MI,49319-9326,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005446,White Pine Family Medicine,White Pine Family Medicine,1427062272,Rural Health Clinics,261 N Main,,Cedar Springs,MI,49319-8041,Kent,PO Box 221K,,Cedar Springs,MI,49319-8041,Kent,Nancy Moore,Practice Manager,616-696-2020,109,nmoore@wpfm.org,Angela Wilholt,Provider Incentive Coordinator,616-696-2020,116,awilholt@wpfm.org,www.wpfm.org
MI-005447,Eastside Periodontics,Eastside Periodontics,1174602049,Dental Providers,25523 Van Dyke Ave,,Center Line,MI,48015-1824,Macomb,25523 Van Dyke Ave.,,Center Line,MI,48015,Macomb,Susan White,Office Manager,586-757-5454,,susan@jackschwarczperio.com,,,,,,
MI-005448,Center Line,MyCare Health Center,1811391212,"Dental Providers, Federally Qualified Health Centers - Medical Services",6900 E 10 Mile Rd,,Center Line,MI,48015-1168,Macomb,6800 E 10 Mile Road,,Center Line,MI,48015,Macomb,Darlene Vasi,Chief Executive Officer,586-619-9986,11,dvasi@mycarehealthcenter.org,Judy Hinson,Business/HR Manager,586-619-9986,16,jhinson@mycarehealthcenter.org,
MI-005449,CENTRAL LAKE FAMILY HLTH CENTER,EAST JORDAN FAMILY HEALTH CENTER,1669680187,Federally Qualified Health Centers - Medical Services,7960 W Old State Rd,,Central Lake,MI,49622-5149,Antrim,601 Bridge St,,East Jordan,MI,49727-9383,Charlevoix,Daniel McKinnon,Executive Director,231-536-2206,111,dmckinnon@ejfhc.org,Diane Hawley,DOO,231-536-2206,102,dhawley@ejfhc.org,
MI-005450,Covered Bridge Healthcare of St. Joseph County,Covered Bridge Healthcare of St. Joseph County,1063876910,Federally Qualified Health Centers - Medical Services,658 E Main St,,Centreville,MI,49032-9627,Saint Joseph,658 E Main St,,Centreville,MI,49032-9627,Saint Joseph,Lisa Loker,Executive Assistant,269-467-3228,227,lisa@coveredbridgehealth.org,Lynn Dobbberteen,Executive Director,269-467-3228,230,,http://www.coveredbridgehealth.org/
MI-005451,Health Department of Northwest Michigan,Northwest Michigan Community Health Agency,1932116191,Family Planning Providers,220 W Garfield Ave,,Charlevoix,MI,49720-1631,Charlevoix,220 W. Garfield,,Charlevoix,MI,49720,Charlevoix,Lisa Peacock,Community Health Supervisor/Family Planning Coordinator,231-587-4370,,l.peacock@nwhealth.org,Mary Williams,Reimbursement Coordinator,231-547-7633,,m.williams@nwhealth.org,www.nwhealth.org
MI-005452,Eaton Community Health Center,"Cherry Street Services, Inc",1427438944,Federally Qualified Health Centers - Medical Services,1033 Healthcare Dr,,Charlotte,MI,48813-1058,Eaton,100 Cherry Street SE,,Grand Rapids,MI,49503,Kent,Dawn Keller,Site Manager,269-945-4220,,dawnkeller@cherryhealth.com,,,,,,cherryhealth.org
MI-005453,Alcona Health Center Cheboygan Site,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,748 S Main St,,Cheboygan,MI,49721-2220,Cheboygan,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005454,District Health Department No. 4-Cheboygan,District Health Department No. 4,1760443584,"Family Planning Providers, Sexually Transmitted Disease Clinics",825 S Huron St,Suite 1,Cheboygan,MI,49721-2276,Cheboygan,100 Woods Circle Suite 200,,Alpena,MI,49707,Alpena,Karen Nowicki-Compeau RN BSN,Family Planning Coordinator,989-356-4507,7960,kcompeau@dhd4.org,Amy Fournier,Account Clerk,989-356-4507,7947,afournier@dhd4.org,http://www.dhd4.org
MI-005455,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED","THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1306244108,Federally Qualified Health Centers - Medical Services,905 W Lincoln Ave,CHEBOYGAN INTERMEDIATE SCHOOL,Cheboygan,MI,49721-1858,Cheboygan,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,,mstyma@tbchs.org,,,,,,http://www.tbchs.org/centers.html
MI-005456,Saginaw Co. Health Dept.,Saginaw Co. Health Dept.,1497863229,Family Planning Providers,147 S Saginaw St,,Chesaning,MI,48616-1265,Saginaw,1600 N. Michigan,,Saginaw,MI,48602,Saginaw,Kemberly Parham,Family Planning Coordinator,989-758-3856,,kparham@saginawcounty.com,,,,,,http://www.saginawpublichealth.org
MI-005457,MidMichigan Medical Offices 6th & Maple,MidMichigan Medical Center - Clare,1740230127,Rural Health Clinics,212 W 6th St,,Clare,MI,48617-1422,Clare,703 N McEwen,,Clare,MI,48617,Clare,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-5101,,ray.stover@midmichigan.org,
MI-005458,MidMichigan Medical Offices - Clare,MidMichigan Medical Center - Clare,1134394026,Rural Health Clinics,602 Beech St,,Clare,MI,48617-1466,Clare,MidMichigan Medical Center - Clare,703 N McEwan,Clare,MI,48617,Clare,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-1101,,ray.stover@midmichigan.org,
MI-005459,Clarksville Family Medicine,Pennock Hospital Board of Trustees,1477940773,Rural Health Clinics,155 Cross St,,Clarksville,MI,48815,Ionia,1009 W Green St,,Hastings,MI,49058,Barry,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005460,Clinton Township,MyCare Health Center,1720482128,Federally Qualified Health Centers - Medical Services,42627 Garfield Rd,Suite 213,Clinton Township,MI,48038-5032,Macomb,6800 E 10 Mile Road,,Center Line,MI,48038,Macomb,Darlene Vasi,Chief Executive Officer,586-619-9986,11,dvasi@mycarehealthcenter.org,Judy Hinson,Business/HR Manager,586-619-9986,16,jhinson@mycarehealthcenter.org,
MI-005461,Groesbeck,MyCare,1639573033,Federally Qualified Health Centers - Medical Services,43740 N Groesbeck Hwy,,Clinton Township,MI,48036-1139,Macomb,6800 E 10 Mile Road,,Center Line,MI,48015,Macomb,Darlene Vasi,Chief Executive Officer,586-619-9986,11,dvasi@mycarehealthcenter.org,Judy Hinson,Business/HR Manager,586-619-9986,,jhinson@mycarehealthcenter.org,
MI-005462,Clio Health Center,"HAMILTON COMMUNITY HEALTH NETWORK, INC.",1922245299,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4154 W Vienna Rd,,Clio,MI,48420-2809,Genesee,225 E. Fifth St Ste 300,,Flint,MI,48502-2045,Genesee,Clarence R Pierce,CEO,810-406-4951,4951,cpierce@hamiltonchn.org,,,,,,
MI-005463,ASPIRUS CRYSTAL FALLS CLINIC,ASPIRUS IRON RIVER HOSPITAL & CLINICS,1356699318,Rural Health Clinics,1328 US Highway 2,,Crystal Falls,MI,49920-1045,Iron,1400 WEST ICE LAKE,,Iron River,MI,49935,Iron,GLENN EDWARD DOBSON,CFO,906-265-0436,436,glenn.dobson@aspirus.org,CONNIE KOUTOUZOS,CEO,906-265-0402,402,connie.koutouzos@aspirus.org,aspirus.org
MI-005464,Midwestern Dental of Dearborn,Midwestern Dental,1881642122,Dental Providers,5050 Schaefer Rd,,Dearborn,MI,48126-3249,Wayne,5050 Schaefer Road,,Dearborn,MI,48126,Wayne,Jeffrey L. Reider,Director of Professional Staff,313-582-8150,,drjreider@mwdentalplans.com,,,,,,
MI-005465,Deckerville Healthcare Services RHC,Deckerville Community Hospital,1780011247,Rural Health Clinics,2433 Black River St,,Deckerville,MI,48427-9425,Sanilac,3559 Pine Street,,Deckerville,MI,48427,Sanilac,Tiffany Messing,Compliance Officer,810-376-7014,,messingt@deckervillehosp.org,Kimberly Gentner,CFO,810-376-7024,,gentnerk@deckervillehosp.org,
MI-005466,Deckerville Main Street Clinic,Deckerville Community Hospital,1164818977,Rural Health Clinics,3532 Main St,,Deckerville,MI,48427-9615,Sanilac,3559 Pine Street,,Deckerville,MI,48427,Sanilac,Tiffany J Messing,Revenue Cycle Manager,810-376-7014,,messingt@deckervillehosp.org,,,,,,
MI-005467,"Deckerville Community Hospital, Inc.",Deckerville Community Hospital,1619095718,Inpatient Hospitals (other than children's hospitals),3559 Pine St,,Deckerville,MI,48427-7703,Sanilac,3559 Pine Street,,Deckerville,MI,48427,Sanilac,Tiffany Messing,Compliance Officer,810-376-7014,,messingt@deckervillehosp.org,Kimberly Gentner,CFO,810-376-7024,,gentnerk@deckervillehosp.org,
MI-005468,Advantage Health Center at Cabrini,Detroit Healthcare for the Homeless,1982072963,Federally Qualified Health Centers - Medical Services,1234 Porter St,,Detroit,MI,48226-2407,Wayne,15400 W McNichols,,Detroit,MI,48235,Jackson,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005469,Oscar Paskal Health Center,Detroit Community Health Connection,1063790186,Federally Qualified Health Centers - Medical Services,12800 E Warren Ave,,Detroit,MI,48215-2061,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,Sandeep Kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005470,East Riverside Family Health Center,Detroit Community Health Center,1982611562,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",13901 E Jefferson Ave,,Detroit,MI,48215-2720,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,sandeep Kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005471,Thea Bowman Community Health Center,DETROIT HEALTH CARE FOR THE HOMELESS,1871645309,"Dental Providers, Federally Qualified Health Centers - Medical Services",15400 W McNichols Rd,,Detroit,MI,48235-3724,Wayne,15400 W McNichols Rd,,Detroit,MI,48235-3724,Wayne,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,Revenue Cycle Manager,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005472,Covenant Community Care Newton,"COVENANT COMMUNITY CARE, INC.",1730465162,Federally Qualified Health Centers - Medical Services,16411 Curtis St,,Detroit,MI,48235-3202,Wayne,559 W Grand Blvd,,Detroit,MI,48216-2200,Wayne,Jan Pillai,CEO,313-228-0216,,ppropson@covenantcommunitycare.org,,,,,,
MI-005473,COVENANT WATERMAN,"COVENANT COMMUNITY CARE, INC.",1255574265,Federally Qualified Health Centers - Medical Services,1700 Waterman St,,Detroit,MI,48209-2022,Wayne,559 W Grand Blvd,,Detroit,MI,48216-2200,Wayne,Paul Propson,CEO,313-228-0216,,ppropson@covenantcommunitycare.org,,,,,,
MI-005474,Detroit-Corktown Satellite,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",1726 Howard St,,Detroit,MI,48216-1921,Wayne,950 Victor's Way Suite 100,,Ann Arbor,MI,48106,Washtenaw,Tammara Warren,Chief Operating Officer,734-926-4819,4819,tammara.warren@PPMI.org,Taleia Collins,Medical Administrative Coordinator,734-926-4816,4816,taleia.collins@ppmi.org,https://www.plannedparenthood.org/planned-parenthood-michigan
MI-005475,St John Primary Care Specialty Clinic,St John Community Health Investment Corporation,1235395195,Ryan White Providers,1726 Howard St,Inside Of Help,Detroit,MI,48216-1921,Wayne,15990 W Nine Mile Rd,Community Health Bldg,Southfield,MI,48075,Oakland,David Rupprecht,Lead,248-849-5759,,david.rupprecht@stjohn.org,,,,,,www.stjohn.org
MI-005476,Covenant Joy-Southfield,"COVENANT COMMUNITY CARE, INC.",1558792937,Federally Qualified Health Centers - Medical Services,18917 Joy Rd,,Detroit,MI,48228-3050,Wayne,559 W Grand Blvd,,Detroit,MI,48216-2200,Wayne,Paul M Propson,CEO,313-228-0216,,ppropson@covenantcommunitycare.org,,,,,,
MI-005477,Covenant Moross Health Center,"COVENANT COMMUNITY CARE, INC.",1689925075,"Dental Providers, Federally Qualified Health Centers - Medical Services",20901 Moross Rd,,Detroit,MI,48236-2058,Wayne,559 W Grand Blvd,,Detroit,MI,48216-2200,Wayne,Paul M Propson,CEO,313-228-0216,,ppropson@covenantcommunitycare.org,,,,,,
MI-005478,Adult Hemophilia Treatment Center,Henry Ford Health System,1134144801,Hemophilia Treatment Centers,2799 W Grand Blvd,K-13 Hem-Onc,Detroit,MI,48202-2689,Wayne,2799 West Grand Boulevard,,Detroit,MI,48202,Wayne,Philip Kuriakose,Medical Director,313-916-3790,,PKuriak1@hfhs.org,Tom Nantais,Chief Operating Officer,313-876-9205,,TNantais@hfhs.org,www.HenryFord.com
MI-005479,"The Wellness Plan, Gateway Medical Center","WELLNESS PLAN, THE",1043373244,"Dental Providers, Federally Qualified Health Centers - Medical Services",2888 W Grand Blvd,,Detroit,MI,48202-2612,Wayne,2888 W Grand Blvd,,Detroit,MI,48202-2612,Wayne,Anthony King,CEO,313-202-6848,,aking@wellplan.com,,,,,,www.wellplan.com
MI-005480,Team Wellness Center,Team Mental Health Services,1588855100,Community Mental Health Centers,2925 Russell St,,Detroit,MI,48207-4825,Wayne,921 Howard,,Dearborn,MI,48124,Wayne,Michael Hunter,CIO,248-763-5289,,michael.hunter@t-mhs.com,Pamela Lamb,"President, COO",810-240-2703,,pamela.lamb@t-mhs.com,www.teamwellnesscenter.com
MI-005481,Childrens Hospital of Michigan,University Pediatricians,1811920549,Hemophilia Treatment Centers,3901 Beaubien St,,Detroit,MI,48201-2119,Wayne,3901 Beaubien Blvd.,,Detroit,MI,48201,Wayne,Mark Harrison,CEO,313-745-5437,,MHarriso@dmc.org,Michael Callaghan,340b director,248-953-5250,,mcallagh@med.wayne.edu,www.childrensdmc.org
MI-005482,Childrens Hospital of Michigan (children's inpatient hospital),"VHS Children's Hospital of Michigan, Inc.",1538471800,Children's Hospitals (inpatient only),3901 Beaubien St,,Detroit,MI,48201-2119,Wayne,"1445 Ross Avenue, Suite 1400",,Dallas,TX,75202-2703,Dallas,Lisa Hutchings,CFO,313-745-6132,,lhutchin2@dmc.org,Kimberly Lubbers,Managed Care Director,313-966-2550,,klubbers@dmc.org,www.childrensdmc.org
MI-005483,Children's Hospital of Michigan (dental provider),"VHS Children's Hospital of Michigan, Inc.",1538471800,Dental Providers,3901 Beaubien St,,Detroit,MI,48201-2119,Wayne,"1445 Ross Ave., Ste 1400",,Dallas,TX,75202-2703,Dallas,Lisa Hutchings,CFO,313-745-6132,,lhutchin2@dmc.org,Kimberly Lubbers,Managed Care Director,313-966-2550,,klubbers@dmc.org,www.childrensdmc.org
MI-005484,Childrens Hospital of Michigan (sexually transmitted disease clinics),"VHS Children's Hospital of Michigan, Inc.",1538471800,Sexually Transmitted Disease Clinics,3901 Beaubien St,,Detroit,MI,48201-2119,Wayne,"1445 Ross Avenue, Suite 1400",,Dallas,TX,75202-2703,Dallas,Lisa Hutchings,CFO,313-745-6132,,lhutchin2@dmc.org,Kimberly Lubbers,Managed Care Director,313-966-2550,,klubbers@dmc.org,www.childrensdmc.org
MI-005485,Detroit Receivng Hospital,Detroit Medical Center,1073827101,Hemophilia Treatment Centers,4201 Saint Antoine St,7b Uhc,Detroit,MI,48201-2153,Wayne,4201 St. Antoine,7B UHC,Detroit,MI,48201,Wayne,Kimberly Lubbers,Contract Specialist,313-966-2550,,klubbers@dmc.org,,,,,,
MI-005486,University Health Center - St. Antoine,"HEALTH CENTERS DETROIT FOUNDATION, INC.",1770657785,Federally Qualified Health Centers - Medical Services,4201 Saint Antoine St,,Detroit,MI,48201-2153,Wayne,4201 Saint Antoine St Ste 9C,,Detroit,MI,48201-2153,Wayne,Andrew Dignan,CIO,313-966-5187,,asdignan@hcdmg.org,Herbert Smitherman Jr. M.D.,CEO,313-966-5187,,hsmitherman@hcdmg.org,hcdmg.org
MI-005487,Planned Parenthood of Michigan - Detroit Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",4229 Cass Ave,,Detroit,MI,48201-1709,Wayne,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005488,"American Indian Health & Family Services, S.E. Michigan (Detroit, MI)Amei","American Indian Health & Family Services, S.E. Michigan (Detroit, MI)",1366552804,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",4880 Lawndale St,,Detroit,MI,48210-2010,Wayne,4880 Lawndale St,,Detroit,MI,48210-2010,Wayne,Ashley Tuomi,CEO,313-846-3718,1001,atuomi@aihfs.org,Chasity Dial,COO,313-846-3718,1004,cdial@aihfs.org,www.aihfs.org
MI-005489,"The Wellness Plan, East Medical Center","WELLNESS PLAN, THE",1669632816,"Dental Providers, Federally Qualified Health Centers - Medical Services",4909 E Outer Dr,,Detroit,MI,48234-3446,Wayne,2888 W Grand Blvd,,Detroit,MI,48202-2612,Wayne,Anthony King,CEO,313-202-6848,,aking@wellplan.com,,,,,,www.wellplan.com
MI-005490,Mercy Primary Care Center,Trinity Health,1942333786,Other ECP Providers,5555 Conner St,Suite 2691,Detroit,MI,48213-3812,Wayne,5555 Conner Ave Suite 2691,,Detroit,MI,48213,Wayne,Tawana Nettles Robinson,Executive Director,313-692-8400,,tawana.nettles-robinson@trinity-health.org,"Margaret Meyers, MD",Medical Director,313-692-8400,,margaret.meyers@stjoeshealth.org,
MI-005491,COMMUNITY HEALTH AND SOCIAL SERVICES (CHASS),"COMMUNITY HEALTH AND SOCIAL SERVICES CENTER, INC.",1982694196,"Dental Providers, Federally Qualified Health Centers - Medical Services",5635 W Fort St,,Detroit,MI,48209-3154,Wayne,5635 W Fort St,,Detroit,MI,48209-3154,Wayne,Percola Brooks,CFO,313-849-3920,5018,pbrooks@chasscenter.org,Marylu Villarreal,COO,313-849-3920,5017,mvillarreal@chasscenter.org,https://chasscenter.org
MI-005492,Covenant Michigan Avenue Clinic,"COVENANT COMMUNITY CARE, INC.",1720134943,"Dental Providers, Federally Qualified Health Centers - Medical Services",5716 Michigan Ave,,Detroit,MI,48210-3039,Wayne,559 W Grand Blvd,,Detroit,MI,48216-2200,Wayne,Jan Pillai,CEO,313-228-0216,,ppropson@covenantcommunitycare.org,,,,,,
MI-005493,Waller Health Center on Cathedral Green,DETROIT HEALTH CARE FOR THE HOMELESS,1396839981,"Dental Providers, Federally Qualified Health Centers - Medical Services",60 E Warren Ave,,Detroit,MI,48201-1312,Wayne,15400 W McNichols Rd,,Detroit,MI,48235-3724,Wayne,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,Revenue Cycle Manager,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005494,Sinai Grace Specialty Care,WSU Adult HIV/AIDS Programs,1245281435,Ryan White Providers,6001 W Outer Dr,Suite 207,Detroit,MI,48235-2626,Wayne,6001 W. Outer Drive,Ste. 207,Detroit,MI,48235-2626,Wayne,Evelyn Postell-Franklin,Program Coordinator,313-966-8515,,efranklin@med.wayne.edu,Renee Stanton,Physicians Billing Service Representative,734-462-0340,,TY1222@aol.com,
MI-005495,Woodward Corridor Family Health Center,Detroit Community Health Connection,1275576886,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",611 Martin Luther King Jr Blvd,,Detroit,MI,48201-2273,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,Sandeep Kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005496,Dr. Feleta Wilson Health Center,Detroit Community Health Connection,1053574236,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",6550 W Warren Ave,,Detroit,MI,48210-1134,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,Sandeep Kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005497,East Jefferson Avenue,"HEALTH CENTERS DETROIT FOUNDATION, INC.",1518026541,Federally Qualified Health Centers - Medical Services,7633 E Jefferson Ave,Suite 340,Detroit,MI,48214-3732,Wayne,4201 Saint Antoine St Ste 9C,,Detroit,MI,48201-2153,Wayne,Andrew Dignan,CIO,313-966-5187,,asdignan@hcdmg.org,Herbert Smitherman Jr. M.D.,CEO,313-966-5187,,hsmitherman@hcdmg.org,hcdmg.org
MI-005498,Children's Dental Center - Main,DETROIT HEALTH CARE FOR THE HOMELESS,1346591336,Dental Providers,79 W Alexandrine St,,Detroit,MI,48201-2015,Wayne,15400 W McNichols,,Detroit,MI,48235,Wayne,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,Revenue Cycle Manager,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005499,Dr. Sophie Womack Health Center,Detroit Community Health Center,1275796468,"Dental Providers, Federally Qualified Health Centers - Medical Services",7900 Kercheval St,,Detroit,MI,48214-2439,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,Sandeep Kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005500,Bell Health Center,Detroit Healthcare for the Homeless,1548649833,Federally Qualified Health Centers - Medical Services,882 Oakman Blvd,,Detroit,MI,48238-3710,Wayne,15400 W McNichols,,Detroit,MI,48235,Wayne,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,Revenue Cycle Manager,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005501,Pokagon Health Services,Pokagon Band of Potawatomi Indians,1497833271,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",32652 Kno Drive,,Dowagiac,MI,49047,Cass,58620 Sink Road,,Dowagiac,MI,49047,Cass,Priscilla Gatties,Director of Health Services,269-462-4403,,matt.clay@pokagonband-nsn.gov,Priscilla Gatties,Business Manager,269-462-4403,,priscilla.gatties@pokagonband-nsn.gov,www.pokagonband-nsn.gov
MI-005502,Memorial Durand Family Health Center,Memorial Healthcare,1316008006,Rural Health Clinics,9099 E Lansing Rd,Suite A,Durand,MI,48429-1083,Shiawassee,Memorial Healthcare,826 West King Street,Owosso,MI,48867,Shiawassee,"Pam Mahoney, CPC","Practice Manager, Primary Care",989-723-5211,3807,pmahoney@memorialhealthcare.org,Joyce Bremer,"Director, Primary Care",989-729-4528,,jbremer@memorialhealthcare.org,
MI-005503,EAST JORDAN FAMILY HEALTH CENTER,EAST JORDAN FAMILY HEALTH CENTER,1114958691,Federally Qualified Health Centers - Medical Services,601 Bridge St,,East Jordan,MI,49727-9383,Charlevoix,601 Bridge St,,East Jordan,MI,49727-9383,Charlevoix,Daniel McKinnon,Executive Director,231-536-2206,111,dmckinnon@ejfhc.org,Diane Hawley,COO,231-536-2206,102,dhawley@ejfhc.org,
MI-005504,Michigan State University Center for Bleeding and Clotting Disorders,Michigan State University,1972517811,Hemophilia Treatment Centers,1355 S Bogue,B220 Life Science,East Lansing,MI,48824,Ingham,1355 S. Bogue,Room B240,East Lansing,MI,48824,Ingham,Roshni Kulkarni,Director,517-353-9385,,roshni@msu.edu,Laura Carlson,Clinic Coordinator,517-353-9385,,pletche4@msu.edu,
MI-005505,Eaton Rapids Medical Center Family Practice,Eaton Rapids Medical Center,1437383296,Rural Health Clinics,1500 S Main St,,Eaton Rapids,MI,48827-1952,Eaton,1500 S Main Street,,Eaton Rapids,MI,48827,Eaton,Dawn Wartenbe,Enrollment & Contract Specialist,517-663-9473,473,dwartenbe@ermchealth.org,Tracey Lee,Billing Manager,517-663-9573,573,tlee@ermchealth.org,
MI-005506,INTERCARE EAU CLAIRE,INTERCARE COMMUNITY HEALTH NETWORK,1861402067,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",6270 W Main St,,Eau Claire,MI,49111-9480,Berrien,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005507,Medics PC,Medics PC,1083705024,Rural Health Clinics,1131 E Howard City Edmore Rd,,Edmore,MI,48829-8743,Montcalm,PO Box 529,,Edmore,MI,48829-0529,Montcalm,Alexandrine Brown,CLINIC MANAGER,989-427-5070,,browna1965@yahoo.com,Bruce Robert Reames JR,President,989-427-5070,,,
MI-005508,OMH Medical Group Boyne Valley RHC,Otsego Memorial Hospital,1992146807,Rural Health Clinics,2572 North Us-131,,Elmire,MI,49730,Antrim,850 N. Otsego Ave,,Gaylord,MI,49735,Otsego,Kevin A Wahr,Chief Revenue Officer,989-731-7920,,kwahr@myomh.org,Bob Courtois,CFO,989-731-2238,,bcourtois@myomh.org,www.myomh.org
MI-005509,Public Health Delta and Menominee Co.,Public Health Delta and Menominee Co.,1912051293,Family Planning Providers,2920 College Ave,,Escanaba,MI,49829-9597,Delta,2920 College Ave,,Escanaba,MI,49829-9597,Delta,Debbie Poquette,Family Planning Coordinator,906-789-8123,,dpoquette@phdm.org,Lynn Woelffer,Director of Finance,906-789-8115,,lwoelffer@phdm.org,http://www.phdm.org
MI-005510,St. Francis Hospital,OSF Healthcare System,1922058551,Inpatient Hospitals (other than children's hospitals),3401 Ludington St,,Escanaba,MI,49829-1300,Delta,800 NE Glen Oak Ave,,Peoria,IL,61603,Peoria,Randy Billings,Senior Vice President Managed Care and ACO,309-624-2362,,randy.m.billings@osfhealthcare.org,,,,,,
MI-005511,SPECTRUM HEALTH - EVART CLINIC,Spectrum Health Reed City Hospital,1538265343,Rural Health Clinics,5991 95th Ave,,Evart,MI,49631-9386,Osceola,300 N Patterson,,Reed City,MI,49677,Osceola,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005512,"FAIRVIEW CLINIC, PLC",FAIRVIEW CLINIC,1730197278,Rural Health Clinics,1392 Maple Dr,,Fairview,MI,48621-8703,Oscoda,1392 Maple Dr,,Fairview,MI,48621,Oscoda,Cheryl Henry,FNP-BC & Clinic Owner,989-848-5644,,cheryl@fairviewclinic.net,,,,,,
MI-005513,MidMichigan Medical Offices - Farwell,MidMichigan Medical Center - Clare,1134394026,Rural Health Clinics,2812 W Cadillac Dr,,Farwell,MI,48622-9757,Clare,MidMichigan Medical Center - Clare,703 N. McEwen,Clare,MI,48617,Clare,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-5101,,ray.stover@midmichigan.org,
MI-005514,Nordic Medical Center,Dickinson County Healthcare System,1639112774,Rural Health Clinics,W4243 Highway M69,PO Box 139,Felch,MI,49831-0139,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peg Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005515,Planned Parenthood of Michigan - Ferndale Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",23338 Woodward Ave,,Ferndale,MI,48220-1302,Oakland,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005516,HURLEY MEDICAL CENTER,Hurley Medical Center,1598717480,Inpatient Hospitals (other than children's hospitals),1 Hurley Plz,,Flint,MI,48503-5902,Genesee,1 Hurley Plz,,Flint,MI,48503,Genesee,William McGregor,Sr Dir Revenue Integrity,810-262-9905,,wmcgreg1@hurleymc.com,,,,,,
MI-005517,Hurley Medical Center - Hemophilia Clinic,Hurley Medical Center,1598717480,Hemophilia Treatment Centers,1 Hurley Plz,,Flint,MI,48503-5902,Genesee,1 Hurley Plz,,Flint,MI,48503,Genesee,William McGregor,Sen Dir Revenue Integrity,810-262-9905,,wmcgreg1@hurleymc.com,,,,,,
MI-005518,"Hamilton Community Health Network, Inc. - New Main","HAMILTON COMMUNITY HEALTH NETWORK, INC.",1700950235,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2900 N Saginaw St,,Flint,MI,48505-4452,Genesee,225 E. Fifth Street Suite 300,,Flint,MI,48502-2045,Genesee,Clarence R Pierce,CEO,810-406-4951,4951,cpierce@hamiltonchn.org,,,,,,
MI-005519,GCHC Atherton East,GENESEE HEALTH SYSTEM,1982018610,Federally Qualified Health Centers - Medical Services,3109 Kleinpell St,,Flint,MI,48507-2167,Genesee,725 Mason St,,Flint,MI,48503-2421,Genesee,Honor Potvin,Interim Executive Director,810-496-5547,,hpotvin@genhs.org,,,,,,
MI-005520,GCHC Center City,GENESEE HEALTH SYSTEM,1851630115,"Dental Providers, Federally Qualified Health Centers - Medical Services",422 W 4th Ave,,Flint,MI,48503-2404,Genesee,725 Mason St,,Flint,MI,48503-2421,Genesee,Honor Potvin,Interim Executive Director,810-496-5547,,hpotvin@genhs.org,,,,,,
MI-005521,HCHN - NORTH POINTE CLINIC,"HAMILTON COMMUNITY HEALTH NETWORK, INC.",1336213875,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5710 Clio Rd,Suite B,Flint,MI,48504-1525,Genesee,225 E. Fifth Street Ste 300,,Flint,MI,48502-2045,Genesee,Keith Johnson,CEO,810-406-4920,4920,kjohnson@hamiltonchn.org,,,,,,
MI-005522,Genesee County Health Department,GENESEE COUNTY HEALTH DEPARTMENT,1154370344,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",630 S Saginaw St Ste 4,Mccree Courts And Human Services Bldg.,Flint,MI,48502-1540,Genesee,630 S. Saginaw St,Suite #4,Flint,MI,48502,Genesee,Toni LaRocco,Director of Nursing,810-237-4544,,tlarocco@gchd.us,Dianna LaBonte,Public Health Nursing Supervisor,810-237-4608,,dlabonte@gchd.us,www.gchd.us
MI-005523,Planned Parenthood of Michigan - Flint Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",G3371 Beecher Rd,,Flint,MI,48532-3621,Genesee,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005524,HCHN - DENTAL NORTH,"HAMILTON COMMUNITY HEALTH NETWORK, INC.",1669548582,Dental Providers,G5399 N Saginaw St,,Flint,MI,48505-1536,Genesee,225 E. Fifth Street Suite 300,,Flint,MI,48505,Genesee,Clarence R Pierce,CEO,810-406-4951,4951,cpierce@hamiltonchn.org,,,,,,
MI-005525,Spectrum Health Gerber Memorial Family Medicine - Fremont,Spectrum Health Gerber Memorial,1750403325,Rural Health Clinics,204 W Main St,,Fremont,MI,49412-1181,Newaygo,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005526,SHGM OB/GYN,Spectrum Health Gerber Memorial,1609009554,Rural Health Clinics,212 S Sullivan Ave,,Fremont,MI,49412-1548,Newaygo,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Teresa Arlene Treiber,Finance Manager RH and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005527,Spectrum Health Gerber,Newaygo County General Hospital Association,1063836963,Inpatient Hospitals (other than children's hospitals),212 S Sullivan Ave,,Fremont,MI,49412-1548,Newaygo,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Janice Myers,Remibursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005528,Spectrum Health Gerber Memorial Multispecialty Clinic Fremont,Spectrum Health Gerber Memorial,1194118265,Rural Health Clinics,230 W Oak St,,Fremont,MI,49412-1526,Newaygo,212 S Sullivan,,Fremont,MI,49412,Newaygo,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005529,OTSEGO MEMORIAL HOSPITAL MEDCARE RURAL HEALTH CLINIC,Otsego Memorial Hospital,1093911364,Rural Health Clinics,1996 Walden Dr,,Gaylord,MI,49735-8241,Otsego,1996 Walden Drive,,Gaylord,MI,49735,Otsego,Kevin A. Wahr,Chief Revenue Officer,989-731-7920,,kwahr@myomh.org,Bob Courtois,CFO,989-731-2238,,bcourtois@myomh.org,www.myomh.org
MI-005530,OTSEGO MEMORIAL HOSPITAL (inpatient hospital),OTSEGO MEMORIAL HOSPITAL,1124028972,Inpatient Hospitals (other than children's hospitals),825 N Center Ave,,Gaylord,MI,49735-1560,Otsego,850 N. OTSEGO AVE.,,GAYLORD,MI,49735,Otsego,kEVIN A. WAHR,CHIEF REVENUE OFFICER,989-731-7920,,KWAHR@MYOMH.ORG,BOB COURTOIS,CFO,989-731-2238,,BCOURTOIS@MYOMH.ORG,WWW.MYOMH.ORG
MI-005531,OTSEGO MEMORIAL HOSPITAL (other ecp providers),OTSEGO MEMORIAL HOSPITAL,1124028972,Other ECP Providers,825 N Center Ave,,Gaylord,MI,49735-1560,Otsego,850 N. OTSEGO AVE.,,GAYLORD,MI,49735,Otsego,kEVIN A. WAHR,CHIEF REVENUE OFFICER,989-731-7920,,KWAHR@MYOMH.ORG,BOB COURTOIS,CFO,989-731-2238,,BCOURTOIS@MYOMH.ORG,WWW.MYOMH.ORG
MI-005532,Otsego Memorial Hospital Rural Health Clinic,Otsego Memorial Hospital,1164628426,Rural Health Clinics,829 N Center Ave,,Gaylord,MI,49735-1595,Otsego,850 N. Otsego Ave.,,Gaylord,MI,49735,Otsego,Kevin A. Wahr,Chief Revenue Officer,989-731-7920,,kwahr@myomh.org,Bob Courtois,CFO,989-731-2238,,bcourtois@myomh.org,www.myomh.org
MI-005533,Health Department of Northwest Michigan,Northwest Michigan Community Health Agency,1932116191,Family Planning Providers,95 Livingston Blvd,,Gaylord,MI,49735-9464,Otsego,220 W. Garfield,,Charlevoix,MI,49720,Charlevoix,Lisa Peacock,Community Health Supervisor/Family Planning Coordinator,231-587-4370,,l.peacock@nwhealth.org,Mary Williams,Reimbursement Coordinator,231-547-7633,,m.williams@nwhealth.org,www.nwhealth.org
MI-005534,Central Michigan Dist. Health Dept.,Central Michigan Dist. Health Dept.,1245283977,"Family Planning Providers, Ryan White Providers",103 N Bowery Ave,,Gladwin,MI,48624-1479,Gladwin,2012 E Preston St,,Mt Pleasant,MI,48858,Isabella,Lorrie Youngs,Director,989-773-5921,1462,lyoungs@cmdhd.org,,,,,,http://www.cmdhd.org
MI-005535,MidMichigan Medical Offices - Gladwin,MidMichigan Medical Center - Gladwin,1881869774,Rural Health Clinics,609 Quarter St,,Gladwin,MI,48624-1941,Gladwin,515 Quarter Street,,Gladwin,MI,48624,Gladwin,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-5101,,ray.stover@midmichigan.org,
MI-005536,Ottawa County Department of Public Health,Ottawa County Department of Public Health,1679653422,"Family Planning Providers, Sexually Transmitted Disease Clinics",1207 S Beechtree St,Suite B,Grand Haven,MI,49417-2839,Ottawa,12251 James Street Ste 500,,Holland,MI,49424-9675,Ottawa,Connie Kross,Family Planning Supervisor,616-393-5732,,ckross@miottawa.org,KEITH FALKOWFKI,Senior Accountant,616-738-4627,,KFALKOWFKI@MIOTTAWA.ORG,
MI-005537,Heart of the City Health Center,Cherry Street Services Inc,1669530986,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,100 Cherry Street SE,,Grand Rapids,MI,49503-4526,Kent,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,Pam Robinson,Credentialing,616-965-8200,,pamelarobinson@cherryhealth.com,
MI-005538,Spectrum Health Helen DeVos Children's Hospital (children's inpatient hospital),Spectrum Health Hospitals,1922090554,Children's Hospitals (inpatient only),100 Michigan St NE,,Grand Rapids,MI,49503-2560,Kent,100 Michigan Street NE,,Grand Rapids,MI,49503-2560,Kent,Elisabeth Lacey,Credentialing Manager,616-486-6793,,elisabeth.lacey@spectrumhealth.org,Melinda Weis,Payer Relations Manager,616-643-9170,,melinda.weis@spectrumhealth.org,
MI-005539,Spectrum Health Helen DeVos Children's Hospital (multiple outpatient ECP categories),Spectrum Health Hospitals,1922090554,"Dental Providers, Hemophilia Treatment Centers",100 Michigan St NE,,Grand Rapids,MI,49503-2560,Kent,100 Michigan Street NE,,Grand Rapids,MI,49503-2560,Kent,Elisabeth Lacey,Credentialing Manager,616-486-6793,,elisabeth.lacey@spectrumhealth.org,Melinda Weis,Payer Relations Manager,616-643-9170,,melinda.weis@spectrumhealth.org,
MI-005540,Spectrum Health Hospitals,Spectrum Health Hospitals,1922090554,Inpatient Hospitals (other than children's hospitals),100 Michigan St NE,,Grand Rapids,MI,49503-2560,Kent,100 Michigan St NE,,Grand Rapids,MI,49503,Kent,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005541,Catherine's Health Center,Catherine's Health Center,1912055872,Other ECP Providers,1211 Lafayette Ave NE,,Grand Rapids,MI,49505-5092,Kent,1211 Lafayette Ave NE,,Grand Rapids,MI,49505,Kent,Karen Kaashoek,Executive Director,616-336-8800,205,kkaashoek@catherineshc.org,,,,,,CatherinesHC.org
MI-005542,Leonard Street Counseling Center,"CHERRY STREET SERVICES, INC.",1043592629,Federally Qualified Health Centers - Medical Services,1400 Leonard St NE,,Grand Rapids,MI,49505-5515,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,Chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005543,Cherry Street Services Inc,"CHERRY STREET SERVICES, INC.",1982764643,"Dental Providers, Federally Qualified Health Centers - Medical Services",1800 Tremont Blvd NW,Union High School Health Center,Grand Rapids,MI,49504-4868,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005544,Cherry Street Services Inc,"CHERRY STREET SERVICES, INC.",1124187471,"Dental Providers, Federally Qualified Health Centers - Medical Services",2055 Rosewood Ave SE,Ottawa Hills High School Health Center,Grand Rapids,MI,49506-5248,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005545,Burton Health Center,"CHERRY STREET SERVICES, INC.",1770656605,"Dental Providers, Federally Qualified Health Centers - Medical Services",2135 Buchanan Ave SW,,Grand Rapids,MI,49507-2911,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005546,Southside Health Center,"CHERRY STREET SERVICES, INC.",1386926004,Federally Qualified Health Centers - Medical Services,2303 Kalamazoo Ave SE,,Grand Rapids,MI,49507-3780,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005547,Mercy Health Infectious Disease (Trinity Health Corp),Trinity Health Corporation,1447456173,Ryan White Providers,310 Lafayette Ave SE,Suite 410,Grand Rapids,MI,49503-4693,Kent,200 Jefferson Ave.,,Grand Rapids,MI,49503,Kent,Daneen A. Caro,Chief Operations Officer,616-685-1810,,carod@mercyhealth.com,,,,,,www.mercyhealthsaintmarys.com/hiv_aids_care
MI-005548,HEARTSIDE CLINIC,TRINITY HEALTH CORPORATION,1902002272,Federally Qualified Health Centers - Medical Services,359 Division Ave S,,Grand Rapids,MI,49503-4537,Kent,200 Jefferson Ave SE,,Grand Rapids,MI,49503-4502,Kent,Daneen A. Caro,Chief Operations Officer,616-685-1810,,carod@mercyhealth.com,,,,,,
MI-005549,Cherry Street Services Inc,Cherry Street Services Inc,1316340094,"Community Mental Health Centers, Dental Providers",421 Fountain St NE,Innovation Central High School Health Center,Grand Rapids,MI,49503-3334,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,Pam Robinson,Credentialing,616-965-8200,7207,pamelarobinson@cherryhealth.com,
MI-005550,Planned Parenthood of Michigan - Grand Rapids Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",425 Cherry St SE,,Grand Rapids,MI,49503-4601,Kent,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005551,Cherry Street Health Center,"CHERRY STREET SERVICES, INC.",1558459164,"Dental Providers, Federally Qualified Health Centers - Medical Services",550 Cherry St SE,,Grand Rapids,MI,49503-4748,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005552,Westside Health Center,"CHERRY STREET SERVICES, INC.",1891867495,"Dental Providers, Federally Qualified Health Centers - Medical Services",669 Stocking Ave NW,,Grand Rapids,MI,49504-5176,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CEO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005553,SAINT MARY'S CLINICA SANTA MARIA,TRINITY HEALTH CORPORATION,1154584373,Federally Qualified Health Centers - Medical Services,730 Grandville Ave SW,,Grand Rapids,MI,49503-4920,Kent,200 Jefferson Ave SE,,Grand Rapids,MI,49503-4502,Kent,Daneen A. Caro,Chief Operations Officer,616-685-1810,,carod@mercyhealth.com,,,,,,
MI-005554,Belknap Commons Health Center,"CHERRY STREET SERVICES, INC.",1154495901,"Dental Providers, Federally Qualified Health Centers - Medical Services",751 Lafayette Ave NE,,Grand Rapids,MI,49503-1628,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005555,Mercy Health Dental Clinic,TRINITY HEALTH CORPORATION,1700287448,Dental Providers,781 36th St SE,,Grand Rapids,MI,49548-2319,Kent,200 Jefferson Ave SE,,Grand Rapids,MI,49503-4502,Kent,Daneen A. Caro,Chief Operations Officer,616-685-1810,,carod@mercyhealth.com,,,,,,
MI-005556,FAMILY HEALTH CARE - GRANT,BALDWIN FAMILY HEALTH CARE,1306955315,"Dental Providers, Federally Qualified Health Centers - Medical Services",11 N Maple St,,Grant,MI,49327-7900,Newaygo,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005557,Grant Medical Center,Spectrum Health Gerber Memorial,1013040492,Rural Health Clinics,230 S Maple St,,Grant,MI,49327-9006,Newaygo,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005558,Grant Teen Health Center,BALDWIN FAMILY HEALTH CARE,1669759437,"Dental Providers, Federally Qualified Health Centers - Medical Services",96 E 120th St,,Grant,MI,49327-8502,Newaygo,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005559,GRAYLING COMMUNITY HEALTH CENTER,Munson Healthcare Grayling,1891191698,Rural Health Clinics,1250 E Michigan Ave,,Grayling,MI,49738-7074,Crawford,1100 E. Michigan Ave.,,Grayling,MI,49738,Crawford,Trisha Teare,Billing Manager,231-876-7234,,tteare@mhc.net,,,,,,
MI-005560,District Health Department. #10.,District Health Department # 10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",501 Norway St,,Grayling,MI,49738-1719,Crawford,1049 Newell St.,P.O. Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005561,Montcalm Area Health Center,"CHERRY STREET SERVICES, INC.",1942498670,"Dental Providers, Federally Qualified Health Centers - Medical Services",1003 N Lafayette St,Suite 100,Greenville,MI,48838-1168,Montcalm,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005562,Sparrow Medical Group Greenville,Sparrow Carson Hospital,1689644403,Rural Health Clinics,1014 E Washington St,,Greenville,MI,48838-2463,Montcalm,406 East Elm St,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005563,SPECTRUM HEALTH UNITED HOSPITAL FAMILY MEDICINE AND OBSTETRICS AND GYNECOLOGY,Spectrum Health United,1538436852,Rural Health Clinics,1202 W Oak St,,Greenville,MI,48838-2155,Montcalm,615 S Bower St,,Greenville,MI,48838,Montcalm,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005564,Spectrum Health United Hospital,Spectrum Health United,1457304495,Inpatient Hospitals (other than children's hospitals),615 S Bower St,,Greenville,MI,48838-2614,Montcalm,615 S Bower St,,Greenville,MI,48838,Montcalm,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005565,GWINN FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1104158690,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",135 E State Highway M35,,Gwinn,MI,49841-9160,Marquette,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005566,SAWYER FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1164893491,Dental Providers,301 Explorer St,,Gwinn,MI,49841-2813,Marquette,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005567,SAWYER FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1700103777,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 Explorer St,,Gwinn,MI,49841-2813,Marquette,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005568,Hale Clinic,Sterling Area Health Center,1255712873,Federally Qualified Health Centers - Medical Services,436 W Main St,,Hale,MI,48739-9246,Iosco,725 East State Street,,Sterling,MI,48659,Arenac,James J Balten Jr,President/Chief Executive Officer,989-524-3750,,JBalten@sterlinghealth.net,,,,,,
MI-005569,WCHC - Hamtramck Health Center,"WAYNE, COUNTY OF",1700215977,Federally Qualified Health Centers - Medical Services,9021 Joseph Campau St,,Hamtramck,MI,48212-3726,Wayne,500 Griswold St Fl 31,,Detroit,MI,48226-3480,Wayne,MARVA HAIRSTON,Executive Director,313-871-1926,,mhairston@waynecounty.com,Andre Stringfellow,Chief Financial Officer,313-871-1926,,astringf@waynecounty.com,
MI-005570,UPPER GREAT LAKES FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1205217239,Dental Providers,1550 W Quincy St,,Hancock,MI,49930-1223,Houghton,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005571,HANCOCK FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1659792026,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",500 Campus Dr,,Hancock,MI,49930-1452,Houghton,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,BUSINESS OFFICE DIRECTOR,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005572,UPPER GREAT LAKES FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1255755757,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",506 Campus Dr,,Hancock,MI,49930-1569,Houghton,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,BUSINESS OFFICE DIRECTOR,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005573,Western Upper Peninsula Health Department,Michigan Department of Community Health,1326175050,"Family Planning Providers, Sexually Transmitted Disease Clinics",540 Depot St,,Hancock,MI,49930-2031,Houghton,540 Depot St,,Hancock,MI,49930-2031,Houghton,Barbara Auten,Director of Public Health and Education,906-482-7382,,bauten@wuphd.org,,,,,,http://www.westernuphealth.org
MI-005574,Alcona Health Center Emmet County Site,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,3434 M 119,,Harbor Springs,MI,49740-9373,Emmet,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005575,Health Department of Northwest Michigan,Northwest Michigan Community Health Agency,1932119161,Family Planning Providers,3434 M 119,Suite A,Harbor Springs,MI,49740-9373,Emmet,220 W Garfield,,Charlevoix,MI,49720,Charlevoix,Lisa Peacock,Family Planning Coordinator/Family Health Supervisor,231-587-4370,,l.peacock@nwhealth.org,Mary Williams,Reimbursement Coordinator,231-547-7633,,m.williams@nwhealth.org,www.nwhealth.org
MI-005576,Central Michigan District Health Department,Central Michigan District Health Department,1245283977,"Family Planning Providers, Ryan White Providers",815 N Clare Ave,Suite B,Harrison,MI,48625-8177,Clare,2012 E Preston St,,Mt Pleasant,MI,48858,Isabella,Lorrie Youngs,Director,989-773-5921,1462,lyoungs@cmdhd.org,,,,,,
MI-005577,MidMichigan Health Park Harrison,MidMichigan Medical Center - Clare,1134394026,Rural Health Clinics,815 N Clare Ave,,Harrison,MI,48625-8176,Clare,Ray Stover,703 N McEwan,Clare,MI,48617,Clare,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-5101,,ray.stover@midmichigan.org,
MI-005578,AHC TIGER HEALTH EXTENSION,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,181 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005579,Alcona Health Centers - Harrisville Services,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,205 N State St,Suite A,Harrisville,MI,48740-9255,Alcona,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005580,"Alcona Citizens For Health, Inc.","ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,51 N Barlow Rd,AHC Tiger Health Extension - Alcona Middle & High School,Harrisville,MI,48740-9606,Alcona,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005581,Spectrum Health Family Medicine Hart,Memorial Medical Center of West Michigan,1861800674,Rural Health Clinics,2481 N 72nd Ave,,Hart,MI,49420-8008,Oceana,1 Atkinson Drive,,Ludington,MI,49431,Mason,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005582,District Health Department No. 10,District Health Dept. No. 10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",3986 N Oceana Dr,,Hart,MI,49420-8358,Oceana,1049 Newell St,P.O. Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005583,MHPP Hart Family Medical,Mercy Health Physician Partners,1518383025,Rural Health Clinics,611 E Main St,,Hart,MI,49420-1190,Oceana,611 E Main,,Hart,MI,49420,Oceana,Colleen Johnson,Director Northshore Primary Care Network,231-728-5935,,johnsoco@mercyhealth.com,Mary Welsh,Quality Management Manager Northshore Primary Care Network,231-861-3402,,welshm@mercyhealth.com,
MI-005584,Spectrum Health Pennock,Pennock Hospital,1023001146,Inpatient Hospitals (other than children's hospitals),1009 W Green St,,Hastings,MI,49058-1710,Barry,1009 W Green St,,Hastings,MI,49058,Barry,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005585,Barry Community Health Center - Dental,"CHERRY STREET SERVICES, INC.",1962800680,Dental Providers,1230 W State St,,Hastings,MI,49058-9712,Barry,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CEO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005586,Barry Community Health Center,"CHERRY STREET SERVICES, INC.",1265862841,Federally Qualified Health Centers - Medical Services,330 W Woodlawn Ave,,Hastings,MI,49058-1035,Barry,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005587,HESPERIA MEDICAL CENTER,Spectrum Health Gerber Memorial,1396878773,Rural Health Clinics,78 N Division St,,Hesperia,MI,49421-5100,Oceana,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005588,Nolan Family Health Center,Detroit Community Health Connection,1851554034,"Dental Providers, Federally Qualified Health Centers - Medical Services",111 W 7 Mile Rd,,Highland Park,MI,48203-1968,Wayne,13901 East Jefferson,,Detroit,MI,48215,Wayne,sandeep kadimpaty,"Director - Clinical Quality, Corporate Compliance and Patient Safety",313-670-0968,,sandeepk@dchcquality.org,Rao Kakarala,Sr. V. P. & Chief Financial Officer,313-343-2873,,raok@dchcquality.org,www.dchcquality.com
MI-005589,THUNDER BAY COMMUNITY HEALTH SERVICE - HILLMAN,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1942253851,Federally Qualified Health Centers - Medical Services,15774 State St,,Hillman,MI,49746-7961,Alpena,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,,mstyma@tbchs.org,,,,,,
MI-005590,MEDILODGE OF HILLMAN,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1437426731,Federally Qualified Health Centers - Medical Services,631 Caring St,,Hillman,MI,49746-8818,Montmorency,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,,mstyma@tbchs.org,,,,,,
MI-005591,"Hillsdale Medical Associates, PLC","Hillsdale Medical Associates, PLC",1902841208,Rural Health Clinics,1456 Hudson Rd,,Hillsdale,MI,49242-8314,Hillsdale,PO Box 743,,Hillsdale,MI,49242,Hillsdale,Deborah J Koehneke,Office Manager,517-439-0200,237,dkoehneke@comcast.net,,,,,,
MI-005592,Center for Family Health HIllsdale,Center for Family Health,1144634775,Federally Qualified Health Centers - Medical Services,240 W Carleton Rd,,Hillsdale,MI,49242-5034,Hillsdale,505 N. Jackson St.,,Jackson,MI,49201,Jackson,Molly Kaser,President & CEO,517-748-5500,1525,mkaser@cfhinc.org,Michelle Mayo,Patient Accounts Manager,517-748-5500,1150,mmayo@cfhinc.org,
MI-005593,"Robert E Schall, MD","Hillsdale Medical Associates, PLC",1912239708,Other ECP Providers,32 S Broad St,,Hillsdale,MI,49242-1859,Hillsdale,PO Box 743,,Hillsdale,MI,49242,Hillsdale,Deborah J Koehneke,Office Manager,517-439-0200,237,dkoehneke@comcast.net,,,,,,
MI-005594,Ottawa County Department of Public Health,Ottawa County Department of Public Health,1679653422,"Family Planning Providers, Sexually Transmitted Disease Clinics",12251 James St,Suite 500,Holland,MI,49424-8944,Ottawa,12251 James Street Ste 500,,Holland,MI,49424-9675,Ottawa,Connie Kross,Family Planning Supervisor,616-393-5732,,ckross@miottawa.org,KEITH FALKOWFKI,Senior Accountant,616-738-4627,,KFALKOWFKI@MIOTTAWA.ORG,
MI-005595,INTERCARE HOLLAND,INTERCARE COMMUNITY HEALTH NETWORK,1932119153,"Dental Providers, Federally Qualified Health Centers - Medical Services",285 James St,,Holland,MI,49424-1849,Ottawa,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005596,Aspirus Houghton Clinic,Aspirus Keweenaw Hospital,1215092572,Rural Health Clinics,1000 Cedar St,,Houghton,MI,49931-1978,Houghton,205 Osceola Street,,Lauirum,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005597,HOUGHTON FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1811325103,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 Macinnes Dr,,Houghton,MI,49931-1144,Houghton,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005598,HOUGHTON LAKE SBHC,"MIDMICHIGAN HEALTH SERVICES, INC",1316104995,Federally Qualified Health Centers - Medical Services,4433 W Houghton Lake Dr,,Houghton Lake,MI,48629-9786,Roscommon,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005599,MIDMICHIGAN HEALTH PARK - HOUGHTON LAKE,"MIDMICHIGAN HEALTH SERVICES, INC",1912998287,Federally Qualified Health Centers - Medical Services,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005600,Medics PC,Medics PC,1194949990,Rural Health Clinics,220 Ensley St,,Howard City,MI,49329-8656,Montcalm,PO BOX 517,,Howard City,MI,49329-0517,Montcalm,Alexandrine Brown,CLINIC MANAGER,231-937-6226,,browna1965@yahoo.com,Bruce Robert Reames JR,President,989-427-5070,,browna1965@yahoo.com,
MI-005601,Ottawa County Department of Public Health,Ottawa County Department of Public Health,1679653422,"Family Planning Providers, Sexually Transmitted Disease Clinics",3100 Port Sheldon St,,Hudsonville,MI,49426-9094,Ottawa,12251 James Street Ste 500,,Holland,MI,49424-9675,Ottawa,Connie Kross,Family Planning Supervisor,616-393-5732,,ckross@miottawa.org,KEITH FALKOWFKI,Senior Accountant,616-738-4627,,KFALKOWFKI@MIOTTAWA.ORG,
MI-005602,GLBHC Imlay City,Great Lakes Bay Health Centers,1710181128,"Dental Providers, Federally Qualified Health Centers - Medical Services",6800 Newark Rd,Suite 200,Imlay City,MI,48444-9656,Lapeer,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005603,OMH MEDICAL GROUP-INDIAN RIVER RHC,Otsego Memorial Hospital,1639420557,Rural Health Clinics,3696 S Straits Hwy,,Indian River,MI,49749-5136,Cheboygan,850 N. Otsego Ave.,,Gaylord,MI,49735,Otsego,Kevin A. Wahr,Chief Revenue Officer,989-731-7920,,kwahr@myomh.org,Bob Courtois,CFO,989-731-2238,,BCOURTOIS@MYOMH.ORG,www.myomh.org
MI-005604,AHC Indian River Health Center,"Alcona Citizens for Health, Inc.",1326055450,Federally Qualified Health Centers - Medical Services,6135 Cressy St,,Indian River,MI,49749-5151,Cheboygan,177 N. Barlow Rd.,,Harrisville,MI,48740,Alcona,Christine M. Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005605,WESTERN WAYNE FAMILY HEALTH CENTER,WESTERN WAYNE FAMILY HEALTH CENTERS,1972530277,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",2700 Hamlin Blvd,,Inkster,MI,48141-2206,Wayne,2700 HAMLIN BLVD,,Inkster,MI,48141-2348,Wayne,Linda R Atkins,CEO,313-561-5100,210,latkins@wwfhc.org,Donna Russell,CFO,734-491-4991,237,drussell@wwfhc.org,www.wwfhc.org
MI-005606,Sparrow Medical Group Ionia,Sparrow Ionia Hospital,1033271143,Rural Health Clinics,550 E Washington St,,Ionia,MI,48846-2202,Ionia,3565 S. State Rd.,,Ionia,MI,48846,Ionia,Michael Rich,Director of Regional Practices,989-584-3971,394,michael.rich@sparrow.org,Lacey Sherlock,Performance Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,
MI-005607,Dickinson OB/GYN Clinic,Dickinson County Healthcare System,1205030053,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1001 S Hemlock St,,Iron Mountain,MI,49801-3805,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005608,Dickinson Internal Medicine/Nephrology Clinic,Dickinson County Healthcare System,1578595872,Rural Health Clinics,1711 S Stephenson Ave,Suite 225,Iron Mountain,MI,49801-3652,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005609,Dickinson Pediatric Clinic,Dickinson County Healthcare System,1083659502,Rural Health Clinics,1711 S Stephenson Ave,Suite 210,Iron Mountain,MI,49801-3649,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005610,Dickinson County Memorial Hospital,Dickinson County Healthcare System,1801887013,Inpatient Hospitals (other than children's hospitals),1721 S Stephenson Ave,,Iron Mountain,MI,49801-3637,Dickinson,1721 S Stephenson Avenue,,Iron Mountain,MI,49802,Dickinson,Elizabeth A Linn,Reimbursement Coordinator,906-776-5312,5312,elizabeth.linn@dchs.org,Eileen Sparpana,CFO,906-776-5506,5506,eileen.sparpana@dchs.org,
MI-005611,ASPIRUS IRON RIVER HOSPITAL,ASPIRSU IRON RIVER HOSPITALS & CLINICS,1497750830,Inpatient Hospitals (other than children's hospitals),1400 W Ice Lake Rd,,Iron River,MI,49935-9526,Iron,1400 WEST ICE LAKE ROAD,,Iron River,MI,49935,Iron,GLENN EDWARD DOBSON,CFO,906-265-0436,436,glenn.dobson@aspirus.org,,,,,,
MI-005612,ICE LAKE FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1508289273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1500 W Ice Lake Rd,,Iron River,MI,49935-8509,Iron,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005613,ASPIRUS GENESEE,ASPIRUS IRON RIVER HOSPITAL & CLINICS,1497750830,Outpatient Hospital Clinics,229 W Genesee St,,Iron River,MI,49935-1438,Iron,1400 WEST ICE LAKE ROAD,,Iron River,MI,49935,Iron,GLENN EDWARD DOBSON,CFO,906-265-0436,436,glenn.dobson@aspirus.org,,,,,,
MI-005614,Dickinson Iron Dist. Health Dept.,Michigan Dept. of Community Health,1073609400,"Family Planning Providers, Sexually Transmitted Disease Clinics",601 Washington Ave,,Iron River,MI,49935-2140,Iron,601 Washington Ave,,Iron River,MI,49935-2140,Iron,Barbara Peterson,Family Planning Coordinator,906-265-4187,,bpeterson@hline.org,Stephen Markham,Health Officer/Director,906-265-4192,,smarkham@hline.org,http://www.didh.org
MI-005615,Aspirus Grand View Hospital,Aspirus Grand View,1992704753,Inpatient Hospitals (other than children's hospitals),N10561 Grandview Ln,,Ironwood,MI,49938-9622,Gogebic,N10561 Grand View Lane,,Ironwood,MI,49938,Gogebic,Tera Hamel,Clinic Director,906-932-7660,,tera.hamel@aspirus.org,,,,,,
MI-005616,Aspirus Ironwood Clinic,Aspirus Grand View,1992704753,Rural Health Clinics,N10565 Grandview Ln,,Ironwood,MI,49938-9622,Gogebic,N10565 Grand View Lane,,Ironwood,MI,49938,Gogebic,Tera Hamel,Clinic Director,906-932-7660,,tera.hamel@aspirus.org,,,,,,
MI-005617,Sparrow Medical Group Ithaca,Sparrow Carson Hospital,1770553547,Rural Health Clinics,114 N Main St,,Ithaca,MI,48847-1132,Gratiot,406 East Elm Street,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005618,MidMichigan Medical Offices - Ithaca,MidMichigan Medical Center - Gratiot,1265596126,Rural Health Clinics,121 N Pine River St,,Ithaca,MI,48847,Gratiot,300 E. Warwick Drive,,Alma,MI,48801,Gratiot,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Mark Santamaria,President,989-466-3258,,mark.santamaria@midmichigan.org,
MI-005619,Mid-Michigan District Health Department,Mid-Michigan District Health Department,1851386106,"Family Planning Providers, Sexually Transmitted Disease Clinics",151 Commerce Dr,,Ithaca,MI,48847-1627,Gratiot,615 N,,Stanton,MI,48888,Montcalm,Andrea Tabor,Director of Community Health and Education,989-831-3639,3639,atabor@mmdhd.org,Jenniffer Efaw,Nurse Practitioner,989-875-1013,1013,jefaw@mmdhd.org,www.mmdhd.org
MI-005620,Planned Parenthood of Michigan - Jackson Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",2009 W Michigan Ave,,Jackson,MI,49202-4010,Jackson,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005621,"FAMILY HEALTH CENTER, INC.",FAMILY HEALTH CENTER INC.,1811065576,Federally Qualified Health Centers - Medical Services,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005622,FAMILY HEALTH CENTER BURDICK,FAMILY HEALTH CENTER INC.,1891005906,Dental Providers,1308 N Burdick St,,Kalamazoo,MI,49007-2503,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005623,Hemophilia Treatment Center of West Michigan Cancer Center,West Michigan Cancer Center,1447261730,Hemophilia Treatment Centers,200 N Park St,,Kalamazoo,MI,49007-3731,Kalamazoo,200 North Park St.,,Kalamazoo,MI,49007,Kalamazoo,Nancy Inverso,Hemophilia Program Manager,269-373-7479,,ninverso@wmcc.org,Linda Inman,Billing and Collections Manager,269-384-8612,,Linman@wmcc.org,
MI-005624,FAMILY HEALTH CENTER SHERIDAN,FAMILY HEALTH CENTER INC.,1598068553,"Dental Providers, Federally Qualified Health Centers - Medical Services",2918 Portage St,,Kalamazoo,MI,49001-3755,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005625,COMMUNITY MENTAL HEALTH CLINIC,FAMILY HEALTH CENTER INC.,1790192946,Federally Qualified Health Centers - Medical Services,418 W Kalamazoo Ave,,Kalamazoo,MI,49007-3334,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005626,Planned Parenthood of Michigan - Kalamazoo Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",4201 W Michigan Ave,,Kalamazoo,MI,49006-5810,Kalamazoo,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005627,HEALTHCARE FOR THE HOMELESS,FAMILY HEALTH CENTER INC.,1821132937,Federally Qualified Health Centers - Medical Services,431 N Rose St,,Kalamazoo,MI,49007-3637,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005628,BRONSON METHODIST HOSPITAL,BRONSON METHODIST HOSPITAL,1831116441,Children's Hospitals (inpatient only),601 John St # 36,,Kalamazoo,MI,49007-5341,Kalamazoo,601 John St Box 36,,Kalamazoo,MI,49007,Kalamazoo,Krista Hampton,Business Development Administrator for Bronson Childrens Hospital,269-341-8454,,hamptonk@bronsonhg.org,,,,,,
MI-005629,Family Health Center Inc.,FAMILY HEALTH CENTER INC.,1700901246,Federally Qualified Health Centers - Medical Services,924 Russell St,EDISON SCHOOL BASED HEALTH CENTER,Kalamazoo,MI,49001-3026,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-005630,Kalkaska Medical Associates,Kalkaska Memorial Health Center,1306968102,Rural Health Clinics,419 S Coral St,,Kalkaska,MI,49646-2503,Kalkaska,419 S Coral Street,,Kalkaska,MI,49646,Kalkaska,Teresa Smith,Administration,231-258-7500,,tsmith@mhc.net,,,,,,
MI-005631,District Health Department #10,District Health Department #10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",625 Courthouse Dr,,Kalkaska,MI,49646-8495,Kalkaska,1049 Newell St.,P.O Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005632,Dickinson Iron Dist. Health Dept.,Dickinson Iron Dist. Health Dept.,1073609400,"Family Planning Providers, Sexually Transmitted Disease Clinics",818 Pyle Dr,,Kingsford,MI,49802-4455,Dickinson,818 Pyle Dr,,Kingsford,MI,49802-4455,Dickinson,Barbara Peterson,Family Planning Coordinator,906-779-7243,,bpeterson@hline.org,Stephen Markham,Health Officer/Director,906-779-7201,,smarkham@hline.org,http://www.didh.org
MI-005633,Dickinson Family Practice Center Kingsford,Dickinson County Healthcare System,1134166101,Rural Health Clinics,844 Pyle Dr,,Kingsford,MI,49802-4442,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005634,Grand Traverse County Health Department,Michigan Dept. of Community Health,1528382538,Family Planning Providers,112 S Brownson Ave,PO Box 117,Kingsley,MI,49649-5103,Grand Traverse,2600 lafranier rd ste A,,Traverse city,MI,49686,Grand Traverse,Erin Carlson,Accountant,231-995-6103,,ecarlson@gtchd.org,Marissa Milliron,finance director,231-995-6102,,mmilliro@gtchd.org,
MI-005635,Kingston Family Practice,Hills & Dales General Hospital,1457570574,Rural Health Clinics,5915 State St,,Kingston,MI,48741-5112,Tuscola,4675 Hill Street,,Cass City,MI,48726-1224,Tuscola,Kenneth E Baranski,Director of Finance,989-912-6225,,kbaranski@hillsanddales.com,Jean Anthony,President and CEO,989-912-6328,,janthony@hillsanddales.com,
MI-005636,District Health Department #10,District Health Department # 10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",6180 W Sanborn Rd,Suite 1,Lake City,MI,49651-8848,Missaukee,1049 Newell St.,P.O. Box 850,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005637,Benzie-Leelanau Dist. Health Department #002,Benzie-Leelanau District Health Department,1881719086,Family Planning Providers,7401 E Duck Lake Rd,Suite 100,Lake Leelanau,MI,49653-8701,Leelanau,7401 E. Duck Lake Rd,,Lake Leelanau,MI,49653,Leelanau,Michelle Klein,Director of Personal Health,231-256-0210,,mklein@bldhd.org,,,,,,
MI-005638,Aspirus Lake Linden Clinic,Aspirus Keweenaw Hospital,1649320524,Rural Health Clinics,110 Calumet St,,Lake Linden,MI,49945-1308,Houghton,205 Osceola Street,,Laurium,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,Bailey Patrick,Clinic Manager,906-337-6560,9063376560,bailey.patrick@aspirus.org,aspirus.org
MI-005639,LAKE LINDEN FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1740603885,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",945 9th St,,Lake Linden,MI,49945-1100,Houghton,506 CAMPUS DRIVE,,Hancock,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005640,Lakewood Family Health Care,Pennock Hospital Board of Trustees,1962889584,Rural Health Clinics,4294 Laurel Dr,,Lake Odessa,MI,48849-8430,Ionia,1009 West Green St,,Hastings,MI,49058,Barry,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005641,Lakeview Family Medicine,Spectrum Health United,1790104206,Rural Health Clinics,418 Washington St,,Lakeview,MI,48850-7102,Montcalm,615 S Bower St,,Greenville,MI,48838,Montcalm,Teresa Arlene Treiber,Finance Manager RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,Roxanne.brower@spectrumhealth.org,
MI-005642,Spectrum Health Kelsey Hospital,Spectrum Health Kelsey,1538102173,Inpatient Hospitals (other than children's hospitals),418 Washington St,,Lakeview,MI,48850-7102,Montcalm,418 Washington Ave,,Lakeview,MI,48850,Montcalm,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005643,Western Upper Peninsula Health Department,Michigan Department of Community Health,1366579096,"Family Planning Providers, Sexually Transmitted Disease Clinics",303 Baraga Ave,,L'Anse,MI,49946-1465,Baraga,303 Baraga Ave.,,L'Anse,MI,49946,Baraga,Barbara Auten,Director of Public Health and Education,906-482-7382,,bauten@wuphd.org,,,,,,http://www.westernuphealth.org
MI-005644,ICHD - Sexton Health Center,County of Ingham,1487930152,Federally Qualified Health Centers - Medical Services,102 McPherson Ave,,Lansing,MI,48915-1760,Ingham,5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,Russell Kolski,DHO / ED,517-887-4361,,RKolski@ingham.org,Isaias Solis,Health Center Supervisor,517-702-3525,,ISolis@ingham.org,www.chc.ingham.com
MI-005645,ICHD - River Oak Community Health Center,County of Ingham,1710386776,Federally Qualified Health Centers - Medical Services,1115 S Pennsylvania Ave,,Lansing,MI,48912-1669,Ingham,5303 S. Cedar St.,,Lansing,MI,48911-3800,Ingham,Russell Kolski,DHO /ED,517-887-4361,,RKolski@ingham.org,Tricia Ware,Health Center Supervisor,517-887-4464,,hc_tware@ingham.org,www.chc.ingham.org
MI-005646,Ingham Co. Health Dept.- Public Health Services,County of Ingham,1578625661,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2136 S Cedar St,,Lansing,MI,48910-3130,Ingham,5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,Debbie Edokopolo,DHO,517-272-4120,,dedokpolo@ingham.org,Russell Kolski,DHO,517-887-4361,,RKolski@ingham.org,http://www.ingham.org
MI-005647,ICHD - Eastern Health Center,County of Ingham,1437402534,Federally Qualified Health Centers - Medical Services,220 N Pennsylvania Ave,,Lansing,MI,48912-1515,Ingham,5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,Russell Kolski,DHO / ED,517-887-4361,,RKolski@ingham.org,Isaias Solis,Health Center Supervisor,517-702-3525,,ISolis@ingham.org,www.chc.ingham.org
MI-005648,ICHD - Forest Community Health Center,County of Ingham,1518339654,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2316 S Cedar St,,Lansing,MI,48910-3152,Ingham,5303 S. Cedar St.,,Lansing,MI,48911-3800,Ingham,Russell Kolski,DHO / ED,517-887-4361,,RKolski@ingham.org,Izabela wackowski,Health Center Supervisor,517-887-4464,,IWackowski@ingham.org,www.chc.ingham.org
MI-005649,Planned Parenthood of Michigan - Lansing Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",300 N Clippert St,,Lansing,MI,48912-4691,Ingham,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005650,ICHD - Willow Health Center,County of Ingham,1053539460,Federally Qualified Health Centers - Medical Services,306 W Willow St,,Lansing,MI,48906-4740,Ingham,5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,Michelle Releford,DHO / ED,517-887-4359,,mreleford@ingham.org,Isaias Solis,Health Center Supervisor,517-887-4464,,cgildner@ingham.org,www.chc.ingham.org
MI-005651,Midwestern Dental of Farmington,Midwestern Dental,1699724864,Dental Providers,3525 S Martin Luther King Jr Blvd,,Lansing,MI,48910-4300,Ingham,5050 Schaefer Road,,Dearborn,MI,48126,Wayne,Jeffrey L. Reider DDS MS,Director of Professional Staff,313-582-8150,,drjreider@mwdentalplans.com,,,,,,
MI-005652,ICHD - Cedar Community Health Center,County of Ingham,1568560308,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,5303 S. Cedar St.,,Lansing,MI,48911-3800,Ingham,Russell Kolski,CHO / ED,517-887-4361,,RKolski@ingham.org,Anne Scott,Health Center Supervisor,517-887-4407,,ascott@ngham.org,www.chc.ingham.org
MI-005653,ICHD - Birch Health Center,"INGHAM, COUNTY OF",1639422728,Federally Qualified Health Centers - Medical Services,812 E Jolly Rd,,Lansing,MI,48910-6820,Ingham,5303 S Cedar St,,Lansing,MI,48911-3800,Ingham,Barbara Mastin,DHO / ED,517-887-4361,,bmastin@ingham.org,Cheryl Gildner,Compliance Manager,517-887-4464,,cgildner@ingham.org,www.chc.ingham.org
MI-005654,Lapeer Medical Clinic,"Hamilton Community Health Network, INC",1093180952,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1570 Suncrest Dr,,Lapeer,MI,48446-1154,Lapeer,225 E. Fifth Street Suite 300,,Flint,MI,48502,Genesee,Keith Johnson,CEO,810-406-4920,4920,kjohnson@hamiltonchn.org,,,,,,
MI-005655,Aspirus Keweenaw Hospital,Aspirus Keweenaw Hospital,1326115569,Inpatient Hospitals (other than children's hospitals),205 Osceola St,,Laurium,MI,49913-2134,Houghton,205 Osceola Street,,Laurium,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005656,Aspirus Laurium Clinic,Aspirus Keweenaw Hospital,1205998713,Rural Health Clinics,205 Osceola St,,Laurium,MI,49913-2134,Houghton,205 Osceola St,,Laurium,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005657,Aspirus Laurium Clinic,Aspirus Keweenaw Hospital,1205998713,Rural Health Clinics,300 Hecla St,,Laurium,MI,49913-2128,Houghton,205 Osceola Street,,Laurium,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005658,Aspirus Laurium Wellness Clinic,Aspirus Keweenaw Hospital,1750654661,Rural Health Clinics,300 Helca Street,,Laurium,MI,49913,Houghton,205 Osceola Street,,Laurium,MI,49913,Houghton,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005659,OMH Medical Group Lewistion RHC,Otsego Memorial Hospital,1285867838,Rural Health Clinics,3040 Bourn St,,Lewiston,MI,49756-8134,Montmorency,850 N. Otsego Ave.,,Gaylord,MI,49735,Otsego,Kevin A. Wahr,Chief Revenue Officer,989-731-7920,,kwahr@myomh.org,Bob Courtois,CFO,989-731-2238,,bcourtois@myomh.org,www.myomh.org
MI-005660,ALCONA HEALTH CENTER,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,177 N Barlow Rd,PO Box 279,Lincoln,MI,48742-0279,Alcona,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005661,Western Wayne Southwest Center,WESTERN WAYNE FAMILY HEALTH CENTERS,1508280116,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",25650 Outer Dr,,Lincoln Park,MI,48146-2096,Wayne,2700 HAMLIN BLVD,,Inkster,MI,48141-2348,Wayne,Linda R Atkins,CEO,313-561-5100,2100,latkins@wwfhc.org,Donna Russell,CFO,734-491-4991,237,drussell@wwfhc.org,www.wwfhc.org
MI-005662,Planned Parenthood of Michigan - Livonia Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",37625 Ann Arbor Rd,Suite 107,Livonia,MI,48150-2400,Wayne,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005663,Spectrum Health Ludington Hospital,Memorial Medical Center of West Michigan,1972589489,Inpatient Hospitals (other than children's hospitals),1 N Atkinson Dr,,Ludington,MI,49431-1906,Mason,1 N Atkinson Dr,,Ludington,MI,49431,Mason,Janice Myers,Reimburse Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005664,Primary Health Services,Primary Health Services,1578676441,Rural Health Clinics,505 W Ludington Ave,,Ludington,MI,49431-2029,Mason,505 W Ludingon Ave,,Ludingon,MI,49431,Mason,Candace Sextyon,office manager,231-848-4777,,wellstonmedical@kaltelnet.net,,,,,,
MI-005665,MHPP Sable Point Family Care,Mercy Health Physician Partners,1518385806,Rural Health Clinics,5656 W US Highway 10,,Ludington,MI,49431-2454,Mason,5656 W US 10 HWY,,Ludington,MI,49431,Mason,Colleen Johnson,Director Northshore Primary Care,231-728-5835,,johnsoco@mercyhealth.com,Mary Welsh,Quality Management Manager,231-861-3402,,welshm@mercyhealth.com,
MI-005666,District Health Department #10,District Health Department #10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",916 Diana St,,Ludington,MI,49431-2599,Mason,1049 Newell St.,,White Cloud,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005667,Spectrum Health Ludington Hospital Family and Internal Medicine - Ludington,Memorial Medical Center of West Michigan,1346628518,"Black Lung Clinics, Rural Health Clinics",922 Lawndale St,,Ludington,MI,49431-1928,Mason,1 Atkinson Dr,,Ludington,MI,49431,Mason,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005668,Sparrow Medical Group Lyons,Sparrow Carson Hospital,1538576061,Rural Health Clinics,545 Bridge St,,Lyons,MI,48851,Ionia,406 East Elm Street,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Director of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005669,Mackinaw City Medical Clinic,Mackinac Straits Health System,1124283502,Rural Health Clinics,420 S Nicolet St,,Mackinaw City,MI,49701-9657,Cheboygan,1140 N State ST.,,Saint Ignace,MI,49781,Mackinac,Laura Anderson,Clinic Manager,906-643-0439,,landerson@mshosp.org,Kelly Champion,Administrative Assistant,906-643-6527,,kchampion@mshosp.org,
MI-005670,Sacred Heart,MyCare Health Center,1609271105,Federally Qualified Health Centers - Medical Services,1400 E 12 Mile Rd,,Madison Heights,MI,48071-2651,Oakland,6800 E 10 Mile Road,,Center Line,MI,48071,Oakland,Darlene Vasi,Chief Executive Officer,586-619-9986,11,dvasi@mycarehealthcenter.org,Judy Hinson,Business/HR Manager,586-619-9986,16,jhinson@mycarehealthcenter.org,
MI-005671,Health Department of Northwest Michigan,Northwest Michigan Community Health Agency,1932116191,Family Planning Providers,205 Grove St,,Mancelona,MI,49659-8018,Antrim,220 W. Garfield,,Charlevoix,MI,49720,Charlevoix,Lisa Peacock,Family Planning Coordinator/Community Health Supervisor,231-587-4370,,l.peacock@nwhealth.org,Mary Williams,Reimbursement Coordinator,231-547-7633,,m.williams@nwhealth.org,www.nwhealth.org
MI-005672,Munson Healthcare Manistee OBGYN,Munson Healthcare Manistee Hospital,1851753032,Rural Health Clinics,1293 E Parkdale Ave,,Manistee,MI,49660-8904,Manistee,1465 East Parkdale,,Manistee,MI,49660,Manistee,Theresa Anderson,Director of Business Operations,231-398-1875,,tanderson2@mhc.net,Darrell Lavender,Chief Operating Officer,231-398-1000,,,
MI-005673,Munson Manistee Family Care,Munson Healthcare Manistee Hospital,1487010609,Rural Health Clinics,1391 E Parkdale Ave,,Manistee,MI,49660-9352,Manistee,1465 East Parkdale Road,,Manistee,MI,49660,Manistee,Theresa Anderson,Director of Business Operations,231-398-1875,,tanderson2@mhc.net,Darrell Lavender,Chief Operating Officer,231-398-1000,,,
MI-005674,Munson Healthcare Manistee Primary Care,Munson Healthcare Manistee Hospital,1407949191,Rural Health Clinics,1400 E Parkdale Ave,,Manistee,MI,49660-9776,Manistee,1465 East Parkdale Ave,,Manistee,MI,49660,Manistee,Theresa Anderson,Director of Business Operations,231-398-1875,,tanderson2@mhc.net,Darrell Lavender,,,,,
MI-005675,District Health Department #10,District Health Department #10,1316279045,"Family Planning Providers, Sexually Transmitted Disease Clinics",385 3rd St,,Manistee,MI,49660-1718,Manistee,1049 Newell St.,P.O.Box 850,Manistee,MI,49349,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005676,LMAS District Health Department,LMAS District Health Department,1578691242,Family Planning Providers,300 Walnut St,Room 155,Manistique,MI,49854-1495,Schoolcraft,300 Walnut Street room 155,,Manistique,MI,49854-1495,Schoolcraft,Nicole Robinson,Family Planning Coordinator,906-387-2297,415,nrobinson@lmasdhd.org,,,906-387-2297,,,http://www.lmasdhd.org
MI-005677,Manistique Tribal Health Center,Sault Tribe of Chippewa Indians,1477721058,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",5698W Hwy US2,,Manistique,MI,49854,Schoolcraft,2864 Ashmun Street,,Sault Sainte Marie,MI,49783,Chippewa,Bonnie L. Culfa,Health Division Director,906-632-5257,,bculfa@saulttribe.net,,,,,,
MI-005678,Planned Parenthood of Michigan - Marquette Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",1219 N 3rd St,,Marquette,MI,49855-3009,Marquette,950 Victors Way,Suite 100,Ann Arbor,MI,48108,Kent,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005679,GREAT LAKES FAMILY CARE - MCBAIN,BALDWIN FAMILY HEALTH CARE,1871799791,Federally Qualified Health Centers - Medical Services,117 N Roland St,,Mc Bain,MI,49657-9683,Missaukee,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005680,MENOMINEE FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1801214218,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1110 10th Ave,,Menominee,MI,49858-3058,Menominee,506 CAMPUS DRIVE,,HANCOCK,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005681,Public Health Delta and Menominee Co.,Public Health Delta and Menominee Co.,1912051293,Family Planning Providers,909 10th Ave,,Menominee,MI,49858-3014,Menominee,909 10th Ave,,Menominee,MI,49858-3014,Menominee,Debbie Poquette,Family Planning Coordinator,906-789-8123,,dpoquette@phdm.org,Lynn Woelffer,Director of Finance,906-789-8115,,lwoelffer@phdm.org,http://www.phdm.org
MI-005682,MidMichigan Medical Offices-Community Mental Health for Central Michigan,"MIDMICHIGAN HEALTH SERVICES, INC",1982094876,Federally Qualified Health Centers - Medical Services,218 Fast Ice Dr,,Midland,MI,48642-6167,Midland,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005683,Midland Co. Health Dept.,Michigan Department of Health of Human Services,1295741551,"Family Planning Providers, Sexually Transmitted Disease Clinics",220 W Ellsworth St,,Midland,MI,48640-5180,Midland,109 W. Michigan Avenue,,Lansing,MI,48933-1557,Ingham,Mary MacInnes,Family Planning Coordinator,989-832-6769,,mmacinnes@co.midland.mi.us,,,313-456-0532,,,http://www.co.midland.mi.us/health
MI-005684,District Health Dept. No. 2,District Health Dept. No. 2,1205805181,Family Planning Providers,393 S Mount Tom Rd,,Mio,MI,48647-9306,Oscoda,393 S Mount Tom Rd,,Mio,MI,48647-9368,Oscoda,Marsha Schnautz,Public Health Coordinator,989-345-5020,1802,mschnautz@dhd2.org,Denise Bryon,Health Officer,989-345-5020,1800,dbryon@dhd2.org,http://www.dhd2.org
MI-005685,Monroe County Health Department,County of Monroe,1801010707,Family Planning Providers,2353 S Custer Rd,Suite 2,Monroe,MI,48161-5047,Monroe,2353 S. Custer Rd,,Monroe,MI,48161-5047,Monroe,Bridget Huss,Personal Health Services Director,734-240-7831,,bridget_huss@monroemi.org,Deanna Gower,Family Planning Coordinator,734-240-7847,,deanna_gower@monroemi.org,
MI-005686,Family Medical Center of Michigan Monroe,FAMILY MEDICAL CENTER OF MICHIGAN INC,1922397447,Federally Qualified Health Centers - Medical Services,905 N Macomb St,,Monroe,MI,48162-3075,Monroe,8765 Lewis Ave,,Temperance,MI,48182-9583,Monroe,Ed Louis Larkins,CEO,734-654-2169,,elarkins@familymedical.org,,,,,,
MI-005687,MyCare Health Center,MyCare Health Center,1265749683,Federally Qualified Health Centers - Medical Services,18 Market St,Suite C,Mount Clemens,MI,48043-7403,Macomb,6800 E 10 Mile Road,,Center Line,MI,48015,Macomb,Darlene Vasi,Chief Executive Officer,586-619-9986,11,dvasi@mycarehealthcenter.org,Judy Hinson,Accountant,586-619-9986,16,jhinson@mycarehealthcenter.org,
MI-005688,Central Health Center,Macomb County Health Department,1528159258,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",43525 Elizabeth St,,Mount Clemens,MI,48043-1078,Macomb,43525 Elizabeth Road,,Mt. Clemens,MI,48043,Macomb,Patricia Detrick,Program Manager,586-469-2055,,patricia.detrick@macombgov.org,Lillian Schreiber,Public Health Services Director,586-469-5523,,lillian.schreiber@macombgov.org,
MI-005689,Central Michigan District Health Department,Central Michigan District Health Department,1245283977,"Family Planning Providers, Ryan White Providers",2012 E Preston St,,Mount Pleasant,MI,48858-8990,Isabella,2012 E Preston St,,Mount Pleasant,MI,48858,Isabella,Lorrie Youngs,Director,989-773-5921,1462,lyoungs@cmdhd.org,,,989-773-5921,,,
MI-005690,"Isabella Citizens for Health, Inc","Isabella Citizens for Health, Inc.",1104177195,Federally Qualified Health Centers - Medical Services,2940 Health Pkwy,,Mount Pleasant,MI,48858-9342,Isabella,2940 Health Parkway,,Mount Pleasant,MI,48858,Isabella,Jennifer White,Executive Director,989-953-5191,,jennifer.white@isabellahealth.org,Julia Paradine-Rice,Finance Director,989-779-5642,,julia.paradine-rice@isabellahealth.org,
MI-005691,Isabella Citizens for Health II,"Isabella Citizens for Health, Inc.",1942675525,Federally Qualified Health Centers - Medical Services,2935 Health Pkwy,,Mt Pleasant,MI,48858-8931,Isabella,2940 Health Parkway,,Mt. Pleasant,MI,48858,Isabella,Jennifer L. White,Executive Director,989-953-5191,,jennifer.white@isabellahealth.org,Diana Downing,Outreach & Enrollment Specialist,989-944-5214,,diana.downing@isabellahealth.org,www.isabellahealth.org
MI-005692,MidMichigan Health Park Mt. Pleasant,MidMichigan Medical Center - Gratiot,1265596126,Rural Health Clinics,4851 E Pickard St,,Mt Pleasant,MI,48858-2078,Isabella,300 E. Warwick Drive,,Alma,MI,48801,Gratiot,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Mark Santamaria,President,989-466-3258,,mark.santamaria@midmichigan.org,
MI-005693,Sparrow Medical Group Muir,Sparrow Ionia Hospital,1144382250,Rural Health Clinics,1044 Hayden Rd,,Muir,MI,48860-9767,Ionia,3565 S. State Rd.,,Ionia,MI,48846,Ionia,Michael Rich,Director of Regional Practices,989-584-3971,394,michael.rich@sparrow.org,Lacey Sherlock,Performance Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,
MI-005694,Bay Care Medical Center,Munising Memorial Hospital,1629120415,Rural Health Clinics,1500 Sandpoint Rd,,Munising,MI,49862-1406,Alger,1500 Sand Point Road,,Munising,MI,49862,Alger,Nicole Willis,CLINIC MANAGER,906-387-4110,110,nwillis@mmhos.org,Wendy Rautio,CFO,906-387-4110,102,wrautio@mmhos.org,
MI-005695,Munising Tribal Health Center,Sault Tribe of Chippewa Indians,1477721058,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",622 W Superior St,,Munising,MI,49862-1329,Alger,2864 Ashmun Street,,Sault Sainte Marie,MI,49783,Chippewa,Bonnie L. Culfa,Health Division Director,906-632-5257,,bculfa@saulttribe.net,,,,,,
MI-005696,LMAS District Health Department,LMAS District Health Department,1578691242,Family Planning Providers,E9562 Prospect St,,Munising,MI,49862-9243,Alger,E9562 Prospect Street,,Munising,MI,49862,Alger,Nicole Robinson,Family Planning Coordinator,906-387-2297,415,nrobinson@lmasdhd.org,,,,,,http://www.lmasdhd.org
MI-005697,Hackley Community Care Center Leahy Site,Hackley Community Care Center,1427437326,Federally Qualified Health Centers - Medical Services,1675 Leahy St Ste 103,Hackley Community Care Center Leahy Site,Muskegon,MI,49442-5538,Muskegon,"255 Seminole, Ste. 201A",,Muskegon,MI,49444,Muskegon,Valerie Blondin,CFO,231-733-6657,,blondinv@hccc-health.org,Sheri Weglarz,COO,231-733-6610,,Weglarzs@hccc-health.org,www.hackleycommunitycare.com
MI-005698,Planned Parenthood of Michigan - Muskegon Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",209 E Apple Ave,,Muskegon,MI,49442-3406,Muskegon,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005699,MUSKEGON FAMILY CARE,M.G.H. FAMILY HEALTH CENTER,1255331583,"Dental Providers, Federally Qualified Health Centers - Medical Services",2201 S Getty St,,Muskegon,MI,49444-1207,Muskegon,2201 S Getty St,,Muskegon,MI,49444-1207,Muskegon,Sheila Bridges,CEO,231-737-1751,,BRIDGESS@MFC-HEALTH.ORG,Marsha DeBoer,CFO,231-737-1744,,deboerm@mfc-health.org,www.mfc-health.org
MI-005700,Hackley Community Care Center Inc.,Hackley Community Care Center,1356720262,Federally Qualified Health Centers - Medical Services,376 E Apple Ave,Hackley Community Care Center Inc.,Muskegon,MI,49442-3466,Muskegon,"255 Seminole, Ste. 201A",,Muskegon,MI,49444,Muskegon,Valerie Blondin,CFO,231-733-6657,,blondinv@hccc-health.org,Sheri Weglarz,COO,231-733-6610,,weglarzs@hccc-health.org,www.hackleycommunitycare.com
MI-005701,HACKLEY COMMUNITY CARE CENTER,Hackley Community Care Center,1629066238,"Dental Providers, Federally Qualified Health Centers - Medical Services",2700 Baker St,Suite 3A,Muskegon Hts,MI,49444-2157,Muskegon,255 Seminole,Ste 201A,Muskegon,MI,49444,Muskegon,Valerie Blondin,CFO,231-733-6657,,blondinv@hccc-health.org,Sheri Weglarz,COO,231-733-6610,,weglarzs@hccc-health.org,www.hackleycommunitycare.org
MI-005702,Marquette County Health Department,MARQUETTE COUNTY HEALTH DEPARTMENT,1346333226,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",184 Us 41 Hwy E,,Negaunee,MI,49866,Marquette,184 US 41 East,,Negaunee,MI,49866,Marquette,Gerald Messana,Health Officer,906-315-2604,,gmessana@mqtco.org,Bobbie Champion,Community Health Division Director,906-315-2620,,bchampion@mqtco.org,
MI-005703,DCS NEW HAVEN COMMUNITY SERVICES,DOWNRIVER COMMUNITY SERVICES INC,1679571392,Federally Qualified Health Centers - Medical Services,58144 Gratiot Ave,,New Haven,MI,48048,Macomb,555 Saint Clair River Dr,,Algonac,MI,48001-1802,Saint Clair,Michael Baranowski,CEO,586-270-8055,251,mbaranowski@downrivercs.org,Janice Daugherty,Billing Supervisor,586-749-5197,234,jdaugherty@downrivercs.org,
MI-005704,Spectrum Health Gerber Memorial Family Medicine Newaygo,Spectrum Health Gerber Memorial,1467845537,Rural Health Clinics,211 W Pine Lake Dr,,Newaygo,MI,49337-8029,Newaygo,212 S Sullivan Ave,,Fremont,MI,49412,Newaygo,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005705,LMAS District Health Department,LMAS District Health Department,1578691242,Family Planning Providers,14150 Hamilton Lake Rd,,Newberry,MI,49868,Luce,14150 Hamilton Lake Road,,Newberry,MI,49868,Luce,Nicole Robinson,Family Planning Coordinator,906-387-2297,415,nrobinson@lmasdhd.org,,,,,,http://www.lmasdhd.org
MI-005706,HELEN NEWBERRY JOY HOSPITAL (inpatient hospital),Helen Newberry Joy Hospital and Healthcare Center,1497742050,Inpatient Hospitals (other than children's hospitals),502 W Harrie St,,Newberry,MI,49868-1209,Luce,502 W. Harrie St,,Newberry,MI,49868-1209,Luce,Denise Danaher,Director of Community Clinics,906-293-9239,,ddanaher@hnjh.org,Mary LaLonde,CFO,906-293-9164,,mlalonde@hnjh.org,
MI-005707,HELEN NEWBERRY JOY HOSPITAL (rural health clinics),Helen Newberry Joy Hospital and Healthcare Center,1497742050,Rural Health Clinics,502 W Harrie St,,Newberry,MI,49868-1209,Luce,502 W. Harrie St,,Newberry,MI,49868-1209,Luce,Denise Danaher,Director of Community Clinics,906-293-9239,,ddanaher@hnjh.org,Mary LaLonde,CFO,906-293-9164,,mlalonde@hnjh.org,
MI-005708,Berrien County Health Department-Niles,Berrien County Health Department,1326005109,"Family Planning Providers, Sexually Transmitted Disease Clinics",1205 N Front St,Suite 900,Niles,MI,49120-1627,Berrien,2149 East Napier Avenue,,Benton Harbor,MI,49022,Berrien,Peggy Hamel,Family Planning Coordinator,269-927-5663,,phamel@bchdmi.org,Stephanie Schadler,Clinic Coordinator,269-926-7121,5289,sschadler@bchdmi.org,http://www.bchd.org
MI-005709,Niles Community Health Center Dental,LAKELAND IMMEDIATE CARE CENTER,1447701008,Dental Providers,122 Grant St,,Niles,MI,49120-2281,Berrien,261 M-62,,Cassopolis,MI,49031,Cass,Meredith Neary,Chief Financial Officer,269-445-3874,137,mneary@cassfamilyclinic.org,Mary Middleton,Chief Executive officer,269-445-3874,109,mmiddleton@cassfamilyclinic.org,
MI-005710,Niles Community Health Center,LAKELAND IMMEDIATE CARE CENTER,1760802912,Federally Qualified Health Centers - Medical Services,24 N Saint Joseph Ave,Suite G,Niles,MI,49120-2263,Berrien,261 M 62,,Cassopolis,MI,49031-1034,Cass,Mary Geegan Middleton,CEO,269-445-5244,,mmiddleton@cassfamilyclinic.org,Tammy Howard,Chief Operating Officer,269-445-3874,135,thoward@cassfamilyclinic.org,http://cassfamilyclinic.org
MI-005711,Cassopolis Family Clinic OB/GYN,LAKELAND IMMEDIATE CARE CENTER,1982677548,Federally Qualified Health Centers - Medical Services,60 N Saint Joseph Ave,,Niles,MI,49120-2296,Berrien,261 M 62,,Cassopolis,MI,49031-1034,Cass,Mary Geegan Middleton,CEO,269-445-5244,,mmiddleton@cassfamilyclinic.org,Tammy Howard,Chief Operating Officer,269-445-3874,135,thoward@cassfamilyclinic.org,http://cassfamilyclinic.org/
MI-012452,Center for Vein Restoration,Center for Vein Restoration,1720388267,Other ECP Providers,837 Seminole Rd,Suite 204,Norton Shores,MI,49441-6734,Muskegon,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
MI-005712,Dickinson Family and Geriatric Clinic,Dickinson County Healthcare System,1053580365,Rural Health Clinics,500 Main St,,Norway,MI,49870-1238,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005713,Dickinson Family Practice Center Norway,Dickinson County Healthcare System,1740504943,Rural Health Clinics,N1667 Hwy 8,PO Box 215,Norway,MI,49870-0215,Dickinson,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager of Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
MI-005714,"The Wellness Plan, Northwest Medical Center","WELLNESS PLAN, THE",1982863478,Federally Qualified Health Centers - Medical Services,21040 Greenfield Rd,,Oak Park,MI,48237-3025,Oakland,2888 W Grand Blvd,,Detroit,MI,48202-2612,Wayne,Anthony King,CEO,313-202-6848,,aking@wellplan.com,,,,,,www.wellplan.com
MI-005715,THUNDER BAY COMMUNITY HEALTH SERVICE - ONAWAY,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1508804246,Federally Qualified Health Centers - Medical Services,21258 M 68 Hwy,,Onaway,MI,49765-9692,Presque Isle,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,2335,mstyma@tbchs.org,,,,,,
MI-005716,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED","THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1821228958,Federally Qualified Health Centers - Medical Services,4549 M 33,ONAWAY AREA COMMUNITY SCHOOLS,Onaway,MI,49765-9623,Presque Isle,15774 State St,,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,2335,mstyma@tbchs.org,,,,,,http://www.tbchs.org/centers.html
MI-005717,Western Upper Peninsula Health Department,Michigan Department of Community Health,1962539502,"Family Planning Providers, Sexually Transmitted Disease Clinics",408 Copper St,,Ontonagon,MI,49953-1161,Ontonagon,408 Copper St.,,Ontonagon,MI,49953,Ontonagon,Barbara Auten,Director of Public Health and Education,906-482-7382,,bauten@wuphd.org,,,,,,http://www.westernuphealth.org
MI-005718,Aspirus Ontonagon Family Practice Clinic,Aspirus Ontonagon Hospital,1023161932,Rural Health Clinics,601 S 7th St,,Ontonagon,MI,49953-1459,Ontonagon,601 S. 7th St,,Aspirus Ontonagon Hospital,MI,49953,Ontonagon,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005719,Aspirus Ontonagon Hospital,Aspirus Ontonagon Hospital,1346590882,Inpatient Hospitals (other than children's hospitals),601 S 7th St,,Ontonagon,MI,49953-1459,Ontonagon,601 South 7th Street,,Ontonagon,MI,49953,Ontonagon,Amanda Shelast,Regional Clinic Director,906-337-6077,19802,amanda.shelast@aspirus.org,,,,,,www.aspirus.org
MI-005720,ONTONAGON FAMILY HEALTH CENTER,UPPER GREAT LAKES FAMILY HEALTH CENTER,1336563832,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",751 S 7th St,,Ontonagon,MI,49953-1450,Ontonagon,506 CAMPUS DRIVE,,Hancock,MI,49930,Houghton,BECKY GAFFNEY,Business Office Director,906-483-1128,,rgaffney@portagehealth.org,Donald Simila,CEO,906-483-1325,,donald.simila@uglhealth.org,
MI-005721,ALCONA HLTH CTRS - OSCODA SVCS,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,"Dental Providers, Federally Qualified Health Centers - Medical Services",5671 N Skeel Ave,Suite 8,Oscoda,MI,48750-1535,Iosco,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005722,ALCONA HLTH CTRS-OSSINEKE SVCS,"ALCONA CITIZENS FOR HEALTH, INC.",1326055450,Federally Qualified Health Centers - Medical Services,11745 US Highway 23 S,,Ossineke,MI,49766-9582,Alpena,177 N Barlow Rd,,Harrisville,MI,48740-9607,Alcona,Christine M Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005723,GLBHC Integrated Care Shiawassee,Great Lakes Bay Health Centers,1134491202,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1555 Industrial Dr,,Owosso,MI,48867-9775,Shiawassee,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005724,Memorial Arnold Medical Clinic,Memorial Healthcare,1316008006,Rural Health Clinics,1975 W M 21,,Owosso,MI,48867-8163,Shiawassee,826 West King Street,,Owosso,MI,48867,Shiawassee,"Pam Mahoney, CPC","Practice Manager, Primary Care",989-723-5211,3807,pmahoney@memorialhealthcare.org,Joyce Bremer,"Director, Primary Care",989-729-4528,,jbremer@memorialhealthcare.org,
MI-005725,GLBHC Shiawassee,Great Lakes Bay Health Centers,1184054892,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 N Caledonia Dr,,Owosso,MI,48867-8844,Shiawassee,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005726,Spectrum Health Family Medicine - Pentwater,Memorial Medical Center of West Michigan,1497163216,Rural Health Clinics,500 N Hancock St,,Pentwater,MI,49449-8935,Oceana,1 Atkinson Dr,,Ludington,MI,49431,Mason,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005727,Memorial Perry Family Practice,Memorial Healthcare,1316008006,Rural Health Clinics,3337 Britton Rd,,Perry,MI,48872-9706,Shiawassee,Memorial Healthcare,826 West King Street,Owosso,MI,48867,Shiawassee,"Pam Mahoney, CPC","Practice Manager, Primary Care",989-723-5211,3807,pmahoney@memorialhealthcare.org,Joyce Bremer,"Director, Primary Care",989-729-4528,,jbremer@memorialhealthcare.org,
MI-005728,Grand Traverse Band (GTB) Health Center,Grand Traverse Band (GTB) Health Center,1134281132,"Dental Providers, Federally Qualified Health Centers - Medical Services",2300 N Stallman Rd,Suite A,Peshawbestown,MI,49682-9158,Leelanau,2300 N Stallman Rd Ste A,,Peshawbestown,MI,49682-9158,Leelanau,Loi Chambers,Health Director,231-534-7477,,loi.chambers@gtbindians.com,,,,,,
MI-005729,Planned Parenthood of Michigan - Petoskey Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",1003 Spring St,,Petoskey,MI,49770-2810,Emmet,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005730,Mina Mskiki Gumik,Little Traverse Bay Bands of Odawa Indians,1124052816,"Dental Providers, Federally Qualified Health Centers - Medical Services",1250 Lears Rd,,Petoskey,MI,49770-9252,Emmet,1250 Lears Road,,Petoskey,MI,49770,Emmet,Sharon Sierzputowski,Health Director,231-242-1612,,ssierzputowski@ltbbodawa-nsn.gov,Sandra DuBois,Medical Billing Specialist,231-242-1704,,sdubois@ltbbodawa-nsn.gov,
MI-005731,AHC Pickford Medical Center,"Alcona Citizens for Health, Inc.",1326055450,Federally Qualified Health Centers - Medical Services,7742 N M 129,,Pickford,MI,49774-9003,Chippewa,177 N. Barlow Rd.,,Harrisville,MI,48740,Alcona,Christine M. Baumgardner,Chief Executive Officer,989-736-9868,,cbaumgard@alconahc.org,,,,,,
MI-005732,Orchard Lake Center,Oakland Integrated Healthcare Network,1962765529,Federally Qualified Health Centers - Medical Services,114 Orchard Lake Rd,,Pontiac,MI,48341-2244,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005733,Children's Village,Oakland Integrated Healthcare Network,1003206038,Federally Qualified Health Centers - Medical Services,1200 N Telegraph Rd,Dept 87,Pontiac,MI,48341-1032,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,
MI-005734,Baldwin Family Medicine Center,Oakland Integrated Healthcare Network,1457711202,Federally Qualified Health Centers - Medical Services,1701 Baldwin Ave,,Pontiac,MI,48340-3412,Oakland,461 W Huron St.,Ste 103,Pontiac,MI,48341,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005735,Jump Start Center,Oakland Integrated Healthcare Network,1265975122,Federally Qualified Health Centers - Medical Services,196 Cesar E Chavez Ave,,Pontiac,MI,48342-1094,Oakland,PO Box 430150,,Pontiac,MI,48342,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7413,,dbrinson@oihn.org,www.oihn.org
MI-005736,The Henderson Clinic,"WELLNESS PLAN, THE",1447675434,Federally Qualified Health Centers - Medical Services,44405 Woodward Ave,,Pontiac,MI,48341-5023,Oakland,2888 W Grand Blvd,,Detroit,MI,48202-2612,Oakland,Anthony King,CEO,313-202-6848,,aking@wellplan.com,,,,,,www.wellplan.com
MI-005737,Family Medicine Center,Oakland Integrated Healthcare Network,1316214299,Federally Qualified Health Centers - Medical Services,461 W Huron St,Suite 107,Pontiac,MI,48341-1601,Oakland,461 W Huron St.,Ste 103,Pontiac,MI,48341-1601,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005738,OAKLAND PRIMARY HEALTH SERVICES,OAKLAND PRIMARY HEALTH SERVICES INC.,1780601740,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",46156 Woodward Ave,Suite B,Pontiac,MI,48342-5033,Oakland,46156 Woodward Avenue,Suite B,Pontiac,MI,48342,Oakland,Sharon Berry,Chief Financial Officer,248-857-3251,,sberry@oaklandphs.org,Steve Grant,Chief Executive officer,248-322-6747,232,sgrant@oaklandphs.org,
MI-005739,Joslyn Smile Center,Oakland Integrated Healthcare Network,1558629238,Dental Providers,816 Joslyn Ave,,Pontiac,MI,48340-2919,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005740,DCS Port Huron Medical Clinic,DOWNRIVER COMMUNITY SERVICES INC,1184935488,Federally Qualified Health Centers - Medical Services,1011 Military St,,Port Huron,MI,48060-5416,Saint Clair,555 Saint Clair River Dr,,Algonac,MI,48001-1802,Saint Clair,Michael Baranowski,CEO,586-270-8055,251,mbaranowski@downrivercs.org,Janice Daugherty,Billing Supervisor,586-749-5197,234,jdaugherty@downrivercs.org,
MI-005741,FAMILY HEALTH CENTER CENTRE,FAMILY HEALTH CENTER INC.,1659567956,"Dental Providers, Federally Qualified Health Centers - Medical Services",325 E Centre Ave,,Portage,MI,49002-5512,Kalamazoo,117 W Paterson St,,Kalamazoo,MI,49007-2557,Kalamazoo,Denise Crawford,President & CEO,269-349-4257,,denise.crawford@fhckzoo.com,Eileen Chiang,CFO,269-349-4257,,eileen.chiang@fhckzoo.com,
MI-012453,Center for Vein Restoration,Center for Vein Restoration,1720388267,Other ECP Providers,3810 W Centre Ave,Suite A,Portage,MI,49024-4632,Kalamazoo,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
MI-005742,Sparrow Medical Group Portland,Sparrow Ionia Hospital,1295801108,Rural Health Clinics,9751 E Grand River Ave,,Portland,MI,48875-9774,Ionia,3565 S. State Rd,,Ionia,MI,48846,Ionia,Michael Rich,Director of Regional Practices,989-584-3971,394,michael.rich@sparrow.org,Lacey Sherlock,Performance Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,
MI-005743,PRESCOTT CLINIC PC,PRESCOTT CLINIC PC,1881622835,Rural Health Clinics,125 N Washington St,,Prescott,MI,48756-5117,Ogemaw,125 N. Washington,,Prescott,MI,48756-5117,Ogemaw,William E Berner,Clinic Administrator,989-892-7722,,Bernermedical@hotmail.com,,,,,,
MI-005744,Ogemaw Clinic,Sterling Area Health Center,1881679645,Federally Qualified Health Centers - Medical Services,1827 Greenwood Rd,,Prescott,MI,48756-8626,Ogemaw,725 E State Street,,Sterling,MI,48659,Arenac,James J Balten Jr,President/Chief Executive Officer,989-524-3750,,JBalten@sterlinghealth.net,,,,,,
MI-005745,Central Michigan Dist. Health Dept.,Central Michigan Dist. Health Dept.,1245283977,"Family Planning Providers, Ryan White Providers",1015 Short Dr,M-18,Prudenville,MI,48651-8450,Roscommon,2012 E Preston St,,Mt Pleasant,MI,48858,Isabella,Steve Hall,Director,989-773-5921,1421,shall@cmdhd.org,,,,,,http://www.cmdhd.org
MI-005746,PRUDENVILLE COMMUNITY HEALTH CENTER,Munson Healthcare Grayling,1144626052,Rural Health Clinics,2585 W Houghton Lake Dr,,Prudenville,MI,48651-9624,Roscommon,1100 E. Michigan Ave.,,Grayling,MI,49738,Crawford,Trisha Teare,Billing Manager,231-876-7234,,tteare@mhc.net,,,,,,
MI-005747,INTERCARE PULLMAN,INTERCARE COMMUNITY HEALTH NETWORK,1457361677,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",5498 109th Ave,,Pullman,MI,49450-9631,Allegan,50 Industrial Park Rd,,Bangor,MI,49013-1246,Van Buren,Velma Hendershott,CEO/President,269-427-7937,51200,vhendershott@intercare.org,Jody Elliott,Director of Patient Financial Services,269-427-7937,51107,jelliott@intercare.org,
MI-005748,Central Michigan Dist. Health Dept.,Central Michigan Dist. Health Dept.,1245283977,"Family Planning Providers, Ryan White Providers",22054 Professional Dr,Suite D,Reed City,MI,49677-7508,Osceola,2012 E Preston St,,Mt Pleasant,MI,48858,Isabella,Lorrie Youngs,Director,989-773-5921,1462,lyoungs@cmdhd.org,,,,,,http://www.cmdhd.org
MI-005749,SPECTRUM HEALTH REED CITY FAMILY PRACTICE,Spectrum Health Reed City Hospital,1730280025,Rural Health Clinics,300 N Patterson Rd,,Reed City,MI,49677-8041,Osceola,300 N Patterson,,Reed City,MI,49677,Osceola,Teresa Treiber,Finance Manager RHC and CAH,231-832-8509,,Teresa.treiber@spectrumhealth.org,,,,,,
MI-005750,SPECTRUM HEALTH REED CITY HOSPITAL,Spectrum Health Reed City Hospital,1437259843,Inpatient Hospitals (other than children's hospitals),300 N Patterson Rd,,Reed City,MI,49677-8041,Osceola,300 N Patterson,,Reed City,MI,49677,Osceola,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MI-005751,District Health Department No. 4-Rogers City,District Health Department No. 4,1760443584,"Family Planning Providers, Sexually Transmitted Disease Clinics",106 E Huron Ave,Suite A,Rogers City,MI,49779-1317,Presque Isle,100 Woods Circle Suite 200,,Alpena,MI,49707,Alpena,Karen Nowicki-Compeau RN BSN,Family Planning Coordinator,989-356-4507,7960,kcompeau@dhd4.org,Amy Fournier,Account Clerk,989-356-4507,7947,afournier@dhd4.org,http://www.dhd4.org
MI-005752,THUNDER BAY COMMUNITY HEALTH SERVICE - ROGERS CITY,"THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED",1477591691,Federally Qualified Health Centers - Medical Services,205 S Bradley Hwy,,Rogers City,MI,49779-2137,Presque Isle,15774 State St,PO BOx 427,Hillman,MI,49746-7961,Montmorency,Michelle Styma,CEO,989-742-4583,,mstyma@tbchs.org,,,,,,
MI-005753,MIDMICHIGAN MEDICAL OFFICES - ROSCOMMON,"MIDMICHIGAN HEALTH SERVICES, INC",1841457314,Federally Qualified Health Centers - Medical Services,135 Lake St,,Roscommon,MI,48653-7658,Roscommon,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005754,ROSCOMMON COMMUNITY HEALTH CENTER,Munson Healthcare Grayling,1710383351,Rural Health Clinics,234 Lake St,,Roscommon,MI,48653-9203,Roscommon,1100 E. Michigan Ave.,,Grayling,MI,49738,Crawford,Trisha Teare,Billing Manager,231-876-7234,,tteare@mhc.net,,,,,,
MI-005755,Roscommon SBHC,"MIDMICHIGAN HEALTH SERVICES, INC",1326205907,Federally Qualified Health Centers - Medical Services,299 E Sunset Dr,,Roscommon,MI,48653-9393,Roscommon,9249 W Lake City Rd,,Houghton Lake,MI,48629-9602,Roscommon,James Raschke,Executive Director,989-422-2105,,jim.raschke@midmichiganhs.org,Bill Collin,Finance Director,989-202-4604,,bill.collin@midmichiganhs.org,
MI-005756,Covenant Woodward Avenue,"COVENANT COMMUNITY CARE, INC.",1073834818,Federally Qualified Health Centers - Medical Services,27776 Woodward Ave,,Royal Oak,MI,48067-0930,Oakland,559 W Grand Blvd,,Detroit,MI,48216-2200,Oakland,Paul M Propson,ceo,313-670-5228,,ppropson@covenantcommunitycare.org,,,,,,
MI-005757,GLBHC Janes St.,Great Lakes Bay Health Centers,1780702571,Federally Qualified Health Centers - Medical Services,1522 Janes Ave,,Saginaw,MI,48601-1819,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005758,Saginaw Co. Health Dept.,Michigan Dept. of Community Health,1497863229,Family Planning Providers,1600 N Michigan Ave,,Saginaw,MI,48602-5306,Saginaw,1600 N Michigan Ave,,Saginaw,MI,48602-5306,Saginaw,Kemberly Parham,Family Planning Coordinator,989-758-3856,,kparham@saginawcounty.com,,,313-456-0532,,,http://www.saginawpublichealth.org
MI-005759,GLBHC Roosevelt S. Ruffin,Great Lakes Bay Health Centers,1871611665,Federally Qualified Health Centers - Medical Services,229 Gallagher St,,Saginaw,MI,48601-3252,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005760,WADSWORTH DENTAL CENTER,Great Lakes Bay Health Centers,1063530848,Dental Providers,2308 Wadsworth Ave,,Saginaw,MI,48601-1435,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005761,GLBHC Wolverine Saginaw,Great Lakes Bay Health Centers,1336267111,"Dental Providers, Federally Qualified Health Centers - Medical Services",2424 N Outer Dr,,Saginaw,MI,48601-6010,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005762,Planned Parenthood of Michigan - Saginaw Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",2650 McLeod Dr N,,Saginaw,MI,48604-2850,Saginaw,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005763,GLBHC Integrated Care Saginaw,Great Lakes Bay Health Centers,1235483900,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",500 Hancock St,,Saginaw,MI,48602-4224,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607,Saginaw,Brenda Coughlin,President/CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005764,GLBHC David R. Gamez,Great Lakes Bay Health Centers,1972621753,Federally Qualified Health Centers - Medical Services,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,www.greatlakesbayhealthcenters.org
MI-005765,GLBHC Old Town,Great Lakes Bay Health Centers,1528435526,Federally Qualified Health Centers - Medical Services,804 S Hamilton St,,Saginaw,MI,48602-1516,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607,Saginaw,Brenda Coughlin,President/CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005766,GLBHC St. Vincent,Great Lakes Bay Health Centers,1427176502,"Dental Providers, Federally Qualified Health Centers - Medical Services",925 N River Rd,,Saginaw,MI,48609-6831,Saginaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005767,Southeast Health Center,Macomb County Health Department,1528159258,Family Planning Providers,25401 Harper Ave,,Saint Clair Shores,MI,48081-2297,Macomb,43525 Elizabeth Road,,Mt. Clemens,MI,48043,Macomb,Patricia Detrick,Program Manager,586-469-2055,,patricia.detrick@macombgov.org,Lillian Schreiber,Public Health Services Coordinator,586-469-5523,,lillian.schreiber@macombgov.org,
MI-005768,Mackinac Straits Rural Health Clinic (inpatient hospital),Mackinac Straits Health System,1124283502,Inpatient Hospitals (other than children's hospitals),1140 N State St,Suite 1762,Saint Ignace,MI,49781-1048,Mackinac,1140 N State St,,Saint Ignace,MI,49781,Mackinac,Laura Anderson,Clinic Practice Manager,906-643-0439,,landerson@mshosp.org,Kelly Champion,Administrative Assistant,906-643-6527,,kchampion@mshosp.org,
MI-005769,Mackinac Straits Rural Health Clinic (rural health clinics),Mackinac Straits Health System,1124283502,Rural Health Clinics,1140 N State St,Suite 1762,Saint Ignace,MI,49781-1048,Mackinac,1140 N State St,,Saint Ignace,MI,49781,Mackinac,Laura Anderson,Clinic Practice Manager,906-643-0439,,landerson@mshosp.org,Kelly Champion,Administrative Assistant,906-643-6527,,kchampion@mshosp.org,
MI-005770,St. Ignace Tribal Health Center,Sault Tribe of Chippewa Indians,1477721058,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1140 N State St,,Saint Ignace,MI,49781-1048,Mackinac,2864 Ashmun Street,,Sault Sainte Marie,MI,49783,Chippewa,Bonnie L. Culfa,Health Division Director,906-632-5257,,bculfa@saulttribe.net,,,,,,
MI-005771,LMAS District Health Department,LMAS District Health Department,1578691242,Family Planning Providers,749 Hombach St,,Saint Ignace,MI,49781-1795,Mackinac,749 Hombach Street,,St. Ignace,MI,49871-1735,Mackinac,Nicole Robinson,Family Planning Coordinator,906-387-2297,415,nrobinson@lmasdhd.org,,,,,,http://www.lmasdhd.org
MI-005772,Mid-Michigan District Health Department,Mid-Michigan District Health Department,1851386106,"Family Planning Providers, Sexually Transmitted Disease Clinics",1307 E Townsend Rd,,Saint Johns,MI,48879-9036,Clinton,615 N. State,,Stanton,MI,48888,Montcalm,Andrea Tabor,Director of Community Health and Education,989-831-3639,3639,atabor@mmdhd.org,Jenniffer Efaw,Nurse Practitioner,989-875-1013,1013,jefaw@mmdhd.org,www.mmdhd.org
MI-005773,McKenzie Health System,McKenzie Health System,1497750608,Inpatient Hospitals (other than children's hospitals),120 N Delaware St,,Sandusky,MI,48471-1009,Sanilac,120 N Delaware Street,,Sandusky,MI,48471,Sanilac,Amy Reudiseuli,VP of Finance,810-648-6162,,areudiseuli@mckenziehealth.org,Billi Jo Hennika,VP of Operations,810-648-6138,,bhennika@mckenziehealth.org,
MI-005774,Sanilac County,Sanilac County Health Department,1972532711,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",171 Dawson St,Suite 123,Sandusky,MI,48471-1502,Sanilac,141 Dawson Street,"Ste., 123",Sandusky,MI,48471,Sanilac,Bryant J Wilke,Health Officer,810-684-4098,134,wilkeb@sanilachealth.com,Healther Kohn,Senior Biller,810-648-4098,154,khonh@sanilachealth.com,
MI-005775,McKenzie Rural Health Clinic,McKenzie Health System,1033271135,Rural Health Clinics,75 Dawson St,,Sandusky,MI,48471-3323,Sanilac,120 N Delaware Street,,Sandusky,MI,48471,Sanilac,Amy Reudiseuli,VP of Finance,810-648-6162,,areudiseuli@mckenziehealth.org,Billi Jo Hennika,VP of Operations,810-648-6138,,bhennika@mckenziehealth.org,
MI-005776,MidMichigan Medical Offices - Sanford,MidMichigan Medical Center - Midland,1740230127,Other ECP Providers,40 W Saginaw Rd,,Sanford,MI,48657-9206,Midland,4000 Wellness Drive,,MIDLAND,MI,48640,Midland,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Greg Rogers,President,989-839-3225,,greg.rogers@midmichigan.org,
MI-005777,Sparrow Medical Group Saranac,Sparrow Ionia Hospital,1811380066,Rural Health Clinics,107 N Bridge St,,Saranac,MI,48881-5121,Ionia,3565 S. State Rd.,,Ionia,MI,48846,Ionia,Michael Rich,Director of Regional Pracitces,989-584-3971,394,michael.rich@sparrow.org,Lacey Sherlock,Performance Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,
MI-005778,Sault Tribal Health Center,Sault Tribe of Chippewa Indians,1477721058,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",2864 Ashmun St,,Sault Sainte Marie,MI,49783-3740,Chippewa,2864 Ashmun St,,Sault Sainte Marie,MI,49783-3740,Chippewa,Leo Chugunov,Health Director,906-632-5257,,lchugunov@saulttribe.net,,,,,,
MI-005779,Chippewa Co. Health Dept.,Michigan Dept. of Community Health,1538382650,"Family Planning Providers, Sexually Transmitted Disease Clinics",508 Ashmun St,Suite 120,Sault Sainte Marie,MI,49783-1976,Chippewa,508 Ashmun St Ste 120,,Sault Sainte Marie,MI,49783-1976,Chippewa,Renee Tschirhart,Family Planning Coordinator,906-253-3184,184,rtschirhart@chippewahd.com,Sherri Buckley,Sr. Administrative Assistant,906-635-3591,591,sbuckley@chippewahd.com,http://www.chippewahd.com
MI-005780,Chippewa County War Memorial Hospital Community Care Clinic,Chippewa County War Memorial Hospital,1710240403,Rural Health Clinics,509 Osborn Blvd,Suite 160,Sault Sainte Marie,MI,49783-2071,Chippewa,500 Osborn Blvd,,Sault Ste Marie,MI,49783,Chippewa,Marian Burton,Clinical Director,906-253-0101,,mburton@wmhos.org,JAMMIE ROMERI,,906-635-4401,,jromeri@wmhos.org,
MI-005781,SUPERIOR FAMILY MEDICAL ASSOC,Superior Family Medical Associates,1902817984,Ryan White Providers,550 Osborn Blvd,Suite 101,Sault Sainte Marie,MI,49783-1852,Chippewa,550 Osborn Blvd.,,Sault Sainte Marie,MI,49783-1899,Clinton,Sandra Pahn,RHC Administrator,906-632-0370,,sandy49783@yahoo.com,Carrie Beaudry,Office Manager,906-632-0370,,sfma49783@yahoo.com,
MI-005782,"Riverside Medical Associates, P.C.","Riverside Medical Associates, P.C.",1306832605,Rural Health Clinics,560 Osborn Blvd,,Sault Sainte Marie,MI,49783-1961,Chippewa,560 Osborn Blvd,,Sault Ste Marie,MI,49783,Chippewa,Kellie Popour,Office Manager,906-632-1800,,kellierma@lighthouse.net,,,,,,
MI-005783,MHPP- Lakeshore Medical Shelby,Mercy Health Physician Partners,1588080030,Rural Health Clinics,71 Bevier St,,Shelby,MI,49455-1209,Oceana,71 Bevier St,,Shelby,MI,49455,Oceana,Colleen Johnson,Director of Northshore primary care network,231-728-5935,,johnsoco@mercyhealth.com,Mary Welsh,Quality Management Northshore Primary Care,231-861-3402,,welshm@mercyhealth.com,
MI-005784,Gun Lake Tribal Health Center,Match-E-Be-Nash-She-Wish Band of Pottawatomi,1952685588,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",2880 Mission Dr,,Shelbyville,MI,49344-9580,Allegan,2880 Mission Drive,,Shelbyville,MI,49344,Allegan,Kelly Wesaw,Office Manager,269-397-1760,1103,kelly.wesaw@hhs.glt-nsn.gov,David DeDecker,Project Specialist,269-397-1760,1116,david.dedecker@hhs.glt-nsn.gov,
MI-005785,South Haven Health System (inpatient hospital),South Haven Health System,1346275856,Inpatient Hospitals (other than children's hospitals),955 S Bailey Ave,,South Haven,MI,49090-6743,Van Buren,955 S Bailey Ave,,South Haven,MI,49090,Van Buren,Tammy cochran,Controller,269-637-5271,2314,tcochran@sh-hs.org,Mark Gross,CFO,269-637-2822,,mgross@sh-hs.org,
MI-005786,South Haven Health System (multiple outpatient ECP categories),South Haven Health System,1346275856,"Other ECP Providers, Rural Health Clinics",955 S Bailey Ave,,South Haven,MI,49090-6743,Van Buren,955 S Bailey Ave,,South Haven,MI,49090,Van Buren,Tammy cochran,Controller,269-637-5271,2314,tcochran@sh-hs.org,Mark Gross,CFO,269-637-2822,,mgross@sh-hs.org,
MI-005787,Plum Hollow Center,Oakland Integrated Healthcare Network,1083965065,Federally Qualified Health Centers - Medical Services,22200 W 9 Mile Rd,,Southfield,MI,48033-6008,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005788,Greenfield Avenue,"HEALTH CENTERS DETROIT FOUNDATION, INC.",1386705804,Federally Qualified Health Centers - Medical Services,23077 Greenfield Rd,Suite 489,Southfield,MI,48075-3740,Oakland,4201 Saint Antoine St Ste 9C,,Detroit,MI,48201-2153,Wayne,Andrew Dignan,CIO,313-966-5187,,asdignan@hcdmg.org,Herbert Smitherman Jr. M.D.,CEO,313-966-5187,,hsmitherman@hcdmg.org,hcdmg.org
MI-005789,SPRINGPORT MEDICAL CLINIC,EATON RAPIDS MEDICAL CENTER,1588810709,Rural Health Clinics,400 E Main St,Suite 200,Springport,MI,49284-9774,Jackson,1500 S MAIN STREET,,EATON RAPIDS,MI,48827,Eaton,Dawn Wartenbe,Enrollment & Contracting Specialist,517-663-9473,473,dwartenbe@ermchealth.org,Tracey Lee,Billing Manager,517-663-9573,573,tlee@ermchealth.org,
MI-005790,Central Michigan Dist. Health Dept.,Central Michigan Dist. Health Dept.,1245283977,"Family Planning Providers, Ryan White Providers",4489 M 61,Suite 3,Standish,MI,48658-9272,Arenac,2012 E Preston St,,Mt Pleasant,MI,48858,Isabella,Lorrie Youngs,Director,989-773-5921,1462,lyoungs@cmdhd.org,,,,,,http://www.cmdhd.org
MI-005791,Sparrow Medical Group Stanton,Sparrow Carson Hospital,1821068479,Rural Health Clinics,545 N State St,,Stanton,MI,48888-9331,Montcalm,406 East Elm Street,,Carson City,MI,48811,Montcalm,Lacey Sherlock,Quality Improvement Specialist,989-584-0105,,lacey.sherlock@sparrow.org,Michael Rich,Regional Direcotr of Physician Practices,989-584-3971,394,michael.rich@sparrow.org,
MI-005792,Mid Michigan Dist. Health Dept.,Mid Michigan Dist. Health Dept.,1851386106,"Family Planning Providers, Sexually Transmitted Disease Clinics",615 N State St,Suite No. 2,Stanton,MI,48888-9702,Montcalm,615 N State St,,Stanton,MI,48888-9702,Montcalm,Andrea Tabor,Director of Community Health and Education,989-831-3639,3639,atabor@mmdhd.org,Jenniffer Efaw,Nurse Practitioner,989-875-1013,1013,jefaw@mmdhd.org,www.mmdhd.org
MI-005793,Spectrum Health Big Rapids Hospital Family Medicine Canadian Lakes,Spectrum Health Big Rapids Hospital,1477973493,Rural Health Clinics,8354 100th Ave,Suite 1,Stanwood,MI,49346-8345,Mecosta,605 Oak St,,Big Rapids,MI,49307,Mecosta,Teresa Arlene Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005794,Eastside Family Medical,"Dubois Medical Enterprises, PC",1073534392,Rural Health Clinics,8540 105th Ave,,Stanwood,MI,49346-9764,Mecosta,8540 105th Ave,,Stanwood,MI,49346,Mecosta,MELISSA GOMBER,Office Manager,231-972-2710,231,melissa.gomber@eastsidefamilymedical.com,,,,,,
MI-005795,Sterling Area Health Center,Sterling Area Health Center,1477538239,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",725 E State St,,Sterling,MI,48659-9548,Arenac,725 E State St,,Sterling,MI,48659-9548,Arenac,James J Balten Jr,President/Chief Executive Officer,989-524-3750,,JBalten@sterlinghealth.net,Cindy Potts,Enrollment Specialist,989-654-2491,2051,cpotts@sterlinghealth.net,www.sterlinghealth.net
MI-005796,District Health Dept. No. 2,District Health Dept. No. 2,1205805181,Family Planning Providers,420 W Lake St,PO Box 98,Tawas City,MI,48763-8309,Iosco,420 W Lake St,PO Box 98,Tawas City,MI,48763-8309,Iosco,Marsha Schnautz,Family Planning Coordinator,989-345-5020,1802,mschnautz@dhd2.org,Denise Bryon,Health Officer,989-345-5020,1800,dbryon@dhd2.org,http://www.dhd2.org
MI-005797,Tawas Bay Family Practice,Tawas Bay Family Practice,1275509036,Rural Health Clinics,541 W Lake St,PO Box 369,Tawas City,MI,48763-5105,Iosco,541 W Lake St,PO Box 369,Tawas City,MI,48764-0369,Iosco,Sue Heilig,Administrative Assistant,989-362-5688,,sheilig@tawasbayfp.com,Marianne Fairbanks,Office Supervisor,989-362-3447,,mafairbanks@tawasbayfp.com,
MI-005798,Beaumont Teen Health Center - Taylor,Beaumont Health,1578500724,Family Planning Providers,22650 Eureka Rd,Suite B,Taylor,MI,48180-5268,Wayne,15500 Lundy Parkway,,Dearborn,MI,48126,Wayne,Katherine A Kristofik,Nurse Practitioner,734-942-2273,226,katherine.kristofik@beaumont.org,Jeff Cook,Program Director,734-942-2273,224,jeff.cook@beaumont.org,http://www.oakwood.org
MI-005799,Dupuis Dental,Dupuis Dental,1245408772,Dental Providers,24929 Goddard Rd,,Taylor,MI,48180-3930,Wayne,24929 Goddard,,Taylor,MI,48180,Wayne,Thomas Dupuis,Owner,734-947-3621,,dupuisdental@gmail.com,Sonja Albart,insurance coordinator,734-947-3621,,dupuisdental@gmail.com,
MI-005800,Western Wayne Family Health Center,WESTERN WAYNE FAMILY HEALTH CENTERS,1023250412,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",26650 Eureka Rd,Suite C,Taylor,MI,48180-4835,Wayne,2700 HAMLIN BLVD,,Inkster,MI,48141-2348,Wayne,Donna Russell,CEO,313-561-5100,210,latkins@wwfhc.org,Donna Russell,CFO,734-941-4991,237,drussell@wwfhc.org,www.wwfhc.org
MI-005801,"FAMILY MEDICAL CENTER OF MI, INC",FAMILY MEDICAL CENTER OF MICHIGAN INC,1265591812,"Dental Providers, Federally Qualified Health Centers - Medical Services",8765 Lewis Ave,,Temperance,MI,48182-9583,Monroe,8765 Lewis Ave,,Temperance,MI,48182-9583,Monroe,Ed Louis Larkins,CEO,734-654-2169,,elarkins@familymedical.org,,,,,,
MI-005802,Berrien County Health Department,Berrien County Health Department,1326005109,Family Planning Providers,21 N Elm St,Suite 6,Three Oaks,MI,49128-1600,Berrien,2149 East Napier Avenue,,Benton Harbor,MI,49022,Berrien,Peggy Hamel,Family Planning Coordinator,269-927-5663,,phamel@bchdmi.org,Stephanie Schadler,Clinic Coordinator,269-926-7121,5289,sschadler@bchdmi.org,http://www.bchd.org
MI-005803,Traverse Health Clinic,"TRAVERSE HEALTH CLINIC AND COALITION, DBA Traverse Health Clinic",1417322884,Federally Qualified Health Centers - Medical Services,105 Hall St,,Traverse City,MI,49684-2288,Grand Traverse,3155 Logan Valley Rd.,,Traverse City,MI,49684-4772,Grand Traverse,Arlene Brennan,CEO,231-935-0351,,abrennan@traversehcc.org,,,,,,
MI-005804,"NORTHWEST MICHIGAN HEALTH SERVICES, INC. Benzoina Clinic","NORTHWEST MICHIGAN HEALTH SERVICES, INC",1922464254,"Dental Providers, Federally Qualified Health Centers - Medical Services",10767 E Traverse Hwy,,Traverse City,MI,49684-6219,Leelanau,10767 E Traverse Hwy,,Traverse City,MI,49684-6219,Leelanau,Heidi Britton,Chief Executive Officer,231-947-1112,205,hbritton@nmhsi.org,Mindy Aguilar,Director of Human Resources,231-947-1112,202,maguilar@nmhsi.org,www.nmhsi.org
MI-005805,Northern Regional Bleeding Disorder Center,Munson Medical Center,1619111002,Hemophilia Treatment Centers,1105 Sixth St,,Traverse City,MI,49684-2349,Grand Traverse,1105 Sixth Street,,Traverse City,MI,49684,Grand Traverse,David Rushlow,Program Coordinator,231-935-6385,,drushlow@mhc.net,Michelle Witkop,Doctor of Nursing Practice,231-935-3228,,mwitkop@mhc.net,
MI-005806,Planned Parenthood of Michigan - Traverse City Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",1135 E Eighth St,,Traverse City,MI,49686-2936,Grand Traverse,950 Victors Way,Suite 100,Ann Arbor,MI,48108,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005807,Thomas Judd Care Center,Munson Medical Center,1245314541,Ryan White Providers,1221 Sixth St,Suite 310,Traverse City,MI,49684-2361,Grand Traverse,"1221 Sixth St., Suite #310",,Traverse City,MI,49684-2361,Grand Traverse,Nicholaus Erber,Manager,231-935-2090,,nerber@mhc.net,,,231-935-7548,,,http://www.munsonhealthcare.org/HIVcare
MI-005808,Grand Traverse Co. Health Dept.,Michigan Dept. of Community Health,1538347372,Family Planning Providers,2600 Lafranier Rd,,Traverse City,MI,49686-4765,Grand Traverse,2600 Lafranier Rd,,Traverse City,MI,49686-4765,Grand Traverse,Erin Carlson,Accountant,231-995-6103,,ecarlson@gtchd.org,Marissa Milliron,finance director,231-995-6102,,mmilliro@gtchd.org,http://www.gtchd.org
MI-005809,UPHS Marquette Family Medicine Trenary,UPHS Marquette,1497719108,Rural Health Clinics,E2997 State Highway M67,,Trenary,MI,49891,Alger,1414 West Fair Ave. Ste.36,,Marquette,MI,49855,Alger,Katie Wares,Operations Manager,906-225-3864,,Katie.Wares@mghs.org,,,,,,
MI-005810,SPECTRUM HEALTH TUSTIN FAMILY PRACTICE,Spectrum Health Reed City Hospital,1225236334,Rural Health Clinics,111 E Church St,,Tustin,MI,49688-5114,Osceola,300 N Patterson,,Reed City,MI,49677,Osceola,Teresa Treiber,Manager Finance RHC and CAH,231-832-8509,,teresa.treiber@spectrumhealth.org,Roxanne Brower,analyst,231-832-8533,,roxanne.brower@spectrumhealth.org,
MI-005811,GLBHC Wolverine Vassar,Great Lakes Bay Health Centers,1740308832,"Dental Providers, Federally Qualified Health Centers - Medical Services",1120 Commerce Dr,,Vassar,MI,48768-9588,Tuscola,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President and CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005812,Thompson Community Center,Macomb County Health Department,1528159258,Family Planning Providers,11370 Hupp Ave,,Warren,MI,48089-2505,Macomb,43525 Elizabeth,,Mt. Clemens,MI,48043,Macomb,Patricia Detrick,Program Manager,586-469-2055,,patricia.detrick@macombgov.org,Lillian Schreiber,,586-469-5523,,lillian.schreiber@macombgov.org,
MI-005813,Southwest Health Center,Macomb County Health Department,1528159258,Family Planning Providers,27690 Van Dyke Ave,Suite B,Warren,MI,48093-2842,Macomb,43525 Elizabeth Road,,Mt. Clemens,MI,48043,Macomb,Patricia Detrick,Program Manager,586-469-2055,,patricia.detrick@macombgov.org,Lillian Schreiber,Public Health Services Coordinator,586-469-5523,,lillian.schreiber@macombgov.org,
MI-005814,Planned Parenthood of Michigan - Warren Health Center,Planned Parenthood of Michigan,1366525370,"Family Planning Providers, Sexually Transmitted Disease Clinics",29350 Van Dyke Ave,,Warren,MI,48093-6765,Macomb,950 Victors Way,Suite 100,Ann Arbor,MI,48108-5217,Washtenaw,Taleia Collins,Medical Administrative Coordinator,734-926-4800,4816,taleia.collins@ppmi.org,Amy Kruszkowski,Credentialing Coordinator,616-774-7005,3120,amy.kruszkowski@ppmi.org,
MI-005815,Advantage Family Health Center,DETROIT HEALTH CARE FOR THE HOMELESS,1144371279,Federally Qualified Health Centers - Medical Services,4669 E 8 Mile Rd,,Warren,MI,48091-2709,Macomb,15400 W McNichols Rd,,Detroit,MI,48235-3724,Wayne,Jamie Wetherell,Interim Executive Director,313-416-6232,,jwetherell@advantagehealthcenters.org,D. Nikkey Richardson,Revenue Cycle Manager,313-416-6220,,nrichardson@advantagehealthcenters.org,www.ahcdetroit.org
MI-005816,Miwestern Dental of Sterling Heights,Midwestern Dental,1346299526,Dental Providers,7591 Nine Mile Rd,,Warren,MI,48091,Macomb,5050 Schaefer Road,,Dearborn,MI,48126,Wayne,Jeffrey L. Reider DDS MS,Director of Professional Staff,313-582-8150,,drjreider@mwdentalplans.com,,,,,,
MI-005817,Summit Center,Oakland Integrated Healthcare Network,1124381793,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",279 Summit Dr,,Waterford,MI,48328-3364,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005818,Waterford Teen Health Center,Oakland Integrated Healthcare Network,1982131967,Federally Qualified Health Centers - Medical Services,501 N Cass Lake Rd,,Waterford,MI,48328-2307,Oakland,PO Box 430150,,Pontiac,MI,48343,Oakland,Melissa McQueen,Revenue Cycle Manager,248-724-7413,,mmcqueen@oihn.org,Deb Brinson,CEO,248-724-7438,,dbrinson@oihn.org,www.oihn.org
MI-005819,Lac Vieux Desert Health Center,Lac Vieux Desert Health Center,1760536007,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",E23970 Pow Wow Trail,PO Box 9,Watersmeet,MI,49969-0009,Gogebic,E23970 Pow Wow Trail,,Watersmeet,MI,49969,Gogebic,Kim M Ivey,Pharmacist,906-358-4905,,lacvieuxpharm@hotmail.com,,,,,,
MI-005820,Wellston Medical Center,Wellston Medical Center,1700973922,Rural Health Clinics,14477 Caberfae Hwy,,Wellston,MI,49689-9315,Manistee,14477 Caberfae Hwy,,Wellston,MI,49689,Manistee,Candace Sexton,Office Manager,231-848-4777,,wellstonmedical@kaltelnet.net,,,,,,
MI-005821,West Branch Clinic,Sterling Area Health Center,1609244490,Federally Qualified Health Centers - Medical Services,335 E Houghton Ave,,West Branch,MI,48661-1127,Ogemaw,725 East State Street,,Sterling,MI,48659,Arenac,James J Balten Jr,President/Chief Executive Officer,989-524-3750,,JBalten@sterlinghealth.net,,,,,,
MI-005822,GLBHC Women's Care West Branch,Great Lakes Bay Health Centers,1437147287,Federally Qualified Health Centers - Medical Services,621 Court St,Suite 102,West Branch,MI,48661-8768,Ogemaw,501 Lapeer Ave,,Saginaw,MI,48607-1203,Saginaw,Brenda M Coughlin,President/CEO,989-759-6467,,bcoughlin@glbhealth.org,,,,,,greatlakesbayhealthcenters.org
MI-005823,District Health Dept. No. 2,District Health Dept. No. 2,1205805181,Family Planning Providers,630 Progress St,Suite 200,West Branch,MI,48661-8603,Ogemaw,630 Progress St,,West Branch,MI,48661-8603,Ogemaw,Marsha Schnautz,Pulbic Health Coordinator,989-345-5020,1802,mschnautz@dhd2.org,Denise Bryon,Health Officer,989-345-5020,1800,dbryon@dhd2.org,http://www.dhd2.org
MI-005824,MidMichigan Health Park West Branch,MidMichigan Medical Center - Gladwin,1881869774,Rural Health Clinics,640 Court St,,West Branch,MI,48661-9390,Ogemaw,515 Quarter Street,,Gladwin,MI,48624,Gladwin,Ronette Parks,VICE PRESIDENT,989-839-1877,,ronette.parks@midmichigan.org,Ray Stover,President,989-802-5101,,ray.stover@midmichigan.org,
MI-005825,FAMILY HEALTH CARE - WHITE CLOUD,BALDWIN FAMILY HEALTH CARE,1558470567,"Dental Providers, Federally Qualified Health Centers - Medical Services",1035 E Wilcox Ave,,White Cloud,MI,49349-8794,Newaygo,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CFO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005826,District Health Department #10,District Health Department #10,1316279045,Family Planning Providers,1049 E Newell St,,White Cloud,MI,49349-8795,Newaygo,1049 E Newell St,,White Cloud,MI,49349-8795,Newaygo,Sheryl Slocum,Clinic Supervisor,231-876-3854,3854,sslocum@dhd10.org,Katelyn Travis,MU Coordinator,231-355-7530,7530,ktravis@dhd10.org,http://www.dhd10.org
MI-005827,White Cloud Teen Health Center,BALDWIN FAMILY HEALTH CARE,1790067338,"Dental Providers, Federally Qualified Health Centers - Medical Services",555 E Wilcox Ave,,White Cloud,MI,49349-7512,Newaygo,1615 Michigan Ave,,Baldwin,MI,49304-7984,Lake,Kathy Sather,CEO,231-745-5009,,ksather@familyhealthcare.org,,,,,,
MI-005828,Hannahville Health Center,Hannahville Indian Community,1790869436,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",N15019 Hannaville B-1 Rd,,Wilson,MI,49896,Menominee,N15019 Hannaville B-1 Rd,,Wilson,MI,49896,Menominee,Linda Triest,Business Office Manager,906-723-2520,,linda.triest@hichealth.org,Susie Meshigaud,Health Director,906-723-2500,,,
MI-005829,Wyoming Community Health Center,"CHERRY STREET SERVICES, INC.",1184974263,"Dental Providers, Federally Qualified Health Centers - Medical Services",2929 Burlingame Ave SW,,Wyoming,MI,49509-2600,Kent,100 Cherry St SE,,Grand Rapids,MI,49503-4526,Kent,Chris J Shea,CEO,616-776-2129,,chrisshea@cherryhealth.com,Linda Constantino,CFO,616-776-2128,,lindaconstantino@cherryhealth.com,
MI-005830,Packard Health Ypsilanti,Packard Health,1609988245,Federally Qualified Health Centers - Medical Services,200 Arnet St,Suite 150,Ypsilanti,MI,48198-5753,Washtenaw,3174 Packard Road,,Ann Arbor,MI,48108,Washtenaw,Ray Rion,Executive Director,734-971-1073,,rrion@packardhealth.org,Carrie Dawson,Chief Operating Officer,734-971-1073,,cdawson@packardhealth.org,
MI-005831,Spectrum Health Zeeland Hospital,Zeeland Community Hospital,1275536344,Inpatient Hospitals (other than children's hospitals),8333 Felch St,,Zeeland,MI,49464-2608,Ottawa,8333 Felch St,,Zeeland,MI,49464,Ottawa,Janice Myers,Reimbursement Manager,616-643-9143,,janice.myers@spectrumhealth.org,Lori Bearss,Sr Analyst,616-643-9236,,lori.bearss@spectrumhealth.org,
MN-005832,ESSENTIA HEALTH ADA,Essentia Health Ada,1306836598,Inpatient Hospitals (other than children's hospitals),201 9th St W,,Ada,MN,56510-1279,Norman,201 9th St. W.,,Ada,MN,56510,Norman,Erin Stoltman,Operations Director,218-784-2727,,erin.stoltman@essentiahealth.org,Shawna Enright,Controller,218-784-5255,,shawna.enright@essentiahealth.org,
MN-005833,ESSENTIA HEALTH - ADA CLINIC,Essentia Health Ada,1306836598,Rural Health Clinics,201 9th St W,,Ada,MN,56510-1279,Norman,201 9th St. W.,,Ada,MN,56510,Norman,Erin Stoltman,Operations Director,218-784-2727,,erin.stoltman@essentiahealth.org,Shawna Enright,Controller,218-784-5255,,shawna.enright@essentiahealth.org,
MN-005834,Riverwood Healthcare Aitkin Clinic,Riverwood Healthcare,1902960875,Rural Health Clinics,200 Bunker Hill Dr,,Aitkin,MN,56431-1865,Aitkin,200 Bunker Hill Dr,,Aitkin,MN,56431,Aitkin,Casey R Johnson,CFO,218-429-2387,2387,cjohnson2@riverwoodhealthcare.org,Chad Cooper,CEO,218-927-5175,5175,ccooper@riverwoodhealthcare.org,
MN-005835,Riverwood Healthcare Aitkin Hospital,Riverwood Healthcare,1942277835,Inpatient Hospitals (other than children's hospitals),200 Bunker Hill Dr,,Aitkin,MN,56431-1865,Aitkin,200 Bunker Hill Dr,,Aitkin,MN,56431,Aitkin,Casey R Johnson,CFO,218-429-2387,2387,cjohnson2@riverwoodhealthcare.org,Chad Cooper,CEO,218-927-5175,5175,ccooper@riverwoodhealthcare.org,
MN-005836,"Planned Parenthood Minnesota, North Dakota, South Dakota - Alexandria Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",700 Cedar St,Suite 165,Alexandria,MN,56308-0016,Douglas,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005837,"Planned Parenthood Minnesota, North Dakota, South Dakota - Apple Valley","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",15322 Galaxie Ave,Suite 105,Apple Valley,MN,55124-3151,Dakota,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005838,APPLETON MUNICIPAL HOSPITAL & NH (inpatient hospital),The Board of Appleton Municipal Hospital and Nursing Home,1578590626,Inpatient Hospitals (other than children's hospitals),30 S Behl St,,Appleton,MN,56208-1616,Swift,30 S Behl St,,Appleton,MN,56208,Swift,Jeffrey Cook,CEO,320-289-8508,,jcook@aahsmn.org,Anne Kells,CFO,320-289-8514,,akells@aahsmn.org,
MN-005839,APPLETON MUNICIPAL HOSPITAL & NH (rural health clinics),The Board of Appleton Municipal Hospital and Nursing Home,1578590626,Rural Health Clinics,30 S Behl St,,Appleton,MN,56208-1616,Swift,30 S Behl St,,Appleton,MN,56208,Swift,Jeffrey Cook,CEO,320-289-8508,,jcook@aahsmn.org,Anne Kells,CFO,320-289-8514,,akells@aahsmn.org,
MN-005840,Lake Region Healthcare - Ashby,Lake Region Healthcare,1093713372,Outpatient Hospital Clinics,110 Co Rd 82,,Ashby,MN,56309,Otter Tail,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005841,Prairie Ridge Hospital and Health Services- Ashby Campus,Prairie Ridge Hospital and Health Services,1407838329,Outpatient Hospital Clinics,110 Co Rd 82,,Ashby,MN,56309,Grant,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7334,,kclaassen@prairiehealth.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005842,ESSENTIA HEALTH NORTHERN PINES MEDICAL CENTER,Essentia Health,1639278609,Inpatient Hospitals (other than children's hospitals),5211 Highway 110,,Aurora,MN,55705-1522,Saint Louis,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Population Care Management,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Laura Ackman,Administrator,218-229-4222,,laura.ackman@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005843,ESSENTIA HEALTH BAGLEY CLINIC,Essentia Health,1790861649,Rural Health Clinics,121 Central St W,,Bagley,MN,56621-4393,Clearwater,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Kevin Gish,Administrator,218-435-7630,,kevin.gish@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005844,Sanford Bagley Clinic,Sanford Bagley Clinic,1972875490,Rural Health Clinics,1656 Central St W,,Bagley,MN,56621-4357,Clearwater,1656 Central Street West,,Bagley,MN,56621,Clearwater,Sammi Davidson,Administrative Director,218-694-6501,232,sammi.davidson@sanfordhealth.org,,,,,,
MN-005845,Sanford Bagley Medical Center,Sanford,1932472255,Inpatient Hospitals (other than children's hospitals),203 4th St SW,,Bagley,MN,56621,Clearwater,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005846,Lake Region Healthcare- Barnesville Area Clinic,Lake Region Healthcare,1093713372,Outpatient Hospital Clinics,209 Second St. SE,,Barnesville,MN,56514,Clay,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005847,Lake Region Healthcare- Battle Lake,Lake Region Healthcare,1093713372,Outpatient Hospital Clinics,410 S Lake Ave,,Battle Lake,MN,56515-4238,Otter Tail,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005848,Sanford Bemidji Medical Center,Sanford,1801870191,Inpatient Hospitals (other than children's hospitals),1300 Anne St NW,,Bemidji,MN,56601-5103,Beltrami,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005849,Wildgen Wilimek Asso,Upside Psychiatric,1336443225,Rural Health Clinics,1526 30th St NW,,Bemidji,MN,56601-4140,Beltrami,1526 30th St NW,,Bemidji,MN,56601,Beltrami,Miriam Tell,President,218-751-0887,105,upsidepsych@gmail.com,,,,,,
MN-005850,"Planned Parenthood Minnesota, North Dakota, South Dakota - Bemidji Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",2504 Hannah Ave NW,,Bemidji,MN,56601-2110,Beltrami,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005851,Tri-County Health Care - Bertha Clinic,"Tri-County Health Care, Inc.",1134115942,Rural Health Clinics,214 1st St NW,,Bertha,MN,56437-1295,Todd,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-005852,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1912970872,"Dental Providers, Federally Qualified Health Centers - Medical Services",410 2nd St NW,,Big Falls,MN,56627,Koochiching,20 5th St SE,,Cook,MN,55723-9702,Koochiching,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005853,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1992778849,"Dental Providers, Federally Qualified Health Centers - Medical Services",135 Pine Tree Dr,,Bigfork,MN,56628,Itasca,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005854,United Hospital District,United Hospital District,1952307688,Inpatient Hospitals (other than children's hospitals),515 S Moore St,,Blue Earth,MN,56013-2158,Faribault,P.O. Box 160,,Blue Earth,MN,56013,Faribault,Richard Ash,Chief Executive Officer,507-526-7907,7907,RickAsh@uhd.org,Patrick Justion,Chief Financial Officer,507-526-7908,7908,PJustin@uhd.org,www.uhd.org
MN-005855,United Hospital District - Blue Earth Clinics,United Hospital District,1952307688,Outpatient Hospital Clinics,515 S Moore St,,Blue Earth,MN,56013-2158,Faribault,515 S. Moore Street,P.O. Box 160,Blue Earth,MN,56013,Faribault,Richard Ash,Chief Executive Officer,507-526-7907,7907,RickAsh@uhd.org,Patrick Justin,CFO,507-526-7908,7908,PJustin@uhd.org,www.uhd.org
MN-005856,Boyd Clinic,Johnson Memorial Health Services,1457466716,Rural Health Clinics,115 3rd St,,Boyd,MN,56218-6218,Lac Qui Parle,1282 Walnut Street,,Dawson,MN,56232,Lac Qui Parle,Crystal Bothun,CFO,320-312-2104,,cmbothun@jmhsmn.org,Stacey Lee,CEO,320-312-2101,,slee@jmhsmn.org,
MN-005857,ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER,Essentia Health,1568415974,Inpatient Hospitals (other than children's hospitals),523 N 3rd St,,Brainerd,MN,56401-3054,Crow Wing,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Adam Rees,President,218-828-7667,,adam.rees@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005858,"Planned Parenthood Minnesota, North Dakota, South Dakota - Brooklyn Park","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",6900 78th Ave N,Suite 103,Brooklyn Park,MN,55445-2719,Hennepin,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005859,Brooten Medical Center,Glacial Ridge Health System,1255348223,Rural Health Clinics,111 Pleasant Ave N,,Brooten,MN,56316-4715,Stearns,10 4th Ave SE,,Glenwood,MN,56334,Pope,Kirk Stensrud,CEO,320-634-4521,2208,kirk.stensrud@glacialridge.org,Rachel Wagner,Clinic Manager,320-634-5157,2276,rachel.wagner@glacialridge.org,www.glacialridge.org
MN-005860,Cambridge Medical Center,Allina Health,1568427383,Inpatient Hospitals (other than children's hospitals),701 Dellwood St S,,Cambridge,MN,55008-1920,Isanti,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Trisha Schirmers,Director Reimbursement,612-262-4719,,trisha.schirmers@allina.com,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,
MN-005861,Sanford Canby Medical Center,Sanford,1780781054,Inpatient Hospitals (other than children's hospitals),112 Saint Olaf Ave S,,Canby,MN,56220-1433,Yellow Medicine,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,701-234-2076,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005862,Leech Lake Tribal Health,Leech Lake Tribal Council,1942310875,Federally Qualified Health Centers - Medical Services,115 6th St NW,,Cass Lake,MN,56633-3428,Cass,190 Sailstar Dr,,Cass Lake,MN,56633,Cass,Angela Estey,Billing Specialist,218-335-4506,,angela.estey@llojibwe.org,Carla Losh,Billing Manager,218-335-4535,,carla.losh@llojibwe.org,
MN-005863,Cass Lake Hospital,Cass Lake Hospital,1194754382,"Dental Providers, Indian Health Service, Other ECP Providers",425 7th St NW,,Cass Lake,MN,56633-3360,Cass,425 7th St NW,,Cass Lake,MN,56633-3360,Cass,Louis Erdrich,Acting Service Unit Director,218-335-3205,,louis.erdrich@ihs.gov,Terrance Lascano,Administrative Officer,218-335-3206,,terrance.lascano@ihs.gov,
MN-005864,Chokio Medical Center,Essentia Health,1487613287,Rural Health Clinics,101 S Main St,,Chokio,MN,56221,Stevens,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Julie Rosenberg,Administrator,701-671-4105,,julie.rosenberg@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005865,Open Door Health Center - Clarkfield,Open Door Health Center,1245682905,Dental Providers,1025 10th Ave,,Clarkfield,MN,56223-1301,Yellow Medicine,309 Holly Lane,,Mankato,MN,56001,Blue Earth,"Douglas L. Jaeger, Jr.",Chief Executive Officer,507-388-2120,5500,jaeger.doug@odhc.org,Susan Jaeger,Chief Financial Officer,507-388-2120,,jaeger.susan@odhc.org,www.odhc.org
MN-005866,Sanford Bagley Clearbrook Clinic,Sanford Bagley Clearbrook Clinic,1457624272,Rural Health Clinics,22 Elm St,,Clearbrook,MN,56634,Clearwater,22 Elm Street,,Clearbrook,MN,56634,Clearwater,Sammi Davidson,Administrative Director,218-694-6501,232,sammi.davidson@sanfordhealth.org,,,,,,
MN-005867,Fond Du Lac Band of Lake Superior Chippewa,Fond Du Lac Band of Lake Superior Chippewa,1326053166,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",927 Trettel Ln,,Cloquet,MN,55720-1345,Carlton,927 Trettel Ln,,Cloquet,MN,55720,Carlton,Jennifer DuPuis,Associate Health Director,218-879-1227,,jenniferdupuis@fdlrez.com,,,,,,
MN-005868,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1760457865,"Dental Providers, Federally Qualified Health Centers - Medical Services",12 S River St,,Cook,MN,55723-8131,Saint Louis,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005869,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1437124401,"Dental Providers, Federally Qualified Health Centers - Medical Services",20 5th St SE,,Cook,MN,55723-9702,Saint Louis,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005870,Mercy Hospital,Allina Health System,1316904287,Inpatient Hospitals (other than children's hospitals),4050 Coon Rapids Blvd NW,,Coon Rapids,MN,55433-2522,Anoka,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Trisha Schirmers,Director Reimbursement,612-262-4719,,trisha.schirmers@allina.com,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,
MN-005871,Open Door Health Center - Cottonwood,Open Door Health Center,1225582380,Dental Providers,231 W Main St,,Cottonwood,MN,56229-2121,Yellow Medicine,309 Holly Lane,,Mankato,MN,56001,Blue Earth,"Douglas L. Jaeger, Jr.",Chief Executive Officer,507-388-2120,5500,jaeger.doug@odhc.org,Susan Jaeger,Chief Financial Officer,507-388-2120,,jaeger.susan@odhc.org,www.odhc.org
MN-005872,Riverview Clinic Crookston,Riverview Healthcare Association,1487944898,Rural Health Clinics,323 S Minnesota St,,Crookston,MN,56716-1601,Polk,323 South Minnesota Street,,Crookston,MN,56716,Polk,Betty Arvidson,"VP Finance, CFO",218-281-9200,,barvidson@riverviewhealth.org,Carrie Michalski,CEO,218-281-9200,,cmichalski@riverviewhealth.org,riverviewhealth.org
MN-005873,Riverview Health,Riverview Healthcare Association,1477525566,Inpatient Hospitals (other than children's hospitals),323 S Minnesota St,,Crookston,MN,56716-1601,Polk,323 South Minnesota,,Crookston,MN,56716,Polk,Betty Arvidson,"VP Finance, CFO",218-281-9200,,barvidson@riverviewhealth.org,Carrie Michalski,CEO,218-281-9200,,cmichalski@riverviewhealth.org,riverviewhealth.org
MN-005874,Meeker Memorial Clinic,Meeker Memorial Hospital,1952555146,Outpatient Hospital Clinics,740 Parker Ave W,,Dassel,MN,55325-1024,Meeker,612 S Sibley Avenue,,Litchfield,MN,55355,Meeker,Stephen Plaisance,CFO,320-693-4512,4512,splaisance@meekermemorial.org,,,,,,
MN-005875,Dawson Clinic,Johnson Memorial Health Services,1336145796,Rural Health Clinics,1282 Walnut St,,Dawson,MN,56232-2333,Lac Qui Parle,1282 Walnut Street,,Dawson,MN,56232,Lac Qui Parle,Crystal Bothun,CFO,320-312-2104,,cmbothun@jmhsmn.org,Stacey Lee,CEO,320-312-2101,,slee@jmhsmn.org,
MN-005876,Johnson Memorial Health Services (inpatient hospital),Johnson Memorial Health Services,1093745051,Inpatient Hospitals (other than children's hospitals),1282 Walnut St,,Dawson,MN,56232-2333,Lac Qui Parle,1282 Walnut Street,,Dawson,MN,56232,Lac Qui Parle,Crystal Bothun,CFO,320-312-2104,,cmbothun@jmhsmn.org,Stacey Lee,CEO,320-312-2101,,slee@jmhsmn.org,
MN-005877,Johnson Memorial Health Services (outpatient hospital clinics),Johnson Memorial Health Services,1093745051,Outpatient Hospital Clinics,1282 Walnut St,,Dawson,MN,56232-2333,Lac Qui Parle,1282 Walnut Street,,Dawson,MN,56232,Lac Qui Parle,Crystal Bothun,CFO,320-312-2104,,cmbothun@jmhsmn.org,Stacey Lee,CEO,320-312-2101,,slee@jmshmn.org,
MN-005878,Essentia Health Deer River,Essentia Health,1225049018,Inpatient Hospitals (other than children's hospitals),115 10th Ave NE,,Deer River,MN,56636-8795,Itasca,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Marsha Green,Adminisatrator,218-246-4200,,marsha.green@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005879,ESSENTIA HEALTH ST MARYS DETROIT LAKES,Essentia Health,1679561088,Inpatient Hospitals (other than children's hospitals),1027 Washington Ave,,Detroit Lakes,MN,56501-3409,Becker,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administrator,218-314-7852,,ryan.hill@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005880,Mahube-Otwa Family Health - Detroit Lakes,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,119 Graystone Plz,,Detroit Lakes,MN,56501-3034,Becker,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501-3034,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005881,"Planned Parenthood Minnesota, North Dakota, South Dakota - Duluth Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",1001 E Central Entrance,Suite 200,Duluth,MN,55811-5525,Saint Louis,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005882,ESSENTIA HEALTH ST MARY'S MEDICAL CENTER,Essentia Health,1457393035,Inpatient Hospitals (other than children's hospitals),407 E 3rd St,,Duluth,MN,55805-1950,Saint Louis,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,James Garvey,Administrator,218-786-4878,,james.garvey@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005883,LAKE SUPERIOR COMMUNITY HEALTH CENTER,LAKE SUPERIOR COMMUNITY HEALTH CENTER,1699708297,"Dental Providers, Federally Qualified Health Centers - Medical Services",4325 Grand Ave,,Duluth,MN,55807-2730,Saint Louis,4325 Grand Ave,,Duluth,MN,55807-2730,Saint Louis,JoAnne Axtell,Interim CEO,218-336-3580,,JAxtell@lschc.org,Sarah Leuck,CFO,218-336-3586,,sleuck@lschc.org,
MN-005884,ESSENTIA HEALTH DULUTH,Essentia Health,1033153895,Inpatient Hospitals (other than children's hospitals),502 E 2nd St,,Duluth,MN,55805-1913,Saint Louis,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,James Garvey,Administrator,218-786-4878,,james.garvey@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005885,"Planned Parenthood Minnesota, North Dakota, South Dakota - Eden Prairie Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",582 Prairie Center Dr,Suite 215,Eden Prairie,MN,55344-7935,Hennepin,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,https://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005886,Prairie Ridge Hospital and Health Services (inpatient hospital),Prairie Ridge Hospital and Health Services,1407838329,Inpatient Hospitals (other than children's hospitals),1411 Highway 79 E,,Elbow Lake,MN,56531-4645,Grant,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7334,,kclaassen@prairiehealth.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005887,Prairie Ridge Hospital and Health Services (outpatient hospital clinics),Prairie Ridge Hospital and Health Services,1407838329,Outpatient Hospital Clinics,1411 Highway 79 E,,Elbow Lake,MN,56531-4645,Grant,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7734,,kclaassen@prairiehealth.org,Brett Longtin,CFO/CV Of Finance,218-736-8000,8470,bllongtin@lrhc.org,
MN-005888,ELY BLOOMENSON COMMUNITY HOSPITAL,Ely-Bloomenson Community Hospital,1770542904,Inpatient Hospitals (other than children's hospitals),328 W Conan St,,Ely,MN,55731-1145,Saint Louis,328 W. Conan,,Ely,MN,55731-1145,Saint Louis,Scott Kellerman,CFO,218-365-8760,8760,skellerman@ebch.org,John Fossum,CEO,218-365-8751,8799,jfossum@ebch.org,ebch.org
MN-005889,Prairie Ridge Hospital and Health Services- Evansville Campus,Prairie Ridge Hospital and Health Services,1407838329,Outpatient Hospital Clinics,649 1/2 State St NW,,Evansville,MN,56326-8124,Douglas,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7334,,kclaassen@prairiehealth.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005890,United Hospital District - Fairmont,United Hospital District,1952307688,Outpatient Hospital Clinics,221 E 1st St,,Fairmont,MN,56031-2810,Martin,221 East 1st Street,,Fairmont,MN,56031,Martin,Richard Ash,Chief Executive Officer,507-526-7907,7907,RickAsh@uhd.org,Patrick Justin,CFO,507-526-7908,7908,PJustin@uhd.org,www.uhd.org
MN-005891,District One Hospital,Allina Health,1154741577,Inpatient Hospitals (other than children's hospitals),200 State Ave,,Faribault,MN,55021-6339,Rice,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Trisha Schirmers,Director Reimbursement,612-262-4719,,trisha.schirmers@allina.com,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,
MN-005892,Darveaux Psychological Services,"Dion X. Darveaux, PhD",1952407751,Community Mental Health Centers,121 N Mill St,,Fergus Falls,MN,56537-2134,Otter Tail,121 N. Mill Street,,Fergus Falls,MN,56537,Otter Tail,Dion Darveaux,"Owner, PhD",218-736-3035,,dxdarvo@hotmail.com,,,,,,
MN-005893,Mahube-Otwa Family Health - Fergus Falls,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,128 W Cavour Ave,,Fergus Falls,MN,56537-2102,Otter Tail,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005894,Lake Region Healthcare- Walk in Clinic,Lake Region Healthcare,1093713372,Outpatient Hospital Clinics,2311 W Lincoln Ave,,Fergus Falls,MN,56537-1064,Otter Tail,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005895,Lake Region Healthcare,Lake Region Healthcare,1093713372,Inpatient Hospitals (other than children's hospitals),712 S Cascade St,,Fergus Falls,MN,56537-2913,Otter Tail,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005896,Lake Region Healthcare - Fergus Falls Campus,Lake Region Healthcare,1093713372,Outpatient Hospital Clinics,712 S Cascade St,,Fergus Falls,MN,56537-2913,Otter Tail,712 South Cascade Street,,Fergus Falls,MN,56537,Otter Tail,Courtney McNamee,Revenue Cycle Director,218-739-6653,,ckmcnamee@lrhc.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005897,Riverview Clinic Fertile,Riverview Healthcare Association,1750671186,Rural Health Clinics,306 N Mill Street,,Fertile,MN,56716,Polk,323 South Minnesota Street,,Crookston,MN,56716,Polk,Betty Arvidson,"VP Finance, CFO",218-281-9200,,barvidson@riverviewhealth.org,Carrie Michalski,CEO,218-281-9200,,cmichalski@riverviewhealth.org,riverviewhealth.org
MN-005898,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1174596027,"Dental Providers, Federally Qualified Health Centers - Medical Services",126 W 7th Ave,,Floodwood,MN,55736-1203,Saint Louis,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005899,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1699748533,"Dental Providers, Federally Qualified Health Centers - Medical Services",601 Highway 73,,Floodwood,MN,55736-8450,Saint Louis,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005900,ESSENTIA HEALTH FOSSTON,Essentia Health,1497850119,Inpatient Hospitals (other than children's hospitals),900 Hilligoss Blvd SE,,Fosston,MN,56542-1599,Polk,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Kevin Gish,Administrator,218-786-8176,,kevin.gish@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005901,ESSENTIA HEALTH FOSSTON CLINIC,Essentia Health,1497850119,Rural Health Clinics,900 Hilligoss Blvd SE,,Fosston,MN,56542-1599,Polk,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Kevin Gish,Administrator,218-435-7630,,kevin.gish@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005902,MURRAY COUNTY CLINIC FULDA,Murray County Medical Center,1578735833,Rural Health Clinics,119 N St Paul Ave,,Fulda,MN,56131-1156,Murray,2042 Juniper Avenue,,Slayton,MN,56172,Murray,Renee M. Logan,CFO,507-836-1274,,loganr@murraycountymed.org,Dennis Goebel,CEO,507-836-1277,,goebeld@murraycountymed.org,
MN-005903,Riverwood Healthcare Garrison Clinic,Riverwood Healthcare,1790815777,Rural Health Clinics,27278 State Highway 18,,Garrison,MN,56450-8640,Crow Wing,200 Bunker Hill Dr,,Aitkin,MN,56431,Aitkin,Casey R Johnson,CFO,218-429-2387,2387,cjohnson2@riverwoodhealthcare.org,Chad Cooper,CEO,218-927-5175,5175,ccooper@riverwoodhealthcare.org,
MN-005904,Glencoe Regional Health Services,Glencoe Regional Health Services,1508885633,Inpatient Hospitals (other than children's hospitals),1805 Hennepin Ave N,,Glencoe,MN,55336-1416,McLeod,1805 Hennepin Avenue North,,Glencoe,MN,55336,Mcleod,Jon D. Braband,President & CEO,320-864-7752,,Jon.Braband@grhsonline.org,John Doidge,Vice President Finance,320-864-7753,,John.Doidge@grhsonline.org,
MN-005905,Glacial Ridge Hospital,Glacial Ridge Hospital,1538178520,Inpatient Hospitals (other than children's hospitals),10 4th Ave SE,,Glenwood,MN,56334-1820,Pope,10 4th Ave SE,,Glenwood,MN,56334,Pope,Kirk Stensrud,CEO,320-634-4521,2208,kirk.stensrud@glacialridge.org,Kyle Chase,CFO,320-634-4521,2206,kyle.chase@glacialridge.org,www.glacialridge.org
MN-005906,Glenwood Medical Center,Glacial Ridge Health System,1649285172,Rural Health Clinics,417 Franklin St S,,Glenwood,MN,56334-1518,Pope,10 4th Ave SE,,Glenwood,MN,56334,Pope,Kirk Stensrud,CEO,320-634-4521,2208,kirk.stensrud@glacialridge.org,Rachel Wagner,Clinic Manager,320-634-5157,2276,rachel.wagner@glacialridge.org,www.glacialridge.org
MN-005907,ESSENTIA HEALTH GRACEVILLE CLINIC,Essentia Health,1982673620,Rural Health Clinics,115 W 2nd St # 157,,Graceville,MN,56240-4845,Big Stone,421 N 6th Avenue E,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,"VP, Population Care Management",218-786-1413,,catherine.vonrueden@essentiahealth.org,Kim Bodensteiner,Chief Financial Officer,218-435-7633,,kim.bodensteiner@essentiahealth.org,www.essentiahealth.org
MN-005908,ESSENTIA HEALTH HOLY TRINITY HOSPITAL,Essentia Health,1982673620,Inpatient Hospitals (other than children's hospitals),115 W 2nd St # 157,,Graceville,MN,56240-4845,Big Stone,421 N 6th Avenue E,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,"VP, Population Care Management",218-786-1413,,catherine.vonrueden@essentiahealth.org,Kim Bodensteiner,Chief Financial Officer,218-435-7633,,kim.bodensteiner@essentiahealth.org,
MN-005909,SAWTOOTH MOUNTAIN CLINIC,SAWTOOTH MOUNTAIN CLINIC INC,1306832894,Federally Qualified Health Centers - Medical Services,513 5th Ave W,,Grand Marais,MN,55604-3017,Cook,513 5th Ave W,,Grand Marais,MN,55604-3017,Cook,Rita M Plourde,CEO,218-387-2330,,rita@sawtoothmountainclinic.org,Sue Nordman,COO,218-387-2330,126,sue@sawtoothmountainclinic.org,
MN-005910,GRAND PORTAGE HEALTH SERVICES,SAWTOOTH MOUNTAIN CLINIC INC,1306832894,Federally Qualified Health Centers - Medical Services,62 Upper Rd,,Grand Portage,MN,55605-3010,Cook,513 5th Ave W,,Grand Marais,MN,55604-3017,Cook,Rita M Plourde,CEO,218-387-2330,,rita@sawtoothmountainclinic.org,Sue Nordman,COO,218-387-2330,126,sue@sawtoothmountainclinic.org,www.sawtoothmountainclinic.org
MN-005911,"Planned Parenthood Minnesota, North Dakota, South Dakota - Grand Rapids Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",1404 NW 4th St,,Grand Rapids,MN,55744-2212,Itasca,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005912,Sanford Halstad Clinic,Sanford Health,1407882780,Rural Health Clinics,445 1st St E,,Halstad,MN,56548-4142,Norman,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005913,Gundersen Harmony Clinic,Gundersen Harmony Clinic,1548215361,Rural Health Clinics,805 Main Ave S,,Harmony,MN,55939-6625,Fillmore,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
MN-005914,Hendricks Community Hospital,Hendricks Community Hospital Assn & Retirement Home,1316026370,Inpatient Hospitals (other than children's hospitals),503 E Lincoln St,PO Box 106,Hendricks,MN,56136-9598,Lincoln,PO Box 106,,Hendricks,MN,56136,Lincoln,Julie Hogie,Business Office Mgr,507-275-3134,205,Julie.Hogie@hendrickshosp.org,Jeff Gollaher,CEO,507-275-3134,206,Jeff.Gollaher@hendrickshosp.org,
MN-005915,Tri-County Health Care - Henning Clinic,"Tri-County Health Care, Inc.",1194711986,Rural Health Clinics,401 Douglas Ave,,Henning,MN,56551-4026,Otter Tail,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-005916,Mille Lacs Health System - Hillman,Mille Lacs Health System,1326200411,Rural Health Clinics,26362 370th Ave,PO Box 36,Hillman,MN,56338-2349,Morrison,Mille Lacs Health System,200 Elm St. N.,Onamia,MN,56359,Mille Lacs,Bill Nelson,CEO,320-532-3154,2580,bnelson@mlhealth.org,John Unzen,CFO,320-532-3154,2581,,www.mlhealth.org
MN-005917,Hinckley Clinic,"Gateway Family Health Clinic, Ltd.",1215989686,Rural Health Clinics,45 Lady Luck Drive,,Hinckley,MN,55037,Pine,45 Lady Luck Drive,P.O. Box 309,Hinckley,MN,55037,Pine,Eric Nielsen,Administrator,218-485-2000,,enielsen@gatewayclinic.com,,,,,,
MN-005918,Prairie Ridge Hospital and Health Services- Hoffman Campust,Prairie Ridge Hospital and Health Services,1407838329,Outpatient Hospital Clinics,114 Main Ave,,Hoffman,MN,56339-8139,Grant,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7334,,kclaassen@prairiehealth.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005919,Gundersen Houston Clinic,Gundersen Houston Clinic,1881840015,Rural Health Clinics,511 E Maple St,,Houston,MN,55943-9219,Houston,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
MN-005920,Mille Lacs Health System - Isle,Mille Lacs Health System,1497917587,Rural Health Clinics,375 West Isle Street,PO Box 53,Isle,MN,56342-0053,Mille Lacs,200 Elm St. N.,P.O. Box A,Onamia,MN,56359,Mille Lacs,Bill Nelson,CEO,320-532-3154,2580,bnelson@mlhealth.org,John Unzen,CFO,320-532-3154,2581,junzen@mlhealth.org,www.mlhealth.org
MN-005921,Sanford Clinic Jackson,Sanford Health,1083638357,Rural Health Clinics,1430 North Hwy,,Jackson,MN,56143-1093,Jackson,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005922,Sanford Jackson Hospital,Sanford Health,1326069097,Inpatient Hospitals (other than children's hospitals),1430 North Hwy,,Jackson,MN,56143-1093,Jackson,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005923,Sanford Clinic Lakefield,Sanford Health,1114086311,Rural Health Clinics,209 Main St,,Lakefield,MN,56150-1199,Jackson,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005924,Lindstrom Clinic,St. Croix Regional Medical Center,1043240922,Other ECP Providers,12375 Lindstrom Ln,,Lindstrom,MN,55045-9551,Chisago,235 State Street,,St. Croix Falls,WI,54024,Polk,Wendy Young,Vice President Clinic and Ancillary Services,715-483-0497,,wendy.young@scrmc.org,Sally Bajak,Chief Financial Officer,715-483-0556,,sally.bajak@scrmc.org,www.scrmc.org
MN-005925,Meeker Memorial Hospital,Meeker Memorial Hospital,1598860215,Inpatient Hospitals (other than children's hospitals),612 S Sibley Ave,,Litchfield,MN,55355-3398,Meeker,612 S Sibley Avenue,,Litchfield,MN,55355,Meeker,Stephen Plaisance,CFO,320-693-4512,4512,splaisance@meekermemorial.org,,,,,,www.meekermemorial.org
MN-005926,"Planned Parenthood Minnesota, North Dakota, South Dakota - Rice Street Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",91 Viking Dr W,,Little Canada,MN,55117-1753,Ramsey,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005927,Mahube-Otwa Family Health - Long Prairie,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,20 9th St SE,Centra Care,Long Prairie,MN,56347-1404,Todd,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005928,CRMC-Longville,CRMC,1861414518,Rural Health Clinics,180 Jordan Ln,,Longville,MN,56655-3164,Cass,320 E. Main St,,Crosby,MN,56441,Crow Wing,rachelle M. beseman,"PA-C, MPAS",218-363-3300,,rbeseman@cuyunamed.org,David Plattes,"MD, Medical Director",218-363-3300,,dplattes@cuyunamed.org,
MN-005929,Sanford Luverne Medical Center,Sanford,1497703045,Inpatient Hospitals (other than children's hospitals),1600 N Kniss Ave,,Luverne,MN,56156-1067,Rock,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005930,Lac Qui Parle Clinic,Madison Healthcare Services,1144266156,Rural Health Clinics,900 2nd Ave,,Madison,MN,56256-1006,Lac Qui Parle,900 2nd Ave,,Madison,MN,56256,Lac Qui Parle,Erik Bjerke,CEO,320-698-7141,,ebjerke@mlhmn.org,Carol Borgerson,CFO,320-698-7152,,cborgerson@mlhmn.org,
MN-005931,ESSENTIA ST MARYS MAHNOMEN CLINIC,Essentia Health,1750725586,Rural Health Clinics,117 N Main St,,Mahnomen,MN,56557-4003,Mahnomen,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administrator,218-314-7852,,ryan.hill@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005932,Mahnomen Health Center (inpatient hospital),Mahnomen Health Center,1942233234,Inpatient Hospitals (other than children's hospitals),414 W Jefferson Ave,,Mahnomen,MN,56557-4912,Mahnomen,414 West Jefferson Avenue,,Mahnomen,MN,56557,Mahnomen,Dale Kruger,CEO,218-935-9402,402,dale.kruger@sanfordhealth.org,Lori Guenther,CFO,218-935-9401,401,lori.guenther@mahnomenhealthcenter.com,
MN-005933,Mahnomen Health Center (rural health clinics),Mahnomen Health Center,1942233234,Rural Health Clinics,414 W Jefferson Ave,,Mahnomen,MN,56557-4912,Mahnomen,414 West Jefferson Avenue,,Mahnomen,MN,56557,Mahnomen,Dale Kruger,CEO,218-935-2511,402,dale.kruger@sanfordhealth.org,Lori Guenther,CFO,218-935-2511,401,lori.guenther@mahnomenhealthcenter.com,
MN-005934,"Planned Parenthood Minnesota, North Dakota, South Dakota - Mankato Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",201 N Victory Dr,Suite 211,Mankato,MN,56001-5398,Blue Earth,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005935,Open Door Health Center,Open Door Health Center,1891740908,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",309 Holly Ln,,Mankato,MN,56001-5422,Blue Earth,309 Holly Lane,,Mankato,MN,56001,Blue Earth,"Douglas L. Jaeger, Jr.",Chief Executive Officer,507-388-2120,,jaeger.doug@odhc.org,Susan Jaeger,Chief Financial Officer,507-388-2120,,jaeger.susan@odhc.org,www.odhc.org
MN-005936,SMOC Family Planning Clinic-Marshall,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,109 S 5th St,,Marshall,MN,56258-1240,Lyon,909 5th Ave,,Worthington,MN,56187,Nobles,Donna Erbes,Family Planning Coordinator,507-376-4195,,derbes@smoc.us,,,,,,
MN-005937,Western Mental Health Center,Western Mental Health Center,1982613311,Community Mental Health Centers,1212 E College Dr,,Marshall,MN,56258-2010,Lyon,1212 E College Drive,,Marshall,MN,56258,Lyon,Sarah Ackerman,Executive Director,507-337-4926,,sackerman@wmhcinc.org,Gloria Sabin,Clinical Director,507-337-4948,,gsabin@wmhcinc.org,
MN-005938,SMOC Family Planning Clinic-Marshall,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,1501 State St,,Marshall,MN,56258-3306,Lyon,909 4th Ave,,Worthington,MN,56187,Nobles,Donna Erbes,Health Services Director,507-376-4195,,derbes@smoc.us,,,,,,
MN-005939,Riverwood Healthcare McGregor Clinic,Riverwood Healthcare,1245395409,Rural Health Clinics,2 E Center Ave,,McGregor,MN,55760-1433,Aitkin,200 Bunker Hill Dr,,Aitkin,MN,56431,Aitkin,Casey R Johnson,CFO,218-429-2387,2387,cjohnson2@riverwoodhealthcare.org,Chad Cooper,CEO,218-927-5175,5175,ccooper@riverwoodhealthcare.org,
MN-005940,ESSENTIA HEALTH MENAHGA CLINIC,Essentia Health,1467798322,Rural Health Clinics,212 Aspen Ave NE,,Menahga,MN,56464-3289,Wadena,421 N 6th Ave E,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,"VP, Population Care Management",218-786-6611,,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administrator,218-314-7852,,ryan.hill@essentiahealth.org,www.essentiahealth.org
MN-005941,"Planned Parenthood Minnesota, North Dakota, South Dakota - Minneapolis Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",1200 Lagoon Ave,,Minneapolis,MN,55408-2077,Hennepin,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005942,DBA NORTHPOINT HEALTH AND WELLNESS,HENNEPIN COUNTY,1205113560,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1313 Penn Ave N,,Minneapolis,MN,55411-3047,Hennepin,1313 Penn Ave N,,Minneapolis,MN,55411-3047,Hennepin,Lori Doehne,CFO,612-543-2545,,lori.doehne@hennepin.us,Anne Marie Seward,,612-543-2546,,anne.seward@hennepin.us,
MN-005943,INDIAN HEALTH BOARD OF MINNEAPOLIS INC,"Indian Health Board of Minneapolis, Inc.",1811999162,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1315 E 24th St,Suite 1,Minneapolis,MN,55404-3919,Hennepin,1315 E. 24th Street,,Minneapolis,MN,55404-3975,Hennepin,Kate Hemker,Chief Operating Officer,612-721-9888,,khemker@ihb-mpls.org,Michele Gellerman,Finance Director,612-721-9843,,mgellerman@ihb-mpls.org,
MN-005944,Crown Medical Support Services,Crown Medical Support Services Clinic,1730546672,"Community Mental Health Centers, Other ECP Providers, Outpatient Hospital Clinics, Sexually Transmitted Disease Clinics",1925 1st Ave S,,Minneapolis,MN,55403-3724,Hennepin,Crown Medical Support Services Clinic,1925 1st Avenue South,Minneapolis,MN,55403,Hennepin,"Joyce Onyekaba, M D",Director,612-978-3783,,crownmed@msn.com,,,,,,
MN-005945,Community-University Health Care Center,University of Minnesota,1114019858,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2001 Bloomington Ave,,Minneapolis,MN,55404-3074,Hennepin,2001 Bloomington Ave,,Minneapolis,MN,55404,Hennepin,Colleen McDonald Diouf,CEO,612-301-0698,,mcdon057@umn.edu,May Thao,Chief Quality and Compliance Officer,612-301-0885,,mayt@umn.edu,www.cuhcc.umn.edu
MN-005946,SHC - Twin Cities,Shriners Hospitals for Children,1871636522,Children's Hospitals (inpatient only),2025 E River Pwky,,Minneapolis,MN,55414,Hennepin,2025 E River Pwky,,Minneapolis,MN,55414,Hennepin,Cari Craig,"Corporate Director, Business Development",813-844-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
MN-005947,CENTRAL CLINIC,NEIGHBORHOOD HEALTHSOURCE,1811934763,Federally Qualified Health Centers - Medical Services,2301 Central Ave NE,,Minneapolis,MN,55418-3709,Hennepin,3300 Fremont Ave N,,Minneapolis,MN,55412-2405,Hennepin,Steven J Knutson,Executive Director,612-287-2428,,sknutson@neighborhoodhealthsource.org,,,,,,
MN-005951,Children's Hospital - Minnesota,Children's Minnesota,1881793750,Children's Hospitals (inpatient only),2525 Chicago Ave,,Minneapolis,MN,55404-4289,Hennepin,5901 Lincoln Drive,,Minneapolis,MN,55436,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",952-992-5644,,eric.solnitzky@childrensmn.org,Becky Woitalewicz,Director of Contracting,,,becky.woitalewicz@childrensmn.org,
MN-005954,Children's Primary Clinics,Children's Minnesota,1689852071,"Hemophilia Treatment Centers, Outpatient Hospital Clinics",2530 Chicago Ave,,Minneapolis,MN,55404-4289,Hennepin,5901 Lincoln Drive,,Minneapolis,MN,55436,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",952-992-5644,,eric.solnitzky@childrensmn.org,Becky Woitalewicz,Director of Contracting,,,becky.woitalewicz@childrensmn.org,
MN-005955,Southside Medical Clinic,Southside Community Health Services,1538137757,"Dental Providers, Federally Qualified Health Centers - Medical Services",324 E 35th St,,Minneapolis,MN,55408-4580,Hennepin,Southside Community Health Services,4243 4th Avenue S,Minneapolis,MN,55409-2113,Hennepin,Bill Tendle,Executive Director,612-821-2800,,bill.tendle@southsidechs.org,Ann Cazaban,Associate Director,612-821-2025,,ann.cazaban@southsidechs.org,
MN-005956,Neighborhood HealthSource-Fremont Clinic,NEIGHBORHOOD HEALTHSOURCE,1811934763,Federally Qualified Health Centers - Medical Services,3300 Fremont Ave N,,Minneapolis,MN,55412-2405,Hennepin,Neighborhood HealthSource,,Minneapolis,MN,55412,Hennepin,Steven J. Knutson,Executive Director,612-287-2428,,sknutson@neighborhoodhealthsource.org,,,,,,
MN-005957,Neighborhood HealthSource-Sheridan Clinic,NEIGHBORHOOD HEALTHSOURCE,1811934763,Federally Qualified Health Centers - Medical Services,342 13th Ave NE,,Minneapolis,MN,55413-1265,Hennepin,3300 Fremont Ave. N,,Minneapolis,MN,55412,Hennepin,Steven J. Knutson,Executive Director,612-287-2428,,sknutson@neighborhoodhealthsource.org,,,,,,
MN-005958,"SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.","SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.",1538137757,"Dental Providers, Federally Qualified Health Centers - Medical Services",4243 4th Ave S,,Minneapolis,MN,55409-2113,Hennepin,4243 4th Ave S,,Minneapolis,MN,55409-2113,Hennepin,William H Tendle,Executive Director,612-821-2800,,bill.tendle@southsidechs.org,Ann Cazaban,Associate Director,612-821-2025,,ann.cazaban@southsidechs.org,
MN-005959,Cedar Riverside Clinic,Cedar Riverside People's Center,1548340813,"Dental Providers, Federally Qualified Health Centers - Medical Services",425 20th Ave S,,Minneapolis,MN,55454-4400,Hennepin,425 20th Avenue South,,Minneapolis,MN,55454,Hennepin,Sahra Noor,CEO,612-355-5568,,noors@peoples-center.org,Steve Vincent,Chief Medical Officer,612-332-4973,4167,vincents@peoples-center.org,peoples-center.org
MN-005960,Hennepin Healthcare Inc dba Hennepin County Medical Center,"Hennepin Healthcare System, Inc dba Hennepin County Medical Center",1407897309,Inpatient Hospitals (other than children's hospitals),701 Park Ave,,Minneapolis,MN,55415-1623,Hennepin,701 Park Avenue,,Minneapolis,MN,55415,Hennepin,Barbara Anderson,Business System Automation Facilitator,612-873-8776,,barb.anderson@hcmed.org,Frank Gilbertson,Payor Contracting Manager,612-873-7395,,frank.gilbertson@hcmed.org,http://www.hcmc.org/
MN-005961,"Hennepin Healthcare System, Inc dba Hennepin County Medical Center (dental provider)",Hennepin Healthcare System Inc dba Hennepin County Medical Center,1407897309,Dental Providers,701 Park Ave,,Minneapolis,MN,55415-1623,Hennepin,701 Park Avenue,,Minneapolis,MN,55415,Hennepin,Barbara Anderson,Business System Automation Facilitator,612-873-8776,,barb.anderson@hcmed.org,Frank Gilbertson,Payor Contracting Manager,612-873-7395,,frank.gilbertson@hcmed.org,http://www.hcmc.org/
MN-005962,Hennepin Healthcare System Inc dba Hennepin County Medical Center (multiple outpatient ECP categories),Hennepin Healthcare System Inc dba Hennepin County Medical Center,1407897309,"Outpatient Hospital Clinics, Ryan White Providers",701 Park Ave,,Minneapolis,MN,55415-1623,Hennepin,701 Park Avenue,,Minneaolis,MN,55415,Hennepin,Barbara Anderson,Business System Automation Facilitator,612-873-8776,,barb.anderson@hcmed.org,Frank Gilbertson,Payor Contracting Manager,612-873-7395,,frank.gilbertson@hcmed.org,http://www.hcmc.org/
MN-005963,Abbott Northwestern Hospital,Allina Health System,1760446256,Inpatient Hospitals (other than children's hospitals),800 E 28th St,,Minneapolis,MN,55407-3723,Hennepin,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Jon Tranby,Contract Manager,715-307-6022,,jon.tranby@allina.com,Trisha Schirmers,Director of Reimbursement,612-262-4719,,trisha.schirmers@allina.com,
MN-005964,Children's Behavioral Health Clinics,Children's Minnesota,1689778912,Outpatient Hospital Clinics,910 E 26th St,,Minneapolis,MN,55404-4526,Hennepin,5901 Lincoln Drive,,Minneapolis,MN,55436,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",952-992-5644,,eric.solnitzky@childrensmn.org,Becky Woitalewicz,Director of Contracting,,,becky.woitalewicz@childrensmn.org,
MN-005965,SMOC Family Planning Clinic-Montevideo,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,207 N 1st St Apt 180,,Montevideo,MN,56265-1589,Chippewa,909 4th Ave,,Worthington,MN,56187,Nobles,Donna Erbes,Family Planning Coordinator,507-376-4195,,derbes@smoc.us,,,,,,
MN-005966,Family HealthCare Moorhead Dental,Family HealthCare,1801965967,Dental Providers,715 11th St N,Suite 106B,Moorhead,MN,56560-2000,Clay,301 Np Ave N,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,Mark Woolery,Chief Financial Officer,701-551-2442,,mwoolery@famhealthcare.org,
MN-005967,"Planned Parenthood Minnesota, North Dakota, South Dakota - Moorhead Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",803 Belsly Blvd,,Moorhead,MN,56560-5057,Clay,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005968,"Community Health Service, Inc. - Moorhead",Community Health Service Inc.,1316921406,"Dental Providers, Federally Qualified Health Centers - Medical Services",810 4th Ave S,Suite 101,Moorhead,MN,56560-2800,Clay,810 4th Ave S,Suite 101,Moorhead,MN,56560,Clay,Kristi Halvarson,Executive Director,218-236-6502,,khalvarson@chsiclinics.org,Aaron Kakac,CFO/Assistant Director,218-422-7424,,akakac@chsiclinics.org,
MN-005969,Family HealthCare Concordia College Health Services,Family HealthCare,1043389117,Federally Qualified Health Centers - Medical Services,901 8th St S,,Moorhead,MN,56562-0001,Clay,301 NP Ave N,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,Mark Woolery,Chief Financial Officer,701-551-2442,,mwoolery@famhealthcare.org,
MN-005970,Mahube-Otwa Family Health - Morris,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,24 E 7th St,Prairie Ridge,Morris,MN,56267-1312,Stevens,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005971,Prairie Ridge Hospital and Health Services- Morris Campus,Prairie Ridge Hospital and Health Services,1407838329,Outpatient Hospital Clinics,24 E 7th St,,Morris,MN,56267-1312,Stevens,1411 Highway 79 East,,Elbow Lake,MN,56531,Grant,Kelly Claassen,Revenue Cycle Director,218-685-7334,,kclaassen@prairiehealth.org,Brett Longtin,CFO/VP OF FINANCE,218-736-8000,8470,bllongtin@lrhc.org,
MN-005972,Mahube-Otwa Family Health - Morris,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,600 E 4th St,Umm,Morris,MN,56267-2132,Stevens,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005973,Sanford Clinic Mountain Lake,Sanford Clinic,1568469039,Rural Health Clinics,308 8th St N,,Mountain Lake,MN,56159-1568,Cottonwood,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Exec Dir of Corporate Contracting and Payor Analytics,605-328-9587,,torrey.sundall@sanfordhealth.org,,,,,,
MN-005974,NEW ULM MEDICAL CENTER,Allina Health System,1558328435,Inpatient Hospitals (other than children's hospitals),1324 5th St N,,New Ulm,MN,56073-1514,Brown,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,Trisha Schirmers,Director of Reimbursement,612-262-4719,,trisha.schirmers@allina.com,
MN-005975,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1912970849,"Dental Providers, Federally Qualified Health Centers - Medical Services",12052 Main St,,Northome,MN,56661,Koochiching,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-005976,White Earth Indian Health Center,White Earth Indian Health Center,1093761710,"Dental Providers, Indian Health Service, Outpatient Hospital Clinics",40520 County Highway 34,,Ogema,MN,56569-9612,Becker,40520 County Highway 34,,Ogema,MN,565699612,Becker,Vicki Bellanger,Medical Staff Coordinator,218-983-4300,6209,Vicki.bellanger@ihs.gov,Laura DeGroat,Administrative Officer,218-983-4300,6333,Laura.DeGroat@ihs.gov,
MN-005977,ESSENTIA HEALTH OKLEE CLINIC,Essentia Health,1174812465,Rural Health Clinics,400 Governor St,,Oklee,MN,56742-4227,Red Lake,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Kevin Gish,Administrator,218-435-7630,,kevin.gish@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005978,Renville County Hospital and Clinics,County of Renville d.b.a. Renville County Hospital and Clinics,1629091871,Inpatient Hospitals (other than children's hospitals),100 Healthy Way,,Olivia,MN,56277-1117,Renville,100 Healthy Way,,Olivia,MN,56277,Renville,Nathan G. Blad,CEO,320-523-3575,,bladn@rchospital.com,Nancy Anderson,CFO,320-523-3477,,andersonna@rchospital.com,www.rchospital.com
MN-005979,Renville County Hospital and Clinics,County of Renville d.b.a. Renville County Hospital and Clinics,1932387255,Rural Health Clinics,100 Healthy Way,,Olivia,MN,56277-1117,Renville,100 Healthy Way,,Olivia,MN,56277,Renville,Nathan G. Blad,CEO,320-523-3575,,bladn@rchospital.com,Nancy Anderson,CFO,320-523-3477,,andersonna@rchospital.com,www.rchospital.com
MN-005980,Mille Lacs Health System,Mille Lacs Health System,1548212699,Inpatient Hospitals (other than children's hospitals),200 Elm St N,,Onamia,MN,56359-7901,Mille Lacs,200 Elm St. N.,P.O. Box A,Onamia,MN,56359,Mille Lacs,Bill Nelson,CEO,320-532-3154,2580,bnelson@mlhealth.org,John Unzen,CFO,320-532-3151,2582,juzen@mlhealth.org,www.mlhealth.org
MN-005981,Mille Lacs Health System Family Clinics,Mille Lacs Health System,1275796773,Rural Health Clinics,200 Elm St N,,Onamia,MN,56359-7901,Mille Lacs,200 Elm St. N.,P.O. Box A,Onamia,MN,56359,Mille Lacs,Bill Nelson,CEO,320-532-3154,2580,bnelson@mlhealth.org,John Unzen,CFO,320-532-3154,2581,junzen@mlhealth.org,www.mlhealth.org
MN-005982,Ne-Ia-Shing Health Center,Mille Lacs Band of Ojibwe,1740357169,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",43500 Migizi Dr,,Onamia,MN,56359-2241,Mille Lacs,43500 Migizi Dr,,Onamia,MN,56359-2241,Mille Lacs,Rebecca St. Germaine,HHS Commissioner,320-532-4163,2503,rebeccast.germaine@hhs.millelacsband-nsn.gov,Noya Woodrich,Health Services Director,320-532-4163,2509,noya.woodrich@hhs.millelacsband-nsn.gov,www.millelacsband.com
MN-005983,SMOC Family Planning Clinic-Ortonville,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,127 2nd St NW,,Ortonville,MN,56278-1408,Big Stone,909 4th Ave,,Worthington,MN,56187,Nobles,Donna Erbes,Family Planning Coordinator,507-376-4195,,derbes@smoc.us,,,,,,
MN-005984,Tri-County Health Care - Ottertail Clinic,"Tri-County Health Care, Inc.",1871546663,Rural Health Clinics,232 MN Highway 78 N,,Ottertail,MN,56571-7032,Otter Tail,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-005985,"Community Health Service, Inc. - Owatonna",Community Health Service Inc.,1316921406,Federally Qualified Health Centers - Medical Services,142 W Bridge St,,Owatonna,MN,55060-2918,Steele,810 4th Ave S,Suite 101,Moorhead,MN,56560-2891,Clay,Kristi Halvarson,Executive Director,218-422-7431,,khalvarson@chsiclinics.org,Aaron Kakac,CFO/Assistant Director,218-422-7424,,akakac@chsiclinics.org,
MN-005986,OWATONNA HOSPITAL,Allina Health System,1528025632,Inpatient Hospitals (other than children's hospitals),2250 NW 26th St,,Owatonna,MN,55060-5503,Steele,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,Trisha Schirmers,Director of Reimbursement,612-262-4719,,trisha.schirmers@allina.com,
MN-005987,ESSENTIA HEALTH PARK RAPIDS CLINIC,Essentia Health,1699955344,Rural Health Clinics,705 Pleasant Ave S,,Park Rapids,MN,56470-1440,Hubbard,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administratoe,218-314-7852,,ryan.hill@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005988,Sanford Health Pelican Rapids Clinic,Sanford Health,1114953627,Rural Health Clinics,211 E Mill St,,Pelican Rapids,MN,56572-4234,Otter Tail,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,701-234-2076,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-005989,ESSENTIA PELICAN RAPIDS CLINIC,Essentia Health,1265876023,Rural Health Clinics,301 N Broadway,,Pelican Rapids,MN,56572-4113,Otter Tail,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting $ Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administrator,218-314-7852,,ryan.hill@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-005990,PERHAM HEALTH,PERHAM HEALTH,1790799518,Inpatient Hospitals (other than children's hospitals),1000 Coney St W,,Perham,MN,56573-2102,Otter Tail,1000 Coney St W,,Perham,MN,56573-2102,Otter Tail,Nora Heinecke,Patient Accounts Director,218-347-1341,1341,nora.heinecke@perhamhealth.org,Beth Ulschmid,Director of Clinic Operations,218-347-1213,1213,beth.ulschmid@sanfordhealth.org,
MN-005991,Mahube-Otwa Family Health - Perham,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,200 1st Ave S,,Perham,MN,56573-1445,Otter Tail,1125 West River Road,,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005992,Mahube-Otwa Family Health - Pine River,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,245 Barckay Ave,,Pine River,MN,56474,Cass,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-005993,Red Lake PHS Indian Hospital (inpatient hospital),Red Lake PHS Indian Hospital,1508809765,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",24760 Hospital Drive,,Red Lake,MN,56671,Beltrami,24760 Hospital Drive,,Red Lake,MN,56671,Beltrami,Bonnie Smerud,RN-Quality Improvement Coordinator,218-679-0167,167,Bonnie.Smerud@ihs.gov,"Paul Ditmanson, MD",Clinical Director,218-679-0280,280,Bonnie.Smerud@ihs.gov,
MN-005994,Red Lake PHS Indian Hospital (multiple outpatient ECP categories),Red Lake PHS Indian Hospital,1508809765,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",24760 Hospital Drive,,Red Lake,MN,56671,Beltrami,24760 Hospital Drive,,Red Lake,MN,56671,Beltrami,Bonnie Smerud,RN-Quality Improvement Coordinator,218-679-0167,167,Bonnie.Smerud@ihs.gov,"Paul Ditmanson, MD",Clinical Director,218-679-0280,280,Bonnie.Smerud@ihs.gov,
MN-005995,Riverview Clinic Red Lake Falls,Riverview Healthcare Association,1841581212,Rural Health Clinics,105 International Dr,,Red Lake Falls,MN,56750-4665,Red Lake,323 South Minnesota Street,,Crookston,MN,56716,Polk,Betty Arvidson,"VP Finance, CFO",218-281-9200,,barvidson@riverviewhealth.org,Carrie Michalski,CEO,218-281-9200,,cmichalski@riverviewhealth.org,riverviewhealth.org
MN-005996,SMOC Family Planning Clinic-Redwood Falls Public Health,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,266 E Bridge St,,Redwood Falls,MN,56283-1664,Redwood,"Southwestern MN Opportunity Council, Family Planning",,Worthington,MN,56187,Nobles,Donna Erbes,Family Planning Coordinator,507-376-4195,,derbes@smoc.us,,,,,,
MN-005997,"Planned Parenthood Minnesota, North Dakota, South Dakota - Richfield Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",6527 Lyndale Ave S,,Richfield,MN,55423-1407,Hennepin,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005998,"Planned Parenthood Minnesota, North Dakota, South Dakota - Rochester Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",1212 7th St NW,,Rochester,MN,55901-1733,Olmsted,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-005999,"Community Health Service, Inc. - Rochester",Community Health Service Inc.,1316921406,Federally Qualified Health Centers - Medical Services,1926 College View Rd E,Heintz Center,Rochester,MN,55904-8201,Olmsted,810 4th Ave S,Suite 101,Moorhead,MN,56560,Clay,Kristi Halvarson,Executive Director,218-236-6502,,khalvarson@chsiclinics.org,Aaron Kakac,CFO/Assistant Director,218-422-7424,,akakac@chsiclinics.org,
MN-006000,Winona Health Services,Winona Health,1295789352,Outpatient Hospital Clinics,109 W Jessie St,,Rushford,MN,55971-8837,Fillmore,855 Mankato Ave,,Winona,MN,55987,Winona,Randy Benson,Director Reimbursement,507-457-4321,,rbenson@winonahealth.org,Jan Brosnahan,CFO,507-457-4156,,jbrosnahan@winonahealth.org,www.winonahealth.org
MN-006001,St Cloud Office,Rural AIDS Action Network,1033575444,Ryan White Providers,300 E Saint Germain St,Suite 220,Saint Cloud,MN,56304-2500,Benton,300 E St Germain St,Ste 220,St Cloud,MN,56304,Benton,Mary McCarthy,Executive Director,320-209-1191,,marym@raan.org,Diane Kaeter,Accounting Manager,320-257-3036,9,dianek@raan.org,
MN-006002,"Planned Parenthood Minnesota, North Dakota, South Dakota - St. Cloud Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",451 E Saint Germain St,Suite 100,Saint Cloud,MN,56304-0761,Benton,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-006003,United Family Medicine,UNITED FAMILY PRACTICE HEALTH CENTER,1851300149,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1026 7th St W,,Saint Paul,MN,55102-3828,Ramsey,1026 7th St W,,Saint Paul,MN,55102-3828,Ramsey,Brian Nasi,CEO,651-241-1134,,bnasi@unitedfamilymedicine.org,Melissa Parker,COO,651-241-1084,,mparker@unitedfamilymedicine.org,www.unitedfamilymedicine.org
MN-006004,United Family Medicine Lowertown,United Family Medicine,1255708780,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",166 4th St E,,Saint Paul,MN,55101-1421,Ramsey,1026 West 7th Street,,Saint Paul,MN,55102,Ramsey,Brian Nasi,CEO,651-241-1134,,bnasi@unitedfamilymedicine.org,Melissa Parker,COO,651-241-1084,,mparker@unitedfamilymedicine.org,www.unitedfamilymedicine.org
MN-006005,Gillette Childrens Specialty Healthcare,Gillette Childrens Specialty Healthcare,1447352836,"Dental Providers, Outpatient Hospital Clinics",200 University Ave E,,Saint Paul,MN,55101-2507,Ramsey,200 University Ave E,,Saint Paul,MN,55101,Ramsey,Patrick Nolan,Chief Financial Officer,651-312-3105,,patricknolan@gillettechildrens.com,Barbara Joers,President and Chief Executive Officer,651-578-5611,,bjoers@gillettechildrens.com,www.gillettechildrens.org
MN-006006,GILLETTE CHILDRENS SPECIALTY HOSPITAL,Gillette Children's Specialty Healthcare,1447352836,Children's Hospitals (inpatient only),200 University Ave E,,Saint Paul,MN,55101-2507,Ramsey,200 University Ave E,,Saint Paul,MN,55101-2507,Ramsey,Patrick Nolan,Chief Financial Officer,651-312-3105,,patricknolan@gillettechildrens.com,Barbara Joers,President and Chief Executive Officer,651-578-5611,,BJoers@gillettechildrens.com,www.gillettechildrens.org
MN-006007,United Family Medicine at Sibley Plaza,UNITED FAMILY PRACTICE HEALTH CENTER,1942384193,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2423 7th St W,,Saint Paul,MN,55116-2839,Ramsey,1026 7th St W,,Saint Paul,MN,55102-3828,Ramsey,Brian Nasi,CEO,651-241-1134,,bnasi@unitedfamilymedicine.org,Melissa Parker,COO,651-241-1084,,mparker@unitedfamilymedicine.org,www.unitedfamilymedicine.org
MN-006008,Children's Specialty Clinics,Children's Hospitals & Clinics of Minnesota,1225132566,"Hemophilia Treatment Centers, Outpatient Hospital Clinics",310 Smith Ave N,,Saint Paul,MN,55102-2393,Ramsey,2525 Chicago Avenue South,,Minneapolis,MN,55404,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",651-855-2607,,eric.solnitzky@childrensmn.org,,,,,,
MN-006009,UNITED HOSPITAL,Allina Health System,1457319485,Inpatient Hospitals (other than children's hospitals),333 Smith Ave N,,Saint Paul,MN,55102-2344,Ramsey,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Jon Tranby,Contract Manager,612-262-4867,,jon.tranby@allina.com,Trisha Schirmers,Director of Reimbursement,612-262-4719,,trisha.schirmers@allina.com,
MN-006010,Childrens - St. Paul,Children's Minnesota,1881793750,Children's Hospitals (inpatient only),345 Smith Ave N,,Saint Paul,MN,55102-2346,Ramsey,5901 Lincoln Drive,,Edina,MN,55436,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",952-992-5644,,eric.solnitzky@childrensmn.org,Becky Woitalewicz,Acting CFO,952-992-5646,,becky.woitalewicz@childrensmn.org,
MN-006011,Children's Specialty Clinic,Children's Minnesota,1881793750,Hemophilia Treatment Centers,360 Sherman St,,Saint Paul,MN,55102-2564,Ramsey,5901 Lincoln Drive,,Edina,MN,55436,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",952-992-5644,,eric.solnitzky@childrensmn.org,Becky Woitalewicz,Acting CFO,952-992-5646,,becky.woitalewicz@childrensmn.org,
MN-006012,St. Paul -- Ramsey County Public Health,Saint Paul Ramsey County Public Health,1942369475,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",555 Cedar St,,Saint Paul,MN,55101-2209,Ramsey,555 Cedar St,,Saint Paul,MN,55101,Ramsey,Beth Leindecker,Contract Manager,651-266-1216,,beth.leindecker@co.ramsey.mn.us,Diane Haugen,Clinical Services Division Manager,651-266-1263,,diane.haugen@co.ramsey.mn.us,https://www.ramseycounty.us/residents/health-medical/clinics-services/sexual-reproductive-health
MN-006013,"Planned Parenthood Minnesota, North Dakota, South Dakota - Vandalia Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-006014,Mental Health Outreach Clinic,"Mental Health Resources, Inc.",1790909703,Other ECP Providers,762 Transfer Rd,Suite 21,Saint Paul,MN,55114-1489,Ramsey,762 Transfer Road,Suite 21,St. Paul,MN,55114,Ramsey,Gretchen Nguyen,Compliance Manager,651-659-2971,,gnguyen@mhresources.com,Rosie Kolman-Stich,Director of COmmunity Treatment Services,651-659-2931,,rstich@mhresources.com,
MN-006015,River's Edge Hospital & Clinic - North Sunrise Drive,River's Edge Hospital & Clinic,1407849367,Inpatient Hospitals (other than children's hospitals),1900 Sunrise Dr,,Saint Peter,MN,56082-5376,Nicollet,1900 N Sunrise Drive,,St. Peter,MN,56082,Nicollet,Sheri Schmidt,Patient Financial Services Manager,507-934-7605,,sschmidt@rehc.org,Lori Zook,CFO,507-934-7689,,lzook@rehc.org,
MN-006016,ESSENTIA HEALTH SANDSTONE,Essentia Health,1326041633,Inpatient Hospitals (other than children's hospitals),109 Court Ave S,,Sandstone,MN,55072-5120,Pine,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Michael Hedrix,Administrator,320-245-2212,,michael.hedrix@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-006017,Sandstone Clinic,"Gateway Family Health Clinic, Ltd",1356344451,Rural Health Clinics,204 Lundorff Dr,,Sandstone,MN,55072-5051,Pine,204 Lundorff Drive,,Sandstone,MN,55072,Pine,Eric Nielsen,Administrator,218-485-2000,,enielsen@gatewayclinic.com,,,,,,
MN-006018,Tri-County Health Care - Sebeka Clinic,"Tri-County Health Care, Inc.",1831185636,Rural Health Clinics,106 Minnesota Ave E,,Sebeka,MN,56477-5028,Wadena,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-006019,Slayton Clinic,Murray County Memorial Hospital,1679565287,Rural Health Clinics,2040 Juniper Ave,,Slayton,MN,56172-1017,Murray,2042 Juniper Avenue,,Slayton,MN,56172,Murray,Renee Logan,CFO,507-836-1274,,loganr@murraycountymed.org,,,,,,
MN-006020,MURRAY COUNTY MEMORIAL HOSPITAL,Murray County Memorial Hospital,1053497214,Inpatient Hospitals (other than children's hospitals),2042 Juniper Ave,,Slayton,MN,56172-1008,Murray,2042 Juniper Avenue,,Slayton,MN,56172,Murray,Renee Logan,CFO,507-836-6111,,loganr@murraycountymed.org,Dennis Goebel,CEO,507-836-1277,,goebeld@murraycountymed.org,
MN-006021,Slayton Clinic,Murray County Medical Center,1679565287,Rural Health Clinics,2042 Juniper Ave,,Slayton,MN,56172-1008,Murray,2042 Juniper Avenue,,Slayton,MN,56172,Murray,Renee Logan,CFO,507-836-1274,,loganr@murraycountymed.org,Dennis Goebel,CEO,507-836-1277,,goebeld@murraycountymed.org,
MN-006022,SLEEPY EYE MEDICAL CENTER,Sleepy Eye Medical Center,1215906680,Rural Health Clinics,400 4th Ave NW,,Sleepy Eye,MN,56085-1109,Brown,400 4th Ave NW,,Sleepy Eye,MN,56085-1109,Brown,Kevin Sellheim,Administrator,507-794-3571,3005,ksellheim@semedicalcenter.org,,,,,,semedicalcenter.org
MN-006023,SLEEPY EYE MEDICAL CENTER,Sleepy Eye Medical Center,1952370348,Inpatient Hospitals (other than children's hospitals),400 4th Ave NW,,Sleepy Eye,MN,56085-1109,Brown,400 4th Ave NW,,Sleepy Eye,MN,56085-1109,Brown,Kevin Sellheim,Administrator,507-794-3571,3005,ksellheim@semedicalcenter.org,,,,,,semedicalcenter.org
MN-006024,Childrens - St. Paul,Children's Hospitals & Clinics of Minnesota,1689852071,Hemophilia Treatment Centers,345 Smith Ave N,,St Paul,MN,55102,Ramsey,2525 Chicago Avenue S,,Minneapolis,MN,55404,Hennepin,Eric Solnitzky,"Manager, Payor Contracting",651-855-2607,,eric.solnitzky@childrensmn.org,,,,,,
MN-006025,Lakewood Health System,Lakewood Health System,1295726362,Inpatient Hospitals (other than children's hospitals),49725 County 83,,Staples,MN,56479-5280,Todd,49725 County 83,,Staples,MN,56479,Todd,Lisa Bjerga,CFO,218-894-8352,8352,lisabjerga@lakewoodhealthsystem.com,,,,,,
MN-006026,Sanford Thief River Falls,Sanford,1043218753,Inpatient Hospitals (other than children's hospitals),3001 Sanford Pkwy,,Thief River Falls,MN,56701-2700,Pennington,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006027,BIRCH GROVE CLINIC,SAWTOOTH MOUNTAIN CLINIC INC,1306832894,Federally Qualified Health Centers - Medical Services,9 Good Neighbor Hill Rd,,Tofte,MN,55615,Cook,513 5th Ave W,,Grand Marais,MN,55604-3017,Cook,Rita M Plourde,CEO,218-387-2330,,rita@sawtoothmountainclinic.org,Sue Nordman,COO,218-387-2330,126,sue@sawtoothmountainclinic.org,www.sawtoothmountainclinic.org
MN-006028,SCENIC RIVERS HEALTH SERVICES,"COOK AREA HEALTH SERVICES, INC.",1750633806,"Dental Providers, Federally Qualified Health Centers - Medical Services",415 N Second St,,Tower,MN,55790-2103,Saint Louis,20 5th St SE,,Cook,MN,55723-9702,Saint Louis,Michael A Holmes,CEO,218-361-3127,,mholmes@scenicrivershealth.org,Keith D Harvey,CFO,218-361-3135,,kharvey@scenicrivershealth.org,
MN-006029,Sanford Clinic Tracy,Sanford Health,1699869875,Rural Health Clinics,249 5th St E,,Tracy,MN,56175-1536,Lyon,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006030,Sanford Tracy Hospital,Sanford,1003851171,Inpatient Hospitals (other than children's hospitals),251 5th St E,,Tracy,MN,56175-1536,Lyon,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006031,Sanford Health Twin Valley Clinic,Sanford Health,1689602682,Rural Health Clinics,501 2nd St NW,,Twin Valley,MN,56584,Norman,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006032,Sanford Health Ulen Clinic,Sanford,1801818497,Rural Health Clinics,108 Viking Ave W,,Ulen,MN,56585,Clay,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006033,Tri-County Health Care - Verndale Clinic,"Tri-County Health Care, Inc.",1407262405,Rural Health Clinics,102 S Farwell St,,Verndale,MN,56481-4500,Wadena,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Service Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-006034,"Planned Parenthood Minnesota, North Dakota, South Dakota - Virginia Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",505 S 12th Ave,,Virginia,MN,55792-3099,Saint Louis,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-006035,ESSENTIA HEALTH VIRGINIA,Essentia Health,1083617120,Inpatient Hospitals (other than children's hospitals),901 9th St N,Suite 215,Virginia,MN,55792-2375,Saint Louis,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Sam Stone,Administrator,218-786-4209,,samuel.stone@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
MN-006036,Mahube-Otwa Family Health - Wadena,Mahube-Otwa Community Action Partnership,1588939276,Family Planning Providers,4 Deerwood Ave NW,,Wadena,MN,56482-1253,Wadena,1125 West River Road,PO Box 747,Detroit Lakes,MN,56501,Becker,Sarah Ohrmundt,Family Health Director,218-847-1385,,sohrmundt@mahube.org,,,,,,
MN-006037,Tri-County Health Care - Wadena Clinic,"Tri-County Health Care, Inc.",1134305162,Rural Health Clinics,4 Deerwood Ave NW,,Wadena,MN,56482-1253,Wadena,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-006038,Tri-County Hospital,"Tri-County Health Care, Inc.",1477545333,Inpatient Hospitals (other than children's hospitals),415 Jefferson St N,,Wadena,MN,56482-1264,Wadena,415 Jefferson St N,,Wadena,MN,56482,Wadena,Kathy Waln,Patient Financial Services Director,218-631-5233,,kathy.waln@tchc.org,Kim Aagard,CFO,218-631-5211,,kim.aagard@tchc.org,tchc.org
MN-006039,ESSENTIA HEALTH WALKER CLINIC,Essentia Health,1558607408,Rural Health Clinics,110 Michigan Ave W,,Walker,MN,56484-2274,Cass,421 N 6th Ave E,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,VP Population Care Management,218-786-6611,,catherine.vonrueden@essentiahealth.org,Ryan Hill,Administrator,218-314-7852,,ryan.hill@essentiahealth.org,www.essentiahealth.org
MN-006040,Sanford Health Walker Clinic,Sanford Health,1043232069,Rural Health Clinics,614 Michigan Ave W,,Walker,MN,56484-2276,Cass,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006041,Sanford Clinic Walnut Grove,Sanford Health,1033306931,Rural Health Clinics,830 8th St,,Walnut Grove,MN,56180-1117,Redwood,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006042,NORTH VALLEY HEALTH CENTER (inpatient hospital),"Warren Community Hospital, Inc.",1073516357,Inpatient Hospitals (other than children's hospitals),300 W Good Samaritan Dr,,Warren,MN,56762-1412,Marshall,300 W Good Samaritan Dr,,Warren,MN,56762-1412,Marshall,Jon E. Linnell,CEO,218-745-4211,3262,jon.linnell@northvalleyhealth.org,Mitchel Kotrba,CFO,218-745-4211,3261,Mitchell.Kotrba@northvalleyhealth.org,
MN-006043,NORTH VALLEY HEALTH CENTER (rural health clinics),"Warren Community Hospital, Inc.",1073516357,Rural Health Clinics,300 W Good Samaritan Dr,,Warren,MN,56762-1412,Marshall,300 W Good Samaritan Dr,,Warren,MN,56762-1412,Marshall,Jon E. Linnell,CEO,218-745-4211,3262,jon.linnell@northvalleyhealth.org,Mitchel Kotrba,CFO,218-745-4211,3261,Mitchell.Kotrba@northvalleyhealth.org,
MN-006044,Sanford Clinic Westbrook,Sanford Health,1437196490,Rural Health Clinics,920 Bell Ave,,Westbrook,MN,56183-9669,Cottonwood,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006045,Sanford Westbrook Hospital,Sanford,1942253547,Inpatient Hospitals (other than children's hospitals),920 Bell Ave,,Westbrook,MN,56183-9669,Cottonwood,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006046,Sanford Wheaton,Sanford Health,1245524669,Rural Health Clinics,401 12th St N,,Wheaton,MN,56296-1070,Traverse,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006047,"Community Health Service, Inc. - Willmar",Community Health Service Inc.,1316921406,Federally Qualified Health Centers - Medical Services,1804 Trott Ave SW,,Willmar,MN,56201-2743,Kandiyohi,810 4th Ave S,Suite 101,Moorhead,MN,56560,Clay,Kristi Halvarson,Executive Director,218-422-7431,,khalvarson@chsiclinics.org,Aaron Kakac,CFO/Assistant Director,218-422-7424,,akakac@chsiclinics.org,
MN-006048,"Planned Parenthood Minnesota, North Dakota, South Dakota - Willmar Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",2320 Highway 12 E,Suite 6,Willmar,MN,56201-5811,Kandiyohi,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-006049,WINDOM AREA HOSPITAL,Windom Area Hospital,1841288644,Inpatient Hospitals (other than children's hospitals),2150 Hospital Dr,,Windom,MN,56101-1287,Cottonwood,2150 Hospital Drive,,Windom,MN,56101,Cottonwood,Kimberly Armstrong,CFO,507-831-2400,0615,kimberly.armstrong@sanfordhealth.org,Jennifer Dukleth,Patient Accounts Manager,507-831-2400,0617,jennifer.dukleth@sanfordhealth.org,
MN-006050,Sanford Clinic Windom,Sanford Clinic,1699772178,Rural Health Clinics,591 2nd Ave N,,Windom,MN,56101-1927,Cottonwood,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Exec Dir of Corporate Contracting and Payor Analytics,605-328-9587,,torrey.sundall@sanfordhealth.org,,,,,,
MN-006051,Semcac Family Planning Clinic,Semcac,1194843284,Family Planning Providers,76 W 3rd St,,Winona,MN,55987-3431,Winona,76 W 3rd St,,Winona,MN,55987,Winona,Megan Lehnertz,Family Planning Director,507-452-4307,,megan.lehnertz@semcac.org,,,,,,
MN-006052,Winona Health Services (inpatient hospital),Winona Health,1295789352,Inpatient Hospitals (other than children's hospitals),855 Mankato Ave,,Winona,MN,55987-4868,Winona,PO Box 5600,,Winona,MN,55987,Winona,Randy Benson,Director of Reimb/Payer Relations,507-457-4321,,rbenson@winonahealth.org,Jan Brosnahan,CFO,507-457-4156,,jbrosnahan@winonahealth.org,www.winonahealth.org
MN-006053,Winona Health Services (outpatient hospital clinics),Winona Health,1295789352,Outpatient Hospital Clinics,855 Mankato Ave,,Winona,MN,55987-4868,Winona,855 Mankato Avenue,,Winona,MN,55971,Winona,Randy Benson,Director Reimbursement,507-457-4321,,rbenson@winonahealth.org,Jan Brosnahan,CFO,507-457-5156,,jbrosnahan@winonahealth.org,www.winonahealth.org
MN-006054,"Planned Parenthood Minnesota, North Dakota, South Dakota - Woodbury Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,"Family Planning Providers, Sexually Transmitted Disease Clinics",1795 Radio Dr,Suite D,Woodbury,MN,55125-9457,Washington,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,https://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
MN-006055,Sanford Worthington Medical Center,Sanford,1396712618,Inpatient Hospitals (other than children's hospitals),1018 6th Ave,,Worthington,MN,56187-2202,Nobles,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
MN-006056,Access Family Medical Clinic,"Rural Health Care, Inc.",1215317375,Federally Qualified Health Centers - Medical Services,1216 Ryans Rd,,Worthington,MN,56187-1722,Nobles,"202 Island Dr., Ste 1",,Fort Pierre,SD,57532-7303,Stanley,James M. Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
MN-006057,SMOC Family Planning Clinic-Worthington,"Southwestern MN Opportunity Council, Family Planning",1336237700,Family Planning Providers,909 4th Ave,,Worthington,MN,56187-2365,Nobles,909 4th Ave,,Worthington,MN,56187-2365,Nobles,Neal Steffl,CEO,507-376-4195,226,nsteffl@smoc.us,,,,,,
MO-006058,FAMILY CARE CLINIC ADRIAN,Bates County Memorial Hospital,1578797494,Rural Health Clinics,102 E Main St,,Adrian,MO,64720-8204,Bates,615 W. Nursery St.,,Butler,MO,64730,Bates,"Shirley Goss, RN",Clinic Nurse Supervisor,816-297-2640,,sgoss@bcmhospital.com,Margaret Gregg,Patient Accounts Director,660-200-7108,,mgregg@bcmhospital.com,www.bcmhospital.com
MO-006059,Cross Trails Medical Center,CROSS TRAILS MEDICAL CENTER,1225191752,"Dental Providers, Federally Qualified Health Centers - Medical Services",307 W Gabriel St,,Advance,MO,63730-8301,Stoddard,408 S Broadview St,,Cape Girardeau,MO,63703-5725,Cape Girardeau,Ron Camp,CEO,573-339-1196,,rcamp@crosstrails.us,Chrissy Warren,COO,573-339-1196,,cwarren@crosstrails.us,
MO-006060,OCH ANDERSON RURAL HEALTH CLINIC,"SGOH ACQUISITION, INC.",1063969665,Rural Health Clinics,104 E Main St,,Anderson,MO,64831-4103,McDonald,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006061,Economic Security Corporation of Southwest Area Anderson Clinic,Economic Security Corporation of Southwest Area,1790106938,Family Planning Providers,712 S Highway 59,,Anderson,MO,64831-8486,McDonald,302 South Joplin,,Joplin,MO,64804,Jasper,Ryan Peterson,Director of Women's Health/Family Planning,417-627-2019,,rpeterson@escswa.org,Donna White,Nurse Practioner,417-781-4788,276,dwhite@escswa.org,
MO-006062,Access Family Care,Access Family Care,1043250905,Dental Providers,927 N 71 Business Hwy,,Anderson,MO,64831-9753,McDonald,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006063,Access Family Care-Medical Anderson,Access Family Care,1265428791,Federally Qualified Health Centers - Medical Services,927 N 71 Business Hwy,,Anderson,MO,64831-9753,McDonald,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006064,ANNAPOLIS FAMILY CLINIC,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1225131501,Federally Qualified Health Centers - Medical Services,202 N Allen St,,Annapolis,MO,63620-8778,Iron,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006066,Archie Medical Clinic,Cass Regional Medical Center dba Archie Medical Clinic,1760472922,Rural Health Clinics,709 E Pine St,,Archie,MO,64725-9215,Cass,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006067,Jefferson County Health Department,Jefferson County Health Department,1376573923,"Family Planning Providers, Sexually Transmitted Disease Clinics",1818 Lonedell Rd,,Arnold,MO,63010-1050,Jefferson,1818 Lonedell Rd,,Arnold,MO,63010-1050,Jefferson,Mary Greenwall,Family Planning Coordinator,636-481-2138,,mary.greenwall@jeffcohealth.org,Kelley Vollmar,Director,636-797-3737,104,kelley.vollmar@jeffcohealth.org,http://www.jeffcohealth.org
MO-006068,"Community Treatment, Inc.","Community Treatment, Inc.",1801215504,Federally Qualified Health Centers - Medical Services,21 Municipal Dr,,Arnold,MO,63010-1012,Jefferson,227 E Main Street,,Festus,MO,63028,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006069,CoxHealth Center Aurora,CoxHealth Network,1982064267,Rural Health Clinics,106 Commerce Dr,,Aurora,MO,65605-6260,Lawrence,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006070,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1801225982,Rural Health Clinics,201 S Main,,Auxvasse,MO,65231,Callaway,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006071,Missouri Ozarks Community Health - AVA,"DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",1912904145,"Dental Providers, Federally Qualified Health Centers - Medical Services",504 NW 10th Ave,,Ava,MO,65608,Douglas,504 NW 10th Ave,,Ava,MO,65608,Douglas,Tim Shryack,CEO,417-683-4831,110,tshryack@mo-ozarks.org,Randall L Gann,CFO,417-683-4831,132,rgann@mo-ozarks.org,
MO-006072,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1659327393,Rural Health Clinics,100 Highway 28 E,,Belle,MO,65013-3405,Osage,2505 Mission Drive,,Jefferson City,MO,65101,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006073,West Central Missouri Community Action Agency Family Health Clinic of West Central (Belton),West Central Missouri Community Action Agency,1215188313,"Family Planning Providers, Other ECP Providers",119 Congress St,,Belton,MO,64012-2480,Cass,106 W 4th Street,,Appleton City,MO,64724,Saint Clair,Cheryl Gutshall,Health Clinic Program Manager,660-476-2185,1204,cgutshall@wcmcaa.org,Diann Rice,Health Clinic Reimbursement Specialist,816-322-5012,,drice@wcmcaa.org,www.wcmcaa.org
MO-006074,Swope Health Belton,SWOPE HEALTH SERVICES,1770907347,Federally Qualified Health Centers - Medical Services,204 E North Ave,,Belton,MO,64012-2013,Cass,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,David Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006075,Benton Medical and Dental Center,SOUTHEAST MISSOURI HEALTH NETWORK,1649375940,"Dental Providers, Federally Qualified Health Centers - Medical Services",6724 Hwy 77 E,,Benton,MO,63736,Scott,420 SEMO Dr.,,New Madrid,MO,63869-1942,New Madrid,Darryl Roberts,Chief Operations Officer,573-748-2404,,droberts@semohealthnetwork.org,,,,,,
MO-006076,Bernie Family Medical and Dental Clinic,SOUTHEAST MISSOURI HEALTH NETWORK,1194945154,"Dental Providers, Federally Qualified Health Centers - Medical Services",741 S Walnut St,,Bernie,MO,63822-8900,Stoddard,420 SEMO Dr,,New Madrid,MO,63869-1942,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Darryl Roberts,COO,573-748-2404,,droberts@semohealthnetwork.org,
MO-006077,OCH POLK COUNTY CLINIC,"SGOH ACQUISITION, INC.",1568772481,Rural Health Clinics,910 E San Martin St,,Bolivar,MO,65613-2893,Polk,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006078,Parkland Health Center Bonne Terre,Parkland Health Center,1932117173,Inpatient Hospitals (other than children's hospitals),7245 Raider Rd,,Bonne Terre,MO,63628-3767,Saint Francois,1101 W Liberty St,Administration,Farmington,MO,63640,Saint Francois,Steven Bernstetter,Compliance Director,314-286-2134,,steven.bernstetter@bjc.org,,,,,,
MO-006079,PCMH Clinics,Pike County Memorial Hospital,1124030424,Sexually Transmitted Disease Clinics,1015 W Adams St,,Bowling Green,MO,63334-1974,Pike,2305 Georgia Street,,Louisiana,MO,63353,Pike,Tami Schneidler,Clinic Director,573-754-5531,,contact@pcmh-mo.org,Casey Wommack,Busniess Office Director,573-754-5531,,contact@pcmh-mo.org,http://www.pcmh-mo.org
MO-006080,Hannibal Clinic Operations - Bowling Green,"Hannibal Clinic Operations, LLC",1215916911,Rural Health Clinics,710 S Business 61,,Bowling Green,MO,63334-5239,Pike,100 Medical Drive,,Hannibal,MO,63401,Marion,Marsha Moss,Credentialing Coordinator,573-231-3813,,mmoss@hannibalclinic.com,MELODY REYNOLDS,,573-231-3850,,MREYNOLDS@HANNIBALCLINIC.COM,
MO-006081,North East Community Action Corp. NECAC Family Planning Center,North East Community Action Corp.,1356491955,"Family Planning Providers, Sexually Transmitted Disease Clinics",805 Business Highway 61 N,,Bowling Green,MO,63334-1351,Pike,16 North Court Street,PO Box 470,Bowling Green,MO,63334,Pike,Brenda K. Fuqua,"Deputy Director, Community Health Service Programs",573-324-2231,10118,bfuqua@necac.org,"Claudia Timbrook, RNC/FNP","Program Director, Family Planning & WIC",573-221-3404,,ctimbrook@necac.org,necac.org
MO-006082,CoxHealth Family Medicine Branson 248,CoxHealth Network,1629156971,Rural Health Clinics,1150 State Highway 248,,Branson,MO,65616-3758,Taney,3354 S. National Ave,,Sprinfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006083,Branson Walk-In Clinic,Bridges Medical Services P.C.,1154656940,Rural Health Clinics,1440 State Highway 248,Suite J,Branson,MO,65616-9257,Taney,P.O. Box 1240,,Forsyth,MO,65653,Taney,Heather Culler,Office Manager,417-546-4200,,bridgesbilling@gmail.com,J. Rachelle Bridges,Owner,417-251-2768,,rachellebridges1@gmail.com,
MO-006084,Cox Medical Center Branson,CoxHealth Network,1760443980,Inpatient Hospitals (other than children's hospitals),525 Branson Landing Blvd,,Branson,MO,65616-2052,Taney,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006085,CoxHealth Family Medicine & Obstetrics,CoxHealth Network,1114005451,Rural Health Clinics,525 Branson Landing Blvd,,Branson,MO,65616-2052,Taney,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006086,CoxHealth Center Branson,CoxHealth Network,1679919674,Rural Health Clinics,890 State Highway 248,,Branson,MO,65616-3721,Taney,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006087,CoxHealth Center Branson West,CoxHealth Network,1366520694,Rural Health Clinics,18452 Missouri Bus 13,,Branson West,MO,65737,Stone,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006088,Braymer Clinic,"NORTHWEST HEALTH SERVICES, INC.",1215059209,Federally Qualified Health Centers - Medical Services,109 N Main St,,Braymer,MO,64624-9325,Caldwell,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,
MO-006089,Community Medical Associates,Pershing Health System,1487616256,Rural Health Clinics,130 E. Lockling,PO Box 408,Brookfield,MO,64628-0408,Linn,130 E. Lockling,PO Box 408,Brookfield,MO,64628,Linn,Lorna Woodside,Clinic Director,660-258-1050,1041,cma_manager@phsmo.org,Gary Tandy,CFO,660-258-2222,1288,cfo@pershinghealthsystem.com,phsmo.org
MO-006090,GRAND RIVER MEDICAL CLINIC,"JOHN FITZGIBBON MEMORIAL HOSPITAL, INC",1922032549,Rural Health Clinics,815 E Broadway St,,Brunswick,MO,65236-1468,Chariton,2305 South 65 Highway,,Marshall,MO,65340-3702,Saline,Nancy Harris,Director of Financial Services,660-831-3700,271,nharris@fitzgibbon.org,Lori Benedick,Patient Accounts Manager,660-831-3700,728,lbenedick@fitzgibbon.org,
MO-006091,Live Well Community Health Center Buckner,The Health Care Coalition of Lafayette County,1174992374,"Dental Providers, Federally Qualified Health Centers - Medical Services",324 S Hudson St,,Buckner,MO,64016-8142,Jackson,825 S Business Highway 13,,Lexington,MO,64067,Lafayette,Toniann Richard,Executive Director,660-259-2440,,toniann@hccnetwork.org,Cathy Wallace,Director of Operations,660-259-2440,,cathy@hccnetwork.org,
MO-006092,CoxHealth Center Buffalo,Cox Medical Centers,1124054432,Rural Health Clinics,119 N Ash St,,Buffalo,MO,65622-8590,Dallas,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006093,Compass Health Bates County Dental Clinic,"COMPASS HEALTH, INC.",1245669266,Dental Providers,205 E Dakota St,,Butler,MO,64730-2113,Bates,1800 Community Drive,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006095,BATES COUNTY MEMORIAL HOSPITAL,Bates County Memorial Hospital,1770536740,Inpatient Hospitals (other than children's hospitals),615 W Nursery St,,Butler,MO,64730-1840,Bates,615 W. Nursery St.,,Butler,MO,64730,Bates,Shannon L. Bjerke,Administrative Assistant,660-200-7072,,sbjerke@bcmhospital.com,Margaret Gregg,Patient Accounts Director,660-200-7108,,mgregg@bcmhospital.com,www.bcmhospital.com
MO-006096,Nursery Street Family Care Clinic,Bates County Memorial Hospital,1669606588,Rural Health Clinics,617 W Nursery St,,Butler,MO,64730-1840,Bates,615 W. Nursery St.,,Butler,MO,64730,Bates,Shannon Bjerke,Administrative Assistant,660-200-7072,,sbjerke@bcmhospital.com,Margaret Gregg,Patient Accounts Director,660-200-7108,,mgregg@bcmhospital.com,www.bcmhopsital.com
MO-006097,High Street Family Care Clinic,Bates County Memorial Hospital,1902851843,"Community Mental Health Centers, Rural Health Clinics",706 S High St,,Butler,MO,64730-1833,Bates,615 W. Nursery Street,,Butler,MO,64730,Bates,Shannon L. Bjerke,Administrative Assistant,660-200-7072,,sbjerke@bcmhospital.com,Margaret Gregg,Patient Accounts Director,660-200-7108,,mgregg@bcmhospital.com,www.bcmhospital.com
MO-006098,Compass Health - Butler Medical and Behaviroal Health,Compass Health,1386022002,Federally Qualified Health Centers - Medical Services,805 N Orange St,,Butler,MO,64730-9382,Bates,1800 Community Drive,,Clinton,MO,64735,Henry,Alan Stevens,Executive Vice President - Health Center Operations,573-634-3000,,astevens@pbhc.org,,,,,,
MO-006099,Missouri Ozarks Community Health - CAB,"DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",1710221130,"Dental Providers, Federally Qualified Health Centers - Medical Services",904 Zimmerman Ave,,Cabool,MO,65689-7365,Texas,504 NW 10th Ave,,Ava,MO,65608,Douglas,Tim Shryack,CEO,417-683-4831,110,tshryack@mo-ozarks.org,Randall L Gann,CFO,417-683-4831,132,rgann@mo-ozarks.org,
MO-006100,Cainsville Medical Clinic,"NORTHWEST HEALTH SERVICES, INC.",1053433920,Federally Qualified Health Centers - Medical Services,707 Victory Ln,,Cainsville,MO,64632-9506,Harrison,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,
MO-006101,CHCCM Moniteau Clinic,COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI,1205104403,"Dental Providers, Federally Qualified Health Centers - Medical Services",104 N Gerhart Rd,,California,MO,65018-2436,Moniteau,1016 E Main St,,Linn,MO,65051-9782,Osage,Toby L Barnett,CFO,573-632-2777,,toby.barnett@chccmo.org,,,,,,
MO-006102,LAKE REGIONAL CLINIC-CAMDENTON,LAKE REGIONAL HEALTH SYSTEM,1437440856,Rural Health Clinics,1930 N Business Route 5,Unit 1A,Camdenton,MO,65020-2659,Camden,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006103,Central Ozarks Medical Center,"Richland Medical Center, Inc.",1942750690,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",404 W US Highway 54,,Camdenton,MO,65020-6943,Camden,PO Box 777,,Richland,MO,65556,Pulaski,Robert Stiles,CEO,573-765-5131,,rstiles@centralozarks.org,Paul Bocci,CFO,573-765-5131,,pbocci@centralozarks.org,www.centralozarks.org
MO-006104,Central Ozarks Medical Center,RICHLAND MEDICAL CENTER INC,1659795102,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",948 E US Highway 54,,Camdenton,MO,65020-6834,Camden,304 W Washington Ave,,Richland,MO,65556-7101,Pulaski,Robert Stiles,CEO,573-765-5131,,rstiles@centralozarks.org,Paul Bocci,CFO,573-765-5131,,pbocci@centralozarks.org,www.centralozarks.org
MO-006105,CAMPBELL MEDICAL CLINIC,PIGGOTT COMMUNITY HOSPITAL,1033100870,Rural Health Clinics,413 W Grand Ave,,Campbell,MO,63933-1523,Dunklin,1206 GORDON DUCKWORTH DR,,Piggott,AR,724541911,Clay,JAMES MAGEE,Executive Director,870-598-3881,1201,jamesmagee@pch-health.com,Bobbi Johnson,Rural Health Clinic Coordinator,870-598-3881,1216,bobbi.johnson@pch-health.com,pch-health.com
MO-006106,MEDSTOPONE,MEDSTOPONE,1417959149,Rural Health Clinics,3065 William St,Suite 209,Cape Girardeau,MO,63703-6373,Cape Girardeau,3065 WILLIAM STREET,SUITE 209,CAPE GIRARDEAU,MO,63703-6373,Cape Girardeau,DAVID CANTREL,ADMINISTRATOR/PARTNER,573-335-4100,4,MEDSTOPONE@GMAIL.COM,STACEY GALLAHER,PARTNER,573-335-1779,,SLGALLAHER@MBMR.NET,WWW.MEDSTOPONE.COM
MO-006107,Midwest Family Care,"Midwest Family Care, LLC",1225337298,Rural Health Clinics,36 Doctors Park,,Cape Girardeau,MO,63703-4904,Cape Girardeau,36 Doctors Park,,Cape Girardeau,MO,63703,Cape Girardeau,Steve Mills,provider enrollment specialist,314-968-0076,214,smills@northamericanhms.com,Deborah Seeger,Owner,573-803-1771,,dseeger@mwfamilycare.com,
MO-006108,CROSS TRAILS MEDICAL CENTER,CROSS TRAILS MEDICAL CENTER,1356393268,"Dental Providers, Federally Qualified Health Centers - Medical Services",408 S Broadview St,,Cape Girardeau,MO,63703-5725,Cape Girardeau,408 S Broadview St,,Cape Girardeau,MO,63703-5725,Cape Girardeau,Ron Camp,CEO,573-339-1196,,rcamp@crosstrails.us,Chrissy Warren,COO,573-339-1196,,cwarren@crosstrails.us,
MO-006109,Live Well Community Health Center Carrollton,The Health Care Coalition of Lafayette County,1245609445,Federally Qualified Health Centers - Medical Services,1413 N Jefferson St,,Carrollton,MO,64633-1945,Carroll,825 S Business Highway 13,,Lexington,MO,64067,Lafayette,Toniann Richard,Executive Director,660-259-2440,,toniann@hccnetwork.org,Cathy Wallace,Director of Operations,660-259-2440,,cathy@hccnetwork.org,
MO-006110,OCH JASPER COUNTY PEDIATRIC CLINIC,"SGOH ACQUISITION, INC.",1326496100,Rural Health Clinics,1221 Oak St,,Carthage,MO,64836-2028,Jasper,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,,
MO-006111,Access Family Care,Access Family Care,1386095255,Dental Providers,215 E 3rd St,,Carthage,MO,64836-1661,Jasper,PO Box 758,,Neosho,MO,64850,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006112,OCH JASPER COUNTY CLINIC-CARTHAGE CAMPUS,"SGOH ACQUISITION, INC.",1104229186,Rural Health Clinics,327 E Airport Dr,,Carthage,MO,64836-3402,Jasper,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006113,DOCTOR'S CLINIC,Pemiscot Memorial Health Systems,1437251634,Rural Health Clinics,106 W 12th St,,Caruthersville,MO,63830-1890,Pemiscot,946 Eas,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,,,,
MO-006114,BOOTHEEL PRIMARY CARE CLINIC CARUTHERSVILLE,Pemiscot Memorial Health Systems,1841463551,Rural Health Clinics,1502 Ward Ave,,Caruthersville,MO,63830-2571,Pemiscot,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,,,,
MO-006115,Access Family Care-Dental Cassville,Access Family Care,1891078002,Dental Providers,4016 Main St,,Cassville,MO,65625-9753,Barry,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006116,Access Family Care-Medical Cassville,Access Family Care,1205886769,Federally Qualified Health Centers - Medical Services,4016 Main St,,Cassville,MO,65625-9753,Barry,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006117,Barry County Health Department,Barry County Health Department,1548384670,Family Planning Providers,65 Main St,,Cassville,MO,65625-9400,Barry,PO Box 207,,Cassville,MO,65625,Barry,Carol Landstad,RN,417-847-2114,,carol.landstad@lpha.mo.gov,Roger Brock,Administrator,417-847-2114,,Roger.Brock@lpha.mo.gov,
MO-006118,Cassville Medical Care Associates,CoxHealth Network,1619030681,Rural Health Clinics,75 Smithson Dr,,Cassville,MO,65625-9429,Barry,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006119,Ferguson Medical Group-Charleston Clinic,Ferguson Medical Group,1922332766,"Other ECP Providers, Rural Health Clinics",112 W Commercial St,,Charleston,MO,63834-1601,Mississippi,1012 N. Main St.,,Sikeston,MO,63801,Scott,"Mechelle W. Farmer, MHCA",Director of Public Relations/Comm. Liaison,573-481-5028,0,Mechelle.Farmer@fergusonmedical.com,Sharon Leonard,Director of Operations,573-471-0330,305,Sharon.Leonard@fergusonmedical.com,
MO-006120,HEDRICK MEDICAL CENTER,SAINT LUKES HEALTH SYSTEM,1437191095,Rural Health Clinics,2791 N Washington St,,Chillicothe,MO,64601-2902,Livingston,4401 Wornall Rd,,Kansas City,MO,64111,Jackson,Bob Bonney,Sr VP Network Operations & Development,816-932-3523,,bbonney@saint-lukes.org,,,,,,https://www.saintlukeskc.org/locations/hedrick-medical-center
MO-006121,Hedrick Medical Center (Hospital),SAINT LUKES HEALTH SYSTEM,1912948308,Inpatient Hospitals (other than children's hospitals),2799 N Washington St,,Chillicothe,MO,64601-2902,Livingston,401 E 104th Street,,Kansas City,MO,64131,Jackson,Bob Bonney,Sr VP Network Operations & Development,816-932-3523,,bbonney@saint-lukes.org,,,,,,www.saintlukeshealthsystem.org
MO-006122,McCoy & Samples Dental Clinic,"NORTHWEST HEALTH SERVICES, INC.",1013297530,Dental Providers,850 Fairway Dr,,Chillicothe,MO,64601-3673,Livingston,Northwest Health Services,2303 Village Drive,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006124,Golden Valley Memorial Hospital,Golden Valley Memorial Healthcare,1710075361,Inpatient Hospitals (other than children's hospitals),1600 N 2nd St,,Clinton,MO,64735-1297,Henry,1600 North Second Street,,Clinton,MO,64735,Henry,Tammy Nadler,CFO,660-890-7105,,tnadler@gvmh.org,Craig Thompson,COO,660-890-7109,,cthompson@gvmh.org,gvmh.org
MO-006125,Golden Valley Medical - Clinton,Golden Valley Memorial Healthcare,1003873266,Rural Health Clinics,1602 N 2nd St,,Clinton,MO,64735-1192,Henry,1600 N Second St,,Clinton,MO,64735,Henry,Cindy Naylor,Data Processing/Billing Supervisor,660-890-8001,,cnaylor@gvmh.org,Meredith Cooper,Director of Operations,660-890-8023,,mcooper@gvmh.org,gvmh.org
MO-006126,Compass Health - Clinton Clinic,"Compass Health, Inc.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",1800 Community,,Clinton,MO,64735-8804,Henry,1800 Community Drive,,Clinton,MO,64735,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006127,FAMILY HEALTH CENTER OF BOONE COUNTY,FAMILY HEALTH CENTER OF BOONE COUNTY,1689646143,Federally Qualified Health Centers - Medical Services,1001 W Worley St,,Columbia,MO,65203-2037,Boone,1001 W Worley St,,Columbia,MO,65203-2037,Boone,Gloria L Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Luann Roberts,Business Operations Manager,573-886-6741,,lroberts@fhcmo.org,www.fhcmo.org
MO-006128,Family Dental Center,Family Health Center of Boone County,1275670747,Dental Providers,1101 N Providence Rd,,Columbia,MO,65203-4365,Boone,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Jack Kelly,COO,573-886-6761,,jkelly@fhcmo.org,www.fhcmo.org
MO-006129,Spectrum Health Care,Spectrum Health Care,1063785442,"Ryan White Providers, Sexually Transmitted Disease Clinics",1123 Wilkes Blvd,Suite 100,Columbia,MO,65201-4774,Boone,1123 Wilkes Blvd,Suite 250,Columbia,MO,65201,Boone,CALE MITCHELL,Executive Director,573-875-8687,261,CMITCHELL@SPECTRUMHEALTHCARE.ORG,CHELSEA CHAMBERS,EXECUTIVE ASSISTANT,573-875-8687,220,CCHAMBERS@SPECTRUMHEALTHCARE.ORG,www.missourirain.org
MO-006130,Family Dental Center Columbia East,Family Health Center of Boone County,1073978664,Dental Providers,2475 Broadway Bluffs Dr,,Columbia,MO,65201-8138,Boone,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria L Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Luann Roberts,Business Operations Manager,573-886-6741,,lroberts@fhcmo.org,www.fhcmo.org
MO-006131,Family Health Center Columbia East,Family Health Center of Boone County,1992187843,Federally Qualified Health Centers - Medical Services,2475 Broadway Bluffs Dr,,Columbia,MO,65201-8138,Boone,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Luann Roberts,Business Operations Manager,573-886-6741,,lroberts@fhcmo.org,www.fhcmo.org
MO-006132,Columbia Hemophilia Treatment Center,University of Missouri,1699769901,Hemophilia Treatment Centers,500 N Keene St,,Columbia,MO,65201-8104,Boone,One Hospital Drive,,Columbia,MO,65212,Boone,"Barbara Gruner, MD","Director, Columbia Hemophilia Treatment Center",573-882-3961,,grunerb@health.missouri.edu,,,,,,
MO-006133,Columbia Health Center,Planned Parenthood Great Plains,1679614838,"Family Planning Providers, Sexually Transmitted Disease Clinics",711 N Providence Rd,,Columbia,MO,65203-4357,Boone,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Amanda Addison,Vice President of Health Services,913-345-4659,,Amanda.addison@ppgreatplains.org,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,,shirish.malla@ppgreatplains.org,https://www.plannedparenthood.org/health-center/missouri/columbia/65203/columbia-health-center-2760-90740
MO-006134,Live Well Community Health Center- Concordia,Health Care Collaborative of Rural Missouri,1992142582,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",206 N Bismark St,,Concordia,MO,64020-8180,Lafayette,825 S Business Hwy 13,,Lexington,MO,64067,Lafayette,Cathy Wallace,Vice President of Operations,660-259-2440,,cathy@hccnetwork.org,Toniann Richard,CEO,816-249-1529,,,
MO-006135,Conway Family Clinic Inc.,Conway Family Clinic Inc.,1013993898,Rural Health Clinics,301 S Newport Ave,,Conway,MO,65632-8322,Laclede,301 S Newport Ave,,Conway,MO,65632,Laclede,Victor J. Medlock,Office Manager,417-589-2050,,conwayfamilyclinic@centurytel.net,Deanna Twyman,President,417-589-2050,,dtwyman@centurytel.net,
MO-006136,CoxHealth Center Crane,CoxHealth Network,1538529813,Rural Health Clinics,102 Cortney Ln,,Crane,MO,65633-9192,Stone,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006137,Steven D Crawford DO dba Desoto Family Practice,Desoto Family Practice,1588719413,Rural Health Clinics,12 Jefferson Sq,,De Soto,MO,63020-1031,Jefferson,12 Jefferson Square,,Desoto,MO,63020-1031,Jefferson,Renea Crawford,Business Manager/Secretary,636-586-6685,,lanadfp@yahoo.com,,,,,,
MO-006138,Ferguson Medical Group-Dexter Clinic,Ferguson Medical Group,1225225675,"Other ECP Providers, Rural Health Clinics",1516 W Business US Highway 60,,Dexter,MO,63841-2835,Stoddard,1012 N. Main St.,,Sikeston,MO,63801,Scott,"Mechelle W. Farmer, MHCA",Director of Public Relations/Comm. Liaison,573-481-5028,,Mechelle.Farmer@fergusonmedical.com,"Sharon Leonard, MBA",Director of Operations,573-471-0330,305,Sharon.Leonard@fergusonmedical.com,
MO-006139,Drexel Medical Clinic,Cass Regional Medical Center dba Drexel Medical Clinic,1386680510,Other ECP Providers,210 E Main St,,Drexel,MO,64742-2503,Cass,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006140,Ferguson Medical Group-East Prairie Clinic,Ferguson Medical Group,1982625802,"Other ECP Providers, Rural Health Clinics",320 N Lincoln St,,East Prairie,MO,63845-1160,Mississippi,1012 N. Main St.,,Sikeston,MO,63801,Scott,"Mechelle W. Farmer, MHCA",Director of Public Relations/Comm. Liaison,573-481-5028,,Mechelle.Farmer@fergusonmedical.com,"Sharon Leonard, MBA",Director of Operations,573-471-0330,305,Sharon.Leonard@fergusonmedical.com,
MO-006141,Northeast Family Health,"NORTHEAST MISSOURI HEALTH COUNCIL, INC.",1881730893,Federally Qualified Health Centers - Medical Services,104 E Jackson St,,Edina,MO,63537-1335,Knox,1416 Crown Dr,,Kirksville,MO,63501-2548,Adair,Grimm Andrew,CEO,660-627-5757,17,agrimm@nmhcinc.org,Mandy Herleth,Director of Quality Improvement,660-627-5757,30,mherleth@nmhcinc.org,
MO-006142,Compass Health Cedar County Clinic,"COMPASS HEALTH, INC.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",107 W Broadway St,,El Dorado Springs,MO,64744-1133,Cedar,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-351-6281,,astevens@pbhc.org,,,,,,
MO-006143,CCMH MEDICAL MALL CLINIC,CEDAR COUNTY MEMORIAL HOSPITAL,1881608685,Rural Health Clinics,1317 S State Highway 32,,El Dorado Springs,MO,64744-2302,Cedar,1401 S. Park Street,,EL DORADO SPRINGS,MO,64744,Cedar,CARLA GILBERT,Director of Finance,417-876-3097,,cgilbert@ccmh.co,Jana Witt,CEO,417-876-2511,,jwitt@ccmh.co,www.cedarcountyhospital.org
MO-006144,CEDAR COUNTY MEMORIAL HOSPITAL,CEDAR COUNTY MEMORIAL HOSPITAL,1720039605,Inpatient Hospitals (other than children's hospitals),1401 S Park St,,El Dorado Springs,MO,64744-2037,Cedar,1401 S. PARK ST,,EL DORADO SPRINGS,MO,64744,Cedar,CARLA GILBERT,Director of Finance,414-876-3097,,cgilbert@ccmh.co,Jana Witt,CEO,417-876-2511,,jwitt@ccmh.co,www.cedarcountyhospital.org
MO-006145,LAKE REGIONAL CLINIC-ELDON,LAKE REGIONAL HEALTH SYSTEM,1053427492,Rural Health Clinics,304A E 4th St,,Eldon,MO,65026-1808,Miller,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006146,"BIG SPRINGS MEDICAL ASSOCIATION, INC",Big Springs Medical Association dba Missouri Highlands Health Care,1669575908,"Dental Providers, Federally Qualified Health Centers - Medical Services",110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,110 S. 2nd Street,,Ellington,MO,63638,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006147,BIG SPRINGS DENTAL CLINIC,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1770678211,Dental Providers,115 W Walnut St,,Ellington,MO,63638-9300,Reynolds,110 S. 2nd Street,,Ellington,MO,63638,Sainte Genevieve,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006148,Ellington Family Clinic,Missouri Highlands Health Care,1619917598,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",61 Highway Y,,Ellington,MO,63638-7802,Reynolds,110 South Second Street,PO BOX 157,Ellington,MO,63638,Reynolds,Heather Rhea,Admin Assistant/Marketing Manager,573-663-2313,3955,hhedrick@mohigh.org,,,,,,https://www.mohigh.org/locations/ellington-family-clinic/
MO-006149,Shannon County Family Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1972606895,Federally Qualified Health Centers - Medical Services,1003 S Main,,Eminence,MO,65466,Shannon,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006150,Apollo Healthcare,Apollo Healthcare,1245545391,Rural Health Clinics,1031 E Karsch Blvd,,Farmington,MO,63640-3404,Saint Francois,1031 East Karsch Blvd,,Farmington,MO,63640,Saint Francois,Sunil G. Chand,MD,573-756-7880,,chandsmedical@yahoo.com,Synthia Reese,Office Manager,573-756-7880,,chandsmedical@yahoo.com,
MO-006151,Great Mines Health Center,GREAT MINES HEALTH CENTER,1922446384,"Dental Providers, Federally Qualified Health Centers - Medical Services",508 W Pine St,,Farmington,MO,63640-1426,Saint Francois,1 Southtowne Dr,,Potosi,MO,63664-5729,Washington,Michael L Johnson,CEO,573-438-9355,,mjohnson@gmhcenter.org,Greg Roeback,,573-438-9355,,groeback@gmhcenter.org,
MO-006152,"Community Treatment, Inc.","Community Treatment, Inc.",1538588165,Federally Qualified Health Centers - Medical Services,110 N Mill St,,Festus,MO,63028-1816,Jefferson,227 E Main Street,,Festus,MO,63028,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006153,Betty Jean Kerr People's Health Centers,BETTY JEAN KERR - PEOPLE'S HEALTH CENTERS,1518095470,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",11642 W Florissant Ave,,Florissant,MO,63033-6723,Saint Louis,5701 Delmar Blvd,,Saint Louis,MO,63112-2617,Saint Louis City,Dwayne Butler,CEO,314-367-7848,1220,dbutler@phcenters.com,Mark Sanford,Executive Vice President,314-367-7848,1209,msanford@phcenters.com,www.phcenters.com
MO-006154,North County Health Center,Planned Parenthood of the St. Louis Region and Southwest Misosuri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",2782 N Highway 67,,Florissant,MO,63033-1402,Saint Louis,4251 Forest Park Ave.,,St. Louis,MO,63108-2810,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Sr. VP of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,www.ppslr.org
MO-006155,FORDLAND CLINIC,Fordland Clinic,1881607612,"Dental Providers, Federally Qualified Health Centers - Medical Services",1059 Barton Dr,,Fordland,MO,65652-7350,Webster,1059 Barton Drive,,Fordland,MO,65652-7350,Webster,Robert G Marsh,Executive Director,417-767-2273,2021,director@fordlandclinic.org,Joan Twiton,COO,417-767-2273,2022,manager@fordlandclinic.org,www.fordlandclinic.org
MO-006156,Jordan Valley Community Health Center - Forsyth,ADVOCATES FOR A HEALTHY COMMUNITY INC,1033512454,Dental Providers,15479 US Highway 160,,Forsyth,MO,65653-8150,Taney,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006157,Bridges Medical Services,Bridges Medical Services P.C.,1700902244,Rural Health Clinics,256 State Highway Y,,Forsyth,MO,65653-5618,Taney,P.O. Box 1240,,Forsyth,MO,65653,Taney,Heather Culler,Office Manager,417-546-4200,,bridgesbilling@gmail.com,J. Rachelle Bridges,Owner,417-251-2768,,rachellebridges1@gmail.com,
MO-006158,Madison Medical Center,Madison Medical Center,1720163025,Inpatient Hospitals (other than children's hospitals),611 W Main St,,Fredericktown,MO,63645-1111,Madison,611 west main street,,Fredericktown,MO,63645,Madison,LISA TWIDWELL,Administrator,573-783-3341,3311,ltwidwell@madisonmedicalcenter.net,jennifer penuel,COO,573-783-3341,1060,jpenuel@madisonmedicalcenter.net,www.madisonmedicalcenter.net
MO-006159,Beyer Medical Group,Beyer Medical Group,1629286976,Rural Health Clinics,735 W Main St,,Fredericktown,MO,63645-1113,Madison,735 West Main,,Fredericktown,MO,63645-1113,Madison,Fernando Borrego,Administrator,573-783-8875,,Fernando@BeyerMedical.com,,,,,,BeyerMedicalGroup.com
MO-006160,Options Unlimited of Fulton,"East Central Missouri Behavioral Health Services, Inc.",1144293549,Community Mental Health Centers,5060 County Road 306,,Fulton,MO,65251-5436,Callaway,340 Kelley Parkway,,Mexico,MO,65265-8311,Audrain,Terry M. Mackey,CEO,573-581-1196,3011,tmackey@arthurcenter.com,Linda Hopkins,CFO,573-581-1196,3012,lhopkins@arthurcenter.com,https://www.arthurcenter.com
MO-006161,CHCCM- Fulton Clinic,COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI,1316282239,"Dental Providers, Federally Qualified Health Centers - Medical Services",561 Commons Dr,,Fulton,MO,65251-1408,Callaway,1016 E Main St,,Linn,MO,65051-9782,Osage,Toby L Barnett,CFO,573-632-2777,,toby.barnett@chccmo.org,,,,,,
MO-006162,Missouri Ozarks Community Health - GVL,"DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",1598762593,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 Elm St,,Gainesville,MO,65655-9998,Ozark,504 NW 10th Ave,,Ava,MO,65608,Ozark,Tim Shryack,CEO,417-683-4831,110,tshryack@mo-ozarks.org,Randall L Gann,CFO,417-683-4831,132,rgann@mo-ozarks.org,
MO-006163,Garden City Medical Clinic,Cass Regional Medical Center dba Garden City Medical Clinic,1588654784,Rural Health Clinics,101 Old Highway 7 Rd,Suite B,Garden City,MO,64747-8165,Cass,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006164,Gilman City Medical Clinic,"Cameron Regional Medical Center, Inc.",1962845057,Rural Health Clinics,427 Main St,,Gilman City,MO,64642-9714,Harrison,1600 E Evergreen St.,PO Box 557,Cameron,MO,64429,Clinton,Ashley Pittsenbarger,External Clinic Coordinator,816-632-2101,3359,apittsenbarger@cameronregional.org,"Joseph F Abrutz, Jr",Administrator,816-632-2101,3203,pbestgen@cameronregional.org,
MO-006165,Northland Health Center,Planned Parenthood Great Plains,1679614838,Family Planning Providers,2900 NE 60th St,,Gladstone,MO,64119-2094,Clay,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Shirish Malla,Vice President of Health Services,913-345-4662,4662,Shirish.malla@ppgreatplains.org,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,4662,shirish.malla@ppgreatplains.org,http://www.ppgreatplains.org
MO-006166,OCH GOODMAN FAMILY CLINIC,"SGOH ACQUISITION, INC.",1972050581,Rural Health Clinics,125 E Main St,,Goodman,MO,64843-9784,McDonald,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006167,LAKE REGIONAL CLINIC - LAURIE,LAKE REGIONAL HEALTH SYSTEM,1427162254,Rural Health Clinics,156 Missouri Blvd,Suite B,Gravois Mills,MO,65037-5394,Morgan,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8388,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006168,Hamilton Medical Clinic,"NORTHWEST HEALTH SERVICES, INC.",1841312444,Federally Qualified Health Centers - Medical Services,1 Cross St,,Hamilton,MO,64644-8312,Caldwell,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,
MO-006169,McCoy & Samples Dental Clinic - Hamilton,"NORTHWEST HEALTH SERVICES, INC.",1215212980,Dental Providers,500 1/2 S Davis St,,Hamilton,MO,64644-1424,Caldwell,Northwest Health Services,2303 Village Drive,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006170,Hannibal Ambulatory Care Center,"Hannibal Clinic Operations, LLC",1720450216,Rural Health Clinics,100 Medical Dr,,Hannibal,MO,63401-6877,Marion,100 Medical Drive,,Hannibal,MO,63401,Marion,Marsha Moss,Credentialing Coordinator,573-231-3813,,mmoss@hannibalclinic.com,,,,,,
MO-006171,Preferred Family Healthcare dba Clarity Healthcare,"PREFERRED FAMILY HEALTHCARE, INCORPORATED",1639592256,"Dental Providers, Federally Qualified Health Centers - Medical Services",141 Communication Dr,,Hannibal,MO,63401-3670,Marion,900 E Laharpe St,,Kirksville,MO,63501-4520,Marion,Mark Conover,VP of Healthcare Services,573-603-1460,,mconover@clarity-healthcare.org,,,,,,www.clarity-healthcare.org
MO-006172,North East Community Action Corp. NECAC Family Planning Center,North East Community Action Corp.,1356491955,"Family Planning Providers, Sexually Transmitted Disease Clinics",3518 Palmyra Rd,,Hannibal,MO,63401-2212,Marion,16 North Court Street,PO Box 470,Bowling Green,MO,63334,Pike,Brenda K. Fuqua,"Deputy Director, Community Health Service Programs",573-324-2231,10118,bfuqua@necac.org,"Claudia Timbrook, RNC/FNP","Program Director, Family Planning & WIC",573-221-3404,,ctimbrook@necac.org,necac.org
MO-006173,Harrisonville Medical Clinic,Cass Regional Medical Center dba Harrisonville Medical Clinic,1568443711,Rural Health Clinics,2820 E Rock Haven Rd,,Harrisonville,MO,64701-4411,Cass,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0615,,jelliott@cassregional.org,,,,,,
MO-006174,HARTVILLE MEDICAL CLINIC,"HARTVILLE MEDICAL CENTER, PC",1518902352,Rural Health Clinics,275 S School Ave,,Hartville,MO,65667-8406,Wright,271 S. SCHOOL AVE,,HARTVILLE,MO,65667-8406,Wright,WILLIAM E BERNER,CLINIC ADMINISTRATOR,989-892-7722,,Bernermedical@hotmail.com,,,,,,
MO-006175,Hayti Dental Clinic,SOUTHEAST MISSOURI HEALTH NETWORK,1649697566,Dental Providers,214 E Main St,,Hayti,MO,63851-1637,Pemiscot,6738 St. Hwy. 77,,Benton,MO,63736,Stoddard,Aaron Griffin,Policy Director,573-313-2500,,agriffin@semohealthnetwork.org,Chris Jones,CEO,573-313-2500,,cjones@semohealthnetwork.org,
MO-006176,Hayti Medical Center,SOUTHEAST MISSOURI HEALTH NETWORK,1649697566,"Dental Providers, Federally Qualified Health Centers - Medical Services",223 S 3rd St,,Hayti,MO,63851-1617,Pemiscot,311 Main St,,New Madrid,MO,63869-1942,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Aaron Griffin,Policy Director,573-748-2404,,agriffin@semohealthnetwork.org,
MO-006178,WOMEN'S PRIMARY CARE CLINIC,Pemiscot Memorial Health Systems,1992807390,Rural Health Clinics,701 E Lincoln St,,Hayti,MO,63851-1738,Pemiscot,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3623,,clacey@pemiscot.org,,,,,,
MO-006179,Pemiscot Primary Care Center,Pemiscot Memorial Health Systems,1518065291,Rural Health Clinics,907 E Reed St,,Hayti,MO,63851-1242,Pemiscot,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,,,,
MO-006180,PMHS CONVENIENT CARE CLINIC,Pemiscot Memorial Health Systems,1568574341,Rural Health Clinics,946 E Reed St,,Hayti,MO,63851-1243,Pemiscot,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,573-359-6162,,,
MO-006181,Hermann Medical Arts,Hermann Area Hospital District,1982779914,Rural Health Clinics,134 W 6th St,,Hermann,MO,65041-1018,Gasconade,PO Box 19,,Hermann,MO,65041,Gasconade,Ellen Schaumberg,Director of Clinic Operations,573-486-2256,,eschaumberg@hadh.org,,,,,,
MO-006182,Southwest Medical Associates,Hermann Area Hospital District,1295800761,Rural Health Clinics,1714 Wein St,,Hermann,MO,65041-1571,Gasconade,PO Box 19,,Hermann,MO,65041,Gasconade,Ellen Schaumberg,Director of Clinic Operations,573-486-2256,,eschaumberg@hadh.org,,,,,,
MO-006183,Ozarks Resource Group,OZARKS RESOURCE GROUP,1639421050,"Dental Providers, Federally Qualified Health Centers - Medical Services",102 Jackson St,PO Box 125,Hermitage,MO,65668-9231,Hickory,102 Jackson St,PO Box 125,Hermitage,MO,65668,Hickory,Scott Crouch,CEO,417-745-2121,,scott.crouch@ozarkschc.com,,,,,,www.ozarkschc.com
MO-006184,OCHC - Dental Office,OZARKS RESOURCE GROUP,1326453408,Dental Providers,303 Spring St,,Hermitage,MO,65668,Hickory,102 Jackson St,PO Box 125,Hermitage,MO,65668,Polk,Scott Crouch,CEO,417-745-2121,,scott.crouch@ozarkschc.com,,,,,,www.ozarkschc.com
MO-006185,"Community Treatment, Inc.","Community Treatment, Inc.",1356751648,Federally Qualified Health Centers - Medical Services,1817 Gravois Rd,,High Ridge,MO,63049-2668,Jefferson,227 E Main Street,,Festus,MO,63028,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006186,High Ridge Family Medical Center,"Community Treatment, Inc.",1891040077,Federally Qualified Health Centers - Medical Services,324 Emerson Rd,,High Ridge,MO,63049-2542,Jefferson,227 E Main Street,,Festus,MO,63028,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006187,"Community Treatment, Inc.","Community Treatment, Inc.",1477800340,"Dental Providers, Federally Qualified Health Centers - Medical Services",4 Hickory Ridge Rd,,Hillsboro,MO,63050-5100,Jefferson,227 E Main Street,,Festus,MO,63028,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006188,Jefferson County Health Department,Jefferson County Health Department,1376573923,"Family Planning Providers, Sexually Transmitted Disease Clinics",405 Main St,P. O. Box 437,Hillsboro,MO,63050-4351,Jefferson,405 Main Street,,Hillsboro,MO,63050,Jefferson,Mary Greenwall,Family Planning Clinic Coordinator,636-481-2138,,mary.greenwall@jeffcohealth.org,Kelley Vollmar,Director,636-797-3737,104,kelley.vollmar@jeffcohealth.org,www.jeffcohealth.org
MO-006189,"Holden Family Care, LLC","Holden Family Care, LLC",1205154606,Rural Health Clinics,612 E 10th St,,Holden,MO,64040-9421,Johnson,612 E 10th,,Holden,MO,64040,Johnson,Dorothy L. Adams NP,Owner/practitioner,816-732-6010,,hawqv@aol.com,Carol J Jackson,Office Manager,816-732-6010,,jacksoncarol43@gmail.com,holdenfamilycare.com
MO-006190,"Jordan Valley Community Health Center-Gage DR. Hollister, MO",ADVOCATES FOR A HEALTHY COMMUNITY INC,1417388067,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",33 Gage Dr,,Hollister,MO,65672-5862,Taney,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006191,"Jordan Valley Community Health Center - Hollister, MO",ADVOCATES FOR A HEALTHY COMMUNITY INC,1417388067,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",590 Birch Rd,Suite 2B,Hollister,MO,65672-9607,Taney,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006192,"Community Treatment, Inc.","Community Treatment, Inc.",1982023529,"Dental Providers, Federally Qualified Health Centers - Medical Services",4300 Gravois Rd,,House Springs,MO,63051-2304,Jefferson,227 E Main Street,,Festus,MO,63051,Jefferson,Kristy M Neuman,Credentialing Specialist,636-931-2700,1060,kneuman@comtrea.org,Amy Rhodes,CFO,636-931-2700,1105,arhodes@comtrea.org,
MO-006193,LAKE REGIONAL CLINIC-IBERIA,LAKE REGIONAL HEALTH SYSTEM,1891018784,Rural Health Clinics,2333 Highway 17,,Iberia,MO,65486-9331,Miller,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006194,Swope Health Independence,SWOPE HEALTH SERVICES,1477648327,"Dental Providers, Federally Qualified Health Centers - Medical Services",11320 E Truman Rd,,Independence,MO,64050-2564,Jackson,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,Dave Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006195,Swope Health East,SWOPE HEALTH SERVICES,1083914105,Federally Qualified Health Centers - Medical Services,17844 E 23rd St S,,Independence,MO,64057-1840,Jackson,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,Dave Barber,Chief Executive Officer,816-599-5550,,DBARBER@SWOPEHEALTH.ORG,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006196,TMC Fairmount Family Medical Care,Truman Medical Center Inc,1376686600,Outpatient Hospital Clinics,606 S Hardy Ave,,Independence,MO,64053-1827,Jackson,2301 Holmes Street,,Kansas City,MO,64108,Jackson,Dmeter Dragovich,VP Managed Care & Integrated Health Services,816-404-3540,,dmeter.dragovich@tmcmed.org,Gerard Grimaldi,VP Health Policy & Governmental Relations,816-404-3502,,gerard.grimaldi@tmcmed.org,www.trumed.org
MO-006197,Independence Health Center,Planned Parenthood Great Plains,1679614838,"Family Planning Providers, Sexually Transmitted Disease Clinics",815 N Noland Rd,Suite 6,Independence,MO,64050-2975,Jackson,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,4662,Shirish.malla@ppgreatplains.org,Amanda Addison,Vice President of Health Services,913-345-4659,4659,amanda.addison@ppgreatplains.org,http://www.ppgreatplains.org
MO-006198,WRIGHT MEMORIAL JAMESPORT CLINIC,Saint Luke's Health System,1831202431,Rural Health Clinics,301 W 2nd St,,Jamesport,MO,64648-8208,Daviess,901 East 104th St,,Kansas City,MO,64131,Cass,Bob Bonney,Senior VP Network Operations,816-932-3523,,bbonney@saint-lukes.org,,,,,,
MO-006199,Jefferson City Stadium Clinic,Community Health Center of Central Missouri,1790922920,Federally Qualified Health Centers - Medical Services,1905 Stadium Blvd,,Jefferson City,MO,65109-1961,Cole,PO Box 104780,,Jefferson City,MO,65110,Cole,Sarah Trowbridge,Director of Business Services,573-632-2777,5106,sarah.trowbridge@chccmo.org,Jeff Davis,CEO,573-632-2777,,jeff.davis@chccmo.org,
MO-006201,SSM St. Mary's Jefferson City,SSM Regional Health Services,1518065523,Inpatient Hospitals (other than children's hospitals),2505 Mission Dr,,Jefferson City,MO,65109-9508,Cole,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Brent Vanconia,President SSM Health Care of Mid Missouri,573-681-3121,,Robert_Vanconia@ssmhc.com,,,,,,
MO-006202,CHCCM Jefferson City Clinic,COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI,1427225275,"Dental Providers, Federally Qualified Health Centers - Medical Services",3400 W Truman Blvd,,Jefferson City,MO,65109-5712,Cole,1016 E Main St,,Linn,MO,65051-9782,Osage,Toby L Barnett,CFO,573-632-2777,,toby.barnett@chccmo.org,,,,,,
MO-006204,Access Family Care,Access Family Care,1376582346,Dental Providers,530 S Maiden Ln,,Joplin,MO,64801-3084,Jasper,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006205,Access Family Care-Medical Joplin,Access Family Care,1538151733,Federally Qualified Health Centers - Medical Services,530 S Maiden Ln,,Joplin,MO,64801-3084,Jasper,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006206,Access Family Care-Pediatrics Joplin,Access Family Care,1992995120,Federally Qualified Health Centers - Medical Services,530 S Maiden Ln,,Joplin,MO,64801-3084,Jasper,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006207,Planned Parenthood of the St. Louis Region and Southwest Missouri,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",710 Illinois Ave,,Joplin,MO,64801-5005,Jasper,4251 Forest Park Ave.,,St. Louis,MO,63108,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Sr. VP of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,www.ppslr.org
MO-006208,Patty Brous Health Center,Planned Parenthood Great Plains,1679614838,"Family Planning Providers, Sexually Transmitted Disease Clinics",1001 Emanuel Cleaver II Blvd,,Kansas City,MO,64110-1687,Jackson,4401 W 109th St # 200,,Overland Park,KS,66211-1303,Johnson,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,4662,Shirish.malla@ppgreatplains.org,Amanda Addison,Vice President of Health Services,913-345-4659,4659,amanda.addison@ppgreatplains.org,http://www.ppgreatplains.org
MO-006209,Samuel U. Rodgers Health Center Cabot Westside,"SAMUEL U RODGERS HEALTH CENTER, INC.",1073950135,"Dental Providers, Federally Qualified Health Centers - Medical Services",2121 Summit St,,Kansas City,MO,64108-2126,Jackson,825 Euclid Ave,,Kansas City,MO,64124-2323,Jackson,Hilda Fuentes,President & Chief Executive Officer,816-889-4600,,HFuentes@rodgershealth.org,,,,,,
MO-006210,TMC Hospital Hill Outpatient Clinics,Truman Medical Center Inc,1467595793,"Dental Providers, Outpatient Hospital Clinics",2301 Holmes St,,Kansas City,MO,64108-2640,Jackson,2301 Holmes Street,,Kansas City,MO,64108,Jackson,Dmeter Dragovich,VP Managed Care & Integrated Health Services,816-404-3540,,dmeter.dragovich@tmcmed.org,Gerard Grimaldi,VP Health Policy & Governmental Relations,816-404-3502,,gerard.grimaldi@tmcmed.org,www.trumed.org
MO-006211,Truman Medical Center Hospital Hill,Truman Medical Center Inc,1467595793,Inpatient Hospitals (other than children's hospitals),2301 Holmes St,,Kansas City,MO,64108-2640,Jackson,2301 Holmes Street,,Kansas City,MO,64108,Jackson,Dmeter Dragovich,VP Managed Care & Integrated Health Services,816-404-3540,,dmeter.dragovich@tmcmed.org,Gerard Grimaldi,VP Health Policy & Governmental Relations,816-404-3502,,gerard.grimaldi@tmcmed.org,www.trumed.org
MO-006212,Kansas City CARE Clinic - Meyer,Kansas City CARE Clinic,1396101317,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2340 E Meyer Blvd,Suite 200 Bldg 1,Kansas City,MO,64132-1121,Jackson,3515 Broadway Blvd,,Kansas City,MO,64111,Jackson,Sheilahn Davis-Wyatt,COO,816-777-2795,,sheilahndw@kccareclinic.org,Sheri Wood,President and CEO,816-777-2763,,sheriw@kccareclinic.org,www.kccareclinic.org
MO-006213,CHILDREN'S MERCY HOSPITAL (children's inpatient hospital),Children's Mercy Hospital (The),1366515488,Children's Hospitals (inpatient only),2401 Gillham Rd,,Kansas City,MO,64108-4619,Jackson,2401 Gillham Rd,,Kansas City,MO,64108,Jackson,Chad M. Moore,Sr. Director of Payer Relations,816-559-9374,,cmoore@cmpcn.org,,,816-234-3000,,,http://www.childrensmercy.org
MO-006214,CHILDREN'S MERCY HOSPITAL (dental provider),Children's Mercy Hospital (The),1366515488,Dental Providers,2401 Gillham Rd,,Kansas City,MO,64108-4619,Jackson,2401 Gillham Rd,,Kansas City,MO,64108,Jackson,Chad M. Moore,Sr. Director of Payer Relations,816-559-9374,,cmoore@cmpcn.org,,,816-234-3000,,,http://www.childrensmercy.org
MO-006215,Kansas City Regional Hemophilia Center,Children's Mercy Hospital,1043473556,Hemophilia Treatment Centers,2401 Gillham Rd,,Kansas City,MO,64108-4619,Jackson,2401 Gillham Road,,Kansas City,MO,64108,Jackson,Kim Hendricks,Bleeding & Clotting Disorders Program Manager,816-302-6843,,khendricks@cmh.edu,Shannon Carpenter,Hemophilia Treatment Center Medical Director,816-302-6882,,slcarpenter@cmh.edu,
MO-006216,Swope Health Maple Woods,Swope Health Services,1518402965,Federally Qualified Health Centers - Medical Services,3100 NE 83rd St,Suite 1001,Kansas City,MO,64119-4460,Clay,3801 Blue Parkway,,Kansas City,MO,64130,Jackson,David R. Barber,CEO,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,CFO/COO,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006217,CMH Teen Clinic,Children's Mercy Hospital (The),1366515488,Family Planning Providers,3101 Broadway Blvd,,Kansas City,MO,64111-2659,Jackson,2401 Gillham Road,,Kansas City,MO,64108,Jackson,Chad M. Moore,Sr. Director of Payer Relations,816-559-9372,,cmoore@cmpcn.org,,,,,,http://www.childrensmercy.org
MO-006218,Kansas City CARE Clinic- Broadway,Kansas City CARE Clinic,1215273388,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3515 Broadway Blvd,,Kansas City,MO,64111-2537,Jackson,3515 Broadway Blvd,,Kansas City,MO,64111,Jackson,Sheilahn Davis-Wyatt,COO,816-777-2765,1265,sheilahndw@kccareclinic.org,Sheri Wood,President and CEO,816-777-2763,,sheriw@kccareclinic.org,https://www.kccareclinic.org/
MO-006219,Swope Health Central,SWOPE HEALTH SERVICES,1689760076,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,David Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006220,Children's Mercy Hospitals and Clinics - Northland Teen Clinic,Children's Mercy Hospital (The),1366515488,Family Planning Providers,501 NW Barry Rd,Suite C,Kansas City,MO,64155-2961,Clay,501 NW Barry Rd,,Kansas City,MO,64155-2732,Jackson,Chad M. Moore,Sr. Director of Payer Relations,816-559-9374,,cmoore@cmpcn.org,,,,,,
MO-006221,Samuel U. Rodgers Health Center J.A. Rogers Family Dental,"SAMUEL U RODGERS HEALTH CENTER, INC.",1114236189,Dental Providers,6400 E 23rd St,,Kansas City,MO,64129-1103,Jackson,825 Euclid Avenue,,Kansas City,MO,64124,Jackson,Hilda Fuentes,President & Chief Executive Officer,816-889-4600,,HFuentes@rodgershealth.org,,,,,,
MO-006222,Samuel U. Rodgers Health Center Downtown Campus,"SAMUEL U RODGERS HEALTH CENTER, INC.",1578570982,"Dental Providers, Federally Qualified Health Centers - Medical Services",825 Euclid Ave,,Kansas City,MO,64124-2323,Jackson,825 Euclid Ave,,Kansas City,MO,64124-2323,Jackson,Hilda Fuentes,President & Chief Executive Officer,816-889-4600,,HFuentes@rodgershealth.org,,,,,,
MO-006223,Swope Health Services - Hickman Mills,Swope Health Services,1154796217,Federally Qualified Health Centers - Medical Services,8800 Blue Ridge Blvd,Suite 208,Kansas City,MO,64138-4061,Jackson,3801 Blue Parkway,,Kansas City,MO,64130,Jackson,Dave Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006224,SWOPE HEALTH SOUTH,SWOPE HEALTH SERVICES,1396045423,Federally Qualified Health Centers - Medical Services,8825 Troost Ave,,Kansas City,MO,64131-4731,Jackson,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,Dave Barber,Chief Executive Officer,816-599-5550,,dbarber@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006225,Scheidler Family Clinic,Scheidler Rural Health Clinic LLC,1275686883,Rural Health Clinics,301 South Byp,,Kennett,MO,63857-3252,Dunklin,301 South Bypass,,Kennett,MO,63857,Dunklin,CHRISTINA RAYBURN,Office Manager,573-888-0900,,officemanager@kennettdoctor.com,,,,,,http://www.kennettdoctor.com
MO-006226,Otto Bean Medical Clinic,SOUTHEAST MISSOURI HEALTH NETWORK,1710108766,"Dental Providers, Federally Qualified Health Centers - Medical Services",500 Russell St,,Kennett,MO,63857-2102,Dunklin,420 SEMO Dr.,,New Madrid,MO,63869-1942,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Aaron Griffin,Policy Director,573-748-2404,,agriffin@semohealthnetwork.org,
MO-006227,Twin Rivers Medical Group - Women's Center,"Kennett HMA, LLC",1023342987,Rural Health Clinics,509 South Byp,,Kennett,MO,63857-3248,Dunklin,509 S Bypass Rd,,Kennett,MO,63857,Dunklin,Matthew McGuire,Director of Physician Practice Managment,573-888-8587,8587,matthew.mcguire@twinriversregional.com,,,,,,
MO-006228,Tri-Lakes Community Health Center,Fordland Clinic,1639421365,"Dental Providers, Federally Qualified Health Centers - Medical Services",11863 State Highway 13,Suite 1,Kimberling City,MO,65686-8372,Stone,1059 Barton Drive,,Fordland,MO,65652-7350,Webster,Robert G Marsh,Executive Director,417-767-2273,2021,director@fordlandclinic.org,Joan Twiton,COO,417-767-2273,2022,manager@fordlandclinic.org,www.tri-lakeschc.org
MO-006229,CoxHealth Center Kimberling City,CoxHealth Network,1053499707,Rural Health Clinics,2 Kimberling Manor Est,,Kimberling City,MO,65686-9463,Stone,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth",417-269-7434,,david.raney@coxhealth.com,
MO-006230,King City Clinic,"NORTHWEST HEALTH SERVICES, INC.",1790806842,Federally Qualified Health Centers - Medical Services,305 Rhode Island St,,King City,MO,64463-9622,Gentry,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006231,Kingsville Medical Clinic,Cass Regional Medical Center dba Kingsville Medical Clinic,1518269257,Rural Health Clinics,305 E Pacific St,,Kingsville,MO,64061-2512,Johnson,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006232,Northeast Family Health,"NORTHEAST MISSOURI HEALTH COUNCIL, INC.",1962548974,Federally Qualified Health Centers - Medical Services,1506 Crown Dr,,Kirksville,MO,63501-2553,Adair,1416 Crown Dr,,Kirksville,MO,63501-2548,Adair,Andy Grimm,CEO,660-627-5757,17,agrimm@nmhcinc.org,Mandy Herleth,Director of Quality Improvement,660-627-5757,30,mherleth@nmhcinc.org,
MO-006233,OB/GYN Specialty Group,Northeast Missouri Health Council,1326184334,Federally Qualified Health Centers - Medical Services,402 W Jefferson St,,Kirksville,MO,63501-3407,Adair,1416 Crown Dr,,Kirksville,MO,63501,Adair,Andy Grimm,CEO,660-627-5757,17,agrimm@nmhcinc.org,Mandy Herleth,Director of Quality Improvement,660-627-5757,30,mherleth@nmhcinc.org,
MO-006234,LAKE REGIONAL CLINIC - LAKE OZARK,LAKE REGIONAL HEALTH SYSTEM,1700177128,Rural Health Clinics,1870 Bagnell Dam Blvd,,Lake Ozark,MO,65049-8658,Miller,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8388,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006235,SSM Health Medical Group,SSM Regional Health Services,1558308742,Rural Health Clinics,2265 Bagnell Dam Blvd,Suite 103,Lake Ozark,MO,65049-8603,Miller,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006236,Tri Rivers Family Planning Lake Center,"Tri-Rivers Family Planning, Inc.",1710025754,Family Planning Providers,2545 Bagnell Dam Blvd,Suite 209,Lake Ozark,MO,65049-9806,Miller,PO Box 359,,Rolla,MO,65402,Phelps,Lisa Ecsi Davis,Director of Operations,573-364-1509,,lisa@tririversfamilyplanning.org,Tonia Stubblefield,CEO,573-364-1509,,toni@tririversfamilyplanning.org,www.tririversfamilyplanning.org
MO-006237,ACCESS Family Care Lamar,Ozark Tri-County Health Care Consortium,1487020418,Federally Qualified Health Centers - Medical Services,210 W 10th St,,Lamar,MO,64759-1405,Barton,4301 Doniphan Drive,,Neosho,MO,64850,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,,,,,,www.accessfamilycare.org
MO-006238,"Jordan Valley Community Health Center - Lebanon, MO","Advocates for a Healthy Community, Inc. dba Jordan Valley Community Health Center",1356424352,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1216 Deadra Dr,,Lebanon,MO,65536-4669,Laclede,618 N Benton Ave Ste 100,,Springfield,MO,65806,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006239,"Samuel U. Rodgers Health Center Lafayette Family Medicine, Dental & Services","SAMUEL U RODGERS HEALTH CENTER, INC.",1164614053,"Dental Providers, Federally Qualified Health Centers - Medical Services",811 S Business Highway 13,Suite A,Lexington,MO,64067-1572,Lafayette,825 Euclid Ave,,Kansas City,MO,64124-2323,Jackson,Hilda Fuentes,President & Chief Executive Officer,816-889-4600,,HFuentes@rodgershealth.org,,,,,,
MO-006240,Samuel U. Rodgers Health Center Clay County,"SAMUEL U RODGERS HEALTH CENTER, INC.",1982931655,Federally Qualified Health Centers - Medical Services,800 Haines,,Liberty,MO,64068-1006,Clay,825 Euclid Ave,,Kansas City,MO,64124-2323,Jackson,Hilda Fuentes,President & Chief Executive Officer,816-889-4600,,HFuentes@rodgershealth.org,,,,,,
MO-006241,Linn,Community Health Center of Central Missouri,1538213244,"Dental Providers, Federally Qualified Health Centers - Medical Services",1016 E Main St,,Linn,MO,65051-9782,Osage,1016 E Main St,,Linn,MO,65051,Osage,Toby Barnett,CFO,573-632-2777,,toby.barnett@chccmo.org,,,,,,
MO-006242,PCMH Clinics,Pike County Memorial Hospital,1437265311,Sexually Transmitted Disease Clinics,2305 Georgia St,,Louisiana,MO,63353-2559,Pike,2305 Georgia Street,,Louisiana,MO,63353,Pike,Tami Schneidler,Clinic Director,573-754-5531,,Contact@PCMH-MO.org,Casey Wommack,Business Office Director,573-754-5531,,Contact@PCMH-MO.org,http://www.pcmh-mo.org
MO-006243,PIKE COUNTY MEMORIAL HOSPITAL,Pike County Memorial Hospital,1205837218,Rural Health Clinics,2305 Georgia St,,Louisiana,MO,63353-2559,Pike,2305 Georgia Street,,Louisiana,MO,63353,Pike,Casey Wommack,Business Office Director,573-754-5531,,Contact@pcmh-mo.org,,,,,,http://www.pcmh-mo.org
MO-006244,LAKE REGIONAL CLINIC - MACKS CREEK,LAKE REGIONAL HEALTH SYSTEM,1346530797,Rural Health Clinics,14298 W US Highway 54,,Macks Creek,MO,65786-6730,Camden,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006245,Macon Family Health,Northeast Missouri Health Council,1487038881,Federally Qualified Health Centers - Medical Services,209 N Missouri St,,Macon,MO,63552-2151,Macon,1416 Crown Dr,,Kirksville,MO,63501,Adair,Mandy Herleth,Director of Quality Improvement,660-627-5757,30,mherleth@nmhcinc.org,,,,,,
MO-006246,West County Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",1 Stonegate Ctr,,Manchester,MO,63088-1215,Saint Louis,4251 Forest Park Ave,,Saint Louis,MO,63108-2810,Saint Louis,Mary M. Kogut,Vice President of Patient Services,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Vice President of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,http://www.ppslr.org
MO-006247,Missouri Ozarks Community Health - MFD,"DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",1912904004,"Dental Providers, Federally Qualified Health Centers - Medical Services",804 N Highway 5,,Mansfield,MO,65704-7301,Wright,504 NW 10th Ave,,Ava,MO,65608,Douglas,Tim Shryack,CEO,417-683-4831,110,tshryack@mo-ozarks.org,Randall L Gann,CFO,417-683-4831,132,rgann@mo-ozarks.org,
MO-006248,CROSS TRAILS MEDICAL CENTER,CROSS TRAILS MEDICAL CENTER,1962565499,"Dental Providers, Federally Qualified Health Centers - Medical Services",109 Hwy 51 North,,Marble Hill,MO,63764,Bollinger,408 S Broadview St,,Cape Girardeau,MO,63703-5725,Cape Girardeau,Ron Camp,CEO,573-339-1196,,rcamp@crosstrails.us,Chrissy Warren,COO,573-339-1196,,cwarren@crosstrails.us,
MO-006249,Marble Hill Medical Clinic LLC,Marble Hill Medical Clinic LLC,1194022921,Rural Health Clinics,307 Broadway St,,Marble Hill,MO,63764-8321,Bollinger,307 Broadway Street,,Marble Hill,MO,63764,Bollinger,Natalie Fluchel,Medical Billing,573-450-7606,,nataliefluchel@yahoo.com,,,,,,
MO-006250,Family Health Center @ Marceline,Family Health Center of Boone County,1407855158,Federally Qualified Health Centers - Medical Services,1600 N Kansas Ave,,Marceline,MO,64658,Linn,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Jack Kelly,COO,573-886-6761,,jkelly@fhcmo.org,www.fhcmo.org
MO-006251,Family Dental Center @ Marceline,Family Health Center of Boone County,1972920213,Dental Providers,1600 North Kansas,,Marceline,MO,64658,Linn,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Luann Roberts,Business Operations Manager,573-886-6741,,lroberts@fhcmo.org,www.fhcmo.org
MO-006252,Katy Trail Community Health - Marshall,Regional Health Care Clinic Inc.,1972981942,Federally Qualified Health Centers - Medical Services,1825 Atchison Ave,,Marshall,MO,65340-9752,Saline,821 Westwood Dr.,,Sedalia,MO,65301,Pettis,Steve Bevans,Chief Financial Officer,660-826-1571,2,sbevans@katyhealth.org,Christine Stewart,Chief Executive officer,660-826-1571,3,cstewart@katyhealth.org,
MO-006253,FITZGIBBON PROFESSIONAL BUILDING,"JOHN FITZGIBBON MEMORIAL HOSPITAL, INC",1215059985,Rural Health Clinics,2305 S Highway 65,Bldg A,Marshall,MO,65340-3702,Saline,2305 South 65 Highway,,Marshall,MO,65340-3702,Saline,Holly Rayl,Director of Financial Services,660-831-3700,271,hrayl@fitzgibbon.org,Lori Benedick,Patient Accounts Manager,660-831-3700,728,lbenedick@fitzgibbon.org,
MO-006254,FITZGIBBON HOSPITAL,"JOHN FITZGIBBON MEMORIAL HOSPITAL, INC",1730182478,Inpatient Hospitals (other than children's hospitals),2305 S Hwy 56,,Marshall,MO,65340,Saline,2305 South 65 Highway,,Marshall,MO,65340-3702,Saline,Holly Rayl,Director of Financial Services,660-831-3700,271,hrayl@fitzgibbon.org,Lori Benedick,Patient Accounts Manager,660-831-3700,728,lbenedick@fitzgibbon.org,
MO-006255,"Jordan Valley Community Health Center - Marshfield, MO.","Advocates for a Healthy Community, Inc. dba Jordan Valley Community Health Center",1356519524,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1166 Banning St,,Marshfield,MO,65706-1015,Webster,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006256,"Tri-County Psychological Services, Inc.","Tri-County Psychological Services, Inc.",1548306855,Other ECP Providers,541 W Hubble Dr,,Marshfield,MO,65706-1532,Webster,PO Box 256,,Marshfield,MO,65706,Webster,Gwendolyn M. Lawson,Clinic Administrator,417-859-7746,,tcpsych@yahoo.com,Gayla Heape,Clinic Manager,417-859-7746,,tcpsych@yahoo.com,www.ozarkscare.com
MO-006257,OCH WELLPOINTE FAMILY MEDICAL CLINIC,"SGOH ACQUISITION, INC.",1225338155,Rural Health Clinics,543 W Hubble Dr,,Marshfield,MO,65706-1532,Webster,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006258,CoxHealth Center Marshfield,CoxHealth Network,1972533347,Rural Health Clinics,941 E Hubble Dr,,Marshfield,MO,65706-2538,Webster,3554 S National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006259,Meadville Medical Clinic,Pershing Health System,1285995944,Rural Health Clinics,101 E Hayward St,,Meadville,MO,64659-9201,Linn,130 E. Lockling,,Brookfield,MO,64628,Linn,Lorna Woodside,Clinic Director,660-258-1050,1041,cma_manager@phsmo.org,Gary Tandy,CFO,660-258-2222,1288,cfo@pershinghealthsystem.com,phsmo.org
MO-006260,Audrain County Health Department,Audrain County Health Department,1023099439,"Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1130 S Elmwood Dr,PO Box 957,Mexico,MO,65265-1373,Audrain,PO Box 957,1130 S. Elmwood Drive,Mexico,MO,65265-0957,Audrain,"Sandra M. Hewlett, MS, APRN, CBCN, FACHE",Administrator & CEO,573-581-1332,25,shewlett@audraincountyhealth.org,"Chris Schroeder, BS, CPA",Accounting & HR Manager,573-581-1332,35,cschroeder@audraincountyhealth.org,www.audraincountyhealth.org
MO-006261,Arthur Center Community Health,"East Central Missouri Behavioral Health Services, Inc.",1265853063,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",340 Kelley Pkwy,,Mexico,MO,65265-3811,Audrain,340 Kelley Parkway,,Mexico,MO,65265,Audrain,Terry M. Mackey,Chief Executive Officer,573-581-1196,3011,tmackey@arthurcenter.com,Linda Hopkins,Chief Financial Officer,573-581-1196,3012,lhopkins@arthurcenter.com,https://www.arthurcenter.com
MO-006262,SSM Health Medical Group - Pediatrics,SSM Regional Health Services,1457469637,Rural Health Clinics,3626 S Clark St,Suite A,Mexico,MO,65265-4104,Audrain,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006263,SSM Health Medical Group/Internal Medicine,SSM Regional Health Services,1871503466,Rural Health Clinics,600 Medical Park Dr,,Mexico,MO,65265-3724,Audrain,2505 Mission Dr.,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006264,"SSM Audrain Health Care, Inc.",St. Mary's Hospital-Audrain,1952390122,Inpatient Hospitals (other than children's hospitals),620 E Monroe St,,Mexico,MO,65265-2919,Audrain,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Donna Jacobs,President SSM Audrain Health Center,573-581-8100,,Donna_Jacobs@ssmhc.com,Brent VanConia,President SSM Health Care of Mid Missouri,573-681-3121,,Robert_VanConia@ssmhc.com,
MO-006265,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1467462010,Rural Health Clinics,626 E Summit St,Suite L,Mexico,MO,65265-3298,Audrain,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006266,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1790838316,Rural Health Clinics,809 Medical Park Dr,Suite 101,Mexico,MO,65265-3753,Audrain,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-581-8100,,michael.baumgartner@ssmhealth.com,
MO-006267,Northeast Family Health,"NORTHEAST MISSOURI HEALTH COUNCIL, INC.",1144366154,Federally Qualified Health Centers - Medical Services,52334 Business Highway 5,,Milan,MO,63556-3040,Sullivan,1416 Crown Dr,,Kirksville,MO,63501-2548,Adair,Andy Grimm,CEO,660-627-5757,17,agrimm@nmhcinc.org,Mandy Herleth,Director of Quality Improvement,660-627-5757,30,mherleth@nmhcinc.org,
MO-006268,Randolph County Health Department,Randolph County Health Department,1194805267,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",423 E Logan St,Randolph County Health Department,Moberly,MO,65270-2222,Randolph,Randolph County Health Department,423 East Logan St.,Moberly,MO,65270,Randolph,Debra Laird,Administrator,660-263-6643,3005,lairdd@randolphcountyhealth.org,Sharon Wisenand,Chief Finance Officer,660-263-6643,3048,whises@randolphcountyhealth.org,
MO-006269,Family & Occupational Medicine of Monett,CoxHealth Network,1275993552,Rural Health Clinics,2200 E Cleveland St,,Monett,MO,65708-6149,Lawrence,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006270,Cox Family Medicine of Monett,CoxHealth Network,1972963254,Rural Health Clinics,307 W Benton St,,Monett,MO,65708-1665,Barry,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David.Raney@coxhealth.com,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006271,Cox Monett Hospital,CoxHealth Network,1194757500,Inpatient Hospitals (other than children's hospitals),801 N Lincoln Ave,,Monett,MO,65708-1641,Barry,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006272,Family Practice & Obstetrics of Monett,CoxHealth Network,1790145076,Rural Health Clinics,815 N Lincoln Ave,,Monett,MO,65708-1641,Barry,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006273,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1407865710,Rural Health Clinics,240 Pickering St,,Montgomery City,MO,63361-1941,Montgomery,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006274,Associated Medical Arts,Hermann Area Hospital District,1811062375,Rural Health Clinics,504 N Sturgeon St,,Montgomery City,MO,63361-1829,Montgomery,PO Box 19,,Hermann,MO,65041,Gasconade,Ellen Schaumberg,Director of Clinic Operations,573-486-2256,,eschaumberg@hadh.org,,,,,,
MO-006275,Mound City Clinic,"NORTHWEST HEALTH SERVICES, INC.",1437270915,"Dental Providers, Federally Qualified Health Centers - Medical Services",1303 State St,,Mound City,MO,64470-1717,Holt,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006277,Mt. Vernon Clinic,Mt. Vernon Clinic,1649332156,Rural Health Clinics,1011 S East St,,Mount Vernon,MO,65712-1331,Lawrence,1011 South East st,,Mt.Vernon,MO,65712,Lawrence,Kim Roberts,Office Manager,417-466-7191,502,cowgirlcat@live.com,,,,,,
MO-006278,CoxHealth Center Mt. Vernon,CoxHealth Network,1780778449,Rural Health Clinics,10763 Highway 39,Suite 200,Mount Vernon,MO,65712-7855,Lawrence,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006279,OCH LAWRENCE COUNTY CLINIC,"SGOH ACQUISITION, INC.",1568502631,Rural Health Clinics,108 S Hickory St,,Mount Vernon,MO,65712-1407,Lawrence,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006280,CoxHealth Center Mountain Grove,CoxHealth Network,1871539023,Rural Health Clinics,1602A N Main St,,Mountain Grove,MO,65711-1010,Wright,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006281,Missouri Ozarks Community Health - MG,"DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",1518342153,"Dental Providers, Federally Qualified Health Centers - Medical Services",1604C N Main St,,Mountain Grove,MO,65711-1010,Wright,504 NW 10th Ave,,Ava,MO,65608,Douglas,Tim Shryack,CEO,417-683-4831,110,tshryack@mo-ozarks.org,Randall L Gann,CFO,417-683-4831,132,rgann@mo-ozarks.org,
MO-006282,"Mountain Grove Medical and Laser Center,pc","Mountain Grove Medical and Laser Center,pc",1972573699,Rural Health Clinics,601 N Busch Ave,,Mountain Grove,MO,65711-1415,Wright,601 N. Busch,,Mountain Grove,MO,65711,Wright,William E. Berner,Admin.,989-892-7722,,Bernermedical@hotmail.com,Laurie K.Berner,Assistant Admin.,989-892-7722,,bernermedical@hotmail.com,
MO-006283,Naylor Medical Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1104920420,Federally Qualified Health Centers - Medical Services,220 E. Broad St,,Naylor,MO,63953,Ripley,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006284,Economic Security Corp of Southwest Area Neosho,Economic Security Corporation of Southwest Area,1790106938,Family Planning Providers,116 N Jefferson St,,Neosho,MO,64850-1546,Newton,302 S Joplin,,Joplin,MO,64801,Jasper,Ryan Peterson,Director of Woman's Health,417-781-4788,,rpeterson@escswa.org,Donna White,Nurse Practitioner,417-781-4788,276,dwhite@escswa.org,https://www.escswa.org/index.html
MO-006285,Access Family Care-Medical Neosho,Access Family Care,1508168782,Federally Qualified Health Centers - Medical Services,412 E McKinney St,,Neosho,MO,64850-1913,Newton,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006286,Access Family Care,Access Family Care,1013368984,Dental Providers,516 W McCord St,,Neosho,MO,64850-1424,Newton,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006287,Access Family Care,Access Family Care,1558712422,Dental Providers,204 N Cedar St,,Nevada,MO,64772-2310,Vernon,PO Box 758,,Neosho,MO,64850-9120,Newton,Sheila Long,CFO,417-451-9450,210,sheila.long@accessfamilycare.org,Don McBride,CEO,417-451-9450,212,don.mcbride@accessfamilycare.org,www.accessfamilycare.org
MO-006289,NowCare Clinic,Nevada Regional Medical Center,1427385517,Rural Health Clinics,345 S Barrett Ln,,Nevada,MO,64772-4255,Vernon,345 S Barrett,,Nevada,MO,64772,Vernon,Michelle Casey,PFS Director,417-667-3355,2432,mcasey@nrmchealth.com,,,,,,
MO-006290,Nevada Regional Primary Care Clinic,Nevada Regional Medical Center,1144605312,Rural Health Clinics,627 S Ash St,,Nevada,MO,64772-3218,Vernon,627 S Ash,,Nevada,MO,64772,Vernon,Michelle Casey,PFS Director,417-667-3355,2432,mcasey@nrmchealth.com,,,,,,
MO-006291,Nevada City Hospital DBA Nevada Regional Medical Center,Nevada Regional Medical Center,1942283866,Inpatient Hospitals (other than children's hospitals),800 S Ash St,,Nevada,MO,64772-3224,Vernon,800 S Ash,,Nevada,MO,64772,Vernon,Michelle Casey,PFS Director,417-667-3355,2432,mcasey@nrmchealth.com,,,,,,
MO-006292,NEVADA MEDICAL CLINIC,"Nevada Medical Clinic, LLC",1104821867,Rural Health Clinics,900 S Adams St,,Nevada,MO,64772-3210,Vernon,900 South Adams,,Nevada,MO,64772,Vernon,David Harms,Administrator,417-667-6015,341,dharms@nevadamedicalclinic.com,Sheryl Torres,Financial Officier,417-667-6015,376,storres@nevadamedicalclinic.com,
MO-006293,BOOTHEEL DENTAL CLINIC,SOUTHEAST MISSOURI HEALTH NETWORK,1457570681,Dental Providers,202B Main St,,New Madrid,MO,63869-1911,New Madrid,420 SEMO Dr.,,New Madrid,MO,63869,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Aaron Griffin,Policy Director,573-748-2404,,agriffin@semohealthnetwork.org,
MO-006294,New Madrid Family Clinic,SOUTHEAST MISSOURI HEALTH NETWORK,1609095975,"Dental Providers, Federally Qualified Health Centers - Medical Services",421 Semo Dr,,New Madrid,MO,63869-1733,New Madrid,420 SEMO Dr.,,New Madrid,MO,63869-1942,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Aaron Griffin,Policy Director,573-748-2404,,agriffin@semohealthnetwork.org,
MO-006295,OCH MCDONALD COUNTY CLINIC,"SGOH ACQUISITION, INC.",1386985521,Rural Health Clinics,125 Main St,,Noel,MO,64854-9124,McDonald,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006296,Compass Health - Odessa,"COMPASS HEALTH, INC.",1245669266,Federally Qualified Health Centers - Medical Services,1278 W. Us 40 Hwy,,Odessa,MO,64076,Lafayette,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006297,North East Community Action Corporation Family Planning Center,North East Community Action Corp.,1467584367,"Family Planning Providers, Sexually Transmitted Disease Clinics",3400 Meadow Pointe Dr,,O'Fallon,MO,63365,Saint Charles,16 North Court Street,PO Box 470,Bowling Green,MO,63366,Pike,Brenda K. Fuqua,"Deputy Director, Community Health Service Programs",573-324-2231,10118,bfuqua@necac.org,"Claudia Timbrook, RNC/FNP","Program Director, Family Planning & WIC",573-221-3404,,ctimbrook@necac.org,necac.org
MO-006298,LAKE REGIONAL CLINIC - OSAGE BEACH,LAKE REGIONAL HEALTH SYSTEM,1245520691,Rural Health Clinics,1057 Medical Park Dr,Suite A,Osage Beach,MO,65065-3000,Camden,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8399,,DHALSELL@LAKEREGIONAL.COM,
MO-006299,Central Ozarks Medical Center,RICHLAND MEDICAL CENTER INC,1891931978,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3870 Columbia Ave,,Osage Beach,MO,65065-8689,Miller,304 W Washington Ave,,Richland,MO,65556-7101,Pulaski,Robert Stiles,CEO,573-765-5131,,rstiles@centralozarks.org,Paul Bocci,CFO,573-765-5131,,pbocci@centralozarks.org,www.centralozarks.org
MO-006300,LAKE REGIONAL HEALTH SYSTEM,LAKE REGIONAL HEALTH SYSTEM,1386619450,Inpatient Hospitals (other than children's hospitals),54 Hospital Dr,,Osage Beach,MO,65065-3050,Camden,54 HOSPITAL DRIVE,,OSAGE BEACH,MO,65065,Camden,JESSICA HASTY,Managed Care Coordinator,573-348-8399,,JHASTY@LAKEREGIONAL.COM,DAVID HALSELL,CFO,573-348-8388,,DHALSELL@LAKEREGIONAL.COM,
MO-006301,Compass Health - Osceola,Compass Health,1699104687,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 Hospital Dr,,Osceola,MO,64776-9547,Saint Clair,1800 Community Drive,,Clinton,MO,64735,Henry,Alan Stevens,"Executive Vice President, Health Center Operations",660-351-6281,,astevens@pbhc.org,,,,,,
MO-006302,GOLDEN VALLEY MEDICAL - OSCEOLA,Golden Valley Memorial Healthcare,1124437918,Rural Health Clinics,286 Chestnut St,,Osceola,MO,64776-2930,Saint Clair,1600 N Second St,,Clinton,MO,64735,Henry,Cindy Naylor,Data Processing/Billing Supervisor,660-890-8001,,cnaylor@gvmh.org,Meredith Cooper,Director of Operations,660-890-8023,,mcooper@gvmh.org,gvmh.org
MO-006303,Medical Clinic of Owensville,Hermann Area Hospital District,1235204702,Rural Health Clinics,708 E Highway 28,,Owensville,MO,65066-1588,Gasconade,PO Box 19,,Hermann,MO,65041,Gasconade,Ellen Schaumberg,Director of Clinic Operations,573-486-2256,,eschaumberg@hadh.org,,,,,,
MO-006304,Hannibal Clinic - Palmyra,"Hannibal Clinic Operations, LLC",1962481663,Rural Health Clinics,1811 S Main St,,Palmyra,MO,63461-1961,Marion,100 Medical Drive,,Hannibal,MO,63401,Marion,Marsha Moss,Credentialing Coordinator,573-231-3813,,mmoss@hannibalclinic.com,,,,,,
MO-006305,PARIS FAMILY MEDICAL CLINIC,PARIS FAMILY MEDICAL CLINIC,1982781530,Rural Health Clinics,102 E Marion St,,Paris,MO,65275-1041,Monroe,102 E Marion St,,Paris,MO,65275,Monroe,Joy Ridgeway,Office Manager,660-327-4911,13,pfmc2004@yahoo.com,,,,,,
MO-006306,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1548520026,Rural Health Clinics,221 N Main St,,Paris,MO,65275-1328,Monroe,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006307,East Missouri Action Agency Women's Wellness Center,East Missouri Action Agency Women's Wellness Center,1508260696,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",403 Parkway Dr,,Park Hills,MO,63601-4435,Saint Francois,403 Parkway Dr,,Park Hills,MO,63601-4435,Saint Francois,LUCIA OBERGOENNER,Family Planning Coordinator,573-334-2516,2300,LOBERGOENNER@EASTMOAA.ORG,Donna Yeargain,Program Assistant,573-334-2516,2300,dyeargain@eastmoaa.org,
MO-006308,Peculiar Medical Center,Cass Regional Medical Center dba Peculiar Medical Clinic,1598747545,Other ECP Providers,300 S Main St,,Peculiar,MO,64078-9603,Cass,2800 E Rock Haven Road,,Harrisonville,MO,64701,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006309,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1255340246,Rural Health Clinics,1223 E Main St,,Perry,MO,63462-1410,Ralls,2505 Mission Drive,,Jefferson City,MO,65109,Ralls,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006310,Cross Trails Medical Center,CROSS TRAILS MEDICAL CENTER,1215368402,"Dental Providers, Federally Qualified Health Centers - Medical Services",1314 Brenda Ave,,Perryville,MO,63775-2303,Perry,408 S Broadview St,,Cape Girardeau,MO,63703-5725,Cape Girardeau,Ron Camp,CEO,573-339-1196,,rcamp@crosstrails.us,Chrissy Warren,COO,573-339-1196,,cwarren@crosstrails.us,
MO-006311,Iron County Medical Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1306037411,Federally Qualified Health Centers - Medical Services,315 W Mulberry,,Pilot Knob,MO,63663,Iron,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006312,Iron County Hospital Family Care Clinic,Iron County Hospital District,1073799367,Rural Health Clinics,600 North Main St,,Pilot Knob,MO,63663,Iron,PO Box 548,,Pilot Knob,MO,63663,Iron,Terry W. Nichols,Chief Executie Officer,573-546-8003,,tnichols@icmedcenter.org,Cindy Sadler,Chief Nursing Officer,573-546-1260,,cfinley@icmedcenter.org,
MO-006313,OCH PINEVILLE MEDICAL CLINIC,"SGOH ACQUISITION, INC.",1386191989,Rural Health Clinics,412 US Highway 71,Suite J&I,Pineville,MO,64856-9310,McDonald,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006314,Pineville Medical Clinic,"Elk River Health Services, Inc.",1548269046,Rural Health Clinics,5265 S Bus Hwy 71 Ste J,PO Box 265,Pineville,MO,64856-0265,McDonald,PO Box 160,,Southwest City,MO,648630160,McDonald,Vicki Plumlee,Director of Clinics,417-223-4290,,vplumlee@elkriverhealth.com,Scarlett Frost,Administrative Assistant,417-223-3441,,sfrost@elkriverhealth.com,www.elkriverhealth.com
MO-006315,New Liberty Medical and Hospital Corp,Plattsburg Medical Clinic,1376568121,Rural Health Clinics,400 W Clay Ave,,Plattsburg,MO,64477-1424,Clinton,400 W Clay Ave,,Plattsburg,MO,64477-1424,Clinton,Sheila Feekes,Clinic Manager,816-539-2117,23,pmclinic400@gmail.com,,,,,,
MO-006316,Pleasant Hill Medical Clinic,Cass Regional Medical Center dba Pleasant Hill MEdical Clinic,1538159058,Rural Health Clinics,1601 N Hwy 7,,Pleasant Hill,MO,64080-1945,Cass,2800 E Rock Haven Rd,,Harrisonville,MO,64701-4411,Cass,Janie Elliott,Business Office Manager,816-887-0315,,jelliott@cassregional.org,,,,,,
MO-006317,POPLAR BLUFF COMMUNITY DENTAL CL,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1295820348,Dental Providers,1407 N Westwood Blvd,,Poplar Bluff,MO,63901-3315,Butler,110 S. 2nd Street,,Ellington,MO,63638,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006318,BUTLER COUNTY HEALTH DEPARTMENT,BUTLER COUNTY HEALTH DEPARTMENT,1114080108,"Family Planning Providers, Tuberculosis Clinics",1619 N Main St,,Poplar Bluff,MO,63901-3445,Butler,1619 N. Main St.,,Poplar Bluff,MO,63901,Butler,Robert Hudson,Administrator,573-785-8478,,Robert.Hudson@lpha.mo.gov,,,573-751-6411,,,
MO-006319,Missouri Highlands Medical Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1083745475,Federally Qualified Health Centers - Medical Services,225 Physicians Park,Suite 303,Poplar Bluff,MO,63901-3930,Butler,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006320,PORTAGEVILLE PRIMARY CARE,Pemiscot Memorial Health Systems,1699873372,Rural Health Clinics,314 E Main St,,Portageville,MO,63873-1616,New Madrid,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,,,,
MO-006321,Great Mines Health Center,GREAT MINES HEALTH CENTER,1376536953,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Southtowne Dr,,Potosi,MO,63664-5729,Washington,1 Southtowne Dr,,Potosi,MO,63664-5729,Washington,Michael Johnson,CEO,573-438-9355,,mjohnson@gmhcenter.org,Greg Roeback,CFO,573-438-9355,,groeback@gmhcenter.org,
MO-006322,Saint Luke's Mercer County Clinic,Saint Luke's Health System,1962877514,Rural Health Clinics,400 N Fullerton St,,Princeton,MO,64673-1418,Mercer,901 East 104th St,,Kansas City,MO,64131,Cass,Bob Bonney,Senior VP Network Operations,816-932-3523,,bbonney@saint-lukes.org,,,,,,https://www.saintlukeskc.org/location
MO-006323,Compass Health - Raymore,Compass Health,1518329499,Federally Qualified Health Centers - Medical Services,1010 Remington Plz,,Raymore,MO,64083-8640,Cass,1800 Community Drive,,Clinton,MO,64735,Henry,Alan Stevens,Executive Vice President - Health Center Operations,573-634-3000,,astevens@pbhc.org,,,,,,
MO-006324,TMC Raytown Family Medical Care,Truman Medical Center Inc,1376686600,Outpatient Hospital Clinics,9406 E 63rd St,,Raytown,MO,64133-4904,Jackson,2301 Holmes Street,,Kansas City,MO,64108,Jackson,Dmeter Dragovich,VP Managed Care & Integrated Health Services,816-404-3540,,dmeter.dragovich@tmcmed.org,Gerard Grimaldi,VP Health Policy & Governmental Relations,816-404-3502,,gerard.grimaldi@tmcmed.org,www.trumed.org
MO-006325,Jordan Valley Community Health Center,ADVOCATES FOR A HEALTHY COMMUNITY INC,1073939849,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",550 E Harrison St,,Republic,MO,65738-1353,Greene,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006326,CoxHealth Center Republic,CoxHealth Network,1972849115,Rural Health Clinics,820 S Illinois Ave,,Republic,MO,65738-1177,Greene,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006327,Rich Hill Family Medical Clinic,Nevada Regional Medical Center,1417049511,Rural Health Clinics,320 N 14th St,,Rich Hill,MO,64779-2145,Bates,320 N 14th St,,Rich Hill,MO,64779,Bates,Michelle Casey,PFS Director,417-667-3355,2432,mcasey@nrmchealth.com,,,,,,
MO-006328,Central Ozarks Medical Center,"Richland Medical Center, Inc.",1245361344,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",304 W Washington Ave,,Richland,MO,65556-7101,Pulaski,304 W Washington Ave,,Richland,MO,65556-7101,Pulaski,Robert Stiles,CEO,573-765-5131,,rstiles@centralozarks.org,Paul Bocci,CFO,573-765-5131,,pbocci@centralozarks.org,www.centralozarks.org
MO-006329,Central Ozarks Medical Center,"Richland Medical Center, Inc.",1598968489,Dental Providers,304 W Washington Ave,,Richland,MO,65556-7101,Pulaski,PO Box 777,,Richland,MO,65556,Pulaski,Robert Stiles,CEO,573-765-5131,,rstiles@centralozarks.org,Paul Bocci,CFO,573-765-5131,,pbocci@centralozarks.org,www.centralozarks.org
MO-006330,SWOPE HEALTH NORTHLAND,SWOPE HEALTH SERVICES,1568557205,"Dental Providers, Federally Qualified Health Centers - Medical Services",4443 NW Gateway Ave,,Riverside,MO,64150-9720,Platte,3801 Blue Pkwy,,Kansas City,MO,64130-2807,Jackson,Shannon Weigand,Chief Executive Officer,816-599-5712,,sweigand@swopehealth.org,Naimish Patel,Chief Financial Officer,816-599-5552,,npatel@swopehealth.org,www.swopehealth.org
MO-006331,OCH WEBSTER COUNTY CLINIC,"SGOH ACQUISITION, INC.",1942335203,Rural Health Clinics,101 S Main St,,Rogersville,MO,65742-9357,Webster,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006332,CoxHealth Center Rogersville,CoxHealth Network,1164456612,Rural Health Clinics,151 Johnstown Dr,,Rogersville,MO,65742-9366,Webster,3554 S. National AVe,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006333,Tri-Rivers Family Planning Rolla Center,"Tri-Rivers Family Planning, Inc.",1710025754,Family Planning Providers,1032 Kingshighway St,Suite B,Rolla,MO,65401-2921,Phelps,PO Box 359,,Rolla,MO,65402,Phelps,Lisa Ecsi Davis,Director of Operations,573-364-1509,,lisa@tririversfamilyplanning.org,Tonia Stubblefield,CEO,573-364-1509,,toni@tririversfamilyplanning.org,www.tririversfamilyplanning.org
MO-006334,South Central Missouri Community Health Center,South Central Missouri Community Health Center,1164669172,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1081 E 18th St,,Rolla,MO,65401-2448,Phelps,1081 East 18th Street,,Rolla,MO,65401,Phelps,Angie Jones,Business Office Manager,573-426-6712,,ajones@your-chc.org,Kelly Miller,CEO,573-426-6712,,ajones@your-chc.org,
MO-006335,St. Charles Clinic,"COMPASS HEALTH, INC.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",102 Compass Point Dr,,Saint Charles,MO,63301-4404,Saint Charles,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006336,Family Planning Clinic of Franklin Co.,Family Planning Clinic of Franklin Co.,1912999251,Family Planning Providers,920 L St Clair Plaza Dr,,Saint Clair,MO,63077,Franklin,920 St Clair Plaza Dr,,Saint Clair,MO,63077,Franklin,Brenda Moran,Clinic Director,636-629-0300,,fpc@yhti.net,,,,,,
MO-006337,North End Health Center,"NORTHWEST HEALTH SERVICES, INC.",1396866737,Federally Qualified Health Centers - Medical Services,1515 Saint Joseph Ave,,Saint Joseph,MO,64505-2631,Buchanan,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006338,FAMILY MEDICINE ASSOCIATES,"NORTHWEST HEALTH SERVICES, INC.",1629190822,Federally Qualified Health Centers - Medical Services,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006339,Northwest Family Dental,"NORTHWEST HEALTH SERVICES, INC.",1538281738,Dental Providers,3608 Faraon St,,Saint Joseph,MO,64506-3044,Buchanan,Northwest Health Services,2303 Village Drive,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006340,South Side Health Center,"NORTHWEST HEALTH SERVICES, INC.",1194846550,Federally Qualified Health Centers - Medical Services,5001 Lake Ave,,Saint Joseph,MO,64504-1170,Buchanan,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006341,Homeless Outreach Medical Express Unit,"NORTHWEST HEALTH SERVICES, INC.",1861646168,"Dental Providers, Federally Qualified Health Centers - Medical Services",501 S 6th St,Suite A,Saint Joseph,MO,64501,Buchanan,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Deanna Lamb,CEO,816-271-8262,,deannalamb@nwhealth-services.org,Mark Scates,Senior Director of Clinical Operations,816-271-8234,,markscates@nwhealth-services.org,www.nwhealth-services.org
MO-006342,Social Welfare Board,Social Welfare Board,1497024145,"Family Planning Providers, Sexually Transmitted Disease Clinics",904 S 10th St,Suite A,Saint Joseph,MO,64503-2400,Buchanan,"904 S. 10th, Suite A",,Saint Joseph,MO,64503,Buchanan,Linda Carmel Judah,Executive Director,816-344-5201,,lindajudah@socialwelfareboard.org,Deborah Borchers,Director of Operations,816-233-5188,110,deborahborchers@socialwelfareboard.org,www.socialwelfareboard.org
MO-006343,Barnes Jewish Hospital,Barnes Jewish Hospital,1649299827,Inpatient Hospitals (other than children's hospitals),1 Barnes Jewish Hospital Plz,,Saint Louis,MO,63110-1003,Saint Louis City,1 Barnes Jewish Hospital Plaza,Mailstop 90-71-307,Saint Louis,MO,63110,Saint Louis City,Steven Bernstetter,Compliance Director,314-286-2134,,steven.bernstetter@bjc.org,,,,,,
MO-006344,St. Louis Children's Hospital,St. Louis Children's Hospital,1992727663,Children's Hospitals (inpatient only),1 Childrens Pl,,Saint Louis,MO,63110-1002,Saint Louis City,1 Children's Place,Administration STE 3S-36,Saint Louis,MO,63110,Saint Louis City,Steven Bernstetter,Compliance Director,314-286-2134,,steven.bernstetter@bjc.org,Ellie Glenn,Government Relations Director,314-286-2144,,Ellie.Glenn@bjc.org,
MO-006346,Christian Hospital,Christian Hospital Northeast-Northwest,1639186760,Inpatient Hospitals (other than children's hospitals),11133 Dunn Rd,,Saint Louis,MO,63136-6163,Saint Louis,11133 Dunn Rd,97-CHNE,Saint Louis,MO,63136,Saint Louis,Steven Bernstetter,Compliance Director,314-286-2134,,steven.bernstetter@bjc.org,,,,,,
MO-006347,Affinia Healthcare Inc,Affinia Healthcare Inc,1427221027,Federally Qualified Health Centers - Medical Services,1430 Olive St,Suite 400,Saint Louis,MO,63103-2303,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,cfears@affiniahealthcare.org,www.affiniahealthcare.org
MO-006348,Cardinal Glennon Children's Hospital,SSM Health Cardinal Glennon Children's Hospital,1508935891,Children's Hospitals (inpatient only),1465 S Grand Blvd,,Saint Louis,MO,63104-1003,Saint Louis City,1465 South Grand Boulevard,,Saint Louis,MO,63104,Saint Louis City,Louis C. Rotter,"Vice President, Managed Care",314-989-2309,,Lou_Rotter@ssmhc.com,Steven Burghart,President,314-577-5610,,Steven_Burghart@ssmhc.com,
MO-006349,Costas Center,SSM Cardinal Glennon Children's Hospital,1508811068,Hemophilia Treatment Centers,1465 S Grand Blvd,,Saint Louis,MO,63104-1003,Saint Louis City,1465 S. Grand,,St. Louis,MO,63104,Saint Louis City,Anne Bisch,Nursing Director,314-678-3071,,anne.bisch@ssmhealth.com,Lydia Johnson,Hemostasis Clinical Nurse Coordinator,314-577-5332,,Lydia.Johnson@ssmhealth.com,
MO-006350,Affinia Healthcare Inc,Affinia Healthcare Inc,1346634003,Dental Providers,1500 Park Ave,,Saint Louis,MO,63104-3024,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniahealthcare.org
MO-006351,Affinia Healthcare Inc,Affinia Healthcare Inc,1902816077,"Dental Providers, Federally Qualified Health Centers - Medical Services",1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniahealthcare.org
MO-006352,Affinia Healthcare Inc,Affinia Healthcare Inc,1710395611,Federally Qualified Health Centers - Medical Services,1908 Ofallon St,,Saint Louis,MO,63106-3259,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniaheatlhcare.org
MO-006353,Affinia Healthcare Inc,Affinia Healthcare Inc,1003824293,Federally Qualified Health Centers - Medical Services,2220 Lemp Ave,,Saint Louis,MO,63104-2700,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniahealthcare.org
MO-006354,HOMER G. PHILLIPS HEALTH CENTER,"MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.",1376685529,"Dental Providers, Federally Qualified Health Centers - Medical Services",2425 Whittier St,,Saint Louis,MO,63113-2950,Saint Louis City,5471 Dr Martin Luther King Dr,,Saint Louis,MO,63112-4265,Saint Louis City,Angela Clabon,CEO,314-367-5820,2227,aclabon@mhdchc.org,,,,,,
MO-006345,Vivent Health,Vivent Health,1689043812,"Ryan White Providers, Sexually Transmitted Disease Clinics",2653 Locust St,Suite 700,Saint Louis,MO,63103-1411,Saint Louis City,1027 Vandeventer,Suite 700,St. Louis,MO,63110,Saint Louis City,Tawnya Brown,Vice President of Operations,314-754-0128,,tawnya.brown@viventhealth.org,Ann Ritz,Social Services Director,314-256-2156,,ann.ritz@viventhealth.org,
MO-006355,South Grand Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",3401 S Grand Blvd,,Saint Louis,MO,63118-1003,Saint Louis City,4251 Forest Park Ave.,,St. Louis,MO,63108-2810,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Sr. VP of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,www.ppslr.org
MO-006356,Saint Louis University,Center for Bleeding and Thrombotic Disorders,1659480242,Hemophilia Treatment Centers,3655 Vista Ave,West Pavilion - 2nd Floor,Saint Louis,MO,63110-2539,Saint Louis City,Saint Louis University,3655 Vista Avenue,Saint Louis,MO,63110,Saint Louis City,Debra I. Hauptman,Social Worker,314-577-6178,,dbader7@slu.edu,Azadeh Golkar,Nurse Practitioner,314-577-8062,,,https://www.slucare.edu/hemonc/hemophilia-blood-disorders-center.php
MO-006357,Affinia Healthcare Inc,Affinia Healthcare Inc,1013925890,Federally Qualified Health Centers - Medical Services,3930 S Broadway,,Saint Louis,MO,63118-4626,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniahealthcare.org
MO-006358,Family Care Health Centers - Carondelet,FAMILY CARE HEALTH CENTERS,1508867508,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",401 Holly Hills Ave,,Saint Louis,MO,63111-2410,Saint Louis City,401 Holly Hills Ave,,Saint Louis,MO,63111-2410,Saint Louis City,Robert K Massie,CEO,314-481-1615,1315,bmassie@fchcstl.org,Lynn Kersting,Clinic Director,314-481-1615,1315,lkersting@fchcstl.org,http://familycarehealthcenter.org
MO-006359,Betty Jean Kerr People's Health Centers,BETTY JEAN KERR - PEOPLE'S HEALTH CENTERS,1841668688,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4055 Lindell Blvd,,Saint Louis,MO,63108-3201,Saint Louis City,5701 Delmar Blvd,,Saint Louis,MO,63112-2617,Saint Louis City,Dwayne Butler,CEO,314-367-7848,1220,dbutler@phcenters.com,Mark Sanford,Executive Vice President,314-367-7848,1209,msanford@phcenters.com,www.phcenters.com
MO-006360,Family Care at Places for People,FAMILY CARE HEALTH CENTERS,1003218868,Federally Qualified Health Centers - Medical Services,4130 Lindell Blvd,,Saint Louis,MO,63108-2914,Saint Louis City,401 Holly Hills Ave,,Saint Louis,MO,63111-2410,Saint Louis City,Robert K Massie,CEO,314-481-1615,1315,bmassie@fchcstl.org,Lynn Kersting,COO,314-481-1615,1315,lkersting@fchcstl.org,http://familycarehealthcenter.org
MO-006361,Central West End Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",4251 Forest Park Ave,,Saint Louis,MO,63108-2810,Saint Louis City,4251 Forest Park Ave.,,St. Louis,MO,63108-2810,Saint Louis City,Kristina Winkelman,Admin/HR Assistant,314-531-7526,346,KRISTINA.WINKELMAN@PPSLR.ORG,Danielle Uding,Program Implementation Coordinator,314-531-7526,330,danielle.uding@ppslr.org,www.ppslr.org
MO-006362,FOREST PARK SOUTHEAST,FAMILY CARE HEALTH CENTERS,1023285624,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4352 Manchester Ave,,Saint Louis,MO,63110-2138,Saint Louis City,401 Holly Hills Ave,,Saint Louis,MO,63111-2410,Saint Louis City,Robert K Massie,CEO,314-481-1615,1315,bmassie@fchcstl.org,Lynn Kersting,Family Planning Coordinator,314-481-1615,1315,lkersting@fchcstl.org,http://www.familycarehealthcenter.org
MO-006363,SHC - St. Louis,Shriners Hospitals for Children,1942343447,Children's Hospitals (inpatient only),4400 Clayton Ave,,Saint Louis,MO,63110-1624,Saint Louis City,4400 Clayton Ave,,Saint Louis,MO,63110,Saint Louis,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
MO-006364,Affinia Healthcare Inc,Affinia Healthcare Inc,1093723959,"Dental Providers, Federally Qualified Health Centers - Medical Services",4414 N Florissant Ave,,Saint Louis,MO,63107-1812,Saint Louis City,1717 Biddle St,,Saint Louis,MO,63106-3454,Saint Louis City,Cindy Fears,"Director, Patient Financial Services",314-814-8515,,cfears@affiniahealthcare.org,Janet Voss,CFO,314-814-8571,,janetv@affiniahealthcare.org,www.affiniahealthcare.org
MO-006365,"MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.","MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.",1609245448,"Dental Providers, Federally Qualified Health Centers - Medical Services",4500 Pope Ave,,Saint Louis,MO,63115-2512,Saint Louis City,5471 Dr. Martin Luther King Dr.,,Saint Louis,MO,63112-4265,Saint Louis City,Brigitte Curtis,Credentialing,314-367-5820,2306,bcurtis@mhdchc.org,Angela R. Clabon,CEO,314-367-5820,2227,aclabon@mhdchc.org,www.mhdchc.org
MO-006366,"WASHINGTON UNIVERSITY, THE",Washington University ID Clinic,1508882812,Ryan White Providers,4523 Clayton Ave,# 8051,Saint Louis,MO,63110,Saint Louis City,"620 S Taylor Ave, suite 100",,Saint Louis,MO,63110,Saint Louis City,Andrew Fleming,"Sr Director, Managed Care, Washington University",314-273-0416,,fleminga@wusm.wustl.edu,,,,,,https://wuphysicians.wustl.edu/for-patients/accepted-health-insurance/health-exchange-marketplans-affordable-care-act-aca
MO-006367,Contraceptive Choice Center,Washington University in St. Louis School of Medicine,1760422265,Family Planning Providers,4533 Clayton Ave # 8219,,Saint Louis,MO,63110-1501,Saint Louis City,660 S. Euclid Ave.,,Saint Louis,MO,63110,Saint Louis City,Christina Buckel,Project Manager,314-747-1530,,buckelcm@wudosis.wustl.edu,,,,,,
MO-006368,"MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.","MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.",1972596088,"Dental Providers, Federally Qualified Health Centers - Medical Services",5471 Dr Martin Luther King Dr,,Saint Louis,MO,63112-4265,Saint Louis City,5471 Dr Martin Luther King Dr,,Saint Louis,MO,63112-4265,Saint Louis City,Angela Clabon,CEO,314-367-5820,2227,aclabon@mhdchc.org,,,,,,www.mhdchc.org
MO-006369,FLORENCE HILL HEALTH CENTER,"MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTERS, INC.",1649312570,"Dental Providers, Federally Qualified Health Centers - Medical Services",5541 Riverview Blvd,,Saint Louis,MO,63120-2443,Saint Louis City,5471 Dr Martin Luther King Dr,,Saint Louis,MO,63112-4265,Saint Louis City,Angela Clabon,CEO,314-367-5820,2227,aclabon@mhdchc.org,,,,,,
MO-006370,Betty Jean Kerr People's Health Centers,BETTY JEAN KERR - PEOPLE'S HEALTH CENTERS,1194797787,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5701 Delmar Blvd,,Saint Louis,MO,63112-2617,Saint Louis City,5701 Delmar Blvd,,Saint Louis,MO,63112-2617,Saint Louis City,Dwayne Butler,CEO,314-367-7848,1220,dbutler@phcenters.com,Mark Sanford,Executive Vice President,314-367-7848,1209,msanford@phcenters.com,www.phcenters.com
MO-006371,Washington University Center for the Treatment of Bleeding and Clotting Disorders,Washington University,1407100696,Hemophilia Treatment Centers,660 S Euclid Ave,,Saint Louis,MO,63110-1010,Saint Louis City,660 South Euclid Avenue,,St. Louis,MO,63110,Saint Louis,Dr. Elaine Majerus,Assistant Professor and Director,314-362-7216,,emajerus@dom.wustl.edu,Glenda Bullock,Director of Research and Business Administration,314-362-8806,,gbullock@dom.wustl.edu,
MO-006372,Betty Jean Kerr People's Health Centers,BETTY JEAN KERR - PEOPLE'S HEALTH CENTERS,1639207590,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7200 Manchester Rd,,Saint Louis,MO,63143-2403,Saint Louis,5701 Delmar Blvd,,Saint Louis,MO,63112-2617,Saint Louis,Dwayne Butler,CEO,314-367-7848,1220,dbutler@phcenters.com,Mark Sanford,Executive Vice President,314-367-7848,1209,msanford@phcenters.com,www.phcenters.com
MO-006373,St. Peters Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",208 Mid Rivers Ctr,,Saint Peters,MO,63376-4325,Saint Charles,4251 Forest Park Ave,,Saint Louis,MO,63108-2810,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Sr. Vice President of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,http://www.ppslr.org
MO-006374,Family Dental Center @ Salisbury,Family Health Center of Boone County,1245479526,Dental Providers,307 S Broadway,,Salisbury,MO,65281-1037,Chariton,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Luann Roberts,Business Operations Manager,573-886-6741,,lroberts@fhcmo.org,www.fhcmo.org
MO-006375,Family Health Center @ Salisbury,Family Health Center of Boone County,1346213535,Federally Qualified Health Centers - Medical Services,307 S Broadway,,Salisbury,MO,65281-1037,Chariton,1001 W. Worley,,Columbia,MO,65203,Boone,Gloria Crull,CEO,573-886-6713,,gcrull@fhcmo.org,Jack Kelly,COO,573-886-6761,,jkelly@fhcmo.org,www.fhcmo.org
MO-006376,Savannah Medical Clinic,"NORTHWEST HEALTH SERVICES, INC.",1104947126,"Dental Providers, Federally Qualified Health Centers - Medical Services",803 W US Highway 71,,Savannah,MO,64485-1151,Andrew,2303 Village Dr,,Saint Joseph,MO,64506-4954,Buchanan,Matt Younger,CEO,816-271-8201,,mattyounger@nwhealth-services.org,Deb Mason,Executive Administrative Assistant,816-271-8262,,deborahmason@nwhealth-services.org,www.nwhealth-services.org
MO-006377,Ferguson Medical Group Scott City,Ferguson Medical Group Scott City,1245361427,Rural Health Clinics,100 E Outer Rd,,Scott City,MO,63780-1229,Scott,PO Box 1068,,Sikeston,MO,63801,Scott,Sharon Leonard,Director of Operations,573-471-0330,1104,sharon.leoanard@fergusonmedical.com,,,,,,
MO-006378,Katy Trail Community Health - Sedalia,Regional Health Care Clinic Inc.,1922057504,"Dental Providers, Federally Qualified Health Centers - Medical Services",821 Westwood Dr,,Sedalia,MO,65301-2102,Pettis,821 Westwood Dr,,Sedalia,MO,65301-2102,Pettis,Steve Bevans,Chief Financial Officer,660-826-1571,2,sbevans@katyhealth.org,Christine Stewart,Chief Executive officer,660-826-1571,3,cstewart@katyhealth.org,
MO-006379,CoxHealth Center Seymour,CoxHealth Network,1558391912,Rural Health Clinics,202 N Commercial,PO Box 427,Seymour,MO,65746-0427,Webster,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006380,SHELDON FAMILY MEDICAL CLINIC,Nevada Regional Medical Center,1245330265,Rural Health Clinics,810 W Main St,,Sheldon,MO,64784-9223,Vernon,810 W Main,,Sheldon,MO,64784,Vernon,Michelle Casey,PFS Director,417-667-3355,2432,mcasey@nrmchealth.com,,,,,,
MO-006381,CoxHealth Center Shell Knob,CoxHealth Network,1215396635,Rural Health Clinics,25376 State Highway 39,,Shell Knob,MO,65747-7343,Barry,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,"Sr. Director, CoxHealth Network",417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006382,Ferguson Medical Group-Sikeston Clinic,Ferguson Medical Group,1285655100,"Other ECP Providers, Rural Health Clinics",1012 N Main St,,Sikeston,MO,63801-5044,Scott,1012 N. Main St.,,Sikeston,MO,63801,Scott,"Mechelle W. Farmer, MHCA",Director of Public Relations/Comm. Liaison,573-481-5028,,Mechelle.Farmer@fergusonmedical.com,"Sharon Leonard, MBA",Director of Operations,573-471-0330,305,Sharon.Leonard@fergusonmedical.com,
MO-006383,SEMOHN Sikeston Medical Clinic,SOUTHEAST MISSOURI HEALTH NETWORK,1104045475,Federally Qualified Health Centers - Medical Services,200 Southland Dr,,Sikeston,MO,63801-4403,New Madrid,420 SEMO Dr,,New Madrid,MO,63869-1942,New Madrid,Chris Jones,CEO,573-748-2404,,cjones@semohealthnetwork.org,Darryl Roberts,COO,573-748-2404,,droberts@semohealthnetwork.org,
MO-006384,Sikeston Dental Center,SOUTHEAST MISSOURI HEALTH NETWORK,1134340102,Dental Providers,220 Southland Dr,,Sikeston,MO,63801-4403,New Madrid,420 SEMO Dr,,New Madrid,MO,63869,New Madrid,Chris Jones,Chief Operations Officer,573-748-2404,,droberts@semohealthnetwork.org,,,,,,
MO-006385,AKEMAN MCBURNEY HEALTH CLINIC,"JOHN FITZGIBBON MEMORIAL HOSPITAL, INC",1952611436,Rural Health Clinics,420 W Front St,,Slater,MO,65349-1328,Saline,2305 South 65 Highway,,Marshall,MO,65340-3702,Saline,Nancy Harris,Director of Financial Services,660-831-3700,271,nharris@fitzgibbon.org,Lori Benedick,Patient Accounts Manager,660-831-3700,728,lbenedick@fitzgibbon.org,
MO-006386,OCH SOUTHWEST CITY COMMUNITY CLINIC,"SGOH ACQUISITION, INC.",1801343405,Rural Health Clinics,109 N Broadway St,,South West City,MO,64863-9417,McDonald,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006387,OCH SPARTA CLINIC,"SGOH ACQUISITION, INC.",1811391717,Rural Health Clinics,155 Village Dr,,Sparta,MO,65753-8104,Christian,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006388,Sparta Health Clinic,"Rural Health Care Providers, Inc.",1689758872,Rural Health Clinics,515 Hugh Ave,,Sparta,MO,65753-1220,Christian,PO BOX 449,,Sparta,MO,65753,Christian,Angela Helms,Manager,417-634-3000,231,info@spartahc.com,Paul Glynn,Physician,417-634-3000,,pglynn@spartahc.com,
MO-006389,Jordan Valley Community Health Center - Med Towers,"Advocates for a Healthy Community, Inc. dba Jordan Valley Community Health Center",1952410995,Federally Qualified Health Centers - Medical Services,1443 N Robberson Ave,Suite 505,Springfield,MO,65802-1964,Greene,618 N Benton Ave Ste 100,,Springfield,MO,65806,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006390,OCH PAIN CLINIC AT EVERGREEN,"SGOH ACQUISITION, INC.",1114924768,Other ECP Providers,1540 E Evergreen St,,Springfield,MO,65803-4300,Greene,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006391,AIDS Project of the Ozarks,AIDS Project of the Ozarks,1366634859,"Ryan White Providers, Sexually Transmitted Disease Clinics",1901 E Bennett St,Suite D,Springfield,MO,65804-1434,Greene,1901 E. Bennett,Suite D,Springfield,MO,65804,Greene,Lynne Meyerkord,Executive Director,417-881-1900,105,lynne.meyerkord@apo-ozarks.org,Sandra Terrell,Chief Financial Officer,417-881-1900,120,sandra.terrell@apo-ozarks.org,aidsprojectoftheozarks.org
MO-006392,Ozarks Area Community Action Corp.,"Missouri Family Health Council, Inc",1881093979,Family Planning Providers,215 S Barnes Ave,,Springfield,MO,65802-2204,Greene,215 S Barnes Ave,,Springfield,MO,65802-2204,Greene,Diane Anthony,Clinic Director,417-864-3410,,danthony@oacac-caa.org,,,,,,http://www.oacac-caa.org
MO-006393,OCH MEDICAL OFFICES CLINIC,"SGOH ACQUISITION, INC.",1114924768,Other ECP Providers,2828 N National Ave,,Springfield,MO,65803-4306,Greene,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
MO-006394,Cox Medical Centers,CoxHealth Network,1093740128,Inpatient Hospitals (other than children's hospitals),3801 S National Ave,,Springfield,MO,65807-5210,Greene,3354 S. National Ave,,Springfield,MO,65807,Greene,Audra Lesly,Sr. Director,417-269-6243,,audra.lesly@coxhealth.com,David Raney,"VP, CoxHealth Network",417-269-7434,,david.raney@coxhealth.com,
MO-006395,Jordan Valley Community Health Center - Tampa Street Facility,ADVOCATES FOR A HEALTHY COMMUNITY INC,1164657318,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",440 E Tampa St,,Springfield,MO,65806-1131,Greene,618 N Benton Ave Ste 100,,Springfield,MO,65806-1105,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Lisa Odom,Vice President of Administration,417-851-1551,1194,lodom@jordanvalley.org,www.jordanvalley.org
MO-006396,Jordan Valley Community Health Center - Benton,"Advocates for a Healthy Community, Inc. dba Jordan Valley Community Health Center",1407954407,Federally Qualified Health Centers - Medical Services,618 N Benton Ave,,Springfield,MO,65806-1102,Greene,PO Box 5681,,Springfield,MO,65801,Greene,Alison Lee,Executive Director of Finance,417-851-1551,1138,alilee@jordanvalley.org,Brenda Tunstill,Corporate Compliance Officer,417-851-1551,1318,btunstill@jordanvalley.org,
MO-006397,Springfield Health Center,Planned Parenthood of the St. Louis Region and Southwest Missouri,1205898574,"Family Planning Providers, Sexually Transmitted Disease Clinics",626 E Battlefield St,,Springfield,MO,65807-4806,Greene,4251 Forest Park Ave.,,St. Louis,MO,63108,Saint Louis City,Mary M. Kogut,CEO,314-531-7526,318,mary.kogut@ppslr.org,Tom Hemingway,Sr. VP of Finance and Operations,314-531-7526,308,tom.hemingway@ppslr.org,www.ppslr.org
MO-006398,BOOTHEEL PRIMARY CARE CLINIC-STEELE,Pemiscot Memorial Health Systems,1558514901,Rural Health Clinics,213 S Walnut St,,Steele,MO,63877-1714,Pemiscot,946 East Reed,,Hayti,MO,63851,Pemiscot,Cathy Lacey,Central Billing Supervisor,573-359-3659,,clacey@pemiscot.org,,,,,,
MO-006399,Katy Trail Community Health - Stover,Regional Health Care Clinic Inc.,1972981942,Dental Providers,701 N Oak St,,Stover,MO,65078-0842,Morgan,821 Westwood Dr.,,Sedalia,MO,65301,Pettis,Steve Bevans,Chief Financial Officer,660-826-1571,2,sbevans@katyhealth.org,Christine Stewart,Chief Executive officer,660-826-1571,3,cstewart@katyhealth.org,
MO-006400,Missouri Baptist Sullivan Hospital,Missouri Baptist Hospital Sullivan,1295743169,Inpatient Hospitals (other than children's hospitals),751 Sappington Bridge Rd,,Sullivan,MO,63080-2354,Crawford,751 Sappington Bridge Rd,Administration,Sullivan,MO,63080,Crawford,Steven Bernstetter,Compliance Director,314-286-2134,,steven.bernstetter@bjc.org,,,,,,https://www.missouribaptistsullivan.org/
MO-006402,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1659327393,Rural Health Clinics,875 Hwy 5 South,,Tipton,MO,65081,Moniteau,2505 Mission Drive,,Jefferson City,MO,65101,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006403,Women's Health Services,Green Hills Community Action Agency,1538329529,Family Planning Providers,1506 Oklahoma Ave,,Trenton,MO,64683-2587,Grundy,1506 Oklahoma Avenue,,Trenton,MO,64683,Grundy,LINDA BAUGHER,Office Records Manager,660-359-2855,1055,LBAUGHER@CAPNCM.ORG,Jenny Dean-Batson,PROGRAM DIRECTOR,660-359-2855,1062,jdbatson@capncm.org,
MO-006404,Wright Memorial Physicians Group,Saint Luke's Health System,1700895711,Rural Health Clinics,189 Iowa Blvd,,Trenton,MO,64683-8343,Grundy,901 East 104th St,,Kansas City,MO,64131,Cass,Bob Bonney,Senior VP Network Operations,816-932-3523,,bbonney@saint-lukes.org,,,,,,
MO-006405,WRIGHT MEMORIAL HOSPITAL,Saint Luke's Health System,1841274057,Inpatient Hospitals (other than children's hospitals),191 Iowa Blvd,,Trenton,MO,64683-8343,Grundy,901 East 104th St,,Kansas City,MO,64131,Clay,Bob Bonney,Senior VP Network Operations,816-932-3523,,bbonney@saint-lukes.org,,,,,,
MO-006406,Saint Luke's Green Hills Medical Clinic,Saint Luke's Health System,1699186387,Rural Health Clinics,3300 E 10th St,,Trenton,MO,64683-9579,Grundy,901 East 104th St,,Kansas City,MO,64131,Cass,Bob Bonney,Senior VP Network Operations,816-932-3523,,bbonney@saint-lukes.org,,,,,,
MO-006407,"Crider Health Center, Inc.","COMPASS HEALTH, INC.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",1780 Old Highway 50 E,,Union,MO,63084-3397,Franklin,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006409,PUTNAM COUNTY MEMORIAL HOSPITAL,Putnam County Memorial Hospital,1609870195,Inpatient Hospitals (other than children's hospitals),1926 Oak St,PO Box 389,Unionville,MO,63565-1180,Putnam,1926 Oak St,PO Box 389,Unionville,MO,63565,Putnam,Angela Pettengill,Credentialing,660-947-2411,2226,apettengill@pcmhosp.com,Susan Daniels,CFO,660-947-2411,2312,sdaniels@pcmhosp.com,
MO-006410,Putnam County Rural Health Clinic,Putnam County Memorial Hospital,1124125539,Rural Health Clinics,1926 Oak St,PO Box 389,Unionville,MO,63565-1180,Putnam,1926 Oak St,PO Box 389,Unionville,MO,63565,Putnam,Angela Pettengill,Credentialing,660-947-2411,2226,apettengill@pcmhosp.com,Susan Daniels,CFO,660-947-2411,2312,sdaniels@pcmhosp.com,
MO-006411,Big Springs Medical Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1225045321,Federally Qualified Health Centers - Medical Services,405 Main St,,Van Buren,MO,63965,Carter,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006412,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1902815228,Rural Health Clinics,204 W Washington St,,Vandalia,MO,63382-1473,Audrain,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006413,"Katy Trail Community Health, Prairie Hills",Regional Health Care Clinic Inc.,1053694422,Federally Qualified Health Centers - Medical Services,1109 W Clay Rd,,Versailles,MO,65084-1177,Morgan,821 Westwood Dr,,Sedalia,MO,65301-2102,Pettis,Steve Bevans,Chief Financial Officer,660-826-1571,2,sbevans@katyhealth.org,Christine Stewart,Chief Executive officer,660-826-1571,3,cstewart@katyhealth.org,
MO-006414,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1447257571,Rural Health Clinics,801 Kidwell Dr,,Versailles,MO,65084-1787,Morgan,2505 Mission Drive,,Jefferson City,MO,65101,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006415,Viburnum Medical Clinic,"BIG SPRINGS MEDICAL ASSOCIATION, INC",1477657609,Federally Qualified Health Centers - Medical Services,18 Viburnum Center Rd,,Viburnum,MO,65566-7802,Iron,110 S 2nd St,,Ellington,MO,63638-9400,Reynolds,Karen White,CEO,573-663-2313,3965,kwhite@mohigh.org,Debbie Tarvid,COO,573-663-2313,3959,dtarvid@mohigh.org,
MO-006416,North East Community Action Agency NECAC Family Planning Center,North East Community Action Corp.,1467584367,"Family Planning Providers, Sexually Transmitted Disease Clinics",120 E Main St,,Warrenton,MO,63383-2004,Warren,16 North Court Street,PO Box 470,Bowling Green,MO,63334,Pike,Brenda K. Fuqua,"Deputy Director, Community Health Service Programs",573-324-2231,10118,bfuqua@necac.org,"Claudia Timbrook, RNC/FNP","Program DIrector, Family Planning & WIC",573-221-3404,,ctimbrook@necac.org,necac.org
MO-006417,"Warrenton Medical, Dental, & Behavioral Health","COMPASS HEALTH, INC.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",19515 Brune Pkwy,,Warrenton,MO,63383-6505,Warren,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006418,Katy Trail Community Health - Warsaw,"REGIONAL HEALTH CARE CLINIC, INC.",1053533539,"Dental Providers, Federally Qualified Health Centers - Medical Services",17571 N Dam Access Rd,,Warsaw,MO,65355-6396,Benton,821 Westwood Dr,,Sedalia,MO,65301-2102,Pettis,Steve Bevans,Chief Financial Officer,660-826-1571,2,sbevans@katyhealth.org,Christine Stewart,Chief Executive officer,660-826-1571,3,cstewart@katyhealth.org,
MO-006419,GOLDEN VALLEY MEDICAL - WARSAW,Golden Valley Memorial Healthcare,1366490971,Rural Health Clinics,1771 Commercial St,,Warsaw,MO,65355-3096,Benton,1600 N Second St,,Clinton,MO,64735,Henry,Cindy Naylor,Data Processing/Billing Supervisor,660-890-8001,,cnaylor@gvmh.org,Meredith Cooper,Director of Operations,660-890-8023,,mcooper@gvmh.org,gvmh.org
MO-006420,Live Well Community Health Center-Waverly,Health Care Collaborative of Rural Missouri,1174960769,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",608 Missouri St,,Waverly,MO,64096-8241,Lafayette,825 S Business Hwy 13,,Lexington,MO,64067,Lafayette,Cathy Wallace,Vice President of Operations,660-259-2440,,cathy@hccnetwork.org,Toniann Richard,CEO,816-249-1529,,toniann@hccnetwork.org,
MO-006421,SSM Health Medical Group - Family Medicine,SSM Regional Health Services,1942219266,Rural Health Clinics,111 W Bates St,,Wellsville,MO,63384-1616,Montgomery,2505 Mission Drive,,Jefferson City,MO,65109,Cole,Becky Miller,COO,573-681-3133,,becky.miller@ssmhealth.com,Mike Baumgartner,CEO,573-582-8100,,michael.baumgartner@ssmhealth.com,
MO-006422,Crider Health Center,"COMPASS HEALTH, INC.",1245669266,"Dental Providers, Federally Qualified Health Centers - Medical Services",1032 Crosswinds Ct,,Wentzville,MO,63385-4836,Saint Charles,1800 Community,,Clinton,MO,64735-8804,Henry,Alan Stevens,Executive Vice President,660-885-8131,,astevens@pbhc.org,,,,,,
MO-006423,Southern Missouri Community Health Center West Plains Clinic,"RURAL ALLIANCE FOR BETTER FAMILY HEALTH, THE",1144280132,"Dental Providers, Federally Qualified Health Centers - Medical Services",1137 Independence Dr,,West Plains,MO,65775-4221,Howell,1137 Independence Dr,,West Plains,MO,65775-4221,Howell,Pat Richards,CEO,417-255-8464,,prichards@smchc.org,Angela Gargus,CFO,417-255-8464,1401,agargus@smchc.org,www.smchc.org
MO-006424,"Burton Creek Rural Clinic, LLC","Burton Creek Rural Clinic, LLC",1720075161,Rural Health Clinics,805 N Kentucky Ave,,West Plains,MO,65775-2022,Howell,805 N. Kentucky Avenue,,West Plains,MO,65775,Howell,Sonja Stauffer,Administrator,417-256-2111,232,sstauffer@burtonmc.com,,,,,,
MO-006425,"VALLEY MEDICAL CENTER, PC","VALLEY MEDICAL CENTER, PC",1740225598,Rural Health Clinics,308 S Harris St,,Willow Springs,MO,65793-1621,Howell,308 S HARRIS,,WILLOW SPRINGS,MO,65793-1621,Howell,WILLIAM E BERNER,CLINIC ADMINISTRATOR,989-892-7722,,Bernermedical@hotmail.com,,,417-469-3175,,,
MO-006426,GOLDEN VALLEY MEDICAL - WINDSOR,Golden Valley Memorial Healthcare,1316995939,Rural Health Clinics,100 S Tebo St,,Windsor,MO,65360-1161,Henry,1600 N Second St,,Clinton,MO,64735,Henry,Cindy Naylor,Data Processing/Billing Supervisor,660-647-2147,,cnaylor@gvmh.org,Meredith Cooper,Director of Operations,660-890-8023,,mcooper@gvmh.org,gvmh.org
MS-006427,Pioneer Community Hospital of Aberdeen,Pioneer Health Services,1710927215,Inpatient Hospitals (other than children's hospitals),400 S Chestnut St,,Aberdeen,MS,39730-3335,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,Chief Financial Officer,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Strategic Develop & Network Alignment,601-849-6440,385,laurenwilliams@phscorporate.com,
MS-006428,Chestnut Medical Clinic,"Pioneer Health Services of Monroe County, Inc.",1083658595,Rural Health Clinics,502 Jackson St,Suite 6,Aberdeen,MS,39730-3303,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,Chief Financial Officer,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Clinic Director,601-849-6440,,heidinelson@phscorporate.com,
MS-006429,Nina Jurney's Family Medical Practice,"Pioneer Health Services of Monroe County, Inc.",1790864577,Rural Health Clinics,502 Jackson St,Suite 4,Aberdeen,MS,39730-3303,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006430,Pioneer Family Medical,"Pioneer Health Services of Monroe County, Inc.",1386689438,Rural Health Clinics,502 Jackson St,Suite 5,Aberdeen,MS,39730-3303,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006431,Pioneer Surgical Clinic of Aberdeen,"Pioneer Health Services of Monroe County, Inc.",1760880785,Other ECP Providers,502 S Chestnut St,,Aberdeen,MS,39730-3337,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006432,Choctaw Regional Medical Center,Choctaw Regional Medical Center,1568879864,Other ECP Providers,8613 Mississippi Highway 12,,Ackerman,MS,39735,Choctaw,8613 Mississippi Highway 12,,Ackerman,MS,39735,Choctaw,Joanie M. Perkins,Chief Compliance Officer,662-756-1703,1008,joanie.perkins@northsunflower.com,Jamie Rogers,CEO,662-285-4400,,jamie.rogers@choctawregional.com,http://www.choctawregional.com/
MS-006433,Pioneer Family Medical of Amory,"Pioneer Health Services of Monroe County, Inc.",1750536090,Rural Health Clinics,1506 Highway 278 E,Suite A,Amory,MS,38821-5906,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006434,North Mississippi Primary Health Care,North Mississippi Primary Health Care,1821092552,Federally Qualified Health Centers - Medical Services,15921 Boundary Dr,,Ashland,MS,38603-7740,Benton,15921 Boundary Drive,,Ashland,MS,38603,Benton,Christina Nunnally,Chief Quality Officer,662-502-3156,,christina.nunnally@nmphc.org,,,,,,
MS-006435,NURSE MED 2,"NurseMed, Inc.",1497820310,Rural Health Clinics,1031 Northridge Rd,,Baldwyn,MS,38824-1173,Prentiss,1031 Northridge Rd,,Baldwyn,MS,38824-1173,Prentiss,Anita Turner,Owner,662-365-9305,,nursemed12@yahoo.com,Lynn Corbin,Office Manager,662-365-9305,,lscorbin@hotmail.com,
MS-006436,AARON E. HENRY - BATESVILLE CLINIC,"AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1003814104,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",216 Highway 51 N,,Batesville,MS,38606-2311,Panola,510 Highway 322,,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,,,662-563-1858,,,http://www.aehchc.org/
MS-006437,Hancock Clinic,COASTAL FAMILY HEALTH CENTER,1124016209,Federally Qualified Health Centers - Medical Services,109 Hospital Dr,,Bay St Louis,MS,39520-1604,Hancock,PO Box 475,,Biloxi,MS,39533,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006438,Beaumont Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1831167998,Federally Qualified Health Centers - Medical Services,1411 Bradley Ave,,Beaumont,MS,39423-0235,Perry,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006439,"GORTON RURAL HEALTH CLINIC, LLC","Gorton Rural Health Clinic, LLC",1699801654,Ryan White Providers,107 Church St,,Belzoni,MS,39038-3929,Humphreys,107 Church Street,,Belzoni,MS,39038-3929,Humphreys,Leanne Duett,Office Manager,662-247-2105,,LDUETTGC@BELLSOUTH.NET,,,,,,
MS-006440,Biloxi Clinic,COASTAL FAMILY HEALTH CENTER,1821086083,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",715A Division St,,Biloxi,MS,39530-2209,Harrison,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006441,Biloxi Pediatric Clinic,COASTAL FAMILY HEALTH CENTER,1528312519,Federally Qualified Health Centers - Medical Services,735 Division St,,Biloxi,MS,39530-2209,Harrison,PO Box 475,,Biloxi,MS,39533,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006442,Cotton Plant Clinic,Cotton Plant Clinic,1447596325,Rural Health Clinics,1755 County Road 81,,Blue Mountain,MS,38610-9657,Union,1755 County Road 81,,Blue Mountain,MS,38610,Union,"Paula DeCanter, CFNP",Owner/Provider,662-538-4111,,pdecanter74@bellsouth.net,Kristy Jarvis,Office Manager,662-538-0017,,krstyjarvis@yahoo.com,
MS-006443,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1760414494,Federally Qualified Health Centers - Medical Services,9700 I 20 Frontage Rd,Bolton-Edwards Elem/Middle School Based Clinic,Bolton,MS,39041-9126,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006444,"Family Health Care Clinic, Inc. --Brandon","FAMILY HEALTH CARE CLINIC, INC.",1346266616,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1551 W Government St,,Brandon,MS,39042-2408,Rankin,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret A. Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,COO,601-825-7280,5003,cmayes@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006445,"Family Health Care Clinic, Inc. --Brookhaven","FAMILY HEALTH CARE CLINIC, INC.",1689816001,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",290 Highway 51 N,,Brookhaven,MS,39601-2654,Lincoln,4635 Highway 80 E,,Pearl,MS,39208-4226,Lincoln,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,COO,602-825-7280,5003,cmayes@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006446,BROOKSVILLE PRIMARY CARE CLINIC,Noxubee General Critical Access Hospital,1669657565,Rural Health Clinics,1560 Oliver St,,Brooksville,MS,39739,Noxubee,78 Hospital Rd,,Macon,MS,39341,Noxubee,Jessica Hunt,Clinic Administrator,662-738-4424,553,jessica.hunt@ngcah.com,,,,,,
MS-006447,Byhalia Family Health Center,"Northeast Mississippi Health Care, Inc.",1558410738,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12 Brunswick St,,Byhalia,MS,38611-7000,Marshall,P O Box 698,,Byhalia,MS,38611,Marshall,Clifton Rodgers,Executive Director,662-838-2163,201,crodgersnemhc@yahoo.com,ANDREA CHRISTMAN,,662-838-2163,,ACHRISTMANNEMHC@YAHOO.COM,
MS-006448,Byhalia Family Dental Clinic,"Northeast Mississippi Health Care, Inc.",1619025269,Dental Providers,34 Brunswick St,,Byhalia,MS,38611-7000,Marshall,P O Box 698,,Byhalia,MS,38611,Marshall,Clifton Rodgers,Executive Director,662-838-2163,201,crodgersnemhc@yahoo.com,,,,,,
MS-006449,"Family Health Care Clinic, Inc. --Calhoun City","FAMILY HEALTH CARE CLINIC, INC.",1720234248,Federally Qualified Health Centers - Medical Services,105 Legion Ave,,Calhoun City,MS,38916-6601,Calhoun,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006450,"G. A Carmichael Family Health Center, Inc.","G.A. Carmichael Family Health Center, Inc.",1801952809,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1668 W Peace St,,Canton,MS,39046-5332,Madison,1668 W. Peace Street,,Canton,MS,39046-0588,Madison,"Dr. James L. Coleman, Jr.",Chief Executive Officer,601-859-5213,2288,jcoleman@gacfhc.org,"Joseph Davis, Jr.",Chief Operations Officer,601-859-5213,2264,jdavis@gacfhc.org,
MS-006451,Dr. Arenia C. Mallory CHC - Canton,Dr. Arenia C. Mallory Community Health Center Inc.,1013034636,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",276 Nissan Pkwy,Bldg C,Canton,MS,39046-7006,Madison,17280 Highway 17 South,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,http://www.mallorychc.org
MS-006452,Red Water Community Satellite Clinic,Choctaw Health Center,1275611543,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1930 N Pearl St,,Carthage,MS,39051-8220,Leake,210 Hospital Circle,,Choctaw,MS,39350,Neshoba,Tina Scott,Health Director,601-389-4500,,TScott@choctaw.org,,,,,,www.choctawhealthcenter.org
MS-006453,CENTREVILLE CLINIC,FIELD MEMORIAL COMMUNITY HOSPITAL,1134166812,Rural Health Clinics,178 Highway 24 E,Suite A,Centreville,MS,39631-4171,Wilkinson,178 HWY 24 E,,CENTREVILLE,MS,39631,Amite,ANGELA JACKSON,CLINIC ADMINISTRATOR,601-888-3421,125,ajackson@fhsms.org,Chad Netterville,Administrator,601-890-0545,,cnetterville@fhsms.org,
MS-006454,FIELD MEMORIAL COMMUNITY HOSPITAL,FIELD MEMORIAL COMMUNITY HOSPITAL,1770574048,Inpatient Hospitals (other than children's hospitals),178 Highway 24 E,,Centreville,MS,39631-4171,Wilkinson,178 HWY 24 E,,CENTREVILLE,MS,39631-4171,Amite,Chad Netterville,Administrator,601-890-0545,,cnetterville@fhsms.org,,,,,,
MS-006455,Tallahatchie General Hospital,Tallahatchie General Hospital,1679733497,Inpatient Hospitals (other than children's hospitals),201 S Church St,,Charleston,MS,38921-2204,Tallahatchie,P O Box 230,,Charleston,MS,38921,Tallahatchie,Frankie J Tartt,Clinic Director,662-625-7162,,ftartt@mytgh.com,Jim Blackwood,CEO,662-625-7115,,jblackwood@mytgh.com,www.mytgh.com
MS-006456,Charleston Rural Health Clinic,Tallalhatchie General Hospital,1194860502,Rural Health Clinics,401 S Church St,,Charleston,MS,38921-2257,Tallahatchie,Tallahatchie General Hospital,201 South Market Street,Charleston,MS,38921,Tallahatchie,Frankie J Tartt,Clinic Director,662-625-7162,,ftartt@mytgh.com,Jim Blackwood,CEO,662-625-7114,,jblackwood@mytgh.com,http://www.mytgh.com/
MS-006457,Choctaw Hospital (Philadelphia),Choctaw Hospital (Philadelphia),1790865780,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",210 Hospital Cir,,Choctaw,MS,39350-6781,Neshoba,210 Hospital Cir,,Choctaw,MS,39350-6781,Neshoba,Tina Scott,Health Director,601-389-4500,,TScott@choctaw.org,,,,,,www.choctawhealthcenter.org
MS-006458,AARON E. HENRY - CLARKSDALE CLINIC,"AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1144227901,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",800 Ohio Ave,,Clarksdale,MS,38614-7200,Coahoma,510 Highway 322,,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,,,,,,http://www.aehchc.org/
MS-006459,Bolivar Medical Center,LifePoint Health,1457321036,Inpatient Hospitals (other than children's hospitals),901 E Sunflower Rd,,Cleveland,MS,38732-2833,Bolivar,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,FRED CHISLM,CFO,615-920-7774,,FRED.CHISLM@LPN.NET,
MS-006460,Arrington Medical Clinic,Arrington Medical Clinic,1578987889,Rural Health Clinics,14415 Main St,,Coffeeville,MS,38922-2589,Yalobusha,14415 Main Street,,Coffeeville,MS,38965,Yalobusha,Calvin Johnson,Clinic Administrator,662-473-5271,,cjohnson@yalobushageneral.net,Terry Varner,Hospital Administrator,662-473-5901,,tvarner@yalobushageneral.com,
MS-006461,M.J. Edwards Center,"AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1841616265,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",643 W Service Dr,,Coldwater,MS,38618-3822,Tate,510 Highway 322,,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,,,662-233-7086,,,http://www.aehchc.org
MS-006462,Family Medical Associates (inpatient hospital),Covington County Hospital,1598769044,Inpatient Hospitals (other than children's hospitals),701 S Holly Ave,,Collins,MS,39428-3894,Covington,701 S. Holly Ave.,,Collins,MS,39428,Covington,ANISSA PROMISE,Clinic Support Manager,601-798-0328,,APROMISE@COVINGTONCOUNTYHOSPITAL.COM,Anissa Promise,Clinic Support Representative,601-765-3180,,apromise@covingtoncountyhospital.com,
MS-006463,Family Medical Associates (rural health clinics),Covington County Hospital,1598769044,Rural Health Clinics,701 S Holly Ave,,Collins,MS,39428-3894,Covington,701 S. Holly Ave,,Collins,MS,39428,Covington,ANISSA PROMISE,Clinic Operation Manager,601-698-0328,,APROMISE@COVINGTONCOUNTYHOSPITAL.COM,ELIZABETH SAULTERS,Clinic Coordinator,601-765-2746,,ESAULTERS@COVINGTONCOUNTYHOSPITAL.COM,
MS-006464,Rush Medical Clinic/Collinsville,"Laird Hospital, Inc.",1518924752,Rural Health Clinics,9097 Collinsville Rd,,Collinsville,MS,39325-9779,Lauderdale,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006465,"Family Health Care Clinic, Inc., --Columbia","FAMILY HEALTH CARE CLINIC, INC.",1679747703,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",628 Main St,,Columbia,MS,39429-2936,Marion,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006466,Conehatta Community Satellite Clinic,Choctaw Health Center,1013092600,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",376 Campus Rd,,Conehatta,MS,39057-2800,Newton,210 Hospital CIrcle,,Choctaw,MS,39350,Neshoba,Tina Scott,Health Director,601-389-4500,,TScott@choctaw.org,,,,,,www.choctawhealthcenter.org
MS-006467,John C. Stennis Memorial Hospital,"Kemper CAH, Inc.",1679875645,Inpatient Hospitals (other than children's hospitals),14365 Highway 16 W,,De Kalb,MS,39328-7974,Kemper,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006468,Rush Medical Clinic/Dekalb,"Kemper CAH, Inc.",1912348616,Rural Health Clinics,14365 Highway 16 W,,De Kalb,MS,39328-7974,Kemper,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006469,KEMPER FAMILY MEDICAL CENTER,"GREATER MERIDIAN HEALTH CLINIC, INC",1982701223,"Dental Providers, Federally Qualified Health Centers - Medical Services",201 Birch St,,De Kalb,MS,39328-8017,Kemper,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,CEO,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006470,Decatur Family Medical,"Laird Hospital, Inc.",1033460878,Rural Health Clinics,14884 Hwy 15,,Decatur,MS,39327-0217,Newton,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006471,D'Iberville Clinic,COASTAL FAMILY HEALTH CENTER,1629309117,Federally Qualified Health Centers - Medical Services,3446 Big Ridge Road,,D'Iberville,MS,39540-2421,Harrison,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006472,Dr. Arenia C. Mallory CHC - DURANT CLINIC,ARENIA C. MALLORY COMM HLTH CTR,1902923527,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",33795 Hwy 12 E,,Durant,MS,39063,Holmes,17280 Highway 17,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,www.mallorychc.org
MS-006473,Pontotoc Health Services RHC Ecru,"Pontotoc Health Services, Inc.",1053728139,Rural Health Clinics,202 Main St,,Ecru,MS,38841-9604,Pontotoc,176 S Main St,,Pontotoc,MS,38863,Pontotoc,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006474,Jackson-Hinds Edwards Site,Jackson-Hinds Comprehensive Health Center,1346684826,Federally Qualified Health Centers - Medical Services,100 Magnolia St,,Edwards,MS,39066,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006475,Ellisville Pediatric Clinic,"South Central Clinics, Inc.",1427098003,Rural Health Clinics,1203 B Ave,Suite 200,Ellisville,MS,39437-2080,Jones,PO BOX 247,,Laurel,MS,394410247,Jones,KERI PARISH,Credentialing Specialist,601-425-7550,,KPARISH@SCRMC.COM,Monica Morrow,Director of Clinic Support Services,601-425-7550,,mmorrow@scrmc.com,
MS-006476,Webster Health Services Eupora Family Medical Clinic,"Webster Health Services, Inc.",1639584352,Rural Health Clinics,1301 Veterans Memorial Blvd,,Eupora,MS,39744-2064,Webster,70 Medical Plaza,,Eupora,MS,39744,Webster,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006477,Webster Health Services Eupora Pediatric Clinic,"Webster Health Services,Inc",1346584836,Rural Health Clinics,15 Medical Plz,,Eupora,MS,39744-4019,Webster,70 Medical Plaza,,Eupora,MS,39744,Webster,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006478,Eupora Primary Care RHC,"Webster Health Services, Inc.",1851729214,Rural Health Clinics,70 Medical Plz,,Eupora,MS,39744-4018,Webster,70 Medical Plaza,,Eupora,MS,39744,Webster,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006479,Jefferson Comprehensive Health Center,"Jefferson Comprehensive Health Center, Inc",1962517185,Federally Qualified Health Centers - Medical Services,225 Community Drive,,Fayette,MS,39069,Jefferson,P.O. Box 98,,Fayette,MS,39069,Jefferson,Shirley Ellis-Stampley,CEO,601-786-3475,20,sellis2020@aol.com,Katrina Collins,Human Resources Director,601-786-3475,24,katrina_mln@yahoo.com,
MS-006480,"Jefferson Comprehensive Health Center, Inc.","Jefferson Comprehensive Health Center, Inc.",1922271691,"Dental Providers, Federally Qualified Health Centers - Medical Services",2277 Main St,Jefferson Comprehensive Health Center School Clinic-High School,Fayette,MS,39069-5515,Jefferson,P.O. Box 98,,Fayette,MS,39069,Jefferson,Shirley Ellis-Stampley,CEO,601-786-3475,20,sellis2020@aol.com,Katrina Malone-Collins,Human Resources Director,601-786-3475,,katrina_mln@yahoo.com,
MS-006481,"Jefferson Comprehensive Health Center, Inc.","Jefferson Comprehensive Health Center, Inc.",1770756447,"Dental Providers, Federally Qualified Health Centers - Medical Services",468 Highway 33,Jefferson Comprehensive Health Center School Clinic-Middle School,Fayette,MS,39069-4546,Jefferson,P.O. Box 98,,Fayette,MS,39069,Jefferson,Shirley Ellis-Stampley,CEO,601-786-3475,20,sellis2020@aol.com,Katrina Collins,Human Resources Director,601-786-3475,,katrina_mln@yahoo.com,
MS-006482,"Family Health Care Clinic, Inc. --Flowood","FAMILY HEALTH CARE CLINIC, INC.",1790701944,Federally Qualified Health Centers - Medical Services,1307B Airport Rd N,,Flowood,MS,39232-8890,Rankin,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,COO,601-825-7280,5003,cmayes@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006483,Primary Health Care,"Scott Regional Medical Center, Inc.",1679831531,Rural Health Clinics,1080 Highway 35 S,,Forest,MS,39074-9423,Scott,PO Box 2065,,Meridian,MS,39302-2065,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006484,Community Health Clinic,"Independent Healthcare Mgmt, Inc.",1255376729,Rural Health Clinics,1123 Highway 35 S,,Forest,MS,39074-8829,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006485,Lackey Pediatric Clinic,"Independent Healthcare Mgmt, Inc.",1154670719,Rural Health Clinics,1129 Highway 35 S,Suite 1,Forest,MS,39074-8829,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006486,S.E. Lackey Memorial Hospital,"Pioneer Health Services, INC",1306909734,Inpatient Hospitals (other than children's hospitals),330 N Broad St,,Forest,MS,39074-3508,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,Chief Financial Officer,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Strategic Alignment & Network Development,601-849-6440,385,laurenwilliams@phscorporate.com,
MS-006487,GLOSTER CLINIC,FIELD MEMORIAL COMMUNITY HOSPITAL,1144274622,Rural Health Clinics,434 N Captain Gloster Dr,,Gloster,MS,39638-3401,Amite,178 HWY 24 E,,CENTREVILLE,MS,39631,Amite,Angela Jackson,Clinic Administrator,601-888-3421,125,ajackson@fhsms.org,Chad Netterville,Administrator,601-890-0545,,cnetterville@fhsms.org,
MS-006488,Crossroads Clinics North,Delta Regional Medical Center,1295770709,Ryan White Providers,313 Arnold Ave,,Greenville,MS,38701-4712,Washington,1400 E Union St,,Greenville,MS,38701,Washington,Chadric Neal,Program Director,662-332-1398,,cneal@deltaregional.com,Janet Benzing,Director of Ancillary Services,662-725-2768,,jbenzing@deltaregional.com,
MS-006489,Delta Regional Health Clinic,Delta Regional Medical Center,1366592610,Rural Health Clinics,344 Arnold Ave,,Greenville,MS,38701-4711,Washington,P.O. Box 4739,,Greenville,MS,38704-4739,Washington,Carolyn Jacks-Thompson,Operations Coordinator,662-725-2749,2749,cjacks@deltaregional.com,,,,,,
MS-006490,Magnolia Medical Clinic,Greenwood Leflore Hospital,1376724799,"Rural Health Clinics, Ryan White Providers",1413 Strong Ave,,Greenwood,MS,38930-4035,Leflore,1401 Reiver Road,,Greenwood,MS,38930,Leflore,Kawanis Collins,Program Coordinator,662-451-7384,,kcollins@glh.org,,,,,,
MS-006491,Dr. Arenia C. Mallory CHC - Greenwood,Dr. Arenia C. Mallory Community Health Center Inc.,1053649749,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",201 E Washington St,,Greenwood,MS,38930-4407,Leflore,17281 Highway 17 South,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,http://www.mallorychc.org
MS-006492,"Family Health Care Clinic, Inc., --Grenada","FAMILY HEALTH CARE CLINIC, INC.",1629224696,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1732 Commerce St,,Grenada,MS,38901-4615,Grenada,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006493,Gulfport Clinic,COASTAL FAMILY HEALTH CENTER,1841220357,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",15024 Martin Luther King Jr Blvd,,Gulfport,MS,39501-8306,Harrison,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006494,Pioneer Family Medical of Hamilton,"Pioneer Health Services of Monroe County, Inc.",1326083619,Rural Health Clinics,40128 Hamilton Rd,,Hamilton,MS,39746-9686,Monroe,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006495,Harrisville Medical Clinic,"Simpson Community Healthcare, Inc.",1356427843,Rural Health Clinics,1652 Simpson Highway 469,,Harrisville,MS,39082-4002,Simpson,1842 Simpson Hwy 149,,Mendenhall,MS,39114,Simpson,DAVID WELCH,CEO,601-847-7151,,DAVID.WELCH@SIMPSONGENERAL.COM,Gwen Williams,Administrative Assistant,601-847-7151,,gwen.williams@simpsongeneral.com,simpsongeneral.com
MS-006496,Hattiesburg Family Health Center - Downtown,"Southeast Mississippi Rural Health Initiative, Inc.",1265461719,Federally Qualified Health Centers - Medical Services,100 W Front St,,Hattiesburg,MS,39401-3460,Forrest,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006497,"Southeast Mississippi Rural Health Initiative, Inc.","Southeast Mississippi Rural Health Initiative, Inc.",1518907054,Federally Qualified Health Centers - Medical Services,180 WSF Tatum Dr,N R Burger School and Community Clinic,Hattiesburg,MS,39401,Forrest,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006498,Hattiesburg Center,"Planned Parenthood Southeast, Inc.",1609829282,Family Planning Providers,214 S 27th Ave,,Hattiesburg,MS,39401-7165,Forrest,"241 Peachtree Street NE, Suite 400",,Atlanta,GA,30303,Fulton,Sara Woodson,CFO,404-567-8285,,sara.woodson@ppse.org,Staci Fox,CEO,404-688-9300,,staci.fox@ppse.org,www.ppse.org
MS-006499,Minor Care Clinic,"Southeast Mississippi Rural Health Initiative, Inc.",1508874769,Federally Qualified Health Centers - Medical Services,222 S 27th Ave,,Hattiesburg,MS,39401-7165,Forrest,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006500,Hattiesburg Public School and Community Clinic,"Southeast Mississippi Rural Health Initiaitive, Inc.",1023087400,Federally Qualified Health Centers - Medical Services,404 Lillie Burney St,Hattiesburg Public School and Community Center,Hattiesburg,MS,39401-5505,Forrest,5488 U S Hwy 49,,Hattiesburg,MS,39401-7806,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentaling Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006501,"Southeast Mississippi Rural Health Initiative, Inc.","Southeast Mississippi Rural Health Initiative, Inc.",1760451777,Federally Qualified Health Centers - Medical Services,605 Stadium Dr,Hattiesburg High School and Community Clinic,Hattiesburg,MS,39401-4156,Forrest,5488 U S Hwy 49,,Hattiesburg,MS,39401-7806,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentailing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006502,Women's Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1831167998,"Dental Providers, Federally Qualified Health Centers - Medical Services",62 Old Airport Rd,,Hattiesburg,MS,39401-8382,Forrest,5488 U S Hwy 49,,Hattiesburg,MS,39401-7806,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentailing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006503,Hattiesburg Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1538136940,"Dental Providers, Federally Qualified Health Centers - Medical Services",66 Old Airport Rd,,Hattiesburg,MS,39401-8382,Forrest,5488 U S Hwy 49,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006504,Hattiesburg Community Dental Center,Southeast Mississippi Rural Health Center,1366468266,Dental Providers,68 Old Airport Rd,,Hattiesburg,MS,39401-8382,Forrest,5488 U S Hwy 49,,Hattiesburg,MS,39401-7806,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006505,Hardy Wilson Memorial Hospital,Hardy Wilson Memorial Hospital,1588667281,Inpatient Hospitals (other than children's hospitals),233 Magnolia St,,Hazlehurst,MS,39083-2228,Copiah,233 Magnolia Street,,Hazlehurst,MS,39083,Copiah,Benjamin Lott,CEO,601-894-6242,,blott@hwmhospital.com,Bryan Stevens,CFO,601-894-6254,,bstevens@hwmhospital.com,
MS-006506,Copiah County Medical Center,Copiah County Medical Center,1588667281,Inpatient Hospitals (other than children's hospitals),27190 Highway 28,,Hazlehurst,MS,39083-2224,Copiah,27190 Highway 28,,Hazlehurst,MS,39083,Copiah,Benjamin Lott,CEO,601-574-7200,,blott@copiahhealth.org,Dean Snider,CFO,601-574-7202,,dsnider@copiahhealth.org,
MS-006507,Copiah Comprehensive Health Complex,Jackson-Hinds Comprehensive Health Center,1760420335,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",550 Caldwell Dr,,Hazlehurst,MS,39083-2304,Copiah,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006508,JASPER MEDICAL CLINIC,"OUTREACH HEALTH SERVICE, INC.",1255521480,"Dental Providers, Federally Qualified Health Centers - Medical Services",309 N Pine Ave,,Heidelberg,MS,39439-3412,Jasper,309 PINE AVE,,Heidelberg,MS,39439-0485,Jasper,SABRINA HOWZE,EXECUTIVE DIRECTOR,601-687-1391,,SHOWZE@OUTREACHHS.ORG,TAMARA CLARK,BILLING SPECIALIST,601-687-1391,,TCLARK@OUTREACHHS.ORG,
MS-006509,Holcomb Clinic,Tallalhatchie General Hospital,1932591468,Rural Health Clinics,195 Highway 35 S,,Holcomb,MS,38940-9713,Grenada,201 Market Street,,Charleston,MS,38921,Tallahatchie,Frankie J Tartt,Clinic Director,662-625-7162,,ftartt@mytgh.com,Jim Blackwood,CEO,662-625-7114,,jblackwood@mytgh.com,http://www.mytgh.com/
MS-006510,GSV Care Medical Clinic,GSV Care Medical Clinic,1275874281,Rural Health Clinics,400 Third Avenue Hwy 32 W,,Houlka,MS,38850,Chickasaw,400 Third Avenue Hwy 32 W,,Houlka,MS,38850,Chickasaw,LENE BLAIR,DNP,662-568-2013,,ONLY1LENEBLAIR@YAHOO.COM,Lene Blair,Office Manager,662-568-2013,,gsvcare@gmail.com,
MS-006511,Jackson-Hinds Comprehensive Health Center South Clinic,"Central Mississippi Civic Improvement Association, Inc.",1275561862,"Dental Providers, Federally Qualified Health Centers - Medical Services",145 Raymond Rd,,Jackson,MS,39204-3802,Hinds,3502 W Northside Dr,,Jackson,MS,39213-4454,Hinds,Dr. Jasmin Chapman,Chief Executive Officer,601-364-5142,,jhchc@comcast.net,,,,,,www.jhchc.org
MS-006512,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1255360483,Federally Qualified Health Centers - Medical Services,1655 Whiting Rd,Van Winkle Elementary School,Jackson,MS,39209-5826,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006513,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1376732313,Federally Qualified Health Centers - Medical Services,1716 Isable St,Isable Elementary School,Jackson,MS,39204-2352,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006514,Jackson-Hinds Bennie G. Thompson Facility,Jackson-Hinds Comprehensive Health Center,1659618106,Federally Qualified Health Centers - Medical Services,1860 Chadwick Dr,Suite 300,Jackson,MS,39204-3470,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006515,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1447448667,Federally Qualified Health Centers - Medical Services,2185 Fortune St,Jim Hill High School,Jackson,MS,39204-2333,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006516,Jackson-Hinds at the Jackson Medical Mall,Jackson-Hinds Comprehensive Health Center,1427377266,Federally Qualified Health Centers - Medical Services,350 W Woodrow Wilson Ave,,Jackson,MS,39213-7681,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006517,Mississippi State Department of Health,Hinds County Department of Health,1053489260,"Dental Providers, Rural Health Clinics",350 W Woodrow Wilson Ave,Suite 3516,Jackson,MS,39213-7681,Hinds,350 West Woodrow Wilson Avenue,Suite 3516,Jackson,MS,39216,Hinds,Betty Price,Director,601-432-4881,,Betty.Price@msdh.state.ms.us,,,,,,
MS-006518,Jackson-Hinds Comprehensive Health Center,"Central Mississippi Civic Improvement Association, Inc",1134151442,"Dental Providers, Federally Qualified Health Centers - Medical Services",3502 W Northside Dr,,Jackson,MS,39213-4454,Hinds,3502 West Northside Drive,,Jackson,MS,39213,Hinds,Jasmin Chapman,Chief Executive Officer,601-364-5142,1223,jhchc@comcast.net,,,,,,
MS-006519,The Village Apartment Complex,Jackson-Hinds Comprehensive Health Center,1689047201,Federally Qualified Health Centers - Medical Services,386 Raymond Rd,,Jackson,MS,39204-3700,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006520,Commonwealth Apartment Complex,Jackson-Hinds Comprehensive Health Center,1689047292,Federally Qualified Health Centers - Medical Services,3930 Skyview Drive,,Jackson,MS,39213,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006521,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1134592777,Federally Qualified Health Centers - Medical Services,415 Claiborne Ave,Pecan Park Elementary School Based Clinic,Jackson,MS,39209-5321,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006522,Ethel James Ivory Homeless Clinic,Jackson-Hinds Comprehensive Health Center,1205021946,Federally Qualified Health Centers - Medical Services,427 J R Lynch St,,Jackson,MS,39203-3518,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006523,Jackson-Hinds Bennie G. Thompson Facility,Jackson-Hinds Comprehensive Health Center,1912260522,Federally Qualified Health Centers - Medical Services,514 E Woodrow Wilson Ave,,Jackson,MS,39216-4538,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006524,AHF Healthcare Center - Jackson,AIDS Healthcare Foundation,1255688057,Other ECP Providers,766 Lakeland Dr,Suite A,Jackson,MS,39216-4610,Hinds,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
MS-006525,Rush Family Practice/Lake,"Scott Regional Medical Center, Inc.",1932478476,Rural Health Clinics,24489 Highway 80,,Lake,MS,39092-3511,Newton,PO Box 2065,,Meridian,MS,39302-2065,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006526,"Family Health Center, INC. OB/GYN Clinic","Family Health Center, INC.",1003096785,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",103 S 12th Ave,,Laurel,MS,39440-4322,Jones,103 South 12th Avenue,,Laurel,MS,39440,Jones,Coney L. Johnson,COO/HR Director,601-425-3033,157,cljohnson@laurelfhc-ms.com,Sherrin Roberts,Chief Financial Officer,601-425-3033,177,sroberts@laurelfhc-ms.com,www.lfhc.net
MS-006527,"Family Health Center, INC. Main Clinic","Family Health Center, INC.",1760488357,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",117 S 11th Ave,,Laurel,MS,39440-4312,Jones,117 South 11th Avenue,,Laurel,MS,39440,Jones,Coney L. Johnson,COO/HR Director,601-425-3033,157,cljohnson@laurelfhc-ms.com,Sherrin Roberts,Chief Financial Officer,601-425-3033,177,sroberts@laurelfhc-ms.com,www.lfhc.net
MS-006528,South Central Urgent Care,"South Central Clinics, Inc.",1669609111,Rural Health Clinics,1430 Jefferson St,,Laurel,MS,39440-4243,Jones,PO BOX 247,,Laurel,MS,394410247,Jones,Erin Walker,Credentialing Specialist,601-399-6165,,ewalker@scrmc.com,Monica Morrow,Director of Clinic Support Services,601-425-7550,,mmorrow@scrmc.com,
MS-006529,Laurel Pediatric Clinic,"South Central Clinics, Inc.",1316975394,Rural Health Clinics,234 S 12th Ave,,Laurel,MS,39440-4325,Jones,PO BOX 247,,Laurel,MS,394410247,Jones,Erin Walker,Credentialing Specialist,601-399-6165,,ewalker@scrmc.com,Monica Morrow,Director of Clinic Support Services,601-425-7550,,mmorrow@scrmc.com,
MS-006530,Leakesville Clinic,COASTAL FAMILY HEALTH CENTER,1801999479,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1616 Williams Dr,,Leakesville,MS,39451-5622,Greene,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006531,LELAND MEDICAL CLINIC,Delta Health Alliance,1679673917,Rural Health Clinics,201 Baker Blvd,,Leland,MS,38756-3401,Washington,201 Baker Blvd,,Leland,MS,38756-3401,Washington,Daniel Thomas,Clinic Director,662-686-4121,3916,dthomas@deltahealthalliance.org,Sam Dawkins,VP of Information Systems,662-686-7004,3868,sdawkins@deltahealthalliance.org,http://www.lelandmedicalclinic.org
MS-006532,Dr. Arenia C. Mallory CHC - Lexington,Dr. Arenia C. Mallory Community Health Center Inc.,1740308873,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",17280 Highway 17,,Lexington,MS,39095-6614,Holmes,17280 Highway 17 South,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,http://www.mallorychc.org/
MS-006533,Dr. Arenia C. Mallory CHC -Lexington Pediatric Complex,ARENIA C. MALLORY COMM HLTH CTR,1740624881,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",300 Yazoo St,,Lexington,MS,39095-3623,Holmes,17280 Highway 17,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,www.mallorychc.org
MS-006534,"AMITE COUNTY MEDICAL SERVICES, INC.","Amite County Medical Services, Inc.",1073634226,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",102 W Freedom Dr,,Liberty,MS,39645-7295,Amite,PO Box 511,,Liberty,MS,39645-0511,Amite,Pam T Poole,Executive Director,601-657-4326,126,acmsinc@bellsouth.net,Sally Toler,Assistant Executive Director,601-657-4326,126,stoler@acmsinc.org,www.acmsinc.org
MS-006535,Liberty Dental Services,Amite County Medical Services,1659693083,Dental Providers,102 W Freedom Dr,,Liberty,MS,39645-7295,Amite,PO Box 511,,Liberty,MS,39645-0511,Amite,Aleda Jean Dillon,Credentialing/Insurance,601-657-4326,127,adillon@acmsinc.org,Aleda Dillon,Credentialing/Insurance,601-657-4326,127,adillon@acmsinc.org,
MS-006536,Liberty Clinic,Field Memorial Community Hospital,1669818480,Rural Health Clinics,1410 Main Street E,,Liberty,MS,39645,Amite,178 Hwy 24 E,,Centreville,MS,39631,Amite,Angela Jackson,Clinic Administrator,601-888-3421,125,ajackson@fhsms.org,Chad Netterville,Administrator,601-890-0545,,cnetterville@fhsms.org,
MS-006537,Winston County Family Medical Center,"GREATER MERIDIAN HEALTH CLINIC, INC",1770680019,Federally Qualified Health Centers - Medical Services,199 Highway 15 S,Suite D,Louisville,MS,39339-6608,Winston,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,CEO,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006538,Lumberton Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1164499174,Federally Qualified Health Centers - Medical Services,598 W 11th Ave,,Lumberton,MS,39455-2530,Lamar,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006539,MACON MEDICAL CLINIC,Noxubee General Critical Access Hospital,1700062734,Rural Health Clinics,3878 Jefferson St,,Macon,MS,39341-2291,Noxubee,78 Hospital Rd,,Macon,MS,39341,Noxubee,Jessica Hunt,Clinic Administrator,662-726-4264,553,jessica.hunt@ngcah.com,,,,,,
MS-006540,MACON PRIMARY CLINIC,Noxubee General Critical Access Hospital,1730148123,Rural Health Clinics,78 Hospital Rd,,Macon,MS,39341-2490,Noxubee,78 Hospital Rd,,Macon,MS,39341,Noxubee,Jessica Hunt,Clinic Administrator,662-726-4264,553,jessica.hunt@ngcah.com,,,,,,
MS-012482,Mississippi Center for Advanced Medicine,Mississippi Center for Advanced Medicine,1790227627,Hemophilia Treatment Centers,7730 Old Canton Rd,Bldg B,Madison,MS,39110-9299,Madison,7730 Old Canton Rd Bldg B,,Madison,MS,39110,Madison,Kayla Douglas,Director of Pharmacy,601-499-0935,,ksdouglas@msadvancedmedicine.com,Spencer Sullivan,CEO,601-499-0935,,sksullivan@msadvancedmedicine.com,msadvancedmedicine.com
MS-006541,Mantachie Rural Health Dental Clinic,"Mantachie Rural Health Care, Inc.",1063779130,Dental Providers,5500 Highway 363,,Mantachie,MS,38855-7197,Itawamba,5681 Highway 363,,Mantachie,MS,38855,Itawamba,MARJORIE MCKINNEY,CEO,662-282-4226,114,mckinney.mrhc@yahoo.com,Karen Burns,Office Manager,662-282-4226,124,karen.burns@hotmail.com,
MS-006542,Mantachie Behavioral Health Clinic,"Mantachie Rural Health Care, Inc.",1033169545,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",5510 Highway 363,,Mantachie,MS,38855-7197,Itawamba,PO Box 40,,Mantachie,MS,38855,Itawamba,MARJORIE MCKINNEY,Chief Executive Officer,662-282-4226,114,mckinney.mrhc@yahoo.com,,,,,,
MS-006543,Mantachie Rural Health Medical Clinic,"Mantachie Rural Health Care, Inc.",1033169545,Federally Qualified Health Centers - Medical Services,5681 Highway 363,,Mantachie,MS,38855-7632,Itawamba,5681 Highway 363,,Mantachie,MS,38855-7632,Itawamba,MARJORIE MCKINNEY,CHIEF EXECUTIVE OFFICER,662-282-4226,114,mckinney.mrhc@yahoo.com,KAREN BURNS,OFFICE MANAGER,662-282-4226,124,KAREN.BURNS12@HOTMAIL.COM,
MS-006544,Marion Primary Care Center,"Kemper CAH, Inc.",1669812962,Rural Health Clinics,5334 Dale Dr,,Marion,MS,39342-9604,Lauderdale,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006545,"Aaron E. Henry Community Health Services Center, Inc.","AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1538167564,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1362 Martin Luther King Dr,Aaron E Henry - Quitman School Base Clinic,Marks,MS,38646-1833,Quitman,510 Highway 322,,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,LaQuitta Green,Chief Financial Officer,662-624-4292,1106,lgreen@aehchc.org,http://www.aehchc.org
MS-006546,"Pike County Medical Services, Inc.","Amite County Medical Services, Inc.",1609242056,Federally Qualified Health Centers - Medical Services,300 Rawls Dr,Suite 1300,McComb,MS,39648-2866,Pike,102 West Freedom Drive,,Liberty,MS,39645,Amite,Pam Poole,Executive Director,601-657-4326,237,acmsinc@bellsouth.net,,,,,,www.acmsinc.org
MS-006547,FRANKLIN COUNTY MEMORIAL HOSPITAL,Franklin County Memorial Hospital,1669705612,Inpatient Hospitals (other than children's hospitals),40 Union Church Rd,,Meadville,MS,39653-8336,Franklin,P O BOX 636,,Meadville,MS,39653,Franklin,LILLIE HIGGINBOTHAM,REV CYCLE DIR,601-384-8143,,lillie.higginbotham@fcmh.net,KATHY FARR,CONTROLLER,601-384-8120,,kathy.farr@fcmh.net,www.fcmh.net
MS-006548,Family Health Care Clinic - Meadville,"Family Health Care Clinic, Inc",1235371659,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",445 Main St E,,Meadville,MS,39653-9293,Franklin,4635 Hwy 80 East,,Pearl,MS,39208,Rankin,Margaret A. Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006549,FAMILY MEDICAL GROUP,FAMILY MEDICAL GROUP,1023140811,Rural Health Clinics,595 Main St E,,Meadville,MS,39653-9233,Franklin,595 Main Street E,P O Box 636,Meadville,MS,39653,Franklin,RHONDA TERRELL,Office Manager,601-384-3199,8210,RHONDA.TERRELL@FCMH.NET,Lillie Higginbotham,Revenue Cycle Dir,601-384-8143,,lillie.higginbotham@fcmh.net,
MS-006550,SGH Medical Clinic,"Simpson Community Healthcare, Inc",1609069962,Rural Health Clinics,1827C Simpson Highway 149,,Mendenhall,MS,39114-3439,Simpson,1842 Simpson Hwy 149,,Mendnehall,MS,39114,Simpson,DAVID WELCH,CEO,601-847-7151,,DAVID.WELCH@SIMPSONGENERAL.COM,Gwen Williams,Administrative Assistant,601-847-7151,,gwen.williams@simpsongeneral.com,simpsongeneral.com
MS-006551,Simpson General Hospital,"Simpson Community Healthcare, Inc",1144339839,Inpatient Hospitals (other than children's hospitals),1842 Simpson Highway 149,,Mendenhall,MS,39114-3438,Simpson,1842 Simpson Hwy 149,,Mendenhall,MS,39114,Simpson,DAVID WELCH,CEO,601-847-7151,,DAVID.WELCH@SIMPSONGENERAL.COM,Gwen Williams,Administrative Assistant,601-847-7151,,gwen.williams@simpsongeneral.com,
MS-006552,"Family Health Care Clinic, Inc. --MENDENHALL","FAMILY HEALTH CARE CLINIC, INC.",1982620274,Federally Qualified Health Centers - Medical Services,401 Main St N,,Mendenhall,MS,39114-3303,Simpson,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006553,Rush Foundation Hospital,Rush Medical Foundation,1770543399,Inpatient Hospitals (other than children's hospitals),1314 19th Ave,,Meridian,MS,39301-4116,Lauderdale,PO Box 5208,,Meridian,MS,39302-5208,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006554,Family Medical Clinic,"Laird Hospital, Inc.",1114330347,Rural Health Clinics,1500 Highway 19 N,,Meridian,MS,39307-5335,Lauderdale,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006555,Immediate Care Family Clinic,"Kemper CAH, Inc.",1275885378,Rural Health Clinics,1710 14th St,,Meridian,MS,39301-4140,Lauderdale,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006556,Rush Medical Group Primary Care,Rush Medical Foundation,1275910663,Rural Health Clinics,1800 12th St,,Meridian,MS,39301-4158,Lauderdale,PO Box 5208,,Meridian,MS,39302-5208,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006557,"GREATER MERIDIAN HEALTH CLINIC, INC.","GREATER MERIDIAN HEALTH CLINIC, INC",1134225071,"Dental Providers, Federally Qualified Health Centers - Medical Services",2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,Chief Executive Officer,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006558,North Hills Family Medical Clinic,"Kemper CAH, Inc.",1275879314,Rural Health Clinics,4331 Highway 39 N,,Meridian,MS,39301-1007,Lauderdale,1314 19th Ave,,Meridian,MS,39301,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006559,"East Mississippi Medical Clinic, PLLC","East Mississippi Medical Clinic, PLLC",1881640142,Rural Health Clinics,4711 Poplar Springs Dr,,Meridian,MS,39305-2622,Lauderdale,9425 Eastside Drive Extension Highway 15 North,,Newton,MS,39345,Newton,Kristy Certain,Office Manager,601-485-7777,,eastmississippimedical@comcast.net,Razee Ahmad,MD,601-485-7777,,eastmississippimedical@comcast.net,emmconline.net
MS-006560,Central Mississippi Family Health Clinic,Rush Medical Foundation,1811233950,Rural Health Clinics,905C S Frontage Rd,,Meridian,MS,39301-6113,Lauderdale,PO Box 5208,,Meridian,MS,39302-5208,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,David Butler,Chief Financial Officer,601-703-3082,,david.butler@rushhealth.com,
MS-006561,Lawrence County Family Practice,Lawrence County Family Practice,1245289172,Rural Health Clinics,1135 E Broad St,,Monticello,MS,39654-7682,Lawrence,215 Marion Avenue,,McComb,MS,39648,Pike,JENNIFER MOAK,CFO- Lawrence County Hospital,601-250-4351,,JENNIFER.MOAK@SMRMC.COM,PHILLIP LANGSTON,Administrator - Lawrence County Hospital,601-587-1202,,PHILLIP.LANGSTON@SMRMC.COM,
MS-006562,Family Health Care Clinic - Monticello,"Family Health Care Clinic, Inc",1093731234,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",430 W Broad St,,Monticello,MS,39654-7723,Lawrence,4635 Highway 80 East,,Pearl,MS,39208,Rankin,Margaret A. Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006563,Scott Regional Medical Center,"Scott Regional Medical Center, Inc.",1134278435,Inpatient Hospitals (other than children's hospitals),317 Highway 13 S,,Morton,MS,39117-3353,Scott,PO Box 2065,,Meridian,MS,39302-2065,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006564,Clark Medical Clinic,"Scott Regional Medical Center, Inc.",1003166117,Rural Health Clinics,321 Highway 13 S,,Morton,MS,39117-3353,Scott,PO Box 2065,,Meridian,MS,39302-2065,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006565,Main Street Medical of Morton,"Independent Healthcare Mgmt, Inc.",1952694994,Rural Health Clinics,347 S Fourth St,,Morton,MS,39117-3407,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006566,Moss Point Clinic,COASTAL FAMILY HEALTH CENTER,1679581599,Federally Qualified Health Centers - Medical Services,4770 Amoco Dr,,Moss Point,MS,39563-9627,Jackson,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006567,Delta Health Center,Delta Health Center Incorporated,1659378610,"Dental Providers, Federally Qualified Health Centers - Medical Services",702 Martin Luther King St,,Mound Bayou,MS,38762-9314,Bolivar,702 Martin Luther King Road,,Mound Bayou,MS,38762,Bolivar,John Fairman,Chief Executive Officer,662-741-8880,,ceo1@deltahealthcenter.org,Hazel Whiting,Chief Financial Officer,662-741-8871,,cfo@deltahealthcenter.org,www.deltahealthcenter.org
MS-006568,Mt. Pleasant Family Health Clinic,"Northeast Mississippi Health Care, Inc.",1386792992,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",154 Mt. Pleasant Rd,,Mt. Pleasant,MS,38649,Marshall,P O Box 698,,Byhalia,MS,38611,Marshall,Clifton Rodgers,Executive Director,662-838-2163,201,crodgersnemhc@yahoo.com,ANDREA CHRISTMAN,,662-838-2163,,ACHRISTMAN@NEMHC@YAHOO.COM,
MS-006569,"Jefferson Comprehensive Health Center, Inc.","Jefferson Comprehensive Health Center, Inc",1295037372,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 Cottage Home Dr,School Based Clinic Adams,Natchez,MS,39120-2753,Adams,P.O. Bo 98,,Fayette,MS,39069,Jefferson,Shirley Ellis-Stampley,CEO,601-786-3475,20,sellis2020@aol.com,Katrina Collins,Human Resources Director,601-786-3475,,katrina_mln@yahoo.com,
MS-006570,Adams County Family Health Clinic,"Jefferson Comprehensive Health Center, Inc.",1205009966,"Dental Providers, Federally Qualified Health Centers - Medical Services",145 Homochitto St,,Natchez,MS,39120-3906,Adams,P.O. Box 98,,Fayette,MS,39069,Adams,Shirley Ellis-Stampley,CEO,601-786-3475,24,katrina_mln@yahoo.com,Katrina Collins,Human Resources Director,601-786-3475,,katrina_mln@yahoo.com,
MS-006571,Pontotoc Health Services RHC New Albany,"Pontotoc Health Services, Inc",1063813335,Rural Health Clinics,400 Doctors Dr,,New Albany,MS,38652-3109,Union,176 South Main St,,Pontotoc,MS,38863,Pontotoc,James P Stanell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006572,Family Clinic of New Albany,Family Clinic of New Albany,1609884733,Rural Health Clinics,474 W Bankhead St,,New Albany,MS,38652-3319,Union,474 West Bankhead Street,,New Albany,MS,38652-3319,Union,Robert Ira Vail,Administrator,662-534-7777,,robertvail@bellsouth.net,Gena Vail,Owner,662-534-7777,,gvail@acutecareclinics.net,
MS-006573,New Augusta Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1881661874,Federally Qualified Health Centers - Medical Services,404 Main Street,,New Augusta,MS,39462,Perry,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006574,"Family Health Care Clinic, Inc., --New Hebron","FAMILY HEALTH CARE CLINIC, INC.",1740206036,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",202 Jefferson St,,New Hebron,MS,39140-3809,Lawrence,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMYAES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006575,Newton Family Medical Associates,"Laird Hospital, Inc.",1124466214,Rural Health Clinics,252 Northside Dr,,Newton,MS,39345-9756,Newton,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006576,"East Mississippi Medical Clinic, PLLC","East Mississippi Medical Clinic, PLLC",1497096036,Rural Health Clinics,9425 Eastside Drive Ext,Highway 15 North,Newton,MS,39345,Newton,4711 Poplar Springs Drive,,Meridian,MS,39305,Lauderdale,Kristy Certain,Office Manager,601-485-7777,,eastmississippimedical@comcast.net,Razee Ahmad,MD,601-485-7777,,eastmississippimedical@comcast.net,emmconline.net
MS-006577,Newton Family and Pediatric Clinic,"Independent Healthcare Mgmt, Inc.",1396118378,Other ECP Providers,9427 Eastside Drive Ext,Suite A,Newton,MS,39345-8063,Newton,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006578,Oakland Medical Clinic,Yalobusha General Hospital,1942547161,Rural Health Clinics,14101 Hickory St,,Oakland,MS,38948-2631,Yalobusha,PO Box 728,,WATER VALLEY,MS,38965,Yalobusha,TERRY VARNER,CEO,662-473-1411,5907,tvarner@yalobushageneral.com,STEPHANIE BURNS,Clinic Administrator,662-473-5242,5271,SSURRETTE@YALOBUSHAGENERAL.NET,
MS-006579,"Children's Clinic of Oxford, P.A.","Children's Clinic of Oxford, P.A.",1801916481,Rural Health Clinics,2888 S Lamar Blvd,,Oxford,MS,38655-5347,Lafayette,SAME AS ABOVE,,Oxford,MS,38655,Lafayette,JOE HARRIS,MD,662-234-8286,,DRJOE47@MSN.COM,BENTLEY DENHAM,Office Manager,662-234-8286,11,BDENHAM@OXFORDKIDS.COM,
MS-006580,Pass Christian Clinic,COASTAL FAMILY HEALTH CENTER,1801102793,Federally Qualified Health Centers - Medical Services,257 Davis Ave,Suite A,Pass Christian,MS,39571-4541,Harrison,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006581,"Family Health Care Clinic, Inc. --PEARL","FAMILY HEALTH CARE CLINIC, INC.",1043236326,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006582,"Family Health Care Clinic, Inc.--Pelahatchie","FAMILY HEALTH CARE CLINIC, INC.",1467478743,Federally Qualified Health Centers - Medical Services,100 N Brooks Ave,,Pelahatchie,MS,39145-3092,Rankin,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,COO,601-825-7280,5003,cmayes@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006583,Neshoba County General Hospital,Neshoba County General Hospital,1083659734,Inpatient Hospitals (other than children's hospitals),1001 Holland Ave,,Philadelphia,MS,39350-2161,Neshoba,P.O. Box 648,,Philadelphia,MS,39350-0648,Neshoba,Scott H. McNair,CFO,601-663-1233,,smcnair@neshoba-hospital.com,Mary Jenkins,PFS Director,601-663-1260,,mej@neshoba-hospital.com,
MS-006584,Surgery Clinic of Philadelphia,Neshoba County General Hospital,1861578536,Other ECP Providers,1003 Holland Ave,Suite 101,Philadelphia,MS,39350-2180,Neshoba,1001 Holland Avenue,PO Box 648,Philadelphia,MS,39350,Neshoba,Cheryl Savell,Credentialing Coordinator,601-663-1285,,csavell@neshoba-hospital.com,Scott McNair,CFO,601-663-1233,,smcnair@neshoba-hospital.com,www.neshobageneral.com
MS-006585,Rush Medical Clinic/Philadelphia,"Laird Hospital, Inc.",1275873572,Rural Health Clinics,1106 Central Dr,,Philadelphia,MS,39350-8972,Winston,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006586,Neshoba Urgent Care Clinic,Neshoba County General Hospital,1528295532,Rural Health Clinics,1120 E Main St,Suite 1,Philadelphia,MS,39350-2300,Neshoba,1001 Holland Avenue,PO Box 648,Philadelphia,MS,39350,Neshoba,Cheryl Savell,Credentialing Coordinator,601-663-1285,,csavell@neshoba-hospital.com,Scott McNair,CFO,601-663-1233,,smcnair@neshoba-hospital.com,www.neshobageneral.com
MS-006587,Bogue Chitto Community Satellite Clinic,Choctaw Health Center,1144305731,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",124 Big Creek Cir,,Philadelphia,MS,39350-9004,Neshoba,210 Hospital Circle,,Choctaw,MS,39350,Neshoba,Tina Scott,Health Director,601-389-4500,,TScott@choctaw.org,,,,,,www.choctawhealthcenter.org
MS-006588,Neshoba Medical Associates,Neshoba County General Hospital,1003834979,Rural Health Clinics,213 Hospital Rd E,,Philadelphia,MS,39350-2119,Neshoba,1001 Holland Avenue,,Philadelphia,MS,39350,Neshoba,Cheryl Savell,Credentialing Coordinator,601-663-1285,,csavell@neshoba-hospital.com,Scott McNair,CFO,601-663-1233,,smcnair@neshoba-hospital.com,www.neshobageneral.com
MS-006589,Picayune Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1003013764,Federally Qualified Health Centers - Medical Services,1911 Read Rd,,Picayune,MS,39466-2730,Pearl River,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2140,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006590,Children's International Medical Group Picayune,"Chidlren's International, LLC",1073620498,Rural Health Clinics,801 Williams Ave,,Picayune,MS,39466-3956,Pearl River,59101 Amber st,,Slidell,LA,70461,Saint Tammany,Zach H Allen,Divisional Sr VP,601-337-2464,1,zach.allen@cimgpeds.com,Lacey Sones,Regional Director of Ops,985-646-1580,6,lacey.sones@cimgpeds.com,www.cimgpeds.com
MS-006591,"Pontotoc Health Services, Inc.","Pontotoc Health Services, Inc.",1821103516,Inpatient Hospitals (other than children's hospitals),176 S Main St,,Pontotoc,MS,38863-3311,Pontotoc,176 South Main St,,Pontotoc,MS,38863,Pontotoc,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006592,Pontotoc Health Services RHC Pontotoc,"Pontotoc Health Services, Inc",1538576772,Rural Health Clinics,345 Highway 15 N,,Pontotoc,MS,38863-1105,Pontotoc,176 South Main St,,Pontotoc,MS,38863,Pontotoc,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006593,Pearl River Family Clinic Rural Health Clinic,Pearl River Family Clinic,1770715450,Rural Health Clinics,302 Highway 11 S,,Poplarville,MS,39470-2625,Pearl River,"302 Highway 11, South",,Poplarville,MS,39470,Pearl River,Tommie Staten,Administrative Services Director,601-240-2020,,tommie.staten@prc-med.com,,,,,,
MS-006594,Pearl River County Hospital,Pearl River County Hospital & Nursing Home,1760789903,Inpatient Hospitals (other than children's hospitals),305 W Moody St,,Poplarville,MS,39470-7338,Pearl River,305 W. Moody Street,,Poplarville,MS,39470,Pearl River,Tommie Staten,Administrative Services Director,601-240-2020,,tommie.staten@prc-med.com,,,,,,
MS-006595,Jefferson Davis Rural Health Clinic,Forrest County General Hospital d/b/a Jefferson Davis Rural Health Clinic,1689952707,Rural Health Clinics,1014 Rose St,,Prentiss,MS,39474-5271,Jefferson Davis,P. O. Box 1288,,Prentiss,MS,39474,Jefferson Davis,Jimmy Graves,Administrator,601-792-1232,,JGraves@jeffersondavisch.com,CATHA JONES,,601-792-1232,,CATHAJONES@JEFFERSONDAVISCH.COM,
MS-006596,"Family Health Care Clinic, Inc., --Prentiss","FAMILY HEALTH CARE CLINIC, INC.",1144246398,Federally Qualified Health Centers - Medical Services,910 Second St,,Prentiss,MS,39474-9117,Jefferson Davis,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006597,The Medical Group of Quitman,Rush Medical Foundation,1164773438,Rural Health Clinics,603 S Archusa Ave,,Quitman,MS,39355-2331,Clarke,PO Box 5208,,Meridian,MS,39302-5208,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006598,HC Watkins Memorial Hospital,Rush Medical Foundation,1912079625,Inpatient Hospitals (other than children's hospitals),605 S Archusa Ave,,Quitman,MS,39355-2331,Clarke,PO Box 5208,,Meridian,MS,39302-5208,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006599,"Family Health Care Clinic, Inc. --Raleigh","FAMILY HEALTH CARE CLINIC, INC.",1588853154,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",226 Whiteoak Ave,,Raleigh,MS,39153-6082,Smith,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,Clinton Mayes,COO,601-825-7280,5003,cmayes@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006600,"MINOR MED CARE, PA","Minor Med Care, PA",1669575627,Rural Health Clinics,120 West Main Street,,Raymond,MS,39154,Hinds,P. O. BOX 1223,,RAYMOND,MS,39154,Hinds,DARLENE ESTES,VICE PRESIDENT,601-857-2341,,MINORMECARE@AOL.COM,,,,,,
MS-006601,The Doctors Clinic,Perry County General Hospital,1932143989,Inpatient Hospitals (other than children's hospitals),206 Bay Ave,,Richton,MS,39476-2941,Perry,P.O. Box 1665,,Richton,MS,39476,Perry,J. David Paris,CEO,601-788-6316,206,dparis@pcghosp.com,KATE LYON,Business Office Manager,601-788-6316,203,KLYON@PCGHOSP.COM,
MS-006602,NURSE MED INC,"NURSEMED, INC",1356335756,Rural Health Clinics,716 S Main St,,Ripley,MS,38663-2909,Tippah,716 S Main St,,Ripley,MS,38663,Tippah,Anita Turner,Owner,662-837-1534,,nursemed12@yahoo.com,Tina Miller,Office Manager,662-837-1534,,tinamiller_12@yahoo.com,
MS-006603,Andrew George MD,Andrew George MD,1538178777,Rural Health Clinics,25 S Fourth St,,Rolling Fork,MS,39159-5146,Sharkey,25 S Fourth St,,Rolling Fork,MS,39159,Sharkey,Andrew George,Owner,662-873-0477,,doc@ageorge.us,,,,,,
MS-006604,Jackson Rural Health Clinic,Jackson Rural Health Clinic,1316975287,Rural Health Clinics,29 S Fourth St,,Rolling Fork,MS,39159-5146,Sharkey,29 S. Fourth Street,,Rolling Fork,MS,39159,Sharkey,Evelyn Durst,Office Manager,662-873-4361,,evelynjd@bellsouth.net,,,,,,
MS-006605,North Sunflower Medical Center,North Sunflower Medical Center,1508913609,Inpatient Hospitals (other than children's hospitals),840 N Oak Ave,,Ruleville,MS,38771-3227,Sunflower,840 North Oak Avenue,,Ruleville,MS,38771,Sunflower,Joanie Perkins,Chief Compliance officer,662-719-6867,,joanie.perkins@northsunflower.com,Sam Miller,Chief Execitive Officer,662-756-2711,,smiller@northsunflower.com,
MS-006606,Sunflower Rural Health Clinic,North Sunflower Medical Center,1154488393,"Dental Providers, Rural Health Clinics",840 N Oak Ave,,Ruleville,MS,38771-3227,Sunflower,840 North Oak,,Ruleville,MS,38771,Sunflower,Joanie M. Perkins,Chief Compliance officer,662-756-1703,,joanie.perkins@northsunflower.com,Sam Miller,CEO,662-756-2711,,sam.miller@northsunflower.com,http://northsunflower.com/
MS-006607,"Family Health Center, INC. Sandersville Clinic","Family Health Center, INC.",1578744900,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",203 Broad St,,Sandersville,MS,39477,Jones,203 Broad Street,,Sandersville,MS,39477,Jones,Coney L. JOhnson,COO/HR Director,601-425-3033,157,cljohnson@laurelfhc-ms.com,Sherrin Roberts,Chief Financial Officer,601-425-3033,177,sroberts@laurelfhc-ms.com,www.lfhc.net
MS-006608,SARDIS FAMILY MEDICAL CLINIC,SARDIS FAMILY MEDICAL CLINIC,1932399276,Rural Health Clinics,124 S Main St,,Sardis,MS,38666-1721,Panola,124 S MAIN ST,,SARDIS,MS,38666,Panola,LORI CRAIN,Office Manager,662-487-1064,204,ljensen@sardisfamilymedical.com,LINDA TROY,CEO,662-487-1064,,linltry@aol.com,
MS-006609,Saucier Clinic,COASTAL FAMILY HEALTH CENTER,1942298195,Federally Qualified Health Centers - Medical Services,23453 Central Dr,,Saucier,MS,39574-7521,Harrison,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006610,Scooba Family Medical Center,"GREATER MERIDIAN HEALTH CLINIC, INC",1962509208,Federally Qualified Health Centers - Medical Services,927 Kemper St,,Scooba,MS,39358,Kemper,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,CEO,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006611,Sebastopol Medical and Dental Clinic,East Central MS Health Care,1699721209,"Dental Providers, Rural Health Clinics",1488 Highway 487,,Sebastopol,MS,39359,Scott,Walnut Grove Medical Clinic,199 Rimmer Street,Walnut Grove,MS,39189,Leake,Jill Bishop,Executive Director,601-625-7140,,jbishop@ecmhci.com,Diannae Campbell,Outreach & Enrollment Coordinator,601-625-7403,265,dcampbell@ecmhci.com,
MS-006612,Main Street Medical of Sebastopol,"Independent Healthcare Mgmt, Inc.",1760778609,Rural Health Clinics,17509 Hwy 21,,Sebastopol,MS,39359,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
MS-006613,Seminary Family Health Center,"Southeast Mississippi Rural Health Initiative, Inc.",1851368260,Federally Qualified Health Centers - Medical Services,100 Highway 535,,Seminary,MS,39479-8809,Covington,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006614,SHUBUTA MEDICAL CLINIC,"OUTREACH HEALTH SERVICES, INC.",1548359565,"Dental Providers, Federally Qualified Health Centers - Medical Services",130 N High St,,Shubuta,MS,39360-8870,Clarke,130 NORTH HIGH ST,,SHUBUTA,MS,39360-8870,Clarke,SABRINA HOWZE,EXECUTIVE DIRECTOR,601-687-1391,,SHOWZE@OUTREACHHS.ORG,TAMARA CLARK,BILLING SPECIALIST,601-687-1391,,TCLARK@OUTREACHHS.ORG,
MS-006615,SHUQUALAK/NOXUBEE HEALTH CENTER,"GREATER MERIDIAN HEALTH CLINIC, INC",1841397189,Federally Qualified Health Centers - Medical Services,67 Mulberry St,,Shuqualak,MS,39361-9128,Noxubee,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,CEO,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006616,DeSoto Community Health Center,"Northeast Mississippi Health Care, Inc.",1447665385,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7535 Airways Blvd,,Southaven,MS,38671-5834,DeSoto,P O Box 698,,Byhalia,MS,38611,Marshall,Clifton Rodgers,Executive Director,662-838-2163,201,crodgersnemhc@yahoo.com,ANDREA CHRISTMAN,,662-838-2163,,ACHRISTMAN@NEMHC@YAHOO.COM,
MS-006617,OKTIBBEHA FAMILY MEDICAL CENTER,"GREATER MERIDIAN HEALTH CLINIC, INC",1396842027,Federally Qualified Health Centers - Medical Services,105 Felix Long St,,Starkville,MS,39759-8608,Oktibbeha,2701 Davis St,,Meridian,MS,39301-5708,Lauderdale,Wilbert L Jones,CEO,601-693-0116,,wjones@gmhcinc.org,Cynthia Ransom Wells,Health Information and Credentialing Manager,601-693-0118,149,cransom@gmhcinc.org,www.gmhcinc.org
MS-006618,Starkville Outpatient Infusion,Clay County Medical Corporation,1639284409,Outpatient Hospital Clinics,1205 Highway 182 W,,Starkville,MS,39759-9820,Oktibbeha,835 Medical Center Drive,,West Point,MS,39773,Clay,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006619,State Line Medical,COASTAL FAMILY HEALTH CENTER,1528161197,Federally Qualified Health Centers - Medical Services,256 Main St,,State Line,MS,39362-9499,Wayne,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006620,SUMRALL FAMILY HEALTH CENTER,"Southeast Mississippi Rural Health Initiative, Inc.",1184694036,Federally Qualified Health Centers - Medical Services,1016 Highway 42,,Sumrall,MS,39482-9634,Lamar,P O Box 1729,,Hattiesburg,MS,39403-1729,Forrest,Dr. Geroldean Dyse,CEO,601-545-8700,2104,ldobbs@semrhi.com,Lisa G Dobbs,Credentialing Coordinator,601-545-8700,2217,ldobbs@semrhi.com,www.semrhi.com
MS-006621,"Family Health Center, INC. Taylorsville Clinic","Family Health Center, INC.",1487695813,Federally Qualified Health Centers - Medical Services,531 Highway 28 E,,Taylorsville,MS,39168-5635,Smith,117 So 11th Avenue,,Laurel,MS,39440,Jones,Coney L. Johnson,COO/HR Director,601-425-3033,157,cljohnson@laurelfhc-ms.com,Sherrin Roberts,Chief Financial Officer,601-425-3033,177,sroberts@laurelfhc-ms.com,www.lfhc.net
MS-006622,Dr. Arenia C. Mallory CHC - TCHULA CLINIC,ARENIA C. MALLORY COMM HLTH CTR,1881713519,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",9715 Highway 12,,Tchula,MS,39169-3692,Holmes,17280 Highway 17,,Lexington,MS,39095-6614,Holmes,Clyde Rozell Chapman,Chief Executive Officer,662-834-2566,,cchapman@mallorychc.org,,,,,,www.mallorychc.org
MS-006623,"Aaron E. Henry Community Health Services Center, Inc.","AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1912905993,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1100 Rosa Fort St,AARON E. HENRY SCHOOL,Tunica,MS,38676-9295,Tunica,510 Highway 322,P O Box 1216,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,LaQuitta Green,Chief Financial Officer,662-624-4292,1106,lgreen@aehchc.org,http://www.aehchc.org
MS-006624,AARON E. HENRY - TUNICA CLINIC,"AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.",1609874700,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1820 Peabody St,,Tunica,MS,38676-9441,Tunica,510 Highway 322,,Clarksdale,MS,38614-4717,Coahoma,Aurelia Jones-Taylor,Executive Director,662-624-4292,1119,ataylor@aehchc.org,LaQuitta Green,Chief Financial Officer,662-624-4292,1106,lgreen@aehchc.org,http://www.aehchc.org/
MS-006625,Family Care Medical Clinic,Family Care Medical Clinic,1437210457,Rural Health Clinics,109 Park Gate Ext,,Tupelo,MS,38801-3038,Lee,109 Parkgate Ext,,Tupelo,MS,38801,Lee,Jeff Blanchard,COO,662-840-4175,,jblanchard19@hotmail.com,,,,,,
MS-006626,NMMC Longtown Pain Center,"North Mississippi Medical Center, Inc.",1598875460,Outpatient Hospital Clinics,4381 S Eason Blvd,,Tupelo,MS,38801-6583,Lee,830 S Gloste St,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006627,NMMC Behavioral Health Center,"North Mississippi Medical Center, Inc",1598875460,Inpatient Hospitals (other than children's hospitals),4579 S Eason Blvd,,Tupelo,MS,38801-6539,Lee,830 S Gloster St,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006628,"North Mississippi Medical Center, Inc","North Mississippi Medical Center, Inc",1598875460,Inpatient Hospitals (other than children's hospitals),830 S Gloster St,,Tupelo,MS,38801-4934,Lee,830 S. Gloster Street,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006629,NMMC Outpatient Infusion Oncology,"North Mississippi Medical Center, Inc.",1598875460,Outpatient Hospital Clinics,959 S Gloster St,,Tupelo,MS,38801-6343,Lee,830 S Gloster St,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006630,NMMC Hematology/Oncology,"North Mississippi Medical Center, Inc.",1598875460,Outpatient Hospital Clinics,961 S Gloster St,,Tupelo,MS,38801-6343,Lee,830 S Gloster St,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006631,NMMC Radiation Oncology,"North Mississippi Medical Center, Inc",1598875460,Outpatient Hospital Clinics,990 S Madison St,,Tupelo,MS,38801-6308,Lee,830 S Gloster St,,Tupelo,MS,38801,Lee,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006632,"Family Health Care Clinic, Inc. --Tylertown","FAMILY HEALTH CARE CLINIC, INC.",1427221290,Federally Qualified Health Centers - Medical Services,113 Enochs St,,Tylertown,MS,39667-2711,Walthall,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006633,Family Medical Group of Union,"Laird Hospital, Inc.",1851643928,Rural Health Clinics,24345 Highway 15,,Union,MS,39365-8575,Newton,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006634,Laird Hospital,"Laird Hospital, Inc.",1518924752,Inpatient Hospitals (other than children's hospitals),25117 Highway 15,,Union,MS,39365-9088,Newton,PO Box 2106,,Meridian,MS,39302-2106,Lauderdale,Darrell Wildman,Treasurer,601-703-9992,,darrell.wildman@rushhealth.com,CHUCK REECE,Executive VP/COO,601-703-9192,,CHUCK.REECE@RUSHHEALTH.COM,
MS-006635,Jackson-Hinds Comprehensive Health Center - Utica Clinic,"CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.",1700813052,"Dental Providers, Federally Qualified Health Centers - Medical Services",129 White Oak St,,Utica,MS,39175-8803,Hinds,3502 W Northside Dr,,Jackson,MS,39213-4454,Hinds,Dr. Jasmin Chapman,Chief Executive Officer,601-364-5142,,jhchc@comcast.net,,,,,,www.jhchc.org
MS-006636,Jackson-Hinds Comprehensive Health Center,Jackson-Hinds Comprehensive Health Center,1700813052,Federally Qualified Health Centers - Medical Services,260 Highway 18 & 27,Utica Elementary School-based Clinic,Utica,MS,39175,Hinds,3502 W. Northside Drive,,Jackson,MS,39213,Hinds,Dr. Jasmin Owens Chapman,Chief Executive Officer,601-362-5321,,JACKSONHINDS@JHCHC.ORG,TECHSANDRA MAYS,,601-364-5182,,TMAYS@JHCHC.ORG,www.jhchc.org
MS-006637,Vancleave Clinic,COASTAL FAMILY HEALTH CENTER,1104814359,Federally Qualified Health Centers - Medical Services,10828 Highway 57,,Vancleave,MS,39565-8264,Jackson,PO Box 475,,Biloxi,MS,39533-0475,Harrison,Angel Greer,CEO,228-374-2494,1133,angel_greer@coastalfamilyhealth.org,Donna Ramirez,Revenue Cycle Supervisor,228-374-2494,1114,dramirez@coastalfamilyhealth.org,https://coastalfamilyhealth.org
MS-006638,Family Health Care Clinic-Water Valley,"Family Health Care Clinic, Inc.",1083087985,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",102 Blackmur Dr,,Water Valley,MS,38965-3003,Yalobusha,4635 Highway 80 East,,Pearl,MS,39208-4226,Rankin,Margaret A. Gray,President and CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,VP and COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,familyhealthcareclinic.com
MS-006639,ODOM RURAL HEALTH CLINIC,Odom Rural Health CLinic,1356402002,Rural Health Clinics,604 S Main St,,Water Valley,MS,38965-3468,Yalobusha,604 South Main St,,WATER VALLEY,MS,38965,Yalobusha,Calvin Johnson,Clinic Administrator,662-473-5271,,cjohnson@yalobushageneral.net,Terry Varner,Hospital Administrator,662-473-5901,,tvarner@yalobushageneral.com,
MS-006640,Yalobusha Urgent Care Clinic,Yalobusha General Hospital,1386024438,Outpatient Hospital Clinics,606 S Main St,,Water Valley,MS,38965-3468,Yalobusha,PO Box 728,,WATER VALLEY,MS,38965,Yalobusha,Calvin Johnson,Clinic Administrator,662-473-5271,,cjohnson@yalobushageneral.net,Terry Varner,CEO,662-473-5907,,tvarner@yalobushageneral.com,
MS-006641,YALOBUSHA GENERAL HOSPITAL,YALOBUSHA HEALTH SERVICES,1649397308,Inpatient Hospitals (other than children's hospitals),630 S Main St,,Water Valley,MS,38965-3468,Yalobusha,630 SOUTH MAIN,,WATER VALLEY,MS,38965,Yalobusha,TERRY VARNER,CEO,662-473-5907,,TVARNER@YGH4U.COM,STEPHANIE BURNS,Clinic Administrator,662-473-5242,,SSURRETTE@YALOBUSHAGENERAL.NET,
MS-006642,Clay County Medical Corporation,Clay County Medical Corporation,1639284409,Inpatient Hospitals (other than children's hospitals),150 Medical Center Dr,,West Point,MS,39773-0428,Clay,835 Medical Center Drive,,West Point,MS,39773,Clay,James P Stanzell,Chief Compliance officer,662-377-4148,,jim.stanzell@nmhs.net,,,,,,
MS-006643,"Family Health Care Clinic, Inc.--Winona","FAMILY HEALTH CARE CLINIC, INC.",1124274196,Federally Qualified Health Centers - Medical Services,123 N Front St,,Winona,MS,38967-2239,Montgomery,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006644,Woodland Clinic,Woodland Clinic LLC,1629282330,Rural Health Clinics,120 Market St,P O Box 186,Woodland,MS,39776-9104,Chickasaw,120 Market Street,P O Box 186,Woodland,MS,39776,Chickasaw,Penny Deans,Manager,662-456-0111,,woodlandclinic@bellsouth.net,JERRIE SULLIVAN,,662-456-0133,,WOODLANDCLINIC@BELLSOUTH.NET,
MS-006645,"Family Health Care Clinic, Inc. --Woodville","FAMILY HEALTH CARE CLINIC, INC.",1336381946,Federally Qualified Health Centers - Medical Services,1495 US Highway 61 S,Suite A,Woodville,MS,39669-3564,Wilkinson,4635 Highway 80 E,,Pearl,MS,39208-4226,Rankin,Margaret Ann Gray,CEO,601-825-7280,5005,drmgray1@bellsouth.net,CLINTON MAYES,COO,601-825-7280,5003,CMAYES@FAMILYHEALTHCARECLINIC.COM,FAMILYHEALTHCARECLINIC.COM
MS-006646,CATCHINGS CLINIC,Field Memorial Community Hospital,1881648376,Rural Health Clinics,451 Bank St,,Woodville,MS,39669-6000,Wilkinson,178 Hwy 24 E,,Centreville,MS,39631,Amite,Angela Jackson,Clinic Administrator,601-888-3421,125,ajackson@fhsms.org,Chad Netterville,Administrator,601-890-0545,,cnetterville@fhsms.org,
MT-006647,Arlee Health Station,Confederated Salish and Kootenai Tribes,1669502316,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",71972 Bitterroot Jim Rd.,,Arlee,MT,59821,Lake,42487 Complex Blvd,PO Box 278,Pablo,MT,59855-0278,Lake,Vernon Finley,Chairman,406-675-2700,,vernon.finley@cskt.org,Kevin Howlett,Department Head,406-745-3525,,,
MT-006648,BVHC-Ashland,"Bighorn Valley Health Center, Inc.",1932575149,Federally Qualified Health Centers - Medical Services,501 Main Street,,Ashland,MT,59003,Rosebud,Bighorn Valley Health Center,10 4th Street West,Hardin,MT,59034,Big Horn,David Mark,CEO,406-665-4103,,david.mark@bighornvalley.org,,,,,,www.bighornvalley.org
MT-006649,Community Health Partners - Belgrade,"Community Health Partners, Inc.",1487741005,Federally Qualified Health Centers - Medical Services,19 E Main St,,Belgrade,MT,59714-3715,Gallatin,126 S. Main St.,,Livingston,MT,59047-2624,Gallatin,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6301,,haler@chphealth.org,www.chphealthmt.org
MT-006650,Planned Parenthood of Montana Billings Heights Clinic,Planned Parenthood of Montana,1134297179,"Family Planning Providers, Sexually Transmitted Disease Clinics",100 W Wicks Ln,,Billings,MT,59105-3540,Yellowstone,1116 Grand Ave.,Suite 201,Billings,MT,59102,Yellowstone,Kevin Booke,Billing Manager,406-869-5005,,kevin.booke@ppmontana.org,Lacey Huckle,Compliance Officer,406-830-3481,,lacey.huckle@ppmontana.org,http://www.plannedparenthood.org/montana
MT-006651,Indian Health Board of Billings,Indian Health Board of Billings,1295878445,Federally Qualified Health Centers - Medical Services,1127 Alderson Ave,,Billings,MT,59102-4200,Yellowstone,1127 Alderson Ave,,Billings,MT,59102,Yellowstone,Jenny Denny,Health Specialist/ Biller,406-245-7318,209,jdenny@ihbbillings.org,,,,,,
MT-006652,RiverStone Health,RiverStone Health,1841219698,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",123 S 27th St,,Billings,MT,59101-4227,Yellowstone,123 South 27th Street,,Billings,MT,59101,Yellowstone,Nancy Taylor,Vice President of Clinical Operations,406-247-3200,,nancy.tay@riverstonehealth.org,,,,,,www.riverstonehealht.org
MT-006653,Planned Parenthood of Montana Billings West,Planned Parenthood of Montana,1134297179,"Family Planning Providers, Sexually Transmitted Disease Clinics",1844 Broadwater Ave,Suite 4,Billings,MT,59102-4875,Yellowstone,1116 Grand Ave.,Suite 201,Billings,MT,59102,Yellowstone,Kevin Booke,Billing Manager,406-869-5005,,kevin.booke@ppmontana.org,Lacey Huckle,Compliance Officer,406-830-3481,,lacey.huckle@ppmontana.org,http://www.plannedparenthood.org/montana
MT-006654,Ag Worker Health & Services - Billings,MONTANA MIGRANT & SEASONAL FARM WORKERS COUNCIL INC,1346299930,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3318 3rd Ave N,Suite 200,Billings,MT,59101-1900,Yellowstone,3318 3rd Ave N,STE 200,Billings,MT,59101-1900,Yellowstone,Carol Townsend,Executive Director,406-248-3149,,ctownsend@mtmigrantcouncil.org,Claudia Stephens,Strategic Planning Specialist,406-248-3149,,cstephens@mtmigrantcouncil.org,http://mtmigrantcouncil.org
MT-006655,Chippewa-Cree Tribe - (Rocky Boy's),Chippewa-Cree Tribe - (Rocky Boy's),1598802332,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",535 Clinic Rd E,,Box Elder,MT,59521-8826,Hill,535 Clinic Rd E,,Box Elder,MT,59521-8818,Hill,Amber Nault,Revenue Generation Leader,406-395-4486,2095,anault@rbclinic.org,Jill Monteau,Health Resource Division Chief,406-395-4486,2092,jmonteau@rbclinic.org,
MT-006656,White Sky Hope Center - Rocky Boy,White Sky Hope Center - Rocky Boy,1811210578,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",535 Clinic Rd E,,Box Elder,MT,59521-8826,Hill,535 Clinic Rd E,,Box Elder,MT,59521-8826,Hill,Amber Nault,Revenue Generation Leader,406-395-4486,2095,anault@rbclinic.org,Jill Monteau,Health Resource Division Chief,406-395-4486,2092,jmonteau@rbclinic.org,
MT-006657,Community Health Partners - Bozeman Dental,"Community Health Partners, Inc.",1487741005,Dental Providers,120 N 19th Ave,,Bozeman,MT,59718-3911,Gallatin,126 S. Main St.,,Livingston,MT,59047-2624,Park,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6301,,haler@chphealth.org,www.chphealthmt.org
MT-006658,Community Health Partners - Bozeman,"Community Health Partners, Inc.",1487741005,Federally Qualified Health Centers - Medical Services,214 E Mendenhall St,,Bozeman,MT,59715-3638,Gallatin,126 S. Main St.,,Livingston,MT,59047-2625,Park,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6316,,haler@chphealth.org,www.chphealthmt.org
MT-006659,Bridgercare,Bridgercare,1700855830,"Family Planning Providers, Sexually Transmitted Disease Clinics",300 N Willson Ave,Suite 2001,Bozeman,MT,59715-3572,Gallatin,300 N Willson Ave Ste 2001,,Bozeman,MT,59715-3572,Gallatin,Mari Dominguez,Executive Director,406-587-0681,17,mdominguez@bridgercare.org,Stephanie McDowell,Associate Director,406-587-0681,31,smcdowell@bridgercare.org,http://www.bridgercare.org/
MT-006660,BLACKFEET COMMUNITY HOSPITAL (inpatient hospital),BLACKFEET SERVICE UNIT,1861409955,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",760 Hospital Circle,,Browning,MT,59417,Glacier,760 HOSPITAL CIRCLE,,BROWNING,MT,59417,Glacier,WENDY STIFFARM,HEALTH SYSTEM SPECIALIST,406-338-6369,,wendy.stiffarm-paul@ihs.gov,,,,,,
MT-006661,BLACKFEET COMMUNITY HOSPITAL (multiple outpatient ECP categories),BLACKFEET SERVICE UNIT,1861409955,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Indian Health Service",760 Hospital Circle,,Browning,MT,59417,Glacier,760 HOSPITAL CIRCLE,,BROWNING,MT,59417,Glacier,WENDY STIFFARM,HEALTH SYSTEM SPECIALIST,406-338-6369,,wendy.stiffarm-paul@ihs.gov,,,,,,
MT-006662,Crystal Creek Lodge,Crystal Creek Lodge,1285854885,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",807 N Piegan St,,Browning,MT,59417-5300,Glacier,PO Box 450,,Browning,MT,59417-0450,Glacier,Durand Bear Medicine,Acting Director,406-338-6327,,durandbm@hotmail.com,,,,,,
MT-006663,Butte Family Planning Clinic,Butte-Silver Bow County Unified Government,1689793614,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",25 W Front St,,Butte,MT,59701-2801,Silver Bow,155 W Granite St,,Butte,MT,59701-2801,Silver Bow,Tina Randall,Clinic Administrator,406-497-5001,,trandall@bsb.mt.gov,,,,,,
MT-006664,"Butte Silver Bow Primary Health Care Clinic, Inc",Southwest Montana Community Health Center,1285725143,"Dental Providers, Federally Qualified Health Centers - Medical Services",445 Centennial Ave,,Butte,MT,59701-2870,Silver Bow,445 Centennial Ave,,Butte,MT,59701,Silver Bow,Jessica Cotton,CEO,406-496-6018,,jcotton@swmtchc.org,,,,,,
MT-006665,Liberty Medical Center Clinic,Liberty County Hospital & Nursing Home DBA Liberty Medical Center,1003984097,Rural Health Clinics,418 West Monroe,,Chester,MT,59522,Liberty,PO Box 705,,Chester,MT,59522,Liberty,April Malan,Clinic Director,406-759-5194,5985,april.malan@lchnh.org,,,,,,
MT-006666,North Valley Professional Center,North Valley Hospital,1285948539,Rural Health Clinics,1675 Talbot Rd,,Columbia Falls,MT,59912,Flathead,1600 Hospital Way,,Whitefish,MT,59937,Flathead,Leslie Carpenter,CLINIC MANAGER,406-892-3208,,lcarpenter@nvhosp.org,Sheila Riley,Clinic Operations Director,,,sriley@nvhosp.org,
MT-006667,Stillwater Billings Clinic,Stillwater Hospital Inc,1730434309,Rural Health Clinics,710 11th St N,,Columbus,MT,59019-7215,Stillwater,po box 959,,Columbus,MT,59019,Stillwater,Barbara Orednick,Director of Clinical Services,406-322-1000,1006,borednick@billingsclinic.org,Michael Follett,Interim CEO,406-322-1001,,mfollett@billingsclinic.org,
MT-006668,Corvallis Family Medicine,Marcus Daly Memorial Hospital,1396832127,Rural Health Clinics,1037 Main St,,Corvallis,MT,59828-9004,Ravalli,1200 Westwood Drive,,Hamilton,MT,59840,Ravalli,Donja C. Erdman,Chief Financial Officer,406-375-4609,,derdman@mdmh.org,Kelly Akkerman,Department Head Patient Financial Services,406-375-4824,,kakkerman@mdmh.org,
MT-006669,Crow/Northern Cheyenne Hospital (Crow Agency Indian Hospital) (inpatient hospital),Crow/Northern Cheyenne Hospital (Crow Agency Indian Hospital),1548393358,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",11010 South 7650 East,PO Box 9,Crow Agency,MT,59022-0009,Big Horn,11010 South 7650 East,P.O. Box 9,Crow Agency,MT,59022-0009,Big Horn,Darren Crowe,Chief Executive Officer,406-638-3468,,Darren.Crowe@ihs.gov,Myrna Small,Business Office Manager,406-638-3416,,myrna.small@ihs.gov,
MT-006670,Crow/Northern Cheyenne Hospital (Crow Agency Indian Hospital) (multiple outpatient ECP categories),Crow/Northern Cheyenne Hospital (Crow Agency Indian Hospital),1548393358,"Dental Providers, Indian Health Service, Other ECP Providers",11010 South 7650 East,PO Box 9,Crow Agency,MT,59022-0009,Big Horn,11010 South 7650 East,P.O. Box 9,Crow Agency,MT,59022-0009,Big Horn,Darren Crowe,Chief Executive Officer,406-638-3468,,Darren.Crowe@ihs.gov,Myrna Small,Business Office Manager,406-638-3416,,myrna.small@ihs.gov,
MT-006671,"Glacier Community Health Center, Inc.","Glacier Community Health Center, Inc.",1780764274,"Dental Providers, Federally Qualified Health Centers - Medical Services",519 E Main St,,Cut Bank,MT,59427-3015,Glacier,519 East Main Street,,Cut Bank,MT,59427,Glacier,Angela Haas,CFO/HR,406-873-5670,303,angiehaas@glacierchc.org,Jennifer Fenger,BILLING COORDINATOR,406-873-5670,306,jfenger@glacierchc.org,www.glacierchc.org
MT-006672,Ag Worker Health & Services - Dillon,MONTANA MIGRANT & SEASONAL FARM WORKERS COUNCIL INC,1891079224,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",116 N Washington St,,Dillon,MT,59725-2631,Beaverhead,3318 3rd Ave N,STE 200,Billings,MT,59101-1900,Yellowstone,Carol Townsend,Executive Director,406-248-3149,,ctownsend@mtmigrantcouncil.org,Claudia Stephens,Strategic Planning Specialist,406-248-3149,,cstephens@mtmigrantcouncil.org,http://mtmigrantcouncil.org
MT-006673,Barrett Hospital Clinic,Barrett Hospital Development Corporation,1326419102,Outpatient Hospital Clinics,30 MT Highway 91 S,,Dillon,MT,59725-3535,Beaverhead,600 MT Highway 91 S.,,Dillon,MT,59725,Beaverhead,Richard Achter,Chief Financial Officer,406-683-3003,,dachter@barretthospital.org,Tina Giem,Controller,406-683-3040,,tgiem@barretthospital.org,
MT-006674,Beaverhead Family Planning,Beaverhead Family Planning,1326227695,Family Planning Providers,41 Barrett St,,Dillon,MT,59725-3508,Beaverhead,41 Barrett Street,,Dillon,MT,59725,Beaverhead,Sue Hansen,Clinic Administrator,406-683-4771,,shansen@beaverheadcounty.org,,,,,,
MT-006675,Southwest Montana CHC-Dillon,Butte Silver Bow Primary Health Center,1235238718,"Dental Providers, Federally Qualified Health Centers - Medical Services",41 Barrett St,,Dillon,MT,59725-3508,Beaverhead,445 Centennial Ave,,Butte,MT,59701,Silver Bow,Jessica Cotton,CEO,406-496-6018,,jcotton@swmtchc.org,,,,,,
MT-006676,Barrett Hospital & HealthCare,Barrett Hospital Development Corporation,1326419102,Inpatient Hospitals (other than children's hospitals),600 MT Highway 91 S,,Dillon,MT,59725-7379,Beaverhead,600 MT Highway 91 S.,,Dillon,MT,59725-7379,Beaverhead,Richard Achter,Chief Financial Officer,406-683-3003,,dachter@barretthospital.org,Tina Giem,Controller,406-683-3040,,tgiem@barretthospital.org,
MT-006677,Elmo Health Station,Confederated Salish and Kootenai Tribes,1669502316,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",33116 Us Highway 93 North,,Elmo,MT,59915,Lake,42487 Complex Blvd,PO Box 278,Pablo,MT,59855,Lake,Vernon Finley,Chairman,406-675-2700,,vernon.finley@cskt.org,Kevin Howlett,Department Head,406-745-3525,,,
MT-006678,North Country Medical Clinic,North Valley Hospital,1336115849,"Outpatient Hospital Clinics, Rural Health Clinics",1343 US Highway 93 N,,Eureka,MT,59917-9503,Lincoln,1600 Hospital Way,,Whitefish,MT,59937,Flathead,Sidney Parley Neilson,Office Manager,406-297-2438,,sneilson@nvhosp.org,Sheila Riley,OPERATIONS DIRECTOR,406-863-3500,,sriley@nvhosp.org,
MT-006679,Ag Worker Health & Services - Fairview,MONTANA MIGRANT & SEASONAL FARM WORKERS COUNCIL INC,1679857007,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",35511 County Road 134,,Fairview,MT,59221-9465,Richland,3318 3rd Ave N,STE 200,Billings,MT,59101-1900,Yellowstone,Carol Townsend,Executive Director,406-248-3149,,ctownsend@mtmigrantcouncil.org,Claudia Stephens,Strategic Planning Specialist,406-248-3149,,cstephens@mtmigrantcouncil.org,http://mtmigrantcouncil.org
MT-006680,"Forsyth, MT","Rosebud Community Hospital, Inc. dba Rosebud Health Care Center",1194827451,Rural Health Clinics,383 17th Ave N.,PO Box 268,Forsyth,MT,59327-0268,Rosebud,383 17th Ave N.,P.O. Box 268,Forsyth,MT,59327,Roosevelt,Ryan Tooke,CEO,406-346-2161,223,tooker@rosebudhealthcare.com,Troy Ruff,Clinic Manager,406-346-2161,249,truff@rosebudhealthcare.com,
MT-006681,Valley County Family Planning,Dawson County Family Planning,1114136397,Family Planning Providers,501 Court Sq,,Glasgow,MT,59230-2494,Valley,207 West Bell,,Glendive,MT,59330,Dawson,Ella Tweten,Clinic Nurse,406-228-6261,,etweten@valleycountymt.gov,Brenda Mischel,Administrative Assistant,406-377-5213,,mischelb@dawsoncountymail.com,http://www.dawsoncountymontana.com/departments/publichealth/index.php
MT-006682,Dawson County Family Planning,Dawson County Family Planning,1114136397,Family Planning Providers,207 W Bell St,,Glendive,MT,59330-1616,Dawson,207 W Bell St,,Glendive,MT,59330-1616,Dawson,Timber Dempewolf,Clinic Director,406-377-5213,4113,dempewolft@dawsoncountymail.com,Brenda Mischel,Administrative Assistant,406-377-2935,,mischelb@dawsoncountymail.com,http://www.dawsoncountymontana.com/departments/publichealth/index.php
MT-006683,Community Health Care Center,Cascade County Community Health Care Center,1902948946,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",115 4th St S,,Great Falls,MT,59401-3618,Cascade,115 4th Street S,,Great Falls,MT,59401,Cascade,Leslie Southworth,CEO,406-791-9263,,lsouthworth@cascadecountymt.gov,Melissa Olson,Administrative Assistant,406-454-6973,,molson@cascadecountymt.gov,
MT-006684,"Indian Family Health Clinic (Great Falls, MT","Indian Family Health Clinic (Great Falls, MT",1861616674,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1220 Central Ave,Suite 1-B,Great Falls,MT,59401-3752,Cascade,1220 Central Ave Ste 1-B,,Great Falls,MT,59401-3752,Cascade,Ernestine Belcourt,Executive Director,406-268-1587,118,ebelcourt@indianfamilyhealth.org,Elizabeth Little,RN,406-268-1510,111,elittle@indianfamilyhealth.org,
MT-006685,Planned Parenthood of Montana Great Falls Clinic,Planned Parenthood of Montana,1134297179,"Family Planning Providers, Sexually Transmitted Disease Clinics",211 9th St S,,Great Falls,MT,59405-2115,Cascade,1116 Grand Ave.,Ste 201,Billings,MT,59102,Yellowstone,Kevin Booke,Billing Manager,406-869-5005,,kevin.booke@ppmontana.org,Lacey Huckle,Compliance Officer,406-830-3481,,lacey.huckle@ppmontana.org,http://www.plannedparenthood.org/montana
MT-006686,Bitterroot Physicians Clinic,Marcus Daly Memorial Hospital,1881794949,Rural Health Clinics,1200 Westwood Dr,,Hamilton,MT,59840-2345,Ravalli,1200 Westwood Drive,,Hamilton,MT,59840,Ravalli,Donja C. Erdman,Chief Financial Officer,406-375-4609,,derdman@mdmh.org,Kelly Akkerman,Department Head Patient Financial Services,406-375-4824,,kakkerman@mdmh.org,
MT-006687,Convenient Care,Marcus Daly Memorial Hospital,1346337664,Rural Health Clinics,1200 Westwood Dr,,Hamilton,MT,59840-2345,Ravalli,1200 Westwood Drive,,Hamilton,MT,59840,Ravalli,Donja C. Erdman,Chief Financial Officer,406-375-4609,,derdman@mdmh.org,Kelly Akkerman,Department Head Patient Financial Services,406-375-4824,,kakkerman@mdmh.org,
MT-006688,Sapphire Community Health Inc,Sapphire Community Health Inc,1003146812,Federally Qualified Health Centers - Medical Services,303 N 3rd St,,Hamilton,MT,59840-2405,Ravalli,303 North 3rd St,,Hamilton,MT,59840,Ravalli,Kate Duggan,Community Outreach,406-541-0032,245,kduggan@sapphirechc.org,Janet Woodburn,CEO,406-541-0032,223,jwoodburn@sapphirechc.org,http://www.sapphirechc.org
MT-006689,BVHC-Hardin,Bighorn Valley Health Center,1255617130,Federally Qualified Health Centers - Medical Services,10 4th St W,Suite B,Hardin,MT,59034-1804,Big Horn,10 WEST 4TH STREET,Ste B,Hardin,MT,59034-1804,Big Horn,Marla Martin,COO,406-784-2346,113,marla.martin@bighornvalley.org,Josh McFarland,Outreach Coordinator,406-665-4103,,josh.mcfarland@bighornvalley.org,www.bighornvalley.org
MT-006690,Fort Belknap Indian Community (Harlem Indian Hospital),Fort Belknap Indian Community (Harlem Indian Hospital),1942367842,"Dental Providers, Indian Health Service, Other ECP Providers",669 Agency Main St,,Harlem,MT,59526-9455,Blaine,669 Agency Main St,,Harlem,MT,59526-9455,Blaine,Alan Barlow,Chief Executive Officer,406-353-3191,,Alan.Barlow@ihs.gov,Charlotte Lamebull,Administrative Officer,406-353-3121,,Charlotte.Lamebull@ihs.gov,
MT-006691,Hill County Family Planning,Hill County Family Planning,1629145008,"Family Planning Providers, Sexually Transmitted Disease Clinics",302 4th Ave,,Havre,MT,59501-3654,Hill,302 4th Ave,,Havre,MT,59501-3654,Hill,Wanda Meredith,Clinic Director,406-265-5481,,meredithw@co.hill.mt.us,Kimberly Larson,Health Department Director,406-265-5481,292,larsonk@co.hill.mt.us,http://www.hillcountyhealth.com/
MT-006692,Bullhook Community Health and Wellness Center,BULLHOOK COMMUNITY HEALTH CENTER,1528258720,"Dental Providers, Federally Qualified Health Centers - Medical Services",521 4th St,,Havre,MT,59501-3649,Hill,521 4th St,,Havre,MT,59501-3649,Hill,Cynthia M Smith,CEO,406-395-4305,6903,smithc@bullhook.com,Rozan M Kerr,P.A.M.,406-395-6919,,kerrr@bullhook.com,www.bullhook.com
MT-006693,Planned Parenthood of Montana Helena Clinic,Planned Parenthood of Montana,1134297179,"Family Planning Providers, Sexually Transmitted Disease Clinics",1500 Cannon St,,Helena,MT,59601-2042,Lewis and Clark,1116 Grand Ave.,Suite 201,Billings,MT,59102,Yellowstone,Kevin Booke,Billing Manager,406-869-5005,,kevin.booke@ppmontana.org,Lacey Huckle,Compliance Officer,406-830-3481,,lacey.huckle@ppmontana.org,http://www.plannedparenthood.org/montana
MT-006694,PureView Health Center,PureView Health Center,1740390756,"Dental Providers, Federally Qualified Health Centers - Medical Services",1930 9th Ave,,Helena,MT,59601-4759,Lewis and Clark,1930 9th Avenue,,Helena,MT,59601-4759,Lewis and Clark,Helen Amundson,Clinical Programs Director,406-457-8946,,hamundson@lccountymt.gov,Helen Mahoney,Executive Secretary,406-457-8971,,hmahoney@lccountymt.gov,
MT-006695,Helena Indian Alliance,Helena Indian Alliance,1497964290,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",501 Euclid Ave,,Helena,MT,59601-2865,Lewis and Clark,501 Euclid Avenue,,Helena,MT,59601-5015,Lewis and Clark,Keith Bailey,Executive Director,406-442-9244,,director@helenaindianalliance.com,Tressie White,Assistant Director,406-442-9244,110,tressie@helenaindianalliance.com,
MT-006696,HEALTHCARE FOR THE HOMELESS,PureView Health Center,1437335544,"Dental Providers, Federally Qualified Health Centers - Medical Services",533 N Last Chance Gulch,,Helena,MT,59601-3346,Lewis and Clark,1930 9th Ave,,Helena,MT,59601-4759,Lewis and Clark,Helen Amundson,Clinical Programs Director,406-457-8946,,hamundson@lccountymt.gov,Helen Mahoney,Executive Director,406-457-8971,,hmahoney@lccountymt.gov,
MT-006697,Flathead Community Health Center,"FLATHEAD, COUNTY OF",1730333667,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1035 1st Ave W,,Kalispell,MT,59901-5607,Flathead,1035 1st Ave W,,Kalispell,MT,59901-5607,Flathead,Jody B White,Executive Director,406-751-8108,,jwhite@flathead.mt.gov,Darlene Hoylman,Administrative Assistant,406-758-2170,,dhoylman@flathead.mt.gov,flathead.mt.gov
MT-006698,Glacier Maternity & Women's Center,North Valley Hospital,1104892678,Other ECP Providers,195 Commons Loop,Suite D,Kalispell,MT,59901-1912,Flathead,1600 Hospital Way,,Whitefish,MT,59937,Flathead,Crystal Boyd,Clinic Office Manager,406-752-8180,,cboyd@nvhosp.org,Sheila Riley,Clinic Operations Director,406-752-3239,,sriley@nvhosp.org,
MT-006699,Lame Deer Health Center (Northern Cheyenne Tribe),Lame Deer Health Center (Northern Cheyenne Tribe),1053487991,"Dental Providers, Indian Health Service, Other ECP Providers",420 N Cheyenne Ave,,Lame Deer,MT,59043,Rosebud,PO Box 70,,Lame Deer,MT,59043-0070,Rosebud,Debby Bends,Chief Executive Officer,406-477-4000,4410,Debby.Bends@ihs.gov,Crystal Colliflower,Administrative Officer,406-477-4000,4402,Crystal.Colliflower@ihs.gov,
MT-006700,Central Montana Community Health Center,Central Montana Community Health Center,1942450432,Federally Qualified Health Centers - Medical Services,406 1st Ave S,,Lewistown,MT,59457-3020,Fergus,406 1st Avenue South,,Lewistown,MT,59457-3020,Fergus,Michele Foy,CEO,406-535-6545,300,mfoy@cmtchc.org,Ryan Kuehn,CFO,406-535-6545,306,rkuehn@cmtchc.org,
MT-006701,Central Montana Family Planning,Central Montana Family Planning,1205901212,"Family Planning Providers, Sexually Transmitted Disease Clinics",505 W Main St,Suite 108,Lewistown,MT,59457-5703,Fergus,505 W Main St Ste 108,,Lewistown,MT,59457-5703,Fergus,Sue Irvin,Executive Director,406-535-8811,,director@cmtfp.org,,,,,,http://www.cmtfp.org/
MT-006702,Northwest Community Health Center,Northwest Community Health Center,1477574713,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",320 E 2nd St,,Libby,MT,59923-2010,Lincoln,320 E 2nd Street,,Libby,MT,59923,Lincoln,Maria Clemons,Executive Director,406-293-6919,,maria.clemons@northwestchc.org,,,,,,www.northwestchc.org
MT-006703,PARKER MEDICAL CENTER,PureView Health Center,1427230226,"Dental Providers, Federally Qualified Health Centers - Medical Services",2463 W Montana Hwy,,Lincoln,MT,59639,Lewis and Clark,1930 9th Ave,,Helena,MT,59601-4759,Lewis and Clark,Helen Amundson,Clinical Programs Director,406-457-8946,,hamundson@lccountymt.gov,Helen Mahoney,Executive Secretary,406-457-8971,,hmahoney@lccountymt.gov,
MT-006704,Community Health Partners - Livingston Dental,"Community Health Partners, Inc.",1487741005,Dental Providers,112 W Lewis St,Suite 3,Livingston,MT,59047-3011,Park,126 S. Main St.,,Livingston,MT,59047-2624,Park,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6301,,haler@chphealth.org,www.chphealthmt.org
MT-006705,Community Health Partners - Livingston,"Community Health Partners, Inc.",1487741005,Federally Qualified Health Centers - Medical Services,126 S Main St,,Livingston,MT,59047-2624,Park,126 S. Main St.,,Livingston,MT,59047-2624,Park,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6301,,haler@chphealth.org,www.chphealthmt.org
MT-006706,Lodge Grass Health Center,Lodge Grass Health Center,1750410395,"Dental Providers, Indian Health Service, Other ECP Providers",418 Harding Ave,,Lodge Grass,MT,59050,Big Horn,PO Box 780,,Lodge Grass,MT,59050-0780,Big Horn,Vivian Swallow,Administrative Officer,406-639-2317,,vivian.swallow@ihs.gov,Myrna B Small,Business Office manager,406-638-3416,,myrna.small@ihs.gov,
MT-006707,Ag Worker Health & Services - Lolo,MONTANA MIGRANT & SEASONAL FARM WORKERS COUNCIL INC,1679984025,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",9801 Valley Grove Dr,D,Lolo,MT,59847-8617,Missoula,3318 3rd Ave N Ste 100,,Billings,MT,59101-1900,Yellowstone,Carol Townsend,Executive Director,406-248-3149,,ctownsend@mtmigrantcouncil.org,Claudia Stephens,Strategic Planning Specialist,406-248-3149,,cstephens@mtmigrantcouncil.org,http://mtmigrantcouncil.org
MT-006708,"Miles City, MT","Custer County Community Health Center, Inc.",1285611129,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",210 S Winchester Ave,,Miles City,MT,59301-4757,Custer,210 South Winchester Ave,,Miles City,MT,59301,Custer,Kent Doughty,CEO,406-874-8700,,k.doughty@onehealthmt.com,Wendy Richards,Finance Director,406-874-8700,,w.richards@onehealthmt.com,www.onehealthmt.com
MT-006709,Planned Parenthood of Montana Missoula Clinic,Planned Parenthood of Montana,1134297179,"Family Planning Providers, Sexually Transmitted Disease Clinics",219 E Main St,,Missoula,MT,59802-4423,Missoula,"1116 Grand Ave., Suite 201",,Billings,MT,59102,Yellowstone,Lacey Huckle,Billing Manager,406-830-3481,,lacey.huckle@ppmontana.org,Lacey Huckle,Compliance Officer,406-830-3481,,,http://www.plannedparenthood.org/montana
MT-006710,Partnership Health Center,Partnership Health Center,1326336454,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",401 Railroad St W,,Missoula,MT,59802-4109,Missoula,401 Railroad St W,,Missoula,MT,59802,Missoula,Terry Delgadillo,Compliance Officer,406-258-4183,,delgadillot@phc.missoula.mt.us,Jan Thomas,Finance Director,406-258-4445,,thomasj@phc.missoula.mt.us,
MT-006711,SHERIDAN MEMORIAL Hospital,SHERIDAN MEMORIAL HOSPITAL ASSOCIATION,1396970638,Rural Health Clinics,440 W Laurel Ave,,Plentywood,MT,59254-1596,Sheridan,440 west laurel ave,,Plentywood,MT,59254,Sheridan,Rachael Archer,Clinic Manager,406-765-3718,,rarcher@sheridanmemorial.net,Leann Woodman,Business office Manger,406-765-3700,5,LWOODMAN@SHERIDANMEMORIAL.NET,
MT-006712,Polson Health Center,Confederated Salish and Kootenai Tribes,1669502316,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",5 4th Ave E,,Polson,MT,59860-2117,Lake,42487 Complex Blvd,PO Box 278,Pablo,MT,59855,Lake,Vernon Finley,Chairman,406-675-2700,,vernon.finley@cskt.org,Kevin Howlett,Department Head,406-745-3525,,,
MT-006713,Lake County Family Planning,MT DPHHS Women's and Men's Health,1659327120,"Family Planning Providers, Sexually Transmitted Disease Clinics",802 Main St,Suite A,Polson,MT,59860-3200,Lake,802 Main St Ste A,,Polson,MT,59860-3200,Lake,Emily Colomeda,Executive Director,406-883-7291,,ecolomeda@mt.gov,,,406-444-2457,,,http://www.lakecountypublichealth.org/index.php/family-planning/
MT-006714,Verne E. Gibbs Health Center(Poplar),Fort Peck Tribal Health Program,1588791594,"Indian Health Service, Other ECP Providers",107 H. St,,Poplar,MT,59255,Roosevelt,PO Box 67,,Poplar,MT,59255-0067,Roosevelt,Julie Bemer,Chief Executive Officer,406-768-3491,,Jackie.Hippe@ihs.gov,,,,,,
MT-006715,Mental Health -HPDP,Fort Peck Tribes,1609020080,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",417 East 13th,,Poplar,MT,59255,Roosevelt,417 East 13th,,Poplar,MT,59255,Roosevelt,Kenneth R. Smoker Jr.,HPDP Director,406-768-3085,,krsmoker@yahoo.com,Rae Jean Belgarde,Deputy Director HPDP,406-768-3052,,raejeanbelgarde@hotmail.com,
MT-006716,Pryor Health Station,Pryor Health Station,1407076219,"Dental Providers, Indian Health Service, Other ECP Providers",2 Pryor Gap,,Pryor,MT,59066,Big Horn,2 Pryor Gap,,Pryor,MT,59066,Yellowstone,Myrna b small,Business office manager,406-638-3416,,myrna.small@ihs.gov,,,,,,
MT-006717,St. Luke Community Hospital,St. Luke Community Hospital,1336213446,Inpatient Hospitals (other than children's hospitals),107 6th Ave SW,,Ronan,MT,59864-2634,Lake,107 6th Ave SW,,Ronan,MT,59864,Lake,Paul Soukup,CFO,406-676-4441,291,psoukup@stlukehealthcare.org,Chris Ellingson,,406-528-5495,,cellingson@stlukehealthcare.org,
MT-006718,Ronan Health Station,Confederated Salish and Kootenai Tribes,1669502316,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",35860 Round Butte Rd,,Ronan,MT,59864-2316,Lake,42487 Complex Blvd,PO Box 278,Pablo,MT,59855,Lake,Vernon Finley,Chairman,406-675-2700,,vernon.finley@cskt.org,Kevin Howlett,Department Head,406-745-3525,,,
MT-006719,Musselshell County Family Planning,Central Montana Family Planning,1205901212,"Family Planning Providers, Sexually Transmitted Disease Clinics",1202 3rd St W,,Roundup,MT,59072-1816,Musselshell,"505 West Main, Suite 108",,Lewistown,MT,59457,Fergus,Sue Irvin,Director,406-535-8811,,director@cmtfp.org,,,,,,www.cmtfp.org
MT-006720,St. Luke Community Rural Health Clinic,St. Luke Community Hospital,1316125677,"Outpatient Hospital Clinics, Rural Health Clinics",330 Tract Ln,,Saint Ignatius,MT,59865,Lake,107 6th Ave SW,,Ronan,MT,59864,Lake,Paul Soukup,CFO,406-676-4441,291,psoukup@stlukehealthcare.org,,,,,,
MT-006721,St. Ignatius Health Center,Confederated Salish and Kootenai Tribes,1669502316,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",35401 Mission Drive,,Saint Ignatius,MT,59865,Lake,42487 Complex Blvd,PO Box 278,Pablo,MT,59855,Lake,Vernon Finley,Chairman,406-675-2700,,vernon.finley@cskt.org,Kevin Howlett,Department Head,406-745-3525,,,
MT-006722,DANIELS MEMORIAL HEALTHCARE CENTER,DANIELS MEMORIAL HOSPITAL ASSOC.,1750459632,Rural Health Clinics,105 5th Ave E.,,Scobey,MT,59263,Daniels,PO Box 400,,SCOBEY,MT,59263,Daniels,MELISSA ALDRICH,BUSINESS OFFICE/CLINIC MANAGER,406-487-2296,223,aldrim@dmha.net,DAVE RYERSE,CEO,406-487-2296,235,DRYERSE@BILLINGSCLINIC.ORG,
MT-006723,"Marias Healthcare Services, Inc. - Shelby",MARIAS HEALTHCARE SERVICES INC,1881697209,Federally Qualified Health Centers - Medical Services,670 Park Ave,,Shelby,MT,59474-1663,Toole,670 Park Ave,,Shelby,MT,59474-1663,Toole,Jamie Brownell,CEO,406-434-3100,,jbrownell@mmcmt.org,,,,,,
MT-006724,"Marias Healthcare Services, Inc. - Dentistry",MARIAS HEALTHCARE SERVICES INC,1881697209,Dental Providers,865 Oilfield Ave,,Shelby,MT,59474-2702,Toole,670 Park Ave,,Shelby,MT,59474-1663,Toole,Jamie Brownell,CEO,406-434-3100,,jbrownell@mmcmt.org,,,,,,
MT-006725,RUBY VALLEY HOSPITAL AND MEDICAL CLINIC,RUBY VALLEY HOSPITAL,1962547653,Rural Health Clinics,210 E Crofoot Ln,,Sheridan,MT,59749-7714,Madison,PO BOX 366,,Sheridan,MT,59749,Madison,BILLIE JO ROWBERRY,Revenue Cycle Manager,406-842-5454,18,browberry@rubyvalleyhospital.com,,,,,,
MT-006726,Richland County Family Planning,Dawson County Family Planning,1114136397,Family Planning Providers,1201 W Holly St,Suite No. 1,Sidney,MT,59270-3596,Richland,207 West Bell,,Glendive,MT,59330,Dawson,Lesley Thiessen RN,Clinic Administrator,406-433-2207,,lthiessen@richland.org,Brenda Mischel,Administrative Assistant,406-377-2935,,mischelb@dawsoncountymail.com,http://www.dawsoncountymontana.com/departments/publichealth/index.php
MT-006727,"Marias Healthcare Services, Inc. - Sunburst",MARIAS HEALTHCARE SERVICES INC,1245481159,Federally Qualified Health Centers - Medical Services,13 1st Ave South,,Sunburst,MT,59482,Toole,670 Park Ave,,Shelby,MT,59474-1663,Toole,Jamie Brownell,CEO,406-434-3100,,jbrownell@mmcmt.org,,,,,,
MT-006728,Three Rivers Clinic,Three Rivers Clinic,1851425789,Rural Health Clinics,16 Railway Ave,,Three Forks,MT,59752-9080,Gallatin,PO Box 1078,,Three Forks,MT,59752,Gallatin,Jessica Oehmcke,Credentialing,406-285-3251,109,providers@threeriversmedicalclinic.net,,,,,,www.threeriversmedicalclinic.net
MT-006729,Northwest Community Health Center Troy,Lincoln County Community Health Center,1417243213,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",206 Callahan Creek Rd,,Troy,MT,59935-8805,Lincoln,320 E 2nd St,,Libby,MT,59923,Lincoln,Maria Clemons,Executive Director,406-283-6919,,maria.clemons@northwestchc.org,,,,,,
MT-006730,"Marias Healthcare Services, Inc. - Valier",MARIAS HEALTHCARE SERVICES INC,1255582615,Federally Qualified Health Centers - Medical Services,422 Montana St,,Valier,MT,59486-5506,Pondera,670 Park Ave,,Shelby,MT,59474-1663,Toole,Jamie Brownell,CEO,406-434-3100,,jbrownell@mmcmt.org,,,,,,
MT-006731,Community Health Partners - West Yellowstone,"Community Health Partners, Inc.",1487741005,Federally Qualified Health Centers - Medical Services,11 S Electric St,,West Yellowstone,MT,59758,Gallatin,126 S. Main St.,,Livingston,MT,59047-2624,Park,Lander Cooney,CEO,406-823-6316,,cooneyl@chphealth.org,Rebecca Hale,CFO,406-823-6301,,haler@chphealth.org,www.chphealthmt.org
MT-006732,Biar Medical Clinic,Mountainview Medical Center,1548395197,Rural Health Clinics,16 W Main St,PO Box Q,White Sulphur Springs,MT,59645-9036,Meagher,16 W main st,PO Box Q,White Sulphur Springs,MT,59645,Meagher,Rob Brandt,CEO,406-547-3321,,rbrandt@mvmc.org,Jennifer Stidham,Executive Assistant,406-547-3312,,jstidham@mvmc.org,www.mvmc.org
MT-006733,North Valley Surgical Services,North Valley Hospital,1891189585,Other ECP Providers,2000 Hospital Way,,Whitefish,MT,59937-7858,Flathead,1600 Hospital Way,,Whitefish,MT,59937,Flathead,Sheila Riley,Clinic Operations Director,406-862-5575,,sriley@nvhosp.org,Rhonda Tallman,Senior Director of Clinic Operations,406-862-3783,,rtallman@nvhosp.org,
MT-006734,North Valley Behavioral Health,North Valley Hospital,1487085098,Outpatient Hospital Clinics,2004 Hospital Way,,Whitefish,MT,59937-7858,Flathead,1600 Hospita; Way,,Whitefish,MT,59937,Flathead,Jo Mae Burns,Office Manager,406-862-1030,,jburns@nvhosp.org,,,,,,
MT-006735,Roosevelt County Family Planning,Dawson County Family Planning,1114136397,Family Planning Providers,124 Custer St,Suite A,Wolf Point,MT,59201-1640,Roosevelt,207 West Bell,,Glendive,MT,59330,Dawson,Vicki Bell,Director,406-653-6223,,vbell2@mt.gov,Brenda Mischel,Administrative Assistant,406-377-2935,,mischelb@dawsoncountymail.com,http://www.dawsoncountymontana.com/departments/publichealth/index.php
MT-006736,Wolf Point (Chief Redstone) Indian Health Center,Wolf Point (Chief Redstone) Indian Health Center,1588791594,"Indian Health Service, Other ECP Providers",550 6th Ave N,,Wolf Point,MT,59201-6000,Roosevelt,PO Box 729,,Wolf Point,MT,59201-0729,Roosevelt,Loren Bisbee,Clinical Manager,406-653-1641,,Loren.Bisbee@Ihs.gov,Jackie Hippe,Health System Revenue Specialist,406-768-2106,,Jackie.Hippe@ihs.gov,
NC-006737,Ahoskie Comprehensive Care,"ROANOKE CHOWAN COMMUNITY HEALTH CENTER, INC.",1407881691,Federally Qualified Health Centers - Medical Services,120 Health Center Dr,,Ahoskie,NC,27910-8161,Hertford,120 Health Center Dr,,Ahoskie,NC,27910-8161,Hertford,Kim A Schwartz,Chief Executive Officer,252-209-0237,,kschwartz@rcchc.org,Melissa Owens,Chief Financial Officer,252-209-0237,7126,mowens@rcchc.org,
NC-006738,Hertford Co. Health Dept.,North Carolina Dept. of Health and Human Services,1205990173,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",828 Academy St S,,Ahoskie,NC,27910-3263,Hertford,PO Box 694,,Ahoskie,NC,27910-0694,Hertford,Ramona Bowser,Health Director,252-358-7833,,ramona.bowser@hcpha.net,,,,,,http://www.hertfordpublichealth.com/phsd-familyplanning.htm
NC-006739,Stanly Co. Health Dept.,North Carolina Dept. of Health and Human Services,1124167796,"Dental Providers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1000 N 1st St,Suite 3,Albemarle,NC,28001-2819,Stanly,1000 N 1st St Ste 3,,Albemarle,NC,28001-2819,Stanly,Dennis Joyner,Executive Director,704-986-3000,,djoyner@stanlycountync.gov,Patricia Hancock,Director of Nursing,704-982-9171,,phancock@stanlycountync.gov,http://www.co.stanly.nc.us
NC-006740,ANGIER MEDICAL CENTER,FIRST CHOICE COMMUNITY HEALTH CENTERS,1457374324,Federally Qualified Health Centers - Medical Services,84 Medical Dr,,Angier,NC,27501-6087,Harnett,40 Autumn Fern Trail,,Lillington,NC,27546,Harnett,Sheila L. Simmons,Chief Executive Officer,910-364-0972,1600,slsimmons@firstchoicechc.org,,,,,,www.firstchoicechc.org
NC-006741,Advance Community Health - Apex,Advance Community Health,1598751463,Federally Qualified Health Centers - Medical Services,212 S Salem St,,Apex,NC,27502-1825,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610-1821,Wake,Penella M. Washington,CEO,919-250-2923,,pwashington@advancechc.org,Ryan Jury,COO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-006742,Arden Health Center,"Blue Ridge Community Health Services, Inc.",1912324740,Federally Qualified Health Centers - Medical Services,142 Airport Rd,Suite K,Arden,NC,28704-8597,Buncombe,PO Box 5151,,Hendersonville,NC,28793,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Blue Ridge Community Health Services Inc.,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,brchs.com
NC-006743,MERCE MEDICAL RESOURCE CENTER,"MEDICAL RESOURCE CENTER FOR RANDOLPH COUNTY, INC.",1801953088,Federally Qualified Health Centers - Medical Services,1831 N Fayetteville St,,Asheboro,NC,27203-3273,Randolph,1831 N Fayetteville St,,Asheboro,NC,27203-3273,Randolph,Teresa M Shackleford,CEO,336-672-1300,209,tshackleford@mercemedical.com,Bsmith@mercemedical.com,Finance Director,336-672-1300,,bsmith@mercemedical.com,
NC-006744,Randolph County Health Department,Randolph County Health Department,1720011729,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2222 S Fayetteville St Ste B,Randolph County Health Department,Asheboro,NC,27205-7368,Randolph,2222-B S Fayetteville St,,Asheboro,NC,27205,Randolph,Susan Hayes,Health Director,336-318-6217,6217,susan.hayes@randolphcountync.gov,Debbie Thompson,Accounting Clerk,336-318-6286,6286,debbie.thompson@randolphcountync.gov,
NC-006745,MERCE DENTAL CENTER,"MEDICAL RESOURCE CENTER FOR RANDOLPH COUNTY, INC.",1851548002,Dental Providers,308 Brewer St,,Asheboro,NC,27203-4896,Randolph,1831 N. Fayetteville St.,,Asheboro,NC,27203,Randolph,Teresa M Shackleford,CEO,336-672-1300,209,tshackleford@mercemedical.com,Vickie Brown,Dental Practice Manager,336-610-7000,,vbrown@mercedental.com,
NC-006746,South French Broad Care Center,Appalachian Mountain Community Health Centers,1487033908,Federally Qualified Health Centers - Medical Services,165 S French Broad Ave,Ground Floor,Asheville,NC,28801-3900,Buncombe,PO Box 2597,"7 McDowell Str, Ste 200",Asheville,NC,28801,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul C Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006747,May's Care Center,Appalachian Mountain Community Health Centers,1619356136,Federally Qualified Health Centers - Medical Services,225 Patton Ave,Suite 200,Asheville,NC,28801-2641,Buncombe,PO Box 2597,"7 McDowell Str, Ste 200",Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul C Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006748,Minnie Jones Health Center,WESTERN NC COMMUNITY HEALTH SERVICES INC,1780801050,"Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",257 Biltmore Ave,Suite 100,Asheville,NC,28801-4131,Buncombe,257 Biltmore Ave Ste 100,,Asheville,NC,28801-4131,Buncombe,Kim Wagenaar,Executive Director,828-285-0622,2408,kwagenaar@wncchs.org,Cody McKinney,Chief Financial Officer,828-285-0622,2037,cmckinney@wncchs.org,www.wncchs.org
NC-006749,Mission Hospital,Mission Health System,1881626075,Inpatient Hospitals (other than children's hospitals),509 Biltmore Ave,,Asheville,NC,28801-4601,Buncombe,509 Biltmore Avenue,,Asheville,NC,28801,Buncombe,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006750,Buncombe County Health Dept.,Buncombe County Dept. of Health and Human Services,1669537593,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",53 S French Broad Ave,Suite 100,Asheville,NC,28801-3282,Buncombe,40 Coxe Ave,,Asheville,NC,28801-3308,Buncombe,Jannine Shepard,Health Director,828-250-5000,,jannine.shepard@buncombecounty.org,Jennifer Mullendore,Medical Director,828-250-5000,,jennifer.mullendore@buncombecounty.org,http://www.buncombecounty.org
NC-006752,Planned Parenthood Asheville Health Center,Planned Parenthood South Atlantic,1194861492,Family Planning Providers,68 McDowell St,,Asheville,NC,28801-4104,Buncombe,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,Vice President of Patient Services,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/asheville/28801/asheville-health-center-4134-90860
NC-006753,Dale Fell Health Center,Appalachian Mountain Community Health Centers,1336528314,Federally Qualified Health Centers - Medical Services,7 McDowell St,Suite 200,Asheville,NC,28801-4116,Buncombe,PO Box 2597,,Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006754,Leicester Community Health Center,Appalachian Mountain Community Health Centers,1154701415,Federally Qualified Health Centers - Medical Services,711 New Leicester Hwy,,Asheville,NC,28806-1048,Buncombe,PO Box 2597,,Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5660,,rjp@appalachianmountain.org,Paul Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006755,Downtown Care Center,Appalachian Mountain Community Health Centers,1386193944,Federally Qualified Health Centers - Medical Services,75 Haywood St,Suite B,Asheville,NC,28801-2849,Buncombe,PO Box 2597,"7 McDowell Str, Ste 200",Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul C Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006756,Mission Infectious Disease Associaties,Mission Infectious Disease Associaties,1952736712,"Rural Health Clinics, Ryan White Providers",900 Hendersonville Rd,Suite 205,Asheville,NC,28803-1753,Buncombe,Mission Infectious Disease Associates,900 Hendersonville Road Suite 205,Asheville,NC,28803,Buncombe,Sabrina Sims,Executive Director over Patient Financial Services,828-651-6321,0,sabrina.sims@hcahealthcare.com,,,,,,
NC-006757,BLACK RIVER HEALTH CLINIC,Black River Health Services,1174511976,Federally Qualified Health Centers - Medical Services,109 W Church St,,Atkinson,NC,28421-9230,Pender,301 S Campbell St,,Burgaw,NC,28425,Pender,"Lee Ann Amann, MHA",CEO,910-283-5011,200,lamann@blackriverhealth.org,,,,,,blackriverhealth.org
NC-006758,Mitchell County Health Department,Toe River Health District,1295864452,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",130 Forest Service Dr,Suite A,Bakersville,NC,28705-7081,Mitchell,861 Greenwood Road,,Spruce Pine,NC,28777,Mitchell,Betty McKinney,Finance Officer,828-765-2239,24,bmckinney@trhd.dst.nc.us,Paula McClellan,Billing,828-765-2239,20,paula.mcclellan@trhd.dst.nc.us,www.toeriverhealth.org
NC-006759,Bakersville Community Medical Clinic,BAKERSVILLE COMMUNITY MEDICAL CLINIC INC,1043315054,Federally Qualified Health Centers - Medical Services,86 N Mitchell Ave,,Bakersville,NC,28705-6502,Mitchell,86 N Mitchell Ave,,Bakersville,NC,28705-6502,Mitchell,Chuck Shelton,CEO,828-688-2104,,cshelton@mchp.care,Kayle Buchanan,Executive Administrative Assistant,828-688-2104,,kbuchanan@mchp.care,thebchc.org
NC-006760,Dosher Medical-Bald Head Island,J. Arthur Dosher Memorial Hospital,1376961219,Outpatient Hospital Clinics,253 Edward Teach Wynd,,Bald Head Island,NC,28461,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-006761,Pamlico County Health Department,Pamlico County Health Department,1427176866,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",203 North St,,Bayboro,NC,28515-0010,Pamlico,203 North Street,,Bayboro,NC,28515,Pamlico,DAWN JONES,Administrative Officer I,252-745-3734,,DAWN.JONES@PAMLICOCOUNTY.ORG,,,,,,https://www.pamlicocounty.org/health-department.aspx
NC-006762,Pamlico Community Health Center,"Greene County Health Care, Incorporated",1619244084,"Dental Providers, Federally Qualified Health Centers - Medical Services",313 Main St,,Bayboro,NC,28515-9529,Pamlico,7 Professional Drive,,Snow Hill,NC,28580,Greene,Beverly Stroud,CFO,252-747-8162,2204,bstroud@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-006763,BENSON AREA MEDICAL CENTER INC,"Benson Area Medical Center, Inc",1831130798,Rural Health Clinics,3333 NC Highway 242 N,,Benson,NC,27504-7844,Johnston,3333 NC Hwy 242 N,,Benson,NC,27504-7844,Johnston,"William W Massengill, Jr",CEO,919-894-2011,270,wmassengill@bensonmedical.org,Dixie Nunnery,Financial Operations Manager,919-207-4403,,dnunnery@bensonmedical.org,
NC-006764,CommWell Health of McGee's Crossroads,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1376899252,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",70 Crape Myrtle Dr,Suite 104,Benson,NC,27504-8034,Johnston,3331 Easy St,,Dunn,NC,28334-7988,Sampson,Pam Tripp,CEO,910-567-7006,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-006765,BESSEMER CITY HEALTH CARE CENTER,GASTON FAMILY HEALTH SERVICES INC,1003935750,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",119 W Pennsylvania Ave,,Bessemer City,NC,28016-2635,Gaston,991 W Hudson Blvd,,Gastonia,NC,28052-6430,Gaston,Robert E Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006766,GOSHEN MEDICAL CTR - BEULAVILLE,"GOSHEN MEDICAL CENTER, INC.",1639294309,Federally Qualified Health Centers - Medical Services,119 Crossover Rd,,Beulaville,NC,28518-8801,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006767,Brunswick Co. Health Dept.,North Carolina Dept. of Health and Human Services,1841248622,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",25 Courthouse Dr,PO Box 9,Bolivia,NC,28422-7582,Brunswick,25 Courthouse Dr,,Bolivia,NC,28422,Brunswick,David Stanley,Executive Director,910-253-2250,2274,david.stanley@brunswickcountync.gov,Cris Harrelson,Health Director,910-252-2250,2298,cris.harrrelson@brunswickcountync.gov,http://www.brunsco.net
NC-006768,GOSHEN MEDICAL CENTER - BOLTON,"GOSHEN MEDICAL CENTER, INC.",1164695375,Federally Qualified Health Centers - Medical Services,213 9th St,,Bolton,NC,28423-8410,Columbus,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006770,High Country Community Health - Watauga Dental,HIGH COUNTRY COMMUNITY HEALTH,1750646741,Dental Providers,126 Poplar Grove Connector,,Boone,NC,28607-5915,Watauga,PO Box 1490,,Boone,NC,28607-1490,Watauga,Tonya Harris,C.F.O.,828-262-3886,24,tonyaharris@hcchmail.org,Tonya Elledge,Director of Revenue Cycle and Reinburstment,828-262-3886,108,tonyaelledge@hcchmail.org,https://highcountrycommunityhealth.com/
NC-006771,Watauga County Health Department,Appalachian District Health Department,1487727459,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",126 Poplar Grove Connector,,Boone,NC,28607-5915,Watauga,PO Box 308,,Boone,NC,28607,Watauga,Jennifer Greene,Health Director / CEO,828-264-4995,3117,jen.greene@apphealth.com,Angie Poole,Finance Officer / CFO,336-372-5641,1113,angie.scott@apphealth.com,www.apphealthcare.com
NC-006769,High Country Community Health - Watauga Medical,HIGH COUNTRY COMMUNITY HEALTH,1750646741,Federally Qualified Health Centers - Medical Services,935 State Farm Rd,,Boone,NC,28607-4948,Watauga,108 Doctors Dr,,Boone,NC,28607-5000,Watauga,Tiffany Melchers,C.F.O.,828-262-3886,120,tiffanymelchers@hcchmail.org,Tonya Elledge,Director of Revenue Cycle and Reinburstment,828-262-3886,108,tonyaelledge@hcchmail.org,https://www.highcountrycommunityhealth.com/departments
NC-006772,Transylvania County Health Dept.,Transylvania County Health Dept,1821142845,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",106 E Morgan St,Suite 105,Brevard,NC,28712-3718,Transylvania,106 E. Morgan St. Ste 105,,Brevard,NC,28712,Transylvania,Judith Elaine Russell,Health Director,828-884-3135,1747,elaine.russell@transylvaniacounty.org,,,,,,
NC-006773,Transylvania Regional Hospital,Transylvania Regional Hospital,1376098244,Children's Hospitals (inpatient only),260 Hospital Dr,,Brevard,NC,28712-3378,Transylvania,260 Hospital Drive,,Brevard,NC,28712,Transylvania,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006774,Brevard Health Center,Blue Ridge Community Center,1578827507,Federally Qualified Health Centers - Medical Services,89 Hospital Dr,,Brevard,NC,28712-4837,Transylvania,PO Box 5151,,Hendersonville,NC,28712,Henderson,Belinda Elmore,Director of Patient Financial Service,828-692-4289,2201,belmore@brchs.com,Brain Morton,CFO,828-692-4289,2201,belmore@brchs.com,brchs.com
NC-006775,Transylvania Co. Health Dept.,North Carolina Dept. of Health and Human Services,1821142845,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",98 E Morgan St,,Brevard,NC,28712-4514,Transylvania,98 E Morgan St,,Brevard,NC,28712-4514,Transylvania,Elaine Russell,Executive Director,828-884-3135,,elaine.russell@transylvaniacounty.org,Angela Leopard,Business Officer,828-884-3135,,angela.leopard@transylvaniacounty.org,http://health.transylvaniacounty.org
NC-006776,Swain Community Hospital,LifePoint Health,1689780249,Inpatient Hospitals (other than children's hospitals),45 Plateau St,,Bryson City,NC,28713-4200,Swain,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Matt Seagroves,CFO,828-488-2155,,,
NC-006777,Swain Co. Health Dept.,North Carolina Dept. of Health and Human Services,1356490973,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",545 Center St,,Bryson City,NC,28713-6609,Swain,545 Center St,,Bryson City,NC,28713-6609,Swain,Alison Cochran,Executive Director,828-488-3198,2002,alisonc@swaincountync.gov,Amber Frost,Clinical Services Director,828-488-3198,2025,amberf@swaincountync.gov,http://www.swaincountync.gov/health/health-home.html
NC-006778,BLACK RIVER FAMILY PRACTICE,Black River Health Service,1093703886,Federally Qualified Health Centers - Medical Services,301 S Campbell St,,Burgaw,NC,28425-5011,Pender,301 S Campbell St,,Burgaw,NC,28425-5011,Pender,"Lee Ann Amann, MHA",Executive Administrator,910-259-5721,200,lamann@blackriverhealth.org,,,,,,blackriverhealth.org
NC-006779,Pender Memorial Hospital,"Pender Memorial Hospital, Inc",1295703130,Inpatient Hospitals (other than children's hospitals),507 E Fremont St,,Burgaw,NC,28425-5131,Pender,507 E. Fremont Street,,Burgaw,NC,28425,Pender,Ruth Glaser,President,910-300-4002,,ruth.glaser@nhrmc.org,Cynthia Faulkner,Chief Nurse Executive,910-300-4021,,cynthia.faulkner@nhrmc.org,
NC-006780,Pender County Health Department,North Carolina Dept. of Health and Human Services,1508887076,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",803 S Walker St,,Burgaw,NC,28425-5001,Pender,803 S WALKER ST,,BURGAW,NC,28425,Pender,BRANDY LANIER,DIRECTOR OF NURSING,910-259-1359,,BLANIER@PENDERCOUNTYNC.GOV,Carolyn Moser,Executive Director,910-259-1230,,,http://www.penderhealthdept.com
NC-006781,Burlington Community Health Center,"Piedmont Health Services, Inc",1497058804,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1214 Vaughn Rd,,Burlington,NC,27217-2863,Alamance,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006782,Piedmont Health SeniorCare Burlington,"Piedmont Health Services, Inc.",1841449410,Federally Qualified Health Centers - Medical Services,1214 Vaughn Rd,,Burlington,NC,27217-2863,Alamance,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006783,Charles Drew Community Health Center,"Piedmont Health Services, Inc",1588768527,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",221 N Graham Hopedale Rd,,Burlington,NC,27217-2971,Alamance,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006784,Alamance Co. Health Dept.,North Carolina Dept. of Health and Human Services,1316002629,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",319 N Graham Hopedale Rd,,Burlington,NC,27217-2990,Alamance,319 N Graham Hopedale Rd,,Burlington,NC,27217-2990,Alamance,Stacie Saunders,Executive Director,336-513-5514,,stacie.saunders@alamance-nc.com,Gayle Shoffner,Director of Nursing,336-570-6568,,gayle.shoffner@alamance-nc.com,http://www.alamance-nc.com
NC-006785,SCOTT COMMUNITY HEALTH CENTER,"Piedmont Health Service, Inc",1013014596,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5270 Union Ridge Rd,,Burlington,NC,27217-7594,Alamance,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006786,Celo Health Center,Celo Health Education Corporation,1053393272,Family Planning Providers,116 Seven Mile Ridge Rd,,Burnsville,NC,28714-8509,Yancey,116 Seven Mile Ridge Road,,Burnsville,NC,28714,Yancey,Kimberly Hughes,Office Manager,828-675-4116,304,poplargirl1@yahoo.com,Rebecca Ayala,Treasurer,828-675-4116,324,celohealth@yahoo.com,
NC-006787,Celo Health Center,"Bakersville Community Medical Clinic, Inc.",1568914521,Federally Qualified Health Centers - Medical Services,116 Seven Mile Ridge Rd,,Burnsville,NC,28714-8509,Yancey,86 N. Mitchell Ave,,Bakersville,NC,28705,Mitchell,Chuck Shelton,CEO,828-688-2104,,cshelton@mchp.care,Kayle Buchanan,Executive Administrative Assistant,828-688-2104,,kbuchanan@mchp.care,thebchc.org
NC-006788,Yancey County Health Department,Toe River Health District,1295864452,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",202 Medical Campus Dr,,Burnsville,NC,28714-9004,Yancey,861 Greenwood Road,,Spruce Pine,NC,28777,Mitchell,Betty McKinney,Finance Officer,828-765-2239,24,bmckinney@trhd.dst.nc.us,Paula McClellan,Billing,828-765-2239,20,paula.mcclellan@trhd.dst.nc.us,
NC-006789,Blue Ridge Specialty Services - Yancey,Blue Ridge Regional Hospital,1063838712,Rural Health Clinics,800 Medical Campus Dr,,Burnsville,NC,28714-9010,Yancey,800 Medical Campus Drive,,Burnsville,NC,28714,Yancey,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006790,Camden County Health Department,North Carolina Dept. of Health and Human Services,1265513329,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",160 Us 158,,Camden,NC,27921,Camden,PO Box 189,,Elizabeth City,NC,27907-0189,Camden,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006791,BENHAVEN MEDICAL CENTER,FIRST CHOICE COMMUNITY HEALTH CENTERS,1740203611,Federally Qualified Health Centers - Medical Services,985 NC Highway 87 S,,Cameron,NC,28326-7520,Harnett,40 Autumn Fern Trail,,Lillington,NC,27546,Harnett,Sheila L Simmons,Chief Executive Officer,910-364-0972,1600,slsimmons@firstchoicechc.org,,,,,,www.firstchoicechc.org
NC-006792,CARRBORO COMMUNITY HEALTH CENTER,"Piedmont Health Services, Inc",1164526109,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",301 Lloyd St,,Carrboro,NC,27510-1823,Orange,127 Kingston Dr,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006793,Moore County Health Department,North Carolina Dept. of Health and Human Services,1346387883,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",705 Pinehurst Ave,PO Box 279,Carthage,NC,28327-6085,Moore,705 Pinehurst Ave,PO Box 279,Carthage,NC,28327-6085,Moore,Robert Wittmann,Executive Director,910-947-3300,4500,rwittmann@moorecountync.gov,,,910-947-4500,,,http://www.moorecountync.gov/health
NC-006794,Advance Community Health - Cary at Dorcas Plaza,Advance Community Health,1275085144,Federally Qualified Health Centers - Medical Services,173 High House Rd,,Cary,NC,27511-6715,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610,Wake,Penella M. Washington,CEO,919-250-2923,,agoodwin@advancechc.org,Ryan Jury,COO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-006795,Goshen Medical Center Chadbourn,"GOSHEN MEDICAL CENTER, INC.",1598143836,Federally Qualified Health Centers - Medical Services,110 N Brown St,,Chadbourn,NC,28431-1716,Columbus,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-006796,UNC Infectious Diseases Clinic,University of North Carolina,1780669200,Ryan White Providers,101 Manning Dr Bldg 1,Floor Memorial Hospital,Chapel Hill,NC,27514-4423,Orange,130 Mason Farm Rd,2100 Bioinformatics Building,Chapel Hill,NC,27599,Orange,Amy Heine,Program Director,919-843-5174,,amy_heine@med.unc.edu,Claire Farel,"Medical Director, UNC ID Clinic",919-966-2536,,claire_farel@med.unc.edu,http://www.med.unc.edu/infdis
NC-006797,InterFaith Council Community Health Center,"Piedmont Health Services, Inc",1831576719,"Dental Providers, Federally Qualified Health Centers - Medical Services",1315 Martin Luther King Jr Blvd,,Chapel Hill,NC,27514-6605,Orange,127 Kingston Dr,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006798,Planned Parenthood Chapel Hill Health Center,Planned Parenthood South Atlantic,1013021377,Family Planning Providers,1765 Dobbins Dr,,Chapel Hill,NC,27514-5876,Orange,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/chapel-hill/27514/chapel-hill-health-center-4169-90860
NC-006799,Chapel Hill Community Health Center,"Piedmont Health Services, Inc",1356712921,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1828 Martin Luther King Jr Blvd,Suite B14,Chapel Hill,NC,27514-7415,Orange,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006800,Orange County Health Department - Chapel Hill Site,Orange Co. Health Dept.,1760576722,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2501 Homestead Rd,,Chapel Hill,NC,27516-9087,Orange,2501 Homestead Rd,,Chapel Hill,NC,27516-9087,Orange,Colleen Bridger,Health Director,919-245-2400,,cbridger@orangecountync.gov,Rebecca Crawford,Finance and Administrative Services Director,919-245-2414,,rcrawford@orangecountync.gov,http://www.co.orange.nc.us/health/
NC-006801,UNC Hemophilia & Thrombosis Center,University of North Carolina - Chapel Hill,1164634952,Hemophilia Treatment Centers,6340 Quadrangle Dr,Suite 50,Chapel Hill,NC,27517-7841,Durham,"6340 Quadrangle Drive, Suite 170",,Chapel Hill,NC,27517,Orange,Kathy Cooper,Reimbursement Specialist,919-843-9255,,kathy_cooper@med.unc.edu,Dan Dalton,HTC Pharmacy Program Manager,919-843-9255,,dan_dalton@med.unc.edu,https://www.med.unc.edu/htcenter/patient-care/bleeding-disorders
NC-012484,Levine Childrens Hospital,Levine Childrens Hospital,1316104425,Hemophilia Treatment Centers,1001 Blythe Blvd,MCP Suite 601,Charlotte,NC,28203-6107,Mecklenburg,1001 Blythe Blvd,MCP Suite 601,Charlotte,NC,28203,Mecklenburg,Ashley Hinson,MD,704-381-9900,,ashley.hinson@atriumhealth.org,Kearia King,Hemophilia Project Manager,980-442-5831,,kearia.king@atriumhealth.org,
NC-012485,The Hemophilia Treatment Center of Levine Cancer Institute and Levine Children's,The Charlotte Mecklenburg Hospital Authority dba Atrium Health,1750365128,Hemophilia Treatment Centers,1021 Morehead Medical Dr,Suite 50100,Charlotte,NC,28204-2990,Mecklenburg,1021 Morehead Medical Dr.,Suite 50100,CHARLOTTE,NC,28204,Mecklenburg,Mary Ann Knovich,Medical Director,980-442-4363,,Maryann.Knovich@AtriumHealth.org,Kearia King,Project Manager,980-442-5831,,Kearia.King@atriumhealth.org,https://atriumhealth.org/medical-services/specialty-care/cancer-care
NC-006802,Mecklenburg Co. Health Dept.,"North Carolina Dept. of Health and Human Services, FP Program",1043352594,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",249 Billingsley Rd,,Charlotte,NC,28211-1003,Mecklenburg,249 Billingsley Rd,,Charlotte,NC,28211-1003,Mecklenburg,Marcus Plescia MD MPH,Mecklenburg County Health Director,980-314-9020,,Marcus.Plescia@mecklenburgcountync.gov,,,,,,http://charmeck.org/mecklenburg/county/HealthDepartment/Pages/default.aspx
NC-006803,Mecklenburg Co. Clinic,North Carolina Dept. of Health and Human Services,1043352594,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2845 Beatties Ford Rd,,Charlotte,NC,28216-3711,Mecklenburg,2845 Beatties Ford Rd,,Charlotte,NC,28216-3711,Mecklenburg,GIBBIE HARRIS,Mecklenburg County Health Director,980-314-9020,,GIBBIE.HARRIS@MECKNC.GOV,CARDRA BURNS,Deputy Department Director,980-314-9157,,CARDRA.BURNS@MECKNC.GOV,https://www.mecknc.gov/HealthDepartment/Pages/default.aspx
NC-006804,"C.W. Williams Community Health Center, Inc.","C.W. Williams Community Health Center, Inc.",1558308080,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Sexually Transmitted Disease Clinics",3333 Wilkinson Blvd,,Charlotte,NC,28208-5631,Mecklenburg,3333 Wilkinson Blvd,,Charlotte,NC,28208,Mecklenburg,Debra Weeks,CEO,704-391-0819,,dweeks@cwwilliams.org,Hiep Pham MD,CMO,704-393-7720,1063,hpham@cwwilliams.org,www.cwwilliams.org
NC-006805,Quality Comprehensive Health Center,Quality Home Care Services,1184703589,"Other ECP Providers, Ryan White Providers",3552 Beatties Ford Rd,,Charlotte,NC,28216-3742,Mecklenburg,3552 Beatties Ford Road,,Charlotte,NC,28216,Mecklenburg,Lisa M. Wigfall,CEO,704-394-8968,104,lwigfall@qchealth.org,Faye Marshall,COO,704-493-8621,,fmarshall@qchealth.org,www.qhcsnc.org
NC-006807,CCHC West,Charlotte Community Health Clinic,1902251275,"Dental Providers, Federally Qualified Health Centers - Medical Services",5301 Wilkinson Blvd,,Charlotte,NC,28208-5455,Mecklenburg,8410 Medical Plaza Drive,Suite 300,Charlotte,NC,28262,Mecklenburg,Carolyn C. Allison,Chief Executive Officer,704-316-6574,,carolynallison@cchc-clt.org,Danita K. Washington,Billing Supervisor,704-316-6561,18515,danita@cchc-clt.org,www.CharlotteCommunityHealthClinic.org
NC-006808,Ballantyne Family Medicine,Ballantyne Family Medicine,1366429094,"Ryan White Providers, Sexually Transmitted Disease Clinics",6010 E W T Harris Blvd,,Charlotte,NC,28215-4084,Mecklenburg,6010 E. WT Harris Blvd.,,Charlotte,NC,28215,Mecklenburg,Joel Wesley Thompson,Owner and provider,704-996-7352,,wthompson@carolina.rr.com,April Hill,Office Manager,704-930-3848,,karmy1975@hotmail.com,
NC-006806,Planned Parenthood Charlotte Health Center,Planned Parenthood South Atlantic,1861538175,Family Planning Providers,700 S Torrence St,,Charlotte,NC,28204-2928,Mecklenburg,100 S. Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/charlotte/28205/charlotte-health-center-2703-90860
NC-006809,CCHC University,"CHARLOTTE COMMUNITY HEALTH CLINIC, INC",1528363868,Federally Qualified Health Centers - Medical Services,8401 Medical Plaza Dr,Suite 300,Charlotte,NC,28262-8702,Mecklenburg,8401 Medical Plaza Drive,Suite 300,Charlotte,NC,28262-8702,Mecklenburg,Carolyn C. Allison,Chief Executive Officer,704-316-6574,,carolynallison@cchc-clt.org,Danita K. Washington,Billing Supervisor,704-316-6561,18515,danita@cchc-clt.org,www.CharlotteCommunityHealthClinic.org
NC-006810,Cherokee Indian Hospital,Cherokee Indian Hospital Authority,1770662348,"Community Mental Health Centers, Dental Providers, Indian Health Service, Other ECP Providers",1 Hospital Rd,Caller Box 268-C,Cherokee,NC,28719-9253,Swain,1 Hospital Rd,Caller Box 268-C,Cherokee,NC,28719-9253,Swain,Jonathan Dando,Director of Business Dept,828-497-9163,6361,enrollment@cherokeehospital.org,Susan Perez,Enrollment Technician,828-497-9163,6259,enrollment@cherokeehospital.org,
NC-006811,UNITY HEALING CENTER YRTC,Indian Health Service-Nashville Area,1295815314,"Federally Qualified Health Centers - Medical Services, Indian Health Service",448 Wilbur Sequoyah Rd,,Cherokee,NC,28719,Swain,711 Stewarts Ferry Pike,,Nashville,TN,37214,Davidson,Tracey Grant,Clinical Supervisor,828-497-3958,209,tracey.grant@ihs.gov,CAPT Tiara Ruff,Executive Director,828-497-3958,203,tiara.ruff@ihs.gov,
NC-006812,GFHS Cherryville Adult & Pediatric Medicine,Gaston Family Health Services,1770808198,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",112 Oak St,,Cherryville,NC,28021-3423,Gaston,200 E. Second Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-006813,Cherryville Health Center,GASTON FAMILY HEALTH SERVICES INC,1770808198,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",609 E Academy St,,Cherryville,NC,28021-3429,Gaston,991 W Hudson Blvd,,Gastonia,NC,28052-6430,Gaston,Robert E Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006814,China Grove Family Medicine,"CABARRUS COMMUNITY HEALTH CENTERS, INC.",1528304235,Federally Qualified Health Centers - Medical Services,308 E Centerview St,,China Grove,NC,28023-2553,Rowan,202D McGill Ave NW,,Concord,NC,28025-4615,Cabarrus,Kim Wagenaar,CEO,704-792-2203,,kawagenaar@crchc.org,Cody McKinney,CFO,704-792-2208,,clmckinney@crchc.org,www.crchc.org
NC-006815,CommWell Health - Building Bridges,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1134422041,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",306 Beaman St,,Clinton,NC,28328-2908,Sampson,P.O. Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7006,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-006816,Sampson County Health Department,Sampson County Health Department,1619036399,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",360 County Complex Rd,Suite 200,Clinton,NC,28328-4846,Sampson,"360 County Complex Rd, Suite 200",,Clinton,NC,28328,Sampson,Wanda Robinson,Health Director,910-592-1131,4971,wrobinson@sampsonnc.com,Kathie Johnson,Director of Nursing,910-592-1131,4968,kathiej@sampsonnc.com,
NC-006817,GOSHEN MEDICAL CENTER - FAIRVIEW,"GOSHEN MEDICAL CENTER, INC.",1023424686,Federally Qualified Health Centers - Medical Services,408 Fairview St,,Clinton,NC,28328-2312,Sampson,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006818,GOSHEN MEDICAL CENTER - CLINTON,"GOSHEN MEDICAL CENTER, INC.",1073638557,Federally Qualified Health Centers - Medical Services,906 N US 421 Hwy,,Clinton,NC,28328-0410,Sampson,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,tstrickland@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006819,Goshen Medical Center Clinton Dental Services,"GOSHEN MEDICAL CENTER, INC.",1477878874,Federally Qualified Health Centers - Medical Services,908 N US 421 Hwy,,Clinton,NC,28328-0410,Sampson,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,1311,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,http://www.goshenmedical.org/
NC-006820,Haywood County Public Health Department,Haywood County Health and Human Service Agency,1598810285,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",157 Paragon Pkwy,,Clyde,NC,28721-9463,Haywood,157 Paragon Pkwy,,Clyde,NC,28721,Haywood,"Patrick Johnson, RN-C, MPA",Health Director,828-356-2244,,phjohnson@haywoodnc.net,"Lisa Davis, BSN, RN",Nursing Director,828-356-2253,,ldavis@haywoodnc.net,http://www.haywoodnc.net/
NC-006821,Haywood Regional Medical Center,LifePoint Health,1811158215,Inpatient Hospitals (other than children's hospitals),262 Leroy George Dr,,Clyde,NC,28721-7430,Haywood,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Jeff Meigs,CFO,828-452-8861,,,
NC-007123,Haywood Health Center,Blue Ridge Community Health Center Inc.,1407200264,Federally Qualified Health Centers - Medical Services,490 Hospital Dr,,Clyde,NC,28721-8026,Haywood,PO Box 5151,,Hendersonville,NC,28791,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,https://www.brchs.com/haywood-health-center
NC-006822,COLERAIN PRIMARY CARE,"ROANOKE CHOWAN COMMUNITY HEALTH CENTER, INC.",1790851004,Federally Qualified Health Centers - Medical Services,109 W River St,,Colerain,NC,27924-9006,Bertie,120 Health Center Dr,,Ahoskie,NC,27910-8161,Hertford,Kim A Schwartz,Chief Executive Officer,252-209-0237,7124,kschwartz@rcchc.org,Melissa Owens,Chief Financial Officer,252-209-0237,7126,mowens@rcchc.org,
NC-006823,COLLETTSVILLE MEDICAL CENTER,West Caldwell Health Council Inc,1346302429,Federally Qualified Health Centers - Medical Services,4330 Collettsville Rd,,Collettsville,NC,28611-9000,Caldwell,4330 Collettsville Rd,,Collettsville,NC,28611-9000,Caldwell,Kelly C Melton,CFO,828-754-2409,105,kmelton@westcaldwellhc.org,Thomas McRary,CEO,828-754-6850,240,tmcrary@westcaldwellhc.org,
NC-006824,Tyrrell County Health Department,Martin-Tyrrell-Washington District Health Department,1235283847,"Family Planning Providers, Sexually Transmitted Disease Clinics",408 Bridge St,,Columbia,NC,27925,Tyrrell,198 NC Hwy 45 North,,Plymouth,NC,27962,Tyrrell,Bonnie B. Phelps,Administrative Assistant II,252-791-3119,,bonnie.phelps@mtwdistricthealth.org,Nicole Barnes,Processing Assistant IV,252-791-3118,,nicole.barnes@mtwdistricthealth.org,www.mtwdistricthealth.org
NC-006825,Polk Health Center,Blue Ridge Community Health Services Inc.,1326587932,Federally Qualified Health Centers - Medical Services,155 W Mills St,,Columbus,NC,28722-9412,Polk,PO Box 5151,,Hendersonville,NC,28793,Henderson,Belinda Elmore,Director of PFS,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-006826,Collins Dental,Blue Ridge Community Health Services Inc.,1619468766,Federally Qualified Health Centers - Dental Services,158 White Dr,,Columbus,NC,28722-9465,Polk,PO Box 5151,,Hendersonville,NC,28739,Polk,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-006827,Polk County Health Department,Rutherford Polk McDowell Health District,1285791087,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",161 Walker St,,Columbus,NC,28722-9433,Polk,221 Callahan Koon Rd,,Spindale,NC,28160,Rutherford,Joshua Kennedy,Assistant Health Director,828-894-8271,,jkennedy@rpmhd.org,,,,,,
NC-006828,MCGILL FAMILY MEDICINE,"CABARRUS COMMUNITY HEALTH CENTERS, INC.",1396782710,Federally Qualified Health Centers - Medical Services,202D McGill Ave NW,,Concord,NC,28025-4615,Cabarrus,202D McGill Ave NW,,Concord,NC,28025-4615,Cabarrus,Kim Wagenaar,CEO,704-792-2203,,kawagenaar@crchc.org,Cody McKinney,CFO,704-792-2208,,clmckinney@crchc.org,www.crchc.org
NC-006829,LOGAN FAMILY RESOURCE CENTER,"CABARRUS COMMUNITY HEALTH CENTERS, INC.",1689870941,Federally Qualified Health Centers - Medical Services,298 Lincoln St SW,,Concord,NC,28025-5469,Cabarrus,202D McGill Ave NW,,Concord,NC,28025-4615,Cabarrus,Kim Wagenaar,CEO,704-792-2203,,kawagenaar@crchc.org,Cody McKinney,CFO,704-792-2208,,clmckinney@crchc.org,www.crchc.org
NC-006830,Fairgrove Primary Health,Catawba Valley Medical Center,1306899950,Ryan White Providers,3412 Graystone Pl SE,Suite A,Conover,NC,28613-8263,Catawba,810 Fairgrove Church Rd SE,,Hickory,NC,28602-9998,Catawba,Heather Hayworth,Director of Managed Care,828-326-3052,,hhayworth@cvmc.us,David Boone,CFO,828-326-3809,,dboone@cvmc.us,https://catawbavalleymedical.org/medical-services/specialized-services/ryan-white-part-c-clinic/
NC-006831,South Granville Primary Care,Granville Health Systems,1265430854,Rural Health Clinics,1614 NC-56,,Creedmoor,NC,27522,Granville,1010College Street,,Oxford,NC,27565,Granville,Deborah Jirschele,Practice Manager,919-693-6541,231,djirschele@granvillemedical.com,Kyla Fisher,Director Probill,919-690-3000,3288,kfisher@granvillemedical.com,
NC-006832,Creswell Primary Care,Roanoke Chowan Community Health Center,1619342706,Federally Qualified Health Centers - Medical Services,9500 NC Highway 94 N,,Creswell,NC,27928-8300,Washington,120 Health Center Drive,,Ahoskie,NC,27910,Hertford,Kim Schwartz,CEO,252-209-0237,7124,kschwartz@rcchc.org,Melissa Owens,CFO,252-209-0237,7126,mowens@rcchc.org,
NC-006833,Currituck County Health Department,North Carolina Dept. of Health and Human Services,1659468130,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2795 Caratoke Hwy,,Currituck,NC,27929-9609,Currituck,PO Box 189,,Elizabeth City,NC,27909-0189,Currituck,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006834,Pioneer Family Medical of Danbury,"Pioneer Health Services of Stokes County, Inc.",1912294687,Rural Health Clinics,1020 Hospice Dr,,Danbury,NC,27016-7379,Stokes,110 Pioneer Way,,Magee,MS,39110,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
NC-006835,Pioneer Pediatric of Danbury,"Pioneer Health Services of Stokes County, Inc.",1306133079,Other ECP Providers,1030 Hospice Dr,,Danbury,NC,27016-7379,Stokes,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
NC-006837,Surry County Health and Nutrition Center,Surry County Health and Nutrition Center,1790825206,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",118 Hamby Rd,,Dobson,NC,27017-8471,Surry,118 Hamby Rd,,Dobson,NC,27017,Surry,Laura Hodges,Billing administrator,336-401-8400,8440,hodgesl@co.surry.nc.us,Michelle Hunter,Assistant Billing Administrator,336-401-8400,8589,huntermi@co.surry.nc.us,http://www.surry.com
NC-006838,CommWell Health of Newton Grove/Spivey's Corner - Dental,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1790815611,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",1508 Maple Grove Church Rd,,Dunn,NC,28334-7688,Sampson,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pamela Tripp,CEO,910-567-7006,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-006839,CommWell Health of Newton Grove/Spivey's Corner,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1427087709,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",3331 Easy St,,Dunn,NC,28334-7988,Sampson,P.O. Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,http://www.cphealthnet.org/tricounty.htm
NC-006840,Goshen Medical Center Tilghman,"GOSHEN MEDICAL CENTER, INC.",1780193557,Federally Qualified Health Centers - Medical Services,801 Tilghman Dr,Suite A,Dunn,NC,28334-4958,Harnett,444 SW Center St,,Faison,NC,28341-8820,Davie,Greg Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-006841,Planned Parenthood Durham Health Center,Planned Parenthood South Atlantic,1639501166,Family Planning Providers,105 Newsom St,Suite 101,Durham,NC,27704-2197,Durham,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Services,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/durham/27704/durham-health-center-4171-90860
NC-006842,"Lincoln Community Health Center, Inc.","Lincoln Community Health Center, Inc.",1114978582,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1301 Fayetteville St,,Durham,NC,27707-2325,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,
NC-006843,Lyon Park Clinic,"Lincoln Community Health Center, Inc.",1598709198,Federally Qualified Health Centers - Medical Services,1313 Halley St,,Durham,NC,27707-1227,Durham,1301 Fayetteville Street,,Durham,NC,27707-1227,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006844,Duke University Pediatric Infectious Diseases (inpatient hospital),Duke University Hospital,1992703540,Inpatient Hospitals (other than children's hospitals),2301 Erwin Rd,Childrens Health Center T915,Durham,NC,27705-4699,Durham,2301 Erwin Road,,Durham,NC,27710,Durham,"Coleen Cunningham, MD","Chief, Pediatric Infectious Diseases",919-668-4851,,coleen.cunningham@duke.edu,"Julieta Giner, RN, ACRN",Clinical Trials Coordinator III,919-668-4844,,julieta.giner@duke.edu,
NC-006845,Duke University Pediatric Infectious Diseases (ryan white providers),Duke University Hospital,1992703540,Ryan White Providers,2301 Erwin Rd,Childrens Health Center T915,Durham,NC,27705-4699,Durham,2301 Erwin Road,,Durham,NC,27710,Durham,"Coleen Cunningham, MD","Chief, Pediatric Infectious Diseases",919-668-4851,,coleen.cunningham@duke.edu,"Julieta Giner, RN, ACRN",Clinical Trials Coordinator III,919-668-4844,,julieta.giner@duke.edu,
NC-006846,Durham Recovery Response Center,"Lincoln Community Health Center, Inc.",1013202373,Federally Qualified Health Centers - Medical Services,309 Crutchfield St,,Durham,NC,27704-2754,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Pt Acct Super,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,
NC-006847,John H. Lucas Wellness Center at Hillside High School,"Lincoln Community Health Center, Inc.",1649210279,Federally Qualified Health Centers - Medical Services,3727 Fayetteville St,John H. Lucas Wellness Center at Hillside High School,Durham,NC,27707-4718,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006848,Live Well Primary Care Clinic,"Lincoln Community Health Center, Inc.",1801295936,Federally Qualified Health Centers - Medical Services,3901 N Roxboro St,Suite 102,Durham,NC,27704-2181,Durham,1301 Fayetteville St,,Durham,NC,27707-2325,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006849,Holton Clinic,"Lincoln Community Health Center, Inc.",1376770537,Federally Qualified Health Centers - Medical Services,401 N Driver St,,Durham,NC,27703-3007,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006850,Health Care for the Homeless,"Lincoln Community Health Center, Inc.",1942240544,Federally Qualified Health Centers - Medical Services,412 Liberty St,,Durham,NC,27701-3408,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Pt Acct Super,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006851,Durham County Department of Public Health,Durham County Department of Public Health,1457435349,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",414 E Main St,,Durham,NC,27701-3720,Durham,414 E Main St,,Durham,NC,27701-3720,Durham,Gayle Harris,Public Health Director,919-560-7650,,gharris@dconc.gov,Joanne Pierce,Assistant Health Director,919-560-7609,,jpierce@dconc.gov,http://www.dconc.gov/government/departments-f-z/public-health
NC-006852,Lincoln CHC-Durham County Human Services,"Lincoln Community Health Center, Inc.",1891742557,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",414 E Main St,,Durham,NC,27701-3720,Durham,1301 Fayetteville St.,,Durham,NC,27707,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,,www.lincolnchc.org
NC-006853,Walltown Clinic,"Lincoln Community Health Center, Inc.",1780631374,Federally Qualified Health Centers - Medical Services,815 Broad St,,Durham,NC,27705-4137,Durham,1301 Fayetteville Street,,Durham,NC,27707-2325,Durham,Musa Ali,Patient Accounts Supervisor,919-956-4508,,hassan.ali@duke.edu,William seagroves,CFO,919-956-4534,,william.seagroves@duke.edu,www.lincolnchc.org
NC-006854,Morehead Memorial Hospital DBA Rockingham County Student Health Centers,Morehead Memorial Hospital,1326048810,Outpatient Hospital Clinics,134 N Pierce St,,Eden,NC,27288-3531,Rockingham,117 E Kings Highway,,Eden,NC,27288,Rockingham,Ray Owings,CFO Morehead Memorial Hospital,336-623-9711,2218,ray.owings@morehead.org,Catherine DeMason,Director Rockingham County Student Health Centers,336-623-9711,2341,cdemason@rock.k12.nc.us,www.morehead.org
NC-012454,James Austin Health Center,Caswell Family Medical Center,1205486297,Federally Qualified Health Centers - Medical Services,207 E Meadow Rd,Suite 6,Eden,NC,27288-3469,Rockingham,P.O. BOX 1448,,YANCEYVILLE,NC,27379,Caswell,BECKY HATCHETT,Billing Supervisor,336-694-1181,204,bhatchett@caswellmedical.org,William Crumpton,CEO,336-694-9331,,bhatchett@caswellmedical.org,www.caswellmedical.org
NC-006855,Chowan County Health Department,North Carolina Dept. of Health and Human Services,1235226630,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",202 W Hicks St,,Edenton,NC,27932-1865,Chowan,PO Box 189,,Elizabeth City,NC,27907-0189,Chowan,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006856,"Gateway Community Health Centers, Inc.","GATEWAY COMMUNITY HEALTH CENTERS, INC.",1487936514,Federally Qualified Health Centers - Medical Services,1129 Horseshoe Rd,,Elizabeth City,NC,27909-8507,Pasquotank,PO Box 297,,Gatesville,NC,27938-0297,Gates,Rose Turner,CEO,252-357-1226,,RTurner@GCHCHealth.com,,,,,,
NC-006857,Albemarle Regional Health Services,North Carolina Dept. of Health and Human Services,1659468130,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",711 Roanoke Ave,PO Box 189,Elizabeth City,NC,27909-5643,Pasquotank,PO Box 189,711 Roanoke Ave.,Elizabeth City,NC,27907-0189,Pasquotank,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006858,Bladen Co. Health Dept.,North Carolina Dept. of Health and Human Services,1083779797,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 Mercer Mill Rd,,Elizabethtown,NC,28337-3959,Bladen,300 Mercer Rd,,Elizabethtown,NC,28337,Bladen,Terri Duncan,Human Services Director,910-862-6900,6253,tduncan@bladenco.org,,,,,,https://bladennc.govoffice3.com/index.asp?SEC=A8A2468C-7CA6-406E-AA96-D7D4A14CD741&Type=B_BASIC
NC-006859,CommWell Health of Dublin - Dental,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1124158043,Dental Providers,73 Dixon St,,Elizabethtown,NC,28337,Bladen,P.O.Box 227,,Newton Grove,NC,28334-7988,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,919-567-7008,,CStanley@commwellhealth.org,
NC-006860,CFHC Dental Center,"Carolina Family Health Centers, Inc.",1093883852,Dental Providers,8282 NC 58 S,Bldg A,Elm City,NC,27822-8079,Wilson,303 Green Street E,,Wilson,NC,27893-4105,Wilson,Annette Eatmon,Chief Operating Officer,252-293-0013,320,aeatmon@cfhcnc.org,Paula McMillian,Chief Financial Officer,252-293-0013,323,pmcmillian@cfhcnc.org,www.cfhcnc.org
NC-006861,HARVEST FAMILY HEALTH CENTER,CAROLINA FAMILY HEALTH CENTERS INC,1093883852,"Dental Providers, Federally Qualified Health Centers - Medical Services",8282 NC 58 S,,Elm City,NC,27822-8079,Wilson,303 Green St E,,Wilson,NC,27893-4105,Wilson,Annette Eatmon,Chief Operating Officer,252-293-0013,320,aeatmon@cfhcnc.org,Marty Johnson,Outreach Enrollment Manager,252-293-0013,312,mjohnson@cfhcnc.org,www.cfhcnc.org
NC-006862,Rural Health Group at Enfield,"Rural Health Group, Inc.",1952665929,Federally Qualified Health Centers - Medical Services,114 Market St,,Enfield,NC,27823-1423,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006863,Engelhard Medical Center,ENGELHARD MEDICAL CENTER,1063472116,Federally Qualified Health Centers - Medical Services,33270 US Highway 264,,Engelhard,NC,27824-9557,Hyde,PO BOX 543,,Ocracoke,NC,27960-0543,Hyde,Jamie Tunnell Carter,Billing Manager,252-925-0058,,jvtohc@yahoo.com,ERIN ONEAL,C.O.O.,252-928-1511,,EMOOHC@YAHOO.COM,
NC-006864,SOUTH ROBESON MEDICAL CENTER,ROBESON HEALTH CARE CORPORATION,1417914722,Federally Qualified Health Centers - Medical Services,1212 S Walnut St,,Fairmont,NC,28340-1848,Robeson,60 Commerce Plaza,,Pembroke,NC,28372-7386,Robeson,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-006865,GOSHEN MEDICAL CENTER - FAISON,"GOSHEN MEDICAL CENTER, INC.",1154378933,Federally Qualified Health Centers - Medical Services,444 SW Center St,,Faison,NC,28341-8820,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006866,GMC FAISON DENTAL SERVICES,"GOSHEN MEDICAL CENTER, INC.",1902084486,Dental Providers,460 SW Center St,,Faison,NC,28341-8820,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006867,Cumberland Co. Health Dept.,North Carolina Dept. of Health and Human Services,1831249986,"Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1235 Ramsey St,,Fayetteville,NC,28301-4401,Cumberland,1235 Ramsey St,,Fayetteville,NC,28301-4401,Cumberland,Buck Wilson,Executive Director,910-433-3700,,bwilson@co.cumberland.nc.us,Dr. Lan Tran-Phu,Medical Director,910-433-3652,,ltphu@co.cumberland.nc.us,http://www.co.cumberland.nc.us/health/index.html
NC-006868,Southern Regional Area Health Education Center,"Fayetteville Area Health Education Foundation, Inc",1811072812,Ryan White Providers,1601 Owen Dr,,Fayetteville,NC,28304-3425,Cumberland,1601 Owen Dr,,Fayetteville,NC,28304-3425,Cumberland,Tina Carter,Assistant Controller,910-678-0136,,tina.carter@sr-ahec.org,Jennifer Powell,Clinical Business Office Manager,910-678-0117,,jennifer.powell@sr-ahec.org,
NC-006869,WADE FAMILY MEDICAL CENTER DOWNTOWN,"STEDMAN-WADE HEALTH SERVICES, INC.",1609186790,Federally Qualified Health Centers - Medical Services,2409 Murchison Rd,Suite B,Fayetteville,NC,28301-3519,Cumberland,PO BOX 449,,Wade,NC,28395-9749,Cumberland,Melva Jackson,PATIENT SERVICES COORDINATOR,910-483-6694,7027,OM@SWHS-NC.ORG,HATTIE LASSITER,CFO,910-483-6694,7010,CFO@SWHS-NC.ORG,
NC-006870,GOSHEN MEDICAL CENTER - CAPE FEAR,"GOSHEN MEDICAL CENTER, INC.",1215366216,Federally Qualified Health Centers - Medical Services,3613 Cape Center Dr,,Fayetteville,NC,28304-4457,Cumberland,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006871,Planned Parenthood Fayetteville Health Center,Planned Parenthood South Atlantic,1174955249,Family Planning Providers,4551 Yadkin Rd,,Fayetteville,NC,28303-3421,Cumberland,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/fayetteville/28303/fayetteville-health-center-4173-90860
NC-006872,CommWell Health of Four Oaks - Dental,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1700054574,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 E Sanders St,,Four Oaks,NC,27524-7776,Johnston,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-006873,Franklin Community Health Center,Appalachian Mountain Community Health Centers,1891148748,Federally Qualified Health Centers - Medical Services,100 Thomas Heights Rd,Suite 201,Franklin,NC,28734-9799,Macon,PO Box 2597,"7 McDowell Str, Ste 200",Asheville,NC,28802,Buncombe,Reuben J. Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul C Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-006874,Angel Medical Center,Angel Medical Center,1710430822,Inpatient Hospitals (other than children's hospitals),120 Riverview St,,Franklin,NC,28734-2612,Macon,Angel Medical Center,120 Riverview Street,Franklin,NC,28734,Franklin,Cheryl T Williams,Executive Director Patient Accounting,828-651-4160,0,cheryl.williams2@msj.org,,,,,,
NC-006875,Macon County Public Health,Macon County Public Health,1720161334,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1830 Lakeside Dr,,Franklin,NC,28734-6778,Macon,1830 Lakeside Drive,,Franklin,NC,28734,Macon,James Bruckner,Health Director,828-349-2424,,jbruckner@maconnc.org,Diane Keener,Coordinator Health Information,828-349-2424,,dkeener@maconnc.org,http://maconnc.org/
NC-006877,GOSHEN MEDICAL CENTER - FREMONT,"GOSHEN MEDICAL CENTER, INC.",1679718316,Federally Qualified Health Centers - Medical Services,109 S Sycamore St,,Fremont,NC,27830-8710,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006878,Dare County Health Department,Dare County Dept. of Health and Human Services - Public Health Division,1770637381,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",50347 NC Hwy 12,,Frisco,NC,27936,Dare,50347 NC Hwy 12,,Frisco,NC,66211-1303,Dare,Sheila Davies,Health Director,252-475-5093,,sheila.davies@darenc.com,Debbie Dutton,Nursing Director,252-475-9366,,debbie.dutton@darenc.com,www.darenc.com
NC-006879,Advance Community Heatlh - Fuquay-Varina,Advance Community Health,1114913092,Federally Qualified Health Centers - Medical Services,130 N Judd Pkwy NE,,Fuquay Varina,NC,27526-2367,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610,Wake,Penella M. Washington,CEO,919-250-2923,,pwashington@advancechc.org,Ryan Jury,COO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-006880,Wake County - Southern Regional Center,Wake County Human Services - Health Department,1801957576,"Family Planning Providers, Sexually Transmitted Disease Clinics",130 N Judd Pkwy NE,,Fuquay Varina,NC,27526-2367,Wake,Wake County Health Department,10 Sunnybrook Rd,Raleigh,NC,27610-1808,Wake,Sue Lynn Ledford,Health Director,919-250-4516,,Sue.Ledford@wakegov.com,Ida Dawson,Clinics Division Director,919-250-4629,,idawson@wakegov.com,http://www.wakegov.com
NC-006881,Goshen Medical Center- Garland,"GOSHEN MEDICAL CENTER, INC.",1912170002,Federally Qualified Health Centers - Medical Services,105 Lisbon Ave,,Garland,NC,28441,Bladen,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006882,Rural Health Group at KIPP,"Rural Health Group, Inc.",1053742056,Federally Qualified Health Centers - Medical Services,320 Pleasant Hill Rd,,Gaston,NC,27832-9511,Northampton,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006883,GASTON FAMILY MEDICAL CENTER,Gaston Family Health Services,1548389125,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",111 E 3rd Ave,,Gastonia,NC,28052-4343,Gaston,200 E 2nd Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006884,Senior Total Life Care Center,Gaston Family Health Services,1205251766,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1875 Remount Rd,,Gastonia,NC,28054-7413,Gaston,200 E Secound Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@kintegra.org,Veronica Feduniec,Chief Operating Officer,704-874-1906,,vfeduniec@kintegra.org,http://www.seniortlc.org/
NC-006885,Gaston Complete Health,Gaston Family Health Services,1518418763,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2505 Court Dr,,Gastonia,NC,28054-2140,Gaston,200 E. Second Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-006886,CaroMont Regional Medical Center,CaroMont Health,1013918960,Inpatient Hospitals (other than children's hospitals),2525 Court Dr,,Gastonia,NC,28054-2140,Gaston,2525 Court Drive,,Gastonia,NC,28054,Gaston,Lynda Hoyt,Director Managed Care Contracting,704-671-5307,,lynda.hoyt@caromonthealth.org,betty.herbert@caromonthealth.org,Senior Director,704-834-4532,,betty.herbert@caromonthealth.org,www.caromont.org
NC-006887,GFHS Adult and Pediatrics,Gaston Family Health Services,1477079283,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2721 X Ray Dr,,Gastonia,NC,28054-7491,Gaston,200 E 2nd Ave.,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006888,Gaston Family Counseling Center,GASTON FAMILY HEALTH SERVICES INC,1114322922,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",409 S Oakland St,,Gastonia,NC,28052-4312,Gaston,991 W Hudson Blvd,,Gastonia,NC,28052-6430,Gaston,Robert E Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006889,Highland Health Center,Gaston Family Health Services,1174767073,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",609 N Highland St,,Gastonia,NC,28052-2179,Gaston,200 E 2nd Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-874-1900,1902,rspencer@gfhs.info,,,,,,
NC-006890,GFHS Pediatric Dentistry,Gaston Family Health Services,1154662369,Dental Providers,890 Summit Crossing Pl,,Gastonia,NC,28054-2192,Gaston,200 East Second Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006891,Gaston Family Health Services,Gaston Family Health Services,1215932215,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",991 W Hudson Blvd,,Gastonia,NC,28052-6430,Gaston,200 E. 2nd Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-006892,Gates County Health Department,North Carolina Dept. of Health and Human Services,1811084239,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",29 Medical Center Rd,,Gates,NC,27937-9816,Gates,PO Box 189,,Elizabeth City,NC,27907-0189,Gates,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006893,"Gateway Community Health Centers, Inc.","GATEWAY COMMUNITY HEALTH CENTERS, INC.",1518247576,Federally Qualified Health Centers - Medical Services,501 Main St,,Gatesville,NC,27938-9424,Gates,PO Box 297,,Gatesville,NC,27938-0297,Gates,Rose Turner,CEO,252-357-1226,,RTurner@GCHCHealth.com,,,,,,
NC-006894,"Gateway Community Health Centers, Inc.","GATEWAY COMMUNITY HEALTH CENTERS, INC.",1437431541,Federally Qualified Health Centers - Medical Services,88 US Highway 158 W,,Gatesville,NC,27938-9438,Gates,PO Box 297,,Gatesville,NC,27938-0297,Gates,Rose Turner,CEO,252-357-1226,,RTurner@GCHCHealth.com,Valerie Corder,Billing Agent,256-604-9203,,cordervalerie@bellsouth.net,
NC-006895,GOSHEN MEDICAL CENTER - ROSEWOOD,"GOSHEN MEDICAL CENTER, INC.",1194128991,Federally Qualified Health Centers - Medical Services,104 Adair Dr,,Goldsboro,NC,27530-4516,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006896,Goshen Medical Center Rosewood Dental,"GOSHEN MEDICAL CENTER, INC.",1326443870,Dental Providers,104 Adair Dr,Bldg C,Goldsboro,NC,27530-4516,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,1311,tstrickland@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,,tstrickland@goshenmed.com,
NC-006897,GOSHEN MEDICAL CENTER - EASTPOINTE,"GOSHEN MEDICAL CENTER, INC.",1083739429,Federally Qualified Health Centers - Medical Services,200 W Ash St,Suite 202,Goldsboro,NC,27530-3679,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006898,GOSHEN MEDICAL CENTER-GOLDSBORO,"GOSHEN MEDICAL CENTER, INC.",1255456794,Federally Qualified Health Centers - Medical Services,2701 Medical Office Pl,,Goldsboro,NC,27534-9458,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,,,tstrickland@goshenmed.com,
NC-006899,Wayne County Health Department,Wayne County Health Department,1871594622,"Dental Providers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 N Herman Street,Box CC,Goldsboro,NC,27530,Wayne,301 North Herman Street,BOX CC,Goldsboro,NC,27530,Wayne,Davin Madden,Health Director,919-705-1934,1934,davin.madden@wayengov.com,Ken Stern,Business Officer,919-731-1234,1234,ken.stern@waynegov.com,http://waynegov.com/260/Programs-Services
NC-006900,TAPM Family Medicine at Eugene,"TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",1063712727,Federally Qualified Health Centers - Medical Services,1002 S Eugene St,,Greensboro,NC,27406-1308,Guilford,1002 S. EUGENE ST.,,Greensboro,NC,27406,Guilford,MICHELLE LEWIS,CEO,336-355-9715,,MLEWIS@TAPMEDICINE.COM,,,,,,WWW.TAPMEDICINE.COM
NC-006901,TAPM Pediatrics at Wendover,"TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",1598762940,Federally Qualified Health Centers - Medical Services,1046 E Wendover Ave,,Greensboro,NC,27405-6712,Guilford,1002 S. EUGENE ST.,,Greensboro,NC,27406,Guilford,MICHELLE LEWIS,CEO,336-355-9715,,MLEWIS@TAPMEDICINE.COM,,,,,,WWW.TAPMEDICINE.COM
NC-006902,Guilford County Health Department,"North Carolina Dept. of Health and Human Services, FP Program",1245272657,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1100 E Wendover Ave,,Greensboro,NC,27405-6713,Guilford,1203 Maple St,,Greensboro,NC,27405-6910,Guilford,Merle Green,Executive Director,336-641-3288,,mgreen@myguilford.com,,,,,,https://www.guilfordcountync.gov/our-county/human-services/health-department/contact-us
NC-006903,TAPM Family Medicine at E. Market St.,Triad Adult and Pediatric Medicine,1063882165,Federally Qualified Health Centers - Medical Services,1102 E Market St,,Greensboro,NC,27401-6056,Guilford,1002 S. EUGENE ST.,,GREENSBORO,NC,27406,Guilford,MICHELLE LEWIS,CEO,336-355-9715,,MLEWIS@TAPMEDICINE.COM,,,,,,WWW.TAPMEDICINE.COM
NC-006904,Guilford County DHHS-DPH Chandler Dental Clinic,Guilford County Department of Health and Human Services-Division of Public Health,1245272657,Dental Providers,1103 W Friendly Ave,,Greensboro,NC,27401-1863,Guilford,1203 Maple Street,,Greensboro,NC,27405,Guilford,Merle Green,Health Director,336-641-3288,,mgreen@myguilford.com,,,,,,http://www.myguilford.com/humanservices/health/
NC-006905,Triad Adult & Pediatric Medicine at Arlington,Triad Adult & Pediatric Medicine,1881059723,Federally Qualified Health Centers - Medical Services,1205 Arlington St,,Greensboro,NC,27406-1420,Guilford,1002 S. Eugene Street,,Greensboro,NC,27405,Guilford,Robin Durham,HR Mgr,336-355-9720,7720,RDurham@tapmedicine.com,Michelle Lewis,CEO,336-355-9696,7715,MLewis@tapmedicine.com,
NC-006906,Planned Parenthood Greensboro Health Center,Planned Parenthood South Atlantic,1487790762,Family Planning Providers,1704 Battleground Ave,,Greensboro,NC,27408-7905,Guilford,100 S. Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Services,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/greensboro/27408/greensboro-health-center-2846-90860
NC-006907,CENTRAL CAROLINA HEALTH NETWORK,Central Carolina Health Network,1942666953,Ryan White Providers,301 E Wendover Ave,Suite 113,Greensboro,NC,27401-1209,Guilford,301 E Wendover Ave Ste 113,,Greensboro,NC,27401-1209,Guilford,Kent Gammon,President/CEO,336-292-0665,25,kent.gammon@cchn4.org,,,,,,http://epi.publichealth.nc.gov/cd/hiv/docs/HIVPatientManagementNetworks.pdf
NC-006908,TAPM Pediatrics at Meadowview,"TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",1831197938,Federally Qualified Health Centers - Medical Services,433 W Meadowview Rd,,Greensboro,NC,27406-4316,Guilford,1002 S. EUGENE ST.,,Greensboro,NC,27406,Guilford,MICHELLE LEWIS,CEO,336-355-9715,,MLEWIS@TAPMEDICINE.COM,,,,,,WWW.TAPMEDICINE.COM
NC-006909,Pitt County Public Health Center,Pitt County Public Health Department,1306904917,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 Government Cir,Pitt County Public Health Department,Greenville,NC,27834-8198,Pitt,201 Government Circle,,Greenville,NC,27834,Pitt,"John Howard Morrow, MD, MPH",Public Health Director,252-902-2443,,john.morrow@pittcountync.gov,John Reed,Director of Administration,252-902-2445,,john.reed@pittcountync.gov,
NC-006910,Infectious Disease and Travel Clinic,East Carolina University,1841493400,Ryan White Providers,2300 Beasley Dr,Doctors Park #6a,Greenville,NC,27834,Pitt,600 Moye Blvd,,Greenville,NC,27834,Pitt,Diane Campbell,MD,252-744-5728,,campbelldi@ecu.edu,,,,,,https://www.ecu.edu/cs-dhs/ecuphysicians/locations.cfm?location=61
NC-006911,JAMES D. BERNSTEIN MEDICAL CTR,"Greene County Health Care, Incorporated",1194811026,"Dental Providers, Federally Qualified Health Centers - Medical Services",261 Belvoir Rd,,Greenville,NC,27834-8661,Pitt,7 Professional Dr,,Snow Hill,NC,28580-1332,Greene,Doug Smith,CEO,252-747-8162,2205,dsmith@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-006912,East Carolina University,East Carolina University,1043260474,"Hemophilia Treatment Centers, Ryan White Providers",600 Moye Blvd,Brody Outpatient Center Module F,Greenville,NC,27834-4300,Pitt,600 Moye Boulevard,,Greenville,NC,27834,Pitt,Becky Gardner,Business Services Coordinator,252-744-5405,,gardnerre@ecu.edu,,,,,,
NC-006915,Halifax County Health Department,Halifax County Health Department,1740217785,"Family Planning Providers, Other ECP Providers, Tuberculosis Clinics",19 Dobbs St,,Halifax,NC,27839-7502,Halifax,19 North Dobbs St,,Halifax,NC,27839-7502,Halifax,Elizabeth Buffaloe,Administrative Assistant,252-583-5021,223,buffaloee2@halifaxnc.com,Tina Davis,Lead Worker,252-583-5021,314,davist@halifaxnc.com,www.halifaxnc.com
NC-006916,Goshen Medical Center Hamlet,"GOSHEN MEDICAL CENTER, INC.",1023549094,Federally Qualified Health Centers - Medical Services,106 Jefferson St,,Hamlet,NC,28345-3100,Richmond,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-006917,CommWell Health of Harrells,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1942223318,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",194 Tomahawk Hwy,,Harrells,NC,28444-9765,Sampson,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7006,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7067,,CStanley@commwellhealth.org,
NC-006918,Clay Comprehensive Health Services,Chatuge Family Practice,1659362911,Other ECP Providers,241 Church St,,Hayesville,NC,28904-9688,Clay,241 Church St,PO Box 1309,Hayesville,NC,28904,Clay,Carie Free,Practice Administrator,828-389-6383,13,cfree@chatugefp.org,,,,,,www.chatugefp.org
NC-006919,Clay County Health Department,Clay County Health Department,1629159884,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",345 Courthouse Dr,,Hayesville,NC,28904-0020,Clay,345 Courthouse Drive,,Hayesville,NC,28904,Clay,Tanya Long,Nursing Supervisor,828-389-8052,128,tanyalong@clayhdnc.us,Janice Patterson,Heatlh Director,828-389-8052,126,janicepatterson@clayhdnc.us,
NC-006920,Rural Health Group at Henderson,"Rural Health Group, Inc.",1124269022,Federally Qualified Health Centers - Medical Services,100 W Parkview Dr,,Henderson,NC,27536-5923,Vance,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006921,Vance County Health Department,Granville Vance Public Health,1184783409,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 Charles Rollins Rd,,Henderson,NC,27536-2946,Vance,101 Hunt Drive,PO Box 367,Oxford,NC,27565,Granville,Sandra Durham,Management Support Supervisor,919-693-2141,285,sdurham@gvdhd.org,"Leigh Anne Fowler, RN",Nursing Supervisor,919-693-2141,155,lfowler@gvdhd.org,www.gvph.org
NC-006922,Northern Outreach Clinic,"Warren-Vance Community Health Center, Inc.",1558652784,"Rural Health Clinics, Ryan White Providers",511 Ruin Creek Rd,Suite 105,Henderson,NC,27536-5919,Vance,511 Ruin Creek Rd,Suite 105,Henderson,NC,27536,Vance,Michelle Collins Ogle,Clinic Director,252-572-2610,,mdenise.ogle@gmail.com,,,,,,
NC-006923,Maria Parham Medical Center,LifePoint Health,1164707725,Inpatient Hospitals (other than children's hospitals),566 Ruin Creek Rd,,Henderson,NC,27536-2927,Vance,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Michael Gordian,CFO,252-436-1101,,,
NC-006924,Park Ridge Health,Adventist Health System/Sunbelt Inc.,1427075027,Inpatient Hospitals (other than children's hospitals),100 Hospital Dr,,Hendersonville,NC,28792-5272,Henderson,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,David Strosnider,Director Managed Care,828-684-8501,,David.Strosnider@ahss.org,,,,,,
NC-006925,Rainbow Pediatrics,"Blue Ridge Community Health Services, Inc.",1326587932,Federally Qualified Health Centers - Medical Services,110 Chadwick Square Ct,,Hendersonville,NC,28739-3237,Henderson,PO Box 5151,,Hendersonville,NC,28793-5151,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,
NC-006926,Henderson County Department of Public Health,Henderson County Department of Public Health,1902957954,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1200 Spartanburg Hwy,,Hendersonville,NC,28792-5855,Henderson,1200 Spartanburg Highway,,Hendersonville,NC,28792,Henderson,Steven Elliott Smith,Director,828-692-4223,6033,ssmith@hendersoncountync.org,Cathy Nicholson,Administrative Officer,828-692-4223,6036,cathyn@hendersoncountync.org,http://www.hendersoncountync.org/health/
NC-006927,Mainstay,"Blue Ridge Community Health Services, Inc.",1932464351,Federally Qualified Health Centers - Medical Services,133 5th Ave W,,Hendersonville,NC,28792-4334,Henderson,PO Box 5151,,Hendersonville,NC,28793,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,belmore@brchs.com,brchs.com
NC-006928,"Blue Ridge Community Health Services, Inc",Blue Ridge Community Health Services Inc,1225029051,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",2579 Chimney Rock Rd,,Hendersonville,NC,28792-9181,Henderson,PO Box 5151,,Hendersonville,NC,28792,Henderson,Belinda Elmore,Director of Patient Financil Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-006929,Stokes Dental,"Blue Ridge Community Health Services, Inc.",1457332421,Federally Qualified Health Centers - Dental Services,2595 Chimney Rock Rd,,Hendersonville,NC,28792-9181,Henderson,PO Box 5151,,Hendersonville,NC,28792,Henderson,Belinda Elmore,Director Of Patient Financial Services Inc.,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-006930,"Blue Ridge Community Health Services, Inc.","Blue Ridge Community Health Services, Inc.",1225029051,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",271 Bearcat Blvd,Bruce Drysdale Elementary School Health,Hendersonville,NC,28792-4577,Henderson,PO Box 5151,,Hendersonville,NC,28793-5151,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,
NC-006931,"Blue Ridge Community Health Services, Inc.","Blue Ridge Community Health Services, Inc.",1619958451,Federally Qualified Health Centers - Medical Services,43 Fruitland Rd,Apple Valley School Health,Hendersonville,NC,28792-8506,Henderson,PO Box 5151,,Hendersonville,NC,28792,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2201,belmore@brchs.com,https://www.brchs.com/
NC-006932,7th Avenue Health Center,"Blue Ridge Community Health Services, Inc.",1801261391,Federally Qualified Health Centers - Medical Services,628 7th Ave E,,Hendersonville,NC,28792-3801,Henderson,PO Box 5151,,Hendersonville,NC,28792-9181,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-006933,Hendersonville Family Health Center,"Blue Ridge Community Health Services, Inc.",1437593787,Family Planning Providers,709 N Justice St,,Hendersonville,NC,28791-3454,Henderson,PO Box 5151,,Hendersonville,NC,28793-5151,Henderson,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,
NC-006934,Perquimans County Health Department,North Carolina Dept. of Health and Human Services,1487738951,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",103 Arpdc St,,Hertford,NC,27944-1219,Perquimans,PO Box 189,,Elizabeth City,NC,27907-0189,Perquimans,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-006935,Catawba Family Care,Gaston Family Health Services,1437586302,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",133 1st Ave SE,,Hickory,NC,28602-3005,Catawba,200 E 2nd Avenue,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006936,Catawba Valley Family Medicine Northeast Hickory,Gaston Family Health Services,1407133069,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2365 Springs Rd NE,,Hickory,NC,28601-3067,Catawba,200 E. Second Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-006937,Catawba County Public Health,Catawba County Public Health,1992857841,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3070 11th Avenue Dr SE,,Hickory,NC,28602-8336,Catawba,3070 11th Avenue Drive SE,,Hickory,NC,28602,Catawba,Sarah Rhodes,Clinical Nurse Supervisor,828-695-5800,5835,smrhodes@catawbacountync.gov,Jennifer McCracken,Assistant Health Director,828-695-5800,5820,jmccrack@catawbacountync.gov,
NC-006938,Catawba Family Dentistry,Gaston Family Health Services,1154662369,Dental Providers,3070 11th Avenue Dr SE,,Hickory,NC,28602-8336,Catawba,200 East Second Avenue,,Gastonia,NC,28054,Gaston,Robert Spencer,CEO115,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006939,Frye Regional Medical Center,LifePoint Health,1801823349,Inpatient Hospitals (other than children's hospitals),420 N Center St,Suite 20,Hickory,NC,28601-5046,Catawba,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Jamey Stoner,CFO,828-315-3111,,,
NC-006940,TAPM Family Medicine at Brentwood,"TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",1972050979,Federally Qualified Health Centers - Medical Services,2039 Brentwood St,,High Point,NC,27263-1805,Guilford,1002 S. Eugene Street,,Greensboro,NC,27406-1308,Guilford,Michelle Lewis,CEO,336-355-9715,,mlewis@tapmedicine.com,Danielle Cole,Finance Director,336-355-9728,,dcole@tapmedicine.com,
NC-006941,TAPM Family Medicine at E. Commerce,"TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",1629077490,Federally Qualified Health Centers - Medical Services,400 E Commerce Ave,,High Point,NC,27260-5221,Guilford,1002 S. EUGENE ST.,,Greensboro,NC,27406,Guilford,MICHELLE LEWIS,CEO,336-355-9715,,MLEWIS@TAPMEDICINE.COM,,,,,,WWW.TAPMEDICINE.COM
NC-006942,High Point GCDHHS DPH Clinic,Guilford County DHHS-DPH,1245272657,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",501 E Green Dr,,High Point,NC,27260-6700,Guilford,501 E Green Dr,,High Point,NC,27260,Guilford,Merle Green,Executive Director,336-641-3288,,mgreen@myguilford.com,,,,,,http://www.myguilford.com/humanservices/health/
NC-006943,Highlands - Cashiers Hospital,Highlands - Cashiers Hospital,1346456597,Children's Hospitals (inpatient only),190 Hospital Dr,,Highlands,NC,28741-7600,Macon,190 Hospital Drive,,Highlands,NC,28741,Macon,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006944,Macon County Health Department Highlands Site,Macon County,1720161334,Family Planning Providers,52 Aunt Dora Dr,,Highlands,NC,28741-7620,Macon,1830 Lakeside Drive,,Franklin,NC,28734,Macon,Jim Bruckner,Health Director,828-349-2423,,jbruckner@maconnc.org,Diane Keener,Clerical Supervisor,828-349-2424,,dkeener@maconnc.org,
NC-006945,Orange County Health Department - Hillsborough Site,Orange County Health Department,1760576722,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 W Tryon St,,Hillsborough,NC,27278-2438,Orange,300 W. Tryon Street,,Hillsborough,NC,27278,Orange,Rebecca Crawford,Finance and Administrative Services Director,919-245-2414,,rcrawford@orangecountync.gov,,,,,,
NC-006946,Rural Health Group at Twin County,Rural Health Group Inc.,1902995145,Federally Qualified Health Centers - Medical Services,204 Evans Rd,,Hollister,NC,27844-9247,Halifax,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian O Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006947,Hot Springs Medical Center,Hot Springs Health Program,1376510875,Federally Qualified Health Centers - Medical Services,66 NW US 25 70 Hwy,,Hot Springs,NC,28743-9642,Madison,590 Medical Park Drive,P.O. Box 69,Marshall,NC,28753,Madison,Teresa B. Strom,Executive Director,828-649-9566,4155,tstrom@hotspringshealth-nc.org,Pam Gregg,Associate Director,828-649-9566,4174,pamg@hotspringshealth-nc.org,https://www.hotspringshealth-nc.org/our-services
NC-006948,Rural Health Group at Jackson,"Rural Health Group, Inc.",1689626178,Federally Qualified Health Centers - Medical Services,9425 NC Highway 305,,Jackson,NC,27845-9679,Northampton,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006949,Northampton County Health Department,NORTHAMPTON COUNTY HEALTH DEPARTMENT,1023174711,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9495 Nc 305 Hwy,,Jackson,NC,27845,Northampton,9495 NC Highway 305,PO Box 635,Jackson,NC,27845-9679,Northampton,John White,Acting Health Director,252-534-5841,619,john.white@nhcnc.net,,,,,,http://www.northamptonhd.com
NC-006950,GOSHEN MEDICAL CENTER - NEW RIVER,"GOSHEN MEDICAL CENTER, INC.",1669797700,Federally Qualified Health Centers - Medical Services,1200 Hargett St,,Jacksonville,NC,28540-5933,Onslow,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006951,Onslow County Health Department,Onslow County Health Department,1477692606,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",612 College St,,Jacksonville,NC,28540-5311,Onslow,612 College Street,,Jacksonville,NC,28540-5311,Onslow,Angela Lee,Health Director,910-989-3983,,angela_lee@onslowcountync.gov,Brenda Brown,Administrative Manager,910-989-3913,,brenda_brown@onslowcountync.gov,
NC-006952,AppHealthCare Dental Clinic,Appalachian District Health Department,1043761513,Dental Providers,225 Court St,,Jefferson,NC,28640,Ashe,PO BOX 208,,Jefferson,NC,28640,Ashe,Jennifer Greene,Health Director / CEO,828-264-4995,3117,jen.greene@apphealth.com,Angie Poole,Finance Officer / CFO,336-372-5641,1113,angie.scott@apphealth.com,www.apphealthcare.com
NC-006953,Ashe Health Center,Appalachian District Health Department,1427121144,Federally Qualified Health Centers - Medical Services,413 McConnell St,,Jefferson,NC,28640-9772,Ashe,PO BOX 208,,Jefferson,NC,28640,Ashe,Jennifer Greene,Health Director / CEO,828-264-4995,3117,jen.greene@apphealth.com,Angie Poole,Finance Officer / CFO,336-372-5641,1113,angie.scott@apphealth.com,www.apphealthcare.com
NC-006954,Cabarrus Health Alliance,Cabarrus Health Alliance,1558498972,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 Mooresville Rd,,Kannapolis,NC,28081-0304,Cabarrus,300 Mooresville Rd,,Kannapolis,NC,28081,Cabarrus,Suzanne Knight,Clinical Director,704-920-1322,,suzanne.knight@cabarrushealth.org,Kathy Hartsell,Senior Accounting Tech,704-920-1340,,kathy.hartsell@cabarrushealth.org,www.cabarrushealth.org
NC-006955,Goshen Medical Center - Women's Health,"GOSHEN MEDICAL CENTER, INC.",1265767172,Federally Qualified Health Centers - Medical Services,212 Duplin St,,Kenansville,NC,28349-9024,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006956,Duplin County Health Department,Duplin County Health Department,1235198177,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",340 Seminary St.,PO Box 948,Kenansville,NC,28349,Duplin,340 Seminary St.,PO Box 948,Kenansville,NC,28349,Duplin,Ila Susan Davis,Health Director,910-296-2130,8147,ilad@duplincountync.com,Billie Jo Dunn,Finance Officer,910-296-2130,8146,billied@duplincountync.com,
NC-006957,Pioneer Family Medical of King,"Pioneer Health Services of Stokes County, Inc.",1144668195,Other ECP Providers,304 Mountainview Rd,,King,NC,27021-8768,Stokes,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
NC-006958,Pioneer Medical Center of King,"Pioneer Health Services of Stokes County, Inc.",1114214871,Other ECP Providers,402 W King St,,King,NC,27021-9170,Stokes,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
NC-006959,Lenoir County Health Department,Lenoir County Health Department,1679600969,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 N McLewean St,PO,Kinston,NC,28501-4997,Lenoir,201 N. McLewean St,PO,Kinston,NC,28501,Lenoir,Joey Huff,Director,252-526-4200,2525264212,jhuff@health.co.lenoir.nc.us,Melanie Abbott,Director of Nursing,252-526-4200,2525264202,mabbott@health.co.lenoir.nc.us,
NC-006960,"Kinston Community Health Center, Inc.","Kinston Community Health Center, Inc.",1104859313,"Dental Providers, Federally Qualified Health Centers - Medical Services",324 N Queen St,,Kinston,NC,28501-4932,Lenoir,324 North Queen Street,,Kinston,NC,28501,Lenoir,Darlene Ennett,CEO,252-522-4350,221,darlene.ennett@kinstonchc.org,Daphne Betts-Hemby,CFO,252-522-4350,238,daphne.hemby@kinstonchc.org,www.kinstonhealth.org
NC-006961,Scotland Co. Health Dept.,North Carolina Dept. of Health and Human Services,1427188176,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1405 West Blvd,PO Box 69,Laurinburg,NC,28352-9170,Scotland,1405 West Blvd,PO Box 69,Laurinburg,NC,28352-9170,Scotland,Wayne Raynor,Health Director,910-277-2440,4499,bmullis@scotlandcounty.org,Tina Clark,Director of Nursing,910-277-2740,4466,tclark@scotlandcounty.org,http://www.scotlandcounty.org/health
NC-006962,Scotland County Community Health Center,ROBESON HEALTH CARE CORPORATION,1750648077,Federally Qualified Health Centers - Medical Services,705B Lauchwood Dr,,Laurinburg,NC,28352-5544,Scotland,60 Commerce Plaza Cir,,Pembroke,NC,28372-7386,Robeson,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-006963,Happy Valley Medical Center,West Caldwell Health Council Inc,1467513143,Federally Qualified Health Centers - Medical Services,1345 NC Highway 268,,Lenoir,NC,28645-9027,Caldwell,4330 Collettsville Rd,,Collettsville,NC,28611-9000,Caldwell,Kelly C Melton,CFO,828-754-2409,105,kmelton@westcaldwellhc.org,Thomas McRary,CEO,828-754-6850,240,tmcrary@westcaldwellhc.org,
NC-006964,Caldwell Co. Health Dept.,North Carolina Dept. of Health and Human Services,1083756571,"Dental Providers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2345 Morganton Blvd SW,Suite B,Lenoir,NC,28645-4973,Caldwell,2345 Morganton Blvd SW,,Lenoir,NC,28645-4973,Caldwell,Denise Michaud,Health Director,828-426-8415,,dmichaud@caldwellcountync.org,Brittany Dobbins,Assistant Health Director,828-426-8413,,bdobbins@caldwellcountync.org,http://www.caldwellcountync.org/caldwell-county-nc-departments/health-department-2/
NC-006965,Lewiston Community Health Center,Bertie County Rural Health Association,1841541877,Federally Qualified Health Centers - Medical Services,307 S Main St,PO Box 39,Lewiston,NC,27849-0039,Bertie,307 South Main Street,P.O. Box 39,Lewiston,NC,27849,Bertie,Shavonda Pugh,CEO,252-794-1835,111,spugh@bcrha.org,Sharon Lee,COO,252-794-2117,112,slee@bcrha.org,bcrha.org
NC-006966,Davidson Health Services General Dentistry,Gaston Family Health Services,1154662369,Dental Providers,32 Kirkwood Ave,,Lexington,NC,27292-4024,Davidson,200 east 2nd Ave.,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006967,Davidson Health Center,Gaston Family Health Services,1407188071,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",420 N Salisbury St,,Lexington,NC,27292-3548,Davidson,200 E 2nd Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006968,Davidson County Health Department,Davidson County Health Department,1366589483,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",915 N Greensboro St,,Lexington,NC,27292-2699,Davidson,915 Greensboro St,,Lexington,NC,27292-2699,Davidson,Cheryl Lomax,Office Support Unit Supervisor,336-242-2357,2303,cheryl.lomax@davidsoncountync.gov,Jenny Loflin,Office Support IV,336-242-2834,2303,jenny.loflin@davidsoncountync.gov,http://www.co.davidson.nc.us/Health
NC-006969,Harnett Co. Health Department,Harnett Co. Health Department,1215048459,"Family Planning Providers, Sexually Transmitted Disease Clinics",307 W Cornelius Harnett Blvd,,Lillington,NC,27546-9335,Harnett,307 Corneilius Harnett Blvd,,Lillington,NC,27546,Harnett,"John Rouse, Jr",Health Director,910-893-7550,,jrouse@harnett.org,Patricia Purvis,Nursing Supervisor,910-893-7550,,ppurvis@harnett.org,
NC-006970,First Choice Community Health Centers,FIRST CHOICE COMMUNITY HEALTH CENTERS,1083971279,Federally Qualified Health Centers - Medical Services,40 Autumn Fern Trl,,Lillington,NC,27546-5155,Harnett,40 Autumn Fern Trail,,Lillington,NC,27546,Harnett,Sheila L Simmons,Chief Executive Officer,910-364-0972,1600,slsimmons@firstchoicechc.org,,,,,,www.firstchoicechc.org
NC-006971,Lincoln Co. Health Dept.,North Carolina Dept. of Health and Human Services,1740405745,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 Gamble Dr,,Lincolnton,NC,28092-4421,Lincoln,151 Sigmon Rd,,Lincolnton,NC,28092-8577,Lincoln,Davin Madden,Health Director,704-736-8636,,dmadden@lincolncounty.org,Lena Jones,Deputy Health Director,704-736-8647,,ljones@lincolncounty.org,http://www.co.lincoln.nc.us/index.aspx?nid=117
NC-006972,Helping Hands Health Center,Gaston Family Health Services,1710209473,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",206 Gamble Dr,Suite C,Lincolnton,NC,28092-4439,Lincoln,200 E 2nd Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-006973,Rural Health Group at Lake Gaston,"Rural Health Group, Inc.",1093767535,Federally Qualified Health Centers - Medical Services,108 Mosby Ave,,Littleton,NC,27850-9411,Halifax,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian O Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-006974,Franklin County Health Department,Franklin County Health Department,1619058955,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",107 Industrial Dr,Suite C,Louisburg,NC,27549-2371,Franklin,107C Industrial Drive,,Louisburg,NC,27549,Franklin,Dr. Christopher M. Szwagiel,Local Health Director,919-496-8111,8111,cszwagiel@franklincountync.us,Vickie Cowan,CFO,919-496-8112,8112,vcowan@franklincountync.us,
NC-006975,Advance Community Health - Louisburg,Advance Community Health,1497918338,Federally Qualified Health Centers - Medical Services,111 S Church St,,Louisburg,NC,27549-2501,Franklin,1001 Rock Quarry Rd,,Raleigh,NC,27610,Wake,Penella M. Washington,CEO,919-250-2923,,pwashington@advancechc.org,Ryan Jury,COO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-006976,LUMBERTON HEALTH CENTER,ROBESON HEALTH CARE CORPORATION,1184681496,Federally Qualified Health Centers - Medical Services,402 N Pine St,,Lumberton,NC,28358-5563,Robeson,60 Commerce Plaza,,Pembroke,NC,28372-7386,Robeson,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-006977,Robeson Co. Health Dept.,North Carolina Dept. of Health and Human Services,1932287182,"Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",460 Country Club Rd,,Lumberton,NC,28360-9494,Robeson,460 Country Club Rd,,Lumberton,NC,28360-9494,Robeson,William Smith,Executive Director,910-671-3404,,william.smith@co.robeson.gov,Elizabeth Rowell,Director of Nursing,910-671-3405,,beth.rowell@hth.co.robeson.nc.us,http://publichealth.southernregionalahec.org/Robeson
NC-006978,Dare County Health Department,Dare County Department of H&HS - Public Health Division,1770637381,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",109 Exeter St,,Manteo,NC,27954-9400,Dare,109 Exeter ST,,Manteo,NC,27954,Dare,Sheila Davies,Health Director,252-475-5093,,sheila.davies@darenc.com,Debbie Dutton,Nursing Director,252-475-9366,,debbie.dutton@darenc.com,www.darenc.com
NC-006979,MAPLE HILL MEDICAL CENTER,Black River Health Services,1356339154,Federally Qualified Health Centers - Medical Services,4811 NC-50,,Maple Hill,NC,28454,Pender,301 S Campbell St,,Burgaw,NC,28425,Pender,"Lee Ann Amann, MHA",CEO,910-259-6973,200,lamann@blackriverhealth.org,,,,,,blackriverhealth.org
NC-006980,McDowell Internal Medicine and OB/Gyn,McDowell Internal Medicine and OB/Gyn,1295037067,"Family Planning Providers, Rural Health Clinics",1633 Sugar Hill Rd,Suite 1,Marion,NC,28752-5239,McDowell,McDowell Internal Medicine and OB/Gyn,1633 Sugar Hill Road,Marion,NC,28752,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,0,cheryl.williams2@msj.org,,,,,,
NC-006981,McDowell Pediatrics,McDowell Hospital,1033410840,Rural Health Clinics,387 US 70 W,,Marion,NC,28752-6202,McDowell,387 US 70 West,,Marion,NC,28752,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,0,cheryl.williams2@msj.org,,,,,,
NC-006982,McDowell Health Department,Rutherford Polk McDowell Health District,1285791087,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",408 Spaulding Rd,,Marion,NC,28752-5212,McDowell,221 Callhan Koon Rd,,Spindale,NC,28160,Rutherford,Joshua Kennedy,Assistant Health Director,828-287-6124,,jkennedy@rpmhd.org,,,,,,
NC-006983,McDowell Hospital,Mission Health System,1699772657,Inpatient Hospitals (other than children's hospitals),430 Rankin Dr,,Marion,NC,28752-6568,McDowell,430 Rankin Drive,,Marion,NC,28752,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006984,Family Medicine Glenwood,The McDowell Hospital,1053690065,Rural Health Clinics,5623 US 221 S,,Marion,NC,28752-7028,McDowell,5623 US 221 South,,Marion,NC,28752,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006985,Mars Hill Medical Center,Hot Springs Health Program,1780651695,Federally Qualified Health Centers - Medical Services,119 Mountain View Rd,,Mars Hill,NC,28754-9500,Madison,590 Medical Park Drive,P.O. Box 69,Marshall,NC,28753,Madison,Teresa B. Strom,Executive Director,828-649-9566,4155,tstrom@hotspringshealth-nc.org,Pam Gregg,Associate Director,828-649-0800,4174,pamg@hotspringshealth-nc.org,
NC-006986,Madison Co. Health Dept.,North Carolina Dept. of Health and Human Services,1356469357,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",493 Medical Park Dr,,Marshall,NC,28753-3901,Madison,493 Medical Park Dr,,Marshall,NC,28753-3901,Madison,Tammy Cody,Deputy Health Director,828-649-3531,230,tcody@madisoncountync.gov,Diana Rogers,Director of Nursing,828-649-3531,227,drogers@madisoncountync.gov,
NC-006987,Mashburn Medical Center,Hot Springs Health Program,1942277454,Federally Qualified Health Centers - Medical Services,590 Medical Park Dr,,Marshall,NC,28753-6807,Madison,590 Medical Park Drive,P.O. Box 69,Marshall,NC,28753,Madison,Teresa B. Strom,Executive Director,828-649-9566,4155,tstrom@hotspringshealth-nc.org,Pam Gregg,Associate Director,828-649-0800,4174,pamg@hotspringshealth-nc.org,
NC-006988,Laurel Medical Center,Hot Springs Health Program,1811964729,Federally Qualified Health Centers - Medical Services,80 Guntertown Rd,,Marshall,NC,28753-7806,Madison,590 Medical Park Drive,,Marshall,NC,28753,Madison,Teresa B. Strom,Executive Director,828-649-0800,4155,tstrom@hotspringshealth-nc.org,Pam Gregg,Associate Director,828-649-0800,4155,pamg@hotspringshealth-nc.org,
NC-006989,MAXTON MEDICAL CENTER,ROBESON HEALTH CARE CORPORATION,1093772410,Federally Qualified Health Centers - Medical Services,610 E Dr Martin Luther King Jr Dr,,Maxton,NC,28364-1800,Robeson,60 Commerce Plaza,,Pembroke,NC,28372-7386,Robeson,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-006990,MONCURE COMMUNITY HEALTH CENTER,"Piedmont Health Services, Inc",1871697599,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7228 Pittsboro Moncure Rd,,Moncure,NC,27559,Chatham,127 Kingston Dr,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-006991,Union County Division of Public Health,Union County Division of Public Health,1386787422,"Dental Providers, Family Planning Providers, Ryan White Providers",1224 W Roosevelt Blvd,,Monroe,NC,28110-2820,Union,1224 W Roosevelt Blvd,,Monroe,NC,28110,Union,Phillip Eugene Tarte Jr.,Public Health Director,704-296-4801,,philliptarte@unioncountync.gov,Patricia Simpson,Accounting Tech,704-296-4816,,patriciasimpson@unioncountync.gov,
NC-006992,ARMS Union,"Anson Regional Medical Services, Inc.",1649540105,Federally Qualified Health Centers - Medical Services,1315 E Sunset Dr,Suite 101,Monroe,NC,28112-4333,Union,203 Salisbury Street,,Wadesboro,NC,28170,Anson,Gwendolyn E Reed,CEO,704-694-6700,223,arms1475@usa.net,Pamela Nicholson,DAIO,704-694-6700,222,pnicholson.arms@charlotte.twcbc.com,www.arms-chc.org
NC-006993,Carteret Co. Health Dept.,North Carolina Dept. of Health and Human Services,1083738645,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3820 Bridges St,Suite A,Morehead City,NC,28557-2979,Carteret,3820 Bridges St Ste A,,Morehead City,NC,28557-2979,Carteret,David Jenkins,Health Director,252-728-8552,5732,david.jenkins@carteretcountync.gov,Kimberly Davis,Nursing Supervisor,252-728-8550,,,http://www.carteretcountyhealth.com
NC-006994,Mission Surgical Services Burke,McDowell Hospital,1487076345,Rural Health Clinics,149 W Parker Rd,,Morganton,NC,28655-4673,Burke,149 West Parker Road,,Morganton,NC,28655,Burke,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-006995,High Country Community Health- Burke Medical,HIGH COUNTRY COMMUNITY HEALTH,1780127431,Federally Qualified Health Centers - Medical Services,350 E Parker Rd,Suite 102,Morganton,NC,28655-5129,Burke,PO Box 1490,,Boone,NC,286071490,Watauga,Tonya Harris,C.F.O,828-262-3886,24,tonyaharris@hcchmail.org,Tonya Elledge,Director of Revenue Cycle and Reinburstment,828-262-3886,108,tonyaelledge@hcchmail.org,
NC-006996,Burke County Health Department,Burke County Health Department,1457356651,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",700 E Parker Rd Unit A,,Morganton,NC,28655-6762,Burke,700 East Parker Road,,Morganton,NC,28655,Burke,Rebecca McLeod,Health Director,828-794-9160,,rebecca.mcleod@burkenc.org,Melissa Estep,Processing Assistant V,828-764-9226,,melissa.estep@burkenc.org,
NC-006997,Goshen Medical Center- Lambert,"GOSHEN MEDICAL CENTER, INC.",1043336415,Federally Qualified Health Centers - Medical Services,130 N Center St,,Mount Olive,NC,28365-1701,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006998,Community Health Services,"GOSHEN MEDICAL CENTER, INC.",1700901287,Federally Qualified Health Centers - Medical Services,325 NC Highway 55 W,,Mount Olive,NC,28365-8527,Wayne,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-006999,Hertford County Student Wellness Center,Roanoke Chowan Community Health Center,1003257437,Federally Qualified Health Centers - Medical Services,1850 NC Highway 11,,Murfreesboro,NC,27855-9336,Hertford,120 Health Center Drive,,Ahoskie,NC,27910,Hertford,Kim Schwartz,CEO,252-209-0237,7124,kschwartz@rcchc.org,Melissa Owens,CFO,252-209-0237,7126,mowens@rcchc.org,
NC-007000,Murfreesboro Primary Care,"ROANOKE CHOWAN COMMUNITY HEALTH CENTER, INC.",1497776470,Federally Qualified Health Centers - Medical Services,305 Beechwood Blvd,,Murfreesboro,NC,27855-1134,Hertford,120 Health Center Dr,,Ahoskie,NC,27910-8161,Hertford,Kim Schwartz,Chief Executive Officer,252-209-0237,7124,kschwartz@rcchc.org,Melissa Owens,Chief Financial Officer,252-209-0237,7126,mowens@rcchc.org,
NC-007001,Cherokee County Health Department,Cherokee County,1023172228,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",228 Hilton St,,Murphy,NC,28906-2814,Cherokee,75 Peachtree St.,,Murphy,NC,28906,Cherokee,Towanna Roberts,Health Director,828-837-7486,501,Towanna.Roberts@cherokeecounty-nc.gov,Nicky Stalcup,Business Office Manager,828-837-7486,502,Nicky.Stalcup@cherokeecounty-nc.gov,
NC-007002,Peachtree Community Health Center,Appalachian Mountain Community Health Centers,1356896187,Federally Qualified Health Centers - Medical Services,4048 E US 64 Alt,Suite 1,Murphy,NC,28906-6966,Cherokee,PO Box 2597,,Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-007003,Nash County Health Department.,Nash County Health Department,1497880033,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",214 S Barnes St,PO Box 849,Nashville,NC,27856-0849,Nash,214 S Barnes St,PO Box 849,Nashville,NC,27856-1204,Nash,Shannon Lee,Admin Asst III,252-459-9819,1238,shannon.lee@nashcountync.gov,,,252-459-9819,,,http://www.health.co.nash.nc.us
NC-007004,Mission Family Medicine Nebo,The McDowell Hospital,1821376542,Rural Health Clinics,339 Nebo School Rd,,Nebo,NC,28761-6848,McDowell,339 Nebo School Road,,Nebo,NC,28761,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-007005,CCHD - Craven County Community Health Center,CRAVEN COUNTY GOVERNMENT,1295801827,Federally Qualified Health Centers - Medical Services,2818 Neuse Blvd,,New Bern,NC,28562-2850,Craven,406 Craven St,,New Bern,NC,28560-4911,Craven,Scott Harrelson,Health Director,252-636-4960,,sharrelson@hotmail.com,Jennifer Tyndall,Credentialing Specialist,252-636-4920,2144,jtyndall@cravencountync.gov,http://www.cravencounty.com/depts/hth/hthmain.htm
NC-007006,GOSHEN MEDICAL CENTER - NEW BERN,"GOSHEN MEDICAL CENTER, INC.",1003227893,Federally Qualified Health Centers - Medical Services,4114 Dr ML King Jr Blvd,,New Bern,NC,28562-2233,Craven,PO Box 187,,Faison,NC,28341-0187,Duplin,Teela Strickland,Credentilaing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,,,,,,http://www.goshenmedical.org/
NC-007007,High Country Community Health - Avery Medical,HIGH COUNTRY COMMUNITY HEALTH,1083979082,Federally Qualified Health Centers - Medical Services,448 Cranberry St,,Newland,NC,28657-8800,Avery,PO Box 1490,,Boone,NC,286071490,Watauga,Tiffany Melchers,C.F.O.,828-262-3886,120,tiffanymelchers@hcchmail.org,Tonya Elledge,Director of Revenue Cycle and Reinburstment,828-262-3886,108,tonyaelledge@hcchmail.org,https://www.highcountrycommunityhealth.com/departments
NC-007008,High Country Community Health - Avery Dental,HIGH COUNTRY COMMUNITY HEALTH,1083979082,Dental Providers,504 Pineola St,,Newland,NC,28657-7604,Avery,PO Box 1490,,Boone,NC,286071490,Watauga,Tonya Harris,C.F.O,828-262-3886,24,tonyaharris@hcchmail.org,Tonya Elledge,Director of Revenue Cycle and Reinburstment,828-262-3886,108,tonyaelledge@hcchmail.org,
NC-007009,Avery County Health Dept.,Toe River Health District,1295864452,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",545 Schultz Cir,,Newland,NC,28657-7714,Avery,861 Greenwood Road,,Spruce Pine,NC,28777,Mitchell,Betty McKinney,Finance Officer,828-765-2239,24,bmckinney@trhd.dst.nc.us,Paula McClellan,Billing,828-765-2239,20,paula.mcclellan@trhd.dst.nc.us,
NC-007010,Newport Family Practice,Richard A Bloomfield,1114993276,Rural Health Clinics,338 Howard Blvd,,Newport,NC,28570-7928,Carteret,338 Howard Blvd,,Newport,NC,28570,Carteret,Nena Hamilton,Office Mgr.,252-223-5054,,newportfamily@gmail.com,Karen Allen,Insurance Clerk,252-223-5054,,newportfamilypractice@gmail.com,
NC-007011,Rural Health Group at Norlina,"Rural Health Group, Inc.",1700045820,Federally Qualified Health Centers - Medical Services,110 Division St,,Norlina,NC,27563-9041,Warren,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007012,CommWell Health of Ocean Isle Beach,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1538476973,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6934 Beach Dr SW,Suite 4,Ocean Isle Beach,NC,28469-5797,Brunswick,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7067,,aadogbe@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007013,Ocracoke Health Center,Ocracoke Health Center,1689726101,Federally Qualified Health Centers - Medical Services,305 Back Rd,,Ocracoke,NC,27960,Hyde,PO BOX 543,,Ocracoke,NC,27960,Hyde,Jamie Tunnell Carter,Billing Manager,252-925-0058,,jvtohc@yahoo.com,ERIN ONEAL,C.O.O.,252-928-1511,,EMOOHC@YAHOO.COM,https://ocracokehealthcenter.org/
NC-007014,Community Medicine Old Fort,The McDowell Hospital,1790002160,Rural Health Clinics,32 E Main St,,Old Fort,NC,28762-0017,McDowell,32 East Main Street,,Old Fort,NC,28762,Mcdowell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-007015,Granville County Health Department,Granville Vance Public Health,1184783409,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",101 Hunt Drive,PO Box 367,Oxford,NC,27565-0367,Granville,101 Hunt Drive,PO Box 367,"Oxford, NC",NC,27565,Granville,Sandra Durham,Management Support Supervisor,919-693-2141,285,sdurham@gvdhd.org,Leigh Anne Fowler,Nursing Supervisor,919-693-2141,155,lfowler@gvdhd.org,www.gvph.org
NC-007016,Granville Internal Medicine,Granville Health Systems,1811999055,Rural Health Clinics,1032 College St,,Oxford,NC,27565-2507,Granville,1010 College Street,,Oxford,NC,27565,Granville,Deborah Jirschele,Practice Manager,919-693-6541,231,djirschele@granvilleprimary.com,Kyla Fisher,Director of Probill,919-690-3000,3288,kfisher@granvillemedical.com,
NC-007017,JULIAN T. PIERCE HEALTH CENTER,ROBESON HEALTH CARE CORPORATION,1750348538,Federally Qualified Health Centers - Medical Services,307 E Wardell Dr,,Pembroke,NC,28372-7998,Robeson,60 Commerce Plaza,,Pembroke,NC,28372-7386,Robeson,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-007018,Vidant Family Medicine Pinetops,Vidant Edgecombe Hospital,1821076589,Rural Health Clinics,1473 NC 42 43 W,,Pinetops,NC,27864-7188,Edgecombe,1473 NC 42-43 West,,Pinetops,NC,27864-7188,Edgecombe,Teresa E. Dew,Practice Manager,252-641-8585,,tekeel@vidanthealth.com,,,,,,www.vidanthealth.com
NC-007019,Piedmont Health SeniorCare Pittsboro,"Piedmont Health Services, Inc",1376986679,Federally Qualified Health Centers - Medical Services,163 Chatham Business Dr,,Pittsboro,NC,27312-9726,Chatham,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,Toni Beckham,Credentialing Specialist,919-933-8494,1478,beckhamt@piedmonthealth.org,https://piedmonthealthseniorcare.org/
NC-007020,Washington County Health Department,Martin-Tyrrell-Washington District Health Department,1194706671,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",198 NC Highway 45 N,,Plymouth,NC,27962-9232,Washington,198 NC Hwy 45 North,,Plymouth,NC,27962,Washington,Wes Gray,Health Director,252-791-3101,,wes.gray@mtwdistricthealth.org,Andrea Freeman,Finance Officer,252-791-3104,,andrea.freeman@mtwdistricthealth.org,www.mtwdistricthealth.org
NC-007021,WASHINGTON COUNTY HOSP INC,Rural Community Hospitals of America,1124018494,Inpatient Hospitals (other than children's hospitals),958 US Highway 64 E,,Plymouth,NC,27962-9216,Washington,958 US Highway 64 East,,Plymouth,NC,27962,Washington,Melanie Perry,CEO,252-793-7655,,melanie_perry@wchonline.com,Jacque Swanston,Director of Managed Care Contracting,918-236-4020,,JSwanston@ruralcommunityhospitals.com,
NC-007022,FREEDOM HILL COMMUNITY HEALTH CENTER,CAROLINA FAMILY HEALTH CENTERS INC,1770651655,Federally Qualified Health Centers - Medical Services,162 NC Highway 33 E,,Princeville,NC,27886-8582,Edgecombe,303 Green St E,,Wilson,NC,27893-4105,Wilson,Annette Eatmon,Chief Operating Officer,252-293-0013,320,aeatmon@cfhcnc.org,Marty Johnson,Outreach Enrollment Manager,252-293-0013,312,mjohnson@cfhcnc.org,www.cfhcnc.org
NC-007023,Prospect Hill Community Health Center,"Piedmont Health Services, Inc",1154425890,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",322 Main St,,Prospect Hill,NC,27314-9438,Caswell,127 Kingston Dr,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-007024,Hoke County Health Department,Hoke County Health Department,1134286321,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",683 E Palmer St,,Raeford,NC,28376-6648,Hoke,683 East Palmer Road,,Raeford,NC,28376,Hoke,Helene Edwards,Health Director,910-875-3717,2111,hedwards@hokehealth.org,Jenny McDuffie,Administrative Officer,910-875-3717,2114,jmcduffie@hokehealth.org,
NC-007025,"Karen L Smith, MD,PA","Karen L Smith, MD, PA",1609066158,Other ECP Providers,929 W Prospect Rd,,Raeford,NC,28376-9543,Hoke,929 West Prospect Avenue,,Raeford,NC,28376,Hoke,"Karen L Smith, MD",Owner,910-904-1695,,schw1960@earthlink.net,Judy Wood,Billing Specialist,910-904-1695,221,jwood@karensmithmd.com,
NC-007026,Wake County Health Department,Wake County Human Services,1801957576,"Dental Providers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",10 Sunnybrook Rd,PO Box 14049,Raleigh,NC,27610-1808,Wake,10 Sunnybrook Rd,PO Box 14049,Raleigh,NC,27610-1808,Wake,Sue Lynn Ledford,Public Health Director,919-212-7000,,Sue.Ledford@wakegov.com,Ida Dawson,Clinics Division Director,919-250-4629,,idawson@wakegov.com,http://www.wakegov.com
NC-007027,Planned Parenthood Raleigh Health Center,Planned Parenthood South Atlantic,1811033210,Family Planning Providers,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/raleigh/27603/raleigh-health-center-3338-90860
NC-007029,Advance Community Health - Southeast Raleigh,Advance Community Health,1245223783,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",1011 Rock Quarry Rd,,Raleigh,NC,27610-3825,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610-3825,Wake,Penella M. Washington,CEO,919-250-2923,,pwashington@advancechc.org,Ryan Jury,COSO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-007030,Advance Community Health - Horizon at Women's Center,Advance Community Health,1447702634,Federally Qualified Health Centers - Medical Services,112 Cox Ave,,Raleigh,NC,27605-1817,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610,Wake,Penella M. Washington,CEO,919-250-2923,,agoodwin@advancechc.org,Ryan Jury,COO,919-250-2921,,rjury@advancechc.org,http://www.advancechc.org
NC-012455,Advance Community Health - Horizon at Oak City Cares,Advance Community Health,1114479011,Federally Qualified Health Centers - Medical Services,1430 S Wilmington St,,Raleigh,NC,27603-2526,Wake,1001 Rock Quarry Rd,,Raleigh,NC,27610-3825,Wake,Teresa Faulconer,Credentialing and Enrollment Specialist,919-250-2934,,tfaulconer@advancechc.org,Ryan Jury,Chief Operations and Strategy Officer,919-250-2923,,rjury@advancechc.org,http://www.advancechc.org
NC-012486,"NeighborHealth Center, Inc.","NeighborHealth Center, Inc.",1255771119,Federally Qualified Health Centers - Medical Services,4201 Lake Boone Trl,Suite 5,Raleigh,NC,27607-7511,Wake,4201 Lake Boone Trail,Ste 5,Raleigh,NC,27607,Wake,Sue Ellen Thompson,CEO,919-332-7467,,sthompson@neighborhealthcenter.org,George Derbyshire,CFO,919-630-0011,,gderbyshire@neighborhealthcenter.org,neighborhealthcenter.org
NC-007032,Rural Health Group at Rich Square,"Rural Health Group, Inc.",1962454447,Federally Qualified Health Centers - Medical Services,200 S Main St,,Rich Square,NC,27869-9582,Northampton,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007033,Rural Health Group Family & Women's Health,"Rural Health Group, Inc.",1073971347,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1381 Medical Center Dr,,Roanoke Rapids,NC,27870-5130,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007034,Rural Health Group Pediatrics,"Rural Health Group, Inc.",1255683157,Federally Qualified Health Centers - Medical Services,2064 NC Highway 125,,Roanoke Rapids,NC,27870-9436,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007035,Rural Health Group at Roanoke Rapids,"Rural Health Group, Inc.",1720030232,Federally Qualified Health Centers - Medical Services,2066 NC Highway 125,,Roanoke Rapids,NC,27870-9436,Halifax,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian O Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007036,Rural Health Group at Halifax Regional Medical Center (inpatient hospital),"Rural Health Group, Inc.",1528489895,Inpatient Hospitals (other than children's hospitals),250 Smith Church Rd,,Roanoke Rapids,NC,27870-4914,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007037,Rural Health Group at Halifax Regional Medical Center (multiple outpatient ECP categories),"Rural Health Group, Inc.",1528489895,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",250 Smith Church Rd,,Roanoke Rapids,NC,27870-4914,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007038,Graham County Public Health,Graham County Public Health,1669515953,"Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",21 S Main St,,Robbinsville,NC,28771-9054,Graham,21 South Main Street,,Robbinsville,NC,28771,Graham,Alicia Parham,Health Director,828-479-7900,2610,alicia.parham@grahamcounty.org,Christy Silvers,Administrative Office Assistant,282-479-7900,2629,christy.silvers@grahamcounty.org,www.health.grahamcounty.org
NC-007039,Tallulah Community Health Center,Appalachian Mountain Community Health Centers,1780064832,Federally Qualified Health Centers - Medical Services,409 Tallulah Rd,,Robbinsville,NC,28771-8500,Graham,PO Box 2597,,Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-007040,RICHMOND COUNTY HEALTH DEPARTMENT,RICHMOND COUNTY GOVERNMENT,1588705776,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",127 Caroline St,,Rockingham,NC,28379-3567,Richmond,127 CAROLINE STREET,,ROCKINGHAM,NC,28379,Richmond,IRA T JARRELL,HEALTH DIRECTOR,910-997-8365,,tommy.jarrell@richmondnc.com,JULIE SANDERS,PATIENT ACCOUNTS,910-997-8306,,julie.sanders@richmondnc.com,
NC-007041,Goshen Medical Center Rockingham,"GOSHEN MEDICAL CENTER, INC.",1285165266,Federally Qualified Health Centers - Medical Services,921 S Long Dr,Suite 104,Rockingham,NC,28379-4874,Richmond,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-0421,1311,tstrickland@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-007042,OIC Family Medical Center - Community Health Plaza,"Opportunities Industrialization Center, Inc.",1750734307,Federally Qualified Health Centers - Medical Services,1041 Noell Ln,Medical Plaza B,Rocky Mount,NC,27804,Nash,402 E. Virginia St.,,Rocky Mount,NC,27802,Edgecombe,Brian K Ellerby,Director of Integrated Health Services,252-446-3333,4000,bellerby1@yahoo.com,,,,,,
NC-007043,OIC Family Medicine Center at Fairview,Opportunities Industrialization Center,1922020908,Federally Qualified Health Centers - Medical Services,111 S Fairview Rd,,Rocky Mount,NC,27801-6971,Edgecombe,402 E. Virginia St.,,Rocky Mount,NC,27802,Edgecombe,Brian Ellerby,Director of Integrated Health Care,252-446-3333,232,bellerby@oicone.org,,,,,,www.oicone.org
NC-007044,OIC Family Medical Center - Dental Office,"Opportunities Industrialization Center, Inc.",1962898296,Dental Providers,300 N Grace St,,Rocky Mount,NC,27804-5345,Nash,402 E. Virginia St.,,Rocky Mount,NC,27802,Edgecombe,Brian Ellerby,Director of Integrated Health Services,252-446-3333,4000,bellerby@oicone.org,,,,,,www.oicone.org
NC-007045,OIC Family Medical Center - Happy Hill,"Opportunities Industrialization Center, Inc.",1528478237,Federally Qualified Health Centers - Medical Services,300 N Grace St,,Rocky Mount,NC,27804-5345,Nash,402 E. Virginia St.,,Rocky Mount,NC,27802,Edgecombe,Brian Ellerby,Director of Integrated Health Services,252-446-3333,232,bellerby@oicone.org,,,,,,www.oicone.org
NC-007046,Nash County Health Department,Nash County,1497880033,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",322 S Franklin St,,Rocky Mount,NC,27804-5711,Nash,Nash County Health Department,Nash County,Nashville,NC,27856,Nash,Shannon Lee,Admin Asst III,252-459-9819,1238,shannon.lee@nashcountync.gov,,,,,,
NC-007047,OIC Family Medical Center - Guardian Court,OIC Family Medical Center,1396103305,Federally Qualified Health Centers - Medical Services,90 Guardian Ct,,Rocky Mount,NC,27804-3017,Nash,402 E. Virginia St.,,Rocky Mount,NC,27802,Edgecombe,Brian Ellerby,Director of Integrated Health Services,252-446-3333,4000,bellerby@oicone.org,,,,,,www.oicone.org
NC-007048,PLAINVIEW HEALTH SERVICES,"GOSHEN MEDICAL CENTER, INC.",1801911383,Federally Qualified Health Centers - Medical Services,360 E Charity Rd,,Rose Hill,NC,28458-8303,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007049,ROSE HILL MEDICAL CENTER,DUPLIN MEDICAL ASSOCIATION,1164503702,Rural Health Clinics,600 S Sycamore St,,Rose Hill,NC,28458-4700,Duplin,600 SOUTH SYCAMORE STREET,,ROSE HILL,NC,28458,Duplin,"KRISTINE LEWIS, PA-C",CLINIC DIRECTOR,910-289-3027,,myabcgirls457@earthlink.net,SANTANA CASH,OFFICE MANAGER,910-289-3027,,duplinmedical@embarqmail.com,
NC-007050,Person County Health Department,Person County Health Department,1730256017,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",355 S Madison Blvd,Suite A,Roxboro,NC,27573-5485,Person,355-A South Madison Boulevard,,Roxboro,NC,27573,Person,Janet Oakley Clayton,Health Director,336-597-2204,2241,jclayton@personcounty.net,Pam Cook,Administrative Assistant,336-597-2204,2242,pcook.pchd@personcounty.net,http://www.personcounty.net/index.aspx?page=139
NC-007051,Person Memorial Hospital,LifePoint Health,1881977593,Inpatient Hospitals (other than children's hospitals),615 Ridge Rd,,Roxboro,NC,27573-4629,Person,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Jessica Ayers,CFO,336-503-4803,,,
NC-007052,"Person Family Medical Center, Inc.","Person Family Medical Center, Inc",1952493587,"Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",702 N Main St,PO Box 350,Roxboro,NC,27573-0350,Person,702 N. Main St.,P. O Box 350,Roxboro,NC,27573,Person,Jennifer Daye,Outreach/Marketing,336-599-9271,234,jdaye@pfmcinc.org,Glenn Martin,CEO,336-599-9271,359,gmartin@pfmcinc.org,https://www.personfamilymedical.com
NC-007053,Rutherford Regional Medical Center,LifePoint Health,1245321181,Inpatient Hospitals (other than children's hospitals),288 South Rigecrest Avenue,,Rutherfordton,NC,28139,Rutherford,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,John Bostwick,CFO,828-286-5201,,,
NC-007054,CommWell Health of Salemburg,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1992728950,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",500 S Fayetteville St,,Salemburg,NC,28385-8406,Sampson,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007055,Rowan County Health Department,Rowan County Health Department,1427128651,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1811 E Innes St,,Salisbury,NC,28146-6030,Rowan,1811 East Innes Street,,Salisbury,NC,28146,Rowan,Nina Oliver,Health Director,704-216-8871,,nina.oliver@rowancountync.gov,June Miller,Office Manager,704-216-8824,,june.miller@rowancountync.gov,
NC-007056,Lee Co. Health Dept.,North Carolina Dept. of Health and Human Services,1871637975,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",106 Hillcrest Dr,,Sanford,NC,27330-4021,Lee,106 Hillcrest Dr,,Sanford,NC,27330-4021,Lee,HEATH CAIN,Executive Director,919-718-4640,5331,HCAIN@LEECOUNTYNC.GOV,Carol P Thompson,Finance Officer,919-718-4640,5350,cathompson@leecountync.gov,http://www.leecountync.gov/Departments/PublicHealth.aspx
NC-007057,Central Carolina Hospital,LifePoint Health,1902836943,Inpatient Hospitals (other than children's hospitals),1135 Carthage St,,Sanford,NC,27330-4162,Lee,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Debbie Kyzar,CFO,919-774-2102,,,
NC-007058,Rural Health Group at Scotland Neck,"Rural Health Group, Inc.",1881841518,Federally Qualified Health Centers - Medical Services,919 Jr High School Rd,,Scotland Neck,NC,27874-1219,Halifax,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian O Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007059,CommWell Health of Shallotte - Medical,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1003218439,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",341 Whiteville Rd NW,,Shallotte,NC,28470-4507,Brunswick,P. O. Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007060,Cleveland Co. Health Dept.,North Carolina Dept. of Health and Human Services,1720151525,"Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",200 S Post Rd,,Shelby,NC,28152-6269,Cleveland,200 S Post Road,,Shelby,NC,28152,Cleveland,Tiffany Hansen,Health Director,980-484-5200,,Tiffany.hansen@clevelandcountync.gov,Tammy Cobb,Administrative,980-484-5303,,Tammy.cobb@clevelandcounty.com,http://www.ccncgov.com/public/health/homepage.htm
NC-007061,Chatham County Public Health Department Clinic,Chatham County Public Health Department,1346335312,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1000 South Tenth Street,,Siler City,NC,27344,Chatham,80 East Main Street,,Pittsboro,NC,27312,Chatham,"Lloyd Layton Long, Jr.",Health Director,919-542-8215,,layton.long@chathamnc.org,Debbie Garrett,Director of Nursing,919-742-5641,8250,debbie.garrett@chathamnc.org,http://www.chathamnc.org/index.aspx?page=124
NC-007062,SILER CITY COMMUNITY HEALTH CENTER,"Piedmont Health Services, Inc",1821192865,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",224 S 10th Ave,,Siler City,NC,27344-2779,Chatham,127 Kingston Dr,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-007063,Commwell Of Smithfield,TRI COUNTY COMMUNITY HEALTH COUNCIL,1407039324,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",507 N Brightleaf Blvd,Suite 209,Smithfield,NC,27577-4405,Johnston,P.O. Box 227,,Newton Grove,NC,28366,Sampson,Pamela Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,,,CStanley@commwellhealth.org,
NC-007064,Johnston County Public Health Department,Johnston County Public Health Department,1528157211,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",517 N Brightleaf Blvd,,Smithfield,NC,27577-4407,Johnston,517 N. Bright Leaf Blvd.,,Smithfield,NC,27577,Johnston,"Marilyn Pearson, MD",Health Director,919-989-5225,,marilyn.pearson@johnstonnc.com,Steve Strickland,Asst. Health Director,919-989-5226,,steve.strickland@johnstonnc.com,
NC-007065,Sylvan Community Health Center,"Piedmont Health Service, Inc",1144583055,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7718 Sylvan Rd,,Snow Camp,NC,27349-9504,Alamance,127 Kingston Drive,,Chapel Hill,NC,27514,Orange,Chiffon Jenkins,Director of Patient Accounts,919-933-8494,1492,jenkinsc@piedmonthealth.org,,,,,,piedmonthealth.org
NC-007066,GREENE COUNTY STUDENT HEALTH SVR,"Greene County Health Care, Incorporated",1083616809,Federally Qualified Health Centers - Medical Services,140 School Dr,,Snow Hill,NC,28580-7288,Greene,7 Professional Dr,,Snow Hill,NC,28580-1332,Greene,Doug Smith,CEO,252-747-8162,2205,dsmith@greenecountyhealthcare.com,Beverly Stroud,CFO,252-747-8162,2204,bstroud@greenecountyhealthcare.com,www.greenecountyhealthcare.com
NC-007067,KATE B. REYNOLDS MEDICAL CENTER,"Greene County Health Care, Incorporated",1700888542,Federally Qualified Health Centers - Medical Services,205 Martin L King Jr Pkwy,,Snow Hill,NC,28580-1320,Greene,7 Professional Dr,,Snow Hill,NC,28580-1332,Greene,Doug Smith,CEO,252-747-8162,2205,dsmith@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-007068,Greene County Health Department,GREENE COUNTY HEALTH DEPARTMENT,1346302759,Family Planning Providers,227 Kingold Blvd,Suite B,Snow Hill,NC,28580-1303,Greene,227 Kingold Blvd S,,Snow Hill,NC,28580,Greene,Michael U. Rhodes,Health Director,252-747-8183,343,michael.rhodes@greenecountync.gov,Chris Miller,Director of Nursing,252-747-8181,337,chris.miller@greenecountync.gov,
NC-007069,Snow Hill Medical Center,"Greene County Health Care, Incorporated",1891798054,Federally Qualified Health Centers - Medical Services,302 N Greene St,,Snow Hill,NC,28580-1412,Greene,7 Professional Dr,,Snow Hill,NC,28580-1332,Greene,Doug Smith,CEO,252-747-8162,2205,dsmith@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-007070,Greene Dental Services,"Greene County Health Care, Incorporated",1568464386,Dental Providers,6 Professional Dr,,Snow Hill,NC,28580-1333,Greene,7 Professional Dr,,Snow Hill,NC,28580,Greene,Beverly Stroud,CFO,252-747-8162,2204,bstroud@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-007071,Dosher Medical-Southport,J. Arthur Dosher Memorial Hospital,1194016055,Outpatient Hospital Clinics,11 E 9th St,,Southport,NC,28461-3083,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007072,Dosher Medical-Smithville Crossing,J. Arthur Dosher Memorial Hospital,1053727693,Outpatient Hospital Clinics,1513 N Howe St,,Southport,NC,28461-2769,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CFO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007073,Dosher Medical Wellness Center,J. Arthur Dosher Memorial Hospital,1487002788,Outpatient Hospital Clinics,3009 Medical Plaza Lane,,Southport,NC,28461,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007074,Dosher Medical-General Surgery,J. Arthur Dosher Memorial Hospital,1194016055,Outpatient Hospital Clinics,819 N Atlantic Ave,,Southport,NC,28461-3531,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3912,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007075,Dosher Medical-Women's Health,J. Arthur Dosher Memorial Hospital,1194016055,Outpatient Hospital Clinics,823 N Atlantic Ave,,Southport,NC,28461-3531,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007076,Dosher Medical-N Howe Street,J. Arthur Dosher,1831505346,Outpatient Hospital Clinics,905 N Howe St,,Southport,NC,28461-3037,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007077,J. Arthur Dosher Memorial Hospital,J. Arthur Dosher Memorial Hospital,1538260229,Inpatient Hospitals (other than children's hospitals),924 N Howe St,,Southport,NC,28461-3038,Brunswick,924 N. Howe Street,,Southport,NC,28461,Brunswick,Tom Siemers,President/CEO,910-457-3911,,tomsiemers@dosher.org,Dan Porter,Sr VP/CFO,910-457-3912,,danporter@dosher.org,http://www.dosher.org
NC-007078,Alleghany Health Center,Appalachian District Health Department,1538270814,Federally Qualified Health Centers - Medical Services,157 Health Services Rd,,Sparta,NC,28675-3000,Alleghany,PO Box 309,,Sparta,NC,28675-0309,Alleghany,Jennifer Greene,Health Director / CEO,828-264-4995,3117,jen.greene@apphealth.com,Angie Poole,Finance Officer / CFO,336-372-5641,1113,angie.scott@apphealth.com,www.apphealthcare.com
NC-007079,Northern Rowan Family Medicine,"Cabarrus Rowan Community Health Centers, Inc.",1205204476,Federally Qualified Health Centers - Medical Services,300 N Salisbury Ave,,Spencer,NC,28159-2514,Rowan,202D McGill Ave NW,,Concord,NC,28025,Cabarrus,Kim Wagenaar,CEO,704-792-2203,,kawagenaar@crchc.org,Cody McKinney,CFO,704-792-2208,,clmckinney@crchc.org,www.crchc.org
NC-012371,Rutherford Dental,Blue Ridge Community Health Services Inc,1487050738,Federally Qualified Health Centers - Dental Services,187 W Main St,,Spindale,NC,28160-1539,Rutherford,PO Box 5151,,Hendersonville,NC,28793,Henderson,Belinda Elmore,"Director of Patient Financial Services, Inc.",828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-007080,Rutherford Health Center,"Blue Ridge Community Health Services, Inc.",1437593787,Federally Qualified Health Centers - Medical Services,187 W Main St,,Spindale,NC,28160-1539,Rutherford,PO Box 5151,,Hendersonville,NC,28793,Rutherford,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-007081,Rutherford Health Department,Rutherford Polk McDowell Health District,1285791087,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",221 Callahan Koon Rd,,Spindale,NC,28160-2207,Rutherford,221 Callhan Koon Rd,,Spindale,NC,28160,Rutherford,Joshua Kennedy,Assistant Health Director,828-287-6124,,jkennedy@rpmhd.org,,,,,,www.rpmhd.org
NC-007082,ANDERSON CREEK MEDICAL CENTER,FIRST CHOICE COMMUNITY HEALTH CENTERS,1902829153,Federally Qualified Health Centers - Medical Services,6750 Overhills Rd,,Spring Lake,NC,28390-8872,Harnett,40 Autumn Fern Trail,,Lillington,NC,27546,Harnett,Sheila L Simmons,Chief Executive Officer,910-364-0972,1600,slsimmons@firstchoicechc.org,,,,,,www.firstchoicechc.org
NC-007083,Mission Community Primary Care - Spruce Pine,Blue Ridge Regional Hospital,1629089776,Rural Health Clinics,11728 S 226 Hwy,,Spruce Pine,NC,28777-8954,Mitchell,11728 South 226 Highway,,Spruce Pine,NC,28777,Mitchell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-007084,Mission Community Obstetrics and Gynecology Specialist,Blue Ridge Regional Hospital,1992186092,Inpatient Hospitals (other than children's hospitals),125 Hospital Dr,,Spruce Pine,NC,28777-3035,Mitchell,125 Hospital Dr,,Spruce Pine,NC,28777,Mitchell,Cheryl T Williams,business office,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-007085,Mission Health Mauzy-Phillips Center,Blue Ridge Regional Hospital,1790760213,Rural Health Clinics,189 Hospital Dr,,Spruce Pine,NC,28777-3035,Mitchell,189 Hospital Drive,,Spruce Pine,NC,28777,Mitchell,Cheryl T Williams,Executive Director Physician Revenue Cycle,828-651-4160,,cheryl.williams2@msj.org,,,,,,
NC-007086,Spruce Pine Office,BAKERSVILLE COMMUNITY MEDICAL CLINIC INC,1770821589,Federally Qualified Health Centers - Medical Services,36 Hospital Dr,,Spruce Pine,NC,28777-8943,Mitchell,86 N Mitchell Ave,,Bakersville,NC,28705-6502,Mitchell,Chuck Shelton,CEO,828-688-2104,,cshelton@mchp.care,Kayle Buchanan,Executive Administrative Assistant,828-688-2104,,kbuchanan@mchp.care,thebchc.org
NC-007087,Toe River Health District,Toe River Health District,1295864452,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",861 Greenwood Rd,,Spruce Pine,NC,28777-3113,Mitchell,861 Greenwood Road,,Spruce Pine,NC,28777,Mitchell,Betty McKinney,Finance Officer,828-765-2239,24,bmckinney@trhd.dst.nc.us,Paula McClellan,Billing,828-765-2239,20,paula.mcclellan@trhd.dst.nc.us,
NC-007088,Montgomery County Community Health Center,ROBESON HEALTH CARE CORPORATION,1629334016,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",103 Cotton Creek Rd,,Star,NC,27356-7954,Montgomery,60 Commerce Plaza,,Pembroke,NC,28372-7386,Montgomery,Tim Hall,President and CEO,910-521-2900,118,gt_hall@rhcc1.com,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,www.rhcchealth.org
NC-007089,Statesville Family Medicine,Gaston Family Health Services,1326235821,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1022 Shelton Ave,,Statesville,NC,28677-6826,Iredell,200 E 2nd Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-007090,Iredell County Health Department,Iredell County Health Department,1093790859,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",318 Turnersburg Hwy,,Statesville,NC,28625-2798,Iredell,318 Turnersburg Hwy.,,Statesville,NC,28625,Iredell,William Griffith,Director of Finance and Operations,704-761-2446,,wsgriffith@co.iredell.nc.us,Jane Hinson,Health Director,704-878-5302,,jane.hinson@co.iredell.nc.us,
NC-007091,Statesville Childrens Clinic,Gaston Family Health Services,1710237367,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",518 Brookdale Dr,,Statesville,NC,28677-4108,Iredell,200 E. Second Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-007092,Stedman Family Dental Center,"STEDMAN-WADE HEALTH SERVICES, INC.",1578534871,Dental Providers,6540 Clinton Rd,,Stedman,NC,28391-8846,Cumberland,PO BOX 449,,Wade,NC,28395-9749,Cumberland,Melva Jackson,PATIENT SERVICES COORDINATOR,910-483-6694,7027,OM@SWHS-NC.ORG,HATTIE LASSITER,CFO,910-483-6694,7010,CFO@SWHS-NC.ORG,
NC-007093,Rural Health Group at Stovall,"Rural Health Group, Inc.",1609236371,Federally Qualified Health Centers - Medical Services,100 Durham St,,Stovall,NC,27582-9602,Granville,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007094,Commwell of Bolivia,TRI COUNTY COMMUNITY HEALTH COUNCIL INC.,1992171060,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6 Doctors Cir,Suite 1,Supply,NC,28462-6358,Brunswick,P.O. Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,919-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007095,Hyde Co. Health Dept.,North Carolina Dept. of Health and Human Services,1962405159,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1151 Main St,,Swanquarter,NC,27885-9754,Hyde,1151 Main St,,Swan quarter,NC,27885,Hyde,David Howard,Director,252-926-4387,,dhoward@hydehealth.com,Luana Gibbs,Director of Nursing,252-926-4398,,lgibbs@hydehealth.com,http://www.hydecounty.org/government/health_dept.asp
NC-007096,Mission Women's Care Sylva,Angel Medical Center,1558770180,Rural Health Clinics,111 Central St,,Sylva,NC,28779-5412,Jackson,120 Riverview St,,Franklin,NC,28734,Macon,Joy Martin,Business Office,828-776-1913,,Margaret.Martin@msj.org,,,,,,
NC-007097,Sylva Community Health Center,Appalachian Mountain Community Health Centers,1841644531,Federally Qualified Health Centers - Medical Services,154 Medical Park Loop,Suite 210,Sylva,NC,28779-5271,Jackson,PO Box 2597,,Asheville,NC,28802,Buncombe,Reuben J Pettiford,Administration and Operations Director,828-202-5660,,rjp@appalachianmountain.org,Paul Tax,Project Administrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-007098,Sylva Health Center,Blue Ridge Community Health Center Inc.,1881130540,Federally Qualified Health Centers - Medical Services,293 Hospital Rd,,Sylva,NC,28779-5195,Jackson,PO Box 5151,,Hendersonville,NC,28793,Polk,Belinda Elmore,Director of Patient Financial Services,828-692-4289,2201,belmore@brchs.com,Brian Morton,CFO,828-692-4289,2250,bmorton@brchs.com,brchs.com
NC-007099,Jackson County Department of Public Health,Jackson County Health Department,1609912096,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",538 Scotts Creek Rd,Suite 100,Sylva,NC,28779-5281,Jackson,"538 Scotts Creek Road, Suite 100",,Sylva,NC,28779,Jackson,Paula Green Carden,Health Director,828-586-8994,254,paulacarden@jacksonnc.org,Carla Morgan,Nursing Supervisor,828-586-8994,226,carlamorgan@jacksonnc.org,health.jacksonnc.org
NC-007100,Harris Regional Hospital,LifePoint Health,1407962046,Inpatient Hospitals (other than children's hospitals),68 Hospital Rd,,Sylva,NC,28779-2722,Jackson,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Matt Seagroves,CFO,828-586-7100,,,
NC-007101,Goshen Medical Center Tabor City,"GOSHEN MEDICAL CENTER, INC.",1295113371,Federally Qualified Health Centers - Medical Services,106 Tabor Crossing,,Tabor City,NC,28463,Columbus,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentilaing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-007102,CommWell Health of Tar Heel,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1770506149,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",16526 NC Highway 87 W,,Tar Heel,NC,28392-8608,Bladen,P. O Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007103,Edgecombe County Health Department,Edgecombe County Health Department,1770610602,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",122 E Saint James St,,Tarboro,NC,27886-5016,Edgecombe,Edgecombe County Helath Department,122 E St. James Street,Tarboro,NC,27886,Edgecombe,Karen Lachapelle,Health Director,252-641-7531,,karenlachapelle@edgecombeco.com,,,,,,
NC-007104,Alexander County Health Department,Alexander County Health Department,1487633053,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",338 1st Ave SW,,Taylorsville,NC,28681,Alexander,338 1st ave sw,,Tsaylorsville,NC,28681,Alexander,Leeanne Whisnant,Health Director,828-632-9704,405,lwhisnant@alexandercountync.gov,Laurie Pishner,Finance Director,828-632-9704,430,lpishner@alexandercountync.gov,
NC-007105,Davidson Health Services-Thomasville,GASTON FAMILY HEALTH SERVICES INC,1225445331,Federally Qualified Health Centers - Medical Services,102 Forest Park Dr,,Thomasville,NC,27360-3407,Davidson,991 W Hudson Blvd,,Gastonia,NC,28052-6430,Gaston,Robert E Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-007106,Thomasville Medical Group,Gaston Family Health Services,1225445331,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",611 Randolph St,,Thomasville,NC,27360-5126,Davidson,200 East Second Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-007107,GOSHEN MEDICAL CTR - TRENTON,"GOSHEN MEDICAL CENTER, INC.",1750407128,Federally Qualified Health Centers - Medical Services,104 E Lakeview Dr,,Trenton,NC,28585-8893,Jones,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007108,Jones County Health Department,"County of Jones, Jones County Health Department",1851496269,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",418 NC Highway 58 N Unit C,,Trenton,NC,28585-9619,Jones,418 NC Hwy 58 North,Unit C,Trenton,NC,28585,Jones,Wesley P Smith,Health Director,252-448-9111,3000,wsmith@jonescountync.gov,Jennifer Thomas,Administrative Officer,252-448-9111,3008,jthomas@jonescountync.gov,www.jonescountyhealth.com
NC-007109,"MID CAROLINA FAMILY MEDICINE, PA","MID CAROLINA FAMILY MEDICINE, PA",1497755953,Rural Health Clinics,1038 Albemarle Rd,,Troy,NC,27371-8684,Randolph,1038 ALBEMARLE ROAD,,TROY,NC,27371-8684,Randolph,JUDY LEMONDS,PRACTICE MANAGER,910-572-1785,,jelmonds@midcarolinafm.com,,,,,,
NC-007110,Montgomery County Health Department,Montgomery County Health Department,1134295850,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",217 S Main St,,Troy,NC,27371-3200,Montgomery,217 S. Main St,,Troy,NC,27371,Montgomery,Mary Perez,Public Health Director,910-572-1393,248,mary.perez@montgomerycountync.com,Julie Clark,Nursing Supervisor,910-572-1393,241,julie.clark@montgomerycountync.com,
NC-007111,"Gateway Community Health Centers, Inc.","GATEWAY COMMUNITY HEALTH CENTERS, INC.",1679853642,Federally Qualified Health Centers - Medical Services,2869 Virginia Rd,,Tyner,NC,27980-9777,Chowan,PO Box 297,,Gatesville,NC,27938-0297,Pasquotank,Rose Turner,CEO,252-357-1226,,RTurner@GCHCHealth.com,Valerie Corder,Billing Agent,256-604-9203,,cordervalerie@bellsouth.net,
NC-007112,WADE FAMILY MEDICAL CENTER,"STEDMAN-WADE HEALTH SERVICES, INC.",1578534871,Federally Qualified Health Centers - Medical Services,7118 Main St,,Wade,NC,28395-9749,Cumberland,PO BOX 449,,Wade,NC,28395-9749,Cumberland,Melva Jackson,PATIENT SERVICES COORDINATOR,910-483-6694,7027,OM@SWHS-NC.ORG,Melva Jackson,Patient Services Coordinator,910-483-6694,7027,om@swhs-nc.org,WWW.SWHS-NC.ORG
NC-007113,Anson Co. Health Dept.,Anson Co. Health Dept.,1154418754,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",110 E Ashe St,,Wadesboro,NC,28170-2702,Anson,110 Ashe St,,Wadesboro,NC,28170-2702,Anson,Lisa Clark,Processing Assistant 5,704-994-3326,,lclark@co.anson.nc.us,Fred Thompson,Health Director,704-694-3327,,fthompson@co.anson.nc.us,http://www.co.anson.nc.us/health
NC-007114,ARMS - Main,"Anson Regional Medical Services, Inc.",1992840003,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",203 Salisbury St,,Wadesboro,NC,28170-2155,Anson,203 Salisbury Street,P.O. Box 192,Wadesboro,NC,28170,Anson,Gwendolyn E Reed,CEO,704-694-6700,223,arms1475@usa.net,Pamela Nicholson,DAIO,704-694-6700,222,pnicholson.arms@charlotte.twcbc.com,www..arms-chc.org
NC-007115,Wake County Health Department - Northern Regional Center,Wake County Health Department - Northern Regional Center,1801957576,"Family Planning Providers, Sexually Transmitted Disease Clinics",350 E Holding Ave,,Wake Forest,NC,27587-2904,Wake,350 E Holding Ave,,Wake Forest,NC,27587-2904,Wake,Sue Lynn Ledford,Health Director,919-250-4516,,sue.ledford@co.wake.nc.us,Ida Dawson,Clinics Division Director,919-250-4629,,idawson@wakegov.com,http://www.wakegov.com
NC-007116,GOSHEN MEDICAL CENTER - WALLACE,"GOSHEN MEDICAL CENTER, INC.",1457477820,Federally Qualified Health Centers - Medical Services,110 Eastwood Dr,,Wallace,NC,28466-9201,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007117,WALSTONBURG HEALTH CENTER,"Greene County Health Care, Incorporated",1194727925,Federally Qualified Health Centers - Medical Services,204 S Main St,,Walstonburg,NC,27888-8900,Greene,7 Professional Dr,,Snow Hill,NC,28580-1332,Greene,Doug Smith,CEO,252-747-8162,2205,dsmith@greenecountyhealthcare.com,,,,,,www.greenecountyhealthcare.com
NC-007118,Warren County Health Department,Warren County Health Department,1770669962,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",544 W Ridgeway St,,Warrenton,NC,27589-1716,Warren,544 West Ridgeway Street,,Warrenton,NC,27859,Warren,MARGARET BRAKE,Health Director,252-257-1185,6000,MARGARETBRAKE@WARRENCOUNTYNC.US,Sharon Bartholomew,Administrative Officer,252-257-1185,6026,sharonbartholomew@warrencountync.us,
NC-007119,Goshen Medical Center - Warsaw Wellness Center,"GOSHEN MEDICAL CENTER, INC.",1457477820,Federally Qualified Health Centers - Medical Services,113 S Pine St,,Warsaw,NC,28398-1924,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007120,GOSHEN MEDICAL CTR - WARSAW,"GOSHEN MEDICAL CENTER, INC.",1346365822,Federally Qualified Health Centers - Medical Services,603 E College St,,Warsaw,NC,28398-2104,Duplin,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007121,AGAPE COMMUNITY HEALTH CENTER,METROPOLITAN COMMUNITY HEALTH,1366488280,Federally Qualified Health Centers - Medical Services,120 W Martin Luther King Jr Dr,,Washington,NC,27889-4906,Beaufort,120 W Martin Luther King Jr. Dr,,Washington,NC,27889-4934,Beaufort,Laurence Doby,Operations Manager,252-644-7003,,ldoby@metrocommunityhealth.org,Michael McDuffie,Executive Director,252-644-7002,,mmcduffie@metrocommunityhealth.org,
NC-007122,Beaufort County Health Department,Beaufort County Health Department,1679576763,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1436 Highland Dr,,Washington,NC,27889-3222,Beaufort,1436 Highland Drive,,Washington,NC,27889-3222,Beaufort,James Madson,Health Director,252-946-1902,226,James.Madson@bchd.net,Sara Graham,Business Officer,252-946-1902,227,Sara.Graham@bchd.net,http://www.bchd.net
NC-007124,Balsam Community Health Center,Appalachian Mountain Community Health Centers,1730532680,Federally Qualified Health Centers - Medical Services,91 Timberlane Rd,Suite 200,Waynesville,NC,28786-7927,Haywood,PO Box 2597,"7 McDowell Str, Ste 200",Asheville,NC,28802,Buncombe,Reuben J Pettiford,President and CEO,828-202-5335,,rjp@appalachianmountain.org,Paul C Tax,Project Admnisitrator,828-202-5203,,pct@appalachianmountain.org,www.amchc.org
NC-007125,Rural Health Group at Weldon Elementary,"Rural Health Group, Inc.",1962771006,Federally Qualified Health Centers - Medical Services,805 Washington Ave,,Weldon,NC,27890-1839,Halifax,500 Jackson St.,,Roanoke Rapids,NC,27870,Halifax,Brian Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007126,Rockingham County Health Department,Rockingham County Division of Public Health,1306947445,"Dental Providers, Family Planning Providers",371 NC-65,Suite 204,Wentworth,NC,27375-0204,Rockingham,371 NC 65,,Wentworth,NC,27375,Rockingham,Susan Young,Director of Nursing/Interim Health Director,336-342-8151,8151,sjoyce@co.rockingham.nc.us,Felissa Ferrell,Director of Health and Human Services,336-343-7098,7098,fferrell@co.rockingham.nc.us,http://www.rockinghamcountypublichealth.org/
NC-007127,Rural Health Group at Whitakers,"Rural Health Group, Inc.",1013157171,Federally Qualified Health Centers - Medical Services,105 SE Railroad St,,Whitakers,NC,27891,Nash,500 Jackson St,,Roanoke Rapids,NC,27870-2602,Halifax,Brian O Harris,Chief Executive Officer,252-536-5929,,brian.harris@rhgnc.org,,,,,,www.rhgnc.org
NC-007128,Columbus County Community Health Center,ROBESON HEALTH CARE CORPORATION,1659351146,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",15 Hill Plz,Suite A,Whiteville,NC,28472-4950,Columbus,60 COMMERCE DRIVE,,Pembroke,NC,28372,Robeson,JENNIFER MCLAMB,Chief Operating Officer,910-521-2900,104,JENNIFER_MCLAMB@RHCC1.COM,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,
NC-007129,Columbus County Health Department,Columbus County Health Department,1699950865,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",304 Jefferson St,,Whiteville,NC,28472-3602,Columbus,304 Jefferson Street,PO Box810,Whiteville,NC,28472,Columbus,Kimberly Smith,Health Director,910-640-6615,7016,Kim.L.Smith@columbusco.org,,,,,,
NC-007130,GOSHEN MEDICAL CENTER - WHITEVILLE,"GOSHEN MEDICAL CENTER, INC.",1538407036,Federally Qualified Health Centers - Medical Services,5 Whiteville Town Ctr,,Whiteville,NC,28472,Columbus,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg M Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentialing Coordinator,910-267-2042,,tstrickland@goshenmed.com,
NC-007131,Goshen Medical Center Vineland,"GOSHEN MEDICAL CENTER, INC.",1114479326,Federally Qualified Health Centers - Medical Services,630 S Madison St,,Whiteville,NC,28472-4130,Columbus,444 SW Center St,,Faison,NC,28341-8820,Duplin,Greg Bounds,CEO,910-267-1942,,gbounds@goshenmed.com,Teela Strickland,Credentilaing Coordinator,910-267-0421,1311,tstrickland@goshenmed.com,
NC-007132,Wilkes County Health Department,Wilkes County Health Department,1962565788,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",306 College St,,Wilkesboro,NC,28697-2854,Wilkes,306 College St,,Wilkesboro,NC,28697-2854,Wilkes,Ann Absher,Health Director,336-651-7464,,aabsher@wilkescounty.net,Debbie Nicholson,Director of Nursing,336-651-7461,,dnicholson@wilkescounty.net,http://www.wilkeshealth.com
NC-007133,CommWell Health of Penderlea,"TRI COUNTY COMMUNITY HEALTH COUNCIL, INC",1396768776,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5531 Eleanor Roosevelt Ln,,Willard,NC,28478-6621,Pender,P.O.Box 227,,Newton Grove,NC,28366,Sampson,Pam Tripp,CEO,910-567-7004,,PTripp@commwellhealth.org,Cheryl Stanley,CFO,910-567-7008,,CStanley@commwellhealth.org,
NC-007134,Agape Community Health Clinic - Williamston,METROPOLITAN COMMUNITY HEALTH,1801222716,Federally Qualified Health Centers - Medical Services,1130 Godwin Dr,,Williamston,NC,27892-6828,Martin,120 W Martin Luther King Jr. Dr,,Washington,NC,27889-4934,Beaufort,Laurence Doby,Operations Manager,252-644-7003,,ldoby@metrocommunityhealth.org,Michael McDuffie,Executive Director,252-644-7002,,,
NC-007135,Martin Co. Health Dept.,Martin-Tyrrell-Washington District Health Department,1104970714,"Family Planning Providers, Sexually Transmitted Disease Clinics",210 W Liberty St,,Williamston,NC,27892-1712,Martin,210 W Liberty St,,Williamston,NC,27892-1712,Martin,Bonnie Phelps,Administrative Assistant II,252-791-3119,,bonnie.phelps@mtwdistricthealth.org,Nicole Barnes,Processing Assistant II,252-791-3118,,nicole.barnes@mtwdistricthealth.org,http://www.mtwdistricthealth.org/
NC-007136,Planned Parenthood Wilmington Health Center,Planned Parenthood South Atlantic,1124165451,Family Planning Providers,1925 Tradd Ct,,Wilmington,NC,28401-6638,New Hanover,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/wilmington/28401/planned-parenthood-wilmington-health-center-of-wilmington-nc-2595-90860
NC-007137,New Hanover County Health Department,New Hanover County Health Department,1902934292,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2029 S 17th St,,Wilmington,NC,28401-6699,New Hanover,2029 S. 17th St.,,Wilmington,NC,28401,New Hanover,Carla Turner,Personal Health Services Manager,910-798-6559,6559,cturner@nhcgov.com,,,,,,
NC-007138,MedNorth Health Center,New Hanover Community Health Center Inc dba MedNorth Health Center,1912954090,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",925 N 4th St,,Wilmington,NC,28401-3450,New Hanover,925 N 4th Street,,Wilmington,NC,28401,New Hanover,Althea Johnson,Chief Executive Officer,910-202-8623,,ajohnson@mednorth.org,"Sarah Towne, DO",Chief Medical Officer,910-202-8604,,stowne@mednorth.org,www.mednorth.org
NC-007139,WILSON MEDICAL CENTER,LifePoint Health,1215359922,Inpatient Hospitals (other than children's hospitals),1705 Tarboro St SW,,Wilson,NC,27893-3428,Wilson,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Melissa Packer,CFO,252-399-8040,,,
NC-007140,Wilson County Health Department,Wilson County Health Department,1467507640,"Family Planning Providers, Other ECP Providers",1801 Glendale Dr SW,,Wilson,NC,27893-4401,Wilson,1801 Glendale Drive Sw,,Wilson,NC,27893,Wilson,Teresa Ellen,Health Director,252-291-5470,6276,tcellen@wilson-co.com,Cinnamon Narron,Deputy Director,252-291-5470,6271,cnarron@wilson-co.com,
NC-007141,Wilson Community Health Center,CAROLINA FAMILY HEALTH CENTERS INC,1184792103,Federally Qualified Health Centers - Medical Services,303 Green St E,,Wilson,NC,27893-4105,Wilson,303 Green St E,,Wilson,NC,27893-4105,Wilson,Annette Eatmon,Chief Operating Officer,252-293-0013,320,aeatmon@cfhcnc.org,Marty Johnson,Outreach Enrollment Manager,252-293-0013,312,mjohnson@cfhcnc.org,www.cfhcnc.org
NC-007142,Bertie County Health Department,North Carolina Dept. of Health and Human Services,1841387263,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",102 Rhodes Ave,,Windsor,NC,27983-9656,Bertie,PO Box 189,,Elizabeth City,NC,27907-0189,Bertie,Battle Betts,Finance Director,252-338-4491,,bbetts@arhs-nc.org,,,,,,http://www.arhs-nc.org
NC-007143,Windsor Community Health Center,Bertie County Rural Health Association,1396886842,Federally Qualified Health Centers - Medical Services,104 Rhodes Ave,PO Box 628,Windsor,NC,27983-0628,Bertie,104 Rhodes Avenue,P.O. Box 628,Windsor,NC,27983,Bertie,Shavonda Pugh,CEO,252-794-1835,111,spugh@bcrha.org,Sharon Lee,COO,252-794-2117,112,slee@bcrha.org,bcrha.org
NC-007144,Southside United Health Center at the Commons,Southside United Health Center,1811136476,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1430 Felicity Lane,,Winston Salem,NC,27101,Forsyth,3009 Waughtown St,,Winston Salem,NC,27107,Forsyth,Wynne Renee Brown,Chief Medical Officer,336-293-8728,3365295112,wbrown@southsideunitedhealth.org,LaShun Huntley,CEO,336-529-5691,3365291983,lhuntley@southsideunitedhealth.org,www.uhcenters.org
NC-007145,AShley Wellness Center,Gatson Family Health Services,1578719886,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1647 NE Ashley School Cir,,Winston Salem,NC,27105-5444,Forsyth,200 East Second Ave,,Gastonia,NC,28052,Gaston,Robert Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,
NC-007146,United Health Centers @ Peters Creek Parkway,Southside United Health Center,1811136476,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2101 Peters Creek Pkwy,Suite 16-19,Winston Salem,NC,27127-3726,Forsyth,P.O. Box 12341,,Winston Salem,NC,27117,Forsyth,LaShun Huntley,CEO,336-529-5691,,lhuntley@uhcenters.org,,,,,,
NC-007147,Planned Parenthood Winston Salem Health Center,Planned Parenthood South Atlantic,1689711632,Family Planning Providers,3000 Maplewood Ave,,Winston Salem,NC,27103-4002,Forsyth,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/north-carolina/winston-salem/27103/winston-salem-health-center-2845-90860
NC-007148,United Health Center at Waughtown,United Health Centers (formerly Southside United Health Centers),1811136476,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3009 Waughtown St,,Winston Salem,NC,27107-1634,Forsyth,3009 Waughtown Street,,Winston Salem,NC,27107,Forsyth,Wynne Renee Brown,Chief Medical Officer,336-293-8728,3365295112,wbrown@southsideunitedhealth.org,LaShun Huntley,CEO,336-529-5691,,lhuntley@southsideunitedhealth.org,www.uhcenters.org
NC-007149,Mineral Springs Health Center,Gaston Family Health Services,1154453496,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4555 Ogburn Ave,,Winston Salem,NC,27105-2726,Forsyth,200E. Second Ave,,Gastonia,NC,28052,Gaston,Robert E. Spencer,CEO,704-616-2245,,rspencer@gfhs.info,,,,,,www.gfhs.info
NC-007150,Wake Forest University Health Sciences,Wake Forest University Comprehensive Hemophilia Diagnostic and Treatment Center,1003803032,Hemophilia Treatment Centers,Medical Center Blvd.,,Winston Salem,NC,27157-1081,Forsyth,Medical Center Blvd.,,Winston-Salem,NC,27157-1081,Forsyth,"Anita Ripperger Smith, NP",Nurse Practitioner/Hemophilia Program Coordinator,336-716-4324,,ansmith@wakehealth.edu,"Katharine Batt, MD",Hemophilia Program Director,336-713-5440,,kbatt@wakehealth.edu,
NC-007151,THE VILLAGE,ROBESON HEALTH CARE CORPORATION,1063554095,Community Mental Health Centers,108 W Fire Tower Rd,Suite E,Winterville,NC,28590-8408,Pitt,ROBESON HEALTH CARE CORPORATION,60 COMMERCE DRIVE,Pembroke,NC,28372,Robeson,JENNIFER MCLAMB,Chief Operating Officer,910-521-2900,104,JENNIFER_MCLAMB@RHCC1.COM,Al Bishop,Corporate Compliance Officer,910-521-2900,105,al_bishop@rhcc1.com,
NC-007152,Yadkin County Medical Clinic,Yadkin County Medical Clinic,1417019514,Other ECP Providers,638 W Main St,,Yadkinville,NC,27055-7804,Yadkin,P.O. Box 548,,Yadkinville,NC,27055,Yadkin,Trish Belton,Administrative Officer,336-849-7910,7602,tbelton@yadkincountync.gov,Jessica Wall,Assistant Director,336-849-7910,7588,jwall@yadkincountync.gov,www.yadkincountync.gov
NC-007153,Person Family Dental Center,Person Family Medical Center Inc,1194899542,Dental Providers,1076 NC Highway 86 N,,Yanceyville,NC,27379-8645,Caswell,702 N Main Street,,Roxboro,NC,27573,Person,Priscilla Bumphus,CEO,336-599-2900,359,janetwalker@esinc.net,Janet Walker,CFO,336-599-2900,355,janetwalker@esinc.net,
NC-012456,Caswell County Health Department,Caswell Family Medical Center,1518518901,Federally Qualified Health Centers - Medical Services,189 County Park Rd,,Yanceyville,NC,27379-9376,Caswell,P.O. BOX 1448,,YANCEYVILLE,NC,27379,Caswell,BECKY HATCHETT,Billing Supervisor,336-694-1181,204,bhatchett@caswellmedical.org,William Crumpton,CEO,336-694-9331,,bhatchett@caswellmedical.org,www.caswellmedical.org
NC-007154,CASWELL FAMILY MEDICAL CENTER,"CASWELL FAMILY MEDICAL CENTER INC., THE",1134201387,Federally Qualified Health Centers - Medical Services,439 US Highway 158 W,,Yanceyville,NC,27379-8304,Caswell,439 US Highway 158 W,,Yanceyville,NC,27379-8304,Caswell,William Crumpton,CEO,336-694-1181,209,wcrumpton@caswellmedical.org,Pam Collie,CFO,336-694-1181,202,pcollie@caswellmedical.org,http://caswellmedical.org
NC-007155,Wake County - Eastern Regional Center,Wake Co. Health Dept.,1801957576,"Family Planning Providers, Sexually Transmitted Disease Clinics",1002 Dogwood Dr,,Zebulon,NC,27597-6814,Johnston,1002 Dogwood Dr,,Zebulon,NC,27597-6814,Wake,Sue Lynn Ledford,Health Director,919-250-4516,,Sue.Ledford@wakegov.com,Ida Dawson,Clinics Division Director,919-250-4629,,idawson@wakegov.com,http://www.wakegov.com/humanservices/publichealth/Pages/clinics.aspx
ND-007156,AMC Ashley Clinic,Ashley Medical Center,1851335830,Rural Health Clinics,612 Center Ave N,,Ashley,ND,58413-7013,McIntosh,PO Box 450,612 Center Ave N,Ashley,ND,58413-0450,Mcintosh,Corinne Lepp,CLINIC MANAGER,701-288-3448,292,clepp@primecare.org,Jerry Lepp,Adm/CEO,701-288-3433,264,jlepp@primecare.org,
ND-007157,Quentin N. Burdick Hospital/Belcourt Indian Hospital (inpatient hospital),Quentin N. Burdick Hospital/Belcourt Indian Hospital,1952346934,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",1300 Hospital Loop,,Belcourt,ND,58316,Rolette,PO Box 160,,Belcourt,ND,58316-0160,Rolette,Shelly Harris,Chief Executive Officer,701-477-6111,8440,shelly.harris@ihs.gov,Duane Marcellais,Deputy CEO,701-477-6111,8438,duane.marcellais@ihs.gov,
ND-007158,Quentin N. Burdick Hospital/Belcourt Indian Hospital (multiple outpatient ECP categories),Quentin N. Burdick Hospital/Belcourt Indian Hospital,1952346934,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Sexually Transmitted Disease Clinics",1300 Hospital Loop,,Belcourt,ND,58316,Rolette,PO Box 160,,Belcourt,ND,58316-0160,Rolette,Shelly Harris,Chief Executive Officer,701-477-6111,8440,shelly.harris@ihs.gov,Duane Marcellais,Deputy CEO,701-477-6111,8438,duane.marcellais@ihs.gov,
ND-007159,COAL COUNTRY COMMUNITY HEALTH CENTER,COAL COUNTRY COMMUNITY HEALTH CENTER,1942288329,Federally Qualified Health Centers - Medical Services,1312 Highway 49 N,,Beulah,ND,58523-6038,Mercer,1312 Hwy 49 N,,Beulah,ND,58523,Mercer,Darrold Bertsch,CEO,701-880-1440,,dbertsch@smcnd.org,,,,,,
ND-007160,Sanford Medical Center,Sanford,1538245634,Inpatient Hospitals (other than children's hospitals),300 N 7th St,,Bismarck,ND,58501-4439,Burleigh,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007161,Bismarck-Burleigh Public Health,Bismarck-Burleigh Public Health,1174599070,Ryan White Providers,500 E Front Ave,Suite 3,Bismarck,ND,58504-5689,Burleigh,500 East Front Ave,Suite 3,Bismarck,ND,58504,Burleigh,Jodi Herman,Business Manager,701-355-1540,,jherman@bismarcknd.gov,Kjersti Hintz,RN,701-355-1540,,khintz@bismarcknd.gov,
ND-007162,Cooperstown Medical Center,Cooperstown Medical Center,1235239229,Inpatient Hospitals (other than children's hospitals),1200 Roberts Ave NE,,Cooperstown,ND,58425-7101,Griggs,1200 Roberts Ave NE,,Cooperstown,ND,58425,Griggs,Annie Dewald,Health Information Manager/Corporate Compliance,701-797-2221,7149,adewald@coopermc.com,Tanya Homiston,Director of Nursing,701-797-2221,7131,tanyah@coopermc.com,
ND-007163,Cooperstown Medical Center-Clinic,Cooperstown Medical Center,1962548214,Rural Health Clinics,1200 Roberts Ave NE,,Cooperstown,ND,58425-7101,Griggs,1200 Roberts Ave NE,,Cooperstown,ND,58425,Griggs,Annie Dewald,Health Information Manager-Corporate Compliance,701-797-2221,7149,adewald@coopermc.com,Karen Johnson,LPN,701-797-2221,7148,kjohnson@coopermc.com,
ND-007164,Heart of America Johnson Clinic Dunseith,Good Samaritan Hospital Association DBA Heart of America Medical Center,1568633865,Rural Health Clinics,215 Main St SE,,Dunseith,ND,58329,Rolette,800 South Main Ave.,,Rugby,ND,58368-2118,Pierce,Dustin Hager,CMO / Clinic Manager,701-776-5235,,dhager@hamc.com,Ashley Wasvick,Administrative Assistant,701-776-5455,2842,awasvick@hamc.com,
ND-007165,Elgin Community Clinic,Jacobson Memorial Hospital Care Center,1871691519,Rural Health Clinics,601 East St N,,Elgin,ND,58533-7105,Grant,601 East St. N.,,Elgin,ND,58533,Grant,Theo Stoller,CEO,701-584-2792,233,tastoller@primecare.org,Scott Ostenson,CFO,701-584-2792,236,sostenson@jmhcc.org,
ND-007166,Jacobson Memorial Hospital Care Center,Jacobson Memorial Hospital Care Center,1336196039,Inpatient Hospitals (other than children's hospitals),601 East St N,,Elgin,ND,58533-7105,Grant,601 East St. N.,,Elgin,ND,58533,Grant,Theo Stoller,CEO,701-584-2792,233,tastoller@primecare.org,Scott Ostenson,CFO,701-584-2792,236,sostenson@jmhcc.org,
ND-007167,Sanford Health Ellendale Clinic,Sanford Health,1346256682,Rural Health Clinics,141 Main St,,Ellendale,ND,58436-7101,Dickey,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Coporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007168,Sanford Health Enderlin Clinic,Sanford Health,1285666271,Rural Health Clinics,201 4th Ave,,Enderlin,ND,58027-1325,Ransom,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007169,Family HealthCare Fargo Dental,Family HealthCare,1033281050,Dental Providers,301 Np Ave N,,Fargo,ND,58102-4835,Cass,301 NP Ave N,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,Mark Woolery,Chief Financial Officer,701-551-2442,,mwoolery@famhealthcare.org,
ND-007170,Family HealthCare Fargo Medical,Family HealthCare,1710066352,Federally Qualified Health Centers - Medical Services,301 Np Ave N,,Fargo,ND,58102-4835,Cass,301 NP Avenue,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,Mark Woolery,Chief Financial Officer,701-551-2442,,mwoolery@famhealthcare.org,
ND-007171,Family HealthCare Homeless Health Services,Family HealthCare,1609945781,Federally Qualified Health Centers - Medical Services,311 Np Ave N,,Fargo,ND,58102-4835,Cass,Family HealthCare,301 NP Avenue,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,,,,,,
ND-007172,Family HealthCare South Fargo,Family HealthCare,1841701877,Federally Qualified Health Centers - Medical Services,4025 9th Ave S,,Fargo,ND,58103-2101,Cass,301 NP Avenue,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,,,,,,
ND-007173,Sanford Medical Center,Sanford,1528009412,Inpatient Hospitals (other than children's hospitals),801 Broadway N,,Fargo,ND,58102-3641,Cass,1305 W 18th St,,Fargo,ND,58102,Cass,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,karin.dulski@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007174,Sanford Health Forman Clinic,Sanford Health,1073520003,Rural Health Clinics,336 Main Street,,Forman,ND,58032-0184,Sargent,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007175,Fort Totten Service Unit/Spirit Lake Health Center,Fort Totten Service Unit/Spirit Lake Health Center,1467867895,"Dental Providers, Indian Health Service, Other ECP Providers",3883 74th Ave NE,,Fort Totten,ND,58335,Benson,PO Box 309,,Fort Totten,ND,58335-0309,Benson,Kathey Wilson,Chief Executive Officer,701-766-1600,,kathleen.wilson@ihs.gov,Sharon Whitmer,Director of Nursing,701-766-1600,,sharon.whitmer@ihs.gov,
ND-007176,Glen Ullin Family Medical Clinic,Jacobson Memorial Hospital Care Center,1003929944,Rural Health Clinics,602 E Ash Ave,,Glen Ullin,ND,58631-7138,Morton,601 East St. N.,,Elgin,ND,58533,Grant,Theo Stoller,CEO,701-584-2792,233,tastoller@primecare.org,Scott Ostenson,CFO,701-584-2792,236,sostenson@jmhcc.org,
ND-007177,"Community Health Service, Inc. - Grafton",Community Health Service Inc.,1316921406,Federally Qualified Health Centers - Medical Services,701 W 6th St,,Grafton,ND,58237-1379,Walsh,810 4th Ave S,Suite 101,Moorhead,MN,56560,Clay,Kristi Halvarson,Executive Director,218-236-6502,,khalvarson@chsiclinics.org,Aaron Kakac,CFO/Assistant Director,218-422-7424,,akakac@chsiclinics.org,
ND-007178,Grand Forks Public Health Department,Grand Forks Public Health Department,1801907720,Ryan White Providers,151 S 4th St,Suite N301,Grand Forks,ND,58201-4715,Grand Forks,151 South 4th Street Suite N301,,Grand Forks,ND,58201,Grand Forks,Twyla Streibel,Ryan White Case Manager,701-787-8100,8122,tstreibel@grandforksgov.com,Theresa Knox,Nursing and Nutrition Supervisor,701-787-8100,8113,tknox@grandforksgov.com,www.grandforksgov.com/publichealth
ND-007179,Valley Community Health Centers Dental Clinic,VALLEY COMMUNITY HEALTH CENTERS,1689878324,Dental Providers,212 S 4th St,Suite 101,Grand Forks,ND,58201-4776,Grand Forks,212 S. 4th Street,Ste 101,Grand Forks,ND,58201,Grand Forks,Pat Lizakowski,business office,701-757-2100,2005,pat.lizakowski@valleychc.org,Tiffany Schmidt,CFO,701-757-2100,2002,tiffaney.schmidt@valleychc.org,
ND-007180,Valley Community Health Centers-Grand Forks,VALLEY COMMUNITY HEALTH CENTERS,1114343423,Federally Qualified Health Centers - Medical Services,212 S 4th St,Suite 301,Grand Forks,ND,58203,Grand Forks,212 S 4th St,Suite200,Grand Forks,ND,58203,Grand Forks,Mara Jiran,CEO,701-757-2100,2001,mara.jiran@valleychc.org,Ben Shannon,Operations Manager,701-757-2100,2008,ben.shannon@valleychc.org,
ND-007181,Valley Health,Valley Health,1194922328,Family Planning Providers,360 Division Ave,Suite 200,Grand Forks,ND,58201-4702,Grand Forks,360 Division Ave,Suite200,Grand Forks,ND,58201,Grand Forks,Kerry Anderson,Administrative Manager,701-775-4251,,kerry@myvalleyhealth.com,,,,,,
ND-007182,Sakakawea Hazen Clinic,SAKAKAWEA MEDICAL CENTER - CAH,1174597173,Inpatient Hospitals (other than children's hospitals),510 8th Ave NE,,Hazen,ND,58545-4637,Mercer,517 8th Ave NE,,Hazen,ND,58545,Mercer,Pam Fitzgerald,Clinic Manager,701-748-2256,,pfitzgerald@smcnd.org,,,,,,
ND-007183,Sakakawea Hazen Clinic,SAKAKAWEA MEDICAL CENTER - CAH,1174597173,Rural Health Clinics,517 8th Ave NE,,Hazen,ND,58545-4637,Mercer,517 8th Ave NE,,Hazen,ND,58545,Mercer,Pam Fitzgerald,Clinic Manager,701-748-2256,,pfitzgerald@smcnd.org,,,,,,
ND-007184,COAL COUNTRY CHC - CENTER,COAL COUNTRY COMMUNITY HEALTH CENTER,1003052952,Federally Qualified Health Centers - Medical Services,111 Main St,,Hensler,ND,58530-4712,Oliver,1312 Hwy 49 N,,Beulah,ND,58523,Mercer,Darrold Bertsch,CEO,701-880-1440,,dbertsch@smcnd.org,,,,,,
ND-007185,Sanford Medical Center Hillsboro,Sanford,1184725194,Inpatient Hospitals (other than children's hospitals),12 3rd St SE,,Hillsboro,ND,58045-4840,Traill,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007186,Sanford Hillsboro Clinic,Sanford Health,1265464259,Rural Health Clinics,315 E Caledonia Ave,,Hillsboro,ND,58045-4701,Traill,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,karin.dulski@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007187,Coal Country Community Health Center,Coal Country Community Health Centers,1407235575,Federally Qualified Health Centers - Medical Services,150 Central Ave N,,Killdeer,ND,58640,Dunn,1312 Hwy 49 N,,Beulah,ND,58523,Mercer,Darrold Bertsch,CEO,701-873-4445,,dbertsch@smcnd.org,,,,,,
ND-007188,Sanford Health LaMoure Clinic,Sanford Health,1164439196,Rural Health Clinics,100 1st St SW,Suite 2,Lamoure,ND,58458-7419,Lamoure,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007189,Cavalier County Memorial Hospital Clinic,Cavalier County Memorial Hospital and Clinics,1730126640,Rural Health Clinics,901 2nd St,,Langdon,ND,58249-2407,Cavalier,909 2nd street,,Langdon,ND,58249,Cavalier,Chris Wyatt,CEO,701-256-6180,180,chrisw@ccmhnd.com,Darla Roder,Clinic Director,701-256-6120,236,darlar@ccmhnd.com,
ND-007190,Cavalier County Memorial Hospital,Cavalier County Memorial Hospital,1750328662,Inpatient Hospitals (other than children's hospitals),909 2nd St,,Langdon,ND,58249-2407,Cavalier,909 2nd street,909 2nd street,Langdon,ND,58249,Cavalier,Chris Wyatt,CEO,701-256-6180,180,chrisw@ccmhnd.com,,,,,,
ND-007191,Valley Community Health Centers Larimore,VALLEY COMMUNITY HEALTH CENTERS,1255317905,Federally Qualified Health Centers - Medical Services,607 Towner Ave,,Larimore,ND,58251-4501,Grand Forks,212 S 4th St Suite200,,Grand Forks,ND,58201,Grand Forks,Pat Lizakowski,business office,701-757-2100,2005,pat.lizakowski@valleychc.org,Ben Shannon,HR,701-757-2100,2008,ben.shannon@valleychc.org,
ND-007192,Ransom County Public Health - FP Satellite Clinic,Richland County Family Planning,1396820452,"Family Planning Providers, Sexually Transmitted Disease Clinics",404 Forest St,,Lisbon,ND,58054-4136,Ransom,413 N. 3rd Ave.,,Wahpeton,ND,58075,Richland,Jean Smith,Family Planning Clinic Director,701-642-7735,,jksmith@co.richland.nd.us,,,,,,
ND-007193,Heart of America Johnson Clinic Maddock,Good Samaritan Hospital Association,1740451038,Rural Health Clinics,301 Roosevelt Ave,,Maddock,ND,58348-7138,Benson,800 South Main Ave.,,Rugby,ND,58368-2118,Pierce,Dustin Hager,CMO / Clinic Manager,701-776-5235,,dhager@hamc.com,Ashley Wasvick,Administrative Assistant,701-776-5455,2842,awasvick@hamc.com,
ND-007194,Sanford Mayville Medical Center,Sanford,1518061803,Inpatient Hospitals (other than children's hospitals),42 6th Ave SE,,Mayville,ND,58257-1506,Traill,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
ND-007195,CHI - St. Francis Health - Milnor Clinic,CHI - St. Francis Health,1235215252,Rural Health Clinics,401 Main St,,Milnor,ND,58060-4001,Sargent,CHI - St. Francis Health,4200 St. Francis Drive,Breckenridge,MN,56520,Wilkin,Ross Pederson,Clinic Manager,218-643-0250,,rosspederson@catholichealth.net,David Nelson,CEO,218-643-0400,,davidnelson@catholichealth.net,
ND-007196,First District Health Unit,First District Health Unit,1245314533,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",801 11th Ave SW,,Minot,ND,58701-4274,Ward,PO Box 1268,,Minot,ND,58702,Ward,Beth Weidler,Ryan White Case Manager,701-852-1376,137,bjweidler@nd.gov,Penny Hamilton,Director of Nursing,701-852-1376,125,phamilton@nd.gov,
ND-007197,Elbowoods Memorial Health Center,Elbowoods Memorial Health Center,1831365519,"Dental Providers, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1058 College Dr,,New Town,ND,58763-9112,Mountrail,1058 College Drive,,New Town,ND,58763,Mountrail,Kathryn R. Eagle-Williams,Chief Executive Officer,701-627-4750,7791,kathy.eagle@mhahealth.com,Melissa Brady,Administrative Officer,701-627-4750,7614,Melissa.brady@mhahealth.com,
ND-007198,First Care Health Center,P R Health Corporation,1306850706,Rural Health Clinics,115 Vivian St W,,Park River,ND,58270-4540,Walsh,PO Box I,,Park River,ND,58270,Walsh,Louise Dryburgh,CEO,701-284-7500,538,louise.dryburgh@1stcarehc.com,Layne Ensrude,CFO,701-284-7500,540,layne.ensrude@1stcarehc.com,
ND-007199,Northland Community Health Center - Rolette,NORTHLAND HEALTH PARTNERS COMMUNITY,1689758039,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",402 2nd Ave,,Rolette,ND,58366,Rolette,104 Main St,,Turtle lake,ND,58575-4205,McLean,Nadine Boe,Director of Business Development,701-448-2054,,nboe@northlandchc.org,Jessica Westphal,Outreach and Enrollment Coordinator,701-448-2054,,jwestphal@northlandchc.org,
ND-007200,Northland Community Health Center - Rolette Dental,Northland Community Health Center,1235153099,Dental Providers,402 2nd Ave,,Rolette,ND,58366,Rolette,104 Main St,,Turtle lake,ND,58575,McLean,Patrick Butler,Chief Executive Officer,701-448-2054,,pbutler@northlandchc.org,Nadine Boe,Director of Busines Development,701-448-2054,,nboe@northlandchc.org,www.northlandchc.org
ND-007201,Heart of America Johnson Clinic Rugby,Good Samaritan Hospital Association DBA Heart of America Medical Center,1578734869,Rural Health Clinics,800 S Main Ave,,Rugby,ND,58368-2118,Pierce,800 South Main Avenue,,Rugby,ND,58368-2118,Pierce,Dustin Hager,CMO / Clinic Manager,701-776-5235,,dhager@hamc.com,Ashley Wasvick,Administrative Assistant,701-776-5455,2842,awasvick@hamc.com,
ND-007202,Mountrail County Medical Clinic,Mountrail County Health Center,1831289362,Rural Health Clinics,615 6th St SE,,Stanley,ND,58784-4444,Mountrail,615 6th st se,,Stanley,ND,58784-0399,Mountrail,Heather Lee,Revenue Cycle Director,701-628-2424,139,hlee@stanleyhealth.org,Wally Kowitz,CFO,701-628-2424,150,wkowitz@stanleyhealth.org,
ND-007203,Heart of America Johnson Clinic Towner,Good Samaritan Hospital Association DBA Heart of America Medical Center,1760908669,Outpatient Hospital Clinics,2 3rd St SW,,Towner,ND,58788,McHenry,800 South Main Ave,,Rugby,ND,58368-2118,Pierce,Dustin Hager,CMO / Clinic Manager,701-776-5235,,dhager@hamc.com,Ashley Wasvick,Administrative Assistant,701-776-5455,2842,awasvick@hamc.com,
ND-007204,Northland Community Health Center - Turtle Lake Dental,Northland Community Health Center,1568843878,Dental Providers,416 Kundert St,,Turtle Lake,ND,58575-4205,McLean,104 Main Street,,Turtle lake,ND,58575,McLean,Patrick Butler,Chief Executive Officer,701-448-2054,,pbutler@northlandchc.org,Nadine Boe,Director of Busines Development,701-448-2054,,nboe@northlandchc.org,www.northlandchc.org
ND-007205,Richland County Health Department,Richland County Health Department,1396820452,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",413 3rd Ave N,,Wahpeton,ND,58075-4427,Richland,413 N. 3rd Ave.,,Wahpeton,ND,58075,Richland,Jean Smith,Family Planning Clinic Director,701-642-7735,,jksmith@co.richland.nd.us,,,,,,www.richlandcountyhealth.org
ND-007206,Walhalla Clinic,Cavalier County Memorial Hospital,1497815310,Rural Health Clinics,301 5th St,,Walhalla,ND,58282-4625,Pembina,909 2nd St,,Langdon,ND,58249,Cavalier,Marcus Lewis,CFO,701-256-6177,6177,marcusl@ccmhnd.com,Darla Roder,COO,701-256-6236,6236,darlar@ccmhnd.com,
ND-007207,Family HealthCare West Fargo,Family HealthCare,1962863324,Federally Qualified Health Centers - Medical Services,726 13th Ave E,,West Fargo,ND,58078-3304,Cass,301 NP Avenue,,Fargo,ND,58102,Cass,Patrick Gulbranson,Chief Executive Officer,701-239-2285,,pgulbranson@famhealthcare.org,Mark Woolery,Chief Financial Officer,,,mwoolery@famhealthcare.org,
NE-007208,Heartland Family Medicine Alma Clinic,Harlan County Health System,1124035225,Rural Health Clinics,715 Brown St,,Alma,NE,68920-2132,Harlan,717 Brown Street,,Alma,NE,68920,Harlan,Manuela Wolf,CEO,308-928-2151,134,mwolf@harlancohealth.org,Candice Bell,Clinic Manager,308-928-2103,,cbell@harlancohealth.org,
NE-007209,HARLAN COUNTY HEALTH SYSTEM,Harlan County Health System,1124035225,Inpatient Hospitals (other than children's hospitals),717 Brown St,,Alma,NE,68920-2180,Harlan,717 North Brown,,Alma,NE,68920,Harlan,Manuela Wolf,CEO,308-928-2151,134,mwolf@harlancohealth.org,Suzanne Lans,CFO,308-928-2151,218,slans@harlancohealth.org,harlancountyhealth.com
NE-007210,Stuart,"Greater Sandhills Family Healthcare, PC",1902091671,Rural Health Clinics,418 E 5th St,PO Box 403,Atkinson,NE,68713-4885,Holt,PO Box 70,,Stuart,NE,68780,Holt,Elaine Tubbs,Business Manager,402-924-3777,,etubbs@nehp.net,"Erica Tubbs, PA-C",Site Director,402-924-3777,,erica_tubbs@yahoo.com,
NE-007211,Bassett,"Greater Sandhills Family Healthcare, PC",1295920981,Rural Health Clinics,101 E South St,Pob 143,Bassett,NE,68714-5508,Rock,PO Box 70,,Stuart,NE,68780,Holt,Elaine Tubbs,Business Manager,402-924-3777,,etubbs@nehp.net,"Erica Tubbs, PA-C",Site Director,402-924-3777,,erica_tubbs@yahoo.com,
NE-007212,Beatrice Internal Medicine,Beatrice Community Hospital & Health Center,1588002422,Rural Health Clinics,1201 N 10th St,,Beatrice,NE,68310-2003,Gage,4800 Hospital Parkway,,Beatrice,NE,68310,Gage,Carmen McKeever,Practice Administrator,402-228-3545,,cmckeever@bchhc.org,,,,,,
NE-007213,Beatrice Medical Center,Beatrice Community Hospital DBA Beatrice Medical Center,1306284237,Rural Health Clinics,805 W Court St,,Beatrice,NE,68310-3525,Gage,4800 Hospital Parkway,,Beatrice,NE,68310,Gage,Connie M Lovell,Practice Administrator,402-228-3366,,clovell@bchhc.org,Eric Trusty,Practice Administrator,402-223-6761,,etrusty@bchhc.org,
NE-007214,OneWorld Bellevue Clinic,"OneWorld Community Health Centers, Inc.",1295105112,"Dental Providers, Federally Qualified Health Centers - Medical Services",2207 Georgia Ave,,Bellevue,NE,68005-4524,Sarpy,4920 S 30th Street,Suite 103,Omaha,NE,68107,Douglas,Andrea Skolkin,Chief Executive Officer,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007215,VCHS Medical Clinic - Burwell,Valley County Health System,1942254222,"Family Planning Providers, Rural Health Clinics",150 N 9th Ave,Suite B,Burwell,NE,68823-4117,Garfield,2707 L St.,,Ord,NE,68862,Valley,Gary Satchell,CLINIC MANAGER,308-728-4202,4312,gsatchell@valleycountyhealthsystem.org,Ashley Woodward,CFO,308-728-4202,4351,awoodward@valleycountyhealthsystem.org,https://www.valleycountyhealthsystem.org/
NE-007216,CAPWN Dental Clinic-Chadron,COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA,1437261211,Dental Providers,221 Chadron Ave,,Chadron,NE,69337-2347,Dawes,3350 10th St,,Gering,NE,69341,Scotts Bluff,Sherry L Belgum,Operations Research Analyst,308-632-2540,3262,sbelgum@capwn.org,Jeff Tracy,COO,308-632-2540,3228,jtracy@capwn.org,
NE-007217,Western Community Health Resources,"Chadron Community Hospital, Corp dba Western Community Health Resources",1720145188,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",300 Shelton St,,Chadron,NE,69337-2312,Dawes,300 Shelton Street,,Chadron,NE,69337-2312,Dawes,Kimberly Ouderkirk,Billing Coordinator,308-432-8979,,dawesom@wchr.net,Sandy Roes,Director,308-432-8979,,director@wchr.net,www.wchr.net
NE-007218,Chadron Community Hospital (inpatient hospital),Chadron Community Hospital,1467675629,Inpatient Hospitals (other than children's hospitals),825 Centennial Dr,,Chadron,NE,69337-9400,Dawes,825 Centennial Dr,,Chadron,NE,69337,Dawes,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,
NE-007219,Chadron Community Hospital (outpatient hospital clinics),Chadron Community Hospital,1467675629,Outpatient Hospital Clinics,825 Centennial Dr,,Chadron,NE,69337-9400,Dawes,825 Centennial Dr,,Chadron,NE,69337,Dawes,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,
NE-007220,CHI HEALTH CLARKSON CLINIC,"Catholic Health Initiatives, Payer Strategy",1093890576,Rural Health Clinics,322 Pine St,,Clarkson,NE,68629-4094,Colfax,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
NE-007221,GOOD NEIGHBOR COMMUNITY HEALTH CENTER,EAST CENTRAL DISTRICT HEALTH DEPT,1740491786,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4321 41st Ave,,Columbus,NE,68601-2131,Platte,4321 41st Ave,,Columbus,NE,68601,Platte,Rebecca J Rayman,Executive Director,402-562-8950,210,rrayman@ecdhd.ne.gov,Kristie Stricklin,Chief Operating Officer,402-562-9000,258,kstricklin@ecdhd.ne.gov,www.ecdhd.ne.gov
NE-007222,Legend Buttes Health Services,Chadron Community Hospital dba Legend Buttes Health Services,1922269828,Rural Health Clinics,11 Paddock St,,Crawford,NE,69339-1143,Dawes,825 Centennial Dr,,Chadron,NE,69337,Dawes,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,Sandra Summers,Revenue Cycle Director,308-432-0264,,Medicare@Chadronhospital.com,
NE-007223,Avera Medical Group Crofton,Sacred Heart Health Services,1316206949,Rural Health Clinics,203 W Main St,PO Box 425,Crofton,NE,68730-3307,Knox,1000 W 4th ST STE 8,,Yankton,SD,57078,Yankton,Renae Brooks,Clinic Manager,605-655-1370,,rbrooks@avera.org,,,,,,
NE-007224,Burgess Family Clinic - Decatur,Burgess Health Center,1386836559,Rural Health Clinics,823 S Broadway St,,Decatur,NE,68020-2000,Burt,1600 Diamond,,Onawa,IA,51040,Monona,Teresa Butler,VP Clinical Services,712-423-9373,,tbutler@burgesshc.org,,,,,,www.burgesshc.org
NE-007225,The Fairbury Clinic,Jefferson Community Health Center Inc.,1922462902,Rural Health Clinics,825 22nd St,,Fairbury,NE,68352-1221,Jefferson,2200 H Street,,Fairbury,NE,68352,Jefferson,Chance Klasek,CFO,402-729-6856,,chance.klasek@jchc.us,,,,,,
NE-007226,Good Neighbor Fremont,East Central District Health Department,1902287261,"Dental Providers, Federally Qualified Health Centers - Medical Services",2400 N Lincoln Ave,,Fremont,NE,68025-2457,Dodge,4321 41st Ave,,Columbus,NE,68601,Platte,Rebecca Rayman,Executive Director,402-562-8950,210,rrayman@ecdhd.ne.gov,Kristie Stricklin,Chief Operating Officer,402-562-7500,258,kstricklin@ecdhd.ne.gov,www.ecdhd.ne.gov
NE-007227,"Fillmore County Medical Center, PC","Fillmore County Medical Center, PC",1740201771,Rural Health Clinics,1840 F Sreet,,Geneva,NE,68361,Fillmore,"Fillmore County Medical Center, PC",1840 F Street,Geneva,NE,68361,Fillmore,Karen A Leach,CLINIC MANAGER,402-759-4485,,kleach@fcmcpc.com,"Jason L Bespalec, MD",Owner/President,402-759-4485,,jbespalec@fcmcpc.com,
NE-007228,CAPWN Health Center,COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA,1437261211,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",975 Crescent Dr,,Gering,NE,69341-1712,Scotts Bluff,3350 10th St,,Gering,NE,69341-1724,Scotts Bluff,Sherry Belgum,Operations Research Analyst,308-632-2540,3262,sbelgum@capwn.org,Jeff Tracy,COO,308-632-2540,3228,jtracy@capwn.org,
NE-007229,GOTHENBURG MEMORIAL HOSPITAL,Gothenburg Memorial Hospital,1922051531,Inpatient Hospitals (other than children's hospitals),910 20th St,,Gothenburg,NE,69138-1253,Dawson,910 20th St.,,Gothenburg,NE,69138,Dawson,Mick Brant,CEO,308-537-3661,204,mbrant@gothenburghospital.org,Cassie Hilbers,CNO/CQO,308-537-3661,212,chilbers@gothenburghospital.org,
NE-007230,Gothenburg Rural Health Clinic,Gothenburg Memorial Hospital,1477953305,Rural Health Clinics,918 20th St,,Gothenburg,NE,69138-1237,Dawson,910 20th Street,,Gothenburg,NE,69138-1237,Dawson,Laura Urbanec,Compliance/Credentialing,308-537-4036,,lurbanec@ghospital.org,Taci Bartlett,CFO,308-537-3661,205,taci@ghospital.org,
NE-007231,"Central Health Center, Inc.","Central Health Center, Inc.",1912086257,Family Planning Providers,217 E Stolley Park Rd,Suite E,Grand Island,NE,68801-8206,Hall,217 E Stolley Park Rd,,Grand Island,NE,68801-8201,Hall,Brady Kerkman,Chief Executive Officer,308-384-7625,202,bkerkman@centralhealthcenter.org,,,,,,www.centralhealthcenter.org
NE-007232,CHI HEALTH ST FRANCIS,Catholic Health Initiatives,1982675955,Inpatient Hospitals (other than children's hospitals),2620 W Faidley Ave,,Grand Island,NE,68803-4205,Hall,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
NE-007233,Heartland Health Center,Heartland Health Center,1275954299,"Dental Providers, Federally Qualified Health Centers - Medical Services",3307 W Capital Ave,,Grand Island,NE,68803-1334,Hall,3307 W. Capital Avenue,,Grand Island,NE,68803,Hall,Sharon Rickman,CEO,308-382-4297,509,srickman@heartlandhealthcenter.org,Kari Wilcox,Finance Director,308-382-4297,512,kwilcox@heartlandhealthcenter.org,www.heartlandhealthcenter.org
NE-007234,Avera Medical Group Hartington,Sacred Heart Health Services,1518226190,Rural Health Clinics,405 W Darlene St,PO Box 937,Hartington,NE,68739-4806,Cedar,1000 W 4th ST STE 8,,Yankton,SD,57078,Yankton,Renae Brooks,Clinic Manager,605-655-1370,,rbrooks@avera.org,,,,,,
NE-007235,Community Health Center,Nebraska Reproductive Health Nebraska Dept of Health & Human Services,1831203488,Family Planning Providers,606 N Minnesota Ave,Suite 1,Hastings,NE,68901-5256,Adams,606 N. Minnesota Ave. Ste. 1,,Hastings,NE,68901,Adams,Deena Burbach,Clinic Manager,402-463-5687,,dburbach@marylanning.org,,,,,,
NE-007236,Hooper Medical Clinic,"Franciscan Care Services, Inc.",1609298074,Rural Health Clinics,600 E Fulton St,Suite A,Hooper,NE,68031-3074,Dodge,500 E Decatur St,,West Point,NE,68788-1566,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007237,Howells Family Practice,"Franciscan Care Services, Inc.",1598779456,Rural Health Clinics,119 S 3rd St,,Howells,NE,68641-3090,Colfax,500 E Decatur St,,West Point,NE,68788-1566,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007238,CHI HEALTH HOWELLS CLINIC,Catholic Health Initiatives,1801979653,Rural Health Clinics,121 S 6th St,PO Box 98,Howells,NE,68641-4067,Cuming,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
NE-007239,CHI HEALTH GOOD SAMARITAN,"Catholic Health Initiatives, Payer Strategy",1982675955,Inpatient Hospitals (other than children's hospitals),10 E 31st St,,Kearney,NE,68847-2908,Buffalo,7261 Mercy Road,,Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007240,Central Health Center Kearney Center,"Central Health Center, Inc.",1912086257,Family Planning Providers,4503 2nd Ave,Suite 209,Kearney,NE,68847-2432,Buffalo,4503 2nd Ave,,Kearney,NE,68847-2432,Buffalo,Brady Kerkman,Chief Executive Officer,308-384-7625,202,bkerkman@centralhealthcenter.org,,,,,,www.centralhealthcenter.org
NE-007241,LEXINGTON REGIONAL HEALTH CENTER,Lexington Regional Health Center,1316016165,Inpatient Hospitals (other than children's hospitals),1201 N Erie St,PO Box 980,Lexington,NE,68850-1560,Dawson,1201 North Erie Street,PO Box 980,Lexington,NE,68850,Dawson,Wade Eschenbrenner,CFO,308-324-8302,,weschenbrenner@lexrhc.org,Rebecca Walton,Executive Assistant,308-324-8303,,rwalton@lexrhc.org,www.lexingtonregional.org
NE-007242,Lexington Regional Health Center Family Medicine Specialists,Lexington Regional Health Center Family Medicine Specialists,1104228451,Rural Health Clinics,1201 N Erie St,PO Box 980,Lexington,NE,68850-1560,Dawson,1201 North Erie St,PO Box 980,Lexington,NE,68850,Dawson,Wade Eschenbrenner,CFO,308-324-8302,302,weschenbrenner@lexrhc.org,Rebecca Walton,Executive Assistant,308-324-8303,303,rwalton@lexrhc.org,http://www.lexingtonregional.org/
NE-007243,"Central Health Center, Inc. Lexington Center","Central Health Center, Inc.",1912086257,Family Planning Providers,1308 N Adams St,,Lexington,NE,68850-1201,Dawson,1308 N Adams St,,Lexington,NE,68850,Colfax,Brady Kerkman,Chief Executive Officer,308-384-7625,202,bkerkman@centralhealthcenter.org,,,,,,www.centralhealthcenter.org
NE-007244,People's Health Center,People's Health Center,1932156114,"Dental Providers, Federally Qualified Health Centers - Medical Services",1021 N 27th St,,Lincoln,NE,68503-1803,Lancaster,1021 N 27th St.,,Lincoln,NE,68503,Lancaster,Brad Meyer,Chief Executive Officer,402-470-5424,,bmeyer@phclincoln.org,,,,,,www.phclincoln.org
NE-007245,Meyer,People's Health Center,1326436577,Federally Qualified Health Centers - Medical Services,2246 O St,,Lincoln,NE,68510-1121,Lancaster,1021 N 27th St.,,Lincoln,NE,68503,Lancaster,Brad Meyer,Chief Executive Officer,402-470-5424,,bmeyer@phclincoln.org,,,,,,www.phclincoln.org
NE-007246,Health 360,People's Health Center,1326436577,"Dental Providers, Federally Qualified Health Centers - Medical Services",2300 O St,,Lincoln,NE,68510-1123,Lancaster,1021 N 27th St.,,Lincoln,NE,68503,Lancaster,Brad Meyer,Chief Executive Officer,402-470-5424,,bmeyer@phclincoln.org,,,,,,www.phclincoln.org
NE-007247,Nebraska Urban Indian Medical Center,Nebraska Urban Indian Health Coalition,1033184866,Federally Qualified Health Centers - Medical Services,2331 Fairfield St,Suite 1,Lincoln,NE,68521-1348,Lancaster,2240 Landon Court,,Omaha,NE,68102,Douglas,Ageda Montes de Oca,Business Manager,402-434-7177,309,amontesdeoca@nuihc.com,Donna Manstedt,Clinic Manager,402-434-7177,317,dmanstedt@nuihc.com,
NE-007248,Lincoln South Health Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,5631 S 48th St,Suite 100,Lincoln,NE,68516-4107,Lancaster,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
NE-007249,VCHS Medical Clinic - Loup City,Valley County Health System,1427495308,"Family Planning Providers, Rural Health Clinics",130 N 6th St,,Loup City,NE,68853-8005,Sherman,2707 L St.,,Ord,NE,68862,Valley,Gary Satchell,CLINIC MANAGER,308-728-4202,4312,gsatchell@valleycountyhealthsystem.org,Ashley Woodward,CFO,308-728-4202,4351,awoodward@valleycountyhealthsystem.org,https://www.valleycountyhealthsystem.org/
NE-007250,Carl T Curtis Health Education Center,Omaha Tribe of Nebraska,1114922143,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",100 Indian Hills Dr,,Macy,NE,68039-3023,Thurston,100 Indian Hills Drive,,Macy,NE,68039-0250,Thurston,Audrey Parker,Health Systems Specialist,402-846-5700,4308,audrey.parker@ihs.gov,Crystal Appleton,Business Office Manager,402-846-5700,4307,crystal.appleton@ihs.gov,
NE-007251,Madison Medical Clinic,"Midtown Health Center, Inc.",1740516764,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",222 S Main St,,Madison,NE,68748-6485,Madison,302 W Phillip Ave,,Norfolk,NE,68701,Madison,Kathy Nordby,Executive Director,402-371-8000,,knordby@midtownhealthne.org,Melodee Drenkow,Human Resource Director,402-371-8000,,mdrenkow@midtownhealthne.org,
NE-007252,Peoples Family Health Services McCook Clinic,Peoples Family Health Services Inc,1356656623,"Family Planning Providers, Sexually Transmitted Disease Clinics",111 W C St,PO Box 367,McCook,NE,69001-3613,Red Willow,102 South Elm Street,,North Platte,NE,69101,Lincoln,Rachel Stahr,Executive Director,308-534-3075,,exdir@pfhs.org,Pamela Johnson,Family Planning Coordinator,308-534-3077,,fpc@pfhs.org,
NE-007253,CHI HEALTH ST MARY'S,Catholic Health Initiatives,1528016995,Inpatient Hospitals (other than children's hospitals),1301 Grundman Blvd,,Nebraska City,NE,68410-3319,Otoe,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007254,Nebraska City Medical Clinic,"Catholic Health Initiatives, Payer Strategy",1851737316,Rural Health Clinics,1301 Grundman Blvd,Suite A,Nebraska City,NE,68410-3320,Otoe,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007255,Ponca Hills Health & Wellness,Ponca Hills Health & Wellness,1285987735,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",1800 Syracuse Ave,,Norfolk,NE,68701-2458,Madison,1800 Syracuse Ave,,Norfolk,NE,68701,Madison,Lawrence Voegele,CEO,402-734-5275,,lvoegele@poncatribe-ne.org,,,,,,
NE-007256,Midtown Health Center,"Midtown Health Center, Inc.",1487837696,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",302 W Phillip Ave,,Norfolk,NE,68701-5248,Madison,302 W Phillip Ave,,Norfolk,NE,68701-5248,Madison,Kathy Nordby,Executive Director,402-371-8000,,knordby@midtownhealthne.org,Melodee Drenkow,Human Resource Director,402-371-8000,,mdrenkow@midtownhealthne.org,
NE-007257,Peoples Family Health Services Inc,Nebraska Reproductive Health Nebraska Dept of Health & Human Services,1356656623,"Family Planning Providers, Sexually Transmitted Disease Clinics",102 S Elm St,,North Platte,NE,69101-5170,Lincoln,102 S Elm St,,North Platte,NE,69101,Lincoln,Rachel Stahr,Executive Director,308-534-3075,,exdir@pfhs.org,Pamela Johnson,Family Planning Coordinator,308-534-3077,,fpc@pfhs.org,
NE-007258,Oakland Family Practice,"Franciscan Care Services, Inc.",1790799658,Rural Health Clinics,100 W 9th St,,Oakland,NE,68045-1024,Burt,500 E Decatur St,,West Point,NE,68788-1566,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007259,Charles Drew Health Center - Siena Francis House,"Charles Drew Health Center, Inc.",1003100991,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1111 N 17th St,,Omaha,NE,68102-4102,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007260,Charles Drew Health Center,"Charles Drew Health Center, Inc.",1285941997,"Dental Providers, Federally Qualified Health Centers - Medical Services",1311 N 24th St,Kellom Elementary School,Omaha,NE,68102-4010,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007261,Charles Drew Health Center - Campus of HOPE,"Charles Drew Health Center, Inc.",1932493822,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1490 N 16th St,,Omaha,NE,68102-4101,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007262,"Oneworld Community Health Centers, Inc.","OneWorld Community Health Centers, Inc.",1164735759,Federally Qualified Health Centers - Medical Services,2021 Saint Marys Ave,Liberty Elementary School,Omaha,NE,68102-2415,Douglas,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007263,Fred LeRoy Health & Wellness Center,Fred LeRoy Health & Wellness Center,1710172879,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",2602 J St,,Omaha,NE,68107-1643,Douglas,2602 J St,,Omaha,NE,68107-1643,Douglas,Lawrence Voegele,Family Planning Coordinator,402-734-5275,,lvoegele@poncatribe-ne.org,Lawrence Voegele,Chief Executive Officer,402-734-5275,,lvoegele@poncatribe-ne.org,
NE-007264,Charles Drew Health Center,"Charles Drew Health Center, Inc.",1255302170,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Sexually Transmitted Disease Clinics",2915 Grant St,,Omaha,NE,68111-3863,Douglas,2915 Grant St.,,Omaha,NE,68111-3683,Douglas,Kenny D. McMorris,Chief Executive Officer,402-475-1245,,kenny.mcmorris@charlesdrew.com,Tarsha Jackson,Chief Financial Officer,402-457-1215,,tarsha.jackson@charlesdrew.com,
NE-007265,Northwest Health Center,Planned Parenthood of the Heartland,1144260027,Family Planning Providers,3105 N 93rd St,,Omaha,NE,68134-4717,Douglas,818 5th Ave,Suite 200,Des Moines,IA,50309-1307,Polk,Felicia Jenkins,Credentialing Specialist,515-235-0462,,felicia.jenkins@ppheartland.org,Jamie Bussell,Chief Financial Officer,515-235-0420,,jamie.bussell@ppheartland.org,http://www.ppheartland.org
NE-007266,"Oneworld Community Health Centers, Inc.","OneWorld Community Health Centers, Inc.",1063725554,Federally Qualified Health Centers - Medical Services,3121 U St,Indian Hill Elementary School,Omaha,NE,68107-3378,Douglas,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007267,Charles Drew Health Center - Evans Tower,"Charles Drew Health Center, Inc.",1023365582,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3600 N 24th St,,Omaha,NE,68110-1872,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007268,Charles Drew Health Center,"Charles Drew Health Center, Inc.",1639486343,"Dental Providers, Federally Qualified Health Centers - Medical Services",3720 Florence Blvd,King Science and Technology Magnet Middle School,Omaha,NE,68110-1737,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007269,Charles Drew Health Center,"Charles Drew Health Center, Inc.",1629385331,"Dental Providers, Federally Qualified Health Centers - Medical Services",3775 Curtis Ave,Belvedere Elementary School,Omaha,NE,68111-1169,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007270,OneWorld West,"OneWorld Community Health Centers, Inc.",1538417290,"Dental Providers, Federally Qualified Health Centers - Medical Services",4101 S 120th St,,Omaha,NE,68137-1250,Douglas,4920 South 30th Street,,Omaha,NE,68107,Douglas,Andrea M Skolkin,Chief Executive Officer,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007271,"Oneworld Community Health Centers, Inc.","OneWorld Community Health Centers, Inc.",1942513494,Federally Qualified Health Centers - Medical Services,4215 S 20th St,Spring Lake Magnet Elementary School,Omaha,NE,68107-2018,Douglas,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007272,Northwest Quick Sick Clinic,"OneWorld Community Health Centers, Inc.",1417388919,Federally Qualified Health Centers - Medical Services,4229 N 90th St,,Omaha,NE,68134-4136,Douglas,4920 South 30th Street,Suite 103,Omaha,NE,57107,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007273,OneWorld Community Health Centers Northwest Omaha,"OneWorld Community Health Centers, Inc.",1417388919,"Dental Providers, Federally Qualified Health Centers - Medical Services",4229 N 90th St,,Omaha,NE,68134-4136,Douglas,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007274,OneWorld Teen and Young Adult Clinic,"OneWorld Community Health Centers, Inc.",1144690074,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4310 S 24th St,,Omaha,NE,68107-1805,Douglas,4920 S 30th Street,Suite 103,Omaha,NE,68107,Douglas,Andrea Skolkin,Chief Executive Officer,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007275,Charles Drew Health Center - St. Richards,"Charles Drew Health Center, Inc.",1649653551,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4320 Fort St,,Omaha,NE,68111-1849,Douglas,2915 Grant St.,,Omaha,NE,68111,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007276,"Oneworld Community Health Centers, Inc.","OneWorld Community Health Centers, Inc.",1285977660,Federally Qualified Health Centers - Medical Services,4700 Giles Rd,Bryan High School,Omaha,NE,68157-2641,Sarpy,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007277,OneWorld Quick Sick Clinic,"OneWorld Community Health Centers, Inc.",1952330649,Federally Qualified Health Centers - Medical Services,4910 S 30th St,,Omaha,NE,68107-1519,Douglas,4920 S 30th Street,Suite 103,Omaha,NE,68107,Douglas,Andrea Skolkin,Chief Executive Officer,402-502-8845,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007278,OneWorld Livestock Exchange Building,"OneWorld Community Health Centers, Inc.",1952330649,"Dental Providers, Federally Qualified Health Centers - Medical Services",4920 S 30th St,,Omaha,NE,68107-1590,Douglas,4920 South 30th Street,,Omaha,NE,68107,Douglas,Andrea M Skolkin,Chief Executive Officer,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007279,OneWorld Women's Health Center,"OneWorld Community Health Center, Inc.",1952330649,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4930 S 30th St,,Omaha,NE,68107-1521,Douglas,4920 S 30th Street,Suite 103,Omaha,NE,68107,Douglas,Andrea Skolkin,Chief Executive Officer,402-502-8845,,askolkin@oneworldomaha.org,Joel Dougherty,Chief Operating Officer,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007280,Charles Drew Health Center - Florence Tower,"Charles Drew Health Center, Inc.",1952659930,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5100 Florence Blvd,,Omaha,NE,68110-5346,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007281,Charles Drew Health Center - Crown Tower,"Charles Drew Health Center, Inc.",1346597895,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5904 Henninger Dr,,Omaha,NE,68104-1258,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007282,Charles Drew Health Center - Jackson Tower,"Charles Drew Health Center, Inc.",1720335284,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 S 27th St,,Omaha,NE,68105-1502,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executive Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007283,CHI HEALTH CREIGHTON UNIVERSITY MEDICAL CENTER,"Catholic Health Initiatives, Payer Strategy",1811242969,Inpatient Hospitals (other than children's hospitals),601 N 30th St,,Omaha,NE,68131-2128,Douglas,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director of Payer Strategy and Operations,402-717-7424,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
NE-007284,CHI HEALTH IMMANUEL,"Catholic Health Initiatives, Payer Strategy",1912085184,Inpatient Hospitals (other than children's hospitals),6901 N 72nd St,,Omaha,NE,68122-1709,Douglas,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Directory Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007285,CHI HEALTH BERGAN MERCY,Catholic Health Initiatives,1508941097,Inpatient Hospitals (other than children's hospitals),7500 Mercy Rd,,Omaha,NE,68124-2319,Douglas,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007286,Specialty Care Center,Nebraska Medicine,1417912114,Ryan White Providers,804 S 52nd St,,Omaha,NE,68106-1802,Douglas,988106 Nebraska Medicine,,Omaha,NE,68198-8106,Douglas,"Susan Swindells, MBBS",Medical Director & Ryan White Part C & D Director,402-559-5392,,sswindells@unmc.edu,,,,,,http://unmc.edu/intmed/divisions/id/hiv/
NE-007287,Children's Hospital & Medical Center,Children's Hospital & Medical Center,1346297843,Children's Hospitals (inpatient only),8200 Dodge St,,Omaha,NE,68114-4113,Douglas,8200 Dodge Street,,Omaha,NE,68114,Douglas,Kelly Weiler,"Director, Managed Care",402-955-6826,,kweiler@childrensomaha.org,Michael Brown,SVP,402-955-4106,,mbrown@childrensomaha.org,https://www.childrensomaha.org/
NE-007288,Charles Drew Health Center,"Charles Drew Health Center, Inc.",1811260219,"Dental Providers, Federally Qualified Health Centers - Medical Services",8204 Crown Point Ave,Northwest High School,Omaha,NE,68134-1922,Douglas,2915 Grant St,,Omaha,NE,68111-3863,Douglas,Kenny McMorris,Chief Executve Officer,402-457-1245,,kenny.mcmorris@charlesdrew.com,,,,,,
NE-007289,Nebraska Hemophilia Treatment Center,University of Nebraska Medical Center,1609820240,Hemophilia Treatment Centers,982168 Nebraska Medical Ctr,Department Of Pediatrics,Omaha,NE,68198-2168,Douglas,982168 Nebraska Medical Center,Department of Pediatrics,Omaha,NE,68198-2168,Douglas,"James Harper, MD",Director and Principle Investigator,402-559-7257,,jlharper@unmc.edu,Betty Esser,Adminstrative Assistant,402-559-7257,,eesser@unmc.edu,
NE-007290,Valley County Health System,Valley County Health System,1528018561,"Family Planning Providers, Outpatient Hospital Clinics, Rural Health Clinics",2707 L St,,Ord,NE,68862-1275,Valley,2707 L Street,,Ord,NE,68862,Valley,Gary Satchell,CLINIC MANAGER,308-728-4202,4312,gsatchell@valleycountyhealthsystem.org,Ashley Woodward,CFO,308-728-4202,,awoodward@valleycountyhealthsystem.org,https://www.valleycountyhealthsystem.org/
NE-007291,Heartland Family Medicine Oxford Clinic,Harlan County Health System,1124035225,Rural Health Clinics,811 Howell St,,Oxford,NE,68967-6754,Furnas,717 North Brown,,Alma,NE,68920,Harlan,Manuela Wolf,CEO,308-928-2151,134,mwolf@harlancohealth.org,Candice Bell,Clinic Manager,308-928-2103,168,cbell@harlancohealth.org,
NE-007292,Pawnee County Memorial Hospital and Rural Health Clinic,Pawnee County Memorial Hospital and Rural Health Clinic,1851345573,Rural Health Clinics,600 I St,,Pawnee City,NE,68420-3001,Pawnee,P.O. Box 433,,Pawnee City,NE,68420,Pawnee,Ruth Stephens,CEO,402-852-2231,114,ruths@pcmhrhc.com,Barb Freeman,HIM Manager,402-852-2231,149,barbs@pcmhrhc.com,
NE-007293,Pawnee County Memorial Hospital and Rural Health Clinic,Pawnee County Memorial Hospital and Rural Health Clinic,1992759781,Inpatient Hospitals (other than children's hospitals),600 I St,,Pawnee City,NE,68420-3001,Pawnee,P.O. Box 433,600 I Street,Pawnee City,NE,68420,Pawnee,Ruth Stephens,CEO,402-852-2231,114,ruths@pcmhrhc.com,Barb Freeman,HIM Manager,402-852-2231,149,barbf@pcmhrhc.com,
NE-007294,CHI HEALTH PLAINVIEW,"Catholic Health Initiatives, Payer Strategy",1861765034,Inpatient Hospitals (other than children's hospitals),704 N 3rd St,,Plainview,NE,68769-2047,Pierce,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,chihealth.com
NE-007295,CHI HEALTH PLAINVIEW CLINIC,"Catholic Health Initiatives, Payer Strategy",1407128671,Rural Health Clinics,704 N 3rd St,,Plainview,NE,68769-2047,Pierce,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,"Director, Payer Strategy and Operations",402-717-7275,,IlsaBarnard2@Catholichealth.net,,,,,,chihealth.com
NE-007296,"OneWorld Community Health Centers, Inc. Cass Family Medicine","OneWorld Community Health Centers, Inc.",1952330649,Federally Qualified Health Centers - Medical Services,122 S 6th St,,Plattsmouth,NE,68048-1934,Cass,4920 S 30th St Ste 103,,Omaha,NE,68107-1656,Douglas,Andrea Skolkin,CEO,402-502-8842,,askolkin@oneworldomaha.org,Joel Dougherty,COO,402-502-8881,,jdougherty@oneworldomaha.org,www.oneworldomaha.org
NE-007297,WEBSTER COUNTY COMMUNITY HOSPITAL,WEBSTER COUNTY CLINIC,1144318023,Rural Health Clinics,721 W 6th Ave,PO Box 465,Red Cloud,NE,68970-2278,Webster,721 W 6TH AVENUE,PO BOX 465,RED CLOUD,NE,68970-0465,Webster,Stephanie Evert,Clinic Manager,402-746-5614,,severt@websterhospital.org,,,,,,www.websterhospital.org
NE-007298,CHI HEALTH SCHUYLER,Payer Strategy and Operations,1568547032,Inpatient Hospitals (other than children's hospitals),104 W 17th St,,Schuyler,NE,68661-1304,Colfax,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer and Strategy,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
NE-007299,CHI HEALTH SCHUYLER CLINIC,Payer Strategy and Operations,1184709669,Rural Health Clinics,1721 Colfax St,,Schuyler,NE,68661-1400,Colfax,7261 Mercy Road,"South Building, Third Floor",Omaha,NE,68124,Douglas,Ilsa Barnard,Director Payer Strategy and Operations,402-717-7275,,IlsaBarnard2@catholichealth.net,,,,,,
NE-007300,Scribner Medical Clinic,"Franciscan Care Services, Inc.",1891709721,Rural Health Clinics,429 Main St,,Scribner,NE,68057-3037,Dodge,500 E Decatur St,,West Point,NE,68788-1566,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007301,Siouxland Community Health of Nebraska,Siouxland Community Health Center,1558355305,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3410 Futures Dr,,South Sioux City,NE,68776-3917,Dakota,Siouxland Community Health Center,1021 Nebraska Street,Sioux City,IA,51105,Woodbury,Marilyn (Mari) Kaptain-Dahlen,CEO,712-202-1011,,mkaptaindahlen@slandchc.com,Jan Anderson,CFO,712-202-1001,,janderson@slandchc.com,www.slandchc.com
NE-007302,"Family Health Services, Inc.","Family Health Services, Inc.",1316045461,Family Planning Providers,509 Broadway St,,Tecumseh,NE,68450-2306,Johnson,509 Broadway Street,,Tecumseh,NE,68450,Johnson,Jean M. Brinkman,Ex. Director,402-335-2988,,jean.brinkman@fhsi.org,Amber Seitz,Program Manager,402-466-1012,,amber.seitz@fhsi.org,
NE-007303,St. Francis Memorial Hospital,"Franciscan Care Services, Inc.",1588673578,Inpatient Hospitals (other than children's hospitals),430 N Monitor St,,West Point,NE,68788-1555,Cuming,430 N Monitor St,,West Point,NE,68788,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007304,Dinklage Medical Clinic,"Franciscan Care Services, Inc.",1003923079,Rural Health Clinics,500 E Decatur St,,West Point,NE,68788-1565,Cuming,500 E Decatur St,,West Point,NE,68788,Cuming,Jerry J Wordekemper,President/CEO,402-372-2404,2101,jwordekemper@fcswp.org,Alisa Brunsing,Accounting Manager,402-372-6717,,abrunsing@fcswp.org,www.fcswp.org
NE-007305,Winnebago Hospital,Winnebago Hospital,1659392454,"Indian Health Service, Other ECP Providers",Hwy 77/75,PO Box HH,Winnebago,NE,68071-0767,Thurston,HH 77/75,P.O. Box HH,Winnebago,NE,68071,Thurston,TARIA WOLFE,Chief Executive Officer,402-878-2231,2159,TARIA.WOLFE@IHS.GOV,DENNIS HAAG,Business Office Manager,402-878-2331,2159,D.HAAG@WINNEBAGOHOSPITAL.GOV,
NE-007306,Winnebago Tribe of Nebraska Health,Winnebago Tribe of Nebraska,1497938542,"Community Mental Health Centers, Dental Providers, Tribal Health Program operated under P.L. 93-638",Hwy 77/75,,Winnebago,NE,68071,Thurston,225 So Bluff St,,Winnebago,NE,68071,Thurston,Mona Zuffante,Health Administrator,402-878-2294,1256,mona.zuffante@ihs.gov,,,,,,
NH-007307,Mid-State Health Center - Bristol,MID-STATE HEALTH CENTER,1225154065,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 Robie Rd,,Alexandria,NH,03222-6063,Grafton,101 Boulder Point Dr Ste 1,,Plymouth,NH,03264-3170,Grafton,Sharon Beaty,Chief Executive Officer,603-536-4000,1001,sbeaty@midstatehealth.org,William Sweeney,Chief Financial Officer,603-536-4000,1002,bsweeney@midstatehealth.org,http://midstatehealth.org/
NH-007308,Alton Family Medicine,Huggins Hospital,1871534792,Outpatient Hospital Clinics,27 New Durham Rd,,Alton,NH,03809-4917,Belknap,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007309,Antrim Medical Group,The Monadnock Community Hospital,1235483520,Rural Health Clinics,12 Elm St,,Antrim,NH,03440-3916,Hillsborough,452 Old Street Road,,Peterborough,NH,03458,Hillsborough,Rochelle Manuel-Sokol,Controller,603-924-4699,1739,rochelle.sokol@mchmail.org,Janet Willis,Director of Revenue Management,603-924-4699,4133,janet.willis@mchmail.org,
NH-007310,Pleasant Street Clinic,Coos County Family Health Services,1346242054,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",133 Pleasant St,,Berlin,NH,03570-2006,Coos,54 Willow St,,Berlin,NH,03570-2084,Coos,Kenneth E Gordon,CEO,603-752-3669,4018,kgordon@ccfhs.org,,,,,,http://www.coosfamilyhealth.org/
NH-007311,Androscoggin Valley Hospital,Androscoggin Valley Hospital,1386680593,Inpatient Hospitals (other than children's hospitals),59 Page Hill Rd,,Berlin,NH,03570-3531,Coos,59 Page Hill Road,,Berlin,NH,03570,Coos,Michael Peterson,President,603-326-5602,,michael.peterson@avhnh.org,Suzanne L. Landry,"Sr. Director, Admin and Revenue Cycle Services",603-326-5608,,suzanne.landry@avhnh.org,www.avhnh.org
NH-007312,AVH Surgical Associates,AVH Surgical Associates,1679526644,Outpatient Hospital Clinics,59 Page Hill Rd,,Berlin,NH,03570-3531,Coos,59 Page Hill Road,,Berlin,NH,03570,Coos,Michael Peterson,President,603-326-5602,,michael.peterson@avhnh.org,Suzanne Landry,"Sr. Director, Admin and Revenue Cycle Services",603-326-5608,,suzanne.landry@avhnh.org,www.avhnh.org
NH-007313,Page Hill Clinic,"COOS COUNTY FAMILY HEALTH SERVICES, INC.",1427050012,Federally Qualified Health Centers - Medical Services,59 Page Hill Rd,,Berlin,NH,03570-3531,Coos,133 Pleasant St,,Berlin,NH,03570-2006,Coos,Kenneth E Gordon,CEO,603-752-3669,4018,kgordon@ccfhs.org,,,603-752-3027,,,www.coosfamilyhealth.org
NH-007315,Charlestown Family Medicine,"Springfield Medical Care Systems, Inc.",1205161676,Federally Qualified Health Centers - Medical Services,125 Main St,,Charlestown,NH,03603-4914,Sullivan,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
NH-007316,Planned Parenthood of Northern New England- Claremont,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,136 Pleasant St,,Claremont,NH,03743-2651,Sullivan,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
NH-007317,Valley Regional Hospital,Valley Regional Hospital Inc.,1306933619,Inpatient Hospitals (other than children's hospitals),243 Elm St,,Claremont,NH,03743-4921,Sullivan,243 Elm Street,,Claremont,NH,03743,Sullivan,Peter Wright,CEO,603-542-3400,,peter.wright@vrh.org,Jean Shaw,CFO,603-542-3421,,jean.shaw@vrh.org,
NH-007318,INDIAN STREAM HEALTH CENTER,"Indian Stream Health Center, Inc.",1386673952,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",141 Corliss Ln,,Colebrook,NH,03576-3206,Coos,141 Corliss Lane,,Colebrook,NH,03576,Coos,Jonathan Brown,CEO,603-237-8336,,jbrown@indianstream.org,,,,,,
NH-007319,Upper Connecticut Valley Hospital,Upper Connecticut Valley Hospital,1861489437,Inpatient Hospitals (other than children's hospitals),181 Corliss Ln,,Colebrook,NH,03576-3207,Coos,181 Corliss Lane,,Colebrook,NH,03576,Coos,Scott G. Colby,President,603-388-4110,,scolby@ucvh.org,Celeste Pitts,Chief Financial Officer,603-788-5321,,Celeste.Pitts@weeksmedical.org,www.ucvh.org
NH-007320,White Mountain Community Health Center,White Mountain Community Health Center,1659470383,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics",298 White Mountain Hwy,PO Box 2800,Conway,NH,03818-4204,Carroll,298 White Mt,PO Box 2800,Conway,NH,03818,Carroll,Toni Howard,Billing Manager,603-447-8900,324,thoward@whitemountainhealth.org,,,,,,whitemountaincommunityheatlh.org
NH-007321,Planned Parenthood of Northern New England-Derry,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,4 Birch St,,Derry,NH,03038-2136,Rockingham,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,http://www.ppnne.org
NH-007322,Planned Parenthood of Northern New England-Exeter,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,108 High St,,Exeter,NH,03833-2939,Rockingham,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,http://www.ppnne.org
NH-007323,ACHS - Franconia,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1275742660,Federally Qualified Health Centers - Medical Services,1095 Profile Rd,Suite B,Franconia,NH,03580-4938,Grafton,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Edward D Shanshala,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007324,ACHS - Franconia,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1275742660,Federally Qualified Health Centers - Medical Services,155 Main St,,Franconia,NH,03580-4802,Grafton,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Edward D Shanshala,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007325,Franklin Regional Hospital,LRGHealthcare,1700960895,Inpatient Hospitals (other than children's hospitals),15 Aiken Ave,,Franklin,NH,03235-1259,Merrimack,80 Highland Street,,Laconia,NH,03246-3235,Belknap,Henry D Lipman,"Sr Vice President, Financial Strategy & External Relations",603-527-2802,2802,hlipman@lrgh.org,Lise Johnson,Credentialing Specialist,603-524-3211,6563,ljohnson@lrgh.org,
NH-007326,Westside Healthcare,LRGHealthcare,1689764912,Rural Health Clinics,15 Aiken Ave,,Franklin,NH,03235-1259,Merrimack,80 Highland Street,,Laconia,NH,03246-3235,Belknap,Henry D Lipman,"Sr Vice President, Financial Strategy & External Relations",603-527-2802,2802,hlipman@lrgh.org,Lise Johnson,Credentialing Specialist,603-524-3211,6563,ljohnson@lrgh.org,
NH-007327,"HEALTHFIRST FAMILY CARE CENTER, Inc.","HEALTHFIRST FAMILY CARE CENTER, Inc.",1134180367,Federally Qualified Health Centers - Medical Services,841 Central St,,Franklin,NH,03235-2053,Merrimack,841 Central Street,,Franklin,NH,03235-2053,Merrimack,Ted Bolognani,CFO,603-934-0177,115,tbolognani@healthfirstfamily.org,Richard Silverberg,CEO,603-934-0177,107,rsilverberg@healthfirstfamily.org,www.healthfirstfamily.org
NH-007328,Gorham Clinic,"COOS COUNTY FAMILY HEALTH SERVICES, INC.",1275535999,Federally Qualified Health Centers - Medical Services,2 Broadway Ave,,Gorham,NH,03581-1502,Coos,133 Pleasant St,,Berlin,NH,03570-2006,Coos,Kenneth E Gordon,CEO,603-752-3669,4018,kgordon@ccfhs.org,,,603-752-3027,,,http://www.coosfamilyhealth.org/
NH-007329,Joan G. Lovering Health Center,Feminist Health Center of Portsmouth,1376619585,"Family Planning Providers, Sexually Transmitted Disease Clinics",559 Portsmouth Ave,,Greenland,NH,03840-2251,Rockingham,559 Portsmouth Avenue,,Greenland,NH,03840,Rockingham,Linda Griebsch,Executive Director,603-436-7588,,lindag@jglhc.org,Sue Brinton,Accounts Receivable,603-436-7588,,sue@jglhc.org,www.jglhc.org
NH-007330,WEEKS MEDICAL CENTER - GROVETON,Weeks Medical Center,1205857372,Rural Health Clinics,47 Church St,,Groveton,NH,03582-4061,Coos,173 Middle Street,,Lancaster,NH,03584,Coos,Michael Lee,President,603-788-5030,,michael.lee@weeksmedical.org,Celeste Pitts,CFO,603-788-5321,,Celeste.Pitts@weeksmedical.org,
NH-007331,Hillsboro Family Health,Concord Hospital Inc,1801840764,"Family Planning Providers, Rural Health Clinics, Ryan White Providers",15 Antrim Rd,,Hillsboro,NH,03244-5250,Hillsborough,250 Pleasant Street,,Concord,NH,03301,Merrimack,Scott W. Sloane,CFO,603-227-7000,6059,ssloane@crhc.org,Kathy Smith,Director,603-227-7000,7463,katsmith@crhc.org,
NH-007332,Planned Parenthood of Northern New England-Keene,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,8 Middle St,,Keene,NH,03431-3305,Cheshire,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,http://www.ppnne.org
NH-007333,CAP Belknap Merrimack Co.,CAP Belknap Merrimack Co.,1821266578,Family Planning Providers,121 Belmont Rd,,Laconia,NH,03246-3725,Belknap,121 Belmont Rd,,Laconia,NH,03246-3725,Belknap,Susan Wnuk,Director Community Health and Nutrition Services,603-524-5453,,swnuk@bm-cap.org,Jean Boynton,Site Manager,603-524-5453,,jboynton@bmcap-lrfc.org,
NH-007334,HealthFirst Family Care Center - Laconia Office,"HEALTHFIRST FAMILY CARE CENTER, Inc.",1093080707,Federally Qualified Health Centers - Medical Services,22 Strafford St,Suite 1,Laconia,NH,03246-4702,Belknap,841 Central Street,,Franklin,NH,03235-2053,Merrimack,Ted Bolognani,CFO,603-934-0177,115,tbolognani@healthfirstfamily.org,Richard Silverberg,President and CEO,603-934-0177,107,rsilverberg@healthfirstfamily.org,www.healthfirstfamily.org
NH-007335,LRGHealthcare Dental Resource Center,"HEALTHFIRST FAMILY CARE CENTER, Inc.",1134180367,Dental Providers,29 Elliott St,,Laconia,NH,03246-3130,Belknap,841 Central Street,,Franklin,NH,03235,Merrimack,Ted Bolognani,CFO,603-934-0177,115,tbolognani@healthfirstfamily.org,Richard Silverberg,President and CEO,603-934-0177,107,rsilverberg@healthfirstfamily.org,www.healthfirstfamily.org
NH-007336,Lakes Region General Hospital,LRGHealthcare,1053495234,Inpatient Hospitals (other than children's hospitals),80 Highland St,,Laconia,NH,03246-3235,Belknap,80 Highland Street,,Laconia,NH,03246-3235,Belknap,Henry D Lipman,"Sr Vice President, Financial Strategy & External Relations",603-527-2802,2802,hlipman@lrgh.org,Lise Johnson,Credentialing Specialist,603-524-3211,6563,ljohnson@lrgh.org,
NH-007337,WEEKS MEDICAL CENTER - LANCASTER,Weeks Medical Center,1003820838,"Family Planning Providers, Rural Health Clinics",170 Middle St,,Lancaster,NH,03584-3556,Coos,173 Middle Street,,Lancaster,NH,03584,Coos,Michael Lee,President,603-788-5030,,michael.lee@weeksmedical.org,Celeste Pitts,,603-788-5321,,Celeste.Pitts@weeksmedical.org,
NH-007338,Weeks Medical Center,Weeks Medical Center,1265536718,Inpatient Hospitals (other than children's hospitals),173 Middle St,,Lancaster,NH,03584-3508,Coos,173 Middle St,,Lancaster,NH,03584-3508,Coos,Michael Lee,President,603-788-5030,5030,michael.lee@weeksmedical.org,Celeste Pitts,CFO,603-788-5321,5321,celestepitts@weeksmedical.org,weeksmedical.org
NH-007339,Weeks Medical Center - Physician Services,Weeks Medical Center,1548364003,Outpatient Hospital Clinics,173 Middle St,,Lancaster,NH,03584-3508,Coos,173 Middle Street,,Lancaster,NH,03584,Coos,Michael Lee,President,603-788-5030,,michael.lee@weeksmedical.org,Celeste Pitts,CFO,603-788-5321,,celestepitts@weeksmedical.org,
NH-007340,MARY HITCHCOCK MEMORIAL HOSPITAL (inpatient hospital),Mary Hitchcock Memorial Hospital,1023092053,Inpatient Hospitals (other than children's hospitals),1 Medical Center Dr,,Lebanon,NH,03756-1000,Grafton,1 Medical Center Dr,,Lebanon,NH,03756-1000,Grafton,Lynn M. Guillette,"Vice President, Payment Innovation",603-653-1255,,Lynn.m.guillette@hitchcock.org,Tammy L. Benoit,Contract Manager,603-653-1256,,tammy.l.benoit@hitchcock.org,http://www.dartmouth-hitchcock.org/
NH-007341,MARY HITCHCOCK MEMORIAL HOSPITAL (multiple outpatient ECP categories),Mary Hitchcock Memorial Hospital,1023092053,"Hemophilia Treatment Centers, Ryan White Providers",1 Medical Center Dr,,Lebanon,NH,03756-1000,Grafton,1 Medical Center Dr,,Lebanon,NH,03756-1000,Grafton,Lynn M. Guillette,"Vice President, Payment Innovation",603-653-1255,,Lynn.M.Guillette@Hitchcock.org,Tammy L. Benoit,"Director, Contract Administration",603-653-1256,,Tammy.L.Benoit@hitchcock.org,http://www.dartmouth-hitchcock.org/
NH-007342,Alice Peck Day Memorial Hospital,Alice Peck Day Memorial Hospital,1003803495,Inpatient Hospitals (other than children's hospitals),10 Alice Peck Day Dr,,Lebanon,NH,03766-2900,Grafton,Alice Peck Day Memorial Hospital,,Lebanon,NH,03766-2900,Grafton,Perla Fuenmayor,"Associate Vice President, Revenue Cycle Operations",603-448-7488,7488,fuenmayorp@apdmh.org,Timothy Graham,CFO,603-448-7453,7453,grahamt@apdmh.org,
NH-007343,ACHS - Dental,"Ammonoosuc Community Health Services, Inc.",1598716755,"Dental Providers, Federally Qualified Health Centers - Dental Services",202 Cottage St,,Littleton,NH,03561-4101,Grafton,25 Mount Eustis Road,,Littleton,NH,03561,Grafton,Kenneth L. Riebel,CFO,603-444-8220,,ken.riebel@achs-inc.org,Edward Shanshala,CEO,603-444-8223,,ed.shanshala@achs-inc.org,ammonoosuc.org
NH-007344,Ammonoosuc Community Health Services Inc,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1619196409,Federally Qualified Health Centers - Medical Services,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Edward D Shanshala,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007345,North Country Primary Care,Littleton Hospital Association,1811944523,Rural Health Clinics,580 Saint Johnsbury Rd,,Littleton,NH,03561-3437,Grafton,PO Box 160,,Littleton,NH,03561,Grafton,Andrew Majka,Chief Financial Officer,603-444-9504,,amajka@lrhcares.org,Amy Logue,Director PFS,603-444-9395,,alogue@lrhcares.org,littletonhospital.org
NH-007346,Littleton Regional Healthcare,Littleton Regional Healthcare,1144223702,Inpatient Hospitals (other than children's hospitals),600 Saint Johnsbury Rd,,Littleton,NH,03561-3442,Grafton,600 St Johnsbury Road,,Littleton,NH,03561,Grafton,Amy Logue,"Director, PFS",603-444-9395,,alogue@lrhcares.org,Andrew Majka,Chief Financial Officer,603-444-9504,,amajka@lrhcares.org,http://littletonhealthcare.org/
NH-007347,Child Health Services,MANCHESTER COMMUNITY HEALTH CENTER,1457744898,Federally Qualified Health Centers - Medical Services,1245 Elm St,,Manchester,NH,03101-1308,Hillsborough,145 Hollis St,,Manchester,NH,03101,Hillsborough,Kris McCracken,President/CEO,603-935-5210,,kmccracken@mchc-nh.org,Michele Croteau,CFO,605-935-5232,,mcroteau@mchc-nh.org,
NH-007348,MANCHESTER COMMUNITY HEALTH CENTER - Hollis Street,MANCHESTER COMMUNITY HEALTH CENTER,1083617013,Federally Qualified Health Centers - Medical Services,145 Hollis St,,Manchester,NH,03101-1235,Hillsborough,145 Hollis St,,Manchester,NH,03101,Hillsborough,Kris McCracken,President/CEO,603-935-5210,,kmccracken@mchc-nh.org,Michele Croteau,CFO,605-935-5232,,mcroteau@mchc-nh.org,
NH-007349,GREATER MANCHESTER MENTAL HLTH,MANCHESTER COMMUNITY HEALTH CENTER,1609848811,Community Mental Health Centers,1555 Elm St,,Manchester,NH,03101-1204,Hillsborough,145 Hollis St,,Manchester,NH,03101-1235,Hillsborough,Kris McCracken,President/CEO,603-935-5210,,kmccracken@mchc-nh.org,Lisa Deschenaum,VP of Administration,603-206-8565,,deschenl@mhcgm.org,
NH-007350,Health Care for the Homeless Program,Catholic Medical Center,1285928259,Federally Qualified Health Centers - Medical Services,177 Lake Ave,,Manchester,NH,03103-5321,Hillsborough,195 McGregor Street,Suite LL22,Manchester,NH,03102-3754,Hillsborough,Amy L Pratte,Office Coordinator,603-663-8701,,apratte@cmc-nh.org,Marianne J Savarese,Program Coordinator,603-663-8716,,msavarese@cmc-nh.org,
NH-007351,Tarrytown Road,MANCHESTER COMMUNITY HEALTH CENTER,1699012492,Federally Qualified Health Centers - Medical Services,184 Tarrytown Rd,,Manchester,NH,03103-2713,Hillsborough,145 Hollis St,,Manchester,NH,03101,Hillsborough,Kris McCracken,President/CEO,603-935-5210,,kmccracken@mchc-nh.org,Michele Croteau,CFO,605-935-5232,,mcroteau@mchc-nh.org,
NH-007352,Health Care for the Homeless Program,Catholic Medical Center,1942215819,Federally Qualified Health Centers - Medical Services,199 Manchester St,,Manchester,NH,03103-5232,Hillsborough,195 McGregor Street,Suite LL22,Manchester,NH,03102-3754,Hillsborough,Amy L Pratte,Office Coordinator,603-663-8701,,apratte@cmc-nh.org,Marianne Savarese,Program Coordinator,603-663-8716,,msavarese@cmc-nh.org,
NH-007353,Planned Parenthood of Northern New England-Manchester,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,24 Pennacook St,,Manchester,NH,03104-3554,Hillsborough,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,http://www.ppnne.org
NH-007354,West Side Neighborhood Health Center,MANCHESTER COMMUNITY HEALTH CENTER,1487022992,Federally Qualified Health Centers - Medical Services,88 McGregor St,,Manchester,NH,03102-3750,Hillsborough,145 Hollis St,,Manchester,NH,03101,Hillsborough,Kris McCracken,President/CEO,603-935-5210,,kmccracken@mchc-nh.org,Michele Croteau,CFO,605-935-5232,,mcroteau@mchc-nh.org,
NH-007355,Moultonborough Family Medicine,Huggins Hospital,1639166077,Outpatient Hospital Clinics,984 Whittier Hwy,,Moultonborough,NH,03254-3305,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007356,LAMPREY HEALTH CARE,"LAMPREY HEALTH CARE, INC.",1841202512,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",22 Prospect St,,Nashua,NH,03060-3924,Hillsborough,207 S Main St,,Newmarket,NH,03857-1835,Rockingham,Gregory A. White,Chief Executive Officer,603-292-7214,7214,gwhite@lampreyhealth.org,Evalie Crosby,Chief Financial Officer,603-292-7215,7215,ecrosby@lampreyhealth.org,
NH-007357,Harbor Care Health and Wellness Center,"HARBOR HOMES, INC.",1699705079,"Dental Providers, Federally Qualified Health Centers - Medical Services",45 High St,,Nashua,NH,03060-3312,Hillsborough,45 High St,,Nashua,NH,03060-3312,Hillsborough,Peter Kelleher,President,603-882-3616,,p.kelleher@nhpartnership.org,Carol Furlong,Vice President,603-882-3616,,c.furlong@nhpartnership.org,
NH-007358,Harbor Care Clinic and Wellness Center,"HARBOR HOMES, INC.",1699705079,Federally Qualified Health Centers - Medical Services,615 Amherst St,,Nashua,NH,03063-1052,Hillsborough,45 High St,,Nashua,NH,03060-3312,Hillsborough,Peter Kelleher,President,603-882-3616,,p.kelleher@nhpartnership.org,Carol Furlong,Vice President,603-882-3616,,c.furlong@nhpartnership.org,
NH-007359,Southern New Hampshire Medical Center,Southern New Hampshire Medical Center,1598700940,Inpatient Hospitals (other than children's hospitals),8 Prospect St,,Nashua,NH,03060-3925,Hillsborough,8 Prospect Street,,Nashua,NH,03060,Hillsborough,Emily Blatt,"Associate Vice President, Provider Contracting",603-281-9369,,emily.blatt@snhhs.org,Paul Trainor,Chief Financial Officer,603-281-9290,,paul.trainor@snhhs.org,
NH-007360,New London Hospital,"The New London Hospital Association, Inc.",1831200583,Inpatient Hospitals (other than children's hospitals),273 County Rd,,New London,NH,03257-5736,Merrimack,273 County Road,,New London,NH,03257-5736,Merrimack,Bruce P. King,President/CEO,603-526-2911,,bruce.king@newlondonhospital.org,Donald Griffin,Chief Financial Officer,603-526-2911,,donald.griffin@newlondonhospital.org,www.newlondonhospital.org
NH-007361,LAMPREY HEALTH CARE,"LAMPREY HEALTH CARE, INC.",1568412237,Federally Qualified Health Centers - Medical Services,207 S Main St,,Newmarket,NH,03857-1835,Rockingham,207 S Main St,,Newmarket,NH,03857-1835,Rockingham,Gregory A. White,Chief Executive Officer,603-292-7214,7214,gwhite@lampreyhealth.org,Evalie Crosby,Chief Financial Officer,603-292-7215,7215,ecrosby@lampreyhealth.org,
NH-007362,Newport Health Center,"The New London Hospital Association, Inc.",1770684672,Rural Health Clinics,11 John Stark Hwy,,Newport,NH,03773-1807,Sullivan,273 County Road,,New London,NH,03257,Merrimack,Bruce P. King,President/CEO,603-526-2911,,bruce.king@newlondonhospital.org,Donald Griffin,Chief Financial Officer,603-526-2911,,donald.griffin@newlondonhospital.org,www.newlondonhospital.org
NH-007363,The Memorial Hospital,MEMORIAL HOSPITAL,1700864709,Inpatient Hospitals (other than children's hospitals),3073 White Mountain Hwy,,North Conway,NH,03860-7101,Carroll,3073 White Mountain Hwy,,North Conway,NH,03860-7101,Carroll,Diana McLaughlin,Interim Vice President of Finance,603-356-5461,2537,djmclaugh@memorialhospitalnh.org,Ann Bento,Administrative Coordinator,603-356-5461,2405,abento@memorialhospitalnh.org,
NH-007364,Weeks Medical Center - North Stratford,Weeks Medical Center,1669739454,Rural Health Clinics,43 Main St,,North Stratford,NH,03590-4005,Coos,43 Main St,,North Stratford,NH,03590-4005,Coos,Mike Lee,CEO,603-788-5030,5030,michael.lee@weeksmedical.org,Celeste Pitts,CFO,603-788-5321,,Celeste.Pitts@weeksmedical.org,
NH-007365,CAP Belknap Merrimack Co.,CAP Belknap Merrimack Co.,1821266578,Family Planning Providers,127 Route 28,Mountainside Business Ctr,Ossipee,NH,03864-7300,Carroll,127 Route 28,Mountainside Business,Ossipee,NH,03864-7300,Carroll,Susan Wnuk,Director Community Health and Nutrition Services,603-225-3295,1158,swnuk@bm-cap.org,Jean Boynton,Site Manager,603-524-5453,,jboynton@bmcap-lrfc.org,
NH-007366,Ossipee Family Medicine,Huggins Hospital,1619094075,Outpatient Hospital Clinics,3 Water Village Rd,,Ossipee,NH,03864-7268,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007367,The Monadnock Community Hospital,The Monadnock Community Hospital,1457304149,Other ECP Providers,452 Old Street Rd,,Peterborough,NH,03458-1263,Hillsborough,452 Old Street Road,,Peterborough,NH,03458,Hillsborough,Rochelle Manuel-Sokol,Controller,603-924-4699,1739,rochelle.sokol@mchmail.org,Janet Willis,Director of Revenue Management,603-924-4699,4133,janet.willis@mchmail.org,
NH-007368,Mid-State Health Center - Plymouth,MID-STATE HEALTH CENTER,1235170549,Federally Qualified Health Centers - Medical Services,101 Boulder Point Dr,Suite 1,Plymouth,NH,03264-3170,Grafton,101 Boulder Point Dr Ste 1,,Plymouth,NH,03264-3170,Grafton,Sharon Beaty,Chief Executive Officer,603-536-4000,1001,sbeaty@midstatehealth.org,William Sweeney,Chief Financial Officer,603-536-4000,1002,bsweeney@midstatehealth.org,http://midstatehealth.org/
NH-007369,Speare Primary Care,Speare Memorial Hospital,1841342540,Rural Health Clinics,103 Boulder Point Dr,,Plymouth,NH,03264-3168,Grafton,16 Hospital Road,,Plymouth,NH,03264,Grafton,Thomas Lenkowski,C.F.O.,603-238-2218,,tlenkowski@spearehospital.com,Michelle McEwen,C.E.O.,603-238-2230,,mmcewen@spearehospital.com,
NH-007370,Plymouth OB/GYN,Speare Memorial Hospital,1437291515,Rural Health Clinics,16 Hospital Rd,,Plymouth,NH,03264-1126,Grafton,16 Hospital Road,,Plymouth,NH,03264,Grafton,Thomas Lenkowski,C.F.O.,603-238-2218,,tlenkowski@spearehospital.com,Michelle McEwen,C.E.O.,603-238-2230,,mmcewen@spearehospital.com,
NH-007371,Speare Memorial Hospital,Speare Memorial Hospital,1760496376,Inpatient Hospitals (other than children's hospitals),16 Hospital Rd,,Plymouth,NH,03264-1126,Grafton,16 Hospital Road,,Plymouth,NH,03264,Grafton,Thomas Lenkowski,C.F.O.,603-238-2218,,tlenkowski@spearehospital.com,Michelle McEwen,C.E.O.,603-238-2230,,mmcewen@spearehospital.com,
NH-007372,Families First Dental Program,"FAMILIES FIRST OF THE GREATER SEACOAST, INC",1811150519,Dental Providers,100 Campus Dr,Suite 12,Portsmouth,NH,03801-5892,Rockingham,100 Campus Drive,Suite 12,Portsmouth,NH,03801-5892,Rockingham,Helen Taft,Executive Director,603-422-8208,120,htaft@familiesfirstseacoast.org,Sandie York,IT Director,603-422-8208,103,syork@familiesfirstseacoast.org,http://www.familiesfirstseacoast.org
NH-007373,FAMILIES FIRST HEALTH CENTER,"FAMILIES FIRST OF THE GREATER SEACOAST, INC",1639339948,Federally Qualified Health Centers - Medical Services,100 Campus Dr,Suite 12,Portsmouth,NH,03801-5892,Rockingham,100 Campus Drive,Suite 12,Portsmouth,NH,03801-5892,Rockingham,Helen Taft,Executive Director,603-422-8208,120,htaft@familiesfirstseacoast.org,Sandie York,IT Director,603-422-8208,103,syork@familiesfirstseacoast.org,http://www.familiesfirstseacoast.org
NH-007374,Cross Roads House,"FAMILIES FIRST OF THE GREATER SEA COAST, INC",1881978658,Federally Qualified Health Centers - Medical Services,600 Lafayette Rd,Room 120,Portsmouth,NH,03801-5435,Rockingham,100 Campus Drive,Suite 12,Portsmouth,NH,03801-5892,Rockingham,Helen Taft,Executive Director,603-422-8208,120,htaft@familiesfirstseacoast.org,Sandie York,IT Director,603-422-8208,103,syork@familiesfirstseacoast.org,http://www.familiesfirstseacoast.org
NH-007375,LAMPREY HEALTH CARE,"LAMPREY HEALTH CARE, INC.",1811909617,Federally Qualified Health Centers - Medical Services,128 Route 27,,Raymond,NH,03077-1230,Rockingham,207 S Main St,,Newmarket,NH,03857-1835,Rockingham,Gregory A. White,Chief Executive Officer,603-292-7214,7214,gwhite@lampreyhealth.org,Evalie Crosby,Chief Financial Officer,603-292-7215,7215,ecrosby@lampreyhealth.org,
NH-007376,Greater Seacoast Community Health,Greater Seacoast Community Health,1578854287,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",311 Route 108,,Somersworth,NH,03878-1522,Strafford,311 Route 108,,Somersworth,NH,03878,Strafford,Elizabeth Carmer,Administrative Assistant,603-953-0065,,ecarmer@goodwinch.org,Erin Ross,CFO,603-516-2549,549,eross@goodwinch.org,www.goodwinch.org
NH-007377,Tamworth Family Medicine,Huggins Hospital,1255587937,Outpatient Hospital Clinics,577 White Mountain Hwy,,Tamworth,NH,03886-4631,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007378,ACHS - Warren,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1982821765,Federally Qualified Health Centers - Medical Services,333 NH Route 25,,Warren,NH,03279-4431,Grafton,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Edward D Shanshala,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007379,ACHS - Whitefield,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1164631552,Federally Qualified Health Centers - Medical Services,14 King Sq Frnt 100,,Whitefield,NH,03598-3346,Coos,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Edward D Shanshala,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007380,Weeks Medical Center-Whitefield,Weeks Medical Center,1508819566,"Family Planning Providers, Rural Health Clinics",8 Clover Ln,,Whitefield,NH,03598-3343,Coos,173 Middle Street,,Lancaster,NH,03584,Coos,Michael Lee,President,603-788-5030,5030,michael.lee@weeksmedical.org,Celeste Pitts,CFO,603-788-5321,,Celeste.Pitts@weeksmedical.org,
NH-007381,Huggins Hospital,Huggins Hospital,1366476079,Inpatient Hospitals (other than children's hospitals),240 S Main St,,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget and Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007382,Internal Medicine Associates of Wolfeboro,Huggins Hospital,1437147584,Outpatient Hospital Clinics,240 S Main St,Suite J,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007383,Orthopedic Surgeons,Huggins Hospital,1730126459,Outpatient Hospital Clinics,240 S Main St,,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007384,Wolfeboro Family Medicine,Huggins Hospital,1568459931,Outpatient Hospital Clinics,240 S Main St,,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,Suite A,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007385,Wolfeboro General Surgery,Huggins Hospital,1255313326,Outpatient Hospital Clinics,240 S Main St,,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007386,Wolfeboro Pediatrics,Huggins Hospital,1629091830,Outpatient Hospital Clinics,240 S Main St,Suite C,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007387,Wolfeboro Women's Health,Huggins Hospital,1881689354,Outpatient Hospital Clinics,240 S Main St,,Wolfeboro,NH,03894-4411,Carroll,240 South Main Street,,Wolfeboro,NH,03894,Carroll,Jeremy Roberge,President & CEO,603-569-7510,,jroberge@hugginshospital.org,Henry Isaacson,Director of Budget & Reimbursement,603-569-7571,,hisaacson@hugginshospital.org,www.hugginshospital.org
NH-007388,Rowe Health Center,Cottage Hospital,1275857328,Rural Health Clinics,103 Swiftwater Rd,,Woodsville,NH,03785-1423,Grafton,103 Swiftwater Road,,Woodsville,NH,03785,Grafton,Steven Plant,Chief Financial Officer,603-747-9146,,splant@cottagehospital.org,,,,,,
NH-007389,ACHS - Woodsville,AMMONOOSUC COMMUNITY HEALTH SERVICES INC,1437376209,Federally Qualified Health Centers - Medical Services,79 Swiftwater Rd,,Woodsville,NH,03785-1447,Grafton,25 Mount Eustis Rd,,Littleton,NH,03561-3712,Grafton,Kenneth Riebel,Chief Executive Officer,603-444-8223,,Ed.Shanshala@ACHS-Inc.Org,Kenneth Riebel,Chief Financial Officer,603-444-8220,,ken.riebel@achs-inc.org,
NH-007390,Cottage Hospital,Cottage Hospital,1528162799,Inpatient Hospitals (other than children's hospitals),90 Swiftwater Rd,,Woodsville,NH,03785-1421,Grafton,90 Swiftwater Road,,Woodsville,NH,03785,Grafton,Steven Plant,Chief Financial Officer,603-747-9146,,splant@cottagehospital.org,,,,,,
NJ-007391,VNACJ CHC Asbury Park,"Visiting Nurse Association of Central Jersey Community Health Center, Inc.",1841240561,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1301 Main St,,Asbury Park,NJ,07712-5359,Monmouth,1301 Main Street Asbury Park,,Asbury Park,NJ,07712,Monmouth,Amanda Caruso,Executive Assistant and Grant Project Manager,732-502-5150,,amanda.caruso@vnahg.org,Dr. Kristine McCoy,Executive Director,732-502-5151,,Kristine.McCoy@vnahg.org,
NJ-007392,Women and Children's Health Pavilion,"Southern Jersey Family Medical Centers, Inc.",1598939506,Federally Qualified Health Centers - Medical Services,1125 Atlantic Ave,Suite 101,Atlantic City,NJ,08401-4806,Atlantic,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007393,Atlantic City Center,"Southern Jersey Family Medical Centers, Inc.",1285758318,"Dental Providers, Federally Qualified Health Centers - Medical Services",1301 Atlantic Ave,,Atlantic City,NJ,08401-7247,Atlantic,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007394,AtlantiCare Regional Medical Center-Infectious Disease Clinic,AtlantiCare Regional Medical Center,1568663250,Ryan White Providers,1401 Atlantic Ave,Suite 2200,Atlantic City,NJ,08401-7022,Atlantic,1925 Pacific Ave,,Atlantic City,NJ,08401,Atlantic,Harmeet Chawla,Practice Manager,609-572-6024,6095726024,harmeet.chawla@Atlanticare.org,Sandra Festa,Executive Director,609-572-6000,,Sandra.Festa@atlanticare.org,
NJ-007395,Mission Healthcare Healthplex,AtlantiCare Health Services,1760527782,Federally Qualified Health Centers - Medical Services,1401 Atlantic Ave,Suite 2600,Atlantic City,NJ,08401-7022,Atlantic,1401 Atlantic Ave,Suite 2600,Atlantic City,NJ,08401,Atlantic,Sumer Smith,Practice Manager,609-572-8515,,sumer.smith@atlanticare.org,Sandy Festa,CEO,609-412-8969,,sandy.festa@atlanticare.org,
NJ-007396,Mission Health Care,AtlantiCare Health Services,1215987771,Federally Qualified Health Centers - Medical Services,2009 Bacharach Blvd,,Atlantic City,NJ,08401-3003,Atlantic,2009 Bacharach Blvd,,Atlantic City,NJ,08401,Atlantic,Sumer Smith,CEO,609-512-8515,,sumer.smith@atlanticare.org,Sumer Smith,Practice Coordinator,609-572-8515,,sumer.smith@atlanticare.org,
NJ-007397,Mission Health Care - Covenant House,AtlantiCare Health Services,1497704845,Federally Qualified Health Centers - Medical Services,929 Atlantic Ave,,Atlantic City,NJ,08401-7401,Atlantic,1401 Atlantic Ave,Suite 2600,Atlantic City,NJ,08401,Atlantic,Sumer Smith,Office Manager,609-572-8515,,sumer.smith@atlanticare.org,Sandy Festa,Executive Director,609-412-8969,,Sandra.Festa@atlanticare.org,
NJ-007398,PPNCSNJ Bellmawr Clinic,"Planned Parenthood of Northern, Central, and Southern New Jersey, Inc",1629186374,Family Planning Providers,35 E Browning Rd,,Bellmawr,NJ,08031-2345,Camden,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,
NJ-007399,RiteCare at Upper Deerfield ShopRite,"COMMUNITY HEALTH CARE, INC.",1912163817,Federally Qualified Health Centers - Medical Services,1000 N Pearl St,,Bridgeton,NJ,08302-1215,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007400,Bridgeton Women's Medical Professionals,"COMMUNITY HEALTH CARE, INC.",1720198740,"Dental Providers, Federally Qualified Health Centers - Medical Services",105 Manheim Ave,Suite 11,Bridgeton,NJ,08302-2139,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007401,"COMMUNITY HEALTH CARE, INC.","COMMUNITY HEALTH CARE, INC.",1407959588,Federally Qualified Health Centers - Medical Services,111 N West Ave,Teen Center at Bridgeton High School,Bridgeton,NJ,08302-1348,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,http://completecarenj.org/services/school-services/teen-center/
NJ-007402,"Community Health Center, Inc.","COMMUNITY HEALTH CARE, INC.",1790103679,Family Planning Providers,1369 Highway 77,Upper Deerfield Township Schools,Bridgeton,NJ,08302-5997,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007403,Bridgeton Pediatric and Family Medical Professionals,"COMMUNITY HEALTH CARE, INC.",1215242516,Federally Qualified Health Centers - Medical Services,265 Irving Ave,,Bridgeton,NJ,08302-2121,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007404,Famcare Inc. Bridgeton,"Famcare, Inc.",1093053738,Family Planning Providers,30 Magnolia Ave,,Bridgeton,NJ,08302-1721,Cumberland,30 Magnolia Ave,,Bridgeton,NJ,08302-1721,Cumberland,Dawn Hickman,CEO,856-881-9531,,dhickman@famcareinc.org,Rebecca Brady,COO,856-794-1235,1213,rbrady@famcareinc.org,http://www.famcareinc.com
NJ-007405,Bridgeton Adult & Specialty Medical Professionals,"COMMUNITY HEALTH CARE, INC.",1700816816,Federally Qualified Health Centers - Medical Services,70 Cohansey St,,Bridgeton,NJ,08302-1918,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007406,Burlington City Office,"Southern Jersey Family Medical Centers, Inc.",1265557326,Federally Qualified Health Centers - Medical Services,651 High St,,Burlington,NJ,08016-2737,Burlington,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007407,PPNCSNJ Camden Clinic,"Planned Parenthood of Northern, Central and Southern New Jersey, Inc",1629186374,Family Planning Providers,317 S Broadway,,Camden,NJ,08103-1209,Camden,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,
NJ-007408,West Street Health Center,"Project H.O.P.E., Inc.",1891969218,Federally Qualified Health Centers - Medical Services,519-525 West Street,,Camden,NJ,08103,Camden,519-525 West Street,,Camden,NJ,08103,Camden,Patricia DeShields,CEO,856-541-6092,1016,deshieldsp@projecthopecamden.org,Dorcas J Hagerty,Director of Operations,856-541-6092,1014,hagertyd@projecthopecamden.org,
NJ-007409,Cape May Medical Professionals,"COMMUNITY HEALTH CARE, INC.",1689785610,Federally Qualified Health Centers - Medical Services,3 Broadway,,Cape May Court House,NJ,08210-1937,Cape May,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007410,Cape May Co. Dept. of Health Family Planning Program,Cape May Co Department of Health Family Planning Program,1710008255,Family Planning Providers,6 Moore Rd,,Cape May Court House,NJ,08210-1654,Cape May,6 Moore Rd,,Cape May Court House,NJ,08210-1654,Cape May,Natalie Sendler,Clinic Administrator,609-465-6841,,natalie.sendler@co.cape-may.nj.us,Mary Thighe,Assistant Director,609-465-6825,,mary.thighe@co.cape-may.nj.us,http://www.co.cape-may.nj.us/cit-e-access/webpage.cfm?TID=5&TPID=2936
NJ-007411,PPNCSNJ Delran Clinic,"Planned Parenthood of Northern, Central and Southern New Jersey, Inc",1629186374,Family Planning Providers,8008 Route 130 Bldg B Ste 305,Delran Professional Center,Delran,NJ,08075-1869,Burlington,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,
NJ-007412,Zufall Health Center - Dover Dental,"Zufall Health Center, INC",1902990880,Dental Providers,17 S Warren St,,Dover,NJ,07801-4506,Morris,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,Raksha Tripathi,CFO,973-328-9100,310,rtripathi@zufallhealth.org,
NJ-007413,Zufall Health Center,"Zufall Health Center, INC",1548515091,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",18 W Blackwell St,,Dover,NJ,07801-3841,Morris,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,Raksha Tripathi,CFO,973-328-9100,,rtripathi@zufallhealth.org,
NJ-007414,Hope House,Catholic Family & Community Services,1194105833,"Other ECP Providers, Ryan White Providers",19-21 Belmont Ave,,Dover,NJ,07801-4107,Morris,24 De Grasse Street,,Paterson,NJ,07505,Passaic,CHRIS BARTON,Executive Director,973-279-7100,2021,CBARTON@CATHOLICHARITIES.ORG,B Jacob,Chief Finance Officer,973-279-7100,2026,bjacob@catholicharities.org,www.catholicharities.org
NJ-007415,PPMNJ- East Orange Clinic,Planned Parenthood of Metropolitan NJ,1508839804,Family Planning Providers,560 Dr Martin Luther Kin,,East Orange,NJ,07018,Essex,238 Mulberry St,1st floor,Newark,NJ,07102,Essex,Joanna Lewin,V.P for Finance,973-622-3900,1223,joanna.lewin@ppmnj.org,Kathy Butts,Controller,973-622-3900,1226,kathy.butts@ppmnj.org,http://www.plannedparenthood.org/ppmnj/
NJ-007416,PPNCSNJ Elizabeth Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1508930561,Family Planning Providers,1171 Elizabeth Ave,,Elizabeth,NJ,07201-2200,Union,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007417,Neighborhood Health Services Elizabeth,Neighborhood Health Services Corporation,1538383666,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",184 1st St,,Elizabeth,NJ,07206-1855,Union,1700 Myrtle Ave,,Plainfield,NJ,07063,Union,Esie Clodomir-Dennis,Director of Patient Financial Services,908-546-1244,,kpowell@nhscnj.org,Barbara Ferguson,,908-731-7401,,bferguson@nhscnj.org,www.nhscnj.org
NJ-007418,Early Intervention Program,Trinitas Regional Medical Center,1770583999,Ryan White Providers,655 Livingston St Bldg 2,Monastery Floor,Elizabeth,NJ,07206-1391,Union,Trinitas Regional Medical Center - NPC,655 East Jersey Street,Elizabeth,NJ,07206,Union,Judith A. Lacinak,Director - HIV Services,908-994-7605,,jlacinak@trinitas.org,,,,,,www.trinitasrmc.org
NJ-007419,North Hudson Community Action Corporation Health Center @ Englewood,North Hudson Community Action Corporation,1902167463,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",197 S Van Brunt St,,Englewood,NJ,07631-4010,Bergen,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007420,PPNCSNJ Englewood Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1770657736,Family Planning Providers,46 N Van Brunt St,,Englewood,NJ,07631-2707,Bergen,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007421,PPNCSNJ TCNJ Clinic,"Planned Parenthood of Northern, Central and Southern New Jersey, Inc.",1831570860,Family Planning Providers,2000 Pennington Rd,,Ewing,NJ,08618-1104,Mercer,196 Speedwell Ave.,,Morristown,NJ,07960,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007422,PPNCSNJ Flemington Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1700953056,Family Planning Providers,349 State Route 31 Ste 503,Bldg. B,Flemington,NJ,08822-5777,Hunterdon,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007423,Zufall Healthy Smile Center,"Zufall Health Center, INC",1538597018,Dental Providers,361 State Route 31 Ste 701,Bldg C,Flemington,NJ,08822-5797,Hunterdon,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,,,,,,
NJ-007424,PPNCSNJ Freehold Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1326301979,Family Planning Providers,800 W Main St,,Freehold,NJ,07728-2554,Monmouth,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007425,PPNCSNJ Stockton University,"Planned Parenthood of Northern, Central and Southern New Jersey, Inc",1629186374,Family Planning Providers,Stockton University,West Quad Building Suite 108,Galloway,NJ,08205,Atlantic,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,
NJ-007426,North Hudson Community Action Corporation Health Center @ Garfield,North Hudson Community Action Corporation,1346494788,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",535 Midland Ave,,Garfield,NJ,07026-1658,Bergen,800 31st Street,,Union City,NJ,07026,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007427,Glassboro Medical and Dental Professionals,"COMMUNITY HEALTH CARE, INC.",1518078559,"Dental Providers, Federally Qualified Health Centers - Medical Services",335 Delsea Dr N,,Glassboro,NJ,08028-1403,Gloucester,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Gloucester,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007428,Famcare Inc. Glassboro,"Famcare, Inc.",1043318793,Family Planning Providers,711 N Main St,,Glassboro,NJ,08028-1639,Gloucester,711 N Main St,,Glassboro,NJ,08028-1639,Gloucester,Dawn Hickman,CEO,856-881-9531,,dhickman@famcareinc.org,Rebecca Brady,COO,856-794-1235,1213,rbrady@famcareinc.org,http://www.famcareinc.com
NJ-007429,Famcare Inc. Rowan University,"Famcare, Inc.",1043318793,Family Planning Providers,Rt 322 East St,,Glassboro,NJ,08028,Gloucester,711 N Main St,,Glassboro,NJ,08028-1639,Gloucester,Dawn Hickman,CEO,856-881-9531,,dhickman@famcareinc.org,Rebecca Brady,COO,856-794-1235,1213,rbrady@famcareinc.org,http://www.famcareinc.com
NJ-012457,Center for Vein Restoration,Center for Vein Restoration,1710312699,Other ECP Providers,211 Essex St,Suite 403,Hackensack,NJ,07601-3247,Bergen,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NJ-007430,North Hudson Community Action Corporation Health Center @ Hackensack,North Hudson Community Action Corporation,1306090741,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",25 E Salem St,,Hackensack,NJ,07601-7427,Bergen,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007431,Joseph M. Sanzari Children's Hospital (children's inpatient hospital),Hackensack University Medical Center,1457456279,Children's Hospitals (inpatient only),30 Prospect Ave,,Hackensack,NJ,07601-1915,Bergen,30 Prospect Ave,,Hackensack,NJ,07601,Bergen,Lee Gordon,Director of Budget and Reimbursement,551-996-3373,,Lee.Gordon@HackensackMeridian.org,,,,,,www.hackensackumc.org
NJ-007432,Joseph M. Sanzari Children's Hospital (ryan white providers),Hackensack University Medical Center,1457456279,Ryan White Providers,30 Prospect Ave,,Hackensack,NJ,07601-1915,Bergen,30 Prospect Ave,,Hackensack,NJ,07601,Bergen,Lee Gordon,Director of Budget and Reimbursement,551-996-3373,,Lee.Gordon@HackensackMeridian.org,,,,,,www.hackensackumc.org
NJ-007433,PPNCSNJ Hackensack Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1932251451,Family Planning Providers,575 Main St,,Hackensack,NJ,07601-5917,Bergen,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007434,Zufall Health Center Hackettstown,"Zufall Health Center, INC",1699034777,"Dental Providers, Federally Qualified Health Centers - Medical Services",5 Doctors Park Unit 5,117 Seber Road,Hackettstown,NJ,07840-1716,Warren,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,Raksha Tripathi,CFO,973-328-9100,310,rtripathi@zufallhealth.org,
NJ-007435,PPNCSNJ Hamilton Clinic,"Planned Parenthood of Northern, Central and Southern New Jersey, Inc.",1831570860,Family Planning Providers,2279 Highway 33,,Hamilton Square,NJ,08690-1750,Mercer,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007436,Hammonton Center,"Southern Jersey Family Medical Centers, Inc.",1568473973,"Dental Providers, Federally Qualified Health Centers - Medical Services",860 S White Horse Pike,,Hammonton,NJ,08037-2018,Atlantic,1 N. White Horse Centre,,Hammonton,NJ,08037-1169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007437,North Hudson Community Action Corporation- Harrison Health Center,North Hudson Community Action Corporation,1548626005,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",326 Harrison Ave,,Harrison,NJ,07029-1752,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007438,CarePoint Health - Neighborhood Health Center,Ryan White Program at CarePoint Health,1467645952,Ryan White Providers,122-132 Clinton St,,Hoboken,NJ,07030-8519,Hudson,"CarePoint Health Foundation, Inc.",176 Palisade Avenue,Jersey City,NJ,07306,Hudson,"Gustavo Valdes Rivera, MPH, CSW",Program Director,201-792-6161,34208,Gustavo.Valdes@CarePointhealth.org,Jacqueline Wright,Director of Grants & Foundation Relations,201-217-4716,,Jacqueline.Write@CarePointhealth.org,
NJ-007439,Hoboken Family Planning,Hoboken Family Planning,1154313559,Family Planning Providers,124 Grand St,,Hoboken,NJ,07030-2510,Hudson,124 Grand Street,,Hoboken,NJ,07030,Hudson,William Bullock,Executive Director,201-963-0300,100,bbullock@hobfamplan.org,RoseMay Ringor,Director of Clinical Service,201-963-0300,,rmringor@hobfamplan.org,www.hobfamplan.org
NJ-007440,"Alliance Community Healthcare, Inc.",HORIZON HEALTH CENTER INC,1285662684,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",115 Christopher Columbus Dr,Suite 101,Jersey City,NJ,07302-3551,Hudson,714 Bergen Ave,,Jersey City,NJ,07306-4802,Hudson,Loida Colon,Director of Administrative Services,201-209-2309,,lcolon@allianceCH.org,Marilyn Cintron,Executive Director,201-209-2301,,mcintron@allianceCH.org,www.alliancecommunityhealth.org
NJ-007441,The Center for Comprehensive Care,RWJBarnabas Jersey City Medical Center,1154367803,"Dental Providers, Outpatient Hospital Clinics, Ryan White Providers",1825 John F Kennedy Blvd # 2,,Jersey City,NJ,07305-2106,Hudson,355 Grand Street,,Jersey City,NJ,07302,Hudson,Whitney Bracco,Administrative Director,201-204-0004,1007,whitney.bracco@rwjbh.org,"Adriana Grigoriu, MD",Medical Director,201-204-0004,1008,adriana.grigoriu@rwjbh.org,http://www.barnabashealth.org/Jersey-City-Medical-Center.aspx
NJ-007442,SNYDER HS HEALTH CLINIC,HORIZON HEALTH CENTER INC,1053353342,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",239 Bergen Ave,,Jersey City,NJ,07305-1524,Hudson,714 Bergen Ave,,Jersey City,NJ,07306-4802,Hudson,Loida Colon,Director of Administrative Services,201-209-2309,,lcolon@horizonhealth.org,Marilyn Cintron,Chief Executive Officer,201-679-7119,,mcintron@horizonhealth.org,www.horizonhealth.org
NJ-007443,North Hudson Community Action Corporation @ Jersey City,North Hudson Community Action Corporation,1134374143,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",324 Palisade Ave,,Jersey City,NJ,07307-1791,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007444,HORIZON HEALTH CENTER,HORIZON HEALTH CENTER INC,1053353342,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",714 Bergen Ave,,Jersey City,NJ,07306-4802,Hudson,714 Bergen Ave,,Jersey City,NJ,07306-4802,Hudson,Loida Colon,Director of Administrative Services,201-203-2309,,lcolon@horizonhealth.org,Marilyn Cintron,Executive Director,201-209-2301,,mcintron@horizonhealth.org,www.horizonhealth.org
NJ-007445,Metropolitan Family Health Network at Bergen Ave.,"Metropolitan Family Health Network, Inc.",1982846879,Federally Qualified Health Centers - Medical Services,857 Bergen Ave,,Jersey City,NJ,07306-4405,Hudson,935 Garfield Ave.,,Jersey City,NJ,07304,Hudson,"Scott Carey, COO",Chief Operating Officer,201-478-5829,,scarey@metrofhn.org,,,,,,
NJ-007446,Metropolitan Family Health Network at Garfield Ave.,"Metropolitan Family Health Network, Inc.",1417967456,"Dental Providers, Federally Qualified Health Centers - Medical Services",935 Garfield Ave,,Jersey City,NJ,07304-2731,Hudson,935 Garfield Ave.,,Jersey City,NJ,07304,Hudson,"Scott Carey, COO",Chief Operating Officer,201-478-5829,,scarey@metrofhn.org,,,,,,
NJ-007447,Keansburg Community Health Center,"Visiting Nurse Association of Central Jersey, Community Health Center Inc.",1104964550,Federally Qualified Health Centers - Medical Services,100 Main St,,Keansburg,NJ,07734-1725,Monmouth,1301 Main Street,,Asbury Park,NJ,07712-5359,Monmouth,Kristine McCoy,"Executive Director, VNACJ Center for Primary Care and Public Health",732-502-5151,,Kristine.McCoy@vnahg.org,Darlene Rice,Practice Manager,732-776-3921,,Darlene.Rice@vnahg.org,www.vnachc.org
NJ-012458,Center for Vein Restoration,Center for Vein Restoration,1710312699,Other ECP Providers,206 Bergen Ave,Suite 206,Kearny,NJ,07032-3387,Hudson,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NJ-007448,Keyport Primary Care Center,"Visiting Nurse Association of Central Jersey, Community Health Center Inc.",1003867250,Federally Qualified Health Centers - Medical Services,35 Broad St,,Keyport,NJ,07735-1267,Monmouth,1301 Main St,,Asbury Park,NJ,07712-5359,Monmouth,Kristine McCoy,"Executive Director, VNACJ Center for Primary Care and Public Health",732-502-5151,,Kristine.McCoy@vnahg.org,Darlene Rice,Practice Manager,732-776-3921,,Darlene.Rice@vnahg.org,www.vnachc.org
NJ-007449,Ocean Health Initiatives Manchester,Ocean Health Initiatives,1043306574,"Dental Providers, Federally Qualified Health Centers - Medical Services",686 Route 70,,Lakehurst,NJ,08733-2853,Ocean,101 Second St,,Lakewood,NJ,08701,Ocean,Carol Carter,Billing Director,732-363-6655,8320,ccarter@ohinj.org,,,,,,
NJ-007450,Ocean Health Initiatives,Ocean Health Initiatives,1043306574,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 2nd St,,Lakewood,NJ,08701-3324,Ocean,101 Second St,,Lakewood,NJ,08701,Ocean,Carol Carter,Billing Director,732-363-6655,8320,ccarter@ohinj.org,,,,,,
NJ-007451,LAKEWOOD RESOURCE AND REFERRAL CENTER INC.,Lakewood Resource and Referral Center,1083748297,"Dental Providers, Federally Qualified Health Centers - Medical Services",1771 Madison Ave,,Lakewood,NJ,08701-1251,Ocean,1771 Madison Avenue,,Lakewood,NJ,08701,Ocean,Chedva Werblowsky,Dir of Strategic Planning,732-364-2144,206,cwerblowsky@chemedhealth.org,,,,,,
NJ-007452,Family Planning Center of Ocean Co. Lakewood,Family Planning Center of Ocean Co.,1376684852,"Family Planning Providers, Sexually Transmitted Disease Clinics",290 River Ave,,Lakewood,NJ,08701-4810,Ocean,290 River Ave,,Lakewood,NJ,08701-4810,Ocean,Kathy Fisher,Executive Director,732-364-9696,,kathyfisher@fpcoc.net,Melissa Strippoli,Director of Finance,732-364-9696,111,melissastrippoli@fpcoc.net,http://www.fpcoc.net/
NJ-012459,Center for Vein Restoration,Center for Vein Restoration,1710312699,Other ECP Providers,456 Chestnut St Unit 301,,Lakewood,NJ,08701-6124,Ocean,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NJ-007453,Ocean Health Initiatives Clifton St,Ocean Health Initiatives,1043306574,Federally Qualified Health Centers - Medical Services,625 Clifton Ave,,Lakewood,NJ,08701-2808,Ocean,101 Second St,,Lakewood,NJ,08701,Ocean,Carol Carter,Billing director,732-363-6655,8320,ccarter@ohinj.org,,,,,,
NJ-007454,Monmouth Family Health Center,MONMOUTH FAMILY HEALTH CENTER,1073558391,Federally Qualified Health Centers - Medical Services,270 Broadway,,Long Branch,NJ,07740-7027,Monmouth,270 Broadway,,Long Branch,NJ,07740-7027,Monmouth,Marta Silverberg,CEO,732-923-7145,,msilverberg@mfhcnj.org,Andrea Duncan,Director of patient accounts,732-413-2020,,aduncan@mfhnj.org,
NJ-007455,Monmouth Family Health Center Dental,Monmouth Family Health Center,1962841502,Dental Providers,335 Broadway,,Long Branch,NJ,07740-6901,Monmouth,270 Broadway,,Long Branch,NJ,07740,Monmouth,Marta Cuellar Silverberg,CEO,732-923-7145,,msilverberg@mfhcnj.org,Andrea Duncan,"Director, Patient Accounts",732-413-2020,,aduncan@mfhcnj.org,
NJ-007456,Monmouth Family Health Center OB/GYN Womens Health Service,MONMOUTH FAMILY HEALTH CENTER,1669791869,Federally Qualified Health Centers - Medical Services,80 Pavilion Ave,,Long Branch,NJ,07740-6413,Monmouth,270 Broadway,,Long Branch,NJ,07740-7027,Monmouth,Marta Silverberg,CEO,732-923-7145,,msilverberg@mfhcnj.org,Andrea Duncan,Director of patient accounts,732-413-2020,,aduncan@mfhcnj.org,
NJ-007457,Ocean Health Initiatives Stafford,Ocean Health Initiatives,1043306574,"Dental Providers, Federally Qualified Health Centers - Medical Services",333 Haywood Rd,,Manahawkin,NJ,08050-2707,Ocean,101 Second St,,Lakewood,NJ,08753,Ocean,Carol Carter,Billing director,732-363-6655,8320,ccarter@ohinj.org,,,,,,
NJ-007458,Millville Medical and Dental Professionals,"COMMUNITY HEALTH CARE, INC.",1346342441,"Dental Providers, Federally Qualified Health Centers - Medical Services",1200 High St N,Suite 2,Millville,NJ,08332-2517,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007459,PPMNJ-Montclair Clinic,Planned Parenthood of Metropolitan NJ,1386617686,Family Planning Providers,29 N Fullerton Ave,,Montclair,NJ,07042-3464,Essex,238 Mulberry St,,Newark,NJ,07102,Essex,Joanna Lewin,V.P for Finance,973-622-3900,1223,joanna.lewin@ppmnj.org,Kathy Butts,Controller,973-622-3900,1226,kathy.butts@ppmnj.org,http://www.plannedparenthood.org/ppmnj/
NJ-007460,PPNCSNJ Morristown Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1053420992,Family Planning Providers,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007461,Zufall Health Center Morristown,"Zufall Health Center, INC",1841527355,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4 Atno Ave,,Morristown,NJ,07960-3802,Morris,18 West Blackwell Street,,Dover,NJ,07960,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,Rasksha Tripathi,CFO,973-328-9100,310,rtripathi@zufallhealth.org,
NJ-007462,Henry J. Austin Health Center- Primary Care at Oaks Integrated,Henry J. Austin Health Center,1275644809,Federally Qualified Health Centers - Medical Services,770 Woodlane Rd,,Mount Holly,NJ,08060-3804,Burlington,Henry J. Austin Health Center,,Trenton,NJ,08618,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Dr. Anita Porbeni,Program Coordinator,609-278-6020,,anita.porbeni@henryjaustin.org,
NJ-007463,A-Team Dental Clinic,A-Team Dental Clinic,1154492676,"Dental Providers, Ryan White Providers",1828 W Lake Ave,Suite 201,Neptune,NJ,07753-4663,Monmouth,1828 West Lake Ave,Suite 201,Neptune,NJ,07753,Monmouth,Druanne Meissner,A-Team Dental Coordinator,732-869-5770,,Druanne.Meissner@hackensackmeridian.org,,,,,,
NJ-007464,Jersey Shore Medical Center (A - Team),Jersey Shore University Medical Center,1346247368,"Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1828 W Lake Ave,Suite 203,Neptune,NJ,07753-4663,Monmouth,1945 Route 33,,Neptune,NJ,07753,Monmouth,Joanna Wright,Director of the Women's & Children's Service line,732-776-4325,64325,joanna.wright@hackensackmeridianhealth.org,,,,,,http://www.jerseyshoreuniversitymedicalcer
NJ-007465,Jersey Shore University Medical Center (Pediatric),Jersey Shore University Medical Center,1346247368,"Dental Providers, Other ECP Providers, Outpatient Hospital Clinics",61 Davis Ave,,Neptune,NJ,07753-4401,Monmouth,1945 Route 33,,Neptune,NJ,07753,Monmouth,Joanna Wright,Director of the Women's & Children's Service line,732-776-4325,64325,joanna.wright@hackensackmeridianhealth.org,,,,,,
NJ-007466,Bristol-Myers Squibb Children's Hospital,Robert Wood Johnson University Hospital - New Brunswick,1346243375,Children's Hospitals (inpatient only),1 Robert Wood Johnson Pl,,New Brunswick,NJ,08901-1928,Middlesex,1 Robert Wood Johnson Pl,,New Brunswick,NJ,08903,Middlesex,Warren Moore,Chief Administrative Officer,732-828-3000,7051,warren.moore@rwjbh.org,Montana Thares,"Analyst, System Strategy",732-828-3000,8541,montana.thares@rwjbh.org,http://www.rwjuh.edu/rwjuh/home.aspx
NJ-007467,Robert Wood Johnson University Hospital (dental provider),Robert Wood Johnson University Hospital - New Brunswick,1346243375,Dental Providers,1 Robert Wood Johnson Pl,,New Brunswick,NJ,08901-1928,Middlesex,1 Robert Wood Johnson Pl,,New Brunswick,NJ,08903,Middlesex,Warren Moore,Chief Administrative Officer,732-828-3000,7051,warren.moore@rwjbh.org,Montana Thares,"Analyst, System Strategy",732-828-3000,8541,montana.thares@rwjbh.org,http://www.rwjuh.edu/rwjuh/home.aspx
NJ-007468,Robert Wood Johnson University Hospital (inpatient hospital),Robert Wood Johnson University Hospital - New Brunswick,1346243375,Inpatient Hospitals (other than children's hospitals),1 Robert Wood Johnson Pl,,New Brunswick,NJ,08901-1928,Middlesex,1 Robert Wood Johnson Pl,,New Brunswick,NJ,08903,Middlesex,Warren Moore,Chief Administrative Officer,732-828-3000,7051,warren.moore@rwjbh.org,Montana Thares,"Analyst, System Strategy",732-828-3000,8541,montana.thares@rwjbh.org,http://www.rwjuh.edu/rwjuh/home.aspx
NJ-007469,PPNCSNJ New Brunswick Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1376809004,Family Planning Providers,10B Industrial Dr,,New Brunswick,NJ,08901-3632,Middlesex,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007470,Rutgers RWJMS NJ Regional Hemophilia Treatment Center,Rutgers Robert Wood Johnson Medical School NJ Regional Hemophilia Treatment Center,1588927370,Hemophilia Treatment Centers,125 Paterson St,Ste 5200,New Brunswick,NJ,08901-1962,Middlesex,125 Paterson Street,Rutgers Robert Wood Johnson Medical School,New Brunswick,NJ,08901-1962,Middlesex,"Vicki Craig, MD",Sr Associate Dean Clinical Affairs,732-235-7887,,craigvl@rwjms.rutgers.edu,"Joseph Barone, MD",Sr Associate Dean Clinical Affairs,732-235-6305,,baronejg@rutgers.edu,
NJ-007471,Children's Specialized Hospital,Children's Specialized Hospital,1396886297,Children's Hospitals (inpatient only),200 Somerset St,,New Brunswick,NJ,08901-1942,Middlesex,150 New Providence Road,,Mountainside,NJ,07092,Union,Joseph J. Dobosh Jr.,Vice President & CFO,732-258-7052,,jdobosh@childrens-specialized.org,Amy Mansue,President & CEO,732-258-7050,,amansue@childrens-specialized.org,
NJ-007472,Buttonwood Center,"Southern Jersey Family Medical Centers, Inc.",1205951019,"Dental Providers, Federally Qualified Health Centers - Medical Services",600 Pemberton Browns Mills Rd,,New Lisbon,NJ,08068-1537,Burlington,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007473,Family Treatment Center,NEWARK BETH ISRAEL MEDICAL CENTER,1033210323,Ryan White Providers,166 Lyons Ave,,Newark,NJ,07112-2016,Essex,201 Lyons Ave,,Newark,NJ,07112-2027,Essex,Danielle Boyd,Administrative Director,973-926-7300,2471,daboyd@barnabashealth.org,Kristen Ehlers,Manager,973-926-7000,4982,kehlers@barnabashealth.org,http://www.barnabashealth.org/Newark-Beth-Israel-Medical-Center.aspx
NJ-007474,Hemophilia Center,Newark Beth Israel Medical Center,1528071164,Hemophilia Treatment Centers,201 Lyons Ave,Hemophilia Center/Newark Beth Israel Medical Cent,Newark,NJ,07112-2027,Essex,Hemophilia Center/Newark Beth Israel Medical Centet,201 Lyons Avenue,Newark,NJ,07112,Essex,Phyllis Kandl,Program Manager,973-926-6511,,pkandl@barnabashealth.org,"Alice Cohen, MD",Medical Director,973-926-6511,,acohen@barnabashealth.org,barnabashealth.org
NJ-007475,PPMNJ- Newark- Mulberry Clinic,Planned Parenthood of Metropolitan NJ,1346213337,Family Planning Providers,240 Mulberry St,,Newark,NJ,07102-3528,Essex,238 Mulberry Street,,Newark,NJ,07102,Essex,Joanna Lewin,V.P for Finance,973-622-3900,1223,joanna.lewin@ppmnj.org,Kathy Butts,Controller,973-622-3900,1226,kathy.butts@ppmnj.org,http://www.plannedparenthood.org/ppmnj/
NJ-007476,Broadway House for Continuing Care,"Newark AIDS Consortium, Inc., d/b/a Broadway House for Continuing Care",1538168885,Ryan White Providers,298 Broadway,,Newark,NJ,07104-8000,Essex,298 Broadway,,Newark,NJ,07104,Essex,James R. Gonzalez,President and Chief Executive Officer,973-268-9797,,gonzalj1@uhnj.org,Virginia Brown,Director of Behavioral Health Services,973-268-9797,1064,brownvm@uhnj.org,http://broadwayhouse.org/
NJ-007477,Rutgers Community Health Center,Rutgers Nursing Faculty Practice,1669737755,Federally Qualified Health Centers - Medical Services,449 Broad St,,Newark,NJ,07102-3224,Essex,Rutgers Community Health Center,"65 Bergen Street, Room 1136",Newark,NJ,07107,Essex,Susan VonNessen-Scanlin,Interim CEO,732-357-7460,,SV430@SN.RUTGERS.EDU,Daina Bungs,Project Manager,973-972-8370,,dbungs@sn.rutgers.edu,
NJ-007478,PPMNJ-Newark-Ironbound Clinic,Planned Parenthood of Metropolitan NJ,1760455695,Family Planning Providers,70 Adams St,Suite 13,Newark,NJ,07105-2354,Essex,238 Mulberry St,1st floor,Newark,NJ,07102,Essex,Joanna Lewin,V.P for Finance,973-622-3900,1223,joanna.lewin@ppmnj.org,Kathy Butts,Controller,973-622-3900,1226,kathy.butts@ppmnj.org,http://www.plannedparenthood.org/ppmnj/
NJ-007479,Zufall Health Center Newton,Zufall Health Center INC,1235593435,"Dental Providers, Federally Qualified Health Centers - Medical Services",238 Spring St,Suite A,Newton,NJ,07860-2115,Sussex,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,,,,,,
NJ-007480,PPNCSNJ Newton Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1790851434,Family Planning Providers,8 Moran St,,Newton,NJ,07860-1806,Sussex,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007481,North Hudson Community Action Corporation Health Center @ North Bergen,North Hudson Community Action Corporation,1043465057,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1116 43rd St,,North Bergen,NJ,07047-2712,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007482,North Hudson Community Action Corporation Health Center @ Passaic 110,North Hudson Community Action Corporation,1457506461,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",110 Main Ave,,Passaic,NJ,07055-4427,Passaic,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007483,North Hudson Community Action Corporation Health Center @ Passaic 8th Street,North Hudson Community Action Corporation,1124272232,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",148 8th Street,,Passaic,NJ,07055,Passaic,800 31st Street,,Union City,NJ,07055,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007484,PPMNJ- Paterson Clinic,Planned Parenthood of Metropolitan NJ,1649243932,Family Planning Providers,680 Broadway,,Paterson,NJ,07514-1524,Passaic,238 Mulberry St,1st floor,Newark,NJ,07102,Essex,Joanna Lewin,V.P for Finance,973-622-3900,1223,joanna.lewin@ppmnj.org,Kathy Butts,Controller,973-622-3900,1226,kathy.butts@ppmnj.org,http://www.plannedparenthood.org/ppmnj/
NJ-007485,St. Joseph's Children's Hospital,St. Joseph's Healthcare System,1669462420,Children's Hospitals (inpatient only),703 Main St,,Paterson,NJ,07503-2621,Passaic,703 Main Street,,Paterson,NJ,07503,Passaic,Thomas Barnes,"Vice President, Revenue Cycle",973-754-2136,,barnest@sjhmc.org,Cheryl Cheff,"Manager, Managed Care Services",973-754-4914,,cheffc@sjhmc.org,
NJ-007486,St. Joseph's Regional Medical Center,St. Joseph's Healthcare System,1669462420,Inpatient Hospitals (other than children's hospitals),703 Main St,,Paterson,NJ,07503-2621,Passaic,703 Main Street,,Paterson,NJ,07503,Passaic,Thomas Barnes,"Vice President, Revenue Cycle",973-754-2136,,barnest@sjhmc.org,Cheryl Cheff,"Manager, Managed Care Services",973-754-4914,,cheffc@sjhmc.org,
NJ-007487,Famcare Inc. Pennsville,"Famcare, Inc.",1043318793,Family Planning Providers,370 S Broadway,,Pennsville,NJ,08070-2655,Salem,370 S Broadway,,Pennsville,NJ,08070-2655,Salem,Dawn Hickman,CEO,856-881-9531,,dhickman@famcareinc.org,Rebecca Brady,COO,856-794-1235,1213,rbrady@famcareinc.org,http://www.famcareinc.com
NJ-007488,PPNCSNJ Perth Amboy Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1639435811,Family Planning Providers,450 Market St,,Perth Amboy,NJ,08861-4544,Middlesex,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007489,Raritan Bay Medical Center,Meridian Health,1770569832,Inpatient Hospitals (other than children's hospitals),530 New Brunswick Ave,,Perth Amboy,NJ,08861-3654,Middlesex,1350 Campus Parkway,,Neptune,NJ,07753,Monmouth,Kevin M. Field,"Sr. Director, Reimbursement & Financial Technology",732-293-2311,,kevin.field@hackensackmeridian.org,Kathryn Gibbons,"Director, Budgets & Reimbursements",732-751-3372,,kathryn.gibbons@hackensackmeridian.org,www.rbmc.org
NJ-007490,Neighborhood Health Center Plainfield,Neighborhood Health Services Corporation,1316981707,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1700 Myrtle Ave,,Plainfield,NJ,07063-1000,Union,1700 Myrtle Ave,,Plainfield,NJ,07063,Union,Elsie Clodimir-Dennise,Director of Patient Financial Services,908-546-1042,,edennis@nhscnj.org,Barbara Ferguson,,908-731-7401,,bferguson@nhscnj.org,www.nhscnj.org
NJ-007491,Pleasantville Center,"Southern Jersey Family Medical Centers, Inc.",1578687851,"Dental Providers, Federally Qualified Health Centers - Medical Services",932 S Main St,,Pleasantville,NJ,08232-3646,Atlantic,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007492,Henry J. Austin Health Center- Primary Care at All Access Mental Health (AAMH),Henry J. Austin Health Center,1275644809,Federally Qualified Health Centers - Medical Services,819 Alexander Rd,,Princeton,NJ,08540-6303,Mercer,321 N. Warren Street,,Trenton,NJ,08618,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Dr. Anita Porbeni,Program Coordinator,609-278-6020,,anita.porbeni@henryjaustin.org,
NJ-007493,Riverview Medical Center (inpatient hospital),Riverview Medical Center,1336147834,Inpatient Hospitals (other than children's hospitals),1 Riverview Plz,,Red Bank,NJ,07701-1864,Monmouth,Jersey Shore University Medical Center,,Neptune,NJ,07753,Monmouth,Joanna Wright,Director the Women's & Children's Service line,732-776-4325,,joanna.wright@hackensackmeridianhealth.org,,,,,,http://www.riverviewmedicalcenter.com
NJ-007494,Riverview Medical Center (multiple outpatient ECP categories),Riverview Medical Center,1336147834,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Riverview Plz,,Red Bank,NJ,07701-1864,Monmouth,Jersey Shore University Medical Center,,Neptune,NJ,07753,Monmouth,Joanna Wright,Director the Women's & Children's Service line,732-776-4325,,joanna.wright@hackensackmeridianhealth.org,,,,,,http://www.riverviewmedicalcenter.com
NJ-007495,Red Bank Community Health Center,"Visiting Nurse Association of Central Jersey, Community Health Center Inc.",1699712166,Federally Qualified Health Centers - Medical Services,176 Riverside Ave,,Red Bank,NJ,07701-1063,Monmouth,1301 Main St,,Asbury Park,NJ,07712-5359,Monmouth,Amanda Caruso,"Executive Director, VNACJ Center for Primary Care and Public Health",732-502-5150,,amanda.caruso@vnahg.org,Darlene Rice,Practice Manager,732-776-3921,,Darlene.Rice@vnahg.org,www.vnachc.org
NJ-007496,RiteCare at Rio Grande ShopRite,"COMMUNITY HEALTH CARE, INC.",1073954988,Federally Qualified Health Centers - Medical Services,1700 Route 47,,Rio Grande,NJ,08242-1406,Cape May,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007497,Salem Center,"Southern Jersey Family Medical Centers, Inc.",1104940493,"Dental Providers, Federally Qualified Health Centers - Medical Services",238 E Broadway,,Salem,NJ,08079-1108,Salem,1 N. White Horse Centre,,Hammonton,NJ,80371169,Atlantic,Linda Y. Flake,President/CEO,609-567-0434,4116,sjfmc@sjfmc.org,Ronald Kaplan,CFO,609-567-0434,4142,Ronald.kaplan@sjfmc.org,
NJ-007498,PPNCSNJ Shrewsbury Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1770635260,Family Planning Providers,69 Newman Springs Rd E,,Shrewsbury,NJ,07702-4038,Monmouth,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007499,Zufall Health Center Somerville,"Zufall Health Center, INC",1053736314,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",71 4th St,,Somerville,NJ,08876-3235,Somerset,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,,,,,,
NJ-007500,Ocean Health Initiatives Toms River,Ocean Health Initiatives,1043306574,"Dental Providers, Federally Qualified Health Centers - Medical Services",301 Lakehurst Rd,,Toms River,NJ,08755-7335,Ocean,101 Second St,,Lakewood,NJ,08753,Ocean,Carol Carter,Billing Director,732-363-6655,8320,ccarter@ohinj.org,,,,,,
NJ-007501,Henry J. Austin Health Center-Ewing,HENRY J AUSTIN HEALTH CENTER INC,1114101607,"Dental Providers, Federally Qualified Health Centers - Medical Services",112 Ewing St,,Trenton,NJ,08609-1004,Mercer,321 N Warren St,,Trenton,NJ,08618-4794,Mercer,Dr. Kemi Alli,Chief Executive Offcer,609-278-5939,,kemi.alli@henryjaustin.org,Renee P. Haynes,Chief Operating Officer,609-278-5901,,renee.haynes@henryjaustin.org,
NJ-007502,Henry J. Austin Health Center- Primary care at Family Guidance Center,Henry J. Austin Health Center,1275644809,Federally Qualified Health Centers - Medical Services,1931 Nottingham Way,,Trenton,NJ,08619-3554,Mercer,Henry J. Austin Health Center,,Trenton,NJ,08618,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Dr. Anita Porbeni,Program Coordinator,609-278-6020,,anita.porbeni@henryjaustin.org,
NJ-007503,Henry J. Austin Health Center-Chambers,HENRY J AUSTIN HEALTH CENTER INC,1710161823,Federally Qualified Health Centers - Medical Services,317 Chambers St,,Trenton,NJ,08609-2603,Mercer,321 N Warren St,,Trenton,NJ,08618-4794,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Renee P. Haynes,Chief Operating Officer,609-278-5901,,renee.haynes@henryjaustin.org,
NJ-007504,Henry J. Austin Health Center-Warren,HENRY J AUSTIN HEALTH CENTER INC,1275644809,"Dental Providers, Federally Qualified Health Centers - Medical Services",321 N Warren St,,Trenton,NJ,08618-4794,Mercer,321 N Warren St,,Trenton,NJ,08618-4794,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Renee P. Haynes,Chief Operating Officer,609-278-5901,,renee.haynes@henryjaustin.org,http://henryjaustin.org
NJ-007505,Henry J. Austin Health Center- Primary Care at Catholic Charities,Henry J. Austin Health Center,1275644809,Federally Qualified Health Centers - Medical Services,383 W State St,,Trenton,NJ,08618-5705,Mercer,321 N. Warren Street,,Trenton,NJ,08618,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Dr. Anita Porbeni,Program Coordinator,609-278-6020,,anita.porbeni@henryjaustin.org,
NJ-007506,Henry J. Austin Health Center-Bellevue,HENRY J AUSTIN HEALTH CENTER INC,1477980845,Federally Qualified Health Centers - Medical Services,433 Bellevue Ave,,Trenton,NJ,08618-4514,Mercer,321 N Warren St,,Trenton,NJ,08618-4794,Middlesex,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Renee P. Haynes,Chief Operating Officer,609-278-5901,,renee.haynes@henryjaustin.org,
NJ-007507,PPNCSNJ Trenton Clinic,"Planned Parenthood of Northern, Central and Southern New Jersey",1831570860,Family Planning Providers,437 E State St,,Trenton,NJ,08608-1501,Mercer,196 Speedwell Ave,,Morristown,NJ,07960,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007508,Saint Francis Medical Center,Saint Francis Medical Center,1255419651,"Outpatient Hospital Clinics, Ryan White Providers",601 Hamilton Ave,,Trenton,NJ,08629-1915,Mercer,601 Hamilton Avenue,,Trenton,NJ,08629,Mercer,Joseph T Sirak,Dir. Case Management and Outreach,609-599-5554,,jsirak@stfrancismedical.org,,,,,,http://www.stfrancismedical.org/
NJ-007509,Henry J. Austin Health Center-Rescue Mission Site,Henry J. Austin Health Center,1275644809,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",98 Carroll St,,Trenton,NJ,08609-1008,Mercer,321 N. Warren Street,,Trenton,NJ,08618,Mercer,Dr. Kemi Alli,Chief Executive Officer,609-278-5939,,kemi.alli@henryjaustin.org,Dr. Anita Porbeni,Program Coordinator,609-278-6020,,anita.porbeni@henryjaustin.org,
NJ-007510,Hoboken Family Planning Union City Clinic,Hoboken Family Planning,1154313559,Family Planning Providers,1206 Summit Ave,,Union City,NJ,07087-6214,Hudson,1206 Summit Ave,,Union City,NJ,07087-6214,Hudson,William Bullock,Executive Director,201-963-0300,100,bbullock@hobfamplan.org,RoseMay Ringor,Director of Clinical Services,201-963-0300,,rmringor@hobfamplan.org,www.hobfamplan.org
NJ-007511,North Hudson Community Action Corporation Health Center,North Hudson Community Action Corporation,1427362078,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2500 Kennedy Blvd,Union City High School,Union City,NJ,07087-2295,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007512,North Hudson Community Action Corporation Health Center @ Union City,North Hudson Community Action Corporation,1851546865,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",714 31st St,,Union City,NJ,07087-2427,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Fiancial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007513,Complete Care Health Network,Adult Medical,1598868671,Federally Qualified Health Centers - Medical Services,1038 E Chestnut Ave,Suite 250,Vineland,NJ,08360-5800,Cumberland,Complete Care Health Network,53 S. Laurel St,Bridgeton,NJ,08302,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,www.completecarenj.org/
NJ-007514,RiteCare at Vineland ShopRite,"COMMUNITY HEALTH CARE, INC.",1699089847,Federally Qualified Health Centers - Medical Services,1255 W Landis Ave,,Vineland,NJ,08360-3423,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007515,Vineland Medical and Dental Campus,"COMMUNITY HEALTH CARE, INC.",1568572568,"Dental Providers, Federally Qualified Health Centers - Medical Services",319 W Landis Ave,Suite 2,Vineland,NJ,08360-8101,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007516,Vineland Women's Medical Professionals,"COMMUNITY HEALTH CARE, INC.",1154592459,Federally Qualified Health Centers - Medical Services,484 S Brewster Rd,,Vineland,NJ,08361-7874,Cumberland,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007517,Famcare Inc. Vineland,"Famcare, Inc.",1093053738,Family Planning Providers,80 S Main Rd,Suite 101,Vineland,NJ,08360-7829,Cumberland,80 S Main Rd,,Vineland,NJ,08360-7829,Cumberland,Dawn Hickman,CEO,856-881-9531,,dhickman@famcareinc.org,Rebecca Brady,COO,856-794-1235,1213,rbrady@famcareinc.org,http://www.famcareinc.com
NJ-007518,PPNCSNJ Washington Clinic,"Planned Parenthood of Northern, Central and Southern NJ",1982770624,Family Planning Providers,66 E Washington Ave,,Washington,NJ,07882-1913,Warren,196 Speedwell Ave,,Morristown,NJ,07960-2934,Morris,Carolyn Lally,Director of Billing & Revenue Cycle,973-539-9580,,carolyn.lally@ppgnnj.org,Triste Brooks,CEO,973-539-9580,,triste.brooks@ppgnnj.org,www.ppgnnj.org
NJ-007519,Metropolitan Family Health Network at West New York,"Metropolitan Family Health Network, Inc.",1780892406,Federally Qualified Health Centers - Medical Services,5300 Bergenline Ave,,West New York,NJ,07093-5616,Hudson,935 Garfield Ave.,,Jersey City,NJ,07304,Hudson,"Scott Carey, COO",Chief Operating Officer,201-478-5829,,scarey@metrofhn.org,,,,,,
NJ-007520,North Hudson Community Action Corporation Health Center @ West New York,North Hudson Community Action Corporation,1659323442,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5301 Broadway,,West New York,NJ,07093-2622,Hudson,800 31st Street,,Union City,NJ,07087,Hudson,Ed McGinnis,Director of Patient Financial Services,201-210-0100,10125,eginnis@nhcac.org,Michael Shababb,Chief Financial Officer,201-210-0100,10107,michaels@nhcac.org,nhcac.org
NJ-007521,Hoboken Family Planning West New York Clinic,Hoboken Family Planning,1154313559,Family Planning Providers,5305 Hudson Ave,,West New York,NJ,07093-2615,Hudson,5305 Hudson Ave,,West New York,NJ,07093-2615,Hudson,William Bullock,Executive Director,201-963-0300,,bbullock@hobfamplan.org,RoseMay Ringor,Director of Clinical Services,201-963-0300,,rmringor@hobfamplan.org,www.hobfamplan.org
NJ-007522,Zufall Health Center West Orange,"Zufall Health Center, INC",1902217276,"Dental Providers, Federally Qualified Health Centers - Medical Services",95 Northfield Ave,Suite 2,West Orange,NJ,07052-4731,Essex,18 West Blackwell Street,,Dover,NJ,07801,Morris,Amy Weber,Billing Director,973-328-9100,313,aweber@zufallhealth.org,,,,,,
NJ-007523,Wildwood Medical and Dental Professionals,"COMMUNITY HEALTH CARE, INC.",1730527805,"Dental Providers, Federally Qualified Health Centers - Medical Services",3700 New Jersey Ave,,Wildwood,NJ,08260-6154,Cape May,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NJ-007524,Woodbury Family Medicine Center,"COMMUNITY HEALTH CARE, INC.",1235535113,Federally Qualified Health Centers - Medical Services,75 W Red Bank Ave,,Woodbury,NJ,08096-1694,Gloucester,53 S Laurel St Fl 2,,Bridgeton,NJ,08302-1946,Cumberland,Claudia Villalpando,Asst VP of Business Services,856-451-4700,1167,cvillalpando@chcinj.org,Richard Elwell,Executive VP of Business Services,856-451-4700,2045,relwell@chcinj.org,
NM-007525,LAS CLINICAS DEL NORTE - ABIQUIU,LAS CLINICAS DEL NORTE,1083834436,Federally Qualified Health Centers - Medical Services,185 US-84,#21192,Abiquiu,NM,87510,Rio Arriba,PO Box 237,,EL RITO,NM,87530,Rio Arriba,REGINA MARTINEZ,BILLING ASSITANT/CREDENTIALING,575-581-4728,226,REGINA@LCDN.ORG,ANDY R LOPEZ,CEO,575-581-4728,224,ANDY@LCDN.ORG,
NM-007526,Acoma-Canoncito-Laguna Hospital,Acoma-Canoncito-Laguna Hospital,1225103922,"Dental Providers, Indian Health Service, Other ECP Providers",80b Veterans Blvd,,Acoma,NM,87034,Valencia,PO Box 130,,San Fidel,NM,87049-0130,Cibola,Melody Price-Yonts,Chief Executive Officer,505-552-5303,,melody.price-yonts@ihs.gov,Arlene Crawford,Business Office Manager,505-552-5386,,arlene.crawford@ihs.gov,
NM-007527,Alamo Navajo Health Center,Alamo Navajo School Board,1861412777,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638","Hwy 169, MM 30",,Alamo,NM,87825,Socorro,PO Box 5055,,Alamo,NM,87825,Socorro,Dr Ron Reid,Health Services Director/Clinic Director,575-854-2626,101,rreid@ansbi.org,Dr Ron Reid,Director/Health System Administrator,575-854-2626,101,rreid@ansbi.org,
NM-007528,Otero County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1207 8th St,,Alamogordo,NM,88310-5834,Otero,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,88310-5834,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007529,PMS - Alamogordo Family Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1501 10th St,,Alamogordo,NM,88310-5044,Otero,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Executive VP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007530,PMS - Alamogordo Behavioral Health Family Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1900 10th St,,Alamogordo,NM,88310-5053,Otero,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,
NM-007531,Ben Archer Health Center- Alamogordo,"BEN ARCHER HEALTH CENTER, INC.",1902831977,"Dental Providers, Federally Qualified Health Centers - Medical Services",2150 Highway 54 S,,Alamogordo,NM,88310-7330,Otero,255 Highway 87,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,
NM-007532,Otero County Hospital Association,Gerald Champion Regional Medical Center,1861450579,Inpatient Hospitals (other than children's hospitals),2669 Scenic Dr,,Alamogordo,NM,88310-8700,Otero,2669 Scenic Drive,,Alamogordo,NM,88310-8700,Otero,Pete Seaman,VP of Finance,575-443-7827,,cfo@gcrmc.org,Bashar Naser,CFO,575-443-7848,,cfo@gcrmc.org,
NM-007533,FCCH/NORTH VALLEY CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1922269117,Federally Qualified Health Centers - Medical Services,1231 Candelaria Rd NW,,Albuquerque,NM,87107-2767,Bernalillo,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007534,FCCH/SOUTH BROADWAY CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1205097490,Federally Qualified Health Centers - Medical Services,1401 William St SE,,Albuquerque,NM,87102-4661,Bernalillo,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007535,UNM - Maternity & Family Planning - South Broadway Clinic,UNM - Health Science Center Maternity & Family Planning,1689747552,Family Planning Providers,1500 Walter St SE,,Albuquerque,NM,87102-4658,Bernalillo,2211 Lomas Blvd NE,,Albuquerque,NM,87106-2745,Bernalillo,Pamela Stanley,Director of Managed Care,505-272-3911,,PJStanley@msn.com,,,,,,
NM-007536,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.","FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1902993132,"Dental Providers, Federally Qualified Health Centers - Medical Services",2001 El Centro Familiar Blvd SW,Suite 1,Albuquerque,NM,87105-4592,Bernalillo,2001 El Centro Familiar Blvd SW Ste 1,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007537,Southwest Valley Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007538,T.R. Montoya Hemophilia Treatment Center,UNM SOM Pediatrics,1295822302,Hemophilia Treatment Centers,2211 Lomas Blvd NE,,Albuquerque,NM,87106-2719,Bernalillo,Department of Peds Hem/Onc,MSC10 5590 1UNM,Albuquerque,NM,87131,Bernalillo,Moyna Robeson,Program Manager,505-925-7858,,mrobeson@salud.unm.edu,,,,,,
NM-007539,UNM HOSPITAL (inpatient hospital),UNM HOSPITAL,1689747552,Inpatient Hospitals (other than children's hospitals),2211 Lomas Blvd NE,,Albuquerque,NM,87106-2719,Bernalillo,2211 Lomas Blvd NE,,Albuquerque,NM,87106-2719,Bernalillo,Pamela Stanley,Director of Managed Care,505-272-3911,,PJStanley@msn.com,,,,,,
NM-007540,UNM HOSPITAL (multiple outpatient ECP categories),UNM HOSPITAL,1689747552,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Outpatient Hospital Clinics",2211 Lomas Blvd NE,,Albuquerque,NM,87106-2719,Bernalillo,2211 Lomas Blvd NE,,Albuquerque,NM,87106-2719,Bernalillo,Pamela Stanley,Director of Managed Care,505-272-3911,,PJStanley@msn.com,,,,,,
NM-007541,"First Choice Community Healthcare, Inc.","FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1073775326,Federally Qualified Health Centers - Medical Services,2300 Arenal Rd SW,FCCH/RIO GRANDE HIGH SCHOOL SBHC,Albuquerque,NM,87105-4160,Bernalillo,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007542,Midtown Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2400 Wellesley Dr NE,,Albuquerque,NM,87107-1812,Bernalillo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007543,First Nations Community HealthSource,First Nations Community HealthSource,1932199171,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",5608 Zuni Rd SE,,Albuquerque,NM,87108-2926,Bernalillo,5608 Zuni SE,,Albuquerque,NM,87108,Bernalillo,Linda Stone,CEO,505-262-6546,,linda.son-stone@fnch.org,,,,,,www.fnch.org
NM-007544,Alamosa Public Health Office,State of New Mexico Department of Health - PHD,1134257249,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6900 Gonzales Rd SW,Suite F,Albuquerque,NM,87121-2401,Bernalillo,1190 S. St. Francis Drive,Suite S1050,Santa Fe,NM,87501,Santa Fe,Michelle Cisneros,Administrative Operations Manager II,505-827-0664,,michelle.cisneros@state.nm.us,Heather Black,Chief Nurse,505-827-2308,,heather.black@state.nm.us,https://nmhealth.org/
NM-007545,FCCH/ALAMOSA CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1699936880,Federally Qualified Health Centers - Medical Services,6900 Gonzales Rd SW,,Albuquerque,NM,87121-2401,Bernalillo,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007546,UNM - Maternity & Family Planning - West Mesa Clinic,UNM - Health Science Center Maternity & Family Planning,1689747552,Family Planning Providers,6900 Gonzales Rd SW,Suite H,Albuquerque,NM,87121-2401,Bernalillo,2211 Lomas Blvd NE,,Albuquerque,NM,87106-2745,Bernalillo,Pamela Stanley,Director of Managed Care,505-272-3911,,PJStanley@msn.com,,,,,,
NM-007547,Planned Parenthood of the Rocky Mountains -- San Mateo,Planned Parenthood of the Rocky Mountains,1851440945,"Family Planning Providers, Sexually Transmitted Disease Clinics",701 San Mateo Blvd NE,,Albuquerque,NM,87108-1434,Bernalillo,7155 East 38th Avenue,,Denver,CO,80207,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NM-007548,Southeast Heights Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7525 Zuni Rd SE,,Albuquerque,NM,87108-3354,Bernalillo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007549,FCCH/ALAMEDA CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1447412796,Federally Qualified Health Centers - Medical Services,7704 2nd St NW,,Albuquerque,NM,87107-6755,Bernalillo,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007550,Northwest Valley Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7704 2nd St NW,,Albuquerque,NM,87107-6755,Bernalillo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007551,UNM Truman Health Services,UNM Truman Health Services,1831218627,"Ryan White Providers, Sexually Transmitted Disease Clinics",801 Encino Pl NE,Suite F,Albuquerque,NM,87102-2639,Bernalillo,933 Bradbury Drive SE,Suite 2222,Albuquerque,NM,87106-4301,Bernalillo,Pamela Stanley,Director of Managed Care,505-272-3911,,PJStanley@msn.com,,,,,,http://www.unmtruman.com/
NM-007552,Albuquerque Indian Health Center,Indian Health Service,1659458917,"Indian Health Service, Outpatient Hospital Clinics",801 Vassar Dr NE,,Albuquerque,NM,87106-2725,Bernalillo,801 Vassar Dr NE,,Albuquerque,NM,87106,Bernalillo,John E. Rael,CEO,505-248-4052,,john.rael@ihs.gov,Tracy Sanchez,AO,505-248-7819,,Tracy.Sanchez@ihs.gov,
NM-007553,Northeast Heights Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",8120 La Mirada Pl NE,,Albuquerque,NM,87109-1605,Bernalillo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007554,Albuquerque IHS Dental Clinic,Albuquerque Area Indian Health Service,1497849186,"Dental Providers, Indian Health Service",9169 Coors Blvd NW,,Albuquerque,NM,87120-3101,Bernalillo,PO Box 67830,,Albuquerque,NM,87193,Bernalillo,Maureen R. Cordova,CEO,505-922-4248,,maureen.cordova@ihs.gov,,,,,,
NM-007555,Planned Parenthood of the Rocky Mountains - Northeast Heights,"Planned Parenthood of the Rocky Mountains, Inc.",1295884351,"Family Planning Providers, Sexually Transmitted Disease Clinics",9809 Candelaria Rd NE,Bldg 2 Suites C&D,Albuquerque,NM,87112-1458,Bernalillo,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NM-007556,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1689034662,Federally Qualified Health Centers - Medical Services,6301 Highway 28,LCDF GADSDEN SCHOOL BASE,Anthony,NM,88021-8597,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,VMEDINA@LCDFNM.ORG,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007557,LCDF ANTHONY MEDICAL,"LA CLINICA DE FAMILIA, INC.",1699748921,Federally Qualified Health Centers - Medical Services,855 N Main,,Anthony,NM,88021-9325,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007558,Anthony Public Health Office,State of NM Department of Health - PHD,1134257249,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",865 N Main St,,Anthony,NM,88021-9354,Dona Ana,1190 S. St. Francis Drive,Suite S1050,Santa Fe,NM,87501,Santa Fe,Michelle D Cisneros,Administrative Operations Manager II,505-827-0664,,michelle.cisneros@state.nm.us,Heather Black,Chief Nurse,505-827-2308,,heather.black@state.nm.us,https://nmhealth.org/
NM-007559,LCDF MENTAL HEALTH SERVICES,"LA CLINICA DE FAMILIA, INC.",1033599022,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",880 Anthony Dr,,Anthony,NM,88021-9346,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,CREDENTIALING SPECIAILIST,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007560,Eddy County Public Health Office Artesia,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1001 Memorial Dr,,Artesia,NM,88210-1125,Eddy,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Billing and EHR Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007561,PMS Artesia Family Health Center,Presbyterian Medical Services Inc,1518910553,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1105 Memorial Dr,,Artesia,NM,88210-1189,Eddy,1422 Paseo de Peralta,,Santa Fe,NM,87504-2267,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007562,PMS - Artesia Family Health Center PSR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,2002 W Grand Ave,Room 2,Artesia,NM,88210-1676,Eddy,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Executive Vice President,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007563,FCCH/BELEN CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1447411632,Federally Qualified Health Centers - Medical Services,120 S 9th St,,Belen,NM,87002-3102,Valencia,2001 El Centro Familiar Blvd SW Ste 1,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007564,Belen Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",617 Becker Ave,PO Box 686,Belen,NM,87002-3633,Valencia,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,Admin Ops II - Public Health,505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,Chief Nurse - Public Health,505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007565,El Pueblo Health Services,"El Pueblo Health Services, Inc.",1144302415,Federally Qualified Health Centers - Medical Services,121 Calle del Presidente,,Bernalillo,NM,87004-6091,Sandoval,121 Calle del Presidente,,Bernalillo,NM,87004,Sandoval,Rick Adesso,Executive Director,505-771-5208,,rick.adesso@gmail.com,Carolyn Bueno,Office Manager,505-867-2324,,cbueno@epfh.org,
NM-007566,PMS - Sandoval County Health Commons Dental Services,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Dental Providers,1500 Idalia Rd,Bldg B,Bernalillo,NM,87004-6303,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007567,Sandoval County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1500 Idalia Rd,Bldg B,Bernalillo,NM,87004-6303,Sandoval,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007568,Sandia Health Center,Pueblo of Sandia,1548588643,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",203 Sandia Day School Rd,,Bernalillo,NM,87004-9015,Sandoval,481 Sandia Loop,,Bernalillo,NM,87004,Sandoval,Carrie Sarnicky,Director,505-867-4696,5092,csarnicky@sandiapueblo.nsn.us,Susan Seefeldt,Business Office Manager,505-867-4696,5116,sseefeldt@sandiapueblo.nsn.us,
NM-007569,Dzilth-Na-O-Dith-Hle Health Center,Dzilth-Na-O-Dith-Hle Health Center,1760427587,"Dental Providers, Indian Health Service, Other ECP Providers",6 Road 7586,,Bloomfield,NM,87413-4934,San Juan,6 Road 7586,,Bloomfield,NM,87413-4934,San Juan,Arlene Sandoval,Business Office Supervisor,505-365-8015,,arlene.sandoval@ihs.gov,Fannessa Comer,Chief Executive Officer,505-368-6006,,fannessa.comer@ihs.gov,
NM-007570,Bloomfield Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",903 W Broadway Ave,,Bloomfield,NM,87413-5726,San Juan,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing and EHR Manager, DOH Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,Chief Nurse PHD,505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007571,PMS - JEMEZ VALLEY MEDICAL CLINIC,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,8372 Highway 4,,Canon,NM,87024-9727,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007572,Eddy County Public Health Office Carlsbad,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1306 W Stevens St,,Carlsbad,NM,88220-4240,Eddy,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007573,PMS Carlsbad Family Health Center,Presbyterian Medical Services,1518910553,Federally Qualified Health Centers - Medical Services,2013 San Jose Blvd,,Carlsbad,NM,88220-5426,Eddy,1422 Paseo de Peralta,,Santa Fe,NM,87504,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,
NM-007574,"Presbyterian Medical Services, Inc.","PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,3000 W Church St,"PMS - CARLSBAD SCHOOL BASED HLTH CTR, THE CAVE",Carlsbad,NM,88220-3110,Eddy,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Execurtive Vice President,505-982-5565,,doug.smith@pmsnm.org,,,,,,pmsnm.org
NM-007575,PMS - Carlsbad Family Health Center Behavioral Health,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,914 N Canal St,,Carlsbad,NM,88220-5110,Eddy,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Esecutive Vice President,505-982-5565,,Doug.Smith@pmsnm.org,,,,,,pmsn.org
NM-007576,PMS -ORTIZ MOUNTAIN HLTH CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,6b Main St,,Cerrillos,NM,87010,Santa Fe,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007577,PMS - Chaparral Family Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,204 Angelina,,Chaparral,NM,88081-7558,Dona Ana,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,pmsnm.org
NM-007578,Chaparral Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",317 McCombs Rd,,Chaparral,NM,88081-7937,Dona Ana,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007579,CHAPARRAL DENTAL,"LA CLINICA DE FAMILIA, INC.",1871889337,Dental Providers,510 E Lisa Dr,,Chaparral,NM,88081-7809,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,CREDENITALING SPECIALIST,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007580,LCDF CHAPARRAL MEDICAL,"LA CLINICA DE FAMILIA, INC.",1508838004,Federally Qualified Health Centers - Medical Services,510 E Lisa Dr,,Chaparral,NM,88081-7809,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007581,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1962862938,Federally Qualified Health Centers - Medical Services,800 S County Line Dr,LCDF CHAPARRAL SCHOOL BASE,Chaparral,NM,88081-7830,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007582,Union Clayton Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",100 Court St,PO Box 158,Clayton,NM,88415-0158,Union,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007583,PMS - SACRAMENTO MTN MEDICAL CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,74 James Canyon Hwy,,Cloudcroft,NM,88317,Otero,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EvP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007584,La Casa De Buena Salud Inc,LA CASA DE BUENA SALUD INC,1760788137,Dental Providers,100 Commerce Way,La Casa School Based Dental Clinic Clovis Marshall Middle School,Clovis,NM,88101-4768,Curry,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007585,Curry County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1216 Cameo St,Suite G,Clovis,NM,88101-5571,Curry,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Billing and EHR Manager, New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Cheif Nurse, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007586,"LA CASA DE BUENA SALUD, INC.",La Casa Family Health Center,1518067669,Federally Qualified Health Centers - Medical Services,1221 Maple St,,Clovis,NM,88101-6166,Curry,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007587,La Casa SB Dental Program Freshman Campus,LA CASA DE BUENA SALUD INC,1588960959,Dental Providers,1400 Cameo St,,Clovis,NM,88101-5401,Curry,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007588,LA CASA DE BUENA SALUD - CLOVIS,LA CASA DE BUENA SALUD INC,1518067669,"Dental Providers, Federally Qualified Health Centers - Medical Services",1521 W 13th St,,Clovis,NM,88101-5568,Curry,1515 W Fir St,,Portales,NM,88130-5703,Curry,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007589,Ben Archer Health Center - Columbus,"BEN ARCHER HEALTH CENTER, INC.",1598790222,"Dental Providers, Federally Qualified Health Centers - Medical Services",626 Taft St,,Columbus,NM,88029,Luna,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,
NM-007590,PMS - COUNSELOR CLINIC,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,9837 Us Hwy 550,,Counselor,NM,87018,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007591,Crownpoint Hospital,Crownpoint Hospital,1114960093,"Dental Providers, Indian Health Service, Other ECP Providers",Hwy 191 Phs Dr,,Crownpoint,NM,87313,McKinley,PO Box 358,,Crownpoint,NM,87313-0358,McKinley,Francelia Mitchell,Business Office Supervisor,505-786-6387,,francelia.mitchell@ihs.gov,Anslem Roanhorse,Chief Executive Officer,505-786-5291,,anslem.roanhorse@ihs.gov,
NM-007592,Pueblo Pintado Health Center (Crownpoint Service Unit),Pueblo Pintado Health Center,1023051133,"Dental Providers, Indian Health Service, Other ECP Providers",10 Pueblo Pintado School,,Cuba,NM,87013,Sandoval,PO Box 358,,Crownpoint,NM,87313-0358,McKinley,Francelia Mitchell,Business Office Supervisor,505-786-6387,,francelia.mitchell@ihs.gov,Anslem Roanhorse,Chief Executive Officer,505-786-6313,,anslem.roanhorse@ihs.gov,
NM-007593,"Presbyterian Medical Services, Inc.","PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,50 Cr 13,PMS - Cuba School-Based Health Center,Cuba,NM,87013,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007594,PMS - Cuba Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Dental Providers, Federally Qualified Health Centers - Medical Services",6349 Us Hwy 550,,Cuba,NM,87013,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007595,Cuba Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6362 US Highway 550,,Cuba,NM,87013-6032,Sandoval,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"EHR and Billing Manager, New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"CHief Nurse, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007596,Ben Archer Health Center - Deming,"BEN ARCHER HEALTH CENTER, INC.",1205861283,"Dental Providers, Federally Qualified Health Centers - Medical Services",125 Chaparrel Blvd NW,,Deming,NM,88030-8629,Luna,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,
NM-007597,Luna County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",215 S Silver Ave,,Deming,NM,88030-3715,Luna,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007598,PMS - Deming Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,300 S Diamond Ave,,Deming,NM,88030-3752,Luna,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007599,PMS - Deming Behavioral Health Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,901 W Hickory St,,Deming,NM,88030-4046,Luna,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Executive Vice President,505-982-5565,,Doug.Smith@pmsnm.org,,,,,,pmsnm.org
NM-007600,Dexter Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",206 S Monroe,PO Box 493,Dexter,NM,88230-0493,Chaves,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Administrative Operations Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007601,FCCH/EDGEWOOD CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1962663153,"Dental Providers, Federally Qualified Health Centers - Medical Services",8 Medical Center Rd,,Edgewood,NM,87015-7086,Santa Fe,2001 El Centro Familiar Blvd SW,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007602,LAS CLINICAS DEL NORTE,LAS CLINICAS DEL NORTE,1053314831,"Dental Providers, Federally Qualified Health Centers - Medical Services",STATE RD # 571,BLDG 28,EL RITO,NM,87530,Rio Arriba,PO Box 237,,EL RITO,NM,87530,Rio Arriba,REGINA MARTINEZ,BILLING ASSITANT/CREDENTIALING,575-581-4728,226,REGINA@LCDN.ORG,ANDY R LOPEZ,CEO,575-581-4728,224,ANDY@LCDN.ORG,
NM-007603,PMS Espanola Family Wellness Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1200 N Paseo de Onate,,Espanola,NM,87532-2687,Rio Arriba,PO Box 2267,,Santa Fe,NM,87504,Santa Fe,Sarah Howse,Director of Operational Support,505-954-2334,,sarah.howse@pmsnm.org,,,,,,
NM-007604,Rio Arroba County Espanola Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2010 Industrial Park Rd,,Espanola,NM,87532-3600,Rio Arriba,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007605,PMS Valley Community Health Center,Presbyterian Medical Services,1518910553,Federally Qualified Health Centers - Medical Services,835 Spruce St Ste C,Suite C&D,Espanola,NM,87532-3455,Rio Arriba,1422 Paseo de Peralta,,Santa Fe,NM,87501-4391,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007606,Estancia Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 S 8th St,,Estancia,NM,87016,Torrance,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007607,PMS Esperanza Family Health Center,Presbyterian Medical Services,1518910553,"Dental Providers, Federally Qualified Health Centers - Medical Services",903 C N. 5th St,,Estancia,NM,87016,Torrance,1422 Paseo de Peralta,,Santa Fe,NM,87504-2267,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007608,PMS - FARMINGTON COMM HLTH CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1001 W Broadway,Suite D,Farmington,NM,87401-5638,San Juan,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007609,PMS - TOTAH BEHAVORIAL HLTH AUTHORITY,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1615 Ojo Ct,,Farmington,NM,87401,San Juan,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007610,Planned Parenthood of the Rocky Mountains--Farmington,"Planned Parenthood of the Rocky Mountains, Inc.",1851440945,"Family Planning Providers, Sexually Transmitted Disease Clinics",2804 E 20th St,,Farmington,NM,87402-4404,San Juan,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NM-007611,San Juan County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",355 S Miller Ave,,Farmington,NM,87401-6463,San Juan,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007612,Debaca Family Practice Clinic,DEBACA FAMILY PRACTICE CLINIC,1699082644,Federally Qualified Health Centers - Medical Services,1001 Sumner Ave,FORT SUMNER SCHOOL BASED HLTH,Fort Sumner,NM,88119,De Baca,546 N. 10th St,,Fort Sumner,NM,88119,De Baca,Lisa Walraven,CEO,575-355-2420,,lisawwork@plateautel.net,Heather McConnell,COO,575-355-2420,,heatherm@plateautel.net,
NM-007614,DeBaca County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",546 N 10th St,PO Box 929,Fort Sumner,NM,88119-0929,De Baca,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Administrative Operations Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007615,PMS- GALLUP TEEN HEALTH CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1055 1/2 Rico St,,Gallup,NM,87301,McKinley,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007616,"Rehoboth McKinley Christian Health Care Services, Inc.","Rehoboth McKinley Christian Health Care Services, Inc.",1720084999,Inpatient Hospitals (other than children's hospitals),1901 Red Rock Dr,,Gallup,NM,87301-5683,McKinley,1901 Red Rock Dr.,,Gallup,NM,87301,Mckinley,Teresa Lopez,Executive Admin Assistant,505-863-7335,,tlopez@rmchcs.org,Margaret Gavaldon,Senior Accountant,505-863-7275,,mgavaldon@rmchcs.org,
NM-007617,McKinley County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1919 College Dr,,Gallup,NM,87301-7010,McKinley,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007618,PMS - WESTERN NM MED GRP-BH - GALLUP,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2025 E Aztec Ave,,Gallup,NM,87301-4803,McKinley,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007619,Gallup Indian Medical Center,Gallup Indian Medical Center,1225002322,"Dental Providers, Indian Health Service, Other ECP Providers",516 E Nizhoni Blvd,,Gallup,NM,87301-5748,McKinley,PO Box 1337,,Gallup,NM,87305-1337,McKinley,Sharon Brokeshoulder,Business Office Manager,505-722-1172,,sharon.brokeshoulder@ihs.gov,Vida Khow,Chief Executive officer,505-722-1405,,vida.khow@ihs.gov,
NM-007620,PMS WEstern NM Medical Group - Gallup,Presbyterian Medical Services,1518910553,Federally Qualified Health Centers - Medical Services,610 N Fifth St,,Gallup,NM,87301-5306,McKinley,1422 Paseo de Peralta,,Santa Fe,NM,87504-2267,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsn.org
NM-007621,Cibola General Hospital,Cibola General Hospital.,1780677039,Inpatient Hospitals (other than children's hospitals),1016 E Roosevelt Ave,,Grants,NM,87020-2118,Cibola,1016 E Roosevelt,,Grants,NM,87020,Cibola,Ed Brown,Interim CFO,505-287-5302,,ed_brown@cibolahospital.com,,,,,,
NM-007622,PMS -WESTERN NM MED GRP - GRANTS,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1217 Bonita St,,Grants,NM,87020-2103,Cibola,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Executive Vice President,505-982-5565,,doug.smith@pmsnm.org,,,,,,pmsnm.org
NM-007623,Cibola Family Health Center,Cibola General Hospital,1457675266,Outpatient Hospital Clinics,1423 E Roosevelt Ave,,Grants,NM,87020-2245,Cibola,Cibola General Hosptal,1016 E Roosevelt Ave,Grants,NM,87020,Cibola,Ed Brown,Interim CFO,505-287-5302,,ed_brown@cibolahospital.com,,,,,,
NM-007624,PMS Grants Family Counseling,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,210 E Santa Fe Ave,,Grants,NM,87020-2443,Cibola,PO Box 2267,,Santa Fe,NM,87501,Santa Fe,Sarah Howse,Director of Operational Support,505-954-2334,,sarah.howse@pmsnm.org,,,,,,
NM-007625,Grants Public Health Office,New Mexico Dept. of Health,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",700 E Roosevelt Ave,Suite 100,Grants,NM,87020-2178,Cibola,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007626,Ben Archer Health Center - Hatch,"BEN ARCHER HEALTH CENTER, INC.",1154352532,"Dental Providers, Federally Qualified Health Centers - Medical Services",255 Hwy 187,,Hatch,NM,87937,Dona Ana,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,
NM-007627,Hatch Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3 Chili Capital Lane,,Hatch,NM,87937,Dona Ana,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007628,Lea County Public Health Office Hobbs,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1923 N Dal Paso St,Suite B,Hobbs,NM,88240-3023,Lea,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007629,PMS - HOBBS FAMILY HEALTH CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,200 W Lea St,,Hobbs,NM,88240-5110,Lea,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,
NM-007630,LA CASA DE BUENA SALUD INC,La Casa Family Health Center,1205957487,Federally Qualified Health Centers - Medical Services,103 Don Pablo Ln,,Hondo,NM,88336,Lincoln,1515 W Fir St,,Portales,NM,88130-5703,Lincoln,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007631,Jemez Pueblo Comprehensive Health Center,Pueblo Of Jemez,1417082215,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",110 Sheep Springs Way,,Jemez Pueblo,NM,87024,Sandoval,PO Box 279,,Jemez Pueblo,NM,87024,Sandoval,"David L. Tempest, M.D.",Medical Director,575-834-7413,169,david.tempest@jemezpueblo.us,Basil Pina,Financial Analyst,575-834-7413,176,basil.pina@jemezpueblo.us,
NM-007632,LCDF SAN MIGUEL MEDICAL,"LA CLINICA DE FAMILIA, INC.",1396718631,Federally Qualified Health Centers - Medical Services,18420 S Highway 28,,La Mesa,NM,88044-9605,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007633,"Presbyterian Medical Services, Inc.","PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,700 Broadway,PMS - Lake Arthur School-Based Health Center,Lake Arthur,NM,88253,Chaves,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EvP,505-982-5565,,doug.smith@pmsnm.org,,,,,,pmsnm.org
NM-007634,MENTAL HEALTH CENTER,"LA CLINICA DE FAMILIA, INC.",1871973297,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",100 W Griggs Ave,,Las Cruces,NM,88001-1234,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007635,ACT PROGRAM,"LA CLINICA DE FAMILIA, INC",1164802310,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",105 W Griggs Ave,,Las Cruces,NM,88001-1235,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,CHEIF OPERATING OFFICER,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007636,Dona Ana County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1170 N Solano Dr,Suite M,Las Cruces,NM,88001-2371,Dona Ana,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Billing and EHR Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, Pubic Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007637,LCDF MULTI-SYSTEMIC CENTER,"LA CLINICA DE FAMILIA, INC",1639559891,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",118 S Main St,,Las Cruces,NM,88001-1266,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,CHEIF OPERATING OFFICER,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007638,LCDF PSYCHO SOCIAL REHAB CENTER,"LA CLINICA DE FAMILIA, INC",1073993200,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",125 S Main St,,Las Cruces,NM,88001-1270,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,CHEIF OPERATING OFFICER,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007639,Ben Archer Health Center - Dona Ana,"BEN ARCHER HEALTH CENTER, INC.",1780619411,"Dental Providers, Federally Qualified Health Centers - Medical Services",1600 Thorpe Rd,,Las Cruces,NM,88012-9776,Dona Ana,251 NM 187,,Hatch,NM,87937,Dona Ana,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,
NM-007640,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1639553928,Federally Qualified Health Centers - Medical Services,1950 Sonoma Ranch Blvd,LCDF CENTENNIAL SCHOOL BASE,Las Cruces,NM,88011-1701,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007641,"Ben Archer Health Center, Inc.","BEN ARCHER HEALTH CENTER, INC.",1699105320,"Dental Providers, Federally Qualified Health Centers - Medical Services",1955 N Valley Dr,Ben Archer Health Center Mayfield School Base,Las Cruces,NM,88007-5154,Dona Ana,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,721,mrooker@bahcnm.org,
NM-007642,Ben Archer Health Center of Las Cruces,"BEN ARCHER HEALTH CENTER, INC.",1427330513,"Dental Providers, Federally Qualified Health Centers - Medical Services",1998 N Motel Blvd,,Las Cruces,NM,88007-4100,Dona Ana,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,721,mrooker@bahcnm.org,
NM-007643,Ben Archer Health Center,Ben Archer Health Center,1487026563,"Dental Providers, Federally Qualified Health Centers - Medical Services",3331 Del Rey Blvd,,Las Cruces,NM,88012-7713,Dona Ana,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,Mar,CEO,575-267-3280,721,mgaray@bahcnm.org,
NM-007644,LCDF LAS CRUCES DENTAL,"LA CLINICA DE FAMILIA, INC.",1295912301,Dental Providers,385 Calle de Alegra,Bldg. C,Las Cruces,NM,88005-3423,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,CHEIF OPERATIONS OFFICER,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007645,LCDF LAS CRUCES MEDICAL BLDG. B,"LA CLINICA DE FAMILIA, INC.",1205809944,Federally Qualified Health Centers - Medical Services,385 Calle de Alegra,Suite A,Las Cruces,NM,88005-3423,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007646,LCDF LAS CRUCES MEDICAL BLDG. C,"LA CLINICA DE FAMILIA, INC.",1346213808,Federally Qualified Health Centers - Medical Services,385 Calle de Alegra,BLDG. C,Las Cruces,NM,88005,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007647,LCDF FIRST STEP CENTER,"LA CLINICA DE FAMILIA, INC.",1740286863,Federally Qualified Health Centers - Medical Services,390 Calle de Alegra,,Las Cruces,NM,88005-3280,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007648,LCDF EAST MESA MEDICAL,"LA CLINICA DE FAMILIA, INC.",1285607754,Federally Qualified Health Centers - Medical Services,8600 BATAAN MEMORIAL EAST,,Las Cruces,NM,88011,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007649,San Miguel County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",18 Gallegos Rd,,Las Vegas,NM,87701-4512,San Miguel,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007650,Hidalgo County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",530 De Moss St,,Lordsburg,NM,88045-2617,Hidalgo,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007651,HMS,Hidalgo Medical Services,1306843180,Federally Qualified Health Centers - Medical Services,530 DE Moss St,,Lordsburg,NM,88045-2618,Hidalgo,530 De Moss Street,,Lordsburg,NM,88045-2618,Hidalgo,Audelina (Missy) Morelos,Credentialing Dept. Coordinator,575-542-2368,,mmorelos@hmsnm.org,Corrine Flores,Credentialing Clerk Specialist,575-542-2307,,cflores@hmsnm.org,
NM-007652,Los Alamos Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1183 Diamond Dr,Suite D,Los Alamos,NM,87544-2228,Los Alamos,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007653,FCCH/LOS LUNAS CENTER,"FIRST CHOICE COMMUNITY HEALTHCARE, INC.",1649431834,"Dental Providers, Federally Qualified Health Centers - Medical Services",145 Don Pasqual Rd NW,,Los Lunas,NM,87031-8841,Valencia,2001 El Centro Familiar Blvd SW Ste 1,,Albuquerque,NM,87105-4592,Bernalillo,Robert DeFelice,CEO,505-873-7401,,bob@fcch.com,Melissa Manlove,COO,505-873-7474,,melissa_manlove@fcch.com,www.fcch.com
NM-007654,Los Lunas Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",445 Camino del Rey Dr Ste A,PO Box 177,Los Lunas,NM,87031-0177,Valencia,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007655,PMS - LOVING HEALTH CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,602 S 4th St,,Loving,NM,88256,Eddy,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007656,Lea County Public Health Office Lovington,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",302 N 5th St,,Lovington,NM,88260-3911,Lea,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007657,PMS Magdalena Area Health Center,Presbyterian Medical Services,1518910553,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",801 10th St,,Magdalena,NM,87825,Socorro,1422 Paseo de Peralta,,Santa Fe,NM,87504-2267,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007658,Mescalero Service Unit,Mescalero Service Unit/IHS,1891886065,"Indian Health Service, Other ECP Providers",318 Abalone Loop,,Mescalero,NM,88340,Otero,318 abalone Loop,,Mescalero,NM,88340,Otero,Dorlynn Simmons,CEO,575-464-4441,,Dorlynn.simmons@ihs.gov,,,,,,
NM-007659,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1285607754,Federally Qualified Health Centers - Medical Services,2355 AVENIDA DE MESILLA,RIO GRANDE SCHOOL BASE MEDICAL CLINIC,MESILLA,NM,88046,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007660,"MORA VALLEY COMMUNITY HEALTH SERVICE, INC.","MORA VALLEY COMMUNITY HEALTH SERVICES, INCORPORATED",1508840117,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",3 Mora Valley Clinic Rd,,Mora,NM,87732-2202,Mora,3 Mora Valley Clinic Road,,Mora,NM,87732,Mora,Julian F. Barela D.B.A.,Chief Executive Officer,575-387-5069,,jbarela@mvchs.org,Joseph Lopez,Development & Special Projects Director,505-387-3311,,joseph.lopez@mvchs.org,
NM-007661,Mora County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",Highway 518 N Ranger Dr,PO Box 187,Mora,NM,87732-0187,Mora,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007662,Moriarty Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1110 Rt 66,PO Box 2460,Moriarty,NM,87035-2460,Torrance,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007663,PMS - MOUNTAINAIR FAM HLTH CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,105 E Pinon St,,Mountainair,NM,87036,Torrance,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007664,Toadlena Health Station,Toadlena Health Station (part of Shiprock SU-NAIHS),1952526337,"Indian Health Service, Other ECP Providers",Navajo Rt. 19,,Newcomb,NM,87455,San Juan,POB 160,,Shiprock,NM,87420,San Juan,Helena Burbank,Business Office Supervisor,505-368-6060,,helena.burbank@ihs.gov,Fannessa Comer,Chief Executive Officer,505-368-6006,,fannessa.comer@ihs.gov,
NM-007665,LAS CLINICAS DEL NORTE - OJO CALIENTE,LAS CLINICAS DEL NORTE,1437379880,Federally Qualified Health Centers - Medical Services,Highway 285,Bldg 35282,Ojo Caliente,NM,87549,Taos,PO Box 237,,EL RITO,NM,87530,Rio Arriba,REGINA MARTINEZ,BILLING ASSISTANT/CREDENTIALING,575-581-4728,226,REGINA@LCDN.ORG,ANDY R LOPEZ,CEO,575-581-4728,224,ANDY@LCDN.ORG,
NM-007666,PMS - OJO ENCINO CLINIC,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,2 Ojo Encino Chapter Rd,,Ojo Encino,NM,87013,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007667,Peocs Valley Medical Center,Pecos Valley Medical Center,1497801047,"Dental Providers, Federally Qualified Health Centers - Medical Services",199 highway 50,,Pecos,NM,87552,San Miguel,PO Box 710,,Pecos,NM,87552,San Miguel,Kevin Norris,CEO,505-757-6482,,kevinnorris@pecoshealth.org,CeCe Kurzweg,Cheif Compliance Officer,505-757-6482,,ceciliakurzweg@pecoshealth.org,www.pecoshealth.org
NM-007668,Pine Hill Health Center,Pine Hill Health Center,1619001849,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",Bia Rt 125 Mp 12.5,,Pinehill,NM,87357,Cibola,PO Box 310,,Pinehill,NM,87357-0310,Cibola,Alvin Raphlito,Health and Human Services Director,505-495-9140,,alvin@rnsb.k12.nm,William Becker,PHHC Clinic Administrator,505-775-3271,256,william.becker@ihs.gov,http://rnsb.k12.nm.us
NM-007669,La Casa Family Health Center Student Health Services ENMU-Portales,LA CASA DE BUENA SALUD INC,1972603165,Federally Qualified Health Centers - Medical Services,1500 S Avenue K,,Portales,NM,88130-7400,Roosevelt,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007670,LA CASA DE BUENA SALUD INC,La Casa Family Health Center,1972603165,"Dental Providers, Federally Qualified Health Centers - Medical Services",1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007671,Roosevelt County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1515 W Fir St,PO Box 999,Portales,NM,88130-5703,Roosevelt,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007672,PMS - Quemado Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,8 Old Town Loop,,Quemado,NM,87829,Catron,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007673,PMS - QUESTA HEALTH CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Dental Providers, Federally Qualified Health Centers - Medical Services",2573 Nm 522,,Questa,NM,87556,Taos,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,
NM-007674,Ben Archer Health Center - Radium Springs,"BEN ARCHER HEALTH CENTER, INC.",1770734865,"Dental Providers, Federally Qualified Health Centers - Medical Services",12080 Lb Lindbeck Rd,,Radium Springs,NM,88054,Dona Ana,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,
NM-007675,Colfax County Public Health Office,State of NM Department of Health - Public Health Division,1134257249,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",226 4th Ave,,Raton,NM,87740-2643,Colfax,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"Billing and EHR Manager NM Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,Chief Nurse - Public Health Division,505-827-0644,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007676,PMS - CATRON COUNTY MED CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Foster Ln,,Reserve,NM,87830,Catron,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,Executive Vice President,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-476-8882,,,pmsnm.org
NM-007677,PMS - RIO RANCHO FAMILY HLTH CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,184 Unser Blvd NE,,Rio Rancho,NM,87124-4045,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,
NM-012460,Center for Vein Restoration,Center for Vein Restoration,1891342994,Other ECP Providers,2220 Grande Blvd SE,Suite B,Rio Rancho,NM,87124-1687,Sandoval,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NM-007678,Presbyterian Medical Services Family Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2300 Grande Blvd SE,,Rio Rancho,NM,87124-1755,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007679,La Casa Family Health Center,LA CASA DE BUENA SALUD INC,1215037379,Federally Qualified Health Centers - Medical Services,1511 S Grand Ave,,Roswell,NM,88203-5407,Chaves,1515 W Fir St,,Portales,NM,88130-5703,Chaves,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007680,Chaves County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 E Chisum St,,Roswell,NM,88203-5412,Chaves,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007681,Los Ninos Pediatrics,LA CASA DE BUENA SALUD INC,1265721427,Federally Qualified Health Centers - Medical Services,200 W Wilshire Blvd,Suite A,Roswell,NM,88201-0627,Chaves,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-012461,Center for Vein Restoration,Center for Vein Restoration,1891342994,Other ECP Providers,400 Military Heights Pl,,Roswell,NM,88201-6407,Chaves,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NM-007682,La Casa Family Health Center ENMU-Roswell Health & Dental Services,LA CASA DE BUENA SALUD INC,1215037379,"Dental Providers, Federally Qualified Health Centers - Medical Services",Enmu-Roswell Health Science Building 75 Univer,PO Box 6000,Roswell,NM,88202-6000,Chaves,1515 W Fir St,,Portales,NM,88130-5703,Roosevelt,Seferino M Montano,CEO,575-356-6695,3813,smontano@lacasahealth.com,Carmen Pacheco-Munoz,COO,575-356-6695,3801,cpacheco@lacasahealth.com,www.lacasahealth.com
NM-007683,Lincoln County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",117 Kansas City Rd,,Ruidoso,NM,88345-6922,Lincoln,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse of New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007684,PMS - Ruidoso Behavioral Health Center,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1400 Sudderth Dr,,Ruidoso,NM,88345-6103,Lincoln,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,Doug.Smith@pmsnm.org,,,,,,
NM-007685,Zia Health Center,ASU/Indian Health Service,1831250398,"Dental Providers, Indian Health Service, Outpatient Hospital Clinics",155 Capitol Square Dr,,San Ysidro,NM,87053-6013,Sandoval,155 Capital Square,,Albuquerque,NM,87053,Sandoval,John E. Rael,CEO,505-248-4062,,john.rael@ihs.gov,Mario Wilmath,Facilities Director,505-867-5258,,mario.wilmath@ihs.gov,
NM-007686,Sanostee Health Station,Sanostee Health Station (part of Shiprock SU-NAIHS),1083839476,"Indian Health Service, Other ECP Providers",Navajo Rt 34,,Sanostee,NM,87461,San Juan,POB 160,,Shiprock,NM,87420,McKinley,Helena Burbank,Business Office Supervsior,505-368-6060,,helena.burbank@ihs.gov,Fannessa Comer,Chief Executive Officer,505-368-6006,,fannessa.comer@ihs.gov,
NM-007687,Santa Ana Health Center,ASU/Indian Health Service,1649331323,"Indian Health Service, Outpatient Hospital Clinics",02-C Dove Rd,,Santa Ana Pueblo,NM,87004-5906,Sandoval,801 Vassar Dr NE,,Albuquerque,NM,87106,Bernalillo,John E. Rael,CEO,505-248-4062,,john.rael@ihs.gov,Raymond Cook,Facilities Director,505-867-2497,,Raymond.Cook@ihs.gov,
NM-007688,LA FAMILIA MEDICAL CENTER,LA FAMILIA MEDICAL CENTER,1346251782,Federally Qualified Health Centers - Medical Services,1035 Alto St,,Santa Fe,NM,87501-2406,Santa Fe,1035 Alto St,,Santa Fe,NM,87501-2406,Santa Fe,Jay Jolly,CEO,505-955-0310,,jjolly@lfmctr.org,Bernadette Pacheco,Clinic Director,505-955-0303,,,
NM-007689,Santa Fe Indian Hospital,Santa Fe Service Unit,1285613836,"Dental Providers, Family Planning Providers, Indian Health Service",1700 Cerrillos Rd,,Santa Fe,NM,87505-3026,Santa Fe,1700 Cerrillos,,Santa Fe,NM,87505,Santa Fe,Leslie Dye,CEO,505-946-9204,,leslie.dye@ihs.gov,Adam Archuleta,CFO,505-946-9206,,adam.archuleta@ihs.gov,
NM-007690,Presbyterian Medical Services Inc,Presbyterian Medical Services Inc,1518910553,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2100 Yucca St,PMS Teen Health Center Santa Fe High School,Santa Fe,NM,87505-5456,Santa Fe,1422 Paseo de Peralta,,Santa Fe,NM,87504,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007691,LA FAMILIA - SOUTHSIDE CLINIC,LA FAMILIA MEDICAL CENTER,1346251782,Federally Qualified Health Centers - Medical Services,2145 Caja del Oro Grant Rd,,Santa Fe,NM,87507-3279,Santa Fe,1035 Alto St,,Santa Fe,NM,87501-2406,Santa Fe,Jay Jolly,CEO,505-955-0310,,jjolly@lfmctr.org,Bernadette Pacheco,Clinic Director,505-438-3195,,,
NM-007692,PMS - SANTA FE COMM GUIDANCE CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2960 Rodeo Park Dr W,,Santa Fe,NM,87505-6351,Santa Fe,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007693,Presbyterian Medical Services Inc,Presbyterian Medical Services Inc,1518910553,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4851 Paseo del Sol,PMS Teen Health Center Capital High School,Santa Fe,NM,87507-3027,Santa Fe,1422 Paseo de Peralta,,Santa Fe,NM,87507,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,pmsnm.org
NM-007694,Santa Fe County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",605 Letrado St,Suite B,Santa Fe,NM,87505-4146,Santa Fe,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007695,La Famila Medical Center Dental Clinic,LA FAMILIA MEDICAL CENTER,1346251782,Dental Providers,6401 S Richards Ave,,Santa Fe,NM,87508-4887,Santa Fe,1035 Alto Street,,Santa Fe,NM,87501,Santa Fe,Jay Jolly,CEO,505-955-0310,,jjolly@lfmctr.org,Dale Jenkins,Dental Director,505-424-5697,,,
NM-007696,SOUTHWEST C. A. R. E. CENTER,Southwest CARE Center,1871602698,Ryan White Providers,649 Harkle Rd,Suite E,Santa Fe,NM,87505-4765,Santa Fe,649 Harkle Road,Suite E,Santa Fe,NM,87505,Santa Fe,Jeffrey Thomas,CEO,505-989-8200,1006,jthomas@southwestcare.org,,,,,,http://www.swchc.org/id20.html
NM-007697,Planned Parenthood of the Rocky Mountains - Santa Fe,"Planned Parenthood of the Rocky Mountains, Inc.",1851440945,"Family Planning Providers, Sexually Transmitted Disease Clinics",730 Saint Michaels Dr,Suite 4B,Santa Fe,NM,87505-7606,Santa Fe,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NM-007698,LFMC HEALTHCARE FOR THE HOMELESS,LA FAMILIA MEDICAL CENTER,1346251782,Federally Qualified Health Centers - Medical Services,818 Camino Sierra Vis,,Santa Fe,NM,87505-3018,Santa Fe,1035 Alto St,,Santa Fe,NM,87501-2406,Santa Fe,Jay Jolly,CEO,505-955-0310,,jjolly@lfmctr.org,Jeanell Abeyta,COO,505-955-0312,,jabeyta@lfmctr.org,
NM-007699,Guadalupe County Hospital,Guadalupe County Hospital,1346249968,Inpatient Hospitals (other than children's hospitals),117 Camino de Vida,Suite 100,Santa Rosa,NM,88435-2267,Guadalupe,117 Camino de Vida,Suite 100,Santa Rosa,NM,88435,Guadalupe,Christina Campos,Administrator,575-472-3417,1010,ccampos@gchnm.org,Frank Tenorio,Asst. Administrator,575-472-3417,1011,ftenorio@gchnm.org,
NM-007700,Guadalupe Family Dental Clinic,DEBACA FAMILY PRACTICE CLINIC,1962743534,Dental Providers,552 Highway 54,,Santa Rosa,NM,88435-2210,Guadalupe,546 N 10th St,,Fort Sumner,NM,88119,De Baca,Lisa Walraven,CEO,575-355-2420,,lisawwork@plateautel.net,Heather McConnell,COO,575-355-2440,,heatherm@plateautel.net,www.debacaclinic.com
NM-007701,Santa Rosa Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",722 Lake Dr,,Santa Rosa,NM,88435-2559,Guadalupe,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007702,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1083687115,Federally Qualified Health Centers - Medical Services,100 Airport Rd,LCDF SANTA TERESA SCHOOL BASE,Santa Teresa,NM,88008-9703,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2434,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007703,"La Clinica De Familia, Inc.","LA CLINICA DE FAMILIA, INC.",1730152281,Dental Providers,100 Airport Rd,SANTA TERESA SCHOOL BASE DENTAL CLINIC,Santa Teresa,NM,88008-9703,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,Las Cruces,NM,88005,Dona Ana,FELISHA JOHNSON,Credentialing Specialist,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operating Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007704,Santo Domingo Health Center,Kewa Pueblo Health Center (Santo Domingo),1467739888,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",85 West Highway 22,Kewa Pueblo Health Corporation,Santo Domingo,NM,87052,Sandoval,Po Box 340,,Santo Domingo,NM,87052,Sandoval,Dave Panana,Health Center Director,505-465-3060,1206,dpanana@kp-hc.org,Paul Gurule,Finance Controller,505-465-3060,1209,pgurule@kp-hc.org,
NM-007705,Northern Navajo Medical Center (Part of Shiprock Service Unit) (inpatient hospital),Northern Navajo Medical Center (Part of Shiprock Service Unit),1780639971,Inpatient Hospitals (other than children's hospitals),Hwy 491 N,,Shiprock,NM,87420,San Juan,PO Box 160,,Shiprock,NM,87420-0160,San Juan,Helena Burbank,Business Office Supervisor,505-368-6060,,helena.burbank@ihs.gov,Fannessa Comer,Chief Executive Officer,505-368-6001,,fannessa.comer@ihs.gov,
NM-007706,Northern Navajo Medical Center (Part of Shiprock Service Unit) (multiple outpatient ECP categories),Northern Navajo Medical Center (Part of Shiprock Service Unit),1780639971,"Dental Providers, Family Planning Providers, Indian Health Service",Hwy 491 N,,Shiprock,NM,87420,San Juan,PO Box 160,,Shiprock,NM,87420-0160,San Juan,Helena Burbank,Business Office Supervisor,505-368-6060,,helena.burbank@ihs.gov,Fannessa Comer,Chief Executive Officer,505-368-6001,,fannessa.comer@ihs.gov,
NM-007707,Grant County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2610 N Silver St,,Silver City,NM,88061-7299,Grant,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Chief Nurse, New Mexico Department of Health, Public Health Division",505-827-2308,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007708,PMS Socorro Mental Health,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1200 Highway 60,,Socorro,NM,87801-3914,Socorro,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007709,PMS Socorro Teen Health Center,Presbyterian Medical Services,1215284146,Federally Qualified Health Centers - Medical Services,1200 Michigan St.,,Socorro,NM,87801,Socorro,PO Box 2267,,Santa Fe,NM,87501,Santa Fe,Sarah Howse,Director of Operational Support,505-954-2334,,sarah.howse@pmsnm.org,,,,,,
NM-007710,PMS-SOCORRO COMM HEALTH CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1300 Enterprise Rd,,Socorro,NM,87801-4199,Socorro,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,pmsnm.org
NM-007711,Socorro County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",214 Neel Ave,,Socorro,NM,87801-4649,Socorro,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007712,LCDF SUNLAND PARK MEDICAL,"LA CLINICA DE FAMILIA, INC.",1730152281,Federally Qualified Health Centers - Medical Services,2625 McNutt Rd,,Sunland Park,NM,88063-9019,Dona Ana,385 CALLE DE ALEGRA,BLDG. A,LAS CRUCES,NM,88005,Dona Ana,FELISHA JOHNSON,CREDENTIALING SPECIALSIT,575-528-5537,2437,FJOHNSON@LCDFNM.ORG,VIRGIL MEDINA,Chief Operations Officer,575-526-1105,2461,VMEDINA@LCDFNM.ORG,WWW.LCDFNM.ORG
NM-007713,Sunland Park Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3807 McNutt Rd,,Sunland Park,NM,88063-9081,Dona Ana,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007714,Taos Picuris Health Center,Taos Picuris Health Center,1548372071,"Dental Providers, Family Planning Providers, Indian Health Service",1090 Goat Springs Rd,PO Box 1946,Taos,NM,87571-1946,Taos,1090 Goat Springs Road,P O Box 1946,Taos,NM,87571,Taos,Tamy Leung,TPSU Acting CEO,575-758-6987,,tamy.leung@ihs.gov,Connie Loretto,Business Office Manager,575-758-6966,,connie.loretto@ihs.gov,
NM-007715,Taos Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1400 Weimer Rd,,Taos,NM,87571-6346,Taos,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007716,PMS - WESTERN NM MED GRP - THOREAU,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,15 Navarre Blvd,,Thoreau,NM,87323,McKinley,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,
NM-007717,Thoreau Health Station,Thoreau Health Station,1679516702,"Dental Providers, Indian Health Service, Other ECP Providers",3 Navaree St,,Thoreau,NM,87323,McKinley,POB 358,,Crownpoint,NM,87301,McKinley,Francelia Mitchell,Business Office Supervisor,505-786-6387,,francelia.mitchell@ihs.gov,Anslem Roanhorse,Chief Executive Officer,505-786-6313,,anslem.roanhorse@ihs.gov,
NM-007718,LA CLINICA DEL PUEBLO DE RIO ARRIBA,LA CLINICA DEL PUEBLO,1598797805,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",Cr 324 Hwy 84 N #14,,Tierra Amarilla,NM,87575,Rio Arriba,County Rd 0324 Hwy 84,,Tierra Amarilla,NM,87575,Rio Arriba,Darren DeYapp,Executive Director,575-588-6131,,ddeyapp@la-clinica.org,Paula Gurule,Executive Assistant,575-588-6139,,pmgurule@la-clinica.org,www.laclinicanm.com
NM-007719,ESCALANTE TEEN WELLNESS CENTER,LA CLINICA DEL PUEBLO,1598797805,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",CR 531,Bldg 158,Tierra Amarilla,NM,87575,Rio Arriba,CR 324,Hwy 84,Tierra Amarilla,NM,87575,Rio Arriba,Darren DeYapp,Executive Director,575-588-6131,,ddeyapp@la-clinica.org,Paula Gurule,Executive Assistant,575-588-6139,,pmgurule@la-clinica.org,www.laclinicanm.com
NM-007720,Tohatchi Health Center,Tohatchi Health Center,1902875594,"Dental Providers, Indian Health Service, Other ECP Providers",07 Chooshgai Drive,,Tohatchi,NM,87325,McKinley,PO Box 142,,Tohatchi,NM,87325-0142,McKinley,Angela Pinto,Business Office Supervsior,505-733-8212,,angela.pinto@ihs.gov,Lydia Hubbard-Pourier,HSA,505-733-8415,,angela.pinto@ihs.gov,
NM-007721,PMS - TORREON HEALTH CLINIC,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,"Dental Providers, Federally Qualified Health Centers - Medical Services",2500 Nm 197,,Torreon,NM,87013,Sandoval,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Sarah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,,,,,,
NM-007722,"Ben Archer Health Center, Inc.","BEN ARCHER HEALTH CENTER, INC.",1710903844,"Dental Providers, Federally Qualified Health Centers - Medical Services",1950 N Date St,Ben Archer Health Center - T or C School-Aged Health Center,Truth Or Consequences,NM,87901-3701,Sierra,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,
NM-007723,Ben Archer Health Center,Ben Archer Health Center,1710903844,"Dental Providers, Federally Qualified Health Centers - Medical Services",1960 N Date St,,Truth Or Consequences,NM,87901-3701,Sierra,255 Highway 187,PO Box 370,Hatch,NM,87937,Dona Ana,Mary Rooker,CFO,575-267-3280,722,mrooker@bahcnm.org,Mary Alice Garay,CEO,575-267-3280,721,mgaray@bahcnm.org,
NM-007724,Sierra County Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 E 4th Ave,,Truth Or Consequences,NM,87901-2444,Sierra,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,MICHELLE CISNEROS,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,MICHELLE.CISNEROS@STATE.NM.US,HEATHER BLACK,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-0664,,HEATHER.BLACK@STATE.NM.US,http://nmhealth.org/
NM-007725,Sierra Vista Clinics,Sierra Vista Clinics,1689638942,"Community Mental Health Centers, Family Planning Providers, Rural Health Clinics",800 E 9th Ave,,Truth Or Consequences,NM,87901-1954,Sierra,800 East 9th Street,,Truth or Consequences,NM,87901,Sierra,Terri Markel,Clinic Business Office Manager,575-894-3221,363,terri.markel@svhnm.org,Sharon Finarelli,Director Ancillary Services,575-894-3221,204,sharon.finarelli@svhnm.org,
NM-007726,PMS - QUAY CTY FAMILY HLTH CTR,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,1302 E Main St,,Tucumcari,NM,88401-2508,Quay,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,SArah Howse,Director of Operational Support,505-982-5565,,sarah.howse@pmsnm.org,Lisa Stephens,Grants & Contracts Manager,505-982-5565,,lisa.stephens@pmsnm.org,pmsnm.org
NM-007727,Quay County Public Health Office,STATE OF NEW MEXICO DBA DEPARTMENT OF HEALTH,1134257249,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",402 E Miel de Luna Ave,,Tucumcari,NM,88401-3828,Quay,1190 S Saint Francis Dr Ste S-1150,,Santa Fe,NM,87505-4173,Santa Fe,Colleen Schaeffer,"BEHR Billing Manager of New Mexico Department of Health, Public Health Division",505-827-0664,,Colleen.Schaeffer@state.nm.us,Sandra Martinez,"Deputy Director of New Mexico Department of Health, Public Health Division",505-827-9700,,SandraE.Martinez2@state.nm.us,http://nmhealth.org/
NM-007728,PMS - TULAROSA MEDICAL CENTER,"PRESBYTERIAN MEDICAL SERVICES, INC.",1518910553,Federally Qualified Health Centers - Medical Services,111 Central Ave,,Tularosa,NM,88352-2063,Otero,1422 Paseo de Peralta Bldg 1,,Santa Fe,NM,87501-4304,Santa Fe,Doug Smith,EVP,505-982-5565,,doug.smith@pmsnm.org,,,,,,
NM-007729,Zuni Indian Hospital,Zuni Indian Hospital,1497843734,"Dental Providers, Indian Health Service, Other ECP Providers",Route 201 North 21 B Ave,,Zuni,NM,87327,McKinley,PO Box 467,,Zuni,NM,87327-0467,McKinley,Colleen,Chief Executive Officer,505-782-7300,321,jean.othole@ihs.gov,Colleen Leekity,Supervisory Health System Specialist,505-782-7321,321,colleen.leekity@ihs.gov,
NV-007730,Lincoln County Medical Associates - Alamo,Lincoln County Hospital District,1174602056,Outpatient Hospital Clinics,33 Joshua Tree St,,Alamo,NV,89001-2060,Lincoln,PO Box 1010,,Caliente,NV,89008,Lincoln,Jason Bleak,Administrator / CEO,775-726-3171,103,jkbleak@gcdmc.org,Missie Rowe,COO,775-726-3171,105,missie@gcdmc.org,www.gcdmc.org
NV-007731,AMARGOSA VALLEY MEDICAL CLINIC,"NEVADA HEALTH CENTERS, INC.",1831278720,Federally Qualified Health Centers - Medical Services,845 E Farm Rd,,Amargosa Valley,NV,89020-9795,Nye,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007732,AUSTIN MEDICAL CLINIC,"NEVADA HEALTH CENTERS, INC.",1982781134,Federally Qualified Health Centers - Medical Services,121 Main St,,Austin,NV,89310-9995,Lander,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007733,Battle Mountain General Hospital District,Battle Mountain General Hospital,1245312321,Inpatient Hospitals (other than children's hospitals),535 S Humboldt St,,Battle Mountain,NV,89820-1988,Lander,535 South Humboldt Street,,Battle Mountain,NV,89820,Lander,Holly Heese,Compliance Officer,775-635-2550,161,hheese@bmgh.org,Peggy Lindsey,CEO,775-635-2550,111,PLindsey@bmgh.org,
NV-007734,Battle Mountain Hospital District,Battle Mountain Rural Health Clinic,1790851616,Rural Health Clinics,535 S Humboldt St,,Battle Mountain,NV,89820-1988,Lander,535 South Humboldt Street,,Battle Mountian,NV,89820,Lander,Holly Heese,Compliance Officer,775-635-2550,161,hheese@bmgh.org,Peggy Lindsey,CEO,775-635-2550,111,PLindsey@bmgh.org,
NV-007735,Community Health Nursing-Lander County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1265664387,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",535 S Humboldt St,,Battle Mountain,NV,89820-1988,Lander,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007736,Boulder City Hospital,Boulder City Hospital,1881739613,Inpatient Hospitals (other than children's hospitals),901 Adams Blvd,,Boulder City,NV,89005-2213,Clark,901 Adams Blvd,,Boulder City,NV,89005,Clark,Doug Lewis,CFO,702-293-4111,509,dlewis@bouldercityhospital.org,Tom Maher,CEO,702-293-4111,,tmaher@bouldercityhospital.org,
NV-007737,Grover C. Dils Medical Center,Lincoln County Hospital District,1659423341,Inpatient Hospitals (other than children's hospitals),700 N. Spring Street,,Caliente,NV,89008,Lincoln,PO Box 1010,,Caliente,NV,89008,Lincoln,Jason Bleak,CEO,775-726-3171,103,jkbleak@gcdmc.org,Melissa Rowe,COO,775-726-3171,108,missie@gcdmc.org,www.gcdmc.org
NV-007738,Lincoln County Medical Associates - Caliente,Lincoln County Hospital District,1598843054,Rural Health Clinics,700 North Spring Street,,Caliente,NV,89008,Lincoln,PO Box 1010,,Caliente,NV,89008,Lincoln,Jason Bleak,Administrator / CEO,775-726-3171,103,jkbleak@gcdmc.org,Missie Rowe,COO,775-726-3171,105,missie@gcdmc.org,www.gcdmc.org
NV-007739,Carlin Community Health Center,"NEVADA HEALTH CENTERS, INC.",1376621722,Federally Qualified Health Centers - Medical Services,310 Memory Ln,,Carlin,NV,89822-9902,Elko,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007740,Sierra Nevada Health Center & Administrative Offices,"NEVADA HEALTH CENTERS, INC.",1265519813,Federally Qualified Health Centers - Medical Services,3325 Research Way,,Carson City,NV,89706-7913,Carson City,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007741,Nevada Health Centers Carson City School Based,"NEVADA HEALTH CENTERS, INC.",1619348489,Federally Qualified Health Centers - Medical Services,618 W Musser St,Nevada Health Centers Carson City School Based,Carson City,NV,89703-4931,Carson City,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter B. Davis,Chief Executive Officer,775-887-1590,1114,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007742,"Division of Public and Behavioral Health,Rural Community Health Services","NEVADA DEPT OF HHS,DIVISION OF PUBLIC & BEHAVIORAL HEALTH",1255416491,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",727 Fairview Dr,Suite A,Carson City,NV,89701-5493,Carson City,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007743,Carson City Health and Human Services,Carson City Health and Human Services,1922024314,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",900 E Long St,,Carson City,NV,89706-3100,Carson City,900 E Long St,,Carson City,NV,89706-3100,Carson City,Veronica (Roni) Galas,Clinical Services Manager,775-283-7620,,vgalas@carson.org,Nicki Aaker,Director,775-887-2190,,Naaker@carson.org,http://www.gethealthycarsoncity.org
NV-007744,Community Health Nursing-Lyon Co. Dayton,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1518199645,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5 Pine Cone Rd,Suite 103,Dayton,NV,89403-6309,Lyon,727 Fairview DR A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-012487,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,247 Bluffs Ave,Suite 102,Elko,NV,89801-2488,Elko,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007745,Elko Service Unit/Southern Bands Health Center,Elko Service Unit/Southern Bands Health Center,1780961102,"Dental Providers, Indian Health Service, Other ECP Providers",515 Shoshone Cir,,Elko,NV,89801-5072,Elko,515 Shoshone Cir,,Elko,NV,89801-5072,Elko,Cathy Welchert,Chief Executive Officer,775-738-2252,,AMCAULIFFE@IHS.GOV,maryellen snell,Busness Officer,775-748-1402,,maryellen.snell@ihs.gov,
NV-012488,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,515 Shoshone Cir,,Elko,NV,89801-5072,Elko,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007746,Elko Family Medical and Dental Center,"NEVADA HEALTH CENTERS, INC.",1073690616,"Dental Providers, Federally Qualified Health Centers - Medical Services",762 14th St,,Elko,NV,89801-3413,Elko,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007747,William Bee Ririe Hospital,White Pine County Hospital District,1487648804,Inpatient Hospitals (other than children's hospitals),1500 Avenue H,,Ely,NV,89301-2615,White Pine,1500 Ave H,,Ely,NV,89301,White Pine,Matthew Walker,CEO,775-289-3001,222,Mwalker@wbrhely.org,Tracie Gust,CNO,775-289-3001,222,Tgust@wbrhely.org,
NV-007748,Community Health Nursing-Wjite Pine County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1962634089,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",297 11th St E,,Ely,NV,89301-2300,White Pine,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007782,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,6 Steptoe Cir,,Ely,NV,89301-2692,White Pine,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber M. Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007750,William Bee Ririe Clinic,William Bee Ririe Hospital and Clinic,1437145422,Rural Health Clinics,6 Steptoe Cir,,Ely,NV,89301-2692,White Pine,1500 Ave H,,Ely,NV,89301,White Pine,Matthew Walker,CEO,775-289-3001,222,Mwalker@wbrhely.org,Tracie Gust,CNO,775-289-3001,222,Tgust@wbrhely.org,
NV-007751,Fallon Tribal Health Center,Fallon Paiute Shoshone Tribe,1023057478,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1001 Rio Vista Dr,,Fallon,NV,89406-5463,Churchill,565 Rio Vista Dr,,Fallon,NV,89406,Churchill,Joseph Herman,Executive Director,775-423-3634,222,fthcdirector@fpst.org,,,,,,
NV-007752,Community Health Nursing-Churchill County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1801028931,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",485 W B St,Suite 101,Fallon,NV,89406-2765,Churchill,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007753,Banner Churchill Community Hospital,Banner Health,1265811251,Inpatient Hospitals (other than children's hospitals),801 E Williams Ave,,Fallon,NV,89406-3052,Churchill,801 East Williams Avenue,,Fallon,NV,89406,Churchill,Hoyt Skabelund,CEO,775-867-7009,,hoyt.skabelund@bannerhealth.com,Steve Fraker,CFO,775-867-7002,,steve.fraker@bannerhealth.com,
NV-007754,Community Health Nursing-Lyon Co. Fernley,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1467684597,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",555 E Main St,,Fernley,NV,89408-9537,Lyon,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007755,Douglas County Community Health,Carson City Health and Human Services,1871867556,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1329 Waterloo Ln,,Gardnerville,NV,89410-5385,Douglas,900 East Long Steet,,Carson City,NV,89706,Carson City,"Veronica Galas, RN, BSN",Clinic Services Manger,775-283-7620,,vgalas@carson.org,Nicki,Aaker,775-887-2190,,naaker@carson.org,http://www.douglascountynv.gov/index.aspx?nid=340
NV-007756,Washoe Tribe Health Center,Washoe Tribe Health Center,1396778379,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1559 Watasheamu Rd,,Gardnerville,NV,89460-7455,Douglas,1559 Watasheamu Rd,,Gardnerville,NV,89460-7455,Douglas,Suni Miller,Deputy Director,775-265-4215,,smiller@washoetribe.us,Trisha Oconnor,Third Party Billing Supervisor,775-265-4215,,Trisha.Oconnor@washoetribe.us,
NV-007757,Mt Grant General Hospital,Mt Grant General Hospital,1336197086,Rural Health Clinics,200 South A Street,,Hawthorne,NV,89415,Mineral,PO Box 1510,,Hawthorne,NV,89415,Mineral,Richard Munger,Administrator,775-945-2461,,richardm@mtgrantgenhospital.org,Tammy Strange,,775-945-2461,265,tammyn@mtgrantgenhospital.org,
NV-007758,Mt Grant General Hospital,Mt Grant General Hospital,1801844527,Inpatient Hospitals (other than children's hospitals),200 South A Street,,Hawthorne,NV,89415,Mineral,PO Box 1510,,Hawthorne,NV,89415,Mineral,Richard Munger,Administrator,775-945-2461,,richardm@mtgrantgenhospital.org,Tammy Strange,,775-945-2461,265,tammyn@mtgrantgenhospital.org,
NV-007759,Community Health Nursing-Mineral County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1962634097,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",331 1st St,,Hawthorne,NV,89415,Mineral,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007760,"The Empowerment Centre, LLC",The Empowerment Centre,1720384845,Community Mental Health Centers,2501 N Green Valley Pkwy,Suite 116,Henderson,NV,89014-2158,Clark,2501 N. Green Valley Pkwy,"Bldg. D, Ste. 118",Henderson,NV,89014,Clark,Ramona Beasley,Managing Member/Clinical Director,702-605-2766,,rhbeasley@gmail.com,,,,,,
NV-007761,Nevada Health Centers Bower School Based at Basic Academy,Nevada Health Centers Inc.,1811496607,Federally Qualified Health Centers - Medical Services,400 Palo Verde Dr,,Henderson,NV,89015-6028,Clark,3325 Research,,Carson City,NV,89706-7913,Carson City,Patricia Schroeder,Provider Relations Manager,775-888-6610,,pschroeder@nvhealthcenters.org,Walter B. Davis,Chief Executive Officer,775-887-1590,,wdavis@nvhealthcenters.org,www.nvhealthcenters.org
NV-007762,Southern Nevada Health District Henderson Public Health Center,Southern Nevada Health District,1275550212,Other ECP Providers,520 E Lake Mead Pkwy,,Henderson,NV,89015-5578,Clark,P.O. Box 3902,,Las Vegas,NV,89127,Clark,Richard Cichy,Interim Chief Health Nurse,702-759-1000,,cichy@snhdmail.org,Loni Benard,Materials Management Supervisor,702-759-1244,,benard@snhdmail.org,http://southernnevadahealthdistrict.org
NV-007763,Henderson Family Health Center,"NEVADA HEALTH CENTERS, INC.",1063891182,Federally Qualified Health Centers - Medical Services,98 E Lake Mead Pkwy,Suite 103,Henderson,NV,89015-6443,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007764,Searchlight Healthcare Henderson,Searchlight Healthcare Henderson,1598106049,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",98 E Lake Mead Pkwy,Suite 305,Henderson,NV,89015-6444,Clark,98 E Lake Mead Pkwy Ste 305,,Henderson,NV,89015,Clark,Luis Alfonso Rocha C.,CEO,786-328-4437,,lrocha51@gmail.com,Quentin Weathers,Program Manager,702-249-9686,,quentinweathers@live.com,
NV-007765,JACKPOT COMMUNITY HEALTH CENTER,"NEVADA HEALTH CENTERS, INC.",1497833768,Federally Qualified Health Centers - Medical Services,950 Lady Luck Dr,,Jackpot,NV,89825,Elko,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007766,Kingston Rural Health Clinic,Battle Mountain General Hospital District,1508255019,Rural Health Clinics,99 Toiyabe Rd,,Kingston,NV,89310,Lander,535 South Humboldt Street,,Battle Mountain,NV,89820,Lander,Holly Heese,Compliance Officer,775-635-2550,161,hheese@bmgh.org,Peggy Lindsay,CEO,775-635-2550,111,PLindsey@bmgh.org,
NV-007767,Community Outreach Medical Center,Community Outreach Medical Center,1073721361,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",1140 Almond Tree Ln,Suite 306,Las Vegas,NV,89104-3233,Clark,1140 Almond Tree Lane,Suite 306,Las Vegas,NV,89104,Clark,"Bonnie Carlisle, RN, MSN",Clinical Coordinator,702-657-3873,320,bcarlisle@nvcomc.org,Evelyn Fraire,Operations Manager,702-657-3873,322,efraire@nvcomc.org,
NV-007768,First Person Complete Care,First Person Care Clinic,1548629132,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",1200 S 4th St,Suite 111,Las Vegas,NV,89104-1046,Clark,1200 S. 4th Street,Suite 111,Las Vegas,NV,89104,Clark,Tina Drago,CEO,702-380-8118,5,tdrago@firstpersoncc.org,Ryan Jacob,Clinical Manager,702-380-8118,5,rjacob@firstpersoncc.org,www.firstpersoncc.org
NV-012382,Nevada Health Centers at Enterprise,"Nevada Health Centers, Inc.",1801452206,Federally Qualified Health Centers - Medical Services,1700 Wheeler Peak Dr,,Las Vegas,NV,89106-2150,Clark,3325 Research Way,,Carson City,NV,89706,Carson City,Patricia Schroeder,Provider Relations Manager,775-888-6610,,pschroeder@nvhealthcenters.org,Walter B. Davis,Chief Executive Officer,775-888-6610,,wdavis@nvhealthcenters.org,www.nvhealthcenters.org
NV-007769,Nevada Care Center,Nevada Integrated Behavioral Services Inc.,1952852097,Community Mental Health Centers,1721 E Charleston Blvd,,Las Vegas,NV,89104-1902,Clark,1721 east charleston blvd,,Las Vegas,NV,89104,Clark,festus ebonka,Program Director,702-515-9680,7026850620,febonka@yahoo.ca,valando sterling,Director of Operation,702-588-0130,7026850620,febonka@yahoo.ca,
NV-007770,"All for Health, Health for All","All for Health, Health for All",1982149613,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1735 N Nellis Blvd,Suite G,Las Vegas,NV,89115-3671,Clark,1735 North Nellis Blvd,Suite G,Las Vegas,NV,89115,Clark,Monique Beltran,Office Manager,702-342-8804,,mbeltran@all4health.org,Ninet Abgarian,Chief Operations Officer,818-409-3020,,nabagarian@all4health.org,
NV-007771,Martin Luther King Health Center,"NEVADA HEALTH CENTERS, INC.",1740355858,Federally Qualified Health Centers - Medical Services,1799 Mount Mariah Dr,,Las Vegas,NV,89106-1501,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007772,University Medical Center of Southern Nevada,University Medical Center of Southern Nevada,1548393127,Inpatient Hospitals (other than children's hospitals),1800 W Charleston Blvd,,Las Vegas,NV,89102-2329,Clark,1800 W Charleston Blvd,,Las Vegas,NV,89102,Clark,Gail Yedinak,Sr Management Analyst-Government Relations,702-383-6209,,gail.yedinak@umcsn.com,Rose Coker,"Director, Managed Care/Business Development",702-383-3982,,rose.coker@umcsn.com,
NV-012383,Huntridge Family Clinic,Huntridge Family Clinic,1134553068,"Ryan White Providers, Sexually Transmitted Disease Clinics",1830 E Sahara Ave,Suite 201,Las Vegas,NV,89104-3739,Clark,1830 E. Sahara Ave,Suite 201,Las Vegas,NV,89104,Clark,John Phoenix,"Owner, APRN",702-979-1111,,jphoenixaprn@huntridgefcf.org,Vanessa Rodriguez,Office manager,702-982-0332,,vrodriguez@huntridgefcf.org,www.huntridgefamilyclinic.org
NV-007773,Silver State Health Services,Silver State Health Services,1598202913,Federally Qualified Health Centers - Medical Services,1909 S Jones Blvd,,Las Vegas,NV,89146-1260,Clark,1909 S JONES BLVD,,Las Vegas,NV,89146,Clark,Ryan Linden,CEO,702-937-3418,,r.linden@silverstatehealth.org,Kendall Looney,COO,214-384-7936,,k.looney@silverstatehealth.org,
NV-007774,Eastern Family Medical and Dental Center,Nevada Health Centers Inc.,1780831925,"Dental Providers, Federally Qualified Health Centers - Medical Services",2212 S Eastern Ave,,Las Vegas,NV,89104-4124,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007775,Southern Nevada Health District-Decatur Public Health Center,Southern Nevada Health District,1275550212,"Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",280 S Decatur Blvd,,Las Vegas,NV,89107-2936,Clark,P.O. Box 3902,,Las Vegas,NV,89127,Clark,Richard Cichy,Interim Chief Health Nurse,702-759-1000,,cichy@snhdmail.org,Loni Benard,Materials Management Supervisor,702-759-1244,,benard@snhdmail.org,https://southernnevadahealthdistrict.org
NV-007777,AHF Healthcare Center - Las Vegas,AIDS Healthcare Foundation,1043645930,"Other ECP Providers, Ryan White Providers",3201 S Maryland Pkwy,Suite 218,Las Vegas,NV,89109-2424,Clark,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5016,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
NV-007778,Planned Parenthood of the Rocky Mountains - Las Vegas West Charleston,"Planned Parenthood of the Rocky Mountains, Inc.",1295884351,"Family Planning Providers, Sexually Transmitted Disease Clinics",3220 W Charleston Blvd,,Las Vegas,NV,89102-1932,Clark,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NV-007779,Planned Parenthood of the Rocky Mountains - Las Vegas East Flamingo,"Planned Parenthood of the Rocky Mountains, Inc.",1295884351,"Family Planning Providers, Sexually Transmitted Disease Clinics",3300 E Flamingo Rd,Suite 25,Las Vegas,NV,89121-4398,Clark,7155 E 38th Ave,,Denver,CO,80207-1630,Denver,kate hayes,Director of Payer Relations,303-813-7769,,kate.hayes@pprm.org,,,,,,
NV-007780,FirstMed Health and Wellness Center,FIRSTMED HEALTH AND WELLNESS CENTER,1396054169,Federally Qualified Health Centers - Medical Services,3343 S Eastern Ave,,Las Vegas,NV,89169-3312,Clark,3343 S Eastern Ave,,Las Vegas,NV,89169-3312,Clark,Roxana Valeton,Interim CEO,305-303-8108,,rvaleton@fmhwc.org,,,,,,
NV-007781,CAMBRIDGE FAMILY HLTH CTR,"NEVADA HEALTH CENTERS, INC.",1073688198,Federally Qualified Health Centers - Medical Services,3900 Cambridge St,Suite 102,Las Vegas,NV,89119-7440,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007783,Southern Nevada Health District East Las Vegas Public Health Center,Southern Nevada Health District,1275550212,"Family Planning Providers, Other ECP Providers",560 N Nellis Blvd,Suite D1,Las Vegas,NV,89110-5369,Clark,P.O. Box 3902,,Las Vegas,NV,89127,Clark,Suzann Chesebrough-Pruitt,CHN Supervisor,702-759-0889,,pruitt@snhdmail.org,Loni Benard,Materials Management Supervisor,702-759-1224,,benard@snhdmail.org,http://southernnevadahealthdistrict.org
NV-007784,University Medical Center of So. Nevada - Wellnes Center,University Medical Center of So. Nevada - Wellness Center,1598889008,Ryan White Providers,701 Shadow Ln,Suite 200,Las Vegas,NV,89106-4178,Clark,"701 Shadow Lane ,Ste. 200",,Las Vegas,NV,89106,Clark,Dr. Alireza Farabi,MD,702-383-2691,,alireza.farabi@umcsn.com,Jane Vergara,RN,702-383-2691,,jane.vergara@umcsn.com,
NV-007776,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,8352 W Warm Springs Rd,Suite 200,Las Vegas,NV,89113-3629,Clark,8352 West Warm Springs Rd.,Suite 200,LAS VEGAS,NV,89113,Clark,"Amber Federizo, APRN, FNP-BC",Family Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007785,Community Health Nursing-Pershing County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1316179435,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",535 Western Ave,,Lovelock,NV,89419,Pershing,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007786,Pershing Physician Center,Pershing General Hospital and Nursing Home,1124110317,Rural Health Clinics,850 6th St,,Lovelock,NV,89419-8020,Pershing,855 6th Street,PO Box 661,Lovelock,NV,89419,Pershing,Patricia Bianchi,CEO,775-273-2621,201,pbianchi@pershinghospital.org,Cindy Hixenbaugh,COO,775-273-2621,202,cindy@pershinghospital.org,http://pershinghospital.org/
NV-007787,Pershing General Hospital,Pershing General Hospital and Nursing Home,1669490306,Inpatient Hospitals (other than children's hospitals),855 6th St,,Lovelock,NV,89419-8020,Pershing,855 6th Street,PO Box 661,Lovelock,NV,89419,Pershing,Patricia Bianchi,CEO,775-273-2621,201,pbianchi@pershinghospital.org,Cindy Hixenbaugh,COO,775-273-2621,202,cindy@pershinghospital.org,http://pershinghospital.org/
NV-007788,Fort McDermitt Health Station,Fort McDermitt Health Station,1588710719,"Indian Health Service, Other ECP Providers",112 Reservation Rd,,Mc Dermitt,NV,89421,Humboldt,PO Box 315,,Mc Dermitt,NV,89421-0315,Humboldt,JIN J BAE - MDPHD,Acting Chief Executive Officer,775-532-8522,,JBAE888@YAHOO.COM,MAXINE SNART,Business Officer,775-532-8024,,JUNG111@GMAIL.COM,
NV-007789,MINDEN FAMILY MEDICINE AND COMPLETE CARE,Washoe Barton Medical Clinic,1265737084,Rural Health Clinics,1649 Lucerne St,,Minden,NV,89423-4369,Douglas,1107 US Hwy 395,,Gardnerville,NV,89410,Douglas,Gina Zink,Director of Clinics,775-782-1550,,gzink@cvmchospital.org,,,,,,
NV-007790,Irene Benn Medical Center (Moapa Clinic),Irene Benn Medical Center (Moapa Clinic),1942318654,"Indian Health Service, Rural Health Clinics",10 Lincoln St,,Moapa,NV,89025,Clark,10 LINCOLN STREET,,Moapa,NV,92363,Clark,ELIZABETH HELSEL,Chief Executive Officer,928-669-3114,,ELIZABETH.HELSEL@IHS.GOV,,,,,,
NV-007791,LAS VEGAS OUTREACH CLINIC,"NEVADA HEALTH CENTERS, INC.",1134295058,Federally Qualified Health Centers - Medical Services,47 W Owens Ave,,N Las Vegas,NV,89030-6865,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007792,Pyramid Lake Tribal Health Center,Pyramid Lake Tribal Health Center,1285740035,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",705 NV-446,Po Box 705,Nixon,NV,89424,Washoe,Hwy 446,Po Box 705,Nixon,NV,89424,Washoe,Dawna Brown,Director,775-574-1018,1216,Dawna.Brown@ihs.gov,Shari D. Williams,Business Office Manager,775-574-1018,1248,swilliams@plpt.nsn.us,
NV-007793,Nevada Health Centers at C.P. Squires,"NEVADA HEALTH CENTERS, INC.",1558489427,Federally Qualified Health Centers - Medical Services,1312 E Tonopah Ave,,North Las Vegas,NV,89030-7111,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007794,AHF Healthcare Center - North Las Vegas,AIDS Healthcare Foundation,1053746933,"Other ECP Providers, Ryan White Providers",1815 E Lake Mead Blvd,Suite 113,North Las Vegas,NV,89030-7188,Clark,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
NV-007795,North Las Vegas Family Health Center,"NEVADA HEALTH CENTERS, INC.",1497820500,Federally Qualified Health Centers - Medical Services,2225 Civic Center Dr,Suite 224,North Las Vegas,NV,89030-6332,Clark,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007796,Brooks Behavioral Health Center,Brooks Behavioral Health Center,1548548597,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers",3550 W Cheyenne Ave,Suite 130,North Las Vegas,NV,89032-8252,Clark,3550 W. Cheyenne Avenue Suite #130,,North Las Vegas,NV,89032,Clark,Devin Brooks,Executive Director,702-910-5773,,devinjabrooks@gmail.com,Claudia Ellis,,702-499-6218,,ce@brooksbhcnv.com,www.brooksbhcnv.com
NV-007797,Hope Christian Health Center,Hope Christian Health Center,1629595889,Federally Qualified Health Centers - Medical Services,4040 N M.L.K. Blvd,Suite A,North Las Vegas,NV,89032,Clark,4040 North Martin Luther King,Suite A,North Las Vegas,NV,89032,Clark,Doug Self,CEO,702-644-4673,,doug@hopehealthvegas.org,Frances Davis,Accountant,702-644-4673,,frances@hopehealthvegas.org,hopehealthvegas.org
NV-007798,Hope Christian Health Center Corp,Hope Christian Health Center,1639540719,Federally Qualified Health Centers - Medical Services,4357 Corporate Center Dr,Suite 450,North Las Vegas,NV,89030-0226,Clark,4357 Corporate Center Drive,Suite 450,North Las Vegas,NV,89030,Carson City,Ivyfer Dela Cruz,Clinic Administrator,702-644-4673,,ivy@hopehealthvegas.org,,,,,,
NV-007799,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,"Hemophilia Treatment Centers, Indian Health Service",1623 Hospital Loop,,Owyhee,NV,89832-1200,Elko,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber M. Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007800,Owyhee Community Health Facility,Owyhee Community Health Facility,1528230224,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1623 Hospital Loop,PO Box 130,Owyhee,NV,89832-1200,Elko,Po Box 219,,Owyhee,NV,89832,Elko,Anthony Marshall,Health Administrator,775-757-2415,4303,marshall.anthony@shopai.org,Shawna Hicks,Health Information Manager,775-757-2415,4229,hicks.shawna@shopai.org,
NV-007801,Community Health Nursing-Nye Co. Pahrump,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1043442163,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1981 E Calvada Blvd Apt 100,,Pahrump,NV,89048-6772,Nye,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007802,DVH Hospital Alliance LLC,DVH Hospital Alliance LLC dba Desert View Hospital,1073963138,Inpatient Hospitals (other than children's hospitals),360 S Lola Ln,,Pahrump,NV,89048-0884,Nye,360 South Lola Lane,,Pahrump,NV,89048,Nye,Mary Williams,Business Office Manager,775-751-7508,,mary.williams@uhsinc.com,Susan Davila,CEO,775-751-7500,,Susan.Davila@uhsinc.com,
NV-007803,Community Health Nursing- Lincoln County,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1912139049,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1005 Main St,,Panaca,NV,89042,Lincoln,727 Fairview DR A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007804,Washoe County Health District,Washoe County Health District,1104816594,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1001 E 9th St,,Reno,NV,89512-2845,Washoe,PO Box 11130,,Reno,NV,89520-0027,Washoe,Steve Kutz,Clinic Director,775-328-6159,,skutz@washoecounty.us,Lisa Lottritz,Public Health Nurse Supervisor,775-328-2465,,llottritz@wasoecounty.us,https://www.washoecounty.us/health/index.php
NV-007805,Community Health Alliance - Wells Avenue Medical/Dental Center,Community Health Alliance,1326162710,"Dental Providers, Federally Qualified Health Centers - Medical Services",1055 S Wells Ave,,Reno,NV,89502-2550,Washoe,680 S. Rock Blvd.,,Reno,NV,89502-4113,Washoe,Charles Duarte,Chief Executive Officer,775-329-6300,,cduarte@chanevada.org,Diahann Barrera,Chief Finance Officer,775-329-6300,,dbarrera@chanevada.org,www.chanevada.org
NV-007806,Renown Children's Hospital,Renown Children's Hospital,1124098421,Children's Hospitals (inpatient only),1155 Mill St,,Reno,NV,89502-1576,Washoe,1155 Mill Street,,Reno,NV,89502,Washoe,Jenny Juchtzer,Contracts Manager,775-982-5177,,jjuchtzer@renown.org,Megan Landon,Director of Contracting,775-982-5709,,mlandon@renown.org,www.renown.org
NV-007807,RENOWN REGIONAL MEDICAL CENTER,RENOWN REGIONAL MEDICAL CENTER,1124098421,"Family Planning Providers, Other ECP Providers, Rural Health Clinics",1155 Mill St,,Reno,NV,89502-1576,Washoe,1155 Mill Street,,Reno,NV,89502,Washoe,Jenny Juchtzer,Contracts Manager,775-982-5177,,jjuchtzer@renown.org,Megan Landon,Director of Contracting,775-982-5709,,mlandon@renown.org,
NV-007808,Reno-Sparks Tribal Health Center,Reno-Sparks Tribal Health Center,1497700801,"Community Mental Health Centers, Dental Providers, Tribal Health Program operated under P.L. 93-638",1715 Kuenzli St,,Reno,NV,89502-1117,Washoe,1715 Kuenzli St,,Reno,NV,89502-1117,Washoe,Andrea Johnson-Harper,Director,775-329-5162,1900,aharper@rsicclinic.org,Jovino Lorenzo,Business Office Manager,775-329-5162,1910,jlorenzo@rsicclinic.org,www.rsic.org
NV-007809,Community Health Alliance,Community Health Alliance,1326446386,Federally Qualified Health Centers - Medical Services,1950 Villanova Dr,Community Health Alliance - School Based Health Center,Reno,NV,89502-3142,Washoe,680 S. Rock Blvd.,,Reno,NV,89502-4113,Washoe,Chuck Duarte,Chief Executive Officer,775-329-6300,,cduarte@chanevada.org,Diahann Barrera,Chief Finance Officer,775-329-6300,,dbarrera@chanevada.org,www.chanevada.org
NV-007810,Community Health Alliance - Center For Complex Care,Community Health Alliance,1548644594,Federally Qualified Health Centers - Medical Services,330 Crampton St,,Reno,NV,89502-2480,Washoe,680 S Rock Blvd,,Reno,NV,89502-4113,Washoe,Chuck Duarte,Chief Executive Officer,775-336-3017,,cduarte@chanevada.org,Diahann Barrera,Chief Finance Officer,775-336-3018,,dbarrera@chanevada.org,www.chanevada.org
NV-007811,Community Health Alliance - Outreach Health Center,Community Health Alliance,1225371750,Federally Qualified Health Centers - Medical Services,335 Record St,Suite 254,Reno,NV,89512-3327,Washoe,680 S. Rock Blvd.,,Reno,NV,89502-4113,Washoe,Chuck Duarte,Chief Executive Officer,775-329-6300,,cduarte@chanevada.org,Diahann Barrera,Chief Finance Officer,775-329-6300,,dbarrera@chanevada.org,www.chanevada.org
NV-007812,"Community Health Alliance Nell J. Redfield Health Center, Neil Road",Community Health Alliance,1013143312,Federally Qualified Health Centers - Medical Services,3915 Neil Rd,,Reno,NV,89502-6808,Washoe,680 S. Rock Blvd.,,Reno,NV,89502-4113,Washoe,Jorge Chavez,Chief Executive Officer,775-336-3003,,Jchavez@chanevada.org,Diahann Barrera,Chief Finance Officer,775-336-3018,,dbarrera@chanevada.org,www.chanevada.org
NV-007813,Reno Fifth Clinic,PLANNED PARENTHOOD MAR MONTE,1497708770,Family Planning Providers,455 W 5th St,,Reno,NV,89503-4413,Washoe,1691 The Alameda,,San Jose,CA,95126,Santa Clara,Jennifer Stork,Director of Payor Development & Mgmt,408-795-3618,,jennifer_stork@ppmarmonte.org,Dominique Lee,VP of Services,408-795-3688,,dominique_lee@ppmarmonte.org,http://www.plannedparenthood.org/mar-monte/
NV-007814,Northern Nevada HOPES,"NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES",1659792810,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",580 W 5th St,,Reno,NV,89503-4407,Washoe,580 West 5th Street,,Reno,NV,89503,Washoe,Rachel Tatro,Director of Development and Marketing,775-997-7533,,rtatro@nnhopes.org,Jessica Lance,Chief Financial Officer,775-348-2882,,jlance@nnhopes.org,
NV-012489,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,6880 S McCarran Blvd,Suite 4,Reno,NV,89509-6129,Washoe,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007815,Community Health Nursing-Lyon Co. Silver Springs,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1336371467,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2965 Fort Churchill Rd,,Silver Springs,NV,89429-8905,Lyon,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007816,Silver Springs Rural Health Center,Eastern Sierra Medical Group LLC,1316925381,Rural Health Clinics,3595 US Highway 50,,Silver Springs,NV,89429-9613,Lyon,1155 Mill St,,Reno,NV,89502,Washoe,Annette Lagorio,Supervisor of Business Office,775-982-6461,6461,alagorio@renown.org,,,,,,
NV-007817,Community Health Alliance - Sparks Health Center,Community Health Alliance,1568828085,Federally Qualified Health Centers - Medical Services,224 Oddie Blvd.,,Sparks,NV,89431,Washoe,680 S. Rock Blvd.,,Reno,NV,89502,Washoe,Chuck Duarte,CEO,775-329-6300,,cduarte@chanevada.org,Diahann Barrera,CFO,775-329-6300,,dbarrera@chanevada.org,www.chanevada.org
NV-007818,"Community Health Alliance - Nell J. Redfield Health Center, Sun Valley",Community Health Alliance,1427283860,Federally Qualified Health Centers - Medical Services,5295 Sun Valley Blvd,Suite 5,Sun Valley,NV,89433-7955,Washoe,680 S. Rock Blvd.,,Reno,NV,89502-4113,Washoe,Chuck Duarte,Chief Executive Officer,775-329-6300,,cduarte@chanevada.org,Diahann Barrera,Chief Finance Officer,775-329-6300,,dbarrera@chanevada.org,www.chanevada.org
NV-007819,Community Health Nursing- Nye Co. Tonopah,"NEVADA DEPT OF HHS, DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1164654299,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Frankee Ave,,Tonopah,NV,89049,Nye,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007820,Nevada Health Centers at Virginia City,"NEVADA HEALTH CENTERS, INC.",1417321902,Federally Qualified Health Centers - Medical Services,175 E Carson St,Suite A,Virginia City,NV,89440,Storey,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter B. Davis,Chief Executive Officer,775-887-1590,1114,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-007821,DHHS IHS PHOENIX AREA NEVADA SKIES YOUTH WELLNESS CENTER,NEVADA SKIES YOUTH WELLNESS CENTER,1689800013,"Indian Health Service, Other ECP Providers",104 Big Bend Ranch Rd,PO Box 280,Wadsworth,NV,89442-0280,Washoe,104 BIG BEND RANCH ROAD,POB 280,WADSWORTH,NV,89442,Washoe,HOLLY M ELLIOTT,CHIEF EXECUTIVE OFFICER,520-562-4205,4205,holly.elliott@ihs.gov,GAGE RIDDOCH,PROGRAM DIRECTOR,775-352-6847,6843,GAGE.RIDDOCH@IHS.GOV,https://www.ihs.gov/phoenix/index.cfm/adolescenttreatmentcenters/
NV-007822,TOPAZ RANCH MEDICAL CLINIC,Washoe Barton Medical Clinic,1700118536,Rural Health Clinics,3919 Carter Way,,Wellington,NV,89444-9319,Douglas,1107 US Hwy 395,,Gardnerville,NV,89410,Douglas,Gina Zink,Director of Clinics,775-782-1550,,gzink@cvmchospital.org,,,775-783-3096,,,
NV-007823,Smith Valley Physician Clinic,"SOUTH LYON HEALTH CENTER, INC.",1538129549,Rural Health Clinics,445 STATE HWY 338,,Wellington,NV,89444,Lyon,213 S. WHITACRE,,YERINGTON,NV,89447,Lyon,DAVID LOUIS BEZARD,CFO,702-463-6402,,david@southlyonmedicalcenter.org,TONI INSERRA,Administrator,702-463-6404,,toni@southlyonmedicalcenter.org,http://www.southlyonmedicalcenter.org
NV-007824,WENDOVER COMMUNITY HEALTH CENTER,"NEVADA HEALTH CENTERS, INC.",1033297304,Federally Qualified Health Centers - Medical Services,925 Wells Ave,,West Wendover,NV,89883,Elko,3325 Research Way,,Carson City,NV,89706-7913,Carson City,Walter Davis,Chief Executive Officer,775-887-1590,1161,wdavis@nvhealthcenters.org,Patricia Schroeder,Provider Relations Manager,775-888-6610,1110,pschroeder@nvhealthcenters.org,www.nvhealthcenters.org
NV-012490,Hemostasis and Thrombosis Center of Nevada,Hemostasis and Thrombosis Center of Nevada,1508378977,Hemophilia Treatment Centers,118 E Haskell St,,Winnemucca,NV,89445-3247,Humboldt,8352 West Warm Springs Rd.,Suite 200,Las Vegas,NV,89113,Clark,Amber Federizo,Nurse Practitioner,702-960-5712,,amber.federizo@htcnv.org,Jerry Fox,Executive Director,702-960-5373,,jerry.fox@htcnv.org,www.htcnv.org
NV-007825,Humboldt General Hospital,Humboldt General Hospital,1750498010,Inpatient Hospitals (other than children's hospitals),118 E Haskell St,,Winnemucca,NV,89445-3247,Humboldt,118 E Haskell Street,,Winnemucca,NV,89445,Humboldt,Sandrae J Lehman,Chief Financial Officer,775-623-5222,1124,lehmans@hghospital.org,Eddy Davis,Controller,775-623-5222,1122,davise@hghospital.org,
NV-007826,Humboldt General Hospital Rural Health Clinics,Humboldt General Hospital,1558633933,Rural Health Clinics,118 E Haskell St,,Winnemucca,NV,89445-3247,Humboldt,118 E Haskell Street,,Winnemucca,NV,89445,Humboldt,Sandrae J Lehman,Chief Financial Officer,775-623-5222,1124,lehmans@hghospital.org,Eddy Davis,Controller,775-623-5222,1124,davise@hghospital.org,
NV-007827,Community Health Nursing-Humboldt County,"NEVADA DEPT OF HHS,DIVISION OF PUBLIC & BEHAVIORAL HEALTH",1629200746,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",50 E Haskell St,Suite B,Winnemucca,NV,89445-3576,Humboldt,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,gkitchingman@health.nv.gov,
NV-007829,SOUTH LYON MEDICAL CENTER,"SOUTH LYON HEALTH CENTER, INC.",1376917302,Inpatient Hospitals (other than children's hospitals),213 S Whitacre St,,Yerington,NV,89447-2561,Lyon,213 S WHITACRE ST,,YERINGTON,NV,89447,Lyon,DAVID LOUIS BEZARD,CFO,775-463-6402,,david@southlyonmedicalcenter.org,TONI INSERRA,Administrator,775-463-6404,,toni@southlyonmedicalcenter.org,http://southlyonmedicalcenter.org
NV-007830,South Lyon Medical Center Barnett Clinic,"SOUTH LYON HEALTH CENTER, INC.",1649230665,Rural Health Clinics,213 S Whitacre St,,Yerington,NV,89447-2561,Lyon,213 S. WHITACRE,,YERINGTON,NV,89447,Lyon,DAVID LOUIS BEZARD,CFO,775-463-6402,,david@southlyonmedicalcenter.org,TONI INSERRA,Administrator,775-463-6404,,toni@southlyonmedicalcenter.org,http://www.southlyonmedicalcenter.org/
NV-007831,Community Health Nursing-Lyon Co.Yerington,"NEVADA DEPT OF HHS,DIVISION OF PUBLIC AND BEHAVIORAL HEALTH",1508098633,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",26 Nevin Way,,Yerington,NV,89447-2327,Lyon,727 Fairview Dr A,,Carson City,NV,89701,Carson City,Theresa Carsten,Health Program Manager,775-684-5022,,tcarsten@health.nv.gov,Greg Kitchingman,Clinical Director,775-684-5023,,,
NV-007832,South Lyon Physician Clinic,"SOUTH LYON HEALTH CENTER, INC.",1992765085,Rural Health Clinics,311 Surprise Ave,,Yerington,NV,89447-2565,Lyon,213 S. WHITACRE,,YERINGTON,NV,89447,Lyon,DAVID LOUIS BEZARD,CFO,775-463-6402,,david@southlyonmedicalcenter.org,TONI INSERRA,Administrator,775-463-6404,,toni@southlyonmedicalcenter.org,http://www.southlyonmedicalcenter.org
NY-007833,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",13180 US Route 11,Wilson Elementary School,Adams Center,NY,13606-2276,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/our-locations/#toggle-id-8
NY-007834,Upper Hudson Planned Parenthood,Upper Hudson Planned Parenthood - Albany,1881755601,"Family Planning Providers, Sexually Transmitted Disease Clinics",855 Central Ave,Suite 4,Albany,NY,12206-1506,Albany,855 Central Ave Ste 4,,Albany,NY,12206-1506,Albany,Marielle McKasty-Stagg,COO,518-434-5678,140,marielle@uhpp.org,AnnMarie McIntosh,Finance Director,518-434-5678,123,Annmarie@uhpp.org,https://www.plannedparenthood.org/planned-parenthood-upper-hudson
NY-007835,Whitney M. Young Jr. Health Center Inc.,Whitney M. Young Jr. Health Center Inc.,1417924762,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",920 Lark Dr,,Albany,NY,12207-1300,Albany,920 Lark Drive,,Albany,NY,12207,Albany,David Shippee,President & CEO,518-591-4459,,dshippee@wmyhealth.org,Elizabeth Cole,Chief Operating Officer,518-591-4453,,ecole@wmyhealth.org,
NY-007836,Oak Orchard Health- Albion,Oak Orchard Health,1558584458,Federally Qualified Health Centers - Medical Services,301 West Ave,,Albion,NY,14411-1522,Orleans,301 West Avenue,,Albion,NY,14411,Orleans,Rhiannon McDevitt,"Dir., Business Development",585-637-3905,221,rmcdevitt@oochc.org,Pam Keller,Chief Information Officer,585-637-3905,218,pkeller@oochc.org,
NY-007837,Allegany County Health Dept - Alfred Family Planning,Allegany County Health Department,1275592149,"Family Planning Providers, Sexually Transmitted Disease Clinics",10 Upper College Drive T.S. Parish Hall,,Alfred,NY,14802,Allegany,"10 Upper College Drive, T.S. Parish Hall",,Alfred,NY,14802-1102,Allegany,Laurie Hennessy,Director of Patient Services,585-268-9256,,hennesla@alleganyco.com,Kristin Fuller,RN/Family Planning Program Manager,585-268-9655,,fullerk@alleganyco.com,http://www.alleganyco.com
NY-007838,Hudson River HealthCare Amenia,"Hudson River HealthCare, Inc.",1568526838,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3360 Route 343,PO Box 108,Amenia,NY,12501-0108,Dutchess,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-007839,Planned Parenthood Mohawk Hudson - Amsterdam,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",4803 State Highway 30,,Amsterdam,NY,12010-7418,Montgomery,1040 State St,Kem Plaza,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-007840,Hometown Health Center at Amsterdam,Hometown Health Centers,1225238116,Federally Qualified Health Centers - Medical Services,67 Division St,,Amsterdam,NY,12010-4099,Montgomery,1044 State Street,,Schenectady,NY,12307,Schenectady,Eric Burton,Chief Operating Officer,518-688-3420,4129,EBurton@hhchc.org,George Wilhelm,Chief Financial Officer,518-370-1441,4102,GWilhelm@hhchc.org,
NY-007841,Arverne,Joseph P. Addabbo Family Health Center,1497700736,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",6200 Beach Channel Dr,,Arverne,NY,11692-1409,Queens,6200 Beach Channel Drive,,Arverne,NY,11692,Queens,Jennifer Stultz,Ryan White Program Director,718-945-7150,1232,jstultz@addabbo.org,Maria I Mamba,Acting CFO,718-945-7150,1312,imamba@addabbo.org,
NY-007842,East Hill Family Medical Inc.,East Hill Family Medical Inc.,1609813971,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Sexually Transmitted Disease Clinics",144 Genesee St,,Auburn,NY,13021-3503,Cayuga,144 Genesee Street,Suite 500,Auburn,NY,13021,Cayuga,April Miles,Director of Clinical Services,315-253-6796,502,amiles@easthillmedical.com,Keith Cuttler,CEO,315-253-6796,506,kcuttler@easthillmedical.com,www.easthillmedical.com
NY-007843,Reproductive Health Center,Livingston County Department of Health,1295753788,"Family Planning Providers, Sexually Transmitted Disease Clinics",2077 Route 15,Suite 3,Avon,NY,14414,Livingston,2 Murray Hill Drive,,Mt. Morris,NY,14510,Livingston,Cindy Sheflin,Center for Preventive Services,585-243-7540,7295,csheflin@co.livingston.ny.us,Sandra Bradt,Supervising Public Health Nurse,585-243-7540,7538,sbradt@co.livingston.ny.us,www.livingstoncounty.us.doh/htm
NY-007844,"Planned Parenthood of Central and Western New York, Inc. - Batavia","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",222 W Main St,,Batavia,NY,14020-1909,Genesee,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-007845,Bath Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1457689119,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",117 E Steuben St,,Bath,NY,14810-1636,Steuben,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-007846,Allegany County Health Department,New York State Dept. of Health,1275592149,"Family Planning Providers, Sexually Transmitted Disease Clinics",7 Court St,Room 30,Belmont,NY,14813-1060,Allegany,7 Court St,Room 30,Belmont,NY,14813-1044,Allegany,Laurie Hennessy,Director of Patient Services,585-268-9256,,hennesla@alleganyco.com,Kristin Fuller,RN/ Family Planning Program Manager,585-268-9655,,fullerk@alleganyco.com,
NY-007847,Binghamton Health Center,"Family Planning of South Central New York, Inc.",1033114004,Family Planning Providers,117 Hawley St,,Binghamton,NY,13901-3903,Broome,37 Dietz Street,,Oneonta,NY,13820,Otsego,Debra Marcus,Chief Executive Officer,607-432-2252,316,debra.marcus@fpscny.org,Wilson Li,Director of Finance,607-432-2252,314,wilson.li@fpscny.org,www.fpscny.org
NY-007848,Cornerstone Family Healthcare at The Binghamton Housing Authority,Cornerstone Family Healthcare,1689669079,Federally Qualified Health Centers - Medical Services,35 Felters Rd,,Binghamton,NY,13903-2600,Broome,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12518,Orange,Christopher J. Lennon,Director of Grants and Regulatory Affairs,845-220-3154,,clennon@cornerstonefh.org,Linda S. Muller,President and CEO,845-220-3110,,lmuller@cornerstonefh.org,www.cornerstonefamilyhealthcare.org
NY-007849,Bolton Health Center,Hudson Headwaters Health Network,1295758423,Federally Qualified Health Centers - Medical Services,11 Cross St,,Bolton Landing,NY,12814-7711,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-007850,Brentwood Mental Health Clinic,Suffolk County,1720091945,Community Mental Health Centers,1841 Brentwood Rd,,Brentwood,NY,11717-4625,Suffolk,3500 Sunrise Hwy,,Great River,NY,11739,Suffolk,Cari Faith Besserman,"Deputy Director, Div. CMHS",631-853-8500,6990,cari.besserman@suffolkcountyny.gov,Barbara Russo,Principal FInancial Analyst,631-853-8500,8533,barbara.russo@suffolkcountyny.gov,
NY-007851,HRHCare Brentwood,"Hudson River HealthCare, Inc.",1659755817,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1869 Brentwood Rd,,Brentwood,NY,11717-4625,Suffolk,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-007852,Open Door Family Medical Center @ Brewster,"OPEN DOOR FAMILY MEDICAL CENTER, INC.",1003152240,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",155 Main St,,Brewster,NY,10509-1521,Putnam,165 Main St,,Ossining,NY,10562-4702,Westchester,LIndsay Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzota@odfmc.org,
NY-007853,Oak Orchard Health,"Oak Orchard Community Health Center, Inc.",1598707812,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 West Ave,,Brockport,NY,14420-1118,Monroe,300 West Ave,,Brockport,NY,14420-1118,Monroe,Pamela Keller,CIO/Director of Patient Accounts,585-637-3905,218,pkeller@oochc.org,Bill Namestnik,COO,585-637-3905,,,http://www.oakorchardhealth.org/
NY-007854,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1265596548,"Dental Providers, Federally Qualified Health Centers - Medical Services",1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,1065 Southern Bouelvard,,Bronx,NY,10459,Bronx,Paloma Hernandez,President/CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,Cheraine Case,Senior Director of Adminsitrative Services,718-589-2440,2111,cheraine.case@urbanhealthplan.org,urbanhealthplan.org
NY-007855,Bronx Care Ogden Family Medical & Dental Center,"Dr. Martin Luther King, Jr. Health Center",1740558568,"Dental Providers, Federally Qualified Health Centers - Medical Services",1067 Ogden Ave,,Bronx,NY,10452-4601,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007856,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1116 Sheridan Ave,The Family School/The Sheridian Academy,Bronx,NY,10456-4903,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007857,FRANKLIN AVENUE WOMEN'S SHELTER,CARE FOR THE HOMELESS,1588900245,Federally Qualified Health Centers - Medical Services,1122 Franklin Ave,,Bronx,NY,10456-5305,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,Bronx,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007858,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",120 E 184th St,Elizabeth Barret Browning,Bronx,NY,10468-6603,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,apagan@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007859,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",120 W 231st St,"Marie Curie School for Medicine, Nursing, and Health Professions / x237",Bronx,NY,10463-5905,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudeet Phipps,"VP - Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007860,EDDIE FERNANDEZ HOUSE,"URBAN HEALTH PLAN, INC.",1487952784,Federally Qualified Health Centers - Medical Services,1215 Seneca Ave,,Bronx,NY,10474-4620,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,
NY-007861,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",125 E 181st St,Creston Academy,Bronx,NY,10453-3405,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007862,"Dr. Martin Luther King, Jr. Health Center","Dr. Martin Luther King, Jr. Health Center",1437231693,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1265 Franklin Ave,,Bronx,NY,10456-3501,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007863,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1831497130,Federally Qualified Health Centers - Medical Services,1290 Spofford Ave,P.S. 48,Bronx,NY,10474-6511,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,ALEXANDRA.BORBON@URBANHEALTHPLAN.ORG,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,https://www.urbanhealthplan.org/school-based-health-program/
NY-007864,Mount Hope Family Practice,The Institute for Family Health,1073886131,Federally Qualified Health Centers - Medical Services,130 W Tremont Ave,,Bronx,NY,10453-5436,Bronx,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007865,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1245651637,Federally Qualified Health Centers - Medical Services,1300 Boynton Ave,Monroe Academy,Bronx,NY,10472-1511,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,https://www.urbanhealthplan.org/school-based-health-program/
NY-007866,PLAZA DEL CASTILLO HEALTH CENTER,"URBAN HEALTH PLAN, INC.",1568518611,Federally Qualified Health Centers - Medical Services,1515 Southern Blvd Frnt 1,,Bronx,NY,10460-5980,Bronx,1065 SOUTHERN BOULAVARD,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007867,HELP/PSI Bronx Health Center,HELP/PSI SERVICES CORP.,1003093436,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1543 Inwood Ave,,Bronx,NY,10452-2001,Bronx,71 W. 23rd Street,Fl 8,New York,NY,10010,New York,Carol Murphy,Chief Operating Officer,718-681-8700,4418,cmurphy@brightpointhealth.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-007868,James Monroe Annex,"URBAN HEALTH PLAN, INC.",1962709980,Federally Qualified Health Centers - Medical Services,1551 E 172nd St,,Bronx,NY,10472-2141,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,
NY-007869,Bronx Care Crotona Park Family Practice,"Dr. Martin Luther King, Jr. Health Center",1043518467,Federally Qualified Health Centers - Medical Services,1591 Fulton Ave,,Bronx,NY,10457-8234,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007870,NELSON AVENUE FAMILY RESIDENCE,CARE FOR THE HOMELESS,1952647430,Federally Qualified Health Centers - Medical Services,1605 Nelson Ave # 11,,Bronx,NY,10453-7068,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007871,Bronx Care Mid Bronx Desperados Family Practice,"Dr. Martin Luther King, Jr. Health Center",1073811485,Federally Qualified Health Centers - Medical Services,1690 Bryant Ave,,Bronx,NY,10460-5300,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007872,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1700 Macombs Rd,CIS 232/ MS 303/ x365,Bronx,NY,10453-7048,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-012462,Center for Vein Restoration,Center for Vein Restoration,1700122728,Other ECP Providers,1749 Grand Concourse,,Bronx,NY,10453-8241,Bronx,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NY-007873,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",175 W. 166th Street,Marjorie H. Dunbar School PS 126,Bronx,NY,10452,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007874,St. Lawrence Community Health Center,"URBAN HEALTH PLAN, INC.",1689910622,Federally Qualified Health Centers - Medical Services,1764 Westchester Ave # 66,,Bronx,NY,10472-3022,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007875,Bronx Care Dental,"Dr. Martin Luther King, Jr. Health Center",1619275039,"Dental Providers, Federally Qualified Health Centers - Medical Services",1775 Grand Concourse # 6,,Bronx,NY,10453-8202,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007876,Walton Family Health Center,The Institute for Family Health,1053685289,"Dental Providers, Federally Qualified Health Centers - Medical Services",1894 Walton Ave,,Bronx,NY,10453-6018,Bronx,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007877,Willow Avenue Family Residence,CARE FOR THE HOMELESS,1760728430,Federally Qualified Health Centers - Medical Services,190 Willow Ave,,Bronx,NY,10454-3518,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007878,Susan's Place,CARE FOR THE HOMELESS,1013154657,"Dental Providers, Federally Qualified Health Centers - Medical Services",1911 Jerome Ave # 21,,Bronx,NY,10453-5707,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,Geroge Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007879,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1930 Andrews Ave,PS 396 / MS 390,Bronx,NY,10453-3004,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,Presdient and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007880,Kips Bay Boys and Girls Club/Crest Smile Shoppe Dental Clinic,"URBAN HEALTH PLAN, INC.",1932499274,Dental Providers,1930 Randall Ave,,Bronx,NY,10473-2608,Bronx,1065 Southern Boulevard,,Bronx,NY,10459,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,
NY-007881,Peninsula Community Health Center,"URBAN HEALTH PLAN, INC.",1770847014,Federally Qualified Health Centers - Medical Services,1967 Turnbull Ave,Suite 17,Bronx,NY,10473-2519,Bronx,1065 Southern Boulevard,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.ORG,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007882,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2100 Walton Ave,MS/PS 279 Captain Manuel Rivera,Bronx,NY,10453-3452,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007883,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2225 Webster Ave,Theater Arts Production Company School (TAPCo),Bronx,NY,10457-2439,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP - Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007884,HELP/PSI Harm Reduction Health Center at CitiWide,HELP/PSI SERVICES CORP.,1003093436,Federally Qualified Health Centers - Medical Services,226 E 144th St,,Bronx,NY,10451-5909,Bronx,71 W. 23rd Street,Fl 8,Bronx,NY,10452-4050,New York,Carol Murphy,Chief Operating Officer,718-681-8700,4418,cmurphy@brightpointhealth.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-007885,Bronx Care Poe Medical & Dental Center,"Dr. Martin Luther King, Jr. Health Center",1700184116,"Dental Providers, Federally Qualified Health Centers - Medical Services",2432 Grand Concourse,,Bronx,NY,10458-5204,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007886,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2474 Crotona Ave,Grace Dodge High School SBHC,Bronx,NY,10458-6402,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleg,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP - Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007887,The Counseling Center at Walton Avenue,Morris Heights Health Center,1265651020,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",25 E 183rd St,,Bronx,NY,10453-1242,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP - Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007888,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",250 E 164th St,Mott Hall High School Science & Technology Academy,Bronx,NY,10456-6201,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP - Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007889,HELP/PSI Westchester Square Mental Health Clinic,HELP/PSI SERVICES CORP.,1003093436,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2510 Westchester Ave,,Bronx,NY,10461-3585,Bronx,71 W. 23rd Street,Fl 8,New York,NY,10010,New York,Carol Murphy,Chief Operating Officer,718-681-8700,4418,cmurphy@projectsamaritan.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-007890,The Institute for Family Health Center for Counseling,The Institute for Family Health,1508126186,Federally Qualified Health Centers - Medical Services,2590 Frisby Ave # 1,,Bronx,NY,10461-3240,Bronx,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007891,Third Avenue Family Health Center,"Damian Family Care Centers, Inc.",1790154466,Federally Qualified Health Centers - Medical Services,2604 3rd Ave,,Bronx,NY,10454-1199,Bronx,138-02 Queens Blvd,2nd floor,Briarwood,NY,11435,Queens,Elizabeth King,Director of Clinical Services,347-505-7000,5527,eking@damian.org,Nikki Langford,Credentialing Specialist,718-657-1100,4139,nlangford@damian.org,www.damianhealth.org
NY-007892,Bronx Care at 3rd Avenue Medical & Dental Center,"Dr. Martin Luther King, Jr. Health Center",1588962906,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2737 3rd Ave # 41,,Bronx,NY,10451-5801,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. Stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007893,PART OF THE SOLUTION,CARE FOR THE HOMELESS,1891184750,"Dental Providers, Federally Qualified Health Centers - Medical Services",2759 Webster Ave,,Bronx,NY,10458-3708,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007894,The Dominican Sisters Family Health Services Inc,The Dominican Sisters Family Health Services Inc,1821184839,Ryan White Providers,279 Alexander Ave,,Bronx,NY,10454-1115,Bronx,299 N. Highland Ave,,Ossining,NY,10562,Westchester,Sarah-Ann Celestin,Program Director,718-665-6558,1410,scelestin@dsfhs.org,,,,,,http://www.dsfhs.org/home.nxg
NY-007895,Callen-Lorde Bronx,"Community Health Project, Inc",1295108025,Federally Qualified Health Centers - Medical Services,3144 3rd Ave,Ground Floor,Bronx,NY,10451-4629,Bronx,356 West 18th Street,,New York,NY,10011,New York,Wendy Stark,Executive Director,212-271-7200,7147,wstark@callen-lorde.org,Daniel Hunt,Director of Finance,212-271-7200,,dhunt@callen-lorde.org,www.callen-lorde.org
NY-007896,Boricua Community Health Center,"URBAN HEALTH PLAN, INC.",1467857433,Federally Qualified Health Centers - Medical Services,3209 3rd Ave,,Bronx,NY,10451-4203,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-012463,Center for Vein Restoration,Center for Vein Restoration,1700122728,Other ECP Providers,3250 Westchester Ave,Suite 201,Bronx,NY,10461-4580,Bronx,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
NY-007897,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",345 Brook Ave,International Community High School,Bronx,NY,10454-2112,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007898,Planned Parenthood of New York City - Bronx Health Center,Planned Parenthood of New York City,1417959701,Family Planning Providers,349 E 149th St,,Bronx,NY,10451-5603,Bronx,26 Bleecker Street,,New York,NY,10012,New York,Jonathan Segal,Chief Financial Officer,212-274-7230,,jonathan.segal@ppnyc.org,Meg Barnette,Chief Strategy Officer,212-274-7274,,meg.barnette@ppnyc.org,http://www.ppnyc.org
NY-007899,Care Coordination Program,Unique People Services,1861616518,Ryan White Providers,350 Bainbridge Ave,,Bronx,NY,10460,Bronx,4234 Vireo Ave,,Bronx,NY,10470,New York,Michael Ealy,Program Director,718-231-4900,,MichaelE@uniquepeopleservices.org,Cheryelle Cruickshank,Associate Executive DIrector,718-231-7711,1039,Cheryellec@Uniqpeopleservices.org,www.uniquepeopleservices.org
NY-007900,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",350 Gerard Ave,Health Opportunities High School,Bronx,NY,10451-5432,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007901,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",40 W Tremont Ave,The Arts Village School PS 306/MS 331,Bronx,NY,10453-5400,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007902,Tremont Health Center,"COMMUNITY HEALTHCARE NETWORK, INC.",1639459142,"Dental Providers, Family Planning Providers, Ryan White Providers",4215 3rd Ave,,Bronx,NY,10457-4501,Bronx,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development and Operations,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,evrodriguez@chnnyc.org,www.chnnyc.org
NY-007903,Urban Horizons Family Health Center,The Institute for Family Health,1740553841,Federally Qualified Health Centers - Medical Services,50 E 168th St Apt 1,,Bronx,NY,10452-7929,Bronx,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007904,Segundo Ruiz Belvis Diagnostic and Treatment Center,NEW YORK CITY HEALTH AND HOSPITALS CORPORATION,1467543330,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",545 E 142nd St,,Bronx,NY,10454-2110,Bronx,125 Worth St Rm 514,,New York,NY,10013-4006,New York,Ms. Elizabeth Rodriguez-Suarez,Executive Director,718-579-1765,,Elizabeth.Rodriguez@nychhc.org,Walid Michelen,,718-960-2750,,walid.michelen@nychhc.org,
NY-007905,Harrison Circle,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",57 W Burnside Ave # 69,,Bronx,NY,10453-4038,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007906,MHHC at 137th Street,Morris Heights Health Center,1184694291,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",625 E 137th St,,Bronx,NY,10454-3142,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007907,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1962823328,Federally Qualified Health Centers - Medical Services,628 Tinton Ave,Ponce de Leon Elementary School/P.S. 161,Bronx,NY,10455-3218,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,ALEXANDRA.BORBON@URBANHEALTHPLAN.ORG,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,https://www.urbanhealthplan.org/school-based-health-program/
NY-007908,JACKSON AVENUE FAMILY RESIDENCE,CARE FOR THE HOMELESS,1306182076,Federally Qualified Health Centers - Medical Services,691 E 138th St,,Bronx,NY,10454-3307,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,Bronx,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007909,Women's Health Pavilion,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",70 W Burnside Ave,,Bronx,NY,10453-4016,Bronx,85 w. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007910,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1649578949,Federally Qualified Health Centers - Medical Services,730 Bryant Ave,M.S. 424,Bronx,NY,10474-6006,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,ALEXANDRA.BORBON@URBANHEALTHPLAN.ORG,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,https://www.urbanhealthplan.org/school-based-health-program/
NY-007911,Stevenson Family Health Center,The Institute for Family Health,1194073056,"Dental Providers, Federally Qualified Health Centers - Medical Services",731 White Plains Rd,,Bronx,NY,10473-2631,Bronx,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007912,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",750 Baychester Ave,Harry S. Truman / Bronx Health Science,Bronx,NY,10475-1701,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007913,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",758 Courtland Ave,The Melrose School MS/PS 29,Bronx,NY,10451-4308,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007914,MHHC at Melrose Avenue,Morris Heights Health Center,1184694291,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",779 Melrose Ave,,Bronx,NY,10451-4440,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007915,THE LIVING ROOM,CARE FOR THE HOMELESS,1740679695,Federally Qualified Health Centers - Medical Services,800 Barretto St,,Bronx,NY,10474-5304,Bronx,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007916,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1285055665,Federally Qualified Health Centers - Medical Services,800 Home St,X-158,Bronx,NY,10456-5443,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,https://www.urbanhealthplan.org/school-based-health-program/
NY-007917,MHHC at 233rd Street,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",825 E 233rd St,,Bronx,NY,10466-3203,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453-4015,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Fund Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007918,MHHC at Burnside Avenue,Morris Heights Health Center,1184694291,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",85 W Burnside Ave,,Bronx,NY,10453-4015,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453-4015,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP-Fund Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007919,Bronx Care Tiffany Medical and Pediatric Practice,"Dr. Martin Luther King, Jr. Health Center",1528366937,Federally Qualified Health Centers - Medical Services,853 Tiffany St,,Bronx,NY,10459-4503,Bronx,1265 Franklin Avenue,,Bronx,NY,10456-3501,Bronx,Lionel P. stewart,Executive Director,718-466-6072,,lstewart@bronxleb.org,Victor G. DeMarco,CFO,718-901-8600,,vdemarco@bronxleb.org,
NY-007920,Bella Vista Community Health Center,"URBAN HEALTH PLAN, INC.",1043514615,"Dental Providers, Federally Qualified Health Centers - Medical Services",882 Hunts Point Ave,,Bronx,NY,10474-5402,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007921,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1114224128,Federally Qualified Health Centers - Medical Services,888 Rev James a Polite Ave,PS 333/PS 335,Bronx,NY,10459-4107,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,https://www.urbanhealthplan.org/school-based-health-program/
NY-007922,BELLA VISTA HEALTH CENTER,"URBAN HEALTH PLAN, INC.",1982758066,Federally Qualified Health Centers - Medical Services,890 Hunts Point Ave,,Bronx,NY,10474-5402,Bronx,1065 SOUTHERN BOULEVARD,,BRONX,NY,10459,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007923,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1962709980,Federally Qualified Health Centers - Medical Services,900 Tinton Ave,JANE ADAMS HIGH SCHOOL,Bronx,NY,10456-7411,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,https://www.urbanhealthplan.org/school-based-health-program/
NY-007924,The Children's Aid Society - Bronx Health Services,The Children's Aid Society,1730124025,Family Planning Providers,910 E 172nd St # 3,,Bronx,NY,10460-5802,Bronx,711 3rd Avenue,7th Floor,New York,NY,10017,New York,Jaime Huertas,Vice President for Health and Wellness Division,212-503-6808,,jaimeh@childrensaidsociety.org,Lisa Handwerker,Chief Medical Officer,212-949-4957,,lhandwerker@childrensaidsociety.org,http://www.childrensaidsociety.org
NY-007925,Albert Tuitt Educational Campus,Morris Heights Health Center,1184694291,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",921 E 228th St,,Bronx,NY,10466-4611,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Fund Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,
NY-007926,Adolescent Health and Wellness Center,"URBAN HEALTH PLAN, INC.",1699072686,Federally Qualified Health Centers - Medical Services,960 Southern Blvd,,Bronx,NY,10459-3402,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-991-4833,4222,alexandra.borbon@urbanhealthplan.org,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007927,Morris Heights Health Center,Morris Heights Health Center,1184694291,"Dental Providers, Federally Qualified Health Centers - Medical Services",965 Longwood Ave,Banana Kelly HS / Holcombe L. Rucker School / Co-Op Tech,Bronx,NY,10459-4058,Bronx,85 W. Burnside Avenue,,Bronx,NY,10453,Bronx,Gabriel Vonleh,President and CEO,718-483-1270,2323,gvonleh@mhhc.org,Claudette Phipps,"VP- Development, Planning, Ext. Affairs",718-483-1270,2312,cphipps@mhhc.org,http://www.mhhc.org/Our-Services/School-Based-Health-Centers.aspx
NY-007928,BRONX HEALTH CENTER,"COMMUNITY HEALTHCARE NETWORK, INC.",1316014103,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",975 Westchester Ave,,Bronx,NY,10459-3204,Bronx,60 Madison Ave Ste 501,,New York,NY,10010-1683,Bronx,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Woman's Health Manager,212-545-2415,,evrodriguez@chnnyc.org,www.chnnyc.org
NY-007929,"URBAN HEALTH PLAN, INC.","URBAN HEALTH PLAN, INC.",1730487034,Federally Qualified Health Centers - Medical Services,984 Faile St,PS 75,Bronx,NY,10459-3703,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbion,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,https://www.urbanhealthplan.org/school-based-health-program/
NY-007930,MIKE BRESLIN HOUSE,"URBAN HEALTH PLAN, INC.",1467750760,Federally Qualified Health Centers - Medical Services,999 Freeman St,,Bronx,NY,10459-2153,Bronx,1065 Southern Blvd,,Bronx,NY,10459-2417,Bronx,Alexandra Borbon,"Director, Managed Care, Contracting and Credentialing",718-589-2440,4222,alexandra.borbon@urbanhealthplan.org,Paloma Hernandez,President and CEO,718-991-4833,,paloma.hernandez@urbanhealthplan.org,
NY-007931,CARIBBEAN HOUSE HEALTH CENTER,"COMMUNITY HEALTHCARE NETWORK, INC.",1477764496,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1167 Nostrand Ave,,Brooklyn,NY,11225-5417,Kings,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,http://www.chnnyc.org
NY-007932,"Joseph P. Addabbo Family Health Center, Inc. - Red Hook",THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC,1578810883,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",120 Richards St,,Brooklyn,NY,11231-1635,Kings,6200 Beach Channel Dr,,Arverne,NY,11692-1409,Kings,Alfonso Chan,Chief Medical Officer,718-945-7150,,chan.alfonso@gmail.com,,,,,,www.addabbo.org
NY-007933,Ezra Medical Center,LRefuah Medical and Rehabilitation Center,1427098227,"Dental Providers, Federally Qualified Health Centers - Medical Services",1312 38th St,,Brooklyn,NY,11218-3612,Kings,1312 38th Street,,Brooklyn,NY,11218,Kings,Miryam Nakash,Credentialing Manager,347-820-1872,,MNakash@EzraMedical.Org,Allen Lichtenstein,COO,718-686-7600,2015,ALichtenstein@EzraMedical.Org,
NY-007934,ODA Primary Health Care Network,ODA Primary Health Care Network,1720177066,Federally Qualified Health Centers - Medical Services,14 Heyward St,,Brooklyn,NY,11249-7823,Kings,14 Heyward Street,,Brooklyn,NY,11249,Kings,Lauren Levine,Communications Director,718-260-4600,305,l.levine@odahealth.org,Joseph Deutsch,Chief Executive Officer,718-260-4600,301,j.deutsch@odahealth.org,www.odahealth.org
NY-007935,Bedford-Stuyvesant Family Health Center,Bedford-Stuyvesant Family Health Center,1033178561,"Dental Providers, Federally Qualified Health Centers - Medical Services",1456 Fulton St,,Brooklyn,NY,11216-2505,Kings,1456 Fulton Street,,Brooklyn,NY,11216,Kings,Jack Murray,Special Projects Officer,347-464-6658,,jmurray@bsfhc.org,Daniel Desire,Chief Financial Officer,347-464-6533,,ddesire@bsfhc.org,www.bsfhc.org
NY-007936,"Sunset Park Health Council, Inc.","SUNSET PARK HEALTH COUNCIL, INC.",1619341716,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",150 55th St,,Brooklyn,NY,11220-2508,Kings,150 55th Street,,Brooklyn,NY,11220,Kings,Astrid P. Gonzalez,Vice President of Finance,718-630-7047,,Astrid.Gonzalez@nyumc.org,Larry K. McReynolds,Executive Director,718-630-7147,,LarryK.Mcreynolds@nyumc.org,http://www.lutheranhealthcare.org/Main/LutheranFamilyHealthCenters.aspx
NY-007937,Bedford Mental Health Clinic,HELP/PSI SERVICES CORP.,1003093436,Community Mental Health Centers,1669 Bedford Ave,,Brooklyn,NY,11225-2009,Kings,71 W. 23rd Street,,New York,NY,10010,New York,Carol Murphy,Chief Operating Officer,718-681-8700,4418,cmurphy@brightpointhealth.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-007938,BUSHWICK FAMILY RESIDENCE,CARE FOR THE HOMELESS,1114263357,Federally Qualified Health Centers - Medical Services,1675 Broadway,,Brooklyn,NY,11207-1495,Kings,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007939,Public Health Solutions - Eastern Parkway,Public Health Solutions,1578754222,Family Planning Providers,1873 Eastern Pkwy,,Brooklyn,NY,11233-3214,Kings,1873 Eastern Pkwy,,Brooklyn,NY,11233-3214,Kings,Sandra Williams,Senior Director,646-619-6400,6704,swilliams@healthsolutions.org,Rachel Baum,"Deputy Dir, Clinical & Comm Health",646-619-6400,6518,rbaum@healthsolutions.org,http://www.healthsoultions.org
NY-007940,Bridging Access to Care,Bridging Access to Care,1548368756,Ryan White Providers,2261 Church Ave,,Brooklyn,NY,11226-3201,Kings,2261 Church Ave,,Brooklyn,NY,11226,Kings,Glenda G Smith,Executive Director,347-505-5114,114,gsmith@bac-ny.org,Nadine Akinyemi,Director of Social Supportive Services,347-505-5115,115,nranger@bac-ny.org,www.bac-ny.org
NY-007941,ENY Community Health Center,Housing Works Community Health Center,1114950151,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",2640 Pitkin Ave,,Brooklyn,NY,11208-2763,Kings,57 Willoughby St,,Brooklyn,NY,11201,Kings,Nadine Juste-Beckles,Vice President of Operations,212-260-8868,,n.juste-beckles@housingworks.org,Sakina Nejumi,Director of Operations,347-971-2480,,s.nejumi@housingworks.org,
NY-007942,CHI Health Center,"Community Health Initiatives, Inc.",1033581608,Federally Qualified Health Centers - Medical Services,2882 W 15th St,Lower Level,Brooklyn,NY,11224-2770,Kings,2882 W. 15th Street,lower level,Brooklyn,NY,11224,Kings,Alex Movshovich,CEO,718-210-3110,813,alex@chihealthcenter.com,Alessandra DaCruz,CFO,718-210-3110,806,adacruz@ijrconsulting.com,www.chihealthcenter.com
NY-007943,Public Health Solutions - Ft. Greene,Public Health Solutions,1942491691,Family Planning Providers,295 Flatbush Avenue,Ext # 3,Brooklyn,NY,11201-3001,Kings,295 Flatbush Ave Ext # 3,,Brooklyn,NY,11201-3001,Kings,Sandra Williams,Senior Director,646-619-6400,6704,swilliams@healthsolutions.org,Rachel Baum,"Deputy Dir, Clinical & Comm Health",646-619-6400,6518,rbaum@healthsolutions.org,http://www.healthsoultions.org
NY-007944,Wyckoff Heights Medical Center,Wyckoff Heights Medical Center,1700886322,Inpatient Hospitals (other than children's hospitals),374 Stockholm St,,Brooklyn,NY,11237-4006,Kings,374 Stockholm Street,,Brooklyn,NY,11237,Kings,Zachariah Hennessey,"AVP, Special Projects and Evaluation",718-907-4952,,zhennessey@wyckoffhospital.org,Vali Gache,"AVP, Budget and Reimbursement",718-240-1795,,vgache@wyckoffhospital.org,
NY-007945,Planned Parenthood of New York City - Joan Malin Brooklyn Health Center,Planned Parenthood of New York City,1417959701,Family Planning Providers,44 Court St,,Brooklyn,NY,11201-4405,Kings,26 Bleecker Street,,New York,NY,10012,New York,Jonathan Segal,Chief Financial Officer,212-274-7230,,jonathan.segal@ppnyc.org,Meg Barnette,Chief Strategy Officer,212-274-7274,,meg.barnette@ppnyc.org,http://www.ppnyc.org
NY-007946,AJS Brooklyn Medical Practice,AIDS Healthcare Foundation,1972850782,Other ECP Providers,475 Atlantic Ave # 2,,Brooklyn,NY,11217-1812,Kings,6255 W. Sunset Blvd.,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5025,,donna.stidham@aidshealth.org,,,,,,
NY-007947,Park Avenue Primary Health Care Center,ODA Primary Health Care Network,1720177066,Federally Qualified Health Centers - Medical Services,517 Park Ave,Suite 201,Brooklyn,NY,11205-1784,Kings,14 Heyward Street,,Brooklyn,NY,11249,Kings,Lauren Levine,Communications Director,718-260-4600,305,l.levine@odahealth.org,Joseph Deutsch,Chief Executive Officer,718-260-4600,301,j.deutsch@odahealth.org,www.odahealth.org
NY-007948,BMS Family Health and Wellness Center,Brownsville Community Development Corporation,1578612412,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",592 Rockaway Ave,,Brooklyn,NY,11212-5539,Kings,592 Rockaway Avenue,,Brooklyn,NY,11212,Kings,Harvey Lawrence,President and CEO,718-345-5000,1123,hlawrence@bmsfhc.org,Marcia Lawrence,Fund Developer,718-437-5737,,fineline2000@earthlink.net,www.bmsfhc.org
NY-007949,HealthCare Choices,HealthCare Choices,1770521270,"Dental Providers, Federally Qualified Health Centers - Medical Services",6209 16th Ave,,Brooklyn,NY,11204-2702,Kings,6209 16th Avenue,,Brooklyn,NY,11204,Kings,Crystal Jordan,CQI Consultant,605-593-2405,,cjordan@healthcarechoices.org,Maria Siebel,CEO,718-234-0073,,msiebel@healthcarechoicesny.org,
NY-007950,ST. JOHN'S BREAD AND LIFE,CARE FOR THE HOMELESS,1811233786,Federally Qualified Health Centers - Medical Services,795 Lexington Ave,,Brooklyn,NY,11221-2903,Kings,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007951,HELP/PSI Brooklyn Health Center,HELP/PSI SERVICES CORP.,1003093436,Federally Qualified Health Centers - Medical Services,803 Sterling Pl,,Brooklyn,NY,11216-3903,Kings,71 W. 23rd Street,Fl 8,New York,NY,10010,New York,Carol Murphy,Chief Operating Officer,718-681-8700,4418,cmurphy@brightpointhealth.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-007952,PETER JAY SHARP CENTER FOR OPPT,CARE FOR THE HOMELESS,1295071447,Federally Qualified Health Centers - Medical Services,89 Porter Ave # 111,,Brooklyn,NY,11237-1417,Kings,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Executive officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-007953,C.A.B.S. CENTER,"COMMUNITY HEALTHCARE NETWORK, INC.",1497822209,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",94 Manhattan Ave # 98,,Brooklyn,NY,11206-2501,Kings,60 Madison Ave Ste 501,,New York,NY,10010-1683,Kings,Elizabeth Howell,VP of Development and Public Relations,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,http://www.chnnyc.org
NY-007954,DR BETTY SHABAZZ HEALTH CENTER,"COMMUNITY HEALTHCARE NETWORK, INC.",1154498822,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",999 Blake Ave,,Brooklyn,NY,11208-3535,Kings,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-007955,Buffalo General Primary Care Center,Kaleida Health,1639209596,Outpatient Hospital Clinics,100 High St,,Buffalo,NY,14203-1126,Erie,100 High Street 11 South,,Buffalo,NY,14203,Erie,Jennifer Dunn,Manager of Managed Care Contracting,716-859-8321,,jdunn@kaleidahealth.org,Steven Moll,Director Ambulatory Clinics,716-859-7265,,smoll@kaleidahealth.org,
NY-012384,"Western New York BloodCare, Inc.","Western New York BloodCare, Inc.",1952433757,Hemophilia Treatment Centers,1010 Main St,Suite 300,Buffalo,NY,14202-1102,Erie,1010 Main St.,Suite 300,Buffalo,NY,14202,Erie,Laurel Reger,Executive Director,716-896-2470,4001,lreger@wnybloodcare.org,Lauren Lewis,Compliance Officer/Executive Assistant,716-896-2470,4002,llewis@wnybloodcare.org,www.wnybloodcare.org
NY-007956,Hodge Pediatrics,Kaleida Health,1245365196,Outpatient Hospital Clinics,125 Hodge Ave,,Buffalo,NY,14222-2035,Erie,Kaleida Health,100 High Street - 11 South,Buffalo,NY,14203,Erie,Jennifer Dunn,Manager of Managed Care Contracting,716-859-8321,,jdunn@kaleidahealth.org,Momba Chia,Director Public Health,716-878-7807,,mchia@kaleidahealth.org,
NY-007957,"Neighborhood Health Center Northwest dba of NORTHWEST BUFFALO COMMUNITY HEALTH CARE CENTER, INC.",NORTHWEST BUFFALO COMMUNITY HEALTH CARE CENTER,1881789014,"Dental Providers, Federally Qualified Health Centers - Medical Services",155 Lawn Ave,,Buffalo,NY,14207-1816,Erie,155 Lawn Ave,,Buffalo,NY,14207-1816,Erie,Joanne E Haefner,Executive Director,716-875-2904,230,j.haefner@nwbchcc.org,Hilary Kirk,Quality Director,716-875-2904,265,h.kirk@nwbchcc.org,
NY-007958,Jericho Road Community Health Center - Genesee Street,Jericho Road Community Health Center,1619307022,Federally Qualified Health Centers - Medical Services,1609 Genesee St,,Buffalo,NY,14211-1616,Erie,184 Barton Street,,Buffalo,NY,14213,Erie,Brett Lawton,COO,716-348-3000,430,brett.lawton@jrchc.org,Jackie Endress,Credentialing Specialist,716-348-3000,331,jackie.endress@jrchc.org,www.jrchc.org
NY-007959,Jericho Road Community Health Center - Barton Street,Jericho Road Community Health Center,1972944080,Federally Qualified Health Centers - Medical Services,184 Barton St,,Buffalo,NY,14213-1573,Erie,184 Barton St.,,Buffalo,NY,14213,Erie,Brett Lawton,COO,716-348-3000,430,brett.lawton@jrchc.org,Jackie Endress,Credentialing Specialist,716-348-3000,331,jackie.endress@jrchc.org,www.jrchc.org
NY-007960,EHS INC,dba Evergreen Health Services,1356390918,"Rural Health Clinics, Ryan White Providers",206 S Elmwood Ave,Suite 2,Buffalo,NY,14201-2398,Erie,206 S Elmwood Ave,,Buffalo,NY,14201-2398,Erie,Sheila R Stephens,AVP of Reimbursement Services,716-847-0212,3381,sstephens@evergreenhs.org,Michael Lee,Senior Director of Business Development,716-847-0212,3440,mlee@evergreenhs.org,
NY-007961,"Planned Parenthood of Central and Western New York, Inc.","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",2697 Main St,,Buffalo,NY,14214-1701,Erie,114 University Ave,,Rochester,NY,14605-2929,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-007962,Neighborhood Health Center- Mattina,Neighborhood Health Center dba Northwest Buffalo Community Health Care Center,1881789014,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 Niagara St,,Buffalo,NY,14201-2135,Erie,155 Lawn Ave,,Buffalo,NY,14207,Erie,Hilary Kirk,Quality Director,716-875-2904,265,h.kirk@nwbchcc.org,Joanne Haefner,Executive Director,716-875-2904,230,j.haefner@nwbchcc.org,
NY-007963,CHCB,"Community Health Center of Buffalo, Inc.",1790787919,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",34 Benwood Ave,,Buffalo,NY,14214-1761,Erie,34 Benwood Ave.,,Buffalo,NY,14214,Erie,Arvela Heider,Director,716-986-9199,1004,aheider@chcb.net,LaVonne Ansari,CEO,716-986-9199,1002,lansari@chcb.net,www.chcb.net
NY-007964,Towne Garden Pediatric Clinic,Kaleida Health,1245365196,Outpatient Hospital Clinics,461 William St,,Buffalo,NY,14204-1811,Erie,100 High Street 11 South,,Buffalo,NY,14203,Erie,Jennifer Dunn,Manager of Managed Care Contracting,716-859-8321,,jdunn@kaleidahealth.org,Momba Chia,Director of Public Health,716-878-7807,,mchia@kaleidahealth.org,
NY-007965,Jesse Nash Health Center,Erie County Department of Health,1134210313,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",608 William St,,Buffalo,NY,14206-1649,Erie,95 Franklin Street,9th Floor,Buffalo,NY,14202,Erie,Jacquelyn Andula,Medical Care Administrator,716-858-7731,,andulaj@erie.gov,Mick Kubik,Assistant Director of Administration,716-858-8080,,kubikm@erie.gov,
NY-007966,Oishei Childrens Hospital,Kaleida Health,1245365196,Children's Hospitals (inpatient only),818 Ellicott St,,Buffalo,NY,14203-1021,Erie,100 High Street,,Buffalo,NY,14203,Erie,Jennifer Dunn,Manager of Managed Care Contracting,716-859-8321,,jdunn@kaleidahealth.org,Momba Chia,Director of Public Health,716-878-7807,,mchia@kaleidahealth.org,
NY-007967,Hertel Elmwood Internal Medicine Clinic,Kaleida Health,1639209596,Outpatient Hospital Clinics,900 Hertel Ave,,Buffalo,NY,14216-2611,Erie,100 High Street 11 South,,Buffalo,NY,14203,Erie,Jennifer Dunn,Manager of Managed Care Contracting,716-859-8321,,jdunn@kaleidahealth.org,Steven Moll,Director of Ambulatory Clinics,716-859-7265,,smoll@kaleidahealth.org,
NY-007968,"Hemophilia Center of Western New York, Inc.","Hemophilia Center of Western New York, Inc.",1952433757,Hemophilia Treatment Centers,936 Delaware Ave,Suite 300,Buffalo,NY,14209-1880,Erie,936 Delaware Ave,Suite 300,Buffalo,NY,14209,Erie,Laurel Reger,Executive Director,716-896-2470,4001,lreger@hemoctr.com,Lauren Lewis,Compliance Officer/Executive Assistant,716-896-2470,4002,llewis@hemoctr.com,hemophiliawny.com
NY-007969,"Planned Parenthood of Central and Western New York, Inc. - Canandaigua","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",15 Lafayette Ave,,Canandaigua,NY,14424-2049,Ontario,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-007970,Community Health Center of the North Country,"UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC.",1467432765,"Dental Providers, Federally Qualified Health Centers - Medical Services",4 Commerce Ln,,Canton,NY,13617-3739,Saint Lawrence,4 Commerce Ln,,Canton,NY,13617-3739,Saint Lawrence,Anne F Richey,Executive Director,315-386-1156,8310,anne@cpnorthcountry.org,Pamela Mahaffy,Chief Financial Officer,315-386-1156,8320,pmahaffy@cpnorthcountry.org,http://www.chcnorthcountry.org
NY-007971,Planned Parenthood of the North Country NY - Canton,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,9 Miner St,,Canton,NY,13617-1208,Saint Lawrence,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,Nicole.Hills@ppncny.org,http://www.plannedparenthood.org/northcountry
NY-007972,Greene County Family Planning - Catskill,Greene Co. Family Planning,1932281706,"Family Planning Providers, Sexually Transmitted Disease Clinics",411 Main St,Suite 300,Catskill,NY,12414-1363,Greene,411 Main St,,Catskill,NY,12414-1363,Greene,Laura Churchill,Deputy Director of Public Health & Clinical Services,519-719-3580,,lchurchill@discovergreene.com,Kim Kaplan,Interim Director of Public Health,518-719-3600,,kkaplan@discovergreene.com,
NY-007973,"Oswego County Opportunities, Inc. - The Ctr for Reproductive Health at Central Square","Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,544 S Main St,,Central Square,NY,13036-9779,Oswego,239 Oneida Street,,Fulton,NY,13069,Oswego,Inga Back,Coordinator of Administrative Operations,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director of Health and Nutrition,315-598-4715,1228,eholst@oco.org,http://www.oco.org
NY-007974,North Country Family Health,Hudson Headwaters Health Network,1245285170,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",481 State Route 11,,Champlain,NY,12919-4819,Clinton,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-007975,CHC Cheektowaga,"Community Health Center of Buffalo, Inc.",1790787919,Federally Qualified Health Centers - Medical Services,934 Cleveland Dr,,Cheektowaga,NY,14225-1279,Erie,34 Benwood Ave.,,Buffalo,NY,14214,Erie,Arvela R. Heider,Director,716-986-9199,1004,aheider@chcb.net,LaVonne Ansari,CEO,716-986-9199,1002,lansari@chcb.net,www.chcb.net
NY-007976,Chester-Horicon Health Center,Hudson Headwaters Health Network,1609899848,Federally Qualified Health Centers - Medical Services,6223 State Route 9,,Chestertown,NY,12817-2823,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-007977,Family Health Network - Cincinnatus Health Center,"Family Health Network of Central New York, Inc.",1659654101,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2805 Cincinnatus Rd,,Cincinnatus,NY,13040-9685,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-007978,Family Health Network - Cincinnatus SBHC,"Family Health Network of Central New York, Inc",1043374853,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2809 Cincinnatus Rd,,Cincinnatus,NY,13040-9685,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-007979,Planned Parenthood Mohawk Hudson - Clifton Park,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",1673 Route 9,Healthplex Plaza,Clifton Park,NY,12065-4461,Saratoga,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-007980,Planned Parenthood Mohawk Hudson - Cobleskill,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",109 Legion Dr,,Cobleskill,NY,12043-5111,Schoharie,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-007981,"Tri-County Family Medicine Program, Inc. - Cohocton","Tri-County Family Medicine Program, Inc.",1588649503,Federally Qualified Health Centers - Medical Services,25 Park Ave,,Cohocton,NY,14826-9401,Steuben,PO Box 601,,Dansville,NY,14437,Steuben,Joyce Wheaton,CEO,585-335-3416,,smyers@tcfmedicine.com,Susan Myers,Administrative Assistant,585-335-3416,,smyers@tcfmedicine.com,www.tcfmedicine.com
NY-007982,Planned Parenthood Southern Finger Lakes - Corning Center,Planned Parenthood Southern Finger Lakes,1881761484,Family Planning Providers,135 Walnut St,,Corning,NY,14830-2545,Steuben,620 West Seneca Street,,Ithaca,NY,14850,Tompkins,Alicia Kenaley,CEO,607-273-1526,2329,alicia.kenaley@ppsfl.org,Liz Weissbrot,Vice President for Patient Services,607-273-1513,2324,liz.weissbrot@ppsfl.org,http://www.plannedparenthood.org/ppsfl
NY-007983,Plaza del Sol Health Center,"URBAN HEALTH PLAN, INC.",1710125141,Federally Qualified Health Centers - Medical Services,3712 108th St,,Corona,NY,11368-2025,Queens,1065 SOUTHERN BOULEVARD,,Bronx,NY,10459-2417,Bronx,ALEXANDRA BORBON,"Director, Managed Care, Contracting & Credentialing",718-589-2440,4222,ALEXANDRA.BORBON@URBANHEALTHPLAN.ORG,PALOMA HERNANDEZ,PRESIDENT AND CEO,718-991-4833,,,
NY-007984,Pediatric/Family Practice Health Center,Family Health Network,1811342827,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",24 Groton Ave,,Cortland,NY,13045-2014,Cortland,17 Main Street,Suite 302,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-007985,Family Health Network - Cortland Health Center,"Family Health Network of Central New York, Inc.",1093946691,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4038 West Rd,,Cortland,NY,13045-1842,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-007986,Jacobus Center for Reproductive Health,Cortland County Health Department,1609876564,"Family Planning Providers, Sexually Transmitted Disease Clinics",60 Central Ave,,Cortland,NY,13045-2795,Cortland,60 Central Avenue,,Cortland,NY,13045,Cortland,Catherine Feuerherm,Public Health Director,607-753-5135,,cfeuerherm@cortland-co.org,,,,,,http://cchd.cortland-co.org/index.php/divisions/jacobus-center
NY-007987,"Southern Tier Community Health Center Network, Inc - Cuba Site","Southern Tier Community Health Center Network, Inc.",1306174727,Federally Qualified Health Centers - Medical Services,132 W Main St,,Cuba,NY,14727-1317,Allegany,135 N. Union Street,,Olean,NY,14760,Cattaraugus,Gail Speedy Mayeaux,Executive Director,716-701-6831,,gspeedy@upchealth.net,Mike Malick,Chief Financial Officer,716-701-6842,,mmalick@upchealth.net,www.upchealth.net
NY-007988,Reproductive Health Center,Livingston County Department of Health,1295753788,"Family Planning Providers, Sexually Transmitted Disease Clinics",3 Chestnut Ave,,Dansville,NY,14437-1601,Livingston,2 Murray Hill Drive,,Mt. Morris,NY,03878-1522,Livingston,Cindy Sheflin,Center for Preventive Services,585-243-7540,7295,csheflin@co.livingston.ny.us,Sandra Bradt,Supervising Public Health Nurse,585-243-7540,7538,sbradt@co.livingston.ny.us,www.livingstoncounty.us.doh/htm
NY-007989,"Tri-County Family Medicine Program, Inc.","Tri-County Family Medicine Program, Inc.",1588649503,Federally Qualified Health Centers - Medical Services,60 Red Jacket St,Suite 1,Dansville,NY,14437-1758,Livingston,PO Box 601,,Dansville,NY,14437,Steuben,Joyce Wheaton,DEO,585-335-3416,,smyers@tcfmedicine.com,Susan Myers,Administrative Assistant,585-335-3416,,smyers@tcfmedicine.com,www.tcfmedicine.com
NY-007990,Family Health Network - DeRuyter SBHC,"Family Health Network of Central New York, Inc.",1043374853,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",711 Railroad St,,De Ruyter,NY,13052-9700,Madison,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-007991,Dundee Dental Center,"Finger Lakes Migrant Health Care Project, Inc.",1669568465,Dental Providers,6 Stoll St,,Dundee,NY,14837-1013,Yates,14 Maiden Lane,,Penn Yan,NY,14527,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-007992,The Chautauqua Center - Central Avenue Center,The Chautauqua Center,1760747521,"Dental Providers, Federally Qualified Health Centers - Medical Services",1134 Central Ave,,Dunkirk,NY,14048-3423,Chautauqua,319 Central Avenue,,Dunkirk,NY,14048,Chautauqua,Michael C Pease,CEO,716-363-6050,,mpease@thechautauquacenter.org,Amy Walters,CFO,716-363-6050,,awalters@thechautauquacenter.org,
NY-007993,Dunkirk Dental Center,The Chautauqua Center,1760747521,Dental Providers,314 Central Ave,,Dunkirk,NY,14048-2136,Chautauqua,319 Central Avenue,Suite B,Dunkirk,NY,14048,Chautauqua,Amy Walters,CFO,716-363-6050,,awalters@thechautauquacenter.org,Michael C Pease,CEO,716-363-6050,,mpease@thechautauquacenter.org,
NY-007994,Dunkirk Health Center,The Chautauqua Center,1760747521,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",319 Central Ave,,Dunkirk,NY,14048-2137,Chautauqua,319 Central Avenue,,Dunkirk,NY,14048,Chautauqua,Michael C Pease,CEO,716-363-6050,205,mpease@thechautauquacenter.org,Rebecca Ruiz,Operations Director,716-363-6050,222,rruiz@thechautauquacenter.org,
NY-007995,Nassau University Medical Center (inpatient hospital),Nassau Health Care Corp,1801857172,Inpatient Hospitals (other than children's hospitals),2201 Hempstead Tpke,,East Meadow,NY,11554-1859,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,Nanette Ecker,"Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,Stan Bravo,Grants Manager,516-572-5285,,sbravo@numc.edu,http://www.numc.edu
NY-007996,Nassau University Medical Center (multiple outpatient ECP categories),Nassau Health Care Corp,1801857172,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2201 Hempstead Tpke,,East Meadow,NY,11554-1859,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,Nanette Ecker,"Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,Stan Bravo,Grants Manager,516-572-5285,,sbravo@numc.edu,http://www.numc.edu
NY-007997,Ellenville Family Health Center,The Institute for Family Health,1699048751,"Dental Providers, Federally Qualified Health Centers - Medical Services",6 Healthy Way,,Ellenville,NY,12428-5612,Ulster,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-007998,NEW YORK CITY HEALTH AND HOSPITALS CORPORATION/ Elmhurst Hospital Center (children's inpatient hospital),New York City Health+Hospitals,1063426377,Children's Hospitals (inpatient only),7901 Broadway,,Elmhurst,NY,11373-1329,Queens,7901 Broadway,,Elmhurst,NY,11373,Queens,Bruce E. Bernstein,Administrator,718-334-5827,,bernsteb2@nychhc.org,Bruce Bernstein,Sr. Associate Director,718-334-5827,,bernsteb2@nychhc.org,
NY-007999,NEW YORK CITY HEALTH AND HOSPITALS CORPORATION/ Elmhurst Hospital Center (multiple outpatient ECP categories),New York City Health+Hospitals,1063426377,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Hemophilia Treatment Centers, Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",7901 Broadway,,Elmhurst,NY,11373-1329,Queens,7901 Broadway,,Elmhurst,NY,11373,Queens,Pat Freedman,Administrator,718-334-3448,,FREEDMAP@nychhc.org,Bruce Bernstein,Sr. Associate Director,718-334-5827,,bernsteb2@nychhc.org,
NY-008000,Planned Parenthood Southern Finger Lakes - Elmira Center,Planned Parenthood Southern Finger Lakes,1881761484,Family Planning Providers,755 E Church St,,Elmira,NY,14901-2836,Chemung,620 West Seneca Street,,Ithaca,NY,14850,Tompkins,Alicia Kenaley,Interim CEO,607-273-1526,2329,alicia.kenaley@ppsfl.org,Liz Weissbrot,Vice President for Patient Services,607-273-1513,2324,liz.weissbrot@ppsfl.org,https://www.plannedparenthood.org/planned-parenthood-southern-finger-lakes
NY-008001,LIFQHC Elmont,Nassau Health Care Corp,1912211012,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",161 Hempstead Tpke,,Elmont,NY,11003-1432,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,"Ms. Nanette Ecker, MA","Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,,,,,,http://numc.edu
NY-008002,Far Rockaway,"AIDS Center of Queens County, Inc.",1629274972,"Community Mental Health Centers, Other ECP Providers, Ryan White Providers",1139 Foam Place A/K/A 1603 Central Ave,,Far Rockaway,NY,11691,Queens,"161-21 Jamaica Avenue, 6th Floor",,Jamaica,NY,11432-6113,Richmond,Mitchel Eisenberg,CFO,718-896-2500,5720,meisenberg@acqc.org,Rosemary Lopez,Associate Executive Director,718-896-2500,5736,rlopez@acqc.org,www.acqc.org
NY-008003,JOSEPH P. ADDABBO FAMILY HEALTH CENTER,THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC,1871848234,"Dental Providers, Federally Qualified Health Centers - Medical Services",1288 Central Ave,,Far Rockaway,NY,11691-3909,Queens,6200 Beach Channel Dr,,Arverne,NY,11692-1409,Queens,Alfonso Chan,Chief Medical Officer,718-945-7150,,chan.alfonso@gmail.com,,,,,,www.addabbo.org
NY-008004,Farmingville Mental Health Clinic,Suffolk County,1700989050,Community Mental Health Centers,15 Horseblock Pl,,Farmingville,NY,11738-1204,Suffolk,3500 Sunrise Hwy,,Great River,NY,11739,Suffolk,Cari Faith Besserman,"Deputy Director, Div. CMHS",631-853-8500,6990,cari.besserman@suffolkcountyny.gov,Barbara Russo,PrincipalFinancial Analyst,631-853-6500,8533,barbara.russo@suffolkcountyny.gov,
NY-008005,"Charles B. Wang Community Health Center, Inc.","CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.",1144203498,Federally Qualified Health Centers - Medical Services,13626 37th Ave,,Flushing,NY,11354-6533,Queens,268 Canal St,,New York,NY,10013-3599,New York,Jane T. Eng,Chief Executive Officer,212-379-6988,,jeng@cbwchc.org,Betty Cheng,Chief Operating Officer,718-886-1212,,bcheng@cbwchc.org,http://www.cbwchc.org/
NY-008006,"Charles B. Wang Community Health Center, Inc.","Charles B. Wang Community Health Center, Inc.",1144203498,Federally Qualified Health Centers - Medical Services,13739 45th Ave,,Flushing,NY,11355-4094,Queens,268 Canal St,,New York,NY,10013,New York,Jane T. Eng,Chief Executive Officer,212-379-6988,,jeng@cbwchc.org,Betty Cheng,Chief Operating Officer,718-886-1212,,bcheng@cbwchc.org,http://www.cbwchc.org/
NY-008007,Fort Edward-Kingsbury Health Center,Hudson Headwaters Health Network,1124320247,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",48 East St,,Fort Edward,NY,12828-1811,Washington,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008008,LIFQHC South Ocean Care,Nassau Health Care Corp,1215241302,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 S Bergen Pl,,Freeport,NY,11520-3528,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,David Nemeroff,Exucutive Director,516-572-0086,,dnemirof@numc.edu,,,,,,http://lifqhc.com
NY-008009,"Oswego County Opportunities, Inc.","Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,239 Oneida St,,Fulton,NY,13069-1228,Oswego,239 Oneida St,,Fulton,NY,13069-1228,New York,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,www.oco.org
NY-008010,Fulton Health Center,"Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,510 S 4th St,Suite 600,Fulton,NY,13069-2904,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008011,"Oswego County Opportunities, Inc. - The Ctr for Reproductive Health at Fulton","Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,522 S 4th St,Suite 500,Fulton,NY,13069-2936,Oswego,239 Oneida Street,,Fulton,NY,13069,New York,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,http://www.oco.org/
NY-008012,Reproductive Health Center,Livingston County Department of Health,1295753788,"Family Planning Providers, Sexually Transmitted Disease Clinics",1 College Cir,,Geneseo,NY,14454-1401,Livingston,2 Murray Hill Drive,,Mt. Morris,NY,14510,Livingston,Cindy Sheflin,Center for Preventive Services,585-243-7540,7295,csheflin@co.livingston.ny.us,Sandra Bradt,Supervising Public Health Nurse,585-243-7540,7538,sbradt@co.livingston.ny.us,www.livingstoncounty.us.doh/htm
NY-008013,"Tri-County Family Medicine Program, Inc. - Geneseo","Tri-County Family Medicine Program, Inc.",1588649503,Federally Qualified Health Centers - Medical Services,50 E South St,Suite 700,Geneseo,NY,14454-1387,Livingston,PO Box 601,,Dansville,NY,14437,Steuben,Joyce Wheaton,CEO,585-335-3416,,smyers@tcfmedicine.com,Susan Myers,Administrative Assistant,585-335-3416,,smyers@tcfmedicine.com,www.tcfmedicine.com
NY-008014,Geneva Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1487771911,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",601B W Washington St,,Geneva,NY,14456-2119,Ontario,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008015,Planned Parenthood Nassau County - Glen Cove,Planned Parenthood Nassau County,1427090190,Family Planning Providers,110 School St,,Glen Cove,NY,11542-2569,Nassau,540 Fulton Ave,,Hempstead,NY,11550-4364,Nassau,Nancy O'Keefe,Senior VP for Health Services,516-750-2501,,nancy.okeefe@ppnc.org,Tammy Umansky,CFO,516-750-2606,,tammy.umansky@ppnc.org,
NY-008016,Health Center Broad St.,Hudson Headwaters Health Network,1851305577,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",100 Broad St,,Glens Falls,NY,12801-4349,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008017,Health Center Broad St. Annex,Hudson Headwaters Health Network,1811367170,Federally Qualified Health Centers - Medical Services,118 Broad St,,Glens Falls,NY,12801-4348,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008018,North Country Obstetrics & Gynecology,Hudson Headwaters Health Network,1154589083,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",90 South St,,Glens Falls,NY,12801-4353,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008019,Goshen Dental & Audiology,Cornerstone Family Healthcare,1689669079,"Dental Providers, Federally Qualified Health Centers - Medical Services",2 Fletcher St,,Goshen,NY,10924-1402,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12518,Orange,Linda S. Muller,President and CEO,845-220-3110,,lmuller@ghvfhc.org,Chris Lennon,Grants Director,845-220-3154,,clennon@ghvfhc.org,www.ghvfhc.org
NY-008020,Planned Parenthood Mid Hudson Valley - Goshen,Planned Parenthood Mid Hudson Valley,1013035112,Family Planning Providers,7 Coates Dr,Suite 4,Goshen,NY,10924-6749,Orange,178 Church Street,,Poughkeepsie,NY,12601,Dutchess,Laura Bunora,VP Health Center Operations,845-471-1530,122,Laura.Bunora@ppmhv.org,Lisa Murphy,Billing Manager,845-471-1530,138,Lisa.murphy@ppmhv.org,http://www.ppmhv.org
NY-008021,Community Health Center of the North Country,"United Cerebral Palsy Association of the North Country, Inc.",1467432765,Federally Qualified Health Centers - Medical Services,77 W Barney St,,Gouverneur,NY,13642-1040,Saint Lawrence,4 Commerce Ln,,Canton,NY,13617-3739,Saint Lawrence,Anne Richey,Executive Director,315-386-1156,8310,anne@cpnorthcountry.org,Pamela Mahaffy,Chief Financial Officer,315-386-1156,8320,pmahaffy@cpnorthcountry.org,http://www.chcnorthcountry.org
NY-008022,Hudson River HealthCare Greenport,"Hudson River HealthCare, Inc.",1851585962,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",327 Front St,,Greenport,NY,11944-1515,Suffolk,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008023,LIAAC,"Long Island Association for AIDS Care, Inc.",1154446557,"Other ECP Providers, Ryan White Providers",60 Adams Ave,Suite 100,Hauppauge,NY,11788-3611,Suffolk,60 Adams Ave,,Hauppauge,NY,11788,Suffolk,Catherine Hart,COO,631-385-2451,106,chart@liaac.org,,,,,,
NY-008024,Hudson River HealthCare Haverstraw,"Hudson River HealthCare, Inc.",1740474535,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",31 W Broad St # 3,,Haverstraw,NY,10927-1615,Rockland,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008025,LIFQHC Hempstead,Nassau Health Care Corp,1215241302,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",135 Main St,,Hempstead,NY,11550-2414,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,Nanette Ecker,"Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,,,,,,http://www.numc.edu
NY-008026,Hempstead,Planned Parenthood Nassau County,1427090190,Family Planning Providers,540 Fulton Ave,,Hempstead,NY,11550-4364,Nassau,540 Fulton Ave,,Hempstead,NY,11550-4364,New York,Nancy O'Keefe,Senior VP for Health Services,516-750-2501,,nancy.okeefe@ppnc.org,Tammy Umansky,CFO,516-750-2606,,tammy.umansky@ppnc.org,
NY-008027,Cornerstone Family Healthcare at Highland Falls,"The Greater Hudson Valley Family Health Center, Inc.",1689669079,Federally Qualified Health Centers - Medical Services,127 Main St,,Highland Falls,NY,10928-4019,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12518,Orange,Linda S. Muller,President and CEO,845-220-3110,,lmuller@ghvfhc.org,Chris Lennon,Grants Director,845-220-3154,,clennon@ghvfhc.org,www.ghvfhc.org
NY-008028,Saint Regis Mohawk Health Services,Saint Regis Mohawk Tribe,1457344558,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",412 State Highway 37,,Hogansburg,NY,13655,Franklin,412 STATE HIGHWAY 37,,HOGANSBURG,NY,13655,New York,Lori Thompson,Business Office Manager,518-358-3141,7104,lorit@regis.nashville.ihs.gov,Timothy Basenfelder,Asst. Business Office Manager,518-358-2179,7140,tim@regis.nashville.ihs.gov,www.srmt-nsn.gov
NY-008029,Planned Parenthood Southern Finger Lakes - Hornell Center,Planned Parenthood Southern Finger Lakes,1881761484,Family Planning Providers,111 Seneca St,,Hornell,NY,14843-1304,Steuben,620 West Seneca Street,,Ithaca,NY,14850,Tompkins,Alicia Kenaley,CEO,607-273-1526,2329,alicia.kenaley@ppsfl.org,Liz Weissbrot,Vice President for Patient Services,607-273-1513,2324,liz.weissbrot@ppsfl.org,https://www.plannedparenthood.org/planned-parenthood-southern-finger-lakes
NY-008030,Oak Orchard Health - Hornell,"Oak Orchard Community Health Center, Inc.",1548647779,Federally Qualified Health Centers - Medical Services,20 Elm St Lowr Level,,Hornell,NY,14843-1933,Steuben,300 West Ave,,Brockport,NY,14420-1118,Monroe,Pamela Keller,CIO,585-637-3905,218,pkeller@oochc.org,Bill Namestnik,COO,585-637-3905,,,https://www.oakorchardhealth.org/
NY-008031,"Southern Tier Community Health Center Network, Inc. - Houghton Site","Southern Tier Community Health Center Network, Inc.",1942538368,"Dental Providers, Federally Qualified Health Centers - Medical Services",9864 Luckey Dr,,Houghton,NY,14744-8706,Allegany,135 N. Union Street,,Olean,NY,14760,Allegany,Gail Speedy Mayeaux,Executive Director,716-701-6831,,gspeedy@upchealth.net,Mike Malick,Chief Financial Officer,716-701-6842,,mmalick@upchealth.net,www.upchealth.net
NY-008032,Upper Hudson Planned Parenthood - Hudson,Upper Hudson Planned Parenthood,1881755601,"Family Planning Providers, Sexually Transmitted Disease Clinics",190 Fairview Ave,,Hudson,NY,12534-1260,Columbia,855 Central Ave,,Albany,NY,12206,Columbia,Marielle McKasty-Stagg,COO,518-434-5678,140,marielle@uhpp.org,AnnMarie McIntosh,Finance Director,518-434-5678,123,annmarie@uhpp.org,http://www.plannedparenthood.org/uhpp/
NY-008033,Columbia County Department of Health,Columbia County Department of Health,1578752192,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",325 Columbia St,,Hudson,NY,12534-1902,Columbia,325 Columbia St. Suite 100,,Hudson,NY,12534,Columbia,Elizabeth Galle,Director of Patient Services,518-828-3358,1295,Elizabeth.Galle@columbiacountyny.com,John Mabb,Director of Public Health,518-828-3358,1262,Jack.Mabb@columbiacountyny.com,
NY-008034,Hudson River HealthCare Hudson,"Hudson River HealthCare, Inc.",1922426881,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",750 Union St,,Hudson,NY,12534-3002,Columbia,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008035,Planned Parenthood Hudson Peconic - Huntington,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",755 New York Ave,Suite 333,Huntington,NY,11743-4285,Suffolk,"4 Skyline Drive, Suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Carmela Colpa-Lewis,"Regional Director, Patient Services and Operations, East",631-240-1111,,carmela.colpa-lewis@pphp.org,http://www.pphp.org
NY-008036,Family Practice Center of Hyde Park,The Institute for Family Health,1407129562,Federally Qualified Health Centers - Medical Services,11 Crum Elbow Rd,,Hyde Park,NY,12538-2852,Dutchess,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008037,Valley Family Health Center,ROCHESTER PRIMARY CARE NETWORK,1528428208,Federally Qualified Health Centers - Medical Services,55 Central Plz,Suite B,Ilion,NY,13357-1701,Herkimer,"259 Monroe Avenue, Level B",,Rochester,NY,14607,Monroe,Michael Leary,President/CEO,585-325-2280,7302,mleary@rpcn.org,,,,,,www.rpcn.org
NY-008038,Indian Lake Health Center,Hudson Headwaters Health Network,1548276801,Federally Qualified Health Centers - Medical Services,6356 State Rt. 30,,Indian Lake,NY,12842,Hamilton,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008039,Cattaraugus Indian Reservation Health Center,Seneca Nation of Indians,1477562288,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",36 Thomas Indian School Dr,,Irving,NY,14081-9300,Chautauqua,90 Ohi:Yo' Way,,Salamanca,NY,14779,Cattaraugus,Tim Waterman,CEO,716-945-5894,5259,tim.waterman@senecahealth.org,Paris Marino,Business Office Manager,716-945-5894,3349,paris.marino@senecahealth.org,www.senecahealth.org
NY-008040,Planned Parenthood Southern Finger Lakes - Ithaca Center,Planned Parenthood Southern Finger Lakes,1881761484,Family Planning Providers,620 W Seneca St,,Ithaca,NY,14850-3326,Tompkins,620 West Seneca Street,,Ithaca,NY,14850,Tompkins,Alicia Kenaley,CEO,607-273-1526,2329,alicia.kenaley@ppsfl.org,Liz Weissbrot,VP for Patient Services,607-273-1513,2324,liz.weissbrot@ppsfl.org,http://www.plannedparenthood.org/ppsfl
NY-008041,HELP/PSI Queens Health Center,HELP/PSI SERVICES CORP.,1003093436,Federally Qualified Health Centers - Medical Services,10504 Sutphin Blvd,,Jamaica,NY,11435-5022,Queens,71 W. 23rd Street,Fl 8,New York,NY,10010,New York,Carol Murphy,Chief Operating Officer,718-681-8700,,cmurphy@brightpointhealth.org,"Barbara Zeller, MD",Chief Clinical Officer,718-681-8700,,bzeller@brightpointhealth.org,www.brightpointhealth.org
NY-008042,Joseph P. Addabbo Family Health Center at Sutphin Blvd.,THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC,1467708107,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",11439 Sutphin Blvd,,Jamaica,NY,11434-1022,Queens,6200 Beach Channel Dr,,Arverne,NY,11692-1409,Queens,Alfonso Chan,Chief Medical Officer,718-945-7150,,chan.alfonso@gmail.com,,,,,,www.addabbo.org
NY-008043,Joseph P. Addabbo Family Health Center at Guy Brewer Blvd.,THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC,1750638961,"Dental Providers, Federally Qualified Health Centers - Medical Services",11811 Guy R Brewer Blvd,,Jamaica,NY,11434-2101,Queens,6200 Beach Channel Dr,,Arverne,NY,11692-1409,Queens,Alfonso Chan,Chief Medical Officer,718-945-7150,,chan.alfonso@gmail.com,,,,,,www.addabbo.org
NY-008044,Springfield Gardens Family Inn,CARE FOR THE HOMELESS,1720324650,Federally Qualified Health Centers - Medical Services,14680 Guy R Brewer Blvd,,Jamaica,NY,11434-5340,Queens,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Finacial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-008045,Jamaica Main,"AIDS Center of Queens County, Inc.",1629274972,"Community Mental Health Centers, Other ECP Providers, Ryan White Providers",161-21 Jamaica Avenue A/K/A 89-74 162nd St,6th Floor,Jamaica,NY,11432,Queens,"161-21 Jamaica Avenue, 6th Floor",,Jamaica,NY,11432-6113,Queens,Mitchel Eisenberg,CFO,718-896-2500,5720,meisenberg@acqc.org,Rosemary Lopez,Associate Executive Director,718-896-2500,5736,rlopez@acqc.org,www.acqc.org
NY-008046,Jamaica Family Assessment Center,CARE FOR THE HOMELESS,1679819825,Federally Qualified Health Centers - Medical Services,17510 88th Ave,,Jamaica,NY,11432-5720,Queens,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-008047,Briarwood Family Residence,CARE FOR THE HOMELESS,1225373723,Federally Qualified Health Centers - Medical Services,8020 134th St,,Jamaica,NY,11435-1002,Queens,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Finacial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-008048,NYC Health + Hospitals / Queens (children's inpatient hospital),NYC Health + Hospitals,1801803903,Children's Hospitals (inpatient only),8268 164th St,,Jamaica,NY,11432-1121,Queens,82-68 164th Street,,Jamaica,NY,11432,Queens,Bruce E. Bernstein,Senior Associate Director,718-334-5827,,bernsteb2@nychhc.org,,,,,,
NY-008049,NYC Health + Hospitals / Queens (multiple outpatient ECP categories),NYC Health + Hospitals,1801803903,"Dental Providers, Family Planning Providers, Freestanding Cancer Centers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",8268 164th St,,Jamaica,NY,11432-1121,Queens,82-68 164th Street,,Jamaica,NY,11432,Queens,Bruce E. Bernstein,Senior Associate Director,718-334-5827,,bernsteb2@nychhc.org,,,,,,
NY-008050,Jamaica Satellite,"AIDS Center of Queens County, Inc.",1629274972,"Community Mental Health Centers, Other ECP Providers, Ryan White Providers",8931 161st St,Suite 710,Jamaica,NY,11432-6130,Queens,"161-21 Jamaica Avenue, 6th Floor",,Jamaica,NY,11432-6113,Queens,Mitchel Eisenberg,CFO,718-896-2500,5720,meisenberg@acqc.org,Rosemary Lopez,Associate Executive Director,718-896-2500,5736,rlopez@acqc.org,www.acqc.org
NY-008051,Family Health Center,"COMMUNITY HEALTHCARE NETWORK, INC.",1124396874,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",9004 161st St Fl 5,,Jamaica,NY,11432-6103,Queens,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008052,Salvation Army Jamaica Citadel,CARE FOR THE HOMELESS,1013253327,Federally Qualified Health Centers - Medical Services,9023 161st St,,Jamaica,NY,11432-6107,Queens,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Finacial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-008053,QUEENS HEALTH CENTER SITE,"COMMUNITY HEALTHCARE NETWORK, INC.",1184791923,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",9704 Sutphin Blvd,,Jamaica,NY,11435-4721,Queens,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008054,Jamestown Health Center,The Chautauqua Center,1760747521,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",110 E 4th St,,Jamestown,NY,14701-5340,Chautauqua,319 Central Avenue,,Dunkirk,NY,14048,Chautauqua,Michael C Pease,CEO,716-363-6050,205,mpease@thechautauquacenter.org,Rebecca Ruiz,Operations Director,716-363-6050,222,rruiz@thechautauquacenter.org,
NY-008055,Planned Parenthood Mohawk Hudson - Johnstown,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",400 N Perry St,,Johnstown,NY,12095-1115,Fulton,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008056,Adirondack Medical Center-Keene,Adirondack Medical Center,1699709576,Rural Health Clinics,2841 State Route 73,,Keene,NY,12942,Essex,2233 State Route 86,,Saranac Lake,NY,12983,Franklin,Tristan Glanville,CFO,518-897-2301,,tglanville@adirondackhealth.org,Kathy Bauer,Director Patient Financial Services,518-897-2222,,kbauer@adirondackhealth.org,adirondackhealth.org
NY-008057,Keuka College Family Planning,"Finger Lakes Migrant Health Care Project, Inc.",1669568465,Family Planning Providers,141 Central Ave,,Keuka Park,NY,14478-9764,Yates,14 Maiden Lane,,Penn Yan,NY,14527,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,http://www.flchealth.org
NY-008058,Kingston Family Health Center,The Institute for Family Health,1477827624,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Family Practice Dr,,Kingston,NY,12401-6449,Ulster,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008059,OB/GYN and Specialty Care Center of Kingston,The Institute for Family Health,1194098251,Federally Qualified Health Centers - Medical Services,1 Foxhall Ave,,Kingston,NY,12401-5107,Ulster,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008060,HVCS Ulster,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,138 Pine St,,Kingston,NY,12401-4947,Ulster,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputy Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008061,Planned Parenthood Mid Hudson Valley - Kingston,Planned Parenthood Mid Hudson Valley,1013035112,Family Planning Providers,21 Grand St,,Kingston,NY,12401-3933,Ulster,178 Church Street,,Poughkeepsie,NY,12601,Dutchess,Laura Bunora,Vice President of Health Center Operations,845-471-1530,122,Laura.Bunora@ppmhv.org,Lisa Murphy,Billing Manager,845-471-1530,138,Lisa.murphy@ppmhv.org,http://www.ppmhv.org
NY-008062,Adirondack Medical Center-Lake Placid,Adirondack Medical Center,1699709576,"Dental Providers, Rural Health Clinics",29 Church St,,Lake Placid,NY,12946-1817,Essex,2233 State Route 86,,Saranac Lake,NY,12983,Franklin,Tristan Glanville,CFO,518-897-2301,,tglanville@adirondackhealth.org,Kathy Bauer,Director Patient Financial Services,518-897-2222,,kbauer@adirondackhealth.org,adirondackhealth.org
NY-008063,CHC Lockport,"Community Health Center of Buffalo, Inc.",1790787919,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",38 Heritage Ct,,Lockport,NY,14094-3616,Niagara,34 Benwood Ave.,,Buffalo,NY,14214,Erie,Arvela R. Heider,Director,716-986-9199,1004,aheider@chcb.net,LaVonne Ansari,CEO,716-986-9199,1002,lansari@chcb.net,www.chcb.net
NY-008064,Lockport Service Unit,Lockport Service Unit,1477959120,"Indian Health Service, Other ECP Providers, Rural Health Clinics",6507 Wheeler Rd,,Lockport,NY,14094-9416,Niagara,6507 Wheeler Rd,,Lockport,NY,14094-9416,Niagara,Brittainy A. Cortilet,Chief Executive Officer,716-280-3850,,brittainy.cortilet@ihs.gov,,,,,,
NY-008065,Healthcare Choices LIC,Healthcare Choices,1770521270,"Dental Providers, Federally Qualified Health Centers - Medical Services",2110 Borden Ave,,Long Island City,NY,11101-4518,Queens,6209 16th Avenue,,Brooklyn,NY,11204,Kings,Crystal Jordan,CQI Consultant,605-593-2405,,cjordan@healthcarechoices.org,Maria Siebel,CEO,718-234-0073,,msiebel@healthcarechoicesny.org,
NY-008066,Planned Parenthood of New York City - Diane L. Max Health Center,Planned Parenthood of New York City,1417959701,Family Planning Providers,2141 45th Rd,,Long Island City,NY,11101-4706,Queens,26 Bleecker St,,New York,NY,10012-2413,New York,Jonathan Segal,Chief Financial Officer,212-274-7230,,jonathan.segal@ppnyc.org,Meg Barnette,Chief Strategy Officer,212-274-7274,,meg.barnette@ppnyc.org,www.ppnyc.org
NY-008067,Long Island City Health Center,"COMMUNITY HEALTHCARE NETWORK, INC.",1952542771,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3611 21st St,,Long Island City,NY,11106-4705,Queens,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008068,The Floating Hospital,The Floating Hospital,1306954631,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",4143 Crescent St,,Long Island City,NY,11101-3805,Queens,PO Box 8397,,Long Island City,NY,11101,Queens,Shani Andre,VP/CMO,718-784-2240,140,sandre@thefloatinghospital.org,Sean Granahan,President/General Counsel,718-784-2240,105,sgranahan@thefloatinghospital.org,www.thefloatinghospital.org
NY-008069,Planned Parenthood of the North Country NY - Lowville,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,7398 Turin Rd,,Lowville,NY,13367-1714,Lewis,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,http://www.plannedparenthoo.com/northcountry
NY-008070,North Country Family Health Center - Lowville,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",7785 N State St,,Lowville,NY,13367-1229,Lewis,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,dparks@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,
NY-008071,Oak Orchard Health - Lyndonville,Oak Orchard Health,1407189582,Federally Qualified Health Centers - Medical Services,77 S Main St,,Lyndonville,NY,14098-9771,Orleans,77 S. Main Street,,Lyndonville,NY,14098,Orleans,Rhiannon McDevitt,"Dir., Business Development",585-637-3905,221,rmcdevitt@oochc.org,Pam Keller,Chief Information Officer,585-637-3905,218,pkeller@oochc.org,
NY-008072,Wayne Community Health Center,ROCHESTER PRIMARY CARE NETWORK,1780010975,Dental Providers,1519 Nye Rd,,Lyons,NY,14489-9133,Wayne,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Stacy Wormuth,Social Worker Care Navigator,585-554-4400,7163,swormuth@rpcn.org,,,,,,http://www.rpcn.org
NY-008073,Cattaraugus County Health Dept. - Machias,Cattaraugus County Health Department,1134148570,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9824 Route 16,PO Box 188,Machias,NY,14101-9771,Cattaraugus,9824 Route 16,PO Box 188,Machias,NY,14101-9771,Cattaraugus,Susan A. Andrews,Director of Patient Services,716-701-3438,,saandrews@cattco.org,Patti G. Williams,Supervising Community Health Nurse,716-701-3422,,pgwilliams@cattco.org,http://www.cattco.org
NY-008074,Planned Parenthood of the North Country NY - Malone,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,246 W Main St,Suite No. 1,Malone,NY,12953-1747,Franklin,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,NIcole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,http://www.plannedparenthood.com/northcountry
NY-008075,Community Health Center of the North Country,"UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC.",1467432765,Federally Qualified Health Centers - Medical Services,380 County Route 51,,Malone,NY,12953-4504,Franklin,4 Commerce Ln,,Canton,NY,13617-3739,Saint Lawrence,Anne F Richey,Executive Director,315-386-1156,8310,anne@cpnorthcountry.org,Pamela Mahaffy,Chief Financial Officer,315-386-1156,8320,pmahaffy@cpnorthcountry.org,http://www.chcnorthcountry.org
NY-008076,North Shore University Hospital,Northwell Health,1366459570,Ryan White Providers,400 Community Dr,Division Of Infectious Diseases,Manhasset,NY,11030-3815,Nassau,1979 Marcus Avenue,"Northwell Health Provider Enrollment, Suite C101",New Hyde Park,NY,11042,Nassau,Dr. Joseph McGowan,Medical Director,516-562-4282,,JMcGowan@northwell.edu,John D'agostino,Administrative Director,516-562-4188,,JDAgosti@northwell.edu,
NY-008077,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",423 N Main St,Mannsville Elementary School,Mannsville,NY,13661-2200,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/about-our-school-based-health-centers/
NY-008078,Family Health Network - Marathon Jr/Sr SBHC,"Family Health Network of Central New York, Inc.",1043374853,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Main St,,Marathon,NY,13803-7708,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-008079,Family Health Network - Marathon Health Center,"Family Health Network of Central New York, Inc.",1114158276,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",22-24 E Main St,,Marathon,NY,13803-3208,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-008080,Family Health Network - Marathon Appleby SBHC,"Family Health Network of Central New York, Inc.",1043374853,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",24 Albro Rd,,Marathon,NY,13803-2808,Cortland,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director Of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive Officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-008081,Planned Parenthood Nassau County - Massapequa,Planned Parenthood Nassau County,1427090190,Family Planning Providers,35 Carmans Rd,,Massapequa,NY,11758-4703,Nassau,540 Fulton Ave,,Hempstead,NY,11550-4364,Nassau,Nancy O'Keefe,Senior VP for Health Services,516-750-2501,,nancy.okeefe@ppnc.org,Tammy Umansky,CFO,516-750-2606,,tammy.umansky@ppnc.org,
NY-008082,Massena Memorial Hospital,Massena Memorial Hospital,1972604460,Inpatient Hospitals (other than children's hospitals),1 Hospital Dr,,Massena,NY,13662-1056,Saint Lawrence,1 hospital drive,,Massena,NY,13662,Saint Lawrence,Patrick Facteau,CFO,315-769-4207,,pfacteau@massenahospital.org,,,,,,
NY-008083,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc .",1508850280,Federally Qualified Health Centers - Medical Services,16 Fravor Rd,Health Center at Mexico Middle School,Mexico,NY,13114-3011,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008084,Mexico Health Center,"Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,5856 Scenic Ave,,Mexico,NY,13114-3012,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008085,The Center for Reproductive Health at Mexico,"Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,5856 Scenic Ave,,Mexico,NY,13114-3012,Oswego,5856 Scenic Ave,,Mexico,NY,13114-3012,New York,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,http://www.oco.org
NY-008086,"Middletown Community Health Center, Inc.","Middletown Community Health Center, Inc.",1609055409,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",10 Benton Ave,Suite 1,Middletown,NY,10940-5149,Orange,21 Orchard Street,,Middletown,NY,10940,Orange,Taylor Mrazek,Government Initiatives & Planning Strategist,845-741-9192,,tmrazek@middletownchc.org,Sybil Medina,Chief of Programs/Director of HR,845-343-7614,,smedina@middletownchc.org,
NY-008087,Hudson River HealthCare Middletown,"Hudson River HealthCare, Inc.",1932555737,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",24 Union St,,Middletown,NY,10940-4906,Orange,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008088,Moriah Health Center,Hudson Headwaters Health Network,1902900111,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",33 Tom Phelps Lane,,Mineville,NY,12956,Essex,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008089,Ezras Choilim Health Center,"EZRAS CHOILIM HEALTH CENTER, INC.",1063480218,"Dental Providers, Federally Qualified Health Centers - Medical Services",49 Forest Rd,,Monroe,NY,10950-2923,Orange,49 Forest Rd,,Monroe,NY,10950-2923,Orange,Joel Mittelman,CEO,845-782-3242,,jmittelman@echckj.org,,,,,,
NY-008090,Monsey Family Medical Center,"Community Medical and Dental Care, Inc",1972681484,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",40 Robert Pitt Dr,,Monsey,NY,10952-3333,Rockland,40 Robert Pitt Drive,,Monsey,NY,10952,Rockland,Janeen Pendergast,Acting Medical Director,845-352-6800,6862,jpendergast@cmadc.com,Mendel Hoffman,President/CEO,845-352-6800,,mhoffman@cmadc.com,
NY-008091,Planned Parenthood Mid Hudson Valley - Monticello,Planned Parenthood Mid Hudson Valley,1013035112,Family Planning Providers,14 Prince St,,Monticello,NY,12701-1910,Sullivan,178 Church Street,,Poughkeepsie,NY,12601,Dutchess,Laura Bunora,Vice President of Health Center Operations,845-471-1530,122,Laura.Bunora@ppmhv.org,Lisa Murphy,Billing Manager,845-471-1530,138,Lisa.murphy@ppmhv.org,http://www.ppmhv.org
NY-008092,HVCS Sullivan,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,20 Crystal St,,Monticello,NY,12701-1323,Sullivan,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputy Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008093,Hudson River HealthCare Monticello,"Hudson River HealthCare, Inc.",1407910557,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",23 Lakewood Ave,,Monticello,NY,12701-2021,Sullivan,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008094,Family Health Network - Moravia Health Center,"Family Health Network of Central New York, Inc.",1043374853,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",23 Central St,,Moravia,NY,13118-3427,Cayuga,"17 Main Street, Suite 302",,Cortland,NY,13045,Cortland,Kate Alm,Director of Development,607-753-3797,5027,kalm@familyhealthnetwork.org,Walter Priest,Chief Executive officer,607-753-3797,5040,wpriest@familyhealthnetwork.org,www.familyhealthnetwork.org
NY-008095,OPEN DOOR MT. KISCO CLINIC,"OPEN DOOR FAMILY MEDICAL CENTER, INC.",1629237151,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",30 W Main St,,Mount Kisco,NY,10549-1910,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzotta@odfmc.org,
NY-008096,Livingston Community Health Center,ROCHESTER PRIMARY CARE NETWORK,1598073777,Dental Providers,1 Murray Hill Dr,Room 140,Mount Morris,NY,14510-1153,Livingston,"259 Monroe Ave., Level B",,Rochester,NY,14607,Monroe,Marisol Colon,Social Worker Care Navigator,585-325-2280,7313,mcolon@rpcn.org,,,,,,http://www.rpcn.org
NY-008097,Reproductive Health Center,Livingston County Department of Health,1295753788,"Family Planning Providers, Sexually Transmitted Disease Clinics",2 Murray Hill Dr,,Mount Morris,NY,14510-1122,Livingston,2 Murray Hill Drive,,Mt. Morris,NY,14510,Livingston,Cindy Sheflin,Center for Preventive Services,585-243-7540,7295,csheflin@co.livingston.ny.us,Sandra Bradt,Supervising Public Health Nurse,585-243-7540,7538,sbradt@co.livingston.ny.us,www.livingstoncounty.us.doh/htm
NY-008098,Mount Vernon Neighborhood Hlth Ctr,Mount Vernon Neighborhood Hlth Ctr,1396736120,Federally Qualified Health Centers - Medical Services,100 California Rd,Mount Vernon High School Hlth Ctr,Mount Vernon,NY,10552-1404,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opal Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008099,Mount Vernon Neighborhood Hlth Ctr,"Mount Vernon Neighborhood Hlth Ctr, Inc",1396736120,"Dental Providers, Federally Qualified Health Centers - Medical Services",107 W 4th St,,Mount Vernon,NY,10550-4002,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opal Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008100,HVCS Westchester,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,137 S 4th Ave,,Mount Vernon,NY,10550-3118,Westchester,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputy Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008101,Planned Parenthood Hudson Peconic - Mt. Vernon,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",6 Gramatan Ave,Suite 404,Mount Vernon,NY,10550-3209,Westchester,"4 Skyline Drive, Suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Trisha Beck,"Senior Vice President, Patient Services and Operations",914-467-7312,,trisha.beck@pphp.org,http://www.pphp.org
NY-008102,Mount Vernon Neighborhood Hlth Ctr,Mount Vernon Neighborhood Hlth Ctr,1396736120,Federally Qualified Health Centers - Medical Services,9 Union Ave,Williams School Based Health Center,Mount Vernon,NY,10550-3510,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opal Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008103,Long Island Jewish Hemophilia Treatment Center,Long island Jewish Medical Center,1285641514,Hemophilia Treatment Centers,27005 76th Ave,,New Hyde Park,NY,11040-1496,Queens,270-05 76th Ave,,New Hyde Park,NY,11040,Nassau,Suchitra Acharya,Section Head,718-470-3636,,sacharya@nshs.edu,,,,,,
NY-008104,Hudson River HealthCare New Paltz,"Hudson River HealthCare, Inc.",1467515254,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1 Paradies Ln,,New Paltz,NY,12561-4031,Ulster,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008105,New Paltz Family Health Center,The Institute for Family Health,1740554989,Federally Qualified Health Centers - Medical Services,279 Main St,,New Paltz,NY,12561-1623,Ulster,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008106,Planned Parenthood Hudson Peconic - New Rochelle,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",247 North Ave,,New Rochelle,NY,10801,Westchester,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Trisha Beck,Senior Vice Presisdent,914-467-7312,,trisha.beck@pphp.org,http://www.pphp.org
NY-008107,Cornerstone Family Healthcare at New Windsor,Cornerstone Family Healthcare,1689669079,Federally Qualified Health Centers - Medical Services,91 Blooming Grove Tpke,,New Windsor,NY,12553-7757,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12553,Orange,Linda S. Muller,President and CEO,845-220-3110,,lmuller@ghvfhc.org,Chris Lennon,Grants Director,845-220-3154,,clennon@ghvfhc.org,www.ghvfhc.org
NY-008108,Mount Sinai Hemophilia Treatment Center,Mount Sinai Health System,1932103413,Hemophilia Treatment Centers,1 Gustave L Levy Pl,,New York,NY,10029-6504,New York,One Gustave Levy Place,,New York,NY,10029,New York,Mark Kovarik,Sr. Director,646-605-4110,,mark.kovarik@mountsinai.org,,,,,,
NY-008109,WARDS ISLAND PROJECT (HELP USA),CARE FOR THE HOMELESS,1932444528,Federally Qualified Health Centers - Medical Services,1 Wards Is,,New York,NY,10035-6002,New York,30 E 33rd St Fl 5,,New York,NY,10016-5337,New York,George Nashak,Executive Director,212-366-4459,201,gnashak@cfhnyc.org,William Herl,Chief Financial Officer,212-366-4459,223,wherl@cfhnyc.org,http://www.careforthehomeless.org/
NY-008110,Samuels Clinic,"Mount Sinai West, Institute of Advanced Medicine",1104982917,"Dental Providers, Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",1000 10th Ave,Suite 2T,New York,NY,10019-1147,New York,1 Gustave L Levy Pl,Box 1009,New York,NY,10029,New York,Diane Tider,Dir of Special Projects,646-385-5496,,diane.tider@mountsinai.org,Matthew Baney,Sr Administrator,,,matthew.baney@mountsinai.org,http://www.mountsinaihealth.org/patient-care/iam
NY-008111,"William F. Ryan Community Health Center, Inc.","RYAN, WILLIAM F COMMUNITY HEALTH CENTER INC",1851328199,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",110 W 97th St,,New York,NY,10025-6450,New York,110 W 97th St,,New York,NY,10025-6450,New York,Ana Taras,Chief of Strategic Initiatives,212-316-7944,,ana.taras@ryancenter.org,,,,,,www.ryancenter.org
NY-008112,Charles B. Wang Community Health Center,Charles B. Wang Community Health Center,1144203498,"Dental Providers, Federally Qualified Health Centers - Medical Services",125 Walker St Fl 2,2nd Flr.,New York,NY,10013-4135,New York,268 Canal St,,New York,NY,10013-3599,New York,Jane T Eng,Chief Executive Officer,212-379-6988,,jeng@cbwchc.org,Kenneth Shieh,Chief Strategy Officer,212-379-6988,2508,kshieh@cbwchc.org,http://www.cbwchc.org/
NY-008113,The Children's Aid Society - Millbank Medical Group,The Children's Aid Society,1730124025,"Dental Providers, Family Planning Providers",14 W 118th St # 32,,New York,NY,10026-1904,New York,711 3rd Avenue,7th Floor,New York,NY,10017,New York,Jaime Huertas,Vice President for the Health and Wellness Division,212-503-6808,,jaimeh@childrensaidsociety.org,Lisa Handwerker,Chief Medical Officer,212-949-4957,,lhandwerker@childrensaidsociety.org,http://www.childrensaidsociety.org
NY-008114,Catherine M. Abate Health Center,"COMMUNITY HEALTHCARE NETWORK, INC.",1699842500,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",150 Essex St,,New York,NY,10002-2301,New York,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008115,Sidney Hillman and Phillips Family Practice,The Institute for Family Health,1295729408,Federally Qualified Health Centers - Medical Services,16 E 16th St # 3,,New York,NY,10003-3105,New York,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008116,Jack Martin Clinic,Mount Sinai Hospital,1932103413,"Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",17 E 102nd St # 3,,New York,NY,10029-5204,New York,1 Gustave L Levy Pl,Box 1009,New York,NY,10029,New York,Diane Tider,Dir of Special Projects,646-385-5496,,diane.tider@mountsinai.org,Matthew Baney,Sr Administrator,,,matthew.baney@mountsinai.org,http://www.mountsinaihealth.org/patient-care/iam
NY-008117,Heritage Health and Housing Healthcare Center,"Heritage Health and Housing, INC",1851414965,"Dental Providers, Federally Qualified Health Centers - Medical Services",1727 Amsterdam Ave,# 4,New York,NY,10031-4611,New York,416 West 127th St,,New York,NY,10027,New York,"Jason Waterman, DO",Pediatrician,646-979-4523,,jwaterman@heritagenyc.org,"Alvaro Simmons, PhD",CEO,212-866-2600,,asimmons@heritagenyc.org,
NY-008118,Family Health Center of Harlem,The Institute for Family Health,1972877017,"Dental Providers, Federally Qualified Health Centers - Medical Services",1824 Madison Ave,,New York,NY,10035-3832,New York,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008119,"Settlement Health and Medical Services, Inc.","Settlement Health and Medical Services, Inc.",1144250291,Federally Qualified Health Centers - Medical Services,212 E 106th St,,New York,NY,10029-4007,New York,212 East 106th Street,,New York,NY,10029,New York,Ana A. Trilla,CEO,212-360-2661,,mtrilla@settlementhealth.org,Vanessa Clark,Director of Humam Resources,212-360-2699,,vclark@settlementhealth.org,
NY-008120,New Providence,"Project Renewal, Inc",1598770018,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",225 E 45th St,,New York,NY,10017-3301,New York,"200 Varick Street,",9th Fl.,New York,NY,10014,New York,Julia Nabiullina,Healthcare Contract Manager,212-620-0340,347,julia.nabiullina@projectrenewal.org,Aaron Felder,"Director of Healthcare Operations and Planning, Primary Care Services",212-620-0340,443,Aaron.Felder@projectrenewal.org,http://www.projectrenewal.org/
NY-008121,Callen-Lorde 17th Street,"SUNSET PARK HEALTH COUNCIL, INC.",1972913473,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",230 W 17th St,,New York,NY,10011-5325,New York,150 55th St Ste 1,,Brooklyn,NY,11220-2508,Kings,Larry McReynolds,President,718-630-7216,,lmcreynolds@nyumc.org,Wendy Stark,Executive Director,212-271-7147,,wstark@callen-lorde.org,www.callen-lorde.org
NY-008122,Ryan/Frederick Douglass Community Health Center,"William F. Ryan Community Health Center, Inc.",1013360528,Federally Qualified Health Centers - Medical Services,2381 Frederick Douglass Blvd,,New York,NY,10027-1822,New York,110 W 97th St.,,New York,NY,10025-4650,New York,Ana Taras,Chief of Strategic Development,212-316-7944,,ana.taras@ryancenter.org,,,,,,www.ryanhealth.org
NY-008123,Planned Parenthood of New York City - Margaret Sanger Center,Planned Parenthood of New York City,1417959701,Family Planning Providers,26 Bleecker St,,New York,NY,10012-2413,New York,26 Bleecker St,,New York,NY,10012-2413,New York,Jonathan Segal,Chief Financial Officer,212-274-7230,,jonathan.segal@ppnyc.org,Meg Barnette,Chief Strategy Officer,212-274-7274,,meg.barnette@ppnyc.org,www.ppnyc.org
NY-008124,Charles B. Wang Community Health Center,"CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.",1144203498,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",268 Canal St Fl 1,,New York,NY,10013-3599,New York,268 Canal St,,New York,NY,10013-3599,New York,Jane T Eng,Chief Executive Officer,212-379-6988,,jeng@cbwchc.org,Kenneth Shieh,Chief Strategy Officer,212-379-6988,,kshieh@cbwchc.org,www.cbwchc.org
NY-008125,Comprehensive Health Program Downtown,"Mount Sinai Hospital, Institute for Advanced Medicine",1932103413,"Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",275 7th Ave Fl 12,,New York,NY,10001-6756,New York,1 Gustave L Levy Pl,Box 1009,New York,NY,10029,New York,Diane Tider,Dir of Special Projects,646-385-5496,,diane.tider@mountsinai.org,Matthew Baney,Sr Administrator,,,matthew.baney@mountsinai.org,http://www.mountsinaihealth.org/patient-care/iam
NY-008126,Ryan-NENA Community Health Center,"RYAN, WILLIAM F COMMUNITY HEALTH CENTER INC",1588691828,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",279 E 3rd St,,New York,NY,10009-7813,New York,110 W 97th St,,New York,NY,10025-6450,New York,Ana Taras,Chief of Strategic Initiatives,212-316-7944,,ana.taras@ryancenter.org,,,,,,ryancenter.org
NY-008127,Betances Health Center,Betances Health Center,1609897453,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",280 Henry St,,New York,NY,10002-4816,New York,280 Henry Street,,New York,NY,10002-4816,New York,Julia Tsien,Executive Director,212-227-8401,101,jtsien@betances.org,Philip Valdez,Chief Financial Officer,212-227-8401,129,pvaldez@betances.org,
NY-008128,Peter Krueger Clinic,"Mount Sinai Beth Israel, Institute for Advanced Medicine",1174689665,"Dental Providers, Outpatient Hospital Clinics, Rural Health Clinics, Ryan White Providers",317 E 17th St # 1,,New York,NY,10003-3804,New York,1 Gustave L Levy Pl,Box 1009,New York,NY,10029,New York,Diane Tider,Dir of Special Projects,646-385-5496,,diane.tider@mountsinai.org,Matthew Baney,Sr Administrator,,,matthew.baney@mountsinai.org,http://www.mountsinaihealth.org/patient-care/iam
NY-008129,Mount Sinai Adolescent Health Center,"New York State Dept. of Health Bureau of Women, Infant & Adolescent Health",1932103413,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",320 E 94th St # 2,,New York,NY,10128-5604,New York,320 E 94th St # 2,,New York,NY,10128-5604,New York,"Dr. Anne Nucci, MD",Family Planning Coordinator,212-423-2075,,angela.diaz@mountsinai.org,Angela Diaz,"Director, Mount Sinai Adolescent Health Center",212-423-2900,,angela.diaz@mountsinai.org,http://www.mountsinai.org
NY-008130,Broadway Vision Center,Broadway Vision Center Inc.,1982704862,Other ECP Providers,3553 Broadway,Between 145th & 146th Street,New York,NY,10031-3203,New York,3553 Broadway,(between 145th & 146th Street),New York,NY,10031-3203,New York,Nicholas A. Radetzky,OD,212-234-2020,14,nradetzky@bvcnyc.com,Nicholas A. Radetzky,OD,212-234-2020,14,nradetzky@bvcnyc.com,www.eyecare-upper-manhattan.com
NY-008131,CALLEN LORDE COMMUNITY HEALTH CENTER,"SUNSET PARK HEALTH COUNCIL, INC.",1306898432,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",356 W 18th St,,New York,NY,10011-4401,New York,150 55th St Ste 1,,Brooklyn,NY,11220-2508,Kings,Larry McReynolds,President,718-630-7216,,lmcreynolds@lmcmc.com,Wendy Stark,Executive Director,212-271-7147,,wstark@callen-lorde.org,http://www.callen-lorde.org/
NY-008132,Public Health Solutions,Public Health Solutions,1467529529,Family Planning Providers,40 Worth St Fl 5,,New York,NY,10013-2955,New York,40 Worth St,5th Flr.,New York,NY,10013-2904,New York,Sandra Williams,Senior Director,646-619-6400,6704,swilliams@healthsolutions.org,Rachel Baum,"Deputy Dir, Clinical & Comm Health",646-619-6400,6518,rbaum@healthsolutions.org,http://www.healthsolutions.org/
NY-008133,Apicha Community Health Center,Apicha Community Health Center,1730303017,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",400 Broadway,,New York,NY,10013-3698,New York,400 Broadway,,New York,NY,10013-3698,New York,Mihaela Mihai,Clinic Manager,646-744-2599,,mmihai@apicha.org,Yumiko Sano,Chief Operating Officer,646-744-0980,,ysano@apicha.org,www.apicha.org
NY-008134,Morningside Clinic,Mount Sinai St. Luke's,1104982917,"Dental Providers, Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",440 W 114th St Bldg 6,Clark Floor,New York,NY,10025-1796,New York,1 Gustave L Levy Pl,Box 1009,New York,NY,10029,New York,Diane Tider,Dir of Special Projects,646-385-5496,,diane.tider@mountsinai.org,Matthew Baney,Sr Administrator,,,matthew.baney@mountsinai.org,http://www.mountsinaihealth.org/patient-care/iam
NY-008135,Covenant House,Covenant House NY/Under 21,1053588988,Federally Qualified Health Centers - Medical Services,460 W 41st St,,New York,NY,10036-6801,New York,460W 41 street,460W 41 street,Manhattan,NY,10036,New York,Conny Pimentel,Medical Billing-Credentialing,212-613-0300,5315,cpimentel@covenanthouse.org,Conny Pimentel,Medical Billiing-Credentialing,212-613-0300,315,cpimentel@covenanthouse.org,
NY-008136,35th Street Health Center,"Damian Family Care Centers, Inc.",1083093637,"Dental Providers, Federally Qualified Health Centers - Medical Services",500 8th Ave,,New York,NY,10018-6504,New York,138-02 Queens Blvd,2nd floor,Briarwood,NY,11435,Queens,Elizabeth King,Director of Clinical Services,347-505-7000,5527,eking@damian.org,Nikki Langford,Credentialing Specialist,718-657-1100,4139,nlangford@damian.org,www.damianhealth.org
NY-008137,Community League Health Center,"COMMUNITY HEALTHCARE NETWORK, INC.",1467529115,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",511 W 157th St,,New York,NY,10032-7601,New York,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008138,The Door Adolescent Health Center,"The Door - A Center of Alternatives, Inc.",1679620090,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",555 Broome St,,New York,NY,10013-1510,New York,121 Avenue of the Americas,AHC,New York,NY,10013-1510,New York,"Ms, Renee McConey",Director of Health Services,212-941-9090,3209,rmcconey@door.org,Sandra Langston,Clinical Manager,212-941-9090,3213,slangston@door.org,http://www.door.org/programs-services/health-dental-services
NY-008139,Thelma C. Davidson Adair/Ryan Center,"RYAN, WILLIAM F COMMUNITY HEALTH CENTER INC",1730317769,"Dental Providers, Federally Qualified Health Centers - Medical Services",565 Manhattan Ave,,New York,NY,10027-5250,New York,110 W 97th St,,New York,NY,10025-6450,New York,Ana Taras,Chief of Strategic Initiatives,212-316-7944,,ana.taras@ryancenter.org,,,,,,ryancenter.org
NY-008140,Ryan/Chelsea-Clinton Community Health Center,"RYAN, WILLIAM F COMMUNITY HEALTH CENTER INC",1215978960,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",645 10th Ave,,New York,NY,10036-2904,New York,110 W 97th St,,New York,NY,10025-6450,New York,Ana Taras,Chief of Strategic Initiatives,212-316-7944,,ana.taras@ryancenter.org,,,,,,ryancenter.org
NY-008141,Fort Washington,"Project Renewal, Inc",1598770018,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",651 W 168th St,,New York,NY,10032-3703,New York,200 Varick St,Fl 9,New York,NY,10014,New York,Julia Nabiullina,Healthcare Contract Manager,212-620-0340,347,julia.nabiullina@projectrenewal.org,Aaron Felder,"Director of Healthcare Operations and Planning, Primary Care Services",212-620-0340,443,Aaron.Felder@projectrenewal.org,http://www.projectrenewal.org/
NY-008142,Amsterdam Family Health Center,The Institute for Family Health,1942573217,Federally Qualified Health Centers - Medical Services,690 Amsterdam Ave,,New York,NY,10025-6901,New York,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008143,Project Renewal - 3rd Street,Project Renewal,1598770018,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",8 E 3rd St,,New York,NY,10003-8908,New York,200 Varick Street,Fl 9,New York,NY,10014,Kings,Julia Nabiullina,Healthcare Contract Manager,212-620-0340,347,julia.nabiullina@projectrenewal.org,Aaron Felder,"Director of Healthcare Operations and Planning, Primary Care Services",212-620-0340,443,Aaron.Felder@projectrenewal.org,http://www.projectrenewal.org
NY-008144,Women and Children's Health Center,"RYAN, WILLIAM F COMMUNITY HEALTH CENTER INC",1124347182,Federally Qualified Health Centers - Medical Services,801 Amsterdam Ave,,New York,NY,10025-5752,New York,110 W 97th St,,New York,NY,10025-6450,New York,Ana Taras,Chief of Strategic Initiatives,212-316-7944,,ana.taras@ryancenter.org,,,,,,ryancenter.org
NY-008145,HELEN B. ATKINSON CENTER,"COMMUNITY HEALTHCARE NETWORK, INC.",1154498053,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",81 W 115th St,,New York,NY,10026-3138,New York,60 Madison Ave Ste 501,,New York,NY,10010-1683,New York,Elizabeth Howell,VP of Development,212-545-2404,,ehowell@chnnyc.org,Eva Rodriguez,Women's Health Manager,212-545-2415,,,www.chnnyc.org
NY-008146,Newark Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1376882639,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",513 W Union St,,Newark,NY,14513-1365,Wayne,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,Maryz@flchealth.org,Lawreen Duel,Director of Operations / Family Planning Coordinator,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008147,The Lipman Family Dental Center,Cornerstone Family Healthcare,1689669079,Dental Providers,100 Broadway,,Newburgh,NY,12550-5514,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12550,Orange,Christopher J. Lennon,Director of Grants and Regulatory Affairs,845-220-3154,,clennon@cornerstonefh.org,Linda S. Muller,President and CEO,845-220-3110,,lmuller@cornerstonefh.org,www.cornerstonefamilyhealthcare.org
NY-008148,Planned Parenthood Mid Hudson Valley - Newburgh,Planned Parenthood Mid Hudson Valley,1013035112,Family Planning Providers,136 Lake St,Suite No. 11,Newburgh,NY,12550-5245,Orange,178 Church Street,,Poughkeepsie,NY,12601,Dutchess,Laura Bunora,Vice President of Health Center Operations,845-471-1530,122,Laura.Bunora@ppmhv.org,Lisa Murphy,Billing Manager,845-471-1530,138,Lisa.murphy@ppmhv.org,http://www.ppmhv.org
NY-008149,The Kaplan Family Pavilion,Cornerstone Family Healthcare,1689669079,"Dental Providers, Federally Qualified Health Centers - Medical Services",147 Lake St,,Newburgh,NY,12550-5263,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12518,Orange,Diahan Scott,VP of Outreach and External Programs,845-220-3167,,dscott@ghvfhc.org,Christopher Lennon,Director of Grants and Regulatory Affairs,845-220-3154,,clennon@ghvfhc.org,www.ghvfhc.org
NY-008150,HVCS Orange,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,280 Broadway,,Newburgh,NY,12550-5408,Orange,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputry Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008151,The Center for Recovery,Cornerstone Family Healthcare,1689669079,Federally Qualified Health Centers - Medical Services,3 Commercial Pl,,Newburgh,NY,12550-5306,Orange,2570 U.S. Highway 9W,Suite 10,Cornwall,NY,12518,Orange,Christopher J. Lennon,Director of Grants and Regulatory Affairs,845-220-3154,,clennon@cornerstonefh.org,Linda S. Muller,President and CEO,845-220-3110,,lmuller@cornerstonefh.org,www.cornerstonefamilyhealthcare.org
NY-008152,CHC Niagara,"Community Health Center of Buffalo, Inc.",1790787919,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2715 Highland Ave,,Niagara Falls,NY,14305-2466,Niagara,34 Benwood Ave.,,Buffalo,NY,14214,Erie,Arvela Heider,Director,716-986-9199,1004,aheider@chcb.net,LaVonne Ansari,CEO,716-986-9199,1002,lansari@chcb.net,www.chcb.net
NY-008153,Planned Parenthood of Central and Western New York - Niagara Falls,"Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",750 Portage Rd,,Niagara Falls,NY,14301-1924,Niagara,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008154,North Creek Health Center,Hudson Headwaters Health Network,1811091028,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",126 Ski Bowl Rd,,North Creek,NY,12853-2607,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008155,Syracuse Model Neighborhood Facility - North Syracuse,Syracuse Model Neighborhood Facility FP Onondaga County Department of Health,1871710038,Family Planning Providers,113 E Taft Rd,,North Syracuse,NY,13212-3729,Onondaga,113 E Taft Rd,,North Syracuse,NY,13212-3729,Onondaga,Ms. Jean Reilly,Family Planning Project Director,315-435-3285,,hljreil@ongov.net,Sharon Owens,CEO,315-671-5801,,sowens@swccsyr.org,www.smnfswcc.org
NY-008156,Planned Parenthood of Central and Western New York - N. Tonawanda,"Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",15 Webster St,,North Tonawanda,NY,14120-5816,Niagara,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008157,Norwich Health Center,"Family Planning of South Central New York, Inc.",1033114004,Family Planning Providers,5 Cortland St,,Norwich,NY,13815-1316,Chenango,37 Dietz Street,,Oneonta,NY,13820,Otsego,Debra Marcus,Chief Executive Officer,607-432-2252,316,debra.marcus@fpscny.org,Wilson Li,Director of Finance,607-432-2252,314,wilson.li@fpscny.org,www.fpscny.org
NY-008158,"Tri-County Family Medicine Program, Inc. - Nunda","Tri-County Family Medicine Program, Inc.",1588649503,Federally Qualified Health Centers - Medical Services,61 N State St,,Nunda,NY,14517-9785,Livingston,PO Box 601,,Dansville,NY,14437,Steuben,Joyce Wheaton,CEO,585-335-3416,,smyers@tcfmedicine.com,Susan Myers,Administrative Assistant,585-335-3416,,smyers@tcfmedicine.com,www.tcfmedicine.com
NY-008159,Planned Parenthood of the North Country NY - Ogdensburg,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,419 Ford St,,Ogdensburg,NY,13669-1645,Saint Lawrence,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,http://www.plannedparenthood.org/northcountry
NY-008160,Cattaraugus County Health Department - Olean,Cattaraugus County Health Department,1134148570,"Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Leo Moss Dr,Suite No. 4010,Olean,NY,14760-1100,Cattaraugus,1 Leo Moss Dr,,Olean,NY,14760-1100,Cattaraugus,Susan Andrews,Director of Patient Services,716-701-3438,,saandrews@cattco.org,Patti G. Williams,Supervising Community Health Nurse,716-701-3422,,pgwilliams@cattco.org,http://www.cattco.org
NY-008161,"Southern Tier Community Health Center Network, Inc. - Olean Site","Southern Tier Community Health Center Network, Inc.",1184654477,"Dental Providers, Federally Qualified Health Centers - Medical Services",135 N Union St,,Olean,NY,14760-2736,Cattaraugus,135 N. Union Street,,Olean,NY,14760,Cattaraugus,Gail Speedy Mayeaux,Executive Director,716-701-6831,,gspeedy@upchealth.net,Michael Malick,Chief Financial Officer,716-701-6842,,mmalick@upchealth.net,www.upchealth.net
NY-008162,Planned Parenthood Mohawk Hudson - Oneida,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",603 Seneca St,Suite 5,Oneida,NY,13421-2653,Madison,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008163,Oneonta Health Center,"Family Planning of South Central New York, Inc.",1033114004,"Family Planning Providers, Sexually Transmitted Disease Clinics",37 Dietz St,,Oneonta,NY,13820-1882,Otsego,37 Dietz Street,,Oneonta,NY,13820,Otsego,Debra Marcus,Chief Executive Officer,607-432-2252,316,debra.marcus@fpscny.org,Wilson Li,Director of Finance,607-432-2252,314,wilson.li@fpscny.org,www.fpscny.org
NY-008164,"OPEN DOOR FAMILY MEDICAL CENTER, INC.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1467487637,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",165 Main St,,Ossining,NY,10562-4702,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzota@odfmc.org,http://www.opendormedical.org/
NY-008165,"Open Door Family Medical Center, Inc.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1467487637,"Dental Providers, Federally Qualified Health Centers - Medical Services",29 S Highland Ave,Ossining High School - SBHC,Ossining,NY,10562-4811,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzota@odfmc.org,
NY-008166,Oswego Health Center,"Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,10 George St,,Oswego,NY,13126-3276,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008167,The Center for Reproductive Health at Oswego,"Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,10 George St,Suite 100,Oswego,NY,13126-3276,Oswego,10 George St Ste 100,,Oswego,NY,13126-3276,New York,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,http://www.oco.org
NY-008168,"Oswego County Opportunities, Inc. - The Ctr for Reproductive Health at SUCO-Mary Walker","Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,Suny Oswego,,Oswego,NY,13126,Oswego,Suny Oswego,Route 104,Oswego,NY,13126,New York,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,http://www.oco.org
NY-008169,Ovid Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1104165349,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",7150 Main St,,Ovid,NY,14521,Seneca,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Director of Operations / Family Planning Coordinator,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008170,Family Planning,"Tioga Opportunities, Inc",1174799290,Family Planning Providers,110 Central Ave,,Owego,NY,13827-1311,Tioga,PO Box 70,,Owego,NY,13827,Tioga,Nancy Glasgow,Department Director,607-687-5333,307,nglasgow@tiogaopp.org,Andrea Ochoa,Clinic Coordinator,607-687-5333,305,aochoa@tiogaopp.org,
NY-008171,"Joseph P. Addabbo Family Health Center, Inc. - Ozone Park",THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC,1134476443,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",10532 Rockaway Blvd,,Ozone Park,NY,11417-2306,Queens,6200 Beach Channel Dr,,Arverne,NY,11692-1409,Queens,Alfonso Chan,Chief Medical Officer,718-945-7150,,chan.alfonso@gmail.com,,,,,,www.addabbo.org
NY-008172,Parish Health Center,"Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,10 Carlton Dr,,Parish,NY,13131-3308,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008173,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,639 County Route 22,Health Center at APW High School,Parish,NY,13131-3339,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008174,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,640 County Route 22,Health Center at APW Elementary School,Parish,NY,13131-3339,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008175,Planned Parenthood Hudson Peconic - Patchogue,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",450 Waverly Ave,,Patchogue,NY,11772-1555,Suffolk,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Carmela Colpa-Lewis,"Regional Director, Patient Services and Operations, East",631-240-1111,,carmela.colpa-lewis@pphp.org,http://www.pphp.org
NY-008176,Hudson River HealthCare Peekskill,"Hudson River HealthCare, Inc.",1619969458,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1037 Main St,,Peekskill,NY,10566-2913,Westchester,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008177,Penn Yan Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1649519273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",112 Kimball Ave,,Penn Yan,NY,14527-1816,Yates,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008178,Penn Yan Community Health - Dental,"Finger Lakes Migrant Health Care Project, Inc.",1720316482,Dental Providers,160 Main St,,Penn Yan,NY,14527-1204,Yates,14 Maiden Lane,,Penn Yan,NY,14527,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008179,Phoenix Health Center,"Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,7 Bridge St,,Phoenix,NY,13135-1906,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008180,Planned Parenthood of the North Country NY - Plattsburgh,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,66 Brinkerhoff St,,Plattsburgh,NY,12901-2919,Clinton,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,http://www.plannedparenthood.com/northcountry
NY-008181,Port Byron Community Health,"Finger Lakes Migrant Health Care Project, Inc.",1114198819,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",60 Main St,,Port Byron,NY,13140-9767,Cayuga,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2112,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008182,"Open Door Family Medical Center, Inc.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Tamarack Rd,PORT CHESTER HIGH SCHOOL-SBHC,Port Chester,NY,10573-2407,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzota@odfmc.org,
NY-008183,"OPEN DOOR FAMILY MEDICAL CENTER, INC.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",132 Rectory St,EDISON ELEMENTARY SCHOOL BASED,Port Chester,NY,10573-3240,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,Chief Executive Officer,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,Chief Financial Officer,914-502-1470,,mmazzotta@odfmc.org,https://www.opendoormedical.org/services/school-based-health-centers/
NY-008184,"OPEN DOOR FAMILY MEDICAL CENTER, INC.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",40 Olivia St,JOHN F. KENNEDY MAGNET SCHOOL,Port Chester,NY,10573-4802,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,,https://www.opendoormedical.org/services/school-based-health-centers/
NY-008185,OPEN DOOR FAMILY MEDICAL CENTER,"OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5 Grace Church St,,Port Chester,NY,10573-4911,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzotta@odfmc.org,
NY-008186,"Open Door Family Medical Center, Inc.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",75 Park Ave,Park Ave Elementary School - SBHC,Port Chester,NY,10573-2441,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzotta@odfmc.org,
NY-008187,Family Health Center of Port Ewen,The Institute for Family Health,1154695369,Federally Qualified Health Centers - Medical Services,213 Broadway,,Port Ewen,NY,12466-7769,Ulster,2006 Madison Avenue,,New York,NY,10035,New York,Dr. Neil Calman,President and CEO,212-633-0815,,ncalman@institute.org,Alan Woghin,VP of Finance and CFO,212-633-0815,1410,awoghin@institute.org,
NY-008188,Planned Parenthood Mid-Hudson Valley - Poughkeepsie,Planned Parenthood Mid Hudson Valley,1013035112,Family Planning Providers,17 Noxon St,,Poughkeepsie,NY,12601-4101,Dutchess,178 Church Street,,Poughkeepsie,NY,12601-4101,Dutchess,Laura Bunora,Vice President of Health Center Operations,845-471-1530,122,Laura.Bunora@ppmhv.org,Lisa Murphy,Billing Manager,845-471-1530,138,Lisa.murphy@ppmhv.org,http://www.ppmhv.org
NY-008189,Hudson River HealthCare Poughkeepsie Partnership,"Hudson River HealthCare, Inc.",1942364534,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",29 N Hamilton St,,Poughkeepsie,NY,12601-2541,Dutchess,1200 Brown Street,,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008190,Hudson River HealthCare Livingston Street,"Hudson River HealthCare, Inc.",1063858116,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",34 Livingston St,,Poughkeepsie,NY,12601-4713,Dutchess,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008191,HVCS Dutchess,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,40 Garden St,,Poughkeepsie,NY,12601-3131,Dutchess,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputy Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008192,"Hudson River HealthCare, Inc.","Hudson River HealthCare, Inc.",1619969458,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",75 Washington St,,Poughkeepsie,NY,12601-2303,Dutchess,1200 Brown Street,3rd Floor,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008193,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,2 Hinman Rd,Health Center at Lura Sharp Elementary School,Pulaski,NY,13142-2200,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008194,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,4624 Salina St,Health Center at Pulaski Middle-Senior High School,Pulaski,NY,13142-2102,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President,,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008195,Pulaski Health Center,"Northern Oswego County Health Services, Inc.",1508850280,"Dental Providers, Federally Qualified Health Centers - Medical Services",61 Delano St,,Pulaski,NY,13142-1400,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008196,The Center for Reproductive Health at Pulaski,"Oswego County Opportunities, Inc.",1740396324,Family Planning Providers,61 Delano St,,Pulaski,NY,13142-1400,Oswego,239 Oneida Street,,Fulton,NY,13069,Oswego,Inga Back,Coordinator,315-592-0837,,iback@oco.org,Ellen Holst,Senior Director,315-598-4715,1228,eholst@oco.org,http://www.oco.org
NY-008197,"AHF Healthcare Center - Jamaica, Queens NY",AIDS Healthcare Foundation,1558707299,Other ECP Providers,16121 Jamaica Ave,,Queens,NY,11432-6113,Queens,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
NY-008198,Queensbury Family Health,Hudson Headwaters Health Network,1386657534,Federally Qualified Health Centers - Medical Services,14 Manor Dr,,Queensbury,NY,12804-1906,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008199,West Mountain Health Services,Hudson Headwaters Health Network,1013292002,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",161 Carey Rd,,Queensbury,NY,12804-7821,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008200,Planned Parenthood Mohawk Hudson - Greater Glens Falls,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",543 Bay Rd,,Queensbury,NY,12804-1441,Warren,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008201,Hudson Headwaters Health Network,Hudson Headwaters Health Network,1013928159,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",9 Carey Rd,,Queensbury,NY,12804-7880,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008202,Fox Run Health Center,"Damian Family Care Centers, Inc.",1346629995,Federally Qualified Health Centers - Medical Services,216 Fox Hollow Rd,,Rhinebeck,NY,12572-3641,Dutchess,138-02 Queens Blvd,2nd floor,Briarwood,NY,11435,Queens,Elizabeth King,Director of Clinical Services,347-505-7000,5527,eking@damian.org,Nikki Langford,Provider Credentialing Specialist,718-657-1100,4139,nlangford@damian.org,www.damianhealth.org
NY-008203,Richmond Hill Health Center,"Damian Family Care Centers, Inc.",1972982528,Federally Qualified Health Centers - Medical Services,13020 89th Rd,,Richmond Hill,NY,11418-3301,Queens,138-02 Queens Blvd,2nd floor,Briarwood,NY,11435,Queens,Elizabeth King,Director of Clinical Services,347-505-7000,5527,eking@damian.org,Nikki Langford,Credentialing Specialist,718-657-1100,4139,nlangford@damian.org,www.damianhealth.org
NY-008204,HRHCare Riverhead,"Hudson River HealthCare, Inc.",1184094104,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",300 Center Dr,,Riverhead,NY,11901-3393,Suffolk,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008205,Riverhead Mental Health Clinic,Suffolk County,1104920313,Community Mental Health Centers,300 Center Dr,,Riverhead,NY,11901-3393,Suffolk,3500 Sunrise Hwy,,Great River,NY,11739,Suffolk,Cari Faith Besserman,Deputy,631-853-8500,6990,cari.besserman@suffolkcountyny.gov,Barbara Russo,Principal FInancial Analyst,631-853-8500,8533,barbara.russo@suffolkcountyny.gov,
NY-008206,Planned Parenthood Hudson Peconic - Riverhead,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",877 E Main St,Suite 109,Riverhead,NY,11901-2521,Suffolk,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Carmela Colpa-Lewis,"Regional Director, Patient Services and Operations, East",631-240-1111,,carmela.colpa-lewis@pphp.org,http://www.pphp.org
NY-008207,"Planned Parenthood of Central and Western New York, Inc. - Rochester","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",114 University Ave,,Rochester,NY,14605-2929,Monroe,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5927,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008208,Mary M. Gooley Hemophilia Center,Mary M. Gooley Hemophilia Center,1568428621,Hemophilia Treatment Centers,1415 Portland Ave,Suite 500,Rochester,NY,14621-3043,Monroe,1415 Portland Avenue,Suite 500,Rochester,NY,14621,Monroe,Robert Fox,President/CEO,585-922-5700,,robert.fox@rochesterregional.org,Greg Lighthouse,"Vice President, Finance",585-922-5700,,greg.lighthouse@rochesterregional.org,www.hemocenter.org
NY-008209,The Women's Center at Rochester General,ROCHESTER PRIMARY CARE NETWORK,1356412712,Federally Qualified Health Centers - Medical Services,1415 Portland Ave,,Rochester,NY,14621-3038,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Karen Kinter,Executive Director,585-922-0200,,karen.kinter@rochestergeneral.org,,,,,,
NY-008210,NORTHEAST HEALTH SERVICE,ROCHESTER PRIMARY CARE NETWORK,1861568594,Federally Qualified Health Centers - Medical Services,1425 Portland Ave,,Rochester,NY,14621-3001,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Karen Kinter,Executive Director,585-922-4101,,karen.kinter@rochestergeneral.org,,,,,,
NY-008211,Jordan Health at Community Place,ANTHONY L JORDAN HEALTH CORPORATION,1083716088,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",151 Parsells Ave,,Rochester,NY,14609-5118,Monroe,82 Holland St,,Rochester,NY,14605-2199,Monroe,Nicole Schembra,RN-Practice Manager,585-784-5940,,nschembra@jordanhealth.org,Sandra Coleman,Director of Adolescent Health,585-784-5940,,scoleman@jordanhealth.org,
NY-008212,Unity Family Medicine at Orchard Street,ROCHESTER PRIMARY CARE NETWORK,1336366822,Federally Qualified Health Centers - Medical Services,158 Orchard St,,Rochester,NY,14611-1361,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Michael Leary,President/CEO,585-325-2280,,mleary@rpcn.org,Karen Kinter,Executive Director,585-368-4501,,karen.kinter@rochestergeneral.org,
NY-008213,Genesee Health Services,ROCHESTER PRIMARY CARE NETWORK,1760557656,Federally Qualified Health Centers - Medical Services,222 Alexander St,,Rochester,NY,14607-4039,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Karen Kinter,Executive Director,585-922-8003,,karen.kinter@rochestergeneral.org,,,,,,
NY-008214,Unity Family Medicine at St. Bernard's,ROCHESTER PRIMARY CARE NETWORK,1336366822,Federally Qualified Health Centers - Medical Services,2260 Lake Ave,Suite 102,Rochester,NY,14612-5758,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Michael Leary,President/CEO,585-325-2280,,mleary@rpcn.org,Karen Kinter,Executive Director,585-254-1850,,karen.kinter@rochestergeneral.org,
NY-008215,Trillium Health--Monroe Avenue Location,"Trillium Health, Inc.",1861496358,"Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics, Ryan White Providers",259 Monroe Ave,Suite 100,Rochester,NY,14607-3632,Monroe,259 Monroe Avenue--Suite 100,,Rochester,NY,14607,Monroe,Jennifer Sahrle,"Director, Operations",585-210-4209,,JSahrle@trilliumhealth.org,,,,,,www.trilliumhealth.org
NY-008216,Unity Dental at Ridgeway,ROCHESTER PRIMARY CARE NETWORK,1336366822,Dental Providers,2655 Ridgeway Ave,,Rochester,NY,14626-4296,Monroe,"259 Monroe Ave., Level B",,Rochester,NY,14607,Monroe,Karen Kinter,Executive Director,585-368-3031,,karen.kinter@rochestergeneral.org,,,,,,
NY-008217,"Planned Parenthood of Central and Western New York, Inc. - Greece","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",2824 W Ridge Rd,,Rochester,NY,14626-1639,Monroe,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008218,Clinton Family Health Center,ROCHESTER PRIMARY CARE NETWORK,1356412712,Federally Qualified Health Centers - Medical Services,293 Upper Falls Blvd,,Rochester,NY,14605-2184,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Karen Kinter,Executive Director,585-922-0260,,karen.kinter@rochestergeneral.org,,,,,,
NY-008219,The Women's Center at Clinton Family,ROCHESTER PRIMARY CARE NETWORK,1356412712,Federally Qualified Health Centers - Medical Services,309 Upper Falls Blvd,,Rochester,NY,14605-2105,Monroe,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Karen Kinter,Executive Director,585-922-0260,,karen.kinter@rochestergeneral.org,,,,,,
NY-008220,Highland Hospital,"New York State Dept. of Health Bureau of Women, Infant & Adolescent Health",1972548568,Family Planning Providers,757 Clinton Ave S,,Rochester,NY,14620-1401,Monroe,777 Clinton Ave S,,Rochester,NY,14620-1448,Monroe,Ms. Gina Lamanna,Program Manager,585-279-4818,,Gina_Lamanna@urmc.rochester.edu,,,,,,http://www.urmc.rochester.edu/highland
NY-008221,Unity Pediatrics,ROCHESTER PRIMARY CARE NETWORK,1336366822,Federally Qualified Health Centers - Medical Services,819 W Main St,,Rochester,NY,14611-2334,Monroe,"259 Monroe Avenue, Level B",,Rochester,NY,14607,Monroe,Michael Leary,President/CEO,585-325-2280,7302,mleary@rpcn.org,,,,,,www.rpcn.org
NY-008222,Unity Dental Center at St. Mary's,Unity Hospital of Rochester,1336366822,Dental Providers,89 Genesee St,,Rochester,NY,14611-3201,Monroe,89 Genesee Street,,Rochester,NY,14611,Monroe,Karen Kinter,Executive Director,585-922-6735,,karen.kinter@rochestergeneral.org,,,,,,
NY-008223,Unity Family Medicine at St. Mary's,ROCHESTER PRIMARY CARE NETWORK,1336366822,Federally Qualified Health Centers - Medical Services,89 Genesee St,,Rochester,NY,14611-3201,Monroe,"259 Monroe Avenue, Level B",,Rochester,NY,14607,Monroe,Michael Leary,President/CEO,585-325-2280,7302,mleary@rpcn.org,,,,,,www.rpcn.org
NY-008224,Jordan Health at Franklin,ANTHONY L JORDAN HEALTH CORPORATION,1104124494,Federally Qualified Health Centers - Medical Services,950 Norton St,,Rochester,NY,14621-3732,Monroe,82 Holland St,,Rochester,NY,14605-2199,Monroe,Nicole Schembra,RN-Practice Manager,585-784-5940,,nschembra@jordanhealth.org,Sandra Coleman,Director of Adolescent Health,585-784-5940,,scoleman@jordanhealth.org,
NY-008225,Planned Parenthood Mohawk Hudson - Rome,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",111 E Chestnut St,Suite 205,Rome,NY,13440-2886,Oneida,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008226,210 West Dominick Street Clinic,"Upstate Family Health Center, Inc.",1205203023,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",210 W Dominick St,,Rome,NY,13440-5812,Oneida,1002 Oswego Street,,Utica,NY,13502-5031,Oneida,Wanda M. Schmidt CPC COC,AR Manager,315-798-8868,288,wanda.schmidt@upstatecp.org,Darlene Sovey,CFO,315-798-8868,310,darlene.sovey@upstatecp.org,
NY-008227,LIFQHC Roosevelt,Nassau Health Care Corp,1396059499,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",380 Nassau Rd,,Roosevelt,NY,11575-1343,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,Nanette Ecker,"Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,,,,,,http://www.numc.edu
NY-008228,RUSHVILLE COMMUNITY HEALTH CENTER,ROCHESTER PRIMARY CARE NETWORK,1912225236,"Dental Providers, Federally Qualified Health Centers - Medical Services",2 Rubin Dr,,Rushville,NY,14544-9681,Yates,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Stacy Wormuth,Social Work Care Navigator,585-554-4400,7163,swormuth@RPCN.org,,,,,,http://www.rpcn.org
NY-008229,"Open Door Family Medical Center, Inc.","OPEN DOOR FAMILY MEDICAL CENTER, INC.",1285893719,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",113 Bowman Ave,PORT CHESTER MIDDLE SCHOOL - SBHC,Rye Brook,NY,10573-2808,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CEO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,914-502-1470,,mmazzotta@odfmc.org,
NY-008230,Cattaraugus Co. HD - Salamanca Clinic,Cattaraugus County Health Department,1134148570,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",69 Iroquois Dr,,Salamanca,NY,14779-1326,Cattaraugus,69 Iroquois Dr,,Salamanca,NY,14779-1326,Cattaraugus,Susan A. Andrews,Director of Patient Services,716-701-3438,,saandrews@cattco.org,Patti G. Williams,Supervising Community Health Nurse,716-701-3422,,pgwilliams@cattco.org,http://www.cattco.org
NY-008231,Lionel R John Health Center,Seneca Nation of Indians,1609882976,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",987 R C Hoag Dr,,Salamanca,NY,14779-1365,Cattaraugus,90 Ohi:Yo' Way,,Salamanca,NY,14779,Cattaraugus,Tim Waterman,CEO,716-945-5894,5259,Tim.Waterman@senecahealth.org,Paris Marino,Business Office Manager,716-945-5894,3349,paris.marino@senecahealth.org,www.senecahealth.org
NY-008232,CHC Sanborn,"Community Health Center of Buffalo, Inc.",1790787919,Federally Qualified Health Centers - Medical Services,6321 Inducon Dr E,,Sanborn,NY,14132-9016,Niagara,"Community HealtH Center of Buffalo, Inc.",,Buffalo,NY,14214,Erie,Arvela R. Heider,Director,716-987-9199,1004,aheider@chcb.net,LaVonne Ansari,CEO,716-986-9199,1002,lansari@chcb.net,www.chcb.net
NY-008233,"Northern Oswego County Health Services, Inc.","Northern Oswego County Health Services, Inc.",1508850280,Federally Qualified Health Centers - Medical Services,124 Salisbury Street,Health Center at Sandy Creek School,Sandy Creek,NY,13145,Oswego,61 Delano Street,,Pulaski,NY,13142,Oswego,Daniel T. Dey,President/CEO,315-298-6569,2003,ddey@nochsi.org,Karen Paterniti,Senior Vice President/CFO,315-298-6569,2002,kpaterniti@nochsi.org,www.nochsi.org
NY-008234,Adirondack Medical Center-Saranac Lake,Adirondack Medical Center,1699709576,"Black Lung Clinics, Rural Health Clinics",285 County Route 47,Old Lake Colby Rd,Saranac Lake,NY,12983-5403,Franklin,2233 State Route 86,,Saranac Lake,NY,12983,Franklin,Tristan Glanville,CFO,518-897-2301,,tglanville@adirondackhealth.org,Kathy Bauer,Director Patient Financial Services,518-897-2222,,kbauer@adirondackhealth.org,adirondackhealth.org
NY-008235,Planned Parenthood of the North Country NY - Saranac Lake,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,41 Saint Bernard St,,Saranac Lake,NY,12983-1834,Franklin,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,http://www.plannedparenthood.com/northcountry
NY-008236,Planned Parenthood Mohawk Hudson - Saratoga Springs,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",236 Washington St,,Saratoga Springs,NY,12866-5954,Saratoga,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008237,Planned Parenthood Mohawk Hudson -Schenectady,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",1040 State St,,Schenectady,NY,12307-1508,Schenectady,1040 State St,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,www.plannedparenthood.org/ppmh
NY-008238,Hometown Health Centers,Hometown Health Centers,1396711982,"Dental Providers, Federally Qualified Health Centers - Medical Services",1044 State St,,Schenectady,NY,12307-1508,Schenectady,1044 State Street,,Schenectady,NY,12307,Schenectady,Eric Burton,Chief Operating Officer,518-688-3420,4129,EBurton@hhchc.org,George Wilhelm,Chief Financial Officer,518-370-1441,4102,GWilhelm@hhchc.org,
NY-008239,Ellis Hospital,Ellis Hospital,1487644993,Inpatient Hospitals (other than children's hospitals),1101 Nott St,,Schenectady,NY,12308-2425,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008240,Ellis Hospital Inpatient Mental Health,Ellis Hospital,1760472856,Inpatient Hospitals (other than children's hospitals),1101 Nott St,,Schenectady,NY,12308-2425,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008241,Ellis Primary Care Nott Street,Ellis Hospital,1487644993,Outpatient Hospital Clinics,1201 Nott St,Suite 204,Schenectady,NY,12308-2589,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008242,Ellis Outpatient Mental Health Clinic,Ellis Hospital,1487644993,"Community Mental Health Centers, Outpatient Hospital Clinics",216 Lafayette St,,Schenectady,NY,12305-2408,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Manangement,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008243,Bellevue Woman's Center,Ellis Hospital,1487644993,Inpatient Hospitals (other than children's hospitals),2210 Troy Schenectady Rd,,Schenectady,NY,12309-4725,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008244,Ellis Outpatient Mental Health PROS,Ellis Hospital,1487644993,"Community Mental Health Centers, Outpatient Hospital Clinics",502 State St,,Schenectady,NY,12305-2414,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008245,Ellis Dental Care,Ellis Hospital,1487644993,Dental Providers,600 McClellan St,,Schenectady,NY,12304-1009,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008246,Ellis Internal Medicine,Ellis Hospital,1487644993,Outpatient Hospital Clinics,624 McClellan St,Suite G02,Schenectady,NY,12304-1024,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008247,Ellis Outpatient Child and Adolescent Mental Health,Ellis Hospital,1487644993,"Community Mental Health Centers, Outpatient Hospital Clinics",624 McClellan St,Suite 204,Schenectady,NY,12304-1020,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008248,Ellis Pediatric Care,Ellis Hospital,1487644993,Outpatient Hospital Clinics,624 McClellan St,Suite 202,Schenectady,NY,12304-1020,Schenectady,1101 Nott St,,Schenectady,NY,12308,Schenectady,Marc Mesick,VP Finance and CFO,518-243-4144,,mesickm@ellismedicine.org,Ross Leach,Director of Revenue Management,518-612-8672,,leachr@ellismedicine.org,www.ellismedicine.org
NY-008249,Schroon Lake Health Center,Hudson Headwaters Health Network,1740296177,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",24 Fairfield Ave.,,Schroon Lake,NY,12870,Essex,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008250,Sidney Health Center,"Family Planning of South Central New York, Inc.",1033114004,"Family Planning Providers, Sexually Transmitted Disease Clinics",37 Pleasant St,,Sidney,NY,13838-1215,Delaware,37 Dietz Street,,Oneonta,NY,13820,Otsego,Debra Marcus,Chief Executive Officer,607-432-2252,316,debra.marcus@fpscny.org,Wilson Li,Director of Finance,607-432-2252,314,wilson.li@fpscny.org,www.fpscny.org
NY-008251,OPEN DOOR FAM MED--SLEEPY HOLLOW,"OPEN DOOR FAMILY MEDICAL CENTER, INC.",1619136140,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",80 Beekman Ave,,Sleepy Hollow,NY,10591-2503,Westchester,165 Main St,,Ossining,NY,10562-4702,Westchester,Lindsay C Farrell,CDO,914-502-1457,,lfarrell@odfmc.org,Maria Mazzotta,CFO,,,mmazzotta@odfmc.org,
NY-008252,Planned Parenthood Hudson Peconic - Smithtown,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",70 Maple Ave,,Smithtown,NY,11787-3502,Suffolk,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Carmela Colpa-Lewis,"Regional Director, Patient Services and Operations, East",631-240-1111,,carmela.colpa-lewis@pphp.org,http://www.pphp.org
NY-008253,Sodus Community Health (La Clinica),"Finger Lakes Migrant Health Care Project, Inc.",1669568465,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",6692 Middle Rd,Suite 2100,Sodus,NY,14551-9602,Wayne,14 Maiden Lane,,Penn Yan,NY,14527-1205,Yates,Mary Zelazny,CEO,315-531-9102,2102,maryz@flchealth.org,Lawreen Duel,Family Planning Coordinator / Director of Operations,315-531-9102,2121,lawreen@flchealth.org,www.flchealth.org
NY-008254,Moreau Family Health,Hudson Headwaters Health Network,1356355952,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1448 State Rt. 9,,South Glens Falls,NY,12803,Saratoga,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008255,Shinnecock Indian Health Service,Indian Health Service,1093774960,"Indian Health Service, Other ECP Providers",100 Church St,,Southhampton,NY,11968,Suffolk,711 Stewarts Ferry Pike,,Nashville,TN,37214,Davidson,Vickie Claymore,"Director of Field Operations, Nashville AO IHS",615-467-1623,,vickie.claymore@ihs.gov,,,,,,
NY-008256,Hudson River HealthCare Spring Valley,"Hudson River HealthCare, Inc.",1184901928,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2 Perlman Dr,,Spring Valley,NY,10977-5245,Rockland,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,,,,,,
NY-008257,Planned Parenthood Hudson Peconic - Spring Valley,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",25 Perlman Dr,,Spring Valley,NY,10977-5281,Rockland,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Trisha Beck,"Senior Vice President, Patient Services and Operations",914-467-7312,,trisha.beck@pphp.org,http://www.pphp.org
NY-008258,Refuah Health Center,Refuah Health Center,1669470019,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5 Twin Ave,,Spring Valley,NY,10977-3950,Rockland,728 North Main Street,,Spring Valley,NY,10977,Rockland,Chana Vizel,Executive Assistant/Recruiter,845-354-9300,1560,cvizel@rhcnys.com,Lori Masterson,Associate General Counsel,845-354-9300,1217,lmasterson@rhcnys.com,www.refuahhealthcenter.com
NY-008259,HVCS Rockland,"Hudson Valley Community Services, Inc. (HVCS)",1841339728,Ryan White Providers,86 Route 59,,Spring Valley,NY,10977-5214,Rockland,40 Saw Mill River Road,,Hawthorne,NY,10532,Westchester,Andrea Straus,Executive Director,914-785-8265,,astraus@hudsonvalleycs.org,Saqib Altaf,Deputy Executive Director,914-785-8210,,saltaf@hudsonvalleycs.org,
NY-008260,CHCR-153 CANAL ST,"COMMUNITY HEALTH CENTER OF RICHMOND, INC.",1114137403,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",135 Canal St,,Staten Island,NY,10304-2059,Richmond,439 PORT RICHMOND AVENUE,,Staten Island,NY,10302-1714,Richmond,Benny Lindo,CFO,718-924-2254,7414,blindo@chcrichmond.org,Henry Thompson,CEO,718-924-2254,7412,hthompson@chcrichmond.org,www.chcrichmond.org
NY-008261,BCCHC - Annex,Beacon Christian Community Health Center,1750700902,Federally Qualified Health Centers - Medical Services,2031 Forest Ave,,Staten Island,NY,10303-1733,Richmond,2079 Forest Avenue,,Staten Island,NY,10303,Richmond,"David Kim, MD",CEO,718-815-6560,200,beaconcchc@gmail.com,,,,,,www.beaconcchc.com
NY-008262,Beacon Christian Community Health Center,Beacon Christian Community Health Center,1639246358,Federally Qualified Health Centers - Medical Services,2079 Forest Ave,,Staten Island,NY,10303-1865,Richmond,2079 Forest Avenue,,Staten Island,NY,10303,Richmond,"David H. Kim, MD",CEO,718-815-6560,200,beaconcchc@gmail.com,,,,,,www.beaconcchc.com
NY-008263,Planned Parenthood of New York City - Staten Island Center,Planned Parenthood of New York City,1417959701,Family Planning Providers,23 Hyatt St,,Staten Island,NY,10301-1801,Richmond,26 Bleecker Street,,New York,NY,10012,New York,Jonathan Segal,Chief Financial Officer,212-274-7230,,jonathan.segal@ppnyc.org,Meg Barnette,Chief Strategy Officer,212-274-7274,,meg.barnette@ppnyc.org,http://www.ppnyc.org
NY-008264,CHCR - 235 PORT RICHMOND,"COMMUNITY HEALTH CENTER OF RICHMOND, INC.",1114137403,Federally Qualified Health Centers - Medical Services,235 Port Richmond Ave,,Staten Island,NY,10302-1701,Richmond,439 PORT RICHMOND AVENUE,,Staten Island,NY,10302-1701,Richmond,Benny Lindo,CFO,718-924-2254,7414,blindo@chcrichmond.org,Henry Thompson,CEO,718-924-2254,7412,hthompson@chcrichmond.org,www.chcrichmond.org
NY-008265,CHCR-439 PORT RICHMOND,"COMMUNITY HEALTH CENTER OF RICHMOND, INC.",1114137403,"Dental Providers, Federally Qualified Health Centers - Medical Services",439 Port Richmond Ave,,Staten Island,NY,10302-1714,Richmond,439 PORT RICHMOND AVENUE,,Staten Island,NY,10302-1714,Richmond,Benny Lindo,CFO,718-924-2254,7414,blindo@chcrichmond.org,Henry Thompson,CEO,718-924-2254,7412,hthompson@chcrichmond.org,www.chcrichmond.org
NY-008266,"Planned Parenthood of Central and Western New York, Inc. - Syracuse","Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",1120 E Genesee St,,Syracuse,NY,13210-1912,Onondaga,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008267,Syracuse Model Neighborhood Facility - Dr. William Harris Health Ctr,Syracuse Model Neighborhood Facility FP Onondaga County Department of Health,1871710038,Family Planning Providers,401 Slocum Ave,,Syracuse,NY,13204,Onondaga,401 Slocum Ave,,Syracuse,NY,13204,Onondaga,Ms. Jean Reilly,Family Planning Coordinator,315-435-3685,,hljreil@ongov.net,Sharon Owens,CEO,315-671-5801,,sowens@swccsyr.org,www.smnfswcc.org
NY-008268,Family Planning Service of OCHD Civic Center,Syracuse Model Neighborhood Facility FamilyPlanning Service Onondaga CountyHealth Department,1871710038,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",421 Montgomery St Rm 30,Onondaga County Civic Center,Syracuse,NY,13202-2923,Onondaga,428 W Onondaga St,,Syracuse,NY,13202-3210,Onondaga,Ms. Jean Reilly,Family Planning Project Director,315-435-3685,,hljreil@ongov.net,Sharon Owens,CEO,315-671-5801,,sowens@swccsyr.org,www.smnfswcc.org
NY-008269,"AIDS Community Resources, Inc. dba ACR Health","AIDS Community Resources, Inc. dba ACR Health",1477672798,Ryan White Providers,627 W Genesee St,,Syracuse,NY,13204-2303,Onondaga,627 W. Genesee Street,,Syracuse,NY,13204,Onondaga,Wil Murtaugh,Deputy Executive Director,315-475-2430,202,wmurtaugh@acrhealth.org,Jeneatte O'Connor-Shanley,Director of Support Services,315-475-2430,401,joconnorshanley@acrhealth.org,www.ACRHealth.org
NY-008270,UNIVERSITY HOSPITAL S U N Y HEALTH SCIENCE CENTER,University Hospital SUNY Health Science Centers,1578554630,Inpatient Hospitals (other than children's hospitals),750 E Adams St,,Syracuse,NY,13210-2306,Onondaga,750 E Adams Str,,Syracuse,NY,13210-2306,Onondaga,Sarah Spindler,Director of Managed Care Contracting,315-464-8052,,spindles@upstate.edu,Michael Stolicker,Manager of Managed Care Contracting,315-464-8336,,stolickM@upstate.edu,
NY-008271,South Salina,Syracuse Community Health Center,1497796353,"Dental Providers, Federally Qualified Health Centers - Medical Services",819 S Salina St,,Syracuse,NY,13202-3527,Onondaga,819 South Salina Street,,Syracuse,NY,13202,Onondaga,Derrick L. Murry,Executive Vice President/Chief Operating Officer,315-234-5942,,dlm1@schcny.com,,,,,,
NY-008272,Planned Parenthood North Country - Ticonderoga Clinic,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,1019 Wicker St,,Ticonderoga,NY,12883-1039,Essex,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,nicole.hills@ppncny.org,www.plannedparenthood.org/northcountry
NY-008273,Ticonderoga Health Center,Hudson Headwaters Health Network,1952319386,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",102 Race Track Rd,,Ticonderoga,NY,12883-4004,Essex,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008274,Upper Hudson Planned Parenthood - Troy,Upper Hudson Planned Parenthood,1881755601,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 Broadway,,Troy,NY,12180-3291,Rensselaer,855 Central Ave,,Albany,NY,12206,Rensselaer,Marielle McKasty-Stagg,COO,518-434-5678,140,marielle@uhpp.org,AnnMarie McIntosh,Finance Director,518-434-5678,123,annmarie@uhpp.org,http://www.plannedparenthood.org/uhpp/
NY-008275,Troy Whitney Young Health Center,Whitney M. Young Jr. Health Center Inc.,1417924762,"Dental Providers, Federally Qualified Health Centers - Medical Services",6 102nd St,,Troy,NY,12180-1152,Rensselaer,920 Lark Drive,,Albany,NY,12207,Albany,Mary Connolly,Finance,518-591-4461,,mconnolly@wmyhealth.org,,,,,,wmyhealth.org
NY-008276,Adirondack Medical Center-Tupper Lake,Adirondack Medical Center,1699709576,Rural Health Clinics,7 Stetson Rd,,Tupper Lake,NY,12986-2014,Franklin,2233 State Route 86,,Saranac Lake,NY,12983,Franklin,Tristan Glanville,CFO,518-897-2301,,tglanville@adirondackhealth.org,Kathy Bauer,Director Patient Financial Services,518-897-2222,,kbauer@adirondackhealth.org,adirondackhealth.org
NY-008277,"Upstate Family Health Center, Inc.","Upstate Family Health Center, Inc.",1205203023,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",1002 Oswego St,,Utica,NY,13502-5031,Oneida,1002 Oswego Street,,Utica,NY,13502-5031,Oneida,Wanda M. Schmidt CPC COC,AR Manager,315-798-8868,288,wanda.schmidt@upstatecp.org,Darlene Sovey,CFO,315-798-8868,310,darlene.sovey@upstatecp.org,
NY-008278,Planned Parenthood Mohawk Hudson - Utica,Planned Parenthood Mohawk Hudson,1376618843,"Family Planning Providers, Sexually Transmitted Disease Clinics",1424 Genesee St,,Utica,NY,13502-5101,Oneida,1040 State Street,,Schenectady,NY,12307-1508,Schenectady,Mary Radford,Chief Financial Officer,845-554-2623,,m.radford@ppmhchoices.org,Kathryn Reinhardt,Grants Officer,518-374-5353,2251,k.reinhardt@ppmhchoices.org,http://www.plannedparenthood.org/ppmh/
NY-008279,Community Health and Behavioral Services,Upstate Cerebral Palsy,1215098207,Community Mental Health Centers,1427 Genesee St,,Utica,NY,13501-4343,Oneida,1020 Mary Street,,Utica,NY,13501,Oneida,Tara Costello,Vice President of Behavioral Services,315-798-8868,290,tara.costello@upstatecp.org,,,,,,
NY-008280,Utica Community Health Center,ROCHESTER PRIMARY CARE NETWORK,1649587627,"Dental Providers, Federally Qualified Health Centers - Medical Services",1651 Oneida St,,Utica,NY,13501-4866,Oneida,259 Monroe Ave Bsmt B,,Rochester,NY,14607-3632,Monroe,Jennifer Yager,Social Work Lead,315-793-7600,7226,jyager@rpcn.org,,,,,,http://www.rpcn.org
NY-008281,Walton Health Center,"Family Planning of South Central New York, Inc.",1033114004,"Family Planning Providers, Sexually Transmitted Disease Clinics",130 North St,,Walton,NY,13856-1218,Delaware,37 Dietz Street,,Oneonta,NY,13820,Otsego,Debra Marcus,Chief Executive Officer,607-432-2252,316,debra.marcus@fpscny.org,Wilson Li,Director of Finance,607-432-2252,314,wilson.li@fpscny.org,www.fpscny.org
NY-008282,Tucker Dental Services Center,Hudson Headwaters Health Network,1073529301,Dental Providers,3761 Main St,,Warrensburg,NY,12885-1837,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,,,,,,www.hhhn.org
NY-008283,Warrensburg Health Center,Hudson Headwaters Health Network,1194738344,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3767 Main St,,Warrensburg,NY,12885-1837,Warren,9 Carey Rd.,,Queensbury,NY,12804,Warren,Trip Shannon,Chief Development Officer,518-761-0300,31115,tshannon@hhhn.org,Christopher Tournier,Chief Financial Officer,518-761-0300,31558,ctournier@hhhn.org,www.hhhn.org
NY-008284,Oak Orchard Health - Warsaw,"OAK ORCHARD COMMUNITY HEALTH CENTER, INC.",1417393018,"Dental Providers, Federally Qualified Health Centers - Medical Services",81 S Main St,,Warsaw,NY,14569-1571,Wyoming,300 West Ave,,Brockport,NY,14420-1118,Monroe,Pamela Keller,CIO/Director Patient Accounts,585-637-3905,218,pkeller@oochc.org,Bill Namestnik,COO,585-637-3905,,,http://www.oakorchardhealth.org/
NY-008285,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,Federally Qualified Health Centers - Medical Services,1237 Washington St,Case Middle School,Watertown,NY,13601-4350,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/about-our-school-based-health-centers/
NY-008286,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,Federally Qualified Health Centers - Medical Services,1335 Washington St,Watertown High School,Watertown,NY,13601-4531,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/about-our-school-based-health-centers/
NY-008287,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",1351 Washington St,Wiley Intermediate School,Watertown,NY,13601-4531,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/about-our-school-based-health-centers/
NY-008288,Community Health Center of the North Country,"United Cerebral Palsy Association of the North Country, Inc.",1467432765,Other ECP Providers,146 Polk St,Marcy Building Suite 200,Watertown,NY,13601,Jefferson,4 Commerce Ln,,Canton,NY,13617-3739,Saint Lawrence,Anne Richey,Executive Director,315-386-1156,8310,anne@cpnorthcountry.org,Pamela Mahaffy,Chief Financial Officer,315-386-1156,8320,pmahaffy@cpnorthcountry.org,http://www.chcnorthcountry.org
NY-008289,Planned Parenthood of the North Country NY Watertown Health Center,"Planned Parenthood of the North Country New York, Inc.",1407907215,Family Planning Providers,160 Stone St,,Watertown,NY,13601-3250,Jefferson,160 Stone St,,Watertown,NY,13601-3250,Jefferson,Tess Barker,CEO,315-782-1818,223,tess.barker@ppncny.org,Nicole Hills,DPS,315-782-1818,224,Nicole.Hills@ppncny.org,http://www.plannedparenthood.org/northcountry
NY-008290,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.","NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",171 E Hoard St,North Elementary School,Watertown,NY,13601-1515,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,https://www.nocofamilyhealth.org/about-our-school-based-health-centers/
NY-008291,North Country Family Health Center - Main Campus,"NORTH COUNTRY FAMILY HEALTH CENTER, INC.",1609946821,"Dental Providers, Federally Qualified Health Centers - Medical Services",238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,238 Arsenal St,,Watertown,NY,13601-2504,Jefferson,Joey Marie Horton,Executive Director,315-782-9450,,Jhorton@nocofamilyhealth.org,Deidra Parks,Billing Lead,315-782-9450,8072,dparks@nocofamilyhealth.org,
NY-008292,Planned Parenthood Southern Finger Lakes - Watkins Glen Center,Planned Parenthood Southern Finger Lakes,1881761484,Family Planning Providers,106 W 4th St,,Watkins Glen,NY,14891,Schuyler,620 West Seneca Street,,Ithaca,NY,14850,Tompkins,Alicia Kenaley,CEO,607-273-1526,2329,alicia.kenaley@ppsfl.org,Liz Weissbrot,Vice President for Patient Services,607-273-1513,2324,liz.weissbrot@ppsfl.org,http://www.plannedparenthood.org/ppsfl
NY-008293,"Tri-County Family Medicine Progam, Inc. - Wayland","Tri-County Family Medicine Program, Inc.",1588649503,Federally Qualified Health Centers - Medical Services,200 N Main St,,Wayland,NY,14572-1034,Steuben,PO Box 601,,Dansville,NY,14437,Steuben,Joyce Wheaton,CEO,585-335-3416,,smyers@tcfmedicine.com,Susan Myers,Administrative Assistant,585-335-3416,,smyers@tcfmedicine.com,www.tcfmedicine.com
NY-008294,Allegany County Health Department - Wellsville Family Planning,Allegany County Health Department,1275592149,"Family Planning Providers, Sexually Transmitted Disease Clinics",21 E State St,,Wellsville,NY,14895-1220,Allegany,21 E State St,,Wellsville,NY,14895-1220,Allegany,Laurie Hennessy,Director of Patient Services,585-268-9256,,hennesla@alleganyco.com,Kristin Fuller,RN/ Family Planning Program Manager,585-268-9655,,fullerk@alleganyco.com,
NY-008295,Planned Parenthood Hudson Peconic - West Islip,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",180 Sunrise Hwy,,West Islip,NY,11795-2012,Suffolk,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Carmela Colpa-Lewis,"Regional Director, Patient Services and Operations, East",631-240-1111,,carmela.colpa-lewis@pphp.org,http://www.pphp.org
NY-008296,Planned Parenthood of Central and Western New York - Wimbledon Plaza Medical Center,"Planned Parenthood of Central and Western New York, Inc.",1306909957,"Family Planning Providers, Sexually Transmitted Disease Clinics",240 Center Rd,,West Seneca,NY,14224-1947,Erie,114 University Ave,,Rochester,NY,14605,Monroe,Christian Oleck,"VP of Finance, CFO",585-546-2771,344,christian.oleck@ppcwny.org,Melinda Dubois,Vice President of Health Services,716-831-2200,5950,melinda.dubois@ppcwny.org,https://www.plannedparenthood.org/planned-parenthood-central-western-new-york
NY-008297,LIFQHC New Cassel,Nassau Health Care Corp,1215241302,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",682 Union Ave,,Westbury,NY,11590-3552,Nassau,2201 Hempstead Turnpike,,East Meadow,NY,11554-1859,Nassau,Nanette Ecker,"Director, Sexual and Reproductive Health",516-296-2534,,necker@numc.edu,,,,,,http://www.numc.edu
NY-008298,Coachman Family Health Center,Mount Vernon Neighborhood Hlth Ctr,1396736120,"Dental Providers, Federally Qualified Health Centers - Medical Services",123 E Post Rd,,White Plains,NY,10601-5205,Westchester,107 West 4th Street,,Mount Vernon,NY,10550-4002,Westchester,Opan Dunstan,Acting CEO,914-699-7200,602,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008299,Planned Parenthood Hudson Peconic - White Plains,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",175 Tarrytown Rd,,White Plains,NY,10607-1607,Westchester,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Trisha Beck,"Senior Vice President, Patient Services and Operations",914-467-7312,,trisha.beck@pphp.org,http://www.pphp.org
NY-008300,Womens & Childrens Premier,Mount Vernon Neighborhood Hlth Ctr,1396736120,Federally Qualified Health Centers - Medical Services,25 Lake St,,White Plains,NY,10603-4032,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opal Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008301,Greenburgh Health Center,Mount Vernon Neighborhood Hth Ctr,1396736120,"Dental Providers, Federally Qualified Health Centers - Medical Services",295 Knollwood Rd,,White Plains,NY,10607-1822,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opan Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008302,Woodside,"AIDS Center of Queens County, Inc.",1629274972,"Community Mental Health Centers, Other ECP Providers, Ryan White Providers",63-07 Woodside Avenue 3rd Floor,,Wooside,NY,11377,Queens,"161-21 Jamaica Avenue, 6th floor",,Jamaica,NY,11432-6113,Queens,Mitchel Eisenberg,CFO,718-896-2500,5720,meisenberg@acqc.org,Rosemary Lopez,Associate Executive Director,718-896-2500,5736,rlopez@acqc.org,www.acqc.org
NY-008303,HRHCare Wyandanch,"Hudson River HealthCare, Inc.",1952718181,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1556 Straight Path,,Wyandanch,NY,11798-3213,Suffolk,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008304,Hudson River HealthCare Park Care,"Hudson River HealthCare, Inc.",1861631392,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2 Park Ave,,Yonkers,NY,10703-3402,Westchester,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008305,ST JOHN'S RIVERSIDE HOSPITAL,St. John's Riverside Hospital,1578526695,"Dental Providers, Ryan White Providers",2 Park Ave,,Yonkers,NY,10703-3402,Westchester,967 N Broadway,,Yonkers,NY,10701,Westchester,Cheray T. Burnett,"Vice President, Administration",914-964-4769,,cburnett@riversidehealth.org,Gladys Attanasio,AVP of Revenue Cycle,914-964-4205,,gattanasio@riversidehealth.org,
NY-008306,Planned Parenthood Hudson Peconic - Yonkers,Planned Parenthood Hudson Peconic,1285701672,"Family Planning Providers, Sexually Transmitted Disease Clinics",20 S Broadway # 11,,Yonkers,NY,10701-3713,Westchester,"4 Skyline Drive, suite 7",,Hawthorne,NY,10532,Westchester,Vincent Russell,President/CEO,914-467-7315,,vincent.russell@pphp.org,Trisha Beck,"Senior Vice President, Patient Services and Operations",914-467-7312,,trisha.beck@pphp.org,http://www.pphp.org
NY-008307,Yonkers Community Hlth Ctr,"Mount Vernon Neighborhood Hlth Ctr, Inc",1396736120,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 S Broadway,,Yonkers,NY,10701-3712,Westchester,107 West 4th Street,,Mount Vernon,NY,10550,Westchester,Opan Dunstan,Acting CEO,914-699-7200,601,odunstan@aol.com,Audrey Carver,Director of Revenue Cycle Operations,914-699-7200,602,acarver24@aol.com,
NY-008308,Hudson River HealthCare Valentine Lane,"Hudson River HealthCare, Inc.",1730328279,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",503 S Broadway,Suite 210,Yonkers,NY,10705-6202,Westchester,1200 Brown Street,3rd fl,Peekskill,NY,10566,Westchester,Allison DuBois,Chief Operating Officer,914-734-8503,78503,adubois@hrhcare.org,James Sinkoff,Chief Financial Officer,914-734-8722,78722,jsinkoff@hrhcare.org,
NY-008309,ST JOHN'S RIVERSIDE HOSPITAL,St. John's Riverside Hospital,1578526695,Inpatient Hospitals (other than children's hospitals),976 N Broadway,,Yonkers,NY,10701-1302,Westchester,967 N Broadway,,Yonkers,NY,10701,Westchester,Cheray T. Burnett,"Vice President, Administration",914-964-4769,,cburnett@riversidehealth.org,Gladys Attanasio,AVP of Revenue Cycle,914-964-4205,,gattanasio@riversidehealth.org,www.riversidehealth.org
OH-008310,Akron Children's Hospital (children's inpatient hospital),Akron Children's Hospital,1861506560,Children's Hospitals (inpatient only),1 Perkins Sq,,Akron,OH,44308-1062,Summit,1 Perkins Square,,Akron,OH,44308,Summit,Debra Lane,Contract Manager,330-543-3741,33741,dlane@chmca.org,Charlie Solley,"Director, Government Relations",330-543-0371,30371,csolley@chmca.org,
OH-008311,Akron Children's Hospital (dental provider),Akron Children's Hospital,1861506560,Dental Providers,1 Perkins Sq,,Akron,OH,44308-1062,Summit,1 Perkins Square,,Akron,OH,44308,Summit,Debra Lane,Contract Manager,330-543-3741,33741,dlane@chmca.org,Charlie Solley,"Director, Government Relations",330-543-0371,30371,csolley@chmca.org,
OH-008312,Akron Children's Hospital (multiple outpatient ECP categories),Akron Children's Hospital,1861506560,"Hemophilia Treatment Centers, Outpatient Hospital Clinics",1 Perkins Sq,,Akron,OH,44308-1063,Summit,1 Perkins Square,,Akron,OH,44308,Summit,Debra Ann Lane,Contract Manager,330-543-3741,33741,dlane@chmca.org,Charlie Solley,"Director, Government Relations",330-543-0371,30371,csolley@chmca.org,
OH-008313,AxessPointe Arlington,AxessPointe Community Health Center,1548214935,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1400 S Arlington St Unit 38,,Akron,OH,44306-3771,Summit,1400 S. Arlington St.,Suite 38,Akron,OH,44306,Summit,Heather Gunnoe,Certified Application Counselor,888-975-9188,1186,hgunnoe@axesspointe.org,LaTrice D. Snodgrass,COO,888-975-9188,1115,lsnodgrass@axesspointe.org,www.axesspointe.org
OH-008314,AxessPointe Portage Path,AxessPointe Community Health Center,1720490956,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",340 S Broadway St # 2,,Akron,OH,44308-1529,Summit,1400 s arlington st,Suite 38,Akron,OH,44306,Summit,Heather Gunnoe,Certified Application Counselor,888-975-9188,1186,hgunnoe@axesspointe.org,LaTrice Snodgrass,Chief Operations Officer,888-975-9188,1115,lsnodgrass@axesspointe.org,www.axesspointe.org
OH-008315,Planned Parenthood Greater Ohio- Akron Health Center,Planned Parenthood of Greater Ohio,1376648899,Family Planning Providers,444 W Exchange St,,Akron,OH,44302-1711,Summit,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson-Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,,
OH-008316,International Community Health Center- Akron,"Asian Services in Action, Inc",1306298195,Federally Qualified Health Centers - Medical Services,468 E Market St,Suite C,Akron,OH,44304-1594,Summit,730 Carroll St,,Akron,OH,44304-1934,Summit,Michael Byun,CEO,330-535-3263,,mbyun@asiaohio.org,Mao Vue,Deputy Director,330-535-3263,5302,mvue@asiaohio.org,
OH-008317,"AxessPointe Broadway, Internal Medicine (Suite 103) & Women's Health (suite 203)",AxessPointe Community Health Center,1215336953,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",676 S Broadway St,,Akron,OH,44311-1059,Summit,1400 s arlington st,Suite 38,Akron,OH,44306,Summit,Heather Gunnoe,Certified Application Counselor,888-975-9188,1186,hgunnoe@axesspointe.org,LaTrice Snodgrass,Chief Operations Officer,888-975-9188,1115,lsnodgrass@axesspointe.org,www.axesspointe.org
OH-008318,Good Samaritan Community Health Center,ONE Health Ohio,1225169634,"Dental Providers, Federally Qualified Health Centers - Medical Services",1390 S Arch Ave,,Alliance,OH,44601-4111,Stark,726 Wick Ave,,Youngstown,OH,44505-2827,Mahoning,Megan Kovacich,Marketing Director,330-747-9551,77185,mkovacich@onehealthohio.org,Dionna Slagle,CFO,330-747-9551,77132,dslagle@onehealthohio.org,www.onehealthohio.org
OH-008319,Alliance Community Hospital,Alliance Community Hospital,1942385794,Inpatient Hospitals (other than children's hospitals),200 E State St,,Alliance,OH,44601-4936,Stark,200 East State Street,,Alliance,OH,44601,Stark,Cindy Somosko,"Director, Patient Financial Services",330-596-7524,7524,cindy.somosko@achosp.org,,,,,,
OH-008320,Alliance Family Health Center Main,"Alliance Family Health Center, Inc.",1801267232,"Family Planning Providers, Other ECP Providers",270 E State St,Suite G110,Alliance,OH,44601-4957,Stark,270 E. State Street,Suite G110,Alliance,OH,44601,Stark,Amelia Kocher,Executive Director,330-596-7581,,ameliak@alliancefamilyhealth.org,"Sharon Ryan, CNM",Chief Clinical Officer,330-596-7582,,sharonry@alliancefamilyhealth.org,www.alliancefamilyhealth.org
OH-008321,Andover Primary Care,"PRIMARY HEALTH NETWORK, INC.",1821295387,Federally Qualified Health Centers - Medical Services,5594 State Route 7,,Andover,OH,44003-9490,Ashtabula,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,440-293-2444,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
OH-008322,"Family Planning Association of Northeast Ohio, Inc","Family Planning Association of Northeast Ohio, Inc",1689938011,Family Planning Providers,5594 State Route 7,,Andover,OH,44003-9490,Ashtabula,5594 State Route 7,,Andover,OH,44003-9490,Lake,Mary Wynne-Peaspanen,Executive Director,440-352-0608,14,mwp@fpaneo.org,,,,,,http://www.fpaneo.org
OH-008323,UH Samaritan Medical Center,Samaritan Regional Health System,1902882939,Rural Health Clinics,1025 Center St,,Ashland,OH,44805-4097,Ashland,1025 Center Street,,Ashland,OH,44805-4011,Ashland,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008324,Ashland Co. Family Planning Clinic,Kno-Ho-Co. CAC,1356481436,Family Planning Providers,1060 Claremont Ave,Suite No. 3,Ashland,OH,44805-3715,Ashland,120 N 4th St,,Coshocton,OH,43812-1504,Coshocton,Kelly Corrigan,Administrator,740-622-9801,1030,kcorrigan@knohoco.org,,,,,,http://www.knohoco.org
OH-008325,Community Counseling Center of Ashtabula County,Community Counseling Center of Ashtabula County,1720029622,Community Mental Health Centers,2801 C Ct,,Ashtabula,OH,44004-4577,Ashtabula,2801 C Court,,Ashtabula,OH,44004,Ashtabula,Christine Schulz,Billing Specialist,440-998-4210,455,chrissy.schulz@cccohio.com,Jennifer Keefner,CFO,440-998-4210,417,jennifer.keefner@cccohio.com,
OH-008326,"Family Planning Association of Northeast Ohio, Inc.","Family Planning Association of Northeast Ohio, Inc",1164695789,"Family Planning Providers, Sexually Transmitted Disease Clinics",510 W 44th St,Suite 2,Ashtabula,OH,44004-6889,Ashtabula,510 W 44th St,,Ashtabula,OH,44004-6889,Lake,Mary Wynne-Peaspanen,Project Director,440-352-0608,14,mwp@fpaneo.org,,,,,,www.fpaneo.org
OH-008327,Planned Parenthood of Greater Ohio- Athens Health Center,Planned Parenthood of Greater Ohio,1346379807,Family Planning Providers,1005 E State St,Suite W,Athens,OH,45701-2151,Athens,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008328,Fairfield Community Health Center - Baltimore,FAIRFIELD COMMUNITY HEALTH CENTER,1396024212,Federally Qualified Health Centers - Medical Services,1055 W Market St,Suite H,Baltimore,OH,43105-1284,Fairfield,1155 E Main St,,Lancaster,OH,43130-4056,Fairfield,Lisa A. Evangelista,CEO,740-277-6043,1003,levangelista@fairfieldchc.org,,,,,,www.fairfieldchc.org
OH-008329,AxessPointe Barberton,AxessPointe Community Health Center,1356604680,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",390 Robinson Ave,Suite E,Barberton,OH,44203-3659,Summit,1400 S. Arlington St.,Suite 38,Akron,OH,44306,Summit,Lori Jensen,Certified Application Counselor,888-975-9188,1188,ljensen@axesspointe.org,LaTrice D. Snodgrass,COO,888-975-9188,1115,lsnodgrass@axesspointe.org,www.axesspointe.org
OH-008330,Barnesville Family Health Center,Ohio Hills Health Services,1326089129,Federally Qualified Health Centers - Medical Services,101 E Main St,,Barnesville,OH,43713-1005,Belmont,101 E Main St,,Barnesville,OH,43713-1005,Belmont,Jeffrey Britton,CEO,740-239-6447,1016,jbritton@ohiohillshealthservices.com,Lana Phillips,Community Services Director,740-239-6447,1011,lphillips@ohiohillshealthservices.com,
OH-008331,Ohio Hills Health Services,Ohio Hills Health Services,1720496706,"Community Mental Health Centers, Dental Providers",101 E Main St,,Barnesville,OH,43713-1005,Belmont,101 E Main St,,Barnesville,OH,43713,Belmont,Jeff Britton,CEO,740-239-6447,,jbritton@ohiohillshealthservices.com,,,,,,
OH-008332,Batavia Family Practice and Ob/Gyn,"HEALTHSOURCE OF OHIO, INC.",1003862343,Federally Qualified Health Centers - Medical Services,2055 Hospital Dr,Suite 130,Batavia,OH,45103-1978,Clermont,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008333,BEDFORD HEALTH CENTER,Planned Parenthood of Greater Ohio,1427066000,"Family Planning Providers, Other ECP Providers",25350 Rockside Rd,,Bedford Heights,OH,44146-7110,Cuyahoga,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008334,Mary Rutan Hospital,Mary Rutan Hospital,1548254931,Inpatient Hospitals (other than children's hospitals),205 E Palmer Rd,,Bellefontaine,OH,43311-2298,Logan,205 E Palmer Road,,Bellefontaine,OH,43311-2298,Logan,Steven R. Brown,Vice President of Finance,937-599-7001,,Steve.Brown@maryrutan.org,Mandy Goble,President,937-599-7002,,mgoble@maryrutan.org,
OH-008335,Wood County Community Health and Wellness Center,WOOD COUNTY COMBINED GENERAL HEALTH DISTRICT,1750712782,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1840 E Gypsy Lane Rd,,Bowling Green,OH,43402-9173,Wood,1840 East Gypsy Lane Road,,Bowling Green,OH,43402,Wood,Diane Krill,CEO,419-354-4203,,dkrill@co.wood.oh.us,Lexie Jacobs,Billing Manager,419-354-9049,3231,ljacobs@co.wood.oh.us,
OH-008336,Bryan Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1790020733,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 Van Gundy Dr,,Bryan,OH,43506-1153,Williams,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008337,Bucyrus Hospital,Avita Health System,1104914274,Inpatient Hospitals (other than children's hospitals),629 N Sandusky Ave,,Bucyrus,OH,44820-1821,Crawford,269 Portland Way South,,Galion,OH,44833,Crawford,Rhonda Ridenour,"Director, Patient Financial Services",419-468-0511,5511,rridenour@avitahs.org,Theresa Holzwarth,Enrollment Coordinator,419-462-3328,,tholzwarth@avitahs.org,
OH-008338,Harrison County Health Department,Reproductive Health,1225170525,Sexually Transmitted Disease Clinics,538 N Main St,Suite G,Cadiz,OH,43907-1282,Harrison,538 North Main St,Suite G,Cadiz,OH,43907,Harrison,Teresa Pecar,Director of Nursing,740-942-2616,1735,teresa.pecar@odh.ohio.gov,Theresa Mizer,CNP,740-942-2616,1735,harrcohd@odh.ohio.gov,
OH-008339,Noble County Health Department,Noble County General Health District,1396732574,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",44069 Marietta Rd,,Caldwell,OH,43724-9124,Noble,44069 Marietta Rd,,Caldwell,OH,43724-9124,Noble,Shawn Ray,Health Commissioner,740-732-4958,22,shawn.ray@noblecohd.org,Madeline Watson,Director of Nursing,740-732-4958,34,madeline.watson@noblecohd.org,http://www.noblecohd.org
OH-008340,Muskingum Valley Health Center,Muskingum Valley Health Center,1295118883,Federally Qualified Health Centers - Medical Services,1330 Clark St,,Cambridge,OH,43725-9614,Guernsey,716 Adair Ave,,Zanesville,OH,43701,Muskingum,Daniel Atkinson,CEO,740-891-9090,,datkinson@mvhealthcenters.org,Melissa Leckrone,Executive Assistant,740-896-8395,,mleckrone@mvhealthcenters.org,www.mvhccares.org
OH-008341,Southeastern Ohio Regional Medical Center,Southeastern Ohio Regional Medical Center,1346247350,Inpatient Hospitals (other than children's hospitals),1341 Clark St,,Cambridge,OH,43725-9614,Guernsey,1341 Clark Street,PO Box 610,Cambridge,OH,43725,Guernsey,Tim Evancho,CFO,740-439-8179,,TEvan@seormc.org,Stephen Nolan,Reimbursement Director,740-439-8992,,snola@seormc.org,
OH-008342,Cambridge-Guernsey County HD,State of Ohio -- Dept. of Health,1881681989,"Family Planning Providers, Sexually Transmitted Disease Clinics",326 Highland Ave,,Cambridge,OH,43725-2530,Guernsey,326 Highland Ave,,Cambridge,OH,43725-2530,Guernsey,Angela Gray RN,Director of Nursing,740-439-3577,7235,angela.gray@odh.ohio.gov,,,614-387-0652,,,http://www.guernseycountyhealthdepartment.org
OH-008343,Canton Health Center,Planned Parenthood of Greater Ohio,1316015449,Family Planning Providers,2663 Cleveland Ave NW,,Canton,OH,44709-3393,Stark,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Wiliams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008344,Lincoln Street Health Center,"Lifecare Family Health & Dental Center, Inc.",1013964923,"Dental Providers, Federally Qualified Health Centers - Medical Services",2725 Lincoln St E,,Canton,OH,44707-2769,Stark,2725 Lincoln Street East,,Canton,OH,44707,Stark,Janet McPeek,Chief Financial Officer,234-521-7213,,jmcpeek@LifecareFHDC.org,,,,,,
OH-008345,Ninth Street Health Center,"Lifecare Family Health and Dental Center, Inc.",1851592034,Federally Qualified Health Centers - Medical Services,408 9th St SW,,Canton,OH,44707-4714,Stark,2725 Lincoln Street East,,Canton,OH,44707,Stark,Janet C. McPeek,CFO,234-521-7213,,jmcpeek@LifecareFHDC.org,,,,,,
OH-008346,Cedarville Family Practice,Greene Memorial Hospital,1073948774,Rural Health Clinics,29 Kyle Dr,,Cedarville,OH,45314-9580,Greene,1141 N. Monroe Drive,,Xenia,OH,45385,Greene,Mark Floro,Director of Clinical Services,937-352-2571,9373522242,mark.floro@ketteringhealth.org,Jane Kennedy,Practice Manager,937-766-2611,9377669213,jane.miller@ketteringhealth.org,http://www.ketteringhealth.org/
OH-008347,"Family Planning Association of Northeast Ohio, Inc","Family Planning Association of Northeast Ohio, Inc",1962766394,Family Planning Providers,5192 Chillicothe Rd,Suite 104,Chagrin Falls,OH,44022-4196,Geauga,5192 Chillicothe Rd Ste 140,,Chagrin Falls,OH,44022-4196,Lake,Mary Wynne-Peaspanen,Executive Director,440-352-0608,14,mwp@fpaneo.org,,,,,,http://www.fpaneo.org
OH-008348,Chesapeake Family Medical Center,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1215014113,Federally Qualified Health Centers - Medical Services,717 3rd Ave,,Chesapeake,OH,45619-1040,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,,ilcaosheri@live.com,
OH-008349,Hopewell Health Centers Inc.,"HOPEWELL HEALTH CENTERS, INC.",1659468908,Federally Qualified Health Centers - Medical Services,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-4366,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008350,"Healthcare Connection, Inc.,The","HEALTHCARE CONNECTION, INC.,THE",1174867881,Federally Qualified Health Centers - Medical Services,100 Viking Way,Viking School Based Health Center,Cincinnati,OH,45246-1139,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008351,Walnut Street Health Center,City of Cincinnati,1760873921,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1005 Walnut St,,Cincinnati,OH,45202-1109,Hamilton,3101 Burnet Avenue,,Cincinnati,OH,45229,Hamilton,Joyce A Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,www.cincinnati-oh.gov/health
OH-008352,WinMed-City West II,WINTON HILLS MED & HEALTH CTR,1942535505,"Dental Providers, Federally Qualified Health Centers - Medical Services",1019 Linn St,,Cincinnati,OH,45203-1314,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008353,"Healthcare Connection, Inc.,The","HEALTHCARE CONNECTION, INC.,THE",1750797163,Federally Qualified Health Centers - Medical Services,11961 Chesterdale Rd,Heritage Hill School Based Health Center,Cincinnati,OH,45246-2037,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008354,Lincoln Heights Health Center,"HEALTHCARE CONNECTION, INC.,THE",1053337675,"Dental Providers, Federally Qualified Health Centers - Medical Services",1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008355,Greater Cincinnati Behavioral Health Services,"HEALTHCARE CONNECTION, INC.,THE",1912189721,Federally Qualified Health Centers - Medical Services,1501 Madison Rd,,Cincinnati,OH,45206-1706,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008356,WINTON HILLS MED & HEALTH CTR,WINTON HILLS MED & HEALTH CTR,1649421223,Federally Qualified Health Centers - Medical Services,1510 California Ave,Bond Hill Academy Elementary,Cincinnati,OH,45237-5621,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,http://winmedinc.org/School_Based_Health_Centers.htm
OH-008357,Elm Street Health Center,City of Cincinnati,1457468860,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1525 Elm St,,Cincinnati,OH,45202-6957,Hamilton,3101 Burnet Avenue,,Cincinnati,OH,45229,Hamilton,Joyce A Tate,Assistant Health Commissioner/CEO,513-357-7362,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008358,WinMed-Cincinnati-Hamilton County Community Action Agency,WINTON HILLS MED & HEALTH CTR,1932347382,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",1740 Langdon Farm Rd,,Cincinnati,OH,45237-1157,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008359,Mary M. Yeiser Center (Western Hills),Planned Parenthood Southwest Ohio Region,1437219144,"Family Planning Providers, Sexually Transmitted Disease Clinics",2016 Ferguson Rd,,Cincinnati,OH,45238-3718,Hamilton,2314 Auburn Ave,,Cincinnati,OH,45219-2802,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008360,HealthSource Mt. Washington,"HEALTHSOURCE OF OHIO, INC.",1023358892,Federally Qualified Health Centers - Medical Services,2020 Beechmont Ave,,Cincinnati,OH,45230-1696,Hamilton,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008361,City of Cincinnati,City of Cincinnati,1043594260,Dental Providers,2121 Hatmaker St,Delta Dental Center-Oyler School,Cincinnati,OH,45204-1947,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229,Harrison,Nancy Carter,Associate Dental Director,513-357-7383,,nancy.carter@cincinnati-oh.gov,,,,,,http://www.cincinnati-oh.gov/health/news/oyler-does-it-again-dental-center/
OH-008362,Price Hill Health Center,"CINCINNATI, CITY OF",1093728248,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2136 W 8th St,,Cincinnati,OH,45204-2052,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008363,Deaconess Health Check at West High,City of Cincinnati,1083960736,Dental Providers,2146 Ferguson Rd,,Cincinnati,OH,45238-3720,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229,Hamilton,Nancy Carter,Associate Dental Director,513-357-7383,,nancy.carter@cincinnati-oh.gov,,,,,,
OH-008364,Shelterhouse,"CINCINNATI HEALTH NETWORK INC, THE",1750655478,Federally Qualified Health Centers - Medical Services,217 W 12th St,,Cincinnati,OH,45202-7501,Hamilton,2825 Burnet Ave Ste 232,,Cincinnati,OH,45219-2426,Hamilton,Brian Vanderhorst,Director of Operations,513-386-7899,109,bvanderhorst@cintihealthnetwork.org,Kate Bennett,CEO,513-961-0600,309,kbennett@cintihealthnetwork.org,
OH-008365,Adult Hemophilia Treatment Center,University of Cincinnati,1679672158,Hemophilia Treatment Centers,231 Albert Sabin Way,,Cincinnati,OH,45267-0562,Hamilton,231 Albert Sabin Way,,Cincinnati,OH,45267-0562,Hamilton,Elizabeth Billow,Medical Social Worker,513-584-3237,,billoweh@ucmail.uc.edu,Barb Day,Hem-Onc Business Director,513-558-2184,,kilgusba@ucmail.uc.edu,
OH-008366,Elizabeth Campbell Medical Center (Mt. Auburn),Planned Parenthood Southwest Ohio Region,1427110550,"Family Planning Providers, Sexually Transmitted Disease Clinics",2314 Auburn Ave,,Cincinnati,OH,45219-2802,Hamilton,2314 Auburn Ave,,Cincinnati,OH,45219-2802,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008367,University of Cincinnati Factor Program,University of Cincinnati,1679672158,Hemophilia Treatment Centers,234 Goodman St,,Cincinnati,OH,45219-2364,Hamilton,231 Albert Sabin Way,,Cincinnati,OH,45267-0562,Hamilton,Elizabeth Billow,Medical Social Worker III,513-584-3237,,billoweh@ucmail.uc.edu,Barb Day,Hem-Onc Business Director,513-558-2184,,kilgusba@ucmail.uc.edu,
OH-008368,Millvale at Hopple Street Health Center,"CINCINNATI, CITY OF",1841205564,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2750 Beekman St,,Cincinnati,OH,45225-2049,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7308,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008369,Jean K. Spritz Center (Springdale),Planned Parenthood Southwest Ohio Region,1750441267,Family Planning Providers,290 Northland Blvd,,Cincinnati,OH,45246-3614,Hamilton,2314 Auburn Ave,,Cincinnati,OH,45219-2802,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008370,Ambrose H. Clement Health Center,City of Cincinnati,1831102151,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7362,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008371,SHC - Cincinnati,Shriners Hospitals for Children,1659590644,Children's Hospitals (inpatient only),3229 Burnet Ave,,Cincinnati,OH,45229-3018,Hamilton,3229 Burnet Ave.,,Cincinnati,OH,45229,Hamilton,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
OH-008372,CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (children's inpatient hospital),CHILDREN'S HOSPITAL MEDICAL CENTER,1548212988,Children's Hospitals (inpatient only),3333 Burnet Ave,,Cincinnati,OH,45229-3039,Hamilton,3333 Burnet Ave,,Cincinnati,OH,45229-3026,Hamilton,Chris Scowden,"AVP, Contracting & Payor Relations",513-636-8856,,chris.scowden@cchmc.org,,,,,,www.cincinnatichildrens.org
OH-008373,CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (multiple outpatient ECP categories),CHILDREN'S HOSPITAL MEDICAL CENTER,1548212988,"Community Mental Health Centers, Dental Providers, Hemophilia Treatment Centers",3333 Burnet Ave,,Cincinnati,OH,45229-3039,Hamilton,3333 Burnet Ave,,Cincinnati,OH,45229-3026,Hamilton,Chris Scowden,"AVP, Contracting & Payor Relations",513-636-8856,,chris.scowden@cchmc.org,,,,,,www.cincinnatichildrens.org
OH-008374,CENTER FOR RESPITE CARE,"CINCINNATI HEALTH NETWORK INC, THE",1750655478,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",3550 Washington Ave,,Cincinnati,OH,45229-2618,Hamilton,2825 Burnet Ave Ste 232,,Cincinnati,OH,45219-2426,Hamilton,Jackie Campbell Brumley,Program Manager,513-961-0600,304,jcampbellbrumley@cintihealthnetwork.org,Kate Bennett,CEO,513-961-0600,309,kbennett@cintihealthnetwork.org,
OH-008375,Riverview East Academy,City of Cincinnati,1194139287,Federally Qualified Health Centers - Medical Services,3555 Kellogg Ave,,Cincinnati,OH,45226-2180,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Angela Robinson,,513-357-7456,,angela.robinson2@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health
OH-008376,Northside Health Center,"CINCINNATI, CITY OF",1902819154,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3917 Spring Grove Ave,,Cincinnati,OH,45223-3302,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008377,MCMICKEN INTEGRATED CARE CLINIC,"CINCINNATI HEALTH NETWORK INC, THE",1750655478,Federally Qualified Health Centers - Medical Services,40 E McMicken Ave,,Cincinnati,OH,45202-6549,Hamilton,2825 Burnet Ave Ste 232,,Cincinnati,OH,45219-2426,Hamilton,Brian Vanderhorst,Director of Operations,513-386-7899,109,bvanderhorst@cintihealthnetwork.org,Kate Bennett,CEO,513-961-0600,309,kbennett@cintihealthnetwork.org,
OH-008378,ST. BERNARD - ELMWOOD PLACE,WINTON HILLS MED & HEALTH CTR,1851560346,Federally Qualified Health Centers - Medical Services,407 Oak St,,Cincinnati,OH,45219-2504,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008379,"Caracole, Inc.","Caracole, Inc.",1497111363,Ryan White Providers,4138 Hamilton Ave,,Cincinnati,OH,45223-2249,Hamilton,4138 Hamilton Ave,,Cincinnati,OH,45223,Hamilton,Linda Seiter,Executive Director,513-761-1480,,mlwolf@caracole.org,,,,,,www.caracole.org
OH-008380,ST. BERNARD ELEMENTARY SBHC,WINTON HILLS MED & HEALTH CTR,1376712810,Federally Qualified Health Centers - Medical Services,4515 Tower Ave,,Cincinnati,OH,45217-1723,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008381,ST. BERNARD ELMWOOD PLACE HS SBH,WINTON HILLS MED & HEALTH CTR,1750551131,Federally Qualified Health Centers - Medical Services,4615 Tower Ave,,Cincinnati,OH,45217-1724,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008382,Talbert House-Glenway,"HEALTHCARE CONNECTION, INC.,THE",1902075252,Federally Qualified Health Centers - Medical Services,4966 Glenway Ave,Suite 3,Cincinnati,OH,45238-3915,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008383,Crossroad Health Center,Christian Community Health Services,1598719361,Federally Qualified Health Centers - Medical Services,5 E Liberty St,,Cincinnati,OH,45202-8202,Hamilton,5 E. Liberty St,,Cincinnati,OH,45202,Hamilton,James J Berrens,Interim CEO,513-707-5755,,jamieb@crossrd.org,Dr Christy O'Dea,Medical Director,513-381-2247,,christineo1@crossrd.org,www.crossroadhc.org
OH-008384,The Childrens Home of Cincinnati,City of Cincinnati,1881041788,Federally Qualified Health Centers - Medical Services,5051 Duck Creek Rd,,Cincinnati,OH,45227-1440,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Angela Robinson,,513-357-7456,,angela.robinson2@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health
OH-008385,Central Community Mental Health Board,"HEALTHCARE CONNECTION, INC.,THE",1386826196,Federally Qualified Health Centers - Medical Services,522 Maxwell Ave,,Cincinnati,OH,45219-2408,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008386,"WINTON HILLS MEDICAL AND HEALTH CENTER, INC.",WINTON HILLS MED & HEALTH CTR,1437119617,"Dental Providers, Federally Qualified Health Centers - Medical Services",5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,
OH-008387,WINTON HILLS MED & HEALTH CTR,WINTON HILLS MED & HEALTH CTR,1346419991,Federally Qualified Health Centers - Medical Services,5300 Winneste Ave,WINTON HILLS ACADEMY ELEMENTARY,Cincinnati,OH,45232-1133,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,http://winmedinc.org/School_Based_Health_Centers.htm
OH-008388,Eastgate Pediatrics,"HEALTHSOURCE OF OHIO, INC.",1316994072,"Dental Providers, Federally Qualified Health Centers - Medical Services",559 Old State Route 74,,Cincinnati,OH,45244-1518,Clermont,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008389,Braxton F. Cann Memorial Medical Center,"CINCINNATI, CITY OF",1770598492,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5818 Madison Rd,,Cincinnati,OH,45227-1708,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229-3014,Hamilton,Joyce Tate,Assistant Health Commissioner/CEO,513-357-7361,,joyce.tate@cincinnati-oh.gov,Martha Walter,Family Planning Coordinator,513-357-7485,,martha.walter@cincinnati-oh.gov,http://www.cincinnati-oh.gov/health/
OH-008390,Talbert House-Hamilton Avenue,"HEALTHCARE CONNECTION, INC.,THE",1124201694,Federally Qualified Health Centers - Medical Services,5837 Hamilton Ave,,Cincinnati,OH,45224-2923,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008391,Crest,City of Cincinnati,1245553965,Dental Providers,612 Rockdale Ave,,Cincinnati,OH,45229-2919,Hamilton,3101 Burnet Ave,,Cincinnati,OH,45229,Hamilton,Nancy Carter,Associate Dental Director,513-357-7383,,nancy.carter@cincinnati-oh.gov,,,,,,
OH-008392,WINTON HILLS MED & HEALTH CTR,WINTON HILLS MED & HEALTH CTR,1659522092,Federally Qualified Health Centers - Medical Services,7005 Reading Rd,Woodward Career Technical High School,Cincinnati,OH,45237-3802,Hamilton,5275 Winneste Ave,,Cincinnati,OH,45232-1130,Hamilton,Miriam Crenshaw,CEO,513-242-1033,,winmed@aol.com,Tim Vale,CFO,513-242-1033,134,timothyv@winmedinc.org,http://winmedinc.org/School_Based_Health_Centers.htm
OH-008393,Anderson Ob/Gyn,"HEALTHSOURCE OF OHIO, INC.",1942646799,Federally Qualified Health Centers - Medical Services,8074 Beechmont Ave,,Cincinnati,OH,45255-5108,Hamilton,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Hamilton,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008394,Forest Park Health Center,"HEALTHCARE CONNECTION, INC.,THE",1922024553,Federally Qualified Health Centers - Medical Services,924 Waycross Rd,,Cincinnati,OH,45240-3022,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008395,Berger Hospital,Berger Hospital,1326020447,Inpatient Hospitals (other than children's hospitals),600 N Pickaway St,,Circleville,OH,43113-1447,Pickaway,600 N. Pickaway Street,,Circleville,OH,43113,Pickaway,Amy Gregg,Senior Director of Revenue Cycle,740-420-8014,,amy.gregg@bergerhealth.com,Rich Filler,CFO,740-420-8089,,rich.filler@bergerhealth.com,
OH-008396,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1578985453,Federally Qualified Health Centers - Medical Services,600 N Pickaway St Ste 300,Mo Bldg.,Circleville,OH,43113-1447,Pickaway,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-2002,,fikru.nigusse@primaryonehealth.org,Regina Browder,Credentilaing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008397,UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER (inpatient hospital),University Hospitals Health System,1043397292,Inpatient Hospitals (other than children's hospitals),11100 Euclid Ave,,Cleveland,OH,44106-1716,Cuyahoga,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,216-844-7890,,,
OH-008398,UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER (multiple outpatient ECP categories),University Hospitals Health System,1043397292,"Dental Providers, Hemophilia Treatment Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",11100 Euclid Ave,,Cleveland,OH,44106-1716,Cuyahoga,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,216-844-7890,,,
OH-008399,J. Glen Smith Health Center,Cleveland Dept. of Public Health,1740345339,"Family Planning Providers, Sexually Transmitted Disease Clinics",11100 Saint Clair Ave,J. Glen Smith Health Center,Cleveland,OH,44108-1943,Cuyahoga,75 Erieview Plaza,3rd Floor,Cleveland,OH,44114,Cuyahoga,Kathy Rothenberg-James,Acting Commissioner/Health Center Director,216-664-2362,,krothenberg@city.cleveland.oh.us,Jeannie Johnson-Brooks,Director of Nursing,216-664-4354,,jbrooks@city.cleveland.oh.us,
OH-008400,Neighborhood Family Practice,Neighborhood Health Care Incorporated,1437539517,Federally Qualified Health Centers - Medical Services,11709 Lorain Ave,,Cleveland,OH,44111-5443,Cuyahoga,3569 Ridge Road,,Cleveland,OH,44102,Cuyahoga,Christine Porter,Controller,216-281-0872,114,cporter@nfpmedcenter.org,Steve Demeter,Chief Financial Officer,216-281-0872,230,sdemeter@nfpmedcenter.org,
OH-008401,NEON Superior Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1649201732,"Dental Providers, Federally Qualified Health Centers - Medical Services",12100 Superior Ave,,Cleveland,OH,44106-1444,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,austinwfsr@aol.com,http://www.neonhealth.org/
OH-008402,FREE MEDICAL CLINIC OF GREATER CLEVELAND (INC),The Free Medical Clinic of Greater Cleveland,1386609857,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",12201 Euclid Ave,,Cleveland,OH,44106-4310,Cuyahoga,12201 Euclid Ave.,,Cleveland,OH,44106-4310,Cuyahoga,Danny Williams,Executive Director,216-707-3400,,dwilliams@thefreeclinic.org,Joan Palumbo,Chief Advancement Officer,216-707-3403,,jpalumbo@thefreeclinic.org,
OH-008403,NEON Southeast Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1013940949,"Dental Providers, Federally Qualified Health Centers - Medical Services",13301 Miles Ave,,Cleveland,OH,44105-5521,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,austinwfsr@aol.com,http://www.neonhealth.org/
OH-008404,Neighborhood Family Practice,Neighborhood Health Care Incorporated,1306268677,Federally Qualified Health Centers - Medical Services,14037 Puritas Ave,Ste. A & D,Cleveland,OH,44135-2841,Cuyahoga,3569 Ridge Rd,,Cleveland,OH,44102-5443,Cuyahoga,Christine Porter,Controller,216-281-0872,114,cporter@nfpmedcenter.org,Steve Demeter,Chief Financial Officer,216-281-0872,230,sdemeter@nfpmedcenter.org,
OH-008405,NEON Norwood Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1407874589,Federally Qualified Health Centers - Medical Services,1468 E 55th St,,Cleveland,OH,44103-1307,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-1307,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,austinwfsr@aol.com,http://www.neonhealth.org/
OH-008406,Care Alliance Health Center (Downtown),Care Alliance Health Center,1396874426,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1530 Saint Clair Ave NE,,Cleveland,OH,44114-2004,Cuyahoga,1530 St. Clair Avenue NE,,Cleveland,OH,44114-2004,Cuyahoga,Yulanda Lee,BILLING SUPERVISOR,216-535-9100,559,ylee@carealliance.org,Terrance K Byrne,COO,216-781-6228,227,tbyrne@carealliance.org,www.carealliance.org
OH-008407,NEON Collinwood Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1346272267,"Dental Providers, Federally Qualified Health Centers - Medical Services",15322 Saint Clair Ave,,Cleveland,OH,44110-3043,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,mariev@neonhealth.org,http://www.neonhealth.org/
OH-008408,Care Alliance Health Center (Westside),Care Alliance Health Center,1497922520,"Dental Providers, Federally Qualified Health Centers - Medical Services",1795 W 25th St,,Cleveland,OH,44113-3112,Cuyahoga,1530 St Clair Avenue NE,,Cleveland,OH,44114,Cuyahoga,Yulanda Lee,BILLING SUPERVISOR,216-535-9100,559,ylee@carealliance.org,Jennifter Konn,Director of External Affairs,216-781-6228,257,jkonns@carealliance.org,www.carealliance.org
OH-008409,University Hospitals of Cleveland John T Carey Special Immunology Unit,University Hospitals of Cleveland,1760673412,Ryan White Providers,2061 Cornell Rd,,Cleveland,OH,44106-3808,Cuyahoga,11100 Euclid Ave,,Cleveland,OH,44106,Cuyahoga,Barbara Gripshover,Medical Director,216-844-5876,,bxg9@case.edu,Michelle Kucia,Ryan White Program Director,216-844-7862,,kucia.michelle@clevelandactu.org,www.uhhospitals.org
OH-008410,University Hospitals Rainbow Babies & Children's Hospital (children's inpatient hospital),University Hospitals Health System,1518042175,Children's Hospitals (inpatient only),2101 Adelbert Rd,,Cleveland,OH,44106-2624,Cuyahoga,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008411,University Hospitals Rainbow Babies & Children's Hospital (dental provider),University Hospitals Health System,1518042175,Dental Providers,2101 Adelbert Rd,,Cleveland,OH,44106-2624,Cuyahoga,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008412,UH & Rainbow Hemostasis and Trhombosis Center,University Hospitals Cleveland Medical Center,1518042175,Hemophilia Treatment Centers,2102 Adelbert Rd,Rbc 340,Cleveland,OH,44106-2625,Cuyahoga,11100 Euclid Avenue,,Cleveland,OH,44106,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008413,Neighborhood Family Practice,Neighborhood Health Care Incorporated,1316148745,Federally Qualified Health Centers - Medical Services,2358 Professor Ave,,Cleveland,OH,44113-4630,Cuyahoga,3569 Ridge Rd,,Cleveland,OH,44102-5443,Cuyahoga,Christine Porter,Controller,216-281-0872,114,cporter@nfpmedcenter.org,Steve Demeter,Chief Financial Officer,216-281-0872,230,sdemeter@nfpmedcenter.org,
OH-008414,The MetroHealth System,The MetroHealth System Hospital,1700828852,Inpatient Hospitals (other than children's hospitals),2500 Metrohealth Dr,,Cleveland,OH,44109-1998,Cuyahoga,The MetroHealth System,2500 MetroHealth Drive,Cleveland,OH,44109-1998,Cuyahoga,Susan Mego,"executive director, managed care",216-957-2659,,smego@metrohealth.org,Eileen Kein,"Manager, Managed care",216-957-2670,,eklein@metrohealth.org,www.metrohealth.org
OH-008415,CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHAB,CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHAB,1033161948,Children's Hospitals (inpatient only),2801 Martin Luther King Jr Dr,,Cleveland,OH,44104-3815,Cuyahoga,9500 Euclid Ave,,Cleveland,OH,44195,Cuyahoga,Jennifer Manning,Administrator,216-448-6424,,manninj@ccf.org,"Michelle Marks, DO",Medical Director,216-444-4998,,marksm@ccf.org,http://my.clevelandclinic.org/childrens-hospital/specialties-services/therapy-rehab
OH-008416,AHF Healthcare Center - Cleveland,AIDS Healthcare Foundation,1609282672,"Other ECP Providers, Ryan White Providers",2829 Euclid Ave,,Cleveland,OH,44115-2413,Cuyahoga,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,3234365025,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
OH-008417,Care Alliance Health Center (Central),Care Alliance,1023406469,"Dental Providers, Federally Qualified Health Centers - Medical Services",2916 Central Ave,,Cleveland,OH,44115-3229,Cuyahoga,1530 Saint Clair Ave,,Cleveland,OH,44114,Cuyahoga,Yulanda Lee,Billing supervisor,216-535-9100,559,ylee@carealliance.org,Jennifer Konns,Manager of Programs and Development,216-781-6228,279,jkonns@carealliance.org,www.carealliance.org
OH-008418,Old Brooklyn Health Center,Planned Parenthood of Greater Ohio,1730504457,Family Planning Providers,3311 Broadview Rd,PO Box 609009,Cleveland,OH,44109-3315,Cuyahoga,206 E State St,,Columbus,OH,43215-4311,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,614-224-2235,1123,,
OH-008419,Neighborhood Family Practice,Neighborhood Health Care Incorporated,1295786267,Federally Qualified Health Centers - Medical Services,3569 Ridge Rd,,Cleveland,OH,44102-5443,Cuyahoga,3569 Ridge Rd,,Cleveland,OH,44102-5443,Cuyahoga,Christine Porter,Controller,216-281-0872,114,cporter@nfpmedcenter.org,Steve Demeter,Chief Financial Officer,216-281-0872,230,sdemeter@nfpmedcenter.org,
OH-008420,International Community Health Centers- Cleveland,ASIAN SERVICES IN ACTION INC,1992056170,Federally Qualified Health Centers - Medical Services,3820 Superior Ave E,,Cleveland,OH,44114-4166,Cuyahoga,730 Carroll St,,Akron,OH,44304-1965,Summit,Michael Byun,CEO,330-535-3263,,mbyun@asiaohio.org,Mao Vue,COO,330-535-3263,5302,mvue@asiaohio.org,www.asiaohio.org
OH-008421,T.F. McCafferty Health Center,Cleveland Dept. of Public Health,1740345339,"Family Planning Providers, Sexually Transmitted Disease Clinics",4242 Lorain Ave,T.F. Mccafferty Health Center,Cleveland,OH,44113-3715,Cuyahoga,75 Erieview Plaza,3rd Floor,Cleveland,OH,44114,Cuyahoga,Kathy Rothenberg-James,Acting Commissioner/Health Center Director,216-664-2362,,krothenberg@city.cleveland.oh.us,Jeannie Johnson-Brooks,Director of Nursing,216-664-4354,,jbrooks@city.cleveland.oh.us,
OH-008422,Care Alliance Health Center (Eastside),Care Alliance Health Center,1083881114,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6001 Woodland Ave,,Cleveland,OH,44104-2762,Cuyahoga,1530 St. Clair Avenue NE,,Cleveland,OH,44114,Cuyahoga,Yulanda Lee,BILLING SUPERVISOR,216-535-9100,559,ylee@carealliance.org,Jennifer Konns,Director of External Affairs,216-781-6228,257,jkonns@carealliance.org,www.carealliance.org
OH-008423,Neighborhood Family Practice,Neighborhood Health Care Incorpoarted,1477823565,Federally Qualified Health Centers - Medical Services,6412 Franklin Blvd,,Cleveland,OH,44102-3153,Cuyahoga,3569 Ridge Rd,,Cleveland,OH,44102-5443,Cuyahoga,Christine Porter,Controller,216-281-0872,114,cporter@nfpmedcenter.org,Steve Demeter,Chief Financial Officer,216-281-0872,230,sdemeter@nfpmedcenter.org,
OH-008424,Cleveland Health Center,Planned Parenthood of Greater Ohio,1093110009,Family Planning Providers,7997 Euclid Ave,,Cleveland,OH,44103-4226,Cuyahoga,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008425,NEON Hough Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1851302665,"Dental Providers, Federally Qualified Health Centers - Medical Services",8300 Hough Ave,,Cleveland,OH,44103-4247,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1175,mariev@neonhealth.org,http://www.neonhealth.org/
OH-008426,NEON Miles Broadway Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1396093597,Federally Qualified Health Centers - Medical Services,9127 Miles Ave,,Cleveland,OH,44105-6136,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,austinwfsr@aol.com,http://www.neonhealth.org/
OH-008427,The Cleveland Clinic Children's Hospital,The Cleveland Clinic Foundation,1154448769,Children's Hospitals (inpatient only),9500 Euclid Ave,,Cleveland,OH,44195-0001,Cuyahoga,9500 Euclid Ave,,Cleveland,OH,44195,Cuyahoga,Alec G. Kulik,Institute Administrator,216-445-6465,,kulika@ccf.org,"Giovanni Piedimonte, MD",Chair,216-444-2344,,piedimg@ccf.org,http://my.clevelandclinic.org/childrens-hospital?utm_campaign=childrens-url&utm_medium=offline&utm_source=redirect
OH-008428,The Cleveland Clinic Foundation,The Cleveland Clinic Foundation,1154448769,Ryan White Providers,9500 Euclid Ave,,Cleveland,OH,44195-0001,Cuyahoga,9500 Euclid Ave,,Cleveland,OH,44195,Cuyahoga,Alec G. Kulik,Institute Administrator,216-445-6465,,kulika@ccf.org,"Giovanni Piedimonte, MD",Chair,216-444-2344,,piedimg@ccf.org,http://my.clevelandclinic.org/childrens-hospital?utm_campaign=childrens-url&utm_medium=offline&utm_source=redirect
OH-008429,The Cleveland Clinic Hospital,The Cleveland Clinic Foundation,1154448769,Inpatient Hospitals (other than children's hospitals),9500 Euclid Ave,,Cleveland,OH,44195-0001,Cuyahoga,9500 Euclid Ave,,Cleveland,OH,44195,Cuyahoga,Alec G. Kulik,Institute Administrator,216-445-6465,,kulika@ccf.org,"Giovanni Piedimonte, MD",Chair,216-444-2344,,piedimg@ccf.org,http://my.clevelandclinic.org/childrens-hospital?utm_campaign=childrens-url&utm_medium=offline&utm_source=redirect
OH-008430,Valley Health Coal Grove,"Valley Health Systems, Inc.",1629043708,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",205 Marion Pike,,Coal Grove,OH,45638-3165,Lawrence,3377 US Route 60,,Huntington,WV,25705,Cabell,Steve Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/teays-valley/
OH-008431,Lawrence County Clinic,Shawnee Family Health Center,1336173236,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",225 Carlton Davidson Ln,,Coal Grove,OH,45638-2924,Lawrence,901 Washington Street,,Portsmouth,OH,45662,Scioto,Cynthia Holstein,CEO,740-355-8686,,c.holstein@shawneemhc.org,Jill Cottrill,CFO,740-354-7702,1266,j.cottrill@shawneemhc.org,
OH-008432,"AIDS Resource Center Ohio Medical Center, Columbus","AIDS Resource Center Ohio, Inc",1952661373,Ryan White Providers,1033 N High St,,Columbus,OH,43201-2409,Franklin,4400 N High Street,Ste 300,Columbus,OH,43214,Franklin,Anna Wuerth,Director of Healthcare Operations,614-340-6754,,annawuerth@arcohio.org,Trent Stechschulte,Compliance Officer,614-340-6781,,trentstechschulte@arcohio.org,www.arcohio.org
OH-008433,"Lower Lights Christian Health Center, Inc.",LOWER LIGHTS CHRISTIAN HEALTH CENTER INC,1770854473,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1160 W Broad St,,Columbus,OH,43222-1352,Franklin,1160 W Broad St,,Columbus,OH,43222-1359,Franklin,Dana Vallangeon,CEO,614-274-1455,300,dana@llchc.org,Lisa Skidmore,CFO,614-274-1455,320,lisas@llchc.org,
OH-008434,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1851474993,"Dental Providers, Federally Qualified Health Centers - Medical Services",1180 E Main St,,Columbus,OH,43205-1902,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008435,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1881756526,Federally Qualified Health Centers - Medical Services,1500 E 17th Ave,,Columbus,OH,43219-1002,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1939,,regina.browder@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008436,Planned Parenthood Greater Ohio-. Franklinton Health Center,Planned Parenthood of Greater Ohio,1205965753,Family Planning Providers,1511 W Broad St,,Columbus,OH,43222-1000,Franklin,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operaion,330-535-2674,1123,Lillian.Williams@ppoh.org,http://www.ppgoh.org
OH-008437,Lower Lights German Village,LOWER LIGHTS CHRISTIAN HEALTH CENTER INC,1669889044,Federally Qualified Health Centers - Medical Services,1560 S High St,,Columbus,OH,43207-1803,Franklin,1160 W Broad St,,Columbus,OH,43222,Franklin,Dana Vallangeon,CEO,614-274-1455,300,dana@llchc.org,Lisa SKidmore,CFO,614-274-1455,320,lisas@llchc.org,
OH-008438,"Southeast, Inc.","Southeast, Inc.",1194002857,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",16 W Long St,,Columbus,OH,43215-2815,Franklin,PO Box 1809,,Columbus,OH,43216-1809,Franklin,Amanda Gloeckner,Billing and Medical Records Manager,614-225-0980,1224,gloecknera@southeastinc.com,Emily Baker,Practice Manager,614-225-0980,1357,bakere@southeastinc.com,
OH-008439,Lower Lights 5th. Avenue,LOWER LIGHTS CHRISTIAN HEALTH CENTER INC,1053799916,Federally Qualified Health Centers - Medical Services,171 E 5th Ave,,Columbus,OH,43201-2860,Franklin,1160 W Broad St,,Columbus,OH,43222-1359,Franklin,Dana Vallangeon,CEO,614-274-1455,300,dana@llchc.org,Lisa Skidmore,CFO,614-274-1455,320,lisas@llchc.org,
OH-008440,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1194071050,Federally Qualified Health Centers - Medical Services,1791 Alum Creek Dr,Suite 100,Columbus,OH,43207-1708,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008441,North Columbus Health Center,Planned Parenthood of Greater Ohio,1336278860,Family Planning Providers,18 E 17th Ave,,Columbus,OH,43201-1568,Franklin,206 E State St,,Columbus,OH,43215-4311,Franklin,Erica Wilson Domer,Chief Administrative Officer,216-446-6211,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008442,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1710310594,Federally Qualified Health Centers - Medical Services,1905 Parsons Ave,,Columbus,OH,43207-1933,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008443,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1497817142,"Dental Providers, Federally Qualified Health Centers - Medical Services",2300 W Broad St,,Columbus,OH,43204-3783,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1939,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008444,Capital Park and Whitehall Family Health,Heart of Ohio Family Health,1275714289,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2365 Innis Rd,,Columbus,OH,43224-3730,Franklin,882 South Hamilton Road,,Columbus,OH,43213,Franklin,Yammah L. Morgan,Site Manager,614-416-4325,2218,ymorgan@hofhc.org,John Bell,CFO,614-338-6822,,jbell@hofhc.org,
OH-008445,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1720324064,Dental Providers,240 Parsons Ave,,Columbus,OH,43215-5331,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008446,Women's Health Family Planning Clinic,Columbus Public Health,1285874339,Family Planning Providers,240 Parsons Ave,,Columbus,OH,43215-5331,Franklin,240 Parsons Avenue,,Columbus,OH,43215,Franklin,Gretchen Bodnar,Program Manager III,614-645-6573,,GPBodnar@columbus.gov,Susan Hager,Fiscal Analyst,614-645-6541,,SMHager@columbus.gov,
OH-008447,The Ohio State University,Hemostasis and Thrombosis Center,1780621433,Hemophilia Treatment Centers,320 W 10th Ave,M414 Starling Loving,Columbus,OH,43210-1280,Franklin,320 W. 10th Ave.,M414 Starling Loving,Columbus,OH,43210,Franklin,"Leslie Witkoff, RN",Nurse Coordinator,614-293-6357,,leslie.witkoff@osumc.edu,"Eric Kraut, MD",Director Benign Hematology,614-293-2887,,,
OH-008448,EAST Health Center,Planned Parenthood of Greater Ohio,1568472207,Family Planning Providers,3255 E Main St,,Columbus,OH,43213-2739,Franklin,206 E State St,,Columbus,OH,43215-4311,Franklin,Erica Wilson Domer,VP of Finanical Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1161,Lillian.Williams@ppoh.org,
OH-008449,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1346304151,Federally Qualified Health Centers - Medical Services,3433 Agler Rd,Suite 2800,Columbus,OH,43219-3389,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1939,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008450,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1154485910,Federally Qualified Health Centers - Medical Services,3781 S High St,,Columbus,OH,43207-4011,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008451,"Southeast, Inc.","Southeast, Inc.",1922406008,Federally Qualified Health Centers - Medical Services,524B W Broad St,,Columbus,OH,43215-2758,Franklin,PO Box 1809,,Columbus,OH,43216-1809,Franklin,Amanda Gloeckner,Billing and Medical Records Manager,614-225-0980,1224,gloecknera@southeastinc.com,Emily Baker,Practice Manager Manager,614-225-0980,1357,baker3@southeastinc.com,
OH-008452,"Southeast, Inc.","Southeast, Inc.",1609284470,Federally Qualified Health Centers - Medical Services,595 Van Buren Dr,,Columbus,OH,43223-2230,Franklin,PO Box 1809,,Columbus,OH,43216-1809,Franklin,Amanda Gloeckner,Billing and Medical Records Manager,614-225-0980,1224,gloecknera@southeastinc.com,Emily Baker,Practice Manager,614-225-0980,1357,bakere@southeastinc.com,
OH-008453,NATIONWIDE CHILDREN'S HOSPITAL (children's inpatient hospital),NATIONWIDE CHILDREN'S HOSPITAL,1134152986,Children's Hospitals (inpatient only),700 Childrens Dr,,Columbus,OH,43205-2639,Franklin,700 Childrens Dr,,Columbus,OH,43205,Franklin,Brett Taylor,EVP and CAO & CFO,614-355-9859,,brett.taylor@nationwidechildrens.org,Brett A. Taylor,"Director, Payor Relations",614-722-2000,,brett.taylor@nationwidechildrens.org,http://www.nationwidechildrens.org/contact-th
OH-008454,NATIONWIDE CHILDREN'S HOSPITAL (multiple outpatient ECP categories),NATIONWIDE CHILDREN'S HOSPITAL,1134152986,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Hemophilia Treatment Centers, Outpatient Hospital Clinics, Ryan White Providers",700 Childrens Dr,,Columbus,OH,43205-2639,Franklin,700 Childrens Dr,,Columbus,OH,43205,Franklin,Brett Taylor,"Director, Payor Relations",614-355-9859,,brett.taylor@nationwidechildrens.org,Brett Taylor,"Director, Payor Relations",614-355-9859,,brett.taylor@nationwidechildrens.org,http://www.nationwidechildrens.org
OH-008455,Lower Lights Nursing Center,LOWER LIGHTS CHRISTIAN HEALTH CENTER INC,1144589193,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",777 W State St,Suite 201,Columbus,OH,43222-1523,Franklin,1160 W Broad St,,Columbus,OH,43222-1359,Franklin,Dana Vallangeon,CEO,614-274-1455,300,dana@llchc.org,Lisa Skidmore,CFO,614-274-1455,320,lisas@llchc.org,
OH-008456,AHF Healthcare Center - Columbus,AIDS Healthcare Foundation,1093089831,"Other ECP Providers, Ryan White Providers",815 W Broad St,,Columbus,OH,43222-1464,Franklin,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,3234365025,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
OH-008457,UNIVERSITY HOSPITALS CONNEAUT MEDICAL CENTER,University Hospitals Health System,1902996119,Rural Health Clinics,158 W Main Rd,,Conneaut,OH,44030-2039,Ashtabula,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008458,Hopewell Health Centers - Coolville,"HOPEWELL HEALTH CENTERS, INC",1912343955,Federally Qualified Health Centers - Medical Services,25716 Wilson St,,Coolville,OH,45723-8153,Athens,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-4366,2004,mbridenbaugh@hopewellhealth.org,Nicole White,Billing Manager,740-773-4366,2012,nwhite@hopewellhealth.org,
OH-008459,Coshocton Co. Family Planning Clinic,Kno-Ho-Co. CAC,1356481436,"Family Planning Providers, Sexually Transmitted Disease Clinics",120 N 4th St,,Coshocton,OH,43812-1504,Coshocton,120 N 4th St,,Coshocton,OH,43812-1504,Coshocton,Kelly Corrigan,Administrator,740-622-9801,1030,kcorrigan@knohoco.org,Faun McWilliams,RN,419-289-1700,,ashlandfp@knohoco.org,www.knohoco.org
OH-008460,MUSKINGUM VALLEY HEALTH CENTERS,MUSKINGUM VALLEY HEALTH CENTERS,1902237084,"Dental Providers, Federally Qualified Health Centers - Medical Services",406 S 15th St,,Coshocton,OH,43812-2285,Coshocton,859 N Main St,,Malta,OH,43758-9007,Morgan,Daniel J Atkinson,Chief Executive Officer,740-891-9090,,datkinson@mvhealthcenters.org,,,,,,
OH-008461,DAYTON CHILDREN'S HOSPITAL (children's inpatient hospital),DAYTON CHILDREN'S HOSPITAL,1457379448,Children's Hospitals (inpatient only),1 Childrens Plz,,Dayton,OH,45404-1873,Montgomery,1 Childrens Plz,,Dayton,OH,45404-1873,Montgomery,Darlene Flanigan,Revenue Cycle Analyst,937-641-3462,,flanigand@childrensdayton.org,,,,,,www.childrensdayton.org
OH-008462,DAYTON CHILDREN'S HOSPITAL (hemophilia treatment centers),DAYTON CHILDREN'S HOSPITAL,1457379448,Hemophilia Treatment Centers,1 Childrens Plz,,Dayton,OH,45404-1873,Montgomery,1 Childrens Plz,,Dayton,OH,45404-1873,Montgomery,Darlene Flanigan,Revenue Cycle Analyst,937-641-3462,,flanigand@childrensdayton.org,,,,,,www.childrensdayton.org
OH-008463,Five Rivers Center for Women's Health,FIVE RIVERS HEALTH CENTERS,1902169329,Federally Qualified Health Centers - Medical Services,1 Wyoming St,,Dayton,OH,45409-2722,Montgomery,2261 Philadelphia Drive,,Dayton,OH,45406-1814,Montgomery,Dave Bridge,Chief Financial Officer,937-734-6846,,dlbridge@PremierHealth.com,Tara Brown,Billing Manager,937-734-6846,,trroesch@PremierHealth.com,
OH-008464,"AIDS Resource Center Ohio Medical Center, Dayton","AIDS Resource Center Ohio, Inc",1952661373,Ryan White Providers,1222 S Patterson Blvd,Suite 220,Dayton,OH,45402-2643,Montgomery,4400 N High Street,Ste 300,Columbus,OH,43214,Franklin,Anna Wuerth,Director of Healthcare Operations,614-340-6754,,annawuerth@arcohio.org,Trent Stechschulte,Compliance Officer,614-340-6781,,trentstechschulte@arcohio.org,www.arcohio.org
OH-008465,Community Health Centers of Greater Dayton - Charles Drew Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1396986808,Federally Qualified Health Centers - Medical Services,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008466,Community Health Centers of Greater Dayton - Victor Cassano Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1265721542,Federally Qualified Health Centers - Medical Services,165 S Edwin C Moses Blvd,,Dayton,OH,45402-8472,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008467,Childrens Home Care of Dayton (children's inpatient hospital),Childrens Home Care of Dayton,1477722031,Children's Hospitals (inpatient only),18 Childrens Plz,,Dayton,OH,45404-1816,Montgomery,18 Childrens Plaza,,Centerville,OH,45404-1815,Montgomery,Peggy Doyle,Director of Home Care,937-641-5345,5345,doylep@childrensdayton.org,Juliene Vancleve,Administrative Manager,937-641-5344,5344,vanclevej@childrensdayton.org,
OH-008468,Childrens Home Care of Dayton (hemophilia treatment centers),Childrens Home Care of Dayton,1477722031,Hemophilia Treatment Centers,18 Childrens Plz,,Dayton,OH,45404-1816,Montgomery,18 Childrens Plaza,,Centerville,OH,45404-1815,Montgomery,Peggy Doyle,Director of Home Care,937-641-5345,5345,doylep@childrensdayton.org,Juliene Vancleve,Administrative Manager,937-641-5344,5344,vanclevej@childrensdayton.org,
OH-008469,Community Health Centers of Greater Dayton - East Dayton Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1689815482,"Dental Providers, Federally Qualified Health Centers - Medical Services",2132 E 3rd St,,Dayton,OH,45403-1991,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008470,Kettering Philips Center (Dayton),Planned Parenthood Southwest Ohio Region,1033176490,"Family Planning Providers, Sexually Transmitted Disease Clinics",224 N Wilkinson St,,Dayton,OH,45402-3011,Montgomery,2314 Auburn Ave,,Cincinnati,OH,45219,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008471,Five Rivers Family Health Center,FIVE RIVERS HEALTH CENTERS,1053600775,Federally Qualified Health Centers - Medical Services,2261 Philadelphia Dr,,Dayton,OH,45406-1814,Montgomery,2261 Philadelphia Dr,,Dayton,OH,45406-1814,Montgomery,Dave Bridge,Chief Financial Officer,937-734-6846,,dlbridge@PremierHealth.com,Tara Brown,Billing Manager,937-734-6846,,trroesch@PremierHealth.com,
OH-008472,Community Health Centers of Greater Dayton - Corwin Nixon Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1902047707,Federally Qualified Health Centers - Medical Services,2349 Stanley Ave,,Dayton,OH,45404-1201,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008473,Community Health Centers of Greater Dayton - Southview Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1134468549,Community Mental Health Centers,25 Thorpe Dr,,Dayton,OH,45420-1823,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008474,Five Rivers Dental Center,FIVE RIVERS HEALTH CENTERS,1962840884,Dental Providers,30 E Apple St Lowr Level,,Dayton,OH,45409-2939,Montgomery,2261 Philadelphia Drive,,Dayton,OH,45406-1814,Montgomery,Dave Bridge,Chief Financial Officer,937-734-6846,,dlbridge@PremierHealth.com,Tara Brown,Billing Manager,937-734-6846,,trroesch@PremierHealth.com,
OH-008475,Five Rivers Medical Surgical Health Center,FIVE RIVERS HEALTH CENTERS,1093004707,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",725 S Ludlow St,,Dayton,OH,45402-2610,Montgomery,2261 Philadelphia Drive,,Dayton,OH,45406-1814,Montgomery,Dave Bridge,Chief Financial Officer,937-734-6846,,dlbridge@PremierHealth.com,Tara Brown,Billing Manager,937-734-6846,,trroesch@PremierHealth.com,
OH-008476,Five Rivers Samaritan Homeless Clinic,Five Rivers Health Centers,1356721286,"Dental Providers, Federally Qualified Health Centers - Medical Services",921 S Edwin C Moses Blvd,,Dayton,OH,45417-3464,Montgomery,2261 Philadelphia Drive,,Dayton,OH,45406,Montgomery,Dave Bridge,Chief Financial Officer,937-734-6846,,dlbridge@PremierHealth.com,Tara Brown,Billing Manager,937-734-6846,,trroesch@PremierHealth.com,
OH-008477,Defiance Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1780929729,Federally Qualified Health Centers - Medical Services,211 Biede Ave,,Defiance,OH,43512-2408,Defiance,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008478,Trinity Hospital Twin City,Trinity Hospital Twin City,1992096192,Inpatient Hospitals (other than children's hospitals),819 N 1st St,,Dennison,OH,44621-1003,Tuscarawas,Trinity Hospital Twin City,819 N. First Street,Dennison,OH,44621,Tuscarawas,Halli Sell,Director of Finance,740-922-7450,2180,hsell@trinitytwincity.org,Jennifer Demuth,Grant Coordinator,740-922-7450,2198,jdemuth@trinitytwincity.org,www.trinitytwincity.org
OH-008479,Community Family Health Center,"Community Mental Healthcare, Inc.",1487035986,Federally Qualified Health Centers - Medical Services,204 S Bellevue Ave,,Dover,OH,44622-9405,Tuscarawas,201 Hospital Drive,,Dover,OH,44622,Tuscarawas,eric riley,Health Center Administrator,234-801-4747,100,ergrady@gmail.com,,,,,,
OH-008480,The Union Hospital Association,The Union Hospital Association,1871606921,Inpatient Hospitals (other than children's hospitals),659 Boulevard St,,Dover,OH,44622,Tuscarawas,659 Boulevard,,Dover,OH,44622,Tuscarawas,Eugene A Thorn,CFO,330-343-3311,2405,genet@unionhospital.org,Marian Hillyer,"Director, Managed Care Contracting",330-602-0770,,marianh@unionhospital.org,
OH-008481,Tuscarawas Co. General Health District,Tuscarawas County General Health District,1346203122,"Dental Providers, Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",897 E Iron Ave,,Dover,OH,44622-2030,Tuscarawas,897 E Iron Ave,,Dover,OH,44622-2030,Tuscarawas,Katie Seward,Health Commissioner/Executive Director,330-343-5555,164,sewardkatie@gmail.com,Amy Kaser,Director of Nursing,330-343-5555,180,amy.kaser1@gmail.com,www.tchdnow.org
OH-008482,PrimaryOne Health,"COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.",1538569827,Federally Qualified Health Centers - Medical Services,299 Cramer Creek Ct,,Dublin,OH,43017-2586,Franklin,1800 Watermark Dr Ste 420,,Columbus,OH,43215-1072,Franklin,Fikru L. Nigusse,Chief Financial Officer,614-859-1902,,fikru.nigusse@primaryonehealth.org,Regina D. Browder,Credentialing Specialist,614-859-1939,,regina.browder@primaryonehealth.org,primaryonehealth.org
OH-008483,NEON East Cleveland Health Center,"NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",1033142989,"Dental Providers, Federally Qualified Health Centers - Medical Services",15201 Euclid Ave,,East Cleveland,OH,44112-2803,Cuyahoga,4800 Payne Avenue,,Cleveland,OH,44103-2443,Cuyahoga,Vicki Marie,Provider Relations Manager,216-231-7700,1175,mariev@neonhealth.org,"Willie F. Austin, Sr.",President & CEO,216-231-7700,1112,austinwfsr@aol.com,http://www.neonhealth.org/
OH-008484,CAA Health and Behavioral Health Center at East Liverpool,COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC,1427002161,Federally Qualified Health Centers - Medical Services,16687 Saint Clair Ave,,East Liverpool,OH,43920-9401,Columbiana,7880 Lincole Pl,,Lisbon,OH,43920,Columbiana,Terri Welker,Executive Assistant/Credentialing Specialist,330-424-7221,113,terri.welker@caaofcc.org,Mary Ann Pettibon,Chief Executive Officer,330-424-7221,103,maryann.pettibon@caaofcc.org,www.caaofcc.org
OH-008485,Preble County General Health District,Preble County General Health District,1346338688,"Family Planning Providers, Sexually Transmitted Disease Clinics",615 Hillcrest Dr,,Eaton,OH,45320-8559,Preble,615 Hillcrest Dr,,Eaton,OH,45320-8559,Preble,Nanette Smith,Director of Nursing,937-472-0087,239,nan@preblecountyhealth.org,George E. Henry,Board President,937-472-0087,200,pchd@preblecountyhealth.org,http://www.preblecountyhealth.org
OH-008486,Lorain County Health & Dentistry #004,LORAIN COUNTY HEALTH & DENTISTRY,1720485659,Federally Qualified Health Centers - Medical Services,105 Louden Ct,,Elyria,OH,44035-8027,Lorain,1205 Broadway,,Lorain,OH,44052-3409,Lorain,Stephanie Wiersma,CEO,440-233-0159,,Stephanie.Wiersma@lorainhealth-dentistry.org,Lisa M. Hemker,CFO,440-240-1655,,Credentialing@lorainhealth-dentistry.org,
OH-008487,Lorain County Health & Dentistry #003,LORAIN COUNTY HEALTH & DENTISTRY,1891030128,Federally Qualified Health Centers - Medical Services,412 E River St,Suite F,Elyria,OH,44035-5252,Lorain,1205 Broadway,,Lorain,OH,44052-3409,Lorain,Stephanie Wiersma,CEO,440-233-0159,,Credentialing@lorainhealth-dentistry.org,Lisa M. Hemker,CFO,440-240-1655,,Credentialing@lorainhealth-dentistry.org,
OH-008488,Family Planning Services of Lorain County,"Family Planning Services of Lorain County, OH",1629193677,"Family Planning Providers, Sexually Transmitted Disease Clinics",602 Leona St,,Elyria,OH,44035-2404,Lorain,602 Leona St,,Elyria,OH,44035-2404,Lorain,Pat Berger,Project Director,440-322-7526,109,patlberger@aol.com,,,,,,
OH-008489,Primary Health Solutions,Primary Health Solutions,1689046120,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",211 Donald Dr Suite B,Fairfield School-Based Health Center,Fairfield,OH,45014-3006,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,kefolz@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008490,Community Health Services - Fostoria,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",502 Van Buren St,,Fostoria,OH,44830-1533,Hancock,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008491,Talbert House Health Center,TALBERT HOUSE HEALTH CENTER,1265876809,"Dental Providers, Federally Qualified Health Centers - Medical Services",333 Conover Dr,Suite B,Franklin,OH,45005-1900,Warren,333 Conover Dr Ste B-D,,Franklin,OH,45005-1900,Warren,Dolores Glenn,CEO,513-318-1188,,lorieglenn@hotmail.com,Judith Mount,HR Administrator,513-318-1188,,judith.mount@centerpointhealth.org,www.centerpointhealth.org
OH-008492,FREEPORT FAMILY HEALTH CENTER,Ohio Hills Health Services,1275579484,"Dental Providers, Federally Qualified Health Centers - Medical Services",110 W Main St,,Freeport,OH,43973,Harrison,101 E Main St,,Barnesville,OH,43713-1005,Belmont,Jeffrey Britton,Executive Director,740-425-5165,,jbritton@ohiohillshealthservices.com,Lana Phillips,Community Services Director,740-425-5167,,lphillips@ohiohillshealthservices.com,
OH-008493,FREMONT FAMILY PRACTICE,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1220 E State St,,Fremont,OH,43420-4360,Sandusky,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008494,WEST SIDE PEDIATRICS ASSOCIATES,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2276 W State St,,Fremont,OH,43420-1439,Sandusky,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008495,COMMUNITY HEALTH SERVICES,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008496,BIRCHARD MEDICAL CENTER,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",418 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008497,Galion Hospital,Avita Health System,1215907522,Inpatient Hospitals (other than children's hospitals),269 Portland Way S,,Galion,OH,44833-2312,Crawford,269 Portland Way South,,Galion,OH,44833,Crawford,Rhonda Ridenour,"Director, Patient Financial Services",419-468-0511,5511,rridenour@avitahs.org,Theresa Holzwarth,Enrollment Coordinator,419-462-3328,5328,tholzwarth@avitahs.org,
OH-008498,Holzer,Holzer Health System,1942256888,Freestanding Cancer Centers,100 Jackson Pike,,Gallipolis,OH,45631-1560,Gallia,100 Jackson Pike,,Gallipolis,OH,45631,Gallia,Craig Mason,Credentialing Assistant Manager,740-441-1934,,cmason@holzer.org,Mike Haynes,Interim CFO,740-446-5335,,mhaynes@holzer.org,
OH-008499,Gallia County General Health District,State of Ohio -- Dept. of Health,1366576621,Family Planning Providers,499 Jackson Pike,,Gallipolis,OH,45631-1398,Gallia,499 Jackson Pike,,Gallipolis,OH,45631-1398,Gallia,Patty Toler,Family Planning Coordinator,740-441-2956,,patty.toler@odh.ohio.gov,,,614-387-0652,,,http://www.galliacohealth.org
OH-008500,University Hospitals Geneva Medical Center,University Hospitals Health System,1225128432,Rural Health Clinics,870 W Main St,,Geneva,OH,44041-1219,Ashtabula,3605 Warrensville Center Road,MSC 9150,Shaker Heights,OH,44122-5203,Cuyahoga,Shannon DeLozier,Director of Managed Care,216-767-8722,,shannon.delozier@uhhospitals.org,,,,,,
OH-008501,GEORGETOWN PEDIATRICS,"HEALTHSOURCE OF OHIO, INC.",1255372207,Federally Qualified Health Centers - Medical Services,5160 State Route 125,,Georgetown,OH,45121-9518,Brown,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008502,Hopewell Health Centers - Trimble,"HOPEWELL HEALTH CENTERS, INC",1174931000,Federally Qualified Health Centers - Medical Services,18500 Jacksonville Rd,,Glouster,OH,45732-9337,Athens,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-4366,2004,mbridenbaugh@hopewellhealth.org,Nicole White,Billing Manager,740-773-4366,2012,nwhite@hopewellhealth.org,
OH-008503,Highland County Greenfield Outreach,Highland Co. CAO,1861541039,Family Planning Providers,348 South St,,Greenfield,OH,45123-1430,Highland,1487 N High St Suite 500,,Hillsboro,OH,45133-8496,Highland,Ada Amburgey,Project Director,937-393-3060,151,adaamburgeyrn@yahoo.com,Julia Wise,HCCAO Executive Director,937-393-3458,112,,http://hccao.org
OH-008504,"Family Health Services of Darke County, Inc.","Family Health Services of Darke County, Inc.",1366419293,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",5735 Meeker Rd,,Greenville,OH,45331-1180,Darke,5735 Meeker Rd.,,Greenville,OH,45331,Darke,Jean Young,Executive Director,937-548-3806,1031,jyoung@familyhealthservices.org,Shaun Hyre,Certified Application Counselor,937-548-9680,1900,shyre@familyhealthservices.org,
OH-008505,Mary Stark Center (Hamilton),Planned Parenthood Southwest Ohio Region,1093876179,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",11 Ludlow St,,Hamilton,OH,45011-2919,Butler,2314 Auburn Ave,,Cincinnati,OH,45219,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008506,Bever,Primary Health Solutions,1295102127,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",210 S 2nd St,,Hamilton,OH,45011-2811,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,kefolz@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008507,Primary Health Solutions,Primary Health Solutions,1467825158,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",250 N Fair Ave,Hamilton School-Based Health Center,Hamilton,OH,45011-4222,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,kefolz@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008508,Hamilton West,Primary Health Solutions,1346579422,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",903 NW Washington Blvd,Suite A,Hamilton,OH,45013-6367,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,kefolz@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008509,Highland Co. Family Planning Hillsboro Clinic,Highland Co. CAO,1861541039,Family Planning Providers,1487 N High St,Suite 500,Hillsboro,OH,45133-6812,Highland,1487 N High St Suite 500,,Hillsboro,OH,45133-8496,Highland,Ada Amburgey,Clinic Director,937-393-3060,151,adaamburgeyrn@yahoo.com,Julia Wise,HCCAO Executive Director,937-393-3458,112,,http://hccao.org
OH-008510,Western Lucas County Clinic,Toledo-Lucas County Health Department,1669875332,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",330 Oak Terrace Blvd,,Holland,OH,43528-8993,Lucas,635 N. Erie St,Rm 272,Toledo,OH,43604-5317,Lucas,Kathy Fuhr,"Supervisor, Billing",419-213-4049,,fuhrk@co.lucas.oh.us,Jessica Lupica,Billing Account Clerk,419-213-4090,,fuhrk@co.lucas.oh.us,
OH-008511,Ironton Health Care Campus,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1093022287,"Dental Providers, Federally Qualified Health Centers - Medical Services",1408 Campbell Dr,,Ironton,OH,45638-2301,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosheri@live.com,
OH-008512,Lawrence County Health Dept,Lawrence County Health Dept,1437375904,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2122 S 8th St,,Ironton,OH,45638-2598,Lawrence,2122 South 8th street,,Ironton,OH,45638,Lawrence,Georgia Dillon,Whnp /adm,740-532-3962,,georgia.dillon@odh.ohio.gov,,,,,,
OH-008513,Ironton Family Medical Center,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1821175720,Federally Qualified Health Centers - Medical Services,304 N 2nd St,,Ironton,OH,45638-1491,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosheri@live.com,
OH-008514,Ironton And Lawrence County Area Community Action,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1093022287,"Dental Providers, Federally Qualified Health Centers - Medical Services",305 N 5th St,,Ironton,OH,45638-1578,Lawrence,305 N 5th Street,,Ironton,OH,45638-1578,Lawrence,Nancy J. Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosheri@live.com,
OH-008515,JACKSON FAMILY HEALTH CENTER,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1023100955,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",14590 State Route 93,,Jackson,OH,45640-8977,Jackson,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008516,KENT HEALTH CENTER,Planned Parenthood of Greater Ohio,1750486171,Family Planning Providers,138 E Main St Ste 202,2nd Floor,Kent,OH,44240-1408,Portage,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008517,AxessPointe Kent,AxessPointe Community Health Center,1376796862,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",143 Gougler Ave,,Kent,OH,44240-2401,Portage,1400 s arlington st,Suite 38,Akron,OH,44306,Summit,Heather Gunnoe,Certified Application Counselor,888-975-9188,1186,hgunnoe@axesspointe.org,LaTrice Snodgrass,Chief Operations Officer,888-975-9188,1115,lsnodgrass@axesspointe.org,www.axesspointe.org
OH-008518,AxessPointe/Kent,"AxessPointe Community Health Center, Inc.",1396045571,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1993 State Route 59,,Kent,OH,44240-7609,Portage,676 S. Broadway Street,Suite 202,Akron,OH,44311,Summit,Kristine Drummond,CEO,330-785-2051,,CEO@axesspointe.org,Christopher Richardson,COO,330-785-2051,,crichardson@axesspointe.org,www.axesspointe.org
OH-008519,Kenton Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1346588597,"Dental Providers, Federally Qualified Health Centers - Medical Services",111 W Espy St,,Kenton,OH,43326-2117,Hardin,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008520,Aid Family Medical Center,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1770839276,Federally Qualified Health Centers - Medical Services,13804 State Route 141,,Kitts Hill,OH,45645-8848,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosheri@live.com,
OH-008521,Fairfield Community Health Center,FAIRFIELD COMMUNITY HEALTH CENTER,1457676736,Federally Qualified Health Centers - Medical Services,1155 E Main St,,Lancaster,OH,43130-4056,Fairfield,1155 E Main St,,Lancaster,OH,43130-4056,Fairfield,Lisa A. Evangelista,CEO,740-277-6043,1003,levangelista@fairfieldchc.org,,,,,,www.fairfieldchc.org
OH-008522,Fairfield Healthcare Professionals Infectious Disease Wound Care,"Fairfield Healthcare Professionals, Inc.",1457396368,Ryan White Providers,135 N Ewing St,Suite 303,Lancaster,OH,43130-3379,Fairfield,1153 E Main St,PO Box 2563,Lancaster,OH,43130,Fairfield,Sky Gettys,C.F.O.,740-687-8011,,skyg@fmchealth.org,Sharon Scruggs,Revenue Cycle Manager,740-687-8235,,sharons@fmchealth.org,
OH-008523,Fairfield Community Health Center - Hunter Trace,FAIRFIELD COMMUNITY HEALTH CENTER,1922301878,Federally Qualified Health Centers - Medical Services,216 Trace Dr,,Lancaster,OH,43130-4151,Fairfield,1155 E Main St,,Lancaster,OH,43130-4056,Fairfield,Lisa A. Evangelista,CEO,740-277-6043,1003,levangelista@fairfieldchc.org,,,,,,www.fairfieldchc.org
OH-008524,Fairfield Medical Center,Fairfield Medical Center,1467433763,"Outpatient Hospital Clinics, Ryan White Providers",401 N Ewing St,,Lancaster,OH,43130-3372,Fairfield,401 N Ewing St,,Lancaster,OH,43130,Fairfield,Sky Gettys,CFO,740-687-8011,,skyg@fmchealth.org,Sharon Scruggs,Revenue Cycle Manager,740-687-8235,,sharons@fmchealth.org,
OH-008525,HealthSource-Lebanon,"HEALTHSOURCE OF OHIO, INC.",1841624350,Federally Qualified Health Centers - Medical Services,1231 Columbus Ave,Unit A1,Lebanon,OH,45036-8196,Warren,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008526,Warren County Combined Health District,State of Ohio -- Dept. of Health,1326108838,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",416 S East St,,Lebanon,OH,45036-2378,Warren,416 S East St,,Lebanon,OH,45036,Warren,Lori Smyth,Project Direct Director/ Director of Nursing,513-695-1564,,lsmyth@wcchd.com,Ceyrrae Bailey,Secretary III,513-695-1152,,cbailey@wcchd.com,http://www.wcchd.com
OH-008527,Spartan Health Center,HEALTH PARTNERS OF WESTERN OHIO,1740694462,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Spartan Way,,Lima,OH,45801-4561,Allen,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008528,Health Partners - Quick Care,HEALTH PARTNERS OF WESTERN OHIO,1902228844,Federally Qualified Health Centers - Medical Services,1550 N Main St,,Lima,OH,45801-2823,Allen,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008529,Allen County Health Department,Allen County Public Health,1700921954,"Family Planning Providers, Tuberculosis Clinics",219 E Market St,,Lima,OH,45801-4913,Allen,219 E Market Street,,Lima,OH,45801,Allen,Deb Roberts,Director of Nursing,419-228-4457,111,droberts@allenhealthdept.org,Jackie Mericle,Clinic Aide III,419-228-4457,121,jmericle@allenhealthdept.org,
OH-008530,HEALTH PARTNERS OF WESTERN OHIO,HEALTH PARTNERS OF WESTERN OHIO,1811932288,"Dental Providers, Federally Qualified Health Centers - Medical Services",441 E 8th St,,Lima,OH,45804-2482,Allen,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008531,Community Action Agency Of Columbiana County Inc,COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC,1821041401,"Dental Providers, Federally Qualified Health Centers - Medical Services",7880 Lincole Pl,,Lisbon,OH,44432-8322,Columbiana,7880 Lincole Pl,,Lisbon,OH,44432-8322,Columbiana,Mary Ann Pettibon,Chief Executive Officer,330-424-7221,103,maryann.pettibon@caaofcc.org,Terri Welker,Executive Assistant/Credentialing Specialist,330-424-7221,113,terri.welker@caaofcc.org,www.caaofcc.org
OH-008532,Hopewell Health Centers - Logan,"HOPEWELL HEALTH CENTERS, INC.",1881781144,Federally Qualified Health Centers - Medical Services,1383 W Hunter St,,Logan,OH,43138-1013,Hocking,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-1006,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008533,Hocking Valley Community Hospital,Hocking Valley Community Hospital,1295840007,Inpatient Hospitals (other than children's hospitals),601 State Route 664 N,,Logan,OH,43138-8541,Hocking,PO Box 966,,Logan,OH,43138,Hocking,Heather Smith,RCM Director,740-380-8127,8127,hasmith@hvch.org,Julie Grow,CFO,740-380-8389,8389,jgrow@hvch.org,
OH-008534,Rocking Horse Center - Madison,ROCKING HORSE CENTER,1770964850,Federally Qualified Health Centers - Medical Services,212 N Main St,,London,OH,43140-1115,Madison,651 S Limestone St,,Springfield,OH,45505-1965,Clark,Shonda E. Wallace,Chief Financial Officer,937-324-1111,114,swallace@rockinghorsecenter.org,Anne L. Carroll,Patient Accounts Manager,937-324-1111,182,acarroll@rockinghorsecenter.org,
OH-008535,Family Planning Services of Lorain County,Family Planning Services of Lorain County,1629193677,Family Planning Providers,1144 W Erie Ave,,Lorain,OH,44052-1445,Lorain,1144 W Erie Ave,,Lorain,OH,44052-1445,Lorain,Pat Berger,Project Director,440-322-7526,109,patlberger@aol.com,,,216-221-7496,,,
OH-008536,Lorain County Health & Dentistry #001,LORAIN COUNTY HEALTH & DENTISTRY,1841238417,"Dental Providers, Federally Qualified Health Centers - Medical Services",1205 Broadway,,Lorain,OH,44052-3409,Lorain,1205 Broadway,,Lorain,OH,44052-3409,Lorain,Stephanie Wiersma,CEO,440-233-0159,,Credentialing@lorainhealth-dentistry.org,Lisa M. Hemker,CFO,440-240-1655,,Credentialing@lorainhealth-dentistry.org,
OH-008537,Lorain Health Center,Planned Parenthood of Greater Ohio,1649618893,Family Planning Providers,200 W 9th St,Ywca Women S Center,Lorain,OH,44052-1981,Lorain,206 E State St,,Columbus,OH,43215-4311,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008538,Downtown Vision Center,"Brett D. McVey, O.D. Inc.",1639173453,Other ECP Providers,209 W 5th St,,Lorain,OH,44052-1609,Lorain,209 Fifth Street,,Lorain,OH,44052,Lorain,"Brett D. McVey, O.D.",President,440-246-2020,,drbmcvey@centurytel.net,,,,,,
OH-008539,Lorain County Health and Dentistry #002,LORAIN COUNTY HEALTH & DENTISTRY,1598930877,Federally Qualified Health Centers - Medical Services,3745 Grove Ave,,Lorain,OH,44055-2734,Lorain,1205 Broadway,,Lorain,OH,44052-3409,Lorain,Stephanie Wiersma,CEO,440-233-0159,,Credentialing@lorainhealth-dentistry.org,Lisa M. Hemker,CFO,440-240-1655,,Credentialing@lorainhealth-dentistry.org,
OH-008540,HealthSource Loveland,"HEALTHSOURCE OF OHIO, INC.",1306874326,Federally Qualified Health Centers - Medical Services,6535 Snider Rd,,Loveland,OH,45140-9588,Clermont,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008541,MUSKINGUM VALLEY HEALTH CENTERS,MUSKINGUM VALLEY HEALTH CENTERS,1528257789,Federally Qualified Health Centers - Medical Services,859 N Main St,,Malta,OH,43758-9007,Morgan,716 Adair Ave,,Zanesville,OH,43701,Muskingum,Daniel Atkinson,CEO,740-891-9090,,datkinson@mvhealthcenters.org,Melissa Leckrone,Executive Assistant,740-896-8395,,mleckrone@mvhealthcenters.org,www.mvhccares.org
OH-008542,Manchester Family Health Center,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1336550755,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",130 Wayne Frye Dr,,Manchester,OH,45144-9314,Adams,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008543,Mansfield Health Center,Planned Parenthood of Greater Ohio,1760471452,Family Planning Providers,384 Park Ave W,,Mansfield,OH,44906-3116,Richland,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008544,Third Street Family Health Services,Third Street Family Health Services,1336252519,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 W 3rd St,,Mansfield,OH,44906-2633,Richland,600 W Third Street,,Mansfield,OH,44906,Richland,Kari L Westfield,Outreach Coordinator,419-525-6767,,westfieldk@tsfhs.org,Nicole Williams,COO,419-522-6191,,,
OH-008545,Center Street Community Health Center,"CENTER STREET COMMUNITY CLINIC, INC.",1780984211,"Dental Providers, Federally Qualified Health Centers - Medical Services",136 W Center St,,Marion,OH,43302-3704,Marion,136 W Center St,,Marion,OH,43302-3704,Marion,Cliff Edwards,CEO,740-751-6614,,cedwards@centerstreetclinic.org,Audrey Adkins,CFO,740-751-4531,,aadkins@centerstreetclinic.org,
OH-008546,Lower Lights Union Star,LOWER LIGHTS CHRISTIAN HEALTH CENTER INC,1275957557,Federally Qualified Health Centers - Medical Services,773 S Walnut St,,Marysville,OH,43040-1643,Union,1160 W Broad St,,Columbus,OH,43222-1359,Franklin,Dana Vallangeon,CEO,614-274-1455,300,dana@llchc.org,Lisa Skidmore,CFO,614-274-1455,320,lisas@llchc.org,
OH-008547,Union County Health Department,State of Ohio -- Dept. of Health,1104875541,"Family Planning Providers, Sexually Transmitted Disease Clinics",940 London Ave,,Marysville,OH,43040-8036,Union,940 London Ave,,Marysville,OH,43040,Union,Joyce Richmond,Director of Nursing,937-645-2054,,joyce.richmond@uchd.net,Krista Finch,Certified Nurse Practitioner,937-645-2057,,krista.finch@uchd.net,http://www.uchd.net/
OH-008548,Massillon Health Center,"Lifecare Family Health and Dental Center, Inc.",1144694621,Federally Qualified Health Centers - Medical Services,820 Amherst Rd NE,,Massillon,OH,44646-8525,Stark,2725 Lincoln Street East,,Canton,OH,44707,Stark,Janet C. McPeek,CFO,234-521-7213,,jmcpeek@LifecareFHDC.org,,,,,,
OH-008549,Hopewell Health Centers - McArthur,"HOPEWELL HEALTH CENTERS, INC.",1003903360,"Dental Providers, Federally Qualified Health Centers - Medical Services",31891 State Route 93,,Mc Arthur,OH,45651-9006,Vinton,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-1006,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008550,Medina Health Center,Planned Parenthood of Greater Ohio,1245338698,Family Planning Providers,4018 Medina Rd,Suite C,Medina,OH,44256-9675,Medina,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,11161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,,
OH-008551,Community Health Centers of Greater Dayton - Alex Central Health Center,COMMUNITY HEALTH CENTERS OF GREATER DAYTON,1689913097,Federally Qualified Health Centers - Medical Services,5 Alexandersville Rd,,Miamisburg,OH,45342-3672,Montgomery,1323 W 3rd St,,Dayton,OH,45402-6714,Montgomery,Gregory Hopkins,Executive Director,937-586-9733,1023,ghopkins@chcgd.org,,,,,,
OH-008552,Middletown Community Health Center,Primary Health Solutions,1700821386,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",1036 S Verity Pkwy,,Middletown,OH,45044-5513,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,kefolz@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008553,Fulton Co Health Department Williams Co Clinic,Fulton Co. Health Dept.,1922155563,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",310 Lincoln Ave,PO Box 146,Montpelier,OH,43543-0146,Williams,310 Lincoln Ave,Po Box 146,Montpelier,OH,43543-1274,Williams,Stephanie Johnson,Clinic Director,419-337-0915,125,stefanie.johnson@odh.ohio.gov,Deb Roth,Nurse Practitioner,419-337-0915,120,deb.roth@odh.ohio.gov,http://williamscountyhealth.org
OH-012385,Recovery & Prevention Resources of Delaware and Morrow Counties,Recovery & Prevention Resources of Delaware and Morrow Counties,1508976705,Community Mental Health Centers,950 Meadow Dr,Suite C,Mount Gilead,OH,43338-1389,Morrow,118 Stover Drive,,Delaware,OH,43015-8601,Delaware,Tony Williams,Chief Executive Officer,740-369-6811,,tw@rprdm.org,Kristyn Dahler,CFO,740-369-6811,,kristyn.dahgler@rprdm.org,www.rprdm.org
OH-008554,Mt. Healthy Family Practice Center,"HEALTHCARE CONNECTION, INC.,THE",1154347789,Federally Qualified Health Centers - Medical Services,8146 Hamilton Ave,,Mount Healthy,OH,45231-2324,Hamilton,1401 Steffen Ave,,Cincinnati,OH,45215-2338,Hamilton,Dolores J Lindsay,CEO,513-483-3080,,doloresl@healthcare-connection.org,,,,,,
OH-008555,Mt. Orab,"HEALTHSOURCE OF OHIO, INC.",1417992330,"Dental Providers, Federally Qualified Health Centers - Medical Services",150 Health Partners Cir,,Mount Orab,OH,45154-8610,Brown,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008556,Knox County Community Health Center,Knox County General Health District,1740727510,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",11660 Upper Gilchrist Rd,,Mount Vernon,OH,43050-9084,Knox,11660 Upper Gilchrist Road,,Mount Vernon,OH,43050,Knox,Lane K. Belangia,CEO,740-392-2200,2275,lbelangia@knoxhealth.com,Debbie Eiden,Clinical Supervisor,740-392-2200,2262,deiden@knoxhealth.com,www.knoxhealth.com
OH-008557,Knox Co. Family Planning,Kno-Ho-Co. CAC,1356481436,"Family Planning Providers, Sexually Transmitted Disease Clinics",69 Sychar Rd,,Mount Vernon,OH,43050-1346,Knox,120 N 4th St,,Coshocton,OH,43812-1504,Coshocton,Kelly Corrigan,Administrator,740-622-9801,1030,kcorrigan@knohoco.org,Faun McWilliams,RN,419-289-1700,,ashlandfp@knohoco.org,http://www.knohoco.org
OH-008558,Henry County Health Department,Henry County Health Department Reproductive Health and Wellness,1043270374,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1843 Oakwood Ave,,Napoleon,OH,43545-9243,Henry,1843 Oakwood Avenue,,Napoleon,OH,43545-9243,Henry,Barbara Hoffman,R N,419-599-5545,1278,bhoffman@henrycohd.org,Nancy Bannister,Billing Clerk,419-599-5545,1302,nbannister@henrycohd.org,
OH-008559,Community Health Services - Napoleon,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",407 Independence Dr,,Napoleon,OH,43545-8662,Henry,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008560,New Carlisle Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1760640817,"Dental Providers, Federally Qualified Health Centers - Medical Services",106 N Main St,,New Carlisle,OH,45344-1835,Clark,441 E 8th St,,Lima,OH,45804-2482,Allen,Janis L Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008561,Perry County Family Practice,Perry County Family Practice,1174792014,Rural Health Clinics,1625 Airport Rd,,New Lexington,OH,43764-9749,Perry,1625 Airport Road,P.O. Box 596,New Lexington,OH,43764-0596,Perry,Theresa L Ulrich,Office Manager,740-342-5158,218,terri@pcfpohio.com,,,,,,
OH-008562,Hopewell Health Centers - New Lexington,"HOPEWELL HEALTH CENTERS, INC.",1972690238,Federally Qualified Health Centers - Medical Services,2541 Panther Dr NE,,New Lexington,OH,43764-9081,Perry,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-1006,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008563,New Richmond Family Practice,"HEALTHSOURCE OF OHIO, INC.",1942242284,Federally Qualified Health Centers - Medical Services,100 River Valley Blvd,,New Richmond,OH,45157-8566,Clermont,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008564,"Family Health Services of East Central Ohio,Inc.","Family Health Services of East Central Ohio, Inc.",1902855026,Family Planning Providers,100 McMillen Dr,,Newark,OH,43055-1809,Licking,100 McMillen drive,,Newark,OH,43055,Licking,Kimberly Mason,Executive Director,740-344-9291,,kimmson@alink.com,,,,,,
OH-008565,Falls Family Care,"OHIO NORTH EAST HEALTH SYSTEMS, INC.",1477920205,Federally Qualified Health Centers - Medical Services,175 E Broad St,,Newton Falls,OH,44444-1708,Trumbull,726 Wick Ave,,Youngstown,OH,44505-2827,Mahoning,"Ronald Dwinnells, M.D.",CEO,330-747-2330,,rdwinnells@onehealthohio.org,,,,,,
OH-008566,Huron County Public Health,Huron County Public Health,1588619696,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",180 Milan Ave,Suite 8,Norwalk,OH,44857-1168,Huron,180 Milan Avenue,Suite 8,Norwalk,OH,44857,Huron,Christina Cherry,Director of Nursing,419-668-1652,230,ccherry@huroncohealth.com,Karen Boose,Director of Administrative Services,419-668-1652,257,kboose@huroncohealth.com,http://www.huroncohealth.com
OH-008567,Oberlin,Lorain County Health & Dentistry,1821464306,"Dental Providers, Federally Qualified Health Centers - Medical Services",260 Main St,,Oberlin,OH,44074,Lorain,1205 Broadway Ave/Billing/Mail/Main Office,,Lorain,OH,44052-3409,Lorain,Lisa M. Hemker,CFO,440-240-1655,,Credentialing@lorainhealth-dentistry.org,Wanda Washington,Credentialing Associate,440-240-1655,5011,Wanda.Washington@lorainhealth-dentistry.org,
OH-008568,Dunlap Family Physicians,Orrville Hospital Foundation,1891718375,Rural Health Clinics,830 S Main St,,Orrville,OH,44667-2291,Wayne,832 S Main St,,Orrville,OH,44667,Wayne,Nathan Ritter,Associate CFO,330-684-4763,,nathan.ritter@aultman.com,Cy Naumoff,Risk Management Director,330-684-4700,,cy.naumoff@aultman.com,
OH-008569,Aultman Orrville Hospital,Orrville Hospital Foundation,1891718375,Inpatient Hospitals (other than children's hospitals),832 S Main St,,Orrville,OH,44667-2208,Wayne,832 S Main St,,Orrville,OH,44667,Wayne,Nathan Ritter,Associate CFO,330-684-4763,,nathan.ritter@aultman.com,Cy Naumoff,Risk Management Director,330-684-4700,,cy.naumoff@aultman.com,
OH-008570,Oxford Community Health Center,Primary Health Solutions,1225400765,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",10 N Locust St,Suite A,Oxford,OH,45056-1182,Butler,210 S. 2nd Street,Floor 2,Hamilton,OH,45011,Butler,Ken Folz,Chief Financial Officer,513-454-1468,,stephenr@myprimaryhealthsolutions.org,Marc Bellisario,Chief Executive officer,513-454-1459,,marcb1@myprimaryhealthsolutions.org,
OH-008571,"Family Planning Association of Northeast Ohio, Inc","Family Planning Association of Northeast Ohio, Inc",1033100888,"Family Planning Providers, Sexually Transmitted Disease Clinics",54 S State St,Suite 203,Painesville,OH,44077-3445,Lake,54 S State St,Suite 203,Painesville,OH,44077,Lake,Mary Wynne-Peaspanen,Executive Director,440-352-0608,14,mwp@fpaneo.org,,,,,,http://www.fpaneo.org
OH-008572,Cuyahoga County Board of Health,State of Ohio -- Dept. of Health Reproductive Health and Wellness Program,1164577904,"Family Planning Providers, Sexually Transmitted Disease Clinics",5550 Venture Dr,,Parma,OH,44130-9315,Cuyahoga,5550 Venture Dr,,Parma,OH,44130-9315,Cuyahoga,Katie Stadler,Project Director,216-201-2001,1361,kstadler@ccbh.net,Andrew Heffron,Supervisor,216-201-2001,1310,aheffron@cccbh.net,www.ccbh.net
OH-008573,PIKETON FAMILY HEALTH CENTER,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1912099839,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",7777 US Highway 23,,Piketon,OH,45661-9102,Pike,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008574,Meigs County Health Department,Meigs County Health Department,1467454546,Family Planning Providers,112 E Memorial Dr,Suite A,Pomeroy,OH,45769-9569,Meigs,112 East Memorial Drive,Suite A,Pomeroy,OH,45769,Meigs,Courtney Midkiff,Administrator,740-992-6626,1028,courtney.midkiff@meigs-health.com,Sherry Hayman,RHWP Nurse,740-992-6626,1036,sherry.hayman@meigs-health.com,www.meigs-health.com
OH-008575,Hopewell Health Centers - Pomeroy,"HOPEWELL HEALTH CENTERS, INC.",1013101757,"Dental Providers, Federally Qualified Health Centers - Medical Services",41865 Pomeroy Pike,,Pomeroy,OH,45769-9473,Meigs,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-1006,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008576,Ottawa Co. Health Dept.,State of Ohio -- Dept. of Health Reproductive Health and Wellness Program,1669514303,"Family Planning Providers, Sexually Transmitted Disease Clinics",1856 E Perry St,,Port Clinton,OH,43452-1497,Ottawa,1856 E Perry St,,Port Clinton,OH,43452-1497,Ottawa,Nancy Osborn,Health Commissioner,419-734-6800,,nosborn@cros.net,,,,,,http://www.ottawahealth.org
OH-008577,H.B. Magruder Memorial Hospital,H.B. Magruder Memorial Hospital,1922079532,Inpatient Hospitals (other than children's hospitals),615 Fulton St,,Port Clinton,OH,43452-2001,Ottawa,615 Fulton Street,,Port Clinton,OH,43452-2001,Ottawa,Ronald Weiner,VP Finance & CFO,419-734-3131,3121,rweiner@magruderhospital.com,,,,,,
OH-008578,Compass Community Health,COMPASS COMMUNITY HEALTH,1902298466,Federally Qualified Health Centers - Medical Services,1634 11th St,,Portsmouth,OH,45662-4526,Scioto,923 Findlay Street,,Portsmouth,OH,45662,Scioto,Summer Kirby,CEO,740-355-7102,1514,skirby@compasscommunity.org,Beth Shoemaker,Data and Quality Coordinator,740-355-7102,1521,bshoemaker@compasscommunityhealth.org,www.compasscommunityhealth.org
OH-008579,WEST PORTSMOUTH FAMILY PRACTICE,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1003908930,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",23030 State Route 73,,Portsmouth,OH,45663-8861,Scioto,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008580,Portsmouth City Health Department,State of Ohio -- Dept. of Health,1790847101,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",605 Washington St,,Portsmouth,OH,45662-3919,Scioto,605 Washington St,,Portsmouth,OH,45662-3919,Scioto,Christine Thomas,Director of Nursing,740-353-8863,0,Christine.Thomas@portsmouthoh.org,,,740-353-8863,,,http://portsmouthoh.org/health/clinic-nursing
OH-008581,Broadway Street Clinic,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1790116218,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",621 Broadway St,,Portsmouth,OH,45662-4788,Scioto,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008582,Portsmouth Clinic,Shawnee Family Health Center,1336173236,Community Mental Health Centers,901 Washigton St,,Portsmouth,OH,45662,Scioto,901 Washington Street,,Portsmouth,OH,45662,Scioto,Cynthia Holstein,CEO,740-355-8686,,c.holstein@shawneemhc.org,Jill Cottrill,CFO,740-354-7702,1266,j.cottrill@shawneemhc.org,
OH-008583,Proctorville Health Care Center,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1912254574,"Dental Providers, Federally Qualified Health Centers - Medical Services",10777 County Road 107,,Proctorville,OH,45669-8130,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosherI@live.com,
OH-008584,Quaker City Family Health Center,Ohio Hills Health Services,1245586254,Federally Qualified Health Centers - Medical Services,119 W Main St,,Quaker City,OH,43773-9422,Guernsey,101 E Main St,,Barnesville,OH,43713-1005,Belmont,Jeffrey Britton,CEO,740-239-6447,1016,jbritton@ohiohillshealthservices.com,Lana Phillips,Community Services Director,740-239-6447,1011,lphillips@ohiohillshealthservices.com,
OH-008585,RIPLEY,"HEALTHSOURCE OF OHIO, INC.",1841222155,Federally Qualified Health Centers - Medical Services,14 N 2nd St,,Ripley,OH,45167-1101,Brown,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008586,Rocky River Health Center,Planned Parenthood of Greater Ohio,1578986907,Family Planning Providers,20800 Center Ridge Rd,Suite 101,Rocky River,OH,44116-4306,Cuyahoga,206 E State St,,Columbus,OH,43215-4311,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1161,,
OH-008587,Ashtabula Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1699080911,Federally Qualified Health Centers - Medical Services,5266 State Route 45,,Rome,OH,44085-9404,Ashtabula,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,440-563-5028,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
OH-008588,Indian Lake Community Health Center,Community Health & Wellness Partners of Logan Co,1962828293,Federally Qualified Health Centers - Medical Services,8200 State Route 366,Suite 1,Russells Point,OH,43348-9670,Logan,4879 US Rt. 68 South,,West Liberty,OH,43311,Logan,Tara Bair,President/CEO,937-599-1411,,tara.bair@chwplc.org,Andrew Hershberger,CFO,937-599-1411,,andrew.hershberger@chwplc.org,
OH-008589,"Southeast, Inc.","Southeast, Inc.",1164800165,Federally Qualified Health Centers - Medical Services,68353 Bannock Rd,,Saint Clairsville,OH,43950-9736,Belmont,16 West Long Street,,Columbus,OH,43215,Franklin,Amanda Gloeckner,Billing and Medical Records Manager,614-225-0980,1224,gloecknera@southeastinc.com,Felipe DeJesus,Office Manager,614-225-0980,,dejesusf@southeastinc.com,
OH-008590,Belmont Co. General Health District Family Planning Program,Belmont Co. General Health District,1023153319,Family Planning Providers,68501 Bannock Rd,,Saint Clairsville,OH,43950-9736,Belmont,68501 Bannock Rd,,Saint Clairsville,OH,43950-9736,Belmont,Linda Mehl,Family Planning Project Director,740-695-1202,7406951202,lmehl@belmontcountyhealth.org,Robert Sproul,Deputy Health Commissioner,740-695-1202,14,rsproul@belmontcountyhealth.org,www.belmontcountyhealth.com
OH-008591,"CAA Health, Behavioral Health and Dental Center at Melhorn, Salineville",COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC,1508114893,"Dental Providers, Federally Qualified Health Centers - Medical Services",103 W Main St,,Salineville,OH,43945-1048,Columbiana,7880 Lincole Pl,,Lisbon,OH,44432,Columbiana,Terri Welker,Executive Assistant/Credentialing Specialist,330-424-7221,113,terri.welker@caaofcc.org,Mary Ann Pettibon,Chief Executive Officer,330-424-7221,103,maryann.pettibon@caaofcc.org,www.caaofcc.org
OH-008592,Family Health Services of Erie County,Family Health Services of Erie County,1831343805,Federally Qualified Health Centers - Medical Services,1912 Hayes Ave,,Sandusky,OH,44870-4736,Erie,1912 Hayes Avenue,,Sandusky,OH,44870,Erie,Don Branum,CEO,419-502-2822,,donb@familyhs.org,Amanda Corapi,Director of Strategic Initiative and Compliance,419-502-2829,,amandac@familyhs.org,
OH-008593,Erie County Health Department/Erie County Community Health Center,"ERIE, COUNTY OF",1700157492,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",420 Superior St,,Sandusky,OH,44870-1849,Erie,420 Superior St,,Sandusky,OH,44870-1849,Erie,Joseph Palmucci,CEO/CFO,419-626-5623,116,jpalmucci@eriecohealthohio.org,Shari Greene,Chief Health Planning Officer,419-626-5623,132,sgreene@eriecohealthohio.org,http://www.eriecohealthohio.org
OH-008594,SEAMAN,"HEALTHSOURCE OF OHIO, INC.",1205864162,"Dental Providers, Federally Qualified Health Centers - Medical Services",218 Stern Rd,,Seaman,OH,45679-9607,Adams,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008595,South Point Family Medical Center,IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION,1336228212,Federally Qualified Health Centers - Medical Services,55 Township Road 508 E,,South Point,OH,45680-7276,Lawrence,305 N 5th St,,Ironton,OH,45638-1578,Lawrence,Nancy J Lewis,Director of Health,740-532-3534,,nlewis@ilcao.org,Sheri Malone,Billing Manager,740-532-4858,12003,ilcaosheri@live.com,
OH-008596,Springfield Center,Planned Parenthood Southwest Ohio Region,1033176490,"Family Planning Providers, Sexually Transmitted Disease Clinics",1061 N Bechtle Ave,,Springfield,OH,45504-2007,Clark,2314 Auburn Ave,,Cincinnati,OH,45219-2802,Hamilton,Lee Bower,COO,513-824-7832,,lbower@ppswo.org,Marissa Kenkel,Patient Services Administrator,513-824-7803,,mkenkel@ppswo.org,https://www.plannedparenthood.org/planned-parenthood-southwest-ohio
OH-008597,Rocking Horse Center - Keifer Clinic,ROCKING HORSE CENTER,1700116407,Federally Qualified Health Centers - Medical Services,601 Selma Rd,,Springfield,OH,45505-2034,Clark,651 S Limestone St,,Springfield,OH,45505-1965,Clark,Shonda E. Wallace,Chief Financial Officer,937-324-1111,114,swallace@rockinghorsecenter.org,Anne L. Carroll,Patient Accounts Manager,937-324-1111,182,acarroll@rockinghorsecenter.org,
OH-008598,Rocking Horse Center,ROCKING HORSE CENTER,1093952350,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",651 S Limestone St,,Springfield,OH,45505-1965,Clark,651 S Limestone St,,Springfield,OH,45505-1965,Clark,Shonda E. Wallace,Chief Financial Officer,937-324-1111,114,swallace@rockinghorsecenter.org,Anne L. Carroll,Patient Accounts Manager,937-324-1111,182,acarroll@rockinghorsecenter.org,
OH-008599,The Women's Health Center of Jefferson Co. Inc.,State of Ohio -- Dept. of Health Reproductive Health and Wellness Program,1053528000,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",217 Washington St,PO Box 962,Steubenville,OH,43952-2122,Jefferson,217 Washington St,PO Box 962,Steubenville,OH,43952-2122,Jefferson,Linda Bain,Clinic Administrator,740-282-5676,,womenshealth@comcast.net,,,,,,
OH-008601,Trinity Hospital Holding Co,Trinity Hospital Holding Co,1285715144,Inpatient Hospitals (other than children's hospitals),4000 Johnson Rd,,Steubenville,OH,43952-2364,Jefferson,4000 johnson rd,,Steubenville,OH,43952,Jefferson,david werkin,CFO,740-264-8695,,dwerkin@trinityhealth.com,,,,,,www.trinityhealth.com
OH-008602,Community Health Services - Stony Ridge,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",5734 Fremont Pk,,Stony Ridge,OH,43463,Wood,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008603,Hopewell Health Centers - The Plains,"HOPEWELL HEALTH CENTERS, INC.",1902993264,Federally Qualified Health Centers - Medical Services,88 N Plains Rd,Suite 1,The Plains,OH,45780-1160,Athens,1049 Western Ave,,Chillicothe,OH,45601-1104,Ross,Mark Bridenbaugh,CEO,740-773-1006,2004,mbridenbaugh@hopewellhealth.org,,,,,,
OH-008604,Tiffin Community Health Center Firelands,HEALTH PARTNERS OF WESTERN OHIO,1881065092,Federally Qualified Health Centers - Medical Services,46 Ashwood Dr,,Tiffin,OH,44883-1908,Seneca,441 E 8th Street,,Lima,OH,45804-2482,Allen,Janis Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008605,Tiffin Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1518333749,Federally Qualified Health Centers - Medical Services,486 W Perry St,,Tiffin,OH,44883-1902,Seneca,441 E 8th Street,,Lima,OH,45804-2482,Allen,Janis Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008606,Tiffin Community Health Center,HEALTH PARTNERS OF WESTERN OHIO,1548636210,"Dental Providers, Federally Qualified Health Centers - Medical Services",71 S Washington St,,Tiffin,OH,44883-2357,Seneca,441 E 8th Street,,Lima,OH,45804-2482,Allen,Janis Sunderhaus,CEO,419-221-3072,1101,jsunderhaus@hpwohio.org,Loretta Mankin,CFO,419-221-3072,1300,lmankin@hpwohio.org,
OH-008607,NHA Pediatrics,"Neighborhood Health Association of Toledo, Inc.",1427170679,Federally Qualified Health Centers - Medical Services,1 Aurora L Gonzalez Dr,,Toledo,OH,43609-2783,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008608,Navarre Park Family Health Center,"Neighborhood Health Association of Toledo, Inc.",1912330689,Federally Qualified Health Centers - Medical Services,1020 Varland Ave,,Toledo,OH,43605-3245,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008609,River East Community Health Center,"Neighborhood Health Association of Toledo, Inc.",1063533164,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",117 Main St,,Toledo,OH,43605-2091,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008610,Toledo Health Center,Planned Parenthood of Greater Ohio,1255307732,Family Planning Providers,1301 Jefferson Ave,,Toledo,OH,43604-5838,Lucas,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008611,Unison BHG,"Unsion Behavioral Health Group, Inc",1952370561,"Community Mental Health Centers, Ryan White Providers",1425 Starr Ave,,Toledo,OH,43605-2456,Lucas,1425 Starr Ave,,Toledo,OH,43605-2456,Lucas,Stephanie Hill,Credentialing Coordinator,419-936-7533,,shill@unisonbhg.org,Melanie Hanus,Accounts Receivable Manager,419-936-7575,,mhanus@unisonbhg.org,
OH-008612,Mildred Bayer Clinic,"Neighborhood Health Association of Toledo, Inc.",1972624336,"Dental Providers, Federally Qualified Health Centers - Medical Services",2101 Jefferson Ave,,Toledo,OH,43604-5117,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008613,The Toledo Hospital (inpatient hospital),The Toledo Hospital,1407854771,Inpatient Hospitals (other than children's hospitals),2142 N Cove Blvd,,Toledo,OH,43606-3895,Lucas,2142 N. Cove Blvd,,Toledo,OH,43606,Lucas,Scott Fought,"Vice President, Finance",419-291-5909,,scott.fought@promedica.org,,,,,,
OH-008614,The Toledo Hospital (multiple outpatient ECP categories),The Toledo Hospital,1407854771,"Dental Providers, Ryan White Providers",2142 N Cove Blvd,,Toledo,OH,43606-3895,Lucas,2142 N. Cove Blvd,,Toledo,OH,43606,Lucas,Scott Fought,"Vice President, Finance",419-291-5909,,scott.fought@promedica.org,,,,,,
OH-008615,Toledo Children's Hospital,The Toledo Hospital,1205837259,Children's Hospitals (inpatient only),2142 N Cove Blvd,,Toledo,OH,43606-3896,Lucas,2142 N. Cove Blvd,,Toledo,OH,43614,Lucas,Scott Fought,"Vice President, Finance",419-291-5909,,scott.fought@promedica.org,,,,,,
OH-008616,Northwest Ohio Hemophilia Treatment Center,The Toledo Hospital,1407854771,Hemophilia Treatment Centers,2150 W Central Ave,Suite A,Toledo,OH,43606-3859,Lucas,2142 N. Cove Blvd,,Toledo,OH,43606,Lucas,Scott Fought,"Vice President, Finance",419-291-5909,,scott.fought@promedica.org,,,,,,
OH-008617,The Ryan White Program,The University of Toledo Medical Center,1891780300,Ryan White Providers,3000 Arlington Ave,,Toledo,OH,43614-2595,Lucas,3000 Arlington Ave,,Toledo,OH,43614,Lucas,Jamie Dowling Tawes,Program Manager,419-383-5195,,jamie.dowling@utoledo.edu,,,,,,www.utoledo.com
OH-008618,Cordelia Martin Health Center,"Neighborhood Health Association of Toledo, Inc.",1518089762,"Dental Providers, Federally Qualified Health Centers - Medical Services",615 Division St,,Toledo,OH,43604-8400,Lucas,313 Jefferson Avnue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008619,Toledo-Lucas County Health Center,TOLEDO/LUCAS COUNTY HEALTH DEPARTMENT,1932502606,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",635 N Erie St,,Toledo,OH,43604-5317,Lucas,635 N. Erie St.,Rm 272,Toledo,OH,43604-5317,Lucas,Kathy Fuhr,"Supervisor, Billing",419-213-4049,,fuhrk@co.lucas.oh.us,Jessica Lupica,Billing Clerk,419-213-4090,,lupicaj@co.lucas.oh.us,
OH-008620,Southside Community Health Center,"Neighborhood Health Association of Toledo, Inc.",1861513343,Federally Qualified Health Centers - Medical Services,732 South Ave,,Toledo,OH,43609-2768,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008621,Huron Women's Clinic,"Neighborhood Health Association of Toledo, Inc.",1801917273,Federally Qualified Health Centers - Medical Services,923 N Huron St,,Toledo,OH,43604-1715,Lucas,313 Jefferson Avenue,,Toledo,OH,43604-1004,Lucas,Tamara McMurray,Revenue Cycle Manager,419-720-7883,239,tmcmurray@nhainc.org,Amie LW Gohlike,Director of Human Resources,419-720-7883,213,agohlike@nhainc.org,www.nhainc.org
OH-008622,Miami County Public Health,Miami County Public Health,1104964865,"Family Planning Providers, Sexually Transmitted Disease Clinics",510 W Water St,,Troy,OH,45373-2985,Miami,510 W Water St,,Troy,OH,45373-2985,Miami,"Dennis R Propes, RS, MPA",Health Commissioner,937-573-3500,,dpropes@miamicountyhealth.net,Deb French,Director of Nursing,937-573-3521,,dfrench@miamicountyhealth.net,
OH-008623,Wyandot County General Health-Wyandot,State of Ohio -- Dept. of Health,1003805755,Family Planning Providers,127 S Sandusky Ave,Room A,Upper Sandusky,OH,43351-1451,Wyandot,127 S Sandusky Ave Rm A,,Upper Sandusky,OH,43351-1451,Wyandot,Darlene Steward,Family Planning Coordinator,419-294-3852,227,dsteward@co.wyandot.oh.us,,,614-387-0652,,,http://www.wyandothealth.com
OH-008624,"Family Health Care of Northwest Ohio, Inc.","FAMILY HEALTH CARE OF NORTHWEST OHIO, INC.",1568646560,Federally Qualified Health Centers - Medical Services,1052 S Washington St,,Van Wert,OH,45891-2407,Van Wert,1052 S Washington St,,Van Wert,OH,45891-2407,Van Wert,Jennifer L Smith,CEO,419-238-6747,,jensmith0905@gmail.com,,,,,,
OH-008625,Kidz 1st Pediatrics,ONE Health Ohio,1265780746,Federally Qualified Health Centers - Medical Services,1821 E Market St,,Warren,OH,44483-6627,Trumbull,726 Wick Ave,,Youngstown,OH,44505,Mahoning,Megan Kovacich,Marketing Director,330-747-9551,77185,mkovacich@onehealthohio.org,Dionna Slagle,CFO,330-747-9551,77132,dslagle@onehealthohio.org,www.onehealthohio.org
OH-008626,Lloyd McCoy Community Health Center,ONE Health Ohio,1942504089,"Dental Providers, Federally Qualified Health Centers - Medical Services",1977 Niles Rd SE,,Warren,OH,44484-5118,Trumbull,726 Wick Ave,,Youngstown,OH,44505-2827,Mahoning,Megan Kovacich,Marketing Director,330-747-9551,77185,mkovacich@onehealthohio.org,Dionna Slagle,CFO,330-747-9551,77132,dslagle@onehealthohio.org,www.onehealthohio.org
OH-008627,Warren Health Center,Planned Parenthood of Greater Ohio,1215186655,Family Planning Providers,375 N Park Avenue,Suite I,Warren,OH,44481,Trumbull,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008628,Warren West Community Health Center,ONE Health Ohio,1417088980,"Dental Providers, Federally Qualified Health Centers - Medical Services",716 Tod Ave SW,,Warren,OH,44485-3608,Trumbull,726 Wick Ave,,Youngstown,OH,44505,Mahoning,Megan Kovacich,Marketing Director,330-747-9551,77185,mkovacich@onehealthohio.org,Dionna Slagle,CFO,330-747-9551,77132,dslagle@onehealthohio.org,www.onehealthohio.org
OH-008629,Washington Court House,"HEALTHSOURCE OF OHIO, INC.",1164458717,Federally Qualified Health Centers - Medical Services,308 Highland Ave,,Washington Court House,OH,43160-1992,Fayette,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008630,Fulton Co. Health Dept.,State of Ohio -- Dept. of Health Reproductive Health and Wellness Program,1922155563,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",606 S Shoop Ave,,Wauseon,OH,43567-1712,Fulton,606 S Shoop Ave,,Wauseon,OH,43567-1712,Fulton,Stefanie Johnson,Family Planning Coordinator,419-337-0915,125,stefanie.johnson@odh.ohio.gov,Deb Roth,Nurse Practitioner,419-337-0915,120,deb.roth@odh.ohio.gov,http://www.fultoncountyhealthdept.com
OH-008631,FAMILY HEALTH -WAVERLY,"COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE",1891887790,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",227 Valley View Dr,,Waverly,OH,45690-9135,Pike,941 Market St,,Piketon,OH,45661-9757,Pike,Lynn Holland,Special Projects Manager,740-947-7726,7737,lholland@pikecac.org,Cynthia Balzer,Health Center Director,740-947-7726,7700,cbalzer@pikecac.org,
OH-008632,Community Health & Wellness Partners of Logan County,Community Health & Wellness Partners of Logan Co,1689005357,Federally Qualified Health Centers - Medical Services,4879 Us Rt. 68 South,,West Liberty,OH,43357,Logan,4879 US Rt. 68 South,,West Liberty,OH,43357,Logan,Tara Bair,President/CEO,937-599-1411,,tara.bair@chwplc.org,Andrew Hershberger,CFO,937-599-1411,,andrew.hershberger@chwplc.org,
OH-008633,Adams County Clinic,Shawnee Family Health Center,1336173236,"Community Mental Health Centers, Rural Health Clinics",192 Chestnut Ridge Rd,,West Union,OH,45693-9584,Adams,901 Washington Street,,Portsmouth,OH,45662,Scioto,Cynthia Holstein,CEO,740-355-8686,,c.holstein@shawneemhc.org,Jill Cottrill,CFO,740-354-7702,1266,j.cottrill@shawneemhc.org,
OH-008634,Turjoman Pediatrics,"A. John Turjoman, LLC",1396792586,Rural Health Clinics,8930 Ohio River Rd,,Wheelersburg,OH,45694-1922,Scioto,8930 Ohio River Rd,,Wheelersburg,OH,45694,Scioto,Briana Bales,Practice Manager,740-574-1953,,turjomanpediatrics@hotmail.com,A. John Turjoman,MD,740-574-1903,,turjomanpediatrics@hotmail.com,
OH-008635,COMMUNITY HEALTH SRVCS - WILLARD,COMMUNITY & RURAL HEALTH SERVICES,1780683573,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",3909 SR 103 S,,Willard,OH,44890,Huron,410 Birchard Ave,,Fremont,OH,43420-2967,Sandusky,Tyson Bouyack,CFO,419-334-8943,222,tbouyack@fremontchs.com,,,,,,
OH-008636,HealthSource Wilmington,"HEALTHSOURCE OF OHIO, INC.",1417266537,Federally Qualified Health Centers - Medical Services,140 W Main St,,Wilmington,OH,45177-2239,Clinton,5400 DuPont Cir Ste A,,Milford,OH,45150-2770,Clermont,Kimberly Patton,CEO,513-576-7700,3606,kpatton@hsohio.org,Lisa Jackson,VP Marketing and Development,513-576-7700,3605,ljackson@hsohio.org,www.healthsourceofohio.org
OH-008637,Clinton County Family Planning,Highland County Community Action Org.,1861541039,Family Planning Providers,62 E Sugartree St,,Wilmington,OH,45177-2331,Clinton,1487 North High Street Suite 500,,Hillsboro,OH,45133,Highland,Ada Amburgey,Progran Director,937-393-3060,151,adaamburgeyrn@yahoo.com,Julia Wise,HCCAO Executive Director,937-393-3458,112,,http://hccao.org
OH-008638,Family Medical Care Community Health Center,"CHANGE, Inc.",1245244367,Federally Qualified Health Centers - Medical Services,200 Luray Dr,,Wintersville,OH,43953-3973,Jefferson,3158 West ST.,,Weirton,WV,26062,Hancock,Judy Raveaux,CEO,304-797-7733,311,jraveaux@changeinc.org,Rita Coyne,COO,304-797-7733,324,rcoyne@changeinc.org,www.changeinc.org
OH-008639,MONROE FAMILY HEALTH CENTER,Ohio Hills Health Services,1871534677,Federally Qualified Health Centers - Medical Services,37984 Airport Rd,,Woodsfield,OH,43793-9247,Monroe,101 E Main St,,Barnesville,OH,43713-1005,Belmont,Jeffrey Britton,CEO,740-239-6447,1016,jbritton@ohiohillshealthservices.com,Lana Phillps,Community Services Director,740-425-5165,1011,lphillips@ohiohillshealthservices.com,
OH-008640,Wooster Community Hospital,Wooster Community Hospital,1437156247,Inpatient Hospitals (other than children's hospitals),1761 Beall Ave,,Wooster,OH,44691-2342,Wayne,1761 Beall Avenue,,Wooster,OH,44691,Wayne,Scott Alan Boyes,VP of Fiscal Services\CFO,330-263-8148,8148,sboyes@wchosp.org,Kristen Shoup,Director of Revenue Cycle,330-264-8614,8614,kshoup@wchosp.org,https://www.woosterhospital.org
OH-008641,Viola Startzman Clinic,Healthcare 2000 Community Clinic,1518206754,"Dental Providers, Other ECP Providers",1874 Cleveland Rd,,Wooster,OH,44691-2263,Wayne,1874 Cleveland Road,,Wooster,OH,44691,Wayne,Jaime Parsons,Executive Director,330-262-2500,102,jparsons@startzmanfreeclinic.org,,,,,,
OH-008642,Wooster Health Center,Planned Parenthood of Greater Ohio,1770789687,Family Planning Providers,334 E Milltown Rd,,Wooster,OH,44691-1248,Wayne,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008643,Greene County Combined Health DIstrict,Greene County Combined Health District,1831234962,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",360 Wilson Dr,,Xenia,OH,45385-1810,Greene,360 Wilson Dr,P.O Box 250,Xenia,OH,45385-1810,Greene,Robyn Fosnaugh,Director of Community Health Services,937-374-5615,,rfosnaugh@gcchd.org,,,,,,http://www.gcchd.org
OH-008644,Community Physicians of Yellow Springs,Greene Memorial Hospital,1831503853,Rural Health Clinics,888 Dayton Ave,Suite 200,Xenia,OH,45385-2688,Greene,1141 N. Monroe Drive,,Xenia,OH,45385,Greene,Mark Floro,Director of Clinical Services,937-352-2571,9373522242,Mark.Floro@ketteringhealth.org,Jane Miller,Practice Manager,937-767-7291,,jane.miller@ketteringhealth.org,http://www.ketteringhealth.org/
OH-008645,Comprehensive Care Center,Ursuline Center DBA Comprehensive Care Center,1710318282,Ryan White Providers,345 Oak Hill Ave Ste 400,Entrance F 4TH Floor,Youngstown,OH,44502,Mahoning,345 Oak Hill Ave. ste 400,Entrance F 4th Floor,Youngstown,OH,44502,Mahoning,Teaquan Cosper,Clinic Director,330-743-7853,121,tcosper@ursulinesistersaids.org,,,,,,
OH-008646,Youngstown Community Health Center,ONE Health Ohio,1700917267,"Dental Providers, Federally Qualified Health Centers - Medical Services",726 Wick Ave,,Youngstown,OH,44505-2827,Mahoning,726 Wick Ave,,Youngstown,OH,44505-2827,Mahoning,Megan Kovacich,Marketing Director,330-747-9551,77185,mkovacich@onehealthohio.org,Dionna Slagle,CFO,330-747-9551,77132,dslagle@onehealthohio.org,www.onehealthohio.org
OH-008647,Youngstown Health Center,Planned Parenthood of Greater Ohio,1477528594,Family Planning Providers,77 E Midlothian Blvd,,Youngstown,OH,44507-2021,Mahoning,206 E State Street,,Columbus,OH,43215,Franklin,Erica Wilson Domer,VP of Financial Services,330-535-2674,1161,Erica.Wilson@ppoh.org,Lillian Williams,Director of Business Operations,330-535-2674,1123,Lillian.Williams@ppoh.org,
OH-008648,Genesis Hospital,Genesis Healthcare System,1598868655,Inpatient Hospitals (other than children's hospitals),2951 Maple Ave,,Zanesville,OH,43701-1406,Muskingum,2951 Maple Avenue,,Zanesville,OH,43701,Muskingum,Susan Reif,Mgr. Managed Care Contracting,740-454-4277,,sreif@genesishcs.org,Christy Wilson,Director Managed Care,740-454-6260,,swilson@genesishcs.org,
OH-008649,Lung Clinic,Genesis Healthcare System,1598868655,Black Lung Clinics,2951 Maple Ave,,Zanesville,OH,43701-1406,Muskingum,2951 Maple Avenue,,Zanesville,OH,43701,Muskingum,Michele Newlon,"Grant Administration Consultant, Lung Clinic",740-454-4063,,mnewlon@genesishcs.org,Christy Wilson,Director Managed Care,740-454-6260,,cwilson@genesishcs.org,
OH-008650,Ryan White Program- Genesis,Ryan White Program,1598868655,Ryan White Providers,2951 Maple Ave,,Zanesville,OH,43701-1406,Muskingum,2951 Maple Avenue,,Zanesville,OH,43701,Muskingum,Susan Reif,Mgr Managed Care Contracting,740-454-4277,,sreif@genesishcs.org,Christy Wilson,Director Managed Care,740-454-6260,,cwilson@genesishcs.org,
OH-008651,MUSKINGUM VALLEY HEALTH CENTERS,MUSKINGUM VALLEY HEALTH CENTERS,1841472982,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",716 Adair Ave,,Zanesville,OH,43701-2836,Muskingum,859 N Main St,,Malta,OH,43758-9007,Muskingum,Daniel J Atkinson,Chief Executive Officer,740-891-9090,,datkinson@mvhealthcenters.org,,,,,,
OK-008652,Central Oklahoma Family Medical Center - Ada,"CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.",1154704237,Federally Qualified Health Centers - Medical Services,1201 Arlington St,Suite B,Ada,OK,74820-4072,Pontotoc,527 W 3rd St,,Konawa,OK,74849-1415,Seminole,Brenda Ware,CEO,580-925-3286,486,brenda.ware@cofmc.org,,,,,,
OK-008653,Chickasaw Nation Medical Center (Carl Albert Indian Hospital (dental provider),Chickasaw Nation Medical Center (Carl Albert Indian Hospital,1255364923,"Dental Providers, Indian Health Service",1921 Stonecipher Dr,,Ada,OK,74820-3439,Pontotoc,1921 Stonecipher Blvd.,,Ada,OK,74820-3439,Pontotoc,Brenda Teel,Executive Officer of Revenue,580-421-4570,82864,brenda.teel@chickasaw.net,Tina Johnson,Executive Assistant,580-421-4570,82878,tina.johnson@chickasaw.net,www.chickasaw.net
OK-008654,Chickasaw Nation Medical Center (Carl Albert Indian Hospital (inpatient hospital),Chickasaw Nation Medical Center (Carl Albert Indian Hospital,1255364923,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",1921 Stonecipher Dr,,Ada,OK,74820-3439,Pontotoc,1921 Stonecipher Blvd.,,Ada,OK,74820-3439,Pontotoc,Brenda Teel,Executive Officer of Revenue,580-421-4570,82864,brenda.teel@chickasaw.net,Tina Johnson,Executive Assistant,580-421-4570,82878,tina.johnson@chickasaw.net,www.chickasaw.net
OK-008655,Pontotoc County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2330 Arlington St,,Ada,OK,74820-2823,Pontotoc,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,D'Elbie Walker,Regional Director,580-332-2011,,,http://www.ok.gov/health
OK-008656,Mercy Hospital Ada,Mercy Hospital Ada,1952643306,Inpatient Hospitals (other than children's hospitals),430 N Monte Vista St,,Ada,OK,74820-4609,Pontotoc,4300 West Memorial Rd,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Region,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President Mercy Oklahoma,405-752-3085,,diana.smalley@mercy.net,
OK-008657,"Community Health Center of Northeast Oklahoma, Inc",Route 66 Health Clinic,1821410648,Federally Qualified Health Centers - Medical Services,138 S. Main St,PO Box 705,Afton,OK,74331-0705,Ottawa,138 S. Main Street,PO Box 795,Afton,OK,74331,Ottawa,Patrick M. Peer,Chief Executive Officer,918-257-8029,21,ppeer@chcneo.org,,,,,,chcneo.org
OK-008658,Afton Community Health Center,"Community Health Center of Northeast Oklahoma, Inc",1821410648,Federally Qualified Health Centers - Medical Services,21965 Bison Dr,,Afton,OK,74331,Ottawa,PO Box 705,,Afton,OK,74331,Ottawa,Patrick Michael Peer,Chief Executive Officer,918-257-8029,21,ppeer@chcneo.org,"Janet Mendez, RN",Chief Operating Officer,918-257-8029,,jmendez@chcneo.org,www.chcneo.org
OK-008659,JCMH Pediatric Clinic,Jackson County Memorial Hospital Authority,1093763781,Rural Health Clinics,101 S Park Ln,Suite 100,Altus,OK,73521-5731,Jackson,1200 E. Pecan,P.O. Box 8190,Altus,OK,73521,Jackson,JENNIFER HARRISON,Chief Financial Officer,580-379-5510,,JENNIFERHARRISON@JCMH.COM,Steve Hartgraves,Chief Executive Officer,580-379-5500,,stevehartgraves@jcmh.com,www.jcmh.com
OK-008660,JCMH Women's Health Associates,Jackson County Memorial Hospital Authority,1093763781,Rural Health Clinics,101 S Park Ln,Suite 200,Altus,OK,73521-5731,Jackson,1200 E. Pecan,P.O. Box 8190,Altus,OK,73521,Jackson,JENNIFER HARRISON,Chief Financial Officer,580-379-5510,,JENNIFERHARRISON@JCMH.COM,Steve Hartgraves,Chief Executive Officer,580-379-5500,,stevehartgraves@jcmh.com,www.jcmh.com
OK-008661,Jackson County Memorial Hospital,Jackson County Memorial Hospital Authority,1093763781,Inpatient Hospitals (other than children's hospitals),1200 E. Pecan,PO Box 8190,Altus,OK,73522-8190,Jackson,1200 E. Pecan,P.O. Box 8190,Altus,OK,73521,Jackson,JENNIFER HARRISON,Chief Financial Officer,580-379-5510,5510,JENNIFERHARRISON@JCMH.COM,Steve Hartgraves,Chief Executive Officer,580-379-5500,,stevehartgraves@jcmh.com,www.jcmh.com
OK-008662,JCMH Medical Clinic,Jackson County Memorial Hospital,1093763781,Rural Health Clinics,205 S Park Ln,,Altus,OK,73521-5755,Jackson,1200 E. Pecan,P.O. Box 8190,Altus,OK,73521,Jackson,JENNIFER HARRISON,Chief Financial Officer,580-379-5510,,JENNIFERHARRISON@JCMH.COM,Steve Hartgraves,Chief Executive Officer,580-379-5500,,stevehartgraves@jcmh.com,www.jcmh.com
OK-008663,Jackson County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",401 W Tamarack Rd,,Altus,OK,73521-1599,Jackson,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Karen Weaver, BSN, RN",Regional Director,580-482-7308,,,
OK-008664,Woods County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",511 Barnes Ave,,Alva,OK,73717-2229,Woods,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Terri Salisbury,Regional Director,580-327-3192,,,http://www.ok.gov/health
OK-008665,Anadarko Health Center,Anadarko Health Center,1881637403,"Dental Providers, Indian Health Service, Other ECP Providers",201 E Parker Mckenzie Dr,,Anadarko,OK,73005,Caddo,PO Box 828,,Anadarko,OK,73005-0828,Caddo,Terry Hunter,Facility Director,405-247-7901,,terry.hunter@ihs.gov,Greg Ketcher,CEO,580-354-5102,,greg.ketcher@ihs.gov,
OK-008666,Caddo County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",216 W Broadway St,,Anadarko,OK,73005-2808,Caddo,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brandie O'Connor,Regional Director,405-247-2507,,,
OK-008667,Pushmataha County Health Department - Antlers,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",318 W Main St,,Antlers,OK,74523-2034,Pushmataha,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Julianne Montgomery,Regional Director,580-298-6624,,,http://www.ok.gov/health
OK-008668,Mercy Hospital Ardmore,Mercy Hospital Ardmore,1386741635,Inpatient Hospitals (other than children's hospitals),1011 14th Ave NW,,Ardmore,OK,73401-1828,Carter,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008669,Ardmore Health Clinic,Ardmore Health Clinic,1730249186,"Dental Providers, Indian Health Service, Other ECP Providers",2510 Chickasaw Blvd,,Ardmore,OK,73401-1341,Carter,2510 Chickasaw Blvd,,Ardmore,OK,73401-1341,Carter,Brenda Teel,Executive Officer of Revenue,580-421-4570,82864,brenda.teel@chickasaw.net,Tina Johnson,Executive Assistant,580-421-4570,82878,tina.johnson@chickasaw.net,www.chickasaw.net
OK-008670,Carter County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",405 S Washington St,,Ardmore,OK,73401-7044,Carter,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4024,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-223-9705,,,
OK-008671,Choctaw Nation Health Clinic Atoka,Choctaw Nation Health Service Authority,1902078728,"Family Planning Providers, Tribal Health Program operated under P.L. 93-638",1201 W Liberty Rd,,Atoka,OK,74525-1639,Atoka,One Choctaw Way,,Talihina,OK,74571,Le Flore,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,
OK-008672,Family Health Center of Southern Oklahoma Atoka,Family Health Center of Southern Oklahoma,1659797314,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1504 S Virginia Ave,,Atoka,OK,74525-3246,Atoka,610 #. 24th Street,,Tishomingo,OK,73460,Johnston,Caren Atteberry,Financial Officer,580-371-2343,3323,catteberry@fhcso.org,Tina Davis,Executive Director,580-371-0234,,tdavis@fhcso.org,
OK-008673,Atoka County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",932 W 13th St,,Atoka,OK,74525-3425,Atoka,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,D'Elbie Walker,Regional Directory,580-889-2116,,,
OK-008674,Morton Bartlesville Health Center,"MORTON COMPREHENSIVE HEALTH SERVICES, INC.",1275528085,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4140 SE Adams Rd,Suite 105,Bartlesville,OK,74006-8451,Washington,1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,John Silva,CEO,918-295-9399,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008675,Washington County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5121 Jacquelyn Ln,,Bartlesville,OK,74006-7723,Washington,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Larry Bergner,Regional Director,918-335-3005,,,http://www.ok.gov/health
OK-008676,Beaver County Memorial Hospital,Beaver County Hospital Authority,1578540274,Inpatient Hospitals (other than children's hospitals),212 E 8th St,,Beaver,OK,73932-3184,Beaver,PO Box 640,,Beaver,OK,73932,Beaver,Alissa Schlessman,Administrator,580-625-4551,245,bcmhadministrator@beavercountyhospitalauthority.com,Cody Gregory,Comptroller,580-625-4551,234,bcmhcomptroller@beavercountyhospitalauthority.com,
OK-008677,Community Clinic of Beaver,Beaver County Hospital Authority,1487631156,Rural Health Clinics,718 Avenue A,,Beaver,OK,73932-3101,Beaver,PO Box 640,,Beaver,OK,73932,Beaver,Alissa Schlessman,Administrator,580-625-4551,245,bcmhadministrator@beavercountyhospitalauthority.com,Cody Gregory,Comptroller,580-625-4551,234,bcmhcomptroller@beavercountyhospitalauthority.com,
OK-008678,Beaver County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",Highway 270 South,,Beaver,OK,73932,Beaver,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Terri Salisbury,Regional Director,580-625-3693,,,
OK-008679,"CLINICO, L L C","Clinico, L.L.C.",1497766000,Rural Health Clinics,103 E Main St,PO Box 478,Beggs,OK,74421-0478,Okmulgee,103 E Main st,PO box 478,Beggs,OK,74421,Okmulgee,Kyle Ellis,Business Manager,918-267-7000,,Beggsclinico@gmail.com,,,,,,Beggsclinico.com
OK-008680,Kay County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1706 S Main St,,Blackwell,OK,74631-4925,Kay,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Kelli Rader, MS, RN",Regional Director,580-363-5520,,,
OK-008681,McClain County Health Department - Blanchard,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",600 S Main St,PO Box 130,Blanchard,OK,73010,McClain,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Regional Director,405-485-3319,,,http://www.ok.gov
OK-008682,Creek County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",408 W 4th Ave,,Bristow,OK,74010-2702,Creek,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,918-367-3341,,,
OK-008683,Choctaw Nation Health Clinic Broken Bow,Choctaw Nation Health Services Authority,1770559619,Family Planning Providers,1300 E Martin Luther King Dr,,Broken Bow,OK,74728-4160,McCurtain,One Choctaw Way,,Talihina,OK,74571,Le Flore,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,
OK-008684,Kiamichi Family Medical Center,KIAMICHI FAMILY MEDICAL CENTER,1134138720,"Dental Providers, Federally Qualified Health Centers - Medical Services",6026 Battiest Pickens Rd,,Broken Bow,OK,74728-5033,McCurtain,PO Box 180,,Battiest,OK,74722,Mccurtain,AMY GILBREATH,CEO,580-241-5294,234,amy@kiamichimed.org,Scott Rickey,CFO,580-241-5294,,scott@kiamichimed.org,www.kiamichimed.org
OK-008685,Harper County Community Hospital,Harper County Community Hospital,1134128499,Inpatient Hospitals (other than children's hospitals),1003 Hwy 64 North,,Buffalo,OK,73834,Harper,P.O. Box 60,,Buffalo,OK,73834,Harper,Georganna Buss,CEO,580-735-2555,128,hcch@pldi.net,Juana Lizardo,,580-735-2555,125,jlizardo@hcchospital.com,
OK-008687,GSP Health Canton,"GREAT SALT PLAINS HEALTH CENTER, INC.",1427593409,Federally Qualified Health Centers - Medical Services,310 E. Walnut,,Canton,OK,73724,Blaine,405 S. Oklahoma Ave,,Cherokee,OK,73728,Alfalfa,Tim Starkey,CEO,580-596-2800,,tstarkey@gsphealth.org,Marcus Stephens,,580-596-2800,,mstephens1@gsphealth.org,
OK-008688,Carnegie Health Center,Carnegie Health Center,1457459158,"Indian Health Service, Other ECP Providers",212 E 4th St,,Carnegie,OK,73015-9471,Caddo,212 E 4th Street,,Carnegie,OK,73015-1120,Caddo,Terry Hunter,Facility Director,405-247-7901,,terry.hunter@ihs.gov,Greg Ketcher,CEO,580-354-5102,,greg.ketcher@ihs.gov,
OK-008689,Dorothy Smith Family Medical Center,"Community Health Centers, Inc.",1699030528,Federally Qualified Health Centers - Medical Services,105 E Santa Fe St,,Carney,OK,74832-9800,Lincoln,P.O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73140,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008690,Lincoln County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",101 Meadow Ln,,Chandler,OK,74834-8786,Lincoln,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,405-258-2640,,,
OK-008691,Lakeside Rural Health Clinic,Southeastern Oklahoma Family Services,1255648580,Rural Health Clinics,113653 Old Highway 69,,Checotah,OK,74426-8802,McIntosh,PO Box 307,,Eufaula,OK,74432-3019,Mcintosh,Melissa Emerson Busby,Director,405-615-6822,,mbusby@treatmentservices.org,,,,,,
OK-008692,McIntosh County Health Department - Checotah,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",211 W Gentry Ave,,Checotah,OK,74426-2439,McIntosh,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jill Larcade,Regional Director,918-473-5416,,,http://www.ok.gov/health
OK-008693,Checotah Health and Wellness Center,"Stigler Health and Wellness Center, Inc.",1891752853,Federally Qualified Health Centers - Medical Services,212 W Spaulding St,,Checotah,OK,74426-2452,McIntosh,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008694,Cherokee Family Clinic,INTEGRIS Rural Health Inc,1134104128,Rural Health Clinics,221 S Grand Ave,,Cherokee,OK,73728-2029,Alfalfa,5300 N. Independence,Suite 280,Oklahoma City,OK,73112,Oklahoma,Christy Aquino,Manager of Provider Credentialing,405-552-0155,,christy.aquino@integrisok.com,,,,,,
OK-008695,GSP Health - Cherokee,"GREAT SALT PLAINS HEALTH CENTER, INC.",1881876738,"Dental Providers, Federally Qualified Health Centers - Medical Services",405 S Oklahoma Ave,,Cherokee,OK,73728-2545,Alfalfa,405 S Oklahoma Ave,,Cherokee,OK,73728-2545,Alfalfa,Tim Starkey,CEO,580-596-2800,,tstarkey@gsphealth.org,,,,,,
OK-008696,Grady County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2116 W Iowa Ave,,Chickasha,OK,73018-2736,Grady,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,James Smith,Acting Regional Director,405-224-2022,,,
OK-008697,Grady Memorial Hospital,Grady Memorial Hospital Authority,1538169198,Inpatient Hospitals (other than children's hospitals),2220 W Iowa Ave,,Chickasha,OK,73018-2700,Grady,2220 West Iowa Avenue,,Chickasha,OK,73018-2700,Grady,Warren K Spellman,CFO,405-779-2150,2150,kspellman@gradymem.org,Jackie McAdoo,CFO,405-779-2170,2170,jmcadoo@gradymem.org,www.gradymem.org
OK-008698,Claremore Indian Hospital (inpatient hospital),Claremore Indian Hospital,1073527842,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",101 S Moore Ave,,Claremore,OK,74017-5091,Rogers,101 S Moore Ave,,Claremore,OK,74017-5091,Rogers,George Valliere,Chief Executive Officer,918-342-6200,,george.valliere@ihs.gov,"Gary Lang, DO",Clilnical Diredtor,918-342-6434,,gary.lang@ihs.gov,
OK-008699,Claremore Indian Hospital (multiple outpatient ECP categories),Claremore Indian Hospital,1073527842,"Dental Providers, Family Planning Providers, Indian Health Service",101 S Moore Ave,,Claremore,OK,74017-5091,Rogers,101 S Moore Ave,,Claremore,OK,74017-5091,Rogers,George Valliere,Chief Executive Officer,918-342-6200,,george.valliere@ihs.gov,"Gary Lang, DO",Clilnical Diredtor,918-342-6434,,gary.lang@ihs.gov,
OK-008700,Rogers County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2664 N Highway 88 Unit A,,Claremore,OK,74017-0409,Rogers,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Larry Bergner,Regional Director,918-341-3166,,,http://www.ok.gov/health
OK-008701,"Pushmataha Family Medical Center, Inc.",PUSHMATAHA FAMILY MEDICAL CENTER INC.,1891882676,"Dental Providers, Federally Qualified Health Centers - Medical Services",1020 Lawson Blvd,,Clayton,OK,74536,Pushmataha,1020 Lawson Blvd,,Clayton,OK,74536,Pushmataha,Angela Batton,CEO,918-569-4143,,abatton@pfmcok.com,Alaina Bray,CFO,918-569-4143,,,
OK-008702,Pushmataha County Health Department - Clayton,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",Hwy 2 And Cherokee Street,PO Box 118,Clayton,OK,74536-0118,Pushmataha,1000 NE 10th Street,,Oklahoma City,OK,73117-1270,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Julianne Montgomery,Regional Director,918-569-7973,,,http://www.ok.gov/health
OK-008703,Pawnee County Health Department - Cleveland,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1390 W Cherokee St,,Cleveland,OK,74020-4044,Pawnee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Kelli Rader,Regional Director,918-358-2546,,,http://www.ok.gov/health
OK-008704,Clinton Health Center,Clinton Health Center,1205923448,"Dental Providers, Indian Health Service, Other ECP Providers",10321 N 2274 Rd,,Clinton,OK,73601-7521,Custer,10321 N 2274 Rd,,Clinton,OK,73601-7521,Custer,April Wazhaxi,Chief Executive Officer,580-331-3314,,APRIL.WAZHAXI@IHS.GOV,Joseph Bryant,Administrative Officer,580-331-3315,,JOE.BRYANT@IHS.GOV,
OK-008705,Custer County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3030 Custer Ave,,Clinton,OK,73601-9117,Custer,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,580-323-2100,,,
OK-008706,Family Health Center of Southern Oklahoma Coalgate,Family Health Center of Southern Oklahoma,1174830665,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",107 E Post Ave,,Coalgate,OK,74538-3004,Coal,610 E. 24th Street,,Tishomingo,OK,73460,Johnston,Caren Atteberry,Financial Officer,580-371-2343,3323,catteberry@fhcso.org,Tina Davis,Executive Director,580-371-0234,,tdavis@fhcso.org,
OK-008707,Coal County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1404 S Broadway St,,Coalgate,OK,74538-2619,Coal,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,D'Elbie Walker,Regional Director,580-927-2367,,,
OK-008708,Collinsville Health Center,Tulsa City-County Health Department,1891893475,"Family Planning Providers, Sexually Transmitted Disease Clinics",1201 W Center St,,Collinsville,OK,74021-3110,Tulsa,5051 S. 129th E. Ave,,Tulsa,OK,74134,Tulsa,Bruce Dart,Executive Director,918-595-4044,,bdart@tulsa-health.org,Reggie Ivey,Chief Operating Officer,918-595-4404,,rivey@tulsa-health.org,
OK-008709,Comanche Community Health Center,COMANCHE COUNTY HOSPITAL AUTHORITY,1427075498,Federally Qualified Health Centers - Medical Services,513 Hillery Rd,Suite C,Comanche,OK,73529-1200,Stephens,3811 West Gore Blvd,Ste 6,Lawton,OK,73505,Comanche,Sean McAvoy,Executive Director,580-355-5242,2221,mcavoys@ccmhonline.com,,,,,,
OK-008710,Wagoner County Health Department - Coweta,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",28596 E 141st St S,,Coweta,OK,74429-7513,Wagoner,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Larry Bergner,Acting Regional Director,918-486-2845,,,http://www.ok.gov/health
OK-008711,Koweta Indian Health Center,Creek Nation Hospital & Clinics,1366593923,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",31870 E State Highway 51,,Coweta,OK,74429-7900,Wagoner,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008712,Mercy Hospital Logan Rural Health Clinic - Crescent,Mercy Hospital Logan,1659652071,Rural Health Clinics,400 S Grand St,,Crescent,OK,73028-9118,Logan,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008713,Payne County Health Department - Cushing,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1026 N Linwood Ave,,Cushing,OK,74023-2371,Payne,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Kelli Rader,Regional Director,918-225-3377,,,http://www.ok.gov/health
OK-008714,Variety Care Mid-Del Family Health Center,"VARIETY CARE, INC.",1568591477,Federally Qualified Health Centers - Medical Services,3851 Tinker Diagonal,,Del City,OK,73115-2109,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008715,Drumright Rural Health Clinic,Drumright Rural Health Clinic,1659600815,Rural Health Clinics,612 W Bypass,,Drumright,OK,74030-5957,Creek,612 W Bypass,,Drumright,OK,74030,Creek,Jo Ella Wood,Business Operations Manager,918-382-2300,2314,jwood@drumrighthealthcare.com,,,,,,
OK-008716,Stephens County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1401 Bois D'Arc,,Duncan,OK,73533,Stephens,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Acting Regional Director,580-252-0270,,,http://www.ok.gov/health
OK-008717,Bryan County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1524 Chuckwa Dr,,Durant,OK,74701-2142,Bryan,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Julianne Montgomery,Regional Director,580-924-4285,,,
OK-008718,Choctaw Nation Health Clinic Durant,Choctaw Nation Health Services Authority,1396173449,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",1803 Chukka Hina Dr,,Durant,OK,74701-7117,Bryan,One Choctaw Way,,Talihina,OK,74571,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008719,Edmond Health Center,Planned Parenthood Great Plains,1679614838,Family Planning Providers,3431 S Boulevard,Suite 108,Edmond,OK,73013-5514,Oklahoma,619 NW 23rd St,,Oklahoma City,OK,73103-1415,Oklahoma,Shirish Malla,"Project Manager, Operations & Strategic Initiative",913-345-4662,,Shirish.malla@ppgreatplains.org,Amanda Addison,VP of Health Services,913-345-4659,,amanda.addison@ppgreatplains.org,
OK-008720,Canadian County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",100 S Rock Island Ave,,El Reno,OK,73036-2733,Canadian,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,405-262-0042,,,
OK-008721,El Reno Health Center,El Reno Health Center,1386725604,"Indian Health Service, Other ECP Providers",1801 Parkview Dr,,El Reno,OK,73036-2103,Canadian,1801 PARKVIEW DR,,El Reno,OK,73036-5769,Canadian,ANDREA JACKSON,Facility Director,580-331-3300,,ANDREA.JACKSON@IHS.GOV,APRIL WAZHAXI,CHIEF EXECUTIVE OFFICER,580-331-3314,,APRIL.WAZHAXI@IHS.GOV,
OK-008722,Great Plains Regional Medical Center (inpatient hospital),Great Plains Regional Medical Center,1184639122,Inpatient Hospitals (other than children's hospitals),1801 W 3rd St,,Elk City,OK,73644-5145,Beckham,P.O. Box 2339,,Elk City,OK,73648,Beckham,Monica Scott,CFO,580-821-5500,,mscott@gprmc-ok.com,Corey Lively,CEO,580-821-5302,,clively@gprmc-ok.com,
OK-008723,Great Plains Regional Medical Center (outpatient hospital clinics),Great Plains Regional Medical Center,1184639122,Outpatient Hospital Clinics,1801 W 3rd St,,Elk City,OK,73644-5145,Beckham,P.O. Box 2339,,Elk City,OK,73648,Beckham,Monica Scott,CFO,580-821-5500,,mscott@gprmc-ok.com,Corey Lively,CEO,580-821-5302,,clively@gprmc-ok.com,
OK-008724,Beckham County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",400 E 3rd St,,Elk City,OK,73644-4720,Beckham,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Karen Weaver, BSN, RN",Regional Director,580-225-1173,,,
OK-008725,GSPHC - Enid Satellite Location,"GREAT SALT PLAINS HEALTH CENTER, INC.",1245667732,Federally Qualified Health Centers - Medical Services,1101 E Broadway Ave,,Enid,OK,73701-4410,Garfield,405 S Oklahoma Ave,,Cherokee,OK,73728-2545,Alfalfa,Tim Starkey,CEO,580-596-2800,,tstarkey@gsphealth.org,,,,,,
OK-008726,Garfield County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2501 Mercer Dr,,Enid,OK,73701-8602,Garfield,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Carla Dionne,Regional Director,580-233-0650,,,
OK-008727,Eufaula Health and Wellness Center,"Stigler Health and Wellness, Inc",1891752853,Federally Qualified Health Centers - Medical Services,17 Hospital Dr,,Eufaula,OK,74432-4010,McIntosh,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008728,McIntosh County Health Department - Eufaula,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",29 Hospital Road,PO Box 71,Eufaula,OK,74432-0071,McIntosh,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jill Larcade,Regional Director,918-689-7774,,,http://www.ok.gov/health
OK-008729,Eufaula Indian Health Center,Creek Nation Hospital & Clinics,1366593923,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",800 W Forrest Ave,,Eufaula,OK,74432-3249,McIntosh,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Assistant Revenue Cycle,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Manager,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008730,Robert Clark Family Health Center,"Fairfax Medical Facilities, Inc.",1538183173,Federally Qualified Health Centers - Medical Services,212 N Main St,,Fairfax,OK,74637-3023,Osage,212 N. Main St.,,Fairfax,OK,74637,Osage,Karen McConnell,CEO,918-642-3100,233,Kmcconnell@fairfaxclinic.com,Scott Burcher,CFO,918-642-3100,332,Sburcher@fairfaxclinic.com,Fairfaxclinic.com
OK-008731,Fairfax Rural Health Clinic,"CAH, Acquisition Company 12 LLC",1306145339,Rural Health Clinics,40 Hospital Rd,,Fairfax,OK,74637-5084,Osage,40 Hospital Rd,,Fairfax,OK,74637,Osage,Tina Steele,Hospital CEO,918-642-3291,311,tsteele@empowerhms.com,Linda Thompson,,918-642-3291,316,lthompson@fairfaxcommunityhospital.com,
OK-008732,Major County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",501 E Broadway,,Fairview,OK,73737-2207,Major,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Carla Dionne,Regional Director,580-227-3362,,,http://www.ok.gov/health
OK-008733,Fairview Family Clinic,Fairview Regional Medical Center,1356379309,Rural Health Clinics,519 E State Rd,,Fairview,OK,73737-1458,Major,PO Box 548,,Fairview,OK,73737,Major,Roger Knak,CEO,580-227-1370,,rknak@fairviewregional.net,Molly Young,Clinic Manager,580-227-1338,,myoung@fairviewregional.net,
OK-008734,Fairview Regional Medical Center,Fairview Regional Medical Center Authority,1033153309,Inpatient Hospitals (other than children's hospitals),523 E State Rd,,Fairview,OK,73737-1453,Major,PO Box 548,,Fairview,OK,73737,Major,Roger Knak,CEO,580-227-1370,,rknak@fairviewregional.net,Tammy Mallory,Business Office Director,580-227-1365,,tmallory@fairviewregional.net,
OK-008735,Variety Care Ft. Cobb Health Center,"VARIETY CARE, INC.",1275646143,Federally Qualified Health Centers - Medical Services,111 W Main St,,Fort Cobb,OK,73038-5863,Caddo,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008736,Tillman County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1500 N Main St,,Frederick,OK,73542-1421,Tillman,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Karen Weaver,Regional Director,580-335-2163,,,http://www.ok.gov/health
OK-008737,Variety Care at Big Pasture,Variety Care,1336527928,Federally Qualified Health Centers - Medical Services,201 W 1st St,,Grandfield,OK,73546-9236,Tillman,3000 N. Grand Blvd.,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R. Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008738,Mercy Hospital Logan,Mercy Hospital Logan,1306126818,Inpatient Hospitals (other than children's hospitals),200 S Academy Rd,,Guthrie,OK,73044-8727,Logan,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Office West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008739,Logan County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",215 Fairgrounds Rd,Suite A,Guthrie,OK,73044-4755,Logan,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,405-282-3485,,,
OK-008740,Mercy Hospital Logan Rural Health Clinic Division,Mercy Hospital Logan County,1184905507,Rural Health Clinics,2419 S Division St,,Guthrie,OK,73044-6064,Logan,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President Mercy West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008741,Texas County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1410 N East St,,Guymon,OK,73942-3336,Texas,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Terri Salisbury,Regional Director,580-335-2163,,,http://www.ok.gov/health
OK-008742,"Panhandle Counseling and Health Center, Inc.","Panhandle Counseling and Health Center, Inc.",1427464437,Federally Qualified Health Centers - Medical Services,3247 Highway 54,,Guymon,OK,73942,Texas,"Panhandle Counseling and Health Center, Inc.",,Guymon,OK,73942,Texas,Sarah Wagner,CEO,580-338-0072,,sarah.wagner@pchcofguymon.org,"Paul Reed, DO",Medical Director,580-338-0072,,paul.reed@pchcofguymon.org,www.pchcofguymon.org
OK-008743,Pathways,"Panhandle Counseling and Health Center, Inc.",1891102331,Federally Qualified Health Centers - Medical Services,5170 Patricia Blvd.,,Guymon,OK,73942,Texas,3247 Highway 54,,Guymon,OK,73942,Texas,Sarah Wagner,CEO,580-338-0072,,sarah.wagner@pchcofguymon.org,"Paul Reed, DO",Medical Director,580-338-0072,,paul.reed@pchcofguymon.org,www.pchcofguymon.org
OK-008744,Caring Hands Healthcare Centers - Hartshorne,"Caring Hands Healthcare Centers, Inc.",1346324134,Federally Qualified Health Centers - Medical Services,511 Lehigh Ave,,Hartshorne,OK,74547-3413,Pittsburg,P.O. Box 1992,,McAlester,OK,74502,Pittsburg,Sharon Kay Hall,CEO,918-426-2442,211,shall@chhcok.com,Theresa Owens,Billing Manager,918-426-2442,225,towens@chhcok.com,www.chhcok.com
OK-008745,Carter County Health Department,Oklahoma State Health Department,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",173 Franklin St,,Healdton,OK,73438-1821,Carter,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-229-1291,,,
OK-008746,Mercy Hospital Healdton,Mercy Hospital Healdton,1578710406,Inpatient Hospitals (other than children's hospitals),3462 Hospital Rd,,Healdton,OK,73438-6124,Carter,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Office West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008747,Mercy Hospital Rural Health Clinic,Mercy Hospital Rural Health Clinic,1437467388,Rural Health Clinics,3462 Hospital Rd,,Healdton,OK,73438-6124,Carter,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Office - West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President Mercy West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008748,ECOFHC Henryetta NAP - Medical,EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER INC,1881943389,Federally Qualified Health Centers - Medical Services,1102 W Main St,,Henryetta,OK,74437-4232,Okmulgee,PO Box 236,120 E. Broadway,Wetumka,OK,74883-0236,Hughes,Donna S Dyer,CEO,405-452-3151,4101,ddyer@ecofhc.org,Sharilee Strickland,CFO,405-452-3151,4108,sstrickland@ecofhc.org,www.ecofhc.org
OK-008749,"ECOFHC Inc., Henryetta Dental Clinic",EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER INC,1679822175,Dental Providers,217 S 5th St,,Henryetta,OK,74437-5222,Okmulgee,PO Box 236,120 E. Broadway,Wetumka,OK,74883-0236,Hughes,Donna S Dyer,CEO,405-452-3151,4101,ddyer@ecofhc.org,Sharilee Strickland,CFO,405-452-3151,4108,sstrickland@ecofhc.org,www.ecofhc.org
OK-008750,Elkview General Hospital,Kiowa County Hospital Authority,1699758086,Inpatient Hospitals (other than children's hospitals),429 W Elm St,,Hobart,OK,73651-1615,Kiowa,429 West Elm Street,,Hobart,OK,73651,Kiowa,Lisa Anne Hart,Chief Executive Officer,580-726-1962,,lhart@evgh.org,Sandra Strain,Controller,580-726-1963,,sstrain@evgh.org,www.elkviewhospital.com
OK-008751,Kiowa County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",431 W Elm St,,Hobart,OK,73651-1615,Kiowa,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brandie O'Connor,Regional Director,580-726-3316,,,
OK-008752,Hughes County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 McDougal Dr,,Holdenville,OK,74848-2811,Hughes,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda S. Potts,Regional Director,405-379-3313,,,
OK-008753,Harmon County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1104 N 7th St,,Hollis,OK,73550-1445,Harmon,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Karen Weaver, BSN, RN",Regional Director,580-688-3348,,,
OK-008754,"Shortgrass Community Health Center, Inc.",SHORTGRASS COMMUNITY HEALTH CENTER INC.,1255695201,Federally Qualified Health Centers - Medical Services,400 E Sycamore St,,Hollis,OK,73550-1436,Harmon,400 E Sycamore St,,Hollis,OK,73550-1436,Harmon,Michael J Stocking,Interim CEO / CFO,580-688-2800,,michael.stocking@realpractices.net,Janet Tipton,Clinic Manager,580-688-2800,,billsparks@pldi.net,
OK-008755,HOMINY FAMILY HEALTH CENTER,"FAIRFAX MEDICAL FACILITIES, INC",1609040864,"Dental Providers, Federally Qualified Health Centers - Medical Services",119 W Main St,,Hominy,OK,74035-1031,Osage,212 N MAIN ST,,Fairfax,OK,74637,Osage,JOYCE WARD,Credentialing Specialist,918-642-3100,226,JWARD@FAIRFAXCLINIC.COM,Karen McConnell,CEO,918-642-3100,233,kmcconnell@fairfaxclinic.com,Fairfaxclinic.com
OK-008756,Choctaw County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",103 S 4th St,,Hugo,OK,74743-4407,Choctaw,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Julianne Montgomery,Regional Director,580-326-8821,,,
OK-008757,Choctaw Memorial Hospital,Choctaw Memorial Hospital,1881689289,Inpatient Hospitals (other than children's hospitals),1405 E Kirk St,,Hugo,OK,74743-3603,Choctaw,1405 E. Kirk St.,,Hugo,OK,74743,Choctaw,Dawn Ballard,Chief Financial Officer,580-372-2086,286,d.ballard@choctawmemorial.com,,,,,,www.choctawmemorial.com
OK-008758,Kiamichi Family Medical Center - Hugo,"Kiamichi Family Medical Center, Inc.",1902269012,Federally Qualified Health Centers - Medical Services,211 N 3rd St,,Hugo,OK,74743-3821,Choctaw,PO Box 180,,Battiest,OK,74722,Mccurtain,AMY GILBREATH,CEO,580-241-5294,234,amy@kiamichimed.org,Scott Rickey,CFO,580-241-5294,,scott@kiamichimed.org,www.kiamichimed.org
OK-008759,Choctaw Nation Health Clinic Hugo,Choctaw Nation Health Services Authority,1174599088,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",410 N M St,,Hugo,OK,74743-1820,Choctaw,One Choctaw Way,,Talihina,OK,74571,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008760,Hulbert Health Center,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1972597680,Federally Qualified Health Centers - Medical Services,124 E Main St,,Hulbert,OK,74441-8902,Cherokee,127 E Main St,,Hulbert,OK,74441-8901,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008761,McCurtain County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1400 S Lynn Ln,,Idabel,OK,74745-6858,McCurtain,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Julianne Montgomery,Regional Director,580-286-6628,,,http://www.ok.gov/health
OK-008762,KIAMICHI FAMILY MED CTR-IDABEL,KIAMICHI FAMILY MEDICAL CENTER,1184633786,Federally Qualified Health Centers - Medical Services,601 SE Washington St,,Idabel,OK,74745-3319,McCurtain,PO Box 180,,Battiest,OK,74722,Mccurtain,AMY GILBREATH,CEO,580-241-5294,234,amy@kiamichimed.org,Scott Rickey,CFO,580-241-5294,,scott@kiamichimed.org,www.kiamichimed.org
OK-008763,Choctaw Nation Health Clinic Idabel,Choctaw Nation Health Services Authority,1407822497,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",902 E Lincoln Rd,,Idabel,OK,74745-7337,McCurtain,One Choctaw Way,,Talihina,OK,74571,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008764,Sam Hider Health Center,Cherokee Nation Health Services,1659388965,"Dental Providers, Indian Health Service, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",1015 W Washbourne St,,Jay,OK,74346-4205,Delaware,100 S. Bliss Ave,,Tahlequah,OK,74464,Cherokee,Mike Fisher,Health System Administrator,918-253-4271,,mike-fisher@cherokee.org,Mitchell Thornbrugh,Chief Operating Officer,918-207-5507,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008765,OCH JAY FAMILY CLINIC,"SGOH ACQUISITION, INC.",1457808669,Other ECP Providers,2485 N Main St,,Jay,OK,74346-2201,Delaware,2828 N NATIONAL AVE,,Springfield,MO,65803,Greene,LINDA REID,MEDICAL STAFF DIRECTOR,417-837-4004,,LREID@OCHONLINE.COM,BETH HILL,CFO,417-837-2012,,BHILL@OCHONLINE.COM,
OK-008766,Delaware County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",432 S 9th St,,Jay,OK,74346,Delaware,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Regional Directory,,,,
OK-008767,Kingfisher County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",124 E Sheridan Ave Ste 101,Courthouse Annex,Kingfisher,OK,73750-3200,Kingfisher,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,405-375-3008,,,
OK-008768,"CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.","CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.",1831291293,"Dental Providers, Federally Qualified Health Centers - Medical Services",527 W 3rd St,,Konawa,OK,74849-1415,Seminole,527 W 3rd St,,Konawa,OK,74849-1415,Seminole,Brenda Ware,CEO,580-925-3286,,brenda.ware@cofmc.org,,,,,,
OK-008769,Mary Mahoney @ Langston,"Community Health Centers, Inc.",1437133790,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 Martin Luther King St,,Langston,OK,73050,Logan,P.O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73135,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008770,Harper County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7th St and Oklahoma Ave,Suite 9,Laverne,OK,73848,Harper,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Terri Salisbury,Regional Director,580-921-2029,,,
OK-008771,Comanche County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1010 SW Sheridan Rd,,Lawton,OK,73505-1531,Comanche,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brandie O'Connor,Regional Director,580-248-5890,,,
OK-008772,Lawton Indian Hospital,Lawton Indian Hospital,1760489223,"Dental Providers, Family Planning Providers, Indian Health Service",1515 NE Lawrie Tatum Rd,,Lawton,OK,73507-3099,Comanche,1515 NE Lawrie Tatum Rd,,Lawton,OK,73507-3099,Comanche,Greg Ketcher,Chief Executive Officer,580-354-5102,,greg.ketcher@ihs.gov,John Bear,Hospital Administrative Officer,580-354-5103,,john.bear@ihs.gov,
OK-008773,Lawton Community Health Center,COMANCHE COUNTY HOSPITAL AUTHORITY,1588832869,Federally Qualified Health Centers - Medical Services,5404 SW Lee Blvd,,Lawton,OK,73505-9695,Comanche,3401 W Gore Blvd,,Lawton,OK,73505-6332,Comanche,Sean McAvoy,Executive Director,580-355-5242,2221,mcavoys@ccmhonline.com,,,,,,
OK-008774,South Central Medical and Resource Center,SOUTH CENTRAL MEDICAL & RESOURCE CENTER,1366585564,Federally Qualified Health Centers - Medical Services,216 S Main St,,Lindsay,OK,73052-5634,Garvin,216 S Main St,,Lindsay,OK,73052-5634,Garvin,Rick J Pack,CEO,405-756-4612,,rpack@okscmrc.org,Lacy L Curry,COO,405-756-4605,,lcurry@okscmrc.org,www.okscmrc.org
OK-008775,Marshall County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",310 W Lillie Blvd,PO Box 476,Madill,OK,73446-1233,Marshall,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-795-3705,,,http://www.ok.gov/health
OK-008776,JCMH Family Care Medical Clinic of Mangum,Jackson County Memorial Hospital Authority,1093763781,Rural Health Clinics,114 S Louis Tittle Ave,,Mangum,OK,73554-4406,Greer,1200 E. Pecan,P.O. Box 8190,Altus,OK,73521,Jackson,JENNIFER HARRISON,Chief Financial Officer,580-379-5510,,JENNIFERHARRISON@JCMH.COM,Steve Hartgraves,Chief Executive Officer,580-379-5500,,stevehartgraves@jcmh.com,www.jcmh.com
OK-008777,Greer County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2100 N Louis Tittle Ave,,Mangum,OK,73554,Greer,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Karen Weaver, BSN, RN",Regional Director,580-782-5531,,,
OK-008778,Love County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 Ce Colston Dr,,Marietta,OK,73448-1201,Love,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-276-2531,,,
OK-008779,Mercy Hospital Love County,Mercy Hospital Love County,1649221557,Inpatient Hospitals (other than children's hospitals),300 Wanda St,,Marietta,OK,73448-1200,Love,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Communities,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008780,Mercy Love County Rural Health Clinic,Mercy Love County Rural Health Clinic,1578513792,Rural Health Clinics,300 Wanda St,,Marietta,OK,73448-1200,Love,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer,405-752-3924,,gary.raju@mercy.net,Diana Smalley,President Mercy West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008781,Marlow Community Health Center,COMANCHE COUNTY HOSPITAL AUTHORITY,1932127594,Federally Qualified Health Centers - Medical Services,1318 S Broadway St,,Marlow,OK,73055-3864,Stephens,3811 West Gore Blvd,Ste 6,Lawton,OK,73505,Comanche,Sean McAvoy,Executive Director,580-355-5242,2221,mcavoys@ccmhonline.com,,,,,,
OK-008782,Choctaw Nation Health Clinic McAlester,Choctaw Nation Health Services Authority,1952377939,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",1127 S George Nigh Expy,,McAlester,OK,74501-7143,Pittsburg,One Choctaw Way,,Talihina,OK,74571,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,klgray@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008783,Pittsburg County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1400 E College Ave,,McAlester,OK,74501-4288,Pittsburg,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,D'Elbie Walker,Regional Director,918-423-1267,,,http://www.ok.gov/health
OK-008784,"Caring Hands Healthcare Centers, Inc.- McAlester",CARING HANDS HEALTHCARE CENTERS INC,1942435672,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3101 Elk Dr,,McAlester,OK,74501-7606,Pittsburg,P.O. Box 1992,,McAlester,OK,74502,Pittsburg,Sharon K Hall,CEO,918-426-0900,211,shall@chhcok.com,Theresa Owens,Billing Manager,918-426-2442,205,towens@chhcok.com,www.chhcok.com
OK-008785,Kickapoo Tribal Health Center,Kickapoo Tribal Health Center,1265518203,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",105365 S Hwy 102,,McLoud,OK,74851,Pottawatomie,105365 S Hwy 102,,McLoud,OK,74851,Pottawatomie,Gloria Anico,Health Director,405-964-2081,261,gloria.anico@kthcmcloud.com,Michele Ray,Business Office Director,405-964-2081,282,michele.deathrage@ihs.gov,
OK-008786,Grant County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 N Main St,,Medford,OK,73759-1231,Grant,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-9444,56339,LeighN@health.ok.gov,Carla Dionne,Regional Director,580-395-2906,,,
OK-008787,GSPHC - Medford Satellite Location,"GREAT SALT PLAINS HEALTH CENTER, INC.",1699025973,Federally Qualified Health Centers - Medical Services,619 N Front St,,Medford,OK,73759-2704,Grant,405 S Oklahoma Ave,,Cherokee,OK,73728-2545,Alfalfa,Tim Starkey,CEO,580-596-2800,,tstarkey@gsphealth.org,,,,,,
OK-008788,Ottawa County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1930 N Elm St,,Miami,OK,74354-5400,Ottawa,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Regional Director,918-540-2481,,,http://www.ok.gov/health
OK-008789,Cleveland County Health Department- Moore,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",424 S Eastern Ave,,Moore,OK,73160-5942,Cleveland,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Regional Director,405-794-1591,,,
OK-008790,Three Rivers Health Center,Cherokee Nation Health Services,1841207156,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1001 South 41st Steet East,,Muskogee,OK,74403,Muskogee,100 S. Bliss Ave,,Tahlequah,OK,74403,Cherokee,Charles Smith,Health System Administrator,918-781-6500,,charles-smith@cherokee.org,Mitchell Thornbrugh,Chief Operating Officer,918-207-5507,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008791,NeoHealth Muskogee,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1942553946,Federally Qualified Health Centers - Medical Services,1328 S York St,,Muskogee,OK,74403-7650,Muskogee,127 E Main St,,Hulbert,OK,74441-8901,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008792,Muskogee County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",530 S 34th St,,Muskogee,OK,74401-5038,Muskogee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Acting Regional Director,918-683-0321,,,http://www.ok.gov/health
OK-008793,Muskogee Health Center,"Arkansas Verdigris Valley Health Centers, Inc.",1598022899,Federally Qualified Health Centers - Medical Services,619 N Main St,,Muskogee,OK,74401-4431,Muskogee,505 S. Main Street,,Porter,OK,74454,Wagoner,James Turner,Chief Executive Officer,918-906-2871,,james.turner@okhealthservices.com,Sonya Smith,Chief Operating Officer,918-483-0111,,sonya.smith@okhealthservices.com,
OK-008794,Kanza Health Center,Kaw Nation,1487752465,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",3151 E River Rd,PO Box 474,Newkirk,OK,74647-7517,Kay,Drawer 50,,Kaw City,OK,74641,Kay,Jackie Dodson,Health & Human Services Director,580-362-1039,205,jackie.dodson@ihs.gov,,,,,,
OK-008795,NEWKIRK FAMILY HEALTH CENTER,"FAIRFAX MEDICAL FACILITIES, INC",1851535785,"Dental Providers, Federally Qualified Health Centers - Medical Services",716 S Highway 77,,Newkirk,OK,74647-7009,Kay,212 N MAIN ST,,Fairfax,OK,74637,Osage,JOYCE WARD,Credentialing Specialist,918-642-3100,226,JWARD@FAIRFAXCLINIC.COM,Karen McConnell,CEO,918-642-3100,233,kmcconnell@fairfaxclinic.com,Fairfaxclinic.com
OK-008796,Variety Care Pediatric Norman Health Center,"VARIETY CARE, INC.",1144666769,Federally Qualified Health Centers - Medical Services,1237 Alameda St,,Norman,OK,73071-3006,Cleveland,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008797,LI SI WI NWI Health Inc.,Absentee Shawnee Tribal Health Systems,1124152962,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Rural Health Clinics",15951 Little Axe Dr,,Norman,OK,73026-9088,Cleveland,15951 Little Axe Drive,,Norman,OK,73026,Cleveland,Jennifer Harmon,Financial Director,405-447-0300,7907,jharmon@astribe.com,Mark Rogers,Excutive Health Director,405-447-0300,7621,mrogers@astribe.com,
OK-008798,Cleveland County Health Department- Norman,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",250 12th Ave NE,,Norman,OK,73071-5237,Cleveland,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Regional Director,405-321-4048,,,
OK-008799,Variety Care Norman Health Center,"VARIETY CARE, INC.",1427228352,"Dental Providers, Federally Qualified Health Centers - Medical Services",317 E Himes St,,Norman,OK,73069-7810,Cleveland,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-636-1675,10144,treddout@varietycare.org,www.varietycare.org
OK-008800,Variety Care COCMHC-SMI Population,"VARIETY CARE, INC.",1164765145,Federally Qualified Health Centers - Medical Services,909 Alameda St,,Norman,OK,73071-5229,Cleveland,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008801,Will Rogers Health Center,Cherokee Nation Health Services,1891703716,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1020 Lenape Dr,,Nowata,OK,74048-4403,Nowata,100 S. Bliss Ave,,Tahleqauh,OK,74464,Cherokee,Cindy L. Collins,Health System Administrator,918-273-7500,,cindy-l-collins@cherokee.org,mitchell thornbrugh,Chief Operating Officer,918-207-3726,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008802,Morton Nowata Health Center,"MORTON COMPREHENSIVE HEALTH SERVICES, INC.",1275528085,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",207 S Locust St,,Nowata,OK,74048-3660,Nowata,1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008803,Cooweescoowee Health Center,Cherokee Nation Health Services,1871972430,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",295200 W. 2900 Rd.,,Ochelata,OK,74051,Washington,100 S. Bliss Ave,,Tahlequah,OK,74464,Cherokee,Brandi Payton,Health System Administrator,918-535-6000,,Brandi-payton@cherokee.org,mitchell thornbrugh,Chief Operating Officer,918-207-3726,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008804,Okeene Hospital Medical Clinic,Okeene Municipal Hospital and Schallmo Authority,1053478024,Outpatient Hospital Clinics,124 N 6th St,,Okeene,OK,73763-9135,Blaine,PO Box 489,,Okeene,OK,73763,Blaine,Shelly Dunham,CEO,580-822-4321,,sdunham@okeenehospital.com,Sandra Lamle,CFO,580-822-4322,,slamle@okeenehospital.com,www.okeenehospital.com
OK-008805,Okeene Municipal Hospital,Okeene Municipal Hospital and Schallmo Authority,1336142033,Inpatient Hospitals (other than children's hospitals),207 E F St,,Okeene,OK,73763-9441,Blaine,PO Box 489,,Okeene,OK,73763-0489,Blaine,Shelly Dunham,CEO,580-822-4321,,sdunham@okeenehospital.com,Sandra Lamle,CFO,580-822-4322,,slamle@okeenehospital.com,www.okeenehospital.com
OK-008806,Okfuskee County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",125 N 2nd St,,Okemah,OK,74859-2609,Okfuskee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda Potts,Regional Director,918-623-1800,,,http://www.ok.gov/health
OK-008807,Creek Nation Community Hospital (inpatient hospital),Creek Nation Hospital & Clinics,1366593923,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",309 N 14th St,,Okemah,OK,74859-2028,Okfuskee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Manager,918-756-4333,245,Karen.Knight@creekhealth.org,Julie.Shaffer@creekhealth.org,Business Office Manager,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008808,Creek Nation Community Hospital (multiple outpatient ECP categories),Creek Nation Hospital & Clinics,1366593923,"Other ECP Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",309 N 14th St,,Okemah,OK,74859-2028,Okfuskee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Julie.Shaffer@creekhealth.org,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008809,Okemah Community Clinic,Creek Nation Hospital & Clinics,1366593923,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",309 N 14th St,,Okemah,OK,74859-2028,Okfuskee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008810,"SSM Healthcare of Oklahoma, dba St Anthony Hospital","SSM Healthcare of Oklahoma, dba St Anthony Hospital",1366545311,Inpatient Hospitals (other than children's hospitals),1000 N Lee Ave,,Oklahoma City,OK,73102-1036,Oklahoma,1000 N Lee Ave,,Oklahoma City,OK,73102,Oklahoma,Joseph Minerath,SYS DIR REIMBURSEMENT,608-258-6891,6891,Joseph.Minerath@ssmhealth.com,Leslie Sheffield,Sr Financial Analyst Govt Reim,405-272-6566,6566,Leslie.Sheffield@ssmhealth.com,
OK-008811,Oklahoma State Dept. of Health,Oklahoma State Department of Health,1184891525,Family Planning Providers,1000 NE 10th St,,Oklahoma City,OK,73117-1299,Oklahoma,1000 NE 10th St,,Oklahoma City,OK,73117-1207,Oklahoma,Deborah Nichols,Chief Operating Officer,405-271-9444,57974,DeborahN@health.ok.gov,Joyce Marshall,"Director, Maternal and Child Health Service",405-271-9444,56839,joycem@health.ok.gov,http://www.ok.gov/health
OK-008812,Variety Care Straka Family Health Center,"VARIETY CARE, INC.",1780697813,"Dental Providers, Federally Qualified Health Centers - Medical Services",1025 Straka Ter,,Oklahoma City,OK,73139-2544,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008813,OU Children's Physicians,Oklahoma Center for Bleeding & Clotting Disorders,1801869250,Hemophilia Treatment Centers,1200 Childrens Ave,Suite 10A,Oklahoma City,OK,73104-4637,Oklahoma,"1200 Children's Av, Suite 10A",,Oklahoma City,OK,73104,Oklahoma,Carolyn Peek,Pharmacist,405-271-1047,0,carolyn-peek@ouhsc.edu,Joey McCall,JECC manager,404-271-5311,,Joey-McCall@ouhsc.edu,https://www.oumedicine.com/ouphysicians/child-specialties/list-of-child-specialties/children's-hematology---oncology/bleeding-and-clotting-disorders
OK-008814,Perry A. Klaassen Family Medical Center,"Community Health Centers, Inc.",1376725812,"Dental Providers, Federally Qualified Health Centers - Medical Services",1901 Springlake Dr,,Oklahoma City,OK,73111-5201,Oklahoma,P. O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73140,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008815,Oklahoma City-County Health Dept. South,OCCHD,1831174085,Family Planning Providers,2149 SW 59th St,,Oklahoma City,OK,73119-7033,Oklahoma,2149 SW 59th St,,Oklahoma City,OK,73119-7033,Oklahoma,Gary Cox,Clinical Director,405-419-4119,,gary_cox@occhd.org,,,,,,
OK-008816,Variety Care Northwest Oklahoma City,Variety Care,1083086706,Federally Qualified Health Centers - Medical Services,2208 W Hefner Rd,,Oklahoma City,OK,73120-7618,Oklahoma,3000 N. Grand Blvd.,,Oklahoma City,OK,73109-6614,Oklahoma,Lou R. Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008817,Variety Care at NorthCare,Variety Care,1467789610,Federally Qualified Health Centers - Medical Services,2617 General Pershing Blvd,,Oklahoma City,OK,73107-6437,Oklahoma,3000 N. Grand Blvd.,,Oklahoma City,OK,73107-1818,Oklahoma,Lou Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008818,Northeast Partner,OCCHD,1124485263,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2700 NE 63rd Street,,Oklahoma City,OK,73111,Oklahoma,2600 NE 63rd Street,,Oklahoma City,OK,73111,Oklahoma,Tiffany Elmore,Administrator,405-425-4328,,tiffany_elmore@occhd.org,Patrick McGough,Director,405-419-4200,,patrick_mcgough@occhd.org,
OK-008819,Variety Care Tenth Street Family Health Center,"VARIETY CARE, INC.",1033344197,"Dental Providers, Federally Qualified Health Centers - Medical Services",4023 NW 10th St,,Oklahoma City,OK,73107-6038,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008820,Healing Hands,"Community Health Centers, Inc.",1023091519,Federally Qualified Health Centers - Medical Services,411 NW 11th St,,Oklahoma City,OK,73103-3913,Oklahoma,P. O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73140,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008821,OK City Co. Health Dept. - West,OK City Co. Health Dept.,1477713097,Family Planning Providers,4330 NW 10th St,,Oklahoma City,OK,73107-5711,Oklahoma,4330 NW 10th St,,Oklahoma City,OK,73107-5711,Oklahoma,Gary Cox,Director,405-419-4150,,gary_cox@occhd.org,,,,,,
OK-008822,Variety Care at OSU-OKC,Variety Care,1972056372,Federally Qualified Health Centers - Medical Services,440 N Portland Ave,,Oklahoma City,OK,73107-6110,Oklahoma,3000 N. Grand Blvd.,,Oklahoma City,OK,73107-1818,Oklahoma,Lou Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008823,"Community Health Centers, Inc. @ Red Rock","Community Health Centers, Inc.",1518222306,Federally Qualified Health Centers - Medical Services,4400 N Lincoln Blvd,,Oklahoma City,OK,73105-5104,Oklahoma,P.O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73140,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008824,Oklahoma City Indian Clinic,"Central Oklahoma American Indian Health Council, Inc.",1407969728,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",4913 W Reno Ave,,Oklahoma City,OK,73127-6339,Oklahoma,4913 W Reno Ave,,Oklahoma City,OK,73127-6339,Oklahoma,Robyn Sunday-Allen,Chief Executive Officer,405-948-4900,260,robyn.s@okcic.com,Robin Parker,Director of Business Office,405-948-4900,649,robin.p@okcic.com,
OK-008825,Variety Care Educare Pediatric Center,Variety Care,1902189038,Federally Qualified Health Centers - Medical Services,500 SE Grand Blvd,,Oklahoma City,OK,73129-4948,Oklahoma,3000 N. Grand Blvd.,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R. Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008826,"Variety Care, Inc.","VARIETY CARE, INC.",1770826661,Federally Qualified Health Centers - Medical Services,500 SW 36th St,Variety Care at Capitol Hill High School Health Center,Oklahoma City,OK,73109-6614,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008827,Variety Care - Inasmuch Pediatric Health Center,"VARIETY CARE, INC.",1982939526,"Dental Providers, Federally Qualified Health Centers - Medical Services",500 SW 44th St,,Oklahoma City,OK,73109-3540,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008828,Variety Care North Portland Health Center,"VARIETY CARE, INC.",1669787453,Federally Qualified Health Centers - Medical Services,5320 N Portland Ave,Suite A,Oklahoma City,OK,73112-2098,Oklahoma,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008829,Northwest Oklahoma City Health Center,Planned Parenthood Great Plains,1679614838,"Family Planning Providers, Sexually Transmitted Disease Clinics",6112 NW 63rd St,,Oklahoma City,OK,73132-7526,Oklahoma,4401 W 109th St.,,Overland Park,KS,66211,Johnson,Shirish Malla,Vice President of Health Services,913-345-4662,4662,Shirish.malla@ppgreatplains.org,Shirish Malla,"Project Manager, Operations & Strategic Inititiatives",913-345-4662,,shirish.malla@ppgreatplains.org,http://www.ppgreatplains.org
OK-008830,Central Oklahoma City Health Center,Planned Parenthood Great Plains,1679614838,Family Planning Providers,619 NW 23rd St,,Oklahoma City,OK,73103-1415,Oklahoma,619 NW 23rd St,,Oklahoma City,OK,73103-1415,Oklahoma,Shirish Malla,"Project Manager, Operations & Strategic Initiatives",913-345-4662,,Shirish.malla@ppgreatplains.org,Amanda Addison,VP of Health Services,913-345-4659,4659,amanda.addison@ppgreatplains.org,
OK-008831,UNIVERSITY OF OKLAHOMA,University of Oklahoma Health Sciences Center,1801869250,Ryan White Providers,711 Stanton L Young Blvd,Suite 430,Oklahoma City,OK,73104-5022,Oklahoma,1000 Stanton L Young Blvd,LIB121,Oklahoma City,OK,73117,Oklahoma,Contracting Office,Billing and Insurance,405-271-1528,,billingcompliance@ouhsc.edu,Wendy Newport,Project Administrator,405-271-8001,54384,wendy-newport@ouhsc.edu,http://www.ouhsc.edu/bc/ContactPage.asp
OK-008832,Muscogee (Creek) Nation Community Clinic,Creek Nation Hospital & Clinic,1740689488,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1201 S Belmont Ave,Suite 207,Okmulgee,OK,74447-6351,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008833,Muscogee (Creek) Nation Orthopedic Clinic,Creek Nation Hospital & Clinics,1689073413,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1201 S Belmont Ave,Suite 205,Okmulgee,OK,74447-6351,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Manager,918-756-4333,,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008834,Okmulgee County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1304 R D Miller Dr,,Okmulgee,OK,74447-6365,Okmulgee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda Potts,Regional Director,918-756-1883,,,http://www.ok.gov/health
OK-008835,Okmulgee Indian Health Center,Creek Nation Hospital & Clinics,1366593923,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1313 E 20th St,,Okmulgee,OK,74447-6303,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008836,Muscogee (Creek) Nation Medical Center (inpatient hospital),Creek Nation Hospital & Clinics,1902236573,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",1401 Morris Dr,,Okmulgee,OK,74447-6429,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Manager,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Manager,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008837,Muscogee (Creek) Nation Medical Center (multiple outpatient ECP categories),Creek Nation Hospital & Clinics,1902236573,"Other ECP Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",1401 Morris Dr,,Okmulgee,OK,74447-6429,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008838,Muscogee (Creek) Nation LTACH,Creek Nation Hospital & Clinics,1376979955,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",900 E Airport Rd,,Okmulgee,OK,74447-9082,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Manager,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Manager,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008839,Muscogee (Creek) Nation Physical Rehabilitation Center (inpatient hospital),Creek Nation Hospital & Clinics,1467888040,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",900 E Airport Rd,,Okmulgee,OK,74447-9082,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Manager,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008840,Muscogee (Creek) Nation Physical Rehabilitation Center (multiple outpatient ECP categories),Creek Nation Hospital & Clinics,1467888040,"Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",900 E Airport Rd,,Okmulgee,OK,74447-9082,Okmulgee,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,268,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008842,Garvin County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1809 S Chickasaw St,,Pauls Valley,OK,73075-6816,Garvin,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Regional Director,405-238-7346,,,
OK-008843,Osage County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1115 E 15th St,,Pawhuska,OK,74056-1901,Osage,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Larry Bergner,Regional Director,918-287-3740,,,http://www.ok.gov/health
OK-008844,WAH ZHA ZHI HEALTH CENTER,OSAGE NATION,1902272826,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",715 Grandview Ave,,Pawhuska,OK,74056-3201,Osage,715 GRANDVIEW,,Pawhuska,OK,74056,Osage,MARJORIE WILLIAMS,ACTING BUSINESS OF MANAGER,918-287-4491,9336,MARJORIE.WILLIAMS@IHS.GOV,PAULA STABLER,ADMINSTRATIVE ASSISTANT,918-287-4491,9301,PAULA.STABLER@IHS.GOV,
OK-008845,Pawnee Indian Health Center,Pawnee Indian Health Center,1629174081,"Dental Providers, Indian Health Service, Other ECP Providers",1201 Heritage Cir,,Pawnee,OK,74058-3744,Pawnee,1201 Heritage Cir,,Pawnee,OK,74058-3744,Pawnee,Travis Scott,Chief Executive Officer,918-762-2517,,travis.scott@ihs.gov,Pearl Dry,Administrative Officer,918-762-2517,,pearl.dry@ihs.gov,
OK-008846,The Pawnee Clinic,"CAH, Acquisition Company 12 LLC",1598039620,Rural Health Clinics,535 6th St,,Pawnee,OK,74058-2542,Pawnee,40 Hospital Rd,,Fairfax,OK,74637,Osage,Tina Steele,Hospital CEO,918-642-3291,311,tsteele@empowerhms.com,Linda Thompson,Revenue Cycle Manager,918-642-3291,316,lthompson@fairfaxcommunityhospital.com,
OK-008847,Pawnee County Health Department - Pawnee,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",639 7th St,,Pawnee,OK,74058-2540,Pawnee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Kelli Rader,Regional Director,918-762-3643,,,http://www.ok.gov/health
OK-008848,Perkins Family Clinic,Iowa Tribe of Oklahoma,1891943106,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",509 E Highway 33,,Perkins,OK,74059-4129,Payne,PO Box 460,,Perkins,OK,74059,Payne,Angela Daugherty,Health Division Director,405-547-2473,726,adaugherty@iowanation.org,Angela Cantrell,Medical Billing Specialist,405-547-2473,706,acantrell@iowanation.org,
OK-008849,Noble County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 E Fir St,,Perry,OK,73077-4902,Noble,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Kelli Rader,Regional Director,580-336-2257,,,http://www.ok.gov/health
OK-008850,Perry Memorial Hospital,Perry Memorial Hospital Authority,1245236652,Inpatient Hospitals (other than children's hospitals),501 N 14th St,,Perry,OK,73077-5021,Noble,501 14th Street,,Perry,OK,73077,Noble,Courtney Kozikuski,CFO,580-336-2176,3209,ckozikuski@pmh-ok.org,Michelle Leach,Patient Financial Services Manager,580-336-2176,3226,mleach@pmh-ok.org,
OK-008851,White Eagle Health Center,Ponca Tribe of Oklahoma,1699875724,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",200 White Eagle Dr,,Ponca City,OK,74601-8315,Kay,200 White Eagle Drive,,Ponca City,OK,74601,Oklahoma,Modina Waters,Facility Director,580-765-2501,2222,modina.waters@ihs.gov,Randy Ross,Development Officer,580-765-2501,2242,randy.ross@ihs.gov,
OK-008852,Kay County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",433 Fairview Ave,,Ponca City,OK,74601-1923,Kay,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Kelli Rader, MS, RN",Regional Director,580-762-1641,,,
OK-008853,Porter Health Center,"Arkansas Verdigris Valley Health Centers, Inc.",1083740047,"Dental Providers, Federally Qualified Health Centers - Medical Services",505 S Main St,,Porter,OK,74454-1015,Wagoner,505 S. Main Street,,Porter,OK,74454,Wagoner,James Turner,Chief Executive Officer,918-906-2871,,james.turner@okhealthservices.com,Sonya Smith,Chief Operating Officer,918-483-0111,,sonya.smith@okhealthservices.com,
OK-008854,Choctaw Nation Health Clinic Poteau,Choctaw Nation Health Services Authority,1710953799,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",109 Kerr Ave,,Poteau,OK,74953-5270,Le Flore,One Choctaw Way,,Talihina,OK,74571,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008855,LeFlore County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1204 Dewey Ave,,Poteau,OK,74953-4414,Le Flore,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Jill Larcade, MPH, RN",Regional Director,918-647-8601,,,
OK-008856,Poteau Health and Wellness Center,Stigler Health and Wellness Center,1891752853,Federally Qualified Health Centers - Medical Services,204 Wall St,,Poteau,OK,74953-4400,Le Flore,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008857,Prague Community Hospital / Prague Family Clinic,Empower HMS,1184981441,Rural Health Clinics,1322 Klabzuba Ave,PO Box S,Prague,OK,74864-1090,Lincoln,Prague Community Hospital,"1322 Klabzuba, P.O. Drawer S",Prague,OK,74864,Lincoln,Randy Simmons,CEO,405-567-4922,2227,rsimmons@praguehospital.com,Shelly Dyer,Business Office Manager,405-567-4922,2249,smdyer@praguehospital.com,praguehospital.com
OK-008858,Mayes County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",111 NE 1st St,,Pryor,OK,74361-2403,Mayes,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Regional Director,918-825-4224,,,http://www.ok.gov/health
OK-008859,Chickasaw Nation - Purcell Indian Health Clinic,Chickasaw Nation - Purcell Indian Health Clinic,1982764395,"Indian Health Service, Other ECP Providers",1438 Hardcastle Blvd,,Purcell,OK,73080-8233,McClain,1438 Hardcastle Blvd,,Purcell,OK,73080-8233,McClain,Brenda Teel,Executive Officer of Revenue,580-421-4570,82864,brenda.teel@chickasaw.net,Tina Johnson,Executive Assistant,580-421-4570,82878,tina.johnson@chickasaw.net,www.chickasaw.net
OK-008860,McClain County Health Department - Purcell,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",919 N 9th Ave,,Purcell,OK,73080-2028,McClain,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Regional Director,405-527-6541,,,http://www.ok.gov/health
OK-008862,NeoHealth Salina Family Medical Center,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1609254507,Federally Qualified Health Centers - Medical Services,101 E Ferry St,,Salina,OK,74365-2988,Mayes,"127 E. Main St.,",,Hulbert,OK,74441,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008863,Cherokee Nation A-MO Health Center (Salina Community Clinic),Cherokee Nation A-MO Health Center (Salina Community Clinic),1326054081,"Dental Providers, Freestanding Cancer Centers, Tribal Health Program operated under P.L. 93-638",900 N Owen Walters Blvd,,Salina,OK,74365-5003,Mayes,PO Box 490,,Salina,OK,74365-0936,Mayes,Rhonda Cochran,Senior Director of Ambulatory Services,918-434-8500,,rhonda-cochran@cherokee.org,Kathy Smithson,Special Projects Officer,918-434-8500,8503,kathy-smithson@cherokee.org,
OK-008864,Sallisaw Health and Wellness Center,"Stigler Health and Wellness Center, Inc.",1891752853,Federally Qualified Health Centers - Medical Services,1630 S Kerr Blvd,,Sallisaw,OK,74955-7240,Sequoyah,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008865,Redbird Smith Health Center,Cherokee Nation Health Services,1780692723,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",301 S J T Stites St,,Sallisaw,OK,74955-9302,Sequoyah,100 S. Bliss Ave,,Tahlequah,OK,74464,Cherokee,Jerry Caughman,Health System Administrator,918-775-9159,,jerry-caughman@cherokee.org,mitchell thornbrugh,Chief Operating Officer,918-207-5507,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008866,Sequoyah County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",612 N Oak St,,Sallisaw,OK,74955-2827,Sequoyah,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jill Larcade,Regional Director,918-775-6201,,,http://www.ok.gov/health
OK-008867,Sand Springs Health Center,Tulsa City-County Health Department,1891893475,"Family Planning Providers, Sexually Transmitted Disease Clinics",306 E Broadway St,,Sand Springs,OK,74063-7911,Tulsa,5051 S. 129th E. Ave,,Tulsa,OK,74134,Tulsa,Bruce Dart,Executive Director,918-595-4044,,bdart@tulsa-health.org,Reggie Ivey,Chief Operating Officer,918-595-4404,,rivey@tulsa-health.org,
OK-008868,Sapulpa Indian Health Center,Creek Nation Hospital & Clinic,1366593923,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1125 E Cleveland Ave,,Sapulpa,OK,74066-4641,Creek,1101 S Belmont,,Okmulgee,OK,74447,Okmulgee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008869,Creek County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1808 S Hickory St,,Sapulpa,OK,74066-6219,Creek,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,918-224-5531,,,
OK-008870,Beckham County Health Department- Sayre,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 S 4th St,,Sayre,OK,73662-2924,Beckham,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,"Karen Weaver, BSN, RN",Regional Director,580-928-5551,,,
OK-008871,Seminole County Health Department - Seminole,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1900 Boren Blvd,,Seminole,OK,74868-2049,Seminole,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda Potts,Regional Administrator,405-382-4369,,,http://www.ok.gov/health
OK-008872,St Anthony Shawnee Hospital,"SSM Healthcare Of Oklahoma, Inc dba St Anthony Hospital",1134123193,Inpatient Hospitals (other than children's hospitals),1102 W MacArthur St,,Shawnee,OK,74804-1743,Pottawatomie,1102 West Macarthur,,Shawnee,OK,74801,Okfuskee,Joseph Minerath,SYS DIR REIMBURSEMENT,608-258-6891,6891,Joseph.Minerath@ssmhealth.com,Leslie Sheffield,Sr Financial Analyst Govt Reimb,405-272-6566,6566,Leslie.Sheffield@ssmhealth.com,
OK-008873,CHCI Shawnee Family Medical Center,"Community Health Centers, Inc.",1851727754,Federally Qualified Health Centers - Medical Services,1414 N Kennedy Ave,Suite 2,Shawnee,OK,74801-4700,Pottawatomie,P. O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73140,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008874,Pottawatomie County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1904 Gordon Cooper Dr,,Shawnee,OK,74801-8698,Pottawatomie,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda Potts,Regional Director,405-273-2157,,,http://www.ok.gov/health
OK-008875,Citizen Potawatomi Nation,Citizen Potawatomi Nation,1194752949,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",2307 Gordon Cooper Dr,,Shawnee,OK,74801-9007,Pottawatomie,1601 S. Gordon Cooper Dr,,Shawnee,OK,74801-9002,Pottawatomie,Chris Skillings,Director of Health Services,405-273-5236,,chris.skillings@potawatomi.org,Keri Harjo,Clinic Manager,405-273-5236,,kharjo@potawatomi.org,
OK-008876,Citizen Potawatomi Nation West Clinic,Citizen Potawatomi Nation,1881981744,"Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",781 Grand Casino Blvd,,Shawnee,OK,74804-1005,Pottawatomie,1601 S. Gordon Cooper Drive,,Shawnee,OK,74801,Pottawatomie,Chris Skillings,Director of Health Services,405-273-5236,,chris.skillings@potawatomi.org,Keri Harjo,Clinic Manager,405-273-5236,,kharjo@potawatomi.org,
OK-008877,"Family Healthcare Clinic, Inc.","Family Healthcare Clinic, Inc",1659581387,Other ECP Providers,500 W Rogers Blvd,Suite B,Skiatook,OK,74070-1081,Osage,1820 W. Hensley Blvd.,,Bartlesville,OK,74003,Washington,Patricia A. Leach,Executive Director,918-336-4822,,paleach2@aol.com,Alison Roundtree,Financial Operations Manager,918-336-4822,,awalker.fhc@gmail.com,
OK-008878,Mary Mahoney Memorial Health Center,"Community Health Centers, Inc.",1265415806,"Dental Providers, Federally Qualified Health Centers - Medical Services",12716 NE 36th St,,Spencer,OK,73084-9167,Oklahoma,P.O. Box 30589,12716 NE 36th Street,Oklahoma City,OK,73135,Oklahoma,Isabella Lawson,CEO,405-769-3301,1232,isabella.lawson@chciokc.org,Debbie Haller,Development Coordinator,405-769-3301,1205,debbie.haller@chciokc.org,
OK-008879,Haskell County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1407 NE D St,,Stigler,OK,74462-2815,Haskell,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officere,405-271-4042,56339,LeighN@health.ok.gov,"Jill Larcade, MPH, RN",Regional Director,918-967-3304,,,
OK-008880,"Stigler Health and Wellness Center, Inc","Stigler Health and Wellness Center, Inc.",1891752853,"Dental Providers, Federally Qualified Health Centers - Medical Services",1505 E Main St Unit C,,Stigler,OK,74462-2914,Haskell,1505 East Main St,,Stigler,OK,74462-2914,Haskell,Janice Lynn Bracken,Billing/Credentialing,918-967-3368,2138,jbracken@thwcinc.com,,,,,,
OK-008881,Choctaw Nation Health Clinic Stigler,Choctaw Nation Health Services Authority,1184690026,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",2204 E Main St,,Stigler,OK,74462-2822,Haskell,One Choctaw Way,,Talihina,OK,74462-2822,Le Flore,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008882,Haskell County Community Hospital,Haskell County Community Hospital,1922329853,Inpatient Hospitals (other than children's hospitals),401 NW H St,,Stigler,OK,74462-1625,Haskell,"401 NW ""H"" Street",,Sigler,OK,74462,Haskell,Donald E. Buchanan,CEO,918-967-4682,,dbuchanan@hmccah.com,Kellie Hamilton,Director of Revenue Cyc le,918-967-4682,,kmooneyham@haskellhospital.com,
OK-008883,Payne County Health Department - Stillwater,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1321 W 7th Ave,,Stillwater,OK,74074-4360,Payne,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Kelli Radar,Regional Director,405-372-8200,,,http://www.ok.gov/health
OK-008884,Stillwater Medical Center Authority,Stillwater Medical Center,1164494027,Inpatient Hospitals (other than children's hospitals),1323 W 6th Ave,,Stillwater,OK,74074-4306,Payne,1323 West 6th Street,,Stillwater,OK,74074,Payne,Alan Lovelace,CFO,405-742-5729,5729,alovelace@stillwater-medical.org,Liz Micheal,CNO,405-742-5729,5729,lmichael@stillwater-medical.org,
OK-008885,Adair County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",600 W Hickory St,,Stilwell,OK,74960-3622,Adair,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,AleshiaO@health.ok.gov,"Jill Larcade, MPH, RN",Regional Director,918-696-7292,,,
OK-008886,Wilma P. Mankiller Health Center,Cherokee Nation Health Services,1992711345,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",840 Hwy 51 E,PO Box 93,Stilwell,OK,74960-0093,Adair,100 S. Bliss Ave,,Tahlequah,OK,74464,Cherokee,Christie Cooper,Health System Administrator,918-696-8800,,christie-cooper@cherokee.org,mitchell thornbrugh,Chief Operating Offficer,918-207-3726,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008887,Black Hawk Health Center,Black Hawk Health Center,1871663203,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",356110 E 930 Rd,,Stroud,OK,74079-5184,Lincoln,356110 E 930 Rd,,Stroud,OK,74079-5184,Lincoln,DONALD WHITEHEAD,Health Director,918-968-9531,3001,Donald.Whitehead@ihs.gov,,,,,,
OK-008888,Murray County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",730 Cambridge,,Sulphur,OK,73086-4254,Murray,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Keith Reed,Acting Regional Director,580-622-3716,,,http://www.ok.gov/health
OK-008889,Cherokee Nation W.W. Hastings Hospital (inpatient hospital),Cherokee Nation W.W. Hastings Hospital,1669628707,"Inpatient Hospitals (other than children's hospitals), Tribal Health Program operated under P.L. 93-638",100 S Bliss Ave,,Tahlequah,OK,74464-2512,Cherokee,100 S Bliss Ave,,Tahlequah,OK,74464-2512,Cherokee,Brian Hail,Chief Executive Officer,918-458-3100,,brian-hail@cherokee.org,Mitchell Thornbrugh,Chief Operating Officer,918-207-3726,3726,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008890,Cherokee Nation W.W. Hastings Hospital (multiple outpatient ECP categories),Cherokee Nation W.W. Hastings Hospital,1669628707,"Dental Providers, Outpatient Hospital Clinics, Tribal Health Program operated under P.L. 93-638",100 S Bliss Ave,,Tahlequah,OK,74464-2512,Cherokee,100 S Bliss Ave,,Tahlequah,OK,74464-2512,Cherokee,Brian Hail,Chief Executive Officer,918-458-3100,,brian-hail@cherokee.org,Mitchell Thornbrugh,Chief Operating Officer,918-207-3726,3726,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008891,Northeastern Health System,Tahlequah Hospital Authority,1003865999,Inpatient Hospitals (other than children's hospitals),1400 E Downing St,,Tahlequah,OK,74464-3324,Cherokee,PO Box 1008,,Tahlequah,OK,74465,Cherokee,Julie Ward,VP Finance,918-931-7833,,jward@nhs-ok.org,Jennifer Palmer,AVP Reimbursement,918-453-2133,,jpalmer@nhs-ok.org,
OK-008892,NeoHealth OB/Gyn Associates,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1184926362,Federally Qualified Health Centers - Medical Services,1500 E Downing St,Suite 208,Tahlequah,OK,74464-3234,Cherokee,127 E. Main St.,,Hulbert,OK,74441,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008893,NeoHealth Pediatrics,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1891097077,Federally Qualified Health Centers - Medical Services,1500 E Downing St,Suite 102,Tahlequah,OK,74464-3354,Cherokee,"127 E. Main St.,",,Hulbert,OK,74441,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008894,Tahlequah Family Practice,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1972052983,Federally Qualified Health Centers - Medical Services,1500 E Downing St,Suite 101,Tahlequah,OK,74464-3354,Cherokee,PO Box 751,,Hulbert,OK,74441,Cherokee,Mike McGavock,CIO,918-772-3390,1109,mike.mcgavock@neohealth.org,,,,,,www.NeoHealth.org
OK-008895,Tahlequah Health Center,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1366744534,Federally Qualified Health Centers - Medical Services,1500 E Downing St,Suite 214,Tahlequah,OK,74464-3379,Cherokee,127 E Main St,,Hulbert,OK,74441-8901,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008896,Cherokee Nation Ga Du Gi Clinic,Cherokee Nation Health Services,1093722324,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",16944 W Cherokee,,Tahlequah,OK,74464,Cherokee,100 S. Bliss Avenue,,Tahlequah,OK,74464,Cherokee,Joanna McDaniel,Health System Administrator,918-207-4911,,joanna-mcdaniel@cherokee.org,Mitchell Thornbrugh,Chief Operating Officer,918-207-3726,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008897,"NeoHealth Medical Center, NSU Campus","NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1144777319,Federally Qualified Health Centers - Medical Services,529 N Oak Ave,,Tahlequah,OK,74464-2925,Cherokee,127 E. Main St,,Hulbert,OK,744410751,Cherokee,Scott Rosenthal,CEO,918-772-3390,,info@neohealth.org,Crystal Steed,COO,918-772-3390,,info@neohealth.org,neohealth.org
OK-008898,Cherokee County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",912 S College Ave,,Tahlequah,OK,74464-4726,Cherokee,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Regional Director,918-456-8826,,,
OK-008899,Choctaw Nation Health Clinic and Hospital Talihina,Choctaw Nation Health Services Authority,1659347623,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",1 Choctaw Way,,Talihina,OK,74571-2022,Latimer,One Choctaw Way,,Talihina,OK,74571-2022,Latimer,Sherrie Varner,Medicare Technician,580-916-9140,83808,slvarner@cnhsa.com,Kara Gray,Revenue Contracts Manager,580-916-9140,83828,klgray@cnhsa.com,
OK-008900,Variety Care - Thomas,"VARIETY CARE, INC.",1588914196,Federally Qualified Health Centers - Medical Services,100 S 2nd St,,Thomas,OK,73669-8201,Custer,3000 N Grand Blvd,,Oklahoma City,OK,73107-1818,Oklahoma,Lou R Carmichael,CEO,405-636-1675,,lcarmichael@varietycare.org,Tim Reddout,CFO,405-632-6688,10144,treddout@varietycare.org,www.varietycare.org
OK-008901,Mercy Hospital Tishomingo,Mercy Hospital Tishomingo,1932404431,Inpatient Hospitals (other than children's hospitals),1000 S Byrd St,,Tishomingo,OK,73460-3265,Johnston,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,"Chief Financial Office, West Communities",405-752-3924,,gary.raju@mercy.net,Diana Smalley,President Mercy West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008902,Johnston County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1080 S Byrd St,,Tishomingo,OK,73460-3265,Johnston,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-371-2470,,,
OK-008903,Tishomingo,Family Health Center of Southern Oklahoma,1598803942,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",610 E 24th St,,Tishomingo,OK,73460-3245,Johnston,610 E. 24th Street,,Tishomingo,OK,73460,Johnston,Tina Davis,Executive Director,580-371-0234,3322,tdavis@fhcso.org,Caren Atteberry,Finance Officer,580-371-2343,3323,catteberry@fhcso.org,
OK-008904,Tishomingo Health Clinic,Tishomingo Health Clinic,1649330242,"Dental Providers, Indian Health Service, Other ECP Providers",817 E 6th St,,Tishomingo,OK,73460-1800,Johnston,817 E 6th St.,,Tishomingo,OK,73460-1800,Johnston,Brenda Teel,Executive Officer of Revenue,580-421-4570,82864,brenda.teel@chickasaw.net,Tina Johnson,Executive Assistant,580-421-4570,82878,tina.johnson@chickasaw.net,www.chickasaw.net
OK-008905,"Peoria Health Center of Tulsa, OK",Planned Parenthood Great Plains,1831185412,Family Planning Providers,1007 S Peoria Ave,,Tulsa,OK,74120-4495,Tulsa,4401 W 109th St,Suite 200,Overland Park,KS,66211,Johnson,Shirish Malla,"Project Manager, Operations & Strategic Initiative",913-345-4662,4662,Shirish.malla@ppgreatplains.org,Amanda Addison,VP of Health Services,913-345-4659,4659,amanda.addison@ppgreatplains.org,https://www.plannedparenthood.org/health-center/oklahoma/tulsa/74120/peoria-health-center-2416-90740
OK-008906,Morton Midtown Homeless Health Center,"MORTON COMPREHENSIVE HEALTH SERVICES, INC.",1275528085,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",102 N Denver Ave,,Tulsa,OK,74103-1806,Tulsa,1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008907,Morton East Health Center,"MORTON COMPREHENSIVE HEALTH SERVICES, INC.",1275528085,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",11511 E 21st St,,Tulsa,OK,74129-1815,Tulsa,1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008908,Morton Comprehensive Health Services,Morton Comprehensive Health Services,1275528085,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,1334 N. Lansing,,Tulsa,OK,74106,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008909,Kendall Whittier,Community Health Connection,1255612040,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2321 E 3rd St,,Tulsa,OK,74104-1831,Tulsa,2321 E 3rd St,,Tulsa,OK,74104,Tulsa,James Thompson,Quality Improvement Coordinator,918-710-4409,,james.thompson@tchc.us,Jane Rice,,918-710-4411,,jane.rice@tchc.us,
OK-008910,Morton Family & Children's Health Center,"MORTON COMPREHENSIVE HEALTH SERVICES, INC.",1275528085,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2325 S Harvard Ave,,Tulsa,OK,74114-3300,Tulsa,1334 N Lansing Ave,,Tulsa,OK,74106-5907,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008911,Central Regional Health Center,Tulsa City-County Health Department,1891893475,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",315 S Utica Ave,,Tulsa,OK,74104-2203,Tulsa,5051 S. 129th E. Ave,,Tulsa,OK,74133,Tulsa,Bruce Dart,Executive Director,918-594-4044,,bdart@tulsa-health.org,Reggie Ivey,CHEIF OPERATING OFFICER,918-594-4404,,rivey@tulsa-health.org,
OK-008912,James O. Goodwin Health Center,Tulsa City-County Health Department,1891893475,"Family Planning Providers, Sexually Transmitted Disease Clinics",5051 S 129th East Ave,,Tulsa,OK,74134-7004,Tulsa,5051 S. 129th E. Ave,,Tulsa,OK,74134,Tulsa,Bruce Dart,Executive Director,918-595-4044,,bdart@tulsa-health.org,Reggie Ivey,Chief Operating Officer,918-595-4404,,rivey@tulsa-health.org,
OK-008913,Indian Health Care Resource Health Center,Indian Health Care Resource Health Center,1427034958,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",550 S Peoria Ave,,Tulsa,OK,74120-3820,Tulsa,550 S Peoria Ave,,Tulsa,OK,74120-3820,Tulsa,Judy gibson,Chief Financial Officer,918-382-1208,,jgibson@ihcrc.org,Carmelita Skeeter,Chief Executive Officer,918-382-1201,,cskeeter@ihcrc.org,
OK-008914,North Tulsa Health and Wellness Center,Tulsa City-County Health Department,1891893475,"Family Planning Providers, Sexually Transmitted Disease Clinics",5635 N Martin Luther King Jr Blvd,,Tulsa,OK,74126-6409,Tulsa,5051 S. 129th E. Ave.,,Tulsa,OK,74134,Tulsa,Bruce Dart,Executive Director,918-595-4044,,bdart@tulsa-health.org,Reggie Ivey,Chief Operating Officer,918-595-4404,,rivey@tulsa-health.org,
OK-008915,Morton West Tulsa Health Center,Morton Comprehensive Health Services,1275528085,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6116 W 11th St,,Tulsa,OK,74127-7330,Tulsa,1334 N. Lansing,,Tulsa,OK,74106,Tulsa,John Silva,CEO,918-295-9392,,jsilva@mortonhealth.org,Susan Savage,Executive Director,918-295-6151,,ssavage@mortonhealth.org,
OK-008916,Community Health Connection Inc,COMMUNITY HEALTH CONNECTION INC,1194730911,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9912 E 21st St,,Tulsa,OK,74129-1620,Tulsa,2321 E 3rd St,,Tulsa,OK,74104,Tulsa,James Thompson,Quality Improvement Coordinator,918-710-4409,,james.thompson@tchc.us,Jane Rice,Compliance Officer,918-710-4411,,jane.rice@tchc.us,www.communityhealthconnection.org
OK-008917,Community Clinic of Turpin,Beaver County Hospital Authority,1285611756,Rural Health Clinics,104 Hibbs,,Turpin,OK,73950,Beaver,PO Box 299,,Turpin,OK,73950,Beaver,Alissa Schlessman,Administrator,580-625-4551,245,bcmhadministrator@beavercountyhospitalauthority.com,Cody Gregory,Comptroller,580-625-4551,234,bcmhcomptroller@beavercountyhospitalauthority.com,
OK-008918,Craig County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 E Delaware Ave,,Vinita,OK,74301-4204,Craig,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Maria Alexander,Regional Director,918-256-7531,,,
OK-008919,Vinita Health Center,Cherokee Nation Health Services,1558377226,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",27371 S 4410 Rd,,Vinita,OK,74301-7953,Craig,100 S. Bliss Ave,,Tahlequah,OK,74464,Cherokee,Elton Sunday,Health System Administrator,918-323-0191,,elton-sunday@cherokee.org,mitchell thornbrugh,Chief Operating Officer,918-207-3726,,mitchell-thornbrugh@cherokee.org,http://www.cherokee.org/Services/Health.aspx
OK-008920,Wagoner Community Hospital,Wagoner Hospital Authority,1386611580,Inpatient Hospitals (other than children's hospitals),1200 W Cherokee St,,Wagoner,OK,74467-4624,Wagoner,1200 West Cherokee Street,,Wagoner,OK,74467,Wagoner,Dana Denson,Administrative Coordinator,918-485-1403,,ddenson@wagonerhospital.com,Rebecca Sharp,CFO,918-485-1236,,rsharp@wagonerhospital.com,
OK-008921,Wagoner County Health Department - Wagoner,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",212 N Pierce Ave,,Wagoner,OK,74467-4128,Wagoner,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Larry Bergner,Acting Regional Director,918-485-3022,,,http://www.ok.gov/health
OK-008922,Cotton County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1501A S 7th St,,Walters,OK,73572-2463,Cotton,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brandie O'Connor,Regional Director,580-875-6121,,,
OK-008923,Warner Health and Wellness Center,"Stigler Health and Wellness Center, Inc.",1891752853,Federally Qualified Health Centers - Medical Services,700 College Rd,,Warner,OK,74469-2204,Muskogee,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008924,Watonga Health Center,Watonga Health Center,1558458794,"Dental Providers, Indian Health Service, Other ECP Providers",1305 S Clarence Nash Blvd,,Watonga,OK,73772-4820,Blaine,1305 S CLARENCE NASH RD,,Watonga,OK,73772-9706,Blaine,ANDREA JACKSON,Facility Director,580-331-3300,,ANDREA.JACKSON@IHS.GOV,APRIL WAZHAXI,CHIEF EXECUTIVE OFFICER,580-331-3314,,APRIL.WAZHAXI@IHS.GOV,
OK-008925,Mercy Hospital Watonga,Mercy Hospital Watonga,1497017529,Inpatient Hospitals (other than children's hospitals),500 N Clarence Nash Blvd,,Watonga,OK,73772-2845,Blaine,4300 West Memorial Road,,Oklahoma City,OK,73120,Oklahoma,Gary Raju,Chief Financial Officer West Communities,405-452-3924,,gary.raju@mercy.net,Diana Smalley,President West Communities,405-752-3085,,diana.smalley@mercy.net,
OK-008926,Blaine County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",521 W 4th St,,Watonga,OK,73772-2853,Blaine,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,580-623-7977,,,
OK-008927,Jefferson County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",107 E Anderson Ave,,Waurika,OK,73573-3008,Jefferson,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Mendy Spohn,Regional Director,580-228-2313,,,
OK-008928,Waynoka Family Clinic,INTEGRIS Rural Health Inc,1124029293,Rural Health Clinics,1084 N Nickerson St,,Waynoka,OK,73860-1251,Woods,5300 N. Independence,Suite 280,Oklahoma City,OK,73112,Oklahoma,Christy Aquino,Manager of Provider Credentialing,405-552-0155,,christy.aquino@integrisok.com,,,,,,
OK-008929,Custer County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",220 N Bradley St,,Weatherford,OK,73096-5232,Custer,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,580-772-6417,,,
OK-008930,Westville Family Medicine,"NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.",1821390402,Federally Qualified Health Centers - Medical Services,605 Buffington Rd,,Westville,OK,74965-7011,Adair,127 E Main St,,Hulbert,OK,74441-8901,Cherokee,Scott Rosenthal,CEO,918-772-3390,,scott.rosenthal@neohealth.org,Crystal Steed,COO,918-772-3390,1118,crystal.steed@neohealth.org,neohealth.org
OK-008931,"East Central Oklahoma Family Health Center, Inc.",EAST CENTRAL OKLAHOMA FAMILY HEALTH CENTER INC,1316196546,"Dental Providers, Federally Qualified Health Centers - Medical Services",109 S Main St,,Wetumka,OK,74883-4015,Hughes,PO Box 236,120 E. Broadway,Wetumka,OK,74883-0236,Hughes,Donna S Dyer,CEO,405-452-3151,4101,ddyer@ecofhc.org,Sharilee Strickland,CFO,405-452-3151,4108,sstrickland@ecofhc.org,www.ecofhc.org
OK-008932,Wetumka Indian Health Center,Creek Nation Hospital & Clinics,1366593923,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",325 S Washita St,,Wetumka,OK,74883-5522,Hughes,1101 S Belmont,,Okmulgee,OK,74447,Okfuskee,Karen Knight,Asst Revenue Cycle Mgr,918-756-4333,245,Karen.Knight@creekhealth.org,Julie Shaffer,Business Office Mgr,918-756-4333,268,Julie.Shaffer@creekhealth.org,creekhealth.org
OK-008933,ECOFHC - Wewoka,"East Central Oklahoma Family Health Center, Inc.",1093184145,Federally Qualified Health Centers - Medical Services,121 N Mekusukey Ave,,Wewoka,OK,74884-2117,Seminole,PO Box 236,120 E. Broadway,Wetumka,OK,74883-0236,Hughes,Donna Dyer,CEO,405-452-3151,4101,ddyer@ecofhc.org,Sharilee Strickland,CFO,405-452-3151,4108,sstrickland@ecofhc.org,www.ecofhc.org
OK-008934,Seminole County Health Department - Wewoka,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 S Brown St,,Wewoka,OK,74884-2622,Seminole,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Brenda Potts,Regional Director,405-257-5401,,,http://www.ok.gov/health
OK-008935,Wewoka Health Center Wewoka,Wewoka Health Center,1689664195,"Dental Providers, Family Planning Providers, Indian Health Service",Hwy 56 And 270 Jct,,Wewoka,OK,74884,Seminole,HWY 56 and 270 JCT,,Wewoka,OK,74884-0000,Seminole,Farrel Smith,Chief Executive Officer,405-257-7326,,farrel.smith@ihs.gov,Larry Lydick,(A) Administrative Officer,405-257-7514,,larry.lydick@ihs.gov,
OK-008936,Latimer County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 W Main St,,Wilburton,OK,74578-4045,Latimer,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,D'Elbie Walker,Regional Director,918-465-5673,,,
OK-008937,Wilburton Health and Wellness Center,"Stigler Health and Wellness Center, Inc.",1891752853,Federally Qualified Health Centers - Medical Services,802 Highway 2 N,,Wilburton,OK,74578-3625,Latimer,1505 E. Main,,Stigler,OK,74462,Haskell,Connie Olcott,Marketing Director,918-790-2653,2709,colcott@thwcinc.com,Brooke Lattimore,COO,918-790-2653,2707,blattimore@thwcinc.com,
OK-008938,Woodward County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1631 Texas St,,Woodward,OK,73801-3041,Woodward,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Terri Salisbury,Regional Director,580-256-6416,,,http://www.ok.gov/health
OK-008939,Canadian County Health Department,Oklahoma State Department of Health,1184891525,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1023 E Vandament Ave,,Yukon,OK,73099-4949,Canadian,1000 NE 10th Street,,Oklahoma City,OK,73117-1207,Oklahoma,Leigh Newby,Revenue Officer,405-271-4042,56339,LeighN@health.ok.gov,Jay Smith,Regional Director,405-354-4872,,,
OR-008940,CHC of Benton and Linn Counties - Alsea Rural Health Center,Benton County,1588046791,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",435 E Alder St,,Alsea,OR,97324-9634,Benton,530 NW 27th Street,,Corvallis,OR,97330,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,,,,
OR-008941,Ashland Health Center,Planned Parenthood of Southwestern Oregon,1255461737,Sexually Transmitted Disease Clinics,1532 Siskiyou Blvd,,Ashland,OR,97520-2406,Jackson,3579 Franklin Blvd,,Eugene,OR,97403-2356,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-246-1024,,kelly.hall@ppsworegon.org,
OR-008942,Ashland Health Center,Rogue Community Health,1205998309,Federally Qualified Health Centers - Medical Services,99 Central Ave,,Ashland,OR,97520-1787,Jackson,900 E. Main St.,,Medford,OR,97504,Jackson,William North,CEO,541-223-3172,,wnorth@roguech.org,Andy Kennah,CFO,541-542-7642,,akennah@roguech.org,
OR-008943,COASTAL FAMILY HEALTH CENTER,COASTAL FAMILY HEALTH CENTER,1942369772,Federally Qualified Health Centers - Medical Services,2158 Exchange St,Suite 304,Astoria,OR,97103-3316,Clatsop,2158 Exchange Street Suite 304,PO Box 239,Astoria,OR,97103,Clatsop,Cindy Stergar,CEO,503-325-8315,230,cstergar@coastalfhc.org,Wendy Gilmore,CFO,503-741-8031,,wgilmore@coastalfhc.org,
OR-008944,Clatsop County Department of Public Health,Clatsop County Department of Public Health,1518017961,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",820 Exchange St,Suite 100,Astoria,OR,97103-4609,Clatsop,"820 Exchange St., Ste. 100",,Astoria,OR,97103,Clatsop,Tracy Erfling N.D.,Naturopathic Doctor,503-325-8500,1907,terfling@co.clatsop.or.us,Sheri Salber,Clinical Coordinator,503-325-8500,1918,ssalber@co.clatsop.or.us,
OR-008945,Aumsville Medical Clinic,Santiam Memorial Hospital,1013302017,Rural Health Clinics,205 Main St,,Aumsville,OR,97325-9018,Marion,PO Box 139,,Aumsville,OR,97325-0139,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-008946,"Saint Alphonsus Medical Center - Baker City, Inc.",Saint Alphonsus Health System,1386636355,Inpatient Hospitals (other than children's hospitals),3325 Pocahontas Rd,,Baker City,OR,97814-1464,Baker,3325 Pocahontas Road,,Baker City,OR,97814,Baker,Robert Charles Gaslin,Director of Finance,541-523-1737,1737,robert.gaslin@saintalphonsus.org,,,,,,
OR-008947,Baker Co. Health Dept.,Oregon Health Authority Reproductive Health Program,1053422139,"Family Planning Providers, Sexually Transmitted Disease Clinics",3330 Pocahontas Rd,,Baker City,OR,97814-1437,Baker,3330 Pocahontas Rd,,Baker City,OR,97814-1437,Baker,Nancy Staten,Business Manager,541-523-8211,18,nstaten@bakercounty.org,Robin Nudd,Administrator,541-523-8211,11,rnudd@bakercounty.org,
OR-008948,Coast Community Health Center,Coast Community Health Center,1033348289,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1010 1st St SE,Suite 110,Bandon,OR,97411-9301,Coos,1010 1st Street SE,Suite 110,Bandon,OR,97411,Coos,Linda S. Maxon,Executive Director,541-347-2529,110,lindam@bandonchc.org,Robin Thomas,Finance Director,541-347-2529,118,robint@coastcommunityhealth.org,www.coastcommunityhealth.org
OR-012386,ADVENTIST HEALTH TILLAMOOK BANKS,ADVENTIST HEALTH TILLAMOOK,1043740616,Rural Health Clinics,12350 NW Main St,,Banks,OR,97106-9045,Washington,1000 3rd Street,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,VP Physicians & Clinics Services,503-815-2414,,seufergf@ah.org,Twyla Plummer,Practice Adminiatrator,503-324-1568,,plummeta@ah.org,https://www.adventisthealth.org/Tillamook
OR-008949,PPCW Beaverton Health Center,Planned Parenthood Columbia Willamette,1053311860,Family Planning Providers,12220 SW 1st St,Suite 200,Beaverton,OR,97005-2890,Washington,3727 NE Martin Luther King Jr. Blvd.,,Portland,OR,97005,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-008950,Virginia Garcia Beaverton Dental Clinic,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1376970277,Dental Providers,12600 SW Crescent St,Suite 190,Beaverton,OR,97005-1694,Washington,328 W Main Street suite 300,,Hillsboro,OR,97123-3967,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,
OR-008951,Virginia Garcia Memorial Health Center,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1588061139,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",13000 SW 2nd St,Virginia Garcia Beaverton School Based Health Center,Beaverton,OR,97005-2615,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,COO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,
OR-008952,Neighborhood Health Center - Beaverton A,NEIGHBORHOOD HEALTH CENTER,1164793469,"Dental Providers, Federally Qualified Health Centers - Medical Services",17175 SW Tualatin Valley Hwy,,Beaverton,OR,97003-4584,Washington,6420 SW Macadam,,Portland,OR,97239,Multnomah,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-008953,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- BEAVERTON,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1902067861,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2935 SW Cedar Hills Blvd,,Beaverton,OR,97005-1342,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,,,,,,
OR-008954,Deschutes County Mental Health Annex,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,1128 NW Harriman St,,Bend,OR,97703-1947,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008955,Ariel Glen & Ariel South Community Clinic,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,1700 SE Tempest Dr,,Bend,OR,97702-1884,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008956,Mosaic Medical East Bend Clinic,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,2084 NE Professional Ct,,Bend,OR,97701-6077,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008957,Mosaicmedical,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,2150 NE Daggett Ln,Ensworth School-Based Health Center,Bend,OR,97701-6560,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008958,Mosaicmedical,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,230 NE 6th St,Bend High School-Based Health Center,Bend,OR,97701-5103,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008959,PPCW Bend Health Center,Planned Parenthood Columbia Willamette,1053311860,Family Planning Providers,2330 NE Division St,Suite 7,Bend,OR,97701,Deschutes,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-008960,Deschutes County Public Health,Deschutes County Health Services,1023056017,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",2577 NE Courtney Dr,,Bend,OR,97701-7638,Deschutes,2577 NE Courtney Dr.,,Bend,OR,97701,Deschutes,Kathleen Christensen RN,Clinic Supervisor,541-322-7407,7407,kathyc@deschutes.org,,,,,,
OR-008961,Mosaic Medical Complex Care Center,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,2965 NE Conners Ave,Suite 280,Bend,OR,97701-7753,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-008962,Columbia River Community Health Services,COLUMBIA RIVER COMMUNITY HEALTH SERVICES,1710084140,Federally Qualified Health Centers - Medical Services,450 Tatone St,,Boardman,OR,97818-8076,Morrow,PO Box 397,,Boardman,OR,97818-0397,Morrow,Marta Barajas,Interim CEO,541-481-7212,,mbarajas@crchs.net,,,,,,
OR-008963,Curry Community Health-Alder,Curry Community Health,1629322847,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",412 Alder St,,Brookings,OR,97415-9014,Curry,94235 Moore ST. Suite 121,,Brookings,OR,97415,Curry,Kelli Brown,RN,541-425-7545,,brownk@currych.org,Becky Warner,Financial Director,541-373-8060,,warnerb@currych.org,
OR-008964,Curry Community Health,Curry Community Health,1629322847,"Family Planning Providers, Other ECP Providers",625 Pioneer Rd,Curry Community Health School Based Health Center,Brookings,OR,97415-8293,Curry,94235 Moore ST.,,Gold Beach,OR,97444,Douglas,Becky Warner,financial Director,541-373-8060,,warnerb@currych.org,Kelli Brown,RN,541-425-7545,,brownk@currych.org,
OR-008965,Harney Co. Health Dept. Harney County Clinic,Harney Co. Health Dept.,1407830284,"Family Planning Providers, Sexually Transmitted Disease Clinics",420 N Fairview Ave,,Burns,OR,97720-1416,Harney,420 N Fairview Ave,,Burns,OR,97720-1416,Harney,Darbie Kemper,RN/Director,541-573-8180,,darbie.kemper@co.harney.or.us,Charlotte Campbell,biller,541-573-2271,,charlotte.campbell@co.harney.or.us,
OR-008966,HARNEY DISTRICT HOSPITAL FAMILY CARE,Harney District Hospital Family Care,1013276195,Rural Health Clinics,559 W Washington St,,Burns,OR,97720-1441,Harney,Harney District Hospital Family Care,,Burns,OR,97720-1441,Harney,Lynda Haakenson,Clinic Manager,541-573-2074,8868,lhaakenson@harneydh.com,,,,,,
OR-008967,Butte Falls Health Center,Rogue Community Health,1093099616,"Dental Providers, Federally Qualified Health Centers - Medical Services",722 Laurel Ave,,Butte Falls,OR,97522-0089,Jackson,900 E. Main St.,,Medford,OR,97504,Jackson,William North,CEO,541-842-7706,,wnorth@roguech.org,Andy Kennah,CFO,541-542-7642,,akennah@roguech.org,
OR-008968,Neighborhood Health Center Canby,NEIGHBORHOOD HEALTH CENTER,1033489224,Federally Qualified Health Centers - Medical Services,178 SW 2nd Ave,,Canby,OR,97013-4152,Clackamas,3720 SW 141st Ave Ste 100,,Beaverton,OR,97005-2383,Clackamas,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-008969,Siskiyou Community Health Center,Siskiyou Community Health Center,1740428127,Federally Qualified Health Centers - Medical Services,101 S Junction,Siskiyou School Based Health Center Lorna Byrne,Cave Junction,OR,97523,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-008970,Siskiyou Community Health Center Cave Junction,Siskiyou Community Health Center,1669638417,Federally Qualified Health Centers - Medical Services,25647 Redwood Hwy,,Cave Junction,OR,97523-9332,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-008971,Siskiyou Community Health Center CJ Dental,Siskiyou Community Health Center,1417326562,Dental Providers,25647 Redwood Hwy,,Cave Junction,OR,97523-9332,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-008972,Siskiyou Community Health Center,Siskiyou Community Health Center,1841438231,Federally Qualified Health Centers - Medical Services,520 W River St,Siskiyou School Based Health Center Evergreen,Cave Junction,OR,97523-9504,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-008973,Siskiyou Community Health Center,Siskiyou Community Health Center,1558509935,Federally Qualified Health Centers - Medical Services,625 E River St,Siskiyou School Based Health Center IVHS,Cave Junction,OR,97523-9382,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-008974,CHILOQUIN OPEN DOOR FAMILY PRAC.,KLAMATH HEALTH PARTNERS INC,1538155825,Federally Qualified Health Centers - Medical Services,103 S Wasco Ave,,Chiloquin,OR,97624-7002,Klamath,2074 S 6th St,,Klamath Falls,OR,97601-3372,Klamath,Bonnie Ross,CEO,541-880-2021,,Bross@kodfp.org,,,,,,Klamathopendoor.org
OR-008975,Klamath Tribal Health & Wellness Center,Klamath Tribal Health & Family Services,1629078274,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",330 S Chiloquin Blvd,,Chiloquin,OR,97624-6747,Klamath,3949 S. 6th St.,,Klamath Falls,OR,97603,Klamath,Robert Hardy,Health Finance Officer,541-882-1487,201,rhardy@klm.portland.ihs.gov,Nicole Delgadillo,Business Office Manager,541-882-1487,202,nicole.delgadillo@klm.portland.ihs.gov,
OR-008976,La Pine Community Health Center-North Lake,La Pine Community Health Center,1821472366,Federally Qualified Health Centers - Medical Services,87520 Bay Rd,,Christmas Valley,OR,97641,Lake,PO Box 3300,,La Pine,OR,97739,Deschutes,Marie Manes,COO,541-876-1841,1841,mmanes@lapinehealth.org,Charla DeHate,CEO,541-876-1835,1835,cdehate@lapinehealth.org,
OR-008977,TILLAMOOK COUNTY CLOVERDALE CLINIC,"TILLAMOOK, COUNTY OF",1730341975,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",34335 Highway 101 S,,Cloverdale,OR,97112-9400,Tillamook,801 Pacific Ave,,Tillamook,OR,97141-3926,Tillamook,Marlene Putman,Administrator,503-842-3922,,mputman@co.tillamook.or.us,Irene Fitzgerald,Accounting Manager,503-842-3929,,ifitzger@co.tillamook.or.us,
OR-008978,"Confed.Tribes of Coos, Lower Umpqua & Siuslaw Indians/Outreach office Florence & Springfield/Tribal Health Clinic","Confed.Tribes-Coos, L.Umpqua, Siuslaw/Outreach office Florence & Springfield/Tribal Health Clinic",1780755454,Dental Providers,1245 Fulton Ave,,Coos Bay,OR,97420-2895,Coos,1245 Fulton Ave,,Coos Bay,OR,97420-2895,Coos,Vicki Faciane,"Director, Health & Human Services",541-888-9577,,VFACIANE@CTCLUSI.ORG,Iliana Montiel,"Assistant Director, HHSD",541-888-9577,,imontiel@ctclusi.org,
OR-008979,Waterfall Clinic Inc,WATERFALL CLINIC INC,1508133299,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",826 S 11th St,Waterfall School Based Health Center,Coos Bay,OR,97420-1328,Coos,1890 Waite St Ste 1,,North Bend,OR,97459-1229,Coos,Kathryn Laird,CEO,541-756-6232,115,klaird@wfall.org,Kathleen Olson-Gray,HIMSS,541-756-6232,121,kathleen@wfall.org,
OR-008980,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- CORNELIUS,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1679528012,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1151 N Adair St,,Cornelius,OR,97113-8900,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,,,,,,
OR-008981,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- CORNELIUS DENTAL,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1740547694,Dental Providers,44 N 11th Ave,,Cornelius,OR,97113-9020,Washington,328 W Main street St 300,,Hillsboro,OR,97123-3967,Washington,Gil M Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,,,,,,
OR-008982,CHC of Benton and Linn Counties - Lincoln Health Center,Benton County,1982764882,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",121 SE Viewmont Ave,,Corvallis,OR,97333-1968,Benton,530 NW 27th St,,Corvallis,OR,97330-5223,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,,,,
OR-008983,CHC of Benton and Linn Counties - Benton Health Center,Benton County,1932161361,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",530 NW 27th St,,Corvallis,OR,97330-5223,Benton,530 NW 27th St,,Corvallis,OR,97330-5223,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,,,,
OR-008984,Cottage Grove Health Center,Planned Parenthood of Southwestern Oregon,1487784500,Sexually Transmitted Disease Clinics,1450 Birch Ave,,Cottage Grove,OR,97424-1417,Lane,3579 Franklin Blvd,,Eugene,OR,97403-2356,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-344-2632,1024,kelly.hall@ppsworegon.org,
OR-008985,Winding Waters Medical Clinic,Winding Waters Medical Clinic,1922475219,Federally Qualified Health Centers - Medical Services,603 Medical Pkwy,,Enterprise,OR,97828-5124,Wallowa,603 Medical Parkway,,Enterprise,OR,97828,Wallowa,Keli Christman,COO,541-426-4502,5933,keli@windingwatersclinic.org,,,,,,
OR-012366,ADVENTIST HEALTH TILLAMOOK - ESTACADA,ADVENTIST HEALTH TILLAMOOK REGIONAL MEDICAL CENTER,1609328301,Rural Health Clinics,200 SE Highway 224,PO Box 1200,Estacada,OR,97023-7022,Clackamas,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Kristy Rasmor,Practice Administrator,503-662-3126,,rasmorkm@ah.org,https://www.adventisthealth.org/Tillamook
OR-008986,Delta Oaks Clinic,COUNTY OF LANE,1326138314,Federally Qualified Health Centers - Medical Services,1022 Green Acres Rd,,Eugene,OR,97408-6501,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,,,,,,
OR-008987,Lane County Dental Prevention Program,COUNTY OF LANE,1326138314,Dental Providers,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,,,,,,
OR-008988,White Bird Medical and Dental Clinic,WHITE BIRD CLINIC,1700932795,"Dental Providers, Federally Qualified Health Centers - Medical Services",1400 Mill St,,Eugene,OR,97401-4259,Lane,341 E 12th Ave,,Eugene,OR,97401-3275,Lane,CHUCK GERARD,Clinic Coordinator,541-342-8255,109,chuckg@whitebirdclinic.org,Renae Halina Myers,Medical Program Coordinator,541-484-4800,406,renaehalina@whitebirdclinic.org,whitebirdclinic.org
OR-008989,Charnelton Community Clinic,COUNTY OF LANE,1326138314,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",151 W 7th Ave,Suite 100,Eugene,OR,97401-2676,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,Dr. Patrick Luedtke,Chief Medical Officer,541-682-8762,,patrick.luedtke@co.lane.or.us,
OR-008990,Brookside Clinic,COUNTY OF LANE,1326138314,Federally Qualified Health Centers - Medical Services,1680 Chambers St,Suite 103,Eugene,OR,97402-3655,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,,,,,,
OR-008991,HIV Alliance,HIV Alliance,1295134708,Ryan White Providers,1966 Garden Ave,,Eugene,OR,97403-1933,Lane,1966 Garden Avenue,,Eugene,OR,97403,Lane,Renee Yandel,Executive Director,541-342-5088,113,ryandel@hivalliance.org,AMANDA MCCLUSKEY,Business Planning Director,541-342-5088,122,AMCCLUSKEY@HIVALLIANCE.ORG,
OR-008992,Lane County Mental Health,COUNTY OF LANE,1326138314,Federally Qualified Health Centers - Medical Services,2411 Martin Luther King Jr Blvd,,Eugene,OR,97401-5824,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,,,,,,
OR-008993,White Bird Clinic Counseling Program,White Bird Clinic,1740327717,Community Mental Health Centers,341 E 12th Ave,,Eugene,OR,97401-3275,Lane,341 E. 12th Ave,,Eugene,OR,97401,Lane,Chuck Gerard,Clinic Coordinator,541-342-8255,109,chuckg@whitebirdclinic.org,Cindy Peterson,Counseling Program Coordinator,541-342-8255,111,cindy@whitebirdclinic.org,Whitebirdclinic.org
OR-008994,Chrysalis Behavioral Health,White Bird Clinic,1700932357,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",350 E 11th Ave,,Eugene,OR,97401-3246,Lane,341 E. 12th Ave,,Eugene,OR,97401,Lane,Chuck Gerard,Clinic Coordinator,541-342-8255,109,chuckg@whitebirdclinic.org,Larry Weinerman,Chrysalis Program Coordinator,541-683-1641,205,chrysalis_coordinator@whitebirdclinic.org,Whitebirdclinic.org
OR-008995,Eugene-Springfield Health Center,Planned Parenthood of Southwestern Oregon,1730435884,Sexually Transmitted Disease Clinics,3579 Franklin Blvd,,Eugene,OR,97403-2356,Lane,3579 Franklin Blvd,,Eugene,OR,97403-2356,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-246-1024,,kelly.hall@ppsworegon.org,
OR-008996,West Eugene Health Center,Planned Parenthood of Southwestern Oregon,1770613234,Sexually Transmitted Disease Clinics,793 N Danebo Ave,,Eugene,OR,97402-2224,Lane,3579 Franklin Blvd,,Eugene,OR,97403-2356,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-246-1024,,kelly.hall@ppsworegon.org,
OR-008997,Virginia Garcia Memorial Health Center,Virginia Garcia Memorial Health Center,1881960615,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1715 Nichols Ln,Forest Grove SChool Based Health Center,Forest Grove,OR,97116-3216,Washington,328 W Main Street,,Hillsboro,OR,97123-3967,Washington,Maria E Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,Maria E Paredes,Adminstrative Assistant,503-352-8627,8627,mparedes@vgmhc.org,
OR-008998,ASHER CLINIC,ASHER COMMUNITY HEALTH CENTER,1811937485,Federally Qualified Health Centers - Medical Services,712 Jay St,,Fossil,OR,97830-8371,Wheeler,712 Jay St,,Fossil,OR,97830-8371,Wheeler,Joy Andersen,CEO,541-763-2725,,joya@asherhealth.net,,,,,,
OR-008999,La Pine Community Health Center,La Pine Community Health Center,1669889341,Federally Qualified Health Centers - Medical Services,350 Mississippi Dr,Gilchrist School Based Health Center,Gilchrist,OR,97737-3243,Klamath,PO Box 3300,,La Pine,OR,97739,Deschutes,Marie Manes,COO,541-876-1841,1841,mmanes@lapinehealth.org,Charla DeHate,CEO,541-876-1835,1835,cdehate@lapinehealth.org,
OR-009000,GLIDE CLINIC,"UMPQUA COMMUNITY HEALTH CENTER, INC",1609065010,Federally Qualified Health Centers - Medical Services,20170 N Umpqua Hwy,,Glide,OR,97443-9620,Douglas,150 NE Kenneth Ford Dr,,Roseburg,OR,97470-1042,Douglas,Dona Weissenfels,Chief Operations Officer,541-492-2062,,dweissenfels@umpquachc.org,,,,,,
OR-009001,Curry Community Health- Gold Beach,Curry Community Health,1629322847,"Family Planning Providers, Other ECP Providers",94235 Moore St,Suite 121,Gold Beach,OR,97444-9704,Curry,94235 Moore St. Suite 121,,Gold Beach,OR,97444,Curry,Kelli Brown,RN,541-425-7545,,brownk@currych.org,Becky Warner,,541-373-8060,,warnerb@currych.org,
OR-009002,Grand Ronde Health & Wellness Center,Confederated Tribes of Grand Ronde Community of Oregon,1174666358,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",9605 Grand Ronde Rd,,Grand Ronde,OR,97347-9712,Polk,9615 Grand Ronde Road,,Grand Ronde,OR,97347,Polk,Jill Hafliger,Accreditation Coordinator,503-879-2060,,jill.hafliger@grandronde.org,Kelly Rowe,Executive Director Health Services,503-879-2075,,kelly.rowe@grandronde.org,www.grandronde.org
OR-009003,SISKIYOU COMMUNITY HEALTH CENTER,"SISKIYOU COMMUNITY HEALTH CENTER, INC.",1205002136,Dental Providers,1035 NE 6th St,,Grants Pass,OR,97526-1298,Josephine,1701 NW Hawthorne Ave Ste 201,,Grants Pass,OR,97526-1257,Josephine,Kurt W Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-009004,Grants Pass Health Center,Planned Parenthood of Southwestern Oregon,1225168792,Sexually Transmitted Disease Clinics,160 NW Franklin Blvd,,Grants Pass,OR,97526-1086,Josephine,3579 Franklin Boulevard,,Eugene,OR,97403,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-246-1024,,kelly.hall@ppsworegon.org,
OR-009005,SISKIYOU COMMUNITY HEALTH CENTER,"SISKIYOU COMMUNITY HEALTH CENTER, INC.",1427046903,Federally Qualified Health Centers - Medical Services,1701 NW Hawthorne Ave,Suite 201,Grants Pass,OR,97526-1257,Josephine,1701 NW Hawthorne Ave,,Grants Pass,OR,97526,Josephine,Kurt W Higuera,CEO,541-955-6053,,khiguera@siskiyouhealthcenter.com,Kimber Byrd,Billing Office Manager,541-472-4773,,kbyrd@siskiyouhealthcenter.com,
OR-009006,Josephine Co. Health Dept. Grants Pass Clinic,Josephine Co. Health Dept.,1295737336,"Family Planning Providers, Sexually Transmitted Disease Clinics",715 NW Dimmick St,,Grants Pass,OR,97526-1536,Josephine,715 NW Dimmick St,,Grants Pass,OR,97526-1536,Josephine,Rebecca Robinson,Sr Administrative Supervisor,541-474-5328,,rrobinson@co.josephine.or.us,Jenny Kowalczyk,Womens Health Nurse Practitioner,541-474-5325,2218,jkowalczyk@co.josephine.or.us,
OR-009007,Wallace Gresham Clinic,"Wallace Medical Concern, The",1841592110,Federally Qualified Health Centers - Medical Services,254 NW Burnside Rd,,Gresham,OR,97030-3836,Multnomah,124 NE 181st Ave Ste 103,,Portland,OR,97230,Multnomah,Lisa Cline,Chief Executive Officer,503-489-1760,,lisac@wallacemedical.org,Amy Brisson,Chief Financial Officer,503-907-0594,,amyb@wallacemedical.org,
OR-009008,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1912322074,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3505 SE 182nd Ave,CENTENNIAL HIGH SCHOOL-BASED HEALTH CENTER,Gresham,OR,97030-5028,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009009,EAST COUNTY HEALTH CENTER,"MULTNOMAH, COUNTY OF",1518005693,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 NE 8th St,,Gresham,OR,97030-7317,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009010,Pine Eagle Clinic,Pine Eagle Health Planning Committee,1922102128,Rural Health Clinics,218 N Pine St,PO Box 647,Halfway,OR,97834-0647,Baker,"218 N Pine St, PO Box 647",,Halfway,OR,97834,Baker,Terra Lewis,Office Manager,541-742-5023,,finance@pinetel.com,,,,,,
OR-009011,Mirasol Family Health Center,YAKIMA VALLEY FARM WORKERS CLINIC,1427001940,Federally Qualified Health Centers - Medical Services,589 NW 11th St,,Hermiston,OR,97838-6600,Umatilla,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
OR-009012,Virginia Garcia Memorial Health Center,Virginia Garcia Memorial Health Center,1154665867,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1998 SE Century Blvd,Hillsboro School Based Health Center,Hillsboro,OR,97123-8300,Washington,328 W Main Street,,Hillsboro,OR,97123-3967,Washington,Maria E Loredo,COO,503-259-8502,8502,mloredo@vgmhc.org,Maria E Paredes,Adminstrative Assistant,503-352-8627,8627,mloredo@vgmhc.org,
OR-009013,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- HILLSBORO,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1568624849,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",226 SE 8th Ave,,Hillsboro,OR,97123-4218,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,,,,,,
OR-009014,Neighborhood Health Center - Hillsboro,NEIGHBORHOOD HEALTH CENTER,1356725998,"Dental Providers, Federally Qualified Health Centers - Medical Services",266 W Main St,,Hillsboro,OR,97123-3961,Washington,6420 SW Macadam,,Portland,OR,97239,Multnomah,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-009015,Virginia Garcia Women's Clinic,Virginia Garcia Memorial Health Center,1053859694,Federally Qualified Health Centers - Medical Services,333 SE 7th Ave,Suite 5500,Hillsboro,OR,97123-4185,Washington,PO Box 6149,,Aloha,OR,97007,Washington,Gil Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,Araceli Gaytan,CFO,503-359-8508,,agaytan@vgmhc.org,www.virginiagarcia.org
OR-009016,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- HILLSBORO DENTAL,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1063779932,Dental Providers,730 SE Oak St,Suite A,Hillsboro,OR,97123-4245,Washington,328 W Main Street,,"Hillsboro, Oregon",OR,97123-3967,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,
OR-009017,Virginia Garcia/Lifeworks NW Hillsboro,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1003253048,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",971 SW Walnut St,,Hillsboro,OR,97123-5651,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,,,,,,
OR-009018,Hood River County Health Department,Hood River County,1740420181,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1109 June St,,Hood River,OR,97031-1512,Hood River,1109 June Street,,Hood River,OR,97031,Hood River,Ellen Larsen,Director,541-387-6884,,ellen.larsen@co.hood-river.or.us,,,,,,
OR-009019,One Community Health,"LA CLINICA DEL CARINO FAMILY HEALTH CARE CENTER, INC",1982081535,Federally Qualified Health Centers - Medical Services,1220 Indian Creek Rd,Hood River Valley High School Health Center,Hood River,OR,97031-8632,Hood River,849 Pacific Ave,,Hood River,OR,97031-1956,Hood River,Dave Edwards,Chief Executive Officer,541-386-6380,1354,lfrost@onecommunityhealth.org,Elizabeth Aughney,Clinical Integrations Director,541-386-6380,1307,eaughney@onecommunityhealth.org,
OR-009020,Columbia Gorge Family Medicine,"Columbia Gorge Medical Center, PC",1558346064,Rural Health Clinics,1750 12th St,,Hood River,OR,97031-9540,Hood River,1750 12th St,,Hood River,OR,97031,Hood River,Nathan Smith,Administrator,541-386-5070,210,nathan@cgfm.biz,,,,,,www.cgfm.com
OR-009021,La Clinica del Carino Family Health Care Center Inc. d/b/a One Community Health - Hood River,"LA CLINICA DEL CARINO FAMILY HEALTH CARE CENTER, INC",1851385918,"Dental Providers, Federally Qualified Health Centers - Medical Services",849 Pacific Ave,,Hood River,OR,97031-1956,Hood River,849 Pacific Ave,,Hood River,OR,97031-1956,Hood River,Dave Edwards,Chief Executive Officer,541-308-8354,,dedwards@onecommunityhealth.org,Elizabeth Aughney,Clinical Integrations Director,541-386-6380,1307,eaughney@onecommunityhealth.org,
OR-009022,Blue Mountain Hospital,Blue Mountain Hospital District,1356414395,Inpatient Hospitals (other than children's hospitals),170 Ford Rd,,John Day,OR,97845-2009,Grant,170 Ford Road,,John Day,OR,97845,Grant,John Chaddock,Chief Financial Officer,541-575-4152,,jchaddock@bluemountainhospital.org,Barbara Oliver,Business Office Director,541-575-4153,,boliver@bluemountainhospital.org,www.bluemountainhospital.org
OR-009023,Strawberry Wilderness Community Clinic,Blue Mountain Hospital District,1568536035,Rural Health Clinics,180 Ford Rd,,John Day,OR,97845-2009,Grant,170 Ford Road,,John Day,OR,97845,Grant,Lynne J. Combs,CLINIC MANAGER,541-575-0404,2316,lcombs@bluemountainhospital.org,Barb Oliver,Business Office Manager,541-575-4153,2206,boliver@bluemountainhospital.org,
OR-009024,Grant County Health Department,Community Counseling Solutions,1487992665,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Rural Health Clinics",528 E Main St,Suite E,John Day,OR,97845-1289,Grant,120 S Main St,PO Box 496,Heppner,OR,97836,Morrow,Jessica D Winegar,RN Manager,541-575-0429,4516,jessica.winegar@gobhi.net,Elizabeth Boyer,Billing Office Manager,541-575-1466,4504,elizabeth.boyer@gobhi.net,
OR-009025,Klamath Open Door Family Practice,KLAMATH HEALTH PARTNERSHIP INC,1538155825,"Dental Providers, Federally Qualified Health Centers - Medical Services",2074 S 6th St,,Klamath Falls,OR,97601-3372,Klamath,2074 S 6th St,,Klamath Falls,OR,97601-3372,Klamath,Bonnie Ross,CEO,541-880-2021,,BRoss@kodfp.org,,,,,,KlamathOpenDoor.org
OR-009026,La Pine Community Health Center,La Pine Community Health Center,1639316193,Federally Qualified Health Centers - Medical Services,51600 Huntington Rd,,La Pine,OR,97739-8887,Deschutes,PO Box 3300,,La Pine,OR,97739,Deschutes,Marie Manes,COO,541-876-1841,1841,Mmanes@lapinehealth.org,Charla DeHate,CEO,541-876-1835,,Cdehate@lapinehealth.org,
OR-009027,La Pine Community Health Center,La Pine Community Health Center,1063825776,Federally Qualified Health Centers - Medical Services,51605 Coach Rd,La Pine School,La Pine,OR,97739-7556,Deschutes,PO Box 3300,,La Pine,OR,97739,Deschutes,Marie Manes,COO,541-876-1841,1841,mmanes@lapinehealth.org,Charla DeHate,CEO,541-876-1835,1835,cdehate@lapinehealth.org,
OR-009028,Warner Mountain Medical Clinic,Warner Mountain Medical Clinic,1093839888,Rural Health Clinics,620 S J St,,Lakeview,OR,97630-1680,Lake,620 South J Street,,Lakeview,OR,97630,Lake,Dala Pardue,CLINIC MANAGER,541-947-2331,,dala.p@warnermountainmedical.org,,,,,,
OR-009029,CHC of Benton and Linn Counties - East Linn Health Center,Benton County,1093997710,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",100 Mullins Dr,Suite A1,Lebanon,OR,97355-2868,Linn,530 NW 27th St,,Corvallis,OR,97330-5223,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,,,,
OR-009030,Linn County Public Health,Linn County Health Services,1003991365,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",1600 S Main St,,Lebanon,OR,97355-3109,Linn,215 S 4th,,Albany,OR,97321,Linn,Norma O'Mara,Reproductive Health Supervisor,541-967-3888,2125,nomara@co.linn.or.us,Pat Crozier,Program Manager - Public Health,541-967-3888,2322,pcrozier@co.linn.or.us,
OR-009031,ADVENTIST HEALTH TILLAMOOK LINCOLN CITY RHC,ADVENTIST HEALTH TILLAMOOK,1811238322,Rural Health Clinics,1105 SE Jetty Ave,Suite C,Lincoln City,OR,97367-2604,Lincoln,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Pam Eckerson,Practice Administrator,503-842-4444,,eckerspb@ah.org,https://www.adventisthealth.org/Tillamook
OR-009032,Coastal Health Practitioners,Coastal Health Practitioners,1053454355,Rural Health Clinics,3015 NE West Devils Lake Rd,,Lincoln City,OR,97367-5131,Lincoln,3015 ne west devils lake road,,Lincoln city,OR,97367,Lincoln,meg portwood,Owner,541-994-5591,,mycoastalhp@yahoo.com,,,,,,
OR-009033,Lincoln Community Health Center,LINCOLN COUNTY HEALTH AND HUMAN SERVICES,1205161007,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",4422 NE Devils Lake Blvd,Suite 2,Lincoln City,OR,97367-5000,Lincoln,36 SW Nye St,,Newport,OR,97365-3821,Lincoln,Heather Murray,Financial Administration,541-265-0581,,hmurray@co.lincoln.or.us,Rebecca McBee-Wilson,"Division Director, Community Health Center",541-265-0450,,rmcbee-wilson@co.lincoln.or.us,
OR-009034,Jefferson Co. Health Dept. Madras Clinic,Jefferson Co. Health Dept.,1891716783,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",715 SW 4th St,Suite C,Madras,OR,97741-1022,Jefferson,715 SW 4th St Ste C,,Madras,OR,97741-1022,Jefferson,Tom Machala,Public Health Director,541-475-4456,4205,tom.machala@co.jefferson.or.us,Joy Harvey,Family Nurse Practitioner,541-475-4456,4208,joy.harvey@co.jefferson.or.us,
OR-009035,MADRAS MEDICAL GROUP,MADRAS MEDICAL GROUP,1093768533,Rural Health Clinics,76 NE 12th St,,Madras,OR,97741-1827,Jefferson,76 NE 12th St,,Madras,OR,97741-1827,Jefferson,Robert D. Jones,Administrator,541-475-3874,,bjones@madrasmedicalgroup.com,,,,,,
OR-009036,MOSAIC MEDICAL MADRAS,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,910 SW Highway 97,Suite 101,Madras,OR,97741-9247,Jefferson,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-009037,VIRGINIA GARCIA MEMORIAL HEALTH CENTER- MCMINNVILLE,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1295997575,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",115 NE May Ln,,McMinnville,OR,97128-9272,Yamhill,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,,,,,,
OR-009038,Yamhill Co. Health Dept. Including Newberg Annex,Yamhill Co. Health Dept.,1003075698,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",412 NE Ford St,,McMinnville,OR,97128-4608,Yamhill,412 NE Ford St,,McMinnville,OR,97128-4608,Yamhill,Tom Eversole,Public Health Program Manager,503-434-7525,,eversolet@co.yamhill.or.us,Lindsey Manfrin,HHS Operations Manager,503-434-7525,,manfrinl@co.yamhill.or.us,
OR-009039,Evan Street Mental Health,Virginia Garcia Memorial Health Center,1184065393,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",627 NE Evans St,,McMinnville,OR,97128-3923,Yamhill,328 W Main Street,,Hillsboro,OR,97123-3967,Washington,Maria E. Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,Maria E Paredes,Administration Assistant,503-352-8627,8627,mparedes@vgmhc.org,
OR-009040,Medford Health Center,Planned Parenthood of Southwestern Oregon,1639209117,Sexually Transmitted Disease Clinics,125 S Central Ave,Suite 201,Medford,OR,97501-7222,Jackson,3579 Franklin Boulevard,,Eugene,OR,97403,Lane,Chris Miles,Director of Operations,541-344-2632,1039,chris.miles@ppsworegon.org,Kelly Hall,Director of Patient Services,541-246-1024,,kelly.hall@ppsworegon.org,
OR-009041,JACKSON COUNTY PUBLIC HEALTH,JACKSON COUNTY HEALTH & HUMAN SERVICES,1710933379,"Family Planning Providers, Sexually Transmitted Disease Clinics",140 S Holly St,,Medford,OR,97501-3113,Jackson,140 S Holly St,,MEDFORD,OR,97501,Jackson,Jackson Baures,Public Health Division Manager,541-774-8039,,bauresjb@jacksoncounty.org,Stacey Gregg,Reproductive Health Coordinator,541-774-8058,8058,greggsm@jacksoncounty.org,
OR-009042,Medford Health Center,Rogue Community Health,1073511721,Federally Qualified Health Centers - Medical Services,19 Myrtle St,,Medford,OR,97504-7337,Jackson,900 E. Main St.,,Medford,OR,97504,Jackson,William North,CEO,541-842-7706,,wnorth@roguech.org,Andy Kennah,CFO,541-542-7642,,akennah@roguech.org,
OR-009043,Phoenix Health Center,La Clinica del Valle Family Health Care Center Inc,1851327571,Federally Qualified Health Centers - Medical Services,3617 S Pacific Hwy,,Medford,OR,97501-8957,Jackson,3617 S Pacific Highway,,Medford,OR,97501,Jackson,Ida Saito,Chief Operation Officer,541-512-3157,,isaito@laclinicahealth.org,,,,,,
OR-009044,La Clinica Wellness Center,"La Clinica del Valle Family Health Care Center, Inc.",1851327571,Federally Qualified Health Centers - Medical Services,730 Biddle Rd,,Medford,OR,97504-6116,Jackson,3617 South Pacific Hwy,,Medford,OR,97501,Jackson,Toni Gauger,Risk & Compliance Coordinator,541-690-3547,,tgauger@laclinicahealth.org,,,,,,
OR-009045,Santiam Medical Clinic,Santiam Memorial Hospital,1396131389,Rural Health Clinics,280 S 1st Ave,,Mill City,OR,97360-2324,Linn,PO Box 47,,Mill City,OR,97360-0047,Linn,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009046,Neighborhood Health Center Milwaukie SE 32nd,NEIGHBORHOOD HEALTH CENTER,1083984264,"Dental Providers, Federally Qualified Health Centers - Medical Services",10330 SE 32nd Ave,Suite 325,Milwaukie,OR,97222-6656,Clackamas,6420 SW Macadam Ave Ste 300,,Portland,OR,97239-3519,Multnomah,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-009047,PPCW Milwaukie Health Center,Planned Parenthood Columbia Willamette,1548639719,Family Planning Providers,14411 SE McLoughlin Blvd,,Milwaukie,OR,97267-1412,Clackamas,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-009048,Neighborhood Health Center Milwaukie Dental Clinic,NEIGHBORHOOD HEALTH CENTER,1750729257,Dental Providers,3300 SE Dwyer Dr,,Milwaukie,OR,97222-6548,Clackamas,6420 SW Macadam,,Portland,OR,97239,Multnomah,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-009049,TOTAL HEALTH COMMUNITY CLINIC,"NORTHWEST HUMAN SERVICES, INC.",1447332994,Federally Qualified Health Centers - Medical Services,180 Atwater St N,,Monmouth,OR,97361-1801,Polk,681 Center St NE,,Salem,OR,97301-3722,Marion,Paul Logan,CEO,503-588-5831,,plogan@nwhumanservices.org,,,,,,
OR-009050,CHC of Benton and Linn Counties - Monroe Health Center,Benton County,1235299140,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",610 Dragon Dr,,Monroe,OR,97456-9604,Benton,530 NW 27th St,,Corvallis,OR,97330-5223,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,541-766-6835,,,
OR-009051,SHERMAN COUNTY MEDICAL CLINIC,Sherman County Health District,1982692372,Rural Health Clinics,110 Main St,,Moro,OR,97039-3080,Sherman,110 Main Street,,Moro,OR,97039,Sherman,Caitlin Blag,District Administrator,541-565-0536,,medclinic1@embarqmail.com,Mark Corey,FNP,541-565-3325,,healthnut143@msn.com,
OR-009052,Myrtle Creek Clinic,"UMPQUA COMMUNITY HEALTH CENTER, INC",1508018946,Federally Qualified Health Centers - Medical Services,790 S Main St,,Myrtle Creek,OR,97457-9303,Douglas,150 NE Kenneth Ford Dr,,Roseburg,OR,97470-1042,Douglas,Dona Weissenfels,Chief Operations Officer,541-492-2062,,dweissenfels@umpquachc.org,,,,,,
OR-009053,ADVENTIST HEALTH TILLAMOOK MANZANITA RHC,ADVENTIST HEALTH TILLAMOOK,1154699379,Rural Health Clinics,10445 Neahkahnie Creek Rd,,Nehalem,OR,97131-9023,Tillamook,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Megan Swenson,"Director, Operations Outpatient",503-815-2111,,SwensoML@AH.org,https://www.adventisthealth.org/Tillamook
OR-009054,Virginia Garcia Memorial Health Center - Newberg,Virginia Garcia Memorial Health Center,1245661636,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2251 E Hancock St,Suite 103,Newberg,OR,97132-2145,Yamhill,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E Loredo,COO,503-359-8502,,mloredo@vgmhc.org,
OR-009055,Lincoln Community Health Center,LINCOLN COUNTY HEALTH AND HUMAN SERVICES,1982939641,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1010 SW Coast Hwy,Suite 203,Newport,OR,97365-5215,Lincoln,36 SW Nye St,,Newport,OR,97365-3821,Lincoln,Heather Murray,Financial Administration,541-265-0581,,hmurray@co.lincoln.or.us,Rebecca McBee-Wilson,"Division Director, Community Health Center",541-265-0450,,rmcbee-wilson@co.lincoln.or.us,
OR-009056,LINCOLN COUNTY HEALTH AND HUMAN SERVICES,"LINCOLN, COUNTY OF",1992755664,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",36 SW Nye St,,Newport,OR,97365-3821,Lincoln,36 SW Nye St,,Newport,OR,97365-3821,Lincoln,Rebecca C McBee-Wilson,Community Health Center Division Director,541-265-0450,,rmcbee-wilson@co.lincoln.or.us,Heather Murray,Financial Administration,541-265-0581,,hmurray@co.lincoln.or.us,
OR-009057,Lee Street Rehabilitation Services,LINCOLN COUNTY HEALTH AND HUMAN SERVICES,1326414087,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",51 SW Lee St,,Newport,OR,97365-3823,Lincoln,36 SW Nye St,,Newport,OR,97365-3821,Lincoln,Heather Murray,Financial Administration,541-265-0581,,hmurray@co.lincoln.or.us,Rebecca McBee-Wilson,"Division Director, Community Health Center",541-265-0450,,rmcbee-wilson@co.lincoln.or.us,
OR-009058,"WATERFALL CLINIC, INC.",WATERFALL CLINIC INC,1619915113,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1890 Waite St,Suite 1,North Bend,OR,97459-1229,Coos,1890 Waite St Ste 1,,North Bend,OR,97459-1229,Coos,Kathleen Olson-Gray,CEO,541-756-6232,121,kathleen@wfall.org,Kathleen Olson-Gray,HIMSS,541-756-6232,151,kathleen@wfall.org,
OR-009059,Coos County Public Health,Coos Health & Wellness,1063576908,"Family Planning Providers, Sexually Transmitted Disease Clinics",1975 McPherson St,Suite 1,North Bend,OR,97459-3482,Coos,"1975 McPherson, #1",,North Bend,OR,97459,Coos,Lena Hawtin,Clinic Supervisor,541-751-2424,,Lena.Hawtin@chw.coos.or.us,,,,,,
OR-009060,Valley Family Health Care,Valley Family Health Care,1588699524,Dental Providers,17 N 6th St,,Nyssa,OR,97913-3477,Malheur,17 N 6th Street,,Nyssa,OR,97913,Malheur,Cindy King,Practice System and A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
OR-009061,Valley Family Health Care,Valley Family Health Care,1083641310,Federally Qualified Health Centers - Medical Services,17 S 3rd St,,Nyssa,OR,97913-3815,Malheur,17 S. 3rd Street,,Nyssa,OR,97913,Malheur,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
OR-009062,Orchid Health Oakridge Clinic,Orchid Health,1588088983,Rural Health Clinics,47815 Highway 58,,Oakridge,OR,97463-9572,Lane,PO Box 1287,,Oakridge,OR,97463,Lane,Oliver Alexander,Co-Director,971-204-8737,,oliver@orchidhealth.org,,,,,,
OR-009063,"Snake River Pediatrics, PC","Snake River Pediatrics, PC",1720489396,Rural Health Clinics,1050 SW 3rd Ave,Suite 3200,Ontario,OR,97914-4560,Malheur,1050 SW 3rd Ave Ste 3200,,ONTARIO,OR,97914,Malheur,Chelsey Bidwell,Clinic Administrator,541-881-2380,2411,cbidwell@snakeriverpediatrics.com,"Michelle DeVoe, DO","Owner, DO",541-881-2380,2404,michelle_devoe@hotmail.com,www.snakeriverpediatrics.com
OR-009064,Malheur County Health Dept. Ontario Clinic,MALHEUR CO HEALTH DEPT,1417087297,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1108 SW 4th St,,Ontario,OR,97914-4305,Malheur,1108 SW 4th St,,Ontario,OR,97914-4305,Malheur,Angela Gerrard,Health Department Director,541-889-7279,127,angela.gerrard@malheurco.org,Shelbi Schultz,Accounting Specialist,541-889-7279,117,shelbi.schultz@malheurco.org,http://health.malheurco.org/
OR-009065,Valley Family Health Care,Valley Family Health Care,1992732291,"Dental Providers, Federally Qualified Health Centers - Medical Services",2327 SW 4th Ave,,Ontario,OR,97914-1851,Malheur,2327 SW 4th Avenue,,Ontario,OR,97914,Malheur,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
OR-009066,Neighborhood Health Center Dental - Oregon City,NEIGHBORHOOD HEALTH CENTER,1699045872,Dental Providers,19029 Beavercreek Rd,,Oregon City,OR,97045-9537,Clackamas,6420 SW Macadam,,Portland,OR,97239,Multnomah,Jeri Weeks,CEO,503-941-3002,,weeksj@healthcenteror.org,,,,,,
OR-009067,ADVENTIST HEALTH TILLAMOOK PACIFIC CITY RHC,ADVENTIST HEALTH TILLAMOOK,1427399294,Rural Health Clinics,38505 Brooten Rd,Suite A,Pacific City,OR,97135-8049,Tillamook,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Pam Eckerson,Practice Administrator,503-842-4444,,eckerspb@ah.org,https://www.adventisthealth.org/Tillamook
OR-009068,CHI St. Anthony Hospital Family Clinic,St. Anthony Hospital,1780880518,Rural Health Clinics,1312 SE 2nd Street,,Pendleton,OR,97801,Umatilla,2801 St. Anthony Way,,Pendleton,OR,97801,Umatilla,SCOT ATTRIDGE,CFO,541-278-3220,,scotattridge@chiwest.com,Cheryl Pearce,Director-Physician Servicres,,,cherylpearce@chiwest.com,
OR-009069,Pediatric Specialists of Pendleton,Pediatric Specialists of Pendleton,1952630576,Rural Health Clinics,2461 SW Perkins Ave,,Pendleton,OR,97801-4301,Umatilla,2461 S W Perkins Ave,,Pendleton,OR,97801,Umatilla,Susan Platt,Office Manager,541-276-0250,,pspmanager@wtechlink.us,Erin Blair,Office Assistant,541-276-0250,,erinblairpsp@gmail.com,
OR-009070,CHI St. Anthony Hospital,St. Anthony Hospital,1649276734,Inpatient Hospitals (other than children's hospitals),2801 St Anthony Way,,Pendleton,OR,97801-3800,Umatilla,2801 St. Anthony Way,,Pendleton,OR,97801,Umatilla,SCOT ATTRIDGE,CFO,541-278-3220,,scotattridge@chiwest.com,Harold S. Geller,CEO,541-278-3222,,hgeller@chiwest.com,sahpendleton.org
OR-009071,CHI ST ANTHONY HOSPITAL FAMILY CLINIC,CHI ST ANTHONY HOSPITAL FAMILY CLINIC,1780880518,Rural Health Clinics,3001 St Anthony Way,,Pendleton,OR,97801-3836,Umatilla,2801 ST ANTHONY WAY,,Pendleton,OR,97801,Umatilla,SCOT ATTRIDGE,CFO,541-278-3220,3220,scotattridge@chiwest.com,,,,,,
OR-009072,Yellowhawk Tribal Health Center,Yellowhawk Tribal Health Center,1346283488,"Dental Providers, Family Planning Providers, Tribal Health Program operated under P.L. 93-638",73265 Confederated Way,,Pendleton,OR,97801-9099,Umatilla,PO Box 160,,Pendleton,OR,97801-0160,Umatilla,Linda Hettinga,Business Office Manager,541-278-7523,,LindaHettinga@yellowhawk.org,Tim Gilbert,Chief Executive officer,541-966-9830,7547,TimGilbert@yellowhawk.org,
OR-009073,Curry Community Health Port Orford,Curry Community Health,1629322847,"Family Planning Providers, Sexually Transmitted Disease Clinics",1403 Oregon St,,Port Orford,OR,97465-8731,Curry,94235 Moore St. suite 121,,Gold Beach,OR,97465,Curry,Kelli Brown,RN,541-425-7545,,brownk@currych.org,Becky Warner,Financial Director,541-373-8060,,warnerb@currych.org,
OR-009074,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1548400922,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",10000 N Burr Ave,GEORGE MIDDLE SCHOOL-BASED HEALTH CENTER,Portland,OR,97203-1714,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009075,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1063725141,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1034 SE 130th Ave,DAVID DOUGLAS HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97233-1616,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009076,Outside In,OUTSIDE IN,1568401347,Federally Qualified Health Centers - Medical Services,11300 SE 23rd Ave,Milwaukie High School Health and Wellness Center,Portland,OR,97222-7753,Clackamas,1132 SW 13th Ave,,Portland,OR,97205-1703,Multnomah,John Duke,Clinic Director,503-535-3804,,jduke@outsidein.org,Bill Bradford,Finance Director,503-535-3803,,bbradford@outsidein.org,
OR-009077,OUTSIDE IN,OUTSIDE IN,1568401347,Federally Qualified Health Centers - Medical Services,1132 SW 13th Ave,,Portland,OR,97205-1703,Multnomah,1132 SW 13th Ave,,Portland,OR,97205-1703,Multnomah,John Duke,Clinic Director,503-535-3804,,jduke@outsidein.org,Bill Bradford,Finance Director,503-353-3803,,bbradford@outsidein.org,
OR-009078,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1174763494,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12003 NE Shaver St,PARKROSE HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97220-1494,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009079,NARA Wellness Center,NATIVE AMERICAN REHABILITATION ASSOCIATION INC,1053691972,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",12360 E Burnside St,,Portland,OR,97233-1042,Multnomah,1776 SW Madison St,,Portland,OR,97205-1715,Multnomah,Jacqueline A Mercer,CEO,503-224-1044,,narajam@aol.com,Michael Watkins,COO,503-224-1044,,mwatkins@naranorthwest.org,
OR-009080,Wallace Rockwood Clinic,"WALLACE MEDICAL CONCERN, THE",1841592110,Federally Qualified Health Centers - Medical Services,124 NE 181st Ave,Suite 103,Portland,OR,97230-6565,Multnomah,124 NE 181st Ave Ste 103,,Portland,OR,97230-6565,Multnomah,Lisa A Cline,Chief Executive Officer,503-489-1760,,lisac@wallacemedical.org,Amy Brisson,Chief Financial Officer,503-907-0594,,amyb@wallacemedical.org,
OR-009081,MID-COUNTY HEALTH CENTER,"MULTNOMAH, COUNTY OF",1245378322,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",12710 SE Division St,,Portland,OR,97236-3134,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009082,NARA Dental Clinic,"Native American Rehabilitation Association of the NW, Inc.",1174979934,"Dental Providers, Urban Indian Health Program",12750 SE Stark St,,Portland,OR,97233-1539,Multnomah,1776 SW Madison,,Portland,OR,97205,Multnomah,Michael Watkins,Chief Operations Officer,503-224-1044,,mwatkins@naranorthwest.org,,,,,,
OR-009083,NARA Totem Lodge Community Center,NATIVE AMERICAN REHABILITATION ASSOCIATION INC,1619106945,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1438 SE Division St,,Portland,OR,97202-1140,Multnomah,1776 SW Madison St,,Portland,OR,97205-1715,Multnomah,Jacqueline A Mercer,CEO,503-224-1044,,narajam@aol.com,Michael Watkins,COO,503-224-1044,276,mwatkins@naranorthwest.org,
OR-009084,NARA HEALTH CLINIC,NATIVE AMERICAN REHABILITATION ASSOCIATION INC,1396734364,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",15 N Morris St,,Portland,OR,97227-1541,Multnomah,1776 SW Madison St,,Portland,OR,97205-1715,Multnomah,Jacqueline A Mercer,CEO,503-224-1044,,narajam@aol.com,Michael Watkins,COO,503-224-1044,276,mwatkins@naranorthwest.org,
OR-009085,NARA Residential Treatment Center,NATIVE AMERICAN REHABILITATION ASSOCIATION INC,1023007093,"Other ECP Providers, Urban Indian Health Program",17645 NW Saint Helens Rd,,Portland,OR,97231-1729,Multnomah,1776 SW Madison St,,Portland,OR,97205-1715,Multnomah,Jacqueline A Mercer,CEO,503-224-1044,,narajam@aol.com,Michael Watkins,COO,503-224-1044,276,mwatkins@naranorthwest.org,
OR-009086,ROCKWOOD COMMUNITY HEALTH CENTER,"MULTNOMAH, COUNTY OF",1912226325,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2020 SE 182nd Ave,,Portland,OR,97233-5692,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009087,Russell Street Dental Clinic,Oregon Health & Science University,1194070110,Dental Providers,214 N Russell St,,Portland,OR,97227-1620,Multnomah,214 N Russell St,,Portland,OR,97227,Multnomah,Lisa DiTommaso,Practice Manager,503-494-6540,,ditommas@ohsu.edu,Jay Anderson,Director,503-495-6822,,anderjay@ohsu.edu,www.ohsu.edu
OR-009088,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1851531354,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2225 SE 87th Ave,HARRISON PARK K-8 SCHOOL-BASED HEALTH CENTER,Portland,OR,97216-2006,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-012464,Prism Health,CASCADE AIDS PROJECT,1275076168,"Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers",2236 SE Belmont St,,Portland,OR,97214-2817,Multnomah,"520 Northwest Davis Street, Suite 21",,Portland,OR,97209,Multnomah,Chris Altavilla,Clinical Quality Manager,503-802-0185,,CHris@prismhealth.org,Anthony Unger,Assistant,503-445-7699,,Anthony@prismheath.org,https://prismhealth.org/
OR-009089,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1235379629,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2735 NE 82nd Ave,MADISON HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97220-5304,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009090,Randall Children's Hospital at Legacy Emanuel,Randall Children's Hospital at Legacy Emanuel,1831112358,Children's Hospitals (inpatient only),2801 N Gantenbein Ave,,Portland,OR,97227-1623,Multnomah,2801 North Gantenbein Avenue,,Portland,OR,97227,Multnomah,Cindy Hill,"VP, Chief Nursing Officer",503-276-6538,,chill@lhs.org,,,,,,https://mylegacy.lhs.org/Locations/RCH/Pages/default.aspx
OR-009091,Quest Center for Integrative Health,Quest Center for Integrative Health,1144250168,"Community Mental Health Centers, Ryan White Providers",2901 E Burnside St,,Portland,OR,97214-1831,Multnomah,2901 E Burnside St,,Portland,OR,97214,Multnomah,Nicole Judd-Bekken,Director of HIV Services / Quality & Compliance Officer,503-238-5203,311,nicolejb@quest-center.org,David Eisen,Executive Director,503-238-5203,105,david@quest-center.org,
OR-009092,NCNM Clinic,National College of Natural Medicine,1134369978,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",3025 SW Corbett Ave,,Portland,OR,97201-4858,Multnomah,3025 SW Corbett Ave,,Portland,OR,97201,Multnomah,Michael Sorensen,Executive Director,503-552-1975,,msorensen@ncnm.edu,Michael Sorensen,Executive Director of Clinics,503-552-1975,,msorensen@ncnm.edu,www.ncnm.edu
OR-009093,SHC - Portland,Shriners Hospitals for Children,1982793139,Children's Hospitals (inpatient only),3101 SW Sam Jackson Park Rd,,Portland,OR,97239-3009,Multnomah,3101 SW Sam Jackson Park Rd,,Portland,OR,97239,Multnomah,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
OR-009094,PPCW Southeast Portland Health Center,Planned Parenthood Columbia Willamette,1053311860,Family Planning Providers,3231 SE 50th Ave,,Portland,OR,97206-2248,Multnomah,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-009095,BILLI ODEGAARD DENTAL CLINIC,"MULTNOMAH, COUNTY OF",1871843078,Dental Providers,33 NW Broadway,Suite 380,Portland,OR,97209-3580,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009096,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1730329111,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3400 SE 26th Ave,CLEVELAND HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97202-2130,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009097,SOUTHEAST HEALTH CENTER,"MULTNOMAH, COUNTY OF",1720126816,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3653 SE 34th Ave,,Portland,OR,97202-3034,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009098,Lifeworks Satellite Clinic,NATIVE AMERICAN REHABILITATION ASSOCIATION INC,1346520251,"Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",3716 NE M L King Blvd,,Portland,OR,97212-1111,Multnomah,1776 SW Madison St,,Portland,OR,97205-1715,Multnomah,Jacqueline A Mercer,CEO,503-224-1044,,narajam@aol.com,Michael Watkins,COO,503-224-1044,276,mwatkins@naranorthwest.org,
OR-009099,PPCW Northeast Portland Health Center,Planned Parenthood Columbia Willamette,1063882884,Family Planning Providers,3727 NE M L King Blvd,,Portland,OR,97212-1112,Multnomah,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-009101,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1619117934,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5103 N Willis Blvd,CESAR CHAVEZ K-8 SCHOOL-BASED HEALTH CENTER,Portland,OR,97203-3464,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009102,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1922248327,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5210 N Kerby Ave,JEFFERSON HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97217-2656,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009103,NORTHEAST HEALTH CENTER,"MULTNOMAH, COUNTY OF",1427196500,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5329 NE M L King Blvd,,Portland,OR,97211-3237,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009104,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1588804975,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5405 SE Woodward St,FRANKLIN HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97206-2168,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009100,Multnomah County Health Department - HIV Health Services Center,"MULTNOMAH, COUNTY OF",1982992954,Federally Qualified Health Centers - Medical Services,619 NW 6th Avenue,3rd Floor,Portland,OR,97209,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Alexander Lehr,Grants and Compliance,503-988-8393,,alexander.oconnell@multco.us,https://multco.us/health/hiv-health-services-center
OR-009105,LA CLINICA DE BUENA SALUD,"MULTNOMAH, COUNTY OF",1508904681,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6736 NE Killingsworth St,,Portland,OR,97218-3338,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009106,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1346480662,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6941 N Central St,ROOSEVELT HIGH SCHOOL-BASED HEALTH CENTER,Portland,OR,97203-6203,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009107,The Hemophilia Center at OHSU,Oregon Health & Science University,1972688919,Hemophilia Treatment Centers,707 SW Gaines St,,Portland,OR,97239-2901,Multnomah,3181 SW Sam Jackson Park,,Portland,OR,97239,Multnomah,Tamara Vogel,Program Manager,503-494-2753,,vogelta@ohsu.edu,"Michael Recht, MD, PhD",Director,503-494-8716,,rechtm@ohsu.edu,www.ohsu.edu/hemophilia
OR-009108,"Multnomah, County Of","MULTNOMAH, COUNTY OF",1164662557,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7200 SE 60th Ave,LANE MIDDLE SCHOOL-BASED HEALTH CENTER,Portland,OR,97206-7532,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009109,ROSEWOOD FAMILY HEALTH CENTER,YAKIMA VALLEY FARM WORKERS CLINIC,1679526107,Federally Qualified Health Centers - Medical Services,8935 SE Powell Blvd,,Portland,OR,97266-1938,Multnomah,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
OR-009110,NORTH PORTLAND HEALTH CENTER,"MULTNOMAH, COUNTY OF",1609914787,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9000 N Lombard St,,Portland,OR,97203-3006,Multnomah,426 SW Stark Street,9th Floor,Portland,OR,97204-2303,Multnomah,Vanetta M Abdellatif,Integrated Clinical Services Director,503-988-8887,,vanetta.m.abdellatif@multco.us,Christy E Ward,Health Centers Division Ops Director,503-988-6642,,christy.ward@multco.us,
OR-009111,Powers SBHC,WATERFALL CLINIC INC,1609151810,"Family Planning Providers, Other ECP Providers, Rural Health Clinics",400 Fir St,,Powers,OR,97466-9785,Coos,1890 Waite St Ste 1,,North Bend,OR,97459-1229,Coos,Kathryn Laird,CEO,541-756-6232,115,klaird@wfall.org,Kathleen Olson-Gray,HIMSS,541-756-6232,121,kathleen@wfall.org,
OR-009112,MOSAIC MEDICAL PRINEVILLE,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,375 Beaver St,,Prineville,OR,97754,Crook,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-009113,Crook Co. Health Dept.,CROOK COUNTY HEALTH DEPT,1548644867,"Family Planning Providers, Other ECP Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",375 NW Beaver St,Suite 100,Prineville,OR,97754-1802,Crook,375 NW Beaver Street,Suite 100,Prineville,OR,97754,Crook,"Katie Simpson, RN",Reproductive Health Coordinator,541-447-5165,210,ksimpson@h.co.crook.or.us,Mindy Stomner,Clinical Services Supervisor,541-447-5165,209,mstomner@h.co.crook.or.us,
OR-009114,Mosaicmedical,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,757 E 1st St,CROOK COUNTY SCHOOL-BASED HEALTH-CRE,Prineville,OR,97754-2005,Crook,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-009115,Prospect Health Center,Rogue Community Health,1154753069,Federally Qualified Health Centers - Medical Services,280 Mill Creek Dr,,Prospect,OR,97536-9722,Jackson,900 E. Main St.,,Medford,OR,97504,Jackson,William North,CEO,541-842-7706,,wnorth@roguech.org,Andy Kennah,CFO,541-542-7642,,akennah@roguech.org,
OR-009116,Mosaic Medical Redmond,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,111 NW Larch Ave,,Redmond,OR,97756-1322,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-009117,Mosaicmedical,MOSAICMEDICAL,1083633184,Federally Qualified Health Centers - Medical Services,1314 SW Kalama Ave,Lynch School-Based Health Center,Redmond,OR,97756-3054,Deschutes,375 NW Beaver St Ste 101,,Prineville,OR,97754-1802,Crook,MEGAN HAASE,CEO,541-447-0707,,megan.haase@mosaicmedical.org,Lori Kadlec,Revenue Cycle Manager,541-383-3005,,lori.kadlec@mosaicmedical.org,www.mosaicmedical.org
OR-009118,Deschutes County Public Health Redmond,Deschtues County Health Services,1023056017,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",412 SW 8th St,,Redmond,OR,97756-2209,Deschutes,2577 NE Courtney Dr.,,Bend,OR,97701,Deschutes,Kathleen Christensen,Clinic Supervisor,541-322-7407,7407,kathyc@deschutes.org,,,,,,
OR-009119,Dunes Family Health Care,Lower Umpqua Hospital District,1619900370,Rural Health Clinics,620 Ranch Rd,,Reedsport,OR,97467-1720,Douglas,600 Ranch Road,,Reedsport,OR,97467,Douglas,Sheri Aasen,Director of Clinic Services,541-271-2163,,saasen@luhonline.com,,,,,,
OR-009120,ROCKWAY BEACH CLINIC,"TILLAMOOK, COUNTY OF",1184887523,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",276 S Highway 101,,Rockaway Beach,OR,97136-1015,Tillamook,801 Pacific Ave,,Tillamook,OR,97141-3926,Tillamook,Marlene Putman,Administrator,503-842-3922,,mputman@co.tillamook.or.us,Irene Fitzgerald,Accounting Manager,503-842-3929,,ifitzger@co.tillamook.or.us,
OR-009121,UCHC Roseburg Clinic,Umpqua Community Health Center,1396751772,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",150 NE Kenneth Ford Dr,,Roseburg,OR,97470-1042,Douglas,150 Kenneth Ford Drive,,Roseburg,OR,97470,Douglas,Mervyn Chambers,CEO,541-492-2051,,mchambers@umpquachc.org,Dona Weissenfels,COO,541-672-9596,,dweissenfels@umpquachc.org,
OR-009122,"UMPQUA COMMUNITY HEALTH CENTER, INC","UMPQUA COMMUNITY HEALTH CENTER, INC",1396751772,Federally Qualified Health Centers - Medical Services,400 W Harvard Ave,ROSEBURG HIGH SCHOOL,Roseburg,OR,97470-3012,Douglas,150 NE Kenneth Ford Dr,,Roseburg,OR,97470-1042,Douglas,Dona Weissenfels,Chief Operating Officer,541-492-2062,,dweissenfels@umpquachc.org,,,,,,http://www.umpquachc.org/?nav=locations
OR-009123,WEST SALEM CLINIC,"NORTHWEST HUMAN SERVICES, INC.",1871530758,Federally Qualified Health Centers - Medical Services,1233 Edgewater St NW,,Salem,OR,97304-4049,Polk,681 Center St NE,,Salem,OR,97301-3722,Marion,Paul Logan,CEO,503-588-5831,,plogan@nwhumanservices.org,,,,,,
OR-009124,West Salem Mental Health Clinic,Northwest Human Services,1194082867,Community Mental Health Centers,1245 Edgewater St NW,,Salem,OR,97304-4049,Polk,681 Center St NE,,Salem,OR,97301,Marion,Paul Logan,CEO,503-588-5828,,plogan@nwhumanservices.org,,,,,,
OR-009125,QUICKCARE CLINIC,"NORTHWEST HUMAN SERVICES, INC.",1497014914,Federally Qualified Health Centers - Medical Services,1275 Edgewater St NW,,Salem,OR,97304-4049,Polk,681 Center St NE,,Salem,OR,97301-3722,Marion,Paul Logan,CEO,503-588-5828,,plogan@nwhumanservices.org,,,,,,
OR-009126,WEST SALEM DENTAL CLINIC,"NORTHWEST HUMAN SERVICES, INC.",1871530758,Dental Providers,190 Kingwood Ave NW,,Salem,OR,97304-4030,Polk,681 Center St NE,,Salem,OR,97301,Marion,Paul Logan,CEO,503-588-5831,,plogan@nwhumanservices.org,,,,,,
OR-009127,Marion County Health Department,Marion County,1124186531,"Community Mental Health Centers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3180 Center St NE,,Salem,OR,97301-4532,Marion,3180 Center St NE,,Salem,OR,97301,Marion,Mai Cao,BILLING SUPERVISOR,503-361-2648,,mcao@co.marion.or.us,Stacie Neal,Management Analyst,503-576-4589,,sneal@co.marion.or.us,
OR-009128,Chemawa Indian Health Center,Chemawa Indian Health Center,1578565347,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Indian Health Service, Other ECP Providers",3750 Chemawa Rd NE,,Salem,OR,97305-1119,Marion,3750 Chemawa Road NE,,Salem,OR,97305,Marion,Judith Adams,Business Office Manager,503-304-7628,,Judith.Adams@ihs.gov,Teresa Barbo,Administrative Officer,503-304-7667,,Teresa.Barbo@ihs.gov,
OR-009129,PPCW Salem Health Center,Planned Parenthood Columbia Willamette,1053311860,Family Planning Providers,3825 Wolverine St NE,,Salem,OR,97305-1201,Marion,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
OR-009130,Lancaster Family Health Center,YAKIMA VALLEY FARM WORKERS CLINIC,1972684710,Federally Qualified Health Centers - Medical Services,3896 Beverly Ave NE,,Salem,OR,97305-1374,Marion,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
OR-009131,NORTHWEST HUMAN SERVICES-HOAP AND HOTLINE SERVICES,"NORTHWEST HUMAN SERVICES, INC.",1790865798,Federally Qualified Health Centers - Medical Services,694 Church St NE,,Salem,OR,97301-2401,Marion,681 Center St NE,,Salem,OR,97301-3722,Marion,Paul Logan,CEO,503-588-5828,,plogan@nwhumanservices.org,,,,,,
OR-009132,"Legacy Medical Group, Firwood",Legacy Health System,1730472192,Rural Health Clinics,36860 Industrial Way,,Sandy,OR,97055-7371,Clackamas,36860 Industrial Way,,Sandy,OR,97055,Clackamas,Lauren Harris,CLINIC MANAGER,503-525-3060,,laharri@lhs.org,Kelly Landis,Clinic Supervisor,503-525-4402,,klandis@lhs.org,
OR-009133,OHSU Scappoose Family Medicine,OHSU,1417969304,Rural Health Clinics,51377 SW Old Portland Rd,,Scappoose,OR,97056-4023,Columbia,3181 SW Sam Jackson Park Rd,,Portland,OR,97239,Multnomah,Kate Pillar,,503-418-4226,,pillar@ohsu.edu,,,,,,
OR-009134,Siletz Community Health Clinic,Confederated Tribes of Siletz Indians,1316040249,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",200 Gwee Shut Rd,,Siletz,OR,97380-2036,Lincoln,201 SE Swan Ave,,Siletz,OR,97380,Lincoln,Marci Muschamp,Interim Health Director,541-444-9655,1655,marcim@ctsi.nsn.us,Ralene Butler,Admin/QI Coordinator,541-444-9663,1663,ralene.b@ctsi.nsn.us,
OR-009135,County Of Lane,COUNTY OF LANE,1326138314,Federally Qualified Health Centers - Medical Services,1050 10th St,Springfield Schools Health Center,Springfield,OR,97477-4003,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,,,,,,
OR-009136,Riverstone Clinic,COUNTY OF LANE,1326138314,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2073 Olympic St,,Springfield,OR,97477-3413,Lane,125 E 8th Ave,,Eugene,OR,97401-2926,Lane,Ron Hjelm,CEO,541-682-3561,,ron.hjelm@co.lane.or.us,Ivy Kohler,Reproductive Health Coordinator,541-682-3550,,ivy.kohler@co.lane.or.us,
OR-009137,Santiam Orthopaedic Clinic,Santiam Memorial Hospital,1821433129,Outpatient Hospital Clinics,1369 N 10th Ave,,Stayton,OR,97383-2037,Marion,1369 N 10th Ave,,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009138,Santiam General Surgery,Santiam Memorial Hospital,1396152351,Outpatient Hospital Clinics,1371 N 10th Ave,,Stayton,OR,97383-2037,Marion,1371 N 10th Ave,,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009139,Santiam Women's Clinic,Santiam Memorial Hospital,1063731271,Outpatient Hospital Clinics,1373 N 10th Ave,,Stayton,OR,97383-2037,Marion,1373 N 10th Ave,,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009140,Cascade Medical Clinic,Santiam Memorial Hospital,1790171874,Rural Health Clinics,1375 N 10th Ave,Suite B,Stayton,OR,97383-2099,Marion,1375 N 10th Ave,Suite B,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009141,Santiam Medical Associates,Santiam Memorial Hospital,1477909570,Outpatient Hospital Clinics,1401 N 10th Ave,Suite 100,Stayton,OR,97383-1486,Marion,1401 N 10th Ave,STE 100,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009142,Santiam Memorial Hospital,Santiam Memorial Hospital,1154302214,Inpatient Hospitals (other than children's hospitals),1401 N 10th Ave,,Stayton,OR,97383-1311,Marion,1401 N 10th Ave,,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Maggie Hudson,CFO/COO,503-769-9236,,mhudson@santiamhospital.org,
OR-009143,Santiam Pulmonary/Internal Medicine Clinic,Santiam Memorial Hospital,1730426040,Outpatient Hospital Clinics,1401 N 10th Ave,Suite 200,Stayton,OR,97383-1487,Marion,1401 N 10th Ave,STE 200,Stayton,OR,97383,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009144,Sublimity Medical Clinic,Santiam Memorial Hospital,1518354547,Rural Health Clinics,114 SE Church St,,Sublimity,OR,97385-9714,Marion,PO Box 886,,Sublimity,OR,97385,Marion,Terry Fletchall,CEO,503-769-2175,,tfletchall@santiamhospital.org,Lynda Fraser,Clinic Director,503-769-9254,,lfraser@santiamhospital.org,
OR-009145,La Pine Community Health Center-Sunriver,La Pine Community Health Center,1174919674,Federally Qualified Health Centers - Medical Services,56881 Enterprise Dr,,Sunriver,OR,97707-2120,Deschutes,PO Box 3300,,La Pine,OR,97739,Deschutes,Marie Manes,COO,541-876-1841,1841,Mmanes@lapinehealth.org,Charla DeHate,CEO,541-876-1835,1835,Cdehate@lapinehealth.org,
OR-009146,Sutherlin Clinic,"UMPQUA COMMUNITY HEALTH CENTER, INC",1619399888,Federally Qualified Health Centers - Medical Services,123 Ponderosa Dr,,Sutherlin,OR,97479-9812,Douglas,150 NE Kenneth Ford Dr,,Roseburg,OR,97470-1042,Douglas,Dona Weissenfels,Chief Operations Officer,541-492-2062,,dweissenfels@umpquachc.org,,,,,,
OR-009147,Sweet Home Health Center,Benton County,1801278015,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",799 Long St,,Sweet Home,OR,97386-3304,Linn,530 NW 27th Street,,Corvallis,OR,97330,Benton,Sherlyn Dahl,Executive Director,541-766-6835,,sherlyn.dahl@co.benton.or.us,,,,,,
OR-009148,"La Clinica del Carino Family Health Care Center, Inc. d/b/a One Community Health-- The Dalles","LA CLINICA DEL CARINO FAMILY HEALTH CARE CENTER, INC",1093870990,"Dental Providers, Federally Qualified Health Centers - Medical Services",1040 Webber St,,The Dalles,OR,97058-3749,Wasco,849 Pacific Ave,,Hood River,OR,97031-1956,Hood River,Dave Edwards,Chief Executive Officer,541-308-8354,,dedwards@onecommunityhealth.org,Elizabeth Aughney,Clinical Integrations Director,541-386-6380,1307,eaughney@onecommunityhealth.org,
OR-009149,Virginia Garcia Memorial Health Center,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1194099234,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",9000 SW Durham Rd,Tigard School Based Health Center,Tigard,OR,97224-5539,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E. Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,
OR-009150,ADVENTIST HEALTH TILLAMOOK WOMEN'S RHC,ADVENTIST HEALTH TILLAMOOK,1326349416,Rural Health Clinics,1011 3rd St,,Tillamook,OR,97141-8292,Tillamook,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Megan Swenson,"Director, Operations Outpatient",503-815-2111,,SwensoML@AH.org,https://www.adventisthealth.org/Tillamook
OR-009151,ADVENTIST HEALTH TILLAMOOK PLAZA RHC,ADVENTIST HEALTH TILLAMOOK,1841451853,Rural Health Clinics,1100 3rd St,,Tillamook,OR,97141-3402,Tillamook,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Megan Swenson,"Director, Operations Outpatient",503-815-2111,,SwensoML@AH.org,https://www.adventisthealth.org/Tillamook
OR-009152,TILLAMOOK COUNTY HEALTH DEPARTMENT,TILLAMOOK COUNTY HEALTH DEPARTMENT,1528151362,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",801 Pacific Ave,,Tillamook,OR,97141-3926,Tillamook,801 Pacific Ave,,Tillamook,OR,97141-3926,Tillamook,Marlene Putman,Administrator,503-842-3922,,mputman@co.tillamook.or.us,Irene Fitzgerald,Accounting Manager,503-842-3929,,ifitzger@co.tillamook.or.us,
OR-009153,Virginia Garcia Memorial Health Center,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1689064156,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",22300 SW Boones Ferry Rd,Tualatin School Based Health Center,Tualatin,OR,97062-7373,Washington,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,8503,gmunoz@vgmhc.org,Maria E Loredo,COO,503-359-8502,8502,mloredo@vgmhc.org,
OR-009154,Valley Family Health Care,Valley Family Health Care,1235166562,Federally Qualified Health Centers - Medical Services,789 Washington St W,,Vale,OR,97918-1147,Malheur,789 Washington West,,Vale,OR,97918,Malheur,Cindy King,Practice System & A/R Manager,208-642-9376,4107,cking@vfhc.org,,,,,,
OR-009155,ADVENTIST HEALTH TILLAMOOK VERNONIA,ADVENTIST HEALTH TILLAMOOK,1285164921,Rural Health Clinics,1005 Cougar St,,Vernonia,OR,97064-1282,Columbia,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,seufergf@ah.org,Twyla Plummer,Practice Administrator,503-324-1568,,plummeta@ah.org,https://www.adventisthealth.org/Tillamook
OR-009156,Warm Springs Health and Wellness Center,Warm Springs Health and Wellness Center,1417084708,"Dental Providers, Family Planning Providers, Indian Health Service",1270 Kot-Num Rd,,Warm Springs,OR,97761,Jefferson,PO box 1209,,Warm Springs,OR,97761,Jefferson,Carol Prevost,CEO,541-551-1196,2176,carol.prevost@ihs.gov,Carol Cummins,HSA,542-553-1196,,carol.cummins@ihs.gov,
OR-009157,CMH Primary Care Clinic,Columbia Memorial Hospital,1033469663,Rural Health Clinics,1639 SE Ensign Ln,Suite B103,Warrenton,OR,97146-7308,Clatsop,2111 Exchange St,,Astoria,OR,97103,Clatsop,Katrina McPherson,VP of Medical Group,503-338-7505,,kmcpherson@columbiamemorial.org,Selena Burgher,Manager,503-338-4500,,sburgher@columbiamemorial.org,www.columbiamemorial.org
OR-012367,ADVENTIST HEALTH TILLAMOOK HOODLAND,ADVENTIST HEALTH TILLAMOOK,1861944894,Rural Health Clinics,24461 SE Welches Rd,PO Box 378,Welches,OR,97067-7067,Clackamas,1000 3rd St,,Tillamook,OR,97141-3430,Tillamook,Gina Seufert,"VP, Physician & Clinic Services",503-815-2414,,SeuferGF@AH.org,Megan Swenson,"Director, Operations Outpatient",503-815-2111,,SwensoML@AH.org,https://www.adventisthealth.org/Tillamook
OR-009158,The Rinehart Clinic,RINEHART MEDICAL CLINIC,1568546570,Federally Qualified Health Centers - Medical Services,230 Rowe Rd,,Wheeler,OR,97147-0035,Tillamook,230 Rowe Rd,,Wheeler,OR,97147-0035,Tillamook,Margaret Ann Jozsa,CEO,503-368-5182,,mjozsa@rinehartclinic.org,Tammy Durham,Director of Human Resources,503-368-5182,,tdurham@rinehartclinic.org,
OR-009159,White CIty Health Center,Rogue Community Health,1770645871,Federally Qualified Health Centers - Medical Services,8385 Division Rd,,White City,OR,97503-1176,Jackson,900 E. Main St.,,Medford,OR,97504,Jackson,William North,CEO,541-842-7706,,wnorth@roguech.org,Andy Kennah,CFO,541-542-7642,,akennah@roguech.org,
OR-009160,Virginia Garcia Memorial Health Center,VIRGINIA GARCIA MEMORIAL HEALTH CENTER,1144578790,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1100 NE Oaken Hills Dr,Willamina School Based Health Center,Willamina,OR,97396-2723,Yamhill,1151 N Adair St,,Cornelius,OR,97113-8900,Washington,Gil M Munoz,CEO,503-359-8503,,gmunoz@vgmhc.org,,,,,,
OR-009161,SouthRiver Community Health Center,ADAPT,1912061755,Federally Qualified Health Centers - Medical Services,671 SW Main St,,Winston,OR,97496-6571,Douglas,548 SE Jackson St Ste 3,,Roseburg,OR,97470-4970,Douglas,Gregory Brigham,CEO,541-672-2691,208,gbrigham@adapt-or.org,Michelle Watson,COO,541-492-4550,226,michellew@srchc.org,
OR-009162,SALUD MEDICAL CENTER,YAKIMA VALLEY FARM WORKERS CLINIC,1972556496,"Dental Providers, Federally Qualified Health Centers - Medical Services",1175 Mount Hood Ave,,Woodburn,OR,97071-9060,Marion,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
PA-009163,Adagio Health Aliquippa,Adagio Health,1295826022,Family Planning Providers,99 Autumn St,,Aliquippa,PA,15001-1301,Beaver,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009164,Autumn Street Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1992073183,Federally Qualified Health Centers - Medical Services,99 Autumn St,,Aliquippa,PA,15001-1301,Beaver,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-375-5754,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009165,"LeHigh Valley Hospital, Inc.","LeHigh Valley Hospital, Inc.",1164400131,Inpatient Hospitals (other than children's hospitals),1200 S Cedar Crest Blvd,,Allentown,PA,18103-6202,Lehigh,1200 S Cedar Crest Blvd,,Allentown,PA,18103,Lehigh,Marilyn M. Minder,Payer Contracting Manager,484-862-3482,,marilyn.minder@lvhn.org,,,,,,http://www.lvhn.org
PA-009166,"LeHigh Valley Hospital, Inc.","LeHigh Valley Hospital, Inc.",1164400131,Ryan White Providers,1627 Chew St,,Allentown,PA,18102-3648,Lehigh,1200 S Cedar Crest Blvd,,Allentown,PA,18103,Lehigh,Marilyn Minder,Payer Contracting Manager,484-862-3482,,marilyn.minder@lvhn.org,,,,,,http://www.lvhn.org
PA-009167,Neighborhood Health Centers of the Lehigh Valley at Casa Guadalupe,NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY,1841429529,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",218 N 2nd St,,Allentown,PA,18102-3508,Lehigh,333 West Union Street,"Second Floor, Unit One",Allentown,PA,18102,Lehigh,Melissa Craig,Executive Director,610-820-7605,12,MCraig@nhclv.com,Qamar Manzoor,Chief Financial Officer,610-820-7605,14,qmanzoor@nhclv.com,www.nhclv.org
PA-009168,Planned Parenthood Keystone Allentown,Planned Parenthood Keystone,1962597500,Family Planning Providers,29 N 9th St,,Allentown,PA,18101-1102,Lehigh,5920 Hamilton Blvd,,Allentown,PA,18106-8944,Lehigh,Trisha Tashjian,Chief Operating Officer,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,Chief Executive Officer,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009169,ALTOONA COMMUNITY HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1053580886,Federally Qualified Health Centers - Medical Services,1701 12th Ave,,Altoona,PA,16601-3100,Blair,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-942-9600,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009170,Women's Health and Wellness Center,"Family Health Council of Central Pennsylvania, Inc.",1457303885,Family Planning Providers,501 Howard Ave Bldg F6,Blair Medical,Altoona,PA,16601-4810,Blair,501 Howard Ave,Blair Medical Building C,Altoona,PA,16601-4810,Blair,Susan Chew,Family Planning Coordinator,814-946-2020,,chewsk@upmc.edu,,,,,,
PA-009171,ALTOONA BEHAVIORAL HEALTH,"PRIMARY HEALTH NETWORK, INC.",1063641470,Federally Qualified Health Centers - Medical Services,620 Howard Ave,,Altoona,PA,16601-4804,Blair,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-942-5000,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009172,Beaver Falls Primary Care/Dental Center,"PRIMARY HEALTH NETWORK, INC.",1477750123,"Dental Providers, Federally Qualified Health Centers - Medical Services",1302 7th Ave,,Beaver Falls,PA,15010-4217,Beaver,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-843-4400,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009173,Planned Parenthood Keystone Bensalem,Planned Parenthood Keystone,1093975823,Family Planning Providers,2185 Galloway Rd,,Bensalem,PA,19020-2983,Bucks,5920 Hamilton Blvd,,Allentown,PA,18106-8944,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009174,BENTLEYVILLE FAMILY PRACTICE CENTER,CENTERVILLE CLINIC INC,1851514251,Federally Qualified Health Centers - Medical Services,100 Wilson Rd,,Bentleyville,PA,15314-1028,Washington,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009175,NHCLV-Bethlehem,Neighborhood Health Centers of the Lehigh Valley,1326418245,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1210 E 4th St,Fowler Family Center At Donegan Elementary School,Bethlehem,PA,18015-2016,Northampton,333 West Union Street,"Second Floor, Unit One",Allentown,PA,18102,Lehigh,Melissa Miranda Craig,Executive Director,610-820-7605,12,mcraig@nhclv.com,Qamar Manzoor,Chief Financial Officer,610-820-7605,12,qmanzoor@nhclv.com,www.nhclv.org
PA-009176,Columbia Montour Family Health Inc.,Columbia Montour Family Health Inc.,1578582516,"Family Planning Providers, Sexually Transmitted Disease Clinics",2201 5th Street Hollow Rd,,Bloomsburg,PA,17815-7757,Columbia,2201 5th Street Hollow Rd,,Bloomsburg,PA,17815,Columbia,Swanee Marcus,Executive Director,570-387-0236,,swaneecmfh@yahoo.com,,,,,,
PA-009177,BLOSSBURG LAUREL HEALTH CENTER,N PENN COMPREHENSIVE HEALTH SVCS,1154403038,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6 Riverside Plz,,Blossburg,PA,16912-1137,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009178,Squirrel Hill Health Center Brentwood,Squirrel Hill Health Center,1538531710,Federally Qualified Health Centers - Medical Services,103 Towne Square Way,,Brentwood,PA,15227-3254,Allegheny,4516 Browns Hill Rd,,Pittsburgh,PA,15217,Allegheny,Susan Friedberg Kalson,CEO,412-904-5283,,sfkalson@squirrelhillhealthcenter.org,Elisa Lucke,Director of Operations,412-697-7937,,elucke@squirrelhillhealthcenter.org,www.squirrelhillhealthcenter.org
PA-009179,Planned Parenthood Bridgeville,Planned Parenthood of Western PA,1336238120,Family Planning Providers,533 Washington Ave,Suite 203,Bridgeville,PA,15017-2072,Allegheny,933 Liberty Avenue,,Pittsburgh,PA,15222,Allegheny,Kim Evert,CEO,412-258-9530,,kevert@ppwp.org,Kara Cornish,Billing Manager,412-434-8957,9534,kcornish@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009180,"BROAD TOP AREA MEDICAL CENTER, INC.",BROAD TOP AREA MEDICAL CENTER,1063514453,Federally Qualified Health Centers - Medical Services,4133 Medical Center Dr,,Broad Top,PA,16621-9001,Huntingdon,4133 Medical Center Dr,,Broad Top,PA,16621,Huntingdon,Melissa Walls,CEO,814-635-7351,1401,mwalls007@yahoo.com,Kesha Keel,Director Of Operations,814-635-7351,1402,kkeelbtamc@comcast.net,
PA-009181,Allegheny Health Center,Penn Highlands Brookville,1083762876,Rural Health Clinics,22 Industrial Park Rd,,Brookville,PA,15825-7228,Jefferson,100 Hospital Road,,Brookville,PA,15825,Jefferson,Michael Galluzzi,Director,814-375-6350,,magalluzzi@phhealthcare.org,Julie Peer,President,814-849-1461,,jpeer@phhealthcare.org,
PA-009182,Cornerstone Care Community Medical and Dental Plaza,"CORNERSTONE CARE, INC.",1497783559,"Dental Providers, Federally Qualified Health Centers - Medical Services",1227 Smith Township State Rd,,Burgettstown,PA,15021-2828,Washington,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,Rebecca Hancher,Office Manager,724-947-2255,124,rhancher@cornerstonecare.com,http://www.cornerstonecare.com
PA-009183,Adagio Health Butler,Adagio Health,1205927530,Family Planning Providers,323 Sunset Dr,Suite 2,Butler,PA,16001-4017,Butler,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009184,CALIFORNIA FAMILY PRACTICE,CENTERVILLE CLINIC INC,1649491887,Federally Qualified Health Centers - Medical Services,1152 Wood St,,California,PA,15419-1260,Washington,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009185,CAMBRIDGE SPRINGS HEALTH CENTER,Meadville Medical Center,1649661471,Rural Health Clinics,118 Railroad St,,Cambridge Springs,PA,16403-1060,Crawford,751 Liberty Street,,Meadville,PA,16335,Crawford,Regina Ross,Practice Manager,814-373-3530,,rross@mmchs.org,Michael Downing,CEO,814-373-2449,,mdowning@mmchs.org,
PA-009186,Carbondale Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",141 Salem Ave,Suite 302,Carbondale,PA,18407-2500,Lackawanna,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009187,Sadler Health Center Corporation,SADLER HEALTH CENTER CORPORATION,1467494823,"Dental Providers, Federally Qualified Health Centers - Medical Services",100 N Hanover St,,Carlisle,PA,17013-2421,Cumberland,100 N Hanover St,,Carlisle,PA,17013-2421,Cumberland,Kenneth M Green,CEO,717-960-4321,,kgreen@sadlerhealth.org,Mitzi G Richard,Billing Manager,717-960-4325,,mrichard@sadlerhealth.org,www.sadlerhealth.org
PA-009188,CARMICHAELS CLINIC,CENTERVILLE CLINIC INC,1902929185,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",601 W George St,,Carmichaels,PA,15320-1325,Greene,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009189,Keystone Crisis Intervention,Keystone Rural Health Center,1275720880,Federally Qualified Health Centers - Medical Services,112 N 7th St,,Chambersburg,PA,17201-1720,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009190,Keystone Dental Care,Keystone Rural Health Center,1124026703,Dental Providers,767 5th Ave,Suite B3-A,Chambersburg,PA,17201-4207,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009191,Keystone Behavioral Health,Keystone Rural Health Center,1144402736,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",820 5th Ave,,Chambersburg,PA,17201-4219,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,7906,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009192,Keystone Family Medicine,Keystone Rural Health Center,1538166905,Federally Qualified Health Centers - Medical Services,820 5th Ave,,Chambersburg,PA,17201-4219,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,7906,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009193,Keystone Infectious Disease,Keystone Rural Health Center,1770876575,"Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",830 5th Ave,Suite 201,Chambersburg,PA,17201-4224,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009194,Keystone Pediatrics,Keystone Rural Health Center,1861785669,Federally Qualified Health Centers - Medical Services,830 5th Ave,Suite 103,Chambersburg,PA,17201-4224,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,7906,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009195,Keystone Urgent Care,Keystone Rural Health Center,1790064772,Federally Qualified Health Centers - Medical Services,830 5th Ave,Suite 102,Chambersburg,PA,17201-4224,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009196,Keystone Women's Care,Keystone Rural Health Center,1639462427,Federally Qualified Health Centers - Medical Services,830 5th Ave,Suite 202,Chambersburg,PA,17201-4224,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,7906,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009197,Charleroi Medical & Dental Center,CENTERVILLE CLINIC INC,1073734281,"Dental Providers, Federally Qualified Health Centers - Medical Services",200 Chamber Plz,,Charleroi,PA,15022-1605,Washington,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009198,Tri County Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1295087617,Federally Qualified Health Centers - Medical Services,1555 Shawna Rd,,Cherry Tree,PA,15724-9003,Cambria,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-743-5449,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009199,ChesPenn Center for Family Health at Eastside,ChesPenn Health Services,1750329603,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",125 E 9th St,,Chester,PA,19013-6098,Delaware,2600 W. 9th Street,2 North,Chester,PA,19013-2040,Delaware,Michael G. Lucas,President and CEO,610-485-3800,630,mike.lucas@chespenn.org,,,,,,www.chespenn.com
PA-009200,AIDS Care Group,AIDS Care Group,1477592400,"Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",2304 Edgmont Ave,,Chester,PA,19013-5038,Delaware,2304 Edgmont Ave,,Chester,PA,19013,Delaware,Regina Ubaldi-Rosen,Clinical Director,610-872-9101,,regina@aidscaregroup.org,Howell Strauss,Executive Director,610-583-1177,,howellstrauss@aidscaregroup.org,www.aidscaregroup.org
PA-009201,ChesPenn Health Services,ChesPenn Health Services,1659325751,"Dental Providers, Federally Qualified Health Centers - Medical Services",2600 W 9th St,,Chester,PA,19013-2040,Delaware,2600 W 9th St,2 North,Chester,PA,19013-2040,Delaware,Mary McCullough,Administrative Manager,610-485-3800,629,mmccullough@chespenn.org,,,,,,
PA-009202,Magee Clairton,Magee Women's Hospital,1134301021,Inpatient Hospitals (other than children's hospitals),559 Miller Ave,,Clairton,PA,15025-1746,Allegheny,559 Miller Ave,,Clairton,PA,15025-1746,Allegheny,Joe Chuba,"Vice President, Payer Contracting",412-432-7569,,chubajt@upmc.edu,,,,,,http://www.magee.upmc.com
PA-009203,Clarion Hospital,Clarion Hospital,1265422901,Inpatient Hospitals (other than children's hospitals),1 Hospital Dr,,Clarion,PA,16214-8501,Clarion,One Hospital Drive,,Clarion,PA,16214,Clarion,Vincent Lamorella,CFO,814-226-1301,,vlamorella@clarionhospital.org,,,,,,
PA-009204,Adagio Health Clarion,Adagio Health,1952495194,Family Planning Providers,1064 E Main St,Suite A,Clarion,PA,16214-1248,Clarion,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009205,Clarion University of Pennsylvania,Northwest Pennsylvania Rural AIDS Alliance,1477518124,Ryan White Providers,15870 Route 322,Suite 2,Clarion,PA,16214-6376,Clarion,"15870 Route 322, Suite 2",,Clarion,PA,16214,Clarion,"David Miller-Martini, PhD, MBA",Director,814-297-8220,109,dmartini@clarion.edu,Leah Magagnotti BSN,Coordinator of Clinical Operations,814-297-8220,114,lmagagnotti@clarion.edu,www.clarion.edu
PA-009206,Clarion Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1992060446,"Dental Providers, Federally Qualified Health Centers - Medical Services",30 Pinnacle Dr,,Clarion,PA,16214-3800,Clarion,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-223-9900,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009207,Jacksonville Family Medicine Center,"PRIMARY HEALTH NETWORK, INC.",1730386467,Federally Qualified Health Centers - Medical Services,29 Saltsburg Rd,,Clarksburg,PA,15725-7400,Indiana,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-726-0300,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009208,Adagio Health Clearfield,Adagio Health,1699869958,Family Planning Providers,1036 Park Avenue Ext,,Clearfield,PA,16830-4028,Clearfield,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009209,SHAMOKIN COMMUNITY HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1164881553,Federally Qualified Health Centers - Medical Services,4203 Hospital Rd,,Coal Township,PA,17866-9668,Northumberland,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,570-486-4588,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009210,Glendale Area Medical Association,Glendale Area Medical Association,1255300596,"Dental Providers, Federally Qualified Health Centers - Medical Services",850 Main St,,Coalport,PA,16627,Clearfield,850 Main Street,,Coalport,PA,16627,Clearfield,Dustin Kunstbeck,Admimistrator,814-672-5141,220,dustin.kunstbeck@glendale-medical.com,,,,,,
PA-009211,Planned Parenthood Southeastern Pennsylvania Coatesville Health Center,Planned Parenthood Southeastern Pennsylvania,1861635047,"Family Planning Providers, Sexually Transmitted Disease Clinics",1001 E Lincoln Hwy,Suite 101,Coatesville,PA,19320-3554,Chester,1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009212,CONNEAUT LAKE HEALTH CENTER,Meadville Medical Center,1467843771,Rural Health Clinics,10926 State Highway 18,,Conneaut Lake,PA,16316-3526,Crawford,751 Liberty Street,,Meadville,PA,16335,Crawford,Regina Ross,Practice Manager,814-373-3530,,rross@mmchs.org,Michael Downing,CEO,814-373-2449,,mdowning@mmchs.org,
PA-009213,CONNEAUT VALLEY HEALTH CENTER,Meadville Medical Center,1821489139,"Dental Providers, Rural Health Clinics",906 Washington St,,Conneautville,PA,16406-7138,Crawford,751 Liberty Street,,Meadville,PA,16335,Crawford,Regina Ross,Practice Manager,814-373-3530,,rross@mmchs.org,Michael Downing,CEO,814-373-2449,,,
PA-009214,CONNELLSVILLE MEDICAL & DENTAL CENTER,CENTERVILLE CLINIC INC,1790808962,"Dental Providers, Federally Qualified Health Centers - Medical Services",208 S Arch St,,Connellsville,PA,15425-3519,Fayette,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009215,Corry Memorial Hospital,Corry Memorial Hospital Association,1841268877,Inpatient Hospitals (other than children's hospitals),965 Shamrock Ln,,Corry,PA,16407-9121,Warren,965 Shamrock Lane,,Corry,PA,16407,Erie,Barbara D. Nichols,President/CEO,814-664-4641,1001,bnichols@corryhospital.com,Mike Helelr,Chief Financial Officer,814-664-4641,1040,mheller@corryhospital.com,www.corryhospital.com
PA-009216,CHARLES COLE MEMORIAL HOSPITAL,Charles COLE MEMORIAL HOSPITAL,1326161662,Inpatient Hospitals (other than children's hospitals),1001 E 2nd St,,Coudersport,PA,16915-8161,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009217,COUDERSPORT FAMILY MEDICINE,Charles COLE MEMORIAL HOSPITAL,1578637989,"Dental Providers, Rural Health Clinics",1001 E 2nd St,Suite S,Coudersport,PA,16915-8161,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009218,CENTRAL POTTER HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1033283437,Rural Health Clinics,71 Elk St,,Coudersport,PA,16915-9601,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009219,Geisinger Medical Center (dental provider),GEISINGER MEDICAL CENTER,1235215427,Dental Providers,100 N Academy Ave,,Danville,PA,17822-9800,Montour,100 N Academy Ave,,Danville,PA,17822-9800,Montour,David Friel,VP Third Party Contracting,570-214-8792,,dfriel@geisinger.edu,,,,,,
PA-009220,Geisinger Medical Center (inpatient hospital),GEISINGER MEDICAL CENTER,1235215427,Inpatient Hospitals (other than children's hospitals),100 N Academy Ave,,Danville,PA,17822-9800,Montour,100 N Academy Ave,,Danville,PA,17822-9800,Montour,David Friel,VP Third Party Contracting,570-214-8792,,dfriel@geisinger.edu,,,,,,
PA-009221,Janet Weis Children's Hospital at Geisinger Medical Center,GEISINGER MEDICAL CENTER,1235215427,Children's Hospitals (inpatient only),100 N Academy Ave,,Danville,PA,17822-9800,Montour,100 N Academy Ave,,Danville,PA,17822-9800,Montour,David Friel,VP Third Party Contracting,570-214-8792,,dfriel@geisinger.edu,,,,,,
PA-009222,Community Based Organization,Family Service of Montgomery County,1811926918,Ryan White Providers,3125 Ridge Pike,,Eagleville,PA,19403-5708,Montgomery,3125 Ridge Pike,,Eagleville,PA,19403,Montgomery,Daiquiri Yvette Robinson,Project Director,610-630-2111,234,DRobinson@fsmontco.org,,,,,,
PA-009223,HOFFMAN MEMORIAL MEDICAL CENTER,"PRIMARY HEALTH NETWORK, INC.",1265639553,Federally Qualified Health Centers - Medical Services,419 Kellys Way,,East Brady,PA,16028-1403,Clarion,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-526-5600,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009224,Einstein Medical Center Montgomery,Albert Einstein Healthcare Network,1104192590,Inpatient Hospitals (other than children's hospitals),559 W Germantown Pike,,East Norriton,PA,19403-4250,Montgomery,559 W. Germantown Pike,,East Norriton,PA,19403,Montgomery,Marianne DeJesus,Senior Director,215-456-1037,,dejesusm@einstein.edu,Chris McTiernan,VP & Chief Payer Relations Officer,215-867-8810,,mctiernc@einstein.edu,Www.einstein.edu
PA-009225,ASC at St. Luke's Hospital,St. Luke's Hospital,1588043376,Ryan White Providers,100 N 3rd St # 2,,Easton,PA,18042-1869,Northampton,801 Ostrum St.,,Bethlehem,PA,18015,Lehigh,Kyle Cole,"Manager, HIV Initiatives",484-503-8011,,kyle.cole@sluhn.org,Linda Gately,"VP, Physician Billing Services",484-526-3969,,Linda.Gately@sluhn.org,www.slhn.org
PA-009226,Adagio Health Edinboro,Adagio Health,1336233618,Family Planning Providers,118 E Plum St,,Edinboro,PA,16412-2252,Erie,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009227,VALLEY PEDIATRICS,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1477655744,Federally Qualified Health Centers - Medical Services,468 Northampton St,,Edwardsville,PA,18704-4566,Luzerne,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,President,570-825-8741,223,rhced@yahoo.com,Mary Fritz,RN,570-288-1188,1,mfritz@rhc1084.com,www.rhcnepa.com
PA-009228,ELDRED HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1164594495,Rural Health Clinics,139 Main St,,Eldred,PA,16731-4515,McKean,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009229,ELKLAND LAUREL HEALTH CENTER,N PENN COMPREHENSIVE HEALTH SVCS,1003913955,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",103 Forestview Ave,,Elkland,PA,16920-1403,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009230,EMPORIUM HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1275605750,Rural Health Clinics,288 Sizerville Rd,,Emporium,PA,15834-3944,Cameron,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009231,CAMERON COUNTY HEALTH CENTER,KEYSTONE RURAL HEALTH CONSORTIA INC,1609968114,"Dental Providers, Federally Qualified Health Centers - Medical Services",90 E 2nd St,,Emporium,PA,15834-1302,Cameron,90 E 2nd St,,Emporium,PA,15834-1302,Cameron,Kristie Bennardi,Clinic Director,814-486-1115,,kriben@keystoneruralhealth.com,,,,,,http://www.keystoneruralhealth.com
PA-009232,Community Health Net,Community Health Net,1245209170,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1202 State St,,Erie,PA,16501-1914,Erie,1202 State Street,,Erie,PA,16501,Erie,"R. Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn A. Galloway,Director of Administrative Services,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009233,Community Health Net Dental,COMMUNITY HEALTH NET,1447574785,Dental Providers,1611 Peach St,Suite 465,Erie,PA,16501-2129,Erie,Community Health Net Dental,,Erie,PA,16501-1914,Erie,"Ross Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn A. Galloway,Director of Administrative Services,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009234,John E. Horan Garden Apartments Dental Office,COMMUNITY HEALTH NET,1831484922,Dental Providers,2120 E 10th St,,Erie,PA,16511-3111,Erie,1202 State Street,,Erie,PA,16501-1914,Erie,"Ross Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn Galloway,Director of Administrative Service,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009235,Adagio Health Erie,Adagio Health,1245324532,Family Planning Providers,240 W 11th St,Suite No. 102,Erie,PA,16501-1758,Erie,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009236,Stairways Dental,Community Health Net,1902924269,Dental Providers,2922 State St,,Erie,PA,16508-1832,Erie,1202 State Street,,Erie,PA,16501,Erie,"R. Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn A. Galloway,Director of Administrative Services,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009237,HARBORCREEK YOUTH SERVICES,COMMUNITY HEALTH NET,1336301092,Federally Qualified Health Centers - Medical Services,3712 Iroquois Ave,,Erie,PA,16511-2025,Erie,1202 State St,,Erie,PA,16501-1914,Erie,"R. Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn Galloway,Director of Administrative Services,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009238,Harborcreek Health Center,COMMUNITY HEALTH NET,1972826626,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4401 Iroquois Ave,,Erie,PA,16511-2219,Erie,1202 State St,,Erie,PA,16501-1914,Erie,"Ross Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn A. Galloway,Director of Administrative Services,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009239,Erie County Department of Health,Erie County Department of Health,1235355793,"Sexually Transmitted Disease Clinics, Tuberculosis Clinics",606 W 2nd St,,Erie,PA,16507-1199,Erie,606 West 2nd St,,Erie,PA,16507,Erie,Charlotte Berringer,Director of Nursing,814-451-6721,,cberringer@eriecountypa.gov,Susan Carlson,Communicable Disease Nurse Supervisor,814-451-6700,6712,scarlson@eriecountypa.gov,www.ecdh.org
PA-009240,Wayne Primary Care,"PRIMARY HEALTH NETWORK, INC.",1649676511,Federally Qualified Health Centers - Medical Services,650 East Ave,,Erie,PA,16503-1524,Erie,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-455-5505,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009241,UPMC Family Health Services,University of Pittsburgh Medical Center,1295724193,Family Planning Providers,195 Memorial Dr,Suite 4,Everett,PA,15537-7056,Bedford,UPMC Bedford Memorial Hospital,10455 Lincoln Highway,Everett,PA,15537,Bedford,Dianne Ling,Coordinator,814-623-6849,,lingd@upmc.edu,Joyce Ebersole,Administrative Assistant,814-623-6849,,,
PA-009242,FAIRCHANCE CLINIC,CENTERVILLE CLINIC INC,1003037201,Federally Qualified Health Centers - Medical Services,93 N Morgantown St,,Fairchance,PA,15436-1039,Fayette,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009243,Brookville Hospital Family Practice - New Bethlehem,Penn Highlands Brookville,1477693653,Rural Health Clinics,1323 Brookville St,,Fairmount City,PA,16224-1139,Clarion,100 Hospital Road,,Brookville,PA,15825,Jefferson,Michael Galluzzi,Director,814-375-6350,,magalluzzi@phhealthcare.org,Julie Peer,President,814-849-1461,,jpeer@phhealthcare.org,
PA-009244,EXETER TOWNSHIP MEDICAL CENTER,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1205938578,Federally Qualified Health Centers - Medical Services,2795 Sullivans Trl,,Falls,PA,18615-7949,Wyoming,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,Sherry Darby,Family Planning Coordinator,570-388-6151,1,sdarby@rhc1084.com,Edward P. Michael,President,570-825-8741,223,rhced@yahoo.com,www.rhcnepa.com
PA-009245,Health Shoppe,"PRIMARY HEALTH NETWORK, INC.",1417932609,Federally Qualified Health Centers - Medical Services,1600 Roemer Blvd,,Farrell,PA,16121-1754,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-509-1369,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009246,GREEN STREET PRIMARY CARE,"PRIMARY HEALTH NETWORK, INC.",1275730202,Federally Qualified Health Centers - Medical Services,2000 Green St,Bldg B,Farrell,PA,16121-1369,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-342-6900,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009247,Farrell Dental Center,"PRIMARY HEALTH NETWORK, INC.",1578695904,Dental Providers,350 Sharon New Castle Rd,,Farrell,PA,16121-1576,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-981-1721,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009248,FARRELL HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1184821118,Federally Qualified Health Centers - Medical Services,602 Roemer Blvd,,Farrell,PA,16121-1902,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-981-2246,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009249,"Cornerstone Coordinated Health Care, LLC","Cornerstone Coordinated Health Care, LLC",1811269186,Rural Health Clinics,40 W Frack St,,Frackville,PA,17931-1719,Schuylkill,40 West Frack St,,Frackville,PA,17931,Schuylkill,Angela Wentzel,CMA / Office Manager,570-794-6123,,awentzelcornerstone@gmail.com,,,,,,
PA-009250,"CENTERVILLE CLINICS, INC.; Joseph Yablonski Memorial Clinic",CENTERVILLE CLINIC INC,1437272697,"Black Lung Clinics, Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009251,FREELAND HEALTH CENTER,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1336241694,"Dental Providers, Federally Qualified Health Centers - Medical Services",404 Ridge St,,Freeland,PA,18224-1805,Luzerne,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,President,570-825-8741,223,rhced@yahoo.com,Janice Kollar,Family Planning Coordinator,570-636-1556,1,jkollar@rhc1084.com,www.rhcnepa.com
PA-009252,GALETON HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1003988502,Rural Health Clinics,30 River St,,Galeton,PA,16922-1203,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009253,Gettysburg Center,Family First Health Corporation,1144469123,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1275 York Rd,Suite 117,Gettysburg,PA,17325-7565,Adams,116 south george st,,York,PA,17401,York,Jennifer Englerth,CEO,717-801-4804,,jenglerth@familyfirsthealth.org,,,,,,
PA-009254,Community Health Net Dental,Community Health Net,1992185458,Federally Qualified Health Centers - Medical Services,1135 Lake St,Girard School Based Health Center,Girard,PA,16417-1063,Erie,1202 State Street,,Erie,PA,16501-1914,Erie,"R. Anthony Snow, MD",CEO,814-454-4530,227,chnadmin@community-healthnet.com,Gwendolyn A. Galloway,Director of Administative Service,814-454-4530,227,ggalloway@community-healthnet.com,www.community-healthnet.com
PA-009255,Cornerstone Care Greensboro Office,"CORNERSTONE CARE, INC.",1376512582,"Dental Providers, Federally Qualified Health Centers - Medical Services",7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,Marlene Leslie,Office Manager,724-943-3308,,,http://www.cornerstonecare.com
PA-009256,Planned Parenthood -Greensburg,Planned Parenthood of Western PA,1336238120,Family Planning Providers,125 Nature Park Rd,,Greensburg,PA,15601-6960,Westmoreland,933 Liberty Avenue,,Pittsburgh,PA,15222,Allegheny,Kimberlee Evert,CEO,412-258-9530,,kevert@ppwp.org,Kim Mieczkowski,Billing Manager,412-434-8957,9534,kmieczkowski@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009257,Greenville Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1093946626,Federally Qualified Health Centers - Medical Services,348 Main St,,Greenville,PA,16125-2608,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-588-5250,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009258,Adagio Health Greenville,Adagio Health,1578906079,Family Planning Providers,74 Shenango St,,Greenville,PA,16125-2019,Mercer,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009259,NEPA Community Health Care - Hallstead Health Center,"B-K Health Center, Inc.",1245272707,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",25066 State Route 11,,Hallstead,PA,18822-8816,Susquehanna,"191 Erie Blvd., Suite C",,Susquehanna,PA,18822,Susquehanna,Mary W. Wetherall,CEO,570-853-5500,,mwetherall@nepachc.org,Lori Hubal,CFO,570-853-5502,,lhubal@nepachc.org,www.nepachc.org
PA-009260,Hanover Center,Family First Health Corporation,1336203017,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1230 High St,,Hanover,PA,17331-1127,York,116 South George St,,York,PA,17401,York,jennifer englerth,CEO,717-801-4804,,jenglerth@familyfirsthealth.org,,,,,,
PA-009261,Hamilton Health Center,Hamilton Health Center,1558531749,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",110 S 17th St,,Harrisburg,PA,17104-1123,Dauphin,110 S 17th Street,,Harrisburg,PA,17104,Dauphin,Jeannine Peterson,CEO,717-364-9270,,jpeterson@hamiltonhealthcenter.com,,,,,,
PA-009262,HHC-Senior High Rise,"HAMILTON HEALTH CENTER, INC.",1154591345,Federally Qualified Health Centers - Medical Services,1301 N 6th St,,Harrisburg,PA,17102-1249,Dauphin,110 S 17th St,,Harrisburg,PA,17104-1123,Dauphin,Jeannine D Peterson,CEO,717-230-3910,,jpeterson@hamiltonhealthcenter.com,,,,,,
PA-009263,"Hamilton Health Center, Inc.","HAMILTON HEALTH CENTER, INC.",1568632743,Federally Qualified Health Centers - Medical Services,1301 Sycamore St,HHC-Foose School,Harrisburg,PA,17104-3410,Dauphin,110 S 17th St,,Harrisburg,PA,17104-1123,Dauphin,Jeannine D Peterson,CEO,717-230-3910,,jpeterson@hamiltonhealthcenter.com,,,,,,
PA-009264,HHC-Downey School,"HAMILTON HEALTH CENTER, INC.",1558531749,"Dental Providers, Federally Qualified Health Centers - Medical Services",1313 Monroe St,HHC-Downey School,Harrisburg,PA,17103-1139,Dauphin,110 S 17th St,,Harrisburg,PA,17104-1123,Dauphin,Jeannine D. Peterson,CEO,717-230-3910,,jpeterson@hamiltonhealthcenter.com,,,,,,
PA-009265,Planned Parenthood Keystone Harrisburg,Planned Parenthood Keystone,1487655981,Family Planning Providers,1514 N 2nd St,,Harrisburg,PA,17102-2505,Dauphin,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009266,Pinnacle Health System,Pinnacle Health System,1407813603,Ryan White Providers,2501 N 3rd St,,Harrisburg,PA,17110-1904,Dauphin,409 S 2nd Street,Suite 2C,Harrisburg,PA,17104-8700,Dauphin,Rebecca Geiser,REACCH Program Manager,717-782-2750,2363,rgeiser@pinnaclehealth.org,Jade K. Herbst,"Manager Grants, Corporate & Foundation Relations",717-231-8080,8010,jherbst@pinnaclehealth.org,www.pinnaclehealth.org
PA-009267,Community Check-Up Center,"Family Health Council of Central Pennsylvania, Inc.",1629193016,Family Planning Providers,38 Hall Manor,,Harrisburg,PA,17104,Dauphin,38 Hall Manor,,Harrisburg,PA,17104,Dauphin,Linda Hengst,Clinic Administrator,717-233-1700,,cccdirector@comcast.net,,,717-233-1700,,,http://www.communitycheckupcenter.org/
PA-009268,MFHS-Circle of Care Hawley,Maternal and Family Health Svcs.,1851545057,"Family Planning Providers, Sexually Transmitted Disease Clinics",8 Silk Mill Dr,Suite 226,Hawley,PA,18428-1423,Wayne,15 Public Square Suite 600,,Wilkes Barre,PA,18701,Luzerne,John Kearney,VP of program Services and Business Initiatives,570-826-1777,213,john@mfhs.org,,,,,,http://www.mfhs.org
PA-009269,MFHS Hazleton Center,Maternal and Family Health Svcs.,1851545057,"Family Planning Providers, Sexually Transmitted Disease Clinics",10 W Chestnut St,Suite 6,Hazleton,PA,18201-6419,Luzerne,15 Public Square Suite 600,,Wilkes Barre,PA,18701,Luzerne,John Kearney,VP of Program Services and Business Initiatives,570-826-1777,213,john@mfhs.org,,,,,,http://www.mfhs.org
PA-012372,Wyoming Valley AIDS Council,Wyoming Valley AIDS Council,1588080824,"Ryan White Providers, Sexually Transmitted Disease Clinics",1710 E Broad St,Suite A,Hazleton,PA,18201-5695,Luzerne,330 Bowman Street,Unit 1,Wilkes Barre,PA,18702,Luzerne,Kenneth Zula,Executive Director,570-823-5808,302,kzula@wvacinc.org,Arlent Mejia,Case Manager,570-459-6030,,amejia@wvacinc.org,www.wvacinc.org
PA-009270,Buhl Farm Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1972702645,Federally Qualified Health Centers - Medical Services,220 N Buhl Farm Dr,Suite A,Hermitage,PA,16148-1786,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-342-2789,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009271,Hemophilia Center of Central Pennsylvania,The Penn State Milton S. Hershey Center,1568435477,Hemophilia Treatment Centers,500 University Dr,,Hershey,PA,17033-2360,Dauphin,500 University Drive,,Hershey,PA,17033,Dauphin,Gail Long,Database Administration Coordinator,717-531-6603,,glong@hmc.psu.edu,David Towery,Operations Director of Department of Medicine,717-531-7189,7175315831,dtowery@hmc.psu.edu,
PA-009272,Women's Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",110 Park St,,Honesdale,PA,18431-2023,Wayne,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009273,Highland Physicians Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1839 Fair Ave,,Honesdale,PA,18431-2121,Wayne,601 PARK STREET,,HONESDALE,PA,18431,Wayne,FRED JACKSON,EXECUTIVE DIRECTOR,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009274,HONESDALE FAMILY HEALTH CENTER,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 Maple Ave,Suite 2,Honesdale,PA,18431-1436,Wayne,601 Park St,,Honesdale,PA,18431-1445,Wayne,FREDERICK JACKSON,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009275,Together for Health Dental Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,Dental Providers,600 Maple Ave,Suite 7,Honesdale,PA,18431-1460,Wayne,601 PARK STREET,,HONESDALE,PA,18431,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009276,Broad Top Area Medical Center Huntingdon Office,Broad Top Area Medical Center,1780923086,Federally Qualified Health Centers - Medical Services,909 Moore St,,Huntingdon,PA,16652-1836,Huntingdon,4133 Medical Center Dr,,Broad Top,PA,16621,Huntingdon,Melissa Walls,CEO,814-635-7351,1401,mwalls007@yahoo.com,Kesha Keel,Director Of Operations,814-635-7351,1402,kkeelbtamc@comcast.net,
PA-009277,"HYNDMAN AREA HEALTH CENTER, INC.",HYNDMAN AREA HEALTH CENTER INC,1992754014,"Dental Providers, Federally Qualified Health Centers - Medical Services",144 5th Ave,,Hyndman,PA,15545-7379,Bedford,144 5th Ave,,Hyndman,PA,15545-7379,Bedford,Jennifer Kauffman,CFO,814-709-9813,,jkauffman@hyndmanhealth.org,George Barton,CEO,814-709-9801,,gbarton@hyndmanhealth.org,
PA-009278,Adagio Health Indiana,Adagio Health,1871687178,Family Planning Providers,1097 Oak St,,Indiana,PA,15701-1651,Indiana,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009279,Indiana Dental Center,"PRIMARY HEALTH NETWORK, INC.",1992031215,Dental Providers,590 Indian Springs Rd,,Indiana,PA,15701-3600,Indiana,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-465-6100,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009280,JAMESTOWN HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1053517128,Federally Qualified Health Centers - Medical Services,865 E Jamestown Rd,,Jamestown,PA,16134-9505,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-932-2299,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009281,The Wright Center Mid Valley,The Wright Center Medical Group,1194739979,"Dental Providers, Family Planning Providers",5 S Washington Ave,,Jermyn,PA,18433-1121,Lackawanna,111 N. Washington Ave.,first floor,Scranton,PA,18503,Lackawanna,Jennifer Walsh,SVP & General Counsel,570-687-3067,,walshj@thewrightcenter.org,Maria Montoro Edwards,VP for Strategic Initiatives,570-507-2703,,montoroedwardsm@thewrightcenter.org,www.thewrightcenter.org
PA-009282,Johnsonburg Dental Center,KEYSTONE RURAL HEALTH CONSORTIA INC,1164514683,Dental Providers,81 Clarion Rd,,Johnsonburg,PA,15845-1656,Elk,90 E 2nd St,,Emporium,PA,15834-1302,Elk,Kristie Bennardi,CEO,814-486-1115,,kriben@keystoneruralhealth.com,,,,,,www.keystoneruralhealth.com
PA-009283,Planned Parenthood of Western PA Johnstown Clinic,Planned Parenthood of Western PA,1336238120,Family Planning Providers,817 Franklin St,,Johnstown,PA,15901-2800,Cambria,933 Liberty Avenue,,Pittsburgh,PA,15222,Allegheny,Kimberlee Evert,CEO,412-258-9530,,kevert@ppwp.org,Kim Mieczkoski,Billing Manager,412-434-8957,9534,kmieczkowski@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009284,Kane Dental Center,"Keystone Rural Health Consortia, Inc.",1215451927,Dental Providers,118 Fraley St,,Kane,PA,16735-1327,McKean,PO Box 270,,Emporium,PA,15834-0270,Cameron,Sharon Wykoff,Billing Manager,814-486-1115,502,shawyk@keystoneruralhealth.com,Kristie Bennardi,CEO,814-486-1115,500,kriben@keystoneruralhealth.com,
PA-009285,La Comunidad Hispana,"LA COMUNIDAD HISPANA, INC",1285984476,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",731 W Cypress St,,Kennett Square,PA,19348-2419,Chester,731 W Cypress St,,Kennett Square,PA,19348-2419,Chester,Alisa M Jones,President and CEO,610-444-7550,252,ajones@lchps.org,Amy Lambert,Director of Business Operations and Programs,610-444-7550,248,alambert@lchps.org,http://www.lacomunidadhispana.org/
PA-009286,Fox Township Medical Center,"Keystone Rural Health Consortia, Inc.",1053784942,Federally Qualified Health Centers - Medical Services,172 Skyline Dr,,Kersey,PA,15846-9146,Elk,PO Box 270,,Emporium,PA,15834,Cameron,Sharon Wykoff,Billing Manager,814-486-1115,502,shawyk@keystoneruralhealth.com,Kristie Bennardi,CEO,814-486-1115,500,kriben@keystoneruralhealth.com,
PA-009287,Fox Township Dental Center,"Keystone Rural Health Consortia, Inc.",1881146884,Dental Providers,176 Skyline Dr,,Kersey,PA,15846-9146,Elk,PO Box 270,,Emporium,PA,15834-0270,Cameron,Sharon Wykoff,Billing Manager,814-486-1115,502,shawyk@keystoneruralhealth.com,Kristie Bennardi,CEO,814-486-1115,500,shawyk@keystoneruralhealth.com,
PA-009288,"PhysicianCare,P.C.","PhysicianCare, P.C. Family Planning Administration",1023272333,Family Planning Providers,104 Main St,,Laceyville,PA,18623-6702,Wyoming,71 Hospital Drive,,Towanda,PA,18848,Bradford,Cheryl Henninger,Billing Manager,570-265-6300,,cheryl_ahs@yahoo.com,Nciole Cobb,Credentialing Department,570-265-0119,,ncobb@physiciancarepc.com,http://www.physiciancarepc.com
PA-009289,Hamlin Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",543 Easton Tpke,,Lake Ariel,PA,18436-4798,Wayne,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009290,Northern Wayne Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",412 Como Rd,,Lake Como,PA,18437-1020,Wayne,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009291,SouthEast at Water Street,"SOUTHEAST LANCASTER HEALTH SERVICES, INC.",1134458789,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",304 N Water St,,Lancaster,PA,17603-3374,Lancaster,304 N Water St,,Lancaster,PA,17603-3374,Lancaster,Hilda Shirk,President & CEO,717-945-1551,,hilda.shirk@selhs.org,,,,,,www.selhs.org
PA-009292,Planned Parenthood Keystone Lancaster,Planned Parenthood Keystone,1851464317,Family Planning Providers,31 S Lime St,,Lancaster,PA,17602-3564,Lancaster,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009293,SouthEast at Bright Side,"SOUTHEAST LANCASTER HEALTH SERVICES, INC.",1366496416,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",515B Hershey Ave,,Lancaster,PA,17603-5752,Lancaster,333 N Arch St,,Lancaster,PA,17603-2928,Lancaster,Hilda Shirk,President & CEO,717-945-1551,,hilda.shirk@selhs.org,,,,,,www.selhs.org
PA-009294,SouthEast Lancaster Health Services at Reynolds,SouthEast Lancaster Health Services,1457758617,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",605 W Walnut St,,Lancaster,PA,17603-3383,Lancaster,333 North Arch Street,,Lancaster,PA,17603,Lancaster,Hilda Shirk,President & CEO,717-299-6372,11051,hilda.shirk@selhs.org,,,,,,www.selhs.org
PA-009295,SouthEast LANCASTER HEALTH SERVICES at Duke,"SOUTHEAST LANCASTER HEALTH SERVICES, INC.",1801853346,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",625 S Duke St,,Lancaster,PA,17602-4509,Lancaster,333 N Arch St,,Lancaster,PA,17603-2928,Lancaster,Hilda Shirk,President & CEO,717-299-6372,11051,hilda.shirk@selhs.org,,,,,,www.selhs.org
PA-009296,Lancaster Health Center at New Holland Ave,Lancaster Health Center,1538681283,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",802 New Holland Ave,Suite 200,Lancaster,PA,17602-2288,Lancaster,304 North Water Street,,Lancaster,PA,17603-3374,Lancaster,Hilda Shirk,President & CEO,717-945-1151,,hilda.shirk@selhs.org,,,,,,
PA-009297,SouthEast Lancaster Health Services at Philhaven,SouthEast Lancaster Health Services,1306213020,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",812 N Prince St,,Lancaster,PA,17603-2732,Lancaster,333 North Arch Street,,Lancaster,PA,17603,Lancaster,Hilda Shirk,President & CEO,717-299-6372,11051,hilda.shirk@selhs.org,,,,,,www.selhs.org
PA-009298,Family Service Association of Bucks County,Family Service Association of Bucks County,1144329111,Ryan White Providers,4 Cornerstone Dr,,Langhorne,PA,19047-1314,Bucks,4 Cornerstone Drive,,Langhorne,PA,19047,Bucks,Gita E. Krull,HIV/AIDS Program Coordinator,215-757-6916,231,gkrull@fsabc.org,Audrey J.Tucker,CEO,215-757-6916,204,atucker@fsabc.org,www.fsabc.org
PA-009299,Women's Care Services,Excela Health,1265649776,Family Planning Providers,212 W 2nd Ave,,Latrobe,PA,15650-1069,Westmoreland,212 W. Second Avenue,,Latrobe,PA,15650,Westmoreland,Judith Svidron,Manager,724-537-1870,,jsvidron@excelahealth.org,,,,,,
PA-009300,LATROBE HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1659807485,Federally Qualified Health Centers - Medical Services,529 Lloyd Ave,,Latrobe,PA,15650-1721,Westmoreland,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-804-5195,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009301,LAWRENCEVILLE LAUREL HEALTH CENTER,N PENN COMPREHENSIVE HEALTH SVCS,1326148164,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",32 E Lawrence Rd,,Lawrenceville,PA,16929-8801,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009302,Lebanon Ridge Oral Health,WELSH MOUNTAIN MEDICAL AND DENTAL CENTER,1710323001,"Dental Providers, Federally Qualified Health Centers - Medical Services",101 S 9th St,,Lebanon,PA,17042-5108,Lebanon,584 Springville Rd,,New Holland,PA,17557-9564,Lancaster,Georgette DukesMcAllister,CEO,717-354-4711,128,gdukesmcallister@wellspan.org,,,,,,www.welshmountain.org
PA-009303,Lebanon Family Health Services,Family Health Council of Central PA,1255428488,"Family Planning Providers, Sexually Transmitted Disease Clinics",615 Cumberland St,,Lebanon,PA,17042-5233,Lebanon,3461 Market Street,,Camp Hill,PA,17011,Cumberland,Kimberly Kreider Umble,CEO,717-273-6741,308,kim@lebanonfamilyhealth.org,Donna Williams,COO,717-273-6741,305,Donna@lebanonfamilyhealth.org,http://www.lebanonfamilyhealth.org
PA-009305,Lewisberry Center,Family First Health Corporation,1841354529,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",308 Market St,,Lewisberry,PA,17339-9257,York,116 south george st,,York,PA,17401,York,Jennifer englerth,CEO,717-801-4804,,jenglerth@familyfirsthealth.org,,,,,,
PA-009306,Family Planning Plus Lewisburg,"Family Health Council of Central Pennsylvania, Inc.",1043268568,Family Planning Providers,4612 Westbranch Hwy,,Lewisburg,PA,17837-6607,Union,4612 Westbranch Hwy,,Lewisburg,PA,17837-6607,Union,Peggy Moser,Executive Director,570-523-3462,,bsteiner444@gmail.com,Brittney Zechman,AD,570-523-3462,,,http://www.familyplanningplus.org
PA-009307,Lewistown Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1104257310,Federally Qualified Health Centers - Medical Services,21 S Brown St,,Lewistown,PA,17044-8126,Mifflin,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,717-447-0340,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009308,Lewistown Dental Center,"PRIMARY HEALTH NETWORK, INC.",1962880989,Dental Providers,31 S Dorcas St,,Lewistown,PA,17044-2110,Mifflin,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,717-248-9900,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009309,Family Planning Plus lewistown,Family Planning Plus Lewisburg,1043268568,Family Planning Providers,99 N Juniata St,,Lewistown,PA,17044-2049,Mifflin,99 North Juniata St,,Lewistown,PA,17044,Mifflin,Brittney Zechman,Assistant Director,717-248-0175,,bsteiner444@gmail.com,Peggy Moser,Executive Director,570-523-3600,,,
PA-009310,Pike County Behavioral Health and Dental Clinic,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Community Mental Health Centers, Dental Providers",750 Route 739,,Lords Valley,PA,18428-6058,Pike,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009311,Pike Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTER,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",750 Route 739,,Lords Valley,PA,18428-6058,Pike,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,601 PARK STEET,HONESDALE,PA,18431,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009312,Sadler Health Center Corporation Perry County Dental,SADLER HEALTH CENTER CORPORATION,1740414416,Dental Providers,1104 Montour Rd,,Loysville,PA,17047-9200,Perry,100 N Hanover St,,Carlisle,PA,17013-2421,Cumberland,Kenneth M Green,CEO,717-960-4321,,kgreen@sadlerhealth.org,Mitzi G Richard,Billing Manager,717-960-4325,,mrichard@sadlerhealth.org,www.sadlerhealth.org
PA-009313,MANSFIELD LAUREL HEALTH CENTER,N PENN COMPREHENSIVE HEALTH SVCS,1750461455,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",40 W Wellsboro St,,Mansfield,PA,16933-1411,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009314,DRMC Marienville Family Health,Penn Highlands Brookville,1235465592,Rural Health Clinics,125 Chestnut St,,Marienville,PA,16239-4815,Forest,100 Hospital Road,,Brookville,PA,15825,Jefferson,Michael Galluzzi,Director,814-375-6350,,magalluzzi@phhealthcare.org,Julie Peer,President,814-849-1461,,jpeer@phhealthcare.org,
PA-009315,Sto-Rox Family Health Center,Sto-Rox Neighborhood Health Council Inc.,1154354553,"Dental Providers, Federally Qualified Health Centers - Medical Services",710 Thompson Ave,,Mc Kees Rocks,PA,15136-3808,Allegheny,710 Thompson Avenue,,McKees Rocks,PA,15136,Allegheny,Regis J. Ryan,Chief Executive Officer,412-771-6460,234,admin@storoxfqhc.org,John L. Barczynski,Chief Clinical Officer,412-771-6460,227,jbarczynski@storoxfqhc.org,
PA-009316,St. Luke's Miners Health Center - McAdoo,St. Luke's Hospital Miners Campus,1558693739,Rural Health Clinics,14 N Kennedy Dr,,McAdoo,PA,18237-1908,Schuylkill,St. Luke's Miners Campus,360 W Ruddle St,Coaldale,PA,18218,Schuylkill,Micah Gursky,Rural Health Clinic Administrator,570-645-8118,,Micah.Gursky@sluhn.org,Michele Levitz,Director of Finance,570-645-8261,,Michele.Levitz@sluhn.org,www.sluhn.org
PA-009317,Tri-State Community Health Center - Fulton,Tri-State Community Health Center,1932159464,Federally Qualified Health Centers - Medical Services,525 Fulton Dr,,McConnellsburg,PA,17233-8061,Fulton,109 Rayloc Drive,,Hancock,MD,21750,Washington,Sheila DeShong,COO,301-678-5187,226,sdeshong@tschc.com,,,,,,
PA-009318,UPMC Community Medicine-Latterman Family Health Center,Adagio Health,1588622294,Family Planning Providers,2347 5th Ave,,McKeesport,PA,15132-1126,Allegheny,2347 5th Ave,,McKeesport,PA,15132-1126,Allegheny,Cheryl Stiles,Practice Manager,412-673-5504,,stilesca@upmc.edu,Lisa Bollenberg,Practice Manager,412-673-5504,,bolllm@upmc.edu,http://www.upmc.com
PA-009319,Family Planning Services,Meadville Medical Center,1609077213,Family Planning Providers,747 Terrace St,,Meadville,PA,16335-1737,Crawford,751 Liberty Street,,Meadville,PA,16335-1737,Crawford,Brooke Beck,Clinic Director,814-333-7088,,bbeck@mmchs.org,Regina Ross,Practice Manager,814-373-3530,,rross@mmchs.org,http://www.mmchs.org
PA-009320,Meadville Community Health Center,Meadville Medical Center,1730570573,"Community Mental Health Centers, Rural Health Clinics",747 Terrace St,,Meadville,PA,16335-1737,Crawford,751 Liberty Street,,Meadville,PA,16335,Crawford,Regina Ross,Practice Manager,814-373-3530,,rross@mmchs.org,Michael Downing,CEO,814-373-2449,,mdowning@mmchs.org,
PA-009321,Planned Parenthood Southeastern Pennsylvania Media Health Center,Planned Parenthood Southeastern Pennsylvania,1306988498,"Family Planning Providers, Sexually Transmitted Disease Clinics",216 W State St,,Media,PA,19063-3113,Delaware,1144 Locust Street,,Philadelphia,PA,19107,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009322,MERCER PRIMARY CARE,"PRIMARY HEALTH NETWORK, INC.",1447382296,Federally Qualified Health Centers - Medical Services,737 Greenville Rd,,Mercer,PA,16137-5070,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-662-2650,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009323,Conemaugh Meyersdale Medical Center,LifePoint Health,1659376358,Inpatient Hospitals (other than children's hospitals),200 Hospital Dr,,Meyersdale,PA,15552-1249,Somerset,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Paul Scalisi,VP Managed Care,615-920-7473,,Paul.Scalisi@LPNT.net,Linda Fanale,VP Operations,814-410-8293,,,
PA-009324,Schuylkill Community Health Center,Primary Health Network,1699156596,Federally Qualified Health Centers - Medical Services,210 Sunbury St,,Minersville,PA,17954-1346,Schuylkill,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,570-544-9123,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009325,"Mon Valley Community Health Services, Inc.","MON VALLEY COMMUNITY HEALTH SERVICES, INC.",1821084039,Federally Qualified Health Centers - Medical Services,2 Eastgate Ave,,Monessen,PA,15062-1393,Westmoreland,300 Chamber Plz,,Charleroi,PA,15022-1607,Washington,Luther D Sheets,Executive Director,724-489-9100,4114,sheets@sphs.org,Raelynn Jackson,Practice Manager,724-684-8999,4510,Rjackson@spha.org,monvalleyprimarycare.org
PA-009326,MONROE-NOXEN HEALTH CENTER,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1629170980,"Dental Providers, Federally Qualified Health Centers - Medical Services",2888 SR 29 S,Suite 2,Monroe Township,PA,18636-7854,Wyoming,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,President,570-825-8741,223,rhced@yahoo.com,Johanna Jones,RN,570-298-2121,1,jjones@rhc1084.com,www.rhcnepa.com
PA-009327,Magee Monroeville,Magee Women's Hospital,1134301021,Outpatient Hospital Clinics,4075 Monroeville Blvd,Corp. 1 Office Park,Monroeville,PA,15146-2525,Allegheny,4075 Monroeville Blvd,Corp. 1 Office Park,Monroeville,PA,15146-2525,Allegheny,Joe Chuba,"Vice President, Payer Contracting",412-432-7569,,chubajt@upmc.edu,,,,,,http://www.magee.upmc.com
PA-009328,"ENDLESS MOUNTAINS HEALTH SYSTEMS, INC","ENDLESS MOUNTAINS HEALTH SYSTEMS, INC",1215918560,Inpatient Hospitals (other than children's hospitals),100 Hospital Dr,,Montrose,PA,18801-6402,Susquehanna,100 Hospital Drive,,MONTROSE,PA,18801,Susquehanna,Loren Stone,Chief Executive Officer,570-278-3801,3205,Lstone@endlesscare.org,REXFORD CATLIN,Development Officer,570-278-2801,3200,Rcatlin@endlesscare.org,
PA-009329,Matthew W. Stahl Memorial Health Center,"B-K Health Center, Inc.",1619352978,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",498 S Main St,,Montrose,PA,18801-1353,Susquehanna,"191 Erie Blvd., Suite C",,Susquehanna,PA,18847,Susquehanna,Mary W. Wetherall,CEO,570-853-5500,,mwetherall@nepachc.org,Lori Hubal,CFO,570-853-5502,,lhubal@nepachc.org,
PA-009330,Planned Parenthood Moon,Planned Parenthood of Western PA,1336238120,Family Planning Providers,935 Beaver Grade Rd,Suite 12,Moon Township,PA,15108-2747,Allegheny,933 Liberty Avenue,,Pittsburgh,PA,15222,Allegheny,Kimberlee Evert,CEO,412-258-9530,,kevert@ppwp.org,Kim Mieczkowski,Billing Manager,412-434-8957,9534,kmieczkowski@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009331,MOUNT UNION AREA MEDICAL CENTER,MOUNT UNION AREA MEDICAL CENTER,1063477859,Rural Health Clinics,95 S Park St,,Mount Union,PA,17066-1398,Huntingdon,95 S PARK STREET,,MOUNT UNION,PA,17066,Huntingdon,KIM WERDEBAUGH,ADMINISTRATOR,814-542-8627,312,kim.werdebagh@mtunionmedical.org,,,,,,
PA-009332,Cornerstone Care Mt. Morris,Cornerstone Care,1194029819,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",120 Locust Ave Ext,,Mt Morris,PA,15349-1355,Greene,120 Locust Ave Ext,,Mt Morris,PA,15349-1355,Greene,Denise Minor,Office Manager,724-324-9001,,dminor@cornerstonecare.com,,,,,,
PA-009333,Esposito Medical Associates LTD,Esposito Medical Associates LTD,1770577793,Other ECP Providers,599 N Church St,Suite 200,Mt Pleasant,PA,15666-1004,Westmoreland,599 North Church Street - Suite 200,,Mt. Pleasant,PA,15666,Westmoreland,Trisha Farmer,Office Manager,724-542-5349,,tfarmer@espositomedical.com,Rachel F Esposito D.O.,Doctor,724-771-1125,,resposito@espositomedical.com,
PA-009334,St. Luke's Miners Health Center - Nesquehoning,St. Luke's Hospital Miners Campus,1568650836,Rural Health Clinics,108 W Catawissa St,,Nesquehoning,PA,18240-1501,Carbon,St. Luke's Miners Campus,360 W Ruddle St,Coaldale,PA,18218,Schuylkill,Micah Gursky,Rural Health Clinic Administrator,570-645-8118,,Micah.Gursky@sluhn.org,Michele Levitz,Director of Finance,570-645-8261,,Michele.Levitz@sluhn.org,
PA-009335,NEW CASTLE PRIMARY CARE,"PRIMARY HEALTH NETWORK, INC.",1881726644,Federally Qualified Health Centers - Medical Services,1112 S Mill St,,New Castle,PA,16101-4629,Lawrence,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-658-4564,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009336,Adagio Health New Castle,Adagio Health,1104912401,Family Planning Providers,200 S Jefferson St,,New Castle,PA,16101-3924,Lawrence,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009337,New Castle Dental Center/ Fox Chase Health Center,"PRIMARY HEALTH NETWORK, INC.",1871754465,Dental Providers,2807 Wilmington Rd,,New Castle,PA,16105-1263,Lawrence,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-656-3486,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009338,Meadow Creek Family Practice,Welsh Mountain Health Centers,1942437991,Federally Qualified Health Centers - Medical Services,435 S Kinzer Ave,Suite 6,New Holland,PA,17557-8706,Lancaster,584 Springville Road,,New Holland,PA,17557,Lancaster,Georgette Dukes McAllister,CEO,717-354-4711,128,gdukesmcallister@wellspan.org,Donna Fetzer,Finance Director,717-354-4711,129,dfetzer@wellspan.org,www.welshmountain.org
PA-009339,Welsh Mountain Medical and Dental Center,Welsh Mountain Health Centers,1184673790,"Dental Providers, Federally Qualified Health Centers - Medical Services",584 Springville Rd,,New Holland,PA,17557-9564,Lancaster,584 Springville Road,,New Holland,PA,17557,Lancaster,Georgette Dukes McAllister,CEO,717-354-4711,128,gdukesmcallister@wellspan.org,Donna Fetzer,Finance Director,717-354-4711,129,dfetzer@wellspan.org,www.welshmountain.org
PA-009340,"Community Health Clinic, Inc.","COMMUNITY HEALTH CLINIC, INC.",1699701136,"Dental Providers, Federally Qualified Health Centers - Medical Services",947 4th Ave,,New Kensington,PA,15068-6409,Westmoreland,943 Fourth Avenue,,New Kensington,PA,15068-6409,Westmoreland,Brenda Bowman,Office Manager,724-889-2779,,brendab@communityhealthclinic.org,Raji Jayakrishnan,Executive Director,724-889-2777,,raji@communityhealthclinic.org,
PA-009341,Family Health Clinic of Barnes-Kasson Hospital,Barnes-Kasson County Hospital,1497996037,Rural Health Clinics,137 Delaware St,,New Milford,PA,18834-6643,Susquehanna,2872 Turnpike Street,,Susquehanna,PA,18847,Susquehanna,Sara F Adornato,CEO,570-853-3135,224,sadornato@bkhcs.org,,,,,,www.barnes-kasson.org
PA-009342,Planned Parenthood Southeastern Pennsylvania Norristown Health Center,Planned Parenthood Southeastern Pennsylvania,1770625956,"Family Planning Providers, Sexually Transmitted Disease Clinics",1221 Powell St,,Norristown,PA,19401-3303,Montgomery,1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009343,Norristown Regional Health Center,"DELAWARE VALLEY COMMUNITY HEALTH, INC.",1174545115,Federally Qualified Health Centers - Medical Services,1401 Dekalb St,,Norristown,PA,19401-3405,Montgomery,1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,Patricia Deitch,CEO,215-684-5344,,deitchp@dvch.org,Carla Wimbush,CFO,215-684-5344,,wimbushc@dvch.org,dvch.org
PA-009344,BLACK CREEK HEALTH CENTER,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1871695148,"Dental Providers, Federally Qualified Health Centers - Medical Services",75 Pineapple St,,Nuremberg,PA,18241,Schuylkill,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,President,570-825-8741,223,rhced@yahoo.com,Diane Petrovich,Pa-C,570-384-3201,3,dpetrovich@rhc1084.com,www.rhcnepa.com
PA-009345,LCH Oxford Community Health Center,"La Comunidad Hispana, INC",1760854293,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",301 N 3rd St,Suite 2,Oxford,PA,19363-1429,Chester,731 W Cypress Street,,Kennett Square,PA,19348,Chester,Alisa Jones,President and CEO,610-444-7550,252,ajones@lchps.org,Amy Lambert,Director of Business Operations and Programs,610-444-7550,248,alambert@lchps.org,http://www.lacomunidadhispana.org/
PA-009346,PETROLEUM VALLEY MEDICAL CENTER,"PRIMARY HEALTH NETWORK, INC.",1538291828,Federally Qualified Health Centers - Medical Services,296 Church St,,Petrolia,PA,16050,Butler,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-756-2940,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009347,Temple University Hospital Pysch Extended Care,"Temple University Hospital, Inc.",1942364781,Inpatient Hospitals (other than children's hospitals),100 E Lehigh Ave,,Philadelphia,PA,19125-1012,Philadelphia,2450 W. Hunting Park Ave.,,Philadelphia,PA,19129,Philadelphia,Robert Auerbach,Director of Payer Contracting,215-707-4332,,Robert.Auerbach@tuhs.temple.edu,Gerald Oetzel,Chief Financial Officer,215-707-3743,,Gerald.Oetzel@tuhs.temple.edu,
PA-009348,Cardeza Foundation HTC,Jefferson University Physicians,1326093675,Hemophilia Treatment Centers,1015 Chestnut St,Suite 1321,Philadelphia,PA,19107-4313,Philadelphia,833 Chestnut Street,Suite 640,Philadelphia,PA,19107,Philadelphia,Debra Taylor,VP Managed Care Contracting,215-503-4648,2155034648,debra.taylor@jefferson.edu,JoAnn Pinto,,215-503-8960,2155038960,joann.pinto@jefferson.edu,
PA-009349,Planned Parenthood Southeastern Pennsylvania Locust Health Center,Planned Parenthood Southeastern Pennsylvania,1447301122,"Family Planning Providers, Sexually Transmitted Disease Clinics",1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steven.crowley@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009350,Fairmount Primary Care Center at Horizon House,"DELAWARE VALLEY COMMUNITY HEALTH, INC.",1811202153,Federally Qualified Health Centers - Medical Services,120 S 30th St # 2,,Philadelphia,PA,19104-3403,Philadelphia,1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,Patricia Deitch,CEO,215-684-5344,,deitchp@dvch.org,Carla Wimbush,CFO,215-684-5344,,wimbushc@dvch.org,dvch.org
PA-009351,PHMC Care Clinic,PUBLIC HEALTH MANAGEMENT CORPORATION,1467776989,Federally Qualified Health Centers - Medical Services,1200 Callowhill St,Suite 101,Philadelphia,PA,19123-3658,Philadelphia,1500 Market St Ste 1500,,Philadelphia,PA,19102-2100,Philadelphia,Melissa Fox,Managing Director,215-985-2500,,mfox@phmc.org,,,,,,
PA-009352,John Bell Health Center,Philadelphia FIGHT Community Health Centers,1760507859,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1207 Chestnut St,,Philadelphia,PA,19107-4131,Philadelphia,1233 Locust St,,Philadelphia,PA,19107-5461,Philadelphia,Sarah Smith,Administrative Director,215-985-4448,199,sarahs@fight.org,Barbara Bungy,Chief Operating Officer,215-985-4448,,bbungy@fight.org,www.fight.org
PA-009353,Pediatric and Adolescent Health Center,Philadelphia FIGHT Community Health Centers,1487082608,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1207 Chestnut St,,Philadelphia,PA,19107-4131,Philadelphia,1233 Locust Street,,Philadelphia,PA,19107,Philadelphia,Sarah Smith,Chief Quality Officer,215-985-4448,199,sarahs@fight.org,Barbara Bungy,Chief Operating Officer,215-985-4448,,bbungy@fight.org,www.fight.org
PA-009354,Bebashi Transition to Hope,Bebashi-Transition to Hope,1487935805,"Other ECP Providers, Ryan White Providers",1217 Spring Garden St,1st Floor,Philadelphia,PA,19123-3212,Philadelphia,1217 Spring Garden Street,1st Floor,Philadelphia,PA,19123,Montgomery,Gary James Bell,Executive Director,215-769-3561,201,garyb@bebashi.org,Linda Martin,Deputy Executive Director,215-769-3561,104,lindam@bebashi.org,www.bebashi.org
PA-009355,Jonathan Lax Treatment Center,Philadelphia FIGHT Community Health Centers,1760507859,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1233 Locust St Fl 5,,Philadelphia,PA,19107-5461,Philadelphia,1233 Locust St,,Philadelphia,PA,19107-5453,Philadelphia,Sarah Smith,Administrative Director,215-985-4448,199,sarahs@fight.org,Barbara Bungy,Chief Operating Officer,215-985-4448,,bbungy@fight.org,www.fight.org
PA-009356,MARY HOWARD HEALTH CENTER,PUBLIC HEALTH MANAGEMENT CORPORATION,1912943457,Federally Qualified Health Centers - Medical Services,125 S 9th St,Suite 403,Philadelphia,PA,19107-5117,Philadelphia,1500 Market St Ste 1500,,Philadelphia,PA,19102-2100,Philadelphia,Melissa Fox,Managing Director,215-985-2500,,mfox@phmc.org,,,,,,
PA-009357,COOKE FAMILY HEALTH CENTER,"QUALITY COMMUNITY HEALTH CARE, INC.",1952495707,"Dental Providers, Federally Qualified Health Centers - Medical Services",1300 W Louden St,,Philadelphia,PA,19141-2603,Philadelphia,2501 W Lehigh Ave,,Philadelphia,PA,19132-3207,Philadelphia,Marcella E Lingham,President/CEO,215-227-0300,,mlingham@qchc.org,,,,,,
PA-009358,Philadelphia District Health Center #9,City of Philadelphia,1427165307,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",131 E Chelten Ave,,Philadelphia,PA,19144-2153,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009359,Reed Street Health Center,"Spectrum Health Services, Inc",1689045437,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1325 S 33rd St Fl 3,,Philadelphia,PA,19146-3303,Philadelphia,5201 Haverford Avenue,,Philadelphia,PA,19139-1401,Philadelphia,Phyllis B. Cater,President & CEO,215-471-2758,,pcater@spectrumhs.org,Diane C. Lee,Chief Programs and Compliance Officer,215-471-2756,,dlee@spectrumhs.org,http://www.spectrumhs.org
PA-009360,Kensington Hospital,Kensington Hospital,1114953619,Inpatient Hospitals (other than children's hospitals),136 Diamond St,,Philadelphia,PA,19122-1797,Philadelphia,136 W. Diamond Street,,Philadelphia,PA,19122-1721,Philadelphia,Eileen Hause,Chief Executive Officer,215-291-6001,,ehause@kensingtonhospital.org,Maria Zukowski,Executive Assistant,215-426-8100,6502,mdimichele@kensingtonhospital.org,
PA-009361,Covenant House Health and Dental Services,Covenant House Inc.,1306146923,Dental Providers,138 W Chelten Ave,2nd Floor Rear,Philadelphia,PA,19141,Philadelphia,251 E. Bringhurst Street,,Philadelphia,PA,19141,Philadelphia,"Rosetta Smith, RN, BSN, MPH",Chief Executive Officer,215-844-1020,221,rsmith@covenanthousehealth.org,"Susan Stukes, DDS","Director, Dental Services",267-331-9832,318,stukes@covenanthousehealth.org,www.covenanthousehealth.org
PA-009362,GPHA 4th Street Medical Suite,"Greater Philadelphia Health Action, Inc.",1144274077,Federally Qualified Health Centers - Medical Services,1401 S 4th St,Suite 4,Philadelphia,PA,19147-5948,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009363,"URBAN SOLUTIONS, INC.","URBAN SOLUTIONS, INC.",1497961510,Ryan White Providers,1408 S Broad St # 1,,Philadelphia,PA,19146-4808,Philadelphia,1408 S. BROAD ST.,1st floor,Philadelphia,PA,19146,Philadelphia,NOBLE JONES,CEO/ MEDICAL DIRECTOR,215-755-6462,132,NOBLE.JONESMD@GMAIL.COM,YVONNE JONES,RN,215-755-6462,139,yvonne.jones545@gmail.com,WWW.MYURBANSOLUTIONS.COM
PA-009364,GPHA - South Philadelphia Health Center,Greater Philadelphia Health Center,1023485265,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1408 S Broad St # 2,,Philadelphia,PA,19146-4808,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009365,FAIRMOUNT PRIMARY CARE CENTER,"DELAWARE VALLEY COMMUNITY HEALTH, INC.",1285699686,"Dental Providers, Federally Qualified Health Centers - Medical Services",1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,Patricia Deitch,CEO,215-684-5344,,deitchp@dvch.org,Carla Wimbush,CFO,215-684-5344,,wimbushc@dvch.org,www.dvch.org
PA-009366,BROAD STREET HEALTH CENTER,"SPECTRUM HEALTH SERVICES, INC.",1881629012,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1415 N Broad St,Suite 224,Philadelphia,PA,19122-3325,Philadelphia,5201 Haverford Ave,,Philadelphia,PA,19139-1401,Philadelphia,Phyllis B Cater,President & CEO,215-471-2755,,pcater@spectrumhs.org,Diane Lee,Chief Programs & Compliance Officer,215-235-7944,,dlee@spectrumhs.org,http://www.spectrumhs.org
PA-009367,Y-HEP Health Center,Philadelphia FIGHT Community Health Centers,1760507859,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1417 Locust St,,Philadelphia,PA,19102-3829,Philadelphia,1233 Locust St,,Philadelphia,PA,19107-5461,Philadelphia,Sarah Smith,Administrative Director,215-985-4448,199,sarahs@fight.org,Barbara Bungy,Chief Operating Officer,215-985-4448,,bbungy@fight.org,www.fight.org
PA-009368,Partnership Comprehensive Care Practice,Drexel University,1538279732,Ryan White Providers,1427 Vine St # 2,,Philadelphia,PA,19102-1031,Philadelphia,Drexel University College of Medicine,"1427 Vine Street, MS 461",Philadelphia,PA,19102,Philadelphia,"Amy Baranoski, MD",Assistant Professor,215-991-8587,,asb23@drexel.edu,"Angella Yap, MPH, MBA",Department of Medicine Administrator,215-762-1993,,amy29@drexel.edu,
PA-009369,Dorothy Mann Center for Pediatric and Adolescent HIV,St. Christopher's Hospital for Children,1043274376,Ryan White Providers,160 E Erie Ave,St. Christophers Hospital For Children,Philadelphia,PA,19134-1011,Philadelphia,160 E Erie Ave,,Philadelphia,PA,19134,Philadelphia,"Daniel H. Conway, MD","Director, Dorothy Mann Center for Pediatric and Adolescent HIV",215-427-5284,,dconway@drexelmed.edu,,,,,,
PA-009370,St. Christopher's Hospital For Children Adolescent Medicine,Drexel University / St. Christopher's Hospital for Children,1053680827,"Family Planning Providers, Ryan White Providers",160 E Erie Ave,,Philadelphia,PA,19134-1011,Philadelphia,160 E Erie Ave,,Philadelphia,PA,19134,Philadelphia,"Leonard J. Levine, MD",Clinic Director,215-427-3802,,leonard.levine@drexelmed.edu,Enitan Adegite,Physician,215-427-8470,,EA368@DREXEL.EDU,http://www.stchristophershospital.com/
PA-009371,St. Christopher's Hospital For Children Adolescent Medicine,St. Christopher's Hospital for Children Pediatric Associates,1255363578,Children's Hospitals (inpatient only),160 E Erie Ave,,Philadelphia,PA,19134-1011,Philadelphia,160 E Erie Ave,,Philadelphia,PA,19134,Philadelphia,George Rizzuto,CFO,215-427-8901,,george.rizzuto@tenethealth.com,Mark McLoone,CEO,215-427-8481,8481,mark.mcloone@tenethealth.com,http://www.stchristophershospital.com/
PA-009372,MEADE FAMILY HEALTH CENTER,"QUALITY COMMUNITY HEALTH CARE, INC.",1699889477,Federally Qualified Health Centers - Medical Services,1600 N 18th St,,Philadelphia,PA,19121-3232,Philadelphia,2501 W Lehigh Ave,,Philadelphia,PA,19132-3207,Philadelphia,Marcella E Lingham,President/CEO,215-227-0300,,mlingham@qchc.org,,,,,,
PA-009373,Philadelphia District HC #2,City of Philadelphia,1942317094,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1700 S Broad St Unit 201,,Philadelphia,PA,19145-2315,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009374,Temple University Student Health,Temple University,1861519787,Family Planning Providers,1810 Liacouras Walk,4th Floor,Philadelphia,PA,19122-6026,Philadelphia,3401 N. Broad Street,8th Floor - Zone B,Philadelphia,PA,19140,Philadelphia,Monique McCrae,Family Planning Manager,215-707-7225,,Monique.Collins@tuhs.temple.edu,,,,,,https://www.temple.edu/studenthealth/
PA-009375,Philadelphia District Health Center #5,City of Philadelphia,1518074566,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1900 N 20th St,,Philadelphia,PA,19121-2217,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009376,PHMC Health Connection,PUBLIC HEALTH MANAGEMENT CORPORATION,1417382888,Federally Qualified Health Centers - Medical Services,1900 N 9th St,,Philadelphia,PA,19122-2024,Philadelphia,1500 Market St Ste 1500,,Philadelphia,PA,19102-2100,Philadelphia,Melissa Fox,Managing Director,215-985-2500,,mfox@phmc.org,,,,,,
PA-009377,GPHA - Hunting Park Health Center,Greater Philadelphia Health Action Inc.,1063466068,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1999 W Hunting Park Ave,,Philadelphia,PA,19140-2828,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009378,Hub of Hope,PROJECT H.O.M.E.,1982035366,Federally Qualified Health Centers - Medical Services,2 Penn Ctr,,Philadelphia,PA,19102-1710,Philadelphia,1515 Fairmount Ave,,Philadelphia,PA,19130-2936,Philadelphia,Monica Medina McCurdy,"Vice President, Healthcare Services",215-320-6187,5741,monicamccurdy@projecthome.org,Greg Landistratis,Director of Operations,215-320-6187,,greglandistratis@projecthome.org,
PA-009379,Mazzoni Center Behavioral Health Services,Mazzoni Center,1477631307,Ryan White Providers,21 S 12th St # 8,,Philadelphia,PA,19107-3614,Philadelphia,21 S. 12th Street,12th floor,Philadelphia,PA,19107,Philadelphia,"Judy Morrissey, LCSW",Behavioral Health Services Director,215-563-0652,209,jmorrissey@mazzonicenter.org,Ron Powers,Chief Operating Officer,215-563-0652,210,rpowers@mazzonicenter.org,www.mazzonicenter.org
PA-009380,Project HOME - Stephen Klein Wellness Center,Project HOME,1609122506,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",2144 Cecil B Moore Ave,,Philadelphia,PA,19121-4014,Philadelphia,2144 Cecil B Moore Ave,,Philadelphia,PA,19121,Philadelphia,Greg Landistratis,Director of Operations,215-320-6187,5743,glandistratis@projecthome.org,Monica McCurdy,VP Healthcare Services,215-320-6187,5741,mmccurdy@projecthome.org,www.projecthome.org
PA-009381,Philadelphia District Health Center #10,City of Philadelphia,1699882597,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2230 Cottman Ave,,Philadelphia,PA,19149-1230,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009382,The Children's Hospital of Philadelphia-Primary Care Cobbs Creek,THE CHILDREN'S HOSPITAL OF PHILADELPHIA,1932299617,"Family Planning Providers, Outpatient Hospital Clinics",225 S 63rd St,,Philadelphia,PA,19139-3723,Philadelphia,3401 Civic Center Boulevard,,Philadelphia,PA,19104,Philadelphia,"Andrea Bailer, MSN, CRNP",Advanced Practice Nurse Manager - CHOP Care Network,267-425-9841,,Bailer@email.chop.edu,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,www.chop.edu/locations/primary-care-cobbs-creek
PA-009383,Penn Dental Medicine-ICC (Ryan White funded),The Trustees of the Univ. of Pennsylvania,1851370910,Dental Providers,240 S 40th St Fl 2,Schattner Bldg - Dept Of Oral Medicine,Philadelphia,PA,19104-6030,Philadelphia,School of Dental Medicine - ATTN: CRSC/Insurance,240 S. 40th Street,Philadelphia,PA,19104,Philadelphia,Joe Wolk,"Director, Patient Revenue",215-898-3576,,wolkj@upenn.edu,Nina Roulac,Manager of Central Registration and Financial Services,,,nroulac@upenn.edu,www.dental.upenn.edu
PA-009384,"QUALITY COMMUNITY HEALTH CARE, INC.","QUALITY COMMUNITY HEALTH CARE, INC.",1861490583,"Dental Providers, Federally Qualified Health Centers - Medical Services",2501 W Lehigh Ave,,Philadelphia,PA,19132-3207,Philadelphia,2501 W Lehigh Ave,,Philadelphia,PA,19132-3207,Philadelphia,Marcella E Lingham,President/CEO,215-227-0300,,mlingham@qchc.org,,,215-227-8300,,,http://www.stdtestingtreatment.com/quality-corr
PA-009385,Covenant House Health Services,Covenant House Inc.,1659462679,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",251 E Bringhurst St,,Philadelphia,PA,19144-1799,Philadelphia,251 E. Bringhurst Street,,Philadelphia,PA,19141-1799,Philadelphia,"Rosetta Smith, RN, BSN, MPH",Chief Executive Officer,215-844-1020,221,rsmith@covenanthousehealth.org,Carolyn RIchardson-Neal,"Director, Reimbursement Services",215-844-1020,220,crichardson@covenanthousehealth.org,www.covenanthousehealth.org
PA-009386,GPHA - Wilson Park Medical Center,"Greater Philadelphia Health Action, Inc.",1720032659,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2520 Snyder Ave,,Philadelphia,PA,19145-3101,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009387,QCare Convenient Care,"RESOURCES FOR HUMAN DEVELOPMENT, INC.",1265872774,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2800 Fox St,,Philadelphia,PA,19129-1838,Philadelphia,4700 Wissahickon Avenue,Suite 118,Philadelphia,PA,19144,Philadelphia,Emily Nichols,Director of Operations,267-597-3604,,enichols@fpcn.com,Donna Torrisi,Network Executive Director,267-597-3601,,dtorrisi@fpcn.com,www.fpcn.com
PA-009388,Strawberry Mansion Health Center,City of Philadelphia,1417064353,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2840 W Dauphin St,,Philadelphia,PA,19132-4627,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009389,ESPERANZA HEALTH CENTER,"ESPERANZA HEALTH CENTER, INC.",1255726659,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2940 N 5th St,,Philadelphia,PA,19133-2801,Philadelphia,4417 N 6th St,,Philadelphia,PA,19140-2319,Philadelphia,Susan M Post,Executive Director,215-302-3600,333,susan.post@esperanzahealth.com,Glenna J Deem,Credentialing Manager,215-302-3150,300,glenna.deem@esperanzahealth.com,www.esperanzahealth.com
PA-009390,Covenant House Pennsylvania,Covenant House,1871501684,Family Planning Providers,31 E Armat St,,Philadelphia,PA,19144-2201,Philadelphia,31 E Armat St,,Philadelphia,PA,19144,Philadelphia,"Andrea Bailer, MSN, CRNP",Advanced Practice Nurse Manager - CHOP Care Network,267-425-9841,,Bailer@email.chop.edu,,,,,,http://covenanthousepa.org/
PA-009391,Esperanza Health Center K&A,Esperanza Health Center,1255726659,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3156 Kensington Ave,,Philadelphia,PA,19134-2400,Philadelphia,4417 N 6th St,Esperanza Health Cen,Philadelphia,PA,19140-2319,Philadelphia,Glenna J Deem,Credentialing Manager,215-302-3150,300,glenna.deem@esperanzahealth.com,,,,,,
PA-009392,Philadelphia District Health Center #6,City of Philadelphia,1023125085,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Tuberculosis Clinics",321 W Girard Ave,,Philadelphia,PA,19123-1531,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009393,Temple Univ Kornberg School of Dentistry,Temple Univ Kornberg School of Dentistry,1730345471,Dental Providers,3223 N Broad St,Temple Univ Kornberg School of Dentistry,Philadelphia,PA,19140-5007,Philadelphia,3223 North Broad St,,Philadelphia,PA,19140,Philadelphia,Laurie A MacPhail,DMD,215-707-7685,,macphail@temple.edu,Barry R. Dahlen,Administration and Financial Affairs,215-707-5593,,bdahlen@temple.edu,
PA-009394,"Education Plus, Inc.","Education Plus, Inc.",1083013619,Family Planning Providers,3301 Tasker St,Audenried School Based Health Center,Philadelphia,PA,19145-1021,Philadelphia,"100 W. Oxford Street, Suite 1100",,Philadelphia,PA,19122,Philadelphia,Julie Cousler Emig,Executive Director,267-324-5707,,julie@educationplushealth.com,Paula Navas,Finance Director,267-324-5707,,paula@educationplushealth.com,www.educationplushealth.com
PA-009395,American Oncologic Hospital,American Oncologic Hospital,1730195017,Freestanding Cancer Centers,333 Cottman Ave,,Philadelphia,PA,19111-2434,Philadelphia,2450 W. Hunting Park Ave.,"4th Floor, Room 4-108",Philadelphia,PA,19129,Philadelphia,Robert Auerbach,Director of Payer Contracting,215-707-4332,,Robert.Auerbach@tuhs.temple.edu,Anthony Diasio,Chief Financial Officer,215-728-3824,,anthony.diasio@fccc.edu,
PA-009396,Trustees of the University of Pennsylvania,Trustees of the University of Pennsylvania,1851370910,"Dental Providers, Hemophilia Treatment Centers, Ryan White Providers",3400 Spruce St,,Philadelphia,PA,19104-4238,Philadelphia,3400 Spruce Street,,Philadelphia,PA,19104,Philadelphia,John McLean,"Associate Vice President, Managed Care",267-414-2330,,John.Mclean@uphs.upenn.edu,Roy Schwartz,"Vice President, Managed Care Contracts",267-414-2333,,Roy.Schwartz@uphs.upenn.edu,
PA-009399,HEMOSTASIS AND THROMBOSIS CENTER,THE CHILDREN'S HOSPITAL OF PHILADELPHIA,1235209081,Hemophilia Treatment Centers,3401 Civic Center Blvd,11th floor CTRB,Philadelphia,PA,19104-4319,Philadelphia,"Division of Hematology, The Children's Hospital of Philadelphia","11th floor CTRB, 3401 Civic Center Blvd.",Philadelphila,PA,19104,Philadelphia,Rollie Essex,"Administrative Director, Division of Hematology",215-590-4191,,essex@email.chop.edu,"Leslie J. Raffini, M.D.","Medical Director, HTC",215-590-3437,2155904493,raffini@email.chop.edu,https://www.chop.edu/centers-programs/hemostasis-and-thrombosis-center
PA-009397,The Children's Hospital of Philadelphia (children's inpatient hospital),The Children's Hospital of Philadelphia,1215921457,Children's Hospitals (inpatient only),3401 Civic Center Blvd,,Philadelphia,PA,19104-4319,Philadelphia,3401 Civic Center Boulevard,,Philadelphia,PA,19104,Philadelphia,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,Govtaffairs@email.chop.edu,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,http://www.chop.edu/
PA-009398,The Children's Hospital of Philadelphia (dental provider),The Children's Hospital of Philadelphia,1215921457,Dental Providers,3401 Civic Center Blvd,,Philadelphia,PA,19104-4319,Philadelphia,3401 Civic Center Boulevard,,Philadelphia,PA,19104,Philadelphia,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,Govtaffairs@email.chop.edu,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,http://www.chop.edu/
PA-009400,"Temple University Hospital, Main","Temple University Hospital, Inc.",1962579029,Inpatient Hospitals (other than children's hospitals),3401 N Broad St,,Philadelphia,PA,19140-5103,Philadelphia,2450 W. Hunting Park Ave.,"4th Floor, Room 4-108",Philadelphia,PA,19129,Philadelphia,Robert Auerbach,Director of Payer Contracting,215-707-4332,,Robert.Auerbach@tuhs.temple.edu,Gerald Oetzal,Chief Financial Officer,215-728-3824,,Gerald.Oetzel@tuhs.temple.edu,
PA-009401,Temple University Family Planning,Temple University,1194713073,Family Planning Providers,3401 N Broad St # 8,Floor - Zone B,Philadelphia,PA,19140-5103,Philadelphia,3401 N. Broad Street,8th floor - Zone B,Philadelphia,PA,19140,Philadelphia,Nancy Fox,Administrator,215-707-7499,,Nancy.Fox@tuhs.temple.edu,Monique McCrae,Famly Planning Manager,215-707-7225,,Monique.Collins@tuhs.temple.edu,https://www.temple.edu/medicine/departments_centers/clinical_departments/obgyn_reproductive.htm
PA-009402,HOSPITAL OF UNIV OF PENNSYLVANIA,Infectious Disease,1194832899,Ryan White Providers,34th & Spruce St,,Philadelphia,PA,19104,Philadelphia,"Perelman Center for Advanced Medicine , South Pavilion 4th Floor",3400 Civic Center Blvd,Philadelphia,PA,19104,Philadelphia,Karen Russo,Program Manager,215-360-0467,,Karen.Russo@uphs.upenn.edu,,,,,,
PA-009403,The Children's Hospital of Philadelphia Adolescent Initiative,The Children's Hospital of Philadelphia,1710072764,"Outpatient Hospital Clinics, Ryan White Providers",3550 Market St Fl 5,,Philadelphia,PA,19104-3364,Philadelphia,3401 Civic Center Boulevard,,Philadelphia,PA,19104,Philadelphia,Jennifer Goldberg,Program Manager,215-590-0702,,rascogoldberg@email.chop.edu,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,www.chop.edu/centers-programs/adolescent-initiative
PA-009404,The Children's Hospital of Philadelphia Family Care Clinic/Special Immunology,The Children's Hospital of Philadelphia,1710072764,"Outpatient Hospital Clinics, Ryan White Providers",3550 Market St Fl 5,,Philadelphia,PA,19104-3364,Philadelphia,3401 Civic Center Blvd,,Philadelphia,PA,19104,Philadelphia,"Katie Pultman, LCSW",Program Manager,267-426-5185,,pultmank@email.chop.edu,Office of Government Affairs,Manager of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,
PA-009405,SHC - Philadelphia,Shriners Hospitals for Children,1558404632,Children's Hospitals (inpatient only),3551 N Broad St,,Philadelphia,PA,19140-4160,Philadelphia,3551 N Broad St.,,Philadlelphia,PA,19140,Philadelphia,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
PA-009406,St. Christopher's Hospital for Children HTC,St. Christopher's Pediatric Associates,1730309246,Hemophilia Treatment Centers,3635 N Front St,,Philadelphia,PA,19140-4642,Philadelphia,3635 N. Front Street,,Philadelphia,PA,19134,Philadelphia,"Annie Bole, MSW, LSW","HTC Program Coordinator, Hemophilia Social Worker",215-427-5501,,anne.bole@tenethealth.com,"Nataly Apollonsky, MD",HTC Medical Director,215-427-5096,,nataly.apollonsky@tenethealth.com,
PA-009407,Annex West,"RESOURCES FOR HUMAN DEVELOPMENT, INC.",1801295860,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3901 Market St,,Philadelphia,PA,19104-3133,Philadelphia,4700 Wissahickon Avenue,Suite 118,Philadelphia,PA,19144,Philadelphia,Emily Nichols,Director of Operations,267-597-3604,,enichols@fpcn.com,Donna Torrisi,Network Executive Director,267-597-3601,,dtorrisi@fpcn.com,www.fpcn.com
PA-009408,MARIA DE LOS SANTOS HEALTH CTR,"DELAWARE VALLEY COMMUNITY HEALTH, INC.",1114940582,"Dental Providers, Federally Qualified Health Centers - Medical Services",401 W Allegheny Ave # 55,,Philadelphia,PA,19133-3644,Philadelphia,1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,Patricia Deitch,CEO,215-684-5344,,deitchp@dvch.org,Carla Wimbush,CFO,215-684-5344,,wimbushc@dvch.org,dvch.org
PA-009409,"Education Plus, Inc.",Education Plus,1083013619,"Family Planning Providers, Other ECP Providers",4030 Brown St,Belmont School Based Health Center,Philadelphia,PA,19104-4844,Philadelphia,100 W. Oxford Street,Suite 1100,Philadelphia,PA,19122,Philadelphia,Julie Cousler Emig,Exec Director,267-324-5707,,julie@educationplushealth.com,,,,,,
PA-009410,Congreso Health Center,PUBLIC HEALTH MANAGEMENT CORPORATION,1598156804,Federally Qualified Health Centers - Medical Services,412 W Lehigh Ave,,Philadelphia,PA,19133-3148,Philadelphia,1500 Market St Ste 1500,,Philadelphia,PA,19102-2100,Philadelphia,Melissa Fox,Managing Director,215-985-2500,,mfox@phmc.org,,,,,,
PA-009411,Philadelphia District Health Center #4,City of Philadelphia,1144337189,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4400 Haverford Ave,,Philadelphia,PA,19104-1361,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009412,"Esperanza Health Center, Inc.",Esperanza Health Center Inc,1255726659,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4417 N 6th St,,Philadelphia,PA,19140-2319,Philadelphia,4417 N 6th St,,Philadelphia,PA,19140-2319,Philadelphia,Susan M Post,Executive Director,215-302-3150,333,susan.post@esperanzahealth.com,Glenna J Deem,Credentialing Manager,215-302-3150,300,glenna.deem@esperanzahealth.com,www.esperanzahealth.com
PA-009413,GPHA - Frankford Avenue Health Center,"Greater Philadelphia Health Action, Inc.",1659325652,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4510 Frankford Ave,,Philadelphia,PA,19124-3602,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009414,FPCN: Abbottsford Falls Health Center,"RESOURCES FOR HUMAN DEVELOPMENT, INC.",1043204811,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4700 Wissahickon Ave,Suite 118,Philadelphia,PA,19144-4248,Philadelphia,4700 Wissahickon Ave,"Bldg D, Suite 118",Philadelphia,PA,19144-4248,Philadelphia,Donna Torrisi,FPCN: Executive Director,267-597-3601,,dtorrisi@fpcn.com,Jessica Wilson,FPCN: Director of Financial Operations,267-597-3605,,jwilson@fpcn.com,http://www.fpcn.us
PA-009415,The Children's Hospital of Philadelphia - Nicholas and Athena Karabots Pediatric Care Center,THE CHILDREN'S HOSPITAL OF PHILADELPHIA,1134494909,"Family Planning Providers, Outpatient Hospital Clinics",4865 Market St,,Philadelphia,PA,19139-3508,Philadelphia,3401 Civic Center Boulevard,,Philadelphia,PA,19104,Philadelphia,"Andrea Bailer, MSN, CRNP",Advanced Practice Nurse Manager - CHOP Care Network,267-425-9841,,Bailer@email.chop.edu,Office of Government Affairs,Manger of Federal Affairs,267-426-6904,,govtaffairs@email.chop.edu,http://www.chop.edu/locations/karabots-pediatric-care-center-west-philadelphia
PA-009416,GPHA - Woodland Avenue Health Center,"Greater Philadelphia Health Action, Inc",1952356867,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",5000 Woodland Ave,,Philadelphia,PA,19143-5137,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009417,Spectrum Community Health Center,"SPECTRUM HEALTH SERVICES, INC.",1265866107,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5201 Haverford Ave,,Philadelphia,PA,19139-1401,Philadelphia,5201 Haverford Ave,,Philadelphia,PA,19139-1401,Philadelphia,Phyllis B Cater,President & CEO,215-471-2755,,pcater@spectrumhs.org,Diane Lee,Chief Programs and Compliance Officer,215-471-2758,,dlee@spectrumhs.org,http://www.spectrumhs.org
PA-009418,Pathways to Housing - PA,PROJECT H.O.M.E.,1790116788,Federally Qualified Health Centers - Medical Services,5201 Old York Rd,,Philadelphia,PA,19141-2985,Philadelphia,1515 Fairmount Ave,,Philadelphia,PA,19130-2936,Philadelphia,Monica Medina McCurdy,"Vice President, Healthcare Services",215-320-6187,5741,monicamccurdy@projecthome.org,Greg Landistratis,Director of Operations,215-320-6187,,greglandistratis@projecthome.org,
PA-009419,Albert Einstein Medical Center (inpatient hospital),Albert Einstein Medical Center,1902805245,Inpatient Hospitals (other than children's hospitals),5501 Old York Rd,,Philadelphia,PA,19141-3018,Philadelphia,5501 Old York Road,,Philadelphia,PA,19141,Philadelphia,Chris McTIernan,VICE PRESIDENT,215-779-7914,,Mctiernc@einstein.edu,,,,,,Www.einstein.edu
PA-009420,Albert Einstein Medical Center (multiple outpatient ECP categories),Albert Einstein Medical Center,1902805245,"Outpatient Hospital Clinics, Ryan White Providers",5501 Old York Rd,,Philadelphia,PA,19141-3018,Philadelphia,5501 Old York Road,,Philadelphia,PA,19141,Philadelphia,Chris McTIernan,VICE PRESIDENT,215-779-7914,,Mctiernc@einstein.edu,,,,,,Www.einstein.edu
PA-009421,GPHA - Dental & Behavioral HealthCare Center,GPHA - Dental & Behavioral HealthCare Center,1205140902,"Dental Providers, Federally Qualified Health Centers - Medical Services",5501 Woodland Ave,,Philadelphia,PA,19143-5607,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009422,Philadelphia District Health Center #3,City of Philadelphia,1740397769,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",555 S 43rd St,,Philadelphia,PA,19104-4408,Philadelphia,500 S. Broad Street,3rd Floor,Philadelphia,PA,19146-1613,Philadelphia,Thomas Storey,Executive Director,215-685-6782,,Thomas.Storey@Phila.gov,Steven Benson,Chief Financial Officer,215-685-6792,,Steven.Benson@Phila.gov,http://www.phila.gov/health/ambulatoryhealth/index.html
PA-009423,"Education Plus, Inc.",Education Plus,1083013619,Other ECP Providers,5630 Vine St,Daroff School Based Health Center,Philadelphia,PA,19139-1301,Philadelphia,"100 W. Oxford Street, Suite 1100",,Philadelphia,PA,19122,Philadelphia,Julie Cousler Emig,Executive Director,267-324-5707,,julie@educationplushealth.com,,,,,,
PA-009424,Rising Sun Health Center,PUBLIC HEALTH MANAGEMENT CORPORATION,1306285176,Federally Qualified Health Centers - Medical Services,5675 N Front St,,Philadelphia,PA,19120-2719,Philadelphia,1500 Market St Ste 1500,,Philadelphia,PA,19102-2100,Philadelphia,Melissa Fox,Managing Director,215-985-2500,,mfox@phmc.org,,,,,,
PA-009425,"Education Plus, Inc.",Education Plus,1083013619,Other ECP Providers,5720 Media St,Bluford School Based Health Center,Philadelphia,PA,19131-3823,Philadelphia,"100 W. Oxford Street, Suite 1100",,Philadelphia,PA,19122,Philadelphia,Julie Cousler Emig,Exec Director,267-324-5707,,julie@educationplushealth.com,,,,,,www.educationplushealth.com
PA-009426,THE SAYRE HEALTH CENTER,SAYRE HEALTH CENTER,1831209113,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5800 Walnut St Rear,,Philadelphia,PA,19139-3836,Philadelphia,5800 Walnut St Rear,,Philadelphia,PA,19139-3836,Philadelphia,Kent Bream,Medical Director,215-474-4444,,bream@sayrehealth.org,Frederick Carey,Executive Director,215-474-4444,,fcareay@sayrehealth.org,www.sayrehealthcenter.org
PA-009427,FPCN: Health Annex,Resources for Human Development,1285628826,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",6120-B Woodland Ave,2nd Floor,Philadelphia,PA,19142-3224,Philadelphia,4700 Wissahickon Ave,"Bldg D, Suite 118",Philadelphia,PA,19144,Philadelphia,Jessica Wilson,FPCN: Director of Financial Operations,267-597-3605,,Jwilson@fpcn.com,Donna Torrisi,FPCN: Executive Director,267-597-3601,,dtorrisi@fpcn.com,
PA-009428,GPHA - Snyder Avenue Dental Center,"Greater Philadelphia Health Action, Inc.",1760709794,Dental Providers,640 Snyder Ave,,Philadelphia,PA,19148-2419,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009429,Jeanes Hospital,Jeanes Hospital,1912902206,Inpatient Hospitals (other than children's hospitals),7600 Central Ave,,Philadelphia,PA,19111-2442,Philadelphia,2450 W. Hunting Park Avenue,"4th Floor, Room 4-108",Philadelphia,PA,19129,Philadelphia,Robert Auerbach,Director of Payer Contracting,215-707-4332,,Robert.Auerbach@tuhs.temple.edu,Ray Lefton,Chief Financial Officer,215-728-5652,,Ray.Lefton@tuhs.temple.edu,
PA-009430,GPHA - Southeast Health Center,"Greater Philadelphia Health Action, Inc.",1417902362,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",800 Washington Ave,,Philadelphia,PA,19147-4717,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009431,Mazzoni Center Family and Community Medicine,Mazzoni Center,1477631307,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",809 Locust St,,Philadelphia,PA,19107-5507,Philadelphia,21 S. 12th Street,12th floor,Philadelphia,PA,19107,Philadelphia,"Robert Winn, MD",Medical Director,215-563-0658,317,rwinn@mazzonicenter.org,Ron Powers,Chief Operating Officer,215-563-0652,210,rpowers@mazzonicenter.org,www.mazzonicenter.org
PA-009432,Covenant House Mt. Pleasant Medical Center,Covenant House Inc.,1528392008,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",8125 Stenton Ave # 27,,Philadelphia,PA,19150-3530,Philadelphia,251 E. Bringhurst Street,,Philadelphia,PA,19150,Philadelphia,"Rosetta Smith, RN, BSN, MPH",Chief Executive Officer,215-844-1020,221,rsmith@covenanthousehealth.org,Carolyn Richardson-Neal,"Director, Reimbursement Services",215-844-1020,220,crichardson@covenanthousehealth.org,www.covenanthousehealth.org
PA-009433,Planned Parenthood Southeastern Pennsylvania Castor Health Center,Planned Parenthood Southeastern Pennsylvania,1033251087,"Family Planning Providers, Sexually Transmitted Disease Clinics",8210 Castor Ave,,Philadelphia,PA,19152-2719,Philadelphia,1144 Locust Street,,Philadelphia,PA,19107,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009434,Parkview Ob/Gyn Health Center,"DELAWARE VALLEY COMMUNITY HEALTH, INC.",1689873911,Federally Qualified Health Centers - Medical Services,841 E Hunting Park Ave,Suite 201,Philadelphia,PA,19124-4813,Philadelphia,1412 Fairmount Ave,,Philadelphia,PA,19130-2908,Philadelphia,Patricia Deitch,CEO,215-684-5344,,deitchp@dvch.org,Carla Wimbush,CFO,215-684-5344,,wimbushc@dvch.org,dvch.org
PA-009435,FPCN: 11th Street Family Services,Resources for Human Development,1356335129,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",850 N 11th St,,Philadelphia,PA,19123-1957,Philadelphia,4700 Wissahickon Ave,"Bldg D, Suite 118",Philadelphia,PA,19144,Philadelphia,Jessica Wilson,FPCN Director of Financial Operations,267-597-3605,,jwilson@fpcn.com,Donna Torrisi,FPCN Executive Director,267-597-3601,,dtorrisi@fpcn.com,
PA-009436,GPHA - Chinatown Medical Services,Greater Philadelphia Health Action Inc,1689620171,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",930 Washington Ave,,Philadelphia,PA,19147-3840,Philadelphia,432 N. 6th Street,,Philadelphia,PA,19123-4004,Philadelphia,Celeste Johns,Reimbursement Director,215-925-2400,1003,cjohns@gphainc.org,,,,,,
PA-009437,Moshannan Valley Rural Health Center,Penn Highlands Brookville,1578733093,Rural Health Clinics,271 Railroad St,,Philipsburg,PA,16866-2300,Clearfield,100 Hospital Road,,Brookville,PA,15825,Jefferson,Michael Galluzzi,Director,814-375-6350,,magalluzzi@phhealthcare.org,Julie Peer,President,814-849-1461,,jpeer@phhealthcare.org,
PA-009438,Hilltop Community HealthCare Center,Sto-Rox Neighborhood Health Council Inc.,1154354553,Federally Qualified Health Centers - Medical Services,151 Ruth St,,Pittsburgh,PA,15211-2307,Allegheny,710 Thompson Avenue,,McKees Rocks,PA,15136,Allegheny,Regis J. Ryan,Chief Executive Officer,412-771-6460,234,admin@storoxfqhc.org,Dr. John Barczynski,Chief Clinical Officer,412-771-6460,227,jbarczynski@storoxfqhc.org,
PA-009439,Magee Mt. Oliver,Magee Women's Hospital,1134301021,Outpatient Hospital Clinics,1630 Arlington Ave,,Pittsburgh,PA,15210-1737,Allegheny,1630 Arlington Ave,,Pittsburgh,PA,15210-1737,Allegheny,Joe Chuba,"Vice President, Payer Contracting",412-432-7569,,chubajt@upmc.edu,,,,,,http://www.magee.upmc.com
PA-009440,Metro Community Health Center,"METRO FAMILY PRACTICE, INC.",1740283845,Federally Qualified Health Centers - Medical Services,1789 S Braddock Ave,Suite 410,Pittsburgh,PA,15218-1881,Allegheny,1789 S Braddock Ave Ste 410,,Pittsburgh,PA,15218-1842,Allegheny,Marlene Hughes,Executive Director,412-247-5546,,mhughes@metrofamilypractice.org,,,,,,
PA-009442,MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM,UPMC,1134301021,Outpatient Hospital Clinics,300 Halket St,,Pittsburgh,PA,15213-3108,Allegheny,University of Pittsburgh Medical Center,,Pittsburgh,PA,15213-3108,Allegheny,Joe Chuba,"Vice President, Payor Contracting",412-432-7569,,chubajt@upmc.edu,,,,,,http://www.magee.upmc.com
PA-009443,ELFHCC Community Recovery Center,EAST LIBERTY FAMILY HEALTH CARE CENTER,1760642896,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",325 N Highland Ave,,Pittsburgh,PA,15206-2924,Allegheny,7171 Churchland St,,Pittsburgh,PA,15206-1217,Allegheny,Rodney Jones Sr.,CEO,412-362-6353,,rjones@elfhcc.com,,,,,,
PA-009444,Pittsburgh AIDS Center for Treatment (PACT),UPMC Presbyterian Shadyside,1821007881,Ryan White Providers,3601 5th Ave,Suite 700,Pittsburgh,PA,15213-3403,Allegheny,200 Lothrop St.,,Pittsburgh,PA,15213-3320,Allegheny,Bethany Blackburn,Administrative Director,412-864-1724,,blackburnbh@upmc.edu,,,,,,
PA-009445,Hemophilia Center of Western Pennsylvania,Hemophilia Center of Western Pennsylvania,1508939836,Hemophilia Treatment Centers,3636 Blvd of the Allies,,Pittsburgh,PA,15213-4306,Allegheny,3636 Boulevard of the Allies,,Pittsburgh,PA,15213,Allegheny,Jeffrey D. Wahal,Executive Director,412-209-7360,,jwahal@itxm.org,Mary Dulgeroff,Administrative Assistant,412-209-7280,,mdulgeroff@itxm.org,hcwp.net
PA-009446,UPMC Matilda Theiss Health Center,UNIVERSITY OF PITTSBURGH THE,1821007881,Federally Qualified Health Centers - Medical Services,373 Burrows St,,Pittsburgh,PA,15213-2201,Allegheny,3518 5th Ave,,Pittsburgh,PA,15213-3320,Allegheny,Mary Patricia Nowalk,Project Director,412-383-2355,,tnowalk@pitt.edu,Marlene Jancel,Clinic Administrator,412-383-1967,,jancel@upmc.edu,http://www.upmc.com
PA-009448,CHILDREN'S HOSPITAL OF PITTSBURGH OF UPMC (dental provider),UPMC,1164426896,Dental Providers,4401 Penn Ave,,Pittsburgh,PA,15224-1334,Allegheny,2 Hot Metal Street,"Quantum One, 1st Floor, Suite 079.2",Pittsburgh,PA,15203,Allegheny,Henry Churilla,Director Payor Contracting and Revenue Analysis,412-692-3176,,Henry.Churilla@chp.edu,Nicholas Barcellona,CFO,412-692-7331,,barcellonanj@upmc.edu,
PA-009447,UPMC CHILDREN'S HOSPITAL OF PITTSBURGH (children's inpatient hospital),UPMC,1164426896,Children's Hospitals (inpatient only),4401 Penn Ave,,Pittsburgh,PA,15224-1334,Allegheny,2 Hot Metal Street,"Quantum One, 1st Floor, Suite 079.2",Pittsburgh,PA,15203,Allegheny,Henry Churilla,Director Payor Contracting and Revenue Analysis,412-692-3176,,Henry.Churilla@chp.edu,Mario Wilfong,CFO,412-692-8201,,wilfme@upmc.edu,www.chp.edu
PA-009449,Squirrel Hill Health Center,SQUIRREL HILL HEALTH CENTER,1982658308,"Dental Providers, Federally Qualified Health Centers - Medical Services",4516 Browns Hill Rd,,Pittsburgh,PA,15217-2917,Allegheny,4516 Browns Hill Rd,,Pittsburgh,PA,15217-2917,Allegheny,Susan F Kalson,CEO,412-904-5283,,sfkalson@squirrelhillhealthcenter.org,Elisa Lucke,Director of Operations,412-697-7937,,elucke@squirrelhillhealthcenter.org,
PA-009450,NSCHC-Northview Heights,North Side Christian Health Center,1609091578,Federally Qualified Health Centers - Medical Services,525 Mount Pleasant Rd,,Pittsburgh,PA,15214-2427,Allegheny,816 Middle Street,,Pittsburgh,PA,15212,Allegheny,Cynthia Loughman,Executive Director,412-482-6823,,cloughman@nschc.org,,,,,,
PA-009451,Pittsburgh AIDS Task Force,Pittsburgh AIDS Task Force,1013363753,Sexually Transmitted Disease Clinics,5913 Penn Ave,,Pittsburgh,PA,15206-3818,Allegheny,5913 Penn Ave.,,Pittsburgh,PA,15206,Allegheny,Sean DeYoung,Chief Executive Officer,412-345-7456,,sdeyoung@patf.org,Mark Marsen,Director of Human Resources,412-345-7456,,mmarsen@patf.org,www.patf.org
PA-009452,EAST LIBERTY FAMILY HEALTH CARE CENTER,EAST LIBERTY FAMILY HEALTH CARE CENTER,1760642896,Federally Qualified Health Centers - Medical Services,6023 Harvard Sq,Suite 1,Pittsburgh,PA,15206-3053,Allegheny,7171 Churchland St,,Pittsburgh,PA,15206-1217,Allegheny,Rodney Jones Sr.,CEO,412-362-6353,,rjones@elfhcc.com,,,,,,
PA-009453,LINCOLN-LEMINGTON FAM HLTH CARE,EAST LIBERTY FAMILY HEALTH CARE CENTER,1184615577,"Dental Providers, Federally Qualified Health Centers - Medical Services",7171 Churchland St,,Pittsburgh,PA,15206-1217,Allegheny,7171 Churchland St,,Pittsburgh,PA,15206-1217,Allegheny,Rodney Jones Sr.,CEO,412-362-6353,,rjones@elfhcc.com,,,,,,
PA-009454,North Side Christian Health Center,North Side Christian Health Center,1609091578,"Dental Providers, Federally Qualified Health Centers - Medical Services",816 Middle St,,Pittsburgh,PA,15212-4915,Allegheny,816 Middle Street,,Pittsburgh,PA,15212,Allegheny,Cynthia Loughman,Executive Director,412-482-6823,,cloughman@nschc.org,Janice Kondel,Practice Manager,412-482-6825,,,
PA-009455,Planned Parenthood of Western PA,Planned Parenthood of Western PA,1336238120,Family Planning Providers,933 Liberty Ave,,Pittsburgh,PA,15222-3701,Allegheny,933 Liberty Ave,,Pittsburgh,PA,15222-3701,Allegheny,Kimberlee Evert,CEO,412-258-9530,,kevert@ppwp.org,Kim Mieczkowski,Billing Manager,412-434-8957,9534,kmieczkowski@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009456,PORT HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1760554265,Rural Health Clinics,45 N Pine St,,Port Allegany,PA,16743-1238,McKean,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009457,Community Health & Dental Care,Community Health & Dental Care,1295994341,"Dental Providers, Federally Qualified Health Centers - Medical Services",11 Robinson St,Suite 100,Pottstown,PA,19464-6421,Montgomery,Community Health & Dental Care,"11 Robinson Street, Suite 100",Pottstown,PA,19464-9220,Montgomery,Whittina Gregory,Senior Finance Accountant,610-326-9460,223,wgregory@ch-dc.org,Paula Kamp,Community Outreach Director,610-326-9460,209,pkamp@ch-dc.org,www.ch-dc.org
PA-009458,Planned Parenthood Southeastern Pennsylvania Pottstown Health Center,Planned Parenthood Southeastern Pennsylvania,1336281500,"Family Planning Providers, Sexually Transmitted Disease Clinics",2081 E High St,,Pottstown,PA,19464-3231,Montgomery,1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009459,Community Health & Dental Care,"COMMUNITY HEALTH AND DENTAL CARE, INC.",1295994341,"Dental Providers, Federally Qualified Health Centers - Medical Services",700 Heritage Dr,Suite 701,Pottstown,PA,19464-3297,Montgomery,11 Robinson Street,Suite 100,Pottstown,PA,19464-6421,Montgomery,Bridget McGivern,CEO,610-326-9460,,BMcgivern@ch-dc.org,,,,,,
PA-009460,MFHS Pottsville Center,Maternal and Family Health Svcs.,1851545057,"Family Planning Providers, Sexually Transmitted Disease Clinics",2510 W Market St,,Pottsville,PA,17901-1830,Schuylkill,15 Public Square Suite 600,,Wilkes Barre,PA,18701,Luzerne,John Kearney,VP of Program Services and Business Initiatives,570-826-1777,213,john@mfhs.org,,,,,,http://www.mfhs.org
PA-009461,Punxsutawney Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1427335058,Federally Qualified Health Centers - Medical Services,200 Prushnok Dr,Suite 202,Punxsutawney,PA,15767-2345,Jefferson,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-938-3310,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009462,Punxsy OB/GYN,Punxsutawney Medical Services,1821195033,Family Planning Providers,81 Hillcrest Dr,,Punxsutawney,PA,15767-2605,Jefferson,81 Hillcrest Drive,,Punxsutawney,PA,15767,Jefferson,Joanna Uberti,Practice Manager,814-938-1451,,juberti@pah.org,,,,,,
PA-009463,Family Health Care Center of Punxsutawney,Family Health Care Center of Punxsutawney,1295005361,Rural Health Clinics,83 Hillcrest Dr,Suite 200,Punxsutawney,PA,15767-2605,Jefferson,83 Hillcrest Drive,Suite 200,Punxsutawney,PA,15767,Jefferson,Phillip States,CEO,814-938-3550,,pstatesmd@aol.com,Bobbie Reitz,office manager,814-938-3550,,bobbie.reitz@yahoo.com,http://www.punxsydoc.com
PA-009464,Planned Parenthood Keystone Quakertown,Planned Parenthood Keystone,1689835449,Family Planning Providers,401 W Broad St,Suite 1,Quakertown,PA,18951-1264,Bucks,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009465,Berks Community Health Center at Oakbrook,Berks Community Health Center,1649525569,Federally Qualified Health Centers - Medical Services,1040 Liggett Ave,,Reading,PA,19611-1801,Berks,838 Penn Street,,Reading,PA,19602,Berks,Mary Kargbo,CEO,484-772-4091,,mkargbo@berkschc.org,Michael Rossi,CFO,484-772-4097,,mrossi@berkschc.org,www.berkschc.org
PA-009466,Berks Community Health Center at 2nd Street,Berks Community Health Center,1649525569,Federally Qualified Health Centers - Medical Services,430 N 2nd St,,Reading,PA,19601-2753,Berks,838 Penn Street,,Reading,PA,19602,Berks,Mary Kargbo,CEO,484-772-4091,,mkargbo@berkschc.org,Michael Rossi,CFO,484-772-4097,,mrossi@berkschc.org,www.berkschc.net
PA-009467,Planned Parenthood Keystone Reading,Planned Parenthood Keystone,1568639029,Family Planning Providers,48 S 4th St,,Reading,PA,19602-1047,Berks,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009468,Berks Community Health Center,BERKS COMMUNITY HEALTH CENTER,1649525569,Federally Qualified Health Centers - Medical Services,838 Penn St,,Reading,PA,19602-1108,Berks,838 Penn St,,Reading,PA,19602-1108,Berks,Mary H Kargbo,Chief Executive Officer,484-772-4091,,mkargbo@berkschc.org,Michael Rossi,Chief Financial Officer,484-772-4097,,mrossi@berkschc.org,www.berkschc.org
PA-009469,REPUBLIC MEDICAL AND DENTAL CENTER,"Centerville Clinics, Inc.",1043430267,"Dental Providers, Federally Qualified Health Centers - Medical Services",1006 Main St,,Republic,PA,15475,Fayette,1070 Old National Pike Road,,Fredericktown,PA,15333,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009470,Ridgway Medical Center,"Keystone Rural Health Consortia, Inc.",1194260943,Federally Qualified Health Centers - Medical Services,225 South St,Suite 225,Ridgway,PA,15853-2033,Elk,PO Box 270,,Emporium,PA,15834-0270,Cameron,Sharon Wykoff,Billing Manager,814-486-1115,502,shawyk@keystoneruralhealth.com,Kristie Bennardi,CEO,814-486-1115,500,kriben@keystoneruralhealth.com,
PA-009471,Rochester Health Center,"PRIMARY HEALTH NETWORK, INC.",1164831657,Federally Qualified Health Centers - Medical Services,176 Virginia Ave,,Rochester,PA,15074-1723,Beaver,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-770-9095,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009472,Cornerstone Care Rogersville Office,"CORNERSTONE CARE, INC.",1083644744,Federally Qualified Health Centers - Medical Services,140 Church St,,Rogersville,PA,15359-1001,Greene,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,Marlene Leslie,Clinic Director,,,,http://www.cornerstonecare.com
PA-009473,Sandy Lake Community Health Center,Primary Health Network,1083084495,Federally Qualified Health Centers - Medical Services,3205 S Main St,,Sandy Lake,PA,16145,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-376-7111,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009474,GEISINGER - COMMUNITY MEDICAL CENTER,GEISINGER - COMMUNITY MEDICAL CENTER,1366444507,Inpatient Hospitals (other than children's hospitals),1822 Mulberry St,,Scranton,PA,18510-2369,Lackawanna,100 N. Academy Ave,,Danville,PA,17822,Montour,David Friel,VP 3rd Party Contracting,570-214-8792,,dfriel@geisinger.edu,,,,,,
PA-009475,The Wright Center Student Health Services,The Wright Center Medical Group,1194739979,Family Planning Providers,406 N Washington Ave,,Scranton,PA,18503-1306,Lackawanna,501 Madison Ave,,Scranton,PA,18510,Lackawanna,William Dempsey,MD,570-955-1474,,dempseyd@thewrightcenter.org,Kellen Kraky,Director of Student Health Services,570-955-1474,,krakyk@thewrightcenter.org,
PA-009476,Alder Street Family Clinic,"Scranton Primary Health Care Center, Inc.",1801336458,Federally Qualified Health Centers - Medical Services,425 Alder St,,Scranton,PA,18505-4116,Lackawanna,959 Wyoming Avenue,,Scranton,PA,18509,Lackawanna,Joseph H. Hollander,CEO,570-344-3517,3024,jhh.sphcc@gmail.com,Paula Keenan,Chief Nursing Officer,570-344-3517,3005,pkeenan99@aol.com,scrantonprimary.org
PA-009477,MFHS Circle of Care,Maternal and Family Health Svcs.,1851545057,"Family Planning Providers, Sexually Transmitted Disease Clinics",640 Madison Ave,Fl 1; Pine St. Entrance,Scranton,PA,18510-1631,Lackawanna,15 Public Square Suite 600,,Wilkes Barre,PA,18701,Luzerne,John Kearney,VP of Program Services and Business Initiatives,570-826-1777,213,john@mfhs.org,,,,,,http://www.mfhs.org
PA-009478,The Wright Center Infectious Disease Clinic,The Wright Center,1194739979,Ryan White Providers,640 Madison Ave,,Scranton,PA,18510-1631,Lackawanna,501 Madison Ave,,Scranton,PA,18510,Lackawanna,ZAZA VARSIMASHVILI,Grants & Business Coordinator,570-343-2383,2141,varsimashviliz@thewrightcenter.org,Carina Havenstrite,Medical Case Manager,570-343-2383,2221,levisc@thewrightcenter.org,http://thewrightcenter.org/
PA-009479,"SCRANTON PRIMARY HEALTH CARE CENTER, INC.","SCRANTON PRIMARY HEALTH CARE CENTER, INC.",1801871579,"Dental Providers, Federally Qualified Health Centers - Medical Services",959 Wyoming Ave,,Scranton,PA,18509-3023,Lackawanna,959 Wyoming Ave,,Scranton,PA,18509-3023,Lackawanna,Joseph Hollander,Executive Director,570-344-9684,3024,jhh.sphcc@gmail.com,,,,,,scrantonprimary.org
PA-009480,Family Planning Plus Selinsgrove,Family Planning Plus Lewisburg,1043268568,Family Planning Providers,713 Bridge St,Suite 7,Selinsgrove,PA,17870-1250,Snyder,713 Bridge,,Selinsgrove,PA,17870-1250,Snyder,Peggy Moser,Executive Director,570-523-3462,,bsteiner444@gmail.com,Brittney Zechman,AD,570-523-3462,,,http://www.familyplanningplus.org
PA-009481,Adagio Health Seneca,Adagio Health,1629164926,Family Planning Providers,3292 State Route 257,PO Box 409,Seneca,PA,16346-2530,Venango,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009482,Family Planning Plus Shamokin,Family Planning Plus Lewisburg,1043268568,Family Planning Providers,10 E Independence St,,Shamokin,PA,17872-6804,Northumberland,10 East Independence St,,Shamokin,PA,17872-5521,Northumberland,Peggy Moser,Executive Director,570-523-3462,,bsteiner444@gmail.com,Brittney Zechman,AD,570-523-3462,,,http://www.familyplanningplus.org
PA-009483,DAYTON WAY HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1982159786,Federally Qualified Health Centers - Medical Services,1 Dayton Way,,Sharon,PA,16146-2185,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-342-6620,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009484,SHARON MEDICAL GROUP,"PRIMARY HEALTH NETWORK, INC.",1750413159,Federally Qualified Health Centers - Medical Services,63 Pitt St,,Sharon,PA,16146-2102,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-342-6604,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009485,Adagio Health Sharon,Adagio Health,1609219161,Family Planning Providers,87 Stambaugh Ave,Suite 1,Sharon,PA,16146-2754,Mercer,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.familyplanningmc.com
PA-009486,Sharon Community Health Center,Sharon Community Health Center,1942208665,Federally Qualified Health Centers - Medical Services,94 W Connelly Blvd,,Sharon,PA,16146-1754,Mercer,94 west connelly blvd,,Sharon,PA,16146,Mercer,scott barringer,ceo,724-347-5519,,wscott@infonline.net,,,,,,
PA-009487,Sharon Hill Medical,AIDS Care Group,1477592400,Sexually Transmitted Disease Clinics,940 Chester Pike,,Sharon Hill,PA,19079-1413,Delaware,2304 Edgmont Ave,,Chester,PA,19013,Delaware,Kevin Moore,Director of Integrative Medicine,610-583-3800,,kevinmoore@aidscaregroup.org,Howell Strauss,Executive Director,610-583-1177,,howellstrauss@aidscaregroup.org,www.aidscaregroup.org
PA-009488,SHEAKLEYVILLE HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1295867620,Federally Qualified Health Centers - Medical Services,3339 Perry Hwy,,Sheakleyville,PA,16151,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-253-3428,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009489,SHICKSHINNY HEALTH CENTER,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1790887057,Federally Qualified Health Centers - Medical Services,26 N Main St,,Shickshinny,PA,18655-1302,Luzerne,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,President,570-825-8741,223,rhced@yahoo.com,Bernie Diltz,RN,570-542-4141,1,bdiltz@rhc1084.com,www.rhcnepa.com
PA-009490,SHINGLEHOUSE HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1407928757,Rural Health Clinics,129 North Puritan St,,Shinglehouse,PA,16748,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009491,BOWMAN HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1922243393,Rural Health Clinics,83 S Marvin St,,Smethport,PA,16749-2031,McKean,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009492,Mountaintop Area Medical Center,KEYSTONE RURAL HEALTH CONSORTIA INC,1174615686,Federally Qualified Health Centers - Medical Services,402 E Sycamore Rd,,Snow Shoe,PA,16874-8832,Centre,90 E 2nd St,,Emporium,PA,15834-1302,Centre,Kristie K Bennardi,CEO,814-486-1115,,kriben@keystoneruralhealth.com,,,,,,www.keystoneruralhealth.com
PA-009493,Planned Parenthood of Western PA Somerset Clinic,Planned Parenthood of Western PA,1336238120,Family Planning Providers,118 S Kimberly Ave,Suite 101,Somerset,PA,15501-2069,Somerset,933 Liberty Avenue,,Pittsburgh,PA,15222,Allegheny,Kimberlee Evert,CEO,412-258-9530,,kevert@ppwp.org,Kara Cornish,Billing Manager,412-434-8957,8534,kcornish@ppwp.org,http://www.plannedparenthood.org/western-pennsylvania/
PA-009494,The Wright Center Clarks Summit,The Wright Center Medical Group,1194739979,Family Planning Providers,1145 Northern Blvd,,South Abington Township,PA,18411-2221,Lackawanna,111 North Washington Ave.,first floor,Scranton,PA,18503,Lackawanna,Jennifer Walsh,SVP & General Counsel,570-687-3067,,walshj@thewrightcenter.org,Maria Montoro Edwards,VP Strategic Initiatives,570-507-2703,,montoroedwardsm@thewrightcenter.org,www.thewrightcenter.org
PA-009495,Medical Associates of Boswell,Medical Associates of Boswell,1871628651,Rural Health Clinics,136 S Pine Ave,PO Box 340,Stoystown,PA,15563-6002,Somerset,136 S Pine Ave,PO Box 340,Stoystown,PA,15531,Somerset,Carla J Smith,Office Manager,814-893-5568,1422,mabfourbos@yahoo.com,Linda Veres,IT,814-893-5568,1416,mabonebos@yahoo.com,
PA-009496,NEPA Community Health Care - Susquehanna Health Center,"B-K Health Center, Inc.",1851336713,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",155 Erie Blvd,,Susquehanna,PA,18847-2791,Susquehanna,"191 Erie Blvd., Suite C",,Susquehanna,PA,18847,Susquehanna,Mary Wetherall,CEO,570-853-5500,,mwetherall@nepachc.org,Lori Hubal,CFO,570-853-5502,,lhubal@nepachc.org,www.nepachc.org
PA-009497,Barnes-Kasson County Hospital,Barnes-Kasson County Hospital,1932138161,Inpatient Hospitals (other than children's hospitals),2872 Turnpike St,,Susquehanna,PA,18847-2771,Susquehanna,2872 Turnpike Street,,Susquehanna,PA,18847,Susquehanna,Sara F. Adornato,CEO,570-853-3135,224,sadornato@bkhcs.org,,,,,,
PA-009498,Family Health Clinic of Barnes Kasson Hospital,Barnes-Kasson County Hospital,1821239385,Rural Health Clinics,2872 Turnpike St,,Susquehanna,PA,18847-2771,Susquehanna,2872 Turnpike Street,,Susquehanna,PA,18847,Susquehanna,Sara F Adornato,CEO,570-853-3135,224,sadornato@bkhcs.org,,,,,,www.barnes-kasson.org
PA-009499,NEPA Community Health Center,"B-K Health Center, Inc.",1972901718,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",3192 Turnpike St,Susquehanna Community School District,Susquehanna,PA,18847-8154,Susquehanna,"191 Erie Blvd., Suite C",,Susquehanna,PA,18847,Susquehanna,Mary W. Wetherall,CEO,570-853-5500,,mwetherall@nepachc.org,Lori Hubal,CFO,570-853-5502,,lhubal@nepachc.org,
PA-009500,Family Health Clinic of Barnes Kasson Hospital,Barnes-Kasson County Hospital,1962680256,Rural Health Clinics,401 Broad Ave,,Susquehanna,PA,18847-1611,Susquehanna,2872 Turnpike Street,,Susquehanna,PA,18847,Susquehanna,Sara F Adornato,CEO,570-853-3135,224,sadornato@bkhcs.org,,,,,,www.barnes-kasson.org
PA-009501,Pinnacle Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",132 Manly Rd,,Tafton,PA,18464-7829,Pike,601 PARK ST,,HONESDALE,PA,18431,Wayne,Fred Jackson,EXECUTIVE DIRECTOR,570-253-8450,,JACKSONF@WMH.ORG,,,,,,
PA-009502,St. Luke's Miners Health Center- Hometown,St. Luke's Hospital Miners Campus,1598911992,Rural Health Clinics,253 Claremont Ave,,Tamaqua,PA,18252-4302,Schuylkill,St. Luke's Miners Campus,360 W Ruddle St,Coaldale,PA,18218,Schuylkill,Micah Gursky,Rural Health Clinic Administrator,570-645-8118,,Micah.Gursky@sluhn.org,Michele Levitz,Director of Finance,570-645-8261,,Michele.Levitz@sluhn.org,
PA-009503,TIDIOUTE HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1811429947,Dental Providers,115 Main St,,Tidioute,PA,16351-1062,Warren,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-484-7400,,dpierce@primary-health.net,,,,,,
PA-009504,Titusville Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1508182841,Federally Qualified Health Centers - Medical Services,401 W Spring St,,Titusville,PA,16354-2169,Crawford,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-827-8400,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009505,Titusville Area Hospital,Titusville Area Hospital,1891899332,Inpatient Hospitals (other than children's hospitals),406 W Oak St,,Titusville,PA,16354-1404,Crawford,406 West Oak Street,,Titusville,PA,16354,Crawford,Jill Neely,CFO,814-827-8923,,jneely@titusvillehospital.org,Heather King,Business Office Manager,814-827-1851,2570,hking@titusvillehospital.org,
PA-009506,"PhysicianCare, P.C.","PhysicianCare, P.C. Family Planning Administration",1750361945,Family Planning Providers,71 Hospital Dr,,Towanda,PA,18848-9702,Bradford,71 Hospital Dr,,Towanda,PA,18848-9702,Bradford,Cheryl Henninger,Billing Manager,570-265-3000,,cheryl_ahs@yahoo.com,Nciole Cobb,Credentialing Department,570-265-0119,,ncobb@physiciancarepc.com,http://www.physiciancarepc.com
PA-009507,TRANSFER HEALTH CENTER,"PRIMARY HEALTH NETWORK, INC.",1043489511,Federally Qualified Health Centers - Medical Services,225 Edgewood Drive Ext,,Transfer,PA,16154-1817,Mercer,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,724-962-3553,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-012373,Wyoming Valley AIDS Council,Wyoming Valley AIDS Council,1588080824,"Ryan White Providers, Sexually Transmitted Disease Clinics",1 Kim Ave,Suite 2,Tunkhannock,PA,18657-9101,Wyoming,330 Bowman Street,Unit 1,Wilkes Barre,PA,18702,Luzerne,Kenneth Zula,Executive Director,570-823-5808,302,kzula@wvacinc.org,Braden Beamer,Coordinator of MCM,570-823-5808,304,braden.beamer@wvacinc.org,www.wvacinc.org
PA-009508,NORTHERN POTTER HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1275605776,Rural Health Clinics,511 Academy St,,Ulysses,PA,16948-9580,Potter,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009509,Cornerstone Care Uniontown Office,"CORNERSTONE CARE, INC.",1942551403,Dental Providers,140 N Beeson Ave,,Uniontown,PA,15401-2937,Fayette,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,,,,,,
PA-009510,Adagio Health Uniontown,Adagio Health,1558455675,Family Planning Providers,22 Mill St,,Uniontown,PA,15401-3237,Fayette,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009511,UNIONTOWN FAMILY DOCTORS,CENTERVILLE CLINIC INC,1164636759,Federally Qualified Health Centers - Medical Services,86 McClellandtown Rd,,Uniontown,PA,15401-5527,Fayette,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009512,ChesPenn Center for Family Health at Upper Darby,ChesPenn Health Services,1225272263,Federally Qualified Health Centers - Medical Services,5 S State Rd,,Upper Darby,PA,19082-2013,Delaware,2600 W 9th Street,2 North,Chester,PA,19013-2040,Delaware,Michael G. Lucas,President and CEO,610-485-3800,630,mike.lucas@chespenn.org,,,,,,www.chespenn.com
PA-009513,Planned Parenthood Southeastern Pennsylvania Upper Darby Health Center,Planned Parenthood Southeastern Pennsylvania,1972645042,"Family Planning Providers, Sexually Transmitted Disease Clinics",7200 Chestnut St,,Upper Darby,PA,19082-3156,Delaware,1144 Locust Street,,Philadelphia,PA,19107,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009514,"Positive Effect Outreach Ministry, Inc.","Positive Effect Outreach Ministry, Inc.",1538412010,Ryan White Providers,8711 W Chester Pike,,Upper Darby,PA,19082-1115,Delaware,"1701 B S. 28th Street, #311",,Philadelphia,PA,19145,Philadelphia,Marguerite J. Chamberlain,Co-Executive Director,215-840-5960,,kenyamarguerite@msn.com,MARGUERITE CHAMBERLAIN,Executive Director,215-840-5960,,KENYAMARGUERITE@MSN.COM,
PA-009515,"Community Health Clinic, Inc","COMMUNITY HEALTH CLINIC, INC.",1699701136,"Dental Providers, Federally Qualified Health Centers - Medical Services",179 Columbia Ave,,Vandergrift,PA,15690-1203,Westmoreland,943 4th Ave,,New Kensington,PA,15068-6409,Westmoreland,Raji Jayakrishnan,Executive Director,724-335-3334,109,raji@communityhealthclinic.org,,,,,,www.communityhealthclinic.org
PA-009516,McAndrew Family Health Center,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",111 Main St,,Vandling,PA,18421-1711,Lackawanna,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009517,Planned Parenthood Keystone Warminster,Planned Parenthood Keystone,1659531804,Family Planning Providers,610 Louis Dr # 2,,Warminster,PA,18974-2828,Bucks,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009518,Warren Community Health Center,"PRIMARY HEALTH NETWORK, INC.",1043609480,Federally Qualified Health Centers - Medical Services,1885 Market St,Suite B,Warren,PA,16365-1227,Warren,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-723-0100,,dpierce@primary-health.net,,,,,,http://primary-health.net/
PA-009519,WARREN DENTAL CENTER,"PRIMARY HEALTH NETWORK, INC.",1891228136,Dental Providers,2 W Crescent Park,,Warren,PA,16365-2111,Warren,100 Shenango Ave,,Sharon,PA,16146-1503,Mercer,Drew Pierce,CEO,814-723-2333,,dpierce@primary-health.net,,,,,,http://www.primary-health.net
PA-009520,Adagio Health Warren,Adagio Health,1477647501,Family Planning Providers,514 W 3rd Ave,Annex Bldg.,Warren,PA,16365-2201,Warren,960 Penn Avenue,Suite 600,Pittsburgh,PA,15222,Allegheny,Bill Gedman,Chief Financial Officer,412-288-2130,133,wgedman@adagiohealth.org,Leslie Nettelmann,Chief Operating Officer,412-288-2130,182,lnettelmann@adagiohealth.org,http://www.adagiohealth.org
PA-009521,Washington Family Doctors,CENTERVILLE CLINIC INC,1730300971,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",37 Highland Ave,,Washington,PA,15301-4062,Washington,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009522,Cornerstone Care Pediatric Associates of Washington,"CORNERSTONE CARE, INC.",1679503346,Federally Qualified Health Centers - Medical Services,400 Jefferson Ave,,Washington,PA,15301-4261,Washington,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Sheri Hannigan,Office Manager,724-208-7400,100,shannigan@cornerstonecare.com,,,,,,
PA-009523,WAYMART FAMILY HEALTH CENTER,WAYNE MEMORIAL COMMUNITY HEALTH CENTERS,1952395121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",29 Woodlands Dr,,Waymart,PA,18472-9366,Wayne,601 Park St,,Honesdale,PA,18431-1445,Wayne,Fred Jackson,Executive Director,570-253-8450,,jacksonf@wmh.org,,,,,,
PA-009524,Keystone Pediatrics- Waynesboro,Keystone Rural Health Center,1780044685,Federally Qualified Health Centers - Medical Services,45 Roadside Ave,,Waynesboro,PA,17268-2542,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Financial Officer,717-709-7912,,jmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009525,Keystone Dental Mont Alto,Keystone Rural Health Center,1275055873,Dental Providers,6155 Anthony Hwy,,Waynesboro,PA,17268-9718,Franklin,22 St Paul Drive,Suite 200,Chambersburg,PA,17201,Franklin,Joanne Cochran,President and CEO,717-709-7906,,jcochran@keystonehealth.org,John McElwee,Chief Finanical Officer,717-709-7912,,johnmcelwee@keystonehealth.org,www.keystonehealth.org
PA-009526,WAYNESBURG CLINIC,CENTERVILLE CLINIC INC,1417142845,Federally Qualified Health Centers - Medical Services,1150 7th St,,Waynesburg,PA,15370-1660,Greene,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009527,WAYNESBURG COMM MENTAL HLTH CTR,CENTERVILLE CLINIC INC,1497946776,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",190 Bonar Ave,,Waynesburg,PA,15370-1604,Greene,1070 Old National Pike,,Fredericktown,PA,15333-2114,Washington,Barry Niccolai,Executive Director,724-632-6801,2258,bniccolai@centervilleclinics.com,Pete Martorella,Director of Operations,724-632-6801,2229,pmartorella@centervilleclinics.com,http://www.centervilleclinics.com
PA-009528,Cornerstone Care Central Greene Pediatrics,"CORNERSTONE CARE, INC.",1659569036,Federally Qualified Health Centers - Medical Services,236 Elm Dr,,Waynesburg,PA,15370-8265,Greene,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,,,,,,
PA-009529,Family Medicine-Waynesburg,Washington Physician Services Organization,1568483089,Rural Health Clinics,343 E Roy Furman Hwy,,Waynesburg,PA,15370-8084,Greene,Washington Physician Services Organization,PO Box 855,Washington,PA,15301,Washington,Maureen Scanlon,Executive Director,724-229-2422,,mscanlon@whs.org,Wendy Kirschner,Revenue Cycle Manager,724-223-3263,,wkirschner@whs.org,
PA-009530,Cornerstone Care Waynesburg Office,"CORNERSTONE CARE, INC.",1710147004,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",501 W High St,,Waynesburg,PA,15370-7209,Greene,7 Glassworks Rd,,Greensboro,PA,15338-9507,Greene,Robert MtJoy,CEO,724-943-3308,127,rmtjoy@cornerstonecare.com,,,,,,
PA-009531,Laurel Behavioral Health Outpatient Services,N PENN COMPREHENSIVE HEALTH SVCS,1376923896,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",114 East Ave,,Wellsboro,PA,16901-1737,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009532,Wellsboro Laurel Health Center,N PENN COMPREHENSIVE HEALTH SVCS,1043392020,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7 Water St,,Wellsboro,PA,16901-1126,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009533,Planned Parenthood Southeastern Pennsylvania West Chester Health Center,Planned Parenthood Southeastern Pennsylvania,1063655231,"Family Planning Providers, Sexually Transmitted Disease Clinics",8 S Wayne St,,West Chester,PA,19382-2817,Chester,1144 Locust St,,Philadelphia,PA,19107-6734,Philadelphia,Vera Bailey,CFO,215-351-5536,,vera.bailey@ppsp.org,Steve Roche,Data Analyst,267-514-4234,,steve.roche@ppsp.org,http://www.plannedparenthood.org/ppsp/
PA-009534,Reading Hospital and Medical Center,Reading Hospital,1669530069,Ryan White Providers,301 S 7th Ave Ste 225,Dob,West Reading,PA,19611-1450,Berks,6th Ave and Spruce St,,West Reading,PA,19611,Berks,Glenn Young,Program Director,484-628-5488,5488,glenn.young@readinghealth.org,Robert Paul,Director of Ambulatory Practices,484-628-4831,5831,robert.paul@readinghealth.org,https://www.readinghealth.org/services/center-public-health/conditions-treatments/hiv/
PA-009535,WESTFIELD HEALTH CENTER,Charles COLE MEMORIAL HOSPITAL,1861564106,Rural Health Clinics,222 Church St,,Westfield,PA,16950-1538,Tioga,1001 EAST SECOND STREET,,COUDERSPORT,PA,16915,Potter,TRACY LEET,REGULATORY AND NETWORK ANALYST,814-274-7407,,TRACY.LEET@COLEMEMORIAL.ORG,,,,,,
PA-009536,WESTFIELD LAUREL HEALTH CENTER,N PENN COMPREHENSIVE HEALTH SVCS,1366524241,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",236 E Main St,,Westfield,PA,16950-1607,Tioga,101B West Ave,,Wellsboro,PA,16901-1358,Tioga,Craig Osborn,President & CEO,570-723-0527,,cosborn@laurelhs.org,Laurie Wilson,Billing Manager,570-723-3405,,,www.laurelhc.org
PA-009537,"Maternal and Family Health Services, Inc.","Maternal and Family Health Services, Inc.",1851545057,Family Planning Providers,15 Public Sq,Suite 600,Wilkes Barre,PA,18701-1704,Luzerne,15 Public Sq Ste 600,,Wilkes Barre,PA,18701-1704,Luzerne,John Kearney,VP of Program Services and Business Initiatives,570-826-1777,213,john@mfhs.org,,,,,,www.mfhs.org
PA-009538,Wyoming Valley AIDS Council,Wyoming Valley AIDS Council,1588080824,"Ryan White Providers, Sexually Transmitted Disease Clinics",330 Bowman St Unit 1,,Wilkes Barre,PA,18702-5448,Luzerne,330 Bowman Street,Unit 1,Wilkes Barre,PA,18702,Luzerne,Kenneth Zula,Executive Director,570-823-5808,302,kzula@wvacinc.org,Braden Beamer,Coordinator of Case Management,570-823-5808,304,braden.beamer@wvacinc.org,www.wvacinc.org
PA-009539,MCKINNEY CLINIC,RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA,1265801112,Federally Qualified Health Centers - Medical Services,39 E Jackson St,,Wilkes Barre,PA,18701-2709,Luzerne,1084 Highway 315 Blvd,,Wilkes Barre,PA,18702-7012,Luzerne,EDWARD P MICHAEL,Presiden,570-825-8741,223,rhced@yahoo.com,Bernie Baluta,RN,570-825-0881,1,bbaluta@rhc1084.com,www.rhcnepa.com
PA-009540,Planned Parenthood Keystone Wilkes-Barre,Planned Parenthood Keystone,1992972566,Family Planning Providers,63 N Franklin St,,Wilkes Barre,PA,18701-1317,Luzerne,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
PA-009541,Magee Wilkinsburg,Magee Women's Hospital,1134301021,Outpatient Hospital Clinics,720 Penn Ave,,Wilkinsburg,PA,15221-2217,Allegheny,University of Pittsburgh Medical Center,,Pittsburgh,PA,15213-3108,Allegheny,Joe Chuba,"Vice President, Payer Contracting",412-432-7569,,chubajt@upmc.edu,,,,,,http://www.magee.upmc.com
PA-009542,Hosanna House - Dental Clinic,EAST LIBERTY FAMILY HEALTH CARE CENTER,1669709655,Dental Providers,807 Wallace Ave,,Wilkinsburg,PA,15221-2312,Allegheny,7171 Churchland Street,,Pittsburgh,PA,15206,Allegheny,Rodney Jones Sr.,CEO,412-362-6353,,rjones@elfhcc.com,,,,,,
PA-009543,River Valley Health and Dental Center,"SUSQUEHANNA COMMUNITY HEALTH AND DENTAL CLINIC, INC.",1184998361,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",471 Hepburn St,,Williamsport,PA,17701-6122,Lycoming,471 Hepburn St,,Williamsport,PA,17701-6122,Lycoming,Jim Yoxtheimer,CEO,570-567-5414,,jimy@aimhealthy.org,Kurt Williams,CFO,570-567-5411,,kurtw@aimhealthy.org,
PA-009544,Reproductive Health Center,The Williamsport Hospital,1063597334,"Family Planning Providers, Sexually Transmitted Disease Clinics",699 Rural Ave,Suite 202,Williamsport,PA,17701-3250,Lycoming,700 High Street,,Williamsport,PA,17701,Lycoming,Sally Wentzler,Clinic Director,570-321-3138,,swentzler@susquehannahealth.org,,,,,,
PA-009545,Lankenau Hospital Family Planning Service,AccessMatters,1568420529,Family Planning Providers,100 E Lancaster Ave,,Wynnewood,PA,19096-3450,Montgomery,100 E Lancaster Ave,,Wynnewood,PA,19096,Philadelphia,Heather Deliago,Clinical Care Manager,484-476-3067,,deliagoh@mlhs.org,Kristin Scavello,Family Planning Coordinator,484-476-3067,3404,,http://www.mainlinehealth.org/Lankenau
PA-009546,FAMILY FIRST HEALTH CORPORATION,FAMILY FIRST HEALTH CORPORATION,1881639904,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",116 S George St,,York,PA,17401-1474,York,116 S George St,,York,PA,17401-1474,York,Jennifer Englerth,CEO,717-801-4804,,jenglerth@familyfirsthealth.org,,,717-845-8617,,,http://www.familyfirsthealth.org/
PA-009547,Hannah Penn Center,Family FIrst Health Corporation,1720142490,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",415 E Boundary Ave,,York,PA,17403-2811,York,116 south george st,,York,PA,17401,York,jennifer englerth,CEO,717-801-4804,,jenglerth@familyfirsthealth.org,,,,,,
PA-009548,Planned Parenthood Keystone York,Planned Parenthood Keystone,1699814103,Family Planning Providers,728 S Beaver St,,York,PA,17401-2209,York,5920 Hamilton Blvd,,Allentown,PA,18106-8942,Lehigh,Trisha Tashjian,COO,610-709-6072,,ttashjian@ppkeystone.org,Melissa Reed,CEO,610-620-0607,,mreed@ppkeystone.org,http://www.ppkeystone.org
RI-009549,2 Old County Road,East Bay Community Action Program,1609925122,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2 Old County Rd,,Barrington,RI,02806-1600,Bristol,2 Old County Road,,Barrington,RI,02806,Bristol,Bobbi Ozanian,Administrative Assistant,401-437-1008,165,bozanian@ebcap.org,Dennis Roy,CEO,401-437-1000,126,droy@ebcap.org,
RI-009550,"BVCHC, Inc.",Blackstone Valley Community Health Center,1063574135,Federally Qualified Health Centers - Medical Services,1000 Broad St,,Central Falls,RI,02863-1507,Providence,39 East Avenue,,Pawtucket,RI,02863,Providence,Raymond Lavoie,Executive Director,401-312-5246,101,rlavoie@bvchc.org,Sandra Pardus,Chief Finance Officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009551,"Blackstone Valley Community Health Care, Inc.","BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC.",1063574135,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",24 Summer St,CENTRAL FALLS HIGH SCHOOL CLINIC,Central Falls,RI,02863-2142,Providence,39 East Ave,,Pawtucket,RI,02860-4003,Providence,Raymond J Lavoie,Executive Director,401-729-0080,101,rlavoie@bvchc.org,Christine Hansen,Chief Operating Officer,401-729-0080,103,chansen@bvchc.org,http://www.blackstonechc.org
RI-009552,"BVCHC, Inc.",Blackstone Valley Community Health Center,1063574135,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",9 Chestnut St,,Central Falls,RI,02863-2005,Providence,39 East Avenue,,Pawtucket,RI,02860,Providence,Raymond Lavoie,Executive Director,401-312-5246,101,rlavoie@bvchc.org,Sandra Pardus,Chief Finance Officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009553,Family Health Services of Coventry,Comprehensive Community Action Inc.,1609132513,Federally Qualified Health Centers - Medical Services,191 MacArthur Blvd,,Coventry,RI,02816-7244,Kent,311 Doric Ave,,Cranston,RI,02910-7763,Providence,William Hochstrasser-Walsh,Senior Vice President / Chief Operating Officer,401-562-8302,,whochstrasserwalsh@comcap.org,Joanne McGunagle,President / Chief Executive Officer,401-562-8300,,jmcgunagle@comcap.org,http://www.comcap.org/matriarch/default.asp
RI-009554,Family Health Services of Cranston,Comprehensive Community Action Inc.,1366441719,"Dental Providers, Federally Qualified Health Centers - Medical Services",1090 Cranston St,,Cranston,RI,02920-7323,Providence,311 Doric Ave,,Cranston,RI,02910-7763,Providence,William Hochstrasser-Walsh,Senior Vice President / Chief Operating Officer,401-562-8302,,whochstrasserwalsh@comcap.org,Joanne McGunagle,President / Chief Operating Officer,401-562-8302,,jmcgunagle@comcap.org,
RI-009555,CCA INC. BEHAVIORAL HEALTH,"COMPREHENSIVE COMMUNITY ACTION, INC.",1770849259,Federally Qualified Health Centers - Medical Services,311 Doric Ave,Suite 5,Cranston,RI,02910-2903,Providence,311 Doric Ave,,Cranston,RI,02910-2903,Providence,William Hochstrasser-Walsh,Senior Vice President / Chief Operating Officer,401-562-8302,,whochstrasserwalsh@comcap.org,Joanne McGunagle,President / Chief Executive Officer,401-562-8300,,jmcgunagle@comcap.org,
RI-009556,Adams Farley,East Bay Community Action Program,1609925122,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",610 Wampanoag Trl,,East Providence,RI,02915-1504,Providence,610 Wampanoag Trail,,East Providence,RI,02915,Providence,Bobbi Ozanian,Administrative Assistant,401-437-1008,165,bozanian@ebcap.org,Dennis Roy,CEO,401-437-1000,126,droy@ebcap.org,
RI-009557,WellOne Primary Medical and Dental Care,Northwest Community Health Care,1821254525,"Dental Providers, Federally Qualified Health Centers - Medical Services",142A Danielson Pike,,Foster,RI,02825-1485,Providence,36 Bridge Way,PO Box 312,Pascoag,RI,02859,Providence,Peter Bancroft,President & CEO,401-285-5119,,pjbancroft@welloneri.org,Melissa Johnson,Administrative Projects Manager,401-567-0800,181,mjohnson@welloneri.org,
RI-009558,"WOOD RIVER HEALTH SERVICES, INC.","WOOD RIVER HEALTH SERVICES, INC.",1417947383,"Dental Providers, Federally Qualified Health Centers - Medical Services",823 Main St,,Hope Valley,RI,02832-1920,Washington,823 Main St,,Hope Valley,RI,02832-1920,Washington,Michael A Lichtenstein,President and CEO,401-387-9648,,mlichtenstein@wrhsri.org,Eileen Gelzhiser,Director of Finance and Information Systems,401-387-9642,,egelzhiser@wrhsri.org,www.woodriverhealthservices.org
RI-009559,Tri-Town Community Health Center,Tri-Town Economic Opportunity Committee,1396780086,"Dental Providers, Federally Qualified Health Centers - Medical Services",1126 Hartford Ave,,Johnston,RI,02919-7109,Providence,1126 Hartford Avenue,,Johnston,RI,29197109,Providence,Brenda Dowlatshahi,Chief Operating Officer/Health Center Director,401-519-1977,,bdowlatshahi@tri-town.org,Joseph DeSantis,Chief Executive Officer,401-519-1967,,jdesantis@tri-town.org,
RI-009560,East Bay Community Action Program,East Bay Community Action Program,1861439705,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",19 Broadway,,Newport,RI,02840-2937,Newport,19 Broadway,,Newport,RI,02840,Newport,Michelle Benvenuti,Senior Billing/Credentailing,401-437-1008,176,mbenvenuti@ebcap.org,,,,,,
RI-009561,East Bay Family Health Care,East Bay Community Action Program,1609925122,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",6 John H Chafee Blvd,,Newport,RI,02840-1034,Newport,19 Broadway,,Newport,RI,02840-2937,Providence,Bobbi Ozanian,Administrative Assistant,401-437-1008,165,bozanian@ebcap.org,Dennis Roy,CEO,401-437-1000,126,droy@ebcap.org,
RI-009562,WellOne Primary Medical and Dental Care,Northwest Community Health Care,1801951397,"Dental Providers, Federally Qualified Health Centers - Medical Services",308 Callahan Rd,,North Kingstown,RI,02852-7739,Washington,36 Bridge Way,PO Box 312,Pascoag,RI,02859,Providence,Peter Bancroft,President & CEO,401-285-5119,,pjbancroft@welloneri.org,Melissa Johnson,Administrative Projects Manager,401-567-0800,181,mjohnson@welloneri.org,
RI-009563,Tri-Town Health Center of North Providence,Tri-Town Economic Opportunity Committee,1912328600,Federally Qualified Health Centers - Medical Services,33 Maple St,,North Providence,RI,02911-2415,Providence,1126 Hartford Avenue,,Johnston,RI,02919,Providence,Brenda Dowlatshahi,Chief Operating Officer/Health Center Director,401-519-1977,,bdowlatshahi@tri-town.org,Joseph DeSantis,Chief Executive Officer,401-519-1967,,jdesantis@tri-town.org,
RI-009564,WellOne Primary Medical and Dental Care,Northwest Community Health Care,1245219070,"Dental Providers, Federally Qualified Health Centers - Medical Services",36 Bridge Way,,Pascoag,RI,02859-3131,Providence,36 Bridge Way,PO Box 312,Pascoag,RI,02859,Providence,Peter Bancroft,President & CEO,401-285-5119,,pjbancroft@welloneri.org,Melissa Johnson,Administrative Projects Manager,401-567-0800,181,mjohnson@welloneri.org,
RI-009565,"BVCHC, Inc.",Blackstone Valley Community Health Center,1063574135,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1145 Main St,,Pawtucket,RI,02860-4807,Providence,39 East Avenue,,Pawtucket,RI,02860,Providence,Raymond Lavoie,Executive Director,401-312-0081,101,rlavoie@bvchc.org,Sandra Pardus,Chief Finance Officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009566,Blackstone Valley Community Health Dental,Blackstone Valley Community Health Center,1063574135,Dental Providers,210 Main St,,Pawtucket,RI,02860-4008,Providence,39 East Avenue,,Pawtucket,RI,02860,Providence,Raymond Lavoie,Executive Director,401-312-5246,101,rlavoie@bvchc.org,Sandra Pardus,Chief Executive officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009567,Blackstone Valley Community Health,Blackstone Valley Community Health Center,1063574135,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",39 East Ave,,Pawtucket,RI,02860-4003,Providence,39 East Avenue,,Pawtucket,RI,02860,Providence,Raymond Lavoie,Executive Director,401-312-0081,101,rlavoie@bvchc.org,Sandra Pardus,Chief Finance Officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009568,"BVCHC, Inc.",Blackstone Valley Community Health Center,1063574135,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",42 Park Pl,,Pawtucket,RI,02860-4010,Providence,39 East Avenue,,Pawtucket,RI,02860-4003,Providence,Raymond Lavoie,Executive Director,401-312-0081,101,rlavoie@bvchc.org,Sandra Pardus,Chief Finance Officer,401-312-0081,115,spardus@bvchc.org,www.bvchc.org
RI-009569,Randall Square Health Center,"The Providence Community Health Centers, Inc",1669596367,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Randall Sq # 2,,Providence,RI,02904-2709,Providence,375 Allens Avenue,,Providence,RI,02905,Providence,Merrill Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009570,Chafee Health Center,"The Providence Community Health Centers, Inc",1174576342,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Warren Way,,Providence,RI,02905-5000,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009571,Olneyville Health Center,Providence Community Health Centers,1821090358,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",100 Curtis St,,Providence,RI,02909-3623,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Mary Jean Francis,Family Planning Coordinator,401-444-0400,3128,mjfrancis@providencechc.org,www.providencechc.org
RI-009572,The Miriam Hospital Immunology Center,Lifespan: The Miriam Hospital,1275810434,"Ryan White Providers, Sexually Transmitted Disease Clinics",1125 N Main St,,Providence,RI,02904-5739,Providence,164 Summit Avenue,,Providence,RI,02906,Providence,Christopher Botelho,Ryan White Coordinator,401-793-4541,,christopher.botelho@lifespan.org,"Joseph Garland, MD",Ryan White Principal Investigator,401-793-7245,,joseph.garland@lifespan.org,www.miriamhospital.org
RI-009573,Crossroads RI,"The Providence Community Health Centers, Inc",1821120924,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",160 Broad St,,Providence,RI,02903-4028,Providence,375 Allens Ave,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009574,PPSNE-Providence Health Center,"PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND, INC.",1174633143,"Family Planning Providers, Sexually Transmitted Disease Clinics",175 Broad St,,Providence,RI,02903-4026,Providence,345 Whitney Ave,,New Haven,CT,06511-2348,New Haven,Susan Lane,"Director, Financial Analysis and Public Grants",203-752-2821,2037522821,susan.lane@ppsne.org,LINDA COTE,CFO,203-865-5158,2037522850,LINDA.COTE@PPSNE.ORG,http://www.ppsne.org
RI-009575,Central Health Center,"The Providence Community Health Centers, Inc",1508868035,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",239 Cranston St,,Providence,RI,02907-2406,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009576,The Providence Community Health Center at Chad Brown,"The Providence Community Health Centers, Inc",1669596367,Federally Qualified Health Centers - Medical Services,285A Chad Brown St,,Providence,RI,02908-3102,Providence,375 Allens Ave,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009577,Providence Community Health Centers,"The Providence Community Health Centers, Inc.",1295737666,Federally Qualified Health Centers - Medical Services,325 Public St,The Metropolitan School,Providence,RI,02905-2340,Providence,375 Allens Ave,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009578,PCHC Dental Tower,"The Providence Community Health Centers, Inc",1477545549,Dental Providers,335 Prairie Ave,,Providence,RI,02905-2426,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009579,Prairie Ave Health Center,"The Providence Community Health Centers, Inc",1417959867,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",355 Prairie Ave,,Providence,RI,02905-1928,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009580,Capitol Hill Health Center,"The Providence Community Health Centers, Inc",1669474102,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",40 Candace St,,Providence,RI,02908-3747,Providence,375 Allens Avenue,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009581,University Medical Group (UMG),University Medical Group (UMG),1619934254,"Ryan White Providers, Sexually Transmitted Disease Clinics",50 Maude St Fl 2,,Providence,RI,02908-4325,Providence,285 Chalkstone Ave,,Providence,RI,02908,Providence,"Gail Skowron, MD",Prinicpal Investigator,401-456-2437,,gail_skowron@brown.edu,Rebecca Matuszek,Program Coordinator,401-456-2437,,iddiv@chartercare.org,
RI-009582,Providence Community Health Centers at North Main Street,"The Providence Community Health Centers, Inc.",1558650986,Federally Qualified Health Centers - Medical Services,530 N Main St,,Providence,RI,02904-5762,Providence,375 Allens Ave,,Providence,RI,02905-5010,Providence,Merrill R Thomas,CEO,401-444-0400,3130,mthomas@providencechc.org,Denise Andrade,Sr. Project Manager,401-444-0400,3385,dandrade@providencechc.org,www.providencechc.org
RI-009583,ACOS Clients Services Unit,"AIDS CARE OCEAN STATE, INC.",1700902392,Ryan White Providers,557 Broad St,,Providence,RI,02907-1403,Providence,18 Parkis Avenue,,Providence,RI,02907,Providence,Paul Fitzgerald,CEO,401-521-3603,102,paulf@aidscareos.org,Gina Mercure,COO,401-521-3603,,ginam@aidscareos.org,http://www.aidscareos.org
RI-009584,THUNDERMIST HEALTH CENTER,THUNDERMIST HEALTH CENTER,1588691620,"Dental Providers, Federally Qualified Health Centers - Medical Services",557 Broad St,,Providence,RI,02907-1403,Providence,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T. Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,
RI-009585,Rhode Island Hemostasis & Thrombosis Center,Rhode Island Hospital/Hasbro Children's Hospital,1588659528,Hemophilia Treatment Centers,593 Eddy St,Potter 159,Providence,RI,02903-4923,Providence,593 Eddy st,,Providence,RI,02903,Providence,Raysa Marte,Practice Manager,401-444-7731,,rmarte@lifespan.org,,,,,,
RI-009586,Rhode Island Hospital,Rhode Island Hospital/Hasbro Children's Hospital,1588659528,Inpatient Hospitals (other than children's hospitals),593 Eddy St,Potter 159,Providence,RI,02903-4923,Providence,593 Eddy st,,Providence,RI,02903,Providence,Raysa Marte,Practice Manager,401-444-7731,,rmarte@lifespan.org,,,,,,
RI-009587,East Bay Community Action Program,East Bay Community Action Program,1609925122,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",100 Bullocks Point Ave,,Riverside,RI,02915-5351,Providence,19 Broadway,,Newport,RI,02840,Newport,Michelle Benvenuti,Credentialing,401-437-1008,176,mbenvenuti@ebcap.org,,,,,,
RI-009588,WellOne Primary Medical and Dental Care,Northwest Community Health Care,1003362864,"Dental Providers, Federally Qualified Health Centers - Medical Services",35 Village Plaza Way,,Scituate,RI,02857-1849,Providence,36 Bridge Way,PO Box 312,Pascoag,RI,02859,Providence,Peter Bancroft,President & CEO,401-285-5119,,pjbancroft@welloneri.org,Melissa Johnson,Administrative Projects Manager,401-567-0800,181,mjohnson@welloneri.org,
RI-009589,Thundermist Health Center of South County,Thundermist Health Center,1588691620,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 River St,,Wakefield,RI,02879-3214,Washington,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,http://www.thundermisthealth.org/
RI-009590,Everett C. Wilcox Health Center,Comprehensive Community Action Inc.,1750647228,"Dental Providers, Federally Qualified Health Centers - Medical Services",226 Buttonwoods Ave,,Warwick,RI,02886-7541,Kent,311 Doric Ave,,Cranston,RI,02910-7766,Providence,William Hochstrasser-Walsh,Senior Vice President / Chief Operating Officer,401-562-8302,,whochstrasserwalsh@comcap.org,Joanne McGunagle,President / Chief Operating Officer,401-562-8300,,jmcgunagle@comcap.org,
RI-009591,Primary Care Partners,"COMPREHENSIVE COMMUNITY ACTION, INC.",1609253335,Federally Qualified Health Centers - Medical Services,2756 Post Rd,Suite 103,Warwick,RI,02886-3003,Kent,311 Doric Ave Ste 1,,Cranston,RI,02910-2903,Providence,William Hochstrasser-Walsh,Senior Vice President / Chief Operating Officer,401-562-8302,,whochstrasserwalsh@comcap.org,Joanne McGunagle,President / Chief Executive Officer,401-562-8300,,jmcgunagle@comcap.org,
RI-009592,Thundermist Health Center of West Warwick- Dental,Thundermist Health Center,1588691620,Dental Providers,1219 Main St,,West Warwick,RI,02893-4834,Kent,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,
RI-009593,Thundermist Health Center of West Warwick,Thundermist Health Center,1588691620,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",186 Providence St,,West Warwick,RI,02893-2508,Kent,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,,http://www.thundermisthealth.org/
RI-009594,Thundermist Health Center,THUNDERMIST HEALTH CENTER,1588691620,Federally Qualified Health Centers - Medical Services,2 Webster Knight Dr,DEERING MID. SCHOOL HLTH CLINIC,West Warwick,RI,02893-2743,Kent,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,
RI-009595,Thundermist Health Center- Dental,Thundermist Health Center,1588691620,Dental Providers,191 Social St,Suite 900,Woonsocket,RI,02895-3206,Providence,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,
RI-009596,Thundermist Health Center- Woonsocket,Thundermist Health Center,1588691620,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",450 Clinton St,,Woonsocket,RI,02895-3207,Providence,171 Service Avenue,Building 2,Warwick,RI,02886,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,http://www.thundermisthealth.org/
RI-009597,WOONSOCKET HS HEALTH CLINIC,THUNDERMIST HEALTH CENTER,1588691620,Community Mental Health Centers,777 Cass Ave,,Woonsocket,RI,02895-4719,Providence,171 Service Avenue,Building 2,Warwick,RI,02866,Kent,Charles T Jones,Chief Executive Officer,401-767-4100,,chuckj@thundermisthealth.org,Michael Ryan,Finance Director,401-767-4100,3041,miker@thundermisthealth.org,
SC-009598,Abbeville Internal Medicine,Abbeville Area Medical Center,1437346913,Rural Health Clinics,901 W Greenwood St,Suite 5,Abbeville,SC,29620-5718,Abbeville,420 Thomson Circle,,Abbeville,SC,29620,Abbeville,Mary Bethe Barksdale,Practice Manager,864-366-9681,,mbbarksdale@abbevilleareamc.com,,,,,,www.abbevilleareamc.com
SC-009599,Family Medicine Associates,Abbeville Area Medical Center,1629371661,Rural Health Clinics,901 W Greenwood St,Suite 9,Abbeville,SC,29620-5718,Abbeville,420 Thomson Circle,,Abbeville,SC,29620,Abbeville,Mary Bethe Barksdale,Practice Manager,864-366-9681,,mbbarksdale@abbevilleareamc.com,,,,,,www.abbevilleareamc.com
SC-009600,Abbeville Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1518048693,"Family Planning Providers, Sexually Transmitted Disease Clinics",905 W Greenwood St,PO Box 189,Abbeville,SC,29620-5678,Abbeville,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009601,Clyburn Center for Primary Care,"RURAL HEALTH SERVICES, INC.",1447530431,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 Clyburn Pl,,Aiken,SC,29801-4193,Aiken,1000 Clyburn Place,,Aiken,SC,29801,Aiken,Gigina Walker,Chief Operating Officer,803-380-7020,,gwalker@ruralhs.org,Carolyn Emanuel-McClain,Chief Executive officer,803-380-7012,,cmcclain@ruralhs.org,www.ruralhs.org
SC-009602,Family Health Care,"RURAL HEALTH SERVICES, INC.",1053362111,Federally Qualified Health Centers - Medical Services,120 Darlington Dr,,Aiken,SC,29803-8542,Aiken,1000 Clyburn Place,,Aiken,SC,29801,Aiken,Gigina Walker,Chief Operating Officer,803-380-7020,,gwalker@ruralhs.org,Carolyn Emanuel-McClain,Chief Executive officer,803-380-7012,,cmcclain@ruralhs.org,
SC-009603,Aiken Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1144318262,"Family Planning Providers, Sexually Transmitted Disease Clinics",222 Beaufort St NE,,Aiken,SC,29801-4476,Aiken,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009604,Allendale Co Health Dept.,South Carolina Dept. of Health and Environmental Control,1801985635,"Family Planning Providers, Sexually Transmitted Disease Clinics",571 Memorial Ave N,,Allendale,SC,29810-2713,Allendale,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009605,Anderson Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1780767285,"Family Planning Providers, Sexually Transmitted Disease Clinics",220 McGee Rd,,Anderson,SC,29625-2104,Anderson,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009606,Andrews Healthcare Center,St James Santee Family Health Center,1801219845,Federally Qualified Health Centers - Medical Services,675 N Morgan Ave,,Andrews,SC,29510-2417,Georgetown,1189 Tibwin Road,,McClellanville,SC,29458,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gbrown2@tds.net,
SC-009607,Bamberg Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1730260118,"Family Planning Providers, Sexually Transmitted Disease Clinics",370 Log Branch Rd,,Bamberg,SC,29003-8462,Bamberg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009608,Barnwell Pediatrics,"Low Country Health Care System, Inc.",1962442244,Federally Qualified Health Centers - Medical Services,10706 Marlboro Ave,,Barnwell,SC,29812-6376,Barnwell,333 Revolutionary Trail Road,,Fairfax,SC,29827,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,150,abridgmon@lchcs.com,,,,,,
SC-009609,Barnwell Health Dept.,South Carolina Dept. of Health and Environmental Control,1447331822,"Family Planning Providers, Sexually Transmitted Disease Clinics",11015 Ellenton St,,Barnwell,SC,29812-7307,Barnwell,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009610,"HealthWise Family Practice, LLC",HealthWise Family Practice,1033240205,Rural Health Clinics,154 Wren St,,Barnwell,SC,29812-1527,Barnwell,154 Wren Street,,Barnwell,SC,29812,Barnwell,Tracey Proctor,Practice Admin,803-300-0395,,healthwisefamilypractice@yahoo.com,,,,,,
SC-009611,Barnwell Family Medicine,"Low Country Health Care System, Inc.",1578659942,Federally Qualified Health Centers - Medical Services,86 Wren St,,Barnwell,SC,29812-1529,Barnwell,333 Revolutionary Trail Road,,Fairfax,SC,29827,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,150,abridgmon@lchcs.com,,,,,,
SC-009612,Womens Health & Internal Medicine,Eau Claire Cooperative Health Centers,1346249430,Federally Qualified Health Centers - Medical Services,338 E Columbia Ave,,Batesburg-Leesville,SC,29070-9285,Lexington,1800 Saint Julian Place,,Columbia,SC,29204,Richland,Delgado Cantave,CFO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009613,Beaufort Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1689758898,"Family Planning Providers, Sexually Transmitted Disease Clinics",601 Wilmington St,,Beaufort,SC,29902-4956,Beaufort,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009614,CSC Women's Services,CareSouth Carolina Inc,1568859130,Federally Qualified Health Centers - Medical Services,1076 Marlboro Way,,Bennettsville,SC,29512-2495,Marlboro,201 South Fifth St,,Hartsville,SC,29550,Darlington,Tracy B Beasley,Directory of Corporate Compliance,843-857-0111,,tracy.beasley@caresouth-carolina.com,,,,,,
SC-009615,CSC Bennettsville Pediatric Center,CARE SOUTH CAROLINA INC,1639458672,Federally Qualified Health Centers - Medical Services,210 W Main St,,Bennettsville,SC,29512-3122,Marlboro,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009616,Marlboro Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1184793929,"Family Planning Providers, Sexually Transmitted Disease Clinics",711 S Parsonage St,,Bennettsville,SC,29512-4423,Marlboro,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009617,CSC BENNETTSVILLE CENTER,CARE SOUTH CAROLINA INC,1457398521,Federally Qualified Health Centers - Medical Services,999 Cheraw St,,Bennettsville,SC,29512-2420,Marlboro,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009618,CSC Bishopville II Center,CARE SOUTH CAROLINA INC,1275812216,Federally Qualified Health Centers - Medical Services,106 Hospital Sq,,Bishopville,SC,29010-7081,Lee,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009619,CSC BISHOPVILLE CENTER,CARE SOUTH CAROLINA INC,1942247846,Federally Qualified Health Centers - Medical Services,545 Sumter Hwy,,Bishopville,SC,29010-7601,Lee,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009620,Lee Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1699851667,"Family Planning Providers, Sexually Transmitted Disease Clinics",810 Brown St,PO Box 307,Bishopville,SC,29010-1176,Lee,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009621,Cherokee Pediatric Associates dba Carolina Pediatric Associates,Cherokee Pediatric Associates dba Carolina Pediatric Associates,1730233172,Rural Health Clinics,301 W Pine St,,Blacksburg,SC,29702-1549,Cherokee,301 W Pine St,,Blacksburg,SC,29702,Cherokee,Amy Carling,Practice Manager,864-902-8051,,amyssearches2013@yahoo.com,Mindy Martin,Biller,864-490-7907,,mindy_620@yahoo.com,
SC-009622,Family Medical Center of Blackville,"Low Country Health Care System, Inc.",1235225608,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",19340 Solomon Blatt Ave N,,Blackville,SC,29817-2304,Barnwell,333 Revolutionary Trail Road,,Fairfax,SC,29827,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,150,abridgmon@lchcs.com,,,,,,
SC-009623,Lake Monticello Family Practice @ McCrorey-Liston,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,1978 State Highway 215 S,,Blair,SC,29015-9443,Fairfield,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CFO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009624,Bluffton Health Center,South Carolina Dept. of Health and Environmental Control,1689758898,"Family Planning Providers, Sexually Transmitted Disease Clinics",4819 Bluffton Pkwy,,Bluffton,SC,29910-4622,Beaufort,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009625,CALHOUN FALLS FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1871626259,Federally Qualified Health Centers - Medical Services,535 Jackson St,,Calhoun Falls,SC,29628-1222,Abbeville,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009626,Kershaw County Health Dept.,South Carolina Dept. of Health and Environmental Control,1124102306,"Family Planning Providers, Sexually Transmitted Disease Clinics",1116 Church St,PO Box 340,Camden,SC,29020-3502,Kershaw,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009627,"Sandhills Medical, Camden Office",SANDHILLS MEDICAL FOUNDATION,1720372949,Federally Qualified Health Centers - Medical Services,2611 Liberty Hill Rd,,Camden,SC,29020-1871,Kershaw,S. 7th St,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009628,BROOKLAND-CAYCE MEDICAL PRACTICE,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,1115 State St,,Cayce,SC,29033-4342,Lexington,1228 Harden St Fl 2,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009629,Planned Parenthood Charleston Health Center,Planned Parenthood South Atlantic,1851438147,Family Planning Providers,1312 Ashley River Rd,,Charleston,SC,29407-5365,Charleston,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/south-carolina/charleston/29403/charleston-health-center-3859-90860
SC-012491,MUSC Ryan White Clinic,Medical University Hospital Authority,1659435840,Ryan White Providers,135 Rutledge Ave,MSC-752 Division of Infectious Diseases,Charleston,SC,29425,Charleston,MUSC Health Alliance 96 Jonathan Lucas Street Suite 601-J MSC 617,,Charleston,SC,29425,Charleston,"David Louder ,MD",Executive Director MUSC Health Alliance,843-876-2811,,louder@musc.edu,Sonya Floyd,Director Managed Care Contracts,843-876-1344,,floyds@musc.edu,https://medicine.musc.edu/departments/dom/divisions/infectious-diseases/patient-care/ryan-white-clinic
SC-009630,Ryan White Wellness Center,Roper St. Francis Hospital,1104150739,"Outpatient Hospital Clinics, Ryan White Providers",1481 Tobias Gadson Blvd,Suite 1,Charleston,SC,29407-4794,Charleston,Roper St. Francis Hospital,"125 Doughty St, Suite 790",Charleston,SC,29403,Charleston,Kimberly Butler Willis,Director,843-402-1067,,kimberly.butler@rsfh.com,Aaron O'Brien,Manager,843-402-1084,,aaron.obrien@rsfh.com,
SC-009631,MUSC Children's Hospital,Medical University Hospital Authority,1073605879,Children's Hospitals (inpatient only),169 Ashley Ave,,Charleston,SC,29425-8905,Charleston,169 Ashley Avenue,,Charleston,SC,29425,Charleston,Karyn B Rae,"Director, Managed Care",843-876-1343,,raek@musc.edu,Sonya Floyd,"Manager, provider Credentialing and Enrollment",843-876-1344,,floyds@musc.edu,http://www.musckids.org/
SC-009632,Charleston Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1972693885,"Family Planning Providers, Sexually Transmitted Disease Clinics",3 Charleston Center Dr,,Charleston,SC,29401-1162,Charleston,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009633,Fetter Health Care Network-Downtown Site,Fetter Health Care Network Inc,1003827304,Federally Qualified Health Centers - Medical Services,51 Nassau St,,Charleston,SC,29403-5513,Charleston,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009634,Community Dental Center,Fetter Health Care Network Inc,1245639095,Dental Providers,700 Rutledge Ave,,Charleston,SC,29403-4145,Charleston,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009635,CareSouth Carolina Cheraw,CareSouth Carolina Inc,1285677443,Federally Qualified Health Centers - Medical Services,715 South Doctors Drive,"Suite A, B, D & E",Cheraw,SC,29520,Chesterfield,201 South Fifth Street,,HARTVILLE,SC,29550,Darlington,Tracy B Beasley,Director Corporate Compliance,843-857-0111,,tracy.beasley@caresouth-carolina.com,,,,,,
SC-009636,NORTH CENTRAL FAMILY MEDICAL CTR. CHESTER,"COMMUNITY MEDICINE FOUNDATION, INC.",1356618318,Federally Qualified Health Centers - Medical Services,115 Cestrain Sq,,Chester,SC,29706-1979,Chester,1131 Saluda St,,Rock Hill,SC,29730-5776,York,DALE S JOHNSON,CEO,803-325-7744,237,DJOHNSON@NCFMC.NET,Dale S. Johnson,CFO,803-325-7744,243,djohnson@ncfmc.net,
SC-009637,Chester Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1821171539,"Family Planning Providers, Sexually Transmitted Disease Clinics",129 Wylie St,,Chester,SC,29706-1786,Chester,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-676-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009638,Chesterfield Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1497830392,"Family Planning Providers, Sexually Transmitted Disease Clinics",203 N Page St,,Chesterfield,SC,29709-1201,Chesterfield,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009639,CSC CHESTERFIELD PERRY CENTER,CARE SOUTH CAROLINA INC,1629015755,Federally Qualified Health Centers - Medical Services,500 West Blvd,,Chesterfield,SC,29709-1402,Chesterfield,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009640,MARGARET J. WESTON HEALTH CENTER,"RURAL HEALTH SERVICES, INC.",1790846608,Federally Qualified Health Centers - Medical Services,4645 Augusta Rd,,Clearwater,SC,29842-7265,Aiken,1000 Clyburn Place,,Aiken,SC,29801,Aiken,Carolyn Emanuel-McClain,Chief Executive Officer,803-380-7012,,cmcclain@ruralhs.org,Lisa Lewis,Executive Manager,803-380-7012,,llewis@ruralhs.org,
SC-009641,Heritage Essential Medical Services,"FOOTHILLS COMMUNITY HEALTH CARE, INC.",1538417951,Federally Qualified Health Centers - Medical Services,1011 Tiger Blvd,Suite 400,Clemson,SC,29631-1401,Pickens,1011 Tiger Blvd Ste 400,,Clemson,SC,29631-1401,Pickens,George Newby Jr.,Chief Executive Officer,864-722-0283,,gnewby@myfchc.org,Jennifer Soles,Billing Manager,864-722-0283,,JSoles@MyFCHC.org,http://www.myfchc.org/
SC-009642,Laurens County Community Care Center,"Carolina Health Centers, Inc.",1841548229,Federally Qualified Health Centers - Medical Services,22725 Highway 76 E,,Clinton,SC,29325-7527,Laurens,"313 Main St., Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009643,HomeTown Pediatrics,"CAROLINA HEALTH CENTERS, INC.",1518238690,Federally Qualified Health Centers - Medical Services,500 Plaza Cir,Suite J,Clinton,SC,29325-7559,Laurens,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009644,Laurens Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1366454746,"Family Planning Providers, Sexually Transmitted Disease Clinics",93 Human Services Rd,,Clinton,SC,29325-7546,Laurens,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009645,Affinity Health Center - Clover,Affinity Health Center,1073986394,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",300 Clinton Ave,,Clover,SC,29710-1627,York,500 Lakeshore Parkway,,Rock Hill,SC,29730,York,Anita Michele Case,Executive Director,803-909-9710,,acase@affinityhealthcenter.org,Bryan Martin,Finance Director,803-909-9718,,bmartin@affinityhealthcenter.org,www.affinityhealthcenter.org
SC-009646,Waverly Womens Health Center,Eau Claire Cooperative Health Centers,1346249430,Federally Qualified Health Centers - Medical Services,1228 Harden St,,Columbia,SC,29204-1800,Richland,1800 Saint Julian Place,,Columbia,SC,29204,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-012465,Center for Vein Restoration,Center for Vein Restoration,1295391498,Other ECP Providers,1725 Devonshire Dr,,Columbia,SC,29204-2404,Richland,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,240-965-3889,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,815-254-1761,,credentialing@centerforvein.com,centerforvein.com
SC-009647,Richland Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1629152806,"Family Planning Providers, Sexually Transmitted Disease Clinics",2000 Hampton St,,Columbia,SC,29204-1002,Richland,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009648,Transitions Center,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,2025 Main St,,Columbia,SC,29201-2125,Richland,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4155,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009649,South Carolina Dept. of Health and Environmental Control,South Carolina Dept. of Health and Environmental Control,1679607162,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2100 Bull St,,Columbia,SC,29201-2104,Richland,2100 Bull Street,,Columbia,SC,29201,Richland,Nicholas Davidson,Director of Client Services,803-898-1685,,davidsne@dhec.sc.gov,,,,,,www.dhec.sc.gov
SC-009650,WAVERLY FAMILY PRACTICE,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2117 Gervais St,,Columbia,SC,29204-1805,Richland,1228 Harden St Fl 2,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,sonjam@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009651,Planned Parenthood Columbia Health Center,Planned Parenthood South Atlantic,1851438147,Family Planning Providers,2712 Middleburg Dr,Suite 107,Columbia,SC,29204-2478,Richland,100 S. Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Services,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/south-carolina/columbia/29204/columbia-health-center-2646-90860
SC-009652,AHF Healthcare Centers - Columbia Grace Medical,AIDS Healthcare Foundation,1265784912,Other ECP Providers,3025 Farrow Rd,,Columbia,SC,29203-7001,Richland,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
SC-009653,Eau Claire Family Dentistry,Eau Claire Cooperative Health Centers Inc,1346249430,Dental Providers,3800 N Main St,Suite C,Columbia,SC,29203-6446,Richland,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009654,Eau Claire Podiatry,Eau Claire Cooperative Health Centers Inc,1346249430,Federally Qualified Health Centers - Medical Services,3800 N Main St,Suite B,Columbia,SC,29203-6446,Richland,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CFO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009655,Eau Claire Behavioral Medicine,Eau Claire Cooperative Health Centers Inc,1346249430,Federally Qualified Health Centers - Medical Services,4605 Monticello Rd,Suite 1,Columbia,SC,29203-4156,Richland,1800 Saint Julian Place,,Columbia,SC,29204,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009656,Eau Claire Developmental Clinic,Eau Claire Cooperative Health Centers Inc,1346249430,Federally Qualified Health Centers - Medical Services,4605 Monticello Rd,,Columbia,SC,29203-4156,Richland,1228 Harden St Fl 2,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009657,PALMETTO HEALTH RICHLAND,Children's Cancer & Blood Disorders,1760587935,Hemophilia Treatment Centers,5 Richland Medical Park Dr,,Columbia,SC,29203-6863,Richland,"7 Medical Park Drive, Suite 7215",,Columbia,SC,29203,Richland,Robin Jones,RN,803-434-3533,,robin.jones2@palmettohealth.org,James French,MD,803-434-3533,,james.french@palmettohealth.org,
SC-009658,Hemophilia Center of South Carolina,University of South Carolina School of Medicine,1831128586,Hemophilia Treatment Centers,7 Richland Medical Park Dr,Suite 7215,Columbia,SC,29203-6863,Richland,7 Richland Medical Park Dr,Suite 7215,Columbia,SC,29203,Richland,"James French, MD",Medical Director,803-434-3533,,james.french@palmettohealth.org,"Robin Jones, RN",Nurse Coordinator,803-434-3533,3504,robin.jones@palmettohealth.org,
SC-009659,"HEALTH CARE PARTNERS OF S.C., INC.","HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",1043395346,Federally Qualified Health Centers - Medical Services,1608 Main St,,Conway,SC,29526-3572,Horry,1708 Oak St,,Conway,SC,29526-3086,Horry,Barlon Lundgren,Chief Executive Officer,843-488-6035,,blundgren@hcpsc.com,,,,,,
SC-009660,HEALTH CARE PARTNERS OF SC INC,"HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",1699118612,Federally Qualified Health Centers - Medical Services,1708 Oak St,,Conway,SC,29526-3086,Horry,1708 Oak St,,Conway,SC,29526-3086,Horry,Barlon Lundgren,Chief Executive Officer,843-488-6035,,blundgren@hcpsc.com,,,,,,
SC-009661,Conway Public Health Dept.,South Carolina Dept. of Health and Environmental Control,1659457778,"Family Planning Providers, Sexually Transmitted Disease Clinics",1931 Industrial Park Rd,,Conway,SC,29526-5482,Horry,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009662,CONWAY MEDICAL CENTER,CONWAY MEDICAL CENTER,1134172000,Inpatient Hospitals (other than children's hospitals),300 Singleton Ridge Rd,,Conway,SC,29526-9142,Horry,300 Singleton Ridge Road,,Conway,SC,29526-9142,Horry,Frank Grella,Director of Patient Financial Services,843-347-7111,8075,fgrella@cmc-sc.com,Bret Barr,Executive VP of FIscal Services/CFO,843-347-7111,8037,bbarr@cmc-sc.com,www.conwaymedicalcenter.com
SC-009663,Fetter Health Care Network-Elijah Wright Site,Fetter Health Care Network Inc,1396859823,Federally Qualified Health Centers - Medical Services,1681 Old Highway 6,,Cross,SC,29436-3602,Berkeley,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009664,Pee Dee Health Care,"GENESIS HEALTHCARE, INC",1437484862,Federally Qualified Health Centers - Medical Services,201 Cashua St,,Darlington,SC,29532-3301,Darlington,3400 West Ave,,Columbia,SC,29203-6901,Richland,TONY MEGNA,CEO,803-254-3676,2942,ceo@genesisfqhc.org,Katie Noyes,CFO,803-254-3676,2935,katien@genesisfqhc.org,
SC-009665,Darlington Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1396820650,"Family Planning Providers, Sexually Transmitted Disease Clinics",305 Russell St,,Darlington,SC,29532-3323,Darlington,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009666,Denmark Medical,"Family Health Centers, Inc",1700080066,Federally Qualified Health Centers - Medical Services,1241 Sol Blatt Blvd,,Denmark,SC,29042-2509,Bamberg,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officer,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-6952,,melvin.cramer@myfhc.org,
SC-009667,Dillon Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1073696662,"Family Planning Providers, Sexually Transmitted Disease Clinics",201 W Hampton St,,Dillon,SC,29536-3333,Dillon,2100 Bull Street,,Columbia,SC,29291,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009668,CSC Dillon,CARE SOUTH CAROLINA INC,1255762936,Federally Qualified Health Centers - Medical Services,207 E Monroe St,,Dillon,SC,29536-2557,Dillon,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009669,MCLEOD PEDIATRICS-DILLON,MCLEOD PEDIATRICS-DILLON,1346344934,Rural Health Clinics,705 N 8th Ave,Suite 3A,Dillon,SC,29536-2549,Dillon,705 N. 8TH AVE SUITE 3A,,Dillon,SC,29536,Dillon,MITSEY CHURCH,Office Manager,843-487-1753,,mitsey.church@mcleodhealth.org,KELLY SMART,Director,843-601-1057,,KSMART@MCLEODHEALTH.ORG,
SC-009670,Eastover Medical Practice,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,120 Clarkson St,,Eastover,SC,29044-8769,Richland,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009671,Edgefield Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1619051893,"Family Planning Providers, Sexually Transmitted Disease Clinics",21 Star Rd,,Edgefield,SC,29824-4209,Edgefield,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009672,Estill Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1598019341,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",776 2nd St E,,Estill,SC,29918-4926,Hampton,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009673,"Low Country Health Care System, Inc.","Low Country Health Care System, Inc.",1649366022,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",333 Revolutionary Trl,,Fairfax,SC,29827-7109,Allendale,333 Revolutionary Trail Road,,Fairfax,SC,29827,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,150,abridgmon@lchcs.com,,,,,,
SC-009674,"SYCAMORE HEALTH CARE, LLC","SYCAMORE HEALTH CARE, LLC1",1073836383,Rural Health Clinics,7205 Bufords Bridge Hwy,,Fairfax,SC,29827-8456,Allendale,PO BOX 96,,SYCAMORE,SC,29846,Allendale,MARGARET CONE TAYLOR,CEO,803-632-3900,,DRTAYLOR.SHC@GMAIL.COM,,,,,,
SC-009675,HopeHealth @ FMU,HOPEHEALTH INC,1841580412,Federally Qualified Health Centers - Medical Services,121 S Evander Dr,,Florence,SC,29506-4212,Florence,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009676,Florence Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1679658942,"Family Planning Providers, Sexually Transmitted Disease Clinics",145 E Cheves St,,Florence,SC,29506-2526,Florence,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009677,Genesis Healthcare Florence,"GENESIS HEALTHCARE, INC",1255305280,Federally Qualified Health Centers - Medical Services,1523 Heritage Ln Unit A,,Florence,SC,29505-3197,Florence,3400 West Ave,,Columbia,SC,29203,Richland,TONY MEGNA,CEO,803-254-3676,2942,ceo@genesisfqhc.org,Katie Noyes,CFO,803-254-3676,2935,katien@genesisfqhc.org,
SC-009678,HopeHealth Irby,"HopeHealth, Inc.",1801271903,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",360 N Irby St,,Florence,SC,29501-2808,Florence,600 E. Palmetto St.,,Florence,SC,29506,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009679,"HopeHealth, Inc.",HOPEHEALTH INC,1821002411,Federally Qualified Health Centers - Medical Services,600 E Palmetto St,,Florence,SC,29506-2851,Florence,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009680,Affinity Health Center - Fort Mill,Affinity Health Center,1639542699,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",120 Elliott St E,,Fort Mill,SC,29715-1848,York,500 Lakeshore Parkway,,Rock Hill,SC,29730,York,Anita Michele Case,Executive Director,803-909-9710,,acase@affinityhealthcenter.org,Bryan Martin,Finance Director,803-909-9718,,bmartin@affinityhealthcenter.org,
SC-009681,Cherokee Pediatric Associates dba Carolina Pediatric Associates,Cherokee Pediatric Associates dba Carolina Pediatric Associates,1962809509,Rural Health Clinics,1419 N Limestone St,,Gaffney,SC,29340-4748,Cherokee,301 W Pine Street,,Blacksburg,SC,29702,Cherokee,Amy Carling,Practice Manager,864-902-8051,,amyssearches2013@yahoo.com,Mindy Martin,Biller,864-490-7907,,mindy_620@yahoo.com,
SC-009682,REGENESIS HEALTH CARE,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1245409846,Federally Qualified Health Centers - Medical Services,1604 N Limestone St,,Gaffney,SC,29340-2312,Cherokee,460 Langdon Street,,Spartanburg,SC,29304,Spartanburg,Dr. Hilton Perez,CEO,864-582-2817,1301,hperez@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009683,Cherokee Pediatric Associates dba Carolina Pediatric Associates,Cherokee Pediatric Associates dba Carolina Pediatric Associates,1841344280,Rural Health Clinics,1610 N Limestone St,,Gaffney,SC,29340-2312,Cherokee,301 W Pine St,,Blacksburg,SC,29701,Cherokee,Amy Carling,Practice Manager,864-902-8051,,amyssearches2013@yahoo.com,Mindy Martin,Biller,864-490-7907,,mindy_620@yahoo.com,
SC-009684,Cherokee Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1023191707,"Family Planning Providers, Sexually Transmitted Disease Clinics",400 S Logan St,,Gaffney,SC,29341-1609,Cherokee,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,864-649-8038,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov/
SC-009685,Sampit,St James Santee Family Health Center,1538293394,Federally Qualified Health Centers - Medical Services,2482 Powell Rd,,Georgetown,SC,29440-8590,Georgetown,1189 Tibwin Road,,McClellanville,SC,29458,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gbrown2@tds.net,
SC-009686,Georgetown Health Services,St James Santee Family Health Center,1366568594,Federally Qualified Health Centers - Medical Services,422 N Fraser St,,Georgetown,SC,29440-3260,Georgetown,P O Box 608,,McClellanville,SC,29510,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gilliards@tds.net,
SC-009687,Georgetown Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1508940784,"Family Planning Providers, Sexually Transmitted Disease Clinics",531 Lafayette Cir,,Georgetown,SC,29440-2569,Georgetown,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009688,Georgetown Pediatric Center,ST James Santee Family Health Center,1316345846,Federally Qualified Health Centers - Medical Services,57 Jessamine Ave,,Georgetown,SC,29440-5837,Georgetown,1189 Tibwin Road,,McClellanville,SC,29458,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gbrown2@tds.net,
SC-012387,Georgetown Memorial Hospital,Georgetown Memorial Hospital,1982604021,Inpatient Hospitals (other than children's hospitals),606 Black River Rd,,Georgetown,SC,29440-3304,Georgetown,P O Box 421718,,Georgetown,SC,29442,Georgetown,Elizabeth S. Ward,EVP & CFO,843-527-7102,,elward@tidelandshealth.org,Diane Plott,Director of Payor Credentialing,843-527-7102,,dplott@tidelandshealth.org,TidelandsHealth.org
SC-009689,Choppee,St. James Santee Family Health Center,1447382692,Federally Qualified Health Centers - Medical Services,8189 Choppee Rd,,Georgetown,SC,29440-6374,Georgetown,1189 Tibwin Road,,McClellanville,SC,29458,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gbrown2@tds.net,
SC-009690,Goose Creek Health Clinic,South Carolina Dept. of Health and Environmental Control,1144310152,"Family Planning Providers, Sexually Transmitted Disease Clinics",106 Westview Dr,,Goose Creek,SC,29445-3007,Berkeley,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009691,HopeHealth Greeleyville,HopeHealth,1497126015,Federally Qualified Health Centers - Medical Services,86 N Main St,,Greeleyville,SC,29056-9374,Williamsburg,360 N. Irby St,,Florence,SC,29501,Florence,Mark E. Vinson,Chief Financial Office,843-667-9414,1522,mvinson@hope-health.org,Denise Spurling,Billing Manager,843-667-9414,1538,dspurling@hope-health.org,
SC-009692,NEW HORIZON FAMILY DENTAL CARE,"NEW HORIZON FAMILY HEALTH SERVICES, INC",1720157290,Dental Providers,1 Memorial Medical Dr,,Greenville,SC,29605-4407,Greenville,975 W. Faris Road,,Greenville,SC,29605,Greenville,Regina M. Mitchell,President & CEO,864-729-8330,2259,mmitchell@newhorizonfhs.org,,,,,,www.newhorizonfhs.org
SC-009693,Greenville Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1477636140,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 University Rdg,PO Box 2507,Greenville,SC,29601-3635,Greenville,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009694,GHS Children's Hospital,Upstate Affiliate Organization d/b/a Greenville Health System,1689624900,Children's Hospitals (inpatient only),701 Grove Rd,,Greenville,SC,29605-4210,Greenville,701 Grove Rd,,Greenville,SC,29605,Greenville,Pam Sawicki,Senior Planning Analyst,864-797-7512,,psawicki@ghs.org,Bill Schmidt,"GHS Department Chair, Dept. of Pediatric Services",864-455-8401,,wschmidt@ghs.org,
SC-009695,SHC - Greenville,Shriners Hospitals for Children,1326187097,Children's Hospitals (inpatient only),950 W Faris Rd,,Greenville,SC,29605-4255,Greenville,950 W Faris Rd.,,Greenville,SC,29605,Greenville,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
SC-009696,New Horizon Family Health Services Main Site,"NEW HORIZON FAMILY HEALTH SERVICES, INC",1043495526,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",975 W Faris Rd,,Greenville,SC,29605-4241,Greenville,975 W Faris Rd,,Greenville,SC,29605,Greenville,Regina M. Mitchell,President & CEO,864-729-8330,2259,mmitchell@newhorizonfhs.org,,,,,,www.newhorizonfhs.org
SC-009697,THE CHILDREN'S CENTER,"CAROLINA HEALTH CENTERS, INC.",1972636025,Federally Qualified Health Centers - Medical Services,113 Liner Dr,,Greenwood,SC,29646-2311,Greenwood,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-388-0301,,sveer@carolinahealthcenters.org,
SC-009698,Self Regional Healthcare,Self Regional Healthcare,1023046612,Inpatient Hospitals (other than children's hospitals),1325 Spring St,,Greenwood,SC,29646-3875,Greenwood,1325 Spring Street,,Greenwood,SC,296463860,Greenwood,Sonja Williams,Managed Care Coordinator,864-725-5168,,swilliams6@selfregional.org,Timothy Evans,CFO,864-725-4248,,tim.evans@selfregional.org,
SC-009699,Greenwood Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1033295035,"Family Planning Providers, Sexually Transmitted Disease Clinics",1736 Main St S,,Greenwood,SC,29646-4124,Greenwood,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009700,UPTOWN FAMILY PRACTICE CENTER,"CAROLINA HEALTH CENTERS, INC.",1306979521,Federally Qualified Health Centers - Medical Services,313 Main St,Suite A,Greenwood,SC,29646-2757,Greenwood,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009701,Village Family Practice,"Carolina Health Centers, Inc.",1518338698,Federally Qualified Health Centers - Medical Services,420 Epting Ave # B,,Greenwood,SC,29646-4040,Greenwood,"313 Main St., Ste B",,Greenwood,SC,296462757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009702,The Bethany Center,"CAROLINA HEALTH CENTERS, INC.",1538428198,Federally Qualified Health Centers - Medical Services,924 Bypass 25 NE,,Greenwood,SC,29649-2900,Greenwood,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009703,New Horizon Family Health Services - Greer,"NEW HORIZON FAMILY HEALTH SERVICES, INC",1053596536,Federally Qualified Health Centers - Medical Services,111A Berry Ave,,Greer,SC,29651-1307,Greenville,975 W. Faris Rd,,Greenville,SC,29605,Greenville,Regina Mitchell,President & CEO,864-729-8330,2259,mmitchell@newhorizonfhs.org,,,,,,www.newhorizonfhs.org
SC-009704,Hampton Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1316291172,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",200 Elm St E,,Hampton,SC,29924-3430,Hampton,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009705,Donald E. Gatch Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1720332794,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",552 Stiney Rd,,Hardeeville,SC,29927-5228,Jasper,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009706,CSC HARTSVILLE CENTER,CARE SOUTH CAROLINA INC,1720082571,Federally Qualified Health Centers - Medical Services,1268 S 4th St,Suite A,Hartsville,SC,29550-0703,Darlington,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009707,Hartsville Health Department,South Carolina Dept. of Health and Environmental Control,1396820650,"Family Planning Providers, Sexually Transmitted Disease Clinics",130 E Camden Ave,,Hartsville,SC,29550-5726,Darlington,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009708,Holly Hill Health Center,South Carolina Dept. of Health and Environmental Control,1184702227,"Family Planning Providers, Sexually Transmitted Disease Clinics",8423A Old State Rd,,Holly Hill,SC,29059-8880,Orangeburg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009709,Family Health Centers at Holly Hill,"Family Health Centers, Inc",1609279744,Federally Qualified Health Centers - Medical Services,922 Holly St,,Holly Hill,SC,29059-2762,Orangeburg,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-5952,,melvin.cramer@myfhc.org,
SC-009710,Fetter Health Care Network-Hollywood Site,Fetter Health Care Network Inc,1386792976,Federally Qualified Health Centers - Medical Services,5225 Highway 165,,Hollywood,SC,29449-6144,Charleston,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009711,Hopkins Family Practice,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,9023 Garners Ferry Rd,,Hopkins,SC,29061-9540,Richland,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,Sonjam@ecchc.org,www.ecchc.org
SC-009712,SANDHILLS MEDICAL FOUNDATION-Jefferson site,"SANDHILLS MEDICAL FOUNDATION, INC.",1912065467,Federally Qualified Health Centers - Medical Services,409 E Church St,,Jefferson,SC,29718-8701,Chesterfield,S. 7th Street,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009713,Lake Monticello Family Practice,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,9017 Hwy 215 S,,Jenkinsville,SC,29065,Fairfield,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,sonjam@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009714,Angel Oak Family Medicine,Angel Oak Family Medicine,1952351173,Rural Health Clinics,1816 Bohicket Rd,Suite F,Johns Island,SC,29455-3318,Charleston,"1816 Bohicket Road, Suite F",,Johns Island,SC,29455-3318,Charleston,Clara Lobo,Office Manager,843-559-1938,8434608380,claraplobo@gmail.com,Jackie Baer,Owner,843-559-1938,8434422871,jackiebaer@gmail.com,
SC-009715,The Point - Johns Island,South Carolina Dept. of Health and Environmental Control,1972693885,"Family Planning Providers, Sexually Transmitted Disease Clinics",3574 Maybank Hwy,,Johns Island,SC,29455-4822,Charleston,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009716,Fetter Health Care Network-Johns Island Site,Fetter Health Care Network Inc,1487053021,Federally Qualified Health Centers - Medical Services,3627 Maybank Hwy,,Johns Island,SC,29455-4825,Charleston,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singeleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009717,"HEALTH CARE PARTNERS OF SC, INC.","HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",1639255631,Federally Qualified Health Centers - Medical Services,123 E Broadway St,,Johnsonville,SC,29555-4252,Florence,1708 Oak St,,Conway,SC,29526-3086,Horry,Barlon Lundgren,Chief Executive Officer,843-488-6035,,blundgren@hcpsc.com,,,,,,
SC-009718,Kershaw Medical Office,SANDHILLS MEDICAL FOUNDATION,1386902542,Federally Qualified Health Centers - Medical Services,205 W Marion St,,Kershaw,SC,29067-1412,Lancaster,645 S. 7th Street,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009719,Care Health Kershaw,CARE NET OF LANCASTER,1336403807,Federally Qualified Health Centers - Medical Services,212 E Marion St,,Kershaw,SC,29067-1442,Lancaster,212 E Marion St,,Kershaw,SC,29067,Lancaster,Randall S Barre,CEO,843-991-0147,,sbarre@carehealthcenter.net,Shannon Hyde,Practice Manager,803-459-1547,,shyde@carehealthcenter.net,www.carehealthcenter.net
SC-009720,WILLIAMSBURG REGIONAL HOSPITAL,WILLIAMSBURG REGIONAL HOSPITAL,1124192109,Rural Health Clinics,500 Nelson Blvd,,Kingstree,SC,29556-4027,Williamsburg,500 Nelson Blvd,,Kingstree,SC,29556-4027,Williamsburg,Karen Godwin,Director of Physicians Practices,843-355-0174,,kgodwin@wmbgrh.com,Betsy Brown,CFO,843-355-0172,,bbrown@wmbgrh.com,
SC-009721,"Family Medicine Associates, LLC","Family Medicine Associates, LLC",1831445998,Rural Health Clinics,505 Thurgood Marshall Hwy,,Kingstree,SC,29556-4107,Williamsburg,505 Thurgood Marshall Highway,,Kingstree,SC,29556,Williamsburg,"Morris Edward Brown III, MD",Medical Director,843-374-8380,,mbrown3609@aol.com,,,,,,
SC-009722,HopeHealth Kingstree,HOPEHEALTH INC,1568704583,Federally Qualified Health Centers - Medical Services,520 Thurgood Marshall Hwy,Suite B,Kingstree,SC,29556-4108,Williamsburg,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009723,Williamsburg County Health Dept.,South Carolina Dept. of Health and Environmental Control,1376627927,"Family Planning Providers, Sexually Transmitted Disease Clinics",520 Thurgood Marshall Hwy,Suite A,Kingstree,SC,29556-4108,Williamsburg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,803-898-0625,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009724,Lake City Health Center,South Carolina Dept. of Health and Environmental Control,1679658942,"Family Planning Providers, Sexually Transmitted Disease Clinics",137 N Acline St,PO Box 190,Lake City,SC,29560-2107,Florence,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009725,HopeHealth - Lake City,HOPEHEALTH INC,1831442854,Federally Qualified Health Centers - Medical Services,241 Kelley St,,Lake City,SC,29560-2446,Florence,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009726,Hopehealth Inc,HOPEHEALTH INC,1114353786,Federally Qualified Health Centers - Medical Services,652 N Matthews Rd,HopeHealth Lake City School-based Health Center,Lake City,SC,29560-7008,Florence,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009727,"Lake City Family Medicine, LLC","Lake City Family Medicine, LLC",1396969002,Rural Health Clinics,901 N Matthews Rd,,Lake City,SC,29560-7024,Florence,901 N. Matthews Road`,,Lake City,SC,29560,Florence,"Morris E. Brown III, MD",Medical Director,843-374-8380,,mbrown3609@aol.com,,,,,,
SC-009728,CSC LAKE VIEW CENTER,CARE SOUTH CAROLINA INC,1780627943,Federally Qualified Health Centers - Medical Services,103 N Kemper St,,Lake View,SC,29563-3115,Dillon,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009729,Lamar Family Practice,"GENESIS HEALTHCARE, INC",1538543723,Federally Qualified Health Centers - Medical Services,301 W Main St,,Lamar,SC,29069-7102,Darlington,3400 West Ave,,Columbia,SC,29203,Richland,TONY MEGNA,CEO,803-254-3676,2942,ceo@genesisfqhc.org,Katie Noyes,CFO,803-254-3676,2935,katien@genesisfqhc.org,
SC-009730,Lancaster Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1063597987,"Family Planning Providers, Sexually Transmitted Disease Clinics",1833 Pageland Hwy,,Lancaster,SC,29720-7606,Lancaster,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009731,Care Health Lancaster,CARE NET OF LANCASTER,1154510352,Federally Qualified Health Centers - Medical Services,838 W Meeting St,Medical Arts 5 Suite H,Lancaster,SC,29720-6233,Lancaster,838 W Meeting St,"Medical Arts 5, Suite H",Lancaster,SC,29720-6261,Lancaster,Randall S Barre,CEO,843-991-0147,,sbarre@carehealthcenter.net,Shannon Hyde,Practice Manager,803-459-1547,,shyde@carehealthcenter.net,www.carehealthcenter.net
SC-009732,"Landrum Family Healthcare,LLC","Landrum Family Healthcare,LLC",1831323831,Rural Health Clinics,108 W Rutherford St,,Landrum,SC,29356-1526,Spartanburg,108 W Rutherford Street,,Landrum,SC,29356,Spartanburg,Linda Woodfin-Hightower,FNP - Owner,864-457-2363,100,lwoodfin12@aol.com,Samantha Robinson,Office Manager,864-457-2363,101,samlfhc0609@gmail.com,
SC-009733,CSC Latta,CareSouth Carolina Inc,1972980621,Federally Qualified Health Centers - Medical Services,122 Latimer St,,Latta,SC,29565-1828,Dillon,201 S Fifth St,,Hartsville,SC,29550,Darlington,Tracy B Beasley,Director of Corporate Compliance Contracting Credentialing,843-857-0111,,tracy.beasley@caresouth-carolina.com,,,,,,
SC-009734,PED OF BATESBURG-LEESVILLE,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,120 West Church St,,Leesville,SC,29070,Lexington,1800 Saint Julian Place,,Columbia,SC,29204-1800,Lexington,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009735,Lexington County Health Dept.,South Carolina Dept. of Health and Environmental Control,1841375128,"Family Planning Providers, Sexually Transmitted Disease Clinics",1070 S Lake Dr,Suite B,Lexington,SC,29073-3701,Lexington,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009736,Stephen's Crossroads Health Dept.,South Carolina Dept. of Health and Environmental Control,1659457778,"Family Planning Providers, Sexually Transmitted Disease Clinics",107 Highway 57 N,,Little River,SC,29566-7050,Horry,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystal Benton,Preventive Health Program Nurse Manager,843-915-8861,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009737,"Little River Medical Center, Inc.","Little River Medical Center, Inc.",1629021076,"Dental Providers, Federally Qualified Health Centers - Medical Services",4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,4303 Live Oak Dr,,Little River,SC,29566,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,http://www.lrmcenter.com/
SC-009738,LRMC - Loris Site,"LITTLE RIVER MEDICAL CENTER, INC.",1619100096,Federally Qualified Health Centers - Medical Services,3817 Main St,,Loris,SC,29569-3017,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009739,Sandhills Medical Foundation--Lugoff Baldwin Ave,SANDHILLS MEDICAL FOUNDATION,1487712923,Federally Qualified Health Centers - Medical Services,40 Baldwin Ave,,Lugoff,SC,29078-9406,Kershaw,S. 7th St,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009740,HopeHealth Manning Adult,HOPEHEALTH INC,1013259712,Federally Qualified Health Centers - Medical Services,11 W Hospital St,,Manning,SC,29102-2912,Clarendon,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009741,Clarendon County Health Dept.,South Carolina Dept. of Health and Environmental Control,1689757239,"Family Planning Providers, Sexually Transmitted Disease Clinics",110 E Boyce St,,Manning,SC,29102-3408,Clarendon,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,803-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009742,HopeHealth Manning Pediatrics,HOPEHEALTH INC,1336480300,Federally Qualified Health Centers - Medical Services,12 W South St,,Manning,SC,29102-2925,Clarendon,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009743,Health Care Partners of SC,"HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",1770668824,Federally Qualified Health Centers - Medical Services,145 Palmetto Pointe Rd,,Marion,SC,29571-6721,Marion,1708 Oak St,,Conway,SC,29526-3086,Horry,Barlon Lundgren,Chief Executive Officer,843-488-6035,,blundgren@hcpsc.com,,,,,,
SC-009744,SANDHILLS MEDICAL - MCBEE Site,SANDHILLS MEDICAL FOUNDATION,1568541597,Federally Qualified Health Centers - Medical Services,645 S Seventh St,,Mc Bee,SC,29101-7101,Chesterfield,645 S Seventh St,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009745,CSC MCCOLL CENTER,CARE SOUTH CAROLINA INC,1811930076,Federally Qualified Health Centers - Medical Services,225 S Main St,,Mc Coll,SC,29570-2020,Marlboro,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009746,St James Santee Family Health Center - McClellanville,St James Santee Family Health Center,1588618441,Federally Qualified Health Centers - Medical Services,1189 Tibwin Rd,,McClellanville,SC,29458-9405,Charleston,1189 Tibwin Rd,,McClellanville,SC,29458-9405,Charleston,Sandra Gilliard,CEO,843-887-3274,17,gilliards@tds.net,Gwen Brown,Administrative Assistant,843-887-3274,32,gbrown2@tds.net,
SC-009747,MCCORMICK FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1063545119,Federally Qualified Health Centers - Medical Services,1319 S Main St,,McCormick,SC,29835-7928,McCormick,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009748,McCormick Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1427128719,"Family Planning Providers, Sexually Transmitted Disease Clinics",204 Hwy 28,,McCormick,SC,29835,McCormick,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0604,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009749,FAMILY HEALTHCARE SAVANNAH LAKES,SELF MEDICAL GROUP,1629382056,Rural Health Clinics,207 Holiday Rd,,McCormick,SC,29835-3430,McCormick,104 Wells Ave,Suite 103,Greenwood,SC,29646,Greenwood,Sonja Williams,Coord Credential-Contract Comp,864-725-5168,5168,swilliams6@selfregional.org,,,,,,
SC-009750,Moncks Corner Health Center,South Carolina Dept. of Health and Environmental Control,1144310152,"Family Planning Providers, Sexually Transmitted Disease Clinics",109 W Main St,,Moncks Corner,SC,29461-2673,Berkeley,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009751,"Moncks Corner Pediatrics, LLC","Moncks Corner Pediatrics, LLC",1003070103,Rural Health Clinics,5000 Epson Plantation Dr,Suite B,Moncks Corner,SC,29461-3979,Berkeley,5000 Epson Plantation Drive,Suite B,Moncks Corner,SC,29461-3979,Berkeley,Dianna Fain,Office Manger,843-761-2000,,drfain@live.com,,,,,,
SC-009752,Mt. Pleasant Health Center,South Carolina Dept. of Health and Environmental Control,1972693885,"Family Planning Providers, Sexually Transmitted Disease Clinics",1189 Sweetgrass Basket Pkwy,Suite 100,Mount Pleasant,SC,29466-7422,Charleston,1189 Sweetgrass Basket Pkwy Ste 100,,Mount Pleasant,SC,29466-7422,Charleston,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,803-898-0625,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009753,"Palmetto Medical Care, LLC","Palmetto Medical Care, LLC",1295921591,Rural Health Clinics,1002 S Main St,,Mullins,SC,29574-3920,Marion,1002 South Main St,,Mullins,SC,29574,Marion,Kathy J. Thompkins,Owner,843-464-8205,,jrtbrn54@hotmail.com,,,,,,
SC-009754,Marion Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1902975733,"Family Planning Providers, Sexually Transmitted Disease Clinics",206 Airport Ct,,Mullins,SC,29574-6196,Marion,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystal Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009755,Marion Pediatrics,"Marion Physician Services, LLC",1346561602,Federally Qualified Health Centers - Medical Services,2845 E Highway 76,Suite 2,Mullins,SC,29574-6037,Marion,2829 E Highway 76,,Mullins,SC,29574,Marion,Lisa Smith,Executive Assistant - Credentials,843-431-2405,,lsmith@mcmed.org,,,,,,
SC-009756,Street Reach Mission,"LITTLE RIVER MEDICAL CENTER, INC.",1144472119,Federally Qualified Health Centers - Medical Services,1005 Osceola St,,Myrtle Beach,SC,29577-8008,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009757,LRMC HEALTH ACCESS,"LITTLE RIVER MEDICAL CENTER, INC.",1669535225,Federally Qualified Health Centers - Medical Services,1075 Mr Joe White Ave Unit 101,,Myrtle Beach,SC,29577-5658,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009758,LRMC South Strand,Little River Medical Center Inc,1508120619,Federally Qualified Health Centers - Medical Services,3236 Holmestown Rd Unit E1,,Myrtle Beach,SC,29588-7495,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009759,"Careteam Plus, Inc.","Careteam Plus, Inc.",1427363209,Ryan White Providers,3650 Claypond Rd,,Myrtle Beach,SC,29579-7326,Horry,3650 Clay Pond Rd,,Myrtle Beach,SC,20579,Horry,Johanna Haynes,CEO,843-236-9000,4,jhaynes@careteamplus.org,Donna Fiorentino,Compliance Officer,843-236-9000,5,dfiorentino@careteamplus.org,www.careteamplus.org
SC-009760,LRMC CAROLINA FOREST,"LITTLE RIVER MEDICAL CENTER, INC",1346638483,"Dental Providers, Federally Qualified Health Centers - Medical Services",4220 Carolina Exchange Dr,,Myrtle Beach,SC,29579-4220,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009761,Myrtle Beach Health Dept.,South Carolina Dept. of Health and Environmental Control,1659457778,"Family Planning Providers, Sexually Transmitted Disease Clinics",700 21st Ave N,,Myrtle Beach,SC,29577-7400,Horry,2100 Bull Street,,Myrtle Beach,SC,29577-7400,Horry,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009762,LRMC Myrtle Beach,Little River Medical Center Inc,1184783284,Federally Qualified Health Centers - Medical Services,7724 N Kings Hwy,,Myrtle Beach,SC,29572-3041,Horry,4303 Live Oak Dr,,Little River,SC,29566-9138,Horry,Pamela Davis,CEO,843-663-8001,,pdavis@lrmcenter.com,Wendy Gimino,Executive Administrative Manager,843-663-8305,,wgimino@lrmcenter.com,
SC-009763,Norfield Medical,"Family Health Centers, Inc",1669676201,Federally Qualified Health Centers - Medical Services,7061 Norway Rd,,Neeses,SC,29107-9021,Orangeburg,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-5952,,melvin.cramer@myfhc.org,
SC-009764,Newberry Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1578633889,"Family Planning Providers, Sexually Transmitted Disease Clinics",2111 Wilson Rd,,Newberry,SC,29108-1603,Newberry,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009765,Pediatrics of Newberry,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,2525 Kinard St,,Newberry,SC,29108-2909,Newberry,1800 Saint Julian Place,,Columbia,SC,29204-1800,Fairfield,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009766,FAMILY HEALTHCARE NEWBERRY,SELF MEDICAL GROUP,1477880003,Rural Health Clinics,2605 Kinard St,Suite 200,Newberry,SC,29108-2965,Newberry,104 Wells Ave,Suite 103,Greenwood,SC,29646,Greenwood,Sonja Williams,Coord Credential-Contract Comp,864-725-5168,5168,swilliams6@selfregional.org,,,,,,
SC-009767,Fetter Health Care Network-Enterprise Site,Fetter Health Care Network Inc,1487768842,Federally Qualified Health Centers - Medical Services,2047 Comstock Ave,,North Charleston,SC,29405-8117,Charleston,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009768,Northwoods Health Clinic,South Carolina Dept. of Health and Environmental Control,1972693885,"Family Planning Providers, Sexually Transmitted Disease Clinics",2070 Northbrook Blvd,Suite A20,North Charleston,SC,29406-9324,Charleston,2100 Bull Street,,Coumbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009769,North Area Health Department,South Carolina Dept. of Health and Environmental Control,1972693885,"Family Planning Providers, Sexually Transmitted Disease Clinics",3963 Whipper Barony Ln,,North Charleston,SC,29405-7162,Charleston,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009770,Ruth P. Fields Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1649276148,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",721 Okatie Hwy,,Okatie,SC,29909-3963,Beaufort,721 Okatie Hwy. 170 North,P.O. Box 357,Ridgeland,SC,29936,Jasper,J. Brandon Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009771,Olanta Family Care,"GENESIS HEALTHCARE, INC",1255641346,Federally Qualified Health Centers - Medical Services,211 S Jones Rd,,Olanta,SC,29114-9705,Florence,3400 West Ave,,Columbia,SC,29203-6901,Richland,Tony R Megna,CEO,803-254-3676,2942,ceo@genesisfqhc.org,Katie Noyes,CFO,803-254-3676,2935,katien@genesisfqhc.org,
SC-009772,Orangeburg Co. Public Health Dept.,South Carolina Dept. of Health and Environmental Control,1184702227,"Family Planning Providers, Sexually Transmitted Disease Clinics",1550 Carolina Ave Ne,PO Box 1126,Orangeburg,SC,29116-1126,Orangeburg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009773,Changes Clinic,"Low Country Health Care System, Inc.",1386717296,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1857 Joe S Jeffords Hwy,,Orangeburg,SC,29115-7473,Orangeburg,333 Revolutionary Trail Road,,Fairfax,SC,29827,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,150,abridgmon@lchcs.com,,,,,,
SC-009774,"Family Health Centers, Inc.","Family Health Centers, Inc.",1144248451,"Dental Providers, Federally Qualified Health Centers - Medical Services",3310 Magnolia St,,Orangeburg,SC,29115-1466,Orangeburg,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,"Leon A. Brunson, Sr.",Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-6952,,melvin.cramer@myfhc.org,
SC-009775,Pelion Family Practice,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,"Dental Providers, Federally Qualified Health Centers - Medical Services",8063 Edmund Hwy,,Pelion,SC,29123-9805,Lexington,1800 Saint Julian Place,,Columbia,SC,29204-1800,Lexington,Delgado Cantace,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009776,Pickens Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1043396161,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 McDaniel Ave,,Pickens,SC,29671-2527,Pickens,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009777,Sumter Family Health Center Pinewood,Sumter Family Health Center,1811973068,Federally Qualified Health Centers - Medical Services,25 E Clark St,,Pinewood,SC,29125-8989,Sumter,25 East Clark Street,,Pinewood,SC,29125,Sumter,Debbie Prescott,CFO,803-774-4522,,dprescott@sumterfhc.com,Holly Chase,Community Development,803-774-4606,,hchase@sumterfhc.com,sumterfhc.com
SC-009778,Port Royal Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1942554886,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1320 S Ribaut Rd,,Port Royal,SC,29935,Beaufort,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009779,RIDGE SPRING FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1538127352,Federally Qualified Health Centers - Medical Services,201 Aiken Rd,,Ridge Spring,SC,29129-9169,Saluda,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009780,Ridgeland Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1629322466,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1520 Grays Hwy,,Ridgeland,SC,29936-5440,Jasper,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009781,Jasper Co. Health Department,South Carolina Dept. of Health and Environmental Control,1770668261,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",651 Grays Hwy,,Ridgeland,SC,29936-5488,Jasper,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009782,RIDGEWAY FAMILY PRACTICE,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,"Dental Providers, Federally Qualified Health Centers - Medical Services",755 US Highway 21 S,,Ridgeway,SC,29130-6844,Fairfield,1228 Harden St Fl 2,,Columbia,SC,29204-1800,Fairfield,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009783,Rock Hill Health Dept.,South Carolina Dept. of Health and Environmental Control,1841374485,"Family Planning Providers, Sexually Transmitted Disease Clinics",1070 Heckle Blvd,PO Box 3057,Rock Hill,SC,29732-5057,York,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-642-1612,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009784,"COMMUNITY MEDICINE FOUNDATION, INC.","COMMUNITY MEDICINE FOUNDATION, INC.",1528004918,Federally Qualified Health Centers - Medical Services,1131 Saluda St,,Rock Hill,SC,29730-5776,York,1131 Saluda St,,Rock Hill,SC,29730-5776,York,Ernest G Brown,CEO,803-325-7744,237,ernestbrown@ncfmc.net,DALE S JOHNSON,CFO,803-325-7744,243,djohnson@ncfmc.net,
SC-009785,NCFMC Pediatric and Adolescent Center,"COMMUNITY MEDICINE FOUNDATION, INC.",1902173891,Federally Qualified Health Centers - Medical Services,225 S Herlong Ave,,Rock Hill,SC,29732-2730,York,1131 Saluda St,,Rock Hill,SC,29730-5776,York,Ernest G Brown,CEO,803-325-7744,237,ernestbrown@ncfmc.net,DALE S JOHNSON,CFO,803-325-7744,237,djohnson@ncfmc.net,
SC-009786,Catawba Health Service,Catawba Service Unit-Indian Health Service,1467485540,"Dental Providers, Indian Health Service, Other ECP Providers",2893 Sturgis Rd,,Rock Hill,SC,29730-6607,York,2893 Sturgis Road,,Rock Hill,SC,29730,York,Jordan Burchell,Supervisory Health System Specialist,803-372-5675,,jordan.burchell@ihs.gov,Pamela,Wright,803-372-5655,,pamela.wright@ihs.gov,
SC-009787,Affinity Health Center (formerly Catawba Care),Affinity Health Center,1396881066,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",500 Lakeshore Pkwy,,Rock Hill,SC,29730-4273,York,500 Lakeshore Pkwy,,Rock Hill,SC,29730,York,Anita Case,Executive Director,803-909-9710,,acase@affinityhealthcenter.org,Bryan Martin,Finance Director,803-909-9718,,bmartin@affinityhealthcenter.org,www.affinityhealthcenter.org
SC-009788,St. George Medical Center,"Family Health Centers, Inc",1437353794,Federally Qualified Health Centers - Medical Services,401 Ridge St,,Saint George,SC,29477-2451,Dorchester,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-5952,,melvin.cramer@myfhc.org,
SC-009789,Leroy E. Browne Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1427302470,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6315 Jonathan Francis SR Rd,,Saint Helena Island,SC,29920-5310,Beaufort,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,James Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7475,rgardner@bjhchs.org,www.bjhchs.org
SC-009790,Calhoun Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1245311638,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2837 Old Belleville Rd,,Saint Matthews,SC,29135-9010,Calhoun,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,843-579-4524,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009791,"Saluda Family Medicine, PA","Saluda Family Medicine, PA",1700921616,Rural Health Clinics,102 R L Sawyer Md Dr,,Saluda,SC,29138-9199,Saluda,102 RL SAWYER MD DRIVE,,SALUDA,SC,29138-9199,Saluda,"William C. Sawyer, M.D.",President,864-445-2173,,saludafamilymed@embarqmail.com,Durand Hall,Office Manager,864-445-2173,,saludafamilymed@embarqmail.com,
SC-009792,SALUDA FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1811020266,Federally Qualified Health Centers - Medical Services,219 Greenwood Hwy,,Saluda,SC,29138-1143,Saluda,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gimer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-369-0200,,sveer@carolinahealthcenters.org,
SC-009793,Saluda Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1417031097,"Family Planning Providers, Sexually Transmitted Disease Clinics",613 Newberry Hwy,,Saluda,SC,29138-8903,Saluda,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009794,Rosa Clark Medical Clinic,Rosa Clark Medical Clinic,1508903394,Federally Qualified Health Centers - Medical Services,210 S Oak St,,Seneca,SC,29678-3416,Oconee,210 South Oak St.,,Seneca,SC,29678,Oconee,Vicki A. Thompson,Executive Director,864-882-4664,7,rosaclark2@aol.com,,,,,,
SC-009795,Seneca Public Health Office,South Carolina Dept. of Health and Environmental Control,1962587212,"Family Planning Providers, Sexually Transmitted Disease Clinics",609 N Townville St,,Seneca,SC,29678-2642,Oconee,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0604,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009796,Elijah Washington Medical Center,"Beaufort Jasper Hampton Comprehensive Health Services, Inc.",1669726634,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",211 Paige Point Rd,,Sheldon,SC,29941,Beaufort,721 Okatie Hwy. 170 North,PO Box 357,Ridgeland,SC,29936,Jasper,J. Brandon Gaffney,COO,843-987-7400,7475,bgaffney@bjhchs.org,Roland J. Gardner,CEO,843-987-7400,7448,rgardner@bjhchs.org,www.bjhchs.org
SC-009797,CareSouth Carolina Inc,CareSouth Carolina Inc,1174833511,Dental Providers,737 S Main St,,Society Hill,SC,29593-8972,Darlington,201 South Fiftth St,,Hartsville,SC,29550,Darlington,Tracy B Beasley,Director Corporate Compliance,843-857-0111,,tracy.beasley@caresouth-carolina.com,,,,,,
SC-009798,CSC ROSA LEE GERALD CENTER,CARE SOUTH CAROLINA INC,1194763714,Federally Qualified Health Centers - Medical Services,737 S Main St,,Society Hill,SC,29593-8972,Darlington,201 S 5th St,,Hartsville,SC,29550-4211,Darlington,Ann Lewis,CEO,843-857-0111,,ann.lewis@caresouth-carolina.com,Tracy B Beasley,Director Corporate Compliance and Contracting,843-857-0111,,tracy.beasley@caresouth-carolina.com,
SC-009799,Spartanburg Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1205912318,"Family Planning Providers, Sexually Transmitted Disease Clinics",151 E Wood St,,Spartanburg,SC,29303-3016,Spartanburg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0604,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009800,Tobias Teen Clinic,South Carolina Department of Health and Environmental Control,1679607162,Family Planning Providers,1546 George Washington Carver Dr,,Spartanburg,SC,29305,Spartanburg,2600 Bull Street,,Columbia,SC,29201,Richland,Kendall Quinton,Director of Patient Billing,803-898-1164,,quintokf@dhec.sc.gov,,,,,,www.scdhec.gov
SC-009801,ReGenesis Health Care at ELC Park Hills,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1548528714,Federally Qualified Health Centers - Medical Services,301 Crescent Ave,,Spartanburg,SC,29306-4143,Spartanburg,460 Langdon Street,,Spartanburg,SC,29304,Spartanburg,Dr. Hilton Perez,CEO,864-582-2817,1301,tharris@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009802,ReGenesis Dental Clinic,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1316325897,Dental Providers,362 N Pine St,,Spartanburg,SC,29302-1631,Spartanburg,460 Langdon Street,,Spartanburg,SC,29304,Spartanburg,Dr. Hilton Perez,CEO,864-582-2817,1301,hperez@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009803,Regenesis Health at Langdon Street,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1457745952,Federally Qualified Health Centers - Medical Services,460 Langdon St,,Spartanburg,SC,29302-1614,Spartanburg,460 Langdon Street,,Spartanburg,SC,29304,Spartanburg,Dr. Hilton Perez,CEO,864-582-2817,1301,hperez@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009804,REGENESIS COMMUNITY HEALTH CENTER,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1194710426,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",750 S Church St,,Spartanburg,SC,29306-5348,Spartanburg,750 S Church St,,Spartanburg,SC,29306-5348,Spartanburg,Hilton Perez,CEO,864-582-2817,1301,hperez@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009805,USC Upstate Public Health Services,South Carolina Dept. of Health and Environmental Control,1205912318,"Family Planning Providers, Sexually Transmitted Disease Clinics",800 University Way,,Spartanburg,SC,29303-4932,Spartanburg,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009806,St Matthews Medical,"Family Health Centers, Inc",1528262888,Federally Qualified Health Centers - Medical Services,558 Chestnut St,,St Matthews,SC,29135-8104,Calhoun,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-5952,,melvin.cramer@myfhc.org,
SC-009807,Summerville Health Center,South Carolina Dept. of Health and Environmental Control,1902989163,"Family Planning Providers, Sexually Transmitted Disease Clinics",500 N Main St,,Summerville,SC,29483-6439,Dorchester,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009808,Fetter Health Care Network-Summerville Site,Fetter Health Care Network Inc,1982718425,Federally Qualified Health Centers - Medical Services,700 N Pine St,,Summerville,SC,29483-6641,Dorchester,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranlada_Singleton@fetterhealthcare.org,
SC-009809,Sumter Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1003994153,"Family Planning Providers, Sexually Transmitted Disease Clinics",105 N Magnolia St,PO Box 1628,Sumter,SC,29150-4941,Sumter,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Krystle Benton,Preventive Health Program Nurse Manager,843-915-8765,,bentonks@dhec.sc.gov,http://www.dhec.sc.gov
SC-009810,Sumter Family Health Center,Sumter Family Health Center,1386630192,Federally Qualified Health Centers - Medical Services,1278 N Lafayette Dr,,Sumter,SC,29150-2964,Sumter,Sumter Family Health Center,,Sumter,SC,29150,Sumter,Debbie Prescott,CFO,803-774-4522,,dprescott@sumterfhc.com,Holly Chase,Community Development,803-774-4606,,hchase@sumterfhc.com,sumterfhc.com
SC-009811,Carolina Women's Specialists,Sumter Family Health Center,1356772776,Federally Qualified Health Centers - Medical Services,319 N Main St,,Sumter,SC,29150-4258,Sumter,1278 N Lafayette Drive,,Sumter,SC,29150,Sumter,Debbie Prescott,CFO,803-774-4522,,dprescott@sumterfhc.com,Holly Chase,Community Development,803-774-4606,,hchase@sumterfhc.com,sumterfhc.com
SC-009812,SANDHILLS MEDICAL FOUNDATION Inc - Sumter Site,SANDHILLS MEDICAL FOUNDATION,1780742825,Federally Qualified Health Centers - Medical Services,425 N Salem Ave,,Sumter,SC,29150-4115,Sumter,S. 7th Street,,McBee,SC,29101,Chesterfield,Chris Dixon,CEO,843-335-6758,,cdixon@sandhillsmedical.org,,,,,,www.sandhillsmedical.org
SC-009813,HopeHealth Timmonsville,HOPEHEALTH INC,1124360136,Federally Qualified Health Centers - Medical Services,210 E Market St,,Timmonsville,SC,29161-1812,Florence,600 E Palmetto St,,Florence,SC,29506-2851,Florence,Carl Humphries,CEO,843-656-0345,,chumphries@hope-health.org,Mark Vinson,CFO,843-656-0368,,mvinson@hope-health.org,
SC-009814,NEW HORIZON FAMILY HEALTH SERVICES -TRAVELERS REST,"NEW HORIZON FAMILY HEALTH SERVICES, INC",1184808008,Federally Qualified Health Centers - Medical Services,1588 Geer Hwy,,Travelers Rest,SC,29690-9204,Greenville,975 W Faris Rd,,Greenville,SC,29605,Greenville,Regina M. Mitchell,President & CEO,864-729-8330,2259,mmitchell@newhorizonfhs.org,,,,,,www.newhorizonfhs.org
SC-009815,Union Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1598848582,"Family Planning Providers, Sexually Transmitted Disease Clinics",115 Thomas St,,Union,SC,29379-2147,Union,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Suzan Alexander,Preventive Health Program Nurse Manager,864-596-2227,154,alexans2@dhec.sc.gov,http://www.dhec.sc.gov
SC-009816,Vance Community Medical,"Family Health Centers, Inc",1346444601,Federally Qualified Health Centers - Medical Services,10278 Old #6 Highway,,Vance,SC,29163,Orangeburg,3310 Magnolia Street,,Orangeburg,SC,29115,Orangeburg,Leon A. Brunson,Chief Executive Officers,803-531-6905,,leon.brunson@myfhc.org,Melvin Cramer,Controller,803-531-5952,,melvin.cramer@myfhc.org,
SC-009817,Hampton Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1528143013,"Family Planning Providers, Sexually Transmitted Disease Clinics",531 W Carolina Ave,,Varnville,SC,29944-4735,Hampton,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009818,"WALTERBORO FAMILY PRACTICE ASSOCIATES, PA",Walterboro Family Practice Associates PA,1871532721,Rural Health Clinics,107 Church St,,Walterboro,SC,29488-2901,Colleton,107 Church St,,Walterboro,SC,29488-2901,Colleton,Mary Avant Howe,Practice Administrator,843-549-1558,118,bethavanthowewfp@lowcountry.com,"Joseph F Flowers, MD",President,843-549-1558,,bethavanthowewfp@lowcountry.com,
SC-009819,Colleton Co. Health Dept.,South Carolina Dept. of Health and Environmental Control,1447333679,"Family Planning Providers, Sexually Transmitted Disease Clinics",219 S Lemacks St,,Walterboro,SC,29488-4374,Colleton,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Gemma Grady,Preventive Health Program Nurse Manager,843-943-0857,,gradygg@dhec.sc.gov,http://www.dhec.sc.gov
SC-009820,Fetter Health Care Network-Walterboro Site,Fetter Health Care Network Inc,1447308119,Federally Qualified Health Centers - Medical Services,302 Medical Park Dr,Suite 111,Walterboro,SC,29488-5748,Colleton,51 Nassau Street,,Charleston,SC,29403,Charleston,Aretha Jones,CEO,843-722-4112,3004,Aretha_Jones@fetterhealthcare.org,Tranalda Singleton,Credentialing Coordinator,843-722-4112,3008,Tranalda_Singleton@fetterhealthcare.org,
SC-009821,"WALTERBORO ADULT & PEDIATRIC MEDICINE, LLC",Walterboro Adult & Pediatric Medicine,1467438499,Rural Health Clinics,447 Spruce St,,Walterboro,SC,29488-2766,Colleton,447 Spruce St,,Walterboro,SC,29488,Colleton,Cathy Malphrus,Office Manager,843-549-6331,104,cathym@lowcountry.com,,,,,,
SC-009822,Walterboro Family Care,"Genesis Health Care, Inc.",1942757844,Federally Qualified Health Centers - Medical Services,457 Spruce St,,Walterboro,SC,29488-2766,Colleton,3400 West Avenue,,Columbia,SC,29532,Richland,TONY MEGNA,CEO,803-254-3676,2933,ceo@genesisfqhc.org,Katie Noyes,CFO,803-254-3676,2935,katien@genesisfqhc.org,
SC-009823,WARE SHOALS FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1639202922,Federally Qualified Health Centers - Medical Services,85 S Greenwood Ave,,Ware Shoals,SC,29692-1534,Greenwood,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009824,LAKELANDS FAMILY PRACTICE,"CAROLINA HEALTH CENTERS, INC.",1770616013,Federally Qualified Health Centers - Medical Services,17124 Highway 72 W,,Waterloo,SC,29384-5144,Laurens,"313 Main St, Ste B",,Greenwood,SC,29646-2757,Greenwood,Lisa Gilmer,Revenue Cycle Manager,864-941-8121,,lgilmer@carolinahealthcenters.org,Sue Veer,CEO,864-396-0200,,sveer@carolinahealthcenters.org,
SC-009825,BROOKLAND COMMUNITY PEDIATRICS,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,500 N 12th St,,West Columbia,SC,29169-6502,Lexington,1800 Saint Julian Place,,Columbia,SC,29204-1800,Richland,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009826,Williston Family Medicine,Low Country Health Care System Inc.,1922468826,Federally Qualified Health Centers - Medical Services,13975 Church St,,Williston,SC,29853-5835,Barnwell,333 Revolutionary Trail,,Fairfax,SC,29827-7109,Allendale,Amanda Bridgmon,Chief Billing Officer,803-259-5762,2001,abridgmon@lchcs.com,,,,,,
SC-009827,Fairfield Co. Health Department,South Carolina Dept. of Health and Environmental Control,1114003530,"Family Planning Providers, Sexually Transmitted Disease Clinics",1136 Kincaid Bridge Rd,,Winnsboro,SC,29180-7116,Fairfield,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009828,Winnsboro Pediatrics and Family Practice,EAU CLAIRE COOPERATIVE HEALTH CENTER,1346249430,Federally Qualified Health Centers - Medical Services,1136 Kincaid Bridge Rd,,Winnsboro,SC,29180-7116,Fairfield,1228 Harden St Fl 2,,Columbia,SC,29204-1800,Fairfield,Delgado Cantave,CEO,803-733-5969,4146,dcantave@ecchc.org,Sonja McCausland,CFO,803-733-5969,4155,sonjam@ecchc.org,www.ecchc.org
SC-009829,JOHN A MARTIN PRIMARY HEALTH CARE,Community Health Foundation of Fairfield,1306907613,Rural Health Clinics,56 US Highway 321 Byp N,,Winnsboro,SC,29180-7100,Fairfield,56 US Highway 321 Byp N,,Winnsboro,SC,29180-7100,Fairfield,Charles T. McElmurray,Medical Director,803-635-6099,104,Charles.McElmurray@uscmed.sc.edu,,,,,,
SC-009830,FAIRFIELD MEDICAL ASSOCIATES,Fairfield Medical Associates,1184737892,"Black Lung Clinics, Rural Health Clinics",880 W Moultrie St,Suite 200,Winnsboro,SC,29180-2411,Fairfield,880 W Moultrie St,Suite 200,Winnsboro,SC,29180,Fairfield,Sarah Lewis,billing,803-635-6461,122,sarah.moon@fma-sc.com,Elizabeth Mann,office manager,803-635-6461,131,liz.mann@fma-sc.com,www.fairfieldmedical.org
SC-009831,RHC - Woodruff,REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC),1265777908,Federally Qualified Health Centers - Medical Services,220 Irby St,,Woodruff,SC,29388-1618,Spartanburg,460 Langdon Street,,Spartanburg,SC,29304,Spartanburg,Dr. Hilton Perez,CEO,864-582-2817,1301,hperez@myrhc.org,Tonya Harris,CFO,864-582-2817,1303,tharris@myrhc.org,www.myrhc.org
SC-009832,York Health Department,South Carolina Dept. of Health and Environmental Control,1841374485,"Family Planning Providers, Sexually Transmitted Disease Clinics",116 N Congress St,PO Box 149,York,SC,29745-1531,York,2100 Bull Street,,Columbia,SC,29201,Richland,Stephanie Derr,Women's Health Division Director,803-898-0598,,derrsr@dhec.sc.gov,Charice Jones,Preventive Health Program Nurse Manager,803-576-2723,,jonesct@dhec.sc.gov,http://www.dhec.sc.gov
SC-009833,Affinity Health Center - York,Affinity Health Center,1124491188,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",37 Pinckney St,,York,SC,29745-1731,York,500 Lakeshore Parkway,,Rock Hill,SC,29730,York,Anita Michele Case,Executive Director,803-909-9710,,acase@affinityhealthcenter.org,Bryan Martin,Finance Director,803-909-9718,,bmartin@affinityhealthcenter.org,
SD-012388,Avera St Lukes Hospital,Avera Health,1457309270,Inpatient Hospitals (other than children's hospitals),305 S State St,,Aberdeen,SD,57401-4527,Brown,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009834,South Dakota Dept. of Health Brown Co. Community Health Center,South Dakota Dept. of Health Family Planning Program,1467470179,Family Planning Providers,402 S Main St,,Aberdeen,SD,57401-4127,Brown,402 S Main St,,Aberdeen,SD,57401-4127,Brown,Deanna Harber,Family Planning Coordinator,605-626-2628,,deanna.harber@state.sd.us,Amanda Ainslie,Family Planning Program Manager,605-773-4476,,amanda.ainslie@state.sd.us,
SD-009835,Aberdeen Community Health Center,"Horizon Health Care, Inc.",1104248475,Federally Qualified Health Centers - Medical Services,506 S Wilson St,,Aberdeen,SD,57401-5082,Brown,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009836,Alcester Community Health Center,HORIZON HEALTH CARE INC,1598293482,Federally Qualified Health Centers - Medical Services,104 W 2nd St,,Alcester,SD,57001-2281,Union,109 N Main St,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009837,Alcester Dental Clinic,HORIZON HEALTH CARE INC,1245769447,Dental Providers,111 Iowa St,,Alcester,SD,57001,Union,109 N Main Street,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009838,Douglas Co Public Health Services,Douglas Co. Public Health,1104809219,Family Planning Providers,708 8th St,,Armour,SD,57313-2102,Douglas,708 8th St,,Armour,SD,57313-2102,Douglas,Cassandra Weatherford,Family Planning Coordinator,605-724-2758,,cassandra.weatherford@state.sd.us,Amanda Ainslie,Family Planning Program Manager,605-773-4476,,amanda.ainslie@state.sd.us,
SD-009839,Sanford Health Beresford Clinic,Sanford Health,1043231905,Rural Health Clinics,600 W Cedar St,,Beresford,SD,57004-1125,Lincoln,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009840,BISON COMMUNITY CLINIC,"Horizon Health Care, Inc.",1598731648,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",105 W Main St,PO Box 427,Bison,SD,57620-0427,Perkins,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009841,Rural Medical Clinics,Freeman Regional Health Services,1801186150,Rural Health Clinics,208 N Main St,PO Box 17,Bridgewater,SD,57319-0017,McCook,510 E 8th St,PO Box 370,Freeman,SD,57029,Hutchinson,Mark Miller,CFO,605-925-4000,2112,markm@freemanregional.com,Nick Brandner,CEO,605-925-4000,,nickb@freemanregional.com,
SD-012389,Marshall County Healthcare Center/Avera,Avera Health,1558360388,Inpatient Hospitals (other than children's hospitals),413 9th St,,Britton,SD,57430-2274,Marshall,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009842,Brookings Family Planning,SDSU Student Health Clinic,1588819783,Family Planning Providers,1440 N Campus Dr,,Brookings,SD,57007-0001,Brookings,1440 North Campus Dr,,Brookings,SD,57007,Brookings,Allie Luoma,Family Planning Coordinator,605-688-6622,,alexandra.luoma@sdstate.edu,Amanda Ainslie,Family Planning Program Manager,605-773-4476,,amanda.ainslie@state.sd.us,http://sdstate.edu/wellness-center/family/index.cfm
SD-009843,Bryant Community Health Center,"Horizon Health Care, Inc.",1821102856,Federally Qualified Health Centers - Medical Services,110 W Main St,PO Box 176,Bryant,SD,57221-2058,Hamlin,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009844,Buffalo Regional Medical Clinic,Regional Health,1073992004,"Family Planning Providers, Other ECP Providers",209 Ramsland Rd,,Buffalo,SD,57720,Harding,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Lana Grout,Directory Ambulatory,605-717-8507,,lgrout@regionalhealth.com,www.regionalhealth. com
SD-009845,Gregory County Community Health Office,South Dakota Department of Health,1740204221,Family Planning Providers,221 E 8th St,,Burke,SD,57523,Gregory,600 E. Capitol Ave.,,Pierre,SD,57501,Hughes,Kari Williams,Finance Officer,605-773-4939,,kari.williams@state.sd.us,Leah McQuistion,Health Program Specialist,605-773-6031,,leah.mcquistion@state.sd.us,
SD-009846,Canton Inwood Medical Center,Sanford,1740244540,Inpatient Hospitals (other than children's hospitals),440 N Hiawatha Dr,,Canton,SD,57013-5800,Lincoln,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009847,Centerville Medical Clinic,Pioneer Memorial Hospital & Health Services,1528017662,Rural Health Clinics,512 Broadway,PO Box 70,Centerville,SD,57014-0070,Turner,PO Box 368,,Viborg,SD,57070-0368,Turner,Grace Tidball,Director of Ambulatory Operations,605-326-3045,,grace.tidball@sanfordhealth.org,Anne Christiansen,CFO,605-326-3004,,anne.christiansen@sanfordhealth.org,
SD-009848,DAKOTA FAMILY MEDICAL CENTER,"RURAL HEALTH CARE, INC.",1750705232,Federally Qualified Health Centers - Medical Services,101 S Front St,PO Box 27,Chamberlain,SD,57325-0027,Brule,202 Island Dr.,Suite 1,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009849,Brule County Public Health Services,South Dakota Dept. of Health Family Planning Program,1275722928,Family Planning Providers,110 W Beebe Ave,,Chamberlain,SD,57325-1224,Brule,110 W Beebe Ave Ste 1,,Chamberlain,SD,57325-1224,Brule,Tonya Jost,Family Planning Coordinator,605-734-0180,,tonya.jost@state.sd.us,,,,,,
SD-009850,Sanford Chamberlain Medical Center,Sanford,1134140825,Inpatient Hospitals (other than children's hospitals),300 S Byron Blvd,,Chamberlain,SD,57325-9741,Brule,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009851,Sanford Clinic Clark,Sanford Health,1699755413,Rural Health Clinics,211 N Commercial St,,Clark,SD,57225-1525,Clark,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009852,Sanford Clear Lake Medical Center,Sanford,1851305296,Inpatient Hospitals (other than children's hospitals),701 3rd Ave S,,Clear Lake,SD,57226-2016,Deuel,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009853,Custer Regional Medical Clinic,Regional Health,1427243963,"Family Planning Providers, Other ECP Providers",1041 Montgomery St,,Custer,SD,57730-1304,Custer,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Michael DeLano,Directory Ambulatory,605-673-9460,,MDelano@regionalhealth.com,www.regionalhealth.com
SD-009854,South Dakota Dept. of Health Custer County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,447 Crook St,,Custer,SD,57730-1551,Custer,447 Crook St,,Custer,SD,57730-1551,Custer,Judy Bottjen,Family Planning Coordinator,605-673-2847,,judy.bottjen@state.sd.us,,,,,,
SD-012390,Avera De Smet Memorial Hospital,Avera Health,1710155460,Inpatient Hospitals (other than children's hospitals),306 Prairie Ave SW,,De Smet,SD,57231-2285,Kingsbury,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009855,De Smet Community Health Center,"Horizon Health Care, Inc.",1831208883,Federally Qualified Health Centers - Medical Services,401 Prairie Ave SW,,De Smet,SD,57231-2333,Kingsbury,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009856,De Smet Dental Services,"Horizon Health Care, Inc.",1831208883,Dental Providers,401 Prairie Ave SW,,De Smet,SD,57231-2333,Kingsbury,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,942,jmengenhausen@horizonhealthcare.org,
SD-012391,Avera Medical Group De Smet,Avera Health,1881964484,Rural Health Clinics,801 3rd St SW,,De Smet,SD,57231-2224,Kingsbury,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009857,Lead-Deadwood Regional Medical Center,Regional Health,1558740472,"Family Planning Providers, Other ECP Providers",71 Charles St,,Deadwood,SD,57732-1303,Lawrence,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Traci Matthew,Directory Ambulatory,605-720-2608,,tmatthew1@regionalhealth.com,www.regionalhealth.com
SD-009858,Avera Dells Area Hospital,Avera Health,1154350064,Inpatient Hospitals (other than children's hospitals),909 N Iowa Ave,,Dell Rapids,SD,57022-1231,Minnehaha,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009859,South Dakota Dept. of Health Ziebach County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,Main St,,Dupree,SD,57623-0068,Ziebach,PO Box 68,Main Street,Dupree,SD,57623-0068,Ziebach,Mary Harris,Family Planning Coordinator,605-365-5163,,mary.harris@state.sd.us,,,,,,
SD-009860,Cheyenne River Health Center,Cheyenne River Dental Clinic,1851422596,Dental Providers,24276 Airport Rd,PO Box 590,Eagle Butte,SD,57625-0590,Dewey,P.O. Box 590,,Eagle Butte,SD,57625,Dewey,Evvi L. Clausen,Administrative Manager,605-964-0736,736,evvi.clausen@ihs.gov,ASHYK SYKANDER,Chief Dental Officer,605-964-0736,736,ASHYK.SYKANDER@IHS.GOV,
SD-009861,Cheyenne River Sioux Tribe Field Health,Cheyenne River Sioux Tribe Field Health,1457593725,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",24276 Airport Rd,PO Box 590,Eagle Butte,SD,57625-0590,Dewey,24276 166th St. Airport RD,PO Box 590,Eagle Butte,SD,57625,Ziebach,Lynn Provost,CEO,605-964-0785,,lynn.provost@ihs.gov,Melanie Chhaide,Budget Analyst,605-964-0787,,melanie.chhaide@ihs.gov,
SD-009862,Family Health Center of Eagle Butte,"Horizon Health Care, Inc.",1558335349,Federally Qualified Health Centers - Medical Services,8000 E Hwy 212,PO Box 860,Eagle Butte,SD,57625-0860,Dewey,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,650-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009863,Elk Point Community Health Center,"Horizon Health Care, Inc",1841728730,Federally Qualified Health Centers - Medical Services,204 E Main St,,Elk Point,SD,57025-2334,Union,109 N Main St,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009864,Sanford Clinic Estelline,Sanford Health,1548230683,Rural Health Clinics,305 Hospital Drive,,Estelline,SD,57234,Hamlin,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-012392,Avera Medical Group Fairfax,Avera Health,1427090760,Rural Health Clinics,421 Main St,,Fairfax,SD,57335-7713,Gregory,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009865,Faith Community Health Center,"Horizon Health Care, Inc.",1912972712,Federally Qualified Health Centers - Medical Services,112 N 2nd Ave W,PO Box 577,Faith,SD,57626-0577,Meade,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheift Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009866,Faith Dental Clinic,HORIZON HEALTH CARE INC,1760933246,Dental Providers,112 N 2nd Ave W,,Faith,SD,57626,Perkins,109 N Main St,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,650-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009867,Avera Medical Group Flandreau,Avera Health,1619948007,Rural Health Clinics,212 N Prairie St,,Flandreau,SD,57028-1243,Moody,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009868,Avera Flandreau Hospital,Avera Health,1295747608,Inpatient Hospitals (other than children's hospitals),214 N Prairie St,,Flandreau,SD,57028-1243,Moody,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009869,Moody County Public Health Services,Moody County Public Health Services,1760681175,Family Planning Providers,309 N Prairie St,,Flandreau,SD,57028-1253,Moody,309 N Prairie St,,Flandreau,SD,57028-1253,Moody,Samantha VonEye,Family Planning Coordinator,605-997-3779,,samantha.voneye@state.sd.us,,,,,,
SD-009870,OAHE VALLEY HEALTH CENTER,"RURAL HEALTH CARE, INC.",1487667077,Federally Qualified Health Centers - Medical Services,202 Island Dr,Suite 1,Fort Pierre,SD,57532-7303,Stanley,202 Island Dr Ste 1,,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009871,Fort Thompson Community Health Center,"Horizon Health Care, Inc.",1225411945,Federally Qualified Health Centers - Medical Services,SD Hwy 249,PO Box 378,Fort Thompson,SD,57339-0378,Buffalo,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009872,Freeman Medical Center,Freeman Regional Health Services,1003818006,Inpatient Hospitals (other than children's hospitals),510 E 8th St,PO Box 370,Freeman,SD,57029-2086,Hutchinson,510 E 8th St,PO Box 370,Freeman,SD,57029,Hutchinson,Mark Miller,CFO,605-925-4000,2112,markm@freemanregional.com,Nick Brandner,CEO,605-925-4000,,nickb@freemanregional.com,
SD-009873,Rural Medical Clinics,Freeman Regional Health Services,1508156290,Outpatient Hospital Clinics,804 S Walnut St,PO Box 900,Freeman,SD,57029-2033,Hutchinson,510 E 8th St,PO Box 370,Freeman,SD,57029,Hutchinson,Mark Miller,CFO,605-925-4000,2112,markm@freemanregional.com,Nick Brandner,CEO,605-925-4000,,nickb@freemanregional.com,
SD-009874,Avera Gettysburg Hospital,Avera Health,1003887266,Inpatient Hospitals (other than children's hospitals),606 E Garfield Ave,,Gettysburg,SD,57442,Potter,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009875,COMMUNITY CARE CLINIC,"RURAL HEALTH CARE, INC.",1265420004,Federally Qualified Health Centers - Medical Services,608 E Garfield Ave,,Gettysburg,SD,57442-1325,Potter,202 Island Dr.,Suite 1,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009876,Avera Gregory Hospital,Avera Health,1275562027,Inpatient Hospitals (other than children's hospitals),400 Park Ave,,Gregory,SD,57533-1302,Gregory,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009877,HIGHMORE CLINIC,"RURAL HEALTH CARE, INC.",1205824927,Federally Qualified Health Centers - Medical Services,200 Commercial Ave SE,PO Box 259,Highmore,SD,57345-0259,Hyde,202 Island Drive,Suite 1,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009878,Hot Springs Regional Medical Clinic,Regional Health,1427243963,"Family Planning Providers, Other ECP Providers",145 N 16th St,,Hot Springs,SD,57747-1375,Fall River,353 Fairmont blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,clinical integration coordinator,605-755-9052,,sschrempp@regionalhealth.com,Michael DeLano,Directory Ambulatory,605-673-9460,,MDelano@regionalhealth.com,www.regionalhealth.com
SD-009879,Fall River Community Health Office,South Dakota Department of Health,1740204221,Family Planning Providers,906 N River St,,Hot Springs,SD,57747-1309,Fall River,600 E. Capitol Ave.,,Pierre,SD,57501,Hughes,Kari Williams,Finance Officer,605-773-4939,,kari.williams@state.sd.us,Leah McQuistion,Health Program Specialist,605-773-6031,,leah.mcquistion@state.sd.us,
SD-009880,Prairie Winds Dental,"Horizon Health Care, Inc.",1588773386,Dental Providers,112 N Main St,PO Box 577,Howard,SD,57349-9055,Miner,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009881,Howard Community Health Center,"Horizon Health Care, Inc.",1114033164,Federally Qualified Health Centers - Medical Services,208 S Main St,,Howard,SD,57349-8813,Miner,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009882,South Dakota Dept. of Health Miner County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,400 N Main St,PO Box 67,Howard,SD,57349-9007,Miner,400 N Main St,PO Box 67,Howard,SD,57349-9007,Miner,Missy Lauck,Family Planning Coordinator,605-772-5381,,missy.lauck@state.sd.us,,,,,,
SD-009883,James Valley Community Health Center,"Horizon Health Care, Inc.",1245513811,Federally Qualified Health Centers - Medical Services,1000 18th St SW,Suite 27,Huron,SD,57350-3488,Beadle,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009884,South Dakota Department of Health Beadle County Community Health,South Dakota Department of Health Family Planning,1740204221,Family Planning Providers,1110 3rd St SW,,Huron,SD,57350-1717,Beadle,1110 3rd St. SW,,Huron,SD,57350,Beadle,Amanda Ainslie,Family Planning Program Manager,605-773-4476,,amanda.ainslie@state.sd.us,Scarlett Bierne,MCH Director / Assistant Administrator,605-773-4439,,scarlett.bierne@state.sd.us,
SD-009885,Huron Regional Medical Center,Huron Regional Medical Center,1154312429,Inpatient Hospitals (other than children's hospitals),172 4th St SE,,Huron,SD,57350-2510,Beadle,172 4th Street SE,,Huron,SD,57350,Beadle,Marcia Zwanziger,Vice President - Finance,605-353-6545,,mzwanziger@huronregional.org,,,,,,
SD-009886,Sanford Ipswich Clinic,Sanford Health,1962459842,Rural Health Clinics,110 5th Ave,,Ipswich,SD,57451-2038,Edmunds,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009887,South Dakota Dept. of Health Dewey County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,118 Main St,,Isabel,SD,57633,Dewey,118 Main St,,Isabel,SD,57633,Dewey,Mary Harris,Family Planning Coordinator,605-466-2474,,mary.harris@state.sd.us,,,,,,
SD-009888,Isabel Community Clinic,"Horizon Health Care, Inc.",1205800075,Federally Qualified Health Centers - Medical Services,118 N Main St,PO Box 97,Isabel,SD,57633-0097,Dewey,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009889,South Dakota Dept. of Health Jackson County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,720 6th Ave,,Kadoka,SD,57543,Jackson,720 6th Ave,,Kadoka,SD,57543,Jerauld,Vicki Daly,Family Planning Coordinator,605-837-2240,,vicki.daly@state.sd.us,,,,,,
SD-009890,Kennebec Clinic,"RURAL HEALTH CARE, INC.",1740669381,Federally Qualified Health Centers - Medical Services,120 S Main St,,Kennebec,SD,57544,Lyman,202 Island Dr Ste 1,,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009891,Kyle Health Center,Kyle Health Center,1003963497,"Dental Providers, Family Planning Providers, Indian Health Service",1000 Health Center Rd,,Kyle,SD,57752,Oglala Lakota,PO Box 540,,Kyle,SD,57752-0540,Oglala Lakota,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-455-8200,8200,sarah.eagle@ihs.gov,Lia Whirlwind Horse,Performance Improvement Assistant,605-455-8247,8223,Lia.WhirlwindHorse@ihs.gov,www.ihs.gov
SD-009892,South Dakota Dept. of Health Charles Mix Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,400 Main St,,Lake Andes,SD,57356-2503,Charles Mix,400 Main St,,Lake Andes,SD,57356,Charles Mix,Brenda Plooster,Family Planning Coordinator,605-487-7094,,brenda.plooster@state.sd.us,,,,,,
SD-009893,Avera St. Benedict CRHC Lake Andes,Avera Health,1114931797,Rural Health Clinics,756 E Lake St,,Lake Andes,SD,57356-2001,Charles Mix,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009894,Sanford Clinic Lake Norden,Sanford Health,1417927559,Rural Health Clinics,512 Main Ave,,Lake Norden,SD,57248-2138,Hamlin,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009895,Lake Preston Community Health Center,"Horizon Health Care, Inc.",1629181904,Federally Qualified Health Centers - Medical Services,709 4th St SE,,Lake Preston,SD,57249-2116,Kingsbury,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009896,Perkins County Community Health Office,South Dakota Department of Health,1740204221,Family Planning Providers,11 4th St E,,Lemmon,SD,57638-1524,Perkins,600 E. Capitol Ave.,,Pierre,SD,57501,Hughes,Kari Williams,Finance Officer,605-773-4939,,kari.williams@state.sd.us,Leah McQuistion,Health Program Specialist,605-773-6031,,leah.mcquistion@state.sd.us,
SD-009897,Sanford Clinic Lennox,Sanford Health,1518284264,Rural Health Clinics,108 S Main St,,Lennox,SD,57039-2096,Lincoln,1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009898,Lower Brule Indian Health Service,Lower Brule Indian Health Service,1760445613,"Indian Health Service, Other ECP Providers",601 Gall St,,Lower Brule,SD,57548,Lyman,601 Gall St,,Lower Brule,SD,57548,Lyman,George Jeffrey Ceremuga,Clinical Director,605-474-5526,229,george.ceremuga@ihs.gov,,,,,,
SD-009899,South Dakota Dept. of Health Lake County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,200 E Center,,Madison,SD,57042,Lake,200 E Center,,Madison,SD,57042,Lake,Kayla Austerman,Family Planning Coordinator,605-256-5309,,kayla.austerman@state.sd.us,,,,,,
SD-009900,Manderson Field Clinic,Pine Ridge Hospital,1487701348,"Family Planning Providers, Indian Health Service, Rural Health Clinics",100 Clinic Dr,,Manderson,SD,57756,Oglala Lakota,East Hwy 18,,Pine Ridge,SD,57770,Oglala Lakota,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-867-3019,,sarah.eagle@ihs.gov,Jon Schuchardt,Acting Deputy CEO,605-867-3389,,jon.schuchardt@ihs.gov,
SD-009901,Rural Medical Clinics,Freeman Regional Health Services,1740570076,Rural Health Clinics,307 State St,PO Box 9,Marion,SD,57043-0009,Turner,510 E 8th St,PO Box 370,Freeman,SD,57029,Hutchinson,Mark Miller,CFO,605-925-4000,2112,markm@freemanregional.com,Nick Brandner,CEO,605-925-4000,,nickb@freemanregional.com,
SD-009902,Martin Dental Clinic,"Horizon Health Care, Inc.",1972687192,Dental Providers,103 East Bennett St,PO Box 550,Martin,SD,57551-0550,Bennett,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009903,Martin Community Health Center,"Horizon Health Care, Inc.",1316054935,Federally Qualified Health Centers - Medical Services,109 Pugh St,PO Box 550,Martin,SD,57551-7700,Bennett,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009904,Lacreek Clinic,Pine Ridge Hospital,1003208257,"Family Planning Providers, Rural Health Clinics",119 S 1st Ave,,Martin,SD,57551-5835,Bennett,119 South 1st Ave.,,Martin,SD,57551,Bennett,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-867-3019,,sarah.eagle@ihs.gov,Jon Schuchardt,Acting Deputy CEO,605-867-3389,,jon.schuchardt@ihs.gov,
SD-009905,South Dakota Dept. of Health Bennett County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,202 Main St,,Martin,SD,57551,Bennett,PO Box 460,202 Main Street,Martin,SD,57551-0460,Bennett,Vicki Daly,Family Planning Coordinator,605-685-1089,,vicki.daly@state.sd.us,,,,,,
SD-009906,McIntosh Community Clinic,"Horizon Health Care, Inc.",1609842665,Federally Qualified Health Centers - Medical Services,208 Main St,PO Box 195,McIntosh,SD,57641,Corson,109 North Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009907,Rural Medical Clinics,Freeman Regional Health Services,1255621587,Rural Health Clinics,301 S High St,PO Box 307,Menno,SD,57045-2125,Hutchinson,501 E 8th St,PO Box 370,Freeman,SD,57029,Hutchinson,Mark Miller,CFO,605-925-4000,2112,markm@freemanregional.com,Nick Brandner,CEO,605-925-4000,,nickb@freemanregional.com,
SD-009908,South Dakota Dept. of Health Grant County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,210 E 5th Ave,,Milbank,SD,57252-2433,Grant,210 E 5th Ave,,Milbank,SD,57252-2433,Grant,Jennifer Meyer,Family Planning Coordinator,605-432-4596,,jennifer.meyer@state.sd.us,,,,,,
SD-009909,Avera Medical Group Milbank,Avera Health,1750488730,Rural Health Clinics,301 Flynn Dr,,Milbank,SD,57252-1508,Grant,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-012393,Milbank Area Hospital-Avera,Avera Health,1548272818,Inpatient Hospitals (other than children's hospitals),301 Flynn Dr,,Milbank,SD,57252-1508,Grant,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009910,Avera Hand County Memorial Hospital,Avera Health,1922277060,Inpatient Hospitals (other than children's hospitals),300 W 5th St,,Miller,SD,57362-1238,Hand,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-012394,Avera Medical Group Miller,Avera Health,1083679625,Rural Health Clinics,300 W 5th St,,Miller,SD,57362-1238,Hand,Avera Health,3900 W Avera Drive,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009911,Hand County Public Health Services,Hand County Public Health Services,1720231400,Family Planning Providers,318 W 5th St,,Miller,SD,57362-1238,Hand,318 W 5th St,,Miller,SD,57362,Hand,Renae Simons,Family Planning Coordinator,605-853-2147,,renae.simons@state.sd.us,,,,,,
SD-009912,Mission Community Health Center,"Horizon Health Care, Inc.",1578672846,Federally Qualified Health Centers - Medical Services,161 S Main,PO Box 49,Mission,SD,57555-0049,Todd,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009913,South Dakota Dept. of Health Mitchell Family Planning,South Dakota Dept. of Health Family Planning Program,1699793323,Family Planning Providers,1420 N Main St,,Mitchell,SD,57301-1463,Davison,1420 N Main St,,Mitchell,SD,57301-1463,Davison,Natalie VanDrongelen,Family Planning Coordinator,605-995-8040,,Natalie.vandrongelen@state.sd.us,,,,,,
SD-012395,Avera Queen of Peace Hospital,Avera Health,1154324507,Inpatient Hospitals (other than children's hospitals),525 N Foster St,,Mitchell,SD,57301-2966,Davison,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009914,Walworth County Public Health Services,Walworth County Public Health Services,1720237548,Family Planning Providers,1401 10th Ave W,,Mobridge,SD,57601-1106,Walworth,1401 10th Ave W,,Mobridge,SD,57601-1106,Walworth,Shana Friesz,Family Planning Coordinator,605-845-8127,,shana.friesz@state.sd.us,,,,,,http://www.mobridgehospital.org/
SD-009915,JONES COUNTY CLINIC,"RURAL HEALTH CARE, INC.",1720076441,Federally Qualified Health Centers - Medical Services,609 Garfield Ave,PO Box 425,Murdo,SD,57559-4100,Jones,202 Island Dr.,Suite 1,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009916,ONIDA CLINIC,"RURAL HEALTH CARE, INC.",1992793616,Federally Qualified Health Centers - Medical Services,303 S Main St,,Onida,SD,57564-2160,Sully,"202 Island Dr., Ste 1",,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009917,Parker Medical Clinic,Pioneer Memorial Hospital & Health Services,1619925450,Rural Health Clinics,100 E Sanborn,PO Box 760,Parker,SD,57053-0760,Turner,PO Box 368,,Viborg,SD,57070-0368,Turner,Grace Tidball,Director of Ambulatory Operaions,605-326-3045,,grace.tidball@sanfordhealth.org,Anne Christiansen,CFO,605-326-3004,,anne.christiansen@sanfordhealth.org,
SD-009918,Avera St. Benedict CRHC Parkston,Avera Health,1295758266,Rural Health Clinics,401 W Glynn Dr,,Parkston,SD,57366-9605,Hutchinson,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-012396,Avera St Benedict Health Center,Avera Health,1356443725,Inpatient Hospitals (other than children's hospitals),401 W Glynn Dr,,Parkston,SD,57366-9605,Hutchinson,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009919,South Dakota Dept. of Health Haakon County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,140 S Howard,,Philip,SD,57567,Haakon,140 S Howard,,Philip,SD,57567,Haakon,Heidi Burns,Family Planning Coordinator,605-859-2467,,heidi.burns@state.sd.us,,,,,,
SD-009920,Urban Indian Health,Urban Indian Health,1295807568,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1714 Abbey Rd,,Pierre,SD,57501-7805,Hughes,1714 Abbey Rd,,Pierre,SD,57501-7805,Hughes,Karla Kirkpatrick,Business Office Manager,605-224-8841,1119,Karla.Kirkpatrick@sduih.org,,,,,,https://www.sduih.org/
SD-009921,South Dakota Dept. of Health Family Planning Program,South Dakota Department of Health Family Planning,1740204221,Family Planning Providers,600 E Capitol Ave,,Pierre,SD,57501-2536,Hughes,600 E Capitol Ave,,Pierre,SD,57501-2536,Hughes,Amanda Ainslie,Family Planning Program Manager,605-773-4476,,amanda.ainslie@state.sd.us,,,,,,
SD-009922,South Dakota Dept. of Health Pierre Area Family Planning,South Dakota Dept. of Health Family Planning Program,1992727366,Family Planning Providers,740 E Sioux Ave,Suite 107,Pierre,SD,57501-3395,Hughes,740 E Sioux Ave Ste 107,,Pierre,SD,57501-3395,Hughes,Kim Stoeser,Family Planning Coordinator,605-773-3638,,kim.stoeser@state.sd.us,,,,,,
SD-012397,Avera Medical Group Pierre,Avera Health,1780829283,Rural Health Clinics,801 E Sioux Ave,,Pierre,SD,57501-3323,Hughes,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-012398,Avera St Marys Hospital,Avera Health,1669457180,Inpatient Hospitals (other than children's hospitals),801 E Sioux Ave,,Pierre,SD,57501-3323,Hughes,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009923,Pine Ridge Hospital (inpatient hospital),Pine Ridge Hospital,1497786412,"Indian Health Service, Inpatient Hospitals (other than children's hospitals)",East Hwy 18,,Pine Ridge,SD,57770,Oglala Lakota,East Hwy 18,,Pine Ridge,SD,57770,Oglala Lakota,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-867-3021,,sarah.eagle@ihs.gov,Jon Schuchardt,Acting Deputy CEO,605-867-3040,,jon.schuchardt@ihs.gov,
SD-009924,Pine Ridge Hospital (multiple outpatient ECP categories),Pine Ridge Hospital,1497786412,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service",East Hwy 18,,Pine Ridge,SD,57770,Oglala Lakota,East Hwy 18,,Pine Ridge,SD,57770,Oglala Lakota,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-867-3021,,sarah.eagle@ihs.gov,Jon Schuchardt,Acting Deputy CEO,605-867-3040,,jon.schuchardt@ihs.gov,
SD-009925,Aurora County Community Health Clinic,"Horizon Health Care, Inc.",1356459382,Federally Qualified Health Centers - Medical Services,106 S Main St,PO Box 250,Plankinton,SD,57368-2264,Aurora,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009926,Aurora County Dental Clinic,"Horizon Health Care, Inc.",1972967131,Dental Providers,106 S Main St,PO Box 250,Plankinton,SD,57368-2264,Aurora,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,650-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-012399,Platte Health Center Avera,Avera Health,1235133109,Inpatient Hospitals (other than children's hospitals),601 E 7th St,,Platte,SD,57369-2123,Charles Mix,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009927,PLATTE HEALTH CENTER - CAH,Charles Mix Community Health Office,1740204221,Family Planning Providers,612 E 7th St,,Platte,SD,57369-2114,Charles Mix,612 E 7th St,,Platte,SD,57369-2123,Charles Mix,Brenda Plooster,Family Planning Coordinator,605-337-3996,,brenda.plooster@state.sd.us,,,,,,
SD-009928,STANLEY JONES MEMORIAL CLINIC,"RURAL HEALTH CARE, INC.",1528071297,Federally Qualified Health Centers - Medical Services,116 N Main Ave,,Presho,SD,57568,Lyman,202 Island Dr. Ste 1,,Fort Pierre,SD,57532-7303,Stanley,James M Hardwick,CEO,605-223-2200,,jimh@ruralhc.net,April Crago PA-C,Chief Clinical Officer,605-852-2815,,aprilc@ruralhc.net,www.ruralhc.net
SD-009929,Regional Urgent Care North,Regional Health,1124407044,Other ECP Providers,1303 N Lacrosse St,,Rapid City,SD,57701-6956,Pennington,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Mike McGrath,Director Ambulatory,605-755-5732,,MMcgrath@regionalhealth.com,www.regionalhealth.com
SD-009930,Regional Urgent Care West,Regional Health,1306225222,Other ECP Providers,2116 Jackson Blvd,,Rapid City,SD,57702-3495,Pennington,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Mike McGrath,Director Ambulatory,605-755-5732,,MMcgrath@regionalhealth.com,www.regionalhealth.com
SD-009931,Regional Medical Center Western Hills Professional Building,Regional Health,1871972794,Other ECP Providers,2805 5th St,,Rapid City,SD,57701-6003,Pennington,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Clayton Christensen,Director Ambulatory,605-755-3360,,cchristen3@regionalhealth.com,www.regionalhealth.com
SD-009932,Community Health Center of the Black Hills,Community Health Center of the Black Hills,1669508677,"Dental Providers, Federally Qualified Health Centers - Medical Services",350 Pine St,,Rapid City,SD,57701-1669,Pennington,350 Pine St,,Rapid City,SD,57701,Pennington,Tim Trithart,CEO,605-721-8813,,ttrithart@chcbh.org,Laura Jones,Financial Director,605-721-8939,,ljones@chcbh.org,www.chcbh.com
SD-009933,Regional Medical Clinic Aspen Centre,Regional Health,1821477746,"Family Planning Providers, Other ECP Providers",640 Flormann St,,Rapid City,SD,57701-4679,Pennington,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Mike McGrath,Director Ambulatory,605-755-5732,,MMcgrath@regionalhealth.com,www.regionalhealth.com
SD-012400,Redfield Clinic,Avera Health,1972575173,Rural Health Clinics,1010 W 1st St,,Redfield,SD,57469-1502,Spink,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009934,South Dakota Dept. of Health Spink County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,210 E 7th Ave,,Redfield,SD,57469-1283,Spink,210 E 7th Ave,,Redfield,SD,57469-1283,Spink,Amy Rothacker,Family Planning Coordinator,605-472-2434,,amy.rothacker@state.sd.us,,,,,,
SD-009935,Avera Medical Group Revillo,Avera Health,1588677892,Rural Health Clinics,305 N 2nd Ave,,Revillo,SD,57259,Grant,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009936,Horizon Health Care Inc.,Horizon Health Care Inc.,1861563348,Federally Qualified Health Centers - Medical Services,East Hwy 212 PO Box 300,Tiospaye Topa School,Ridgeview,SD,57652-0300,Dewey,109 N. Main Street,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,Wade Erickson,Chief Financial Officer,605-772-4525,903,werickson@horizonhealthcare.org,http://www.horizonhealthcare.org/our-locations/tiospaye-topa-school-clinic/
SD-009937,Rosebud Hospital,Rosebud Hospital,1194757369,"Indian Health Service, Other ECP Providers",400 Soldier Creek Rd,,Rosebud,SD,57570,Todd,PO Box 400,,Rosebud,SD,57570-0400,Todd,Shannon J. Hopkins,Deputy Chief Executive Officer,605-747-3237,,shannon.hopkins@ihs.gov,,,,,,
SD-012401,Avera Medical Group McGreevy Salem,Avera Health,1376575514,Rural Health Clinics,740 S Hill St,,Salem,SD,57058-8760,McCook,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-012402,Landmann Jungman Memorial Hospital,Avera Health,1720026222,Inpatient Hospitals (other than children's hospitals),600 Billars St,,Scotland,SD,57059-2026,Bon Homme,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-012403,Avera Medical Group Selby,Avera Health,1154346625,Rural Health Clinics,4401 Main St,,Selby,SD,57472-2010,Walworth,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009938,Sanford Health Midtown Clinic,Sanford Health Midtown Clinic,1942226147,Family Planning Providers,1205 S Grange Ave,Suite 301,Sioux Falls,SD,57105-0410,Minnehaha,1205 S Grange Ave Ste 301,,Sioux Falls,SD,57105-0410,Minnehaha,Sharon Nelson,Clinic Director,605-312-8350,,sharon.nelson@sanfordhealth.org,,,,,,http://www.sanfordhealth.org/Locations/1067481879
SD-009939,Sanford USD Medical Center,Sanford,1821017880,Inpatient Hospitals (other than children's hospitals),1305 W 18th St,,Sioux Falls,SD,57105-0401,Minnehaha,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009940,Avera McKennan Hospital & University Health Center,Avera Health,1568460772,Inpatient Hospitals (other than children's hospitals),1325 S Cliff Ave,,Sioux Falls,SD,57105-1007,Minnehaha,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009941,Sanford Children's Specialty Clinic (children's inpatient hospital),Sanford Health,1881610889,Children's Hospitals (inpatient only),1600 W 22nd St,,Sioux Falls,SD,57105-1521,Minnehaha,1600 W 22nd St,,Sioux Falls,SD,57117,Minnehaha,Kasey Gauthier,RN,605-312-1000,,kasey.gauthier@sanfordhealth.org,,,,,,
SD-009942,Sanford Children's Specialty Clinic (hemophilia treatment centers),Sanford Health,1881610889,Hemophilia Treatment Centers,1600 W 22nd St,,Sioux Falls,SD,57105-1521,Minnehaha,1600 W 22nd St,,Sioux Falls,SD,57117,Minnehaha,Kasey Gauthier,RN,605-312-1000,,kasey.gauthier@sanfordhealth.org,,,,,,
SD-009943,"Sioux Falls, City Of","SIOUX FALLS, CITY OF",1902130818,"Dental Providers, Federally Qualified Health Centers - Medical Services",1722 E 8th St,Terry Redlin Elementary School,Sioux Falls,SD,57103-1712,Minnehaha,521 N Main Ave,Ste 100,Sioux Falls,SD,57104,Minnehaha,Jill Franken,Public Health Director,605-367-8760,,jfranken@siouxfalls.org,Amy Richardson,Public Health Finance & Information Officer,605-367-8760,,arichardson@siouxfalls.org,http://siouxfalls.org/en/health/falls-community-health
SD-009944,"Sioux Falls, City Of","SIOUX FALLS, CITY OF",1508103243,"Dental Providers, Federally Qualified Health Centers - Medical Services",400 N Valley View Rd,Falls Community Health School Based Site/Hayward,Sioux Falls,SD,57107-1022,Minnehaha,521 N Main Ave,Ste 100,Sioux Falls,SD,57104-6407,Minnehaha,Jill Franken,Public Health Director,605-367-8760,,jfranken@siouxfalls.org,Amy Richardson,Public Health Finance & Information Officer,605-367-8760,,arichardson@siouxfalls.org,http://siouxfalls.org/en/health/falls-community-health
SD-012404,Avera Heart Hospital of South Dakota,Avera Health,1023003969,Inpatient Hospitals (other than children's hospitals),4500 W 69th St,,Sioux Falls,SD,57108-8148,Lincoln,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009945,Falls Community Health Center,Falls Community Health Center,1932295888,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",521 N Main Ave,Suite 100,Sioux Falls,SD,57104-5947,Minnehaha,521 N Main Ave,Ste 100,Sioux Falls,SD,57104-5948,Minnehaha,Jill Franken,Public Health Director,605-367-8760,,jfranken@siouxfalls.org,Amy Richardson,Public Health Finance & Information Officer,605-367-8760,,arichardson@siouxfalls.org,http://siouxfalls.org/en/health/falls-community-health
SD-009946,Falls Community Health/Hawthorne Site,"SIOUX FALLS, CITY OF",1609025907,"Dental Providers, Federally Qualified Health Centers - Medical Services",601 N Spring Ave,,Sioux Falls,SD,57104-2721,Minnehaha,521 N Main Ave,Ste 100,Sioux Falls,SD,57104-6407,Minnehaha,Jill Franken,Public Health Director,605-367-8760,,jfranken@siouxfalls.org,Amy Richardson,Public Health Finance & Information Officer,605-367-8760,,arichardson@siouxfalls.org,http://siouxfalls.org/en/health/falls-community-health
SD-009947,"Planned Parenthood Minnesota, North Dakota, South Dakota - Sioux Falls Clinic","Planned Parenthood Minnesota, North Dakota, South Dakota",1629057146,Family Planning Providers,6511 W 41st St,,Sioux Falls,SD,57106-1286,Minnehaha,671 Vandalia St,,Saint Paul,MN,55114-1312,Ramsey,Kurt Kaiser,CFO,651-389-2875,,kkaiser@ppmns.org,Kristi Besse,Director of Revenue Management,651-696-5651,,kbesse@ppmns.org,http://www.plannedparenthood.org/planned-parenthood-minnesota-north-dakota-south-dakota
SD-009948,Urban Indian Health,Urban Indian Health,1952473233,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",711 N Lake Ave,,Sioux Falls,SD,57104-2203,Minnehaha,711 N Lake Ave,,Sioux Falls,SD,57104-2203,Minnehaha,Edith Hoff,Family Planning Coordinator,605-339-0420,,edith.hoff@sduih.org,Donna Keeler,Executive Director,605-339-0420,,,https://www.sduih.org/
SD-009949,South Dakota Dept. of Health Roberts County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,10 E Hickory St,,Sisseton,SD,57262-1900,Roberts,10 E Hickory St,,Sisseton,SD,57262-1960,Roberts,Morgan Rinke,Family Planning Coordinator,605-698-4183,,morgan.rinke@state.sd.us,,,,,,
SD-009950,Sisseton/W.W. Keeble Memorial Health Care Center,Sisseton/W.W. Keeble Memorial Health Care Center,1366471666,"Dental Providers, Indian Health Service, Other ECP Providers",100 Lake Traverse Dr,,Sisseton,SD,57262-7046,Roberts,100 LAKE TRAVERSE DRIVE,,Sisseton,SD,57262-7046,Roberts,Myles Jones,Chief Executive Officer,605-698-7606,,Myles.Jones@ihs.gov,Joshua A. Donnell,Business Office Manager,605-698-7606,,Joshua.Donnell@ihs.gov,
SD-009951,Coteau des Prairies Clinics,Coteau des Prairies Health Care System,1659410009,Rural Health Clinics,205 Orchard Dr,,Sisseton,SD,57262-2312,Roberts,205 Orchard Sr,,Sisseton,SD,57262,Roberts,Greg Weaver,COO,605-698-4653,,gregw@cdphospital.com,,,,,,
SD-009952,Sisseton Wahpeton Oyate,Dakota Pride Center,1508900507,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",388 Dakota Ave,,Sisseton,SD,57262-3327,Roberts,Sisseton Wahpeton Oyate,,Sisseton,SD,57262,Roberts,Richard F. Bird,Treatment Program Director,605-698-3917,106,RichardB@SWO-NSN.GOV,,,,,,
SD-009953,Queen City Regional Medical Clinic,Regional Health,1578942496,"Family Planning Providers, Other ECP Providers",1420 N 10th St,,Spearfish,SD,57783-1532,Lawrence,353 Fairmont Blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Lana Grout,Director Ambulatory,605-717-8507,,LGrout@regionalhealth.com,www.regionalhealth.com
SD-009954,Spearfish Regional Medical Center,Regional Health,1902285828,"Family Planning Providers, Other ECP Providers",1445 North Ave,,Spearfish,SD,57783-1552,Lawrence,353 Fairmont blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,Clinical Integration Coordinator,605-755-9052,,sschrempp@regionalhealth.com,Angie Leonard,Director Ambulator,605-644-4176,,ALeonard@regionalhealth.com,www.regionalhealth.com
SD-009955,Family Health Education Services,Regional Health Physicians d/b/a Family Health Education Services,1629445390,Family Planning Providers,930 N 10th St,,Spearfish,SD,57783-2202,Lawrence,930 N 10th St,,Spearfish,SD,57783-2202,Lawrence,Elizabeth Moll,Family Planning Coordinator,605-642-6337,,elizabeth.moll@state.sd.us,,,,,,
SD-009956,Massa Berry Regional Medical Clinic,Regional Health,1881073005,"Family Planning Providers, Other ECP Providers",890 Lazelle St,,Sturgis,SD,57785-1611,Meade,353 Fairmont blvd,,Rapid City,SD,57701,Pennington,Serra Schrempp,clinical integration coordinator,605-755-9052,,sschrempp@regionalhealth.com,Kim Jackson,Director Ambulatory,605-720-2635,,KJackson@regionalhealth.com,www.regionalhealth.com
SD-009957,South Dakota Dept. of Health Dewey County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,700 C St,,Timber Lake,SD,57656,Dewey,700 C St,,Timber Lake,SD,57656,Dewey,Mary Harris,Family Planning Coordinator,605-865-3587,,mary.harris@state.sd.us,,,,,,
SD-009958,Avera St. Benedict CRHC Tripp,Avera Health,1740355635,Rural Health Clinics,306 S Main St,,Tripp,SD,57376,Hutchinson,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009959,South Dakota Dept. of Health Bon Homme Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,103 W 18th Ave,,Tyndall,SD,57066,Bon Homme,103 W 18th Ave,,Tyndall,SD,57066,Bon Homme,Paula Gibson,Family Planning Coordinator,605-589-4318,,paula.gibson@state.sd.us,,,,,,
SD-012405,St. Michaels Hospital,Avera Health,1730123522,Inpatient Hospitals (other than children's hospitals),410 W 16th Ave,,Tyndall,SD,57066-2318,Bon Homme,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009960,Vermillion Family Planning Sanford Clinic,South Dakota Dept. of Health Family Planning Program,1376857664,Family Planning Providers,15 S Plum St,,Vermillion,SD,57069-3345,Clay,15 S Plum St,,Vermillion,SD,57069-3345,Clay,Rachel Svartoien,Clinic Director,605-638-8681,,joan.beach@sanfordhealth.org,,,,,,
SD-009961,Sanford Vermillion Hospital,Sanford,1790721280,Inpatient Hospitals (other than children's hospitals),20 S Plum St,,Vermillion,SD,57069-3346,Clay,1805 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009962,Viborg Medical Clinic,Pioneer Memorial Hospital & Health Services,1619926706,Rural Health Clinics,103 W Pioneer,PO Box 337,Viborg,SD,57070-0337,Turner,PO Box 368,,Viborg,SD,57070-0368,Turner,Grace Tidball,Director of Ambulatory Operations,605-326-3045,,grace.tidball@sanfordhealth.org,Anne Christiansen,CFO,605-326-3004,,anne.christiansen@sanfordhealth.org,
SD-009963,Wagner Healthcare Facility,Wagner IHS,1881847028,"Dental Providers, Indian Health Service, Other ECP Providers",111 Washington Ave NW,,Wagner,SD,57380-4300,Charles Mix,111 Washington Ave NW,,Wagner,SD,57380,Charles Mix,Michelle Olson,Physician Assistant,605-384-3621,264,michelle.powers@ihs.gov,Craig Noteboom,Diabetes Coordinator,605-384-3621,,craig.noteboom@ihs.gov,
SD-009964,South Dakota Dept. of Health Charles Mix Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,118B S Main Ave,,Wagner,SD,57380-2000,Charles Mix,118B Main Ave SE,,Wagner,SD,57380,Charles Mix,Kelly Cimpl,Family Planning Coordinator,605-384-3487,,kelly.cimpl@state.sd.us,,,,,,
SD-012406,Wagner Community Memorial Hospital Avera,Avera Health,1326030974,Inpatient Hospitals (other than children's hospitals),513 3rd St SW,,Wagner,SD,57380-9675,Charles Mix,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009965,Wanblee Health Center,Wanblee Health Center,1962559518,"Dental Providers, Family Planning Providers, Indian Health Service, Rural Health Clinics",210 1st St,,Wanblee,SD,57577,Jackson,210 1st St,,Wanblee,SD,57577-0290,Jackson,Dr. Sarah Jumping Eagle,Acting Chief Executive Officer,605-867-3021,,sarah.eagle@ihs.gov,Jon Schuchardt,Acting Deputy CEO,605-867-3040,,jon.schuchardt@ihs.gov,
SD-009966,Watertown Family Planning Sanford Clinic,South Dakota Dept. of Health Family Planning Program,1922123108,Family Planning Providers,703 S Broadway,,Watertown,SD,57201-4752,Codington,703 S Broadway,,Watertown,SD,57201-4752,Codington,Mary Drevecky,Clinic Director,605-882-1852,,mary.drevecky@state.sd.us,,,,,,
SD-009967,Avera Medical Group Waubay,Avera Health,1427003946,Rural Health Clinics,80 N Main St,,Waubay,SD,57273-1901,Day,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009968,Sanford Clinic Webster,Sanford Health,1770505760,Rural Health Clinics,101 Peabody Dr,,Webster,SD,57274-1061,Day,1305 W 18th Street,,Sioux Falls,SD,57105-0401,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009969,Sanford Hospital Webster,Sanford,1831103449,Inpatient Hospitals (other than children's hospitals),1401 W 1st St,,Webster,SD,57274-1054,Day,1305 W 18th St,,Sioux Falls,SD,57105,Minnehaha,Torrey Sundall,Sr Director Corporate Contracting and Payor Analytics,605-312-7099,,torrey.sundall@sanfordhealth.org,,,,,,www.sanfordhealth.org
SD-009970,Jerauld County Community Health Center,"Horizon Health Care, Inc.",1831207844,Federally Qualified Health Centers - Medical Services,602 1st St NE,Suite 1,Wessington Springs,SD,57382-2163,Jerauld,109 N. Main Street,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,Wade Erickson,Chief Financial Officer,605-772-4525,903,werickson@horizonhealthcare.org,
SD-009971,Jerauld County Dental Clinic,"Horizon Health Care, Inc.",1275858979,Dental Providers,602 1st St NE,Suite 2,Wessington Springs,SD,57382-2163,Jerauld,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-012407,Avera Weskota Memorial Medical Center,Avera Health,1316942204,Inpatient Hospitals (other than children's hospitals),604 1st St NE,,Wessington Springs,SD,57382-2166,Jerauld,3900 W Avera Drive,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,Teri Bergeleen,Director of Provider Contracting and ACO Operations,605-322-4576,,teri.bergeleen@avera.org,
SD-009972,South Dakota Dept. of Health Jerauld County Community Health Services,South Dakota Dept. of Health Family Planning Program,1740204221,Family Planning Providers,606 1st St NE,,Wessington Springs,SD,57382,Jerauld,602 1st St NE,,Wessington Springs,SD,57382,Jerauld,Marla Feistner,Family Planning Coordinator,605-539-1271,,marla.feister@state.sd.us,,,,,,
SD-009973,Mellette County Community Health Center,"Horizon Health Care, Inc.",1962511014,Federally Qualified Health Centers - Medical Services,309 East 4th St,PO Box 281,White River,SD,57579-0281,Mellette,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009974,Avera Medical Group Wilmot,Avera Health,1770680787,Rural Health Clinics,409 4th St,,Wilmot,SD,57279-2214,Roberts,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009975,Tripp County Public Health Services,South Dakota Dept. of Health Family Planning Program,1780910679,Family Planning Providers,245 S Main St,,Winner,SD,57580-1746,Tripp,245 S Main St,,Winner,SD,57580-1746,Tripp,Allissa Hoffman,Family Planning Coordinator,605-842-7166,,allissa.hoffman@state.sd.us,,,,,,http://winnerregional.org/
SD-009976,Avera Medical Group Winner,Avera Health,1912959495,Rural Health Clinics,660 W 2nd St,,Winner,SD,57580-1218,Tripp,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
SD-009977,Woonsocket Community Health Center,"Horizon Health Care, Inc.",1033227053,Federally Qualified Health Centers - Medical Services,302 S Dumont Ave,PO Box 368,Woonsocket,SD,57385-0368,Sanborn,109 N Main,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Cheif operations Officer,605-772-4525,942,ckonechne@horizonhealthcare.org,John Mengenhausen,Cheif Executive Officer,605-772-4525,900,jmengenhausen@horizonhealthcare.org,
SD-009978,Yankton Community Health Center,HORIZON HEALTH CARE INC,1013445907,Federally Qualified Health Centers - Medical Services,409 Summit St,Suite 3400,Yankton,SD,57078-3735,Yankton,109 N Main St,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009979,Yankton Dental Clinic,Horizon Health Care,1285163972,Dental Providers,409 Summit St,Suite 3400,Yankton,SD,57078-3735,Yankton,109 N Main St,PO Box 99,Howard,SD,57349,Miner,Christina Konechne,Chief Operations Officer,605-772-4525,,ckonechne@horizonhealthcare.org,John Mengenhausen,Chief Executive officer,605-772-4525,,jmengenhausen@horizonhealthcare.org,
SD-009980,Avera Sacred Heart Hospital,Avera Health,1770693954,Inpatient Hospitals (other than children's hospitals),501 Summit St,,Yankton,SD,57078-3855,Yankton,3900 W Avera Dr,,Sioux Falls,SD,57108,Lincoln,Teri Bergeleen,Provider Contracting Manager,605-322-4576,,teri.bergeleen@avera.org,,,,,,avera.org
TN-009981,"Aristorenas Health Clinic, LLC","Aristorenas Health Clinic, LLC",1477955078,Rural Health Clinics,135 W Main St,,Adamsville,TN,38310-2203,McNairy,135 West Main Street,,Adamsville,TN,38310,McNairy,Wanda Aristorenas,Owner,731-632-3373,,aristofnp@gmail.com,,,,,,
TN-009982,LIfespan Adamsville,Hardin County Regional Health Center dba LIfespan Health,1508292319,Federally Qualified Health Centers - Medical Services,335 US Highway 64,,Adamsville,TN,38310-4078,Hardin,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,731-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-009983,CROCKETT COUNTY HEALTH DEPT.,Tennessee Department of Health,1134264450,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",209 N Bells St,,Alamo,TN,38001-1755,Crockett,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,38243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-009984,"Crockett Medical Clinic, Inc","Crockett Medical Clinic, Inc",1104839703,Rural Health Clinics,58 S Bells St,,Alamo,TN,38001-1700,Crockett,58 South Bells Street,,Alamo,TN,38001,Crockett,Robbie Taylor,Administrator,731-696-5401,,rtaylor@harberlaman.com,,,731-617-0410,,,
TN-009985,CHS Alcoa Good Samaritan Clinic,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",255 E Watt St,,Alcoa,TN,37701-2236,Blount,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-009986,Cheatham County Health Dept,Tennessee Department of Health,1881746782,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",162 County Services Dr,Suite 200,Ashland City,TN,37015-1748,Cheatham,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-009987,Family Health Center of Ashland City PLLC,Family Health Center of Ashland City PLLC,1881939965,Rural Health Clinics,342 Frey St,,Ashland City,TN,37015-1734,Cheatham,342 Frey St,,Ashland City,TN,37015-1734,Cheatham,Kathryn V. Brown,Administrator,615-792-1199,,kbrown@fhcac.com,Jill Thompson,Accounts Manager,615-792-1199,,jthompson@fhcac.com,www.fhcac.com
TN-009988,Athens Pediatrics PLLC,Athens Pediatrics PLLC,1437397809,Rural Health Clinics,111 Epperson St,,Athens,TN,37303-3478,McMinn,111 Epperson Street,,Athens,TN,37303,McMinn,Cindy Ackaouy,Office Manager,423-745-6053,,apeds@aol.com,,,,,,
TN-009989,Starr Regional Medical Center Athens,LifePoint Health,1669567319,Inpatient Hospitals (other than children's hospitals),1114 W Madison Ave,,Athens,TN,37303-4150,McMinn,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,David Alley,CFO,423-744-3202,,,
TN-009990,Womens Center of East Tennessee,Womens Center of East Tennessee,1134324510,Rural Health Clinics,135 N Meadows Dr,Suite B,Athens,TN,37303-4172,McMinn,"135 N Meadows Drive, Suite B",,Athens,TN,373030769,McMinn,Debbie Coleman,Practice Manager,423-507-8067,,tuscany4deb@yahoo.com,,,,,,
TN-009991,Covenant Pediatrics,Covenant Pediatrics,1659670412,Rural Health Clinics,421 Old Riceville Rd,Suite 2,Athens,TN,37303-3074,McMinn,421 Old Riceville Road,,Athens,TN,37303,McMinn,Brittany Carroll,Office Manager,423-744-8755,,brittney1977@covpeds.com,,,,,,
TN-009992,Athens Family Practice,"Athens Physicians Practice, LLC",1629097738,Rural Health Clinics,711 Cook Dr,Suite 100,Athens,TN,37303-3499,McMinn,711 Cook Drive,Suite 100,Athens,TN,37303-3400,McMinn,Vicki Smith,Director,931-403-1197,,vicki.smith@lpnt.net,Steven Schroeder,Senior Director,615-305-0661,,steven.schroeder@lpnt.net,
TN-009993,"Athens Women's Clinic, PC",Athens Women's Clinic PC,1760609218,Rural Health Clinics,817 Cook Dr,,Athens,TN,37303-3485,McMinn,817 Cook Drive,,Athens,TN,37303,McMinn,Cynthia Smith,Practice Administrator,423-745-3394,4237453394,athenswomenclinic@comcast.net,,,,,,
TN-009994,BEAN STATION HEALTH CENTER,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1285 Highway 11W,,Bean Station,TN,37708-5810,Grainger,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-009995,Liberty Medical Clinic PC,Liberty Medical Clinic,1790812956,Rural Health Clinics,4937 College St,,Bells,TN,38006-3483,Crockett,4937 College Street,,Bells,TN,38006,Crockett,Chizoba Nnaji,Official,731-663-3530,,Lmcpc@bellsouth.net,Lisa Oglesby,Office Manager,731-663-3530,,Libertymedical@ymail.com,
TN-009996,Benton Family Health Care Center,Ocoee Regional Health Corporation,1619181484,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",6784 Highway 411,,Benton,TN,37307-4818,Polk,PO Box 308,,Benton,TN,37307,Polk,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-009997,BLAINE HEALTH CENTER,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",880 Rutledge Pike,,Blaine,TN,37709-2317,Grainger,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-009998,Bluff City Medical Center,Rural Health Services Consortium Inc.,1972503753,Federally Qualified Health Centers - Medical Services,229 Highway 19 E,,Bluff City,TN,37618-1865,Sullivan,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-009999,HARDEMAN COUNTY HEALTH DEPT.,Tennessee Department of Health,1841340007,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",10825 Old Highway 64,,Bolivar,TN,38008-3599,Hardeman,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010000,Christian Family Medicine of Bolivar,Christian Family Medicine,1043252620,Rural Health Clinics,610 Nuckolls Rd,,Bolivar,TN,38008-1532,Hardeman,610 Nuckolls Road,,Bolivar,TN,38008,Hardeman,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,,,,,,
TN-010001,HARDEMAN COUNTY COMMUNITY HEALTH CENTER,HARDEMAN COUNTY COMMUNITY HEALTH CENTER,1861468340,Federally Qualified Health Centers - Medical Services,629 Nuckolls Rd,,Bolivar,TN,38008-1599,Hardeman,629 Nuckolls Rd,,Bolivar,TN,38008-1599,Hardeman,Linda Lovelace,CFO,731-658-3388,21,linda.lovelace@hardemanhealth.org,Mary Heinzen,CEO,731-658-3388,147,MARY.HEINZEN@HARDEMANHEALTH.ORG,
TN-010002,Bolivar General Hospital,Bolivar General Hospital,1518957950,Inpatient Hospitals (other than children's hospitals),650 Nuckolls Rd,,Bolivar,TN,38008-1532,Hardeman,650 Nuckolls Road,,Bolivar,TN,38008,Madison,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010003,Atoka Idaville Family Health,Samw,1437334216,Rural Health Clinics,5847 Atoka Idaville Rd,,Brighton,TN,38011-7066,Tipton,5847 Atoka Idaville Rd,,Brighton,TN,38011,Tipton,Robyn Yvette Vanderford,Nurse Practitioner,901-837-0701,,atokaidavilelfamilyhealth@outlook.com,Michelle Newman,,901-837-0701,,atokaidavillefamilyhealth@outlook.com,
TN-010004,Brownsville Family Medicine,Brownsville Family Medicine,1689640724,Rural Health Clinics,2290 N Washington Ave,,Brownsville,TN,38012-1607,Haywood,2290 N Washington Ave,,Brownsville,TN,38012,Haywood,Debra Jackson,Office Manager,731-772-5183,11,djacksonbfm@gmail.com,,,,,,
TN-010005,HAYWOOD COUNTY HEALTH DEPT.,Tennessee Department of Health,1821148073,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",950 E Main St,,Brownsville,TN,38012-2647,Haywood,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010006,BULLS GAP MEDICAL CENTER,Rural Health Services Consortium Inc.,1770583544,Federally Qualified Health Centers - Medical Services,260 Highway 11 E,PO 99,Bulls Gap,TN,37711-3416,Hawkins,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010007,Pickett County Health Department,State of Tennessee Department of Health,1730230558,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1013 Woodlawn Dr,,Byrdstown,TN,38549-2317,Pickett,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010008,CAMDEN GENERAL HOSPITAL,Camden General Hospital,1659347920,Inpatient Hospitals (other than children's hospitals),175 Hospital Dr,,Camden,TN,38320-1617,Benton,175 Hospital Dr,,Camden,TN,38320,Benton,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010009,Benton County Health Dept,Tennessee Department of Health,1730240441,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",225 Hospital Dr,,Camden,TN,38320-1619,Benton,710 James Robertson Pkwy,,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010010,Family Health Care of Camden,Family Health Care of Camden,1164538195,Rural Health Clinics,350 Hospital Dr,,Camden,TN,38320-1650,Benton,350 Hospital Drive,,Camden,TN,38320,Benton,Steven Cannady,Owner,731-584-3330,,stevencannady@gmail.com,,,,,,
TN-010011,Smith County Health Department,State of Tennessee Department of Health,1619028446,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",251 Joy Alford Way,,Carthage,TN,37030-3047,Smith,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010012,Clay County Health Department,State of Tennessee Department of Health,1316098338,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 Guffey St,,Celina,TN,38551-4089,Clay,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010013,SOUTHSIDE COMM HEALTH CTR,CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY,1962597179,Federally Qualified Health Centers - Medical Services,100 E 37th St,,Chattanooga,TN,37410-1401,Hamilton,100 E 37th St,,Chattanooga,TN,37410-1401,Hamilton,Joseph Winick,Interim Executive Director,423-778-2700,,joseph.winick@erlanger.org,,,,,,
TN-010014,Chattanooga Primary Care Clinic,Chattanooga CARES1,1124021340,"Ryan White Providers, Sexually Transmitted Disease Clinics",1000 E 3rd St,Suite 300,Chattanooga,TN,37403-2153,Hamilton,PO BOX 4497,,Chattanooga,TN,37405,Hamilton,Shannon Stephenson,Chief Executive Officer,423-648-9911,,shannons@chattanoogacares.org,,,,,,www.chattanoogacares.org
TN-010016,DODSON AVENUE COMM HEALTH CENTER,CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY,1609961549,"Dental Providers, Federally Qualified Health Centers - Medical Services",1200 Dodson Ave,,Chattanooga,TN,37406-3214,Hamilton,1200 Dodson Ave,,Chattanooga,TN,37406-3214,Hamilton,Joseph Winick,Interim Executive Director,423-778-2800,,joseph.winick@erlanger.org,,,,,,
TN-010015,Cherokee Health Systems - Chattanooga,CHEROKEE HEALTH SYSTEMS,1932586203,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5600 Brainerd Rd,Suite A4,Chattanooga,TN,37411-5336,Hamilton,2018 Western Ave,,Knoxville,TN,37921,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffery Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010017,Infectious Disease Physicians of Chattanooga,Infectious Disease Physicians of Chattanooga,1750504361,Other ECP Providers,725 Glenwood Dr,Suite 486,Chattanooga,TN,37404-1173,Hamilton,725 Glenwood Drive Suite 486,,Chattanooga,TN,37404,Hamilton,Tania Mull,Medical Case Manager,423-653-1972,,tmidpc@epbinternet.com,,,,,,
TN-010018,Homeless Health Care Center,"HAMILTON, COUNTY OF",1215350194,"Dental Providers, Federally Qualified Health Centers - Medical Services",730 E 11th St,,Chattanooga,TN,37403-3103,Hamilton,921 E 3rd St,,Chattanooga,TN,37403-2102,Hamilton,Karen C Guinn,Executive Director,423-209-8232,,kareng@hamiltontn.gov,,,,,,
TN-010019,Children's Hospital at Erlanger,Children's Hospital at Erlanger,1639264575,Children's Hospitals (inpatient only),910 Blackford St,,Chattanooga,TN,37403-1405,Hamilton,910 Blackford St,,Chattanooga,TN,37403,Hamilton,Don Mueller,CEO,423-778-6011,,don.mueller@erlanger.org,,,,,,
TN-010020,ERLANGER MEDICAL CENTER (inpatient hospital),Erlanger Medical Center,1639264575,Inpatient Hospitals (other than children's hospitals),975 E 3rd St,,Chattanooga,TN,37403-2147,Hamilton,975 E 3rd St,,Chattanooga,TN,37403,Hamilton,Kevin Spiegel,CEO,423-778-7000,,kevin.spiegel@erlanger.org,,,,,,
TN-010021,ERLANGER MEDICAL CENTER (ryan white providers),Erlanger Medical Center,1639264575,Ryan White Providers,975 E 3rd St,,Chattanooga,TN,37403-2147,Hamilton,975 E 3rd St,,Chattanooga,TN,37403,Hamilton,Kevin Spiegel,CEO,423-778-7000,,kevin.spiegel@erlanger.org,,,,,,
TN-010022,Hawkins County Health Dept,Tennessee Department of Health,1881749794,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",247 Silver Lake Rd,,Church Hill,TN,37642-3516,Hawkins,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA2,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010023,CLEAR FORK CLINIC,"DAYSPRING FAMILY HEALTH CENTER, INC.",1013049469,Federally Qualified Health Centers - Medical Services,5663 Highway 90,,Clairfield,TN,37715-3632,Claiborne,107 S Main St,,Jellico,TN,37762-2154,Campbell,Angelia Washam,HR/Credentialing Director,423-784-5771,146,angiew@dayspringfhc.com,Patsy Prater,AR Manager,423-784-8492,208,patp@dayspringfhc.com,dayspringfhc.com
TN-010024,Matthew Walker Comprehensive Health Center- Clarksville,Matthew Walker Comprehensive Health Center,1104008747,"Dental Providers, Federally Qualified Health Centers - Medical Services",230 Dover Rd,,Clarksville,TN,37042-4183,Montgomery,230 Dover Rd,,Clarksville,TN,37042,Montgomery,Katina Beard,CEO,615-340-1292,,kbeard@mwchc.org,"Ida M. Williams, M. D.",CMO / Medical Director,615-324-9669,,michele.williams@mwchc.org,www.mwchc.org
TN-010025,Montgomery County Health Dept,Tennessee Department of Health,1194878629,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",330 Pageant Ln,,Clarksville,TN,37040-3854,Montgomery,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010026,Cleveland Family Health Center,Ocoee Regional Health Corporation,1245442169,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1420 Fritz St SE,,Cleveland,TN,37323-6009,Bradley,PO Box 308,,Benton,TN,37307,Polk,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-010027,LIFESPAN CLIFTON,HARDIN COUNTY REGIONAL HEALTH CENTER,1063660595,Federally Qualified Health Centers - Medical Services,207 Main St,,Clifton,TN,38425-5547,Wayne,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,931-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010028,CHS Anderson County,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1107 N Charles G Seivers Blvd,Suite 101,Clinton,TN,37716-3944,Anderson,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010029,Anderson County Health Dept,Tennessee Department of Health,1427102177,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",710 N Main St,,Clinton,TN,37716-3143,Anderson,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010030,Grundy County Primary Care Center,Ocoee Regional Health Corporation,1902010770,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",10120 SR 56,,Coalmont,TN,37313-2505,Grundy,PO Box 308,,Benton,TN,37307,Grundy,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-010031,Upper Cumberland Regional Health Clinic,State of Tennessee Department of Health,1598817017,"Ryan White Providers, Tuberculosis Clinics",1100 England Dr,,Cookeville,TN,38501-0924,Putnam,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010032,Putnam County Health Department,State of Tennessee Department of Health,1649321464,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",701 County Services Dr,,Cookeville,TN,38501-4338,Putnam,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010033,"Armour Family Medicine, PLLC","Armour Family Medicine, PLLC",1205163417,Rural Health Clinics,4501 Mueller Brass Rd,,Covington,TN,38019-3749,Tipton,4501 Mueller Brass Road,,Covington,TN,38019,Tipton,Brenda Huggins,Administrator,901-476-7779,,bhuggins@armourfamilymedicine.com,,,,,,
TN-010034,TIPTON COUNTY HEALTH DEPT.,Tennessee Department of Health,1518017771,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4700 Mueller Brass Rd,,Covington,TN,38019-3754,Tipton,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010035,Family First Medical Center,Christian Family Medicine,1043252620,Rural Health Clinics,899 Highway 51 S,,Covington,TN,38019-2568,Tipton,899 Hwy 51 South,,Covington,TN,38019,Tipton,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,RUSTE VIA,,731-343-2730,,RUSTE@CHRISTIANFAMILYMED.COM,
TN-010036,Cumberland County Health Department,State of Tennessee Department of Health,1487705414,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1503 S Main St,,Crossville,TN,38555-5967,Cumberland,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010037,PLATEAU PEDIATRICS PLC,Plateau Pediatrics,1043285729,Rural Health Clinics,3234 Miller Ave,,Crossville,TN,38555-6116,Cumberland,3234 Miller Avenue,,Crossville,TN,38555,Cumberland,Suzanne Berman,managing partner,931-707-8700,7224,sberman@plateaupediatrics.com,,,,,,http://www.plateaupediatrics.com
TN-010038,FAMILY CARE CLINIC,"JTP Enterprises, LLC",1972852341,Rural Health Clinics,42 Dooley St,,Crossville,TN,38555-4055,Cumberland,42 Dooley St,,Crossville,TN,38555,Cumberland,Tammi Pernell,CFO,931-337-1035,,fwic.tammi@gmail.com,,,,,,
TN-010039,Cumberland Medical Center,Cumberland Medical Center,1871596403,Inpatient Hospitals (other than children's hospitals),421 S Main St,,Crossville,TN,38555-5048,Cumberland,P.O. Box 22790,,Knoxville,TN,37933-0790,Knox,Nancy Beck,Director of Financial Compliance,865-374-6864,,nbeck@covhlth.com,Saralyn Banks,Reimbursment Manager,865-374-3013,,sbanks2@covhlth.com,https://www.cmchealthcare.org
TN-010040,"Rural Medical Services, Inc. Chestnut Hill Center","RURAL MEDICAL SERVICES, INC.",1871535583,Federally Qualified Health Centers - Medical Services,3222 Chestnut Hill School Rd,,Dandridge,TN,37725-7238,Jefferson,PO Box 577,,Newport,TN,37822,Cocke,Larry Stanifer,CEO,423-613-3300,402,lstanifer@rmstn.org,,,,,,
TN-010041,Jefferson County Health Dept,Tennessee Department of Health,1265570170,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",931 Industrial Park Rd,Suite 200,Dandridge,TN,37725-4701,Jefferson,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010042,Rhea County Primary Care Center,Ocoee Regional Health Corporation,1356553267,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",8850 Rhea County Hwy,,Dayton,TN,37321-7932,Rhea,PO Box 308,,Benton,TN,37307,Polk,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-010043,Meigs County Primary Care Center,Ocoee Regional Health Corporation,1760694665,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",305 River Rd,,Decatur,TN,37322-7801,Meigs,PO Box 308,,Benton,TN,37307,Polk,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-010044,DECATUR COUNTY HEALTH DEPT.,Tennessee Department of Health,1184774341,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",155 N Pleasant St,,Decaturville,TN,38329-4084,Decatur,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010045,Kimberly Ray PLLC,Ray Medical,1659444925,Federally Qualified Health Centers - Medical Services,2409 Highway 70 E,,Dickson,TN,37055-6126,Dickson,2409 Hwy 70 East,,Dickson,TN,37055,Dickson,Kimberly Ray,"PhD, owner",615-740-7322,,Raymedical@bellsouth.net,,,,,,
TN-010046,Dickson County Health Dept,Tennessee Department of Health,1023160934,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 W End Ave,,Dickson,TN,37055-1725,Dickson,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010047,Stewart County Health Dept/PC,Tennessee Department of Health,1083767883,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1021 Spring St,,Dover,TN,37058-3302,Stewart,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010048,Reelfoot Family Walk In Clinic,"Dyersburg Family Walk In Clinic, Inc",1174712780,Rural Health Clinics,8633 Highway 22,,Dresden,TN,38225-2309,Weakley,708 E Court St,,Dyersburg,TN,38024,Dyer,Jason Cantu,COO,731-285-8247,300,jason@rfwic.com,J.D. CANTU,Director of Community Relations,731-285-8247,413,JASON@RFWIC.COM,
TN-010049,WEAKLEY COUNTY HEALTH DEPT.,Tennessee Department of Health,1164572327,Family Planning Providers,9852 Highway 22,,Dresden,TN,38225-1804,Weakley,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010050,"Care Rite, PLLC","Care Rite, PLLC",1477827418,Other ECP Providers,1445 US Highway 51 Byp E,,Dyersburg,TN,38024-2127,Dyer,1445 Highway 51 Bypass East,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010051,"MEDSOUTH MEDICAL CENTER, DYERSBURG","West Tennessee Medical Group, Inc",1750688479,Rural Health Clinics,1700 Woodlawn Ave,,Dyersburg,TN,38024-2028,Dyer,620 Skyline,,Jackson,TN,38301,Madison,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010052,DYER COUNTY HEALTH DEPT.,Tennessee Department of Health,1093865263,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1755 Parr Ave,,Dyersburg,TN,38024-2004,Dyer,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010053,Reelfoot Family Walk In Clinic,Reelfoot Family Walk in Clinic,1174712780,"Family Planning Providers, Rural Health Clinics",1954 Saint John Ave,Suite 1,Dyersburg,TN,38024-2034,Dyer,1954 St. John Ave,,Dyersburg,TN,38024,Dyer,Jason Cantu,COO,731-285-6110,120,jason@rfwic.com,Tammy Burns,Director of Community Relations,731-285-6110,112,tammyb@rfwic.com,
TN-010054,Carter County Health Department,Tennessee Department of Health,1801941687,"Community Mental Health Centers, Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",403 E G St,,Elizabethton,TN,37643-3223,Carter,Tennessee Department of Health,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010055,Cherokee Health Systems - Englewood,CHEROKEE HEALTH SYSTEMS,1386878403,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3360 Highway 411 N,,Englewood,TN,37329-5276,McMinn,2018 Western Ave,,Knoxville,TN,37921,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010056,Houston County Community Hospital,Houston County Community Hospital,1851642540,Inpatient Hospitals (other than children's hospitals),5001 E Main St,,Erin,TN,37061-4115,Houston,PO Box 489,,Erin,TN,37061,Houston,Kim Pridgen,CFO,615-384-1515,,kim_pridgen@northcrest.com,Mark Kimball,Administrator,910-440-9134,,Mark_Kimball@northcrest.com,
TN-010057,Houston County Health Dept,Tennessee Department of Health,1033262530,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",60 Court Sq,,Erin,TN,37061-4166,Houston,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010058,Dry Creek Medical Center,Rural Health Services Consortium Inc.,1396745162,Federally Qualified Health Centers - Medical Services,1826 N Main Ave,,Erwin,TN,37650-8932,Unicoi,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010059,Starr Regional Medical Center - Etowah,LifePoint Health,1669567319,Inpatient Hospitals (other than children's hospitals),886 Highway 411 N,,Etowah,TN,37331-1912,McMinn,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,David Alley,CFO,423-744-3202,,,
TN-010060,Williamson County Health Dept-Fairview,Tennessee Department of Health,1386797058,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2629 Fairview Blvd,,Fairview,TN,37062-9084,Williamson,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010061,Mercy Community Healthcare,"MERCY HEALTH SERVICES, INC.",1952480501,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",1113 Murfreesboro Rd,Suite 202,Franklin,TN,37064-1318,Williamson,1113 Murfreesboro Rd,Suite 202,Franklin,TN,37064-1318,Williamson,Margaret Owens,Interim CEO,615-790-0567,229,margareto@mercytn.org,Rhonda Sizemore,Chief Financial Officer,615-790-0567,212,rhondas@mercytn.org,www.mercycommunityhealthcare.org
TN-010062,Vanderbilt Rheumatology Cool Springs,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,2001 Mallory Ln,Suite 100,Franklin,TN,37067-8234,Williamson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010063,Vanderbilt Bone & Joint,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,225 Bedford Way,,Franklin,TN,37064-5527,Williamson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Associate VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010064,Vanderbilt Health Breast Center,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,324 Cool Springs Blvd,Suite B,Franklin,TN,37067-1631,Williamson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Associate Vice President,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010065,Vanderbilt-Ingram Cancer Center Cool Springs,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,324 Cool Springs Blvd,,Franklin,TN,37067-1631,Williamson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010066,"Moore Medical Clinic, LLC","Moore Medical Clinic, LLC",1801250667,Rural Health Clinics,600 Main St,,Friendship,TN,38034-1999,Crockett,600 Main Street,,Friendship,TN,38034,Crockett,Phyllis Park Moore,Owner,731-677-4300,,mooremedicalclinic@gmail.com,,,,,,
TN-010067,Jackson County Health Department,State of Tennessee Department of Health,1316098247,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",600 N Murray St,,Gainesboro,TN,38562-9313,Jackson,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010068,Sumner County Health Dept,Tennessee Department of Health,1295888006,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1005 Union School Rd,,Gallatin,TN,37066-2084,Sumner,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010069,Sumner Regional Medical Center,LifePoint Health,1447571658,Inpatient Hospitals (other than children's hospitals),555 Hartsville Pike,,Gallatin,TN,37066-2400,Sumner,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Manged Care,615-920-7361,,Walter.Franz@LPNT.net,Bob Barrett,CFO,615-328-6897,,,
TN-010070,Takoma Regional Hospital,Adventist Health System/Sunbelt Inc.,1699819003,Inpatient Hospitals (other than children's hospitals),401 Takoma Ave,,Greeneville,TN,37743-4647,Greene,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,David Strosnider,Director Managed Care,828-684-8501,,David.Strosnider@ahss.org,,,,,,
TN-010071,Baileyton Medical Center,"Rural Health Services Consortium, Inc.",1629078498,Federally Qualified Health Centers - Medical Services,580 Van Hill Rd,,Greeneville,TN,37745-7608,Greene,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,buckl@rhsctn.com,Linda W. Buck,CEO,423-921-1817,,buckl@rhsctn.com,
TN-010072,Greene County Health Dept,Tennessee Department of Health,1851444830,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",810 W Church St,,Greeneville,TN,37745-3285,Greene,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010073,"Care Rite, PLLC","Care Rite, PLLC",1477827418,Other ECP Providers,104 E Main St,,Halls,TN,38040-1523,Lauderdale,1445 Highway 51 Bypass East,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010074,SDG Primary & Immediate Care,SDG Primary & Immediate Care,1225437585,Rural Health Clinics,201 S Front St,,Halls,TN,38040-1547,Lauderdale,201 South Front Street,,Halls,TN,38040,Lauderdale,Angela Scallions,Office Manager,731-836-5618,,management@sdgprimarycare.com,STEPHANIE SELLS,,731-836-5618,,MANAGEMENT@SDGPRIMARYCARE.COM,
TN-010075,"Rural Medical Services, Inc. Grassy Fork Center","RURAL MEDICAL SERVICES, INC.",1871537639,Federally Qualified Health Centers - Medical Services,4261 Big Creek Rd,,Hartford,TN,37753-2220,Cocke,PO Box 577,,Newport,TN,37822-0577,Cocke,Larry Stanifer,CEO,423-613-3300,402,lstanifer@rmstn.org,,,,,,
TN-010076,Hartsville Family Clinic,United Neighborhood Health Services,1982893806,Federally Qualified Health Centers - Medical Services,100 Damascus St,,Hartsville,TN,37074-1502,Trousdale,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010077,Henderson Health Center,HARDEMAN COUNTY COMMUNITY HEALTH CENTER,1366637969,Federally Qualified Health Centers - Medical Services,1132 Industrial Dr,,Henderson,TN,38340-1310,Chester,629 Nuckolls Rd,,Bolivar,TN,38008-1599,Hardeman,Linda Lovelace,CFO,731-658-3388,21,linda.lovelace@hardemanhealth.org,,,,,,
TN-010078,Christian Family Medicine of Henderson,Christian Family Medicine,1043252620,Rural Health Clinics,236 North Ave,,Henderson,TN,38340-1816,Chester,236 North Avenue,,Henderson,TN,38340,Chester,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,,,,,,
TN-010079,CHESTER COUNTY HEALTH DEPT.,Tennessee Department of Health,1184774358,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 Quinco Dr,,Henderson,TN,38340-1705,Chester,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010080,"The Grove Primary Care Clinic, LLC","The Grove Primary Care Clinic, LLC",1639345952,"Other ECP Providers, Rural Health Clinics",541 W Park Pl,,Henderson,TN,38340-2027,Chester,541 West Park Place,,Henderson,TN,38340,Chester,Jody Wysor,President,731-300-4232,,jwysor@thegroveclinic.com,Damien Nethery,Owner,731-300-4232,,dnethery@thegroveclinic.com,www.thegroveclinic.com
TN-010081,THE RICKARD CLINIC,"Apex Cardiology, PC dba The Rickard Clinic",1073906616,Rural Health Clinics,557 W Park Pl,,Henderson,TN,38340-2027,Chester,557 W Park Pl,,Henderson,TN,38340-2027,Chester,Pam Seddelmeyer,Office Manager,731-989-1007,,pam@sewdetailed.com,Sherry Smith,Billing Manager,731-423-8200,,ssmith@apexcardio.com,
TN-010082,High Forest Health Group,High Forest Health Group,1326392135,Rural Health Clinics,110 Kittrell St,,Hohenwald,TN,38462-1363,Lewis,110 Kittrell St,,Hohenwald,TN,38462,Lewis,Dorah Johnson-Cole,Office Manager,931-796-1818,,dorahjohcole@gmail.com,,,,,,
TN-010083,Lewis Health Center,MAURY REGIONAL HOSPITAL,1790108934,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",617 W Main St,,Hohenwald,TN,38462-1355,Lewis,1224 Trotwood Ave,,Columbia,TN,38401-4802,Maury,Kella Herrick,Executive Director,931-796-6201,,kherrick@mauryregional.com,,,,,,
TN-010084,Humboldt Family Walk In Clinic,Humboldt Family Walk In Clinic,1841404035,Rural Health Clinics,1600 Coleman Dr,Suite D,Humboldt,TN,38343-1995,Gibson,P.O. Box 68,,Humboldt,TN,38343,Gibson,Deborah Graves,NP/Owner,731-470-4020,,hfwic2016@gmail.com,Leigh Ann Keathley,Billing Clerk,731-470-4020,,hfwic2016@gmail.com,
TN-010085,Carroll County Health Dept,Tennessee Department of Health,1346390515,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",633 High St,,Huntingdon,TN,38344-1703,Carroll,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010086,HUNTSVILLE PRIMARY CARE CENTER,MOUNTAIN PEOPLES HEALTH COUNCILS INC,1326049347,Federally Qualified Health Centers - Medical Services,2974 Baker Hwy,,Huntsville,TN,37756-3806,Scott,470 Industrial Ln,,Oneida,TN,37841-6294,Scott,James Lovett,Chief Executive Officer,423-286-4141,30,lovettj@mphci.com,Patricia Dyer,Chief Operations Officer,423-286-4141,21,swannp@mphci.com,
TN-010087,Scott County Health Dept,Tennessee Department of Health,1780722520,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",344 Court St,,Huntsville,TN,37756-1404,Scott,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010088,AREA HEALTH CENTER,MOUNTAIN PEOPLES HEALTH COUNCILS INC,1720043615,Federally Qualified Health Centers - Medical Services,3826 Norma Rd,,Huntsville,TN,37756-4408,Scott,470 Industrial Ln,,Oneida,TN,37841-6294,Scott,James Lovett,Chief Executive Officer,423-286-4141,30,lovettj@mphci.com,Patricia Dyer,Chief Operations Officer,423-286-4141,21,swannp@mphci.com,
TN-010089,Campbell County Health Dept,Tennessee Department of Health,1962540880,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",162 Sharp-Perkins Ln,,Jacksboro,TN,37757,Campbell,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010090,JACKSON-MADISON COUNTY GENERAL HOSPITAL,Jackson-Madison County General Hospital,1093705428,Inpatient Hospitals (other than children's hospitals),620 Skyline Dr,,Jackson,TN,38301-3923,Madison,620 Skyline Drive,,Jackson,TN,38301,Madison,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010091,MADISON FAMILY PRACTICE,MADISON FAMILY PRACTICE,1407086101,Other ECP Providers,621 Old Hickory Blvd,Suite G,Jackson,TN,38305-2911,Madison,621 G OLD HICKORY BLVD,,Jackson,TN,38305,Madison,JANET NEWSOM,CMA,731-783-1234,,medinafamilypractice@aeneas.com,,,,,,
TN-010092,EAST JACKSON FAMILY MEDICAL CE,Jackson Madison County General Hospital,1417972290,Rural Health Clinics,655 Lexington Ave,,Jackson,TN,38301-5075,Madison,620 Skyline,,Jackson,TN,38301,Madison,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010093,Fentress County Health Department,State of Tennessee Department of Health,1740331792,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",240 Colonial Cir,Suite A,Jamestown,TN,38556-3924,Fentress,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010094,Wilkens Medical Group,Wilkens Medical Group,1992841233,Rural Health Clinics,131 Hospital Ln,,Jellico,TN,37762-4404,Campbell,131 Hospital Lane,,Jellico,TN,37762,Campbell,Debra Sharp,Administrative Assistant,423-784-3667,,sharpdebra@bellsouth.net,Elsie Crawford,VP Operations,423-494-7155,,elsiejcrawford@aol.com,
TN-010095,APPALACHIA HEALTH SERVICES,APPALACHIA HEALTH SERVICES,1427096551,Rural Health Clinics,292 N Main St,,Jellico,TN,37762-2132,Campbell,292 N Main St,,Jellico,TN,37762,Campbell,REGINA GUIMARAES ESCALANTE,OFFICE MANAGER,423-784-3600,,reg1na_ag@yahoo.com.br,DAVID ESCALANTE,DIRECTOR,423-784-3600,,reg1na_ag@yahoo.com.br,
TN-010096,INDIAN MOUNTAIN CLINIC,"DAYSPRING FAMILY HEALTH CENTER, INC.",1023022084,Federally Qualified Health Centers - Medical Services,550 Sunset Trl,,Jellico,TN,37762-2343,Campbell,107 S Main St,,Jellico,TN,37762-2154,Campbell,Angelia Washam,HR/Credentialing Director,423-784-5771,146,angiew@dayspringfhc.com,Patsy Prater,AR Supervisor,423-784-8492,208,patp@dayspringfhc.com,dayspringfhc.com
TN-010097,Washington County Health Dept,Tennessee Department of Health,1447397666,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",219 Princeton Rd,,Johnson City,TN,37601-2052,Washington,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA2,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010098,Christian Family Medicine of Kenton,Christian Family Medicine,1043252620,Rural Health Clinics,100 W College St,,Kenton,TN,38233-1226,Gibson,100 East College Street,,Kenton,TN,38233,Gibson,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,RUSTE VIA,,731-343-2730,,RUSTE@CHRISTIANFAMILYMED.COM,
TN-010099,Kingsport Medical Center,Rural Health Services Consortium Inc.,1649270364,Federally Qualified Health Centers - Medical Services,737 E Sevier Ave,,Kingsport,TN,37660-4912,Sullivan,4966 Hwy 11W,,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010100,"Kingston Family Practice,PC",Kingston Family Practice,1356432041,Rural Health Clinics,820 W Race St,,Kingston,TN,37763-2120,Roane,820 West Race Street,,Kingston,TN,37763,Roane,Rhonda Flanagan,Office Manager,865-374-3406,,rflanaga@covhlth.com,Vickie Allison,Operation Manager,865-374-5133,,vallison@covhlth.com,
TN-010101,CHS Dameron Avenue Clinic,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",140 Dameron Ave,,Knoxville,TN,37917-6413,Knox,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010102,Fort Sanders Regional Medical Center,Fort Sanders Regional Medical Center,1942294814,Inpatient Hospitals (other than children's hospitals),1901 Clinch Ave,,Knoxville,TN,37916-2307,Knox,P.O. Box 22790,,Knoxville,TN,37933-0790,Knox,Nancy Beck,Director of Financial Compliance,865-374-6864,,nbeck@covhlth.com,Saralyn Banks,Reimbursement Manager,865-374-3013,,sbanks2@covhlth.com,https://www.fsregional.com
TN-010103,The University of Tennessee Medical Center,"University Health System, Inc d/b/a The University of Tennessee Medical Center",1538164090,Inpatient Hospitals (other than children's hospitals),1924 Alcoa Hwy,,Knoxville,TN,37920-1511,Knox,9000 Executive Park Drive,"Building D, Suite 230",Knoxville,TN,37923,Knox,Roger Alan Massey,Vice President of Managed Care,865-251-4409,4409,rmassey@utmck.edu,Valerie Ault,Director of Managed Care,865-251-3770,3770,vault@utmck.edu,www.utmedicalcenter.org
TN-010104,EAST TENNESSEE CHILDRENS HOSPITAL,EAST TENNESSEE CHILDRENS HOSPITAL,1760476659,Children's Hospitals (inpatient only),2018 W Clinch Ave,,Knoxville,TN,37916-2301,Knox,2018 Clinch Avenue,,Knoxville,TN,37916,Knox,Kimberlie Bayne,Decision Support Analyst,865-541-8000,,kjbayne@etch.com,,,,,,
TN-010105,CENTER CITY HEALTH CENTER,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2018 Western Ave,,Knoxville,TN,37921-5718,Knox,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010106,Cherokee Health Systems - East Knox,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2202 Martin Luther King Jr Ave,,Knoxville,TN,37915-1570,Knox,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010107,Cherokee Health Systems Knox Homeless Health Center,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",538 W 5th Ave,,Knoxville,TN,37917-7109,Knox,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010108,Knoxville Health Center,"Planned Parenthood of Middle & East Tennessee, Inc.",1952581191,"Family Planning Providers, Sexually Transmitted Disease Clinics",710 N Cherry St,,Knoxville,TN,37914-5254,Knox,50 Vantage Way Ste 255,,Nashville,TN,37228-1516,Davidson,Ashley,Director of Patient Services,615-321-7285,,ashleyg@ppmet.org,,,,,,www.pptnm.org
TN-010109,"Community Health of East Tennessee, Inc","COMMUNITY HEALTH OF EAST TENNESSEE, INC.",1750382164,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",130 Independence Ln,,La Follette,TN,37766-3073,Campbell,PO Box 209,,Jacksboro,TN,37757,Campbell,Teresa W Dabney,CEO,423-566-1156,1032,tdabney@chetn.org,Jada Stanley,COO,423-563-1028,,jstanley@chetn.org,www.chetn.org
TN-010110,Macon County Health Department,State of Tennessee Department of Health,1447301296,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",601 Highway 52 Byp E,,Lafayette,TN,37083-1009,Macon,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010111,Southern Tennessee Regional Health System Lawrenceburg,LifePoint Health,1114003175,Inpatient Hospitals (other than children's hospitals),1607 S Locust Ave,,Lawrenceburg,TN,38464,Lawrence,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Kristie Wisdom-Taylor,CFO,931-766-3189,,,
TN-010112,"One Stop Medical, LLC","One Stop Medical, LLC",1053548487,Rural Health Clinics,325 Geri St,,Lawrenceburg,TN,38464-2392,Lawrence,325 Geri Street,Suite A,Lawrenceburg,TN,38464,Lawrence,Janice Kilburn,Office Manager,731-424-9797,,jkilburn1stop@yahoo.com,,,,,,
TN-010113,Wilson County Health Dept,Tennessee Department of Health,1073666798,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",927 E Baddour Pkwy,,Lebanon,TN,37087-3706,Wilson,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010114,CHS Loudon County,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",501 Adesa Blvd,Suite A150,Lenoir City,TN,37771-6719,Loudon,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010115,CELEBRATION FAMILY CARE PLLC,CELEBRATION FAMILY CARE PLLC,1891053823,Rural Health Clinics,529 W Commerce St,,Lewisburg,TN,37091-3219,Marshall,529 W Commerce St,,Lewisburg,TN,370913219,Marshall,Chad Graham,Administrator,931-580-0112,,chaddgraham@gmail.com,Brooke Braden,A/R Manager,931-270-9729,,braden.brooke@gmail.com,
TN-010116,LENTZ PEDIATRICS PLC,Lentz Pediatrics,1467637611,Rural Health Clinics,10777 Highway 412 W,,Lexington,TN,38351-6283,Henderson,19 Security Dr,,Jackson,TN,38305,Madison,Amanda Longworth,Office Manager,731-664-9040,,alongworth@lentzpediatrics.com,,,731-968-5558,,,
TN-010117,Christian Family Medicine of Lexington,Christian Family Medicine,1043252620,Rural Health Clinics,130 E Church St,Suite 1,Lexington,TN,38351-1822,Henderson,130 East Church Street,,Lexington,TN,38351,Henderson,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,RUSTE VIA,,731-343-2730,,RUSTE@CHRISTIANFAMILYMED.COM,
TN-010118,Advanced Health & Wellness Family Clinic,The Health Tree LLC,1851591317,Rural Health Clinics,16570 Highway 104 N,Suite B,Lexington,TN,38351-3877,Henderson,16224 Hwy 104 N,,Lexington,TN,38351,Henderson,Leslie Lee,Provider/President,731-968-2233,,advancedhealthclinic1@gmail.com,,,,,,
TN-010119,Springer Medical Associates,Springer Medical Associates,1417928854,Rural Health Clinics,16615 Highway 104 N,Suite B,Lexington,TN,38351-5753,Henderson,16615 Hwy 104 N,Ste B,Lexington,TN,38351,Henderson,Alicia Springer,Nurse Practitioner,731-968-0660,,ladydoc80@gmail.com,,,,,,http://www.springermedical.com/
TN-010120,Lexington Family Practice,Lexington Family Practice,1811028475,Rural Health Clinics,524 S Broad St,,Lexington,TN,38351-2202,Henderson,524 South Broad Street,,Lexington,TN,38351,Henderson,Heather McFarland,Owner,731-651-0300,,heather.mcfarland@aeneas.com,,,,,,
TN-010121,HENDERSON COUNTY HEALTH DEPT.,Tennessee Department of Health,1760532923,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",90 Rush St,,Lexington,TN,38351-2241,Henderson,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010122,Limestone Medical Center,Rural Health Services Consortium Inc.,1265432074,Federally Qualified Health Centers - Medical Services,105 Limestone Ruritan Rd,PO 217,Limestone,TN,37681-2515,Washington,4966 Hwy 11W,P.O. Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010123,Perry County Medical Center Inc,PERRY COUNTY MEDICAL CENTER INC,1154322303,Federally Qualified Health Centers - Medical Services,115 E Brooklyn St,,Linden,TN,37096-3515,Perry,115 E Brooklyn St,,Linden,TN,37096-3515,Perry,Phillip Tatum,CEO,931-589-2104,,phillip.tatum@perrymedcenter.org,,,,,,
TN-010124,Walk-In Medical Clinic of Linden,Walk-In Medical Clinic of Linden,1669818050,Rural Health Clinics,847 Squirrel Hollow Dr,,Linden,TN,37096-6479,Perry,847 Squirrel Hollow Drive,,Linden,TN,37096,Perry,Matt Griffin,Owner,931-589-2600,,twimcolmatt@gmail.com,,,,,,
TN-010125,Overton County Health Department,State of Tennessee Department of Health,1902958424,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5880 Bradford Hicks Dr,,Livingston,TN,38570-2236,Overton,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010126,Loudon County Health Dept,Tennessee Department of Health,1316085236,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",600 Rayder Ave,,Loudon,TN,37774-1050,Loudon,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010127,THREE RIVERS COMMUNITY HLTH GRP-HICKMAN,PERRY COUNTY MEDICAL CENTER INC,1659567527,"Dental Providers, Federally Qualified Health Centers - Medical Services",7723 Clearview Church Ln,,Lyles,TN,37098-1674,Hickman,115 E Brooklyn St,,Linden,TN,37096-3515,Perry,"Phillip Tatum, CEO",CEO,931-589-2104,,phillip.tatum@perrymedcenter.org,,,,,,
TN-010128,Madison Family Clinic,United Neighborhood Health Services,1760661714,Federally Qualified Health Centers - Medical Services,601 W Due West Ave,,Madison,TN,37115-4423,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010129,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1679821623,Federally Qualified Health Centers - Medical Services,1000 Green Rd,Madisonville Intermediate School,Madisonville,TN,37354-7062,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010130,Chota Community Health Services,Chota Community Health Services,1649540840,Federally Qualified Health Centers - Medical Services,175 Oak Grove Rd,Madisonville Middle School,Madisonville,TN,37354-5999,Monroe,1206 Hwy 411,,Vonore,TN,37885,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010131,Chota Community Health Services,Chota Community Health Services,1518912955,Federally Qualified Health Centers - Medical Services,225 Hiwassee College Dr,Hiwassee College,Madisonville,TN,37354-4005,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010132,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1568710515,Federally Qualified Health Centers - Medical Services,268 Warren St,Madisonville Primary School,Madisonville,TN,37354-1050,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010133,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1063782522,Federally Qualified Health Centers - Medical Services,3128 Highway 411,SEQUOYAH HIGH SCHOOL,Madisonville,TN,37354-6352,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010134,Monroe County Health Dept,Tennessee Department of Health,1669527230,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3469 New Highway 68,,Madisonville,TN,37354-5148,Monroe,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010135,Chota Community Health Services,CHOTA COMMUNITY HEALTH SERVICES,1548427586,Federally Qualified Health Centers - Medical Services,4798 New Highway 68,,Madisonville,TN,37354-1287,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,
TN-010136,Center For Family Medicine,Coffee Medical Group LLC,1700192028,Rural Health Clinics,1615 McMinnville Hwy,,Manchester,TN,37355-3179,Coffee,481 Interstate Dr,,Manchester,TN,37355,Coffee,Pam Jernigan,Chief Financial Officer,931-461-3466,,pam.jernigan@unitymedctr.com,Doug McAbee,Revenue Cycle Director,931-461-3436,,doug.mcabee@unitymedctr.com,
TN-010137,Manchester Rural Health Clinic,Coffee Medical Group LLC,1043537046,Rural Health Clinics,482 Interstate Dr,,Manchester,TN,37355-3109,Coffee,481 Interstate Dr,,Manchester,TN,37355,Coffee,Pam Jernigan,CFO,931-461-3466,,pam.jernigan@unitymedctr.com,Doug McAbee,Revenue Cycle Director,931-461-3436,,doug.mcabee@unitymedctr.com,
TN-010138,Christian Family Medicine of Weakley County,Christian Family Medicine,1043252620,Rural Health Clinics,105 Highway 431,,Martin,TN,38237-8264,Weakley,105 Hwy 431,,Martin,TN,38237,Weakley,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,,,,,,
TN-010139,Blount County Health Dept,Tennessee Department of Health,1306991286,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 McGhee St,,Maryville,TN,37801-6811,Blount,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010140,Quality Medical Center of Union County,Quality Medical Center of Union County,1376898734,Rural Health Clinics,3459 Maynardville Hwy,,Maynardville,TN,37807-3329,Union,3459 Maynardville Hwy,,Maynardville,TN,37807,Union,kristi walker,Office Administrater,865-368-2068,,ucofficemanager@yahoo.com,,,,,,
TN-010141,CHEROKEE HLTH SYSTEMS - MAYNARDV,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",4330 Maynardville Hwy,,Maynardville,TN,37807-3618,Union,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010142,Union County Health Dept,Tennessee Department of Health,1538207311,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4335 Maynardville Hwy,,Maynardville,TN,37807-3623,Union,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010143,Warren County Health Department,State of Tennessee Department of Health,1437201837,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1401 Sparta St,,McMinnville,TN,37110-1301,Warren,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010145,Pioneer Pediatrics,Pioneer Pediatrics PLLC,1184816720,Rural Health Clinics,236 E Main St,,McMinnville,TN,37110-2508,Warren,236 East Main St,,McMinnville,TN,37110,Warren,Kara Hurst,office manager,931-815-5437,104,khurst@pioneerpeds.com,,,,,,
TN-010144,Family Care Clinic,Family Care Clinic,1780924456,Rural Health Clinics,306 N Chancery St,,McMinnville,TN,37110-2048,Warren,306 NORTH CHANCERY STREET,,McMinnville,TN,37110,Warren,Theresa H. Hill,owner,931-474-4700,,Hills@blomand.net,Angie Gilley,office manager,931-474-4700,,agilley.familycare@blomand.net,www.familycaretn.com
TN-010146,MEDINA FAMILY PRACTICE,MADISON FAMILY PRACTICE,1407086101,Rural Health Clinics,605 HWY 45 E,,Medina,TN,38355,Gibson,MADISON FAMILY PRACTICE,621 G OLD HICKORY BLVD,Jackson,TN,38305,Madison,JANET NEWSOM,CMA,731-783-1234,,medinafamilypractice@aeneas.com,,,,,,
TN-010147,Cawthon Public Health Clinic,Shelby County Health Department,1396766655,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1000 Haynes St,,Memphis,TN,38114-3374,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010148,METHODIST UNIVERSITY HOSPITAL,METHODIST HEALTHCARE MEMPHIS HOSPITALS,1558365890,Inpatient Hospitals (other than children's hospitals),1265 Union Ave,,Memphis,TN,38104-3415,Shelby,1661 International Dr #150,,Memphis,TN,38120,Shelby,Robyn Hornsby,Director of Contracting,901-516-0583,,Robyn.Hornsby@mlh.org,Linda Haynes,Director of Finance and Managed Care,901-516-0707,,Linda.Haynes@mlh.org,
TN-010149,Southland Mall Public Health Clinic,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1278 Southland Mall,,Memphis,TN,38116-7808,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,http://www.shelbytnhealth.com/
TN-010150,University Clinical Health Blood Center,UT-Memphis DBA University of Tennessee Health Science Center,1780676650,"Hemophilia Treatment Centers, Rural Health Clinics",1407 Union Ave,Suite 700,Memphis,TN,38104-3641,Shelby,1407 Union Ave,Ste 700,Memphis,TN,38103,Shelby,Laura Kaplan,Director of Operations,901-866-8546,,laura.kaplan@uthsc.edu,Matthew Mooney,Executive Director of Clinical Operations,901-866-8641,,matthew.mooney@uthsc.edu,universityclinicalhealth.com
TN-010151,Shelby County Health Department,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 Hudson Health Ctr,,Memphis,TN,38152-0001,Shelby,200 Hudson Health Center,,Memphis,TN,38152,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010152,Women's Health Center,CHRIST COMMUNITY HEALTH SERVICES INC,1982686614,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2400 Poplar Ave,Suite 501,Memphis,TN,38112-3255,Shelby,2595 Central Ave,,Memphis,TN,38104-5905,Shelby,Shantelle A Leatherwood,cao,901-260-8542,,shantelle.leatherwood@christchs.org,amber cupples,,901-271-6328,,credentialing@christchs.org,
TN-010153,Planned Parenthood Greater Memphis Region,Planned Parenthood of Tennessee and North Misissippi,1881995173,"Family Planning Providers, Other ECP Providers",2430 Poplar Ave,,Memphis,TN,38112-3246,Shelby,2430 Poplar Avenue,,Memphis,TN,38112,Shelby,Ashley Coffield,CEO,901-725-3003,,acoffield@ppgmr.org,Jo Kendrick,CFO,901-725-3004,,jkendrick@ppgmr.org,https://www.plannedparenthood.org/planned-parenthood-memphis-tennessee
TN-010154,ORANGE MOUND HEALTH CENTER,CHRIST COMMUNITY HEALTH SERVICES INC,1982686614,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2569 Douglass Ave,,Memphis,TN,38114-2532,Shelby,2595 Central Ave,,Memphis,TN,38104-5905,Shelby,Shantelle A Leatherwood,cao,901-260-8542,,shantelle.leatherwood@christchs.org,amber cupples,,901-271-6328,,credentialing@christchs.org,
TN-010155,Cherokee Health Systems - Frayser,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2574 Frayser Blvd,,Memphis,TN,38127-5829,Shelby,2018 Western Avenue,,Knoxville,TN,37921,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010156,"St. Jude Children's Research Hospital, Inc. (children's inpatient hospital)","St. Jude Children's Research Hospital, Inc.",1033112230,Children's Hospitals (inpatient only),262 Danny Thomas Pl,,Memphis,TN,38105-3678,Shelby,262 Danny Thomas Pl,MS 515,Memphis,TN,38105-3678,Shelby,Alison Moore,Contract Coordinator,901-595-4528,,alison.moore@stjude.org,Jane Raymond,Director of Managed Care,901-595-2916,,jane.raymond@stjude.org,http://www.stjude.org
TN-010157,"St. Jude Children's Research Hospital, Inc. (multiple outpatient ECP categories)","St. Jude Children's Research Hospital, Inc.",1033112230,"Hemophilia Treatment Centers, Ryan White Providers",262 Danny Thomas Pl,,Memphis,TN,38105-3678,Shelby,262 Danny Thomas Pl,MS 515,Memphis,TN,38105-3678,Shelby,Alison Moore,Contract Coordinator,901-595-4528,,alison.moore@stjude.org,Jane Raymond,Director of Managed Care,901-595-2916,,jane.raymond@stjude.org,http://www.stjude.org
TN-010158,BROAD AVENUE HEALTH CENTER,Christ Community Health Services Inc,1982686614,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2861 Broad Ave,,Memphis,TN,38112-2903,Shelby,2595 central ave,,Memphis,TN,38104,Shelby,shantelle leatherwood,cao,901-271-6328,,shantelle.leatherwood@christchs.org,amber cupples,,901-271-6328,,credentialing@CHRISTCHS.ORG,
TN-010159,Broad Avenue Dental Center,CHRIST COMMUNITY HEALTH SERVICES INC,1609030832,Dental Providers,2953 Broad Ave,,Memphis,TN,38112-2957,Shelby,2595 central ave,,Memphis,TN,38104,Shelby,Shantelle A Leatherwood,CAO,901-260-8542,,shantelle.leatherwood@christchs.org,amber cupples,provider liaison,901-271-6328,,amber.cupples@christchs.org,
TN-010160,THIRD STREET HEALTH CENTER,CHRIST COMMUNITY HEALTH SERVICES INC,1982686614,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3362 S 3rd St,,Memphis,TN,38109-2944,Shelby,2595 Central Ave,,Memphis,TN,38104-5905,Shelby,Shantelle A Leatherwood,cao,901-260-8542,,shantelle.leatherwood@christchs.org,amber cupples,,901-271-6328,,credentialing@christchs.org,
TN-010161,Raleigh Health Center,Christ Community Health Services Inc,1982686614,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",3481 Austin Peay Hwy,,Memphis,TN,38128-3801,Shelby,2595 central ave,,Memphis,TN,38104,Shelby,shantelle leatherwood,cao,901-271-6328,,credentialing@christchs.org,amber cupples,,901-271-6328,,amber.cupples@christchs.org,
TN-010162,"MEMPHIS HEALTH CENTER, INC.","MEMPHIS HEALTH CENTER, INC.",1144236902,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",360 E EH Crump Blvd,,Memphis,TN,38126-5310,Shelby,360 E Eh Crump Blvd,,Memphis,TN,38126-5310,Shelby,Willeen W Hastings,CEO,901-261-2002,2002,whastings@mphshc.org,Don Holloman,COO/CFO,901-261-2001,2001,dholloman@mphshc.org,http://www.memphishealthcenter.org/
TN-010163,Tri-State Community Health Center,Tri-State Community Health Center,1285002634,Federally Qualified Health Centers - Medical Services,4041 Knight Arnold Rd,Suite 100,Memphis,TN,38118-2128,Shelby,4041 Knight Arnold Rd.,Suite 100,Memphis,TN,38118,Shelby,Cassandra Hart,Human Resources Manager,901-360-0442,6512,chart@caapincorporated.com,Marlita White,CFO,901-360-0442,6008,mwhite@caapincorporated.com,
TN-010164,Cherokee Health Systems - American Way,CHEROKEE HEALTH SYSTEMS,1134128820,Other ECP Providers,4095 American Way,Suite 1,Memphis,TN,38118-8339,Shelby,2018 Western Avenue,,Knoxville,TN,37921,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,,,,,,
TN-010166,Hickory Hill Health Center,CHRIST COMMUNITY HEALTH SERVICES INC,1982686614,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",5366 Winchester Rd,,Memphis,TN,38115-4565,Shelby,2595 Central Ave,,Memphis,TN,38104-5905,Shelby,Shantelle A Leatherwood,cao,901-260-8542,,shantelle.leatherwood@christchs.org,amber cuples,,901-271-6328,,credentialing@christchs.org,
TN-010167,Shelby Crossing Public Health Clinic,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6170 Macon Rd,,Memphis,TN,38134-7502,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010168,Hickory Hill Public Health Clinic,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6590 Kirby Center Cv,,Memphis,TN,38115-4314,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,http://www.shelbytnhealth.com/facilities/facility/details/Hickory-Hill-Public-Health-Clinic-11
TN-010169,Shelby County Health Department,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",814 Jefferson Ave,,Memphis,TN,38105-5041,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,http://www.shelbytnhealth.com/
TN-010170,Planned Parenthood Greater Memphis Region,Planned Parenthood Greater Memphis Region,1881995173,Family Planning Providers,835 Virginia Run Cv,,Memphis,TN,38122-4419,Shelby,2430 Poplar Avenue,,Memphis,TN,38112,Shelby,Ashley Coffield,CEO,901-725-3003,,acoffield@ppgmr.org,Jo Kendrick,CFO,901-725-3004,,jkendrick@ppgmr.org,https://www.plannedparenthood.org/planned-parenthood-memphis-tennessee
TN-010171,Dental Providers,Le Bonheur Children's Hospital,1558365890,Dental Providers,848 Adams Ave,,Memphis,TN,38103-2816,Shelby,848 Adams,,Memphis,TN,38104,Shelby,Helen Leitner,manager decision support,901-287-6943,,helen.leitner@lebonheur.org,,,,,,
TN-010172,LeBonheur Children's Inpatient Hospital,LeBonheur Children's Hospital,1558365890,Children's Hospitals (inpatient only),848 Adams Ave,,Memphis,TN,38103-2816,Shelby,55 Dunlap St,,Memphis,TN,38104,Shelby,meri armour,President and CEO,901-287-5952,,meri.armour@lebonheur.org,kevin todd,CFO,901-287-6009,,kevin.todd@lebonheur.org,
TN-010173,LeBonheur Children's Outpatient Clinics,LeBonheur Children's Hospital,1558365890,Outpatient Hospital Clinics,848 Adams Ave,,Memphis,TN,38103-2816,Shelby,55 Dunlap St,,Memphis,TN,38104,Shelby,meri armour,President and CEO,901-287-5952,,meri.armour@lebonheur.org,kevin todd,CFO,901-287-6009,,kevin.todd@lebonheur.org,
TN-010174,Ryan White,Le Bonheur Children's Hospital,1558365890,"Other ECP Providers, Ryan White Providers",848 Adams Ave,,Memphis,TN,38103-2816,Shelby,848 Adams,,Memphis,TN,38104,Shelby,Helen Leitner,manager decision support,901-287-6943,,helen.leitner@lebonheur.org,,,,,,
TN-010175,REGIONAL ONE HEALTH (inpatient hospital),Regional One Health,1144213117,Inpatient Hospitals (other than children's hospitals),877 Jefferson Ave,,Memphis,TN,38103-2807,Shelby,877 Jefferson Ave,,Memphis,TN,38103,Shelby,Garner Dennis Watson,Staff Attorney,901-545-6490,,denwatson@regionalonehealth.org,Monica Wharton,"SVP, Chief Legal Officer",901-545-8223,,mwharton@regionalonehealth.org,www.regionalonehealth.org
TN-010176,REGIONAL ONE HEALTH (ryan white providers),Regional One Health,1144213117,Ryan White Providers,877 Jefferson Ave,,Memphis,TN,38103-2807,Shelby,877 Jefferson Ave,,Memphis,TN,38103,Shelby,Garner Dennis Watson,Staff Attorney,901-545-6490,,denwatson@regionalonehealth.org,Monica Wharton,"SVP, Chief Legal Officer",901-545-8223,,mwharton@regionalonehealth.org,www.regionalonehealth.org
TN-010177,University Clinical Health,"UT Medical Group, Inc",1780676650,Ryan White Providers,880 Madison Ave,Suite 3E14,Memphis,TN,38103-3409,Shelby,"1407 Union Ave, Ste 700",,Memphis,TN,38104,Shelby,Bradley Chow,Director of Operations,901-866-8053,,bradley.chow@uthsc.edu,,,,,,universityclinicalhealth.com
TN-010178,University of Tennessee Hemophilia Treatment Center,University of Tennessee Health Science Center,1396852273,Hemophilia Treatment Centers,956 Court Ave Bldg B328,Coleman,Memphis,TN,38103-2814,Shelby,956 Court Ave.,Coleman Bldg. 328B,Memphis,TN,38103,Shelby,Catherine Joyce,Clinical Coordinator,901-448-1751,,cjoyce@uthsc.edu,"Sandeep Rajan, MD",Director,901-448-2338,,srajan2@uthsc.edu,
TN-010179,Frayser Health Center,CHRIST COMMUNITY HEALTH SERVICES INC,1982686614,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",969 Frayser Blvd,,Memphis,TN,38127-5977,Shelby,2595 Central Ave,,Memphis,TN,38104-5905,Shelby,Shantelle A Leatherwood,CAO,901-260-8542,,shantelle.leatherwood@christchs.org,amber cupples,,901-271-6328,,credentialing@christchs.org,
TN-010180,"Michie Medical Clinic,Inc","Michie Medical Clinic, Inc",1386699361,Rural Health Clinics,6659 Michie Pebble Hill Rd,,Michie,TN,38357-5115,McNairy,6659 Michie Pebble Hill Road,,Michie,TN,38357,Mcnairy,Mary Sue Rhoads,Family Nurse Practitioner,731-632-1783,,marysue@michiemedical.com,,,,,,
TN-010181,"The Grove Primary Care Clinic, LLC","The Grove Primary Care Clinic, LLC",1639345952,"Other ECP Providers, Rural Health Clinics",702 S Main St,,Middleton,TN,38052-3615,Hardeman,109 East Lafayette Street,,Jackson,TN,38301,Madison,Jody Wysor,President,731-376-1311,,jwysor@thegroveclinic.com,Damien Nethery,Owner,731-300-4232,,dnethery@thegroveclinic.com,www.thegroveclinic.com
TN-010182,Milan General Hospital,Milan General Hospital,1699765453,Inpatient Hospitals (other than children's hospitals),4039 Highland St,,Milan,TN,38358-3493,Gibson,4039 South Highland,,Milan,TN,38358,Gibson,Bill Jones,Director,731-512-1500,,bill.jones@wth.org,,,,,,
TN-010183,GIBSON COUNTY - MILAN CLINIC,Tennessee Department of Health,1821148081,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6501 Telecom Dr,,Milan,TN,38358-3448,Gibson,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010184,Millington Public Health Department,Shelby County Health Department,1396766655,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",8225 US Highway 51 N,,Millington,TN,38053-1707,Shelby,814 Jefferson,,Memphis,TN,38105,Shelby,Morristein Holman,Administrator,901-222-9056,,morristein.holman@shelbycountytn.gov,Lorrie Brooks,Deputy Administrator,901-222-9074,,lorrie.brooks@shelbycountytn.gov,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010185,MOUNTAIN MEDICAL CLINIC,AMG-SOUTHERN TENNESSEE LLC,1922388297,Rural Health Clinics,21 1st St,,Monteagle,TN,37356-7401,Grundy,55 SUNRISE PARK,,WINCHESTER,TN,37398,Franklin,STEPHANIE MCBAY,CBO MANAGER,931-967-1333,,stephanie.mcbay@lpnt.net,LISA BRADFORD,MARKET MANAGER,931-967-8203,,lisa.bradford@lpnt.net,
TN-010186,Hamblen County Health Dept,Tennessee Department of Health,1508904418,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",331 W Main St,,Morristown,TN,37814-4621,Hamblen,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Hamblen,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010187,CHEROKEE HLTH SYSTEMS 5TH STREET CLINIC,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",815 W 5th North St,,Morristown,TN,37814-3810,Hamblen,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010188,Morristown Hamblen Hospital,Morristown Hamblen Hospital,1912997024,Inpatient Hospitals (other than children's hospitals),908 W 4th North St,,Morristown,TN,37814-3894,Hamblen,P.O. Box 22790,,Knoxville,TN,37933-0790,Knox,Nancy Beck,DIrector of Financial Compliance,865-374-6864,,nbeck@covhlth.com,Saralyn Banks,Reimbursement Manager,865-374-3013,,sbanks2@covhlth.com,https://www.morristownhamblen.com
TN-010189,Mountain City Extended Hours Health Center,East Tennessee State University,1295779361,Rural Health Clinics,1901 S Shady St,,Mountain City,TN,37683-2021,Johnson,365 Stout Drive,Box 70403,Johnson City,TN,37614-1703,Washington,Norma J Adams,Credentialing Specialist,423-439-4071,,adamsn@etsu.edu,Betsy Kappes,Business Director,423-439-4068,,kappes@etsu.edu,
TN-010190,Mountain City Medical Center,Rural Health Services Consortium Inc.,1720088537,"Dental Providers, Federally Qualified Health Centers - Medical Services",222 Oak Steet,PO Box 670,Mountain City,TN,37683-0670,Johnson,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010191,Rutherford County Health Dept,Tennessee Department of Health,1356494199,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",100 W Burton St,,Murfreesboro,TN,37130-3657,Rutherford,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010192,Primary Care & Hope Clinic,Rutherford County Primary Care Inc,1114973237,Federally Qualified Health Centers - Medical Services,1453 Hope Way,,Murfreesboro,TN,37129-3140,Rutherford,1453 Hope Way,,Murfreesboro,TN,37129,Rutherford,Lisa Terry,CEO,615-893-9390,203,lisa.terry@hopeclnc.org,Shane Smith,CFO,615-893-9390,202,shane.smith@hopeclnc.org,www.hopeclnc.org
TN-010193,Hope II,Rutherford County Primary Care Inc,1114973237,Federally Qualified Health Centers - Medical Services,608 S Hancock St,,Murfreesboro,TN,37130-4327,Rutherford,1453 Hope Way,,Murfreesboro,TN,37129,Rutherford,Lisa Terry,CEO,615-893-9390,203,lisa.terry@hopeclnc.org,Shane Smith,CFO,615-893-9390,202,shane.smith@hopeclnc.org,www.hopeclnc.org
TN-010194,Meharry Medical Group,Meharry Medical College,1205859279,"Other ECP Providers, Ryan White Providers",1005 Dr Db Todd Jr Blvd,Suite 460,Nashville,TN,37208-3501,Davidson,"1005 Dr. D.B. Todd, Jr. Blvd",Suite 460,Nashville,TN,37208,Davidson,"Duane Thomas Smoot, M.D.",Senior Associate Dean for Health Affairs,615-327-6914,6579,dsmoot@mmc.edu,Memory Johnson,"Executive Director, Meharry Medical Group",615-327-6914,5592,mbjohnson@mmc.edu,home.mmc.edu
TN-010195,Matthew Walker Comprehensive Health Center-Nashville,Walker Comprehensive Health Center,1356405278,"Dental Providers, Federally Qualified Health Centers - Medical Services",1035 14th Ave N,,Nashville,TN,37208-3050,Davidson,1035 14th Avenue North,,Nashville,TN,37208,Davidson,Katina Beard,CEO,615-340-1292,,kbeard@mwchc.org,"Ida M. Williams, M.D.",Chief Medical Officer / Medical Director,615-324-9669,,michele.williams@mwchc.org,www.mwchc.org
TN-010196,Southside Family and Dental Center,United Neighborhood Health Services,1740479674,"Dental Providers, Federally Qualified Health Centers - Medical Services",107 Charles E Davis Blvd,,Nashville,TN,37210-2745,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010197,Medical Arts Building,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,1211 21st Ave,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc Vice President,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010198,VANDERBILT UNIVERSITY MEDICAL CENTER,Vanderbilt University Medical Center,1396882205,Inpatient Hospitals (other than children's hospitals),1211 Medical Center Dr,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,"Associate Vice President, Finance",615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010199,Medical Center East,Vanderbilt University Medical Center,1396882205,Inpatient Hospitals (other than children's hospitals),1215 21st Ave S,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,"Associate Vice President, Finance",615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010200,Dickerson Road Family Clinic,United Neighborhood Health Services,1235401993,Federally Qualified Health Centers - Medical Services,1233 Dickerson Pike,,Nashville,TN,37207-5408,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010201,The Vanderbilt Clinic,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,1301 Medical Center Dr,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010202,The Village at Vanderbilt,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,1500 21st Ave S,,Nashville,TN,37212-3160,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010203,Vanderbilt Dayani Center,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,1500 Medical Center Dr,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010204,Vanderbilt Psychiatric Hospital,Vanderbilt University Medical Center,1558408633,Inpatient Hospitals (other than children's hospitals),1601 23rd Ave S,,Nashville,TN,37212-3133,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Gayla Harvey,Senior Vice President,615-875-9453,,gayla.harvey@vumc.org,Sheri Haun,Associate Vice President,615-936-6009,,sheri.haun@vanderbilt.edu,http://www.vanderbilthealth.com/
TN-010205,Nashville General Hospital at Meharry,The Hosp. Authority of Metro Nashville d/b/a Nashville General Hospital,1568551455,Inpatient Hospitals (other than children's hospitals),1818 Albion St,,Nashville,TN,37208-2918,Davidson,Nashville General Hospital,1818 Albion Street,Nashville,TN,37208-2918,Davidson,Marc Overlock,General Counsel,615-341-4402,,marc.overlock@nashvilleha.org,Joseph Webb,Chief Executive officer,615-341-4491,,joseph.webb@nashvilleha.org,
TN-010206,Lebanon Clinic,United Neighborhood Health Services,1548637093,Federally Qualified Health Centers - Medical Services,217 E High St,Suite 200,Nashville,TN,37087-6709,Wilson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010207,Unity Clinic,United Neighborhood Health Services,1750723029,Federally Qualified Health Centers - Medical Services,2195 Nolensville Pike,,Nashville,TN,37211-2094,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010208,Monroe Carell Jr. Children's Hospital at Vanderbilt,Vanderbilt University Medical Center,1396882205,Children's Hospitals (inpatient only),2200 Children's Way,,Nashville,TN,37232-0005,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,"Associate Vice President, Finance",615-936-6009,,sheri.haun@vumc.org,http://www.childrenshospital.vanderbilt.org/
TN-010209,"Vanderbilt-Ingram Cancer Center, Preston Research Building",Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,2220 Pierce Ave,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010210,Vanderbilt Eye Institute,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,2311 Pierce Ave,,Nashville,TN,37232-0011,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010211,Vanderbilt Sleep Disorders Center Nashville,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,2555 West End Ave,,Nashville,TN,37203-1423,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010212,Priest Lake Family and Women's Health Center,"UNIVERSITY COMMUNITY HEALTH SERVICES, INC.",1275634818,Federally Qualified Health Centers - Medical Services,2637 Murfreesboro Pike,,Nashville,TN,37217-3505,Davidson,601 Benton Ave,,Nashville,TN,37204-2303,Davidson,Suzanne Hurley,Co-CEO,615-932-7628,,suzanne.hurley@uchshealth.org,Caroline Portis-Jenkins,Co-CEO,615-932-7631,,caroline.portis-jenkins@uchshealth.org,
TN-010213,Osher Center for Integrative Medicine at Vanderbilt,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,3401 West End Ave,Suite 380,Nashville,TN,37203-6851,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010214,Vanderbilt Multiple Sclerosis,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,3810 Bedford Ave,Suite 100,Nashville,TN,37215-2554,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010215,Inglewood Clinic,United Neighborhood Health Services,1639546187,Federally Qualified Health Centers - Medical Services,3904 Gallatin Pike,,Nashville,TN,37216-2406,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010216,Wallace Road Family Clinic,United Neighborhood Health Services,1871856906,Federally Qualified Health Centers - Medical Services,395 Wallace Rd,Bldg B,Nashville,TN,37211-4881,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010217,Free Electron Laser Center,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,410 24th Ave S,,Nashville,TN,37232-0038,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc. Vice President,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010218,Nashville Health Center,"Planned Parenthood of Middle & East Tennessee, Inc.",1952581191,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",412 Dr DB Todd Jr Blvd,,Nashville,TN,37203-2838,Davidson,50 Vantage Way Ste 255,,Nashville,TN,37228-1516,Davidson,Ashley,Director of Patient Services,615-321-7285,,ashleyg@ppmet.org,,,,,,www.pptnm.org
TN-010220,Downtown Medical Clinic,United Neighborhood Health Services,1578828489,Federally Qualified Health Centers - Medical Services,526 8th Ave S,,Nashville,TN,37203-4139,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010221,VINE HILL COMMUNITY CLINIC,"UNIVERSITY COMMUNITY HEALTH SERVICES, INC.",1275634818,Federally Qualified Health Centers - Medical Services,601 Benton Ave,,Nashville,TN,37204-2303,Davidson,601 Benton Ave,,Nashville,TN,37204-2303,Davidson,Suzanne Hurley,Co-CEO,615-932-7628,,suzanne.hurley@uchshealth.org,Caroline Portis-Jenkins,Co-CEO,615-932-7631,,caroline.portis-jenkins@uchshealth.org,
TN-010222,Cayce Family Clinic,United Neighborhood Health Services,1942482062,Federally Qualified Health Centers - Medical Services,617 S 8th St,,Nashville,TN,37206-3819,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010223,Downtown Mission Clinic,United Neighborhood Health Services,1154602282,"Dental Providers, Federally Qualified Health Centers - Medical Services",639 Lafayette St,,Nashville,TN,37203-4226,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010224,Vanderbilt University Medical Center 100 Oaks,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,719 Thompson Ln,,Nashville,TN,37204-3609,Davidson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,"Associate Vice President, Finance",615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010225,Main Street Family and Dental Center,United Neighborhood Health Services,1467717306,"Dental Providers, Federally Qualified Health Centers - Medical Services",905 Main St,,Nashville,TN,37206-3609,Davidson,711 Main St.,,Nashville,TN,37206,Davidson,Mary Bufwack,CEO,615-227-3000,1024,mbufwack@neighborhoodhealthtn.org,,,,,,www.neighborhoodhealthtn.org
TN-010226,CHS Claiborne County Health Center,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1596 Highway 33 S,,New Tazewell,TN,37825-7104,Claiborne,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010227,Rural Medical Services Inc. Cosby Center,"RURAL MEDICAL SERVICES, INC.",1962443697,Federally Qualified Health Centers - Medical Services,103 Wilton Springs Rd,,Newport,TN,37821-6405,Cocke,PO Box 577,,Newport,TN,37822-0577,Cocke,Larry Stanifer,CEO,423-613-3300,402,lstanifer@rmstn.org,,,,,,
TN-010228,Cherokee Health Systems - Newport,CHEROKEE HEALTH SYSTEMS,1124418819,"Community Mental Health Centers, Ryan White Providers",215 Hedrick Dr,,Newport,TN,37821-2902,Cocke,2018 Western Avenue,,Knoxville,TN,37921,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010229,"Rural Medical Services, Inc. Newport Center","RURAL MEDICAL SERVICES, INC.",1437191194,Federally Qualified Health Centers - Medical Services,229 Hedrick Dr,,Newport,TN,37821-2902,Cocke,PO Box 577,,Newport,TN,37822-0577,Cocke,Larry Stanifer,CEO,423-613-3300,402,lstanifer@rmstn.org,,,,,,
TN-010230,Cherokee Health Systems,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",320 8th St,,Newport,TN,37821-3902,Cocke,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010231,Cocke County Health Dept,Tennessee Department of Health,1679611560,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",430 College St,,Newport,TN,37821-3752,Cocke,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010232,Pioneer Community Hospital of Scott,"Pioneer Health Services, INC",1932544871,Inpatient Hospitals (other than children's hospitals),18797 Alberta St,,Oneida,TN,37841-2127,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,Chief Financial Officer,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Strategic Alignment & Network Development,601-849-6440,385,laurenwilliams@phscorporate.com,
TN-010233,Family Care Clinic,"Pioneer Health Services of Scott County, Inc.",1396129714,Other ECP Providers,20445 Alberta St,,Oneida,TN,37841-3509,Scott,110 Pioneer Way,,Magee,MS,39111,Simpson,Buddy Yates,CFO,601-849-6440,320,juliegieger@phscorporate.com,Morgan Ingle,Director of Clinic Services,601-849-6440,,heidinelson@phscorporate.com,
TN-010234,Mountain People's Oneida Clinic,"Mountain People's Health Councils, Inc.",1649635939,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",460 Industrial Ln,,Oneida,TN,37841-6294,Scott,470 Industrial Lane,,Oneida,TN,37841,Scott,James Lovett,Chief Executive Officer,423-286-4141,30,lovettj@mphci.com,Patricia Dyer,Chief Operations Officer,423-286-4141,21,swannp@mphci.com,
TN-010235,HENRY COUNTY HEALTH DEPT.,Tennessee Department of Health,1952451114,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",803 Joy St,,Paris,TN,38242-4529,Henry,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010236,"Rural Medical Services, Inc. Parrottsville Center","RURAL MEDICAL SERVICES, INC.",1669417481,Federally Qualified Health Centers - Medical Services,111 Mockingbird Ave,,Parrottsville,TN,37843-2741,Cocke,PO Box 577,,Newport,TN,37822-0577,Cocke,Larry Stanifer,CEO,423-613-3300,402,lstanifer@rmstn.org,,,,,,
TN-010237,Christian Family Medicine of Parsons,Christian Family Medicine,1043252620,Rural Health Clinics,364 Tennessee Ave,,Parsons,TN,38363,Decatur,364 Tennessee Avenue,,Parsons,TN,38363,Decatur,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,,,,,,
TN-010238,ERLANGER BLEDSOE - INTERNAL MEDICINE & PEDIATRICS,Erlanger Bledsoe Internal Medicine & Pediatrics,1821317629,Rural Health Clinics,136 Wheelertown Ave,,Pikeville,TN,37367-5247,Bledsoe,136 Wheelertown Ave,,Pikeville,TN,37637,Bledsoe,Christy Reece,Practice Manager,423-447-3524,,christy.reece@erlanger.org,,,,,,
TN-010239,"Pikeville Clinic, LLC","Pikeville Clinic, LLC",1639472137,Rural Health Clinics,3062 Main St,,Pikeville,TN,37367-5746,Bledsoe,3062 Main Street,,Pikeville,TN,37367,Bledsoe,Ruth Boynton,Owner,423-618-3696,,heather@emmausconsulting.net,,,,,,
TN-010240,"Pikeville Urgent Care, PLLC","Pikeville Urgent Care, PLLC",1316321953,Rural Health Clinics,344 Church St,,Pikeville,TN,37367-5643,Bledsoe,PO Box 190,,Pikeville,TN,37367,Bledsoe,Ruth Ellen Boynton,Owner,423-618-3696,,rboynton52@gmail.com,Laurie Troglin,Office Manager,423-447-2992,,pikevilleurgentcare@gmail.com,
TN-010241,Bledsoe County Primary Care Center,Ocoee Regional Health Corporation,1265645204,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",3625 Main St,,Pikeville,TN,37367-5319,Bledsoe,PO Box 308,,Benton,TN,37307,Polk,Susan Williams,BILLING SUPERVISOR,423-338-8995,1217,swilliams@ocoeerhc.com,Bill Moats,President/CEO,423-338-8995,1212,bmoats@ocoeerhc.com,
TN-010242,ERLANGER BLEDSOE HOSPITAL,Erlanger Children's Hospital,1770678617,Inpatient Hospitals (other than children's hospitals),71 Wheelertown Ave,,Pikeville,TN,37367-5246,Bledsoe,71 Wheelertown Ave,,Pikeville,TN,37367,Bledsoe,Stephanie Boynton,CEO,423-447-2112,,stephanie.boynton@erlanger.org,,,,,,
TN-010243,Sumner County Health Dept - Portland,Tennessee Department of Health,1003090036,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",214 W Longview Dr,,Portland,TN,37148-1641,Sumner,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010244,NORTH KNOX HEALTH CENTER,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Ryan White Providers",7714 Conner Rd,Suite 105,Powell,TN,37849-3559,Knox,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010245,Southern Tennessee Regional Health System Pulaski,LifePoint Health,1841388519,Inpatient Hospitals (other than children's hospitals),1265 E College St,,Pulaski,TN,38478-4541,Giles,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Donald Gavin,CFO,931-363-9310,,,
TN-010246,Just 4 Kids Pediatrics,Just 4 Kids Pediatrics,1619378601,Rural Health Clinics,910 W College St,,Pulaski,TN,38478-3630,Giles,910 West College Street,,Pulaski,TN,38478,Giles,Janice Kilburn,Office Manager,931-363-0077,,jkilburn1stop@yahoo.com,,,,,,
TN-010247,One Stop Medical LLC,One Stop Medical LLC,1053548487,Rural Health Clinics,912 W College St,,Pulaski,TN,38478-3630,Giles,912 West College Street,,Pulaski,TN,38478,Giles,Janice Kilburn,Office Manager,931-424-9797,,jkilburn1stop@yahoo.com,,,,,,
TN-010248,William B Acree Clinic,Citizens of Lake County for Health Care Inc,1851697817,Federally Qualified Health Centers - Medical Services,130 N Main St,,Ridgely,TN,38080-1317,Lake,710 Carl Perkins Parkway,,Tiptonville,TN,38080,Lake,Gayanne Williams,Executive Director,731-253-6690,,gwilliams@clchc.com,Amber Isbell,Finance Officer,731-253-6690,,aisbell@clchc.com,
TN-010249,"Care Rite, PLLC","Care Rite, PLLC",1477827418,Other ECP Providers,124 N Jefferson St,,Ripley,TN,38063,Lauderdale,1445 Highway 51 Bypass East,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010250,"All Care Medical, PLLC",All Care Medical PLLC,1881909877,Rural Health Clinics,313 Cleveland St,,Ripley,TN,38063-1205,Lauderdale,PO Box 244,,Ripley,TN,38063,Lauderdale,Valorie Robinson,Credentialing,512-623-6943,,vrobinson@emds.com,John Feith,Administrator,731-635-6000,,jfeith@allcaretn.com,
TN-010251,Lauderdale County Medical Clinic,Citizens of Lake County for Health Care Inc,1558609628,Federally Qualified Health Centers - Medical Services,317 Cleveland St,,Ripley,TN,38063-1205,Lauderdale,710 Carl Perkins Parkway,,Tiptonville,TN,38079,Lake,Gayanne Williams,Executive Director,731-253-6690,,gwilliams@clchc.com,Amber Isbell,Finance Officer,731-253-6690,,aisbell@clchc.com,
TN-010252,LAUDERDALE COMMUNITY HOSPITAL,Rural Community Hospitals of America,1932421401,Inpatient Hospitals (other than children's hospitals),326 Asbury Ave,,Ripley,TN,38063-5577,Lauderdale,326 Asbury Avenue,,Ripley,TN,38063,Lauderdale,Tammie Hardy,Chief Executive Officer,731-221-2200,,Tammie.Hardy@lauderdalehospital.com,Jacque Swanston,Director of Managed Care Contracting,918-236-4020,,JSwanston@ruralcommunityhospitals.com,
TN-010253,Rural Health Clinics of West TN PLLC,Rural Health Clinics of West TN PLLC,1104864370,Rural Health Clinics,326 Asbury Ave,Suite 101,Ripley,TN,38063-5577,Lauderdale,P O Box 1209,,Dyersburg,TN,38025-1209,Dyer,Ravi Bindra,Manager,731-285-3300,,rbindra@medtn.net,G S Bindra,Partner,731-286-0149,,gsbindramd@gmail.com,
TN-010254,LAUDERDALE COUNTY HEALTH DEPT.,Tennessee Department of Health,1144370305,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",500 Highway 51 S,,Ripley,TN,38063-4583,Lauderdale,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-012408,"Care Rite, PLLC","Care Rite, PLLC",1477827418,Other ECP Providers,521 Highway 51 N,,Ripley,TN,38063-5903,Lauderdale,1445 Highway 51 Bypass E,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia Foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010255,Mid South Convenience Care,Mid South Convenient Care,1477984508,Rural Health Clinics,521 Highway 51 N,,Ripley,TN,38063-5903,Lauderdale,1445 Highway 51 Bypass East,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010256,Christian Family Medicine,Christian Family Medicine,1043252620,Rural Health Clinics,79 Highway 51 S,,Ripley,TN,38063-4580,Lauderdale,79 Hwy 51 South,,Ripley,TN,38063,Lauderdale,Howie Freeman,COO,731-343-0734,,howie@christianfamilymed.com,RUSTE VIA,,731-343-2730,,RUSTE@CHRISTIANFAMILYMED.COM,
TN-010257,Roan Mountain Medical Center,Rural Health Services Consortium Inc.,1568462372,Federally Qualified Health Centers - Medical Services,152 Highway 143,PO Box 250,Roan Mountain,TN,37687-3002,Carter,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010258,HIGHLAND HEALTH CENTER,MOUNTAIN PEOPLES HEALTH COUNCILS INC,1962403428,Federally Qualified Health Centers - Medical Services,715 Rugby Hwy,,Robbins,TN,37852-3755,Scott,470 Industrial Ln,,Oneida,TN,37841-6294,Scott,James Lovett,Chief Executive Officer,423-286-4141,30,lovettj@mphci.com,PATRICIA SWANN,Chief Operations Officer,423-286-4141,21,SWANNP@MPHCI.COM,
TN-010259,Roane County Health Dept,Tennessee Department of Health,1437203809,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1362 N Gateway Ave,,Rockwood,TN,37854-4108,Roane,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010260,Hawkins County Health Dept,Tennessee Department of Health,1982759890,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 Park Blvd,,Rogersville,TN,37857-2919,Hawkins,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010261,Rogersville Medical Complex,Rural Health Services Consortium Inc.,1346672995,Federally Qualified Health Centers - Medical Services,4307 Highway 66 S,PO Box 850,Rogersville,TN,37857-3155,Hawkins,4966 Hwy 11W,PO Box 850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010262,Hawkins Medical Center,Rural Health Services Consortium Inc.,1013917632,Federally Qualified Health Centers - Medical Services,4966 Highway 11W,PO Box,Rogersville,TN,37857-6028,Hawkins,4966 Hwy 11W,P.O.850,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010263,The Rutherford Medical Clinic,The Rutherford Medical Clinic LLC,1962456061,Rural Health Clinics,104 E Main St,,Rutherford,TN,38369-9711,Gibson,104 East Main St,,Rutherford,TN,38369,Gibson,Mary Anne Little,Owner/ Billing,731-665-7741,,maryalittle64@hotmail.com,Mary Anne Little,,731-665-7741,,maryalittle64@hotmail.com,
TN-010264,Grainger County Health Dept,Tennessee Department of Health,1982742821,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",185 Justice Center Dr,,Rutledge,TN,37861,Grainger,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010265,Lifespan Saltillo,HARDIN COUNTY REGIONAL HEALTH CENTER,1962790238,Federally Qualified Health Centers - Medical Services,48073 Highway 69,,Saltillo,TN,38370-4514,Hardin,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,731-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010266,Lifespan Women & Children Center,HARDIN COUNTY REGIONAL HEALTH CENTER,1003055286,Federally Qualified Health Centers - Medical Services,105 Davis St,,Savannah,TN,38372-1855,Hardin,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,731-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010267,LIFESPAN KIDS,HARDIN COUNTY REGIONAL HEALTH CENTER,1003065772,Federally Qualified Health Centers - Medical Services,150 E End Dr,,Savannah,TN,38372-1712,Hardin,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,931-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010268,HARDIN COUNTY HEALTH DEPT.,Tennessee Department of Health,1477603629,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1920 Pickwick St,,Savannah,TN,38372-5309,Hardin,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010269,LIFESPAN HEALTH - SMC,HARDIN COUNTY REGIONAL HEALTH CENTER dba LIFESPAN HEALTH,1982068391,Federally Qualified Health Centers - Medical Services,255 Wayne Rd,,Savannah,TN,38372-1947,Hardin,Hardin County Regional Health Center dba LIfespan Health,PO Box 655,Savannah,TN,38372,Anderson,Y. T. McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,731-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010270,"HARDIN COUNTY REGIONAL HEALTH CENTER, INC. DBA LIFESPAN HEALTH",HARDIN COUNTY REGIONAL HEALTH CENTER dba LIFESPAN HEALTH,1184676157,Federally Qualified Health Centers - Medical Services,765 Florence Rd,PO Box 655,Savannah,TN,38372-0655,Hardin,765 Florence Rd Ste A,PO Box 655,Savannah,TN,38372-5219,Hardin,Y T McGinley,CEO,731-925-2300,8988,janie.mcginley@lifespanhealth.com,Jennifer Williams,CFO,731-925-2300,8983,jennifer.williams@lifespanhealth.com,www.lifespanhealth.com
TN-010271,"The Grove Primary Care Clinic, LLC","The Grove Primary Care Clinic, LLC",1639345952,"Other ECP Providers, Rural Health Clinics",9458 Highway 100,,Scotts Hill,TN,38374-6443,Decatur,109 East Lafayette Street,,Jackson,TN,38301,Madison,Jody Wysor,President,731-349-3010,,jwysor@thegroveclinic.com,Damien Nethery,Owner,731-300-4232,,dnethery@thegroveclinic.com,www.thegroveclinic.com
TN-010272,Trinity Medical Clinic,Trinity Medical Clinic,1013156629,Rural Health Clinics,181 S Y Sq,,Selmer,TN,38375-1739,McNairy,181 South Y,,Selmer,TN,38375,McNairy,Rhonda Hunt,Owner,731-434-0200,,trinitymed38375@yahoo.com,,,,,,
TN-010273,MCNAIRY COUNTY HEALTH DEPT.,Tennessee Department of Health,1184774333,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",725 E Poplar Ave,,Selmer,TN,38375-1800,McNairy,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010274,Sevier County Health Dept,Tennessee Department of Health,1033264916,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",719 Middle Creek Rd,,Sevierville,TN,37862-5016,Sevier,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010275,LeConte Medical Center,LeConte Medical Center,1528052578,Inpatient Hospitals (other than children's hospitals),742 Middle Creek Rd,,Sevierville,TN,37862-5019,Sevier,P.O. Box 22790,,Knoxville,TN,37933-0790,Knox,Nancy Beck,Director of Financial Compliance,865-374-6864,,nbeck@covhlth.com,Saralyn Banks,Reimbursement Manager,865-374-3013,,sbanks2@covhlth.com,https://www.lecontemedicalcenter.com
TN-010276,CHS Sevier County,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",10731 Chapman Hwy,,Seymour,TN,37865-4765,Sevier,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010277,MADISON STREET FAMILY CLINIC,Madison Street Family Clinic,1518238740,Rural Health Clinics,1401 Madison St,,Shelbyville,TN,37160-3629,Bedford,1401 Madison St,,Shelbyville,TN,37160,Bedford,Rod Parsons,Manager,931-685-2022,9312242300,parsonsrod@yahoo.com,,,,,,
TN-010278,BEDFORD URGENT CARE,Bedford Family Practice Urgent Care,1629136379,Rural Health Clinics,1612 N Main St,Suite A,Shelbyville,TN,37160-2392,Bedford,1612 North Main St,Suite A,Shelbyville,TN,37160,Bedford,Rod Parsons,Manager,931-685-2022,,parsonsrod@yahoo.com,,,,,,
TN-012492,Primary Care & Hope Clinic of Shelbyville,Rutherford County Primary Care Inc,1114973237,Federally Qualified Health Centers - Medical Services,1701 N Main St,Suite C,Shelbyville,TN,37160-2301,Bedford,1453 HOPE WAY,,MURFREESBORO,TN,37129,Rutherford,Lisa Terry,CEO,615-893-9390,203,lisa.terry@hopeclnc.org,Shane Smith,CFO,615-893-9390,202,shane.smith@hopeclnc.org,www.hopeclnc.org
TN-010279,Kids Are Special,Kids Are Special,1528477056,Rural Health Clinics,880 Colloredo Blvd,,Shelbyville,TN,37160-2774,Bedford,880 Colloredo Blvd,,Shelbyville,TN,37160,Bedford,Monteserrat Sanchez,Office Manager,931-685-8111,,montserrat.sanchez@kidsarespecialpeds.com,,,,,,
TN-010280,Dekalb County Health Department,State of Tennessee Department of Health,1437200474,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",254 Tiger Dr,,Smithville,TN,37166-6812,DeKalb,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TN-010281,Primary Care & Hope Clinic of Smyrna,Rutherford County Primary Care Inc,1114973237,Federally Qualified Health Centers - Medical Services,351 Quecreek Cir,,Smyrna,TN,37167,Rutherford,1453 Hope Way,,Murfreesboro,TN,37129,Rutherford,Lisa Terry,CEO,615-893-9390,203,lisa.terry@hopeclnc.org,Shane Smith,CFO,615-893-9390,202,shane.smith@hopeclnc.org,www.hopeclnc.org
TN-010282,Matthew Walker Comprehensive Health Center-Smyrna,Matthew Walker Comprehensive Health Center,1174839781,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",739 President Pl,Suite 100,Smyrna,TN,37167-6845,Rutherford,1035 14th Avenue North,,Nashville,TN,37208,Davidson,Katina Beard,CEO,615-340-1292,,kbeard@mwchc.org,"Ida M. Williams, M. D.",CMO / Medical Director,615-324-9669,,michele.williams@mwchc.org,www.mwchc.org
TN-010283,Hancock County Health Dept,Tennessee Department of Health,1689728750,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",178 Willow St,,Sneedville,TN,37869-3666,Hancock,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010284,Sneedville Medical Center,Rural Health Services Consortium Inc.,1669472460,"Dental Providers, Federally Qualified Health Centers - Medical Services",1861 Main St,PO Box 658,Sneedville,TN,37869-3645,Hancock,4966 Hwy 11W,,Rogersville,TN,37857,Hawkins,Linda W. Buck,CEO,423-921-1809,,Buckl@rhsctn.com,Faye Kern,Executive Assistant,423-921-1817,,kernf@rhsctn.com,www.rhsctn.com
TN-010285,FAYETTE COUNTY HEALTH DEPT.,Tennessee Department of Health,1730239997,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",90 Yum Yum Rd,,Somerville,TN,38068-4541,Fayette,Tennessee Department of Health,710 JAMES ROBERTSON PKWY,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010286,White County Health Department,State of Tennessee Department of Health,1811049331,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",135 Walker St,,Sparta,TN,38583-1725,White,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010287,Van Buren County Health Department,State of Tennessee Department of Health,1942352554,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",907 Old McMinnville St,,Spencer,TN,38585-3200,Van Buren,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,https://www.tn.gov/health/health-program-areas/localdepartments.html
TN-010288,Spring City Walk In Medical Center,Spring City Walk In Medical Center,1063433704,Rural Health Clinics,126 Lavender St,,Spring City,TN,37381-5102,Rhea,PO Box 709,,Spring City,TN,37381-0709,Rhea,Beth Young,Office Manager,423-452-9984,,beth.young@rxrefill.net,Annette Durham,MA,423-452-9984,,netta1972@yahoo.com,
TN-010289,Vanderbilt-Ingram Cancer Center at Maury Regional Spring Hill,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,1003 Reserve Blvd,Suite 240,Spring Hill,TN,37174-3246,Maury,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010290,Vanderbilt-Ingram Cancer Center at Northcrest Medical Center,Vanderbilt University Medical Center,1396882205,Outpatient Hospital Clinics,500 NorthCrest Dr,Suite 521,Springfield,TN,37172-4066,Robertson,3319 West End Avenue,,Nashville,TN,37203,Davidson,Angela Simmons,"Vice President, Finance",615-936-8875,,angela.simmons@vumc.org,Sheri Haun,Assoc VP,615-936-6009,,sheri.haun@vumc.org,http://www.vanderbilthealth.com/
TN-010291,Robertson County Health Dept,Tennessee Department of Health,1316090145,"Dental Providers, Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",800 S Brown St,,Springfield,TN,37172-2920,Robertson,Tennessee Department of Health,,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010292,STANTON HEALTH CENTER,HARDEMAN COUNTY COMMUNITY HEALTH CENTER,1356531610,Federally Qualified Health Centers - Medical Services,17 1st St E,,Stanton,TN,38069-4426,Haywood,629 Nuckolls Rd,,Bolivar,TN,38008-1599,Hardeman,Linda Lovelace,CFO,731-658-3388,121,linda.lovelace@hardemanhealth.org,MARY HEINZEN,,731-658-3388,147,MARY.HEINZEN@HADEMANHEALTH.ORG,
TN-010293,SWEETWATER HOSPITAL ASSOCIATION,SWEETWATER HOSPITAL ASSOCIATION,1366441370,Inpatient Hospitals (other than children's hospitals),304 Wright St,,Sweetwater,TN,37874-1181,Monroe,304 Wright St,,Sweetwater,TN,37874-1181,Monroe,DEBBIE THOMPSON,Chief Financial Officer,865-213-8336,336,DEBBIET@SWEETWATERHOSPITAL.ORG,ASHLEY OELGOETZ,ASSISTANT CHIEF FINANCIAL OFFICER,865-213-8582,,ACCOUNTING@SWEETWATERHOSPITAL.ORG,
TN-010294,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1376812636,Federally Qualified Health Centers - Medical Services,414 S High School St,SWEETWATER HIGH SCHOOL,Sweetwater,TN,37874,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010295,"CHEROKEE HEALTH SYSTEMS, INC.",CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6350 W Andrew Johnson Hwy,,Talbott,TN,37877-8605,Hamblen,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010296,Claiborne County Health Dept,Tennessee Department of Health,1184762163,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",620 Davis Dr,,Tazewell,TN,37879,Claiborne,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010297,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1871841825,Federally Qualified Health Centers - Medical Services,120 Old High School Rd,Tellico Plains Junior High School,Tellico Plains,TN,37385-4922,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010298,Chota Community Health Services,Chota Community Health Services,1477823672,Federally Qualified Health Centers - Medical Services,121 Old High School Rd,Tellico Plains Elementary School,Tellico Plains,TN,37385-4965,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010299,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1033467089,Federally Qualified Health Centers - Medical Services,130 Ruritan Rd,Coker Creek Elementary School,Tellico Plains,TN,37385-6075,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010300,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1407104458,Federally Qualified Health Centers - Medical Services,395 Daugherty Spring Rd,Rural Vale Elementary School,Tellico Plains,TN,37385-5604,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010301,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1801834221,Federally Qualified Health Centers - Medical Services,412 Hunt St,,Tellico Plains,TN,37385-5046,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,
TN-010302,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1972873438,Federally Qualified Health Centers - Medical Services,9180 New Highway 68,TELLICO PLAINS HIGH SCHOOL,Tellico Plains,TN,37385-5341,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010303,Lake County Primary Care,Citizens of Lake County for Health Care Inc.,1841311529,Federally Qualified Health Centers - Medical Services,710 Carl Perkins Pkwy,,Tiptonville,TN,38079-1678,Lake,710 Carl Perkins Parkway,,Tiptonville,TN,38079,Lake,Gayanne Williams,Executive Director,731-253-6690,,gwilliams@clchc.com,Amber Isbell,finance Officer,731-253-6690,,aisbell@clchc.com,
TN-010304,GIBSON COUNTY HEALTH DEPT.,Tennessee Department of Health,1073650461,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1250 Manufacturers Row,,Trenton,TN,38382-3632,Gibson,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010305,"Care Rite, PLLC","Care Rite, PLLC",1477827418,Other ECP Providers,2055 US Highway 45 Byp S,,Trenton,TN,38382-3501,Gibson,1445 Highway 51 Bypass East,,Dyersburg,TN,38024-2127,Dyer,Patricia Faye Owen,Administration,731-286-1900,,powen@careritepllc.com,Julia foster,Business Manager,731-286-1900,,julia@careritepllc.com,
TN-010306,Primary Care Clinic of Trezevant,Primary Care Clinic,1609309855,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",45 Hurt St,,Trezevant,TN,38258-2505,Carroll,Primary Care Clinic of Jackson,1430 Union University Drive Suite B,Jackson,TN,38305,Madison,Deborah Leggett,Nurse Practitoner/Owner,731-265-6197,,dbleggett@yahoo.com,Kathy Oconnor-Wray,Owner-Nurse Practitoner,731-265-6197,,pccofjackson@gmail.com,
TN-010308,OBION COUNTY HEALTH DEPT.,Tennessee Department of Health,1154471316,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1008 Mount Zion Rd,,Union City,TN,38261-7694,Obion,Tennessee Department of Health,"710 James Robertson Pkwy, 7th Floor",Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010309,Paula Vassar Inc,Paula Vassar Inc,1639151582,Rural Health Clinics,1117 S Miles Ave,Suite 4,Union City,TN,38261-5439,Obion,1117 S Miles Avenue,Suite 4,Union City,TN,38261,Obion,Billy Vassar,Owner,731-885-6600,,bbvassar@bellsouth.net,RHONDA RAY,,731-885-6600,,PVASSARINC@HOTMAIL.COM,
TN-010310,Michael Chad Odle,Union City Urgent Care,1295722114,Rural Health Clinics,1229 S 1st St,,Union City,TN,38261-5014,Obion,P. O. Box 307,,Union City,TN,38281,Obion,Bridgette Mullins,Office Manager,731-885-8282,,unioncityurgentcare@gmail.com,,,,,,
TN-010311,Reelfoot Family Walk In Clinic,"Dyersburg Family Walk In Clinic, Inc",1174712780,Rural Health Clinics,1509 E Reelfoot Ave,,Union City,TN,38261-5845,Obion,708 E Court St,,Dyersburg,TN,38024,Dyer,Jason Cantu,COO,731-285-8247,300,jason@rfwic.com,J. D. CANTU,Director of Community Relations,731-285-8247,413,JASON@RFWIC.COM,
TN-010312,"Terrell Clinic, LLC","Terrell Clinic, LLC",1053581744,Rural Health Clinics,701 E Reelfoot Ave,Suite 100,Union City,TN,38261-5886,Obion,701 East Reelfoot Ave,Suite 100,Union City,TN,38261,Obion,Rob Terrell,Office Manager,731-884-1737,,terrellclinic@aol.com,Darlene Simmons,Billing Manager,731-885-9687,,,
TN-010313,UNIONVILLE FAMILY PRACTICE,Unionville Family Practice,1730247305,Rural Health Clinics,3335 Highway 41A N,,Unionville,TN,37180-5033,Bedford,3335 Highway 41-A,,Unionville,TN,37180,Bedford,rod Parsons,manager,931-685-2022,,parsonsrod@yahoo.com,,,,,,
TN-010314,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1730459934,Federally Qualified Health Centers - Medical Services,1135 Highway 411,VONORE ELEMENTARY SCHOOL,Vonore,TN,37885-2437,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010315,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1518912955,Federally Qualified Health Centers - Medical Services,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,
TN-010316,CHOTA COMMUNITY HEALTH SERVICES,CHOTA COMMUNITY HEALTH SERVICES,1790055259,Federally Qualified Health Centers - Medical Services,414 Hall St,Vonore Middle School,Vonore,TN,37885-2338,Monroe,1206 Highway 411,,Vonore,TN,37885-2455,Monroe,Laura Harris,CEO,423-442-7268,,lharris@chotahealth.org,Melissa Gray,CFO,423-442-7268,,mgray@chotahealth.org,https://www.chotahealth.org/
TN-010317,Morgan County Health Dept,Tennessee Department of Health,1679611404,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1103 Knoxville Hwy,,Wartburg,TN,37887-4243,Morgan,710 James Robertson Pkwy 7th Floor,,Nashville,TN,37243,Davidson,Erica Jackson,ASA4,615-253-8537,,erica.jackson@tn.gov,,,,,,
TN-010318,Family Medicine West of Wartburg,Family Medicine West of Warburg,1902292865,Rural Health Clinics,1236 Knoxville Hwy Ste 500,P. O. Box 308,Wartburg,TN,37887-4200,Morgan,"1236 Knoxville Highway, Suite 500",P. O. Box 308,Wartburg,TN,37887,Morgan,Melissa Jobe,Office Manager,865-288-4232,,mjobefmw@gmail.com,Michelle Birchfield,Office Manager,865-288-4232,,mbirchfieldfmw@gmail.com,
TN-010319,Morgan County Medical Center,"Morgan County Health Council, Inc",1720099419,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",224 Old Mill Rd,PO Box 408,Wartburg,TN,37887-4163,Morgan,224 Old Mill Road,PO Box 408,Wartburg,TN,37887,Monroe,Theresa Brock,CEO,423-346-6221,224,t.brock@morgancountymedical.com,Judy Byrge,CFO,423-346-6221,225,j.byrge@morgancountymedical.com,http://morgancountymedical.com/
TN-010320,Wartrace Family Practice,Wartrace Family Practice,1952561979,Rural Health Clinics,507 Blackman Blvd W,,Wartrace,TN,37183-2210,Bedford,507 Blackman Blvd,,Wartrace,TN,37183,Bedford,rod Parsons,manager,931-389-0600,,parsonsrod@yahoo.com,,,,,,
TN-010321,WASHBURN CLINIC,CHEROKEE HEALTH SYSTEMS,1134128820,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",7719 Highway 131,,Washburn,TN,37888-4055,Grainger,2018 Western Ave,,Knoxville,TN,37921-5718,Knox,Paula Berry-Armour,Credentialing Manager,423-317-9344,4340,paula.berry@cherokeehealth.com,Jeffrey Howard,CFO,423-317-9344,6708,jeff.howard@cherokeehealth.com,www.cherokeehealth.com
TN-010322,King Family Medical,King Family Medical,1053547760,Rural Health Clinics,215B Holly Ln,,Waverly,TN,37185-3387,Humphreys,215B Holly Lane,,Waverly,TN,37185,Humphreys,Misty Hewitt,Office Manager,931-296-9969,,misty@kingfamilymedical.com,,,,,,
TN-010323,Humphreys County Health Dept,Tennessee Department of Health,1760534556,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",725 Holly Ln,,Waverly,TN,37185-3284,Humphreys,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010324,Hall Medical Group,Hall Medical Group,1023110392,Rural Health Clinics,107 Jv Mangubat Dr,,Waynesboro,TN,38485-2440,Wayne,P.O. Box 689,,Waynesboro,TN,38485,Wayne,Misty Turnbow,Clerical Mgr,931-722-2800,102,hallmedical@hotmail.com,Sherri Barber,Ins/Billing Specialist,931-722-2800,103,hallmedical@hotmail.com,
TN-010325,Hope Family Health Services,Hope Family Health Services,1942337183,Federally Qualified Health Centers - Medical Services,1124 New Highway 52 E,,Westmoreland,TN,37186-5060,Sumner,1124 New Hwy 52 E.,,Westmoreland,TN,37186,Sumner,Angela Mary Harper,Director of HR,615-644-2000,472,angelaharper@hopefamilyhealth.org,Mario Flores,CFO,615-644-2000,469,marioflores@hopefamilyhealth.org,
TN-010326,Dickson County Health Dept - White Bluff,Tennessee Department of Health,1205988144,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 School Rd,,White Bluff,TN,37187-9020,Dickson,"710 JAMES ROBERTSON PKWY, 7TH FLOOR",,Nashville,TN,37243,Davidson,Nancy Lutz-Vanderveer,Program Director 1,615-532-9686,,nancy.lutz-vanderveer@tn.gov,,,,,,
TN-010327,WINFIELD MEDICAL CENTER,MOUNTAIN PEOPLES HEALTH COUNCILS INC,1366443814,Federally Qualified Health Centers - Medical Services,25677 Scott Hwy,,Winfield,TN,37892-2293,Scott,470 Industrial Ln,,Oneida,TN,37841-6294,Scott,James C Lovett,Chief Executive Officer,423-286-4141,30,lovettj@mphci.com,Kay Crowley,Chief Operations Officer,423-286-4141,21,crowleyk@mphci.com,
TN-010328,Cannon County Health Department,State of Tennessee Department of Health,1760532444,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",301 W Main St,Suite 200,Woodbury,TN,37190-1100,Cannon,1100 England Drive,,Cookeville,TN,38501-0924,Putnam,Deborah K Johnson,Regional Director,931-528-7531,,debbie.johnson@tn.gov,,,,,,http://health.state.tn.us/localdepartments.htm
TX-010329,Abilene Community Health Center,TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER,1265810642,Federally Qualified Health Centers - Medical Services,1749 Pine St,,Abilene,TX,79601-3043,Taylor,3601 4th Street,,Lubbock,TX,79430,Lubbock,Linda McMurry,Executive Director,806-743-9571,,linda.mcmurry@ttuhsc.edu,Amy Bell,Finance Director,806-743-9553,,amy.bell@ttuhsc.edu,
TX-010330,Hendrick Medical Center,Hendrick Medical Center,1528064649,Inpatient Hospitals (other than children's hospitals),1900 Pine St,,Abilene,TX,79601-2432,Taylor,1900 Pine St.,,Abilene,TX,79601,Taylor,Jim Lowery,"Director, Managed Care",325-670-3889,,jlowery@hendrickhealth.org,Chris Mabry,"Manager, Reimbursement Services",325-670-5359,,cmabry@hendrickhealth.org,
TX-010331,Big Country AIDS Resources,Big Country AIDS Resources,1235506429,Ryan White Providers,402 Butternut St,,Abilene,TX,79602-1327,Taylor,402 Butternut St,,Abilene,TX,79602,Taylor,Betty Sims,E..D.,325-603-0691,,betty.sims@pacenters.org,Lynn Godbee,Grants Manager,325-603-2888,,lynn.godbee@pacenters.org,http://www.bcartx.com/category/content-category/direct-care-services
TX-010332,Planned Parenthood of Greater Texas - Addison Health Center,"Planned Parenthood of Greater Texas, Inc.",1740541424,"Family Planning Providers, Sexually Transmitted Disease Clinics",5290 Belt Line Rd,Suite 134,Addison,TX,75254,Dallas,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010333,ResourceCare Albany,Shackelford County Community Resource Center,1194804278,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",725 Pate St,,Albany,TX,76430-3225,Shackelford,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010334,Community Action Integration Center Alice,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1316374358,Federally Qualified Health Centers - Medical Services,614 W Front St,,Alice,TX,78332-7112,Jim Wells,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010335,Community Action Health Center,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1063529642,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",700 Flournoy Rd,,Alice,TX,78332-4003,Jim Wells,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010336,Family Health Services of Alpine,"Presidio County Health Services, Inc.",1518347921,Federally Qualified Health Centers - Medical Services,1605 N. Ft. Davis Hwy,,Alpine,TX,79830-2140,Brewster,P.O. Box 267,106 E. Texas,Marfa,TX,79843,Presidio,Linda Molinar,CEO,432-729-1812,,cfo_pchs@yahoo.com,Cynthia A. Esquivel,COO,432-729-1812,,hr_pchs@yahoo.com,
TX-012368,Alto Family Medical Clinic,"Merci,LLC d/b/a Alto Family Medical Clinic",1528413820,Rural Health Clinics,123 Busy Bee St,,Alto,TX,75925-6258,Cherokee,PO Box 427,,Alto,TX,75925,Cherokee,Candice Davis,Executive Administrator,936-642-0841,,cdavis.gfmc@gmail.com,Cynthia Callaway,Administrative Assistant,936-858-2327,,ccallaway.afmc@gmail.com,
TX-010337,Adoue Family Health Center,"STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC",1578730818,"Dental Providers, Federally Qualified Health Centers - Medical Services",1111 W Adoue St,,Alvin,TX,77511-2718,Brazoria,1111 W Adoue St,,Alvin,TX,77511-2718,Brazoria,Mark Young,CEO,281-824-1480,1131,myoung@sfachc.org,Rachel Martinez,CIO,281-824-1480,1103,rmartinez@sfachc.org,
TX-010338,Woman's and Children Health Center,Stephen F Austin Community Health Center,1578730818,Federally Qualified Health Centers - Medical Services,218 E House St,,Alvin,TX,77511-3544,Brazoria,1111 W Adoue,,Alvin,TX,77511,Brazoria,Mark Young,CEO,281-824-1480,1131,myoung@sfachc.org,Rachel Martinez,CIO,281-824-1480,1103,rmartinez@sfachc.org,
TX-012466,FCH Rural Health Clinic Alvord,Faith Community Hospital,1831674209,Rural Health Clinics,115 E Bypass 287,,Alvord,TX,76225-7778,Wise,215 Chisholm Trail,,Jacksboro,TX,76458,Jack,Frank L. Beaman,CEO,940-567-2961,246,fbeaman@fchtexas.com,Bonnie Blevins,CFO,940-567-6633,275,bblevins@fchtexas.com,fchtexas.com
TX-010339,Haven Health Clinics,Women's Health and Family Planning Association of Texas,1902080260,Family Planning Providers,1 Medical Dr,,Amarillo,TX,79106-4137,Potter,1 Medical Drive,1 Medical Drive,Amarillo,TX,79106-4137,Potter,Carolena Cogdill,Chief Executive Officer,806-242-1565,,ccogdill@hhcama.org,Cindy Wilkinson,Director of IT,806-242-1562,,cwilkinson@hhcama.org,http://www.havenhealthamarillo.com
TX-010340,"Regence Health Network, Inc. RMA - ACS","REGENCE HEALTH NETWORK, INC.",1922394097,Federally Qualified Health Centers - Medical Services,1301 S Coulter St,Suite 200,Amarillo,TX,79106-1765,Potter,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinator,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Director RCM,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010341,"Regence Health Network, Inc. RMA - GSRC","REGENCE HEALTH NETWORK, INC.",1033117577,Federally Qualified Health Centers - Medical Services,200 S Tyler St,,Amarillo,TX,79101-1448,Potter,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinator,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Director,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010342,"Regence Health Network, Inc. RMDA - AMR","REGENCE HEALTH NETWORK, INC.",1003813056,"Dental Providers, Federally Qualified Health Centers - Medical Services",850 Martin Rd,,Amarillo,TX,79107-6814,Potter,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinatorq,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Director,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010343,Bayside Clinic,CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT #1,1417032343,"Dental Providers, Federally Qualified Health Centers - Medical Services",621 S. Ross Sterling,,Anahuac,TX,77514,Chambers,200 Hospital Dr,,Anahuac,TX,77514,Chambers,Kaley N Smith,Executive Director,409-267-4126,,ksmith@chambershealth.org,Renee Harris,Business Office Director,409-267-2913,,rharris@chambershealth.org,http://www.chambershealth.org/html/bayside_clinic.html
TX-010344,Adult Health Services - Arlington Clinic,Tarrant County Public Health,1194783183,Sexually Transmitted Disease Clinics,2596 E Arkansas Ln,Suite 190,Arlington,TX,76014-1752,Tarrant,1101 S. Main Street,Room 2419,Fort Wort,TX,76014,Tarrant,Courtney Sherman,Nurse Practitioner,817-321-4869,,cpsherman@tarrantcounty.com,Dr. Catherine Colquitt,Medical Director/Health Authority,817-321-5344,,cacolquitt@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010345,Planned Parenthood of Greater Texas - Arlington Health Center,Planned Parenthood of Greater Texas,1891056586,"Family Planning Providers, Sexually Transmitted Disease Clinics",3701 S Cooper St,Suite 235,Arlington,TX,76015-3483,Tarrant,7424 Greenville Ave Suite 206,,Dallas,TX,75231,Dallas,Sheila McKinney,Cheif Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010346,Arlington Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,536 W Randol Mill Rd,,Arlington,TX,76011-5738,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76104,Tarrant,Cayce Trudo,Clinic Charge Nurse/Registered Nurse,817-321-4716,,chtrudo@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010347,Preventive Medicine Clinic - Arlington Clinic,Tarrant County Public Health,1205006996,Ryan White Providers,536 W Randol Mill Rd,,Arlington,TX,76011-5738,Tarrant,1101 S. Main Street,Room 2419,Fort Worth,TX,76104,Tarrant,Deborah Radaford,Nurse Practitioner,817-321-4850,,dlradaford@tarrantcounty.com,Dr. Catherine Colquitt,Medical Director/Health Authority for Tarrant County,817-321-4850,,cacolquitt@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010348,Stonewall Rural Health Clinic,Stonewall Memorial Hospital District,1184057598,Rural Health Clinics,819 N Broadway St,,Aspermont,TX,79502-2029,Stonewall,821 N Broadway,,Aspermont,TX,79502,Stonewall,Billie Carter,COO,940-989-3551,,billie.carter@smhdhealth.org,,,,,,
TX-010349,East Texas Border Health Clinic dba Genesis Primecare-Ellington,East Texas Border Health Clinic dba Genesis Primecare,1366828303,Federally Qualified Health Centers - Medical Services,1011 S William St,,Atlanta,TX,75551-3245,Cass,P. O. Box 1326,502 East Rusk Street,Marshall,TX,75671,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing Specialist,903-927-3782,20,leighann.richmond@genesisprimecare.org,
TX-010350,CommUnityCare Hancock,TRAVIS COUNTY HEALTHCARE DISTRICT,1619131554,Federally Qualified Health Centers - Medical Services,1000 E 41st St,Bldg O,Austin,TX,78751-4810,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010351,LSCC Family Care Center at Northwest,LONE STAR CIRCLE OF CARE,1780923045,Federally Qualified Health Centers - Medical Services,11111 Research Blvd,Suite 295,Austin,TX,78759-5281,Travis,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010352,CommUnityCare - North Central,TRAVIS COUNTY HEALTHCARE DISTRICT,1720350978,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1210 W Braker Ln,,Austin,TX,78758-3801,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010353,Ben White Health Clinic,LONE STAR CIRCLE OF CARE,1417195942,Federally Qualified Health Centers - Medical Services,1221 W Ben White Blvd,Suite 200B,Austin,TX,78704-7002,Travis,205 E University Ave. Ste 200,,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010354,CommUnityCare Blackstock,Travis County Healthcare District,1467857185,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1313 Red River St,Suite 100,Austin,TX,78701-1923,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010355,CommUnityCare Women's Health,Travis County Healthcare District,1962719914,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1313 Red River St,Suite 320,Austin,TX,78701-1936,Travis,1111 East Cesar Chavez,,Austin,TX,78703,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010356,CommUnityCare ATCIC,TRAVIS COUNTY HEALTHCARE DISTRICT,1982632477,Federally Qualified Health Centers - Medical Services,1631 E 2nd St,,Austin,TX,78702-4490,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010357,CommUnityCare Sandra Joy Anderson Health and Wellness Center,Travis County Healthcare District,1518333004,Federally Qualified Health Centers - Medical Services,1705 E 11th St,,Austin,TX,78702-2709,Travis,1111 East Cesar Chavez,,Austin,TX,78703,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010358,Planned Parenthood of Greater Texas - Downtown Austin Health Center,Planned Parenthood of Greater Texas,1528147204,"Family Planning Providers, Sexually Transmitted Disease Clinics",1823 E 7th St,,Austin,TX,78702-2713,Travis,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Travis,Sheila McKinney,Chief Operating Officer,214-363-2004,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010359,Planned Parenthood of Greater Texas - South Austin Health Center,"Planned Parenthood of Greater Texas, Inc.",1740442383,"Family Planning Providers, Sexually Transmitted Disease Clinics",201 E Ben White Blvd,,Austin,TX,78704-7301,Travis,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010360,CommUnityCare East Austin,TRAVIS COUNTY HEALTHCARE DISTRICT,1982632477,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",211 Comal St,,Austin,TX,78702-4326,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010361,CommUnityCare South Austin,TRAVIS COUNTY HEALTHCARE DISTRICT,1780612275,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2529 S 1st St,,Austin,TX,78704-5466,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010362,CommUnityCare Rosewood-Zaragosa,TRAVIS COUNTY HEALTHCARE DISTRICT,1952339475,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2802 Webberville Rd,,Austin,TX,78702-2947,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010363,CommUnityCare Southeast Health and Wellness Center,TRAVIS COUNTY HEALTHCARE DISTRICT,1205267499,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2901 Montopolis Dr,,Austin,TX,78741-6411,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010364,Central,PEOPLE'S COMMUNITY CLINIC,1568726214,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2909 N Interstate 35,,Austin,TX,78722-2304,Travis,2909 N I35,,Austin,TX,78722-2304,Travis,Regina Rogoff,Chief Executive Officer,512-708-3121,,reginar@austinpcc.org,Alexandra Berry,Director of Compliance,512-684-1715,,alexb@austinpcc.org,http://www.austinpcc.org
TX-010365,CommUnityCare David Powell Clinic,TRAVIS COUNTY HEALTHCARE DISTRICT,1265460745,Federally Qualified Health Centers - Medical Services,4614 N Interstate 35,,Austin,TX,78751-3401,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,http://www.communitycaretx.org
TX-010366,DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS (children's inpatient hospital),Seton Healthcare Family,1447355771,Children's Hospitals (inpatient only),4900 Mueller Blvd,,Austin,TX,78723-3079,Travis,1345 Philomena Street,,Austin,TX,78723,Travis,Debra Brown,"VP, Patient Care Services, COO",512-324-0186,,dmbrown1@seton.org,,,,,,www.dellchildrens.net
TX-010367,DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS (dental provider),Seton Healthcare Family,1447355771,Dental Providers,4900 Mueller Blvd,,Austin,TX,78723-3079,Travis,1345 Philomena Street,,Austin,TX,78723,Travis,Debra Brown,"VP, Patient Care Services, COO",512-324-0186,,dmbrown1@seton.org,,,,,,www.dellchildrens.net
TX-010368,CommUnityCare Austin Resource Center for the Homeless,TRAVIS COUNTY HEALTHCARE DISTRICT,1073541561,Federally Qualified Health Centers - Medical Services,500 E 7th St,,Austin,TX,78701-3319,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010369,CommUnityCare ATCIC-Dove Springs,TRAVIS COUNTY HEALTHCARE DISTRICT,1801237748,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",5015 S I35,,Austin,TX,78744,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010370,CommUnityCare William Cannon,TRAVIS COUNTY HEALTHCARE DISTRICT,1205864774,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6801 S I35,,Austin,TX,78744,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010371,Lone Star Circle of Care at El Buen Samaritano,LONE STAR CIRCLE OF CARE,1396300687,Federally Qualified Health Centers - Medical Services,7000 Woodhue Dr,Bldg B,Austin,TX,78745-5454,Travis,205 E University Ave,Ste 200,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,CEO,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,CFO,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010372,Lone Star Circle of Care at Stassney,LONE STAR CIRCLE OF CARE,1235584848,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",730 W Stassney Ln,Suite 110,Austin,TX,78745-3032,Travis,205 E. University Ave. Ste. 200,,Georgetown,TX,78726-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010373,CommUnityCare ATCIC Rundberg,TRAVIS COUNTY HEALTHCARE DISTRICT,1376784108,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",825 E Rundberg Ln,Suite F-1,Austin,TX,78753-4808,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010374,CommUnityCare Oak Hill,TRAVIS COUNTY HEALTHCARE DISTRICT,1972531440,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",8656A W Highway 71,Suite C,Austin,TX,78735-8078,Travis,1111 E Cesar Chavez St Ste B,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-012409,Lone Star Circle of Care at Collinfield,LONE STAR CIRCLE OF CARE,1699289728,Federally Qualified Health Centers - Medical Services,8913 Collinfield Dr Unit 1,,Austin,TX,78758-6704,Travis,205 E. University Ave,Ste 200,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,CEO,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,CFO,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010375,Park,People's Community Clinic,1568726214,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",900 E 30th St,Suite 303,Austin,TX,78705-3378,Travis,2909 N IH-35 Frontage Rd,,Austin,TX,78722,Travis,Regina Rogoff,Chief Executive Officer,512-708-3121,,reginar@austinpcc.org,Alexandra Berry,Director of Compliance,512-684-1715,,alexb@austinpcc.org,http://www.austinpcc.org
TX-010376,Planned Parenthood of Greater Texas - North Austin Health Center,Planned Parenthood of Greater Texas,1962581546,"Family Planning Providers, Sexually Transmitted Disease Clinics",9041 Research Blvd,Suite 250,Austin,TX,78758-7060,Travis,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010377,ResourceCare Baird,Shackelford County Community Resource Center,1073749784,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",128 W 4th St,,Baird,TX,79504-5314,Callahan,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010378,BALLINGER HOSPITAL CLINIC,BALLINGER MEMORIAL HOSPITAL DISTRICT,1538123617,Rural Health Clinics,2001 Hutchins Ave,Suite C,Ballinger,TX,76821-4453,Runnels,PO Box 617,,Ballinger,TX,76821,Runnels,Sally Lutes,DIRECTOR OF CLINIC,325-365-5337,,sallyl@bmhd.org,RHETT D. FRICKE,CEO/Administrator,325-365-2531,,rhettf@bmhd.org,
TX-010379,BALLINGER MEMORIAL HOSPITAL,BALLINGER MEMORIAL HOSPITAL DISTRICT,1538123617,Inpatient Hospitals (other than children's hospitals),608 Avenue B,,Ballinger,TX,76821-2406,Runnels,PO Box 617,,Ballinger,TX,76821,Runnels,RHETT D. FRICKE,CEO/ADMINISTRATOR,325-365-2531,,rhettf@bmhd.org,LAURA MALLORY,Administrative Assistant,325-365-2531,,lauram@bmhd.org,
TX-010380,Bastrop Community Health Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1629471875,"Dental Providers, Federally Qualified Health Centers - Medical Services",275 Jackson St,,Bastrop,TX,78602-4316,Bastrop,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010381,LSCC Family Care Center at Bastrop,LONE STAR CIRCLE OF CARE,1306236187,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",605 Old Austin Hwy,,Bastrop,TX,78602-5034,Bastrop,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010382,Matagorda Regional Medical Center,Matagorda Regional Medical Center,1679678767,Inpatient Hospitals (other than children's hospitals),104 7th St,,Bay City,TX,77414-4853,Matagorda,104 7th Street,,Bay City,TX,77414,Matagorda,Terri L. Cox,Compliance Officer,979-241-5551,5551,tcox@matagordaregional.org,Bryan Prochnow,Chief Financial Officer,979-241-5525,5525,bprochnow@matagordaregional.org,www.matagordaregional.org
TX-010383,MEHOP Women and Children Center,Matagorda Episcopal Health Outreach Program,1003193848,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",111 Ave F N,,Bay City,TX,77414-3167,Matagorda,101 Ave F N,,Bay City,TX,77414-3167,Matagorda,Eve Chen,CFO,979-245-2098,,echen@mehop.org,,,,,,
TX-010384,MEHOP Primary and Behavioral Health,Matagorda Episcopal Health Outreach Program,1861741779,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1700 Golden Ave,,Bay City,TX,77414-3122,Matagorda,101 Ave F N,,Bay City,TX,77414-3167,Matagorda,Eve Chen,CFO,979-245-2098,,echen@mehop.org,,,,,,
TX-010385,MEHOP Dental,Matagorda Episcopal Health Outreach Program,1073703575,Dental Providers,205 Ida Ave,,Bay City,TX,77414-3144,Matagorda,101 Ave F N,,Bay City,TX,77414-3167,Matagorda,Celeste Harrison,CEO,979-245-2008,302,charrison@mehop.org,Eve Chen,CFO,979-245-2098,,echen@mehop.org,
TX-010386,Harris County Public Health - Baytown Clinic,Harris County Public Health,1407992191,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1000 Lee Dr,,Baytown,TX,77520-6980,Harris,2223 West Loop South,,Houston,TX,77027,Harris,Oluwagbenga Adesope,Section Chief - Clinical Health and Prevention,713-439-6116,,oadesope@hcphes.org,,,,,,
TX-010387,Legacy San Jacinto,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1699117523,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",4301 Garth Rd,Suite 400,Baytown,TX,77521-3159,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010388,Legacy South Park Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1235482878,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",4450 Highland Ave,,Beaumont,TX,77705-5205,Jefferson,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010389,Legacy Central Beaumont,Legacy Community Health Services,1154796829,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",450 N 11th St,,Beaumont,TX,77702-1804,Jefferson,1415 California,,Houston,TX,77006,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010390,Planned Parenthood of Greater Texas - Bedford Health Center,"Planned Parenthood of Greater Texas, Inc.",1760743462,"Family Planning Providers, Sexually Transmitted Disease Clinics",2824 Central Dr,Suite 332,Bedford,TX,76021-7819,Tarrant,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,,,,,,https://www.plannedparenthood.org/health-center/texas/bedford/76021/bedford-health-center-2242-91620
TX-010391,CHRISTUS SPOHN HOSPITAL BEEVILLE,CHRISTUS Health,1447228747,Inpatient Hospitals (other than children's hospitals),1500 E Houston St,,Beeville,TX,78102-5312,Bee,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-010392,CHRISTUS SPOHN MEDICAL CLINIC BEEVILLE,CHRISTUS SPOHN MEDICAL CLINIC BEEVILLE,1881663631,Rural Health Clinics,1602 E Houston St,Suite A,Beeville,TX,78102-5335,Bee,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-010393,Community Action Integration Center Beeville,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1295162436,Federally Qualified Health Centers - Medical Services,2808 SE Industrial Park Blvd,,Beeville,TX,78102-7205,Bee,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010394,Community Action Health Center Bee,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1629415203,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 S Hillside Dr,,Beeville,TX,78102-5307,Bee,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010395,ST. HOPE COMMUNITY HEALTH CLINIC BELLAIRE,"ST. HOPE FOUNDATION, INC.",1558479683,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",6800 West Loop S,Suite 540,Bellaire,TX,77401-4528,Harris,6200 SAVOY DRIVE,SUITE 560,Houston,TX,77036-3338,Harris,MARY R. CAMPBELL,Credentialing,713-839-7111,7965,MCAMPBELL@OFFERINGHOPE.ORG,MIKA SAM COOPER,COO,713-778-1300,,mika@offeringhope.org,
TX-010396,Community Action Health Center Duval,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1609010131,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",115 W Main St,,Benavides,TX,78341,Duval,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010397,Howard County Community Health Center,SOUTH PLAINS RURAL HEALTH SERVICES INC,1609171149,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1300 S Gregg St,,Big Spring,TX,79720-4325,Howard,1000 FM 300,,Levelland,TX,79336,Hockley,Judith Madura,CEO,806-894-7842,,jmadura@sprhs.org,Tara Haskell,CFO,806-894-7842,,thaskell@sprhs.org,
TX-010398,"South Texas Rural Health Services, Inc.- Big Wells","South Texas Rural Health Services, Inc.",1740512755,Federally Qualified Health Centers - Medical Services,1502 Grand Ave.,,Big Wells,TX,78830,Dimmit,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010399,BONHAM COMMUNITY HLTH CENTER,Community Health Service Agency Inc.,1184607723,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",920 N Center St,,Bonham,TX,75418-3751,Fannin,4500 Wesley St,,Greenville,TX,75401-5644,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-012467,FCH Rural Health Clinic Bowie,Jack County Hospital District,1417489956,Rural Health Clinics,1010 N Mill St,,Bowie,TX,76230-3120,Montague,215 Chisholm Trail,,Jacksboro,TX,76458,Jack,Frank L. Beaman,CEO,940-567-2961,246,fbeaman@fchtexas.com,Bonnie Blevins,CFO,940-567-6633,,bblevins@fchtexas.com,fchtexas.com
TX-010400,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1336284785,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",202 James St,,Brackettville,TX,78832,Kinney,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010401,Frontera Healthcare Network - Brady Clinic,FRONTERA HEALTHCARE NETWORK,1801143664,Federally Qualified Health Centers - Medical Services,2205 S Bridge St,,Brady,TX,76825-7443,McCulloch,604 Eaker St,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010402,Breckenridge Medical Center,Stephens Memorial Hospital District dba Breckenridge Medical Center,1336560382,Rural Health Clinics,101 S Hartford St,,Breckenridge,TX,76424-4711,Stephens,101 South Hartford Street,,Breckenridge,TX,76424,Stephens,Jana Earnest,Clinic Director,254-559-3363,23,jana.earnest@smhtx.com,Chris Curtis,Practice Administrator,254-559-3363,11,chris.curtis@smhtx.com,
TX-012369,Stephens Memorial Hospital,Stephens Memorial Hospital District,1285065623,Inpatient Hospitals (other than children's hospitals),200 S Geneva St,,Breckenridge,TX,76424-4702,Stephens,200 S. Geneva St.,,Breckenridge,TX,76424,Stephens,Matthew Brian Kempton,CEO,254-559-2241,201,matt.kempton@smhtx.com,Doug Smith,CFO,254-559-2241,306,doug.smith@smhtx.com,www.smhtx.com
TX-010403,ResourceCare Breckenridge,Shackelford County Community Resource Center,1417248824,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2802 W Walker St,,Breckenridge,TX,76424-4000,Stephens,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010404,FCHC BREMOND CLINIC,Falls Community Hospital,1558311241,Rural Health Clinics,201 N Main St,,Bremond,TX,76629-5296,Robertson,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@fallshospital.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010405,AccessHealth- Brookshire Center,"Fort Bend Family Health Center, Inc., dba AccessHealth",1962884189,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",533 FM 359 Rd S,,Brookshire,TX,77423-9006,Waller,400 Austin Street,,Richmond,TX,77469-4406,Fort Bend,Jared M. Williams,Director of Reporting and Analytics,281-633-3194,,JWilliams@myaccesshealth.org,Michael R. Dotson,Chief Executive officer,281-633-3165,,MDotson@myaccesshealth.org,www.myaccesshealth.org
TX-010406,South Plains Public Health District - Terry County,South Plains Public Health District,1386660991,Family Planning Providers,919 E Main St,,Brownfield,TX,79316-4633,Terry,919 E Main St,,Brownfield,TX,79316-4633,Terry,"Soronya Shafer, RN",Director of Clinical Services,432-758-4022,,sshafer@spphd.org,Janie Fletcher,Administrative Services Manager,806-637-2164,,jfletcher@spphd.org,https://southplainshealth.org/
TX-010407,Su Clinica - Brownsville,SU CLINICA FAMILIAR,1811901655,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",105 E Alton Gloor Blvd,,Brownsville,TX,78526-3391,Cameron,1706 Treasure Hills Blvd,,Harlingen,TX,78550-8911,Cameron,Dr. Elena Marin,CEO,956-365-6750,12301,emarin@suclinica.org,Adam Sasldivar,CFO,956-365-6750,12322,asaldivar@suclinica.org,www.suclinica.org
TX-010408,New Horizon Medical Center,Brownsville Community Health Clinic Corp,1457659468,"Dental Providers, Federally Qualified Health Centers - Medical Services",191 E Price Rd,,Brownsville,TX,78521-3527,Cameron,191 E Price Road,,Brownsville,TX,78521,Cameron,Paula S. Gomez,Executive Director,956-548-7400,,psgomz.bchc@tachc.org,Irma Vela,Provider Enrollment/Billiing Asst,956-621-3593,,ivela.bchc@tachc.org,
TX-010409,Planned Parenthood,Planned Parenthood Cameron County,1699944843,Family Planning Providers,870 E Alton Gloor Blvd,Suite B,Brownsville,TX,78526-3364,Cameron,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-010410,Brownwood Community Health Center,"CROSS TIMBERS HEALTH CLINICS, INC.",1679867576,Federally Qualified Health Centers - Medical Services,104 S Park Dr,,Brownwood,TX,76801-5918,Brown,1100 W Reynosa Ave,,De Leon,TX,76444-1630,Brown,Sherry L Hill,Chief Executive Officer,254-893-5895,,shill@crosstimbersinc.org,,,,,,
TX-010411,Midway Family Planning Clinic,"Midway Family Planning, Inc",1316065170,"Family Planning Providers, Sexually Transmitted Disease Clinics",1500 Terrace Dr Apt 35,,Brownwood,TX,76801-2045,Brown,1500 Terrace #35,,Brownwood,TX,76801,Brown,Carole J Parker,Executive Director,325-646-8429,,midwayfp@gmail.com,Judy Guinn,President of the Board,325-646-8429,,midwayfp@gmail.com,
TX-010412,Cross Timbers Health Clinic Brownwood,"CROSS TIMBERS HEALTH CLINICS, INC.",1588778260,Federally Qualified Health Centers - Medical Services,3804 Highway 377 S,,Brownwood,TX,76801-5120,Brown,1100 W Reynosa Ave,,De Leon,TX,76444-1630,Brown,Sherry L Hill,Chief Executive Officer,254-893-5895,,shill@crosstimbersinc.org,,,,,,
TX-010413,HealthPoint Memorial,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1497183883,Federally Qualified Health Centers - Medical Services,1301 Memorial Dr,,Bryan,TX,77802-5205,Brazos,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010414,BRYAN COLLEGE STATION CHC,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1649265646,Federally Qualified Health Centers - Medical Services,3370 S Texas Ave,,Bryan,TX,77802-3127,Brazos,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@bvcaa.org,,,,,,
TX-010415,Community Health Dental Clinic,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1649265646,Dental Providers,624 Mary Lake Dr,,Bryan,TX,77801-3423,Brazos,1500 University Drive East,,College Station,TX,77840,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010416,HealthPoint Caldwell,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1609150465,Federally Qualified Health Centers - Medical Services,1103 Woodson Dr,,Caldwell,TX,77836-1052,Burleson,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,979-567-7080,,,
TX-010417,CANYON HEALTH CENTER,COMMUNITY HEALTH DEVELOPMENT INC,1841316288,Federally Qualified Health Centers - Medical Services,700 Frio St,,Camp Wood,TX,78833,Real,908 Evans St,,Uvalde,TX,78801-6051,Uvalde,Christina Velasquez,Business Office Manager,830-278-5604,3100,cvelasquez.chdi@tachc.org,Maylela Castanon,CFO,830-278-5604,3100,mcastanon.chdi@tachc.org,
TX-010418,WESTWAY SATELLITE CLINIC,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,"Dental Providers, Federally Qualified Health Centers - Medical Services",1713 Banker Rd,,Canutillo,TX,79835-8960,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010419,Upper Valley Medical Clinic,PROJECT VIDA HEALTH CENTER,1073993184,Federally Qualified Health Centers - Medical Services,950 Anthony St,,Canutillo,TX,79835-6052,El Paso,3607 Rivera Avenue,,El Paso,TX,79905,El Paso,William Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010420,"South Texas Rural Health Services, Inc.-Carrizo Springs","South Texas Rural Health Services, Inc.",1215269956,"Dental Providers, Federally Qualified Health Centers - Medical Services",902 S 5th St,,Carrizo Springs,TX,78834-4206,Dimmit,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010421,MEDICAL CLINIC OF CASTROVILLE,Medina County Hospital District,1386751394,Rural Health Clinics,1028 Country Ln,,Castroville,TX,78009-5027,Medina,3100 Ave E,,Hondo,TX,78861,Medina,Ashley Lowe,Clinis Administrator,830-426-7444,,ALowe@medinahospital.net,Kevin Frosch,CFO,830-426-7898,,kevin.frosch@medinahospital.net,
TX-010422,"Planned Parenthood of Greater Texas, Inc - Cedar Hill Health Center",Planned Parenthood of Greater Texas,1861753279,"Family Planning Providers, Sexually Transmitted Disease Clinics",140 W FM 1382,Suite 160,Cedar Hill,TX,75104,Dallas,7424 Greenville Ave.,Ste 206,Dallas,TX,75231,Dallas,Sheila McKinney,COO,214-254-3021,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,https://www.plannedparenthood.org/health-center/texas/cedar-hill/75104/cedar-hill-health-center-2160-91620
TX-010423,Dell Children's-Circle of Care Pediatrics at Whitestone,LONE STAR CIRCLE OF CARE,1689983066,Federally Qualified Health Centers - Medical Services,1730 E Whitestone Blvd,Suite 101,Cedar Park,TX,78613-7285,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010424,Cedar Park Public Health Center,Williamson County and Cities Health District,1982661633,"Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",350 Discovery Blvd,Suite 102,Cedar Park,TX,78613-2253,Williamson,100 W. 3rd Street,,Georgetown,TX,78626,Williamson,Stacy Schweitzer,Billing Specialist,512-943-3645,,sschweitzer@wcchd.org,Michelle Broddrick,Finance and Administration Director,512-943-3603,,mbroddrick@wcchd.org,http://www.wcchd.org/location_and_hours/
TX-010425,LEON COUNTY COMMUNITY HLTH CTR,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1568519122,Federally Qualified Health Centers - Medical Services,607 W Lassater,,Centerville,TX,75833-1959,Leon,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010426,Fox Rural Health Clinic,Childress Regional Medical Center,1902995525,Rural Health Clinics,1001 US Highway 83 N,,Childress,TX,79201-2322,Childress,901 US Hwy 83,,Childress,TX,79201,Childress,John Marshall Henderson,CEO,940-937-9178,178,jmh@childresshospital.com,Ladonna Willis,Clinic Manager,940-937-9654,654,lwillis@childresshospital.com,www.childresshospital.com
TX-010427,Childress Regional Medical Center,Childress County Hospital District,1326079534,Inpatient Hospitals (other than children's hospitals),901 US Highway 83 N,,Childress,TX,79201-2320,Childress,PO BOX 1030,,Childress,TX,79201,Childress,John Marshall Henderson,CEO,940-937-9178,,jmh@childresshospital.com,Kevin Latimer,CFO,940-937-9181,,,
TX-010428,Clarendon Family Medical Center,Clarendon Family Medical Center,1780767236,Rural Health Clinics,One Medical Center Drive,,Clarendon,TX,79226,Donley,PO Drawer K,,Clarendon,TX,79226,Donley,Jami Vierig,Office Manager,806-874-3531,,jvierig.cfmc@gmil.com,Daniel Burcham,Owner,806-874-3531,,clarendonfamilymedical@gmail.com,
TX-010429,CLAUDE FAMILY MEDICAL CLINIC LLC,Claude Family Medical Clinic LLC,1083862379,Rural Health Clinics,201 Parks St,,Claude,TX,79019-3868,Armstrong,201 Parks St,,Claude,TX,79019-3868,Armstrong,Lynn Levin,Office Manager,806-226-5611,,cmedical@amaonline.com,Janet Bilyeu,Owner/Provider,806-226-5611,,jbilyeu@rocketmail.com,
TX-010430,Goodall-Witcher Hospital Authority,Goodall-Witcher Hospital Authority,1962455832,Inpatient Hospitals (other than children's hospitals),101 Posey Ave,,Clifton,TX,76634-1289,Bosque,101 Posey Avenue,,Clifton,TX,76634,Bosque,Adam Willmann,President/CEO,254-675-8322,7992,awillmann@gwhf.org,Wilson Dingmore,Director of Rural Health Clinics,254-675-8621,7987,wdingmore@gwhf.org,www.gwhf.org
TX-010431,Clifton Medical Clinic,Goodall-Witcher Hospital Authority,1184666026,Rural Health Clinics,201 Posey Ave,,Clifton,TX,76634-1200,Bosque,101 Posey Avenue,,Clifton,TX,76634,Bosque,Adam Willmann,President/CEO,254-675-8322,7992,awillmann@gwhf.org,Wilson Dingmore,Director of Rural Health Clinics,254-675-8621,7987,wdingmore@gwhf.org,www.gwhf.org
TX-010432,ResourceCare Clyde,Shackelford County Community Resource Center,1215205265,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1712 N Access Rd,,Clyde,TX,79510-3352,Callahan,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010434,Health Point ABC,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1275726853,Federally Qualified Health Centers - Medical Services,1602 Rock Prairie Rd,Suite 300,College Station,TX,77845-8309,Brazos,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@bvcaa.org,,,,,,
TX-010435,FAMILY MEDICAL ASSOCIATES,Family Medical Associates,1518976836,Rural Health Clinics,997 W Interstate 20,,Colorado City,TX,79512-2685,Mitchell,997 West Interstate 20,,Colorado City,TX,79512,Mitchell,Murray Hall,Manager,325-728-2693,,murrayhall@mitchellcountyhospital.com,Rpbbie Dewberry,CEO,325-728-3431,,rdewberry@mitchellcountyhospital.com,
TX-010436,ST. HOPE COMMUNITY HEALTH CLINIC CONROE,"St. Hope Foundation, Inc",1265581144,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Ryan White Providers",1414 S Frazier St,Suite 105,Conroe,TX,77301-4475,Montgomery,6200 SAVOY DRIVE,SUITE 560,Houston,TX,77036-3338,Harris,MARY R. CAMPBELL,Credentialing,713-839-7111,7965,MCAMPBELL@OFFERINGHOPE.ORG,MIKA SAM COOPER,COO,713-778-1300,,mika@offeringhope.org,
TX-012410,CENTROMED FAMILY FIRST CLINIC,EL CENTRO DEL BARRIO,1659849875,Federally Qualified Health Centers - Medical Services,9135 Schaefer Rd,,Converse,TX,78109-1979,Bexar,3750 Commercial Ave,,SAN ANTONIO,TX,78221-3117,Bexar,ERNESTO GOMEZ,PRESIDENT & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,ANNA SERRANO,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010437,Cooper Community Health Center,Community Health Service Agency Inc.,1700067253,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",91 W Side Sq,,Cooper,TX,75432-1725,Delta,4500 Wesley St,,Greenville,TX,75401-5644,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010438,Family Medicine Clinic,Family Medicine Rural Health Clinic,1700150869,Rural Health Clinics,2401 Walker Place Blvd,,Copperas Cove,TX,76522-4025,Coryell,207 W. Ave E,,Lampasas,TX,76550,Lampasas,Mia Monroe,Finance Director,512-556-3621,132,mmonroe@fmcmedicine.com,Kim Gabara,Practice Administrator,512-556-3621,,kgabara@fmcmedicine.com,www.fmcmedicine.com
TX-010439,Amistad Community Health Center,AMISTAD COMMUNITY HEALTH CENTER,1386770147,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1533 S Brownlee Blvd,,Corpus Christi,TX,78404-3131,Nueces,1533 S. Brownlee Blvd,,Corpus Christi,TX,78414,Nueces,Joe R Flores,CEO,361-886-3090,,joef.flores@amistadchc.org,Cathie R Threatt,CFO,361-886-3066,,catherine.threatt@amistadchc.org,
TX-010440,Holly Clinic,"Women's and Men's Health Services of the Coastal Bend, Inc.",1982777256,Family Planning Providers,3536 Holly Rd,,Corpus Christi,TX,78415-3214,Nueces,3536 Holly Road,,Corpus Christi,TX,78415-3214,Nueces,Amanda Stukenberg,CEO,361-855-9107,,astukenberg@wamhs.org,Janice Haas,Finance Director,361-855-9107,,jhaas@wamhs.org,
TX-010441,Dillon Clinic,"Women's and Men's Health Services of the Coastal Bend, Inc.",1588738389,Family Planning Providers,4410 Dillon Ln,Suite 1,Corpus Christi,TX,78415-5333,Nueces,3536 Holly Road,,Corpus Christi,TX,78415-3214,Nueces,Amanda Stukenberg,CEO,361-855-9107,,astukenberg@wamhs.org,Janice Haas,Finance Director,361-855-9107,,jhaas@wamhs.org,https://www.wamhs.org/
TX-010442,Family Planning Clinic and Men's Health Center,South Texas Family Planning & Health Corporation,1760535660,"Family Planning Providers, Tuberculosis Clinics",4455 S Padre Island Dr,Suite 30,Corpus Christi,TX,78411-5142,Nueces,4455 South Padre Island Drive,Suite 29,Corpus Christi,TX,78411,Nueces,Martha Zuniga,Executive Director,361-855-7333,11,marthazuniga@stfphc.org,Cynthia Gonzales,Asst. Director / Education Director,361-855-7333,17,cynthiagonzales@stfphc.org,
TX-010443,Coastal Bend Wellness Foundation,Coastal Bend Wellness Foundation,1144523671,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",5633 S Staples St,Suite 700,Corpus Christi,TX,78411-4679,Nueces,5633 S. Staples,Suite 700,Corpus Christi,TX,78411,Nueces,J.R. De La Garza,Director of Clinical Operations,361-814-2001,220,jrd@cbwellness.org,Bill Hoelscher,CEO,361-814-2001,261,billh@cbwellness.org,www.cbwellness.org
TX-010444,"South Texas Rural Health Services, Inc.-Cotulla","South Texas Rural Health Services, Inc.",1952337263,"Dental Providers, Federally Qualified Health Centers - Medical Services",105 S. Stewart St.,,Cotulla,TX,78014,La Salle,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010445,"Hometown Healthcare, LLC","Hometown Healthcare, LLC",1881911030,Rural Health Clinics,408 N Giraud St,,Cotulla,TX,78014-3113,La Salle,P.O. Box 2070,,Orange Grove,TX,78014,Jim Wells,Macy Thompson,Administrator,830-879-2279,,hhmthompson@yahoo.com,,,,,,
TX-010446,CRANE COUNTY HOSPITAL DISTRICT,CRANE COUNTY HOSPITAL DISTRICT,1073763439,Rural Health Clinics,1310 S Alford St,Suite A,Crane,TX,79731-3801,Crane,1310 S ALFORD STREET SUITE A,,CRANE,TX,79731-3809,Crane,FRANKIE D YEAGER,CEO,432-558-3555,133,dyeager@cranememorial.org,JULIE HARDCASTLE,BUSINESS OFFICE MANAGER,432-558-3555,147,jhardcastle@cranememorial.org,www.cranememorial.org
TX-010447,ResourceCare Cross Plains Dental,Shackelford County Community Resource Center,1437551710,Dental Providers,200 N Main St,,Cross Plains,TX,76443-3312,Callahan,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010448,ResourceCare Cross Plains,Shackelford County Community Resource Center,1881985299,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 S Main St,,Cross Plains,TX,76443-2581,Callahan,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010449,Foard County Medical Clinic,Hardeman County Memorial Hospital,1821277211,Rural Health Clinics,200 1st St,,Crowell,TX,79227,Foard,PO Box 90,,Quanah,TX,79252,Foard,Tracy Betts,CFO,940-663-2795,137,tracy.betts@hcmhosp.com,Dennis Thomas,CEO,940-663-2795,,,
TX-010450,Vidaysalud Health System Inc,Vidaysalud Health System Inc,1770511032,Federally Qualified Health Centers - Medical Services,1603 N 11th St,CCISD-VSHSI School-Based Health Clinic,Crystal City,TX,78839,Zavala,308 S Cesar Chavez Ave,,Crystal City,TX,78839-4200,Zavala,Nora Tellez,CEO,830-374-2301,101,norat@vidaysalud.org,Laylaly Menchaca,Program and Grants Consultant,830-279-4220,166,lalym@vidaysalud.org,www.vidaysalud.org
TX-010451,Vidaysalud Health System Inc,Vidaysalud Health System Inc,1770511032,"Dental Providers, Federally Qualified Health Centers - Medical Services",308 S Cesar Chavez Ave,,Crystal City,TX,78839-4200,Zavala,308 S Cesar Chavez Ave,,Crystal City,TX,78839-4200,Zavala,Nora Tellez,CEO,830-374-2301,101,norat@vidaysalud.org,Laylaly Menchaca,Program and Grants Consultant,830-279-4220,166,lalym@vidaysalud.org,www.vidaysalud.org
TX-010452,DALHART FAMILY MEDICINE CLINIC,DALLAM HARTLEY COUNTIES HOSPITAL DISTRICT,1174533103,"Family Planning Providers, Rural Health Clinics",206 E 16th St,,Dalhart,TX,79022-4802,Hartley,PO BOX 2014,,DALHART,TX,79022-2014,Hartley,JOE ANN MOORE,COO OP MEDICAL CLINICS,806-244-9285,,joeannm@dhchd.org,HEATHER RUPPANNER,Assistant Director,806-244-5668,,heatherr@dhchd.org,
TX-010453,Children's Medical Center Dallas,Children's Medical Center Dallas,1194743013,Children's Hospitals (inpatient only),1935 Medical District Dr,,Dallas,TX,75235-7701,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,www.childrens.com
TX-010454,Children's Medical Center (dental provider),Children's Health System of Texas,1194743013,Dental Providers,1935 Medical District Dr,,Dallas,TX,75235-7701,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Robert Allen,Director of Finance,214-456-5996,,robert.allen@childrens.com,,,,,,www.childrens.com
TX-012411,North Texas Hemophilia Center,Children's Medical Center Dallas,1194743013,Hemophilia Treatment Centers,1935 Medical District Dr,,Dallas,TX,75235-7701,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010455,Oak Cliff Clinic,"AIDS Arms, Inc. d/b/a Prism Health North Texas",1275857245,"Ryan White Providers, Sexually Transmitted Disease Clinics",219 Sunset Ave,Suite 116A,Dallas,TX,75208-4531,Dallas,351 West Jefferson Blvd,Suite 300,Dallas,TX,75208-7860,Dallas,"John T Carlo, MD",CEO,214-521-5191,3349,john.carlo@aidsarms.org,Gilbert Kouame,CFO,214-521-5191,3312,gilbert.kouame@aidsarms.org,http://www.prismhealthntx.org
TX-012412,Children's Health Specialty Center at Cityville,Children's Medical Center Dallas,1194743013,Outpatient Hospital Clinics,2222 Medical District Dr,,Dallas,TX,75235-8075,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010456,Texas Scottish Rite Hospital for Children (children's inpatient hospital),Texas Scottish Rite Hospital,1760628184,Children's Hospitals (inpatient only),2222 Welborn St,,Dallas,TX,75219-3924,Dallas,2222 Welborn Street,,Dallas,TX,75219,Dallas,Stephanie Lynn Slaughter,Managed Care,214-559-8425,,Stephanie.Slaughter@tsrh.org,Bill Huston,CFO,214-559-5000,,Bill.Huston@tsrh.org,https://scottishritehospital.org/
TX-010457,Texas Scottish Rite Hospital for Children (outpatient hospital clinics),Texas Scottish Rite Hospital for Children,1760628184,Outpatient Hospital Clinics,2222 Welborn St,,Dallas,TX,75219-3924,Dallas,2222 Welborn Street,,Dallas,TX,75219,Dallas,Stephanie Slaughter,"Director, Managed Care",214-559-8425,,stephanie.slaughter@tsrh.org,Bill Huston,Senior Vice President and CFO,214-559-7605,,bill.huston@tsrh.org,tsrh.org
TX-012413,Children's Health Specialty Center Dallas,Children's Medical Center Dallas,1194743013,Outpatient Hospital Clinics,2350 N Stemmons Fwy,,Dallas,TX,75207-2700,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-012414,Pavilion Surgery Center,Children's Medical Center Dallas,1194743013,Other ECP Providers,2350 N Stemmons Fwy # F1103,,Dallas,TX,75207-2700,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010458,"Los Barrios Unidos Community Clinic, Inc.","LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.",1164417085,"Dental Providers, Federally Qualified Health Centers - Medical Services",3111 Sylvan Ave,,Dallas,TX,75212-4028,Dallas,809 Singelton Blvd,,Dallas,TX,75212,Dallas,Leonor Marquez,CEO,214-540-0323,,lmarquez@lbucc.org,,,,,,
TX-010460,South Dallas Clinic,"AIDS Arms, Inc. d/b/a Prism Health North Texas",1609852813,"Ryan White Providers, Sexually Transmitted Disease Clinics",4922 Spring Ave,,Dallas,TX,75210-1359,Dallas,351 West Jefferson Blvd,Suite 300,Dallas,TX,75208-7860,Dallas,"John T. Carlo, MD",CEO,214-521-5191,3349,john.carlo@aidsarms.org,Gilbert Kouame,CFO,214-521-5191,3312,gilbert.kouame@aidsarms.org,http://www.aidsarms.org/
TX-012415,Children's Health Specialty Center Bass Center,Children's Medical Center Dallas,1194743013,"Community Mental Health Centers, Outpatient Hospital Clinics",6300 Harry Hines Blvd,,Dallas,TX,75235-5259,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-012416,Children's Health Center for Autism and Developmental Disabilities,Children's Medical Center Dallas,1194743013,"Community Mental Health Centers, Outpatient Hospital Clinics",6363 Forest Park Rd Ste BL5.230,,Dallas,TX,75235-5479,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010459,AHF Healthcare Center - Dallas #2 (Dr. Daly),"AIDS Healthcare Foundation, Texas Inc",1346629607,"Other ECP Providers, Ryan White Providers",7777 Forest Ln,Suite B122,Dallas,TX,75230-6806,Dallas,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5325,,donna.stidham@aidshealth.org,Michael O'Malley,Plan Administrator,323-337-9172,,michael.omalley@aidshealth.org,www.aidshealth.org
TX-010461,AHF Healthcare Center - Dallas TX,"AIDS Healthcare Foundation, Texas Inc",1750634184,"Other ECP Providers, Ryan White Providers",7777 Forest Ln,Suite B122,Dallas,TX,75230-6806,Dallas,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
TX-010462,LOS BARRIOS UNIDOS COMMUNITY CLINIC,"LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.",1164417085,"Dental Providers, Federally Qualified Health Centers - Medical Services",809 Singleton Blvd,,Dallas,TX,75212-4014,Dallas,809 Singelton Blvd,,Dallas,TX,75212,Dallas,Leonor Marquez,CEO,214-540-0302,,lmarquez@lbucc.org,,,,,,
TX-012417,Children's Health Specialty Center Park Cities,Children's Medical Center Dallas,1194743013,Outpatient Hospital Clinics,8160 Walnut Hill Ln,Suite 106,Dallas,TX,75231-4373,Dallas,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,Tammie Sibley,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010463,Planned Parenthood of Greater Texas - North Dallas Shelburne Health Center,"Planned Parenthood of Greater Texas, Inc.",1013278290,"Family Planning Providers, Sexually Transmitted Disease Clinics",9100 N Central Expwy,Suite 169,Dallas,TX,75231,Dallas,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,,,,,,https://www.plannedparenthood.org/health-center/texas/dallas/75231/north-dallas-shelburne-health-center-2521-91620
TX-010464,Cross Timbers Community Health Center,"CROSS TIMBERS HEALTH CLINICS, INC.",1134295074,"Dental Providers, Federally Qualified Health Centers - Medical Services",1100 W Reynosa Ave,,De Leon,TX,76444-1630,Comanche,1100 W Reynosa Ave,,De Leon,TX,76444-1630,Comanche,Sherry L Hill,Chief Executive Officer,254-893-5895,,shill@crosstimbersinc.org,,,,,,
TX-010465,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1629320221,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1117 W DE La Rosa St,,Del Rio,TX,78840-6224,Val Verde,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010466,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1669786703,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2209 N Bedell Ave,,Del Rio,TX,78840-8007,Val Verde,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010467,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1992840409,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",913 S Main St,,Del Rio,TX,78840-5828,Val Verde,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010468,Dell City Health Outreach Center,PROJECT VIDA HEALTH CENTER,1619245180,Federally Qualified Health Centers - Medical Services,102 S Dodson St,Bldg B,Dell City,TX,79837,Hudspeth,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010469,Planned Parenthood of Greater Texas - Denton Health Center,"Planned Parenthood of Greater Texas, Inc.",1356602775,"Family Planning Providers, Sexually Transmitted Disease Clinics",2436 S Interstate 35 E,Suite 340,Denton,TX,76205,Denton,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,,sheila.mckinney@ppgt.org,,,,,,http://www.plannedparenthood.org/greater-texas/
TX-010470,Health Services of North Texas,Health Services of North Texas,1194080564,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",4310 Mesa Dr,,Denton,TX,76207-3434,Denton,4401 N I-35 Suite 312,,Denton,TX,76207,Denton,Teri Kay Johnson,Director of Community Outreach,940-239-6009,,tjohnson@healthntx.org,Doreen Rue,CEO,940-381-1501,533001,drue@healthntx.org,www.healthntx.org
TX-010471,South Plains Public Health District - Yoakum,South Plains Public Health District,1750339339,Family Planning Providers,415 Mustang Dr,,Denver City,TX,79323-2749,Yoakum,415 Mustang Dr,,Denver City,TX,79323-2749,Yoakum,"Soronya Shafer, RN",Director of Clinical Services,432-758-4022,,sshafer@spphd.org,Barbara Salazar,Clinic Nurse,806-592-2706,,bsalazar@spphd.org,https://southplainshealth.org/
TX-010472,South Texas Rural Health Services - Devine,"South Texas Rural Health Services, Inc.",1356672570,"Dental Providers, Federally Qualified Health Centers - Medical Services",1010 W Hondo Ave,,Devine,TX,78016-1921,Medina,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010473,MEDICAL CLINIC OF DEVINE,Medina County Hospital District,1952453946,Rural Health Clinics,1250 State Highway 173 N,,Devine,TX,78016-4791,Medina,3100 Ave E,,Hondo,TX,78861,Medina,Ashley Lowe,Clinics Administrator,830-426-7444,,ALowe@medinahospital.net,Kevin Frosch,CFO,830-426-7898,,kevin.frosch@medinahospital.net,
TX-010474,"Hometown Healthcare, LLC","Hometown Healthcare, LLC",1538486790,Rural Health Clinics,205 N Commerce St,,Dilley,TX,78017-3500,Frio,P.O. Box 2070,,Orange Grove,TX,78372,Jim Wells,Macy Thompson,Administrator,830-879-2279,,hhmthompson@yahoo.com,,,,,,
TX-010475,South Texas Rural Health Services - Dilley,"South Texas Rural Health Services, Inc.",1548591753,Federally Qualified Health Centers - Medical Services,606 W Leona St,,Dilley,TX,78017-3705,Frio,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010476,NUESTRA CLINICA DEL VALLE - DONNA,NUESTRA CLINICA DEL VALLE,1881021541,Federally Qualified Health Centers - Medical Services,301 S 17th St,,Donna,TX,78537-3438,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010477,"Dumas Family Practice, LLC","Dumas Family Practice, LLC",1679655153,Rural Health Clinics,120 Beard Ave,,Dumas,TX,79029-4003,Moore,PO Box 755,,Dumas,TX,79029,Moore,Kathryn Bunch,Manager,806-674-9285,,kathrynbunch@yahoo.com,,,,,,
TX-010478,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1245581156,"Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1175 Eidson Rd,,Eagle Pass,TX,78852-5403,Maverick,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010479,Kickapoo Community Health Center,Kickapoo Traditional Tribe of Texas,1821159518,"Dental Providers, Indian Health Service, Tribal Health Program operated under P.L. 93-638",2192 Rosita Valley Rd,,Eagle Pass,TX,78852-2542,Maverick,2192 Rosita Valley Road,,Eagle Pass,TX,78852,Maverick,Silvia Rios,CLINIC MANAGER,830-421-5896,,silvia.rios@ktttribe.org,,,,,,
TX-010480,Eagle Pass Pediatric Health Clinic,Eagle Pass Pediatric Health Clinic,1104958081,Rural Health Clinics,2198 E Garrison St,Suite 2,Eagle Pass,TX,78852-5076,Maverick,"2198 E. Garrison St., Ste. 2",,Eagle Pass,TX,78852-5076,Maverick,Debra W. De Los Santos,CEO,830-773-1103,34,debradls@sbcglobal.net,"Ricardo De Los Santos, Jr.",Office Manager,830-773-1103,36,ricardo.epphc@gmail.com,www.eaglepasspediatrics.com
TX-010481,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1710980669,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",2525 N Veterans Blvd,,Eagle Pass,TX,78852-3302,Maverick,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010482,UNITED MEDICAL CENTERS,UNITED MEDICAL CENTERS,1821411224,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",4018 El Indio Hwy,,Eagle Pass,TX,78852-6690,Maverick,2525 N Veterans Blvd,P.O. Box 1470,Eagle Pass,TX,78852-3302,Maverick,William M. Worrell,Chief Executive Officer,830-773-8917,352,wworrell.umc@tachc.org,,,,,,https://umchealth.com/
TX-010483,NUESTRA CLINICA DEL VALLE - EDCOUCH,NUESTRA CLINICA DEL VALLE,1861829079,Federally Qualified Health Centers - Medical Services,1200 Santa Rosa Ave,,Edcouch,TX,78538-2098,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010484,Frontera Healthcare Network - Eden Clinic,FRONTERA HEALTHCARE NETWORK,1528258555,Federally Qualified Health Centers - Medical Services,551 Eaker St,,Eden,TX,76837,Concho,604 Eaker St,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010485,NUESTRA CLINICA DEL VALLE - SAN CARLOS,NUESTRA CLINICA DEL VALLE,1073940987,Federally Qualified Health Centers - Medical Services,300 N 86th St,,Edinburg,TX,78542-1838,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010486,Access Esperanza Clinics - Edinburg Health Center,"Access Esperanza Clinics, Inc.",1669499026,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",302 S Veterans Blvd,,Edinburg,TX,78539-4718,Hidalgo,916 East Hackberry Ave.,,McAllen,TX,78501-5737,Hidalgo,Patricio Gonzales,Chief Executive Officer,956-688-3700,3707,patricio.gonzales@accessclinics.org,Melinda Cruz,Clinical Operations Director,956-688-3700,3708,melinda.cruz@accessclinics.org,http://www.accessclinics.org
TX-010487,Jackson County Medical Clinic,Jackson County Hospital District,1992748693,Rural Health Clinics,1013A S Wells St,,Edna,TX,77957-4045,Jackson,1013 South Wells,,Edna,TX,77957,Jackson,"Lisa Larkin, RN",Clinic Director,361-782-7823,,llarkin@jchd.org,Lance Smiga,CEO,361-782-7800,252,lsmiga@jchd.org,
TX-010488,MID COAST MEDICAL CLINIC,El Campo Memorial Hospital,1427334077,Rural Health Clinics,305 Sandy Corner Rd,Suite 120,El Campo,TX,77437-9535,Wharton,303 Sandy Corner Road,,El Campo,TX,77437,Wharton,ROBIN MCGINNIS,Clinic Director,979-543-5510,217,ROBIN.MCGINNIS@PRIMECARECHI.ORG,Tisha Zalman,Chief Executive Officer,979-543-6251,252,tzalman@ecmh.org,
TX-010489,Sunset ID Care,Southwest Viral Med,1891961884,"Ryan White Providers, Sexually Transmitted Disease Clinics",1201 E Schuster Ave,Suite 1A,El Paso,TX,79902-4646,El Paso,1201 E Schuster,Ste 1A,El Paso,TX,79902,El Paso,Cynthia Moncivaiz-Hernandez,Admin,915-229-6448,,chernandez@southwestviralmed.org,Ogechika Alozie,Medical Director,915-229-6448,,oalozie@southwestviralmed.org,sunsetidcare.com
TX-010490,JOSE ROMAN PEDIATRIC CLINIC,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,Federally Qualified Health Centers - Medical Services,125 W Hague Rd,Suite 390,El Paso,TX,79902-5818,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010491,Montana Vista Health Center,PROJECT VIDA HEALTH CENTER,1588802102,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",14900 Greg Dr,,El Paso,TX,79938-9213,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010492,La Fe CARE Center - HIV/AIDS,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,Federally Qualified Health Centers - Medical Services,1505 Mescalero Dr,,El Paso,TX,79925-2019,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,http://www.lafe-ep.org
TX-010493,Centro San Vicente's Wellness Center at Emergence Healthcare Network,DAUGHTERS OF CHARITY HLTH SVCS,1942670328,Federally Qualified Health Centers - Medical Services,1600 Montana Ave,,El Paso,TX,79902-5622,El Paso,8061 Alameda Ave,,El Paso,TX,79915,El Paso,"Jose Luna Jr., MD",CEO,915-859-7545,1215,jlunamd@csv.tachc.org,Loreta Galaviz,CFO,915-859-7545,1232,lgalaviz@csv.tachc.org,
TX-010494,Lisbon Satellite Clinic,"CENTRO DE SALUD FAMILIAR LA FE, INC",1285768564,Federally Qualified Health Centers - Medical Services,200 Lisbon St,,El Paso,TX,79905-4604,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010495,UMC - Lower Valley (Ysleta),University Medical Center of El Paso Women's Health Centers,1962653410,Family Planning Providers,300 S Zaragoza Rd,Bldg B,El Paso,TX,79907-6635,El Paso,300 S Zaragoza Rd Bldg B,,El Paso,TX,79907-6635,El Paso,Deborah Eganhouse,Project Director,915-544-1200,43250,deganhouse@umcelpaso.org,,,,,,http://www.umcelpaso.org/
TX-010496,Hueco Health Center,PROJECT VIDA HEALTH CENTER,1023437688,Federally Qualified Health Centers - Medical Services,3501 Hueco Ave,,El Paso,TX,79903-4312,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010497,NAFTZGER CLINIC,PROJECT VIDA HEALTH CENTER,1114072006,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3612 Pera Ave,,El Paso,TX,79905-2412,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010498,University Medical Center of El Paso Women's Health Centers,Women's Health and Family Planning Association of Texas,1033340609,Family Planning Providers,4824 Alberta Ave,Suite 403,El Paso,TX,79905-2709,El Paso,4824 Alberta Ave Ste 403,,El Paso,TX,79905-2709,El Paso,Deborah Eganhouse,Project Director,915-544-1200,43250,deganhouse@umcelpaso.org,,,,,,http://www.umcelpaso.org/WebShell/umcep.nsf/DefaultFrameset/Site+Defaults?OpenDocument&DocID=8E164B0DDE46203887256D85006DAA51
TX-010499,NORTHEAST FAMILY PRACTICE,PROJECT VIDA HEALTH CENTER,1447377924,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",4875 Maxwell Ave,Suite Be,El Paso,TX,79904-1559,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010500,Surety Health Center,PROJECT VIDA HEALTH CENTER,1376948737,Federally Qualified Health Centers - Medical Services,6040 Surety Dr Unit 2,,El Paso,TX,79905-2043,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010501,CENTRAL CLINIC,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,"Dental Providers, Federally Qualified Health Centers - Medical Services",700 S Ochoa St,,El Paso,TX,79901-2936,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010502,CHILD & ADOLESCENT WELLNESS CENTER,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,"Dental Providers, Federally Qualified Health Centers - Medical Services",721 S Ochoa St,,El Paso,TX,79901-2935,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operating Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010503,CENTRO SAN VICENTE,DAUGHTERS OF CHARITY HLTH SVCS,1831267079,"Dental Providers, Federally Qualified Health Centers - Medical Services",8061 Alameda Ave,,El Paso,TX,79915-4705,El Paso,8061 Alameda Ave,,El Paso,TX,79915-4705,El Paso,Dr. Jose Luna,CEO,915-859-7545,1215,JLunamd@csv.tachc.org,Loretta Galaviz,CFO,915-859-7545,1232,LGalaviz@csv.tachc.org,
TX-010504,Yandell Satellite Clinic,"CENTRO DE SALUD FAMILIAR LA FE, INC",1629040621,Federally Qualified Health Centers - Medical Services,823 E Yandell Dr,,El Paso,TX,79902-5331,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010505,La Clinica Guadalupana,PROJECT VIDA HEALTH CENTER,1619348927,Federally Qualified Health Centers - Medical Services,901 Ascencion St,,El Paso,TX,79928-9080,El Paso,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010506,Electra Memorial Hospital,Electra Hospital District,1871583153,Inpatient Hospitals (other than children's hospitals),1207 S Bailey St,,Electra,TX,76360-3221,Wichita,1207 S Bailey,PO Box 1112,Electra,TX,76360,Wichita,Ginnie Holmes,CFO,940-495-3981,123,ginnie.holmes@electrahospital.com,Rebecca McCain,CEO,940-495-3981,,rebecca.mccain@electrahospital.com,www.electrahospital.com
TX-010507,Family Health Center at Elgin,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1568868370,Federally Qualified Health Centers - Medical Services,902 W 2nd St,,Elgin,TX,78621-2515,Bastrop,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010508,South Texas Rural Health Services - Encinal,"South Texas Rural Health Services, Inc.",1477885481,Federally Qualified Health Centers - Medical Services,100 S Main St,,Encinal,TX,78014,La Salle,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010509,Ennis Regional Medical Center,LifePoint Health,1700805678,Inpatient Hospitals (other than children's hospitals),2201 W Lampasas St,,Ennis,TX,75119-5644,Ellis,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Jack Wilcox,CFO,469-256-2158,,,https://www.ennisregional.com/
TX-010510,Hope Clinic,Ellis County Coalition for Health Options,1326236464,Federally Qualified Health Centers - Medical Services,805 W Lampasas St,,Ennis,TX,75119-4535,Ellis,411 E. Jefferson Street,,Waxahachie,TX,75165,Ellis,Annette Prudhomme,Director of Outreach and Compliance,972-923-2440,203,APrudhomme@call4hope.org,Barbara Clark,Director of Operations,972-923-2440,130,BClark@call4hope.org,www.call4hope.org
TX-010511,UMC - Fabens,University Medical Center of El Paso Women's Health Centers,1275784910,Family Planning Providers,101 Potasio,,Fabens,TX,79838,El Paso,101 Potasio,,Fabens,TX,79838,El Paso,Deborah Eganhouse,Project Director,915-544-1200,43250,deganhouse@umcelpaso.org,,,915-764-5000,,,http://www.umcelpaso.org/
TX-010512,Falfurrias Health Center,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1184868663,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1302 S St Marys St,,Falfurrias,TX,78355-5034,Brooks,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010513,FARMERSVILLE FAMILY MEDICAL CLINIC,Community Health Service Agency Inc.,1922081561,Federally Qualified Health Centers - Medical Services,111 N Johnson St,,Farmersville,TX,75442-2103,Collin,4500 Wesley St,,Greenville,TX,75401-5644,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010514,Wilson Community Health Center,"Atascosa Health Center, Inc.",1487833729,"Dental Providers, Federally Qualified Health Centers - Medical Services",540 10th St,Suite 140,Floresville,TX,78114-3167,Wilson,310 W Oaklawn Rd,,PLEASANTON,TX,78064-4033,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,
TX-010515,Ft. Hancock Clinic,Project Vida Health Center,1922376128,Federally Qualified Health Centers - Medical Services,561 Knox Ave,,Fort Hancock,TX,79839,Hudspeth,561 S Knox,,Fort Hancock,TX,79839,Hudspeth,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010516,"Cactus Health Services, Inc. Fort Stockton",CACTUS HEALTH SERVICES INC,1962663740,Federally Qualified Health Centers - Medical Services,301 N Water St,,Fort Stockton,TX,79735-6814,Pecos,301 N. Water Street,,Fort Stockton,TX,79735,Pecos,Luis Villarreal,CEO,432-290-1830,,lyvillarreal@sbcglobal.net,Christina Duarte,Operations/CPI Director,432-336-8110,,cduarte@cactushealth.org,
TX-010517,Family Care Center,Pecos County Memorial Hospital,1457307175,Rural Health Clinics,387 Interstate 10 W,,Fort Stockton,TX,79735-2700,Pecos,387 Interstate 10 W,,Fort Stockton,TX,79735,Pecos,mary gallegos,Director,432-336-4213,,mgallegos@pcmhfs.com,,,,,,WWW.PCMHFS.COM
TX-010518,Pecos County Memorial Hospital,Pecos County Memorial Hospital,1760598692,Inpatient Hospitals (other than children's hospitals),387 Interstate 10 W,,Fort Stockton,TX,79735-2700,Pecos,387 Interstate 10 W,,Fort Stockton,TX,79735,Pecos,mary gallegos,Director,432-336-4213,,mgallegos@pcmhfs.com,,,,,,WWW.PCMHFS.COM
TX-010519,George Rural Health Center,Pecos County Memorial Hospital,1851695316,Rural Health Clinics,511 N Main St,,Fort Stockton,TX,79735-5623,Pecos,387 west i h 10,,Fort Stockton,TX,79735,Pecos,mary gallegos,Director,432-336-4213,,mgallegos@pcmhfs.com,,,,,,
TX-010520,Tarrant County Public Health,Tarrant County Public Health,1194783183,"Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1101 S Main St,Room 1500,Fort Worth,TX,76104-4802,Tarrant,1101 S. Main Street,Room 2419,Fort Worth,TX,76104,Tarrant,Dr. Catherine Colquitt,Medical Director/Health Authority for Tarrant County,817-321-4850,,cacolquitt@tarrantcounty.com,Frances Beckworth,Revenue Coordinator,817-321-4733,,fdbeckworth@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010521,Cook Children's Dodson Specialty Clinic,Cook Children's Health Care System,1750369203,Outpatient Hospital Clinics,1500 Cooper St,,Fort Worth,TX,76104,Tarrant,801 Seventh Ave,,Fort Worth,TX,76104,Tarrant,Greg Jimerson,VP,682-886-3790,,greg.jimerson@cookchildrens.org,,,,,,
TX-010522,Cook Children's Medical Center,Cook Children's Health Care System,1891765178,"Hemophilia Treatment Centers, Ryan White Providers",1500 Cooper St,,Fort Worth,TX,76104-2710,Tarrant,1500 West Rosedale Ave,,Fort Worth,TX,76104,Tarrant,Greg Jimerson,VP,682-885-3790,,greg.jimerson@cookchildrens.org,,,,,,
TX-010523,Bagsby-Williams Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,3212 Miller Ave,,Fort Worth,TX,76119-1948,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76119,Tarrant,Linda Peterson,Clinic Charge Nurse/Registered Nurse,817-531-6738,,lmpeterson@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010524,Planned Parenthood of Greater Texas - Southeast Health Center,Planned Parenthood of Greater Texas,1760633887,"Family Planning Providers, Sexually Transmitted Disease Clinics",3863 Miller Ave,,Fort Worth,TX,76119-2965,Tarrant,7424 Greenville Ave.,Ste 206,Dallas,TX,75231,Tarrant,Sheila McKinney,COO,214-254-3021,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010525,AHF Healthcare Centers - Ft Worth - Tarrant County,"AHF Healthcare Foundation Texas, Inc",1104190115,"Other ECP Providers, Ryan White Providers",400 N Beach St,Suite 104,Fort Worth,TX,76111-7070,Tarrant,6255 W. Sunset Blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-860-5200,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
TX-010526,AIDS Outreach Center,AIDS Outreach Center,1285761999,"Dental Providers, Ryan White Providers",400 N Beach St,Suite 100,Fort Worth,TX,76111-7070,Tarrant,400 N. Beach St.,,Suite 100,TX,76111,Tarrant,Shawna Stewart,Director of Mental Health Services,817-916-5226,,shawnas@aoc.org,Mel LeRoy,Associate Executive Director,817-916-5215,,mell@aoc.org,
TX-010527,La Gran Plaza Mall Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,4200 South Fwy,,Fort Worth,TX,76115-1400,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76104,Tarrant,Cayce Trudo,Clinic Charge Nurse/Registered Nurse,817-920-5752,,chtrudo@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010528,Planned Parenthood of Greater Texas - Southwest Fort Worth Health Center,Planned Parenthood of Greater Texas,1225399934,"Family Planning Providers, Sexually Transmitted Disease Clinics",6464 John Ryan Dr,,Fort Worth,TX,76132-4239,Tarrant,7424 Greenville Ave.,Suite 206,Dallas,TX,75231,Dallas,Beth Watson,VP of Health Services,214-254-3023,10130,beth.watson@ppgt.org,Sheila McKinney,COO,214-363-2004,10125,sheila.mckinney@ppgt.org,http://www.plannedparenthood.org/greater-texas/
TX-010529,Southwest Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,6551 Granbury Rd,,Fort Worth,TX,76133-4926,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76133,Tarrant,Rene Whitley,Clinic Charge Nurse/Registered Nurse,817-370-4530,,prwhitling@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010530,Cook Children's Medical Center (children's inpatient hospital),Cook Children's Health Care System,1891765178,Children's Hospitals (inpatient only),801 7th Ave,,Fort Worth,TX,76104-2733,Tarrant,1500 West Rosedale Ave,,Fort Worth,TX,76104,Tarrant,Greg Jimerson,VP,682-885-3790,,greg.jimerson@cookchildrens.org,,,,,,https://cookchildrens.org/Pages/default.aspx
TX-010531,Cook Children's Medical Center (multiple outpatient ECP categories),Cook Children's Health Care System,1891765178,"Hemophilia Treatment Centers, Ryan White Providers",801 7th Ave,,Fort Worth,TX,76104-2733,Tarrant,1500 West Rosedale Ave,,Fort Worth,TX,76104,Tarrant,Greg Jimerson,VP,682-885-3790,,greg.jimerson@cookchildrens.org,,,,,,
TX-010532,HealthPoint Franklin,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1841562451,Federally Qualified Health Centers - Medical Services,808 W US Highway 79,,Franklin,TX,77856-1728,Robertson,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010533,Freeport Community Health Center,"STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC",1487926804,"Dental Providers, Federally Qualified Health Centers - Medical Services",905 N Gulf Blvd,,Freeport,TX,77541-3907,Brazoria,1111 W Adoue St,,Alvin,TX,77511-2718,Brazoria,Mark D Young,CEO,281-824-1471,,myoung@sfachc.org,Rachel Martinez,CIO,281-824-1480,1103,rmartinez@sfachc.org,
TX-010534,CHRISTUS SPOHN FAMILY HEALTH CENTER FREER,CHRISTUS SPOHN FAMILY HEALTH CENTER FREER,1043289804,Rural Health Clinics,111 Riley St,,Freer,TX,78357,Duval,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-010535,Friona Rural Health Clinic,Friona Rural Health Clinic,1144324211,Rural Health Clinics,1307 Cleveland Ave,,Friona,TX,79035-1121,Parmer,1307 Cleveland Ave.,,Friona,TX,79035,Parmer,Susie Spring,Clinic Director,806-250-2781,106,susiefrhc@wtrt.net,Erika Carrillo,credentialing Specislist/ Clinic IT,806-250-2781,113,ecarrillo@parmermedicalcenter.com,
TX-010536,Texas Scottish Rite for Children,Texas Scottish Rite Hospital,1760628184,Outpatient Hospital Clinics,5700 Dallas Pkwy,,Frisco,TX,75034-9580,Collin,2222 Welborn Street,,Dallas,TX,75219,Dallas,Stephanie Lynn Slaughter,Managed Care,214-559-8425,,Stephanie.Slaughter@tsrh.org,Bill Huston,CFO,214-559-5000,,Bill.Huston@tsrh.org,https://scottishritehospital.org/
TX-010537,Collins Family Planning Clinic,COLLINS FAMILY PLANNING CLINIC,1164576294,Family Planning Providers,2900 SE Loop 820,,Ft Worth,TX,76140-1013,Tarrant,2900 SE LOOP 820,,FORT WORTH,TX,76140,Tarrant,JANICE COLLINS,Executive Director,817-922-8182,8179228182,janicecollins@collinsclinic.org,Claudia Johnson,Outreach Coord,817-922-8182,,claudiajohnson@collinsclinic.org,http://www.collinsfamilyplanningclinic.org/
TX-010538,Coastal Health & Wellness - Galveston,COASTAL HEALTH & WELLNESS,1871766584,"Dental Providers, Federally Qualified Health Centers - Medical Services",4700 Broadway St,,Galveston,TX,77551-4241,Galveston,9850 Emmett F Lowry Expy,,Texas City,TX,77591-2000,Galveston,Kathy Barroso,COFO / Interim CEO,409-938-2401,,kbarroso@gchd.org,Mary McClure,Clinic Director,409-938-2336,,mmcclure@gchd.org,
TX-010539,SHC - Galveston,Shriners Hospitals for Children,1669513941,Children's Hospitals (inpatient only),815 Market St,,Galveston,TX,77550-2725,Galveston,815 Market St.,,Galveston,TX,77550,Galveston,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
TX-010540,Georgetown Public Health Center,Williamson County and Cities Health District,1982661633,"Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",100 W 3rd St,,Georgetown,TX,78626-5030,Williamson,100 W. 3rd Street,,Georgetown,TX,78626,Williamson,Stacy Schweitzer,Billing Specialist,512-943-3645,,sschweitzer@wcchd.org,Michelle Broddrick,Finance and Administration Director,512-943-3603,,mbroddrick@wcchd.org,http://www.wcchd.org/location_and_hours/
TX-010541,Georgetown Women's Center,LONE STAR CIRCLE OF CARE,1972866200,Federally Qualified Health Centers - Medical Services,1900 Scenic Dr,Suite 3326,Georgetown,TX,78626-7876,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010542,LSCC Dental Center,LONE STAR CIRCLE OF CARE,1639129331,Federally Qualified Health Centers - Dental Services,2411 Williams Dr,Suite 111,Georgetown,TX,78628-3268,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010543,Lake Aire Medical Center,LONE STAR CIRCLE OF CARE,1669603361,Federally Qualified Health Centers - Medical Services,2423 Williams Dr,,Georgetown,TX,78628-3200,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010544,Tejas Health Care,TEJAS HEALTH CARE,1215326491,Federally Qualified Health Centers - Medical Services,898 E Richmond St,,Giddings,TX,78942-4252,Lee,753 E Travis St,,La Grange,TX,78945-2353,Fayette,Sheri Kehler,CEO,979-968-6596,120,skehler@tejashealthcare.org,Pam Wyant,Billing Supervisor,979-968-6596,131,pwyant@tejashealthcare.org,
TX-010545,Wellness Pointe - Gilmer,"LONGVIEW WELLNESS CENTER, INC.",1790955847,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",602 Titus St,Suite 130,Gilmer,TX,75644-1780,Upshur,1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,Chad Jones,Chief Executive Officer,903-212-4777,,chad.jones@wellnesspointe.org,Talia Peterson,Chief Financial Officer,903-212-4773,,talia.peterson@wellnesspointe.org,http://www.wellnesspointe.org
TX-010546,Family Practice Clinic of Mills County,Hamilton County Hospital District,1629215041,Rural Health Clinics,1501 W Front St,,Goldthwaite,TX,76844-2056,Mills,400 North Brown Street,,Hamilton,TX,76531,Hamilton,Jeanette Luckie,Director of Rural Health Clinics,254-386-1700,1733,jluckie@hamiltonhospital.org,Grady Hooper,CEO,254-386-1600,1951,ghooper@hamiltonhospital.org,
TX-010547,Gonzales Healthcare Systems,Gonzales Healthcare Systems,1932108214,Inpatient Hospitals (other than children's hospitals),1110 N Sarah Dewitt Dr,,Gonzales,TX,78629,Gonzales,P.O Box 587,,Gonzales,TX,78629,Gonzales,Juli Clay,Legal Compliance Officer,830-672-7581,1011,jclay@gonzaleshealthcare.com,,,,,,https://www.gonzaleshealthcare.com/
TX-010548,Gonzales Community Health Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1285650424,"Dental Providers, Federally Qualified Health Centers - Medical Services",228 Saint George St,,Gonzales,TX,78629-3910,Gonzales,P.O. Box 1890,228 St. George,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010549,Grand Prairie Community Health Center,"LOS BARRIOS UNIDOS COMMUNITY CLINIC, INC.",1164417085,Federally Qualified Health Centers - Medical Services,405 Stadium Dr,,Grand Prairie,TX,75050-3588,Dallas,809 Singelton Blvd,,Dallas,TX,75212,Dallas,Leonor Marquez,CEO,214-540-0302,,lmarquez@lbucc.org,,,,,,
TX-010550,Carevide,Community Health Service Agency Inc.,1821475575,Federally Qualified Health Centers - Medical Services,3005 Joe Ramsey Blvd E,Suite A,Greenville,TX,75401-7776,Hunt,4500 Wesley St,,Greenville,TX,75401,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010551,CHSA DENTAL CLINIC,Community Health Service Agency Inc.,1871844167,Dental Providers,3600 Caddo St,,Greenville,TX,75401-4511,Hunt,4500 Wesley St,,Greenville,TX,75401,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010552,GREENVILLE COMMUNITY HEALTH CTR,Community Health Service Agency Inc.,1528041191,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4311 Wesley St,,Greenville,TX,75401-5639,Hunt,4500 Wesley St,,Greenville,TX,75401-5644,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010553,GROVETON FAMILY MEDICAL CLINIC,Groveton Family Medical Clinic,1114149671,Rural Health Clinics,110 Magee,,Groveton,TX,75845-4185,Trinity,110 N Magee,,GROVETON,TX,75845,Trinity,Candice Davis,Clinic Supervisor,936-642-0841,,cdavis.gfmc@gmail.com,KEITH JONES,Billing Clerk,936-642-0841,,KEITHEJONES@YAHOO.COM,
TX-010554,Family Practice Rural Health Clinic,Hamilton County Hospital District,1679562961,Rural Health Clinics,400 N Brown St,,Hamilton,TX,76531-1518,Hamilton,400 North Brown,,Hamilton,TX,76531,Hamilton,Jeanette Luckie,Director of Rural Health Clinics,254-386-1700,1733,jluckie@hamiltonhospital.org,Grady Hooper,CEO,254-386-1600,1951,ghooper@hamiltonhospital.org,
TX-010555,Lone Star Circle of Care Pediatrics at Harker Heights,LONE STAR CIRCLE OF CARE,1710284542,Federally Qualified Health Centers - Medical Services,200 Nola Ruth Blvd,,Harker Heights,TX,76548-6074,Bell,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Finanical Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010556,Lone Star Circle of Care Behavioral Health at Harker Heights,LONE STAR CIRCLE OF CARE,1528366648,Federally Qualified Health Centers - Medical Services,775 Indian Trl,Suite 200,Harker Heights,TX,76548-7026,Bell,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Executive officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010557,Su Clinica - Harlingen,SU CLINICA FAMILIAR,1427071968,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1706 Treasure Hills Blvd,,Harlingen,TX,78550-8911,Cameron,1706 Treasure Hills Blvd,,Harlingen,TX,78550-8911,Cameron,Dr. Elena Marin,CEO,956-365-6750,12301,emarin@suclinica.org,Adam Saldivar,CFO,956-365-6750,12322,asaldivar@suclinica.org,www.suclinica.org
TX-010558,Valley AIDS Council - Westbrook Clinic,Valley AIDS Council,1740223379,"Dental Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",2306 Camelot Plaza Cir,,Harlingen,TX,78550-8407,Cameron,2306 Camelot Plaza,,Harlingen,TX,78550,Cameron,Wally Cantu,Interim Executive Director/CFO/Director of Quality Assurance,956-507-4880,,wcantu@valleyaids.org,Lizette Saenz,Comptroller,956-507-4814,,lsaenz@valleyaids.org,
TX-010559,Planned Parenthood,Planned Parenthood Cameron County,1760488829,Family Planning Providers,712 N 77 Sunshine Strip,Suite 18,Harlingen,TX,78550-8897,Cameron,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-010560,ROBERTSON COUNTY COMM HLTH CLINIC,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1275620551,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 W Brown St,,Hearne,TX,77859-3063,Robertson,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010561,HealthPoint Hearne,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1558645333,Federally Qualified Health Centers - Medical Services,709 Barton St,,Hearne,TX,77859-3009,Robertson,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010562,Hebbronville,GATEWAY COMMUNITY HEALTH CENTER INC,1134288814,Federally Qualified Health Centers - Medical Services,473 State Highway 285,,Hebbronville,TX,78361-4430,Jim Hogg,1515 Pappas St,,Laredo,TX,78041-1705,Webb,Cristina J. Hernandez,Director of Business Operations,956-718-6259,,cristinah.gateway@tachc.org,,,,,,
TX-010563,SABINE FAMILY MEDICAL CENTER,PREFERRED HOSPITAL LEASING DBA SABINE FAMILY MEDICAL CENTER,1912173030,Rural Health Clinics,1111 Worth St,,Hemphill,TX,75948-7223,Sabine,1111 WORTH ST,,Hemphill,TX,75948,Sabine,ROBIN BERRYHILL,CLINIC MANAGER,409-787-1707,,rberryhill@sabinecountyhospital.com,,,,,,
TX-010564,Sabine County Hospital,Sabine County Hospital,1932379856,Inpatient Hospitals (other than children's hospitals),2301 Worth St,,Hemphill,TX,75948-7216,Sabine,2301 Worth Street,,Hemphill,TX,75948,Sabine,Jerry Howell,Administrator,409-787-3523,,jhowell@sabinecountyhospital.com,Laura Simpson,Administrative Assitant,409-787-3300,,lsimpson@sabinecountyhospital.com,sabinecountyhospital.com
TX-010565,Toledo Bend Family Medicine,Toledo Bend Family Medicine,1811256696,Rural Health Clinics,2421 Worth St,,Hemphill,TX,75948-7215,Sabine,2421 Worth Street,,Hemphill,TX,75948,Sabine,Amy Cummings,Clinic Manager,409-787-1416,,acummings@sabinecountyhospital.com,Jerry Howell,Administrator,409-787-3300,,jhowell@sabinecountyhospital.com,
TX-010566,Health Point Hempstead,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1649689274,Federally Qualified Health Centers - Medical Services,215 FM 1488 Rd,,Hempstead,TX,77445-7866,Waller,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010567,Rusk County Community Health Center,MOUNT ENTERPRISE COMMUNITY HEALTH CLINIC,1649412354,"Dental Providers, Federally Qualified Health Centers - Medical Services",1115 US Highway 259 S,,Henderson,TX,75654-3629,Rusk,106 W Rusk St,,Mount Enterprise,TX,75681-7581,Rusk,Kenneth A. White,Chief Executive Officer,903-822-3076,,kwhite@crossroadsfamilycare.com,Roslyn Grigsby,Credentialing Coordinator,903-822-3076,,rgrigsby@crossroadsfamilycare.com,www.crossroadsfamilycare.com
TX-010568,"Regence Health Network, Inc. RMDA - HRF","REGENCE HEALTH NETWORK, INC.",1588662027,"Dental Providers, Freestanding Cancer Centers",125 W Park Ave,,Hereford,TX,79045-4201,Deaf Smith,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinator,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Coordinator,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010569,Hico Clinic,Hamilton County Hospital District,1710135553,Rural Health Clinics,104 Walnut St,,Hico,TX,76457,Hamilton,400 North Brown,,Hamilton,TX,76531,Hamilton,Jeanette Luckie,Director of Rural Health Clinics,254-386-1700,1733,jluckie@hamiltonhospital.org,Grady Hooper,CEO,254-386-1600,1951,ghooper@hamiltonhospital.org,
TX-010570,FAMILY DIAGNOSTIC MEDICAL CENT,Family Diagnostic Medical Center,1629044326,Rural Health Clinics,1323 E Franklin St,Suite 105,Hillsboro,TX,76645-2679,Hill,1323 E Franklin St Ste 105,,Hillsboro,TX,76645,Hill,Gerardo Carbajal,Administrator,254-582-7481,316,jcarbajal.fdmc@sbcglobal.net,,,,,,
TX-010571,South Texas Rural Health Services - Hondo,"South Texas Rural Health Services, Inc.",1063743284,Federally Qualified Health Centers - Medical Services,2912 Avenue E,,Hondo,TX,78861-3329,Medina,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010572,MEDINA REGIONAL HOSPITAL,Medina County Hospital District,1427048453,Inpatient Hospitals (other than children's hospitals),3100 Avenue E,,Hondo,TX,78861-3534,Medina,3100 Ave E,,Hondo,TX,78861,Medina,Kevin Frosch,CFO,830-426-7898,,kevin.frosch@medinahospital.net,Janice Simons,Administrator,830-426-7880,,JSimons@medinahospital.net,
TX-010573,MEDICAL CLINIC OF HONDO,Medina County Hospital District,1134113855,Rural Health Clinics,3200 Avenue E,,Hondo,TX,78861-3525,Medina,3100 Ave E,,Hondo,TX,78861,Medina,Ashley Lowe,CFO,830-426-7444,,ALowe@medinahospital.net,Kevin Frosch,CFO,830-426-7898,,kevin.frosch@medinahospital.net,
TX-010574,"PUCKETT FAMILY CLINIC, PC",Puckett Family Clinic,1295937449,Rural Health Clinics,1301 E Main St,,Honey Grove,TX,75446-1268,Fannin,1301 E. Main St,,Honey Grove,TX,75446,Fannin,Paul Puckett,"PA-C, Owner",903-378-3444,,plpucket@gmail.com,Melissa Puckett,RN,903-715-2589,,melissapuckett32@yahoo.com,
TX-010575,KIPP Southwest Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1396098638,Federally Qualified Health Centers - Medical Services,10711 Kipp Way Dr,,Houston,TX,77099-2675,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010576,KIPP Sunnyside Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1093068348,Federally Qualified Health Centers - Medical Services,11000 Scott St,,Houston,TX,77047-1500,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010577,Central Care Integrated Health Services,South Central Houston Action Council Inc.,1518215060,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1102 Pinemont Dr,,Houston,TX,77018-1300,Harris,8610 Martin Luther King Jr Blvd,,Houston,TX,77033-2308,Harris,Amy Gallardo,Credentialing / Contract,512-280-7943,114,amy.gallardo@medheads.org,,,,,,
TX-010578,Texas Children's Health Centers - Cy-Fair,Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,11777 FM 1960 Rd W,,Houston,TX,77065-3513,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kcthomps@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations and Community Benefits",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010579,AHF Healthcare Center - Houston TX,"AIDS Healthcare Foundation Texas, INC",1033593181,Other ECP Providers,1200 Binz St,Suite 1290,Houston,TX,77004-6937,Harris,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
TX-010580,HOPE CLINIC WEST,Asian American Health Coalition,1073935441,Federally Qualified Health Centers - Medical Services,12121 Richmond Ave,Suite 215,Houston,TX,77082-2422,Harris,7001 Corporate Dr #120,,Houston,TX,77036,Harris,Andrea Caracostis,CEO,713-337-3640,,acaracostis@hopechc.org,Penny Yang,CFO,713-275-0987,,pyang@hopechc.org,www.hopechc.org
TX-010581,Legacy Bissonnet Street,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1427496546,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12667 Bissonnet St # 17,,Houston,TX,77099-1331,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,melisa garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010582,Northwest Health Center,"Planned Parenthood Gulf Coast, Inc.",1457621864,Family Planning Providers,13169 Northwest Fwy,Suite 115,Houston,TX,77040-6326,Harris,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010583,St. Joseph Medical Center,Steward Healthcare System LLC,1154361475,Inpatient Hospitals (other than children's hospitals),1401 St Joseph Pkwy,,Houston,TX,77002-8301,Harris,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,Divya.Matai,Chief Financial Officer,713-756-5298,,Divya.Matai@steward.org,Bo Beaudry,President - Interim,713-757-7482,,Carl.Beaudry@steward.org,www.steward.org
TX-010584,Central Care Integrated Health Services,South Central Houston Action Council Inc.,1376964858,Federally Qualified Health Centers - Medical Services,14087 Main St,,Houston,TX,77035-5447,Harris,8610 Martin Luther King Jr Blvd,,Houston,TX,77033-2308,Harris,Amy Gallardo,Credentialing / Contract,512-280-7943,114,amy.gallardo@medheads.org,,,,,,
TX-010585,Legacy Montrose Clinic,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1679524961,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",1415 California St,,Houston,TX,77006-2602,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010586,HOPE Clinic - Alief,Asian American Health Coalition,1518345271,Federally Qualified Health Centers - Medical Services,14438 Bellaire Blvd,,Houston,TX,77083-7520,Harris,7001 Corporate Dr # 120,,Houston,TX,77036,Harris,Andrea Caracostis,CEO,713-337-3640,,acaracostis@hopechc.org,Penny Yang,CFO,713-275-0987,,pyang@hopechc.org,www.hopechc.org
TX-010587,Harris Health System,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Inpatient Hospitals (other than children's hospitals),1504 Taub Loop,,Houston,TX,77030-1608,Harris,2525 Holly Hall,,Houston,TX,77054,Harris,Julie T. Rabat-Torki,Senior Manager: Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,,,,,,
TX-010588,SALVATION ARMY FAMILY,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,1603 McGowen St,,Houston,TX,77004-1146,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010589,"Houston Area Community Services, Inc. - Spring Cypress","Houston Area Community Services, Inc.",1013324342,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",17010 Sugar Pine Dr,,Houston,TX,77090-2213,Harris,2150 W. 18th Street,Suite 300,Houston,TX,77008,Harris,Patrice Williams,COO,832-384-1403,,pmwilliams@hacstxs.org,Joe Fuentes,CEO,832-384-1389,,jfuentes@hacstxs.org,www.hacstxs.org
TX-010590,SALLY'S HOUSE,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,1717 Congress St,,Houston,TX,77002-2224,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Amubulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010591,La Nueva Casa de Amigos Health Center,City of Houston,1235274952,"Dental Providers, Family Planning Providers, Ryan White Providers",1809 N Main St,,Houston,TX,77009-8310,Harris,1809 N Main St,,Houston,TX,77009-8310,Harris,Maria De La Cruz,Program Manager,832-393-5058,,maria.delacruz@houstontx.gov,,,,,,http://www.houstontx.gov/health/index.html
TX-010592,STAR OF HOPE MEN'S SHELTER,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,1811 Ruiz St,,Houston,TX,77002-1321,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010593,Texas Children's Hospital - West Campus (children's inpatient hospital),Texas Children's Hospital,1477643690,Children's Hospitals (inpatient only),18200 Katy Fwy,,Houston,TX,77094-1285,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,Assistant Vice President,832-824-2853,,kthompson@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010594,Texas Children's Hospital - West Campus (outpatient hospital clinics),Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,18200 Katy Fwy,,Houston,TX,77094-1285,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kcthomps@texaschildrens.org,Rosie Valadez McStay,Assistant Vice President Gvt Relations,832-824-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010595,"Fourth Ward Clinic, Inc. d.b.a. GOOD NEIGHBOR HEALTHCARE CENTER",FOURTH WARD CLINIC,1588779276,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",190 Heights Blvd,,Houston,TX,77007-3729,Harris,190 Heights Blvd,,Houston,TX,77007-3729,Harris,Ann Thielke,CEO,713-529-3597,7140,athielke@gnhc.org,Tasneem Lokhandwala,CFO,713-529-3597,7111,tlokhandwala@gnhc.org,http://www.gnhc.org/
TX-010596,"Harris Health System, Thomas Street Health Center",Harris County Hospital District dba. Harris Health System,1205900370,Ryan White Providers,2015 Thomas St,,Houston,TX,77009-8044,Harris,2525 Holly Hall,,Houston,TX,77054,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,,,,,,
TX-010597,SALVATION ARMY ADULT REHAB CTR,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,2118 Washington Ave,,Houston,TX,77007-6137,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010598,HACS Main Campus,"Houston Area Community Services, Inc.",1477795417,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",2150 W 18th St,Suite 300,Houston,TX,77008-1289,Harris,2150 W. 18th St.,Suite 300,Houston,TX,77008,Harris,Joe Fuentes,CEO,713-426-0027,389,jfuentes@hacstxs.org,,,,,,www.hacstxs.org
TX-010599,SHF/COMMUNITY HEALTHCARE CENTER MWP,"St. Hope Foundation, Inc",1720460850,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",255 Northpoint Dr,Suite 200,Houston,TX,77060-3203,Harris,6200 Savoy Dr Ste 540,,Houston,TX,77036-3338,Harris,RODNEY GOODIE,CEO,713-778-1300,2341,RODNEY@OFFERINGHOPE.ORG,Timika Sam-Cooper,COO,713-778-1300,2342,mika@offeringhope.org,OFFERINGHOPE.ORG
TX-010600,Star of Hope Cornerstone Community,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,2575 Reed Rd,,Houston,TX,77051-2216,Harris,2525 Holly Hall,,Houston,TX,77054,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010601,Central Care Integrated Health Services,South Central Houston Action Council Inc.,1821177866,"Dental Providers, Federally Qualified Health Centers - Medical Services",3315 Delano St,,Houston,TX,77004-3284,Harris,8610 Martin Luther King Jr Blvd,,Houston,TX,77033-2308,Harris,Amy Gallardo,Credentialing / Contract,512-280-7943,114,amy.gallardo@medheads.org,,,,,,
TX-010602,Lord of the Streets,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,3401 Fannin St,,Houston,TX,77004-3806,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010603,Legacy Branard Campus Clinic,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1356716021,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Freestanding Cancer Centers, Ryan White Providers, Sexually Transmitted Disease Clinics",401 Branard St # 300-302,,Houston,TX,77006-5015,Harris,PO Box 66308,,Houston,TX,77266-6308,Harris,Baine Herrera,Government Grant Writer,832-548-5118,,bherrera@Legacycommunityhealth.org,,,,,,
TX-010604,EL CENTRO DE CORAZON-EASTWOOD,EL CENTRO DEL CORAZON,1932171667,"Dental Providers, Federally Qualified Health Centers - Medical Services",412 Telephone Rd,,Houston,TX,77023-1840,Harris,5001 Navigation Blvd,,Houston,TX,77011-1019,Harris,Marcie Mir,Chief Executive Officer,713-660-1880,1115,mmir@elcentrochc.org,Ana Sierra,Sr. Program Manager,832-494-1758,,asierra@elcentrochc.org,
TX-010605,Denver Harbor Family Clinic,Vecino Health Centers,1093780280,Federally Qualified Health Centers - Medical Services,424 Hahlo St,,Houston,TX,77020-3022,Harris,424 Hahlo,,Houston,TX,77020,Harris,Daniel Montez,CEO,713-343-5450,,dmontez@vecinohealthcenters.org,Nathan Yun,Controller,,,,www.vecinohealthcenters.org
TX-010606,Prevention Park Health Center,"Planned Parenthood Gulf Coast, Inc",1255489399,Family Planning Providers,4600 Gulf Fwy,Suite 100,Houston,TX,77023-3533,Harris,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010607,Sunnyside Health Center,City of Houston,1972648681,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",4605 Wilmington St,,Houston,TX,77051-3333,Harris,4605 Wilmington St,,Houston,TX,77051-3333,Harris,Maria De La Cruz,Program Manager,832-393-5058,,maria.delacruz@houstontx.gov,,,,,,http://www.houstontx.gov/health/index.html
TX-012418,Lone Star Circle of Care at the University of Houston,LONE STAR CIRCLE OF CARE,1871050575,Federally Qualified Health Centers - Medical Services,4849 Calhoun Rd Ste 101A,Health 2 Building,Houston,TX,77204,Harris,205 E University Ave,Ste 200,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,CEO,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,CFO,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010608,KIPP North Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1245583590,Federally Qualified Health Centers - Medical Services,500 Tidwell Rd,,Houston,TX,77022-2122,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010609,KIPP Third Ward Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1447503792,Federally Qualified Health Centers - Medical Services,5400 Martin Luther King Blvd,,Houston,TX,77021-3010,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,https://www.legacycommunityhealth.org/contact-us/
TX-010610,KIPP East End Campus,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1437402781,Federally Qualified Health Centers - Medical Services,5402 Lawndale St,,Houston,TX,77023-3743,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010611,Legacy Lyons Clinic,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1912290693,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",5602 Lyons Ave,Suite 1,Houston,TX,77020-4743,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010612,Legacy Santa Clara Clinic,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1871998831,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",5616 Lawndale St,Suite A110,Houston,TX,77023-3841,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010613,Southwest Health Center,"Planned Parenthood Gulf Coast, Inc.",1942358098,Family Planning Providers,5800 Bellaire Blvd,Suite 120,Houston,TX,77081-5537,Harris,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010614,OPEN DOOR MISSION,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,5803 Harrisburg Blvd,,Houston,TX,77011-4323,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010615,Harris County Public Health - Antoine Clinic,Harris County Public Health,1023163326,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5815 Antoine Dr,,Houston,TX,77091-4417,Harris,2223 West Loop South,,Houston,TX,77027,Harris,Douglas Graham,Director of Disease Control and Clinical Prevention Division,713-439-6116,,dgraham@hcphes.org,,,,,,
TX-010616,EL CENTRO DE CORAZON - SOUTHEAST,EL CENTRO DEL CORAZON,1548538531,Federally Qualified Health Centers - Medical Services,5901 Long Dr,Suite 500,Houston,TX,77087-1003,Harris,5001 Navigation Blvd,,Houston,TX,77011-1019,Harris,Marcie Mir,Chief Executive Officer,713-660-1880,1115,mmir@elcentrochc.org,Ana Sierra,Sr. Program Manager,832-494-1758,,asierra@elcentrochc.org,
TX-010617,Central Care Integrated Health Services,South Central Houston Action Council Inc.,1174907513,Federally Qualified Health Centers - Medical Services,600 E Tidwell Rd,Suite B100,Houston,TX,77022-1800,Harris,8610 Martin Luther King Jr Blvd,,Houston,TX,77033-2308,Harris,Amy Gallardo,Credentialing / Contract,512-280-7943,114,amy.gallardo@medheads.org,,,,,,
TX-010618,Harmony House Respite Center,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,602 Girard St,,Houston,TX,77007-6218,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010619,Jackson Hinds Garden,HARRIS COUNTY HOSPITAL DISTRICT,1205900370,Federally Qualified Health Centers - Medical Services,607 Thornton Rd,,Houston,TX,77018-3353,Harris,2525 Holly Hall St,,Houston,TX,77054-4108,Harris,Julie T. Rabat-Torki,Senior Manager - Government Reporting,713-566-6297,,julie.rabat-torki@harrishealth.org,Linda Kinchen,Director - Ambulatory Care Services Healthcare for the Homeless,713-634-1051,,linda.kinchen@harrishealth.org,
TX-010620,Sharpstown Health Services,City of Houston,1659664522,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",6201 Bonhomme Rd,Suite 300,Houston,TX,77036-4365,Harris,6201 Bonhomme Rd Ste 300,,Houston,TX,77036-4365,Harris,Maria De La Cruz,Program Manager,832-393-5058,,maria.delacruz@houstontx.gov,,,,,,http://www.houstontx.gov/health/index.html
TX-010621,MEMORIAL HERMANN TEXAS MEDICAL CENTER (children's inpatient hospital),Memorial Hermann Health System,1982666111,Children's Hospitals (inpatient only),6411 Fannin St,,Houston,TX,77030-1501,Harris,909 Frostwood,Suite 3:506,Houston,TX,77024,Harris,Susan Distefano,"SVP, CEO - Children's",713-704-6611,,susan.distefano@memorialhermann.org,Steve Hand,"AVP, Government Reporting",713-338-4191,,steve.hand@memorialhermann.org,
TX-010622,MEMORIAL HERMANN TEXAS MEDICAL CENTER (inpatient hospital),Memorial Hermann Health System,1982666111,Inpatient Hospitals (other than children's hospitals),6411 Fannin St,,Houston,TX,77030-1501,Harris,909 Frostwood,Suite 3:506,Houston,TX,77024,Harris,Susan Distefano,"SVP, CEO - Children's",713-704-6611,,susan.distefano@memorialhermann.org,Steve Hand,"AVP, Government Reporting",713-338-4191,,steve.hand@memorialhermann.org,
TX-010623,Legacy Southwest Clinic,Legacy Southwest Clinic,1629361308,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",6441 High Star Dr,,Houston,TX,77074-5005,Harris,1415 California,,Houston,TX,77074-5005,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010624,Legacy Baker Ripley,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1265725949,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",6500 Rookin St,,Houston,TX,77074-5019,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010625,Legacy Mapleridge Clinic,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1538414214,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",6550 Mapleridge St,Suite 106,Houston,TX,77081-4629,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010626,YES Prep Gulfton,Legacy Community Health,1619342375,Federally Qualified Health Centers - Medical Services,6565 De Moss Dr,,Houston,TX,77074-5099,Harris,PO Box 66308,,Houston,TX,77266-6308,Harris,Baine Herrera,Government Grant Writer,832-548-5118,,bherrera@Legacycommunityhealth.org,,,,,,
TX-010627,Texas Children's Hospital (children's inpatient hospital),Texas Children's Hospital,1477643690,Children's Hospitals (inpatient only),6621 Fannin St,,Houston,TX,77030-2358,Harris,6621 Fannin St.,"Assistant Vice President, Revenue Cycle",Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kcthomps@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations",832-824-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010628,Texas Children's Hospital (outpatient hospital clinics),Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,6621 Fannin St,,Houston,TX,77030-2358,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kcthomps@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Gvt Relations",832-824-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010629,Gulf States Hemophilia and Thrombophilia Center,"Univ of Texas Health Science Ctr Houston, Gulf States Hemophilia and Thrombophil",1174710636,Hemophilia Treatment Centers,6655 Travis St,Suite 400,Houston,TX,77030-1343,Harris,"6655 Travis St., Suite 400",,Houston,TX,77030,Harris,Marisela Trujillo,Administrative Director,713-500-8375,,marisela.trujillo@uth.tmc.edu,,,,,,
TX-010630,KIPP CONNECT,Legacy Community Health Services,1740688043,Federally Qualified Health Centers - Medical Services,6700 Bellaire Blvd,,Houston,TX,77074-4906,Harris,1415 California,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,www.legacycommunityhealth.org
TX-010631,BCM Pediatrics Hemophilia Treatment Center,Baylor College of Medicine,1104867175,Hemophilia Treatment Centers,6701 Fannin St,,Houston,TX,77030-2608,Harris,One Baylor Plaza,,Houston,TX,77030,Harris,"Donald Yee, MD",Director,832-822-4861,,dlyee@txch.org,Barkha Chandwani,Hematology Practice Administrator,832-822-4781,,bxchandw@txch.org,http://txch.org/hematology-center/hemophilia-thrombosis-center/
TX-010632,St. Hope Foundation Bellaire Community Health Clinic,St. Hope Foundation,1558479683,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Ryan White Providers",6800 W Loop S,Suite 560,Houston,TX,77401,Harris,6200 Savoy Dr Ste 540,,Houston,TX,77036,Harris,Rodney Goodie,CEO,713-778-1300,2341,RODNEY@OFFERINGHOPE.ORG,Timika Sam-Cooper,COO,713-778-1300,2342,mika@offeringhope.org,OFFERINGHOPE.ORG
TX-010633,SHC - Houston,Shriners Hospitals for Children,1518000306,Children's Hospitals (inpatient only),6977 Main St,,Houston,TX,77030-3701,Harris,6977 Main St.,,Houston,TX,77030,Harris,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
TX-010634,HOPE Clinic,"ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA, INC.",1699966754,Federally Qualified Health Centers - Medical Services,7001 Corporate Dr,Suite 120,Houston,TX,77036-5113,Harris,7001 Corporate Dr. # 120,,Houston,TX,77036,Harris,Andrea Caracostis,CEO,713-337-3640,,acaracostis@hopechc.org,Penny Yang,CFO,713-337-3641,,pyang@hopechc.org,www.hopechc.org
TX-010635,EL CENTRO DE CORAZON - MAGNOLIA,EL CENTRO DEL CORAZON,1700858446,Federally Qualified Health Centers - Medical Services,7037 Capitol St,,Houston,TX,77011-4643,Harris,5001 Navigation Blvd,,Houston,TX,77011-1019,Harris,Marcie Mir,Chief Executive Officer,713-660-1880,1115,mmir@elcentrochc.org,Ana Sierra,Sr. Program Manager,832-494-1758,,asierra@elcentrochc.org,
TX-010636,El Centro de Corazon - John S. Dunn,EL CENTRO DEL CORAZON,1245556885,"Dental Providers, Federally Qualified Health Centers - Medical Services",7635 Canal St,,Houston,TX,77012-1143,Harris,5001 Navigation Blvd,,Houston,TX,77011-1019,Harris,Marcie Mir,Chief Executive Officer,713-660-1880,1115,mmir@elcentrochc.org,Ana Sierra,Sr. Program Manager,832-494-1758,,asierra@elcentrochc.org,
TX-010637,KIPP Sharp,Legacy Community Health,1871846964,Federally Qualified Health Centers - Medical Services,8430 Westglen Dr,,Houston,TX,77063-6312,Harris,PO Box 66308,,Houston,TX,77266-6308,Harris,Baine Herrera,Government Grant Writer,832-548-5118,,bherrera@Legacycommunityhealth.org,,,,,,https://www.legacycommunityhealth.org/contact-us/
TX-010638,KIPP Sharpstown,"LEGACY COMMUNITY HEALTH SERVICES, INC.",1871846964,Family Planning Providers,8440 Westpark Dr,,Houston,TX,77063-5808,Harris,1415 California St,,Houston,TX,77006-2602,Harris,Katy Caldwell,Executive Director,832-548-5050,,kcaldwell@legacycommunityhealth.org,Melisa Garcia,VP of Clinical Business Services,832-548-5074,,mgarcia@legacycommunityhealth.org,https://www.legacycommunityhealth.org/contact-us/
TX-010639,Northside Health Center,City of Houston,1215072939,"Dental Providers, Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",8504 Schuller Rd,,Houston,TX,77093-7603,Harris,8504 Schuller Rd,,Houston,TX,77093-7603,Harris,Maria De La Cruz,Program Manager,832-393-4207,,maria.delacruz@houstontx.gov,,,,,,http://www.houstontx.gov/health/index.html
TX-010640,Central Care IHS @ MLK,Central Care Integrated Health Services,1417036534,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",8610 Martin Luther King Blvd,,Houston,TX,77033-2308,Harris,PO Box 300345,,"Houston, Tx",TX,77230,Harris,LaToya D. Darden,President & CEO,713-734-4580,,ldarden@centralcarechc.org,,,,,,
TX-010641,Bee Busy Wellness Center W Bellfort,Bee Busy Wellness Center,1669603056,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",8785 W Bellfort St,,Houston,TX,77031-2403,Harris,8785 West Bellfort St,,Houston,TX,77031,Harris,Norman Mitchell,CEO,713-771-2292,1001,n.mitchell@mybbwc.org,Norman Mitchell,CEO,713-771-2292,1001,norman@beebusy.org,http://www.mybbwc.org
TX-010642,Northville Health Center,"Planned Parenthood Gulf Coast, Inc.",1790833846,Family Planning Providers,9919 North Fwy,Suite 107,Houston,TX,77037-1272,Harris,4600 Gulf Fwy,,Houston,TX,70023,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010643,Harris County Public Health - Humble Clinic,Harris County Public Health,1255455200,"Dental Providers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1730 Humble Place Dr,,Humble,TX,77338-5275,Harris,2223 West Loop South,,Houston,TX,77027,Harris,Douglas Graham,Director of Disease Control and Clinical Prevention Division,713-439-6116,,dgraham@hcphes.org,,,,,,
TX-010644,Texas Children's Hospital - Kingwood Specialty Care,Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,19298 W Lake Houston Pkwy,Suite 110,Humble,TX,77346-4828,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kthompson@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010645,Walker County Hospital Corporation dba Huntsville Memorial Hospital,Walker County Hospital Corporation dba Huntsville Memorial Hospital,1144225699,Inpatient Hospitals (other than children's hospitals),110 Memorial Hospital Dr,,Huntsville,TX,77340-4940,Walker,110 Memorial Hospital Drive,,Huntsville,TX,77340,Walker,Hollie Randgaard,Credentialing Specialist,936-439-1440,,hollie.randgaard@huntsvillememorial.com,Elizabeth Pippo,Manager,936-439-4448,,elizabeth.pippo@huntsvillememorial.com,
TX-010646,HMH Huntsville Clinic,Walker County Hospital Corporation dba Huntsville Memorial Hospital,1972628816,Rural Health Clinics,125 Medical Park Ln,Suite C,Huntsville,TX,77340-4957,Walker,110 Memorial Hospital Drive,,Huntsville,TX,77340,Walker,Hollie Randgaard,Credentialing Specialist,936-439-1440,,hollie.randgaard@huntsvillememorial.com,Elizabeth Pippo,Manager,936-439-4448,,elizabeth.pippo@huntsvillememorial.com,
TX-010648,Dell Children's - Circle of Care Pediatrics at Hutto,LONE STAR CIRCLE OF CARE,1558675488,Federally Qualified Health Centers - Medical Services,123 Ed Schmidt Blvd,Suite 140,Hutto,TX,78634-5586,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010649,Iowa Park Clinic,Electra Hospital District,1467742254,Rural Health Clinics,405 SE Access Rd,,Iowa Park,TX,76367-6985,Wichita,1207 S Bailey,PO Box 1112,Electra,TX,76360,Wichita,Ginnie Holmes,CFO,940-495-3981,123,ginnie.holmes@electrahospital.com,Rebecca McCain,CEO,940-495-3981,,rebecca.mccain@electrahospital.com,www.electrahospital.com
TX-012468,Jack County Hospital District,Faith Community Hospital,1790777696,Inpatient Hospitals (other than children's hospitals),215 Chisholm Trl,,Jacksboro,TX,76458-1403,Jack,215 Chisholm Trail,,Jacksboro,TX,76458,Jack,Frank L. Beaman,CEO,940-567-2961,246,fbeaman@fchtexas.com,Bonnie Blevins,CFO,940-567-6633,,bblevins@fchtexas.com,fchtexas.com
TX-012469,Jack County Medical Clinic,Jack County Hospital District,1013909936,Rural Health Clinics,215 Chisholm Trl,,Jacksboro,TX,76458-1403,Jack,215 Chisholm Trail,,Jacksboro,TX,76458,Jack,Frank L. Beaman,CEO,940-567-2961,246,fbeaman@fchtexas.com,Bonnie Blevins,CFO,940-567-6633,,bblevins@fchtexas.com,fchtexas.com
TX-010650,Jacksonville Family Circle of Care,TYLER FAMILY CIRCLE OF CARE,1144575820,Federally Qualified Health Centers - Medical Services,510 E Commerce St,,Jacksonville,TX,75766-4910,Cherokee,PO Box 9929,,Tyler,TX,75711,Smith,Erich Koch,CFO,903-525-7497,,erich.koch@tmfhc.org,,,,,,www.tylerfcc.org
TX-010651,Gulf Coast Health Center - JASPER,"GULF COAST HEALTH CENTER, INC.",1639176324,"Dental Providers, Federally Qualified Health Centers - Medical Services",103 W Gibson St,Suite 110,Jasper,TX,75951-4970,Jasper,2548 Memorial Blvd.,,Port Arthur,TX,77640-2825,Jefferson,Marsha Thigpen,MD/Executive Director,409-983-1161,806,mthigpen@gulfcoasthc.org,Linda Solis,Credentialing Coordinator,409-983-1161,817,lsolis@gulfcoasthc.org,
TX-010652,Christus Jasper Family Practice Clinic,CHRISTUS Health,1598749707,Inpatient Hospitals (other than children's hospitals),1275 Marvin Hancock Dr,,Jasper,TX,75951-4935,Jasper,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-010653,Jasper,Jasper Newton County Public Health District,1659461788,Family Planning Providers,139 W Lamar St,,Jasper,TX,75951-4014,Jasper,139 W LAMAR ST,,JASPER,TX,75951,Jasper,Nadia Martindale,Clinic Supervisor,409-384-6829,224,nmartindale@jaspernewton.org,,,,,,https://www.jaspernewton.org/primary-health-care/
TX-010654,Kent County Rural Health Clinic,Stonewall Memorial Hospital District,1679992911,Rural Health Clinics,1447 N Main St,,Jayton,TX,79528,Kent,821 N Broadway,,Aspermont,TX,79502,Stonewall,Billie Carter,COO,940-989-3551,,billie.carter@smhdhealth.org,,,,,,
TX-010655,East Texas Border Health Clinic dba Genesis Primecare-Jefferson,East Texas Border Health Clinic dba Genesis Primecare,1659567337,Federally Qualified Health Centers - Medical Services,106 N Alley St,,Jefferson,TX,75657-1408,Marion,P.O. Box 1326,502 East Rusk Street,Marshall,TX,75671,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing Specialists,903-927-3782,20,leighann.richmond@genesisprimecare.org,
TX-010656,Frontera Healthcare Network - Junction Clinic,FRONTERA HEALTHCARE NETWORK,1548517303,Federally Qualified Health Centers - Medical Services,509 College St,,Junction,TX,76849-4733,Kimble,604 Eaker St,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010657,KARNES COMMUNITY HEALTH CENTER,ATASCOSA HEALTH CENTER INC,1962600106,Federally Qualified Health Centers - Medical Services,302 N Butler St,,Karnes City,TX,78118-2801,Karnes,310 W Oaklawn Rd,,PLEASANTON,TX,78064-4033,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,
TX-010658,Karnes Community Health Center Dental Suite,ATASCOSA HEALTH CENTER INC,1962600106,Dental Providers,302 N Butler St,,Karnes City,TX,78118-2801,Karnes,310 W Oaklawn Rd,,PLEASANTON,TX,78064,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,
TX-010659,KAUFMAN COMMUNITY HLTH CTR,Community Health Service Agency Inc.,1669455101,Federally Qualified Health Centers - Medical Services,101 N Houston St,Suite 5,Kaufman,TX,75142-1949,Kaufman,4500 Wesley St,,Greenville,TX,75401-5644,Hunt,Michelle Carter,CEO,903-455-5986,,mcarter@carevide.org,Jill Alvarado,AR Manager,903-454-3025,146,jalvarado@carevide.org,
TX-010660,Wellness Pointe - Kilgore,"LONGVIEW WELLNESS CENTER, INC.",1982837829,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1711 S Henderson Blvd,Suite 400,Kilgore,TX,75662-3592,Gregg,1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,Chad Jones,Chief Executive Officer,903-212-4777,,chad.jones@wellnesspointe.org,Talia Peterson,Chief Financial Officer,903-212-4773,,talia.peterson@wellnesspointe.org,http://www.wellnesspointe.org
TX-010661,Metroplex Adventist Hospital,Adventist Health System/Sunbelt Inc,1629089966,Inpatient Hospitals (other than children's hospitals),2201 S Clear Creek Rd,,Killeen,TX,76549-4110,Bell,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Brian Loria,Regional Director Managed Care,817-568-5540,,Brian.Loria@AHSS.ORG,,,,,,
TX-010662,Lone Star Circle of Care Pediatrics at Clear Creek,LONE STAR CIRCLE OF CARE,1376840140,Federally Qualified Health Centers - Medical Services,2300 S Clear Creek Rd,Suite 105,Killeen,TX,76549-4985,Bell,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010663,Bell County Public Health District,Bell County Public Health District,1669620159,Family Planning Providers,309 N 2nd St,,Killeen,TX,76541-5204,Bell,PO Box 2149,,Temple,TX,76503-2149,Bell,Bonnie Scurzi,District Director,254-773-4457,251,bscurzi@bellcountyhealth.org,Chelo Elliott,Director of Nurses,254-778-4766,,celliott@bellcountyhealth.org,http://www.bellcountyhealth.org/
TX-010664,Kingsville Clinic,"Women's and Men's Health Services of the Coastal Bend, Inc",1932517067,Family Planning Providers,1022 S 14th St,,Kingsville,TX,78363-6422,Kleberg,3536 Holly Road,,Corpus Christi,TX,78415,Nueces,Amanda Stukenberg,CEO,361-855-9107,,astukenberg@wamhs.org,Janice Haas,Finance Officer,361-855-9107,,jhaas@wamhs.org,https://www.wamhs.org/
TX-010665,Community Action Integration Center Kingsville,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1174950646,Federally Qualified Health Centers - Medical Services,1621 E Corral Ave,,Kingsville,TX,78363-4142,Kleberg,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010666,Community Action Health Center Kleberg,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1164868998,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",415 S 6th St,,Kingsville,TX,78363-5518,Kleberg,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2046,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010667,Kirbyville,Jasper Newton County Public Health District,1932327228,Family Planning Providers,1503 S Margaret Ave,,Kirbyville,TX,75956-2615,Jasper,139 W LAMAR ST,,JASPER,TX,75951,Jasper,Nadia Martindale,Clinic Supervisor,409-384-6829,224,nmartindale@jaspernewton.org,,,,,,https://www.jaspernewton.org/primary-health-care/
TX-010668,Family Planning Center Kyle,Community Action Inc. of Central Texas,1750786919,Family Planning Providers,2810 Dacy Ln,,Kyle,TX,78640-6322,Hays,"101 Uhland Road, Suite 107",,San Marcos,TX,78667-0748,Hays,Carole Belver,Executive Director,512-392-1161,328,cbelver@communityaction.com,,,,,,
TX-010669,Seton Medical Center Hays,Seton Family of Hospitals,1619115383,Inpatient Hospitals (other than children's hospitals),6001 Kyle Pkwy,,Kyle,TX,78640-6112,Hays,4515 Seton Center Parkway,S. 300,Austin,TX,78759,Travis,Mark Jenkins,Sr. Director,512-324-2792,,mjenkins@seton.org,,,,,,
TX-010670,Tejas Health Care,Tejas Health Care,1073779500,Dental Providers,220 W Guadalupe St,,La Grange,TX,78945-1926,Fayette,753 E Travis,,La Grange,TX,78945,Fayette,Sheri Kehler,CEO,979-968-6596,120,skehler@tejashealthcare.org,Pam Wyant,Billing Supervisor,979-968-6596,131,pwyant@tejashealthcare.org,
TX-010671,Tejas Health Care,Tejas Health Care,1073779500,Federally Qualified Health Centers - Medical Services,753 E Travis St,,La Grange,TX,78945-2353,Fayette,753 E Travis St,,La Grange,TX,78945-2353,Fayette,Sheri Kehler,CEO,979-968-6596,120,skehler@tejashealthcare.org,Pam Wyant,Biilling Supervisor,979-968-6596,131,pwyant@tejashealthcare.org,
TX-010672,Vidaysalud Health System Inc,Vidaysalud Health System Inc,1346567948,Federally Qualified Health Centers - Medical Services,117 E Highway 57,LPISD-VSHSI COMMUNTY BASED & SCHOOL BASED HEALTH CLINIC,La Pryor,TX,78872,Zavala,308 S Cesar Chavez Ave,,Crystal City,TX,78839-4200,Zavala,Nora Tellez,CEO,830-374-2301,101,norat@vidaysalud.org,Laylaly Menchaca,Program and Grants Consultant,830-279-4220,166,lalym@vidaysalud.org,www.vidaysalud.org
TX-010673,Lake Worth Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,3800 Adam Grubb St,,Lake Worth,TX,76135-3511,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76104,Tarrant,Linda Peterson,Clinic Charge Nurse/Registered Nurse,817-238-4441,,lmpeterson@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010674,SOUTH PLAINS DENTAL SVS Lamesa,SOUTH PLAINS RURAL HEALTH SERVICES INC,1013033414,Dental Providers,1005 N 16th St,,Lamesa,TX,79331-3151,Dawson,"South Plains Rural Health Services, Inc.",,Levelland,TX,79336,Hockley,Judith Madura,CEO,806-894-7842,,jmadura@sprhs.org,Tara Haskell,CFO,806-894-7842,,thaskell@sprhs.org,
TX-010675,LAMESA PRIMARY CARE CLINIC,SOUTH PLAINS RURAL HEALTH SERVICES INC,1376656207,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",1502 N Avenue K,,Lamesa,TX,79331-3040,Dawson,1000 FM 300,,Levelland,TX,79336,Hockley,Judith Madura,CEO,806-894-7842,,jmadura@sprhs.org,Tara Haskell,CFO,806-894-7842,,thaskell@sprhs.org,
TX-010676,South Plains Public Health District - Dawson County,South Plains Public Health District,1952339798,Family Planning Providers,503 S 1st St,,Lamesa,TX,79331-6245,Dawson,503 S 1st St,,Lamesa,TX,79331-6245,Dawson,"Soronya Shafer, RN",Director of Clinical Services,432-758-4022,,sshafer@spphd.org,Judy Morales,Eligibility Worker,806-872-5863,,jmorales@spphd.org,https://southplainshealth.org/
TX-010677,Family Medicine Clinic,"Family Medicine Rural Health Clinic, PA",1699731257,Rural Health Clinics,187 PR 4060,,Lampasas,TX,76550,Lampasas,207 W. Ave E,,Lampasas,TX,76550,Lampasas,Mia Monroe,Finance Director,512-556-3621,132,mmonroe@fmcmedicine.com,Kim Gabara,Practice Administrator,512-556-3621,,kgabara@fmcmedicine.com,www.fmcmedicine.com
TX-010678,Rollins Brook Community Hospital,Adventist Health System/Sunbelt Inc.,1750392916,Inpatient Hospitals (other than children's hospitals),608 N Key Ave,,Lampasas,TX,76550-1106,Lampasas,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Brian Loria,Regional Director Managed Care,817-568-5540,,Brian.Loria@AHSS.ORG,,,,,,
TX-010679,"GATEWAY COMMUNITY HEALTH CENTER, INC.",GATEWAY COMMUNITY HEALTH CENTER INC,1013948447,"Dental Providers, Federally Qualified Health Centers - Medical Services",1515 Pappas St,,Laredo,TX,78041-1705,Webb,1515 Pappas St,,Laredo,TX,78041-1705,Webb,Cristina J. Hernandez,Director of Business Operations,956-718-6259,,cristinah.gateway@tachc.org,,,,,,
TX-010680,SOUTH CLINIC,GATEWAY COMMUNITY HEALTH CENTER INC,1255376976,"Dental Providers, Federally Qualified Health Centers - Medical Services",2007 S Zapata Hwy,,Laredo,TX,78046-6510,Webb,1515 Pappas St,,Laredo,TX,78041-1705,Webb,Cristina J. Hernandez,Director of Business Operations,956-718-6259,,cristinah.gateway@tachc.org,,,,,,
TX-010681,City of Laredo Health Department Family Planning Clinic,City of Laredo Health Department,1790858769,"Dental Providers, Family Planning Providers, Other ECP Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2600 Cedar Ave,,Laredo,TX,78040-4040,Webb,2600 Cedar Ave,,Laredo,TX,78040-4040,Webb,Hector Gonzalez,Health Director,956-795-4920,,hgonzalez@ci.laredo.tx.us,waldo lopez,associate director,956-795-4905,9567954921,wlopez@ci.laredo.tx.us,http://www.ci.laredo.tx.us/Health/Healthindex.htm
TX-010682,ROLLING HILLS HEALTH,COMMUNITY HEALTH DEVELOPMENT INC,1730205634,Federally Qualified Health Centers - Medical Services,Hwy 83 And Oakhill Dr,,Leakey,TX,78873,Real,908 Evans St,,Uvalde,TX,78801-6051,Uvalde,Christina Velasquez,Business Office Manager,830-278-5604,3100,cvelasquez.chdi@tachc.org,Mayela Castanon,CFO,830-278-5604,3100,mcastanon.chdi@tachc.org,
TX-012419,Lone Star Circle of Care at Jonestown,LONE STAR CIRCLE OF CARE,1902393499,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",18220 FM 1431,Suite D,Leander,TX,78641-4043,Travis,205 E University Ave,Suite 200,Georgetown,TX,78626,Williamson,Rhonda Mundhenk,CEO,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,CFO,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010683,"SOUTH PLAINS RURAL HEALTH SERVICES, INC.",SOUTH PLAINS RURAL HEALTH SERVICES INC,1295746402,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",1000 FM 300 Unit A,,Levelland,TX,79336-6236,Hockley,1000 FM 300 Unit A,,Levelland,TX,79336,Hockley,Judith Madura,CEO,806-894-7842,,jmadura@sprhs.org,Tara Haskell,CFO,806-894-7842,,thaskell@sprhs.org,
TX-010685,Liberty Medical Rural Health Clinic,Liberty Medical Rural Health Clinic,1871590703,Rural Health Clinics,720 Travis St,,Liberty,TX,77575-4828,Liberty,720 Travis,,Liberty,TX,77575,Liberty,FALLON KAY,Office Manager,936-336-6439,108,FKAY@LIBERTYMEDSURG.COM,Katy Taylor,Medical Assistant,936-336-6439,,,
TX-010686,Lamb Healthcare Center,Lamb Healthcare Center,1700854288,Inpatient Hospitals (other than children's hospitals),1500 S Sunset Ave,,Littlefield,TX,79339-4899,Lamb,1500 S. Sunset,,Littlefield,TX,79339,Lamb,Cindy Klein,CFO,806-385-6411,2002,cklein@lambhc.org,Dennis Fleenor,CEO,806-385-6411,2004,dfleenor@lambhc.org,
TX-010687,LHC Family Medicine,LHC Family Medicine,1356308423,"Family Planning Providers, Rural Health Clinics",1600 S Sunset Ave,,Littlefield,TX,79339-4810,Lamb,1600 S. Sunset,,Littlefield,TX,79339,Lamb,Cindy Klein,CFO,806-385-6411,2002,cklein@lambhc.org,Sharla McBride,Clinic Manager,806-385-6424,,smcbride@lambhc.org,
TX-010688,Chief Kina Health Clinic,Alabama Coushatta Tribe of Texas,1619069986,"Indian Health Service, Other ECP Providers",129 Daycare Rd,,Livingston,TX,77351-0061,Polk,129 Daycare Road,,Livingston,TX,77351,Polk,MYRA SYLESTINE,Administrative Assistant,936-563-2058,,MYRAS@NSACOT.NASHVILLE.IHS.GOV,Myra Sylestine,Health Director,936-563-2058,,myras@nsacot.nashville.ihs.gov,
TX-010689,Lockhart Family Practice Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1063894855,"Dental Providers, Federally Qualified Health Centers - Medical Services",2060 S Colorado St,,Lockhart,TX,78644-3951,Caldwell,P.O. Box 1890,228 St. George,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010691,Wellness Pointe - Longview,"LONGVIEW WELLNESS CENTER, INC.",1942269493,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,Chad Jones,Chief Executive Officer,903-212-4777,,chad.jones@wellnesspointe.org,Talia Peterson,Chief Financial Officer,903-212-4773,,talia.peterson@wellnesspointe.org,http://www.wellnesspointe.org/
TX-010692,East Texas Border Health Clinic dba Genesis Primecare-Longview,East Texas Border Health Clinic dba Genesis Primecare,1669872560,Federally Qualified Health Centers - Medical Services,2131 S Mobberly Ave,,Longview,TX,75602-3563,Gregg,P. O. Box 1326,502 East Rusk,Marshall,TX,75671,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing Specialist,903-927-3782,20,leighann.richmond@genesisprimecare.org,
TX-010693,Wellness Pointe - Longview - South,"LONGVIEW WELLNESS CENTER, INC.",1023426665,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",2430 S High St,,Longview,TX,75602-3432,Gregg,1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,Chad Jones,Chief Executive Officer,903-212-4777,,chad.jones@wellnesspointe.org,Talia Peterson,Chief Financial Officer,903-212-4773,,talia.peterson@wellnesspointe.org,http://www.wellnesspointe.org
TX-010694,Woman and Child Health Center of Longview,"Special Health Resources for Texas, Inc.",1043209919,Federally Qualified Health Centers - Medical Services,402 N 7th St,,Longview,TX,75601-6704,Gregg,P. O. Box 2709,,Longview,TX,75608,Gregg,Kim Nesvig,CEO,903-212-7811,,knesvig@shrt.net,David Hayes,COO,903-212-7807,,dhayes@shrt.net,www.shrt.net
TX-010695,Wellness Pointe - Longview North,"LONGVIEW WELLNESS CENTER, INC.",1932598752,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",805 Medical Dr,Suite A,Longview,TX,75605-5130,Gregg,1107 E Marshall Ave,,Longview,TX,75601-5602,Gregg,Chad Jones,Chief Executive Officer,903-212-4777,,chad.jones@wellnesspointe.org,Talia Peterson,Chief Financial Officer,903-212-4773,,talia.peterson@wellnesspointe.org,http://www.wellnesspointe.org
TX-010696,Community Health Center of Lubbock,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1548231046,"Dental Providers, Federally Qualified Health Centers - Medical Services",1610 5th St,,Lubbock,TX,79401-2622,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P. Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1011,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010697,CHCL Community Dental Clinic (Parkway Plaza Strip Center),"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1831118306,Dental Providers,1826 Parkway Dr,,Lubbock,TX,79403-4406,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010698,Combest Sunrise Canyon Clinic,TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER,1750702015,Federally Qualified Health Centers - Medical Services,1950 Aspen Ave,Bldg 100,Lubbock,TX,79404-1211,Lubbock,3601 4th St,,Lubbock,TX,79430-6271,Lubbock,Linda McMurry,Executive Director,806-743-9571,,linda.mcmurry@ttuhsc.edu,Amy Bell,Finance Director,806-743-9553,,amy.bell@ttuhsc.edu,
TX-010699,Chatman Community Health Center,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1528030087,Federally Qualified Health Centers - Medical Services,2301 Cedar Ave,,Lubbock,TX,79404-1629,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010700,CHCL 96 West,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1740551787,Federally Qualified Health Centers - Medical Services,2401 Fulton Ave Apt B,,Lubbock,TX,79407-7727,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010701,Larry Combest Community Health and Wellness Center,TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER,1609023191,Federally Qualified Health Centers - Medical Services,301 40th St,,Lubbock,TX,79404-2746,Lubbock,3601 4th St,,Lubbock,TX,79430-6271,Lubbock,Linda McMurry,Executive Director,806-743-9553,,linda.mcmurry@ttuhsc.edu,Amy Bell,Finance Director,806-743-9553,,amy.bell@ttuhsc.edu,
TX-010702,Arnett Benson Medical and Dental Clinic,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1912944059,"Dental Providers, Federally Qualified Health Centers - Medical Services",3301 Clovis Rd,,Lubbock,TX,79415-5155,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010703,CHCL Medical Plaza,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1831569540,Federally Qualified Health Centers - Medical Services,3502 9th St,Suite 280,Lubbock,TX,79415-5305,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010704,Methodist Children's Hospital (DBA Covenant Children's Hospital) (children's inpatient hospital),Covenant Health,1437171568,Children's Hospitals (inpatient only),4015 22nd Pl,,Lubbock,TX,79410-1119,Lubbock,Covenant Health System,3615 19th Street,Lubbock,TX,79410-1203,Lubbock,AMY THOMPSON,VP Corporate Services,806-725-0000,,AT@COVHS.ORG,LUCAS DIVINE,,806-725-0000,,,
TX-010705,Methodist Children's Hospital (DBA Covenant Children's Hospital) (dental provider),Covenant Health,1437171568,Dental Providers,4015 22nd Pl,,Lubbock,TX,79410-1119,Lubbock,Covenant Health System,3615 19th Street,Lubbock,TX,79410-1203,Lubbock,Lindy Lauderdale,VP Corporate Services,806-725-6160,,THOAMN@COVHS.ORG,LUCAS DIVINE,,806-725-0000,,DIVINELA1@COVHS.ORG,
TX-010706,Parkway Community Health Center,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1891768321,Federally Qualified Health Centers - Medical Services,406 Martin Luther King Blvd,,Lubbock,TX,79403-5210,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010707,CHCL West Medical and Dental Clinic,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1225304686,"Dental Providers, Federally Qualified Health Centers - Medical Services",5424 19th St,Suite 200,Lubbock,TX,79407-2163,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chcl.tachc.org,www.chclubbock.org
TX-010708,Women's Protective Services,"COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE",1356460554,Federally Qualified Health Centers - Medical Services,89th and University,,Lubbock,TX,79413,Lubbock,1610 5th Street,,Lubbock,TX,79401,Lubbock,Michael P Sullivan,Chief Executive Officer,806-765-2611,1108,msullivan@chcl.tachc.org,Barbra Moore,Interim Finance Director,806-765-2611,1201,bmoore@chlc.tachc.org,www.chclubbock.org
TX-010709,Luling Community Health Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1396904686,Federally Qualified Health Centers - Medical Services,111 S Laurel Ave,,Luling,TX,78648-2624,Caldwell,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010710,Luling Community Dental Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1396904686,Dental Providers,651 E Crockett St,,Luling,TX,78648-2602,Caldwell,P.O. Box 1890,228 St. George,Gonzales,TX,78629-3910,Gonzales,Henry Salas,CEO,830-672-6511,204,salash@chcsct.com,Cecilia Montoya,Contracting/Credentialing,830-549-1416,,montoyac@chcsct.com,
TX-010711,LYTLE COMMUNITY HEALTH CENTER,"Atascosa Health Center, Inc.",1003359209,Federally Qualified Health Centers - Medical Services,19010 Priest Blvd,,Lytle,TX,78052-3486,Atascosa,310 W. OAKLAWN RD,,PLEASANTON,TX,780644033,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,http://www.atascosahealthcenter.org/lytle-community-health-center.html
TX-010712,HealthPoint Madisonville,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1245598622,Federally Qualified Health Centers - Medical Services,100 W Cross St,,Madisonville,TX,77864-2432,Madison,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,409-348-3418,,,
TX-010714,People'S Community Clinic,People's Community Clinic,1083019905,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",10335 US Highway 290 E,Manor School-Based Healthcare Center,Manor,TX,78653-4686,Travis,2909 N IH-35 Frontage Rd,,Austin,TX,78722,Travis,Regina Rogoff,Chief Executive Officer,512-708-3121,,reginar@austinpcc.org,Alexandra Berry,Director of Compliance,512-684-1715,,alexb@austinpcc.org,http://www.austinpcc.org
TX-010715,CommUnityCare Manor,Travis County Healthcare District,1598793077,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",600 W Carrie Manor St,,Manor,TX,78653-5035,Travis,1111 E. Cesar Chavez,,Austin,TX,78703,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010716,Marathon Rural Health Center,Pecos County Memorial Hospital,1003256009,Rural Health Clinics,101 South Post Rd,,Marathon,TX,79842,Brewster,387 west i h 10,,Fort stockon,TX,79735,Pecos,mary gallegos,director,432-336-4213,,mgallegos@pcmhfs.com,,,,,,
TX-010717,LSCC Family Care Center at Marble Falls,LONE STAR CIRCLE OF CARE,1164846952,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",802 Avenue J,,Marble Falls,TX,78654-5125,Burnet,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Finanical Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010718,Marfa Community Health Clinic.,PRESIDIO COUNTY HEALTH SERVICES INC,1013196625,Federally Qualified Health Centers - Medical Services,406 S Summer St,,Marfa,TX,79843,Presidio,P.O. Box 267,,Marfa,TX,79843,Presidio,Linda Molinar,CEO,432-729-1812,,cfo_pchs@yahoo.com,Cynthia A. Esquivel,COO,432-729-1812,,hr_pchs@yahoo.com,
TX-010719,Falls Community Rural Health Clinic,Falls Community Hospital & Clinic,1629173737,"Outpatient Hospital Clinics, Rural Health Clinics",307 Live Oak St,,Marlin,TX,76661-2365,Falls,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@fallshospital.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010720,Falls Community Hospital & Clinic,Falls Community Hospital & Clinic,1841294246,Inpatient Hospitals (other than children's hospitals),322 Coleman St,,Marlin,TX,76661-2358,Falls,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@yahoo.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010721,The Doctors Clinic,Falls Community Hospital & Clinic,1093743783,Other ECP Providers,322 Coleman St,,Marlin,TX,76661-2358,Falls,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@fallshospital.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010722,East Texas Border Health Clinic dba Genesis Primecare-Marshall,East Texas Border Health Clinic dba Genesis Primecare,1558329797,Federally Qualified Health Centers - Medical Services,811 S Washington Ave,PO Box 1326,Marshall,TX,75671-1326,Harrison,P. O. Box 1326,502 East Rusk Street,Marshall,TX,75670,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing Specialists,903-927-3782,20,leighann.richmond@genesisprimecare.org,
TX-010723,FCHC Rucker Clinic,Falls Community Hospital and Clinic,1659593028,Outpatient Hospital Clinics,200 N Pearl St,,Mart,TX,76664-1142,McLennan,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@fallshospital.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010724,Frontera Healthcare Network Mason Clinic,FRONTERA HEALTHCARE NETWORK,1235381088,Federally Qualified Health Centers - Medical Services,216 E College St,,Mason,TX,76856,Mason,604 Eaker St,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010725,Community Action Corporation Of South Texas,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1396182739,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",502 E San Patricio Ave,Mathis ISD School Based Health Center,Mathis,TX,78368-2517,San Patricio,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010726,MCGREGOR COMMUNITY CLINIC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1306166830,"Dental Providers, Federally Qualified Health Centers - Medical Services",500 Johnson Dr,,Mc Gregor,TX,76657-1441,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,
TX-010727,Valley AIDS Council - McAllen,Valley AIDS Council,1740223379,"Ryan White Providers, Sexually Transmitted Disease Clinics",300 South 2nd St,Suite 101,McAllen,TX,78501-2702,Hidalgo,2306 Camelot Plaza,,Harlingen,TX,78550,Cameron,Wally Cantu,Interim Executive Director/CFO/Director of Quality Assurance,956-507-4880,,wcantu@valleyaids.org,Lizette Saenz,Comptroller,956-507-4814,,lsaenz@valleyaids.org,
TX-010728,Access Esperanza Clinics - McAllen Health Center,"Access Esperanza Clinics, Inc.",1821015280,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",916 E Hackberry Ave,,McAllen,TX,78501-5737,Hidalgo,916 E Hackberry Ave,,McAllen,TX,78501-5737,Hidalgo,Patricio Gonzales,Chief Executive Officer,956-688-3700,3707,patricio.gonzales@accessclinics.org,Melinda Cruz,Clinical Operations Director,956-688-3700,3708,melinda.cruz@accessclinics.org,http://www.accessclinics.org/
TX-010729,FRONTERA HEALTHCARE NETWORK - Menard Dental Clinic,FRONTERA HEALTHCARE NETWORK,1396976478,Dental Providers,108 East San Saba,,Menard,TX,76859,Menard,604 Eaker Street,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010730,Frontera Healthcare Network - Menard Clinic,FRONTERA HEALTHCARE NETWORK,1447594247,Federally Qualified Health Centers - Medical Services,119 South Ellis St,,Menard,TX,76859,Menard,604 Eaker St,,Eden,TX,76837,Concho,Cam Kleibrink,Executive Director,325-869-5500,,camk@fronterahn.org,Mindy Speck,CFO,325-869-5500,,mspeck@fronterahn.org,
TX-010731,NUESTRA CLINICA DEL VALLE - MERCEDES,NUESTRA CLINICA DEL VALLE,1235267949,Federally Qualified Health Centers - Medical Services,1500 W 1st St,,Mercedes,TX,78570-2551,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010732,ResourceCare Merkel,Shackelford County Community Resource Center,1184096273,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",217 Edwards,,Merkel,TX,79536-3803,Taylor,PO Box 2435,,Albany,TX,76430,Shackelford,Meagan Marshall,CEO,325-762-2447,110,mmarshall@resourcecare.org,Tina Betcher,Billing Manager,325-893-4010,107,tbetcher@resourcecare.org,www.resourcecare.org
TX-010733,Planned Parenthood of Greater Texas - Mesquite Health Center,Planned Parenthood of Greater Texas,1326309022,"Family Planning Providers, Sexually Transmitted Disease Clinics",1220 N Town East Blvd,Suite 240,Mesquite,TX,75150-4682,Dallas,7424 Greenville Ave Ste 206,,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,,,,,,https://www.plannedparenthood.org/health-center/texas/mesquite/75150/mesquite-health-center-2159-91620
TX-010734,Parkview Regional Health Clinic,Parkview Regional Hospital,1730241852,Rural Health Clinics,514 S Bonham St,,Mexia,TX,76667-3600,Limestone,600 South Bonham Street,,Mexia,TX,76667-3603,Limestone,Jill Ferguson,Market Director,254-562-9321,1050,mona.ferguson@lpnt.net,Kim Cravey,Assistant Director,254-562-9321,2086,kimberly.cravey@lpnt.net,
TX-010735,Parkview Regional Hospital,LifePoint Health,1497708929,Inpatient Hospitals (other than children's hospitals),600 S Bonham St,,Mexia,TX,76667-3603,Limestone,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Jack Wilcox,CFO,254-562-5332,,,
TX-010736,COLEMAN CLINIC,MIDLAND COMMUNITY HEALTHCARE SERVICES,1235225087,"Dental Providers, Federally Qualified Health Centers - Medical Services",801 E Florida Ave,,Midland,TX,79701-8212,Midland,600 N. MARIENFELD,SUITE 1090,MIDLAND,TX,79701,Midland,MICHAEL AUSTIN,CEO,432-570-0238,,MICHAEL.AUSTIN@MIDLANDCHS.ORG,VANDANA NAGPAL,CFO,432-570-0238,,VANDANA.NAGPAL@MIDLANDCHS.ORG,
TX-010737,Access Esperanza Clinics - Mission Center,ACCESS ESPERANZA CLINICS INC.,1396762753,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",1201 N Conway Ave,,Mission,TX,78572-4112,Hidalgo,916 East Hackberry Ave.,,McAllen,TX,78501-5737,Hidalgo,Patricio Gonzales,Chief Executive Officer,956-688-3700,3707,patricio.gonzales@accessclinics.org,Melinda Cruz,Clinical Operations Director,956-688-3700,3708,melinda.cruz@accessclinics.org,http://www.accessclinics.org
TX-010738,NUESTRA CLINICA DEL VALLE - MEMORIAL,NUESTRA CLINICA DEL VALLE,1316374556,Federally Qualified Health Centers - Medical Services,201 S Los Ebanos Rd,,Mission,TX,78573-1139,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010739,NUESTRA CLINICA DEL VALLE - MISSION,NUESTRA CLINICA DEL VALLE,1699803312,"Dental Providers, Federally Qualified Health Centers - Medical Services",611 N Bryan Rd,,Mission,TX,78572-6285,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010740,AccessHealth - Missouri City Center,Fort Bend Family Health Center,1154649523,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",307 Texas Pkwy,Suite 100,Missouri City,TX,77489-1151,Fort Bend,"Fort Bend Family Health Center, Inc., dba AccessHealth",400 Austin Street,Richmond,TX,77469-4406,Fort Bend,Jared M. Williams,Director of Reporting and Analytics,281-633-3194,,JWilliams@myaccesshealth.org,Michael R. Dotson,Chief Executive officer,281-633-3165,,MDotson@myaccesshealth.org,www.myaccesshealth.org
TX-010741,Sandhills Family Clinic,Sandhills Family Clinic,1588672448,Rural Health Clinics,813 E 4th St,,Monahans,TX,79756-4015,Ward,PO Box 40,,Monahans,TX,79756,Ward,Leticia Rodriguez,CEO,432-943-2511,176,lrodriguez@wardmemorial.com,Naomi Soltero,Business Office Manager,432-943-2511,140,nsoltero@wardmemorial.com,www.wardmemorial.com
TX-010742,West Chambers Medical Center,CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT #1,1861542235,"Dental Providers, Federally Qualified Health Centers - Medical Services",9825 Eagle Dr,,Mont Belvieu,TX,77523-9847,Chambers,200 Hospital Dr,,Anahuac,TX,77514,Chambers,Kaley N Smith,Executive Director,409-267-4126,,ksmith@chambershealth.org,Renee Harris,Business Office Director,409-267-2913,,rharris@chambershealth.org,http://www.chambershealth.org/html/wcmc.html
TX-010743,Mt. Enterprise Community Health Clinic,MOUNT ENTERPRISE COMMUNITY HEALTH CLINIC,1952342149,Federally Qualified Health Centers - Medical Services,106 W Rusk St,,Mount Enterprise,TX,75681-7581,Rusk,106 W Rusk St,,Mount Enterprise,TX,75681-7581,Rusk,Kenneth A White,Chief Executive Officer,903-822-3076,,kwhite@crossroadsfamilycare.com,Roslyn Grigsby,Credentialing Coordinator,903-822-3076,,rgrigsby@crossroadsfamilycare.com,www.crossroadsfamilycare.com
TX-010744,Muenster Family Health Clinic,Muenster Hospital District,1497750962,Rural Health Clinics,509 N Maple St,,Muenster,TX,76252-2425,Cooke,P.O. Box 370,,Muenster,TX,76252,Cooke,Julie Palmer,CFO,940-759-6181,,jpalmer@muensterhospital.com,Susan Stotz,Clinic Manager,940-759-6212,,sstotz@muensterhospital.com,
TX-010745,Westside Community Clinic,"East Texas Community Health Services, Inc.",1255367090,Dental Providers,1210 Douglass Rd,,Nacogdoches,TX,75964-4904,Nacogdoches,1401 S University Dr,,Nacogdoches,TX,75961-6488,Nacogdoches,Robin L. Moore,CEO,936-560-5413,1101,rmoore@etchc.com,Darla J. O'Neill,Outreach Coordinator,936-560-5413,1115,djoneill@etchc.com,www.etchc.com
TX-010746,EASTSIDE COMMUNITY CLINIC,"EAST TEXAS COMMUNITY HEALTH SERVICES, INC",1255367090,"Dental Providers, Federally Qualified Health Centers - Medical Services",1309 S University Dr,,Nacogdoches,TX,75961-6486,Nacogdoches,1401 S University Dr,,Nacogdoches,TX,75961-6488,Nacogdoches,Robin L Moore,CEO,936-560-5413,1101,rmoore@etchc.com,Darla J. O'Neill,Outreach Coordinator,936-560-5413,1115,djoneill@etchc.com,www.etchc.com
TX-010747,GRIMES COUNTY COMMUNITY HC,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1700973187,Federally Qualified Health Centers - Medical Services,1905 Dove Crossing Ln,Suite C,Navasota,TX,77868-5272,Grimes,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010748,CENTROMED PEDIATRIC CLINIC,EL CENTRO DEL BARRIO,1093048548,Federally Qualified Health Centers - Medical Services,1034 W County Line Rd,,New Braunfels,TX,78130-8338,Comal,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-012420,CENTROMED FAMILY MEDICINE,EL CENTRO DEL BARRIO,1437635596,Federally Qualified Health Centers - Medical Services,226 N Union Ave,,New Braunfels,TX,78130-4450,Comal,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010751,Newton,Jasper Newton County Public Health District,1083832562,Family Planning Providers,210 High St,,Newton,TX,75966-3216,Newton,139 W LAMAR ST,,JASPER,TX,75951,Jasper,Nadia Martindale,Clinic Supervisor,409-384-6829,224,nmartindale@jaspernewton.org,,,,,,https://www.jaspernewton.org/primary-health-care/
TX-010752,Odessa Regional Medical Center,Steward Healthcare System LLC,1801852736,Inpatient Hospitals (other than children's hospitals),520 E 6th St,,Odessa,TX,79761-4527,Ector,111 Huntington Ave,Suite 1800,Boston,MA,02199,Suffolk,Stacey Gerig,President,432-582-8340,,stacey.gerig@steward.org,Mona Mickle,Chief Financial Officer,432-582-8340,,mona.mickle@steward.org,www.steward.org
TX-010753,FHC - West University,MCH Family Health Clinic,1750345088,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6030 W University Blvd,,Odessa,TX,79764-8530,Ector,840 W. Clements,,Odessa,TX,79761,Ector,Adrienne Handley,Finance Director/Operations Manager,432-640-4865,,ahandley@echd.org,David Garcia,Executive Director,432-640-4868,,dgarcia@echd.org,
TX-010754,FHC - Clements,MCH Family Health Clinic,1750345088,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",840 W Clements St,,Odessa,TX,79763-4601,Ector,840 W. Clements,,Odessa,TX,79761,Ector,Adrienne Handley,Finance Director/Operations Manager,432-640-4865,,ahandley@echd.org,David Garcia,Executive Director,432-640-4868,,dgarcia@echd.org,
TX-010756,Triangle Area Network,Triangle Area Network,1629056304,"Dental Providers, Family Planning Providers, Other ECP Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics",3737 N 16th St,,Orange,TX,77632-4630,Orange,1495 N. 7th St.,,Beaumont,TX,77702,Jefferson,Linda F. Clipper,Executive Director,409-832-8338,222,lclipper@tanbmt.com,,,,,,tanbmt.com
TX-010755,Gulf Coast Health Center - ORANGE,"GULF COAST HEALTH CENTER, INC.",1508864216,Federally Qualified Health Centers - Medical Services,610 Strickland Dr,Suite 380,Orange,TX,77630,Orange,1301 W. Park Ave. Ste C,,Orange,TX,77630-4922,Orange,Marsha Thigpen,MD/Executive Director,409-983-1161,806,mthigpen@gulfcoasthc.org,Linda Solis,Credentialing Coordinator,409-983-1161,817,lsolis@gulfcoasthc.org,
TX-010757,Palestine Regional Medical Center,LifePoint Health,1164510673,Inpatient Hospitals (other than children's hospitals),2900 S Loop 256,,Palestine,TX,75801-6958,Anderson,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Celena Brim,CFO,903-731-1298,,,
TX-010758,HealthLink Family Clinic,HealthLink Family Clinic,1598190423,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",3215 W Oak St,,Palestine,TX,75801-8484,Anderson,P.O. Box 145,,Palestine,TX,75802,Anderson,Rita Kucmierz,CEO,972-288-9280,,healthycommunity@yahoo.com,Maria Glover,Director,903-731-7000,,healthycommunity@yahoo.com,
TX-010759,"Planned Parenthood of Greater Texas, Inc - Paris Health Center",Planned Parenthood of Greater Texas,1801047923,"Family Planning Providers, Sexually Transmitted Disease Clinics",1735 17th St NE,,Paris,TX,75460-2827,Lamar,7424 Greenville Ave.,Ste 206,Dallas,TX,75231,Dallas,Sheila McKinney,COO,214-254-3021,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,https://www.plannedparenthood.org/health-center/texas/paris/75460/paris-health-center-2211-91620
TX-010760,Special Health Resources,"Special Health Resources for Texas, Inc.",1043209919,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",3150 Clarksville St,Suite 300,Paris,TX,75460-8082,Lamar,3150 Clarksville Street Suite 300,,Paris,TX,75460,Lamar,Kim Nesvig,CEO,903-212-7811,,knesvig@shrt.net,David Hayes,COO,903-212-7807,,dhayes@shrt.net,www.shrt.net
TX-010761,Paris-Lamar County Health District,Paris-Lamar County Health District,1164778700,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",400 W Sherman St,,Paris,TX,75460-5646,Lamar,400 w. Sherman Street,,Paris,TX,75460-5646,Lamar,Anita Lynn Justiss,Billing/Credentialing Clerk,903-785-4561,247,anitaj@suddenlinkmail.com,Gina Prestridge,Executive Director,903-785-4561,245,ginap@suddenlinkmail.com,parislamarhealth.com
TX-010762,Harris County Public Health - Southeast Clinic,Harris County Public Health,1427172485,"Dental Providers, Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3737 Red Bluff Rd,,Pasadena,TX,77503-3307,Harris,2223 West Loop South,,Houston,TX,77027,Harris,Douglas Graham,Director of Disease Control and Clinical Prevention Division,713-439-6116,,dgraham@hcphes.org,,,,,,
TX-010763,Pasadena Health Center,"Pasadena Health Center, Inc.",1932104965,"Community Mental Health Centers, Dental Providers",908 Southmore Ave,Suite 180,Pasadena,TX,77502-1119,Harris,908 Southmore Ste. 100,,Pasadena,TX,77502-1120,Harris,John M. Sweitzer,CEO,713-554-1091,,CEO@pasadenahealthcenter.com,Diane Thompson,CIO,713-554-1091,,dthompson@pasadenahealthcenter.com,
TX-010764,South Texas Rural Health Services - Pearsall,"South Texas Rural Health Services, Inc.",1033440243,"Dental Providers, Federally Qualified Health Centers - Medical Services",150 Medical Dr,,Pearsall,TX,78061-6624,Frio,611 Thornton St.,,Cotulla,TX,78014,La Salle,Dori Trevino,Finance Officer,830-879-3047,209,fo.strhs@tachc.org,,,,,,
TX-010765,"Hometown Healthcare, LLC","Hometown Healthcare, LLC",1184941346,Rural Health Clinics,404 E San Marcos St,,Pearsall,TX,78061-3226,Frio,P.O. Box 2070,,Orange Grove,TX,78372,Jim Wells,Macy Thompson,Administrator,830-879-2279,,hhmthompson@yahoo.com,,,,,,
TX-010766,Pecos Valley Rural Health Clinic,Reeves County Hospital District,1073654935,Rural Health Clinics,200 Meadowbrook Dr,,Pecos,TX,79772-6607,Reeves,2323 Texas Street,,Pecos,TX,79772-7338,Reeves,Bomi Bharucha,CFO,432-447-3551,6602,bbharucha@rchd.care,Judith Gulihur,Special Projects Manager,432-447-3551,6325,jgulihur@rchd.care,
TX-010767,REEVES COUNTY HOSPITAL DISTRICT,Reeves County Hospital District,1831170273,Inpatient Hospitals (other than children's hospitals),2323 Texas St,,Pecos,TX,79772-7338,Reeves,2323 Texas Street,,Pecos,TX,79772-7338,Reeves,Bomi Bharucha,CFO,432-447-3551,6602,bbharucha@rchd.care,Judith Gulihur,Special Projects Manager,432-447-3551,6325,jgulihur@rchd.care,
TX-010768,CommUnityCare Pflugerville,Travis County Healthcare District,1265460737,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",15822 Foothill Farms Loop,,Pflugerville,TX,78660-3422,Travis,1111 E Cesar Chavez,,Austin,TX,78702-4209,Travis,Ashlee Hays,Provider Contracting Manager,512-978-9914,,ashlee.hays@communitycaretx.org,Stacey Crawford,Grants Manager,512-978-9033,,stacey.crawford@communitycaretx.org,
TX-010769,"Regence Health Network, Inc. RMA - PAS","REGENCE HEALTH NETWORK, INC.",1083613640,Federally Qualified Health Centers - Medical Services,2601 Dimmitt Rd,Suite 102,Plainview,TX,79072-1833,Hale,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinator,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Director,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010770,"Regence Health Network, Inc. RDA - PLNV","REGENCE HEALTH NETWORK, INC.",1114925658,"Dental Providers, Federally Qualified Health Centers - Medical Services",2801 W 8th St,,Plainview,TX,79072-6737,Hale,2801 W 8th St,,Plainview,TX,79072-6737,Hale,Rhonda Kim Read,Managed Care Coordinator,806-374-7341,2231,kim.read@regencehealth.net,Sandy Logan,Administrative Director,806-322-0576,2576,sandy.logan@regencehealth.net,www.rhn.md
TX-010771,Planned Parenthood of Greater Texas - Plano Health Center,Planned Parenthood of Greater Texas,1912268624,"Family Planning Providers, Sexually Transmitted Disease Clinics",600 Central Expy,Suite 601,Plano,TX,75074-6771,Collin,7424 Greenville Aveue,Ste 206,Dallas,TX,75231-4534,Dallas,Sheila McKinney,Chief Operating Officer,214-363-2004,10125,sheila.mckinney@ppgt.org,,,,,,https://www.plannedparenthood.org/health-center/texas/plano/75074/plano-health-center-4193-91620
TX-010772,"Atascosa Health Center, Inc.","Atascosa Health Center, Inc.",1750364998,"Dental Providers, Federally Qualified Health Centers - Medical Services",310 W Oaklawn Rd,,Pleasanton,TX,78064-4033,Atascosa,310 W Oaklawn Rd,,Pleasanton Tx,TX,78064,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,
TX-010773,Gulf Coast Health Center - PORT ARTHUR,"GULF COAST HEALTH CENTER, INC.",1912904897,"Dental Providers, Federally Qualified Health Centers - Medical Services",2548 Memorial Blvd,,Port Arthur,TX,77640-2825,Jefferson,2548 Memorial Blvd,,Port Arthur,TX,77640-2825,Jefferson,Marsha Thigpen,MD/Executive Director,409-983-1161,806,mthigpen@gulfcoasthc.org,Linda Solis,Credentialing Coordinator,409-983-1161,817,lsolis@gulfcoasthc.org,
TX-010774,"The Medical Center of Southeast Texas, LP",Steward Healthcare System LLC,1861467573,Inpatient Hospitals (other than children's hospitals),2555 Jimmy Johnson Blvd,,Port Arthur,TX,77640-2007,Jefferson,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,Richard Gonzalez,Chief Executive Officer,409-853-5900,,richard.gonzalez@steward.org,Jason R Miller,Chief Financial Officer,409-853-5746,,jason.miller1@steward.org,www.steward.org
TX-010775,Gulf Coast Health Center - WEST SIDE,"GULF COAST HEALTH CENTER, INC.",1205275054,Federally Qualified Health Centers - Medical Services,601B Rev Dr Ransom Howard St,,Port Arthur,TX,77640-5963,Jefferson,2548 Memorial Blvd,,Port Arthur,TX,77640-2825,Jefferson,Marsha Thigpen,MD/Executive Director,409-983-1161,806,mthigpen@gulfcoasthc.org,Linda Solis,Credentialing Coordinator,409-983-1161,817,lsolis@gulfcoasthc.org,
TX-010776,PI Medical Day & Night Clinic,PI Medical Day & Night Clinic,1528010782,Rural Health Clinics,1506 Highway 100,Suite A,Port Isabel,TX,78578,Cameron,1506 highway 100 Suite A,,Port Isabel,TX,78578,Cameron,Richard Garza,Owner,956-943-6675,,pimedclinic@yahoo.com,,,,,,
TX-010777,Memorial Medical Clinic,Memorial Medical Clinic,1497153589,Rural Health Clinics,1016 N Virginia St,,Port Lavaca,TX,77979-3000,Calhoun,1016 N Virginia,,Port Lavaca,TX,77979,Calhoun,Danette Bethany,Practice Administrator,361-552-0378,,dabethany@mmcportlavaca.com,,,,,,
TX-010778,"Port Lavaca Clinic Associates, PA","Port Lavaca Clinic Associates, PA",1144262957,Rural Health Clinics,1200 N Virginia St,,Port Lavaca,TX,77979-2507,Calhoun,1200 N Virginia St,,Port Lavaca,TX,77979,Calhoun,Jennifer O'Riley,Business Office Director,361-552-6721,6577,jennifero@plclinic.net,Gary Meyn,Practice Administrator,361-552-6721,6567,gmeyn@plclinic.net,
TX-010779,Presidio County Medical Clinic,PRESIDIO COUNTY HEALTH SERVICES INC,1093890634,Federally Qualified Health Centers - Medical Services,1501 N Erma Ave,,Presidio,TX,79845-4464,Presidio,P.O. Box 267,,Marfa,TX,79843,Presidio,Linda Molinar,CEO,432-729-1812,,cfo_pchs@yahoo.com,Cynthia A. Esquivel,COO,432-729-1812,,hr_pchs@yahoo.com,
TX-010780,Hardeman County Memorial Hospital,Hardeman County Memorial Hospital,1861510521,Inpatient Hospitals (other than children's hospitals),402 Mercer St,,Quanah,TX,79252-4026,Hardeman,PO Box 90,,Quanah,TX,79252,Hardeman,Tracy Betts,CFO,940-663-2795,137,tracy.betts@hcmhosp.com,Dennis Thomas,CEO,940-663-2795,,dennis.thomas@hcmhosp.com,
TX-010781,Hardeman County Clinic,Hardeman County Memorial Hospital,1932426772,Rural Health Clinics,404 Mercer St,,Quanah,TX,79252-4026,Hardeman,PO Box 90,,Quanah,TX,79252,Hardeman,Tracy Betts,CFO,940-663-2795,137,tracy.betts@hcmhosp.com,Dennis Thomas,CEO,940-663-2795,,dennis.thomas@hcmhosp.com,
TX-010782,Su Clinica - Raymondville,SU CLINICA FAMILIAR,1871516807,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",131 FM 3168,,Raymondville,TX,78580-3605,Willacy,1706 Treasure Hills Blvd,,Harlingen,TX,78550-8911,Cameron,Dr. Elena Marin,CEO,956-365-6750,12301,emarin@suclinica.org,Adam Saldivar,CFO,956-365-6750,12322,asaldivar@suclinica.org,www.suclinica.org
TX-010783,Access Health,Ft. Bend Family Health Center dba. Access Health,1972601169,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",400 Austin St,,Richmond,TX,77469-4406,Fort Bend,400 Austin St,,Richmond,TX,77469-4406,Fort Bend,Jared M. Williams,Chief Executive Officer,281-633-3194,,JWilliams@myaccesshealth.org,Jared M. Williams,Director of Reporting and Analytics,281-633-3194,,JWilliams@myaccesshealth.org,www.myaccesshealth.org
TX-010784,NUESTRA CLINICA DEL VALLE - RIO GRANDE CITY,NUESTRA CLINICA DEL VALLE,1205067600,Federally Qualified Health Centers - Medical Services,600 N Garza St,Suite A,Rio Grande City,TX,78582-3538,Starr,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010785,CHRISTUS SPOHN FAMILY HEALTH CENTER ROBSTOWN,CHRISTUS HEALTH,1730157884,Rural Health Clinics,1038 Texas Yes Blvd,,Robstown,TX,78380-6142,Nueces,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-012421,Children's Health Specialty Center South Rockwall,Children's Medical Center Dallas,1194743013,Outpatient Hospital Clinics,1005 W Ralph Hall Pkwy,,Rockwall,TX,75032-6658,Rockwall,1935 Medical District Drive,,Dallas,TX,75235,Dallas,Cindi Haley,Director Government Reimbursement,214-456-7422,,cindi.haley@childrens.com,tammie.sibley@childrens.com,SVP Finance,214-456-8414,,tammie.sibley@childrens.com,childrens.com
TX-010786,NUESTRA CLINICA DEL VALLE - ROMA,NUESTRA CLINICA DEL VALLE,1104057504,Federally Qualified Health Centers - Medical Services,2891 E Grant St,,Roma,TX,78584-8914,Starr,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010787,The Pediatric Care Center,Rural Health Clinics,1124312749,Rural Health Clinics,4857 Old Escobares Highway 83,,Roma,TX,78584-5813,Starr,4857 Old Escobares Hwy 83,,Roma,TX,78584,Starr,Daria Babineaux,"Medical Director, Physician",956-849-0104,,drdariaeve@aol.com,Lilia Pena,Assistant Administrator,956-263-1830,,romatpccl_pena@yahoo.com,
TX-010788,Roma Medical Clinic,Roma Medical Clinic,1093822140,Rural Health Clinics,640 E Bravo Blvd,,Roma,TX,78584-5720,Starr,640 E Bravo Blvd,,Roma,TX,78584,Starr,"Raymond P Mussett, MD",Medical Director/Owner,956-849-2176,,romamedicalclinic@yahoo.com,,,,,,
TX-010789,FCHC Rosebud Medical Clinic,Falls Community Hospital & Clinic,1194777540,Rural Health Clinics,312 N Stallworth,,Rosebud,TX,76570-2254,Falls,322 Coleman,,Marlin,TX,76661,Falls,Jan Stimmel,Clinic Director,254-803-3561,2501,jstimmel@fallshospital.com,Chris Sechelski,Credentialing Specialist,254-803-3561,2153,csechelski@fallshospital.com,
TX-010790,Seton Medical Center Williamson,Seton Family of Hospitals,1578780870,Inpatient Hospitals (other than children's hospitals),201 Seton Center Parkway,,Round Rock,TX,78665,Williamson,4515 Seton Center Parkway,S. 300,Austin,TX,78759,Travis,Mark Jenkins,Sr. Director,512-324-2792,,mjenkins@seton.org,,,,,,
TX-010791,Round Rock Public Health Center,Williamson County and Cities Health District,1982661633,"Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",211 Commerce Blvd,,Round Rock,TX,78664-2184,Williamson,100 W. 3rd Street,,Georgetown,TX,78626,Williamson,Stacy Schweitzer,Billing Specialist,512-943-3645,,sschweitzer@wcchd.org,Michelle Broddrick,Finance and Administration Director,512-943-3603,,mbroddrick@wcchd.org,http://www.wcchd.org/location_and_hours/index.php
TX-010792,ROUND ROCK HEALTH CLINIC,LONE STAR CIRCLE OF CARE,1710027859,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",2120 N Mays St,Suite 430,Round Rock,TX,78664-2108,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010793,LSCC OB/GYN,LONE STAR CIRCLE OF CARE,1447316898,Federally Qualified Health Centers - Medical Services,2300 Round Rock Ave,Suite 106,Round Rock,TX,78681-4025,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010794,LSCC at Texas A&M Health Science Center,LONE STAR CIRCLE OF CARE,1447586961,Federally Qualified Health Centers - Medical Services,3950 N A W Grimes Blvd,Bldg 2,Round Rock,TX,78665-3540,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010795,Sabinal Health Clinic,Sabinal Health Clinic,1659722197,Rural Health Clinics,517 N Center St,,Sabinal,TX,78881-5100,Uvalde,PO Box 725,,Sabinal,TX,78881,Uvalde,Brandi Nutt,Director,830-278-6251,1185,b.nutt@umhtx.org,Christina Velasquez,Revenue Cycle Manager,830-278-6251,1315,ch.velasquez@umhtx.org,
TX-010796,CHRISTUS FAMILY PRACTICE CENTER SAM RAYBURN,CHRISTUS Health,1194797621,Rural Health Clinics,2427 Rural Route 255 West,,Sam Rayburn,TX,75951,Jasper,919 Hidden Ridge,,Irving,TX,75038,Dallas,Ashley Vanicek,"Director, Managed Care",469-282-2505,,ashley.vanicek@christushealth.org,,,,,,
TX-010797,LA ESPERANZA CLINIC,"LA ESPERANZA CLINIC, INC.",1770584187,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",1610 S Chadbourne St,,San Angelo,TX,76903-8510,Tom Green,2029 W Beauregard Ave,,San Angelo,TX,76901-3812,Tom Green,William M Campbell,CEO,325-947-5601,,ceo@esperanzahealth.org,Patsy Onofre,CFO,325-947-5605,,cfo@esperanzahealth.org,esperanzahealth.org
TX-010798,Lakeview Clinic,La Esperanza Clinic,1265601371,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",35 E 31st St,,San Angelo,TX,76903-2207,Tom Green,2029 W Beauregard,,SAN ANGELO,TX,76901,Tom Green,Mike Campbell,CEO,325-947-5601,,ceo@esperanzahealth.org,Patricia Onofre,CFO,325-947-5605,,cfo@esperanzahealth.org,esperanzahealth.org
TX-010799,CENTROMED SARAH E DAVIDSON CLINIC,EL CENTRO DEL BARRIO,1841433562,Federally Qualified Health Centers - Medical Services,1 Haven For Hope Way,Suite 300 Bldg 1,San Antonio,TX,78207-1268,Bexar,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010800,Planned Parenthood,Planned Parenthood San Antonio,1396837100,Family Planning Providers,11514 Perrin Beitel Rd,,San Antonio,TX,78217-2113,Bexar,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-012493,CentroMed Pediatric Huebner Professional Plaza,El Centro Del Barrio,1447805452,Federally Qualified Health Centers - Medical Services,20627 Huebner Rd,A101,San Antonio,TX,78258-4765,Bexar,3750 Commercial Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010801,Planned Parenthood,Planned Parenthood South Texas Surgical Center,1316039456,Family Planning Providers,2140 Babcock Rd,,San Antonio,TX,78229-4439,Bexar,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-010802,Planned Parenthood,Planned Parenthood San Antonio,1265524086,Family Planning Providers,2346 E Southcross Blvd,,San Antonio,TX,78223-2263,Bexar,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-012494,CentroMed Pediatric Santa Rosa Professional Pavilion,El Centro Del Barrio,1013562842,Federally Qualified Health Centers - Medical Services,315 N San Saba,Suite 1075,San Antonio,TX,78207-3155,Bexar,3750 Commerical Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010804,CENTROMED SANTA ROSA CLINIC/RYAN WHITE CLINIC,EL CENTRO DEL BARRIO,1699841569,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",315 N San Saba,Suite 103,San Antonio,TX,78207-3196,Bexar,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010805,Children's Hospital of San Antonio (children's inpatient hospital),CHRISTUS Santa Rosa Health Care,1821004151,Children's Hospitals (inpatient only),333 N Santa Rosa St,,San Antonio,TX,78207-3108,Bexar,100 NE Loop 410,Suite 800,San Antonio,TX,78216,Bexar,Juanita Solis,"System Director, Managed Care",210-321-8014,,juanita.solis@christushealth.org,David Mier,Chief Financial Officer,210-704-3353,,David.Mier@christushealth.org,www.christussantarosa.org
TX-010806,Children's Hospital of San Antonio (dental provider),CHRISTUS Santa Rosa Health Care,1821004151,Dental Providers,333 N Santa Rosa St,,San Antonio,TX,78207-3108,Bexar,100 NE Loop 410,Suite 800,San Antonio,TX,78216,Bexar,Juanita Solis,"System Director, Managed Care",210-321-8014,,juanita.solis@christushealth.org,David Mier,Chief Financial Officer,210-704-3353,,David.Mier@christushealth.org,www.christussantarosa.org
TX-010807,CENTROMED SOUTHSIDE MEDICAL CLINIC,EL CENTRO DEL BARRIO,1104998749,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010809,South Texas Comprehensive Hemophilia Treatment Center,University of Texas Health Science Center San Antonio,1720051717,Hemophilia Treatment Centers,4502 Medical Dr,,San Antonio,TX,78229-4402,Bexar,7703 Floyd Curl Drive,Mail Code 7810,San Antonio,TX,78229,Bexar,"Melissa Frei-Jones, MD, MSCI",Interim Medical Director,210-567-7477,,freijones@uthscsa.edu,Danielle Hardaway,Business Administrator,210-567-7477,,hardaway@uthscsa.edu,
TX-010810,UNIVERSITY HEALTH SYSTEM,Bexar County Hospital District,1821011248,Inpatient Hospitals (other than children's hospitals),4502 Medical Dr,,San Antonio,TX,78229-4402,Bexar,4502 Medical Drive,,San Antonio,TX,78229,Bexar,Bill Bedwell,Executive Director Reimbursement,210-743-6505,,bill.bedwell@uhs-sa.com,Kevin W. Barron,"Director, Managed Care Contracting",210-358-0606,,Kevin.Barron@UHS-SA.com,www.universityhealthsystem.com
TX-012422,CENTROMED BERTO GUERRA JR CLINIC,EL CENTRO DEL BARRIO,1801389044,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",5439 Ray Ellison Blvd,,San Antonio,TX,78242-2219,Bexar,3750 Commercial Ave,,SAN ANTONIO,TX,78221-3117,Bexar,Ernesto Gomez,President and CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010814,CENTROMED SOUTH PARK MEDICAL CLINIC,EL CENTRO DEL BARRIO,1538264429,Federally Qualified Health Centers - Medical Services,6315 S Zarzamora St,,San Antonio,TX,78211-3218,Bexar,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-012495,CentroMed Pediatic M&S tower Medical Building,El Centro Del Barrio,1528613510,Federally Qualified Health Centers - Medical Services,730 N Main Ave,Suite 224,San Antonio,TX,78205-1195,Bexar,3750 Commercial Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-012496,CentroMed Pediatric Medical Center Southwest Building,El Centro Del Barrio,1073168811,Federally Qualified Health Centers - Medical Services,7333 Barlite Blvd,Suite 380,San Antonio,TX,78224-1359,Bexar,3750 Commercial Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010815,"Southwest General Hospital, LP",Steward Healthcare System LLC,1912906298,Inpatient Hospitals (other than children's hospitals),7400 Barlite Blvd,,San Antonio,TX,78224-1308,Bexar,111 Huntington Avenue Suite 1800,,Boston,MA,02199,Suffolk,P. Craig Desmond,CEO,201-921-3512,,CDesmond@iasishealthcare.com,Ron Michael Bennett,CFO,201-921-3547,,RBennett@iasishealthcare.com,www.steward.org
TX-010816,San Antonio Aids Foundation,San Antonio Aids Foundation,1760932081,Ryan White Providers,818 E Grayson St,,San Antonio,TX,78208-1013,Bexar,818 E. Grayson St.,818 E. Grayson St.,San Antonio,TX,78208-1013,Bexar,Virginia Ochoa,Medical Receptionist,210-225-4715,101,Vochoa@sanantonioaids.org,Cynthia Nelson,Cheif Executive Officer,210-225-4715,122,Cnelson@sanantonioaids.org,
TX-010817,Planned Parenthood,Planned Parenthood San Antonio,1487746202,Family Planning Providers,8725 Marbach Rd,Suite 215,San Antonio,TX,78227-2378,Bexar,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-010818,CENTROMED PALO ALTO CLINIC,EL CENTRO DEL BARRIO,1730388018,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",9011 Poteet Jourdanton Fwy,,San Antonio,TX,78224-2124,Bexar,3750 Commercial Ave,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010819,CENTROMED SOUTH PARK DENTAL CLINIC,EL CENTRO DEL BARRIO,1811042567,Federally Qualified Health Centers - Dental Services,910 Wagner Ave,,San Antonio,TX,78211-3213,Bexar,3750 COMMERCIAL AVENUE,,SAN ANTONIO,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010820,Planned Parenthood,Planned Parenthood San Antonio,1518068121,Family Planning Providers,920 San Pedro Ave,,San Antonio,TX,78212-4607,Bexar,2140 Babcock Rd,,San Antonio,TX,78229,Bexar,Adron Cooley,Revenue Cycle Manager,210-736-2244,304,adron.clark@ppsouthtexas.org,Polin C. Barraza,Vice-Chair/Secratary,210-736-2244,334,polin.barraza@ppsouthtexas.org,www.ppsouthtexas.org
TX-012497,CentroMed Pediatric Sorrento Plaza,El Centro Del Barrio,1699320614,Federally Qualified Health Centers - Medical Services,9793 Culebra Rd,Suite 105,San Antonio,TX,78251-3750,Bexar,3750 Commercial Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010821,San Elizario Satellite Clinic,"CENTRO DE SALUD FAMILIAR LA FE, INC",1801920632,"Dental Providers, Federally Qualified Health Centers - Medical Services",12101 Socorro Rd,,San Elizario,TX,79849-7393,El Paso,1314 E Yandell Dr,,El Paso,TX,79902-5529,El Paso,Salvador Balcorta,Chief Executive Officer,915-534-7979,,salvador.balcorta@lafe-ep.org,Robert Gonzales,Chief Operations Officer,915-534-7979,,robert.gonzales@lafe-ep.org,
TX-010822,CENTRO SAN VICENTE SAN ELIZARIO,DAUGHTERS OF CHARITY HLTH SVCS,1780761452,Federally Qualified Health Centers - Medical Services,13017 Perico Dr,,San Elizario,TX,79849-9509,El Paso,8061 Alameda Ave,,El Paso,TX,79915-4705,El Paso,Dr. Jose Luna,CEO,915-859-7545,1215,jlunamd@csv.tachc.org,Loretta Galaviz,CFO,915-859-7545,1232,lgalaviz@csv.tachc.org,
TX-010823,NUESTRA CLINICA DEL VALLE - PSJA SBHC,NUESTRA CLINICA DEL VALLE,1932516242,Federally Qualified Health Centers - Medical Services,2900 N Raul Longoria Rd,,San Juan,TX,78589-9727,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010824,Access Esperanza Clinics-San Juan Community Center,ACCESS ESPERANZA CLINICS INC.,1841372885,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",509 E Earling Rd,,San Juan,TX,78589-4310,Hidalgo,916 East Hackberry Ave,,McAllen,TX,78501-5737,Hidalgo,Patricio Gonzales,Chief Executive Officer,956-688-3700,3707,patricio.gonzales@accessclinics.org,Melinda Cruz,Clinical Operations Director,956-688-3700,3708,melinda.cruz@accessclinics.org,http://www.accessclinics.org
TX-010825,NUESTRA CLINICA DEL VALLE,NUESTRA CLINICA DEL VALLE,1891793246,"Dental Providers, Federally Qualified Health Centers - Medical Services",801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010826,NUESTRA CLINICA DEL VALLE - WOMEN'S HEALTH CENTER,NUESTRA CLINICA DEL VALLE,1053728360,Federally Qualified Health Centers - Medical Services,806 W 3rd St,,San Juan,TX,78589-2250,Hidalgo,801 W 1st St,,San Juan,TX,78589-2276,Hidalgo,Lucy Ramirez Torres,CEO,956-787-8915,231,admin.ncdv@tachc.org,,,,,,www.nuestraclinicadelvalle.org
TX-010827,Central Texas Medical Center,Adventist Health System/Sunbelt Inc.,1821009242,Inpatient Hospitals (other than children's hospitals),1301 Wonder World Dr,,San Marcos,TX,78666-7533,Hays,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Brian Loria,Regional Manager Managed Care,817-568-5540,,Brian.Loria@AHSS.ORG,,,,,,
TX-010828,San Marcos Community Health Services,"Community Action, Inc. of Central Texas",1730225574,Family Planning Providers,611 W. MLK,,San Marcos,TX,78666-5458,Hays,101 Uhland Road,,San Marcos,TX,78667-0748,Hays,Carole Belver,Executive Director,512-392-1161,328,cbelver@communityaction.com,,,,,,http://communityaction.com/
TX-010829,Sanderson Rural Health Center,Pecos County Memorial Hospital,1518216902,Rural Health Clinics,213 Persimmon St,,Sanderson,TX,79848,Terrell,387 west i h 10,,Fort Stockton,TX,79735,Terrell,M Gallegos,director,432-336-4213,,mgallegos@pcmhfs.com,,,,,,
TX-010830,Su Clinica - Santa Rosa Dental,SU CLINICA FAMILIAR,1285643304,Dental Providers,122 FM 506,,Santa Rosa,TX,78593,Cameron,1706 Treasure Hills,,Harlingen,TX,78550-8911,Cameron,Dr. Elena Marin,CEO,956-365-6750,12301,emarin@suclinica.org,Adam Saldivar,CFO,956-365-6750,12322,asaldivar@suclinica.org,www.suclinica.org
TX-010831,Su Clinica - Santa Rosa Medical,SU CLINICA FAMILIAR,1386960862,Federally Qualified Health Centers - Medical Services,124 La Feria Ave,,Santa Rosa,TX,78593,Cameron,1706 Treasure Hills Blvd,,Harlingen,TX,78550-8911,Cameron,Dr. Elena Marin,CEO,956-365-6750,12301,emarin@suclinica.org,Adam Saldivar,CFO,956-365-6750,12322,asaldivar@suclinica.org,www.suclinica.org
TX-012498,CentroMed Pediatric Tri-County Crossing Phase II,El Centro Del Barrio,1376198374,Federally Qualified Health Centers - Medical Services,17323 Interstate 35 N,Suite 113,Schertz,TX,78154-1278,Guadalupe,3750 Commercial Ave,,San Antonio,TX,78221,Bexar,Ernesto Gomez,President & CEO,210-334-3703,2104870971,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010832,Seguin Family Health Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1285893131,"Dental Providers, Federally Qualified Health Centers - Medical Services",1104 Jefferson Ave,,Seguin,TX,78155-5910,Guadalupe,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010833,South Plains Public Health District - Gaines County,South Plains Public Health District,1235197260,Family Planning Providers,704 Hobbs Hwy,Suite B,Seminole,TX,79360-3443,Gaines,704 Hobbs Hwy,,Seminole,TX,79360-3423,Gaines,"Soronya Shafer, RN",Director of Clinical Services,432-758-4022,,sshafer@spphd.org,Amber Carlisle,Clinic Nurse,432-758-4022,,acarlisle@spphd.org,https://southplainshealth.org/
TX-010834,Your Health Clinic,Your Health Clinic,1033148887,"Ryan White Providers, Sexually Transmitted Disease Clinics",1521 Baker Rd,,Sherman,TX,75090-2409,Grayson,P.O. Box 69,,Sherman,TX,75091,Grayson,Gwynne Palmore,Executive Director,903-815-1129,,gwynne.palmore@callieclinic.org,ROBERT STOOLFIRE,Finance Director,903-870-6444,,BOB.STOOLFIRE@CALLIECLINIC.ORG,callieclinic.org
TX-010835,Sierra Blanca Clinic,Project Vida Health Center,1356664460,Federally Qualified Health Centers - Medical Services,500 E Walling St,,Sierra Blanca,TX,79851,Hudspeth,3607 Rivera Avenue,,El Paso,TX,79905,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,Cheryl Feldman,Chief Operating Officer,915-533-7057,250,c.feldman@pvida.net,www.pvida.net
TX-010836,"Gulf Coast Health Center - Silsbee, TX 327","GULF COAST HEALTH CENTER, INC.",1225036932,Federally Qualified Health Centers - Medical Services,710 Highway 327 E,,Silsbee,TX,77656-5022,Hardin,2548 Memorial Blvd,,Port Arthur,TX,77640-2825,Jefferson,Marsha Thigpen,MD/Executive Director,409-983-1161,806,mthigpen@gulfcoasthc.org,Linda Solis,Credentialing Coordinator,409-983-1161,817,lsolis@gulfcoasthc.org,
TX-010837,Cogdell Clinic Briscoe County,WJ Mangold Memorial Hospital,1518032879,Rural Health Clinics,701 Commerce St,,Silverton,TX,79257-2565,Briscoe,PO BOX 37,320 N Main,Lockney,TX,79241,Floyd,Michelle Gamble,Clinic Manager,806-823-2449,,michelleg@mangoldmemorial.org,,,,,,https://www.mangoldmemorial.org/?fbclid=IwAR18ZWafSGo7w_KYoqvaTvoMzPqktVuMGvRY626PilPArliwMzuix53bkos
TX-010838,Community Action Health Center Sinton,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1447696273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",621 E Sinton St,,Sinton,TX,78387-2801,San Patricio,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010839,COGDELL FAMILY CLINIC,Scurry County Hospital District dba Cogdell Family Clinic,1316962103,Rural Health Clinics,1700 Cogdell Blvd,,Snyder,TX,79549-6162,Scurry,Scurry County Hospital District,1700 Cogdell Blvd,Snyder,TX,79549,Scurry,"John H Everett, FACHE",CFO,325-574-7439,,cmh.jeverett@cogdellhospital.com,Ella R Helms,CEO,325-574-7437,,cmh.ehelms@cogdellhospital.com,www.cogdellhospital.com
TX-010840,Cogdell Memorial Hospital,Scurry County Hospital District dba Cogdell Memorial Hospital,1578588463,Inpatient Hospitals (other than children's hospitals),1700 Cogdell Blvd,,Snyder,TX,79549-6162,Scurry,1700 Cogdell Blvd,,Snyder,TX,79549,Scurry,"John H Everett, FACHE",CFO,325-574-7439,,cmh.jeverett@cogdellhospital.com,Ella R Helms,CEO,325-574-7437,,cmh.ehelms@cogdellhospital.com,www.cogdellhospital.com
TX-010841,Cogdell Speciality Clinic,Scurry County Hospital District dba Cogdell Speciality Clinic,1104293737,Rural Health Clinics,1700 Cogdell Blvd,,Snyder,TX,79549-6162,Scurry,1700 Cogdell Blvd,,Snyder,TX,79549,Scurry,"John H Everett, FACHE",CFO,325-574-7439,,cmh.jeverett@cogdellhospital.com,Ella R Helms,CEO,325-574-7437,,cmh.ehelms@cogdellhospital.com,www.cogdellhospital.com
TX-010843,HealthPoint Somerville,"BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.",1427331651,Federally Qualified Health Centers - Medical Services,600 Memory Ln,,Somerville,TX,77879-5073,Burleson,1500 University Dr E Ste 100,,College Station,TX,77840-2600,Brazos,Eric Todd,CEO,979-846-1100,,etodd@healthpoint-tx.com,,,,,,
TX-010844,Spring Health Center,"Planned Parenthood Gulf Coast, Inc.",1245388396,Family Planning Providers,4747 Louetta Rd,,Spring,TX,77388-4420,Harris,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010845,Spur Rural Health Clinic,Stonewall Memorial Hospital District,1336547587,Rural Health Clinics,907 E Hill St,,Spur,TX,79370-2532,Dickens,821 N Broadway,,Aspermont,TX,79502,Stonewall,Billie Carter,COO,940-989-3551,,billie.carter@smhdhealth.org,,,,,,
TX-010846,AccessHealth - Stafford Center,"Fort Bend Family Health Center, Inc., dba AccessHealth",1831263359,"Dental Providers, Federally Qualified Health Centers - Medical Services",10435 Greenbough Dr,Suite 300,Stafford,TX,77477-5034,Fort Bend,400 Austin Street,,Richmond,TX,77469-4406,Fort Bend,Jared M. Williams,Director of Reporting and Analytics,281-633-3194,,JWilliams@myaccesshealth.org,Michael R. Dotson,Chief Executive officer,281-633-3165,,MDotson@myaccesshealth.org,www.myaccesshealth.org
TX-010847,Stafford Health Center,"Planned Parenthood Gulf Coast, Inc.",1437207578,Family Planning Providers,12614 Southwest Fwy,Suite A,Stafford,TX,77477-3839,Fort Bend,4600 Gulf Fwy,,Houston,TX,77023-3548,Harris,Jackie Kinabrew,VP Clinical Operations,713-831-6633,6633,Jackie.Kinabrew@ppgulfcoast.org,Jeffrey Palmer,COO,713-831-6618,6618,jeffrey.palmer@ppgulfcoast.org,https://www.plannedparenthood.org/planned-parenthood-gulf-coast
TX-010848,"Cross Timbers Health Center, Stephenville","CROSS TIMBERS HEALTH CLINICS, INC.",1275830390,"Dental Providers, Federally Qualified Health Centers - Medical Services",135 River North Blvd,,Stephenville,TX,76401-1804,Erath,1100 W Reynosa Ave,,De Leon,TX,76444-1630,Erath,Sherry L Hill,Chief Executive Officer,254-893-5895,,shill@crosstimbersinc.org,,,,,,
TX-010849,ST. HOPE COMMUNITY HEALTH CLINIC SUGARLAND,"ST. HOPE FOUNDATION, INC.",1992869846,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",13020 Dairy Ashford Rd,Suite 100,Sugar Land,TX,77478-3151,Fort Bend,6200 SAVOY DRIVE,SUITE 540,Houston,TX,77036-3338,Harris,MARY R. CAMPBELL,Credentialing,713-839-7111,7965,MCAMPBELL@OFFERINGHOPE.ORG,MIKA SAM COOPER,COO,713-778-1300,,mika@offeringhope.org,
TX-010850,Texas Children's Health Centers - Sugar Land,Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,15400 Southwest Fwy,Suite 200,Sugar Land,TX,77478-3877,Fort Bend,6621 Fannin St,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kthompson@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations and Community Benefits",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010851,Sweetwater-Nolan County Health Department,Women's Health and Family Planning Association of Texas,1760532774,Family Planning Providers,301 E 12th St,,Sweetwater,TX,79556-2317,Nolan,301 E 12th St,,Sweetwater,TX,79556-2317,Nolan,Jamie Mena,Director,325-235-5463,1003,jmena@nolancountyhealth.com,KAY HAMLIN,Financials,325-235-5463,1004,KHAMLIN@NOLANCOUNTYHEALTH.COM,http://nolancountyhealth.com/
TX-010852,Community Action Integration Center Taft,COMMUNITY ACTION CORPORATION OF SOUTH TEXAS,1073940540,Federally Qualified Health Centers - Medical Services,201 Roots Ave,,Taft,TX,78390-3059,San Patricio,204 E 1st St,,Alice,TX,78332-4822,Jim Wells,ANN AWALT,EXECUTIVE DIRECTOR,361-664-0145,2024,ann.awalt@cacost.org,JAVIER GARCIA,Chief Operating Officer,361-664-0145,2046,javier.garcia@cacost.org,
TX-010853,Taylor Public Health Center,Williamson County and Cities Health District,1982661633,"Other ECP Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",115 W 6th St,,Taylor,TX,76574-3534,Williamson,100 W. 3rd Street,,Georgetown,TX,78626,Williamson,Stacy Schweitzer,Billing Specialist,512-943-3645,,sschweitzer@wcchd.org,Michelle Broddrick,Finance and Administration Director,512-943-3603,,mbroddrick@wcchd.org,http://www.wcchd.org/location_and_hours/index.php
TX-010854,Lone Star Circle of Care at Taylor,LONE STAR CIRCLE OF CARE,1457650483,Federally Qualified Health Centers - Medical Services,601A Mallard Ln,,Taylor,TX,76574-1214,Williamson,205 E University Ave Ste 200,,Georgetown,TX,78626-6821,Williamson,Rhonda Mundhenk,Chief Executive Officer,512-686-0152,,rmundhenk@lscctx.org,Jon Calvin,Chief Financial Officer,512-686-0152,,jcalvin@lscctx.org,www.lonestarcares.org
TX-010855,Bell County Public Health District Temple Clinic,Bell County Public Health District,1356399059,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",509 S 9th St,,Temple,TX,76504-5567,Bell,PO Box 2149,,Temple,TX,76503,Bell,Chelo Elliott,DON,254-778-4766,,celliott@bellcountyhealth.org,Bonnie Scurzi,Director,254-773-4457,,bscurzi@bellcountyhealth.org,www.bellcountyhealth.org
TX-010856,Santa Fe Community Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1306234521,Federally Qualified Health Centers - Medical Services,600 S 25th St,Suite 115,Temple,TX,76504-5227,Bell,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/community-clinic-santa-fe/
TX-010857,Health Opportunities for the People of East Texas,The HOPE Project,1124296843,"Dental Providers, Federally Qualified Health Centers - Medical Services",157 Wall St,,Tenaha,TX,75974-5413,Shelby,157 Wall St.,,Tenaha,TX,75974,Shelby,Tracie Cain,COO,936-248-4673,,tcain@hopeprojecttexas.org,Michael Belgard,"PA-C, CEO",936-248-4673,,mbelgard@hopeprojecttexas.org,www.hopetenaha.org
TX-010858,Wadley Regional Medical Center,Steward Healthcare System LLC,1114903523,Inpatient Hospitals (other than children's hospitals),1000 Pine St,,Texarkana,TX,75501-5100,Bowie,111 Huntington Avenue,Suite 1800,Boston,MA,02199,Suffolk,Thomas Gilbert,CEO and President,903-798-8002,,thomas.gilbert@steward.org,,,,,,https://wadleyhealth.org
TX-010859,Special Health Resources,"Special Health Resources for Texas, Inc.",1043209919,"Dental Providers, Federally Qualified Health Centers - Medical Services",1102 Main St,,Texarkana,TX,75501-4313,Bowie,1102 Main Street,P. O. Box 2709,Longview,TX,75604,Bowie,Kim Nesvig,CEO,903-212-7811,,knesvig@shrt.net,David Hayes,COO,903-212-7807,,dhayes@shrt.net,www.shrt.net
TX-010860,ETBHC dba Genesis Primecare - Texarkana,East Texas Border Health Clinic dba Genesis Primecare,1053663690,"Dental Providers, Federally Qualified Health Centers - Medical Services",1400 College Dr,,Texarkana,TX,75503-3534,Bowie,P. O. Box 1326,502 East Rusk Street,Marshall,TX,75671,Harrison,Carla Roadcap,Chief Executive Officer,903-927-3782,13,carla.roadcap@genesisprimecare.org,Leigh Ann Richmond,Credentialing,903-927-3782,20,leighann.richmond@genesisprimecare.org,
TX-010861,CHRISTUS St. Michael Health System,CHRISTUS St. Michael Health System,1295736734,Inpatient Hospitals (other than children's hospitals),2600 Saint Michael Dr,,Texarkana,TX,75503-5220,Bowie,2600 St Michael Drive,,Texarkana,TX,75503,Bowie,Glen Boles,CFO,903-614-2007,,glen.boles@christushealth.org,Sylvia Harrison,Director Payor Operatioins & Network Relations,903-614-2005,,sylvia.harrison@christushealth.org,
TX-010862,Texarkana Bowie County Family Health Center,Women's Health and Family Planning Association of Texas,1902850324,Family Planning Providers,902 W 12th St,,Texarkana,TX,75501-4303,Bowie,902 W 12th St,,Texarkana,TX,75501-4303,Bowie,Kelly Brush,Administrative Manager,903-798-3273,,kelly.brush@txkusa.org,,,,,,https://ci.texarkana.tx.us/391/Health
TX-010863,"ST. HOPE FOUNDATION, INC. - TEXAS CITY","ST. HOPE FOUNDATION, INC.",1942542154,Ryan White Providers,6807 Emmett F Lowry Expy,Suite 302,Texas City,TX,77591-2546,Galveston,6200 SAVOY DRIVE,SUITE 540,Houston,TX,77036-3338,Harris,MARY R. CAMPBELL,Credentialing,713-839-7111,7965,MCAMPBELL@OFFERINGHOPE.ORG,MIKA SAM COOPER,COO,713-778-1300,,mika@offeringhope.org,
TX-010864,Texas Children's Health Centers - The Woodlands,Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,17198 St Lukes Way,Suite 300,The Woodlands,TX,77384-8014,Montgomery,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kthompson@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations and Community Benefits",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010865,Texas Children's Hospital - The Woodlands,Texas Children's Hospital,1477643690,Children's Hospitals (inpatient only),17600 Interstate 45 S,,The Woodlands,TX,77384-5148,Montgomery,6621 Fannin St.,,Houston,TX,77030,Harris,Kabby Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kcthomps@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations",832-824-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010866,Live Oak Community Health Center,"ATASCOSA HEALTH CENTER, INC",1336491083,Federally Qualified Health Centers - Medical Services,105 E Thornton St,,Three Rivers,TX,78071-2720,Live Oak,310 W Oaklawn Rd,,PLEASANTON,TX,78064-4033,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,
TX-010867,Throckmorton Rural Health Clinic,Throckmorton Rural Health Clinic,1114047875,Rural Health Clinics,802 N Minter Ave,,Throckmorton,TX,76483-5357,Throckmorton,PO Box 327,,Throckmorton,TX,76483-0327,Throckmorton,Cynthia Wigington,Office Manager,940-849-2471,,cwigington@throckmortonhospital.com,Kelly Bland,HR/FIN,940-849-2151,435,kbland@throckmortonhospital.com,
TX-010868,MCMULLEN COMMUNITY HEALTH CENTER,"Atascosa Health Center, Inc.",1164899472,Federally Qualified Health Centers - Medical Services,203 Hackberry St,,Tilden,TX,78072,McMullen,310 W. OAKLAWN RD,,PLEASANTON,TX,78064-4033,Atascosa,PRISCILLA RAMOS,Credentialing Specialist,830-569-8940,2112,pramos.achc@tachc.org,MARIA GARCIA,Chief Financial Officer,830-569-8940,2113,mgarcia.achc@tachc.org,http://www.atascosahealthcenter.org/mcmullen-community-health-center.html
TX-010869,University of Texas Health Science Center at Tyler (inpatient hospital),University of Texas Health Science Center at Tyler,1417941295,Inpatient Hospitals (other than children's hospitals),11937 US Highway 271,,Tyler,TX,75708-3154,Smith,P O BOX 731911,,Dallas,TX,75373-1911,Dallas,Kinetha Clark,provider enrollment specialist,903-877-7777,5960,kinetha.clark@uthct.edu,Kris Kavasch,VP/CFO,903-877-7777,7752,kris.kavasch@uthct.edu,
TX-010870,University of Texas Health Science Center at Tyler (multiple outpatient ECP categories),University of Texas Health Science Center at Tyler,1417941295,"Outpatient Hospital Clinics, Tuberculosis Clinics",11937 US Highway 271,,Tyler,TX,75708-3154,Smith,P O BOX 731911,,Dallas,TX,75373-1911,Dallas,Kinetha Clark,provider enrollment specialist,903-877-7777,5960,kinetha.clark@uthct.edu,Kris Kavasch,VP/CFO,903-877-7777,7752,kris.kavasch@uthct.edu,
TX-010871,Special Health Resources,"Special Health Resources for Texas, Inc.",1043209919,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1300 Clinic Dr,P. O. Box 2709,Tyler,TX,75701-2119,Smith,1300 Clinic Dr.,P. O. Box 2709,Tyler,TX,75701,Smith,Kim Nesvig,CEO,903-212-7811,,knesvig@shrt.net,David Hayes,COO,903-212-7807,,dhayes@shrt.net,www.shrt.net
TX-010872,Tyler Family Circle of Care - Pediatrics,TYLER FAMILY CIRCLE OF CARE,1144575820,Federally Qualified Health Centers - Medical Services,214 E Houston St,,Tyler,TX,75702-8131,Smith,PO Box 9929,,Tyler,TX,75711,Smith,Erich Koch,CFO,903-525-7497,,erich.koch@tmfhc.org,,,,,,www.tylerfcc.org
TX-010873,Tyler Family Circle of Care - Pediatrics,TYLER FAMILY CIRCLE OF CARE,1144575820,Federally Qualified Health Centers - Medical Services,2990 N Broadway Ave,,Tyler,TX,75702-2149,Smith,PO Box 9929,,Tyler,TX,75711,Smith,Erich Koch,CFO,903-525-7497,,erich.koch@tmfhc.org,,,,,,www.tylerfcc.org
TX-010874,Tyler Family Circle of Care Annex,TYLER FAMILY CIRCLE OF CARE,1144575820,Federally Qualified Health Centers - Medical Services,523 S Fannin Ave,,Tyler,TX,75702-8204,Smith,523 S. Fannin Ave,,Tyler,TX,75702-8131,Smith,Michael Adams,CEO,903-606-5099,,michael.adams@tmfhc.org,,,,,,tylerfcc.org
TX-010875,"Planned Parenthood of Greater Texas, Inc - Tyler Health Center",Planned Parenthood of Greater Texas,1447401575,"Family Planning Providers, Sexually Transmitted Disease Clinics",601 Turtle Creek Dr,,Tyler,TX,75701-1832,Smith,7424 Greenville Ave.,Ste 206,Dallas,TX,75231,Dallas,Sheila McKinney,COO,214-254-3021,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,https://www.plannedparenthood.org/health-center/texas/tyler/75701/tyler-health-center-2213-91620
TX-010876,Tyler Family Circle of Care Family Practice & Women's Services,TYLER FAMILY CIRCLE OF CARE,1144575820,Federally Qualified Health Centers - Medical Services,928 N Glenwood Blvd,,Tyler,TX,75702-5055,Smith,PO Box 9929,,Tyler,TX,75711,Smith,Erich Koch,CFO,903-525-7497,,erich.koch@tmfhc.org,,,,,,www.tylerfcc.org
TX-010877,Uvalde Medical and Surgical Associates,Uvalde Medical and Surgical Associates,1891126959,Rural Health Clinics,1195 Garner Field Rd,Suite 500,Uvalde,TX,78801-4861,Uvalde,1195 Garner Field Rd,ste 500,Uvalde,TX,78801,Uvalde,Brandi Nutt,Director,830-278-6251,1185,b.nutt@umhtx.org,Christina Velasquez,Revenue Cycle Manager,830-278-6251,1315,ch.velasquez@umhtx.org,
TX-010878,OUR HEALTH/NUESTRO CENTRO DE SALUD,COMMUNITY HEALTH DEVELOPMENT INC,1134102403,Federally Qualified Health Centers - Medical Services,200 Evans St,,Uvalde,TX,78801-5142,Uvalde,908 Evans St,,Uvalde,TX,78801-6051,Uvalde,Christina Velasquez,Business Office Manager,830-278-5604,3100,cvelasquez.chdi@tachc.org,Mayela Castanon,CFO,830-278-5604,3100,mcastanon.chdi@tachc.org,
TX-010879,The Center for Community Wellness: Wellness Center,COMMUNITY HEALTH DEVELOPMENT INC,1093947764,Dental Providers,908 Evans St,,Uvalde,TX,78801-6051,Uvalde,908 Evans St,,Uvalde,TX,78801-6051,Uvalde,Christina Velasquez,Business Office Manager,830-278-5604,3100,cvelasquez.chdi@tachc.org,Mayela Castanon,CFO,830-278-5604,3100,mcastanon.chdi@tachc.org,
TX-010880,Boys and Girls Club of Rural West Texas,PROJECT VIDA HEALTH CENTER,1467871566,Federally Qualified Health Centers - Medical Services,102 E 2nd St,,Van Horn,TX,79855,Culberson,3607 Rivera Ave,,El Paso,TX,79905-2415,El Paso,Bill Schlesinger,CEO,915-533-7057,207,w.schlesinger@pvida.net,,,,,,www.pvida.net
TX-010881,Victoria Community Health Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1558611475,Federally Qualified Health Centers - Medical Services,2603 Hospital Dr,,Victoria,TX,77901-5753,Victoria,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Dee Noack,Contracting/Credentialing,830-339-2093,,noackd@chcsct.com,
TX-010882,Victoria Community Dental Center,"COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS, INC.",1558611475,Dental Providers,2805 N Navarro St,,Victoria,TX,77901-3946,Victoria,P.O. Box 1890,228 Saint George St,Gonzales,TX,78629-3910,Gonzales,Henry F Salas,CEO,830-672-6511,204,salash@chcsct.com,Cecilia Montoya,Contracting/Credentialing,830-549-1416,,montoyac@chcsct.com,
TX-010842,CENTROMED MARIA CASTRO FLORES CLINIC,El Centro del Barrio,1811061872,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",7315 S Loop 1604 W,,Von Ormy,TX,78073,Bexar,3750 Commercial Avenue,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010883,Austin Avenue Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1427464759,Federally Qualified Health Centers - Medical Services,110 S 12th St,,Waco,TX,76701-1810,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,
TX-010884,Meyer Center Community Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1457671984,Federally Qualified Health Centers - Medical Services,1226 Washington Ave,,Waco,TX,76701-1127,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/meyer-center-community-clinic/
TX-010885,FAMILY HEALTH CENTER,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1164409926,"Dental Providers, Federally Qualified Health Centers - Medical Services",1600 Providence Dr,,Waco,TX,76707-2261,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,
TX-010886,SOUTH 18TH STREET COMMUNITY CLINIC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1699096503,"Dental Providers, Federally Qualified Health Centers - Medical Services",1800 Gurley Ln,,Waco,TX,76706-4025,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,
TX-010887,Martin Luther King Community Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1477837730,Federally Qualified Health Centers - Medical Services,1911 N Martin Luther King Jr Blvd,,Waco,TX,76704-1438,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/martin-luther-king-jr-community-clinic/
TX-010888,MacArthur Pediatric Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1861880080,Federally Qualified Health Centers - Medical Services,2201 MacArthur Dr,Suite 103,Waco,TX,76708-3159,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/macarthur-pediatrics/
TX-010889,Waco-McLennan County Public Health District,Waco-McLennan County Public Health District,1871525683,"Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",225 W Waco Dr,,Waco,TX,76707-3836,McLennan,225 W Waco Dr,,Waco,TX,76707,Mclennan,Sherry Williams,Director,254-750-5459,,sherry@wacotx.gov,gladys hand,Vital Statistics and Billing Superisor,254-750-5468,,gladysh@wacotx.gov,http://www.waco-texas.com/cms-healthdepartment/
TX-010890,BELLMEAD COMMUNITY CLINIC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1164742680,Federally Qualified Health Centers - Medical Services,3400 Bellmead Dr,,Waco,TX,76705-3081,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/bellmead-community-clinic/
TX-010891,Community Clinic at MCC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1942584255,Federally Qualified Health Centers - Medical Services,4601 N 19th St,,Waco,TX,76708,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/community-clinic-at-mcc/
TX-010892,West Waco Community Clinic,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1730409269,Federally Qualified Health Centers - Medical Services,600 West Highway 6,,Waco,TX,76712,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/west-waco-community-clinic/
TX-010893,ELM AVENUE COMMUNITY CLINIC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1700055639,"Dental Providers, Federally Qualified Health Centers - Medical Services",609 Elm St,,Waco,TX,76704-2516,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,
TX-010894,Planned Parenthood of Greater Texas - Mary Ruth Duncan Health Center of Waco,Planned Parenthood of Greater Texas,1104959790,"Family Planning Providers, Sexually Transmitted Disease Clinics",700 W Highway 6,Suite B,Waco,TX,76712,McLennan,7424 Greenville Ave.,Ste 206,Dallas,TX,75231,Dallas,Sheila McKinney,COO,214-254-3021,,sheila.mckinney@ppgt.org,Beth Watson,VP of Health Services,214-363-2004,10130,beth.watson@ppgt.org,https://www.plannedparenthood.org/health-center/texas/waco/76712/mary-ruth-duncan-health-center-4284-91620
TX-010895,BELL'S HILL COMMUNITY CLINIC,"HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.",1518136456,Federally Qualified Health Centers - Medical Services,911 S 20th St,,Waco,TX,76706-1955,McLennan,1600 Providence Dr,,Waco,TX,76707-2261,McLennan,Dr. Jackson Griggs,CEO,254-313-4201,,jgriggs@wacofhc.org,Matthew Polk,COO,254-313-4200,,mpolk@wacofhc.org,http://www.wacofhc.org/bells-hill-community-clinic/
TX-010896,Watauga Immunization Clinic,Tarrant County Public Health,1194783183,Other ECP Providers,6601 Watauga Rd,,Watauga,TX,76148-3331,Tarrant,1101 S. Main Street,Room 2400,Fort Worth,TX,76104,Tarrant,Linda Peterson,Clinic Charge Nurse/Registered Nurse,817-514-5036,,lmpeterson@tarrantcounty.com,Nancy Coon-Barksdale,Vaccine Division Manager/Registered Nurse,817-321-5452,,ngbarksdale@tarrantcounty.com,http://www.tarrantcounty.com/en/public-health.html
TX-010897,Ellis County Coalition for Health Options,ELLIS COUNTY COALITION FOR HEALTH OPTIONS,1326236464,"Dental Providers, Federally Qualified Health Centers - Medical Services",411 E Jefferson St,,Waxahachie,TX,75165-3827,Ellis,411 E Jefferson St,,Waxahachie,TX,75165-3827,Ellis,Annette Prudhomme,Director of Outreach and Compliance,972-923-2440,203,APrudhomme@call4hope.org,Barbara Clark,Director of Operations,972-923-2440,130,BClark@call4hope.org,www.call4hope.org
TX-010898,Campbell Clinic,Parker County Hospital District,1427067776,Rural Health Clinics,1517 Texas Dr,,Weatherford,TX,76086-6327,Parker,1517 Texas Dr,,Weatherford,TX,76086,Parker,Misty Martin,Billing Coordiantor,817-458-3356,,misty.putman@pchdtx.org,Amanda Russell,Clinic Manager,817-458-3300,,amanda.russell@pchdtx.org,
TX-010899,Texas Children's Health Center - Clear Lake,Texas Children's Hospital,1477643690,Outpatient Hospital Clinics,940 Clear Lake City Blvd,Suite 200,Webster,TX,77598-6606,Harris,6621 Fannin St.,,Houston,TX,77030,Harris,Karolyn Thompson,"Assistant Vice President, Revenue Cycle",832-824-2853,,kthompson@texaschildrens.org,Rosie Valadez McStay,"Assistant Vice President, Government Relations",832-828-2782,,Lrmcstay@texaschildrens.org,www.texaschildrens.org
TX-010900,Access Esperanza Clinics-Weslaco Center,ACCESS ESPERANZA CLINICS INC.,1770500027,"Family Planning Providers, Other ECP Providers, Sexually Transmitted Disease Clinics",901 James St,,Weslaco,TX,78596-6619,Hidalgo,916 East Hackberry Ave.,,McAllen,TX,78501-5737,Hidalgo,Patricio Gonzales,Chief Executive Officer,956-688-3700,3707,patricio.gonzales@accessclinics.org,Melinda Cruz,Clinical Operations Director,956-688-3700,3708,melinda.cruz@accessclinics.org,http://www.accessclinics.org
TX-010901,Lake Whitney Medical Clinic,Goodall Witcher Hospital Authority,1336546266,"Other ECP Providers, Rural Health Clinics",202 E Jefferson Ave,,Whitney,TX,76692-2398,Hill,101 Posey Ave,,Clifton,TX,76634,Bosque,Robin Townson,Clinic Mgr,254-694-2221,25,rtownson@gwhf.org,Wilson Dingmore,Director of Rural Health Clinics,254-675-8621,7987,wdingmore@gwhf.org,www.gwhf.org
TX-010902,Wilson Family Planning Clinic,North Texas Medical Foundation dba Wilson Family Planning,1447325725,Family Planning Providers,1301 3rd St,Suite 100,Wichita Falls,TX,76301-2245,Wichita,1301 3rd St Ste 100,,Wichita Falls,TX,76301-2245,Wichita,Eva Dickens,Project Director,940-723-0755,341,eva@wfplanning.org,,,,,,http://www.wfplanning.org/
TX-010903,NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER,NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER,1255324141,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 MLK Jr Blvd,,Wichita Falls,TX,76301-1152,Wichita,200 Mlk Jr Blvd,,Wichita Falls,TX,76301-1152,Wichita,Doyle Goodwin,Chief Financial Officer,940-761-1697,,dgoodwin@chcwf.com,Allen Patterson,Chief Executive Officer,940-766-6306,,apatterson@chcwf.com,
TX-010904,Lone Star Community Health Center Willis,Lone Star Community Health Center,1013380708,Federally Qualified Health Centers - Medical Services,201 Lincoln Rdg,,Willis,TX,77378-1420,Montgomery,605 S. Conroe Medical Drive,,Conroe,TX,77379,Montgomery,Karrie Golden,COO,936-523-5277,,kgolden@lonestarfamily.org,Karen Harwell,CFO,936-523-5234,,kharwell@lonestarfamily.org,
TX-010811,CENTROMED NOEMI GALVAN ELING CLINIC,EL CENTRO DEL BARRIO,1760556773,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",5542 Walzem Rd,,Windcrest,TX,78218-2103,Bexar,3750 Commercial Avenue,,San Antonio,TX,78221-3117,Bexar,Ernesto Gomez,President & CEO,210-334-3703,,ernesto.gomez@centromedsa.com,Anna Serrano,VP & Chief Population Health Officer,210-334-3706,,anna.serrano@centromedsa.com,www.centromedsa.com
TX-010905,North Runnels Hospital Clinic,North Runnels County Hospital,1255429155,Rural Health Clinics,7571 State Highway 153,,Winters,TX,79567-7439,Runnels,P.O. Box 185,,Winters,TX,79567,Runnels,Judy Espitia,CEO,325-754-1317,126,jespitia@nrhd.org,,,,,,
TX-010906,Woodsboro Medical Clinic,Refugio County Memorial Hospital District,1467495184,Rural Health Clinics,120 Wood Avenue,,Woodsboro,TX,78393,Refugio,120 Wood Avenue,107 Swift Street,Woodsboro,TX,78393,Refugio,Lydia Schlabach,Administrative Assistant,361-526-2321,111,lschlabach@rcmhospital.org,Susan Parker,Chief Financial Officer,361-526-2321,138,sparker@rcmhospital.org,
TX-010907,Zapata,GATEWAY COMMUNITY HEALTH CENTER INC,1629271648,Federally Qualified Health Centers - Medical Services,210 N Rathmell St,,Zapata,TX,78076,Zapata,1515 Pappas St,,Laredo,TX,78041-1705,Webb,Cristina J. Hernandez,Director of Business Operations,956-718-6259,,cristinah.gateway@tachc.org,,,,,,
UT-010908,"WAYNE COMMUNITY HEALTH CENTER, INC.","WAYNE COMMUNITY HEALTH CENTERS, INC.",1093816282,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",128 S 300 W,,Bicknell,UT,84715,Wayne,128 S 300 W,,Bicknell,UT,84715-0303,Wayne,Regina Flanagan,CEO,435-425-3744,102,ginaf@waynechc.org,Ramona Larsen,CFO,435-425-3744,103,gianf@waynechc.org,
UT-010909,Blue Mountain Hospital,Blue Mountain Hospital,1558513812,Inpatient Hospitals (other than children's hospitals),802 S 200 W,Suite A,Blanding,UT,84511-3910,San Juan,802 S 200 W,Suite A,Blanding,UT,84511,San Juan,Kent Turek,Chief Nursing Officer,435-678-3993,5629,dkturek@bmhutah.org,Jimmy Johnson,Chief Financial Officer,435-678-3993,5649,jjohnson@bmhutah.org,https://www.bmhutah.org
UT-010910,Bryce Valley Clinic,Garfield Memorial Hospital,1013119155,Rural Health Clinics,25 S Redrock Dr,,Cannonville,UT,84718-8001,Garfield,"P.O, Box 389",,Panguitch,UT,84759,Garfield,Alberto Vasquez,Administrator,435-676-1261,,alberto.vasquez@imail.org,Jeanee Shakespeare,Clinic Manager,435-676-1528,,jeanee.shakespeare@imail.org,
UT-010911,Emery Medical Center,Emery Medical Center,1417064205,Ryan White Providers,90 W Main St,,Castledale,UT,84513,Emery,90 W Main St,,Castledale,UT,84513,Emery,Paul Hansen,market manager,435-613-6140,,paul.hansen@lpnt.net,David McCullough,Senior Director,615-564-0552,,david.mccullough@lpnt.net,
UT-010912,Family Health Care Cedar East,Southwest Utah Community Health Center,1659358687,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",245 E 680 S,,Cedar City,UT,84720-3593,Iron,25 North 100 East,Suite 102,St George,UT,84770,Washington,Lori Wright,CEO,435-879-5101,,lori@familyhc.org,Jeff Huyboom,CFO,435-879-5102,,jeff@familyhc.org,www.familyhc.org
UT-010913,Cedar Community Health Center,"PAIUTE INDIAN TRIBE OF UTAH, THE",1700062296,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",440 N Paiute Dr,,Cedar City,UT,84721-6181,Iron,440 N Paiute Dr,,Cedar City,UT,84721-6181,Iron,Michele Lefebrve,Health Director,435-586-1112,400,michele.lefebvre@ihs.gov,Tyler Prisbrey,Health Finance Director,435-586-1112,421,tyler.prisbrey@ihs.gov,
UT-010914,Family Healthcare - Cedar City Harding,Southwest Utah Community Health Center dba Family Healthcare,1659358687,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",74 W Harding Ave,,Cedar City,UT,84720-2562,Iron,25 North 100 East,Suite 102,St George,UT,84770,Washington,Lori Wright,CEO,435-879-5101,,lori@familyhc.org,Jeff Huyboom,CFO,435-879-5102,,jeff@familyhc.org,www.familyhc.org
UT-010915,Circleville Clinic,Garfield Memorial Hospital,1649472796,Rural Health Clinics,110 South 100 East,,Circleville,UT,84723,Piute,P.O. Box 389,,Panguitch,UT,84795,Garfield,Alberto Vasquez,Administrator,435-676-1261,,alberto.vasquez@imail.org,Jeanee Shakepeare,Clinic Manager,435-676-1528,,jeanee.shakespeare@imail.org,
UT-010916,Midtown Community Health Center Davis County Clinic,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1467644740,"Dental Providers, Federally Qualified Health Centers - Medical Services",22 S State St,,Clearfield,UT,84015-1043,Davis,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010917,Carbon Medical Service,"Carbon Medical Service Association, Incorporated",1497717821,"Dental Providers, Federally Qualified Health Centers - Medical Services",305 Center Street,,East Carbon,UT,84520,Carbon,PO Box 930,,East Carbon,UT,84520-0930,Carbon,Carolyn Abeyta,Executive Director,435-888-4411,20,carolyn@carbonmedicalservice.com,Crestina Trujillo,Finance Director,435-888-4411,18,mimi@carbonmedicalservice.com,carbonmedicalservice.com
UT-010918,Enterprise ValleyMedical Clinic,Enterprise Valley Medical Clinic,1659457786,Federally Qualified Health Centers - Medical Services,223 South 200 East,,Enterprise,UT,84725-0370,Washington,Po Box 1,,Enterprise,UT,84725-0370,Washington,Raean Banks,Office Manager,435-878-2281,,raeanbnks@scinternet.net,Rydel Reber,Executive Director,435-878-2281,,rydelr@scinternet.net,
UT-010919,Kazan Memorial Clinic,"WAYNE COMMUNITY HEALTH CENTERS, INC.",1568886000,Federally Qualified Health Centers - Medical Services,570 E Moqui Ln,,Escalante,UT,84726-7753,Garfield,128 S 300 W,,Bicknell,UT,84715-0303,Wayne,Regina Flanagan,CEO,435-425-3744,102,ginaf@waynechc.org,Ramona Larsen,CFO,435-425-3744,103,rlarsen@waynechc.org,
UT-010920,Escalante Dental,"WAYNE COMMUNITY HEALTH CENTERS, INC.",1013318880,Dental Providers,65 N Center St,,Escalante,UT,84726-7713,Garfield,128 S 300 W,,Bicknell,UT,84715-0303,Wayne,Gina Flanagan,CEO,435-425-3744,102,ginaf@waynechc.org,Ramona Larsen,CFO,435-425-3744,103,rlarsen@waynechc.org,
UT-010921,(Uintah & Ouray Res.) Fort Duchesne Health Center,(Uintah & Ouray Res.) Fort Duchesne Health Center,1518244086,"Indian Health Service, Other ECP Providers",6822 E 1000 S,,Fort Duchesne,UT,84026,Uintah,PO Box 160,,Fort Duchesne,UT,84026-0160,Uintah,"Lawrence Zubel, MD",Chief Executive Officer,435-722-5122,,lzubel@ihs.gov,Billie Wooley,Business Office Manager,435-725-6833,,bwooley@ihs.gov,
UT-010922,GREEN RIVER MEDICAL CENTER,GREEN RIVER MEDICAL CENTER,1942317722,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",585 W Main St,,Green River,UT,84525,Emery,585 W Main St,,Green River,UT,84525,Emery,Mary B Winters,Executive Director,435-564-3434,,grmc@grmc.biz,,,,,,
UT-010923,WAYNE COMMUNITY HEALTH HANKSVILLE,"WAYNE COMMUNITY HEALTH CENTERS, INC.",1093863342,Federally Qualified Health Centers - Medical Services,30 South Highway 95,,Hanksville,UT,84734,Wayne,128 S 300 W,,Bicknell,UT,84715-0303,Wayne,Regina Flanagan,CEO,435-425-3744,102,ginaf@waynechc.org,Ramona Larsen,CFO,435-425-3744,103,rlarsen@waynechc.org,
UT-010924,The Helper Clinic,"Carbon Medical Service Association, Incorporated",1679749196,Federally Qualified Health Centers - Medical Services,125 S Main St,,Helper,UT,84526-1535,Carbon,125 S Main Street,,Helper,UT,84526,Carbon,Carolyn Abeyta,Executive Director,435-888-4411,20,carolyn@carbonmedicalservice.com,Crestina Trujillo,Finance Director,435-888-4411,18,mimi@carbonmedicalservice.com,carbonmedicalservice.com
UT-010925,"Southwest Utah Community Health Center, dba Family Healthcare","Southwest Utah Community Health Center, dba Familyhc.org",1659358687,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",391 N 200 W,Family Healthcare Hurricane Middle School,Hurricane,UT,84737-1616,Washington,25 North 100 East,Suite 102,St George,UT,84770,Washington,Lori Wright,CEO,435-879-5101,,lori@familyhc.org,Jeff Huyboom,CFO,435-879-5012,,jeff@familyhc.org,www.familyhc.org
UT-010926,Shivwits Community Health Center,"PAIUTE INDIAN TRIBE OF UTAH, THE",1801063441,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",3705 N 6100 W,,Ivins,UT,84738,Washington,440 N Paiute Dr,,Cedar City,UT,84721,Iron,Michele Lefebvre,Health Director,435-586-1112,401,michele.lefebvre@ihs.gov,Tyler Prisbrey,Health Finance Director,435-586-1112,421,tyler.prisbrey@ihs.gov,
UT-010927,Kanosh Community Health Center,"PAIUTE INDIAN TRIBE OF UTAH, THE",1992972525,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",157 N Reservation Dr,,Kanosh,UT,84637,Millard,440 N Paiute Dr,,Cedar City,UT,84721-6181,Iron,Michele Lefebvre,Health Director,435-586-1112,401,michele.lefebvre@ihs.gov,Tyler Prisbrey,Health Finance Director,435-586-1112,421,tyler.prisbrey@ihs.gov,
UT-010928,Midtown Community Health Center Logan Site,Midtown Community Health Center Inc,1053780171,Federally Qualified Health Centers - Medical Services,272 1/2 N Main St,,Logan,UT,84321-3915,Cache,2240 Adams Avenue,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010929,Planned Parenthood Logan,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,550 N Main St Ste 117,Clock Tower Plaza,Logan,UT,84321-3984,Cache,550 N Main St Ste 117,Clock Tower Plaza,Logan,UT,84321-3984,Cache,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010930,72nd Street Clinic Community Health Center,"Community Health Centers, Inc.",1073611364,Federally Qualified Health Centers - Medical Services,220 W 7200 S,Suite A100,Midvale,UT,84047-1043,Salt Lake,"Community Health Centers, Inc.","220 West 7200 South, Suite A100",Midvale,UT,84047,Salt Lake,Dexter Pearce,Executive Director,801-412-6920,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,www.chc-ut.org
UT-010931,Utah Partners for Health Dental Clinic,UTAH PARTNERS FOR HEALTH,1508299892,Dental Providers,7651 S Main St,,Midvale,UT,84047-7101,Salt Lake,7651 S. Main Street,,Midvale,UT,84047,Salt Lake,Kurt Micka,Executive Director,385-645-6000,,kmicka@upfh.org,Debbie Turner,CFO,385-645-6001,,dturner@upfh.org,www.upfh.org
UT-010932,Mid-Valley Health Clinic,UTAH PARTNERS FOR HEALTH,1508299892,Federally Qualified Health Centers - Medical Services,8446 S Harrison St,,Midvale,UT,84047-3501,Salt Lake,7651 S. Main Street,,Midvale,UT,84047,Salt Lake,Kurt Micka,Executive Director,385-645-6000,,kmicka@upfh.org,Debbie Turner,CFO,385-645-6001,,dturner@upfh.org,www.upfh.org
UT-010933,Moab Regional Hospital,"Moab Valley Healthcare, Inc",1770513236,Inpatient Hospitals (other than children's hospitals),450 Williams Way,,Moab,UT,84532-2185,Grand,450 W. Williams Way,,Moab,UT,84532,Grand,Jennifer Sadoff,Chief Executive Officer,435-719-3514,,jennifers@mrhmoab.org,Craig Daniels,Chief Financial Officer,435-719-3503,,craigd@mrhmoab.org,www.mrhmoab.org
UT-010934,Moab Regional Multi-Speciality Clinic,"Moab Valley Healthcare, Inc.",1770513236,Outpatient Hospital Clinics,450 Williams Way,,Moab,UT,84532-2185,Grand,450 W. Williams Way,,Moab,UT,84532,Grand,Ronnie Boongaling,Director of Medical Clinics,435-719-5554,,ronnieb@mrhmoab.org,Craig Daniels,Chief Financial Officer,435-719-3503,,cdaniels@mrhmoab.org,www.mrhmoab.org
UT-010935,MIDTOWN COMMUNITY HEALTH CENTER,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1548267420,"Dental Providers, Federally Qualified Health Centers - Medical Services",2240 Adams Ave,,Ogden,UT,84401-1511,Weber,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010936,Midtown Community Health Center Weber Midtown Wellnes Clinic,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1104124015,Federally Qualified Health Centers - Medical Services,237 26th St,,Ogden,UT,84401-3105,Weber,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010937,James Madison Elementary Health Center,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1447495981,Federally Qualified Health Centers - Medical Services,2563 Monroe Blvd,,Ogden,UT,84401-2513,Weber,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Martinez,CEO,801-334-1321,,amartinez@midtownchc.org,
UT-010938,Hope Community Health Center,"Midtown Community Health Center, Inc",1609254796,"Dental Providers, Federally Qualified Health Centers - Medical Services",269 W 33rd St,,Ogden,UT,84401-3845,Weber,2240 Adams Avenue,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010939,Planned Parenthood Ogden,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,4387 Harrison Blvd,Suite D8,Ogden,UT,84403-3267,Weber,4387 Harrison Blvd Ste D8,,Ogden,UT,84403-3267,Weber,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010940,Planned Parenthood Utah Valley,Planned Parenthood Assoc. of Utah,1073549614,Family Planning Providers,1086 N 1200 W,,Orem,UT,84057-2840,Utah,1086 N 1200 W,,Orem,UT,84057-2840,Utah,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010941,Garfield Memorial Clinic,Garfield Memorial Hospital,1760684815,Rural Health Clinics,200 North 400 East,,Panguitch,UT,84759-0389,Garfield,P.O. Box 389,,Panguitch,UT,84759,Garfield,Alberto Vasquez,Administrator,435-676-1261,,alberto.vasquez@imail.org,Jeanee Shakespeare,Clinic Manager,435-676-1528,,jeanee.shakespeare@imail.org,
UT-010942,MOUNTAINLANDS FAMILY HEALTH CENTER - PAYSON,"MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",1437364882,"Dental Providers, Federally Qualified Health Centers - Medical Services",910 E 100 N,Suite 155,Payson,UT,84651-1638,Utah,589 S State St,,Provo,UT,84606-5056,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010943,Castleview Hospital,LifePoint Health,1417064205,Inpatient Hospitals (other than children's hospitals),300 N Hospital Dr,,Price,UT,84501-4218,Carbon,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,Sr. Director Managed Care,615-920-7362,,Ian.Andes@LPNT.net,Greg Cook,CFO,435-637-4800,4019,,
UT-010944,Utah County Health Department,Utah County Government,1891865010,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",151 S University Ave # 1900,,Provo,UT,84601-4427,Utah,151 South University Ave #1610,,Provo,UT,84601,Utah,Steven Mickelson,Chief Nursing Officer,801-851-7050,,stevem@utahcounty.gov,Ralph Clegg,Health Officer,801-851-7016,,ralph@utahcounty.gov,
UT-010945,East Bay Health Center,Mountainlands Community Health Center,1427437144,Federally Qualified Health Centers - Medical Services,299 E 900 S,Suite 101,Provo,UT,84606-6107,Utah,589 S. State Street,,Provo,UT,84606,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010946,Mountainlands Community Health Center Main Site Clinic,"MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",1427075134,"Dental Providers, Federally Qualified Health Centers - Medical Services",589 S State St,,Provo,UT,84606-5056,Utah,589 S State St,,Provo,UT,84606-5056,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010947,Mountainlands Family Health Center - Wasatch,"MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",1710329958,Federally Qualified Health Centers - Medical Services,750 N 200 W,,Provo,UT,84601-1677,Utah,589 S State St,,Provo,UT,84606-5056,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010948,Koosharem Community Health Center,"PAIUTE INDIAN TRIBE OF UTAH, THE",1336316975,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",826 N 100 E,,Richfield,UT,84701-1849,Sevier,440 N Paiute Dr,,Cedar City,UT,84721-6181,Iron,Michele Lefebvre,Health Director,435-586-1112,401,michele.lefebvre@ihs.gov,Tyler Prisbrey,Health Finance Director,435-586-1112,421,tyler.prisbrey@ihs.gov,
UT-010949,Southwest Utah Community Health Center dba Family Healthcare,"SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.",1659358687,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",25 N 100 E,,Saint George,UT,84770-7368,Washington,25 N 100 E Ste 102,,Saint George,UT,84770-7369,Washington,Lori Wright,CEO,435-879-5101,,lori@familyhc.org,Jeff Huyboom,CFO,435-879-5102,,jeff@familyhc.org,www.familyhc.org
UT-010950,Planned Parenthood - St. George,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,595 S Bluff St,Suite 1,Saint George,UT,84770-3593,Washington,595 S Bluff St Ste 1,,Saint George,UT,84770-3593,Washington,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010951,PRIMARY CHILDRENS HOSPITAL (children's inpatient hospital),IHC Health Services Inc.,1235148594,Children's Hospitals (inpatient only),100 N Mario Capecchi Dr,,Salt Lake City,UT,84113-1103,Salt Lake,36 S. State St.,,Salt Lake City,UT,84111,Salt Lake,Russell Dow,"Director, Payer Contracting",801-442-3655,,russell.dow@imail.org,Chad Funk,"Manager, Payer Contracting",801-442-3498,,chad.funk@imail.org,
UT-010952,PRIMARY CHILDRENS HOSPITAL (multiple outpatient ECP categories),IHC Health Services Inc.,1235148594,"Hemophilia Treatment Centers, Outpatient Hospital Clinics",100 N Mario Capecchi Dr,,Salt Lake City,UT,84113-1103,Salt Lake,36 S. State St.,,Salt Lake City,UT,84111,Salt Lake,Russell Dow,"Director, Payer Contracting",801-442-3655,,russell.dow@imail.org,Heidi Lane,"Program Coordinator, Intermountain Hemophilia and Thrombosis Center",801-662-4723,,heidi.lane@imail.org,
UT-010953,Salt Lake Regional Medical Center,Steward Healthcare System LLC,1417988833,Inpatient Hospitals (other than children's hospitals),1050 E South Temple,,Salt Lake City,UT,84102-1507,Salt Lake,1050 E South Temple,,Salt Lake City,UT,84102,Salt Lake,Brian Ebright,CFO,801-350-4993,,brian.ebright@steward.org,Dale Johns,CEO,801-350-4008,,dale.johns@steward.org,
UT-010954,SHC - Salt Lake City,Shriners Hospitals for Children,1255461075,Children's Hospitals (inpatient only),1275 E Fairfax Rd,,Salt Lake City,UT,84103-4324,Salt Lake,1275 E Fairfax Rd,,Salt Lake City,UT,84103,Salt Lake,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
UT-010955,Stephen D. Ratcliffe Community Health Center,"Community Health Centers, Inc",1538267828,"Dental Providers, Federally Qualified Health Centers - Medical Services",1365 W 1000 N,,Salt Lake City,UT,84116-1654,Salt Lake,"Community Health Centers, Inc.",220 West 7200 South,Midvale,UT,84047,Salt Lake,Dexter Pearce,Executive Director,801-412-6920,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,www.chc-ut.org
UT-010956,"Community Health Center, Inc.",Community Health Centers Inc,1255757670,"Dental Providers, Federally Qualified Health Centers - Medical Services",1388 S Navajo St Suite C,Neighborhood Clinic at Mountainview School,Salt Lake City,UT,84104-3494,Salt Lake,"Community Health Centers, Inc.",220 West 7200 South,Midvale,UT,84047,Salt Lake,Dexter Pearce,Executive Director,801-412-6920,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,www.chc-ut.org
UT-010957,Metro Health Center,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,160 S 1000 E,Suite 120,Salt Lake City,UT,84102-1428,Salt Lake,654 S 900 E,,Salt Lake City,UT,84102-3478,Salt Lake,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010958,Midtown South Salt Lake Community Health Center,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1033547567,Federally Qualified Health Centers - Medical Services,2253 S State St,,Salt Lake City,UT,84115-2752,Salt Lake,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010959,"WASATCH HOMELESS HEALTH CARE, INC d.b.a Fourth Street Clinic","WASATCH HOMELESS HEALTH CARE, INC.",1528128899,"Dental Providers, Federally Qualified Health Centers - Medical Services",409 W 400 S,,Salt Lake City,UT,84101-1135,Salt Lake,409 W 400 S,,Salt Lake City,UT,84101-1135,Utah,Laura Michalski,CEO,801-364-0134,,laura@fourthstreetclinic.org,Jim Reichelt,COO,385-234-5700,,jim@fourthstreetclinic.org,
UT-010960,Central City Community Health Center,"Community Health Centers, Inc.",1144326208,"Dental Providers, Federally Qualified Health Centers - Medical Services",461 S 400 E,,Salt Lake City,UT,84111-3302,Salt Lake,"Community Health Centers, Inc.","220 West 7200 South, Suite A100",Midvale,UT,84047,Salt Lake,Dexter Pearce,Executive Director,801-412-6920,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,www.chc-ut.org
UT-010961,Clinic 1A,"University of Utah, Division of Infectious Diseases",1033513833,"Outpatient Hospital Clinics, Rural Health Clinics, Ryan White Providers",50 N Medical Dr,,Salt Lake City,UT,84132-0001,Salt Lake,30 N 1900 E RM 4B319,,Salt Lake City,UT,84132-2101,Salt Lake,Harry Rosado-Santos,Medical Director,801-581-8812,,harry.rosado@hsc.utah.edu,Teddy Bryant,Associate Directory,801-585-5507,,teddy.bryant@hsc.utah.edu,https://healthcare.utah.edu/infectiousdiseases/
UT-010962,Planned Parenthood Salt Lake,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,654 S 900 E,,Salt Lake City,UT,84102-3478,Salt Lake,654 S 900 E,,Salt Lake City,UT,84102-3478,Salt Lake,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010963,Planned Parenthood - South Jordan,Planned Parenthood Association of Utah,1073549614,Family Planning Providers,1091 W South Jordan Pkwy,Suite 100,South Jordan,UT,84095-8846,Salt Lake,1091 W South Jordan Pkwy Ste 100,,South Jordan,UT,84095-8846,Salt Lake,Lesley Bailey,Director of Finance,801-532-1586,,lesley.bailey@ppau.org,,,,,,
UT-010964,"Southwest Utah Community Health Center, dba Family Healthcare",Southwest Utah Community Health Center dba Family Healthcare,1659358687,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",2408 E Riverside Dr,Family Healthcare - Millcreek High School,St George,UT,84790-2532,Washington,25 North 100 East,Suite 102,St George,UT,84770,Washington,Lori Wright,CEO,435-879-5101,,lori@familyhc.org,Jeff Huyboom,CFO,435-879-5102,,jeff@familyhc.org,www.familyhc.org
UT-010965,Oquirrh View Community Health Center,"Community Health Centers, Inc.",1801992953,"Dental Providers, Federally Qualified Health Centers - Medical Services",4745 S 3200 W,,Taylorsville,UT,84129-2822,Salt Lake,"Community Health Centers, Inc.","220 West 7200 South, Suite A100",Midvale,UT,84047,Salt Lake,Dexter Pearce,Executive Director,801-412-6920,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,www.chc-ut.org
UT-010966,Mountainlands Family Health Center Vernal Dental Clinic,"MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",1154739787,Dental Providers,133 S 500 E,,Vernal,UT,84078-2728,Uintah,589 S. State Street,,Provo,UT,84606,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010967,Mountainlands Community Health Center - Vernal,"MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",1801226907,Federally Qualified Health Centers - Medical Services,1680 W Highway 40,Suite 201,Vernal,UT,84078-4142,Uintah,589 S State St,,Provo,UT,84606-5056,Utah,Todd Bailey,Executive Director,801-429-2000,1155,todd@mountainlands.org,Eric Johnson,Financial Director,801-429-2000,1091,eric@mountainlands.org,www.mountainlands.org
UT-010968,Midtown Community Health Center Children's Clinic,"MIDTOWN COMMUNITY HEALTH CENTER, INC.",1013186717,Federally Qualified Health Centers - Medical Services,5285 S 400 E,Suite A,Washington Terrace,UT,84405-7194,Weber,2240 Adams Ave,,Ogden,UT,84401-1511,Weber,Sonja Levesque,CFO,801-334-1327,,slevesque@midtownchc.org,Alicia Villalva,COO,801-334-1321,,avillalva@midtownchc.org,
UT-010969,Planned Parenthood West Valley,Planned Parenthood Association of Utah,1073549614,Other ECP Providers,1906 W 3600 S,,West Valley City,UT,84119-4715,Salt Lake,654 South 900 East,,Salt Lake City,UT,84102,Salt Lake,Lesley Bailey,CFO,385-355-1543,,lesley.bailey@ppau.org,,,,,,
UT-010970,Ellis R. Shipp Clinic,"Community Health Centers, Inc",1326417445,Federally Qualified Health Centers - Medical Services,4535 S 5600 W,,West Valley City,UT,84120-4639,Salt Lake,220 West 7200 South,Suite A100,Midvale,UT,84047,Salt Lake,Dexter Alan Pearce,Executive Director,801-858-3451,,dpearce@chc-ut.org,James Christensen,Finance Director,801-412-6920,,jchristensen@chc-ut.org,
VA-010971,Accomack Co Health Dept,Virginia Department of Health,1386739456,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",23191 Front St,,Accomac,VA,23301-1644,Accomack,VDH 109 Governor St 825J,,Richmond,VA,23219,Richmond,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,David Matson,"MD, Health Director",757-787-5880,,david.matson@vdh.virginia.gov,
VA-010972,SOUTHSIDE COMMUNITY HEALTH CENTER,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1831228444,"Dental Providers, Federally Qualified Health Centers - Medical Services",8380 Boydton Plank Rd,,Alberta,VA,23821,Brunswick,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-010973,ALEXANDRIA NEIGHBORHOOD HEALTH SERVICE INC,NEIGHBORHOOD HEALTH,1164620027,Federally Qualified Health Centers - Medical Services,2 E Glebe Rd,,Alexandria,VA,22305-2938,Alexandria City,2 E Glebe Rd,,Alexandria,VA,22305-2938,Alexandria City,Basim Khan,ED,310-592-6681,,bkhan@neighborhoodhealthva.org,,,,,,
VA-010974,Alexandria Health Department,Virginia Department of Health,1275669277,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4480 King St,,Alexandria,VA,22302-1300,Alexandria City,4480 King St,,Alexandria,VA,22302-1300,Alexandria City,Deborah Bowers,Nurse Manager,703-746-4921,,deborah.bowers@vdh.virginia.gov,Regina Lopez-Wurth,Nurse Supervisor,703-746-4955,,regina.lopez-wurth@vdh.virginia.gov,http://www.alexandriava.gov/health
VA-010975,King Street Dental,NEIGHBORHOOD HEALTH,1093136947,Dental Providers,4480 King St,,Alexandria,VA,22302-1300,Alexandria City,6677 Richmond Highway,,Alexandria,VA,22306,Fairfax,Dr. Khan,ED,703-535-5568,,bkhan@neighborhoodhealthva.org,,,,,,
VA-010976,8119 Holland Road,NEIGHBORHOOD HEALTH,1669801403,Federally Qualified Health Centers - Medical Services,8119 Holland Rd,,Alexandria,VA,22306-3135,Fairfax,6677 Richmond Highway,,Alexandria,VA,22306,Fairfax,Dr. Khan,ED,703-535-5568,,bkhan@neighborhoodhealthva.org,,,,,,
VA-010977,Inova Health Care Services (Mount Vernon),Inova Juniper Program,1568488336,Ryan White Providers,8350 Richmond Hwy,,Alexandria,VA,22309-2300,Fairfax,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,http://www.inova.org/juniper
VA-010978,Amelia Co Health Dept,Virginia Department of Health,1821194549,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",16320 Church St,,Amelia Courthouse,VA,23002-4817,Amelia,Piedmont Health District,"111 South Street, 1st Floor",Farmville,VA,23901,Prince Edward,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Direcotr,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-010979,Amherst Co Health Dept,Virginia Department of Health,1881643815,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",224 2nd St,,Amherst,VA,24521-2712,Amherst,"109 Governor Street, 13th Floor",,Richmond,VA,23219-3623,Richmond City,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patty S. Simpson,Administrative Office Services Supr. III,434-477-5955,,patty.simpson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/CentralVirginia/index.htm
VA-010980,Appalachia Family Health Center,Stone Mountain Health Services,1194845552,Federally Qualified Health Centers - Medical Services,507 W Main St,,Appalachia,VA,24216-1723,Wise,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-010981,Appomattox Co Health Dept,Virginia Department of Health,1710936729,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",475 Court St,,Appomattox,VA,24522-9876,Appomattox,"109 Governor Street, 13th Floor",,Richmond,VA,23219-3623,Richmond City,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patty S. Simpson,Administrative Office Services Supr. III,434-477-5955,,patty.simpson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/CentralVirginia/index.htm
VA-010982,Arlington County Public Health,Arlington County Public Health,1871611574,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2100 Washington Blvd,,Arlington,VA,22204-5717,Arlington,2100 Washington Blvd,2nd floor,Arlington,VA,22204,Arlington,Ifiok Ibanga,Administrative Officer,703-228-5583,,iibanga@arlingtonva.us,Ginny Mittereder,Nursing Supervisor,703-228-1212,,gmitte@arlingtonva.us,
VA-010983,Neighborhood Health at Arlington CSB,NEIGHBORHOOD HEALTH,1790001741,Federally Qualified Health Centers - Medical Services,2120 Washington Blvd,,Arlington,VA,22204-5718,Arlington,6677 Richmond Highway,,Alexandria,VA,22306,Fairfax City,Basim Khan,ED,703-535-5568,,bkhan@neighborhoodhealthva.org,,,,,,http://neighborhoodhealthva.org/
VA-010984,BLUE RIDGE MEDICAL CENTER INC,BLUE RIDGE MEDICAL CENTER INC,1518945187,"Dental Providers, Federally Qualified Health Centers - Medical Services",4038 Thomas Nelson Hwy,,Arrington,VA,22922-2302,Nelson,4038 Thomas Nelson Hwy,,Arrington,VA,22922-2302,Nelson,MARGARET J. WHITEHEAD,Executive Director,434-263-4000,,pwhitehead@brmedical.com,Gwen Fitzgerald,Enrollment/Eligibility Program Manager,434-263-4000,1328,Gwen@brmedical.com,www.brmedical.org
VA-010985,Thomas Jefferson Health District Nelson County Health Department,Virginia Department of Health,1679580922,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4038 Thomas Nelson Hwy,,Arrington,VA,22922-2302,Nelson,PO Box 7546,,Charlotteville,VA,22906,Albemarle,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,434-972-6209,,lisa.park@vdh.virginia.gov,Marilyn Pace,Clinic Director,434-263-8315,,marilyn.pace@vdh.virginia.gov,
VA-010986,Hanover Health Dept,Virginia Department of Health,1235187089,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",12312 Washington Hwy,,Ashland,VA,23005-7646,Hanover,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Jim Davidson,,804-365-4349,,jim.davidson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Chickahominy/
VA-010987,KING WILLIAM-DAWN COMMUNITY DOCTORS,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1972631661,Federally Qualified Health Centers - Medical Services,11814 King William Rd,,Aylett,VA,23009-4103,King William,25892 N James Madison Hwy,,New Canton,VA,23123,Virginia Beach City,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-010988,Bassett Family Practice,MHC Coalition for Health & Wellness,1063608081,Federally Qualified Health Centers - Medical Services,324 T B Stanley Hwy,Suites B & C,Bassett,VA,24055-6108,Henry,22 E Church Street,,Martinsville,VA,24112,Martinsville City,Beverly Rakes,Administrative Coordinator,276-403-5090,,brakes@healthycommunitymhc.org,Amanda Brannock,Health Centers Director of Operations,276-629-1076,324,mbrannock@healthycommunitymhc.org,www.healthycommunitymhc.org
VA-010989,Bland County Medical Clinic,Bland County Medical Clinic,1104800671,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",12301 Grapefield Rd,,Bastian,VA,24314-4547,Bland,12301 Grapefield Road,,Bastian,VA,24314,Bland,Susan Greever,Executive Director,276-688-4331,2766880445,sgreever@blandclinic.net,David Holbrook,CFO,276-688-4331,2766880443,dholbrook@blandclinic.net,BlandClinic.com
VA-010990,Bedford Community Health Center,JOHNSON HEALTH CENTER,1609203538,Federally Qualified Health Centers - Medical Services,582 Blue Ridge Ave,,Bedford,VA,24523-2604,Bedford,320 Federal St,,Lynchburg,VA,24504-2306,Bedford,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-010991,Bedford Co Health Dept,Virginia Department of Health,1427018977,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",600 Bedford Ave,,Bedford,VA,24523-1966,Bedford,"109 Governor Street, 13th Floor",,Richmond,VA,23219-3623,Richmond City,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patty S. Simpson,Administrative Office Services Supr. III,434-477-5955,,patty.simpson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/CentralVirginia/index.htm
VA-010992,Bedford Community Dental Center,JOHNSON HEALTH CENTER,1609203652,Dental Providers,603 Mountain Ave,,Bedford,VA,24523-1944,Bedford,320 Federal Street,,Lynchburg,VA,24504,Lynchburg City,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-010993,Bland Co Health Dept,Virginia Department of Health,1447285622,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",209 Jackson St,,Bland,VA,24315,Bland,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,HealthCare Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-010994,Caroline Family Practice,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1952535916,"Dental Providers, Federally Qualified Health Centers - Medical Services",102 W Broaddus Ave,,Bowling Green,VA,22427-9404,Caroline,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-010995,Health Centers of the Piedmont Boydton,"Piedmont Access To Health Services, Inc",1972861151,"Dental Providers, Federally Qualified Health Centers - Medical Services",380 Washington St,,Boydton,VA,23917-3415,Mecklenburg,705 Main St,,Danville,VA,24541,Danville City,Wendy Mitchell,Billing Manager,434-791-4793,1030,wmitchell@pathsinc.org,Kay Crane,CEO,434-791-3630,1012,cranek@pathsinc.org,
VA-010996,Mecklenburg Co Health Dept,Virginia Department of Health,1710938576,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",969 Madison St,,Boydton,VA,23917-3418,Mecklenburg,109 Governor Street,,Richmond,VA,23219,Richmond,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Wayne Peters,Business Manager C,434-766-9828,,wayne.peters@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Southside/
VA-010997,Washington Co Health Dept,Virginia Department of Health,1053355859,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",15068 Lee Hwy,Suite 1000,Bristol,VA,24202-4264,Washington,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-010998,Bristol City Health Dept,Virginia Department of Health,1033153747,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",205 Piedmont Ave,,Bristol,VA,24201-4167,Bristol City,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,HealthCare Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manage,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-010999,Twin City Medical Center,"SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INCORPORATED",1225169295,Federally Qualified Health Centers - Medical Services,2195 Euclid Ave,Suite 6,Bristol,VA,24201-3655,Bristol City,319 5th Ave,,Saltville,VA,24370-3418,Smyth,Bryan Haynes,CEO,276-496-4492,1004,bhaynes@svchs.com,,,,,,
VA-011000,Buckingham Co Health Dept,Virginia Department of Health,1740386457,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",80 Administration Dr,,Buckingham,VA,23921-3422,Buckingham,Piedmont Health District,"111 South Street, 1st Fl",Farmville,VA,23901,Prince Edward,Lisa Park,Office Of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-011001,Buena Vista Health Dept,Virginia Department of Health,1831109032,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2270 Magnolia Ave,,Buena Vista,VA,24416-3122,Buena Vista City,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011002,CHARLES CITY REGIONAL HEALTH SERVICES,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1518095280,"Dental Providers, Federally Qualified Health Centers - Medical Services",10039 Courthouse Rd,,Charles City,VA,23030-3440,Charles City,25892 N James Madison Hwy,,New Canton,VA,23123,Virginia Beach City,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011003,Charles City Co Health Dept,Virginia Department of Health,1306948112,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7501 Adkins Rd,,Charles City,VA,23030-3020,Charles City,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Charles City County Health Department,,804-365-4349,,jim.davidson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Chickahominy/
VA-011004,CHARLOTTE PRIMARY CARE,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1891823498,"Dental Providers, Federally Qualified Health Centers - Medical Services",165 Legrande Ave,,Charlotte Court House,VA,23923-3747,Charlotte,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011005,Charlotte C Health Dept,Virginia Department of Health,1942306659,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",270 David Bruce Ave,,Charlotte Court House,VA,23923-3740,Charlotte,Piedmont Health District,"111 South Street, 1st Fl",Farmville,VA,23901,Prince Edward,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-011006,UVA Infectious Diseases Clinic,Rector and Visitors of the University of Virginia,1194860445,"Outpatient Hospital Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Hospital Dr,,Charlottesville,VA,22908-0001,Charlottesville City,P.O. Box 800545,,Charlottesville,VA,22908-0545,Charlottesville City,Katherine Hoffman,"Grants & Contracts Administrator, ID Clinic",434-982-4478,,kh8x@virginia.edu,Pamela Bickley,Administrative Assistant ID Clinic,434-982-1688,,pab2u@virginia.edu,https://uvahealth.com/services/infectious-diseases/ryan-white-hiv-program
VA-011007,Charlottesville/Albemarle Health Department,Virginia Department of Health,1710993530,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1138 Rose Hill Dr,,Charlottesville,VA,22903-5128,Albemarle,PO BOX 7546,,Charlottesville,VA,22906,Charlottesville City,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Marilyn Pace,Clinic Director,434-972-6219,,marilyn.pace@vdh.virginia.gov,
VA-011008,UVa Battle Building Children's Hospital,UVA Health System,1780630608,Children's Hospitals (inpatient only),1204 W Main St,,Charlottesville,VA,22903-2824,Charlottesville City,1215 Lee Street,,Charlottesville,VA,22908,Albemarle,Brian Don Wilmoth,Strategic Planning and Reimbursement Officer,434-243-9802,,bdw3x@virginia.edu,Michael Ellwood,Quality Analyst,434-924-9088,,mre2u@virginai.edu,
VA-011009,University of Virginia Pediatric Hemophilia Treatment Center,University of Virginia Pediatric Hematology,1962824037,Hemophilia Treatment Centers,1204 W Main St Rm 5121,Battle Building,Charlottesville,VA,22903-2824,Charlottesville City,Box 800386,"Peds Hematology, UVA Hospital",Charlottesville,VA,22908,Albemarle,Margaret Sennett,CPNP,434-924-8499,,mms9d@virginia.edu,,,,,,
VA-011010,UVA Hemophilia Treatment Center,Rector and Visitors of the University of Virginia,1962824037,Hemophilia Treatment Centers,1215 Lee St,,Charlottesville,VA,22908-0816,Charlottesville City,PO Box 800386,,Charlottesville,VA,22908,Albemarle,Colleen Druzgal,"Assistant Professor, Division of Pediatric Hematology/Oncology",434-924-8499,,CHD7B@hscmail.mcc.virginia.edu,Margaret Sennett,Pediatric Nurse Practitioner,434-924-8499,,mms9d@virginia.edu,
VA-011011,Planned Parenthood Charlottesville Health Center,Planned Parenthood South Atlantic,1497017909,Family Planning Providers,2964 Hydraulic Rd,,Charlottesville,VA,22901-8902,Albemarle,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/virginia/charlottesville/22901/charlottesville-health-center-2815-90860
VA-011012,Pittsylvania Co Health Dept,Virginia Department of Health,1588647135,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 H G McGhee Dr,,Chatham,VA,24531-1120,Pittsylvania,PO Box 1159,,Chatham,VA,24531-1159,Pittsylvania,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Lindy Stewart,,434-433-3523,,lindy.stewart@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/pittsylvania/
VA-011013,Health Centers of the Piedmont Chatham,"Piedmont Access To Health Services, Inc",1558545269,Federally Qualified Health Centers - Medical Services,4 S Main St,,Chatham,VA,24531-5436,Pittsylvania,705 Main St,,Danville,VA,24541,Danville City,Wendy Mitchell,Billing Manager,434-791-4793,1030,wmitchell@pathsinc.org,Kay Crane,CEO,434-791-3630,1012,cranek@pathsinc.org,
VA-011014,BAYVIEW COMMUNITY HEALTH CENTER,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1396876975,Federally Qualified Health Centers - Medical Services,22214 S Bayside Rd,,Cheriton,VA,23316,Northampton,20280 Market St,,Onancock,VA,23417-1331,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011015,Chesapeake Health Dept,Virginia Department of Health,1982665188,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",748 Battlefield Blvd N,,Chesapeake,VA,23320-4941,Chesapeake City,109 Governor Street,,Richmond,VA,23219,Richmond City,Marian Vollmer,Clinic Director; Senior Nurse Manager,757-382-8640,8640,marian.vollmer@vdh.virginia.gov,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,Lisa.park@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Chesapeake/index.htm
VA-011016,CHESTERFIELD COUNTY HEALTH DEPARTMENT,Virginia Department of Health,1477572626,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9501 Lucy Corr Cir,,Chesterfield,VA,23832-6697,Chesterfield,109 Governor Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Jeannine Uzel,Nurse Manager,804-748-1706,,jeannine.uzel@vdh.virginia.gov,http://www.vdh.virginia.gov/
VA-011017,CHINCOTEAGUE ISLAND COMM HLTH CTR,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1598895542,Federally Qualified Health Centers - Medical Services,4049 Main St,,Chincoteague Island,VA,23336-2406,Accomack,20280 Market St,,Onancock,VA,23417-1331,Accomack,Nancy J. Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011018,Montgomery Co Health Dept,VDH New River Health District,1306950753,"Family Planning Providers, Sexually Transmitted Disease Clinics",210 Pepper St S,Suite A,Christiansburg,VA,24073-3572,Montgomery,"210 South Pepper Street, Suite A",,Christiansburg,VA,24073-3572,Montgomery,Margaret O'Dell,Health Director,540-585-3304,,molly.odell@vdh.virginia.gov,Ruth B.Wolford,,540-585-3355,,ruth.wolford@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/newriver/INDEX.HTM
VA-011019,Community Health Center of the New River Valley,Free Clinic of the New River Valley,1043648611,"Dental Providers, Federally Qualified Health Centers - Medical Services",215 Roanoke St,,Christiansburg,VA,24073-3025,Montgomery,215 Roanoke St.,,Christiansburg,VA,24073,Montgomery,Lynda Underwood,Clinical Manager,540-381-0820,812,clinicalmanager@chcnrv.org,,,,,,
VA-011020,CARILION NEW RIVER VALLEY MEDICAL CENTER,CARILION NEW RIVER VALLEY MEDICAL CENTER,1376536573,Inpatient Hospitals (other than children's hospitals),2900 Lamb Cir,,Christiansburg,VA,24073-6344,Montgomery,2900 LAMB CIRCLE,,Christiansburg,VA,24073-6374,Montgomery,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011021,Alleghany Health District Clifton Forge Health Department,Virginia Department of Health,1417908708,"Family Planning Providers, Sexually Transmitted Disease Clinics",322 Jefferson Ave,,Clifton Forge,VA,24422-1749,Alleghany,PO Box 747,,Covington,VA,24426-0747,Alleghany,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,Lisa.Park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,Suzanne.Renegar@vdh.virginia.gov,
VA-011022,Dickenson Co Health Dept,Virginia Department of Health,1083675474,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",334 Brush Creek Rd,PO Box 768,Clintwood,VA,24228-7184,Dickenson,224 Clydesway Drive,P.O. Box 2347,Lebanon,VA,24226,Russell,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Anna Stevens,Business Manger,276-415-3360,,anna.stevens@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/cumbplat/
VA-011023,Colonial Heights City Health Dept,Virginia Department of Health,1871513630,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",200 Highland Ave,,Colonial Heights,VA,23834-3142,Colonial Heights City,109 Governor Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Jeannine Uzel,Nurse Manager,804-748-1706,,jeannine.uzel@vdh.virginia.gov,http://www.vdh.virginia.gov/
VA-011024,Southampton Co Health Dept,Virginia Department of Health,1053386979,"Family Planning Providers, Sexually Transmitted Disease Clinics",26022 Administration Center Dr,,Courtland,VA,23837,Southampton,Southampton County Health Department,26022 Administration Center Dr,Courtland,VA,23837,Southampton,Cynthia Hunting,Clinic Director,757-653-3040,,cynthia.hunting@vdh.virginia.gov,Lisa Park,,804-864-7955,,,http://www.vdh.virginia.gov/LHD/WestTide/
VA-011025,Alleghany/Covington Health Department,Virginia Department of Health,1417908708,"Family Planning Providers, Sexually Transmitted Disease Clinics",321 E Beech St,,Covington,VA,24426-2013,Covington City,321 E Beech St,,Covington,VA,24426-2013,Covington City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,Suzanne.Renegar@vdh.virginia.gov,
VA-011026,Culpeper Co Health Dept,Virginia Department of Health,1821188848,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",640 Laurel St,,Culpeper,VA,22701-3910,Culpeper,640 Laurel St,,Culpeper,VA,22727-3910,Culpeper,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,"Charles J. Devine, III, M.D.",Medical Director,540-829-7350,,,http://www.vdh.virginia.gov/LHD/RappahannockRapidan/index.htm
VA-011027,Cumberland Co Health Dept,Virginia Department of Health,1053417766,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",15 Foster Rd,,Cumberland,VA,23040-2645,Cumberland,Piedmont Health District,"111 South Street, 1st Fl",Farmville,VA,23901,Prince Edward,Lisa Park,Office Of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-011028,Konnarock Family Health Center,Stone Mountain Health Services,1225150824,Federally Qualified Health Centers - Medical Services,20471 Azen Rd,,Damascus,VA,24236-4141,Washington,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011029,Holston Family Health Center,Stone Mountain Health Services,1679695316,Federally Qualified Health Centers - Medical Services,306 South Shady Ave,PO Box 456,Damascus,VA,24236-0456,Washington,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011030,Danville Regional Medical Center,LifePoint Health,1154419737,Inpatient Hospitals (other than children's hospitals),142 S Main St,,Danville,VA,24541-2922,Danville City,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Cindy Rios,CFO,434-799-3703,,,
VA-011031,Danville City Health Dept,Virginia Department of Health,1548243603,"Family Planning Providers, Sexually Transmitted Disease Clinics",326 Taylor Dr,,Danville,VA,24541-4188,Danville City,326 Taylor Drive,,Danville,VA,24541,Pittsylvania,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Lindy Stewart,,434-433-3523,,lindy.stewart@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/pittsylvania/
VA-011032,Health Centers of the Piedmont Danville,"Piedmont Access To Health Services, Inc",1578696910,"Dental Providers, Federally Qualified Health Centers - Medical Services",705 Main St,,Danville,VA,24541-1803,Danville City,705 Main St,,Danville,VA,24541,Danville City,Wendy Mitchell,Billing Manager,434-791-4793,1030,wmitchell@pathsinc.org,Kay Crane,CEO,434-791-3630,1012,cranek@pathsinc.org,
VA-011033,Davenport Clinic,Stone Mountain Health Services,1992827604,Federally Qualified Health Centers - Medical Services,3837 Helen Henderson Hwy,PO Box 309,Davenport,VA,24239-0309,Buchanan,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011034,Surry Medical Center,HORIZON HEALTH SERVICES INC,1518137389,Federally Qualified Health Centers - Medical Services,440 Colonial Trl W,,Dendron,VA,23839-2205,Surry,PO BOX 210,,IVOR,VA,23866,Southampton,Cheryl Ebersole,CEO,757-859-5015,,CEBERSOLE@HHSINC.NET,Becky Felts,Director of Finance,757-859-5015,,bfelts@hhsinc.net,
VA-011035,Surry Health Department,VDH-Crater Health District,1518996768,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",474 Colonial Trl W,Surry County Health Department,Dendron,VA,23839-2205,Surry,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Administrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,"OSS Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011036,Dinwiddie Health Department,Crater Health District,1457396335,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12318 Boydton Plank Rd,PO Box 185,Dinwiddie,VA,23841-2454,Dinwiddie,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Adminstrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,"Office Service Specialist Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011037,REGIONAL HEALTH RESOURCES INC,"REGIONAL HEALTH RESOURCES, INC",1841415619,Rural Health Clinics,373 Cecil D Quillen Dr,Suite 101,Duffield,VA,24244-4085,Scott,373 CECIL D. QUILLEN DR. SUITE 101,,DUFFIELD,VA,24244,Scott,Sherrie Williams,Compliance Officer,276-431-1638,,rhrrhc@gmail.com,,,,,,
VA-011038,Inova Health Care Services (Dumfries),Inova Juniper Program,1568488336,Ryan White Providers,18003 Fraley Blvd,Dumfries Plaza,Dumfries,VA,22026-2407,Prince William,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,http://www.inova.org/juniper
VA-011039,"Clinch River Health Services, Inc.","CLINCH RIVER HEALTH SERVICES, INCORPORATED",1558653741,Federally Qualified Health Centers - Medical Services,17285 Veterans Memorial Hwy,,Dungannon,VA,24245-3937,Scott,17633 Veterans Memorial Hwy,,Dungannon,VA,24245-3929,Scott,Carolyn Bowen,Executive Director,276-467-2201,,cbowen@crhealth.org,Mechelle Salyers,Front Office Manager,276-467-2201,,msalyers@crhealth.org,www.crhealth.org
VA-011040,Greensville/Emporia Health Department,VDH-Crater Health District,1659313179,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",140 Uriah Branch Way,,Emporia,VA,23847-6315,Greensville,Crater Health District,301 Halifax Street,Peterburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Administrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,"OSS Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011041,SOUTHERN ALBEMARLE FAMILY PRACTICE,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1588792162,Federally Qualified Health Centers - Medical Services,2256 Irish Rd,,Esmont,VA,22937-1945,Albemarle,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011042,Western Lee Health Clinic,Stone Mountain Health Services,1023237724,Federally Qualified Health Centers - Medical Services,1446 Dr Thomas Walker Rd,PO Box 159,Ewing,VA,24248-8307,Lee,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011043,Inova Health Care Services (Fairfax),Inova Juniper Program,1568488336,Ryan White Providers,2740 Prosperity Ave,Suite 200,Fairfax,VA,22031-4354,Fairfax,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,http://www.inova.org/juniper
VA-011044,Inova Juniper Program (Falls Church),Inova Juniper Program,1568488336,Ryan White Providers,500 N Washington St,Suite 200,Falls Church,VA,22046-3514,Falls Church City,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,https://www.inova.org/locations/inova-juniper-program-falls-church-office
VA-011045,INOVA FAIRFAX HOSPITAL (children's inpatient hospital),Inova Health System,1427227578,Children's Hospitals (inpatient only),8110 Gatehouse Rd 400 W,,Falls Church,VA,22042,Fairfax,8110 Gatehouse Road,,Falls Church,VA,22042,Fairfax,Mary Ellen DeCaprio,"Director, Payor Relations and Contracting",703-204-6342,,maryellen.decaprio@inova.org,"Pitter, Nicola","Vp Mgd Care And Credentialing, Managed Care Contracting",703-289-2018,,Nicola.Pitter@inova.org,
VA-011046,INOVA FAIRFAX HOSPITAL (multiple outpatient ECP categories),Inova Health System,1427227578,"Family Planning Providers, Freestanding Cancer Centers",8110 Gatehouse Rd 400 W,,Falls Church,VA,22042,Fairfax,8110 Gatehouse Road,,Falls Church,VA,22042,Fairfax,Mary Ellen DeCaprio,"Director, Payor Relations and Contracting",703-204-6342,,maryellen.decaprio@inova.org,"Pitter, Nicola","Vp Mgd Care And Credentialing, Managed Care Contracting",703-289-2018,,Nicola.Pitter@inova.org,
VA-011047,Prince Edward Co Health Dept,Piedmont Health District,1912003617,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",111 N South St,Suite A,Farmville,VA,23901-1354,Prince Edward,"111 South Street, 1st Fl",,Farmville,VA,23901,Prince Edward,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-011048,HEALTH CENTER FOR WOMEN & FAMILIES,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1215066782,Federally Qualified Health Centers - Medical Services,833 Buffalo St,Suite 200,Farmville,VA,23901-1111,Prince Edward,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011049,Tri-Area Community Health Center at Ferrum,TRI-AREA COMMUNITY HEALTH,1053442848,Federally Qualified Health Centers - Medical Services,40 Wiley Dr,,Ferrum,VA,24088,Franklin,14558 Danville Pike,,Laurel Fork,VA,24352-3982,Carroll,DEBRA SHELOR,Executive Director,276-398-2292,2213,dshelor@triarea.org,,,,,,
VA-011050,Botetourt County Health Department,Virginia Department of Health,1104879568,"Family Planning Providers, Sexually Transmitted Disease Clinics",21 Academy St,,Fincastle,VA,24090-3316,Botetourt,21 Academy St,,Fincastle,VA,24090,Botetourt,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,suzanne.renegar@vdh.virginia.gov,
VA-011051,Floyd Co Health Dept,VDH New River Health District,1164536652,"Family Planning Providers, Sexually Transmitted Disease Clinics",123 Parkview Rd NE,,Floyd,VA,24091-3809,Floyd,123 Parkview Road NE,,Floyd,VA,24091-3809,Floyd,Margaret O'Dell,Health Director,540-585-3304,,molly.odell@vdh.virginia.gov,Ruth B. Wolford,Nurse Manager,540-585-3355,,ruth.wolford@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/newriver//INDEX:
VA-011052,Tri-Area Community Health Center at Floyd,TRI-AREA COMMUNITY HEALTH,1194908491,Federally Qualified Health Centers - Medical Services,140 Christiansburg Pike NE,,Floyd,VA,24091-3742,Floyd,14558 Danville Pike,,Laurel Fork,VA,24352-3982,Carroll,Nancy Puckett,Executive Director,276-398-1200,2217,npuckett@triarea.org,,,,,,
VA-011053,Agape Business Center,"AFI Outpatient Mental Health Services, Inc.",1407212079,Community Mental Health Centers,106 W 5th Ave,,Franklin,VA,23851-1402,Franklin City,3217 Commander Shepard Blvd.,,Hampton,VA,23666,Hampton City,Dee Robinson,Operations Director,757-244-3500,,drobinson@agapecounselingva.com,Sherie Mawusi,Owner,757-315-8039,,sheriemawusi@yahoo.com,
VA-011054,Franklin City Health Dept,Virginia Department of Health,1720053648,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 Fairview Dr,,Franklin,VA,23851-1216,Franklin City,200 Fairview Dr,,Franklin,VA,23851,Franklin City,Cynthia Hunting,Clinic Director,757-562-6109,,cynthia.hunting@vdh.virginia.gov,Lisa Park,,804-864-7955,,lisa.park@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/WestTide/
VA-011055,FRANKTOWN COMMUNITY HEALTH CTR,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1194856765,"Dental Providers, Federally Qualified Health Centers - Medical Services",9159 Franktown Rd,,Franktown,VA,23354,Northampton,20280 Market St,,Onancock,VA,23417-1331,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011056,Community Health Center of the Rappahannock Region,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1730377706,"Dental Providers, Federally Qualified Health Centers - Medical Services",1965 Jefferson Davis Hwy,Suite 100,Fredericksburg,VA,22401-6213,Fredericksburg City,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-012470,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,301 Park Hill Dr,Suite C,Fredericksburg,VA,22401-3375,Fredericksburg City,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
VA-011057,Fredericksburg City Health Dept,Virginia Department of Health,1336170745,"Family Planning Providers, Sexually Transmitted Disease Clinics",608 Jackson St,,Fredericksburg,VA,22401-5719,Fredericksburg City,109 Govermors Street,,Richmond,VA,23218,Richmond City,Lisa Park,Community Health Services,804-864-7018,,Lisa.Park@vdh.virginia.gov,Sidnee M. Dallas,District Nurse Manager,540-322-5934,,,http://www.vdh.virginia.gov/LHD/rappahan/index.htm
VA-011058,Mount Rogers Health District Galax City Health Department,Virginia Department of Health,1235173949,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",703 S Main St,,Galax,VA,24333-4315,Galax City,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,Healthcare Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-011059,Scott Co Health Dept,Virginia Department of Health,1871602730,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",190 Beech St,Suite 102,Gate City,VA,24251-3600,Scott,109 Governor St,,Richmond,VA,23219,Richmond City,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Michelle McPheron,Nurse Manager,276-328-1926,,michelle.mcpheron@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/lenowisco/index.htm
VA-011060,Gloucester County Health Dept,Virginia Department of Health,1992767131,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6882 Main St,,Gloucester,VA,23061-5163,Gloucester,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,http://www.vdh.virginia.gov
VA-011061,Goochland Co Health Dept,Virginia Department of Health,1831292325,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1800 Sandy Hook Rd,Suite 100,Goochland,VA,23063-3105,Goochland,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Jim Davidson,,804-365-4349,,jim.davidson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Chickahominy/
VA-011062,FAMILY HEALTH CARE CENTER - GRETNA,Danville Physician Practices,1508077603,Rural Health Clinics,305 N Main St,,Gretna,VA,24557-4176,Pittsylvania,"Danville Physician Practices, LLC",142 South Main Street,Danville,VA,24541,Danville City,DEBRA SHELTON,Billing Manager,434-799-4585,,DEBRA.SHELTON@LPNT.NET,ANNA FARRAR,Executive Assistant,434-799-4444,,ANNA.FARRAR@LPNT.NET,
VA-011063,Buchanan Co Health Dept,Virginia Department of Health,1811958200,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1051 Rosebud Rd,PO Box 618,Grundy,VA,24614-7190,Buchanan,224 Clydesway Drive,P.O. Box 2347,Lebanon,VA,24226,Russell,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Anna Stevens,Business Manager,276-415-3360,,anna.stevens@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/cumbplat/
VA-011064,Halifax Co Health Dept,Virginia Department of Health,1629029483,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1030 Cowford Rd,,Halifax,VA,24558-3100,Halifax,109 Governor Street,,Richmond,VA,23219,Richmond,Office of Community Health Services; Lisa Park,Health Care Reimbursment Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Wayne Peters,Business Manager C,434-766-9828,,wayne.peters@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Southside/
VA-011065,Hampton Health Center,Virginia League for Planned Parenthood,1639347990,"Family Planning Providers, Sexually Transmitted Disease Clinics",403 Yale Dr,,Hampton,VA,23666-3721,Hampton City,201 N Hamilton St,,Richmond,VA,23221-2601,Richmond City,Paulette McElwain,CEO,804-483-6136,,paulettemcelwain@vlpp.org,,,,,,www.vlpp.org
VA-011066,Rockingham/Harrisonburg Health Dept,Virginia Department of Health,1023028909,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",110 N Mason St,,Harrisonburg,VA,22802-4109,Harrisonburg City,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011067,Harrisonburg Community Health Center,"HARRISONBURG COMMUNITY HEALTH CENTER, INC.",1871775882,"Dental Providers, Federally Qualified Health Centers - Medical Services",1380 Little Sorrell Dr,Suite 100,Harrisonburg,VA,22801-7372,Harrisonburg City,1380 Little Sorrell Dr Ste 100,,Harrisonburg,VA,22801-7372,Rockingham,Wayne E. Woodson,Interim Executive Director,540-236-3683,,wwoodson@hburgchc.org,,,,,,www.hburgchc.org
VA-011068,Virginia Mennonite Retirement Community,Harrisonburg Community Health Center,1477839413,Federally Qualified Health Centers - Medical Services,1475 Virginia Ave,,Harrisonburg,VA,22802-2433,Harrisonburg City,1380 Little Sorrell Drive #100,,Harrisonburg,VA,22801-7372,Rockingham,Wayne E. Woodson,Interim Executive Director,540-236-3683,,wwoodson@hburgchc.org,Jolene Paige,Accountant,540-236-3684,,jpaige@hburgchc.org,www.hburgchc.org
VA-011069,Haysi Clinic,Stone Mountain Health Services,1952423667,"Dental Providers, Federally Qualified Health Centers - Medical Services",162 Medical Center Blvd,PO Box 653,Haysi,VA,24256-0653,Dickenson,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011070,Northumberland County Health Dept,Virginia Department of Health,1639132137,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",6373 Northumberland Hwy,Suite B,Heathsville,VA,22473-3230,Northumberland,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,http://www.vdh.virginia.gov
VA-011071,Henrico Health District Henrico Health Department - East,Virginia Department of Health,1508951567,"Family Planning Providers, Sexually Transmitted Disease Clinics",1400 N Laburnum Ave,,Henrico,VA,23223-1521,Henrico,109 Governor Street,,Richmond,VA,23219-3635,Richmond City,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,,,,,,
VA-011072,Henrico Health District Henrico Health Department - West,Virginia Department of Health,1447341417,Tuberculosis Clinics,8600 Dixon Powers Dr,,Henrico,VA,23228-2735,Henrico,109 Governor Street,,Richmond,VA,23219-3635,Richmond City,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,,,,,,
VA-011073,HealthWorks for Northern Virginia,Loudoun Community Health Center,1629325758,Federally Qualified Health Centers - Medical Services,1141 Elden St,Suite 300,Herndon,VA,20170-5572,Fairfax,163 Fort Evans Road NE,,Leesburg,VA,20176,Loudoun,Carol Jameson,CEO,703-443-2000,4704,cjameson@hwnova.org,Robine Hardey,CFO,703-443-2000,4707,rhardey@hwnova.org,www.hwnova.org
VA-011074,Inova Health Care Services (Herndon),Inova Juniper Program,1568488336,Ryan White Providers,1175 Herndon Pkwy,Suite 850,Herndon,VA,20170-5543,Fairfax,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,http://www.inova.org/juniper
VA-011075,Carroll Co Health Dept,Virginia Department of Health,1528002235,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",605 Pine St,Suite 15,Hillsville,VA,24343-1453,Carroll,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services;Lisa Park,HealthCare Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-011076,Hopewell Health Department,VDH - Crater Health District,1013946763,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1501 W City Point Rd,,Hopewell,VA,23860-3712,Hopewell City,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Adminstrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,"OSS Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011077,Bath Community Physician Group,Bath Community Physician Group,1851505440,Rural Health Clinics,106 Park Dr,,Hot Springs,VA,24445-2921,Bath,106 park dr,,Hot springs,VA,24445,Bath,June Durnan,Revenue Cycle Director,540-839-7137,,june.durnan@bcchospital.org,greg gutmeir,cfo,540-839-7138,,greg.gutmeir@bcchospital.org,
VA-011078,Bath Community Hospital,Bath Community Hospital,1417989278,Inpatient Hospitals (other than children's hospitals),86 Park Lane,,Hot Springs,VA,24445,Bath,P. O. Drawer Z,,Hot springs,VA,24445,Bath,June Durnan,Revenue Cycle,540-839-7000,7137,june.durnan@bcchospital.org,greg gutmeir,CFO,540-939-7000,7138,greg.gutmeir@bcchospital.org,
VA-011101,Huddleston Health And Wellness,"Sapient Health Services, PLLC",1962940189,Other ECP Providers,9617 Leesville Rd,,Huddleston,VA,24104-3740,Bedford,21430 Timberlake Rd,PMB 318,Lynchburg,VA,24502,Campbell,"Phyllis C Everett, NP-C",Owner,540-297-6026,,peverett@sapienthealth.net,Ruth Inman,Practice Manager,540-297-6026,,office@sapienthealth.net,www.huddlestonhealth.com
VA-011079,Hurley Family Health Center,Stone Mountain Health Services,1801060595,Federally Qualified Health Centers - Medical Services,10279 Hurley Road,PO Box 449,Hurley,VA,24620-0449,Buchanan,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011080,Grayson Co Health Dept,Virginia Department of Health,1619911427,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",186 W Main St,,Independence,VA,24348-4365,Grayson,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-011081,IVOR MEDICAL CENTER,HORIZON HEALTH SERVICES INC,1437378031,Federally Qualified Health Centers - Medical Services,8575 Ivor Rd,,Ivor,VA,23866-3108,Southampton,344 W Main St,,Waverly,VA,23890-3235,Sussex,Cheryl Ebersole,CEO,757-859-6161,,cebersole@hhsinc.net,Becky Felts,Director of Finance,757-859-9070,,bfelts@hhsinc.net,
VA-011082,Lee Co Health Dept,Virginia Department of Health,1699887539,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",134 Hill St,,Jonesville,VA,24263-7965,Lee,109 Governor St,,Richmond,VA,23219,Richmond City,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Michelle McPheron,Nurse Manager,276-328-1926,,michelle.mcpheron@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/lenowisco/index.htm
VA-011083,Jonesville Family Health Center,Stone Mountain Health Services,1295857993,Federally Qualified Health Centers - Medical Services,276 Fieldstone Dr,,Jonesville,VA,24263-1215,Lee,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011084,King & Queen County Health Dept,Virginia Department of Health,1093777260,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",167 Court House Landing Rd,,King and Queen Courthouse,VA,23085-2108,King and Queen,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler@vdh.virginia.gov,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,http://www.vdh.virginia.gov
VA-011085,Rappahannock Health District King George County Health Department,Virginia Department of Health,1184668477,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",8097 Kings Hwy,,King George,VA,22485-7069,King George,PO Box 92,,King George,VA,22485-0092,King George,Lisa Park,Community Health Services,804-864-7018,,Sidnee.Dallas@vdh.virginia.gov,Sidnee M. Dallas,District Nurse Manager,,,,http://www.vdh.virginia.gov/LHD/rappahan/index.htm
VA-011086,King William County Health Department,Virginia Department of Health,1528029675,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",172 Courthouse Ln,,King William,VA,23086-2702,King William,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services; Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,http://www.vdh.virginia.gov
VA-011087,Lancaster County Health Dept,Virginia Department of Health,1508829128,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9049 Mary Ball Rd,,Lancaster,VA,22503-2210,Lancaster,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,
VA-011088,Tri-Area Community Health Center at Laurel Fork,TRI-AREA COMMUNITY HEALTH,1346227584,Federally Qualified Health Centers - Medical Services,14558 Danville Pike,,Laurel Fork,VA,24352-3982,Carroll,14558 Danville Pike,,Laurel Fork,VA,24352-3982,Carroll,DEBRA SHELOR,Executive Director,276-398-2292,2213,dshelor@triarea.org,,,,,,
VA-011089,Brunswick Co Health Dept,Virginia Department of Health,1184680126,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1632 Lawrenceville Plank Rd,,Lawrenceville,VA,23868-3304,Brunswick,109 Governor Street,,Richmond,VA,23219,Richmond,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Wayne Peters,Business Manager C,434-766-9828,,wayne.peters@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Southside/
VA-011090,Russell Co Health Dept,Virginia Department of Health,1649231044,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",75 Rogers St,,Lebanon,VA,24266,Russell,224 Clydesway Drive,,Lebanon,VA,24266,Russell,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Anna Stevens,Business manager,276-415-3360,,anna.stevens@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/cumbplat/
VA-011091,Loudoun County Health Dept,Virginia Department of Health,1154428605,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1 Harrison St SE,PO Box 7000,Leesburg,VA,20175-3102,Loudoun,109 Governor Street,,Richmond,VA,23219-3623,Richmond City,Lisa Park,Office of Community Health Services,804-864-7955,,lisa.park@vdh.virginia.gov,David Goodfriend,Director,703-771-5829,,david.goodfriend@loudoun.gov,www.loudoun.gov/health
VA-011092,HealthWorks for Northern Virginia,Loudoun Community Health Center,1629109806,"Dental Providers, Federally Qualified Health Centers - Medical Services",163 Fort Evans Rd NE,,Leesburg,VA,20176-4420,Loudoun,163 Fort Evans Road NE,,Leesburg,VA,20176-4420,Loudoun,Carol Jameson,CEO,703-443-2000,4704,cjameson@hwnova.org,Robine Hardey,CFO,703-443-2000,4707,rhardey@hwnova.org,www.hwnova.org
VA-012471,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,19450 Deerfield Ave,Suite 150,Leesburg,VA,20176-8424,Loudoun,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
VA-011093,Inova Juniper Program (Leesburg),Inova Juniper Program,1568488336,Ryan White Providers,211 Gibson St NW,Suite 206,Leesburg,VA,20176-2115,Loudoun,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,https://www.inova.org/locations/inova-juniper-program-leesburg-office
VA-011094,CARILION STONEWALL JACKSON HOSPITAL (inpatient hospital),CARILION STONEWALL JACKSON HOSPITAL,1518950484,Inpatient Hospitals (other than children's hospitals),1 Health Cir,,Lexington,VA,24450-2448,Lexington City,1 Health Cir,,Lexington,VA,24450-2448,Lexington City,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011095,CARILION STONEWALL JACKSON HOSPITAL (rural health clinics),CARILION STONEWALL JACKSON HOSPITAL,1518950484,Rural Health Clinics,1 Health Cir,,Lexington,VA,24450-2448,Lexington City,1 Health Cir,,Lexington,VA,24450-2448,Lexington City,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011096,Rockbridge Area Health Center,ROCKBRIDGE AREA FREE CLINIC dba Rockbridge Area Health Center,1205267002,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",25 Northridge Ln,,Lexington,VA,24450-3399,Rockbridge,25 Northridge Ln,,Lexington,VA,24450-3399,Rockbridge,Suzanne Sheridan,CEO,540-464-8700,7111,ssheridan@rockahc.org,Mary Looney,COO,540-464-8700,7127,,
VA-011097,Rockbridge/Lexington Health Dept,Virginia Department of Health,1396858197,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",300 White St,,Lexington,VA,24450-1937,Lexington City,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011098,HEALTH AND WELLNESS CENTER OF LOUISA,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1104014703,"Dental Providers, Federally Qualified Health Centers - Medical Services",115 Jefferson Hwy,,Louisa,VA,23093-6563,Louisa,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011099,Thomas Jefferson Health District Louisa County Health Dept.,Virginia Department of Health,1902813231,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",540 Industrial Dr,,Louisa,VA,23093-4146,Louisa,PO Box 7546,,Charlottesville,VA,22906,Albemarle,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Marilyn Pace,Clinic Director,540-967-3703,,marilyn.pace@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/ThomasJefferson/
VA-011100,Lunenburg County Health Department,Piedmont Health District,1992801609,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",11387 Courthouse Rd,,Lunenburg,VA,23952-2200,Lunenburg,"111 South Street, 1st Fl",,Farmville,VA,23901,Prince Edward,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vhd.virginia.gov,
VA-011102,Lynchburg City Health Department,Virginia Department of Health,1790745321,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",307 Alleghany Ave,,Lynchburg,VA,24501-2605,Lynchburg City,"109 Governor Street, 13th Floor",,Richmond,VA,23219-3623,Richmond City,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patty S. Simpson,Administrative Office Services Supr. III,434-477-5955,,patty.simpson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/CentralVirginia/index.htm
VA-011103,JOHNSON HEALTH CENTER,JOHNSON HEALTH CENTER,1316926538,Federally Qualified Health Centers - Medical Services,320 Federal St,,Lynchburg,VA,24504-2306,Lynchburg City,320 Federal St,,Lynchburg,VA,24504-2306,Lynchburg City,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-011104,JHC Pediatric/OB Clinic,JOHNSON HEALTH CENTER,1821212481,Federally Qualified Health Centers - Medical Services,407 Federal St,Suite A,Lynchburg,VA,24504-2461,Lynchburg City,320 Federal St,,Lynchburg,VA,24504-2306,Lynchburg City,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-011105,Madison Co Health Dept,Virginia Department of Health,1558451575,"Family Planning Providers, Sexually Transmitted Disease Clinics",410 N Main St,,Madison,VA,22727,Madison,410 N Main St,,Madison,VA,22727,Madison,Lisa Park,Office of Community Services,804-864-7108,,lisa.park@vdh.virginia.gov,"Charles J.Devine, III, M.D.",Medical Director,540-948-5481,,charles.devine@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/RappahannockRapidan/index.htm
VA-011106,Amherst County Community Health Center,JOHNSON HEALTH CENTER,1972858660,Federally Qualified Health Centers - Medical Services,134 Elon Rd,,Madison Heights,VA,24572-2536,Amherst,320 Federal St,,Lynchburg,VA,24504-2306,Lynchburg City,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-011107,JAMES RIVER DENTAL CLINIC,JOHNSON HEALTH CENTER,1871760710,Dental Providers,239 Trojan Rd,,Madison Heights,VA,24572-5346,Amherst,320 Federal Street,,Lynchburg,VA,24504,Lynchburg City,Gary Campbell,CEO,434-455-3271,,gcampbell@jhcvirginia.org,Nicole Williamson,Billing Coordinator,434-455-2480,1110,nwilliamson@jhcvirginia.org,
VA-012472,Center for Vein Restoration,Center for Vein Restoration,1487772349,Other ECP Providers,8140 Ashton Ave,Suite 216,Manassas,VA,20109-5698,Prince William,7474 Greenway Center Drive Suite 1000,,Greenbelt,MD,20770,Prince Georges,Dawn Folkenberg,Credentialing specialist,855-830-8346,3889,credentialing@centerforvein.com,Lorena Thomas,Credentialing manager,855-830-8346,,credentialing@centerforvein.com,centerforvein.com
VA-011108,Inova Health Care Services (Manassas),Inova Juniper Program,1568488336,Ryan White Providers,8807 Sudley Rd,Suite 107,Manassas,VA,20110-4719,Manassas City,2740 Prosperity Avenue,Suite 200,Fairfax,VA,22031,Fairfax,Joseph Schmucker,Director,703-321-2600,,joseph_schmucker@inova.org,,,,,,http://www.inova.org/juniper
VA-011109,Prince William Health District,Virginia Department of Health,1528155157,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",9301 Lee Ave,,Manassas,VA,20110-5517,Manassas City,109 Governor Street,,Richmond,VA,23219,Henrico,Lisa Park,Financial Services Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Alison Ansher,Health Director,703-792-6300,,alison.ansher@vdh.virginia.gov,www.vdh.virginia.gov
VA-011110,Greater Prince William Community Health Center,Greater Prince William Community Health Center - Evergreen,1770914939,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",9705 Liberia Ave,Suite 201,Manassas,VA,20110-1744,Manassas City,4379 Ridgewood Center Drive,Suite 102,Woodbridge,VA,22192,Prince William,Mark Meye,Director of Finance,703-680-7950,3109,mmeye@gpwhealthcenter.org,George Barker,Executive Director,703-680-7950,3110,gbarker@gpwhealthcenter.org,
VA-011111,Smyth Co Health Dept,Virginia Department of Health,1376587089,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",201 Francis Marion Ln,,Marion,VA,24354-4227,Smyth,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-011112,MARTINSVILLE PEDIATRICS,"Martinsville Physician Practices, LLC",1265703458,Rural Health Clinics,1109 Brookdale St,Suite C,Martinsville,VA,24112-4543,Martinsville City,PO Box 4788,,Martinsville,VA,24115,Martinsville City,Terri Wright,Enrollment Consultant,276-666-7545,,twright@symplr.com,Debra Shelton,Billing Manager,434-799-4585,,Debra.Shelton@LPNT.net,
VA-011113,Health Centers of the Piedmont Martinsville,"Piedmont Access To Health Services, Inc",1841323151,Federally Qualified Health Centers - Medical Services,287 Commonwealth Blvd W,,Martinsville,VA,24112-1820,Martinsville City,705 Main St,,Danville,VA,24541,Danville City,Wendy Mitchell,Billing Manager,434-791-4793,1030,wmitchell@pathsinc.org,Kay Crane,CEO,434-791-3630,1012,cranek@pathsinc.org,
VA-011114,Henry/Martinsville Health Dept,Virginia Department of Health,1518918200,"Family Planning Providers, Sexually Transmitted Disease Clinics",295 Commonwealth Blvd W,P. O. Box 1032,Martinsville,VA,24112-1820,Martinsville City,109 Governor ST,,Richmond,VA,23230,Martinsville City,Lisa Park,Office of Family Health Services,804-864-7108,,Lisa.Park@vdh.virginia.gov,Verna Burnette,"Nurse Manager, Sr.",276-638-2311,135,Verna.Burnette@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/westpied/index.htm
VA-011115,Memorial Hospital Martinsville and Henry County,LifePoint Health,1386720183,Inpatient Hospitals (other than children's hospitals),320 Hospital Dr,,Martinsville,VA,24112-1900,Martinsville City,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,Doug BeMent,CFO,276-666-7379,,,
VA-011116,Mathews County Health Dept,Virginia Department of Health,1760444871,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",536 Church St,,Mathews,VA,23109-2293,Mathews,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,
VA-011117,Meadowview Health Clinic Services,"SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INCORPORATED",1831398718,Federally Qualified Health Centers - Medical Services,13168 Meadowview Sq,,Meadowview,VA,24361-3328,Washington,319 5th Ave,,Saltville,VA,24370-3418,Smyth,Bryan Haynes,CEO,276-496-4492,1004,bhaynes@svchs.com,,,,,,
VA-011118,PUNGOTEAGUE DENTAL PROGRAM,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1881847135,Dental Providers,28480 Bobtown Rd,,Melfa,VA,23410-3508,Accomack,20280 Market Street,,Onancock,VA,23417,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011119,Rappahannock Health District Caroline County Health Department,Virginia Department of Health,1851332746,Family Planning Providers,17202 Richmond Tnpk,,Milford,VA,22514,Caroline,PO Box 6,,Bowling Green,VA,22427-0006,Caroline,Lisa Park,Community Health Services,804-864-7108,,Lisa.Park@vdh.virginia.gov,Sidnee M. Dallas,District Nurse Manager,540-322-5934,,,http://www.vdh.virginia.gov/LHD/rappahan/index.htm
VA-011120,HIGHLAND MEDICAL CENTER,HIGHLAND MEDICAL CENTER,1194784280,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",120 Jackson River Rd,,Monterey,VA,24465-2416,Highland,120 Jackson River Rd,,Monterey,VA,24465-2416,Highland,DEBRA PERDUE,CEO,540-468-6401,,dperdue@ourhmc.org,Theresa Wagner,CFO,540-468-6402,,twagner@ourhmc.org,www.ourhmc.org
VA-011121,Highland County Health Department,Virginia Department of Health,1144230814,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",140 Fleisher Ave,,Monterey,VA,24465,Highland,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011122,Westmoreland County Health Dept,Virginia Department of Health,1881657211,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",18849 Kings Hwy,,Montross,VA,22520-2965,Westmoreland,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,
VA-011123,WESTMORELAND MEDICAL CENTER,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1306975875,"Dental Providers, Federally Qualified Health Centers - Medical Services",18849 Kings Hwy,,Montross,VA,22520-2965,Westmoreland,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011124,Valley Health Shenandoah Memorial Hospital Family Medicine - Mt. Jackson,Shenandoah Memorial Hospital,1053842468,Rural Health Clinics,5173 Main St,,Mount Jackson,VA,22842-9513,Shenandoah,759 South Main Street,,Woodstock,VA,22664,Shenandoah,Shawn Carrico,Director of Finance,540-459-1120,,scarrico@valleyhealthlink.com,Peter F. Gallagher,Sr. VP & CFO,540-536-8032,,pgallagh@valleyhealthlink.com,www.valleyhealthlink.com
VA-011125,Northampton Co Health Dept,Virginia Department of Health,1669567632,"Family Planning Providers, Rural Health Clinics, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7114 Lankford Hwy,,Nassawadox,VA,23413,Northampton,VDH 109 Governor St 825J,,Richmond,VA,23219,Richmond,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,David Matson,Health Director,757-787-5880,,david.matson@vdh.virginia.gov,
VA-011126,CENTRAL VIRGINIA COMMUNITY HEALTH CENTER,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1235259607,"Dental Providers, Federally Qualified Health Centers - Medical Services",25892 N James Madison Hwy,,New Canton,VA,23123-2234,Buckingham,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011127,Craig County Health Department,Virginia Department of Health,1720031180,"Family Planning Providers, Sexually Transmitted Disease Clinics",161 Main St,,New Castle,VA,24127-8077,Craig,161 Main St,,New Castle,VA,24127,Craig,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,suzanne.renegar@vdh.virginia.gov,
VA-011128,CRAIG COUNTY HEALTH CENTER,Monroe County Health Department,1851585046,Federally Qualified Health Centers - Medical Services,226 Market St,,New Castle,VA,24127-6080,Craig,200 Health Center Dr,,Union,WV,24983-8442,Monroe,Michelle Ballard,COO,304-772-3065,,rstone@monroehealthcenter.com,Rebekah Stone,CFO,,,,
VA-011129,CRAIG COUNTY WELLNESS CENTER,Monroe County Health Department,1851585046,Federally Qualified Health Centers - Medical Services,25239 Craigs Creek Rd,,New Castle,VA,24127-6223,Craig,200 Health Center Dr,,Union,WV,24983-8442,Monroe,Michelle Ballard,COO,304-772-3065,,mballard@monroehealthcenter.com,Rebekah Stone,CFO,,,rstone@monroehealthcenter.com,
VA-011130,Atlantic Community Health Center,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1043341613,"Dental Providers, Federally Qualified Health Centers - Medical Services",5219 Lankford Hwy,,New Church,VA,23415-3332,Accomack,20280 Market St,,Onancock,VA,23417-1331,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011131,New Kent Co Health Dept,Virginia Department of Health,1861595357,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7911 Courthouse Way,,New Kent,VA,23124-2244,New Kent,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services; Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Jim Davidson,,804-365-4349,,jim.davidson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/Chickahominy/
VA-011132,Valley Health Shenandoah Memorial Hospital Multispecialty Clinic - New Market,Shenandoah Memorial Hospital,1740711472,Rural Health Clinics,9166 N Congress St,,New Market,VA,22844-9422,Shenandoah,759 South Main Street,,Woodstock,VA,22664,Shenandoah,Shawn Carrico,Director of Finance,540-459-1120,,scarrico@valleyhealthlink.com,Peter F. Gallagher,Sr. VP & CFO,540-536-8032,,pgallagh@valleyhealthlink.com,www.valleyhealthlink.com
VA-011133,"Riverside Hospital, Inc.","Riverside Healthcare Association, Inc.",1366547747,Inpatient Hospitals (other than children's hospitals),500 J Clyde Morris Blvd,,Newport News,VA,23601-1929,Newport News City,608 Denbigh Boulevard,Suite 601,Newport News,VA,23608,Newport News City,Caleb Andrew Perez,"Sr. Analyst, Payer Relations",804-305-1867,,Caleb.Perez@rivhs.com,Mary Lou DelPrince,System Director of Payer Relations,757-534-6763,,Mary.DelPrince@rivhs.com,https://www.riversideonline.com/
VA-011134,Norfolk Health District - Little Creek Clinic,Virginia Department of Health,1386686731,"Family Planning Providers, Sexually Transmitted Disease Clinics",207 E Little Creek Rd,,Norfolk,VA,23505-2504,Norfolk City,Community Health Services,"109 Governor Street, 13th Floor",Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,Lisa.Park@vdh.virginia.gov,Ronnette Langhorne,Nurse Manager,757-683-2788,,Ronnette.Langhorne@vdh.virginia.gov,http://www.norfolk.gov/pub_health/
VA-011135,LGBT Life Center,LGBT Life Center,1386984771,Ryan White Providers,248 W 24th St,,Norfolk,VA,23517-1304,Norfolk City,222 W. 21ST SUITE F308,,Norfolk,VA,23517,Norfolk City,Stacie Walls,Chief Executive Officer,757-640-0929,215,stacie@accessaids.org,Rena Keogh,CFO,757-640-0929,218,rena@accessaids.org,www.accessaids.org
VA-011136,Park Place Family Health Center,"Portsmouth Community Health Center,Inc",1073833760,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",3415 Granby St,,Norfolk,VA,23504-1421,Norfolk City,664 Lincoln Street,,Portsmouth,VA,23704,Portsmouth City,Barbara Willis,Chief Executive Officer,757-397-0042,312,bwillis@hrchc.org,Maureen Troublefield,Director of Patient Financial Services,757-397-0042,326,mtroublefield@HRCHC.ORG,www.hrchc.org
VA-011137,Hampton Roads I-Care,"PORTSMOUTH COMMUNITY HEALTH CENTER, INC.",1144604877,Federally Qualified Health Centers - Medical Services,3755 E Virginia Beach Blvd,,Norfolk,VA,23502-3238,Norfolk City,664 Lincoln Street,,Portsmouth,VA,23704,Portsmouth City,Barbara Willis,Chief Executive Officer,757-397-0042,312,bwillis@hrchc.org,Maureen Troublefield,Director of Patient Financial Services,757-397-0042,326,mtroublefield@HRCHC.ORG,www.hrchc.org
VA-011138,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC,1912919481,Outpatient Hospital Clinics,601 Childrens Ln,,Norfolk,VA,23507-1910,Norfolk City,601 Childrens Lane,,Norfolk,VA,23507-1910,Norfolk City,GREGORY S JONES,"Director, Managed Care",757-668-9647,,GREGORY.JONES@CHKD.ORG,CATRINA MITCHELL,Manager,757-668-7945,,CATRINA.MITCHELL@CHKD.ORG,
VA-011139,CommuniCare Family Health Center,"PORTSMOUTH COMMUNITY HEALTH CENTER, INC.",1235484544,"Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services",804 Whitaker Ln,,Norfolk,VA,23510-3027,Norfolk City,664 Lincoln Street,,Portsmouth,VA,23704,Portsmouth City,Barbara Willis,Chief Executive Officer,757-397-0042,312,bwillis@hrchc.org,Maureen Troublefield,Director of Patient Financial Services,757-397-0042,325,mtroublefield@HRCHC.ORG,www.hrchc.org
VA-011140,Norfolk Health District - Southampton Clinic,Virginia Department of Health,1386686731,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",830 Southampton Ave,Suite 200,Norfolk,VA,23510-1045,Norfolk City,Community Health Services,"109 Governor Street, 13th Floor",Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,Lisa.Park@vdh.virginia.gov,Ronnette Langhorne,Nurse Manager,757-683-2788,,Ronnette.Langhorne@vdh.virginia.gov,http://www.norfolk.gov/index/
VA-011141,East Ocean View Medical and Dental Center,"PORTSMOUTH COMMUNITY HEALTH CENTER, INC.",1871848184,"Dental Providers, Federally Qualified Health Centers - Medical Services",9581 Shore Dr,,Norfolk,VA,23518-1711,Norfolk City,"Portsmouth Community Health Center, Inc.",,Portsmouth,VA,23704,Portsmouth City,Barbara Willis,Chief Executive Officer,757-397-0042,312,bwillis@hrchc.org,Deidra Singleton,Director of Patient Financial Services,757-397-0042,326,dsingleton@hrchc.org,www.hrchc.org
VA-011142,Bermuda Medical Center,Capital Area Health Network,1710225818,Federally Qualified Health Centers - Medical Services,2740 Bensley Commons Blvd,,North Chesterfield,VA,23237-1723,Chesterfield,PO Box 27947,,Richmond,VA,23237,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,
VA-011143,Tazewell Community Health,"SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INCORPORATED",1083745053,Federally Qualified Health Centers - Medical Services,583C E Riverside Dr,,North Tazewell,VA,24630-9573,Tazewell,319 5th Ave,,Saltville,VA,24370-3418,Smyth,Bryan Haynes,CEO,276-496-4492,1004,bhaynes@svchs.com,,,,,,
VA-011144,Nottoway Co Health Dept,Virginia Department of Health,1902902612,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",207 W Courthouse Rd,,Nottoway,VA,23955,Nottoway,Piedmont Health District,"111 South Street, 1st Fl",Farmville,VA,23901,Prince Edward,Lisa Park,Office of Community Health Services,804-864-7018,,lisa.park@vdh.virginia.gov,Alexander P Samuel,District Director,434-392-3984,131,alexander.samuel@vdh.virginia.gov,
VA-011146,"Shore Health Services, Inc.","Riverside Healthcare Association, Inc.",1619076916,Inpatient Hospitals (other than children's hospitals),20480 Market St,,Onancock,VA,23417-4309,Accomack,608 Denbigh Boulevard,Suite 601,Newport News,VA,23608,Newport News City,Caleb Andrew Perez,"Sr. Analyst, Payer Relations",804-305-1867,,Caleb.Perez@rivhs.com,Mary Lou DelPrince,System Director of Payer Relations,757-534-6763,,Mary.DelPrince@rivhs.com,https://www.riversideonline.com/
VA-011147,Onley Community Health Center,"EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1568592426,Federally Qualified Health Centers - Medical Services,20306 Badger Ln,,Onley,VA,23418,Accomack,20280 Market St,,Onancock,VA,23417-1331,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011148,Orange Co Health Dept,Virginia Department of Health,1871660100,"Family Planning Providers, Sexually Transmitted Disease Clinics",450 N Madison Rd,,Orange,VA,22960-1085,Orange,450 N Madison Rd,,Orange,VA,22960-1085,Orange,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,"Charles J. Devine, III, M.D.",Medical Director,540-672-1291,,charles.devine@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/RappahannockRapidan/index.htm
VA-011149,Fluvanna County Health Department,Virginia Department of Health,1831106327,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",132 Main St,,Palmyra,VA,22963-4179,Fluvanna,PO BOX 7546,,Charlottesville,VA,22906,Albemarle,Office of Comunity Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Marilyn Pace,Clinic Director,434-591-1960,,marilyn.pace@vdh.virginia.gov,
VA-011150,"Eastern Shore Rural Health System, Incorporated","EASTERN SHORE RURAL HEALTH SYSTEM, INCORPORATED",1043463227,Dental Providers,24501 Parksley Rd,METOMPKIN SCHOOL DENTAL PROGRAM,Parksley,VA,23421-2519,Accomack,20280 Market Street,,Onancock,VA,23417,Accomack,Nancy Stern,CEO,757-414-0400,117,nstern@esrh.org,,,,,,
VA-011151,Giles County Health Dept,VDH New River Health District,1184738692,"Family Planning Providers, Sexually Transmitted Disease Clinics",120 N Main St,,Pearisburg,VA,24134-1687,Giles,"210 South Pepper Street, Suite A",,Christiansburg,VA,24073-3572,Montgomery,Margaret O'Dell,Health Director,540-585-3304,,molly.odell@vdh.virginia.gov,Ruth B. Wolford,Nurse Manager,540-585-3355,,ruth.wolford@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/newriver/INDEX.HTM
VA-011152,CARILION GILES COMMUNITY HOSPITAL (inpatient hospital),CARILION GILES COMMUNITY HOSPITAL,1194718304,Inpatient Hospitals (other than children's hospitals),159 Hartley Way,,Pearisburg,VA,24134-2471,Giles,159 HARTLEY WAY,,Pearisburg,VA,24134-2471,Giles,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011153,CARILION GILES COMMUNITY HOSPITAL (rural health clinics),CARILION GILES COMMUNITY HOSPITAL,1194718304,Rural Health Clinics,159 Hartley Way,,Pearisburg,VA,24134-2471,Giles,159 HARTLEY WAY,,Pearisburg,VA,24134-2471,Giles,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011154,ARH Pennington Gap Clinic,"Appalachian Regional Healthcare, Inc.",1063821288,"Outpatient Hospital Clinics, Rural Health Clinics",121 Stacy Dr,,Pennington Gap,VA,24277-1929,Lee,100 Airport Gardens Roac,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
VA-011155,Petersburg Health Department,VA Department of Health - Crater Health District,1144339144,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 Halifax St,,Petersburg,VA,23803-6335,Petersburg City,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Administrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,Office Service Specialist Supervisor,804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011156,APPOMATTOX AREA HEALTH & WELLNESS CENTER,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1588878474,"Dental Providers, Federally Qualified Health Centers - Medical Services",321C Poplar Dr,,Petersburg,VA,23805-9306,Petersburg City,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011157,Petersburg Health Care Alliance,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1134258601,Federally Qualified Health Centers - Medical Services,541 S Sycamore St,,Petersburg,VA,23803-5039,Petersburg City,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,804-957-9601,,,http://www.cvhsinc.org/phca.html
VA-011158,Portsmouth City Health Dept,Virginia Department of Health,1295795078,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1701 High St,Suite 102,Portsmouth,VA,23704-3103,Portsmouth City,109 Governor St,,Richmond,VA,23219,Richmond City,Lisa Park,Financial Services Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Anita Hailey,Nurse Manager,757-393-8585,8537,anita.hailey@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/portsmouth/index.htm
VA-011159,Hampton Roads Community Health Center,"PORTSMOUTH COMMUNITY HEALTH CENTER, INC.",1134199193,"Dental Providers, Federally Qualified Health Centers - Medical Services",664 Lincoln St,,Portsmouth,VA,23704-4818,Portsmouth City,664 Lincoln Street,,Portsmouth,VA,23704,Portsmouth City,Barbara Willis,Chief Executive Officer,757-397-0042,312,bwillis@hrchc.org,Deidra Singleton,Director of Patient Financial Services,757-397-0042,326,dsingleton@hrchc.org,www.hrchc.org
VA-011160,Powhatan Co Health Dept,Virginia Department of Health,1366462137,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",3908 Old Buckingham Rd,Suite 1,Powhatan,VA,23139-5753,Powhatan,109 Governor Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Jeannine Uzel,Nurse Manager,804-748-1706,,jeannine.uzel@vdh.virginia.gov,http://www.vdh.virginia.gov/
VA-011161,HOPEWELL-PRINCE GEORGE COMMUNITY HEALTH CENTER,"CENTRAL VIRGINIA HEALTH SERVICES, INC.",1902934680,"Dental Providers, Federally Qualified Health Centers - Medical Services",4260 Crossings Blvd,Suite 2,Prince George,VA,23875-1400,Prince George,25892 N James Madison Hwy,,New Canton,VA,23123,Buckingham,RODERICK V MANIFOLD,Executive Director,434-581-3271,10700,ceo@cvhsinc.org,,,,,,
VA-011162,Prince George Health Department,VDH - Crater Health District,1952330193,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6450 Administration Dr,Suite 101,Prince George,VA,23875-2572,Prince George,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Administrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jones,"OSS Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011163,Pulaski County Health Dept,VDH New River Health District,1639284979,"Family Planning Providers, Sexually Transmitted Disease Clinics",170 4th St NW,,Pulaski,VA,24301-4524,Pulaski,"210 South Pepper Street, Suite A",,Christiansburg,VA,24073-3572,Montgomery,Margaret O'Dell,Health Director,540-585-3304,,molly.odell@vdh.virginia.gov,Ruth B. Wolford,Nurse Manager,540-585-3355,,ruth.wolford@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/newriver/INDEX.HTM
VA-011164,Radford City Health Dept,VDH New River Health District,1649385907,"Family Planning Providers, Sexually Transmitted Disease Clinics",212 3rd Ave,,Radford,VA,24141-4706,Radford,"210 South Pepper Street, Suite A",,Christiansburg,VA,24073-3572,Montgomery,Margaret O'Dell,Health Director,540-585-3304,,molly.odell@vdh.virginia.gov,Ruth B. Wolford,Nurse Manager,540-585-3355,,ruth.wolford@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/newriver/INDEX.HTM
VA-011165,CLINCH VALLEY PHYSICIANS,"Clinch Valley Physicians, Associates",1821339540,Rural Health Clinics,1 Clinic Dr,,Richlands,VA,24641-1102,Tazewell,1 Clinic Driive,,Richlands,VA,24641,Tazewell,Melissa Robinette,Practice Manager,276-964-1223,,melissa.robinette@lpnt.net,Donna Ashby,HIM/Qualityand Risk,276-964-1242,,donna.ashby@lpnt.net,
VA-011166,Southside Medical Center,Capital Area Health Network,1871818153,Federally Qualified Health Centers - Medical Services,101 Cowardin Ave,,Richmond,VA,23224-2078,Richmond City,PO Box 27947,,Richmond,VA,23223,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,
VA-011167,Richmond City Dept. of Public Health Fan Free Clinic,Virginia Department of Health,1972692143,Family Planning Providers,1010 N Thompson St,,Richmond,VA,23230-4924,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Healthcare Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011168,VCU Medical Center,VCU Health System Authority,1437175734,Inpatient Hospitals (other than children's hospitals),1250 E Marshall St,,Richmond,VA,23298-5051,Richmond City,VCU Health System,Box 980510,Richmond,VA,23298-0510,Richmond City,Sheryl Garland,VP Health Policy and Community Relations,804-828-1290,,sheryl.garland@vcuhealth.org,,,,,,
VA-011169,VCU Ryan White Program,Virginia Commonwealth University Health System,1437175734,"Outpatient Hospital Clinics, Ryan White Providers",1250 E Marshall St,,Richmond,VA,23298-5051,Richmond City,1101 East Marshal Street,"Sanger Hall, 12th Floor, Room 12-018A",Richmond,VA,23298,Richmond City,Lenore Lombardi,"Director, Ryan White Programs",804-828-9713,,Lenore.Lombardi@vcuhealth.org,Matthew Bare,"Assistant Director, Ryan White Programs",804-828-4407,,Matthew.Bare@vcuhealth.org,
VA-011170,Mosby Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",1536 Coalter St,,Richmond,VA,23223-4206,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011171,Hillside Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",1615 Glenfield Ave,,Richmond,VA,23224-7527,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011172,Greater Fulton Medical Center,Capital Area Health Network,1760833008,Federally Qualified Health Centers - Medical Services,1718 Williamsburg Rd,,Richmond,VA,23231-3428,Richmond City,PO Box 27947,,Richmond,VA,23261,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,www.cahealthnet.org
VA-011173,The Southside Community Health Center of Greater Richmond,DAILY PLANET INC,1750792107,Federally Qualified Health Centers - Medical Services,180 E Belt Blvd,,Richmond,VA,23224-1204,Richmond City,517 W Grace St,,Richmond,VA,23220-4911,Richmond City,Helena DeLigt,COO- Programs,804-783-0678,226,deligt@dailyplanetva.org,Tonya Kimbrough,Executive Secretary,804-783-2505,221,kimbrought@dailyplanetva.org,www.dailyplanetva.org
VA-011174,Richmond Health Center,Virginia League for Planned Parenthood,1639347990,"Family Planning Providers, Sexually Transmitted Disease Clinics",201 N Hamilton St,,Richmond,VA,23221-2601,Richmond City,201 N Hamilton St,,Richmond,VA,23221-2601,Richmond City,Paulette McElwain,CEO,804-483-6136,,paulettemcelwain@vlpp.org,,,,,,www.vlpp.org
VA-011175,Northside Medical Center,Capital Area Health Network,1881883007,Federally Qualified Health Centers - Medical Services,2089 North Ave,,Richmond,VA,23222-4914,Richmond City,PO Box 27947,,Richmond,VA,23261,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,
VA-011176,Whitcomb Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",2106 Deforrest St,,Richmond,VA,23223-3665,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011177,Creighton Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",2150 Creighton Rd,,Richmond,VA,23223-4633,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011178,Fairfield Community Resource Center Richmond City Health District,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",2311 N 25th St,,Richmond,VA,23223-4125,Richmond City,2311 N 25th St,,Richmond,VA,23223-4125,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-205-3745,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011179,Glenwood Medical Center,Capital Area Health Network,1396078135,Federally Qualified Health Centers - Medical Services,2711 Bryon Street,,Richmond,VA,23223,Richmond City,PO Box 27947,,Richmond,VA,23261,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,
VA-011180,Richmond City Health Department,Virginia Department of Health,1972692143,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",400 E Cary St,,Richmond,VA,23219-3816,Richmond City,400 E. Cary St.,,Richmond,VA,23219-3816,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,Lisa.Park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/richmondcity/clinic.htm
VA-011181,VCU Medical Center,VCU Health System Authority,1437175734,Outpatient Hospital Clinics,417 N 11th St,,Richmond,VA,23298-5002,Richmond City,VCU Health System,PO Box 980510,Richmond,VA,23298-0510,Richmond City,Sheryl Garland,VP Health Policy and Community Relations,804-828-1290,,sheryl.garland@vcuhealth.org,,,,,,
VA-011182,Gilpin Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",436 Calhoun St,,Richmond,VA,23220-2405,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3712,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011183,Broad Rock Resource Center,Virginia Department of Health,1972692143,"Family Planning Providers, Sexually Transmitted Disease Clinics",4615 Ferguson Ln,,Richmond,VA,23234-1950,Richmond City,400 E. Cary Street,,Richmond,VA,23219,Richmond City,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Danny Avula,Deputy Health Director,804-205-3721,,danny.avula@vdh.virginia.gov,http://www.vdh.virginia.gov/lhd/richmondcity/
VA-011184,Henrico Area Mental Health & Developmental Services East End Center,DAILY PLANET INC,1245632876,Federally Qualified Health Centers - Medical Services,4825 S Laburnum Ave,,Richmond,VA,23231-2713,Henrico,517 W Grace St,,Richmond,VA,23220-4911,Richmond,Helena DeLigt,COO- Programs,804-783-0678,226,deligt@dailyplanetva.org,Tonya Kimbrough,Executive Secretary,804-783-2505,221,kimbrought@dailyplanetva.org,www.dailyplanetva.org
VA-011185,DAILY PLANET HEALTHCARE FOR THE HOMELESS PROGRAM,DAILY PLANET INC,1124097621,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",517 W Grace St,,Richmond,VA,23220-4911,Richmond City,517 W Grace St,,Richmond,VA,23220-4911,Richmond,Helena DeLigt,COO Programs,804-783-0678,226,deligt@dailyplanetva.org,Tonya Kimbrough,Executive Secretary,804-783-2505,221,kimbrought@dailyplanetva.org,http://www.dailyplanetva.org/
VA-011186,THE HEALING PLACE,DAILY PLANET INC,1659669596,Federally Qualified Health Centers - Medical Services,700 Dinwiddie Ave,,Richmond,VA,23224-5522,Richmond City,517 W Grace St,,Richmond,VA,23220-4911,Richmond City,Helena DeLigt,COO-Programs,804-783-0678,226,deligt@dailyplanetva.org,Tonya Kimbrough,Executive Secretary,804-783-2505,221,kimbrought@dailyplanetva.org,www.dailyplanetva.org
VA-011187,Vernon J. Harris Medical Center dba Capital Area Health Network,Capital Area Health Network,1972636330,"Dental Providers, Federally Qualified Health Centers - Medical Services",719 N 25th St,,Richmond,VA,23223-6539,Richmond City,719 N 25th St,,Richmond,VA,23223-6539,Richmond City,Tracy Causey,CEO,804-253-1968,,tcausey@cahealthnet.org,,,,,,www.cahealthnet.org
VA-011188,Saint Joseph's Villa Clinic,DAILY PLANET INC,1215160965,Federally Qualified Health Centers - Medical Services,8000 Brook Rd,,Richmond,VA,23227-1306,Henrico,517 W Grace St,,Richmond,VA,23220-4911,Richmond,Helena DeLigt,COO-Programs,804-783-0678,226,deligt@dailyplanetva.org,Tonya Kimbrough,Executive Secretary,804-783-2505,221,kimbrought@dailyplanetva.org,www.dailyplanetva.org
VA-011189,Roanoke City Health Department,Virginia Department of Health,1376595785,"Family Planning Providers, Sexually Transmitted Disease Clinics",1502 Williamson Rd NE,Suite 2,Roanoke,VA,24012-5100,Roanoke City,1502 Williamson Rd NE,Second Floor,Roanoke,VA,24012-5100,Roanoke City,Lisa Park,Health Care Reimbursement Manager,804-864-7108,,Lisa.Park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,Pamela.Rolen@vdh.virginia.gov,
VA-011190,Carilion Children's Hospital,Carilion Medical Center,1033102942,Children's Hospitals (inpatient only),1906 Belleview Ave SE,,Roanoke,VA,24014-1838,Roanoke City,1906 Belleview Ave SE,,Roanoke,VA,24014,Roanoke,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011191,CARILION ROANOKE MEMORIAL HOSPITAL (inpatient hospital),Carilion Medical Center,1033102942,Inpatient Hospitals (other than children's hospitals),1906 Belleview Ave SE,,Roanoke,VA,24014-1838,Roanoke City,1906 Belleview Ave SE,,Roanoke,VA,24014-1838,Roanoke City,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011192,CARILION ROANOKE MEMORIAL HOSPITAL (ryan white providers),Carilion Medical Center,1033102942,Ryan White Providers,1906 Belleview Ave SE,,Roanoke,VA,24014-1838,Roanoke City,1906 Belleview Ave SE,,Roanoke,VA,24014-1838,Roanoke City,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011193,Planned Parenthood Roanoke Health Center,Planned Parenthood South Atlantic,1134214968,Family Planning Providers,2207 Peters Creek Rd NW,,Roanoke,VA,24017-1618,Roanoke City,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/virginia/roanoke/24017/roanoke-health-center-2768-90860
VA-011194,Kuumba Community Health & Wellness Center Inc.,"KUUMBA COMMUNITY HEALTH & WELLNESS CENTER, INC.",1205815420,"Dental Providers, Federally Qualified Health Centers - Medical Services",3716 Melrose Ave NW,,Roanoke,VA,24017-2716,Roanoke City,3716 Melrose Ave NW,,Roanoke,VA,24017-2716,Roanoke City,EILEEN G LEPRO,CEO,540-362-0360,101,elepro@newhorizonshealthcare.org,Kimberly B. Robertson,COO,540-362-0360,102,krobertson@newhorizonshealthcare.org,
VA-011195,Carilion Franklin Memorial Hospital,Carilion Franklin Memorial Hospital,1710970918,Inpatient Hospitals (other than children's hospitals),180 Floyd Ave,,Rocky Mount,VA,24151-1318,Franklin,180 Floyd Ave,,Rocky Mount,VA,24151-1318,Franklin,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011196,Franklin Co Health Dept,Virginia Department of Health,1548352602,"Family Planning Providers, Sexually Transmitted Disease Clinics",365 Pell Ave,,Rocky Mount,VA,24151-1133,Franklin,VA Departmant of Health,109 Governor ST,Richmond,VA,23219,Richmond,Lisa Park,Office of Family Health Services,804-864-7108,,Lisa.Park@vdh.virginia.gov,Verna Burnette,"Nurse Manager, Sr.",540-484-0292,212,Verna.Burnette@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/westpied/index.htm
VA-011197,Campbell Co Health Dept,Virginia Department of Health,1710949771,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",116 Kabler Ln,,Rustburg,VA,24588,Campbell,"109 Governor Street, 13th Floor",,Richmond,VA,23219-3623,Richmond City,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patty S. Simpson,Administrative Office Services Supr. III,434-477-5955,,patty.simpson@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/CentralVirginia/index.htm
VA-011198,William A Davis,Stone Mountain Health Services,1710104260,Federally Qualified Health Centers - Medical Services,1389 Dante Rd,Post Office Drawer 900,Saint Paul,VA,24283-3658,Russell,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3531,jneff@stonemtn.org,
VA-011199,Roanoke County/Salem Health Department,Virginia Department of Health,1740231067,"Family Planning Providers, Sexually Transmitted Disease Clinics",105 E Calhoun St,,Salem,VA,24153-3838,Salem,105 E Calhoun St,,Salem,VA,24153-3838,Salem,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,suzanne.renegar@vdh.virginia.gov,
VA-011200,SALTVILLE MEDICAL CENTER,"SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INCORPORATED",1952434383,Federally Qualified Health Centers - Medical Services,308 W Main St,,Saltville,VA,24370-3112,Smyth,319 5th Ave,,Saltville,VA,24370-3418,Smyth,Bryan Haynes,CEO,276-496-4492,1004,bhaynes@svchs.com,,,,,,
VA-011201,Southwest Virginia Regional Dental Center,"SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INCORPORATED",1942523006,Dental Providers,319 5th Ave,,Saltville,VA,24370-3418,Smyth,319 5th Ave,,Saltville,VA,24370-3418,Smyth,Bryan Haynes,CEO,276-496-4492,1004,bhaynes@svchs.com,,,,,,
VA-011202,Middlesex County Health Department,Virginia Department of Health,1073576419,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2780 General Puller Hwy,,Saluda,VA,23149-3112,Middlesex,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,
VA-011203,Isle Of Wight Co Health Dept,Virginia Department of Health,1982679874,"Family Planning Providers, Sexually Transmitted Disease Clinics",919 S Church St,,Smithfield,VA,23430-1715,Isle of Wight,919. S. Church Street,,Smithfield,VA,23430,Isle of Wight,Lisa Park,Office of Community Health Services,804-864-7955,,lisa.park@vdh.virginia.gov,Cynthia H. Hunting,"Nurse Manager, Sr.",757-514-4761,,cynthia.hunting@vdh.virginia.gov,
VA-011204,Spotsylvania Co Health Dept,Virginia Department of Health,1134163280,Family Planning Providers,1300 Courthouse Rd,,Spotsylvania,VA,22553,Spotsylvania,Virginia Department of Health,,Richmond,VA,23218,Richmond City,Lisa Park,Community Health Services,804-864-7018,,Lisa.Park@vdh.virginia.gov,Sidnee M. Dallas,District Nurse Manager,540-322-5934,,,http://www.vdh.virginia.gov/LHD/rappahan/index.htm
VA-011205,St. Charles Respiratory Care Center,Stone Mountain Health Services,1215284153,Black Lung Clinics,213 Monarch Road,Post Office Drawer S,St. Charles,VA,24282,Lee,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011206,St. Charles Health Clinic,Stone Mountain Health Services,1144342270,Federally Qualified Health Centers - Medical Services,241 Monarch Road,Post Office Drawer S,St. Charles,VA,24282,Lee,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011207,Stafford Co Health Dept,Virginia Department of Health,1932130424,Family Planning Providers,1300 Courthouse Rd,,Stafford,VA,22554-7232,Stafford,109 Governors Street,,Richmond,VA,23218,Richmond City,Lisa Park,Community Health Services,804-864-7018,,Lisa.Park@vdh.virginia.gov,Sidnee M. Dallas,District Nurse Manager,540-322-5934,,Sidnee.Dallas@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/rappahan/index.htm
VA-011208,Greene County Health Department,Virginia Department of Health,1477560787,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",50 Stanard St,,Stanardsville,VA,22973-3756,Greene,PO BOX 7546,,Charlottesville,VA,22906,Albemarle,Office of Community Health Services;Lisa Park,Health Care Reimbursement Manager,804-864-7108,,lisa.park@vdh.virginia.gov,Marilyn Pace,Clinic Director,434-985-2262,,marilyn.pace@vdh.virginia.gov,
VA-011209,Augusta/Staunton Health Deaprtment,Virginia Department of Health,1710931365,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1414 N Augusta St,,Staunton,VA,24401-2401,Staunton City,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,http://www.vdh.virginia.gov/
VA-011210,Stony Creek Community Health Center,Stony Creek Community Health Center,1376515031,Federally Qualified Health Centers - Medical Services,12454 Hartley St,PO Box 188,Stony Creek,VA,23882-3302,Sussex,12454 Hartley Street,PO Box 188,Stony Creek,VA,23882,Sussex,Joan Ivey,Executive Director,434-246-3501,,jivey@stonycreek.org,,,,,,
VA-011211,Patrick Co Health Dept,Virginia Department of Health,1932218153,"Family Planning Providers, Sexually Transmitted Disease Clinics",106 Rucker St,Suite 123,Stuart,VA,24171-1619,Patrick,109 Governor ST,,Richmond,VA,23219,Richmond,Lisa Park,Office of Family Health Services,804-864-7108,,Lisa.Park@vdh.virginia.gov,Verna Burnette,"Nurse Manager, Sr.",540-484-0292,212,Verna.Burnette@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/westpied/index.htm
VA-011212,Pioneer Community Hospital of Patrick,"Pioneer Health Services, INC",1659513893,Inpatient Hospitals (other than children's hospitals),18688 Jeb Stuart Hwy,,Stuart,VA,24171-1559,Patrick,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Lauren Williams,Director of Strategic Alignment & Network Development,601-849-6440,385,laurenwilliams@phscorporate.com,
VA-011213,Pioneer Family Medical of Stuart,"Pioneer Health Services of Patrick County, Inc.",1285897629,Rural Health Clinics,835 Woodland Dr,Suite 200,Stuart,VA,24171-1586,Patrick,110 Pioneer Way,,Magee,MS,39111,Simpson,Julie Gieger,Chief Financial Officer,601-849-6440,301,juliegieger@phscorporate.com,Brian Enis,Clinic Director,601-849-6440,338,brianenis@phscorporate.com,
VA-011214,Suffolk City Health Dept,Virginia Department of Health,1487629374,"Family Planning Providers, Sexually Transmitted Disease Clinics",135 Hall Ave,Suite A,Suffolk,VA,23434-4657,Suffolk City,Suffolk Health Department,135 Hall Ave Ste A,Suffolk,VA,23434,Suffolk City,Cynthia Hunting,Clinic Director,757-514-4700,,cynthia.hunting@vdh.virginia.gov,Lisa Park,Office of Community Health Services,804-864-7955,,lisa.park@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/WestTide/
VA-011215,Sussex Health Department,VDH - Crater Health District,1558390302,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",20103 Princeton Road,PO Box 1345,Sussex,VA,23884-0345,Sussex,Crater Health District,301 Halifax Street,Petersburg,VA,23803,Petersburg City,Roxanne Marr-Shears,Administrator,804-862-8934,8934,Roxanne.Marr-Shears@vdh.virginia.gov,Cathy Jone,"OSS Supervisor, Sr.",804-862-8937,8937,Cathy.Jones@vdh.virginia.gov,
VA-011216,Essex County Health Department,Virginia Department of Health,1407818701,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",423 N Church Ln,,Tappahannock,VA,22560,Essex,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services;Lisa Park,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,http://www.vdh.virginia.gov
VA-011217,"Riverside Tappahannock Hospital, Inc.","Riverside Healthcare Association, Inc.",1760580757,Inpatient Hospitals (other than children's hospitals),618 Hospital Rd,,Tappahannock,VA,22560-5000,Essex,608 Denbigh Boulevard,Suite 601,Newport News,VA,23608,Newport News City,Caleb Andrew Perez,"Sr. Analyst, Payer Relations",804-305-1867,,Caleb.Perez@rivhs.com,Mary Lou DelPrince,System Director of Payer Relations,757-534-6763,,Mary.DelPrince@rivhs.com,https://www.riversideonline.com/
VA-011218,Carilion Tazewell Community Hospital,Carilion Tazewell Community Hospital,1427040328,Inpatient Hospitals (other than children's hospitals),141 Ben Bolt Ave,,Tazewell,VA,24651-9700,Tazewell,141 BEN BOLT AVE,,Tazewell,VA,24651-9700,Tazewell,Nicole Grisetti,Provider Enrollment Supervisor,540-224-5677,,nagrisetti@carilionclinic.org,Rebecca Johnson,RCM Director,540-224-5715,,rhjohnson@carilionclinic.org,
VA-011219,Tazewell Co Health Dept,Virginia Department of Health,1932160355,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",253 Chambers Dr,PO Box 350,Tazewell,VA,24651-1251,Tazewell,224 Clydesway Drive,P.O. Box 2347,Lebanon,VA,24266,Russell,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.Park@vdh.virginia.gov,Anna Stevens,Business Manager,276-415-3360,,anna.stevens@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/cumbplat/
VA-011220,Vansant Respiratory Care Center,Stone Mountain Health Services,1053668996,Black Lung Clinics,1060 Anchorage Cir,Post Office Box 369,Vansant,VA,24656-7021,Buchanan,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011221,Thompson Family Health Center,Stone Mountain Health Center,1801013354,Federally Qualified Health Centers - Medical Services,1721 Lovers Gap Rd,Post Office Box 1149,Vansant,VA,24656-9781,Buchanan,276 Fieldstone Drive,,Jonesville,VA,24263,Lee,Malcolm Perdue,CEO,276-546-5310,,mperdue@stonemtn.org,Jackie Neff,Executive Assistant,276-546-5310,3135,jneff@stonemtn.org,
VA-011222,Lunenburg Medical Center,"SOUTHERN DOMINION HEALTH SYSTEMS, INC.",1497969091,"Dental Providers, Rural Health Clinics",1508 K V Rd,,Victoria,VA,23974-2624,Lunenburg,1508 K V Rd,,Victoria,VA,23974-2624,Lunenburg,Jill Seamans,CFO,434-696-2165,,seamansj@sdhsinc.com,,,,,,
VA-011223,SDHS Family Dentistry,"Southern Dominion Health System, Inc.",1396995940,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",1685 K-V Rd,PO Box 70,Victoria,VA,23974-0070,Lunenburg,1508 K-V Rd,PO Box 70,Victoria,VA,23974,Lunenburg,Diane Wenrick RT,Credentialing,804-561-5150,,wenrickd@sdhsinc.com,,,,,,
VA-011224,Roanoke County/Vinton Health Department,Virginia Department of Health,1285685487,"Family Planning Providers, Sexually Transmitted Disease Clinics",227 S Pollard St,,Vinton,VA,24179-2529,Roanoke,227 S Pollard St,,Vinton,VA,24179-2529,Roanoke,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Suzanne Renegar,Acting Nurse Manager,540-204-9957,,suzanne.renegar@vdh.virginia.gov,
VA-011225,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC D/B/A HEALTH AND SURGERY CENTER AT CONCERT DRIVE,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC,1912919481,Outpatient Hospital Clinics,2021 Concert Dr,,Virginia Beach,VA,23456-8082,Virginia Beach City,601 Children's Lane,,Norfolk,VA,23507,Norfolk City,Gregory S. Jones,"Director, Managed Care",757-668-9647,,GREGORY.JONES@CHKD.ORG,Catrina Mithcell,"Director, Financial Analytics",757-668-7945,,,
VA-011226,Virginia Beach City Health Dept,Virginia Department of Health,1053362996,"Dental Providers, Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4452 Corporation Ln,Suite 200,Virginia Beach,VA,23462-3173,Virginia Beach City,109 Governor St.,,Richmond,VA,23219,Richmond,Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Nicole Taylor-Baptiste,Nurse Manager,757-518-2673,,nicole.taylor-baptiste@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/vabeach/index.htm
VA-011227,Newtown Health Center,Virginia League for Planned Parenthood,1639347990,"Family Planning Providers, Sexually Transmitted Disease Clinics",515 Newtown Rd,,Virginia Beach,VA,23462-5620,Virginia Beach City,201 N Hamilton St,,Richmond,VA,23221-2601,Richmond City,Paulette McElwain,CEO,804-483-6138,,paulettemcelwain@vlpp.org,,,,,,www.vlpp.org
VA-011228,Bath County Health Department,Virginia Department of Health,1356354963,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",51 Courthouse Hill Rd,,Warm Springs,VA,24484-2277,Bath,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011229,Fauquier Co Health Dept,Virginia Department of Health,1467542480,"Family Planning Providers, Sexually Transmitted Disease Clinics",330 Hospital Dr,,Warrenton,VA,20186-3006,Fauquier,330 Hospital Drive,,Warrenton,VA,20186-3006,Fauquier,Lisa Park,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,"Charles J.Devine, III, M.D.",Medical Director,540-347-6400,,charles.devine@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/RappahannockRapidan/index.htm
VA-011230,Richmond County Health Department,Virginia Department of Health,1740243161,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",5591 Richmond Rd,,Warsaw,VA,22572-5219,Richmond,109 Governor St,,Richmond,VA,23219,Richmond City,Office of Community Health Services,Financial Services Manager I,804-864-7018,,Lisa.Park@vdh.virginia.gov,Lynn Buehler,Business Manager,804-758-2381,,Lynn.Buehler@vdh.virginia.gov,
VA-011231,Rappahannock Co Health Dept,Virginia Department of Health,1649360660,"Family Planning Providers, Sexually Transmitted Disease Clinics",491-A Main St,,Washington,VA,22747,Rappahannock,491-A Main St,,Washington,VA,22747,Washington,Lisa Park,Office of Community Services,804-864-7108,,lisa.park@vdh.virginia.gov,"Charles J. Devine, III, M.D.",Medical Director,540-675-3516,,charles.devine@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/RappahannockRapidan/index.htm
VA-011232,WAVERLY MEDICAL CENTER,HORIZON HEALTH SERVICES INC,1053538421,Federally Qualified Health Centers - Medical Services,344 W Main St,,Waverly,VA,23890-3235,Sussex,344 W Main St,,Waverly,VA,23890-3235,Sussex,Cheryl L Ebersole,CEO,757-859-6161,,cebersole@hhsinc.net,Becky Felts,Director of Finance,757-859-9070,,bfelts@hhsinc.net,
VA-011233,Waynesboro City Health Dept,Virginia Department of Health,1922101393,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",211 W 12th St,,Waynesboro,VA,22980-4772,Waynesboro City,Central Shenandoah Health District,1414 N. Augusta Street,Staunton,VA,24401,Augusta,Community Health Services,Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Dr. Laura Kornegay,Health Director,540-332-7830,341,laura.kornegay@vdh.virginia.gov,www.vdh.virginia.gov
VA-011234,Wise/Norton Health Dept,Virginia Department of Health,1790894780,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",134 Roberts Ave SW,,Wise,VA,24293-5800,Wise,109 Governor St,,Richmond,VA,23219,Richmond City,Lisa Park,Office of Community Health Services,804-864-7108,,lisa.park@vdh.virginia.gov,Michelle McPheron,Nurse Manager,276-328-1926,,michelle.mcpheron@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/lenowisco/index.htm
VA-011235,Prince William Health District Woodbridge Office,Virginia Department of Health,1346337979,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4001 Prince William Pkwy,Suite No. 101,Woodbridge,VA,22192-7666,Prince William,109 Governor Street,,Richmond,VA,23219,Henrico,Office of Community Health Services; Lisa Park,Financial Services Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Alison Ansher,Health Director,703-792-6300,,alison.ansher@vdh.virginia.gov,www.vdh.virginia.gov
VA-011236,Greater Prince William Community Health Center,Greater Prince William Community Health Center,1366591562,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",4379 Ridgewood Center Dr,Suite 102,Woodbridge,VA,22192-8323,Prince William,4379 Ridgewood Center Drive,Suite 102,Woodbridge,VA,22192,Prince William,Mark Meye,Director of Finance,703-680-7950,3109,mmeye@gpwhealthcenter.org,George Barker,Executive Director,703-680-7950,3110,gbarker@gpwhealthcenter.org,
VA-011237,Valley Health Shenandoah Memorial Hospital - Pediatrics,Shenandoah Memorial Hospital,1053848069,Rural Health Clinics,759 S Main St,,Woodstock,VA,22664-1154,Shenandoah,759 South Main Street,,Woodstock,VA,22664,Shenandoah,Shawn Carrico,Director of Finance,540-459-1120,,scarrico@valleyhealthlink.com,Peter F. Gallagher,Sr. VP & CFO,540-536-8032,,pgallagh@valleyhealthlink.com,www.valleyhealthlink.com
VA-011238,Wythe Co Health Dept,Virginia Department of Health,1093759706,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",290 S 6th St,Suite 300,Wytheville,VA,24382-2554,Wythe,201 Francis Marion Lane,,Marion,VA,24354,Smyth,Office of Community Health Services: Lisa Park,Health Care Reimbursement Manager,804-864-7018,,lisa.park@vdh.virginia.gov,Patricia VanHoy,Nursing Manager,276-781-7450,,tricia.vanhoy@vdh.virginia.gov,http://www.vdh.virginia.gov/LHD/mtrogers/index.htm
VA-011239,Wythe County Community Hospital,LifePoint Health,1184706152,Inpatient Hospitals (other than children's hospitals),600 W Ridge Rd,,Wytheville,VA,24382-1044,Wythe,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Kristi Morrow,Sr. VP Integrated Revenue Management,615-920-7000,,KRISTI.MORROW@LPNT.NET,John White,CFO,276-228-0204,,,
VT-011240,Alburg Health Center,"RICHFORD HEALTH CENTER, INC.",1407843543,Federally Qualified Health Centers - Medical Services,64 Industrial Park Rd,PO Box 266,Alburg,VT,05440-0266,Grand Isle,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011241,"BATTENKILL VALLEY HEALTH CENTER, INC.","BATTENKILL VALLEY HEALTH CENTER, INC.",1033530696,"Dental Providers, Federally Qualified Health Centers - Medical Services",9 Church St,,Arlington,VT,05250-4457,Bennington,P.O. Box 61,,Arlington,VT,05250,Bennington,Grace Gilbert-Davis,Chief Executive Officer,802-430-7269,,gracegilbertdavis@bvhcvt.org,Jennifer Petry,Director of Practice Administration,802-430-7254,,jenniferpetry@bvhcvt.org,
VT-011242,Gifford Health Center at Berlin,"Gifford Health Care, Inc.",1184054009,Federally Qualified Health Centers - Medical Services,2418 Airport Rd,Suite 1 - Berlin,Barre,VT,05641-8702,Washington,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,www.giffordhealthcare.org
VT-011243,Planned Parenthood of Northern New England - Barre,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",90 Washington St,,Barre,VT,05641-4239,Washington,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
VT-011244,Rockingham Medical Group,"Springfield Medical Care Systems, Inc.",1992030365,Federally Qualified Health Centers - Medical Services,1 Hospital Ct,,Bellows Falls,VT,05101-1489,Windham,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011245,Planned Parenthood of Northern New England - Bennington,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",194 North St,,Bennington,VT,05201-1874,Bennington,784 Hercules Drive,Suite 110,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
VT-011246,Bethel Health Center,"Gifford Health Care, Inc.",1659701571,Federally Qualified Health Centers - Medical Services,1823 Vt Rte 107,,Bethel,VT,05032-9107,Windsor,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,www.giffordhealthcare.org
VT-011247,Little Rivers Health Care,"LITTLE RIVERS HEALTH CARE, INC.",1033163555,Federally Qualified Health Centers - Medical Services,146 Mill St,,Bradford,VT,05033-4456,Orange,PO Box 338,,Bradford,VT,05033,Orange,Gail Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Lisa Harris,Billing Manager,802-222-4637,105,lharris@littlerivers.org,www.littlerivers.org
VT-011248,Clara Martin Center,"LITTLE RIVERS HEALTH CARE, INC.",1033163555,Federally Qualified Health Centers - Medical Services,1740 Lower Plain,,Bradford,VT,05033-8934,Orange,146 Mill St,,Bradford,VT,05033-4456,Orange,Gail K Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Susan Monica,CFO,802-222-4637,102,smonica@littlerivers.org,www.littlerivers.org
VT-011249,Valley Vista,"LITTLE RIVERS HEALTH CARE, INC.",1316165129,Federally Qualified Health Centers - Medical Services,23 Upper Plain,,Bradford,VT,05033-9016,Orange,146 Mill St,,Bradford,VT,05033-4456,Orange,Gail K Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Susan Monica,CFO,802-222-4637,102,smonica@littlerivers.org,www.littlerivers.org
VT-011250,BRADFORD,"LITTLE RIVERS HEALTH CARE, INC.",1316165129,Federally Qualified Health Centers - Medical Services,437 S Main St,,Bradford,VT,05033-8877,Orange,146 Mill St,,Bradford,VT,05033-4456,Orange,Gail K Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Susan Monica,CFO,802-222-4637,102,smonica@littlerivers.org,www.littlerivers.org
VT-011251,Planned Parenthood of Northern New England - Brattleboro,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",402 Canal St,,Brattleboro,VT,05301-6622,Windham,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011252,Mountain Health Center,"FIVE-TOWN HEALTH ALLIANCE, INC.",1871840843,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",74 Munsill Ave,Suite 100,Bristol,VT,05443-1047,Addison,74 Munsill Ave Ste 100,,Bristol,VT,05443-1047,Addison,Martha Halnon,Executive Director,802-453-5116,,mhalnon@mountainhealthcenter.com,,,,,,
VT-011253,Vermont Regional Hemophilia Treatment Center,University of Vermont,1083904213,Hemophilia Treatment Centers,1 S Prospect St,,Burlington,VT,05401-3456,Chittenden,111 Colchester Ave.,"Main Campus, Main Pavilion, Level 2",Burlington,VT,05401,Chittenden,Katie Michaud,"Director, Cancer Services & Patient Access Center",802-847-4592,,katherine.michaud@uvmhealth.org,,,,,,
VT-011254,University of Vermont Children's Hospital,University of Vermont Medical Center,1568419976,Children's Hospitals (inpatient only),111 Colchester Ave,,Burlington,VT,05401-1473,Chittenden,111 Colchester Ave,,Burlington,VT,05401,Chittenden,Carmone Austin,Director of Contracting,802-847-8051,,carmone.austin@uvmhealth.org,Gretchen Begnoche,Senior Contract Specialist,802-847-9613,,gretchen.begnoche@uvmhealth.org,www.uvmhealth.org
VT-011255,Pearl Street Youth Health Center,"Community Health Centers of Burlington, Inc.",1083832851,Federally Qualified Health Centers - Medical Services,179 Pearl St,,Burlington,VT,05401-3704,Chittenden,617 Riverside Avenue,,Burlington,VT,05401,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011256,Planned Parenthood of Northern New England - Burlington,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",183 Saint Paul St,,Burlington,VT,05401-4636,Chittenden,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011257,SAFE HARBOR HEALTH CENTER,"COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.",1083832851,"Dental Providers, Federally Qualified Health Centers - Medical Services",184 S Winooski Ave,,Burlington,VT,05401-4535,Chittenden,617 Riverside Ave,,Burlington,VT,05401-1601,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011258,"Community Health Centers Of Burlington, Inc.","COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.",1083832851,Dental Providers,6 Archibald St,H.O. WHEELER SCHOOL DENTAL CLINIC,Burlington,VT,05401-4220,Chittenden,617 Riverside Avenue,,Burlington,VT,05401,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011259,RIVERSIDE HEALTH CENTER,"COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.",1083832851,"Dental Providers, Federally Qualified Health Centers - Medical Services",617 Riverside Ave,,Burlington,VT,05401-1601,Chittenden,617 Riverside Ave,,Burlington,VT,05401-1601,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011260,South End Health Center,"Community Health Centers of Burlington, Inc.",1083832851,Federally Qualified Health Centers - Medical Services,789 Pine St,,Burlington,VT,05401-4933,Chittenden,617 Riverside Avenue,,Burlington,VT,05401,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011261,Cabot Health Services,"Northeast Washington County Community Health, Inc.",1902008485,Federally Qualified Health Centers - Medical Services,25 Common Rd,,Cabot,VT,05647-9731,Washington,157 Towne Ave,PO Box 320,Plainfield,VT,05667,Washington,Linda Bartlett,Chief Operations Officer,802-454-8336,348,lbartlett@the-health-center.org,John Matthew,CEO,802-454-8336,,newcch@charter.net,
VT-011262,Indian Stream Health Center Satellite Site,INDIAN STREAM HEALTH CENTER,1215367891,Federally Qualified Health Centers - Medical Services,253 Gale St,,Canaan,VT,05903-9500,Essex,141 Corliss Ln,,Colebrook,NH,03576-3245,Coos,Jonathan Brown,CEO,603-237-8336,,jbrown@indianstream.org,,,,,,
VT-011263,Chelsea Health Center,"Gifford Health Care, Inc.",1457781031,Federally Qualified Health Centers - Medical Services,356 VT Rte 110,,Chelsea,VT,05038-8993,Orange,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,www.giffordhealthcare.org
VT-011264,Chester Family Medicine,Springfield Medical Care Systems Inc,1043545411,Federally Qualified Health Centers - Medical Services,55 Main St Route 11,,Chester,VT,05143,Windsor,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011265,CONCORD HEALTH CENTER,"NORTHERN COUNTIES HEALTH CARE, INC",1295852549,Federally Qualified Health Centers - Medical Services,201 Main St,,Concord,VT,05824-9825,Essex,165 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,Patrick Flood,CEO,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011266,DANVILLE HEALTH CENTER,"NORTHERN COUNTIES HEALTH CARE, INC",1255458501,Federally Qualified Health Centers - Medical Services,26 Cedar Ln,,Danville,VT,05828-9751,Caledonia,165 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,Patrick Flood,ceo,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011267,EAST CORINTH,"LITTLE RIVERS HEALTH CARE, INC.",1972751279,Federally Qualified Health Centers - Medical Services,720 Village Rd,,East Corinth,VT,05040-9783,Orange,146 Mill St,,Bradford,VT,05033-4456,Orange,Gail K Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Susan Monica,CFO,802-222-4637,102,smonica@littlerivers.org,www.littlerivers.org
VT-011268,Enosburg Health Center,"RICHFORD HEALTH CENTER, INC.",1184611378,Federally Qualified Health Centers - Medical Services,382 Main St,PO Box 428,Enosburg Falls,VT,05450-0428,Franklin,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011269,Fairfax Health Center,"RICHFORD HEALTH CENTER, INC.",1164971495,Federally Qualified Health Centers - Medical Services,1199 Main St,,Fairfax,VT,05454-9530,Franklin,"44 Main Street, Suite 200",,Richford,VT,05476,Franklin,Kathy J. Benoit,Finance Director,802-255-5562,,kjbenoit@notchvt.org,,,,,,
VT-011270,NORTHERN COUNTIES DENTAL CENTER,"NORTHERN COUNTIES HEALTH CARE, INC",1114044344,Dental Providers,151 N Main St,,Hardwick,VT,05843-7065,Caledonia,Northern Counties Health Care,165 Sherman Dr,St. Johnsbury,VT,05819,Caledonia,Patrick Flood,CEO,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011271,Hardwick Area Health Center,"NORTHERN COUNTIES HEALTH CARE, INC",1194842450,Federally Qualified Health Centers - Medical Services,4 Slapp Hill,,Hardwick,VT,05843-9300,Caledonia,165 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,Patrick Flood,CEO,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011272,Planned Parenthood of Northern New England - Hyde Park,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",213 E Main St,,Hyde Park,VT,05655-9274,Lamoille,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011273,ISLAND POND HEALTH CENTER,"NORTHERN COUNTIES HEALTH CARE, INC",1992822555,"Dental Providers, Federally Qualified Health Centers - Medical Services",82 Maple St,,Island Pond,VT,05846,Essex,165 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,Patrick Flood,CEO,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011274,Mountain Valley Medical Clinic,"Springfield Medical Care Systems, Inc.",1639544331,Federally Qualified Health Centers - Medical Services,38 VT Route 11,,Londonderry,VT,05148-9555,Windham,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011275,Ludlow Health Center,"Springfield Medical Care Systems, Inc.",1003141474,Federally Qualified Health Centers - Medical Services,1 Elm St,,Ludlow,VT,05149-1301,Windsor,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011276,Ludlow Dental,Springfield Medical Care Systems Inc,1376835405,Dental Providers,8 Main St,,Ludlow,VT,05149-1106,Windsor,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011277,Corner Medical,Northeastern Vermont Regional Hospital,1659459428,Rural Health Clinics,195 Industrial Pkwy,PO Box 83,Lyndonville,VT,05851-4511,Caledonia,1315 Hospital Dr,PO Box 905,St Johnsbury,VT,05819,Caledonia,Laural Ruggles,VP Community Health Improvement,802-748-7590,,l.ruggles@nvrh.org,Robert Hersey,CFO,802-748-7520,,r.hersey@nvrh.org,www.nvrh.org
VT-011278,Planned Parenthood of Northern New England - Middlebury,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,1330 Exchange St,Suite 202,Middlebury,VT,05753-4464,Addison,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
VT-011279,Appleseed Pediatrics,"Copley Professional Services Group, Inc",1124436332,Federally Qualified Health Centers - Medical Services,439 Washington Hwy,,Morrisville,VT,05661-8969,Lamoille,66 Morrisvile Plaza,,Morrisville,VT,05661,Lamoille,Jennifer Holton-Clapp,Analytics & Informatics Director,802-253-9156,,jclapp@chslv.org,,,,,,
VT-011280,Morrisville Family Health Care,"Copley Professional Services Group, Inc",1639127681,Federally Qualified Health Centers - Medical Services,607 Washington Hwy,,Morrisville,VT,05661-8652,Lamoille,66 Morrisvile Plaza,,Morrisville,VT,05661,Lamoille,Jennifer Holton-Clapp,Analytics & Informatics Director,802-253-9156,,jclapp@chslv.org,,,,,,
VT-011281,Neurology Clinic,"Copley Professional Services Group, Inc",1134261076,Other ECP Providers,607 Washington Hwy,,Morrisville,VT,05661-8652,Lamoille,66 Morrisvile Plaza,,Morrisville,VT,05661,Lamoille,Jennifer Holton-Clapp,Analytics & Informatics Director,802-253-9156,,jclapp@chslv.org,,,,,,
VT-011282,Behavioral Health & Wellness,"Copley Professional Services Group, Inc",1851349484,Federally Qualified Health Centers - Medical Services,65 Northgate Plz,Suite 11,Morrisville,VT,05661-5900,Lamoille,66 Morrisvile Plaza,,Morrisville,VT,05661,Lamoille,Jennifer Holton-Clapp,Analytics & Informatics Director,802-253-9156,,jclapp@chslv.org,,,,,,
VT-011283,Planned Parenthood of Northern New England - Newport,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",79 Coventry St,,Newport,VT,05855-2206,Orleans,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011284,Orleans Dental Center,"NORTHERN COUNTIES HEALTH CARE, INC",1114044344,Dental Providers,11 Union St,,Orleans,VT,05860-1218,Orleans,165 Sherman Drive,,St. Johnsbury,VT,05819,Caledonia,Shawn Tester,CEO,802-748-9405,1513,shawnt@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011285,The Health Center,"Northeast Washington County Community Health, Inc.",1699755348,"Dental Providers, Federally Qualified Health Centers - Medical Services",157 Towne Ave,PO Box 320,Plainfield,VT,05667-9425,Washington,157 Towne Ave,PO Box 320,Plainfield,VT,05667,Washington,Linda Bartlett,Chief Operations Officer,802-454-8336,348,lbartlett@the-health-center.org,John Matthew,CEO,802-454-8336,,newcch@charter.net,
VT-011286,Kingwood Health Center,Gifford Health Care,1619427663,"Federally Qualified Health Centers - Medical Services, Outpatient Hospital Clinics",1422 VT Route 66,,Randolph,VT,05060-7718,Orange,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel-Hickory,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,
VT-011287,"Gifford Primary Care, Ob/Gyn and Midwifery, and Pediatrics and Adolescent Care",Gifford Health Care,1326478702,Federally Qualified Health Centers - Medical Services,44 S Main St,,Randolph,VT,05060-1381,Orange,44 South Main Street,,Randolph,VT,05060,Orange,Emma Schumann,Project Manager,802-728-2339,,eschumann@giffordmed.org,,,,,,
VT-011288,Richford Dental Clinic,"RICHFORD HEALTH CENTER, INC.",1154306298,Dental Providers,44 Main St,Suite 400,Richford,VT,05476-1141,Franklin,"44 Main Street, Suite 200",,Richford,VT,05476,Franklin,Kathy Benoit,Finance Director,802-255-5562,,kjbenoit@notchvt.org,,,,,,
VT-011289,Richford Health Center,"RICHFORD HEALTH CENTER, INC.",1750380531,Federally Qualified Health Centers - Medical Services,44 Main St,Suite 200,Richford,VT,05476-1141,Franklin,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011290,Rochester Health Center,"Gifford Health Care, Inc.",1285064105,Federally Qualified Health Centers - Medical Services,235 S Main St,,Rochester,VT,05767-9683,Windsor,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,www.giffordhealthcare.org
VT-011291,Planned Parenthood of Northern New England - Rutland,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,11 Burnham Ave,,Rutland,VT,05701-3205,Rutland,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,krystle.goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,heather.bushey@ppnne.org,www.ppnne.org
VT-011292,NCSS Health Center,"RICHFORD HEALTH CENTER, INC.",1669802351,Federally Qualified Health Centers - Medical Services,107 Fisher Pond Rd,,Saint Albans,VT,05478-6286,Franklin,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011293,St Albans Health Center,"RICHFORD HEALTH CENTER, INC.",1619140696,Federally Qualified Health Centers - Medical Services,48 Lower Newton St,Suite 2,Saint Albans,VT,05478-1907,Franklin,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011294,Fairfield Street Health Center,"RICHFORD HEALTH CENTER, INC.",1093186660,Federally Qualified Health Centers - Medical Services,77 Fairfield St,,Saint Albans,VT,05478-1716,Franklin,44 Main St Ste 200,,Richford,VT,05476,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011295,Planned Parenthood of Northern New England - St. Albans,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",80 Fairfield St,,Saint Albans,VT,05478-1728,Franklin,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011296,ST. JOHNSBURY COMMUNITY HEALTH CENTER,"NORTHERN COUNTIES HEALTH CARE, INC",1851418230,Federally Qualified Health Centers - Medical Services,185 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,165 Sherman Dr,,Saint Johnsbury,VT,05819-9811,Caledonia,Patrick Flood,CEO,802-748-9405,,patrickf@nchcvt.org,Liza Browne,Quality Reporting Manager,802-748-9405,1201,lizab@nchcvt.org,
VT-011297,Planned Parenthood of Northern New England - St. Johnsbury,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",501 Portland St,,Saint Johnsbury,VT,05819-2054,Caledonia,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011298,KEELER BAY HEALTH CENTER,"COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.",1083832851,Federally Qualified Health Centers - Medical Services,564 Route 2,,South Hero,VT,05486-4307,Grand Isle,617 Riverside Ave,,Burlington,VT,05401-1601,Chittenden,Jack Donnelly,CEO,802-864-6309,,jdonnelly@chcb.org,,,,,,
VT-011299,Springfield Health Center,"Springfield Medical Care Systems, Inc.",1992073191,Federally Qualified Health Centers - Medical Services,100 River St,,Springfield,VT,05156-2930,Windsor,25 Ridgewood Road,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011300,The Women's Health Center of Springfield,"Springfield Medical Care Systems, Inc.",1124353412,Federally Qualified Health Centers - Medical Services,29 Ridgewood Rd Unit 100,,Springfield,VT,05156-3060,Windsor,25 Ridgewood Rd,,Springfield,VT,05156,Windsor,"Joshua R. Dufresne, MBA",Chief of Practice Operations & HRSA Project Director,802-885-7620,,jdufresne@springfieldmed.org,,,,,,
VT-011301,Women's Wellness Center,Northeastern Vermont Regional Hospital,1831132299,Rural Health Clinics,1315 Hospital Dr,PO Box 905,St Johnsbury,VT,05819-9210,Caledonia,1315 Hospital Dr,PO Box 905,St Johnsbury,VT,05819,Caledonia,Laural Ruggles,VP Community Health Improvement,802-748-7590,,l.ruggles@nvrh.org,Robert Hersey,CFO,802-748-7520,,r.hersey@nvrh.org,www.nvrh.org
VT-011302,Kingdom Internal Medicine,Northeastern Vermont Regional Hospital,1871870899,Rural Health Clinics,714 Breezy Hill Rd,,St Johnsbury,VT,05819-8882,Caledonia,1315 Hospital Dr,PO Box 905,St Johnsbury,VT,05819,Caledonia,Laural Ruggles,VP Community Health Improvement,802-748-7590,,l.ruggles@nvrh.org,Robert Hersey,CFO,802-748-7520,,r.hersey@nvrh.org,www.nvrh.org
VT-011303,St Johnsbury Pediatrics,Northeastern Vermont Regional Hospital,1487732301,Rural Health Clinics,97 Sherman Dr,PO Box 905,St Johnsbury,VT,05819-9280,Caledonia,1315 Hospital Dr,PO Box 905,St Johnsbury,VT,05819,Caledonia,Laural Ruggles,VP Community Health Improvement,802-748-7590,,l.ruggles@nvrh.org,Robert Hersey,CFO,802-748-7520,,r.hersey@nvrh.org,www.nvrh.org
VT-011304,Stowe Family Practice,"Copley Professional Services Group, Inc",1770541567,Federally Qualified Health Centers - Medical Services,1878 Mountain Rd,Suite 6,Stowe,VT,05672-4775,Lamoille,66 Morrisvile Plaza,,Morrisville,VT,05661,Lamoille,Jennifer Holton-Clapp,Analytics & Informatics Director,802-253-9156,,jclapp@chslv.org,,,,,,
VT-011305,Swanton Health Center,"RICHFORD HEALTH CENTER, INC.",1003803297,Federally Qualified Health Centers - Medical Services,26 Canada St,,Swanton,VT,05488-1335,Franklin,44 Main St Ste 200,,Richford,VT,05476-1141,Franklin,Kathy J Benoit,Finance Director,802-255-5562,562,kjbenoit@notchvt.org,,,,,,
VT-011306,Swanton Health Center,"RICHFORD HEALTH CENTER, INC",1790160984,Dental Providers,26 Canada St,,Swanton,VT,05488-1335,Franklin,"44 Main Street, Suite 200",,Richford,VT,05476,Franklin,Kathy Benoit,Finance Director,802-255-5562,,pparsons@notchvt.org,,,,,,
VT-011307,Grace Cottage Family Health,"Carlos G. Otis Health Care Center, Inc.",1124049960,Rural Health Clinics,185 Grafton Road,,Townshend,VT,05353-0216,Windham,PO Box 216,,Townshend,VT,05353-0216,Windham,Stephen A. Brown,CFO,802-365-3601,120,sbrown@gracecottage.org,,,,,,www.gracecottage.org
VT-011308,Wells River,"LITTLE RIVERS HEALTH CARE, INC.",1861640161,Federally Qualified Health Centers - Medical Services,65 Main St N,,Wells River,VT,05081-9692,Orange,146 Mill St,,Bradford,VT,05033-4456,Orange,Gail K Auclair,CEO,802-222-4637,104,gauclair@littlerivers.org,Susan Monica,CFO,802-222-4637,102,smonica@littlerivers.org,www.littlerivers.org
VT-011309,Twin River Health Center,"Gifford Health Care, Inc.",1073943999,Federally Qualified Health Centers - Medical Services,108 N Main St,,White River Junction,VT,05001-7056,Windsor,PO Box 2000,,Randolph,VT,05060,Orange,Jennifer Ertel,Project Manager,802-728-2339,,jmertel@giffordmed.org,,,,,,
VT-011310,Planned Parenthood of Northern New England - White River Junction,Planned Parenthood of Northern New England,1578529350,Family Planning Providers,79 S Main St,,White River Junction,VT,05001-7071,Windsor,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
VT-011311,Planned Parenthood of Northern New England,Planned Parenthood of Northern New England,1578529350,"Family Planning Providers, Sexually Transmitted Disease Clinics",75 Talcott Rd,Suite 10,Williston,VT,05495-8122,Chittenden,"784 Hercules Dr, Suite 110",,Colchester,VT,05446,Chittenden,Krystle Goodman,Director of Professional Revenue,802-448-9784,,Krystle.Goodman@ppnne.org,Heather Bushey,CFO,802-448-9728,,Heather.Bushey@ppnne.org,www.ppnne.org
WA-011312,SEA MAR - ABERDEEN BH,Sea Mar Community Health Centers,1598951089,Federally Qualified Health Centers - Medical Services,1813 Sumner Ave,,Aberdeen,WA,98520-4600,Grays Harbor,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011313,Sea Mar CHC,Sea Mar Community Health Centers,1306982608,Dental Providers,1813 Sumner Ave,,Aberdeen,WA,98520-4600,Grays Harbor,1040 S Henderson St,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011314,Grays Harbor Public Health Social Services Department,State of Washington Dept. of Health Reproductive Health and Wellness,1518006220,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",2109 Sumner Ave,,Aberdeen,WA,98520-3600,Grays Harbor,2109 Sumner Ave,,Aberdeen,WA,98520-3600,Grays Harbor,Kimberly McCaw,Family Planning Coordinator,360-532-8631,4048,kmcaw@co.grays-harbor.wa.us,Karolyn Holden,Deputy Director,360-500-4063,,kholden@co.grays-harbor.wa.us,http://www.healthygh.org/Default.aspx?ForceServerSideTransform=true
WA-011315,SEA MAR ACACORTES BH,Sea Mar Community Health Centers,1922336478,Federally Qualified Health Centers - Medical Services,1004 M Ave,,Anacortes,WA,98221-1954,Skagit,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011316,CHC of Snohomish County Arlington Medical Dental Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1649602756,"Dental Providers, Federally Qualified Health Centers - Medical Services",326 S Stillaguamish Ave,,Arlington,WA,98223-1652,Snohomish,8609 Evergreen Way,,Everett,WA,98208-2619,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,,,,,,
WA-011317,HealthPoint Auburn,HEALTHPOINT,1730186966,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",126 Auburn Ave,,Auburn,WA,98002-5057,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011318,Muckleshoot Health & Wellness Center,Muckleshoot Indian Tribe,1558448175,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",17500 SE 392nd St,,Auburn,WA,98092-9705,King,39015 172nd Ave SE,,Auburn,WA,98092-9763,King,Lisa James,Tribal Health Director,253-939-6648,,lisa.james@muckleshoot-health.com,Jake Bergstrom,Medical Director,253-939-6648,3633,jake.bergstrom@muckleshoot-health.com,
WA-011319,HealthPoint Valley Cities Auburn,HEALTHPOINT,1972845691,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2704 I St NE,,Auburn,WA,98002-2411,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011320,Auburn Public Health Center,Public Health Seattle & King County,1922105154,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",901 Auburn Way N,Suite A,Auburn,WA,98002-4100,King,401 Fifth Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Karen Russell,Clinic Administrator,206-477-0262,,karen.russell@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011321,HealthPoint Auburn North,HEALTHPOINT,1699156141,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",923 Auburn Way N,,Auburn,WA,98002-4117,King,955 Powell Ave SW,,Renton,WA,98057,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-230-0416,,vhammond@healthpointchc.org,
WA-011322,Sea Mar CHC Battle Ground,SEA-MAR COMMUNITY HEALTH CENTER BATTLE GROUND,1962877423,Federally Qualified Health Centers - Medical Services,118 S Parkway Ave,,Battle Ground,WA,98604-9215,Clark,1040 S Henderson St,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011323,PCHS Belfair Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1528517216,"Dental Providers, Federally Qualified Health Centers - Medical Services",31 NE State Route 300,Suite 200,Belfair,WA,98528-8668,Mason,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011324,ICHS Bellevue Medical and Dental Clinic,INTERNATIONAL COMMUNITY HEALTH SERVICES,1114363157,"Dental Providers, Federally Qualified Health Centers - Medical Services",1050 140th Ave NE,,Bellevue,WA,98005-2972,King,720 8th Ave S Ste 100,,Seattle,WA,98104-3033,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,www.ichs.com
WA-011325,Sea Mar CHC - Bellevue Bell-Red Rd.,SEA-MAR COMMUNITY HEALTH CENTER,1114112687,Federally Qualified Health Centers - Medical Services,12835 Bel Red Rd,Suite 100,Bellevue,WA,98005-2625,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011326,Eastgate Public Health Center,Public Health Seattle & King County,1922105154,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",14350 SE Eastgate Way,,Bellevue,WA,98007-6458,King,401 Fifth Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Fidelis Nkeze,Clinic Administrator,206-477-0555,,fidelis.nkeze@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011327,Bellevue Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",14730 NE 8th St,,Bellevue,WA,98007-4116,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011328,SEA MAR BELLEVUE CHILD & FAMILY,Sea Mar Community Health Centers,1114112687,Federally Qualified Health Centers - Medical Services,1811 156th Ave NE,Suite 2,Bellevue,WA,98007-4344,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011329,SEA MAR BELLEVUE SPECIALTY DENTAL,Sea Mar Community Health Centers,1942665831,Dental Providers,2000 116th Ave NE,,Bellevue,WA,98004-3047,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011330,SEA MAR BELLEVUE DENTAL,Sea Mar Community Health Centers,1154792562,Dental Providers,3801 150th Ave SE,,Bellevue,WA,98006-1668,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011331,SEA MAR - Bellevue Medical,Sea Mar Community Health Centers,1568644714,Federally Qualified Health Centers - Medical Services,3801 150th Ave SE,,Bellevue,WA,98006-1668,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011332,BELLINGHAM HEALTH CENTER,Mt. Baker Planned Parenthood,1790902906,"Family Planning Providers, Sexually Transmitted Disease Clinics",1530 Ellis St,,Bellingham,WA,98225-4905,Whatcom,1509 Cornwall Avenue,,Bellingham,WA,98225,Whatcom,Petra Karpsteinova,Director of Finance,360-603-7708,,petra.karpsteinova@mbpp.org,Linda McCarthy,Executive Director,360-603-7701,,linda.mccarthy@mbpp.org,http://www.plannedparenthood.org/mbpp/
WA-011333,UCNW - Bellingham,Unity Care Northwest,1760430532,"Dental Providers, Federally Qualified Health Centers - Medical Services",220 Unity St,,Bellingham,WA,98225-4429,Whatcom,"1616 Cornwall Ave., Suite 205",,Bellingham,WA,98225,Whatcom,Desmond Skubi,Executive Director,360-788-2620,,des.skubi@ucnw.org,,,,,,
WA-011334,Lummi Tribal Health Center,Lummi Indian Business Council,1669592374,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",2592 Kwina Rd,,Bellingham,WA,98226-9278,Whatcom,2665 Kwina Road,,Bellingham,WA,98226,Whatcom,Stephanie Williams,Business Office Director,360-384-2492,2285,stephaniew@lummi-nsn.gov,,,,,,
WA-011335,Lummi Counseling Services,Lummi Indian Business Council,1407979289,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",2616 Kwina Rd,,Bellingham,WA,98226-9291,Whatcom,2665 Kwina Rd.,,Bellingham,WA,98226,Whatcom,Stephanie Williams,Healthcare Business Office Director,360-312-2000,2285,StephanieW@lummi-nsn.gov,Vanda Patterson,Health & Human Services Executive Director,360-312-2000,2499,VandaP@lummi-nsn.gov,
WA-011336,Lummi Behavioral Health,Lummi Indian Business Council,1225158769,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",2665 Kwina Rd,,Bellingham,WA,98226-9291,Whatcom,2665 Kwina Rd.,,Bellingham,WA,98226,Whatcom,Stephanie Williams,Healthcare Business Office Director,360-312-2000,2285,StephanieW@lummi-nsn.gov,Vanda Patterson,Health & Human Services Director,360-312-2000,2499,VandaP@lummi-nsn.gov,
WA-011337,Sea Mar CHC - Bellingham Behavioral Health,SEA-MAR COMMUNITY HEALTH CENTER,1033302088,Federally Qualified Health Centers - Medical Services,3350 Airport Dr,,Bellingham,WA,98226-7696,Whatcom,1040 S Henderson St,,Seattle,WA,98108-4720,Whatcom,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011338,SEAMAR BELLINGHAM CHILD AND FAMILY,Sea Mar Community Health Centers,1033302088,Federally Qualified Health Centers - Medical Services,3350 Airport Dr # 2,,Bellingham,WA,98226-7696,Whatcom,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011339,SEA MAR - Bellingham Dental,SEA-MAR COMMUNITY HEALTH CENTER,1154479103,Dental Providers,4455 Cordata Pkwy,,Bellingham,WA,98226-8037,Whatcom,1040 S Henderson St,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011340,SEA MAR - Bellingham Medical,Sea Mar Community Health Centers,1225185648,Federally Qualified Health Centers - Medical Services,4455 Cordata Pkwy,,Bellingham,WA,98226-8037,Whatcom,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011341,SEA MAR BELLINGHAM MERCY HOUSING,Sea Mar Community Health Centers,1225185648,Federally Qualified Health Centers - Medical Services,512 Sterling Dr,,Bellingham,WA,98226-5503,Whatcom,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011342,HealthPoint Bothell,HEALTHPOINT,1821096405,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",10414 Beardslee Blvd,,Bothell,WA,98011-3205,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011343,Northshore Public Health Center,Public Health Seattle & King County,1922105154,Federally Qualified Health Centers - Medical Services,10808 NE 145th St,,Bothell,WA,98011-5226,King,401 5th Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,,,,,,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011344,PCHS Wheaton Way Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1407148497,Federally Qualified Health Centers - Medical Services,2508 Wheaton Way,,Bremerton,WA,98310-3303,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011345,PCHS Almira Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1972977924,"Dental Providers, Federally Qualified Health Centers - Medical Services",5455 Almira Dr NE,,Bremerton,WA,98311-8330,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011346,PCHS Bremerton Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1205886934,"Dental Providers, Federally Qualified Health Centers - Medical Services",616 6th St,,Bremerton,WA,98337-1420,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011347,Bremerton Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",723 NE Riddell Rd,,Bremerton,WA,98310-3030,Kitsap,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011348,Family Health Centers Brewster Dental,Family Health Centers,1609804392,Dental Providers,101 6th St,,Brewster,WA,98812-3404,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Deana Abel,Assistant Dental Director,509-422-6705,,dabel@myfamilyhealth.org,www.myfamilyhealth.org
WA-011349,Confluence Health - Brewster Clinic,Confluence Health / Wenatchee Valley Hospital,1811259195,Rural Health Clinics,418 Main Street,,Brewster,WA,98812,Okanogan,820 N. Chelan Avenue,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP - Risk,509-664-4868,7502,Sarah.Brown@hhs.gov,Jeanne Walton,,509-663-8711,,,
WA-011350,Family Health Centers Brewster Indian Avenue Medical,Family Health Centers,1609804392,Federally Qualified Health Centers - Medical Services,520 W Indian Ave,,Brewster,WA,98812,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Melodie White,Clinic Operations Manager,509-689-2525,,mwhite@myfamilyhealth.org,www.myfamilyhealth.org
WA-011351,Family Health Centers Brewster Jay Avenue Medical,Family Health Centers,1609804392,Federally Qualified Health Centers - Medical Services,525 Jay Ave,,Brewster,WA,98812-3403,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Melodie White,Clinic Operations Manager,509-689-3455,,mwhite@myfamilyhealth.org,www.myfamilyhealth.org
WA-011352,Family Health Centers Bridgeport Medical Dental,Family Health Centers,1609804392,"Dental Providers, Federally Qualified Health Centers - Medical Services",1015 Columbia Ave,,Bridgeport,WA,98813-9805,Douglas,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Melodie White,Clinic Operations Manager,509-686-0603,,mwhite@myfamilyhealth.org,www.myfamilyhealth.org
WA-011353,Navos Public Health Center,Public Health Seattle & King County,1922105154,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1210 SW 136th St,,Burien,WA,98166-1214,King,401 5th Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-263-8343,,john.gilvar@kingcounty.gov,Jane Simpson,Clinic Administrator,206-205-6001,,jane.simpson@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011354,Sea Mar CHC - Burien Ambaum Blvd. SW,SEA-MAR COMMUNITY HEALTH CENTER,1245387679,Federally Qualified Health Centers - Medical Services,14434 Ambaum Blvd SW,,Burien,WA,98166-1438,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011355,HealthPoint Evergreen SBHC,HEALTHPOINT,1174888119,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",830 SW 116th St,,Burien,WA,98146-2257,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,vhammond@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011356,Wahkiakum Clinic,Cowlitz Family Health Center,1538497417,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",335 Una Ave,,Cathlamet,WA,98612-9583,Wahkiakum,1057 12th Avenue,,Longview,WA,98632,Cowlitz,Dian Cooper,CEO,360-636-3892,,dcooper@cfamhc.org,Jim Coffee,Deputy Director,360-636-3892,,jcoffee@cfamhc.org,www.cowlitzfamilyhealth.org
WA-011357,Centralia Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1020 W Main St,,Centralia,WA,98531-2853,Lewis,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011358,Valley View Health Center - Centralia Walk-In,Lewis County Community Health Services,1437418175,Federally Qualified Health Centers - Medical Services,1800 Cooks Hill Rd,Suite G,Centralia,WA,98531-9162,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011359,Valley View Health Center - Centralia Pediatrics,Lewis County Community Health Services,1427441849,Federally Qualified Health Centers - Medical Services,230 Washington Way,,Centralia,WA,98531-9325,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9548,,hsliva@vvhc.org,,,,,,
WA-011360,Valley View Health Center - Centralia,Lewis County Community Health Services,1730511205,Federally Qualified Health Centers - Medical Services,2428 W Reynolds Ave,,Centralia,WA,98531-4554,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011361,Valley View Health Center,Lewis County Community Health Services,1134164692,"Dental Providers, Federally Qualified Health Centers - Medical Services",2690 NE Kresky Ave,,Chehalis,WA,98532-2412,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,www.vhc.org
WA-011362,"Mary's Corner Medical Clinic, Inc. PS","Mary's Corner Medical Clinic, Inc. PS",1194973628,Rural Health Clinics,4254 Jackson Hwy,,Chehalis,WA,98532-8424,Lewis,4254 Jackson Highway,,Chehalis,WA,98532,Lewis,Kimberly Inglis,Office Manager,360-262-3966,,mcmc.kinglis@yahoo.com,,,,,,
WA-011363,CVCH - CHELAN CLINIC,COLUMBIA VALLEY COMMUNITY HEALTH,1356374698,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",105 S Apple Blossom Dr,,Chelan,WA,98816-8810,Chelan,600 Orondo Ave Ste 1,,Wenatchee,WA,98801-2800,Chelan,David Olson,CEO,509-664-3528,,david.olson@cvch.org,Cheryle Whisenhunt,Credentialing Specialist,509-664-3527,,cwhisenhunt@cvch.org,cvch.org
WA-011364,Lake Chelan Clinic,Chelan County Public Hospital District no. 2,1124438312,Rural Health Clinics,219 E Johnson Ave,,Chelan,WA,98816-9160,Chelan,219 E. Johnson Ave,,Chelan,WA,98816,Chelan,Vickie Bodle,CFO,509-682-6105,,vbodle@lcch.net,Kevin Abel,CEO,509-682-3300,,kabel@lcch.net,
WA-011365,Lake Chelan Community Hospital,Chelan County Public Hospital District no. 2,1578568853,Inpatient Hospitals (other than children's hospitals),503 E Highland Ave,,Chelan,WA,98816-8631,Chelan,503 E. Highland Ave,,Chelan,WA,98816,Chelan,Vickie Bodle,CFO,509-682-6105,,vbodle@lcch.net,Kevin Abel,CEO,509-682-3300,,kabel@lcch.net,
WA-011366,Cheney Health Center,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1013387836,"Dental Providers, Federally Qualified Health Centers - Medical Services",1720 2nd St,,Cheney,WA,99004-1910,Spokane,"203 N Washington St, Ste 300",,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011367,CHEWELAH COMMUNITY HEALTH CENTER,NEW HEALTH PROGRAMS ASSOCIATION,1679537575,Federally Qualified Health Centers - Medical Services,518 E Clay Ave,,Chewelah,WA,99109-8947,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011368,Clallam Bay Medical Clinic,Public Hospital District #1 Clallam County,1235213034,Rural Health Clinics,74 Bogachiel St,,Clallam Bay,WA,98326-9740,Clallam,530 Bogachiel Way,,Forks,WA,98331,Clallam,Terry L Megiveron,Clinic Administrator,360-374-3162,8502,terrym@forkshospital.org,Tim Cournyer,CEO,360-374-6271,,timc@forkshospital.org,
WA-011369,Tri-State Memorial Hospital (dental provider),Tri-State Memorial Hospital,1760485221,Dental Providers,1221 Highland Ave,,Clarkston,WA,99403-2829,Asotin,PO Box 189,,Clarkston,WA,99403,Asotin,Alex Town,CFO,509-758-4667,,atown@tsmh.org,Don Wee,CEO,509-758-4650,,dwee@tsmh.org,
WA-011370,Tri-State Memorial Hospital (inpatient hospital),Tri-State Memorial Hospital,1760485221,Inpatient Hospitals (other than children's hospitals),1221 Highland Ave,,Clarkston,WA,99403-2829,Asotin,PO Box 189,,Clarkston,WA,99403,Asotin,Alex Town,CFO,509-758-4667,,atown@tsmh.org,Don Wee,CEO,509-758-4650,,dwee@tsmh.org,
WA-011371,Lewis and Clark Dental Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1427379460,Dental Providers,844 6th St,,Clarkston,WA,99403-2013,Asotin,"203 N Washington St, Ste 300",,Spokane,WA,99201-0233,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011372,South Whidbey Community Clinic,Whidbey General Hospital,1154361590,Rural Health Clinics,11245 State Route 525,,Clinton,WA,98236-8638,Island,101 N Main St,,Coupeville,WA,98239-3413,Island,Kellie Harris,Clinic Supervisor,360-341-5252,4305,harrik@whidbeygen.org,Sally Bjorling,Clinic Supervisor,360-679-5590,4035,bjorls@whidbeygen.org,www.whidbeygen.org
WA-011373,Colville,Northeast Tri County Health District,1356426589,"Family Planning Providers, Sexually Transmitted Disease Clinics",240 E Dominion Ave,,Colville,WA,99114-2732,Stevens,240 E. Dominion Ave.,,Colville,WA,99114,Stevens,Sandy Perkins,Community Health Director,509-684-5048,,sperkins@netchd.org,Dave Windom,Administrator,509-684-1301,,dwindom@netchd.org,http://www.netchd.org/
WA-011374,COLVILLE COMMUNITY HEALTH CENTER,NEW HEALTH PROGRAMS ASSOCIATION,1275938672,Federally Qualified Health Centers - Medical Services,358 N Main St,,Colville,WA,99114-2310,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,jessecaj@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011375,COLVILLE COMMUNITY DENTAL CLINIC,NEW HEALTH PROGRAMS ASSOCIATION,1508820879,Dental Providers,370 N Main St,,Colville,WA,99114-2310,Stevens,NEW Health Programs,509 E Main,Chewelah,WA,99109,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011376,Sea Mar CHC - Concrete,SEA-MAR COMMUNITY HEALTH CENTER,1790185759,Federally Qualified Health Centers - Medical Services,7438 S D Ave,,Concrete,WA,98237-9642,Skagit,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011377,CONNELL FAMILY MEDICAL,COLUMBIA BASIN HEALTH ASSOCIATION,1841574241,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1051 Columbia Ave,,Connell,WA,99326-8702,Franklin,140 E Main St,,Othello,WA,99344,Adams,Greg Brandenburg,CEO,509-488-5256,8101,greg@cbha.org,Kent Mosbrucker,CFO,509-488-5256,8102,kentm@cbha.org,
WA-011378,Coulee City Medical Clinic,Coulee Medical Center,1720169048,Rural Health Clinics,130 N Adams St,,Coulee City,WA,99115,Grant,411 Fortuyn Blvd,,Grand Coulee,WA,99133,Grant,Jamie Boyer,Revenue Cycle Director,509-633-1753,,boyerj@cmccares.org,Melanie Slatina,Director of Quality,509-633-1753,,slatinm@cmccares.org,http://www.cmccares.org/
WA-011379,Kalispel Tribe of Indians / Camas Center for Community Wellness/Behavioral Health,Kalispel Indian Community/Camas Center for Community Wellness/Behavioral Health,1396937769,"Dental Providers, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1821 Leclerc Rd N,Suite 1,Cusick,WA,99119-5015,Pend Oreille,PO Box 39,,Cusick,WA,99119-0039,Pend Oreille,Ron Poplawski JR,Clinic Business Manager,509-447-7262,,rpoplawski@camashealth.com,"Daniel Troupe, PAC",PAC - interim medical director,509-447-7111,,dtroupe@camashealth.com,
WA-011380,Skagit Regional Health Darrington Family Medicine,Skagit Regional Health,1013064575,Rural Health Clinics,1190 Riddle St,PO Box 309,Darrington,WA,98241-0309,Snohomish,300 Hospital Parkway,,Mount Vernon,WA,98273,Skagit,LuAnn Zimmerman,Practice Manager,360-618-7902,,luannz@cascadevalley.org,,,,,,
WA-011381,LINCOLN HOSPITAL,Lincoln Hospital District #3,1841234598,Inpatient Hospitals (other than children's hospitals),10 Nicholls St,,Davenport,WA,99122-9729,Lincoln,10 Nicholls St,,Davenport,WA,99122-9729,Lincoln,Tim O'Connell,Chief Financial Officer,509-725-7979,1157,oconnetr@lhd3.org,Tyson Lacy,CEO,509-725-2979,1168,lacyte@lhd3.org,
WA-011382,Davenport RHC,Lincoln Hospital District #3,1558309518,Rural Health Clinics,100 3rd St,,Davenport,WA,99122-5008,Lincoln,10 Nicholls St,,Davenport,WA,99122,Lincoln,Timothy O'Connell,Chief Financial Officer,509-725-2979,1157,oconnetr@lhd3.org,Tyson Lacy,CEO,509-725-2979,1168,lacyte@lhd3.org,
WA-011383,Columbia Family Clinic,Columbia County Health System,1518044551,Rural Health Clinics,1012 S 3rd St,,Dayton,WA,99328-1606,Columbia,1012 South 3rd Street,,Dayton,WA,99328,Columbia,Kathleen Anderson,Clnic Manager,509-382-8401,5411,KathyA@cchd-wa.org,Shane McGuire,Chief Executive officer,509-382-9359,5121,ShaneM@cchd-wa.org,
WA-011384,Dayton General Hospital,Columbia County Public Hospital District #1,1134128911,Inpatient Hospitals (other than children's hospitals),1012 S 3rd St,,Dayton,WA,99328-1606,Columbia,1012 S 3rd Street,,Dayton,WA,99328,Columbia,Cheryl A Skiffington,CFO,509-382-9355,,cheryls@cchd-wa.org,Erin Trump,IT Director,509-382-9369,,erint@cchd-wa.org,
WA-011385,North County Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1912085135,"Dental Providers, Federally Qualified Health Centers - Medical Services",401 S Main St,,Deer Park,WA,99006-8238,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011386,Deer Park Family Care Clinic,Deer Park Family Carer Clinic,1548294150,Rural Health Clinics,905 E D St,PO Box 1529,Deer Park,WA,99006-5167,Spokane,905 East D Street,,Deer PArk,WA,99006,Spokane,Michael Moran,Admin,509-993-0927,,mmoran@dpfcc.com,Linda Polgar,Staff Resources,509-262-9439,,lpolgar@dpfcc.com,
WA-011387,HealthPoint Midway,HEALTHPOINT,1922351527,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",26401 Pacific Hwy S,,Des Moines,WA,98198-9247,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011388,SEA MAR DES MOINES Dental,Sea Mar Community Health Centers,1528432010,Dental Providers,2781 S 242nd St,,Des Moines,WA,98198-5166,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011389,Confluence Health East Wenatchee,Confluence Health / Wenatchee Valley Hospital,1649517467,Rural Health Clinics,100 Highline Dr,,East Wenatchee,WA,98802-5341,Douglas,820 N. Chelan,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,Eric Brinkert,,509-884-0614,,,
WA-011391,East Wenatchee Medical,COLUMBIA VALLEY COMMUNITY HEALTH,1487650636,Federally Qualified Health Centers - Medical Services,900 Eastmont Ave,,East Wenatchee,WA,98802-6602,Douglas,600 Orondo Ave Ste 1,,Wenatchee,WA,98801-2800,Chelan,David Olson,CEO,509-664-3528,,david.olson@cvch.org,Cheryle Whisenhunt,Credentialing Specialist,509-664-3527,1012,cwhisenhunt@cvch.org,cvch.org
WA-011392,Orcas Family Health Center,Orcas Family Health Center,1245214683,Rural Health Clinics,1286 Mount Baker Rd,Suite B102,Eastsound,WA,98245-8931,San Juan,1286 Mount Baker Rd,Suite B102,Eastsound,WA,98245,San Juan,Aaimee R. Johnson,Office Manager,360-376-7778,,ajohnson@orcasfamilyhealthcenter.org,DIxie Morrison,Assistant Manager,360-376-7778,,dixiem@orcasfamilyhealthcenter.org,
WA-011393,"Orcas Island Family Medicine, PC","Orcas Island Family Medicine, PC",1194778498,Rural Health Clinics,33 Urner St,Suite 5,Eastsound,WA,98245-9133,San Juan,PO Box 1989,,Eastsound,WA,98245,San Juan,Michelle Russell,Billing Administrator,360-376-4949,,MRussell@oifmpc.com,"David Russell, MD",Medical Director,360-376-4949,,dr.russell@oifmpc.com,
WA-011394,CHC of Snohomish County Edmonds Medical and Dental Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1437438058,"Dental Providers, Federally Qualified Health Centers - Medical Services",23300 Highway 99,,Edmonds,WA,98026-8744,Snohomish,8609 Evergreen Way,,Everett,WA,98208-2619,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,,,,,,
WA-011395,Ellensburg,Planned Parenthood of Greater Washington and North Idaho,1003061920,Family Planning Providers,613 N Pine St,,Ellensburg,WA,98926-3121,Kittitas,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011396,Elma Family Medicine,Grays Harbor County Public Hospital District No. 1,1811025216,Rural Health Clinics,575 E Main St,,Elma,WA,98541-9551,Grays Harbor,600 E. Main Street,,Elma,WA,98541,Grays Harbor,Will Callicoat,CFO,360-346-2244,,willc@sp-mc.org,,,,,,
WA-011397,Summit Pacific Healthcare Clinic,Grays Harbor County Public Hospital District No. 1,1942554183,Rural Health Clinics,600 E Main St,,Elma,WA,98541-9560,Grays Harbor,600 E. Main Street,,Elma,WA,98541,Grays Harbor,Will Callicoat,CFO,360-346-2244,,willc@sp-mc.org,,,,,,
WA-011398,HealthPoint Valley Cities Enumclaw,HEALTHPOINT,1811351786,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1335 Cole St,,Enumclaw,WA,98022-2654,King,955 Powell Ave SW,,Renton,WA,98057,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011399,Ephrata Community Dental Clinic,MOSES LAKE COMMUNITY HEALTH CENTER,1699862813,Dental Providers,204 12th Ave SW,,Ephrata,WA,98823-2197,Grant,605 S Coolidge St,,Moses Lake,WA,98837-1893,Grant,Sheila A Chilson,CEO,509-765-0674,2411,schilson@mlchc.org,Amanda Duzon,CFO,509-765-0674,2781,aduzon@mlchc.org,www.mlchc.org
WA-011400,Columbia Basin Family Medicine,Grant County Public Hospital District No. 3,1457414799,Rural Health Clinics,220 Nat Washington Way,,Ephrata,WA,98823-1982,Grant,220 Nat Washington Way,,Ephrata,WA,98823,Grant,Rosalinda Kibby,Administrator,509-754-3330,1221,kibbyr@columbiabasinhospital.org,Cheryl Bodi,Exec Asst,509-754-4631,1222,bodic@columbiabasinhospital.org,
WA-011401,CHC of Snohomish County Everett-South Medical Dental Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1669504395,"Dental Providers, Federally Qualified Health Centers - Medical Services",1019 112th St SW,,Everett,WA,98204-4875,Snohomish,8609 Evergreen Way,,Everett,WA,98208-2619,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,,,,,,
WA-011402,CHC of Snohomish County Everett-North Medical Dental Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1932231669,"Dental Providers, Federally Qualified Health Centers - Medical Services",1424 Broadway,,Everett,WA,98201-1720,Snohomish,8609 Evergreen Way,,Everett,WA,98208-2619,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,,,,,,
WA-011403,Everett Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1509 32nd St,,Everett,WA,98201-4302,Snohomish,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011404,Sea Mar CHC - Everett 100th St. SE,Sea Mar Community Health Centers,1962775270,Federally Qualified Health Centers - Medical Services,1920 100th St SE,,Everett,WA,98208-3832,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011405,SEA MAR EVERETT CHILD AND FAMILY,Sea Mar Community Health Centers,1285783480,Federally Qualified Health Centers - Medical Services,1920 100th St SE,Suite A1 & A2,Everett,WA,98208-3832,Snohomish,1040 S Henderson St,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011406,SEA MAR EVERETT DENTAL,Sea Mar Community Health Centers,1326363359,Dental Providers,1920 100th St SE,Suite C2,Everett,WA,98208-3832,Snohomish,1040 S Henderson St,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011407,Sea Mar CHC - Everett Claremont Way,SEA-MAR COMMUNITY HEALTH CENTER,1962775270,Federally Qualified Health Centers - Medical Services,5007 Claremont Way,,Everett,WA,98203-3321,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011408,CHC of Snohomish County Everett College Medical Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1437675188,Federally Qualified Health Centers - Medical Services,930 N Broadway,,Everett,WA,98201-1409,Snohomish,8609 Evergreen Way,,Everett,WA,98208,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,Jim Kee,Grants Mgr,425-789-3700,,jkee@chcsno.org,
WA-011409,Nooksack Indian Tribe/Nooksack Indian Health Department /Dental/Behavioral Health,Nooksack Indian Tribe/Nooksack Community Clinic/Dental/Behavioral Health,1568528842,"Indian Health Service, Other ECP Providers",2510 Sulwhanon Dr,,Everson,WA,98247-8766,Whatcom,5016 Deming Road,,Deming,WA,98244-0157,Whatcom,Lona Johnson,Health Director,360-966-2106,2111,LJohnson@nooksack-nsn.gov,Sonita Auguston,Medical Managed Care & Contracts Manager,360-966-2106,2125,sauguston@nooksack-nsn.gov,www.nooksacktribe.org
WA-011410,Sea Mar CHC - Everson Hannegan Rd.,SEA-MAR COMMUNITY HEALTH CENTER,1689721011,Federally Qualified Health Centers - Medical Services,6884 Hannegan Rd,,Everson,WA,98247-9637,Whatcom,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011411,Federal Way Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1105 S 348th St,Suite B103,Federal Way,WA,98003-7027,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011412,FEDERAL WAY PUBLIC HEALTH CENTER,PUBLIC HEALTH SEATTLE & KING COUNTY,1922105154,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",33431 13th Pl S,,Federal Way,WA,98003-6357,King,401 Fifth Avenue,,Seattle,WA,98104,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Karen Russell,Clinic Administrator,206-477-0262,,karen.russell@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011413,HealthPoint Federal Way,HEALTHPOINT,1679575039,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",33431 13th Pl S,,Federal Way,WA,98003-6357,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011414,UCNW - Ferndale,Unity Care Northwest,1457596975,"Dental Providers, Federally Qualified Health Centers - Medical Services",5616 3rd Ave,,Ferndale,WA,98248-8394,Whatcom,"1616 Cornwall Ave., Suite 205",,Bellingham,WA,98225-4642,Whatcom,Desmond Skubi,Executive Director,360-788-2620,,des.skubi@ucnw.org,,,,,,
WA-011415,Bogachiel Clinic,Public Hospital District No 1 Clallam County,1285683052,Rural Health Clinics,390 Founders Way,,Forks,WA,98331-9062,Clallam,530 Bogachiel Way,,Forks,WA,98331,Clallam,Terry L Megiveron,Clinic Administrator,360-374-6998,5802,terrym@forkshospital.org,Tim Cournyer,CEO,360-374-6271,,timc@forkshospital.org,
WA-011416,Forks Community Hospital,Publich Hospital District No 1 Clallam County,1891879680,Inpatient Hospitals (other than children's hospitals),530 Bogachiel Way,,Forks,WA,98331-9120,Clallam,530 Boachiel Way,,Forks,WA,98331,Clallam,Terry L Megiveron,Clinic Administrator,360-374-6998,8502,terrym@forkshospital.org,Tim Cournyer,CEO,360-374-6271,,timc@forkshospital.org,
WA-011417,Friday Harbor Health Center,Mt. Baker Planned Parenthood,1790902906,"Family Planning Providers, Sexually Transmitted Disease Clinics",470 Reed St Unit 2A,,Friday Harbor,WA,98250,San Juan,1509 Cornwall Avenue,,Bellingham,WA,98225,Whatcom,Petra Karpsteinova,Director of Finance,360-603-7708,,petra.karpsteinova@mbpp.org,Linda McCarthy,Executive Director,360-603-7701,,linda.mccarthy@mbpp.org,http://www.plannedparenthood.org/mbpp/
WA-011418,Sea Mar CHC - Gig Harbor Kimball Drive,SEA-MAR COMMUNITY HEALTH CENTER,1710035100,Federally Qualified Health Centers - Medical Services,6659 Kimball Dr,Suite C305,Gig Harbor,WA,98335-5139,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011419,Klickitat County Public Hospital District #1,Klickitat Valley Health,1386689487,Inpatient Hospitals (other than children's hospitals),310 S Roosevelt St,,Goldendale,WA,98620-9201,Klickitat,310 S Roosevelt Ave,,Goldendale,WA,98620,Klickitat,Jamie Eldred,Director of Finance,509-773-1014,,jeldred@kvhealth.net,Leslie Hiebert,CEO,509-773-1002,,lhiebert@kvhealth.net,
WA-011420,Klickitat Valley Health Family Medicine,Klickitat County Public Hospital District #1,1386689487,Rural Health Clinics,317 Sanders Way,,Goldendale,WA,98620-9059,Klickitat,310 S Roosevelt Ave,,Goldendale,WA,98620,Klickitat,Jamie Eldred,Director of Finance,509-773-1014,,jeldred@kvhealth.net,Leslie Hiebert,CEO,509-773-1002,,lhiebert@kvhealth.net,
WA-011421,Coulee Family Medicine Clinic,Coulee Medical Center,1457420218,Rural Health Clinics,411 Fortuyn Rd,,Grand Coulee,WA,99133-8718,Grant,411 Fortuyn Blvd,,Grand Coulee,WA,99133,Grant,Jamie Boyer,Revenue Cycle Director,509-633-1753,,boyerj@cmccares.org,Melanie Slatina,Director of Quality,509-633-1753,,slatinm@cmccares.org,http://www.cmccares.org/
WA-011422,Coulee Medical Center,Coulee Medical Center,1457420218,Inpatient Hospitals (other than children's hospitals),411 Fortuyn Rd,,Grand Coulee,WA,99133-8718,Grant,411 Fortuyn Blvd,,Grand Coulee,WA,99133,Grant,Jamie Boyer,Revenue Cycle Director,509-633-1753,,boyerj@cmccares.org,Melanie Slatina,Director of Quality,509-633-1753,,slatinm@cmccares.org,http://www.cmccares.org/
WA-011423,YVFWC GRANDVIEW CLINIC,YAKIMA VALLEY FARM WORKERS CLINIC,1134255847,"Dental Providers, Federally Qualified Health Centers - Medical Services",1000 Wallace Way,,Grandview,WA,98930-8805,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011424,MOUNTAINVIEW WOMEN'S HEALTH CENTER,YAKIMA VALLEY FARM WORKERS CLINIC,1518093830,Federally Qualified Health Centers - Medical Services,240 Division St,,Grandview,WA,98930-1357,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011425,Yakima Neighborhood Health Services - Granger,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1497124861,Federally Qualified Health Centers - Medical Services,111 Main St,,Granger,WA,98932-9306,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,rhonda.hauff@ynhs.org,www.ynhs.org
WA-011426,MGH Hoodsport Family Clinic,Public Hospital District No 1 of Mason County,1467881326,Rural Health Clinics,24261 N US Highway 101,,Hoodsport,WA,98548-9456,Mason,901 Mountain View Drive,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medcial Staff Services,360-427-9549,,jfitchitt@masongeneral.com,Rick Smith,Chief Financial Officer,360-426-1611,,rsmith@masongeneral.com,
WA-011427,Ocean Beach Hospital,Public Hospital District 3 of Pacific County,1295771376,Inpatient Hospitals (other than children's hospitals),174 1st Ave N,,Ilwaco,WA,98624-9137,Pacific,174 First Ave N,,Ilwaco,WA,98624,Pacific,Beth Hash,Business Office Manager,360-642-6313,,beth.hash@obhospital.com,Larry Cohen,Interim CEO,360-642-6310,,lcohen@obhospital.com,
WA-011428,Ocean Beach Medical Clinic,Public Hospital District 3 of Pacific County,1639165905,Rural Health Clinics,176 1st Ave N,,Ilwaco,WA,98624-9137,Pacific,PO Box N,,Ilwaco,WA,98624,Pacific,Beth Hash,Business Office Manager,360-642-6313,,bhash@oceanbeachhospital.com,Larry Cohen,CEO,360-642-6310,,lcohen@oceanbeachhospital.com,
WA-011429,INCHELIUM COMMUNITY HLTH CENTER,"CONFEDERATED TRIBES OF THE COLVILLE RESERVATION, THE",1679697155,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",39 Short Cut Rd,,Inchelium,WA,99138,Ferry,State Hwy 155 N,,Nespelem,WA,99155,Okanogan,Alexandria Desautel,Executive Director,509-722-7623,,ali.desautel@colvilletribes.com,Rudy Trevino,Health Director,509-722-7610,,rodolfo.trevino@colvilletribes.com,
WA-011430,SELKIRK COMMUNITY HEALTH CENTER,NEW HEALTH PROGRAMS ASSOCIATION,1912961822,Federally Qualified Health Centers - Medical Services,208 Cedar Creek Ter,,Ione,WA,99139-5011,Pend Oreille,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,,,jessecaj@newhp.org,
WA-011431,SAN POIL VALLEY COMMUNITY HEALTH,"CONFEDERATED TRIBES OF THE COLVILLE RESERVATION, THE",1679697155,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",11665 S Highway 20,,Keller,WA,99140,Ferry,State Hwy 155 N,,Nespelem,WA,99155,Ferry,Alexandria Desautel,Executive Director,509-722-7623,,ali.desautel@colvilletribes.com,Rodolfo Trevino,Medical Director,509-722-7006,,rodolfo.trevino@colvilletribes.com,
WA-011432,SEA MAR KELSO BH,Sea Mar Community Health Centers,1881053353,Federally Qualified Health Centers - Medical Services,1710 Allen St,,Kelso,WA,98626-4907,Cowlitz,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011433,Kelso Clinic,Cowlitz Family Health Center,1366790008,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",300 Oak St,Suite B,Kelso,WA,98626-2304,Cowlitz,1057 12th Avenue,,Loongview,WA,98632,Cowlitz,Dian Cooper,CEO,360-636-3892,,dcooper@cfamhc.org,Jim Coffee,Deputy Director,360-636-3892,,jcoffee@cfamhc.org,www.cowlitzfamilyhealth.org
WA-011434,Tri-Cities Community Health Kennewick Clinic,Tri-Cities Community Health,1225145105,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services","3180 Clearwater Ave, suite A & B",,Kennewick,WA,99336,Benton,515 W. Court St.,,Pasco,WA,99301,Benton,Beth Mahoney,Compliance Officer,509-543-1991,1991,emahoney@mytcch.org,,,,,,
WA-011435,TCCH - Kennewick Behavioral Health,TRI-CITIES COMMUNITY HEALTH,1225145105,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",3180 W Clearwater Ave,Suite E,Kennewick,WA,99336-2765,Benton,515 W. Court Street,,Pasco,WA,99336,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011436,Tri-Cities Community Health Auburn Clinic,Tri-Cities Community Health,1225145105,Federally Qualified Health Centers - Medical Services,721 S Auburn St,,Kennewick,WA,99336-5665,Benton,515 W. Court Street,,Pasco,WA,99301,Benton,Beth Mahoney,Compliance Officer,509-543-1991,1991,emahoney@mytcch.org,,,,,,
WA-011437,KENNEWICK HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1104822931,"Family Planning Providers, Sexually Transmitted Disease Clinics",7426 W Bonnie Pl,,Kennewick,WA,99336-1124,Benton,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011438,Tri-Cities Community Health,TRI-CITIES COMMUNITY HEALTH,1225145105,Federally Qualified Health Centers - Medical Services,830 W Vineyard Dr,TCCH - KENNEWICK SCHOOL BASED HEALTH CLINIC,Kennewick,WA,99336-5579,Benton,515 W. Court Street,,Pasco,WA,99301,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011439,Kent Valley Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",10056 SE 240th St,Suite A,Kent,WA,98031-5126,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011440,KENT PUBLIC HEALTH CENTER-Birch Creek,Public Health Seattle & King County,1922105154,Federally Qualified Health Centers - Medical Services,13111 SE 274th St,,Kent,WA,98030-8929,King,401 5th Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011441,Sea Mar CHC - Kent,SEA-MAR COMMUNITY HEALTH CENTER,1417370735,Federally Qualified Health Centers - Medical Services,233 2nd Ave S,,Kent,WA,98032-5852,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011442,Kent Public Health Center,"KING, COUNTY OF",1922105154,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",25742 104th Ave SE,,Kent,WA,98030-7691,King,401 5th Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011443,SEA MAR KENT MERCY HOUSING,Sea Mar Community Health Centers,1417370735,Federally Qualified Health Centers - Medical Services,25818 26th Pl S,,Kent,WA,98032-5580,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011444,HealthPoint Valley Cities Kent,HEALTHPOINT,1811239544,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",325 W Gowe St,,Kent,WA,98032-5892,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011445,HealthPoint Kent,HEALTHPOINT,1831199454,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",403 E Meeker St,Suite 200,Kent,WA,98030-5904,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011446,PCHS Kingston Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1700326246,Federally Qualified Health Centers - Medical Services,25989 Barber Cut Off Rd NE,,Kingston,WA,98346-8455,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011447,Port Gamble S'Klallam Tribe(PGST)/ PGST See-yeels-out Wellness Center/PGST Mental Health/PGST Recovery Ctr./PGST Tribal Clinic,Port Gamble S'Klallam Tribe(PGST)/ PGST See-yeels-out Wellness Center/PGST Mental Health/PGST Recovery Ctr./PGST Tribal Clinic,1760428650,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",32014 Little Boston Rd NE,,Kingston,WA,98346-9734,Kitsap,32020 Little Boston Rd NE,,Kingston,WA,98346-9734,Kitsap,Kerstin Powell,Health Services Manager,360-297-9649,,kerstin@pgst.nsn.us,Liz Rentola,Health Services Billing Specialist,360-297-9648,,lizrentola@pgst.nsn.us,www.pgst.nsn.us
WA-011448,Swinomish Indian Health Clinic,Swinomish Tribal Community,1164483285,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",17400 Reservation Rd,,La Conner,WA,98257-8801,Skagit,17400 Reservation Rd,,La Conner,WA,98257,Skagit,Monica Carrillo,Physician,360-466-7270,,mcarrillo@swinomish.nsn.us,cheryl rasar,clinical director,360-466-3167,,crasar@swinomish.nsn.us,
WA-011449,SEA MAR - Lacey Dental,SEA-MAR COMMUNITY HEALTH CENTER,1326363359,Dental Providers,669 Woodland Square Loop SE,,Lacey,WA,98503-1038,Thurston,1040 S Henderson,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011450,SEA MAR - Lacey Medical,Sea Mar Community Health Centers,1700101797,Federally Qualified Health Centers - Medical Services,669 Woodland Square Loop SE,,Lacey,WA,98503-1038,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011451,Sea Mar CHC - Tillicum Community Center,SEA-MAR COMMUNITY HEALTH CENTER,1801204078,Federally Qualified Health Centers - Medical Services,14916 Washington Ave SW,,Lakewood,WA,98498-2271,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011452,Cascade Medical,Chelan County Public Hospital District No. 1,1437141215,Rural Health Clinics,817 Commercial St,,Leavenworth,WA,98826-1316,Chelan,817 Commercial Street,,Leavenworth,WA,98826,Chelan,Diane Blake,CEO,509-548-5815,,dianeb@cascademedical.org,Jill Barich,Executive Assistant,509-548-5815,,adminoffice@cascademedical.org,www.cascademedical.org
WA-011453,Cascade Medical,Chelan County Public Hospital District No. 1,1962406389,Inpatient Hospitals (other than children's hospitals),817 Commercial St,,Leavenworth,WA,98826-1316,Chelan,817 Commercial Street,,Leavenworth,WA,98826,Chelan,Diane Blake,CEO,509-548-5815,,dianeb@cascademedical.org,Jill Barich,Executive Assistant,509-548-5815,,adminoffice@cascademedical.org,www.cascademedical.org
WA-011454,Pacific County Public Health Long Beach Clinic,Pacific County Public Health and Human Services Department,1508081217,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",7013 Sandridge Rd,Suite 1,Long Beach,WA,98631-4703,Pacific,1216 W. Robert Bush Drive,,South Bend,WA,98586,Pacific,Mary P. Goelz,Director,360-642-9349,2649,mgoelz@co.pacific.wa.us,,,,,,
WA-011455,Cowlitz Indian Tribe,Cowlitz Indian Tribal Health,1851328447,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",1044 11th Ave,,Longview,WA,98632-2506,Cowlitz,1044 11th Ave.,,Longview,WA,98632,Cowlitz,Rebecca A Jones,BILLING SUPERVISOR,360-353-9431,,rjones.health@cowlitz.org,,,,,,
WA-011456,COWLITZ FAMILY HEALTH CENTER,COWLITZ FAMILY HEALTH CENTER,1891724506,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1057 12th Ave,,Longview,WA,98632-2509,Cowlitz,1057 12th Ave,,Longview,WA,98632-2509,Cowlitz,Dian J Cooper,CEO,360-636-3892,2010,dcooper@cfamhc.org,James Coffe,Deputy Director,360-636-3892,,jcoffee@cfamhc.org,http://cowlitzfamilyhealth.org/
WA-011457,Cowlitz Indian Tribal Health Services,Cowlitz Indian Tribe,1851328447,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",922 Fir St,,Longview,WA,98632-2525,Cowlitz,1044 11th Ave.,,Longview,WA,98632,Cowlitz,Rebecca A Jones,BILLING SUPERVISOR,360-353-9431,,rjones.health@cowlitz.org,,,,,,
WA-011458,LOON LAKE COMMUNITY HEALTH CTR,NEW HEALTH PROGRAMS ASSOCIATION,1295799195,Federally Qualified Health Centers - Medical Services,3994 Colville Rd,,Loon Lake,WA,99148-9789,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011459,Lynnwood Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",19505 76th Ave W,Suite 200,Lynnwood,WA,98036-5045,Snohomish,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011460,Sea Mar CHC - Lynnwood 44th Ave. W.,SEA-MAR COMMUNITY HEALTH CENTER,1033399928,Federally Qualified Health Centers - Medical Services,19707 44th Ave W,,Lynnwood,WA,98036-6757,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011461,CHC of Snohomish County Lynnwood Medical Dental Clinic,COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY,1013049741,"Dental Providers, Federally Qualified Health Centers - Medical Services",4111 194th St SW,,Lynnwood,WA,98036-4604,Snohomish,8609 Evergreen Way,,Everett,WA,98208-2619,Snohomish,Bob Farrell,CEO,425-789-3700,,bfarrell@chcsno.org,,,,,,
WA-011462,Marysville Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",10210 State Ave,,Marysville,WA,98271-7214,Snohomish,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011463,SEA MAR MARYSVILLE DENTAL,Sea Mar Community Health Centers,1942358908,Dental Providers,4922 Grove St,,Marysville,WA,98270-4427,Snohomish,1040 Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011464,Sea Mar CHC - Marysville State Ave.,SEA-MAR COMMUNITY HEALTH CENTER,1578610911,Federally Qualified Health Centers - Medical Services,9710 State Ave,,Marysville,WA,98270-2232,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011465,Mattawa Community Medical Clinic,Mattawa Community Medical Clinic,1699720797,Federally Qualified Health Centers - Medical Services,210 Government Road,,Mattawa,WA,99349,Grant,210 Government Road,,Mattawa,WA,99349,Grant,Dana S. Fox,CEO,509-932-4499,11,mcmcadmin@smwireless.net,,,,,,
WA-011466,WAHLUKE FAMILY CLINIC,COLUMBIA BASIN HEALTH ASSOCIATION,1053539890,"Dental Providers, Federally Qualified Health Centers - Medical Services",601 Government Way,,Mattawa,WA,99349,Grant,140 E Main St,,Othello,WA,99344-1040,Adams,Greg Brandenburg,CEO,509-488-5256,8101,greg@cbha.org,Kent Mosbrucker,CFO,509-488-5256,8102,kentm@cbha.org,
WA-011467,Mark Reed Healthcare Clinic,Grays Harbor County Public Hospital District No. 1,1255401683,Rural Health Clinics,322 S Birch St,,McCleary,WA,98557-9522,Grays Harbor,600 E. Main Street,,Elma,WA,98541,Grays Harbor,Will Callicoat,CFO,360-346-2244,,willc@sp-mc.org,,,,,,
WA-011468,Sea Mar CHC - Monroe Fryelands Blvd. SE,SEA-MAR COMMUNITY HEALTH CENTER,1316095003,Family Planning Providers,14090 Fryelands Blvd SE,,Monroe,WA,98272-2693,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011469,Sea Mar CHC - Monroe W. Main St.,SEA-MAR COMMUNITY HEALTH CENTER,1508049008,Federally Qualified Health Centers - Medical Services,17707 W Main St,,Monroe,WA,98272-1967,Snohomish,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011470,Valley View Health Center - Morton,Lewis County Community Health Services,1700146206,Dental Providers,148 Division Ave,,Morton,WA,98356-9300,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011471,Morton General Hospital,Lewis County PHD#1,1154361814,Inpatient Hospitals (other than children's hospitals),521 Adams St,,Morton,WA,98356-9323,Lewis,521 Adams,,Morton,WA,98356,Lewis,Richard Boggess,Chief Financial Officer,360-496-3647,,rboggess@mortongeneral.org,,,,,,mortongeneral.org
WA-011472,Morton Medical Center,Morton Medical Center,1952415432,Rural Health Clinics,531 Adams St,,Morton,WA,98356-9323,Lewis,531 Adams Avenue,,Morton,WA,98356,Lewis,Charlene Hancock,Office Manager,360-496-5145,3604963563,mortonmedical@lewiscounty.com,,,,,,
WA-011473,MOSES LAKE COMMUNITY HEALTH CENTER,MOSES LAKE COMMUNITY HEALTH CENTER,1699862813,"Dental Providers, Federally Qualified Health Centers - Medical Services",605 S Coolidge St,,Moses Lake,WA,98837-1893,Grant,605 S Coolidge St,,Moses Lake,WA,98837-1893,Grant,Sheila A Chilson,CEO,509-765-0674,2411,schilson@mlchc.org,Amanda Duzon,CFO,509-765-0674,2781,aduzon@mlchc.org,www.mlchc.og
WA-011474,Moses Lake,Planned Parenthood of Greater Washington and North Idaho,1649214958,Family Planning Providers,607 Riviera Ave,,Moses Lake,WA,98837-1815,Grant,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011475,Confluence Health Moses Lake,Confluence Health / Wenatchee Valley Hospital,1629315445,Rural Health Clinics,840 E Hill Ave,,Moses Lake,WA,98837-2238,Grant,820 N. Chelan,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,Gregg Fletcher,,509-765-0216,,,
WA-011476,Riffe Medical Center,Morton General Hospital,1205110830,Rural Health Clinics,745 Williams St,,Mossyrock,WA,98564-9004,Lewis,521 Adams Avenue,,Morton,WA,98356,Lewis,Julie Allen,CLINIC MANAGER,360-983-8990,4101,jallen@mortongeneral.org,Patricia Craig,Clinic RN Supervisor,360-497-3333,4005,pcraig@mortongeneral.org,
WA-011477,Sea Mar CHC - Mt. Vernon E. College Way,SEA-MAR COMMUNITY HEALTH CENTER,1316130768,Federally Qualified Health Centers - Medical Services,1010 E College Way,,Mount Vernon,WA,98273-5624,Skagit,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011478,Sea Mar CHC,SEA-MAR COMMUNITY HEALTH CENTER,1942358908,"Dental Providers, Federally Qualified Health Centers - Medical Services",1400 N Laventure Rd,,Mount Vernon,WA,98273-2766,Skagit,1040 S Henderson,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011479,Sea Mar CHC Womens Health Skagit Valley,SEA-MAR COMMUNITY HEALTH CENTER,1023247541,Federally Qualified Health Centers - Medical Services,1415 E Kincaid St,,Mount Vernon,WA,98274-4126,Skagit,1040 S Henderson St,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011480,MOUNT VERNON HEALTH CENTER,Mt. Baker Planned Parenthood,1790902906,"Family Planning Providers, Sexually Transmitted Disease Clinics",1805 E Division St,,Mount Vernon,WA,98274-4632,Skagit,1509 Cornwall Avenue,,Bellingham,WA,98225,Whatcom,Petra Karpsteinova,Director of Finance,360-603-7708,,petra.karpsteinova@mbpp.org,Linda McCarthy,Executive Director,360-603-7701,,linda.mccarthy@mbpp.org,http://www.plannedparenthood.org/mbpp/
WA-011481,Nasell Clinic,Public Hospital District 3 of Pacific County,1881858140,Rural Health Clinics,21 N Valley Rd,,Naselle,WA,98638-8536,Pacific,174 First Ave N,,Ilwaco,WA,98624,Pacific,Beth Hash,Business Office Manager,360-642-6313,,beth.hash@obhospital.com,Larry Cohen,Interim CEO,360-642-6310,,lcohen@obhospital.com,
WA-011482,Colville Service Unit,Indian Health Services,1811091911,"Dental Providers, Indian Health Service",19 Lakes Street,,Nespelem,WA,99155,Okanogan,POB 71,,Nespelem,WA,99155,Okanogan,Dawn Ensminger,Authorized Representative,509-634-2922,,dawn.ensminger@ihs.gov,,,,,,
WA-011483,Northeast Tri Co. Health District Pend Oreille FP Program,Northeast Tri County Health District,1356426589,"Family Planning Providers, Sexually Transmitted Disease Clinics",605 Highway 20,,Newport,WA,99156-8860,Pend Oreille,240 E. Dominion Ave.,,Colville,WA,99114,Stevens,Sandra Perkins,Community Health Director,509-648-5048,,sperkins@netchd.org,Dave Windom,Administrator,509-648-1301,,dwindom@netchd.org,http://www.netchd.org/
WA-011484,Family Health Center Newport,Pend Oreille County Public Hospital District No 1,1912026360,Rural Health Clinics,714 W Pine St,Bldg C,Newport,WA,99156-9046,Pend Oreille,714 W Pine,,Newport,WA,99156-9046,Pend Oreille,Kim M Manus,CFO,509-447-9310,,kim.manus@nhhsqualitycare.org,Thomas Wilbur,CEO,509-447-9309,,tom.wilbur@nhhsqualitycare.org,
WA-011485,Newport Community Hospital,Newport Community Hospital,1780778423,Inpatient Hospitals (other than children's hospitals),714 W Pine St,,Newport,WA,99156-9046,Pend Oreille,714 W Pine Street,,Newport,WA,99156,Pend Oreille,Kim M Manus,CFO,509-447-2441,4226,kim.manus@nhhsqualitycare.org,Tom Wilbur,CEO,509-447-9309,,tom.wilbur@nhhsqualitycare.org,http://www.phd1.org/
WA-011486,LAKE SPOKANE COMMUNITY HLTH CTR.,NEW HEALTH PROGRAMS ASSOCIATION,1831214329,"Dental Providers, Federally Qualified Health Centers - Medical Services",5952 Blackstone Way,,Nine Mile Falls,WA,99026-4900,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011487,NORTHPORT COMMUNITY HEALTH CTR,NEW HEALTH PROGRAMS ASSOCIATION,1316994247,Federally Qualified Health Centers - Medical Services,411 Summit Ave,,Northport,WA,99157,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,,,jessecaj@newhp.org,
WA-011488,North Whidbey Community Clinic,Whidbey General Hospital,1467497636,Rural Health Clinics,1300 NE Goldie St,,Oak Harbor,WA,98277-4832,Island,101 N Main St,,Coupeville,WA,98239-3413,Island,Kellie Harris,Clinic Supervisor,360-341-5252,4305,harrik@whidbeygen.org,Sally Bjorling,Clinic Supervisor,360-341-5252,4035,bjorls@whidbeygen.org,www.whidbeygen.org
WA-011489,Sea Mar CHC - Oak Harbor BH,SEA-MAR COMMUNITY HEALTH CENTER,1598186553,Federally Qualified Health Centers - Medical Services,31640 State Route 20,,Oak Harbor,WA,98277-3128,Island,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011490,Sea Mar CHC - Oak Harbor 31775 SR 20,SEA-MAR COMMUNITY HEALTH CENTER,1598186553,Dental Providers,31775 SR 20,,Oak Harbor,WA,98277,Island,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011491,North Beach Clinic,Cowlitz Family Health Center,1891856142,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",21610 Pacific Way,,Ocean Park,WA,98640-3206,Pacific,1057 12th Avenue,,Longview,WA,98632,Cowlitz,Dian Cooper,CEO,360-636-3892,2010,dcooper@cfamhc.org,Jim Coffee,Deputy Director,360-636-3892,,jcoffee@cfamhc.org,www.cowlitzfamilyhealth.org
WA-011492,Sea Mar CHC - Ocean Shores Point Brown Ave.,SEA-MAR COMMUNITY HEALTH CENTER,1982768248,Federally Qualified Health Centers - Medical Services,597 Point Brown Ave NW,,Ocean Shores,WA,98569-9632,Grays Harbor,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011493,Odessa Memorial Hospital,Odessa Memorial Healthcare Center,1023122520,Inpatient Hospitals (other than children's hospitals),502 E Amende Dr,,Odessa,WA,99159-7003,Lincoln,502 E Amende Dr,,Odessa,WA,99159-0368,Lincoln,Barbara L Schlimmer,CLINIC MANAGER,509-982-2614,106,schlimb@omhc.org,Monica P Sheldon,CEO,509-982-2611,115,sheldomp@omhc.org,
WA-011494,Odessa Clinic,Odessa Memorial Healthcare Center,1023122520,Rural Health Clinics,510 E Amende Dr,,Odessa,WA,99159-7003,Lincoln,510 E Amende Dr,Odessa Memorial Healthcare Center,Odessa,WA,99159,Lincoln,Barbara L Schlimmer,CLINIC MANAGER,509-982-2614,106,schlimb@omhc.org,Monica P Sheldon,CEO,509-982-2611,115,sheldomp@omhc.org,
WA-011495,Family Health Centers Okanogan Dental,Family Health Centers,1609804392,Dental Providers,626 2nd Ave S,,Okanogan,WA,98840-9766,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Deana Abel,Assistant Dental Director,509-422-6705,,dabel@myfamilyhealth.org,www.myfamilyhealth.org
WA-011496,SEA MAR OLYMPIA MERCY HOUSING,Sea Mar Community Health Centers,1083762355,Federally Qualified Health Centers - Medical Services,1209 Fern St SW,,Olympia,WA,98502-5791,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011497,SEA MAR - Thurston Co Walk-In Clinic,Sea Mar Community Health Centers,1811320757,Federally Qualified Health Centers - Medical Services,205 Lilly Rd NE,Suite A1,Olympia,WA,98506-5069,Thurston,1040 S. Henderson St.,,Seattle,WA,98506,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011498,Sea Mar CHC - Olympia 3030 Limited Lane NW,SEA-MAR COMMUNITY HEALTH CENTER,1083762355,Federally Qualified Health Centers - Medical Services,3030 Limited Ln NW,,Olympia,WA,98502-2704,Thurston,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011499,Valley View Health Center -Olympia,Lewis County Community Health Services,1104265925,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3775 Martin Way E,Suite A,Olympia,WA,98506-5007,Thurston,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011500,Olympia Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",402 Legion Way SE,Suite 201,Olympia,WA,98501-1494,Thurston,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011501,SEA MAR OLYMPIA COMMUNITY YOUTH SERVICES,Sea Mar Community Health Services,1083762355,Federally Qualified Health Centers - Medical Services,520 Pear St SE,,Olympia,WA,98501-1524,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011502,Family Health Centers Omak Medical,Family Health Centers,1609804392,Federally Qualified Health Centers - Medical Services,1003 Koala Dr,,Omak,WA,98841-9247,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Kristine Vargas,Clinic Operations Manager,509-422-5700,2905,kvargas@myfamilyhealth.org,www.myfamilyhealth.org
WA-011503,Mid-Valley Medical Group,Mid-Valley Hospital,1558398230,Rural Health Clinics,529 Jasmine St,,Omak,WA,98841-9589,Okanogan,P.O. Box 793,,Omak,WA,98841,Okanogan,Rebecca A. Corson,Clinic Administrator,509-861-2461,,corsonr@mvhealth.org,Holly Stanley,Chief Financial Officer,509-826-7642,,stanleyh@mvhealth.org,www.omakclinic.com
WA-011504,Confluence Health Omak,Confluence Health / Wenatchee Valley Hospital,1992042709,Rural Health Clinics,916 Koala Ave,,Omak,WA,98841-9759,Okanogan,820 N. Chelan,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,Ed Nickel,,509-826-1800,,,
WA-011505,KETTLE RIVER COMMUNITY HLTH CTR,NEW HEALTH PROGRAMS ASSOCIATION,1386608560,Federally Qualified Health Centers - Medical Services,141 3rd Ave,,Orient,WA,99160-9418,Ferry,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,509-935-4730,,jessecaj@newhp.org,
WA-011506,Family Health Centers Oroville Dental,Family Health Centers,1609804392,Dental Providers,1321 Main St,,Oroville,WA,98844-9384,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Deana Abel,Assistant Dental Director,509-476-4400,,dabel@myfamilyhealth.org,www.myfamilyhealth.org
WA-011507,Confluence Health Oroville,Confluence Health / Wenatchee Valley Hospital,1275870214,Rural Health Clinics,1617 Main St,,Oroville,WA,98844-9380,Okanogan,820 N. Chelan,,Wenatchee,WA,98815,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,,,,,,
WA-011508,OTHELLO FAMILY CLINIC,COLUMBIA BASIN HEALTH ASSOCIATION,1083832232,"Dental Providers, Federally Qualified Health Centers - Medical Services",140 E Main St,,Othello,WA,99344-1040,Adams,140 E Main St,,Othello,WA,99344-1040,Adams,Greg Brandenburg,CEO,509-488-5256,8101,greg@cbha.org,Kent Mosbrucker,CFO,509-488-5256,8102,kentm@cbha.org,
WA-011509,14th AVENUE MEDICAL & DENTAL CENTER,COLUMBIA BASIN HEALTH ASSOCIATION,1427494004,"Dental Providers, Federally Qualified Health Centers - Medical Services",475 N 14th Ave,,Othello,WA,99344-1226,Adams,140 E MAIN,,OTHELLO,WA,99344,Adams,Greg Brandenburg,CEO,509-488-5256,8101,greg@cbha.org,Kent Mosbrucker,CFO,509-488-5256,8102,kentm@cbha.org,
WA-011510,Palouse Health Center,Palouse Health Center,1508861386,Rural Health Clinics,235 E Main St,,Palouse,WA,99161,Whitman,235 E Main St,,Palouse,WA,99161,Whitman,Wendy Griffin,Office Manager,509-878-1263,,wendy-phc@palouse.com,,,,,,
WA-011511,MIRAMAR HEALTH CENTER,YAKIMA VALLEY FARM WORKERS CLINIC,1235265455,Federally Qualified Health Centers - Medical Services,1608 N Road 44,,Pasco,WA,99301-2667,Franklin,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011512,Tri-Cities Community Health,TRI-CITIES COMMUNITY HEALTH,1225145105,Federally Qualified Health Centers - Medical Services,1801 East Shepard Sreet,Ochoa Middle School-Based Health Clinic,Pasco,WA,99301,Franklin,515 W. Court Street,,Pasco,WA,99301,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011513,PASCO HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1255647806,"Family Planning Providers, Sexually Transmitted Disease Clinics",3901 W Court St,,Pasco,WA,99301-2776,Franklin,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011514,TCCH - Pasco,TRI-CITIES COMMUNITY HEALTH,1225145105,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",515 W Court St,,Pasco,WA,99301-3737,Franklin,515 W. Court Street,,Pasco,WA,99301,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011515,La Clinica,Tri-Cities Community Health,1588782106,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",715 W Court St,,Pasco,WA,99301-4153,Franklin,715 W. Court St,,Pasco,WA,99301,Benton,Saul Valencia,CMO,509-543-1907,1907,svalencia@mytcch.org,Beth Mahoney,Compliance and Grants Director,509-543-1991,1991,emahoney@mytcch.org,http://www.mytcch.org/
WA-011516,TCCH Integrated Services Building,TRI-CITIES COMMUNITY HEALTH,1225145105,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",715 W Court St,,Pasco,WA,99301-4153,Franklin,515 W Court St,,Pasco,WA,99301-3737,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011517,UCNW - Point Roberts,Unity Care Northwest,1316182140,Federally Qualified Health Centers - Medical Services,2030 Benson Rd,,Point Roberts,WA,98281-9206,Whatcom,"1616 Cornwall Ave., Suite 205",,Bellingham,WA,98225-4642,Whatcom,Desmond Skubi,Executive Director,360-788-2620,,des.skubi@ucnw.org,,,,,,
WA-011518,GARFIELD COUNTY MEMORIAL HOSPITAL,GARFIELD COUNTY MEMORIAL HOSPITAL,1255429957,Rural Health Clinics,446 Pataha St,,Pomeroy,WA,99347-8634,Garfield,66 NORTH 6TH STREET,,Pomeroy,WA,99347,Garfield,Marni Herres,Medical Staff/Administrative Assistant,509-843-1591,145,marniherres@pomeroymd.com,Jon Smiley,Interim CEO,509-843-1591,120,jsmiley@pomeroymd.com,www.pomeroymd.com
WA-011519,GARFIELD COUNTY MEMORIAL HOSPITAL,GARFIELD COUNTY MEMORIAL HOSPITAL,1255429957,Inpatient Hospitals (other than children's hospitals),66 N 6th St,,Pomeroy,WA,99347-9705,Garfield,66 NORTH 6TH STREET,,Pomeroy,WA,99347,Garfield,Marni Herres,Medical Staff/Administrative Assistant,509-843-1591,145,marniherres@pomeroymd.com,Jon Smiley,Interim CEO,509-843-1591,120,jsmiley@pomeroymd.com,www.pomeroymd.com
WA-011520,Sea Mar CHC - Port Angeles W. 1st St.,SEA-MAR COMMUNITY HEALTH CENTER,1851730691,Dental Providers,228 W 1st St,,Port Angeles,WA,98362-2639,Clallam,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,latashiaredd@seamarchc.org,,,,,,
WA-011521,North Olympic Healthcare Network,North Olympic Healthcare Network,1154702264,Federally Qualified Health Centers - Medical Services,240 W Front St,Suite A,Port Angeles,WA,98362-2609,Clallam,240 W. Front St.,Suite A,Port Angeles,WA,98362,Clallam,Michael S. Maxwell,CEO,360-452-7891,2834,mmaxwell@nohn-pa.org,Beau Brown,CFO,360-452-7891,2828,bbrown@nohn-pa.org,www.nohn-pa.org
WA-011522,LOWER ELWHA TRIBAL HEALTH DEPARTMENT,LOWER ELWHA TRIBAL HEALTH DEPARTMENT,1821114026,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",243511 W Highway 101,,Port Angeles,WA,98363-9472,Clallam,243511 HWY 101 W,,Port Angeles,WA,98363,Clallam,TERRESA DEMOREST,DATA/SITE/BILLING/REFERRAL MANAGER,360-452-6252,7638,terresa.demorest@elwha.org,DEBRA ELLIS,CPC/CPB,360-452-6252,7643,debi.ellis@elwha.org,
WA-011523,Port Angeles Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",426 E 8th St,,Port Angeles,WA,98362-6220,Clallam,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011524,Peninsula Children's Clinic,Peninsula Children's Clinic,1528025293,Rural Health Clinics,902 Caroline St,,Port Angeles,WA,98362-3910,Clallam,902 Caroline,902 Caroline St,Port Angeles,WA,98362,Clallam,Carolyn Anderson,Business Manager,360-457-8578,,childrens@olympicmedical.org,,,,,,www.peninsulachildrensclinic.com
WA-011525,PCHS Port Orchard Dental Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1588041701,Dental Providers,1950 Pottery Ave,Suite 170,Port Orchard,WA,98366-2591,Kitsap,400 Warren Avenue Suite 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011526,PCHS Port Orchard Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1205886934,Federally Qualified Health Centers - Medical Services,320 S Kitsap Blvd,,Port Orchard,WA,98366-3778,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011527,Jefferson Healthcare Family Medicine,Jefferson County PHD no 2 dba Jefferson Healthcare,1760433049,Rural Health Clinics,1010 Sheridan St,,Port Townsend,WA,98368-2901,Jefferson,834 Sheridan,,Port Townsend,WA,98368,Jefferson,Hilary Whittington,CFO,360-385-2200,2094,hwhittington@jgh.org,Erin Brown,Supervisor of Financial Counseling,360-385-2200,2268,ebrown@jgh.org,
WA-011528,Jefferson Co. Public Health Services,Jefferson Co. Public Health Services,1871783753,Family Planning Providers,1500 Van Ness St,Jefferson County Public Health - Port Townsend School-based,Port Townsend,WA,98368-6346,Jefferson,1500 Van Ness St,,Port Townsend,WA,98368-6346,Jefferson,Jessica Syska,Clinic Administrator,360-385-3431,,jsyska@co.jefferson.wa.us,Julia Danskin,Public Health Manager,360-385-9420,,jdanskin@co.jefferson.wa.us,http://jeffersoncountypublichealth.org/
WA-011529,Jefferson Co. Public Health Services,JEFFERSON COUNTY HEALTH AND HUMAN SERVICES,1871783753,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",615 Sheridan St,Castle Hill Center,Port Townsend,WA,98368-2439,Jefferson,615 Sheridan St,,Port Townsend,WA,98368,Jefferson,Jessica Syska,Clinic Administrator,360-385-3431,,jsyska@co.jefferson.wa.us,Julia Danskin,Public Health Manager,360-385-9420,,jdanskin@co.jefferson.wa.us,http://jeffersoncountypublichealth.org/
WA-011530,"Jefferson Healthcare Internal Medicine, Pediatrics and Primary Care",Jefferson County PHD no 2 dba Jefferson Healthcare,1902850753,Rural Health Clinics,915 Sheridan St,,Port Townsend,WA,98368-2931,Jefferson,834 Sheridan,,Port Townsend,WA,98368,Jefferson,Hilary Whittington,CFO,360-385-2200,2094,hwhittington@jgh.org,Erin Brown,Supervisor of Financial Counseling,360-385-2200,2268,ebrown@jgh.org,
WA-011531,Jefferson Healthcare Internal Medicine and Walk in Clinic,Jefferson County PHD no 2 dba Jefferson Healthcare,1952353369,Rural Health Clinics,934 Sheridan St,,Port Townsend,WA,98368-2957,Jefferson,834 Sheridan,,Port Townsend,WA,98368,Jefferson,Hilary Whittington,CFO,360-385-2200,2094,hwhittington@jgh.org,Erin Brown,Supervisor of Financial Counseling,360-385-2200,2268,ebrown@jgh.org,
WA-011532,PCHS Poulsbo Clinic,PENINSULA COMMUNITY HEALTH SERVICES,1013969351,Federally Qualified Health Centers - Medical Services,19917 7th Ave NE,Suite 205,Poulsbo,WA,98370-6555,Kitsap,400 Warren Ave Ste 200,,Bremerton,WA,98337-1408,Kitsap,Joel Andrew Emery,CFO,360-475-6710,,jemery@pchsweb.org,Jennifer Kreidler-Moss,CEO,360-478-2366,,jlkreidlermoss@pchsweb.org,https://www.pchsweb.org/
WA-011533,Valley Vista Medical Group,YAKIMA VALLEY FARM WORKERS CLINIC,1891821013,Federally Qualified Health Centers - Medical Services,820 Memorial St,,Prosser,WA,99350-2504,Benton,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011534,PULLMAN HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1346226750,"Family Planning Providers, Sexually Transmitted Disease Clinics",1525 SE King Dr,,Pullman,WA,99163-7014,Whitman,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011535,Sea Mar CHC - Puyallup 125th Street Ct. E.,SEA-MAR COMMUNITY HEALTH CENTER,1912055286,Federally Qualified Health Centers - Medical Services,10217 125th Street Ct E,,Puyallup,WA,98374-2761,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011536,Sea Mar CHC - Puyallup 101st Avenue Ct. E.,SEA-MAR COMMUNITY HEALTH CENTER,1043407182,Federally Qualified Health Centers - Medical Services,12812 101st Avenue Ct E,,Puyallup,WA,98373-9101,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011537,Puyallup Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",702 30th Ave SW,,Puyallup,WA,98373-2756,Pierce,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011538,Jefferson County Public Health South County Clinic,Jefferson County Public Health,1871783753,"Family Planning Providers, Rural Health Clinics",294843 US Highway 101,,Quilcene,WA,98376-6000,Jefferson,615 Sheridan,,Port Townsend,WA,98368,Jefferson,Jessica Syska,Clinic Administrator,360-385-3431,,jsyska@co.jefferson.wa.us,Julia Danskin,Public Health Manager,360-385-9420,,jdanskin@co.jefferson.wa.us,http://jeffersoncountypublichealth.org/
WA-011539,QUINCY COMMUNITY HEALTH CENTER,MOSES LAKE COMMUNITY HEALTH CENTER,1699862813,"Dental Providers, Federally Qualified Health Centers - Medical Services",1450 1st Ave SW,,Quincy,WA,98848-1695,Grant,605 S Coolidge St,,Moses Lake,WA,98837-1893,Grant,Sheila A Chilson,CEO,509-765-0674,2411,schilson@mlchc.org,Amanda Duzon,CFO,509-765-0674,2781,aduzon@mlchc.org,www.mlchc.org
WA-011540,Randle Clinic,Morton General Hospital,1689604563,Rural Health Clinics,108 Kindle Rd,,Randle,WA,98377-9209,Lewis,521 Adams Avenue,,Morton,WA,98564,Lewis,Julie Allen,CLINIC MANAGER,360-983-8990,4101,jallen@mortongeneral.org,Patricia Craig,Clinic RN Supervisor,360-497-3333,4005,pcraig@mortongeneral.org,
WA-011541,Valley View Health Center - Raymond,Lewis County Community Health Services,1205196540,"Dental Providers, Federally Qualified Health Centers - Medical Services",300 Ocean Ave,,Raymond,WA,98577-3016,Pacific,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011542,REARDAN HEALTH CLINIC,Lincoln Hospital District #3,1639113830,Rural Health Clinics,550 E Broadway Ave,,Reardan,WA,99029,Lincoln,10 Nicholls St.,,Davenport,WA,99122,Lincoln,Tim O'Connell,Chief Financial Officer,509-796-2979,1157,oconnetr@lhd3.org,Tyson Lacy,CEO,509-725-2979,1168,lacyte@lhd3.org,
WA-011543,HealthPoint Redmond,HEALTHPOINT,1891795621,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",16315 NE 87th St,Suite B6,Redmond,WA,98052-3537,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011544,HealthPoint Renton,HEALTHPOINT,1629061353,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 S 2nd St,,Renton,WA,98057-2011,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011545,HealthPoint Valley Cities Renton,HEALTHPOINT,1255795373,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",221 Wells Ave S,,Renton,WA,98057-2161,King,955 Powell Ave SW,,Renton,WA,98057,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011546,RENTON PUBLIC HEALTH CENTER,PUBLIC HEALTH SEATTLE & KING COUNTY,1922105154,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",3001 NE 4th St,,Renton,WA,98056-4122,King,401 Fifth Avenue,,Seattle,WA,98104,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011547,RENTON PUBLIC HEALTH CENTER-RENTON DENTAL CLINIC,"KING, COUNTY OF",1922105154,Dental Providers,3201 NE 7th St,,Renton,WA,98056-3729,King,401 Fifth Avenue,,Seattle,WA,98104,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011548,Northeast Tri Co. Health District Ferry Co. FP,Northeast Tri County Health District,1356426589,"Family Planning Providers, Sexually Transmitted Disease Clinics",147 N Clark St Ste 1,PO Box 584,Republic,WA,99166-8726,Ferry,240 E. Dominion Ave.,,Colville,WA,99114,Stevens,Sandra Perkins,Community Health Director,509-648-5048,,sperkins@netchd.org,Dave Windom,Administrator,509-684-1301,,dwindom@netchd.org,http://www.netchd.org/
WA-011549,TCCH - Richland,TRI-CITIES COMMUNITY HEALTH,1225145105,Federally Qualified Health Centers - Medical Services,829 Goethals Dr,,Richland,WA,99352-3529,Benton,515 W Court St,,Pasco,WA,99301-3737,Franklin,Juan A Cordova,CEO,509-543-1900,,acordova@mytcch.org,,,,,,
WA-011550,Tri-Cities Community Health Wilson Clinic,Tri-Cities Community Health,1225145105,Federally Qualified Health Centers - Medical Services,915 Goethals Dr,,Richland,WA,99352-3527,Benton,515 W. Court Street,,Pasco,WA,99301,Benton,Beth Mahoney,Compliance Officer,509-543-1991,1991,emahoney@mytcch.org,,,,,,
WA-011551,Confluence Health Royal City,Confluence Health / Wenatchee Valley Hospital,1548507338,Rural Health Clinics,101 Camelia NW,,Royal City,WA,99357,Grant,820 N. Chelan,,Wenatchee,WA,98815,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,,,,,,
WA-011552,Sea Mar CHC - Burien 8th Ave. S.,SEA-MAR COMMUNITY HEALTH CENTER,1447308762,Dental Providers,18010 8th Ave S,Suite 416,Seatac,WA,98148-1908,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011553,HealthPoint SeaTac,HEALTHPOINT,1659496248,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4040 S 188th St,Suite 201,Seatac,WA,98188-5070,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFo,425-203-0416,,vhammond@healthpointchc.org,
WA-011554,HealthPoint Tyee SBHC,HEALTHPOINT,1578596748,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4424 S 188th St,,Seatac,WA,98188-5028,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011555,Neighborcare Health,NEIGHBORCARE HEALTH,1760733901,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1012 SW Trenton St,Highland Park School-Based Health Center,Seattle,WA,98106-2421,King,1200 12th Avenuse S,Suite 900,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011556,AHF Healthcare Center - Seattle,AIDS Healthcare Foundation,1265810980,Other ECP Providers,1016 E Pike St Fl 2,,Seattle,WA,98122-3847,King,6255 w sunset blvd,21st Floor,Los Angeles,CA,90028,Los Angeles,Donna Stidham,"Chief, Managed Care",323-436-5025,,donna.stidham@aidshealth.org,,,,,,www.aidshealth.org
WA-011557,Meridian Center for Health,Neighborcare Health,1326443383,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",10521 Meridian Ave N,,Seattle,WA,98133-9509,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011558,Meridian Dental Clinic,Neighborcare Health,1144609231,Dental Providers,10521 Meridian Ave N,,Seattle,WA,98133-9509,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011559,Northgate Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1200 N Northgate Way,,Seattle,WA,98133-8916,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011560,First Hill Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1229 Madison St,Suite 1040,Seattle,WA,98104-3306,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011561,NORTH PUBLIC HEALTH CENTER-LAKE CITY DENTAL,Public Health Seattle & King County,1922105154,Dental Providers,12359 Lake City Way NE,,Seattle,WA,98125-5401,King,401 Fifth Avenue,,Seattle,WA,98104,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Moffett Burgess,Dental Director,206-263-2468,,moffett.burgess@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011562,Neighborcare Health at Lake City,NEIGHBORCARE HEALTH,1962754713,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12721 30th Ave NE,Suite 101,Seattle,WA,98125-4498,King,1200 12th Avenue S,Suite 901,Seattle,WA,98104-2474,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011563,Neighborcare Health,NEIGHBORCARE HEALTH,1750714960,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1301 E Yesler Way,Bailey Gatzert School-Based Health Center,Seattle,WA,98122-5430,King,1200 12TH AVENUE S,SUITE 901,Seattle,WA,98144,King,CHARISSE MARSHALL,BILLING MANAGER,206-548-3102,,charissem@neighborcare.org,JANINE CHILDS,CFO,206-548-3034,,JANINEC@NEIGHBORCARE.ORG,
WA-011564,Neighborcare Health at St. Vincent De Paul,Neighborcare Health,1144629908,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",13555 Aurora Ave N,,Seattle,WA,98133-7511,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011565,Neighborcare Health,NEIGHBORCARE HEALTH,1396813390,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1410 NE 66th St,Roosevelt School-Based Health Center,Seattle,WA,98115-6744,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,charisse marshall,billing manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011566,Neighborcare Health,NEIGHBORCARE HEALTH,1093094203,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1600 S Columbian Way,Mercer School-Based Health Center,Seattle,WA,98108-1565,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011567,45th Street Dental Clinic,Neighborcare Health,1578636346,Dental Providers,1629 N 45th St,,Seattle,WA,98103-6701,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011568,45th Street Medical Clinic,Neighborcare Health,1285664227,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1629 N 45th St,,Seattle,WA,98103-6701,King,1200 12th Avenue S,Suite 901,Seattle,WA,98104-2474,King,Charisse Marshall,Billing Manager,206-548-3050,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011569,INTERNATIONAL COMMUNITY HEALTH SERVICES,INTERNATIONAL COMMUNITY HEALTH SERVICES,1376659151,Family Planning Providers,1700 E Union St,Seattle World School,Seattle,WA,98122-4140,King,International District Health Services,720 8th Ave S,Seattle,WA,98104,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,https://www.ichs.com/ichs-locations/sws-nova/
WA-011570,Ballard Homeless Clinic,"KING, COUNTY OF",1922105154,Federally Qualified Health Centers - Medical Services,1753 NW 56th St,,Seattle,WA,98107-5279,King,401 5th Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,,,,,,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011571,Public Health Seattle & King County - Ingraham Teen HC,Public Health Seattle and King Co. Family Planning Program,1801953252,Family Planning Providers,1819 N 135th St,,Seattle,WA,98133-7709,King,401 Fifth Avenue,,Seattle,WA,98104,King,Heather Maisen,Program Manager,206-263-8295,,heather.maisen@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011572,Neighborcare at Boren,Neighborcare Health,1962877480,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1930 Boren Ave,,Seattle,WA,98101-1406,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-254-3034,,JanineC@neighborcare.org,
WA-011573,Neighborcare Health at Pike Place Market,Neighborcare Health,1356371215,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1930 Post Aly,,Seattle,WA,98101-1015,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011574,Central District Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",2001 E Madison St,,Seattle,WA,98122-2959,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011575,PIONEER SQUARE CLINIC,"KING, COUNTY OF",1053359729,Other ECP Providers,206 3rd Ave S,Suite 100,Seattle,WA,98104-2697,King,401 5th Ave,,Seattle,WA,98104-1818,King,Karen Eaton,Grant and Contracts Manager,206-744-3668,,eatonke@uw.edu,Matt Lund,Director of Contracting,206-744-9753,,lundm2@uw.edu,http://www.uwmedicine.org/harborview
WA-011576,CAROLYN DOWNS FAMILY MED CENTER,COUNTRY DOCTOR COMMUNITY CLINIC,1164642278,Federally Qualified Health Centers - Medical Services,2101 E Yesler Way,,Seattle,WA,98122-5959,King,500 19th Ave E,,Seattle,WA,98112-4007,King,Shonnie Noma,Quality Improvement Manager,206-299-1628,,sanoma@cdchc.org,Raleigh Watts,Executive Director,206-299-1628,,rrwatts@cdchc.org,http://www.countrydoctor.org
WA-011577,Odessa Brown Children's Clinic,Odessa Brown Children's Clinic,1134251747,"Dental Providers, Family Planning Providers, Freestanding Cancer Centers, Other ECP Providers, Sexually Transmitted Disease Clinics",2101 E Yesler Way,,Seattle,WA,98122-5999,King,P.O. Box 5371,M/S RC- 406,Seattle,WA,90145-5005,King,Eileen O'Connor,Sr. Director Contracting and Payor Relations,206-987-5209,,eileen.oconnor@seattlechildrens.org,,,,,,http://www.seattlechildrens.org/contact/odessa-brown/
WA-011578,Central District Dental,Neighborcare Health,1134299373,Dental Providers,2101 E Yesley Way,2nd Floor,Seattle,WA,98122,King,1200 12th Avene S,Suite 901,Seattle,WA,98144,King,Charisse marshall,BIlling Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011579,Downtown Public Health Center,Public Health Seattle & King County,1922105154,"Dental Providers, Federally Qualified Health Centers - Medical Services",2124 4th Ave,,Seattle,WA,98121-2308,King,401 Fifth Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Martha Driver,Clinic Administrator,206-296-4790,,martha.driver@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011580,Neighborcare Health,NEIGHBORCARE HEALTH,1730248642,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2600 SW Thistle St,Chief Sealth School-based Health Center,Seattle,WA,98126-3748,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,charisse marshall,billing manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,,
WA-011581,Neighborcare Health,NEIGHBORCARE HEALTH,1003975095,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2601 SW Kenyon St,Denny International School-Based Health Center,Seattle,WA,98126-3562,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011582,Neighborcare Health,NEIGHBORCARE HEALTH,1225461908,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2820 S Orcas St,Dearborn Park School-Based Health Center,Seattle,WA,98108-3066,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,charisse marshall,Billing Manager,206-548-3100,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011583,Neighborcare Health,NEIGHBORCARE HEALTH,1770642696,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3000 California Ave SW,West Seattle School-Based Health Center,Seattle,WA,98116-3302,King,905 Spruce St Ste 300,,Seattle,WA,98104-2474,King,charisse marshall,billing manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,,
WA-011584,Neighborcare Health,NEIGHBORCARE HEALTH,1376851097,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",301 21st Ave E,Seattle World School Wellness Center,Seattle,WA,98112-5318,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011585,HARBORVIEW MEDICAL CENTER (inpatient hospital),Harborview Medical Center,1053359729,Inpatient Hospitals (other than children's hospitals),325 9th Ave,,Seattle,WA,98104-2499,King,325 Ninth Ave,,Seattle,WA,98104-2420,King,Karen Eaton,Grant & Contract Manager,206-744-3668,,eatonke@uw.edu,Matt Lund,Director of Contracting,206-744-9753,,lundm2@uw.edu,http://www.uwmedicine.org/locations/
WA-011586,HARBORVIEW MEDICAL CENTER (multiple outpatient ECP categories),Harborview Medical Center,1053359729,"Community Mental Health Centers, Family Planning Providers, Other ECP Providers, Ryan White Providers",325 9th Ave,,Seattle,WA,98104-2499,King,325 Ninth Ave,,Seattle,WA,98104-2420,King,Karen Eaton,Grant & Contract Manager,206-744-3668,,eatonke@uw.edu,Matt Lund,Director of Contracting,206-744-9753,,lundm2@uw.edu,http://www.uwmedicine.org/locations/
WA-011587,Neighborcare Health,NEIGHBORCARE HEALTH,1689742678,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3429 NE 45th St,Madison School-Based Health Center,Seattle,WA,98105-5650,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011588,ACRS,INTERNATIONAL COMMUNITY HEALTH SERVICES,1902983109,Federally Qualified Health Centers - Medical Services,3639 Martin Luther King Jr Way S,,Seattle,WA,98144-6847,King,720 8th Ave S Ste 100,,Seattle,WA,98104-3033,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,www.ichs.com
WA-011589,ICHS - HOLLY PARK MEDICAL & DENTAL CLINIC,INTERNATIONAL COMMUNITY HEALTH SERVICES,1902983109,"Dental Providers, Federally Qualified Health Centers - Medical Services",3815 S Othello St,Suite 200,Seattle,WA,98118-3510,King,720 8th Ave S Ste 100,,Seattle,WA,98104-3033,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,www.ichs.com
WA-011590,Neighborcare Health at GREENWOOD,NEIGHBORCARE HEALTH,1518985621,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",415 N 85th St,,Seattle,WA,98103-3701,King,1200 12th Avenue S,Suite 901,Seattle,WA,98104-2474,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011591,Columbia City,Neighborcare Health,1801826821,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4400 37th Ave S,,Seattle,WA,98118-1609,King,1200 12th Avenue South,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janinie Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011592,COLUMBIA PUBLIC HEALTH CENTER,PUBLIC HEALTH SEATTLE & KING COUNTY,1922105154,"Dental Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",4400 37th Ave S,,Seattle,WA,98118-1609,King,401 Fifth Avenue,,Seattle,WA,98104,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,Jane Simpson,Clinic Administrator,206-205-6001,,jane.simpson@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011593,SEATTLE CHILDREN'S HOSPITAL (children's inpatient hospital),SEATTLE CHILDREN'S HOSPITAL,1467536276,Children's Hospitals (inpatient only),4800 Sand Point Way NE # 5371,PO Box C,Seattle,WA,98105-3901,King,P.O. Box 5371,M/S RC- 406,Seattle,WA,90145-5005,King,Eileen O'Connor,Sr. Director Contracting and Payor Relations,206-987-5209,,eileen.oconnor@seattlechildrens.org,Diana Kroemer,DIrector COntracting and Payor Relations,206-987-0673,,dianakroemer@seattlechildrens.org,Seattlechildrens.org
WA-011594,SEATTLE CHILDREN'S HOSPITAL (multiple outpatient ECP categories),SEATTLE CHILDREN'S HOSPITAL,1467536276,"Dental Providers, Family Planning Providers, Hemophilia Treatment Centers, Outpatient Hospital Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",4800 Sand Point Way NE # 5371,PO Box C,Seattle,WA,98105-3901,King,P.O. Box 5371,M/S RC- 406,Seattle,WA,90145-5005,King,Eileen O'Connor,Sr. Director Contracting and Payor Relations,209-987-5209,,eileen.oconnor@seattlechildrens.org,Diana Kroemer,DIrector COntracting and Payor Relations,206-987-0673,,diana.kroemer@seattlechildrens.org,Seattlechildrens.org
WA-011595,COUNTRY DOCTOR COMMUNITY CLINIC,COUNTRY DOCTOR COMMUNITY CLINIC,1629055900,Federally Qualified Health Centers - Medical Services,500 19th Ave E,,Seattle,WA,98112-4007,King,500 19th Ave E,,Seattle,WA,98112-4007,King,Shonnie Noma,Quality Improvement Manager,206-299-1984,,sanoma@cdchc.org,Raleigh Watts,Executive Director,206-299-1628,,rrwatts@cdchc.org,www.CDCHC.Org
WA-011596,Division of Adolescent Medicine Homeless Teen Clinic,University of Washington Department of Pediatrics,1366523615,Other ECP Providers,500 19th Ave E,,Seattle,WA,98112-4007,King,4540 Sand Point Way NE,Suite 200,Seattle,WA,98105,King,Inga Manskopf,Administrator,206-987-1364,,imansk@uw.edu,,,,,,
WA-011597,University District Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",5020 Roosevelt Way NE,Suite 1,Seattle,WA,98105-3644,King,2001 E Madison St,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011598,CDCHC After Hours Clinic,COUNTRY DOCTOR COMMUNITY CLINIC,1497189773,Federally Qualified Health Centers - Medical Services,550 16th Ave,Suite 100,Seattle,WA,98122-5636,King,500 19th Ave E,,Seattle,WA,98112-4007,King,Shonnie Noma,Quality Improvement Manager,206-299-1984,,sanoma@cdchc.org,Raleigh Watts,Executive Director,206-299-1628,,rrwatts@cdchc.org,
WA-011599,Public Health Seattle & King County - Cleveland Teen HC,Public Health Seattle and King Co. Family Planning Program,1801953252,Family Planning Providers,5511 15th Ave S,,Seattle,WA,98108-2823,King,401 Fifth Ave,,Seattle,WA,98104,King,Heather Maisen,Program Manager,206-263-8300,,heather.maisen@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011600,Neighborcare Health Ballard Homeless Clinic,NEIGHBORCARE HEALTH,1275808214,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5710 22nd Ave NW,,Seattle,WA,98107-3144,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,BIlling Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011601,Neighborcare Health at HighPoint,Neighborcare Health,1871523811,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6020 35th Ave SW,,Seattle,WA,98126-3002,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011602,Seattle Indian Health Board,Seattle Indian Health Board,1316012461,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",611 12th Ave S,Suite 200,Seattle,WA,98144-1911,King,611-12th Avenue South,,Seattle,WA,98144,King,Esther Lucero,CEO,206-324-9360,1102,estherl@sihb.org,Crystal Tetrick,COO,206-324-9360,1147,crystalt@sihb.org,www.sihb.org
WA-011603,Georgetown Dental Clinic,NEIGHBORCARE HEALTH,1306916556,Dental Providers,6200 13th Ave S,,Seattle,WA,98108-2706,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011604,Neighborcare Health,NEIGHBORCARE HEALTH,1184057150,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6760 34th Ave SW,West Seattle Elementary School-Based Health Center,Seattle,WA,98126-4208,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011605,ICHS - International District Medical & Dental Clinic,INTERNATIONAL COMMUNITY HEALTH SERVICES,1376659151,"Dental Providers, Federally Qualified Health Centers - Medical Services",720 8th Ave S,,Seattle,WA,98104-3032,King,720 8th Ave S Ste 100,,Seattle,WA,98104-3033,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,www.ichs.com
WA-011606,Neighborcare Health,NEIGHBORCARE HEALTH,1982037834,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",8311 Beacon Ave S,Van Asselt School-Based Health Center,Seattle,WA,98118-4323,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011607,Public Health Seattle & King County - South Lake Teen HC,Public Health Seattle and King Co. Family Planning Program,1801953252,Family Planning Providers,8601 Rainier Ave S,,Seattle,WA,98118-4630,King,401 Fifth Avenue,,Seattle,WA,98104,King,Heather Maisen,Program Manager,206-263-8295,,heather.maisen@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,
WA-011608,Sea Mar CHC - Seattle Medical,SEA-MAR COMMUNITY HEALTH CENTER,1962588426,Federally Qualified Health Centers - Medical Services,8720 14th Ave S,,Seattle,WA,98108-4807,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011609,Public Health Seattle & King County - Rainier Beach Teen HC,Public Health Seattle and King Co. Family Planning Program,1801953252,Family Planning Providers,8815 Seward Park Ave S,,Seattle,WA,98118-4743,King,401 Fifth Avenue,,Seattle,WA,98104,King,Heather Maisen,Program Manager,206-263-8295,,heather.maisen@kingcounty.gov,Anne Shinoda-Mettler,Clinic Administrator,206-205-1953,,Anne.Shinoda-Mettler@kingcounty.gov,
WA-011610,Sea Mar CHC - Seattle 8915 14th Ave. S.,SEA-MAR COMMUNITY HEALTH CENTER,1942358262,Dental Providers,8915 14th Ave S,,Seattle,WA,98108-4813,King,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011611,STD Program - Public Health,Public Health Seattle & King County,1922105154,Sexually Transmitted Disease Clinics,908 Jefferson St Fl 11,,Seattle,WA,98104-2433,King,401 Fifth Ave,,Seattle,WA,98104-1818,King,John Gilvar,Program Manager,206-369-3489,,john.gilvar@kingcounty.gov,,,,,,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011612,Bloodworks,Bloodworks,1053799403,Hemophilia Treatment Centers,921 Terry Ave,,Seattle,WA,98104-1239,King,921 Terry Avenue,,Seattle,WA,98104,King,Mary Spisak,Contract Specialist,206-689-6374,,Marysp@bloodworksnw.org,Karyn Denton,VP Clinical Services,206-689-6289,,Karynd@bloodworksnw.org,
WA-011613,Rainier Beach Dental Clinic,Neighborcare Health,1497828453,Dental Providers,9245 Rainier Ave S,,Seattle,WA,98118-5569,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,Charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011614,Rainier Beach Medical,Neighborcare Health,1275567539,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9245 Rainier Ave S,,Seattle,WA,98118-5569,King,1200 12th Avenue South,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011615,Neighborcare Health,NEIGHBORCARE HEALTH,1679825988,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",9430 30th Ave SW,Roxhill School-Based Health Center,Seattle,WA,98126-3963,King,1200 12th Avenue S,Suite 901,Seattle,WA,98144,King,Charisse Marshall,Billing Manager,206-548-3102,,charissem@neighborcare.org,Janine Childs,CFO,206-548-3034,,JanineC@neighborcare.org,
WA-011616,SEA MAR WHITE CENTER DENTAL,Sea Mar Community Health Centers,1023154077,Dental Providers,9650 15th Ave SW,Suite 100,Seattle,WA,98106-2820,King,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011617,White Center Public Health Center at Greenbridge,Public Health Seattle & King County,1922105154,Federally Qualified Health Centers - Medical Services,9934 8th Ave SW,,Seattle,WA,98106-3036,King,401 5th Ave,,Seattle,WA,98104-1818,King,Lois Schipper,Clinic Administrator,206-477-0018,,lois.schipper@kingcounty.gov,,,,,,http://www.kingcounty.gov/healthservices/health/locations.aspx
WA-011618,White Center Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",9942 8th Ave SW,,Seattle,WA,98106-3036,King,2001 E Madison,,Seattle,WA,98122-2959,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011619,Jamestown Family Health Clinic,Jamestown S'Klallam Tribe,1578812087,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",808 N 5th Ave,,Sequim,WA,98382-3045,Clallam,1033 Old Blyn Highway,,Sequim,WA,98382,Clallam,Cindy Lowe,Deputy Director of Health,360-582-4876,4876,clowe@jamestowntribe.org,Brent Simcosky,Director of Health Services,360-683-5900,4870,bsimcosky@jamestowntribe.org,www.jamestowntribe.org
WA-011620,"MGH Family Health, Ankle and Foot",Public Hospital District No 1 of Mason County,1164876629,Rural Health Clinics,1810 N 13th Loop Rd,,Shelton,WA,98584-2169,Mason,PO Box 1668,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff,360-427-9549,,jfitchitt@masongeneral.com,,,,,,
WA-011621,MGH Olympic Physicians,Public Hospital District No 1 of Mason County,1306274667,Rural Health Clinics,221 Professional Way,,Shelton,WA,98584-4404,Mason,PO Box 1668,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff Services,360-427-9549,,jfitchitt@masongeneral.com,,,,,,
WA-011622,MGH MOUNTAIN VIEW WOMEN'S HEALTH C,Public Hospital District No 1 of Mason County,1679803126,Rural Health Clinics,2300 Kati Ct,Suite A,Shelton,WA,98584-1926,Mason,901 Mountain View Drive,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff Services,360-427-9549,,jfitchitt@masongeneral.com,Rick Smith,Chief Financial Officer,360-426-1611,,rsmith@masongeneral.com,
WA-011623,MGH Olympic Physicians,Public Hospital District No 1 of Mason County,1205264561,Rural Health Clinics,237 Professional Way,,Shelton,WA,98584-4404,Mason,PO Box 1668,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff Services,360-427-9549,,jfitchitt@masongeneral.com,,,,,,
WA-011624,MASON GENERAL HOSPITAL OAKLAND BAY PEDIATRICS,Public Hospital District No 1 of Mason County,1619180213,Rural Health Clinics,247 Professional Way,,Shelton,WA,98584-4404,Mason,901 Mountain View Drive,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff Services,360-426-9549,,jfitchitt@masongeneral.com,Rick Smith,Chief Financial Officer,360-426-1611,,rsmith@masongeneral.com,
WA-011625,Shelton Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",2505 Olympic Hwy N,Suite 400,Shelton,WA,98584-2976,Mason,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011626,MASON GENERAL HOSPITAL & FAMILY OF CLINICS,Public Hospital District No 1 of Mason County,1760568752,Inpatient Hospitals (other than children's hospitals),901 Mountain View Dr,,Shelton,WA,98584-4401,Mason,901 Mountain View Drive,,Shelton,WA,98584,Mason,Rick Smith,Chief Financial Officer,360-426-1611,,rsmith@masongeneral.com,Jennifer Fitchitt,Director Medical Staff Services,360-427-9549,,jfitchitt@masongeneral.com,
WA-011627,MGH Shelton Family Medicine & Orthopedic Clinic,Public Hospital District No 1 of Mason County,1598906455,Rural Health Clinics,939 Mountain View Dr,,Shelton,WA,98584-4410,Mason,PO Box 1668,,Shelton,WA,98584,Mason,Jennifer Fitchitt,Director Medical Staff Services,360-427-9549,,jfitchitt@masongeneral.com,,,,,,
WA-011628,ICHS Shoreline Medical and Dental Clinic,INTERNATIONAL COMMUNITY HEALTH SERVICES,1992124747,"Dental Providers, Federally Qualified Health Centers - Medical Services",16549 Aurora Ave N,,Shoreline,WA,98133-5308,King,720 8th Ave S Ste 100,,Seattle,WA,98104-3033,King,Hermes Shahbazian,Chief Financial Officer,206-788-3618,,hermess@ichs.com,Tianna Huang,Billing and Credentialing,206-788-3617,,tiannah@ichs.com,www.ichs.com
WA-011629,SKOKOMISH HEALTH CENTER,SKOKOMISH TRIBAL COUNCIL,1316056096,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",100 N Tribal Center Rd,,Skokomish Nation,WA,98584-9748,Mason,100 N TRIBAL CENTER ROAD,,SKOKOMISH NATION,WA,98584,Mason,FRANCES LONGSHORE,Billing Specialist,360-463-4539,3604265755,flongshore@skokomish.org,ED FOX,Health Director,360-426-5755,2118,edfox@skokomish.org,
WA-011630,Pacific County Public Health South Bend Clinic,Pacific County Public Health and Human Services Department,1508081217,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1216 W. Robert Bush Drive,,South Bend,WA,98586,Pacific,1216 W. Robert Bush Drive,,South Bend,WA,98586,Pacific,Mary P. Goelz,Director,360-875-9343,2644,mgoelz@co.pacific.wa.us,,,,,,
WA-011631,Denny Murphy Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1184700858,"Dental Providers, Federally Qualified Health Centers - Medical Services",1001 W 2nd Ave,,Spokane,WA,99201-4503,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011632,Sacred Heart Children's Medical Center (children's inpatient hospital),Providence Health and Services,1144471715,Children's Hospitals (inpatient only),101 W 8th Ave,,Spokane,WA,99204-2307,Spokane,W. 101 8th,,Spokane,WA,99204,Spokane,Nicole Lane,Hemophilia RN Coordinator,509-474-2778,2773,nicole.lane@providence.org,Vicki Wendt,Assistant Nurse Manager,509-474-2974,2974,Victoria.Wendt@providence.org,
WA-011633,Sacred Heart Children's Medical Center (hemophilia treatment centers),Providence Health and Services,1144471715,Hemophilia Treatment Centers,101 W 8th Ave,,Spokane,WA,99204-2307,Spokane,W. 101 8th,,Spokane,WA,99204,Spokane,Monica Phipps,Hemophilia RN Coordinator,509-474-2773,2773,Monica.Phipps@providence.org,Vicki Wendt,Assistant Nurse Manager,509-474-2974,2974,Victoria.Wendt@providence.org,
WA-011634,Unify Community Health,YAKIMA VALLEY FARM WORKERS CLINIC,1922051978,Federally Qualified Health Centers - Medical Services,120 W Mission Ave,,Spokane,WA,99201-2358,Spokane,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011635,Spokane Health Center,Planned Parenthood of Greater Washington and North Idaho,1346226750,"Family Planning Providers, Sexually Transmitted Disease Clinics",123 E Indiana Ave,,Spokane,WA,99207-2313,Spokane,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011636,NATIVE Project,The N. A. T. I. V. E. PROJECT,1326123670,"Dental Providers, Federally Qualified Health Centers - Medical Services, Urban Indian Health Program",1803 W Maxwell Ave,,Spokane,WA,99201-2831,Spokane,1803 W Maxwell Ave,,Spokane,WA,99201-2831,Spokane,Toni Lodge,Chief Executive Officer,509-325-5502,134,tlodge@nativeproject.org,Maureen Rosette,COO/Risk Manager,509-325-5502,127,mrosette@nativeproject.org,
WA-011637,Maple Street Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1326005851,"Dental Providers, Federally Qualified Health Centers - Medical Services",3919 N Maple St,,Spokane,WA,99205-1349,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011638,"Unify Community Health, Northeast",YAKIMA VALLEY FARM WORKERS CLINIC,1932400546,"Dental Providers, Federally Qualified Health Centers - Medical Services",4001 N Cook St,,Spokane,WA,99207-5879,Spokane,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011639,Spokane Urgent Care,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1881997831,Federally Qualified Health Centers - Medical Services,5901 N Lidgerwood St,Suite 126,Spokane,WA,99208-1122,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011640,Market Street Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1003994252,Federally Qualified Health Centers - Medical Services,5921 N Market St,,Spokane,WA,99208-2484,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011641,Perry Street Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1770972754,Federally Qualified Health Centers - Medical Services,817 S Perry St Unit B,,Spokane,WA,99202-3443,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011642,SHC - Spokane,Shriners Hospitals for Children,1992848857,Children's Hospitals (inpatient only),911 W 5th Ave,,Spokane,WA,99204-2901,Spokane,911 W 5th Ave.,,Spokane,WA,99204,Spokane,Cari Craig,"Corporate Director, Business Development",813-281-8668,,cacraig@shrinenet.org,Jesse Jacobowitz,National Corporate Contract Manager,813-367-2026,,jjacobowitz@shrinenet.org,
WA-011643,Spokane Valley Health Center,Planned Parenthood of Greater Washington and North Idaho,1346226750,"Family Planning Providers, Sexually Transmitted Disease Clinics",12104 E Main Ave,,Spokane Valley,WA,99206-6113,Spokane,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011644,Spokane Urgent Care-Valley,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1184018954,Federally Qualified Health Centers - Medical Services,1502 N Vercler Rd,,Spokane Valley,WA,99216-1078,Spokane,"203 N Washington St, Ste 300",,Spokane,WA,99201,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8888,,jbrowne@chas.org,www.chas.org
WA-011645,Valley Clinic,COMMUNITY HEALTH ASSOCIATION OF SPOKANE,1336219088,Federally Qualified Health Centers - Medical Services,15812 E Indiana Ave,,Spokane Valley,WA,99216-1875,Spokane,203 N Washington St Ste 300,,Spokane,WA,99201-0254,Spokane,Aaron Wilson,CEO,509-444-8888,,awilson@chas.org,John Browne,CFO,509-444-8200,,jbrowne@chas.org,www.chas.org
WA-011646,SPRINGDALE COMM. DENTAL CLINIC,NEW HEALTH PROGRAMS ASSOCIATION,1407971997,Dental Providers,105 N 2nd St,,Springdale,WA,99173,Stevens,509 E Main,,Chewelah,WA,99109,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,,,jessecaj@newhp.org,
WA-011647,SPRINGDALE COMMUNITY HEALTH CTR,NEW HEALTH PROGRAMS ASSOCIATION,1104880004,Federally Qualified Health Centers - Medical Services,114 S Main St,,Springdale,WA,99173-9740,Stevens,509 E Main Ave,,Chewelah,WA,99109-8964,Stevens,Desiree Sweeney,CEO,509-935-6001,,desirees@newhp.org,Jesseca Jeanneret,Billing Dept Manager,,,jessecaj@newhp.org,
WA-011648,Skamania County Community Health,Skamania County Community Health,1821175456,"Family Planning Providers, Sexually Transmitted Disease Clinics",710 SW Rock Creek Dr,PO Box 369,Stevenson,WA,98648-4418,Skamania,710 SW Rock Creek Dr.,PO Box 369,Stevenson,WA,98648,Skamania,Amanda Cole,PH Nurse Manager,509-527-3850,,cole@co.skamania.wa.us,Kirby Richards,Director,509-427-3850,,richards@co.skamania.wa.us,http://www.skamaniacounty.org/community-health/homepage/public-health/family-planning/
WA-011649,NorthShore Medical Group-Stv,NorthShore Medical Group,1841405206,Rural Health Clinics,875 SW Rock Creek Dr,,Stevenson,WA,98648-4404,Skamania,Po Box 1519,,White Salmon,WA,98672,Klickitat,Emma Kupchin,Payer Relations,509-493-9541,1541,KupchinE@northshore-medical.com,Cindy Robertson,Administrator,509-493-9535,1535,RobertsonC@northshore-medical.com,
WA-011650,Sunnyside Community Hospital Association,Sunnyside Community Hospital Association,1225033814,Inpatient Hospitals (other than children's hospitals),1016 Tacoma Ave,,Sunnyside,WA,98944-2263,Yakima,PO Box 719,,Sunnyside,WA,98944,Yakima,Cary Rowan,CFO,509-837-1655,,cary.rowan@sunnysidehospital.org,Martin Ashton,ACFO,509-837-1643,,martin.ashton@sunnysidehospital.org,
WA-011651,Community Dental Care,YAKIMA VALLEY FARM WORKERS CLINIC,1396874590,Dental Providers,1721 E Lincoln Ave,,Sunnyside,WA,98944-2478,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,carloso@yvfwc.org,,,,,,
WA-011652,"Swofford & Halma Clinic, Inc. P.S.","Swofford & Halma Clinic, Inc. P.S.",1992758486,Rural Health Clinics,2303 Reith Way,,Sunnyside,WA,98944-9521,Yakima,PO Box 119,,Sunnyside,WA,98944,Yakima,Doug Laverman,Business Office Manager,509-837-3933,,tammiedoug@hotmail.com,,,,,,
WA-011653,Immediate Care,YAKIMA VALLEY FARM WORKERS CLINIC,1982046710,Federally Qualified Health Centers - Medical Services,2680 Yakima Valley Hwy,Suite B,Sunnyside,WA,98944-1242,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011654,SUNNYSIDE HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1659526648,"Family Planning Providers, Sexually Transmitted Disease Clinics",2934 Covey Ln,,Sunnyside,WA,98944-8941,Yakima,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011655,Yakima Neighborhood Health Services - Sunnyside,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1588934079,"Dental Providers, Federally Qualified Health Centers - Medical Services",617 Scoon Rd,,Sunnyside,WA,98944-1031,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,,www.ynhs.org
WA-011656,Mid-Valley Community Clinic PLLC,Mid-Valley Community Clinic PLLC,1447203104,Rural Health Clinics,700 S 11th St,,Sunnyside,WA,98944-2243,Yakima,PO Box 957,,Sunnyside,WA,98944,Yakima,Tammie Laverman,Office Manager,509-839-6822,,tdlaverman68@hotmail.com,,,,,,
WA-011657,Suquamish Tribe/Suquamish Tribe Wellness Center,Suquamish Tribe/Suquamish Tribe Wellness Center,1083747216,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",18490 Suquamish Way NE Unit 107,,Suquamish,WA,98392-9533,Kitsap,PO Box 498,,Suquamish,WA,98392-0498,Kitsap,Leonard Forsman,Chairman,360-598-3311,,lforsman@suquamish.nsn.us,Leslie Wosnig,Health and Policy Administrator,360-394-8466,,lwosnig@suquamish.nsn.us,
WA-011658,Sea Mar CHC - Tacoma S. Cushman Ave.,SEA-MAR COMMUNITY HEALTH CENTER,1104974419,Federally Qualified Health Centers - Medical Services,1112 S Cushman Ave,,Tacoma,WA,98405-3631,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011659,SEA MAR TACOMA DENTAL,Sea Mar Community Health Centers,1144378886,Dental Providers,1112 S Cushman Ave,,Tacoma,WA,98405-3631,Pierce,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011660,SEA MAR TACOMA BEHAVIORAL HEALTH PPW,Sea Mar Community Health Centers,1780086686,Federally Qualified Health Centers - Medical Services,1119 Tacoma Ave S,,Tacoma,WA,98402-2005,Pierce,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011661,Community Health Care,Community Health Care,1790762755,"Dental Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",1148 Broadway,Suite 100,Tacoma,WA,98402-3518,Pierce,"1148 Broadway, Suite 100",,Tacoma,WA,98402,Pierce,David Flentge,CEO,253-597-4550,1500,dflentge@commhealth.org,Kristine Powers,AA to CEO,253-597-4550,1501,kpowers@commhealth.org,www.commhealth.org
WA-011662,Sea Mar CHC - Tacoma Dental,SEA-MAR COMMUNITY HEALTH CENTER,1144378886,Dental Providers,1215 S 11th St,,Tacoma,WA,98405-4020,Pierce,1040 S Henderson St,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011663,Tacoma Health Center,Planned Parenthood of the Great Northwest and the Hawaiian Islands,1083700686,"Family Planning Providers, Sexually Transmitted Disease Clinics",1515 Martin Luther King Jr Way,,Tacoma,WA,98405-3933,Pierce,2001 E. Madison Street,,Seattle,WA,98122,King,Scott Boyd,Chief Financial Officer,206-328-7731,,scott.boyd@ppgnhi.org,Nika Graci,Federal Programs Administrator,208-893-6356,,nika.graci@ppgnhi.org,https://www.plannedparenthood.org/planned-parenthood-great-northwest-hawaiian-islands
WA-011664,Sea Mar CHC - Tacoma S. 11th St.,SEA-MAR COMMUNITY HEALTH CENTER,1710035100,Federally Qualified Health Centers - Medical Services,1516 S 11th St,,Tacoma,WA,98405-3332,Pierce,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011665,SEA MAR TACOMA CHILD AND FAMILY,Sea Mar Community Health Centers,1710035100,Federally Qualified Health Centers - Medical Services,2121 S 19th St,,Tacoma,WA,98405-2922,Pierce,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011666,Healthcare Clinic,Metropolitan Development Council,1205234424,"Dental Providers, Federally Qualified Health Centers - Medical Services",2324 Tacoma Ave S,,Tacoma,WA,98402-1408,Pierce,945 Fawcett,,Tacoma,WA,98402,Pierce,Gregory Kleiner,V P Healthcare,253-651-2922,,gkleiner@mdc-hope.org,,,,,,
WA-011667,MARY BRIDGE CHILDREN'S HOSPITAL,MARY BRIDGE CHILDREN'S HOSPITAL,1306952726,Children's Hospitals (inpatient only),317 Martin Luther King Jr Way # 5299,,Tacoma,WA,98405-4234,Pierce,737 Fawcett Ave,737PCON 3,Tacma,WA,98405,Pierce,J N Patel,Vice President Payor Contracting,253-459-8004,,jock.patel@multicare.org,Anna Loomis,SVP Cheif Financial Officer,253-403-8020,,anna.loomis@multicare.org,https://www.multicare.org
WA-011668,Quinault Indian Nation,Roger Saux Health Center,1093888547,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Indian Health Service, Tribal Health Program operated under P.L. 93-638",1505 Kla-Ook-Wa Dr,PO Box 219,Taholah,WA,98587-0219,Grays Harbor,1505 Kla-Ook-Wa Dr,PO Box 219,Taholah,WA,98587,Grays Harbor,MARIAH RALSTON,BUSINESS OFFICE MANAGER,360-276-4405,466,mralston@quinault.org,Ledora McDougle,Health Care Director,360-276-4405,412,lmcdougle@quinault.org,
WA-011669,Shoalwater Bay Tribe/Shoalwater Bay Wellness Center,Shoalwater Bay Indian Tribe/Shoalwater Bay Wellness Center,1063624740,"Dental Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Tribal Health Program operated under P.L. 93-638",2373 Old Tokeland Rd.,Bldg E,Tokeland,WA,98590,Pacific,PO Box 130,,Tokeland,WA,98590-0130,Pacific,Michael Rogers,Tribal Administrator,360-267-8154,8154,mrogers@shoalwaterbay-nsn.gov,,,,,,
WA-011670,Valley View Health Center - Toledo,Lewis County Community Health Services,1942569637,Federally Qualified Health Centers - Medical Services,117 Ramsey Way,,Toledo,WA,98591,Lewis,2690 NE Kresky Ave,,Chehalis,WA,98532,Lewis,Holly Sliva,CFO,360-330-9595,2804,hsliva@vvhc.org,,,,,,www.vvhc.org
WA-011671,Family Health Centers Tonasket Medical,Family Health Centers,1609804392,Federally Qualified Health Centers - Medical Services,106 S Whitcomb Ave,,Tonasket,WA,98855-9286,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Marcie Howell,Clinic Operations Manager,509-486-0114,,mhowell@myfamilyhealth.org,www.myfamilyhealth.org
WA-011672,Confluence Health Tonasket,Confluence Health / Wenatchee Valley Hospital,1891032611,Rural Health Clinics,17 S Western Ave,,Tonasket,WA,98855-9270,Okanogan,820 N. Chelan,,Wenatchee,WA,98815,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,,,,,,
WA-011673,YAKAMA INDIAN HEALTH CENTER,DHHS/IHS/YAKAMA SERVICE UNIT,1528105541,"Dental Providers, Indian Health Service, Other ECP Providers",401 Buster Rd,,Toppenish,WA,98948-9792,Yakima,401 Buster Rd,,Toppenish,WA,98948,Yakima,Evelyn James,Business Office Manager,509-865-2102,270,Evelyn.James@ihs.gov,JAY SAMPSON,Chief Executive officer,509-865-2102,242,JAY.SAMPSON@IHS.GOV,
WA-011674,SHC Medical Center Toppenish,Regional Health,1629596861,Inpatient Hospitals (other than children's hospitals),502 W 4th Ave,,Toppenish,WA,98948-1616,Yakima,1016 Tacoma Ave,,Sunnyside,WA,98944,Yakima,Cary Rowan,CFO,509-837-1356,,cary@regional-health.org,,,,,,regional-health.org
WA-011675,YVFWC - TOPPENISH,YAKIMA VALLEY FARM WORKERS CLINIC,1508817313,"Dental Providers, Federally Qualified Health Centers - Medical Services",518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,360-236-3423,,,
WA-011676,HealthPoint Tukwila,HEALTHPOINT,1215206313,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",13030 Military Rd S,,Tukwila,WA,98168-3085,King,955 Powell Ave SW Ste A,,Renton,WA,98057-2908,King,Thomas Trompeter,CEO,425-277-1311,,tjtrompeter@healthpointchc.org,Vicki Hammond,CFO,425-203-0416,,vhammond@healthpointchc.org,
WA-011677,Cowitz Tribal Health-Seattle,Cowlitz Indian Tribe,1851328447,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",15455 65th Ave S,,Tukwila,WA,98188-2534,King,1044 11th Ave.,,Longview,WA,98632,Cowlitz,Rebecca Jones,BILLING SUPERVISOR,360-353-9431,,rjones.health@cowlitz.org,,,,,,
WA-011678,Tulalip Family & Youth Services,Tulalip Tribes of Washington,1063502946,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",2821 Mission Hill Rd,,Tulalip,WA,98271-9706,Snohomish,2821 Mission Hill Rd,,Tulalip,WA,98271,Snohomish,"Rhonda Nelson, DPM",Health Informatics Manager,360-716-5132,,rnelson@tulaliptribes-nsn.gov,Sonja Deskins,Finance Mananger,360-716-5670,,sonjad@tulaliptribes-nsn.gov,
WA-011679,Tulalip Tribes Family Services - Mental Wellness,Tulalip Tribes of Washington,1013138924,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",2821 Mission Hill Rd,,Tulalip,WA,98271-9706,Snohomish,2821 Mission Hill Rd,,Tulailp,WA,98271,Snohomish,"Rhonda Nelson, DPM",Health Informatics Manager,360-716-5132,,rnelson@tulaliptribes-nsn.gov,Sonja Deskins,Finance Mananger,360-716-5670,,sonjad@tulaliptribes-nsn.gov,
WA-011680,Tulalip Child Youth and Family Mental Wellness,Tulalip Tribes of Washington,1013138924,"Community Mental Health Centers, Tribal Health Program operated under P.L. 93-638",4033 76th Pl NW,,Tulalip,WA,98271-6151,Snohomish,4033 76th Pl NW,,Tulalip,WA,98271,Snohomish,"Rhonda Nelson, DPM",Health Informatics Manager,360-716-5132,,rnelson@tulaliptribes-nsn.gov,Sonja Deskins,Finance Manager,360-716-5670,,sonjad@tulaliptribes-nsn.gov,
WA-011681,Tulalip Dental Clinic,Tulalip Tribes of Washington,1447530399,"Dental Providers, Tribal Health Program operated under P.L. 93-638",7520 Totem Beach Rd,,Tulalip,WA,98271-6160,Snohomish,7520 Totem Beach Rd,,Tulalip,WA,98271,Snohomish,"Rhonda Nelson, DPM",Health Informatics Manager,360-716-5132,,rnelson@tulaliptribes-nsn.gov,Jennifer Williams,Dental Clinic Manager,360-716-5801,,jenniferwilliams@tulaliptribes-nsn.gov,
WA-011682,Tulalip Health Clinic,Tulalip Tribes,1770531501,"Rural Health Clinics, Tribal Health Program operated under P.L. 93-638",7520 Totem Beach Rd,,Tulalip,WA,98271-6160,Snohomish,7520 Totem Beach Rd,,Tulalip,WA,98271,Snohomish,"Rhonda Nelson, DPM",Health Informatics Manager,360-716-5132,,rnelson@tulaliptribes-nsn.gov,"Bryan Cooper, DNP",Chief Medical Officer,360-716-4511,,bcooper@tulaliptribes-nsn.gov,
WA-011683,Sea Mar CHC - Tumwater Custer Way,SEA-MAR COMMUNITY HEALTH CENTER,1487702601,Dental Providers,409 Custer Way SE,,Tumwater,WA,98501-3350,Thurston,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011684,SEA MAR TUMWATER BH,Sea Mar Community Health Centers,1841486339,Federally Qualified Health Centers - Medical Services,6334 Littlerock Rd SW,,Tumwater,WA,98512-7332,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011685,SEA MAR TUMWATER CHILD AND FAMILY,Sea Mar Community Health Centers,1841486339,Federally Qualified Health Centers - Medical Services,6336 Littlerock Rd SW,,Tumwater,WA,98512-7332,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011686,Family Health Centers Twisp Dental,Family Health Centers,1609804392,Dental Providers,110 E 2nd Ave,,Twisp,WA,98856,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Deana Abel,Asst. Dental Director,509-997-0922,,dabel@myfamilyhealth.org,www.myfamilyhealth.org
WA-011687,Family Health Centers Twisp Medical,Family Health Centers,1609804392,Federally Qualified Health Centers - Medical Services,541 W 2nd Ave,,Twisp,WA,98856-9863,Okanogan,716 1st Avenue South,PO Box 1340,Okanogan,WA,98840,Okanogan,Jesus Hernandez,CEO,509-422-7629,,jhernandez@myfamilyhealth.org,Julie Wehmeyer,Clinic Operations Manager,509-997-2011,,jwehmeyer@myfamilyhealth.org,www.myfamilyhealth.org
WA-011688,PPCW Vancouver Health Center,Planned Parenthood Columbia Willamette,1699144865,Family Planning Providers,11516 SE Mill Plain Blvd,Suite 2E,Vancouver,WA,98684-5082,Clark,3727 NE Martin Luther King Jr. Blvd,,Portland,OR,97212-1112,Multnomah,Tiffany Douglass,Patient Services Administrative Assistant,503-775-4931,3319,tiffany.douglass@ppcw.org,Hayley Nunn,Director of Strategic Initiatives,503-775-4931,3357,hayley.nunn@ppcw.org,www.ppcw.org
WA-011689,SEA MAR VANCOUVER CHILD AND FAMILY,Sea Mar Community Health Centers,1508033119,Federally Qualified Health Centers - Medical Services,11801 NE 65th St,Suite A,Vancouver,WA,98662-5527,Clark,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011690,Sea Mar CHC - Vancouver NE 88th St.,SEA-MAR COMMUNITY HEALTH CENTER,1912055138,Dental Providers,1412 NE 88th St,,Vancouver,WA,98665-9620,Clark,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011691,Sea Mar CHC - Vancouver NE 20th Ave,SEA-MAR COMMUNITY HEALTH CENTER,1407002892,Federally Qualified Health Centers - Medical Services,14508 NE 20th Ave,,Vancouver,WA,98686-6424,Clark,1040 S Henderson St,Ste. 102,Seattle,WA,98108-4720,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011692,Sea Mar CHC - Vancouver Women's Health Center,SEA-MAR COMMUNITY HEALTH CENTER,1184047441,Federally Qualified Health Centers - Medical Services,14508 NE 20th Ave,Suite 300,Vancouver,WA,98686-6418,Clark,1040 S Henderson St,,Seattle,WA,98108-4720,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011693,Clark County Public Health,Clark County,1700811635,"Ryan White Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",1601 E Fourth Plain Blvd,,Vancouver,WA,98661-3713,Clark,1601 E. Fourth Plain Blvd.,,Vancouver,WA,98661,Clark,Holly Barnfather,Contract and Procurement Coordinator,360-397-8226,,Holly.Barnfather@clark.wa.gov,Belinda Walker,Program Manager,360-397-8058,,Belinda.Walker@clark.wa.gov,https://www.clark.wa.gov/public-health
WA-011694,SEA MAR HIDDENBROOK DENTAL,Sea Mar Community Health Centers,1497106645,Dental Providers,19005 SE 34th St,,Vancouver,WA,98683-1450,Clark,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011695,SEA MAR HIDDENBROOK MEDICAL,Sea Mar Community Health Centers,1770934929,Federally Qualified Health Centers - Medical Services,19005 SE 34th St,,Vancouver,WA,98683-1450,Clark,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011696,Sea Mar CHC - Vancouver Behavioral Health,SEA-MAR COMMUNITY HEALTH CENTER,1508033119,Federally Qualified Health Centers - Medical Services,5501 NE 109th Ct,,Vancouver,WA,98662-6177,Clark,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011697,Sea Mar CHC 4th Plain,SEA-MAR COMMUNITY HEALTH CENTER,1871961680,Federally Qualified Health Centers - Medical Services,6100 NE Fourth Plain Blvd,,Vancouver,WA,98661-6830,Clark,1040 S Henderson St,,Seattle,WA,98108,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011698,Sea Mar CHC - Vancouver Delaware Lane,SEA-MAR COMMUNITY HEALTH CENTER,1548318868,Federally Qualified Health Centers - Medical Services,7410 Delaware Ln,,Vancouver,WA,98664-1408,Clark,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011699,Cowlitz Indian Tribal Health Services,Cowlitz Indian Tribe,1851328447,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",7700 NE 26th Ave,,Vancouver,WA,98665-0672,Clark,1044 11th Ave.,,Longview,WA,98632,Cowlitz,Rebecca A Jones,BILLING SUPERVISOR,360-353-9431,,rjones.health@cowlitz.org,,,,,,
WA-011700,Sea Mar CHC - Vancouver 7803 NE Fourth Plain Rd.,SEA-MAR COMMUNITY HEALTH CENTER,1508033119,Federally Qualified Health Centers - Medical Services,7803 NE Fourth Plain Blvd,,Vancouver,WA,98662-7246,Clark,1040 S Henderson St,,Seattle,WA,98108-4720,King,LaTashia Redd,Medical Biller,206-764-0502,,LaTashiaRedd@seamarchc.org,,,,,,
WA-011701,Waitsburg Family Clinic,Columbia County Health System,1215018346,Rural Health Clinics,235 Main St,,Waitsburg,WA,99361-9734,Walla Walla,1012 South 3rd Street,,Dayton,WA,99328,Columbia,Kathleen Anderson,CLINIC MANAGER,509-382-8401,5411,KathyA@cchd-wa.org,Shane McGuire,Chief Executive officer,509-382-9359,5125,ShaneM@cchd-wa.org,
WA-011702,FAMILY MEDICAL CENTER,YAKIMA VALLEY FARM WORKERS CLINIC,1700839727,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",1120 W Rose St,,Walla Walla,WA,99362-1662,Walla Walla,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011703,Blue Mountain Heart to Heart,Blue Mountain Heart to Heart,1003008046,Ryan White Providers,1520 Kelly Pl,Suite 120,Walla Walla,WA,99362-8607,Walla Walla,1520 Kelly Place Ste 120,PO Box 40,Walla Walla,WA,99362,Walla Walla,Everett Daniel Maroon,Executive Director,509-529-4744,,e.maroon@bmh2h.org,April Love-King,Contracts Manager,509-529-4744,,a.loveking@bmh2h.org,http://bluemountainheart.org
WA-011704,WALLA WALLA HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1649425638,"Family Planning Providers, Sexually Transmitted Disease Clinics",828 S 1st Ave,,Walla Walla,WA,99362-4003,Walla Walla,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011705,Wapato Mid-Valley Clinic,YAKIMA VALLEY FARM WORKERS CLINIC,1740459833,Federally Qualified Health Centers - Medical Services,620 W 1st St,,Wapato,WA,98951-1108,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,carloso@yvfwc.org,,,,,,
WA-011706,Confluence Health Waterville,Confluence Health / Wenatchee Valley Hospital,1184977704,Rural Health Clinics,117 S Chelan Ave,,Waterville,WA,98858,Douglas,820 N. Chelan,,Wenatchee,WA,98815,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,,,,,,
WA-011707,DAVID C WYNECOOP MEMORIAL CLINIC,DHHS IHS WELLPINIT SERVICE UNIT,1316034580,"Dental Providers, Indian Health Service, Other ECP Providers, Tuberculosis Clinics",6203 Agency Loop Rd,,Wellpinit,WA,99040,Stevens,6203 AGENCY LOOP ROAD,,Wellpinit,WA,99040,Stevens,ROSETTA WYNECOOP,Business Office Manager,509-258-4517,4144,ROSETTA.WYNECOOP@IHS.GOV,MARCUS MARTINEZ,CEO,509-258-4517,4111,MARCUS.MARTINEZ@IHS.GOV,
WA-011708,Spokane Tribe of Indians,Spokane Tribe of the Spokane Res.,1467644294,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",6228 Old School Rd,,Wellpinit,WA,99040,Stevens,6195 Ford Wellpinit Road,P. O. Box 100,Wellpinit,WA,99040,Stevens,Carol Evans,Chairwomam,509-458-6504,,carole@Spokanetraibe.com,Ann C Dahl,"Director, Health and Human Services",509-258-7502,24,annd@spokanetribe.com,
WA-011709,Central Washington Hospital,Confluence Health - Central Washington Hospital,1306883228,Inpatient Hospitals (other than children's hospitals),1201 S Miller St,,Wenatchee,WA,98801-3201,Chelan,1201 S Miller St,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,,,,,,
WA-011710,Children's Behavioral Health North,COLUMBIA VALLEY COMMUNITY HEALTH,1346266152,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",140 Easy Way,,Wenatchee,WA,98801-8108,Chelan,600 Orondo Ave Ste 1,,Wenatchee,WA,98801-2800,Chelan,David Olson,CEO,509-664-3528,,David.Olson@cvch.org,Cheryle Whisenhunt,Credentialing Specialist,509-662-6000,1012,cwhisenhunt@cvch.org,CVCH.org
WA-011390,Columbia Valley Community Health Behavioral Health Services,COLUMBIA VALLEY COMMUNITY HEALTH,1346266152,Community Mental Health Centers,504 Orondo Ave,,Wenatchee,WA,98801,Chelan,600 Orondo Ave Ste 1,,Wenatchee,WA,98801-2800,Chelan,Cheryle Whisenhunt,Credentialing Specialist,509-664-3527,,cwhisenhunt@cvch.org,Mike Romine,CFO,509-664-3572,,mike.romine@cvch.org,www.CVCH.org
WA-011711,Children's Behavioral Health,COLUMBIA VALLEY COMMUNITY HEALTH,1346266152,Community Mental Health Centers,600 Orondo Ave,Suite 1,Wenatchee,WA,98801-2800,Chelan,600 Orondo Ave Ste 1,,Wenatchee,WA,98801-2800,Chelan,David Olson,CEO,509-664-3528,,david.olson@cvch.org,Cheryle Whisenhunt,Credentialing Specialist,509-662-6000,1012,cwhisenhunt@cvch.org,cvch.org
WA-011712,COLUMBIA VALLEY COMMUNITY HEALTH,COLUMBIA VALLEY COMMUNITY HEALTH,1487650636,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",600 Orondo Ave,Suite 1,Wenatchee,WA,98801-2800,Chelan,600 Orondo Ave,Suite 1,Wenatchee,WA,98801-2800,Chelan,David Olson,CEO,509-664-3528,,david.olson@cvch.org,Cheryle Whisenhunt,Credentialing Specialist,509-664-3527,1012,cwhisenhunt@cvch.org,cvch.org
WA-011713,Confluence Health Wenatchee,Confluence Health / Wenatchee Valley Hospital,1730426552,Rural Health Clinics,820 N Chelan Ave,,Wenatchee,WA,98801-2028,Chelan,820 N. Chelan,,Wenatchee,WA,98801,Chelan,Sarah Brown,VP Risk,509-664-4868,7502,sarah.brown@confluencehealth.org,Jeanette Wood,,509-663-8711,,,
WA-011714,Wenatchee,Planned Parenthood of Greater Washington and North Idaho,1649214958,Family Planning Providers,900 Ferry St,,Wenatchee,WA,98801-3405,Chelan,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011715,Columbia Pediatrics,Columbia Valley Community Health,1487650636,Federally Qualified Health Centers - Medical Services,933 Red Apple Rd,Suite C,Wenatchee,WA,98801-3370,Chelan,600 Orondo Ave,Ste 1,Wenatchee,WA,98801-2800,Chelan,Cheryle Whisenhunt,Credentialing Specialist,509-664-3527,,cwhisenhunt@cvch.org,David Olson,CEO,509-664-3528,,david.olson@cvch.org,www.cvch.org
WA-011716,Klickitat County Health Department,Klickitat County Health Department,1346308350,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",501 NE Washington St,PO Box 159,White Salmon,WA,98672-1826,Klickitat,228 W.Main St. MSCH-14,,Goldendale,WA,98620,Klickitat,Theresa Rundell,Nurse Practitioner Program Manager,509-493-1558,6215,terryru@klickitatcounty.org,Lori Koch,Fiscal Manager,509-493-1558,6212,lorik@klickitatcounty.org,
WA-011717,NorthShore Medical Group-WS,NorthShore Medical Group,1841405206,Rural Health Clinics,65371 Highway 14,,White Salmon,WA,98672-8690,Klickitat,Po Box 1519,,White Salmon,WA,98672,Klickitat,Emma Kupchin,Payer Relations,509-493-9541,1541,KupchinE@northshore-medical.com,Cindy Robertson,Administrator,509-493-9535,,RobertsonC@northshore-medical.com,
WA-011718,White Swan Dental Clinic,White Swan Dental Clinic,1245378389,"Dental Providers, Indian Health Service",62 Birdsong Lane,,White Swan,WA,98952,Yakima,PO BOX 693,,WHITE SWAN,WA,98952,Yakima,Evelyn James,Business Office Manager,509-865-2102,270,Evelyn.James@ihs.gov,JAY SAMPSON,Chief Executive officer,509-865-2102,242,JAY.SAMPSON@IHS.GOV,
WA-011719,WILBUR CLINIC,Lincoln Hospital District #3,1972547610,Rural Health Clinics,214 E Main St,,Wilbur,WA,99185,Lincoln,10 Nicholls St.,,Davenport,WA,99122,Lincoln,Tim O'Connell,Chief Financial Officer,509-725-2979,1157,oconnetr@lhd3.org,Tyson Lacy,CEO,509-725-2979,1168,lacyte@lhd3.org,
WA-011720,YNHS Neighborhood Connections,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1972711018,"Dental Providers, Federally Qualified Health Centers - Medical Services",102 S Naches Ave,,Yakima,WA,98901-2947,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,rhonda.hauff@ynhs.org,www.ynhs.org
WA-011721,YAKIMA HEALTH CENTER,Planned Parenthood of Greater Washington and North Idaho,1477708469,"Family Planning Providers, Sexually Transmitted Disease Clinics",1117 Tieton Dr,,Yakima,WA,98902-3835,Yakima,1117 Tieton Drive,,Yakima,WA,98902,Yakima,Robin Easter,Acct. Clerk,509-225-3400,,robin.easter@ppgwni.org,Kim Nelson,VP Finance,509-225-3411,,Kim.nelson@ppgwni.org,
WA-011722,Yakima Neighborhood Health Services - 8th Street Clinic,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1225085624,"Dental Providers, Federally Qualified Health Centers - Medical Services",12 S 8th St,,Yakima,WA,98901-3020,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,rhonda.hauff@ynhs.org,www.ynhs.org
WA-011723,YNHS @ Southeast Yakima Community Center,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1972869063,Federally Qualified Health Centers - Medical Services,1211 S 7th St,,Yakima,WA,98901-3509,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,,www.ynhs.org
WA-011724,LINCOLN AVE Medical-Dental Clinic,YAKIMA VALLEY FARM WORKERS CLINIC,1659407872,"Dental Providers, Federally Qualified Health Centers - Medical Services",2205 W Lincoln Ave,,Yakima,WA,98902-2437,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011725,CHILDREN'S VILLAGE-UPPER VALLEY,YAKIMA VALLEY FARM WORKERS CLINIC,1801925003,Federally Qualified Health Centers - Medical Services,3801 Kern Way,,Yakima,WA,98902-6340,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011726,YNHS at Comprehensive Mental Health,YAKIMA NEIGHBORHOOD HEALTH SERVICES,1902112196,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services",402 S 4th Ave,,Yakima,WA,98902-3546,Yakima,12 S 8th St,,Yakima,WA,98901-3020,Yakima,Anita D Monoian,President / CEO,509-574-5550,,anita.monoian@ynhs.org,Rhonda Hauff,COO / Deputy CEO,509-574-5552,,rhonda.hauff@ynhs.org,www.ynhs.org
WA-011727,COMMUNITY HEALTH OF CENTRAL WASHINGTON,Community Health of Central Washington,1598764920,"Dental Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",501 S 5th Ave,,Yakima,WA,98902-3550,Yakima,501 S 5th Avenue,,Yakima,WA,98902-3550,Yakima,Mike Maples,CEO,509-574-6117,,Mike.Maples@chcw.org,Paul Kaschmitter,CFO,509-574-6110,,paul.kaschmitter@chcw.org,
WA-011728,Behavioral Health Services,YAKIMA VALLEY FARM WORKERS CLINIC,1295788602,Federally Qualified Health Centers - Medical Services,918 E Mead Ave,,Yakima,WA,98903-3720,Yakima,518 W 1st Ave,,Toppenish,WA,98948-1564,Yakima,Carlos Olivares,Chief Executive Officer,509-865-5898,,CarlosO@yvfwc.org,,,,,,
WA-011729,SEA MAR YELM DENTAL,Sea Mar Community Health Centers,1528481470,Dental Providers,202 Cullens St NW,,Yelm,WA,98597-9417,Thurston,1040 S. Henderson St.,,Seattle,WA,98108,King,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WA-011730,SEA MAR - Yelm Medical,Sea Mar Community Health Centers,1144643479,Federally Qualified Health Centers - Medical Services,202 Cullens St NW,,Yelm,WA,98597-9417,Thurston,1040 S. Henderson St.,,Seattle,WA,98597,Thurston,Kathryn Reinitz,Credentialing Coordinator,206-474-2001,,credentialing@seamarchc.org,,,,,,
WI-011731,FPHS Adams County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",139 S Main St,FPHS - Suite G,Adams,WI,53910-9820,Adams,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011732,NORTH SHORE MED CLINIC ALGOMA,Ministry Health Care,1952639833,Rural Health Clinics,815 Jefferson St,,Algoma,WI,54201-1733,Kewaunee,"222 W. College Ave., Suite 3B",,Appleton,WI,54911-5863,Outagamie,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,,,,,,
WI-011733,Bellin Health Algoma,Bellin Memorial,1609838473,Rural Health Clinics,831 Parker Ave,,Algoma,WI,54201-1808,Kewaunee,744 South Webster Avenue,PO Box 23400,Green Bay,WI,54305-3400,Brown,Michelle Conard,TEAM LEADER BMH MANAGED CARE,920-445-7217,,Michelle.Conard@bellin.org,,,,,,
WI-011734,AMERY REGIONAL MEDICAL CTR,Amery Regional Medical Center,1093763518,Inpatient Hospitals (other than children's hospitals),265 Griffin St E,,Amery,WI,54001-1292,Polk,265 Griffin St E,,Amery,WI,54001,Polk,Sandi Reed,VP Ambulatory Services,715-268-0304,,sandi.m.reed@amerymedical.com,Alex Holsman,Clinic Director,715-268-0595,,alexander.j.holsman@amerymedical.com,
WI-011735,Aspirus Antigo Clinic,Aspirus Langlade Hospital,1821151366,Other ECP Providers,110 E 5th Ave,,Antigo,WI,54409-2710,Langlade,112 E 5th Avenue,,Antigo,WI,54409,Langlade,Pat Tincher,Director of Finance/CFO,715-623-9215,,pat.tincher@aspirus.org,,,,,,
WI-011736,Bridge Community Health Clinic Antigo Dental,"PRIMARY CONNECTION HEALTHCARE, INC",1457370744,Dental Providers,1111 Langlade Rd,,Antigo,WI,54409-2787,Langlade,1810 N. 2nd Street,,Wausau,WI,54403,Marathon,Roger Rego,Co-Transitional Executive Director,715-848-4884,,rogerr@bridgeclinic.org,,,,,,
WI-011737,ASPIRUS LANGLADE HOSPITAL,LANGLADE HOSPITAL,1639187412,Inpatient Hospitals (other than children's hospitals),112 E 5th Ave,,Antigo,WI,54409-2710,Langlade,112 E 5th Avenue,,Antigo,WI,54409,Langlade,Pat TIncher,Director of Finance/CFO,715-623-9215,,pat.tincher@aspirus.org,,,,,,
WI-011738,FPHS Langlade County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",2215 Progress Blvd,Suite A,Antigo,WI,54409-2480,Langlade,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011739,ASCENSION ST ELIZABETH HOSPITAL,Ascension Wisconsin,1407803638,Inpatient Hospitals (other than children's hospitals),1506 S Oneida St,,Appleton,WI,54915-1305,Outagamie,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011740,Children's Hospital of Wisconsin - Appleton Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,1506 S Oneida St,5th Floor,Appleton,WI,54915-1305,Outagamie,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011741,Appleton Central Health Center,"Planned Parenthood of Wisconsin, Inc.",1184897027,Family Planning Providers,508 W Wisconsin Ave,,Appleton,WI,54911-4337,Outagamie,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011742,Partnership Community Health Center-Dental,"PARTNERSHIP COMMUNITY HEALTH CENTER, INC.",1225074008,Dental Providers,5337 W Grande Market Dr,,Appleton,WI,54913-8442,Outagamie,5337 W Grande Market Drive,,Appleton,WI,54913-8442,Outagamie,Kristene S Stacker,CEO,920-750-6512,,kristene.stacker@thedacare.org,,,,,,
WI-011743,Appleton,AIDS Resource Center of Wisconsin,1770721607,"Community Mental Health Centers, Ryan White Providers",633C W Wisconsin Ave,,Appleton,WI,54911-4339,Outagamie,820 N Plankinton Avenue,,Milwaukee,WI,53203,Milwaukee,Brian Van Den Heuvel,Director,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,
WI-011744,MEMORIAL MEDICAL CENTER,Memorial Medical Center,1437179231,Inpatient Hospitals (other than children's hospitals),1615 Maple Ln,,Ashland,WI,54806-3689,Ashland,1615 Maple Lane,,Ashland,WI,54806-3610,Ashland,Kent Dumonseau,CFO/VP Finance,715-685-5515,,kdumonseau@ashlandmmc.com,Arthur Mertig,Controller,715-685-5550,,amertig@ashlandmmc.com,
WI-011745,NorthLakes - Ashland,Lakes Community Health Center,1811178825,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",300 Main St W,,Ashland,WI,54806-1639,Ashland,7665 US Hwy 2,,Iron River,WI,54847,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assistant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-011746,"Health Care Clinic, Ashland","Douglas County Community Health Clinic, Inc.",1396889259,"Family Planning Providers, Sexually Transmitted Disease Clinics",313 3rd St W,,Ashland,WI,54806-1674,Ashland,69 N 28th St E,Suite 9,Superior,WI,54880,Douglas,Hillary Peterson,Executive Director,715-394-4117,,hpeterson@hcclinic.org,Heather Willcoxon,Clinic Manager,715-394-4117,,hwillcoxon@hcclinic.org,
WI-011747,Ashland County Health Department,Ashland County Health &Human Services,1871640573,Sexually Transmitted Disease Clinics,630 Sanborn Ave,,Ashland,WI,54806-3537,Ashland,630 Sanborn Avenue,,Ashland,WI,54806,Ashland,Cyndi Zach,Public Health Administrator,715-682-7028,214,czach@hsd.co.ashland.wi.us,,,,,,
WI-011748,BALDWIN AREA MEDICAL CENTER (inpatient hospital),Baldwin Area Medical Center d/b/a Western Wisconsin Health,1467496133,Inpatient Hospitals (other than children's hospitals),1100 Bergslien St,,Baldwin,WI,54002-2600,Saint Croix,1100 Bergslien St,,Baldwin,WI,54002,Saint Croix,Brian Anthony Lovdahl,CFO,715-684-1550,,Brian.Lovdahl@wwhealth.org,Alison Page,CEO,715-684-1100,,Alison.Page@WWHealth.org,www.wwhealth.org
WI-011749,BALDWIN AREA MEDICAL CENTER (rural health clinics),Baldwin Area Medical Center,1467496133,Rural Health Clinics,1100 Bergslien St,,Baldwin,WI,54002-2600,Saint Croix,1100 Bergslien St,,Baldwin,WI,54002,Saint Croix,Brian Lovdahl,CFO,715-684-1550,,Brian.Lovdahl@wwhealth.org,Alison Page,CEO,715-684-1100,,Alison.Page@WWHealth.org,www.wwhealth.org
WI-011750,Polk County Health Department,POLK COUNTY HEALTH DEPART,1780800144,"Family Planning Providers, Sexually Transmitted Disease Clinics",100 Polk Co Plz,Suite 180,Balsam Lake,WI,54810,Polk,100 Polk County Plaza,Suite 180,Balsam Lake,WI,54810,Polk,Gretchen Sampson RN MPH,Community Services Director,715-485-8500,8506,gretchens@co.polk.wi.us,Laurie Whitehead,Fiscal Manager,715-485-8500,8563,lauriew@co.polk.wi.us,www.polkcountyhealthdept.org
WI-011751,NorthLakes Balsam Lake,Lakes Community Health Center,1811178825,Dental Providers,100 Polk County Plz,Suite 180,Balsam Lake,WI,54810-8009,Polk,7665 US Hwy 2,,Iron River,WI,54847,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assistant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-011752,Unity Clinic,St. Croix Regional Medical Center,1043240922,Outpatient Hospital Clinics,1504 190th Ave,,Balsam Lake,WI,54810-7102,Polk,235 State Street,,St. Croix Falls,WI,54024,Polk,Wendy Young,Vice President Clinic and Ancillary Services,715-483-0497,,wendy.young@scrmc.org,Sally Bajak,Chief Financial Officer,715-483-0556,,sally.bajak@scrmc.org,www.scrmc.org
WI-011753,SSM Health St. Clare Hospital,"SSM Health Care of Wisconsin, Inc.",1386641207,Inpatient Hospitals (other than children's hospitals),707 14th St,,Baraboo,WI,53913-1539,Sauk,707 14th Street,,Baraboo,WI,539131539,Sauk,Troy Walker,Director of Finance,608-356-1423,,Troy.Walker@ssmhealth.com,Patrice Werdin,,608-356-1331,,Patrice.Werdin@ssmhealth.com,
WI-011754,House of Wellness - Ho-Chunk Nation,Ho-Chunk Nation of Wisconsin,1316002694,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",S2845 White Eagle Rd,,Baraboo,WI,53913-9064,Sauk,N6520 Lumberjack Guy Road,,Black River Falls,WI,54615-5405,Jackson,Liz Lund,Provider Network Manager,715-284-9851,5081,liz.lund@ho-chunk.com,Wallace L. Apland,Director of Health Finance,715-284-9851,5349,wally.apland@ho-chunk.com,
WI-011755,Mayo Clinic Health System - Northland Barron (inpatient hospital),"Mayo Clinic Health System - Northland, Inc.",1740239557,Inpatient Hospitals (other than children's hospitals),1222 E Woodland Ave,,Barron,WI,54812-1765,Barron,"Mayo Clinic Health System - Northland, Inc.",1222 Woodland Ave,Barron,WI,54812,Barron,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011756,Mayo Clinic Health System - Northland Barron (outpatient hospital clinics),"Mayo Clinic Health System - Northland, Inc.",1740239557,Outpatient Hospital Clinics,1222 E Woodland Ave,,Barron,WI,54812-1765,Barron,1222 Woodland Ave,,Barron,WI,54812,Barron,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9780,,gerdes.Christina1@mayo.edu,
WI-011757,Red Cliff Community Health Center,Red Cliff Band of Lake Superior Chippewa,1497744015,"Dental Providers, Federally Qualified Health Centers - Medical Services, Tribal Health Program operated under P.L. 93-638",36745 Aiken Rd,,Bayfield,WI,54814-4579,Bayfield,36745 Aiken Road,,Bayfield,WI,54814,Bayfield,Patricia Deragon-Navarro,Health Administrator,715-779-3707,2224,pderagon-nav@redcliff-nsn.gov,Elizabeth Marcoux,Health Services Director,715-779-3707,2227,liz.marcoux@redcliff-nsn.gov,
WI-011758,BDCH Medical Clinics 148 Warren Street Clinic,"Beaver Dam Community Hospitals, Inc.",1538491998,Outpatient Hospital Clinics,148 Warren St,,Beaver Dam,WI,53916-3061,Dodge,707 S. University Avenue,,Beaver Dam,WI,53916,Dodge,Donna Hutchinson,Chief Financial Officer,920-887-4041,,dhutchinson@bdch.org,Mason Zantow,Clinic Practice Manager,920-356-6529,,mzantow@bdch.org,www.bdch.org
WI-011759,FHLC Beaver Dam Dental,"La Clinica de los Campesinos, Inc",1790786929,Dental Providers,207 S University Ave,,Beaver Dam,WI,53916-2450,Dodge,"La Clinica de los Campesinos, Inc.",400 S Townline Rd PO Box 1440,Wautoma,WI,54982,Waushara,Laura Waldvogel,CEO,920-787-9406,,Laura.Waldvogel@famhealth.com,Brian Sullivan,CFO,920-787-5514,270,Brian.Sullivan@famhealth.com,www.famhealth.com
WI-011760,BDCH Orthopedics & Sports Medicine Clinic,"Beaver Dam Community Hospitals, Inc.",1023310034,Outpatient Hospital Clinics,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,707 S. University Avenue,,Beaver Dam,WI,53916,Dodge,Donna Hutchinson,Chief Financial Offider,920-887-4041,,dhutchinson@bdch.org,Mason Zantow,Clinic Practice Manager,920-356-6529,,mzantow@bdch.org,www.bdch.org
WI-011761,BDCH Surgical Specialists of Dodge County,"Beaver Dam Community Hospitals, Inc.",1366833394,Outpatient Hospital Clinics,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,707 S. University Avenue,,Beaver Dam,WI,53916,Dodge,Donna Hutchinson,Chief Financial Officer,920-887-4041,,dhutchinson@bdch.org,Mason Zantow,Clinic Practice Manager,920-356-6529,,mzantow@bdch.org,www.bdch.org
WI-011762,"Beaver Dam Community Hospitals, Inc.","Beaver Dam Community Hospitals, Inc.",1023187416,Inpatient Hospitals (other than children's hospitals),707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.bdch.com/
WI-011763,Beloit,AIDS Resource Center of Wisconsin,1770721607,"Community Mental Health Centers, Ryan White Providers",136 W Grand Ave,Suite 202,Beloit,WI,53511-6259,Rock,820 N Plankinton Avenue,,Milwaukee,WI,53203,Milwaukee,Brian Van Den Heuvel,Director,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,
WI-011764,Beloit Area Community Health Center,"COMMUNITY HEALTH SYSTEMS, INC.",1750390670,"Dental Providers, Federally Qualified Health Centers - Medical Services",74 Eclipse Ctr,,Beloit,WI,53511-3550,Rock,74 Eclipse Center,,Beloit,WI,53511-3550,Rock,Julie Sprecher,Chief Executive Officer,608-313-3362,,jsprecher@chsofwi.org,Mark Lundvall,Director of Finance,608-313-3360,,mlundvall@chsofwi.org,
WI-011765,Aspirus Birnamwood Clinic,Aspirus Langlade Hospital,1063574184,Rural Health Clinics,400 Railroad,,Birnamwood,WI,54414-9700,Shawano,112 E 5th Avenue,,Antigo,WI,54409,Langlade,Pat Tincher,Director of Finance/CFO,715-623-9215,,pat.tincher@aspirus.org,,,,,,
WI-011766,Essential Health Clinic - Black River Falls,Options In Reproductive Care Inc. DBA Essential Health Clinic,1326086976,"Family Planning Providers, Sexually Transmitted Disease Clinics",25 S 2nd St,,Black River Falls,WI,54615-1712,Jackson,25 S 2nd St,,Black River Falls,WI,54615-1712,Jackson,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,www.essentialclinic.org
WI-011767,BLACK RIVER MEMORIAL HOSPITAL,Black River Memorial Hospital,1811940331,Inpatient Hospitals (other than children's hospitals),711 W Adams St,,Black River Falls,WI,54615-9108,Jackson,711 West Adams,,Black River Falls,WI,54746,Jackson,MATTHEW STREETER,CFO,715-284-5361,1307,streeterm@brmh.net,Gina LaFaunge,Revenue Cycle Director,715-284-5361,1375,lafaungeg@brmh.net,
WI-011768,FAMILY HEALTH CENTER - BLACK RIVER FALLS DENTAL CENTER,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1437264140,Dental Providers,M6571 Lumberjack Guy Rd,,Black River Falls,WI,54615,Jackson,1000 North Oak Avenue,,Marshfield,WI,54449,Wood,Greg Nycz,Executive Director,715-387-9137,,nycz.greg@marshfieldclinic.org,Mary Dorsch,Assistant Director,715-389-4574,,dorsch.mary@marshfieldclinic.org,
WI-011769,Ho-Chunk Health Care Center / Ho-Chunk Behavioral Health Care Center,Ho-Chunk Nation of Wisconsin,1407911795,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Dental Services, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Tribal Health Program operated under P.L. 93-638",N6520 Lumberjack Guy Rd,,Black River Falls,WI,54615-5405,Jackson,N6520 Lumberjack Guy Rd,,Black River Falls,WI,54615-5405,Jackson,Liz Lund,Provider Network Manager,715-284-9851,5081,liz.lund@ho-chunk.com,Wallace L. Apland III,Health Finance Director,715-284-9851,5349,wally.apland@ho-chunk.com,
WI-012423,FHC Black River Falls Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,N6571 Lumberjack Guy Rd,,Black River Falls,WI,54615-5405,Jackson,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Black%20River%20Falls%20Dental%20Center
WI-011770,GUNDERSEN TRI COUNTY HSPTL AND CLINICS BLAIR,Gundersen Tri County Hospital and Clinic - Blair,1659625192,Rural Health Clinics,420 S Peterson Ave,,Blair,WI,54616-8861,Trempealeau,"Tri-County Memorial Hospital, Inc.",18601 Lincoln Street,Whitehall,WI,54773,Trempealeau,Joni D. Olson,CEO,715-538-4361,64120,jdolson@gundersenhealth.org,,,,,,
WI-011771,Mayo Clinic Health System - Chippewa Valley Bloomer (inpatient hospital),"Mayo Clinic Health System - Chippewa Valley, Inc",1700837812,Inpatient Hospitals (other than children's hospitals),1501 Thompson St,,Bloomer,WI,54724-1257,Chippewa,1501 Thompson St,,Bloomer,WI,54724,Chippewa,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011772,Mayo Clinic Health System - Chippewa Valley Bloomer (outpatient hospital clinics),"Mayo Clinic Health System - Chippewa Valley, Inc.",1700837812,Outpatient Hospital Clinics,1501 Thompson St,,Bloomer,WI,54724-1257,Chippewa,1501 Thompson St,,Bloomer,WI,54724,Chippewa,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011773,Marshfield Clinic Bloomer Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,1711 York St,,Bloomer,WI,54724-1902,Chippewa,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Bloomer%20Center
WI-011774,Gundersen Boscobel Area Hospital,Gundersen Boscobel Area Hospital and Clinics,1760459846,Inpatient Hospitals (other than children's hospitals),205 Parker St,,Boscobel,WI,53805-1642,Grant,205 Parker St,,Boscobel,WI,53805,Grant,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,Deb Randall,Clinic Director,608-375-4144,,djrandal@gundersenhealth.org,
WI-011775,Gundersen Boscobel Clinic,Gundersen Boscobel Area Hospital and Clinics,1871796052,Rural Health Clinics,208 Parker St,,Boscobel,WI,53805-1648,Grant,Gundersen Boscobel Area Hospital and Clinics,205 Parker Street,Boscobel,WI,53805,Grant,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,
WI-011776,Childrens' Hospital of Wisconsin - Child Development Center,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,13800 W North Ave,Suite 120,Brookfield,WI,53005-4977,Waukesha,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev.,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011777,Marshfield Clinic Cadott Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,305 S Highway 27,,Cadott,WI,54727-9561,Chippewa,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Cadott%20Center
WI-011778,Mayo Clinic Health System - Northland Cameron,"Mayo Clinic Health System - Northland, Inc.",1740239557,Outpatient Hospital Clinics,2049 15th Ave,,Cameron,WI,54822-4400,Barron,1222 Woodland Ave,,Barron,WI,54812,Barron,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9780,,gerdes.Christina1@mayo.edu,
WI-011779,SCENIC BLUFFS CHC - CASHTON,"Scenic Bluffs Health Center, Inc",1104890078,"Dental Providers, Federally Qualified Health Centers - Medical Services",238 Front St,,Cashton,WI,54619-2002,Monroe,238 Front St,,Cashton,WI,54619-2002,Monroe,Mari Freiberg,CEO,608-654-5100,270,mfreiberg@scenicbluffs.org,Sheryl Robinson,CFO,608-654-5100,267,sbarker@scenicbluffs.org,scenicbluffs.org
WI-011780,ASCENSION CALUMET HOSPITAL,Ascension Wisconsin,1376541748,Inpatient Hospitals (other than children's hospitals),614 Memorial Dr,,Chilton,WI,53014-1568,Calumet,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011781,Marshfield Clinic Lake Hallie Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,12961 27th Ave,,Chippewa Falls,WI,54729-5699,Eau Claire,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Lake%20Hallie%20Center
WI-011782,Marshfield Clinic Chippewa Falls Center,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1851632111,Federally Qualified Health Centers - Medical Services,2655 County Highway I,,Chippewa Falls,WI,54729-1423,Chippewa,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Chippewa%20Falls%20Center
WI-011783,ST JOSEPHS HOSPITAL,St Josephs Hospital of the Hospital Sisters of the Third Order of St. Francis,1164429908,Inpatient Hospitals (other than children's hospitals),2661 County Highway I,,Chippewa Falls,WI,54729-5407,Chippewa,2661 County Highway I,,Chippewa Falls,WI,54729-5407,Chippewa,Steve Palecek,Director of Finance,715-717-3783,3783,steve.palecek@hshs.org,David Nelson,CFO,715-717-6122,6122,david.nelson@hshs.org,www.stjoeschipfalls.com
WI-011784,Mayo Clinic Health System - Chippewa Valley Chippewa Falls,"Mayo Clinic Health System - Chippewa Valley, Inc",1700837812,Outpatient Hospital Clinics,611 1st Ave,,Chippewa Falls,WI,54729-1242,Chippewa,1501 Thompson St,,Bloomer,WI,54724,Chippewa,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011785,FHC Chippewa Falls Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,850 Lakeland Dr,,Chippewa Falls,WI,54729-1687,Chippewa,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Chippewa%20Falls%20Dental%20Center
WI-011786,Clear Lake Clinic,Amery Regional Medical Center,1366878449,"Outpatient Hospital Clinics, Rural Health Clinics",357 3rd Ave,,Clear Lake,WI,54005-8581,Polk,265 Griffin Street East,,Amery,WI,54001,Polk,Sandi Reed,VP Ambulatory Services,715-268-0304,,sandi.m.reed@amerymedical.com,Alexander Holsman,Director of Clinics,715-268-0595,,alexander.j.holsman@amerymedical.com,
WI-011787,Marshfield Clinic Colby/Abbotsford Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,111 Dehne Dr,,Colby,WI,54421-9581,Marathon,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Colby%20Abbotsford%20Center
WI-011788,COLUMBUS COMMUNITY HOSPITAL,"Columbus Community Hospital, Inc.",1841376183,Inpatient Hospitals (other than children's hospitals),1515 Park Ave,,Columbus,WI,53925-2402,Columbia,1515 PARK AVE,ATTN MMANGAN,Columbus,WI,53925,Columbia,Melissa Mangan,Director of Financial Services,920-623-1219,0,mmangan@cch-inc.com,Phil Roberts,CFO/VP OF FINANCE,920-623-1368,0,proberts@cch-inc.com,www.columbuscommunityhospital.org
WI-012424,"BDCH, Inc. Medical Clinics - Columbus","Beaver Dam Community Hospitals, Inc.",1023187416,Outpatient Hospital Clinics,1580 W James St,,Columbus,WI,53925-1001,Columbia,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.bdch.com/Columbus-Clinic
WI-011789,Marshfield Clinic Cornell Center,"MCHS Hospitals, Inc.",1275007429,Rural Health Clinics,600 Woodside Dr,,Cornell,WI,54732-8003,Chippewa,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Cornell%20Center
WI-011790,Crandon Clinic,NEWCAP Community Health,1285752659,"Family Planning Providers, Sexually Transmitted Disease Clinics",212 N Lake Ave,,Crandon,WI,54520-1387,Forest,1201 Main Street,,Oconto,WI,54153,Oconto,Cheryl Detrick,CEO,920-834-4621,1137,cheryldetrick@newcap.org,V. Jane Muhl,Interim Director,920-373-8187,,janemuhl@newcap.org,www.newcap.org
WI-011791,Ascension St Mary's at Crandon,Ascension Wisconsin,1699068692,Rural Health Clinics,400 W Glen St,,Crandon,WI,54520-1355,Forest,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011792,Forest County Potawatomi(FCP)/FCP Health and Wellness Center/Chemical Dependency Outpatient Program,Forest County Potawatomi(FCP)/FCP Health and Wellness Center/Chemical Dependency Outpatient Program,1285741306,"Dental Providers, Indian Health Service, Other ECP Providers",8201 Mish Ko Swen Dr,,Crandon,WI,54520-8631,Forest,PO Box 396,,Crandon,WI,54520-0396,Forest,David Bertrand,Health Division Director,715-478-4309,,david.bertrand@fcpotawatomi-nsn.gov,,,,,,www.fcpotawatomi.com
WI-011793,SOUTHWEST HEALTH CUBA CITY CLINIC,SOUTHWEST HEALTH,1275886590,Rural Health Clinics,207 E Skelly St,,Cuba City,WI,53807-1453,Grant,1400 Eastside Rd,,Platteville,WI,53818,Grant,Jesse Sookochoff,CFO,608-342-4705,,sookochoff@southwesthealth.org,,,,,,www.southwesthealth.org
WI-011794,Cumberland Healthcare,Cumberland Memorial Hospital Extended Care Unit Inc.,1861736472,Rural Health Clinics,1110 7th Ave,,Cumberland,WI,54829-9138,Barron,1110 7th Ave.,,Cumberland,WI,54829,Barron,Angela J Martens,CFO,715-822-7254,,amartens@cumberlandhealthcare.com,Mike Gutsch,CEO,,,mgutsch@cumberlandhealthcare.com,
WI-011795,Darlington Regional Clinic,"COMMUNITY HEALTH SYSTEMS, INC.",1457592701,Dental Providers,435 Main St,,Darlington,WI,53530-1427,Lafayette,74 Eclipse Center,,Beloit,WI,53511-3550,Rock,Julie Sprecher,Chief Executive Officer,608-313-3362,,jsprecher@chsofwi.org,Mark Lundvall,Director of Finance,608-313-3360,,mlundvall@chsofwi.org,
WI-011796,MEMORIAL HOSPITAL OF LAFAYETTE COUNTY,Memorial Hospital of Lafayette County,1114987054,Inpatient Hospitals (other than children's hospitals),800 Clay St,,Darlington,WI,53530-1228,Lafayette,800 Clay Street,,Darlington,WI,53818,Lafayette,Julie Chikowski,Adminstrator / CEO,608-776-5766,,julie.chikowski@lafayettecountywi.org,,,,,,
WI-011797,Children's Hospital of Wisconsin-West DePere Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,1686 Eisenhower Rd,,De Pere,WI,54115-8145,Brown,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011799,Children's Hospital of Wisconsin - Delafield Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,3195 Hillside Dr,,Delafield,WI,53018-2189,Waukesha,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev.,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011800,Delavan Health Center,"Planned Parenthood of Wisconsin, Inc.",1710152210,Family Planning Providers,312 S 7th St Stop 7,,Delavan,WI,53115-1964,Walworth,302 N. Jackson Street,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011801,SWCAP Neighborhood Health Partners - Dodgeville,SWCAP Neighborhood Health Partners,1679572788,Family Planning Providers,101 E Fountain St,,Dodgeville,WI,53533-1749,Iowa,5 West Mineral St,PO Box 704,Platteville,WI,53818,Grant,Jacquelyne Bodden,Program Director/Nurse Practitioner,608-348-9766,506,j.bodden@swcap.org,Trisha Farrey,Administrative Assistant 3,608-348-9766,501,t.farrey@swcap.org,www.swnhp.org
WI-011802,Dodgeville Dental Clinic,"Access Community Health Centers, Inc.",1417055617,Dental Providers,103 E Fountain St,,Dodgeville,WI,53533-1749,Iowa,2901 W. Beltline Highway,Suite 120,Madison,WI,53713,Dane,Judy Keel,Grants Manager,608-663-5109,,judy.keel@accesshealthwi.org,,,,,,
WI-011803,UPLAND HILLS HEALTH,Upland Hills Health,1487745501,Inpatient Hospitals (other than children's hospitals),800 Compassion Way,,Dodgeville,WI,53533-1956,Iowa,800 Compassion Way,,Dodgeville,WI,53533,Iowa,A Karl Pustina,VP of Finance,608-930-7200,4102,pustinak@uplandhillshealth.org,Lisa Schnedler,CEO,608-930-7200,4001,schnedlerl@uplandhillshealth.org,www.uplandhillshealth.org
WI-011804,CHIPPEWA VALLEY HOSPITAL (inpatient hospital),Adventist Health System/Sunbelt Inc.,1194737817,Inpatient Hospitals (other than children's hospitals),1220 3rd Ave W,,Durand,WI,54736-1600,Pepin,900 Hope Way,,Altamonte Springs,FL,32714,Seminole,Cheryl Wenz,Director Managed Care,913-789-3937,,CHERYL.WENZ@shawneemission.ORG,,,,,,
WI-011805,CHIPPEWA VALLEY HOSPITAL (rural health clinics),CHIPPEWAL VALLEY HOSPITAL & OAKVIEW CARE CENTER INC,1194737817,Rural Health Clinics,1220 3rd Ave W,,Durand,WI,54736-1600,Pepin,1220 3rd Ave West,,Durand,WI,54736,Pepin,Troy Dube,Finance Director,715-672-4211,249,troy.dube@ahss.org,Doug Peterson,Administrator,715-672-4211,112,doug.peterson@ahss.org,www.chippewavalleyhospital.com
WI-011806,Pepin County Health Department,Pepin County Health Department,1750408779,Family Planning Providers,740 7th Ave W,,Durand,WI,54736-1628,Pepin,740 7th Ave West,,Durand,WI,54736,Pepin,Heidi Stewart,Health Officer/ Director,715-672-5961,2,hstewart@co.pepin.wi.us,Penelope Bauer,Accounting Specialist,715-672-5961,,pbauer@co.pepin.wi.us,https://www.co.pepin.wi.us/?SEC=080745F4-E23F-4CEC-BD6E-D6AFCCEF7507
WI-011807,ASCENSION EAGLE RIVER HOSPITAL,Ascension Wisconsin,1346204385,Inpatient Hospitals (other than children's hospitals),201 Hospital Rd,,Eagle River,WI,54521-8835,Vilas,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011808,Marshfield Clinic Eagle River Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,500 Commerce Loop,,Eagle River,WI,54521-8038,Vilas,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Eagle%20River%20Center
WI-011809,Eagle River Clinic,NEWCAP Community Health,1306964440,"Family Planning Providers, Sexually Transmitted Disease Clinics",603 E Wall St,Suite A,Eagle River,WI,54521-8775,Vilas,1201 Main Street,,Oconto,WI,54153,Oconto,Cheryl Detrick,CEO,920-834-4621,1137,cheryldetrick@newcap.org,V. Jane Muhl,Interim Director,920-373-8187,,janemuhl@newcap.org,www.newcap.org
WI-011810,Marshfield Clinic Riverview Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,1000 Starr Ave,,Eau Claire,WI,54703-1821,Eau Claire,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Eau%20Claire%20Riverview%20Center
WI-011811,Family Health Center/Marshfield Clinic - Eau Claire Center,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1851632111,Federally Qualified Health Centers - Medical Services,2116 Craig Rd,,Eau Claire,WI,54701-6149,Eau Claire,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Greg Nycz,Executive Director,715-387-9137,,nycz.greg@marshfieldclinic.org,Mary Dorsch,Assistant Director,715-389-4574,,dorsch.mary@marshfieldclinic.org,
WI-011812,Marshfield Clinic Oakwood Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,3501 Golf Rd,,Eau Claire,WI,54701-8028,Eau Claire,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Eau%20Claire%20Oakwood%20Center
WI-011813,Eau Claire,AIDS Resource Center of Wisconsin,1770721607,"Community Mental Health Centers, Ryan White Providers",505 S Dewey St,Suite 107,Eau Claire,WI,54701-3999,Eau Claire,820 N Plankintion Avenue,,Milwaukee,WI,53203,Milwaukee,Brian Van Den Heuvel,Director,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,
WI-011814,Eau Claire City-County Health Department,Eau Claire City-County Health Department Family Planning Program,1740263326,"Family Planning Providers, Sexually Transmitted Disease Clinics",720 2nd Ave,,Eau Claire,WI,54703-5413,Eau Claire,720 2nd Ave,,Eau Claire,WI,54703,Eau Claire,Paulette Magur,Nursing Supervisor,715-839-4720,,paulette.magur@co.eau-claire.wi.us,Elizabeth Giese,Director,715-839-4718,,elizabeth.giese@co.eau-claire.wi.us,
WI-011815,Sacred Heart Hospital,HSHS Sacred Heart Hospital,1205811221,Inpatient Hospitals (other than children's hospitals),900 W Clairemont Ave,,Eau Claire,WI,54701-5105,Eau Claire,900 W Clairemont Ave.,,Eau Claire,WI,54703,Eau Claire,Steve Palecek,Director of Finance,715-717-3783,3783,steve.palecek@hshs.org,David Nelson,CFO,715-717-6122,6122,david.nelson@hshs.org,www.sacredhearteauclaire.org
WI-011816,Eau Claire Health Center,"Planned Parenthood of Wisconsin, Inc.",1255506754,"Family Planning Providers, Sexually Transmitted Disease Clinics",967 W Clairemont Ave,,Eau Claire,WI,54701-6103,Eau Claire,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,Holly Nearman,Patient Services Coordinator,414-289-3782,,holly.nearman@ppwi.org,https://www.plannedparenthood.org/planned-parenthood-wisconsin
WI-011818,EDGERTON HOSPITAL AND HEALTH SERVICES (inpatient hospital),"Edgerton Hospital and Health Services, Inc.",1154350049,Inpatient Hospitals (other than children's hospitals),11101 N Sherman Rd,,Edgerton,WI,53534-9002,Rock,11101 N Sherman Rd,,Edgerton,WI,53534-9002,Rock,Charles Roeder,Vice President/CFO,608-884-1656,,croeder@edgertonhospital.com,Marcia Miller,Revenue Cycle Manager,608-884-1625,,mmiller@edgertonhospital.com,www.edgertonhospital.com
WI-011819,Aspirus Elcho Clinic,Aspirus Langlade Hospital,1831251040,Rural Health Clinics,10618 Clinic St,,Elcho,WI,54428,Langlade,112 E 5th Avenue,,Antigo,WI,54409,Langlade,Pat Tincher,Director of Finance/CFO,715-623-9215,,pat.tincher@aspirus.org,,,,,,
WI-011820,Children's Hospital of Wisconsin - Walworth County Child Advocacy Center,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,W4063 County Road NN,,Elkhorn,WI,53121-4338,Walworth,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev.,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011821,Ellsworth Office,Pierce County Health Department,1952349573,"Family Planning Providers, Sexually Transmitted Disease Clinics, Tuberculosis Clinics",412 W Kinne St,,Ellsworth,WI,54011-9230,Pierce,412 W. Kinne St.,,Ellsworth,WI,54011,Pierce,Sue Galoff,Director Health Officer,715-273-6755,6569,sgaloff@co.pierce.wi.us,Becky Johnson,Business Manager,715-273-6755,6769,becky.johnson@co.pierce.wi.us,www.co.pierce.wi.us
WI-011822,Mayo Clinic Health System - Red Cedar Elmwood,"Mayo Clinic Health System - Red Cedar, Inc.",1831102615,Outpatient Hospital Clinics,236 Springer Ave,,Elmwood,WI,54740-8806,Pierce,2321 Stout Road,,Menomonie,WI,54751,Dunn,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011823,Elroy Family Health Center,Mile Bluff Medical Center,1285770016,Rural Health Clinics,1515 Academy St,,Elroy,WI,53929-1011,Juneau,1050 Division St,,Mauston,WI,53948,Juneau,Francis J Fish,CFO,608-847-6161,,jfish@milebluff.com,James OKeefe,CEO,608-847-6161,,jokeefe@milebluff.com,milebluff.com
WI-011824,Gundersen St. Joseph's Elroy Clinic,"St. Joseph's Health Services, Inc.",1699788273,Rural Health Clinics,1705 Omaha St,,Elroy,WI,53929-9776,Juneau,Gundersen St. Josephs Hospital and Clinics,400 Water Ave,Hillsboro,WI,54634,Vernon,Kristie McCoic,Clinical Operations Officer,608-489-8106,98106,kjmccoic@gundersenhealth.org,,,,,,
WI-011825,Crossing Rivers Health Clinic - Fennimore,"Prairie du Chien Memorial Hospital Association, Inc.",1760808968,"Other ECP Providers, Outpatient Hospital Clinics",1800 Bronson Blvd,,Fennimore,WI,53809-9778,Grant,37868 US Hwy 18,,Prairie du Chien,WI,53821,Crawford,William Sexton,Chief Executive Officer,608-357-2236,,william.sexton@crossingrivers.org,Dave Breitbach,Chief Financial Officer,608-357-2405,,dave.breitbach@crossingrivers.org,
WI-011826,Gundersen Fennimore Clinic,Gundersen Boscobel Area Hospital and Clinics,1437448891,Rural Health Clinics,220 Lincoln Ave,,Fennimore,WI,53809-1036,Grant,Gundersen Boscobel Area Hospital and Clinics,205 Parker Street,Boscobel,WI,53805,Grant,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,
WI-011827,NORTH SHORE MED CLINIC FISH CREEK,Ministry Health Care,1508198961,Rural Health Clinics,3711 Hwy 42,,Fish Creek,WI,54212,Door,"222 W. College Ave., Suite 3B",,Appleton,WI,54911-5863,Outagamie,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,,,,,,
WI-011828,Florence Medical Center,Dickinson County Healthcare System,1336183052,Rural Health Clinics,1010 Olive Ave,PO Box 380,Florence,WI,54121-0380,Florence,1721 S Stephenson Ave,,Iron Mountain,MI,49801,Dickinson,Peggy Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Manager Physician Services,906-776-5437,,kim.kowalkowski@dchs.org,
WI-011829,St. Agnes Hospital,"Agnesian HealthCare, Inc.",1346228541,Inpatient Hospitals (other than children's hospitals),430 E Division St,,Fond du Lac,WI,54935-4560,Fond du Lac,430 E Division Street,,Fond dd Lac,WI,54935-4560,Fond Du Lac,Barb Faber,"Director, Managed Care & Professional Billing",920-926-8333,,faberb@agnesian.com,Penny Claggett,System Accreditation/Risk Management/Safety Coordinator,920-745-3363,,claggettp@agnesian.com,www.agnes
WI-011830,Fort HealthCare,"Fort HealthCare, Inc.",1811916281,Inpatient Hospitals (other than children's hospitals),611 Sherman Ave E,,Fort Atkinson,WI,53538-1960,Jefferson,"611 Sherman Avenue, East",,Fort Atkinson,WI,53538,Jefferson,James J. Nelson,VP Finance/CFO,920-568-5490,,james.nelson@forthc.com,Diane R. Lunde,Director of Revenue Cycle,920-568-5178,,diane.lunde@forthc.com,forthealthcare.com
WI-011831,Frederic Clinic,St. Croix Regional Medical Center,1811256126,Rural Health Clinics,205 Oak St W,,Frederic,WI,54837-8953,Polk,235 State Street,,St. Croix Falls,WI,54024,Polk,Wendy Young,Vice President Clinic and Ancillar Services,715-483-0497,,wendy.young@scrmc.org,Sally Bajak,CFO,715-483-0556,,sally.bajak@scrmc.org,
WI-011832,MOUNDVIEW MEMORIAL HOSPITAL AND CLINICS (inpatient hospital),"Moundview Memorial Hospital & Clinics, Inc",1710939533,Inpatient Hospitals (other than children's hospitals),402 W Lake St,,Friendship,WI,53934-9699,Adams,402 W Lake St,,Friendship,WI,53934,Adams,Lori Wittig,Director of Clinic Operations,608-339-8318,,lwittig@moundview.org,Don Heinz,CEO,608-339-6814,,dheinz@moundview.org,
WI-011833,MOUNDVIEW MEMORIAL HOSPITAL AND CLINICS (rural health clinics),"Moundview Memorial Hospital & Clinics, Inc",1710939533,Rural Health Clinics,402 W Lake St,,Friendship,WI,53934-9699,Adams,402 W Lake St,,Friendship,WI,53934,Adams,Lori Wittig,Director of Clinic Operations,608-339-8318,,lwittig@moundview.org,Don Heinz,CEO,608-339-6814,,dheinz@moundview.org,
WI-011834,HSHS St Clare Memorial Hospital Gillett Health Center,HSHS St Clare Memorial Hospital,1134250905,Rural Health Clinics,340 N Green Bay Ave,,Gillett,WI,54124-9325,Oconto,855 S Main Street,,Oconto Falls,WI,54154,Oconto,Nicole Stapleton,Director of Clinic Services,920-848-6380,36380,nicole.stapleton@hshs.org,,,,,,
WI-011835,ASPIRUS GILMAN CLINIC,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1285703173,Rural Health Clinics,320 East Main Street,,Gilman,WI,54433,Taylor,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-011836,Mayo Clinic Health System - Red Cedar Glenwood City,"Mayo Clinic Health System - Red Cedar, Inc.",1831102615,Outpatient Hospital Clinics,219 E Oak St,,Glenwood City,WI,54013-8516,Saint Croix,2321 Stout Road,,Menomonie,WI,54751,Dunn,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011837,BURNETT MEDICAL CTR,Burnett Medical Center Inc,1225191687,Inpatient Hospitals (other than children's hospitals),257 W Saint George Ave,,Grantsburg,WI,54840-7827,Burnett,257 W St George Ave,,Grantsburg,WI,54840-7827,Burnett,Charles J Faught,CFO,715-463-7281,,cfaught@burnettmedicalcenter.com,Gordon A Lewis,CEO,715-463-7275,,glewis@burnettmedicalcenter.com,http://www.burnettmedicalcenter.com
WI-011838,BURNETT MEDICAL CTR CLINIC,Burnett Medical Center Inc,1356499784,Rural Health Clinics,257 W Saint George Ave,,Grantsburg,WI,54840-7827,Burnett,257 W St George Ave,,Grantsburg,WI,54840-7827,Burnett,Charles J Faught,CFO,715-463-7281,,cfaught@burnettmedicalcenter.com,Gordon A Lewis,CEO,715-463-7275,,glewis@burnettmedicalcenter.com,http://www.burnettmedicalcenter.com
WI-011839,Golden House,N.E.W. Community Clinic,1487878328,Federally Qualified Health Centers - Medical Services,1120 University Ave,,Green Bay,WI,54302-1416,Brown,622 Bodart St.,,Green Bay,WI,54301,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011840,Green Bay Clinic,NEWCAP Community Health,1962520353,"Family Planning Providers, Sexually Transmitted Disease Clinics",1540 Capitol Dr,,Green Bay,WI,54303-2235,Brown,1201 Main Street,,Oconto,WI,54153,Oconto,Cheryl Detrick,CEO,920-834-4621,1137,cheryldetrick@newcap.org,V. Jane Muhl,Interim Director,920-373-8187,,janemuhl@newcap.org,www.newcap.org
WI-011841,HOUSE OF HOPE,NEW COMMUNITY CLINIC,1487878328,Federally Qualified Health Centers - Medical Services,1660 Christiana St,,Green Bay,WI,54303-2665,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011842,Hemophilia Outreach Center,Hemophilia Outreach Center,1851390686,Hemophilia Treatment Centers,2060 Bellevue St,,Green Bay,WI,54311-5622,Brown,2060 Bellevue Street,,Green Bay,WI,54311,Brown,Jamison C. Buxton,Executive Director,920-965-0606,220,jamisonb@hemophiliaoutreach.org,Dr. Lisa Palmer,Chief Medical Officer,920-965-0606,212,lisap@hemophiliaoutreach.org,
WI-011843,Green Bay Health Center,"Planned Parenthood of Wisconsin, Inc.",1861667362,Family Planning Providers,2605 S Oneida St,Suite 107,Green Bay,WI,54304-5331,Brown,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011844,N.E.W. Clinic at NWTC,NEW COMMUNITY CLINIC,1487878328,"Dental Providers, Federally Qualified Health Centers - Medical Services",2740 W Mason St,,Green Bay,WI,54303-4966,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011845,FREEDOM HOUSE,NEW COMMUNITY CLINIC,1487878328,Federally Qualified Health Centers - Medical Services,2997 Saint Anthony Dr,,Green Bay,WI,54311-5860,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011846,NEW COMMUNITY SHELTER,NEW COMMUNITY CLINIC,1487878328,Federally Qualified Health Centers - Medical Services,301 Mather St,,Green Bay,WI,54303-3447,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011847,St. John's,N.E.W. Community Clinic,1487878328,Federally Qualified Health Centers - Medical Services,411 St. John St,,Green Bay,WI,54301,Brown,622 Bodart St.,,Green Bay,WI,54301,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011848,"AIDS Resource Center of Wisconsin, Inc. - Green Bay",AIDS Resource Center of Wisconsin,1982654091,Rural Health Clinics,445 S Adams St,,Green Bay,WI,54301-4107,Brown,820 N Plankinton Avenue,,Milwaukee,WI,53203-1802,Milwaukee,Brian Van Den Heuvel,Director of Healthcare Revenue,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,www.arcw.org
WI-011849,N.E.W. COMMUNITY CLINIC,NEW COMMUNITY CLINIC INC LTD,1487878328,Federally Qualified Health Centers - Medical Services,622 Bodart St,,Green Bay,WI,54301-4923,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011850,THE SALVATION ARMY,NEW COMMUNITY CLINIC INC LTD,1487878328,Federally Qualified Health Centers - Medical Services,626 Union Ct,,Green Bay,WI,54303-3609,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011851,Micah Center,N.E.W. Community Clinic,1487878328,Federally Qualified Health Centers - Medical Services,700 E Walnut St,,Green Bay,WI,54301-4052,Brown,622 Bodart St.,,Green Bay,WI,54301,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011852,ST VINCENT HOSPITAL,ST VINCENT HOSPITAL,1114908001,Children's Hospitals (inpatient only),835 S Van Buren St,,Green Bay,WI,54301-3526,Brown,835 S Van Buren St,,Green Bay,WI,54301-3526,Brown,Karen Christel,Director of Managed Care,920-884-5815,,Karen.christel@HSHS.org,Joanne Horvath,Vice President - Finance,920-431-3211,,Joanne.horvath@HSHS.org,
WI-011853,Outreach Healthcare Clinic,NEW COMMUNITY CLINIC INC LTD,1487878328,Federally Qualified Health Centers - Medical Services,879 Mather St,,Green Bay,WI,54303-3651,Brown,622 Bodart St,,Green Bay,WI,54301-4923,Brown,Bonnie Kuhr,CEO,920-437-9773,,newcomm@newcommunityclinic.org,,,,,,
WI-011854,Marshfield Clinic Greenwood Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,102 Cannery St,,Greenwood,WI,54437-9705,Clark,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Greenwood%20Center
WI-011855,MEMORIAL MEDICAL CTR GREENWOOD,Memorial Medical Center,1659360097,Rural Health Clinics,201 S Main St,,Greenwood,WI,54437-9733,Clark,216 Sunset Place,,Neillsville,WI,54456,Clark,Kelly Silbernagel,Director of Finance,715-743-3101,8338,ksilbernagel@memorialmedcenter.org,Susan Lewis,Patient Services Manager,715-743-3101,8329,slewis@memorialmedcenter.org,www.memorialmedcenter.org
WI-011856,Sawyer County Health and Human Services,SAWYER COUNTY HEALTH DEPARTMENT,1679566327,"Dental Providers, Family Planning Providers, Other ECP Providers",10610 Main St,,Hayward,WI,54843-6583,Sawyer,10610 Main Street Suite 224,,Hayward,WI,54843,Sawyer,Eileen Simak,Health Officer,715-638-3423,,esimak@sawyerhs.hayward.wi.us,Lynn Schuman,Public Health Nurse,715-638-3410,,lschuman@sawyerhs.hayward.wi.us,
WI-011857,HAYWARD AREA MEMORIAL HOSPITAL,Medical Services Inc,1912992827,Inpatient Hospitals (other than children's hospitals),11040 N State Road 77,,Hayward,WI,54843-6391,Sawyer,11040 N State Rd 77,,Hayward,WI,54843-6391,Sawyer,Kent Dumonseau,CFO,715-685-5515,,kdumonseau@ashlandmmc.com,Brad Zeller,VP,715-934-4245,,bzeller@hamhwe.com,
WI-011858,NorthLakes-Hayward,Lakes Community Health Center,1811178825,"Dental Providers, Family Planning Providers, Other ECP Providers",11128N WI 77,,Hayward,WI,54843,Sawyer,7665 US Hwy 2,,Iron River,WI,54847,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assitant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-011859,Upland Hills Health Clinic - Highland,Upland Hills Health,1972851418,Rural Health Clinics,551 Main St,,Highland,WI,53543-9779,Iowa,800 Compassion Way,,Dodgeville,WI,53533,Iowa,A Karl Pustina,VP of Finance,608-930-7200,4102,pustinak@uplandhillshealth.org,Patty Ramsden,Clinic Manager,608-574-1591,,ramsdenp@uplandhillshealth.org,www.uplandhillshealth.org
WI-011860,Gundersen St. Joseph's Clinic - Hillsboro,"St. Joseph's Health Services, Inc",1104031798,Rural Health Clinics,400 Water Ave,,Hillsboro,WI,54634-9054,Vernon,Gundersen St. Joseph's Hospital and Clinics,400 Water Ave,Hillsboro,WI,54634,Vernon,Robin Nelson,Clinical Operations Officer,608-489-8103,,rrnelson@gundersenhealth.org,,,,,,
WI-011861,Gundersen St. Joseph's Hospital - Hillsboro,"St Joseph's Health Services, Inc",1972591410,Inpatient Hospitals (other than children's hospitals),400 Water Ave,,Hillsboro,WI,54634-9054,Vernon,Gundersen St. Joseph's Hospital and Clinics,400 Water Ave,Hillsboro,WI,54634,Vernon,Kristie McCoic,Attn: Human Resources,608-489-8106,,kjmccoic@gundersenhealth.org,,,,,,
WI-012425,"BDCH, Inc. Medical Clinic - Horicon","Beaver Dam Community Hospitals, Inc.",1023187416,Outpatient Hospital Clinics,610 Washington St,,Horicon,WI,53032-1552,Dodge,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.bdch.com/Horicon-Clinic
WI-011862,HUDSON HOSPITAL,"Hudson Hospital, Inc",1396849303,Inpatient Hospitals (other than children's hospitals),405 Stageline Rd,,Hudson,WI,54016-1793,Saint Croix,405 Stageline Rd,,Hudson,WI,54016-7848,Saint Croix,Khrystyne Vang,Director Finance & Stewardship,715-531-6095,,Chi.K.Vang@HudsonHospital.org,,,,,,www.HudsonHospital.org
WI-011863,Aspirus Hurley Clinic,Aspirus Grand View,1992704753,Rural Health Clinics,501 Granite St,,Hurley,WI,54534-1372,Iron,501 Granite St.,,Hurley,WI,54534,Iron,Tera Hamel,Clinic Director,906-932-7660,,tera.hamel@aspirus.org,,,,,,
WI-011864,Iron County Health Department,County of Iron,1659413441,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",502 Copper St,Suite 2,Hurley,WI,54534-1386,Iron,502 Copper St,Suite 2,Hurley,WI,545341386,Iron,Melissa Geach,RN,715-561-4545,,geachm@ironcountywi.org,Melissa DeCarlo,Office Manager,715-561-4545,,decarlom@ironcountywi.org,
WI-011865,Gundersen Tri County Clinic - Independence,GUNDERSEN TRI COUNTY HSPTL & CLINICS INDEPENDENCE,1285988733,Rural Health Clinics,35791 Osseo Rd,,Independence,WI,54747-9096,Trempealeau,"Tri-County Memorial Hospital, Inc.",18601 Lincoln Street,Whitehall,WI,54773,Trempealeau,Joni D. Olson,CEO,715-538-4361,64120,jdolson@gundersenhealth.org,,,,,,
WI-011866,NorthLakes - Iron River,Lakes Community Health Center,1811178825,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",7665 US Highway 2,,Iron River,WI,54847-4690,Bayfield,7665 US Highway 2,,Iron River,WI,54847-4690,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assistant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-011867,First Choice Women's Health Center,Community Action Inc,1508839150,"Family Planning Providers, Sexually Transmitted Disease Clinics",1015 W Burbank Ave,,Janesville,WI,53546-6154,Rock,20 Eclipse Center,,Beloit,WI,53511,Rock,Tracy Burman,Business Office Manager,608-755-2438,,tburman@community-action.org,Chrissy Arambula,Program Operations Manager,608-755-2438,,carambula@community-action.org,
WI-011868,JANESVILLE COMMUNITY HEALTH CTR,"COMMUNITY HEALTH SYSTEMS, INC.",1750390670,Federally Qualified Health Centers - Medical Services,849 Kellogg Ave,,Janesville,WI,53546-2808,Rock,74 Eclipse Center,,Beloit,WI,53511-3550,Rock,Julie Sprecher,Chief Executive Officer,608-313-3362,,jsprecher@chsofwi.org,Mark Lundvall,Director of Finance,608-313-3360,,mlundvall@chsofwi.org,
WI-011869,"BDCH, Inc. Medical Clinics - Juneau","Beaver Dam Community Hospitals, Inc.",1023187416,Outpatient Hospital Clinics,420 W North St,,Juneau,WI,53039-1165,Dodge,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.bdch.com/Juneau-Clinic
WI-011870,"AIDS Resource Center of Wisconsin, Inc. - Kenosha",AIDS Resource Center of Wisconsin,1982654091,Ryan White Providers,1212 57th St,,Kenosha,WI,53140-4069,Kenosha,820 N Plankinton Avenue,,Milwaukee,WI,53203-1802,Milwaukee,Brian Van Den Heuvel,Director of Healthcare Revenue,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,www.arcw.org
WI-011871,"Kenosha Community Health Center, Inc.",KENOSHA COMMUNITY HEALTH CENTER INC,1942595657,Federally Qualified Health Centers - Medical Services,1330 52nd St,Suite 205,Kenosha,WI,53140-3236,Kenosha,625 57th St Ste 700,,Kenosha,WI,53140-4146,Kenosha,Mary Coffey,Executive Director,262-764-3625,,mcoffey@kenoshachc.org,,,,,,http://www.kenoshachc.org/
WI-011872,Kenosha County Wellness Center,Kenosha County Division of Health,1568459568,"Family Planning Providers, Sexually Transmitted Disease Clinics",2000 63rd St # 2,,Kenosha,WI,53143-4473,Kenosha,Suite 600,,Kenosha,WI,53143,Kenosha,Gwendolyn Perry-Brye,Clinical Services Director,262-605-6700,6764,gwen.brye@kenoshacounty.org,Cynthia Johnson,HealthOfficer/Director,262-605-6700,6760,cynthia.johnson@kenoshacounty.org,
WI-011873,Kenosha Health Center,"Planned Parenthood of Wisconsin, Inc.",1104091610,Family Planning Providers,3601 Roosevelt Rd,,Kenosha,WI,53142-7231,Kenosha,302 N Jackson St,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011874,"Kenosha Community Health Center, Inc.",KENOSHA COMMUNITY HEALTH CENTER INC,1265435960,Federally Qualified Health Centers - Medical Services,4536 22nd Ave,,Kenosha,WI,53140-5917,Kenosha,625 57th St Ste 700,,Kenosha,WI,53140-4146,Kenosha,Mary Coffey,Executive Director,262-764-3625,,mcoffey@kenoshachc.org,,,,,,http://www.kenoshachc.org/
WI-011875,"Kenosha Community Health Center, Inc.",KENOSHA COMMUNITY HEALTH CENTER INC,1770789489,"Dental Providers, Federally Qualified Health Centers - Medical Services",6226 14th Ave,,Kenosha,WI,53143-4413,Kenosha,625 57th St Ste 700,,Kenosha,WI,53140-4146,Kenosha,Mary Coffey,Executive Director,262-764-3625,,mcoffey@kenoshachc.org,,,,,,http://www.kenoshachc.org/
WI-012426,Children's Hospital of Wisconsin - Kenosha Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,6809 122nd Ave,,Kenosha,WI,53142-7335,Kenosha,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011876,Bellin Health Kewaunee,Bellin Memorial,1699737379,Rural Health Clinics,575 4th St,,Kewaunee,WI,54216-1785,Kewaunee,744 South Webster Avenue,PO Box 23400,Green Bay,WI,54305-3400,Brown,Michelle Conard,TEAM LEADER BMH MANAGED CARE,920-445-7217,,Michelle.Conard@bellin.org,,,,,,
WI-011877,Essential Health Clinic - La Crosse,"Options in Reproductive Care, Inc. DBA Essential Health Clinic",1326086976,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1201 Caledonia St,,La Crosse,WI,54603-2514,La Crosse,1201 Caledonia Street,,La Crosse,WI,54603-2514,La Crosse,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,www.essentialclinic.org
WI-011878,Gundersen Lutheran Medical Center (dental provider),Gundersen Lutheran Medical Center,1376593442,Dental Providers,1910 South Ave,,La Crosse,WI,54601-5467,La Crosse,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Scott Rathgaber,CEO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
WI-011879,Gundersen Lutheran Medical Center (inpatient hospital),Gundersen Lutheran Medical Center,1376593442,Inpatient Hospitals (other than children's hospitals),1910 South Ave,,La Crosse,WI,54601-5467,La Crosse,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Scott Rathgaber,CEO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
WI-012499,Scenic Bluffs Health Center LaCrosse Dental,"Scenic Bluffs Health Center, Inc",1457973471,"Dental Providers, Federally Qualified Health Centers - Dental Services",2030 7th St S,,La Crosse,WI,54601-5202,La Crosse,PO Box 39,,Cashton,WI,54619,Monroe,Sheryl Robinson,CFO,608-654-5100,,sbarker@scenicbluffs.org,Deb Korn,Credentialing,608-654-5100,,providers@scenicbluffs.org,
WI-011880,La Crosse,AIDS Resource Center of Wisconsin,1770721607,"Community Mental Health Centers, Ryan White Providers",505 King St,Suite 200,La Crosse,WI,54601-4062,La Crosse,820 N Plankintion Avenue,,Milwaukee,WI,53203,Milwaukee,Brian Van Den Heuvel,Director,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,
WI-012500,Scenic Bluffs Health Center LaCrosse BH,"Scenic Bluffs Health Center, Inc",1760029722,Federally Qualified Health Centers - Medical Services,916 Ferry St,,La Crosse,WI,54601-4717,La Crosse,PO Box 39,,Cashton,WI,54619,Monroe,Sheryl Robinson,CFO,608-654-5100,,sbarker@scenicbluffs.org,Deb Korn,Credentialing,608-654-5100,,providers@scenicbluffs.org,
WI-011881,La Farge Medical Clinic-VMH,"Vernon Memorial Healthcare, Inc",1750387221,Rural Health Clinics,206 N Mill St.,,La Farge,WI,54639,Vernon,507 S. Main St.,,Viroqua,WI,54665,Vernon,Ashley Lagerquist,Manager-Patient Registration and Accounts,608-637-4769,,alagerquist@vmh.org,Mary Koenig,CFO,608-637-4203,,mkoenig@vmh.org,www.vmh.org
WI-011882,"Margie A. Frederickson, MD",La Pointe Community Clinic,1336195536,Other ECP Providers,241 Big Bay Road,PO Box 45,La Pointe,WI,54850-0045,Ashland,La Pointe Community Clinic,241 Big Bay Road,La Pointe,WI,54850,Ashland,MARGIE FREDERICKSON,MD,715-747-2722,,mfredmd@cheqnet.net,,,,,,
WI-011883,Peter Christensen Health Center,Peter Christensen Health Center,1134235047,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",129 Old Abe Rd,,Lac du Flambeau,WI,54538-9386,Vilas,129 Old Abe Road,,Lac du Flambeau,WI,54538,Vilas,Patricia Hillestad,Financial Manager,715-588-3371,1803,phillestad@pchclinic.com,Randy Samuelson,Health Director,715-588-3371,1700,rsamuelson@pchclinic.com,
WI-012427,FHC Ladysmith AODA Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Medical Services,1000 College Ave W,,Ladysmith,WI,54848-2118,Rusk,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Ladysmith%20Alcohol%20and%20Drug%20Recovery%20Center
WI-011884,Rusk County Public Health,RUSK COUNTY HEALTH DEPARTMENT,1932337706,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",311 Miner Ave E,Suite C 220,Ladysmith,WI,54848-2862,Rusk,311 Miner Ave E,Suite C 220,Ladysmith,WI,54848-2862,Rusk,ANTHONY WADE,"DIRECTOR, STD PROGRAM",608-266-2854,,azimmer@ruskcountywi.us,Anita Zimmer,Public Health Officer,715-532-2299,209,azimmer@ruskcountywi.us,
WI-011885,FHC Ladysmith Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,315 Miner Ave W,,Ladysmith,WI,54848-1725,Rusk,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Ladysmith%20Dental%20Center
WI-011886,Marshfield Medical Center - Ladysmith,"MCHS Hospitals, Inc.",1952890873,Inpatient Hospitals (other than children's hospitals),900 College Ave W,,Ladysmith,WI,54848-2116,Rusk,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,http://www.ruskhospital.org/
WI-011887,Marshfield Clinic Ladysmith Center,"MCHS Hospitals, Inc.",1154810810,Rural Health Clinics,906 College Ave W,,Ladysmith,WI,54848-2116,Rusk,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Ladysmith%20Center
WI-011888,Mercy Walworth Hospital and Medical Center,Mercy Health System Corporation,1699728550,Inpatient Hospitals (other than children's hospitals),"Hwys. 50 and 67, N2950 State Road 67",,Lake Geneva,WI,53147,Walworth,1000 Mineral Point Ave,,Janesville,WI,53548,Rock,DuWayne Severson,Director of Contracting,608-741-5626,,dseverson@mhemail.org,Caryn Oleston,Chief Nursing Officier,262-245-7927,,coleston@mhemail.org,
WI-011889,"DBA NORTHERN HEALTH CENTERS, INC.N","NORTHERN HEALTH CENTERS, INC.",1699778233,"Dental Providers, Federally Qualified Health Centers - Medical Services",15397 Hwy 32,,Lakewood,WI,54138,Oconto,15397 State Highway 32,,Lakewood,WI,54138-9702,Oconto,Michele White,CEO,715-276-6321,229,shellyw@nhcmedden.com,Holly Liptack,CFO,715-276-6321,224,hollyl@nhcmedden.com,www.nhcmedden.com
WI-011890,Grant Regional Community Clinic,"Grant Regional Health Center, Inc.",1356776710,Rural Health Clinics,507 S Monroe St,,Lancaster,WI,53813-2054,Grant,507 S Monroe Street,,Lancaster,WI,53813,Grant,Dawn Bandy,CFO,608-723-3202,,dbandy@grantregional.com,Molly Weigel,Clinic Nurse Manager,608-723-5335,,mweigel@grantregional.com,
WI-011891,"Grant Regional Health Center, Inc","Grant Regional Health Center, Inc.",1255339867,Inpatient Hospitals (other than children's hospitals),507 S Monroe St,,Lancaster,WI,53813-2054,Grant,507 S Monroe Street,,Lancaster,WI,53813,Grant,Dawn Bandy,CFO,608-723-3202,,dbandy@grantregional.com,Nicole Clapp,CEO,608-723-3200,,nclapp@grantregional.com,www.grantregional.com
WI-011892,Ascension St Mary's at Laona,Ascension Wisconsin,1467745257,Rural Health Clinics,4876 Mill St,,Laona,WI,54541-9339,Forest,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011893,HSHS St Clare Memorial Hospital Lena Health Center,HSHS St Clare Memorial Hospital,1346371358,Rural Health Clinics,200 S Rosera St,,Lena,WI,54139-9169,Oconto,855 S Main Street,,Oconto Falls,WI,54154,Oconto,Nicole Stapleton,Director of Clinic Services,920-848-6380,36380,nicole.stapleton@hshs.org,,,,,,
WI-011894,MEMORIAL MEDICAL CTR LOYAL,Memorial Medical Center,1376532713,Rural Health Clinics,502 E Elm Dr,,Loyal,WI,54446-9604,Clark,216 Sunset Place,,Neillsville,WI,54456,Clark,Kelly Silbernagel,Director of Finance,715-743-3101,8338,ksilbernagel@memorialmedcenter.org,Susan Lewis,Patient Services Manager,715-743-3101,8329,slewis@memorialmedcenter.org,www.memorialmedcenter.org
WI-011895,Luck Clinic,Amery Regional Medical Center,1851345268,Rural Health Clinics,137 E 1st Ave,,Luck,WI,54853-9057,Polk,265 Griffin St. East,,Amery,WI,54001,Polk,Alex Holsman,Clinic Director,715-268-0595,595,alexander.j.holsman@amerymedical.com,Sandi Reed,Vice-President of Ambulatory Operations,715-268-0304,304,sandi.m.reed@amerymedical.com,
WI-011896,Wingra Family Medical Center,"Access Community Health Centers, Inc.",1669654307,Federally Qualified Health Centers - Medical Services,1102 S Park St,Suite 100,Madison,WI,53715-1708,Dane,2901 W Beltline Hwy Ste 120,,Madison,WI,53713-4231,Dane,Judy Keel,Grants Manager,608-663-5109,,judy.keel@accesshealthwi.org,,,,,,
WI-011897,Joyce & Marshall Erdman Clinic,"Access Community Health Centers, Inc.",1568675858,"Dental Providers, Federally Qualified Health Centers - Medical Services",2202 S Park St,,Madison,WI,53713-1916,Dane,2901 W Beltline Hwy Ste 120,,Madison,WI,53713-4231,Dane,Judy Keel,Grants Manager,608-663-5109,,judy.keel@accesshealthwi.org,,,,,,
WI-011898,Madison South Health Center,"Planned Parenthood of Wisconsin, Inc.",1710151337,Family Planning Providers,2222 S Park St,Suite 210,Madison,WI,53713-2168,Dane,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011899,William T. Evjue Clinic,"Access Community Health Centers, Inc.",1417055617,"Dental Providers, Federally Qualified Health Centers - Medical Services",3434 E Washington Ave,,Madison,WI,53704-4155,Dane,2901 W Beltline Hwy Ste 120,,Madison,WI,53713-4231,Dane,Judy Keel,Grants Manager,608-663-5109,,judy.keel@accesshealthwi.org,,,,,,
WI-011900,Madison East Health Center,"Planned Parenthood of Wisconsin, Inc.",1467626085,Family Planning Providers,3706 Orin Rd,,Madison,WI,53704-3643,Dane,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011901,University of Wisconsin Hospitals & Clinics,UWHC Comprehensive Program for Bleeding Disorders,1922043744,Hemophilia Treatment Centers,600 Highland Ave,,Madison,WI,53792-9749,Dane,600 HIghland Avenue,,Madison,WI,537929749,Dane,Jessica Pindilli,Program Coordinator,608-890-9493,,jpindilli@uwhealth.org,,,,,,
WI-011902,"AIDS Resource Center of Wisconsin, Inc. - Madison",AIDS Resource Center of Wisconsin,1982654091,Ryan White Providers,600 Williamson St,Suite H,Madison,WI,53703-4531,Dane,820 N Plankinton Avenue,,Milwaukee,WI,53203-1802,Milwaukee,Brian Van Den Heuvel,Director of Healthcare Revenue,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,http://www.arcw.org
WI-011903,Manitowoc Health Center,"Planned Parenthood of Wisconsin, Inc.",1790959310,Family Planning Providers,1100 S 30th St,Suite 106,Manitowoc,WI,54220-5594,Manitowoc,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011904,Manitowoc Clinic,"LAKESHORE COMMUNITY HEALTH CARE, INC",1245502673,"Dental Providers, Federally Qualified Health Centers - Medical Services",2719 Calumet Ave,,Manitowoc,WI,54220-5546,Manitowoc,P.O. Box 959,,Sheboygan,WI,53082-0959,Sheboygan,Kristin B. Stearns,CEO,920-783-6633,204,kstearns@lakeshorechc.org,Marty Schaller,CFO/COO,920-783-6633,201,mschaller@lakeshorechc.org,
WI-011905,Marinette Clinic,NEWCAP Community Health,1326166794,"Family Planning Providers, Sexually Transmitted Disease Clinics",1939 Hall Ave,,Marinette,WI,54143-1716,Marinette,1201 Main Street,,Oconto,WI,54153-1541,Oconto,Cheryl Detrick,CEO,920-834-4621,1137,cheryldetrick@newcap.org,V. Jane Muhl,Interim Director,920-373-8187,,janemuhl@newcap.org,www.newcap.org
WI-011906,FAMILY HEALTH CENTER OF A MARSHFIELD INC,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1851632111,Federally Qualified Health Centers - Medical Services,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Greg Nycz,Executive Director,715-387-9137,,nycz.greg@marshfieldclinic.org,Mary Dorsch,Assistant Director,715-389-4574,,dorsch.mary@marshfieldclinic.org,
WI-011907,FHC Marshfield Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,1307 N Saint Joseph Ave,,Marshfield,WI,54449-1340,Wood,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Marshfield%20Dental%20Center
WI-012428,FHC Marshfield AODA Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Medical Services,214 W 2nd St,,Marshfield,WI,54449-2719,Wood,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Marshfield%20Alcohol%20and%20Drug%20Recovery%20Center
WI-011908,MINISTRY SAINT JOSEPHS HOSPITAL,Ministry Health Care,1144224676,Inpatient Hospitals (other than children's hospitals),611 N Saint Joseph Ave,,Marshfield,WI,54449-1832,Wood,"222 W. College Ave., Suite 3B",,Appleton,WI,54911-5863,Outagamie,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,,,,,,
WI-011909,MILE BLUFF CLINIC,Mile Bluff Medical Center,1881930527,Rural Health Clinics,1040 Division St,,Mauston,WI,53948-1931,Juneau,1050 Division St,,Mauston,WI,53948,Juneau,Francis J Fish,CFO,608-847-6161,,jfish@milebluff.com,James OKeefe,CEO,608-847-6161,,jokeefe@milebluff.com,milebluff.com
WI-011910,Mile Bluff Medical Center Inc dba Hess Memorial Hospital,Mile Bluff Medical Center Inc,1568487411,Inpatient Hospitals (other than children's hospitals),1050 Division St,,Mauston,WI,53948-1931,Juneau,1050 Division street,,Mauston,WI,53948,Juneau,James M OKeefe,President,608-847-3881,,jokeefe@milebluff.com,Jimmy Fish,CFO,608-847-2992,,jfish@milebluff.com,
WI-011911,FPHS Juneau County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Sexually Transmitted Disease Clinics",522 Gateway Ave,Suite F,Mauston,WI,53948-1450,Juneau,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011912,Mauston Dental Center,"LA CLINICA DE LOS CAMPESINOS, INC.",1790786929,Dental Providers,880 Herriot Dr,,Mauston,WI,53948-2031,Juneau,400 S. Townline Rd,,Wautoma,WI,54982,Waushara,Laura Waldvogel,CEO,920-787-9406,,Laura.Waldvogel@famhealth.com,Brian Sullivan,CFO,920-787-5514,270,Brian.Sullivan@famhealth.com,www.famhealth.com
WI-011913,FPHS Taylor County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1257 N 8th St,,Medford,WI,54451-1283,Taylor,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011914,ASPIRUS MEDFORD CLINIC,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1427140649,Rural Health Clinics,135 S Gibson St,,Medford,WI,54451-1622,Taylor,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-011915,ASPIRUS MEDFORD HOSPITAL,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1619079597,Inpatient Hospitals (other than children's hospitals),135 S Gibson St,,Medford,WI,54451-1622,Taylor,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-011916,FHC Medford Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,843 W Broadway Ave,,Medford,WI,54451-1307,Taylor,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Medford%20Dental%20Center
WI-011917,Partnership Community Health Center,"PARTNERSHIP COMMUNITY HEALTH CENTER, INC.",1225074008,Federally Qualified Health Centers - Medical Services,1814 Appleton Rd,,Menasha,WI,54952-1110,Winnebago,5337 W Grande Market Dr,,Appleton,WI,54913-8442,Outagamie,Kristene S Stacker,CEO,920-750-6512,,kristene.stacker@thedacare.org,,,,,,
WI-011918,Mayo Clinic Health System - Red Cedar Menomonie,"Mayo Clinic Health System - Red Cedar, Inc.",1154372944,Inpatient Hospitals (other than children's hospitals),2321 Stout Rd,,Menomonie,WI,54751-7003,Dunn,2321 Stout Road,,Menomonie,WI,54751,Dunn,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011919,Mayo Clinic Health System - Red Cedar Menomonie,"Mayo Clinic Health System - Red Cedar, Inc.",1831102615,Outpatient Hospital Clinics,2321 Stout Rd,,Menomonie,WI,54751-7003,Dunn,2321 Stout Road,,Menomonie,WI,54751,Dunn,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011920,Dunn County Health Department,Dunn County Health Department,1003801838,"Family Planning Providers, Sexually Transmitted Disease Clinics",3001 US Highway 12 E,Suite 32,Menomonie,WI,54751-3045,Dunn,3001 US Highway 12 East,Suite 032,Menomonie,WI,54751,Dunn,KATHRYN GALLAGHER,Director/Health Officer,715-231-6440,6441,KGALLAGHER@CO.DUNN.WI.US,,,,,,https://www.co.dunn.wi.us/publichealth
WI-011921,FAMILY HEALTH CENTER - MENOMONIE DENTAL CENTER,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1437264140,Dental Providers,3375 Kothlow Ave,Suite 40,Menomonie,WI,54751-5053,Dunn,1000 North Oak Avenue,,Marshfield,WI,54449-5703,Wood,Greg Nycz,Executive Director,715-387-9137,,nycz.greg@marshfieldclinic.org,Mary Dorsch,Assistant Director,715-389-4574,,dorsch.mary@marshfieldclinic.org,
WI-011922,Marshfield Clinic Menomonie Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,3603 Schneider Ave SE,,Menomonie,WI,54751-5674,Dunn,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Menomonie%20Center
WI-012429,FHC Menomonie Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,404 Red Cedar St,,Menomonie,WI,54751-2332,Dunn,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Menomonie%20Dental%20Center
WI-011923,Children's Hospital of Wisconsin - Mequon Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,1655 W Mequon Rd,,Mequon,WI,53092-3254,Ozaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011924,Bridge Community Health Clinic Merrill,"PRIMARY CONNECTION HEALTHCARE, INC",1457370744,"Dental Providers, Federally Qualified Health Centers - Medical Services",503 S Center Ave,Suite 6,Merrill,WI,54452-3466,Lincoln,1810 N 2nd St,,Wausau,WI,54403-3492,Marathon,Roger Rego,Co-Tranistional Executive Director,715-848-4884,,rogerr@bridgeclinic.org,,,,,,
WI-011925,Ascension Good Samaritan Hospital,Ascension Wisconsin,1124084678,Inpatient Hospitals (other than children's hospitals),601 S Center Ave,,Merrill,WI,54452-3404,Lincoln,400 W. River Woods Parkway,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011926,Children's Hospital of Wisconsin - Dental Center DHC,Children's Hospital of Wisconsin,1750482022,Dental Providers,1020 N 12th St,,Milwaukee,WI,53233-1308,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org/
WI-011927,ST. BENS CLINIC,"OUTREACH COMMUNITY HEALTH CENTERS, INC.",1932357126,Federally Qualified Health Centers - Medical Services,1027 N 9th St,,Milwaukee,WI,53233-1411,Milwaukee,711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011928,16TH St Comm Hlth Ctr-Chavez,"16TH STREET COMMUNITY HEALTH CENTER, INC.",1417912999,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",1032 S Cesar E Chavez Dr,,Milwaukee,WI,53204-2203,Milwaukee,1337 S Cesar E Chavez Dr,,Milwaukee,WI,53204-2712,Milwaukee,Wina M Zorro,Director: Grants and Program Development,414-672-1315,,wina.zorro@sschc.org,Wina M Zorro,Director: Grants and Program Development,414-385-3741,,wina.zorro@sschc.org,
WI-011929,Kilbourn Avenue Health Center,Progressive Community Health Centers,1801262746,Federally Qualified Health Centers - Medical Services,1218 W Kilbourn Ave,Suite 124,Milwaukee,WI,53233-1325,Milwaukee,3522 W. Lisbon Avenue,,Milwaukee,WI,53208,Milwaukee,Jenni Sevenich,CEO,414-934-9465,,jenni.sevenich@progressivechc.org,Candice Cole,CFO,414-882-2030,,candice.cole@progressivechc.org,
WI-011930,WALKERS POINT COMMUNITY CLINIC,"OUTREACH COMMUNITY HEALTH CENTERS, INC.",1932357126,Federally Qualified Health Centers - Medical Services,130 W Bruce St,,Milwaukee,WI,53204-1667,Milwaukee,711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011931,Hillside Family Health Center,"Progressive Community Health Centers, Inc.",1376851311,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1452 N 7th St # 2,,Milwaukee,WI,53205-2301,Milwaukee,3522 W Lisbon Avenue,,Milwaukee,WI,53208,Milwaukee,Michelle Belanger,Executive Assistant,414-882-2028,,shelly.belanger@progressivechc.org,Candice Cole,CFO,414-935-8000,433,candice.cole@progressivechc.org,
WI-011932,FPHS Southside Health Center,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1639 S 23rd St,Room 115,Milwaukee,WI,53204-2550,Milwaukee,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011933,Mitchell Street Health Center,"Planned Parenthood of Wisconsin, Inc.",1831363464,Family Planning Providers,1710 S 7th St,Suite 300,Milwaukee,WI,53204-3538,Milwaukee,302 N. Jackson Street,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011934,SALVATION ARMY,"OUTREACH COMMUNITY HEALTH CENTERS, INC.",1932357126,Federally Qualified Health Centers - Medical Services,1730 N 7th St,,Milwaukee,WI,53205-1701,Milwaukee,711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011935,St. Elizabeth Ann Seton Dental Clinic,"OUTREACH COMMUNITY HEALTH CENTERS, INC.",1932357126,Dental Providers,1730 S 13th St,,Milwaukee,WI,53204-3201,Milwaukee,711 W. Capitol Drive,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011936,"Outreach Community Health Centers, Incorporated","OUTREACH COMMUNITY HEALTH CENTERS, INC.",1932357126,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",210 W Capitol Dr,,Milwaukee,WI,53212-1123,Milwaukee,711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011937,Wisconsin Avenue Health Center,"Planned Parenthood of Wisconsin, Inc.",1093989667,Family Planning Providers,2207 W Wisconsin Ave,,Milwaukee,WI,53233-1923,Milwaukee,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011938,Ascension Columbia St Mary's Hospital Milwaukee,Ascension Wisconsin,1871656082,Inpatient Hospitals (other than children's hospitals),2323 N Lake Dr,,Milwaukee,WI,53211-4508,Milwaukee,400 West River Woods Parkway,,Milwaukee,WI,53212,Milwaukee,Michael Ballinger,Dir. Managed Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011939,MLK Heritage Health Center,"Milwaukee Health Services, Inc.",1518005818,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",2555 N Dr Martin Luther King Dr,,Milwaukee,WI,53212-2709,Milwaukee,2555 N. MLK Drive,,Milwaukee,WI,53212,Milwaukee,Michele M. Grant,Chief Operating Officer,414-372-8080,2026,mgrant@mhsi.org,"Tito Izasrd, MD",President/CEO,414-372-8080,2021,tizard@mhsi.org,
WI-011940,Children's Hospital of Wisconsin - Dental Center (Next Door),Children's Hospital of Wisconsin,1750482022,Dental Providers,2561 N 29th St,Suite 101,Milwaukee,WI,53210-3116,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org/
WI-011941,16TH ST COMM HLTH CTR - PARKWAY,"16TH STREET COMMUNITY HEALTH CENTER, INC.",1518092410,"Federally Qualified Health Centers - Medical Services, Ryan White Providers",2906 S 20th St,,Milwaukee,WI,53215-3732,Milwaukee,1337 S Cesar E Chavez Dr,,Milwaukee,WI,53204-2712,Milwaukee,Wina M Zorro,Director: Grants and Program Development,414-672-1315,,wina.zorro@sschc.org,Wina M Zorro,Director: Grants and Program Deveopment,414-385-3741,,wina.zorro@sschc.org,
WI-011942,FPHS Keenan Health Center,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",3200 N 36th St,,Milwaukee,WI,53216-3716,Milwaukee,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-011943,Ascension St Francis Hospital,Ascension Wisconsin,1225087190,Inpatient Hospitals (other than children's hospitals),3237 S 16th St,,Milwaukee,WI,53215-4526,Milwaukee,400 West River Woods Parkway,,Milwaukee,WI,53215,Milwaukee,Michael Ballinger,Director Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011944,Children's Hospital of Wisconsin - Greenfield Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,3365 S 103rd St,,Milwaukee,WI,53227-4161,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011945,Lisbon Avenue Health Center,"Progressive Community Health Centers, Inc.",1720153653,"Dental Providers, Federally Qualified Health Centers - Medical Services",3522 W Lisbon Ave,,Milwaukee,WI,53208-1953,Milwaukee,3522 W Lisbon Avenue,,Milwaukee,WI,53208,Milwaukee,Jenni Sevenich,CEO,414-934-9465,,jenni.sevenich@progressivechc.org,Candice Cole,CFO,414-935-8000,433,candice.cole@progressivechc.org,
WI-011946,Water Street Health Center,"Planned Parenthood of Wisconsin, Inc.",1407021900,Family Planning Providers,435 S Water St,,Milwaukee,WI,53204-1645,Milwaukee,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011947,Ascension SE Wisconsin Hospital,Ascension Wisconsin,1427007384,Inpatient Hospitals (other than children's hospitals),5000 W Chambers St,,Milwaukee,WI,53210-1650,Milwaukee,400 West River Woods Parkway,,Milwaukee,WI,53212,Milwaukee,Michael Ballinger,Director-Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011948,Northwest Health Center,"Planned Parenthood of Wisconsin, Inc.",1780859280,Family Planning Providers,5380 W Fond du Lac Ave,,Milwaukee,WI,53216-1366,Milwaukee,302 N. Jackson Street,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011949,Children's Hospital of Wisconsin Milwaukee Child Advocacy Center,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,619 W Walnut St,,Milwaukee,WI,53212-3839,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011950,"BloodCenter of Wisconsin, Inc.","BloodCenter of Wisconsin, Inc.",1124098330,Hemophilia Treatment Centers,638 N 18th St,,Milwaukee,WI,53233-2121,Milwaukee,638 N. 18th St.,,Milwaukee,WI,53233,Milwaukee,Ralph Woods,Program Director,414-937-6123,,ralph.woods@bcw.edu,Tiffini Mueller,"Manager, Comprehensive Center for Bleeding Disorders",414-937-6578,,tiffini.mueller@bcw.edu,www.bcw.edu
WI-011951,"Outreach Community Health Centers, Incorporated","OUTREACH COMMUNITY HEALTH CENTERS, INC.",1710032669,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,711 W Capitol Dr,,Milwaukee,WI,53206-3328,Milwaukee,William Jenkins,President & CEO,414-906-5306,2302,billj@orchc-milw.org,Tangela Poole,CFO,414-727-6320,2208,tangelap@orchc-milw.org,www.ochc-milw.org
WI-011952,16th St Comm Hlth Cntr-UCC Senior Center,"16TH STREET COMMUNITY HEALTH CENTER, INC.",1649559642,Federally Qualified Health Centers - Medical Services,730 W Washington St,,Milwaukee,WI,53204-2310,Milwaukee,1337 S Cesar E Chavez Dr,,Milwaukee,WI,53204-2712,Milwaukee,Wina M Zorro,Director: Grants and Program Development,414-672-1315,,wina.zorro@sschc.org,Wina M Zorro,Director: Grants and Program Development,414-385-3741,,wina.zorro@sschc.org,
WI-011953,Capitol Drive Health Center,"Planned Parenthood of Wisconsin, Inc.",1578738084,Family Planning Providers,801 E Capitol Dr Stop 3,,Milwaukee,WI,53212-1300,Milwaukee,302 N Jackson St,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Finacial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011954,"AIDS Resource Center of Wisconsin, Inc. - Milwaukee",AIDS Resource Center of Wisconsin,1982654091,Ryan White Providers,820 N Plankinton Ave,,Milwaukee,WI,53203-1802,Milwaukee,820 N Plankinton Avenue,,Milwaukee,WI,53203-1802,Milwaukee,Brian Vandenheuvel,Director of Healthcare Revenue,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,www.arcw.org
WI-011955,Isaac Coggs Heritage Health Center,"Milwaukee Health Services, Inc.",1518005818,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers",8200 W Silver Spring Dr,,Milwaukee,WI,53218-2552,Milwaukee,8200 W. Silver Spring Dr,,Milwaukee,WI,53210,Milwaukee,Michele M. Grant,Chief Operating Officer,414-372-8080,2026,mgrant@mhsi.org,"Tito Izard, MD",President/CEO,414-372-8080,2021,tizard@mhsi.org,
WI-011956,Children's Hospital of Wisconsin (children's inpatient hospital),Children's Hospital of Wisconsin,1750482022,Children's Hospitals (inpatient only),9000 W Wisconsin Ave,,Milwaukee,WI,53226-4874,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org/
WI-011957,Children's Hospital of Wisconsin (dental provider),Children's Hospital of Wisconsin,1750482022,Dental Providers,9000 W Wisconsin Ave,,Milwaukee,WI,53226-4874,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org/
WI-011958,Children's Hospital of Wisconsin (outpatient hospital clinics),Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,9000 W Wisconsin Ave,,Milwaukee,WI,53226-4874,Milwaukee,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org/
WI-011959,FROEDTERT MEMORIAL LUTHERAN HOSPITAL,Froedtert Health,1255334173,Inpatient Hospitals (other than children's hospitals),9200 W Wisconsin Ave,,Milwaukee,WI,53226-3522,Milwaukee,9200 W. Wisconsin Ave,,Milwauke,WI,53226,Milwaukee,Paul Spencer,VP Managed Care & Revenue Cycle,800-272-3666,,paul.spencer@froedtert.com,Catherine Eastham,Sr VP and General Counsel,800-272-3666,,catherine.eastham@froedtert.com,www.froedtert.com
WI-011960,"Gerald L. Ignace Indian Health Center, Inc. (Milwaukee, WI)","Gerald L. Ignace Indian Health Center, Inc. (Milwaukee, WI)",1023064086,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers, Urban Indian Health Program",930 W Historic Mitchell St,,Milwaukee,WI,53204-3533,Milwaukee,930 W. Historic Mitchell Street,,Milwaukee,WI,53204,Milwaukee,"Lyle Ignace, MD",Executive Director,414-383-9526,5000,lignace@gliihc.net,Mitra Searcy,Operations Manager,414-383-9526,5014,msearcy@gliihc.net,www.gliihc.net
WI-011961,12th Street Urgent Care,Progressive Community Health Centers,1023484961,Federally Qualified Health Centers - Medical Services,945 N 12th St,,Milwaukee,WI,53233-1305,Milwaukee,3522 W. Lisbon Avenue,,Milwaukee,WI,53208,Milwaukee,Jenni Sevenich,CEO,414-934-9465,,jenni.sevenich@progressivechc.org,Candice Cole,CFO,414-882-2030,,candice.cole@progressivechc.org,
WI-011962,Wisconsin HIV Primary Care Support Network - Milwaukee,Medical College of Wisconsin,1053365866,Ryan White Providers,999 N 92nd St,Childrens Corporate Center,Milwaukee,WI,53226-4875,Milwaukee,8701 Watertown Plank Road,,MIlwaukee,WI,53226,Milwaukee,Janice R Hand,Network Program Director,414-337-7076,,jhand@mcw.edu,"Peter L Havens, MD",Network Medical Director,414-337-7072,,phavens@mcw.edu,
WI-011963,Marshfield Clinic Minocqua Center,"MCHS Hospitals, Inc.",1750934493,Rural Health Clinics,9601 Townline Rd,,Minocqua,WI,54548-9099,Oneida,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Minocqua%20Center
WI-012430,FHC Minocqua AODA Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Medical Services,9792 State Highway 70,,Minocqua,WI,54548-8747,Oneida,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Minocqua%20Alcohol%20and%20Drug%20Recovery%20Center
WI-011964,NorthLakes- Minong,Lakes Community Health Center,1811178825,"Federally Qualified Health Centers - Medical Services, Other ECP Providers",600 W Shell Creek Rd,,Minong,WI,54859-9302,Washburn,7665 US Hwy 2,,Iron River,WI,54847,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assistant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-011965,Mayo Clinic Health System - Oakridge Mondovi,"Mayo Clinic Health System - Oakridge, Inc",1912958026,Outpatient Hospital Clinics,700 Buffalo St,,Mondovi,WI,54755-1371,Buffalo,PO Box 70,,Osseo,WI,54758,Trempealeau,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011966,SWCAP Neighborhood Health Partners- Monroe,SWCAP Neighborhood Health Partners,1679572788,Family Planning Providers,1017 17th St,,Monroe,WI,53566-2351,Green,5 West Mineral St,PO Box 704,Platteville,WI,53818,Grant,Jacquelyne Bodden,Program Director/ Nurse Practitioner,608-348-9766,506,j.bodden@swcap.org,Trisha Farrey,Administrative Assistant 3,608-348-9766,501,t.farrey@swcap.org,www.swnhp.org
WI-011967,Upland Hills Health Clinic - Montfort,Upland Hills Health,1679821839,Rural Health Clinics,202 W US Highway 18,,Montfort,WI,53569-9452,Grant,800 Compassion Way,,Dodgeville,WI,53533,Iowa,A Karl Pustina,VP of Finance,608-930-7200,4102,pustinak@uplandhillshealth.org,Patty Ramsden,Clinic Manager,608-943-6308,,ramsdenp@uplandhillshealth.org,www.uplandhillshealth.org
WI-011968,Marshfield Clinic Mosinee Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,390 Orbiting Dr,,Mosinee,WI,54455-1763,Marathon,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Mosinee%20Center
WI-011969,Ascension All Saints Hospital,Ascension Wisconsin,1639123284,Inpatient Hospitals (other than children's hospitals),3801 Spring St,,Mount Pleasant,WI,53405-1667,Racine,400 West River Woods Parkway,,Milwaukee,WI,53212,Milwaukee,Michael Ballinger,Director-Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-011970,Children's Hospital of Wisconsin-Racine County Child Advocacy Center,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,8800 Washington Ave,,Mount Pleasant,WI,53406-3701,Racine,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011971,HSHS St Clare Memorial Hospital Mountain Health Center,HSHS St Clare Memorial Hospital,1568552958,Rural Health Clinics,14353 Hwy 32/64,,Mountain,WI,54149,Oconto,855 S Main Street,,Oconto Falls,WI,54154,Oconto,Nicole Stapleton,Director of Clinic Services,920-848-6380,36380,nicole.stapleton@hshs.org,,,,,,
WI-011972,Muscoda Health Center,"The Richland Hospital, Inc.",1437141710,Rural Health Clinics,1075 N Wisconsin Ave,,Muscoda,WI,53573-9116,Grant,333 E 2nd Street,,Richland Center,WI,53581,Richland,Karen Traynor,Chief Financial Officer,608-647-6321,2205,karen.traynor@richlandhospital.com,Bruce Roesler,Chief Executive Officer,608-647-6321,2200,bruce.roesler@richlandhospital.com,http://www.richlandhospital.com/
WI-011973,Gundersen Muscoda Clinic,Gundersen Boscobel Area Hospital and Clinics,1255620613,Rural Health Clinics,525 N Wisconsin Ave,,Muscoda,WI,53573-9251,Grant,Gundersen Boscobel Area Hospital and Clinics,205 Parker Street,Boscobel,WI,53805,Grant,David Hartberg,CEO,608-375-4112,6400663765,djhartbe@gundersenhealth.org,David Hartberg,CEO,608-375-4112,63765,djhartbe@gundersenhealth.org,
WI-011974,NECEDAH FAMILY MEDICAL CTR,Mile Bluff Medical Center,1447397492,Rural Health Clinics,1408 Wheelihan Ave,,Necedah,WI,54646-8253,Juneau,1050 Division St,,Mauston,WI,53948,Juneau,Francis J Fish,CFO,608-847-6161,,jfish@milebluff.com,James OKeefe,CEO,608-847-6161,,jokeefe@milebluff.com,milebluff.com
WI-011975,Children's Hospital of Wisconsin Fox Valley,Children's Hospital of Wisconsin,1881780302,Children's Hospitals (inpatient only),130 2nd St,West Pavilion,Neenah,WI,54956-2883,Winnebago,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011976,Children's Hospital of Wisconsin Fox Valley (outpatient hospital clinics),Children's Hospital of Wisconsin,1881780302,Outpatient Hospital Clinics,130 2nd St,West Pavilion,Neenah,WI,54956-2883,Winnebago,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011978,Marshfield Clinic Neillsville Center,"MCHS Hospitals, Inc.",1619966793,Rural Health Clinics,216 Sunset Pl,,Neillsville,WI,54456-1706,Clark,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,http://memorialmedcenter.org/clinics/neillsville-clinic/
WI-011977,Marshfield Medical Center - Neillsville,"MCHS Hospitals, Inc.",1346239373,Inpatient Hospitals (other than children's hospitals),216 Sunset Pl,,Neillsville,WI,54456-1706,Clark,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,http://memorialmedcenter.org/
WI-011979,Clark County Health Department,Clark County Health Department,1679617831,"Family Planning Providers, Sexually Transmitted Disease Clinics",517 Court St,Rm 105,Neillsville,WI,54456-1982,Clark,517 Court Street,Room 105,Neillsville,WI,54456,Clark,Kelsey Lynn,Public Health Nurse,715-743-5105,,kelsey.lynn@co.clark.wi.us,,,,,,
WI-011980,FHC Neillsville Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,8 Boon Blvd,,Neillsville,WI,54456-2176,Clark,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Neillsville%20Dental%20Center
WI-011981,Children's Hospital of Wisconsin - New Berlin Clinic,Children's Hospital of Wisconsin,1750482022,Outpatient Hospital Clinics,4855 S Moorland Rd,,New Berlin,WI,53151-7494,Waukesha,9000 W. Wisconsin Avenue,,Milwaukee,WI,53226-4874,Milwaukee,Catherine Burns,Vice President Network Strategy & Dev,414-266-3066,,cburns2@chw.org,Julie Sperka,Director Revenue Integrity,414-266-6225,,jsperka@chw.org,http://www.chw.org
WI-011982,NEW LISBON FAMILY MEDICAL CTR,Mile Bluff Medical Center,1104162841,Rural Health Clinics,901 W Bridge St,,New Lisbon,WI,53950-1083,Juneau,1050 Division St,,Mauston,WI,53948,Juneau,Francis J Fish,CFO,608-847-6161,,jfish@milebluff.com,James OKeefe,CEO,608-847-6161,,jokeefe@milebluff.com,milebluff.com
WI-011983,ThedaCare Medical Center-New London,ThedaCare Medical Center,1538127220,Inpatient Hospitals (other than children's hospitals),1405 Mill St,,New London,WI,54961-2155,Outagamie,1405 Mill Street,,New London,WI,54961,Outagamie,William A. Schmidt,President,920-531-2090,,bill.schmidt@thedacare.org,Barbara Neumann,Quality Coordinator,920-531-2065,,barbara.neumann@thedacare.org,
WI-011984,St. Croix County Reproductive Health,ST. CROIX COUNTY HEALTH DEPT,1780804039,"Family Planning Providers, Sexually Transmitted Disease Clinics",1752 Dorset Ln,St. Croix County Services Center,New Richmond,WI,54017-2452,Saint Croix,1752 Dorset Lane,,New Richmond,WI,54017,Saint Croix,Deborah Lindemann,Health Officer/PH Coordinator,715-246-8363,,Deb.Lindemann@co.saint-croix.wi.us,Roxanne Croes,Program Support Specialist,715-246-8365,,Roxanne.Croes@co.saint-croix.wi.us,http://www.co.saint-croix.wi.us/publichealth
WI-011985,SCENIC BLUFFS CHC-NORWALK,"Scenic Bluffs Health Center, Inc",1588639736,Federally Qualified Health Centers - Medical Services,200 W North St,,Norwalk,WI,54648,Monroe,238 Front St,,Cashton,WI,54619-2002,Monroe,Mari Freiberg,CEO,608-654-5100,270,mfreiberg@scenicbluffs.org,Sheryl Robinson,CFO,608-654-5100,267,sbarker@scenicbluffs.org,scenicbluffs.org
WI-011986,Oconto Clinic,NEWCAP Community Health,1487772836,"Family Planning Providers, Sexually Transmitted Disease Clinics",1201 Main St,,Oconto,WI,54153-1541,Oconto,1201 Main Street,,Oconto,WI,54153-1541,Oconto,Cheryl Detrick,CEO,920-834-4621,1137,cheryldetrick@newcap.org,V. Jane Muhl,Interim Director,920-373-8187,,janemuhl@newcap.org,www.newcap.org
WI-011987,Bellin Health Oconto Hospital & Clinic (inpatient hospital),"Oconto Hospital & Medical Center, Inc. d/b/a Bellin Health Oconto Hospital & Clinic",1609018589,Inpatient Hospitals (other than children's hospitals),820 Arbutus Ave,,Oconto,WI,54153-2004,Oconto,744 S Webster Avenue,,Green Bay,WI,54301,Brown,James Dietsche,CFO,920-433-3796,,james.dietsche@bellin.org,,,,,,www.bellin.org
WI-011988,Bellin Health Oconto Hospital & Clinic (rural health clinics),"Oconto Hospital & Medical Center, Inc. d/b/a Bellin Health Oconto Hospital & Clinic",1609018589,Rural Health Clinics,820 Arbutus Ave,,Oconto,WI,54153-2004,Oconto,744 S Webster Avenue,,Green Bay,WI,54301,Brown,James Dietsche,CFO,920-433-3796,,james.dietsche@bellin.org,,,,,,www.bellin.org
WI-011989,Northern Health Centers Inc.,"NORTHERN HEALTH CENTERS, INC.",1699778233,Dental Providers,820 Arbutus Ave,,Oconto,WI,54153-2004,Oconto,820 Arbutus,,Oconto,WI,54153,Oconto,Michele White,CEO,920-834-4621,1119,shellyw@nhcmedden.com,Holly Liptack,CFO,715-276-6321,224,hollyl@nhcmedden.com,www.nhcmedden.com
WI-011990,Bellin Health Oconto Falls,Bellin Memorial,1285696963,Rural Health Clinics,107 E Highland Dr,,Oconto Falls,WI,54154-1002,Oconto,744 S Webster Ave,PO Box 23400,Green Bay,WI,54305-3400,Brown,Michelle Conard,TEAM LEADER BMH MANAGED CARE,920-445-7217,,Michelle.Conard@bellin.org,,,,,,
WI-011991,HSHS St Clare Memorial Hospital Oconto Falls Health Center,HSHS St Clare Memorial Hospital,1467583096,Rural Health Clinics,835 S Main St,,Oconto Falls,WI,54154-1282,Oconto,855 S Main Street,,Oconto Falls,WI,54154,Oconto,Nicole Stapleton,Director of Clinic Services,920-848-6380,36380,nicole.stapleton@hshs.org,,,,,,
WI-011992,HSHS St. Clare Memorial Hospital,"St. Clare Memorial Hospital, Inc.",1851477913,Inpatient Hospitals (other than children's hospitals),855 S Main St,,Oconto Falls,WI,54154-1241,Oconto,855 S. Main St,,Oconto Falls,WI,54154,Oconto,Michele Miller-Campbell,Director,920-848-6311,,michele.miller-campbell@hshs.org,Karen Christel,Director of Managed Care,,,karen.christel@hshs.org,
WI-011993,Oregon Rehabilitation and Sports Medicine and Urgent Care Clinic,Stoughton Hospital Association,1679558647,Outpatient Hospital Clinics,990 Janesville St Unit 1,,Oregon,WI,53575-2955,Dane,900 Ridge Street,,Stoughton,WI,53589,Dane,Michelle Abey,Director of Finance,608-873-2267,,mabey@stohosp.com,Karen Myers,Chief Financial Officer,608-873-2247,,kmyers@stohosp.com,www.stoughtonhospital.com
WI-011994,LADD MEMORIAL HOSPITAL (inpatient hospital),Ladd Memorial Hospital DBA Osceola Medical Center,1467560227,Inpatient Hospitals (other than children's hospitals),2600 65th Ave,,Osceola,WI,54020-4370,Polk,2600 65th Ave,,Osceola,WI,54020,Polk,Heather A Peterkin,CFO,715-294-2111,4519,heather.peterkin@myomc.org,Kyle Palmer,Accountant,715-294-2111,,kyle.palmer@myomc.org,myomc.org
WI-011995,LADD MEMORIAL HOSPITAL (multiple outpatient ECP categories),Ladd Memorial Hospital DBA Osceola Medical Center,1467560227,"Dental Providers, Rural Health Clinics",2600 65th Ave,,Osceola,WI,54020-4370,Polk,2600 65th Ave,,Osceola,WI,54020,Polk,Heather A Peterkin,CFO,715-294-2111,4519,heather.peterkin@myomc.org,Kyle Palmer,Accountant,715-294-2111,,kyle.palmer@myomc.org,myomc.org
WI-011996,Partnership Community Dental Center,"PARTNERSHIP COMMUNITY HEALTH CENTER, INC.",1225074008,Dental Providers,2310 Westowne Ave,,Oshkosh,WI,54904-7778,Winnebago,5337 W Grande Market Dr,,Appleton,WI,54913-8442,Outagamie,Kristene S Stacker,CEO,920-750-6512,,kristene.stacker@thedacare.org,,,,,,https://www.partnershipchc.org/locations-hours/
WI-011997,Oshkosh Health Center,"Planned Parenthood of Wisconsin, Inc.",1982878518,Family Planning Providers,378 S Koeller St,,Oshkosh,WI,54902-5546,Winnebago,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-011998,"Mayo Clinic Health System - Oakridge, Inc.","Mayo Clinic Health System - Oakridge, Inc.",1912958026,Inpatient Hospitals (other than children's hospitals),13025 8th St,,Osseo,WI,54758-7634,Trempealeau,PO Box 70,,Osseo,WI,54758,Trempealeau,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-011999,Mayo Clinic Health System - Oakridge Osseo,"Mayo Clinic Health System - Oakridge, Inc",1912958026,Outpatient Hospital Clinics,13025 8th St,,Osseo,WI,54758-7634,Trempealeau,PO Box 70,,Osseo,WI,54758,Trempealeau,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-012000,Ascension Our Lady of Victory at Owen,Ascension Wisconsin,1700866399,Rural Health Clinics,6 Johnson St,,Owen,WI,54460-9534,Clark,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. of Man. Care Contracring,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012001,Marshfield Clinic Park Falls Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,50 Sherry Ave,,Park Falls,WI,54552-1467,Price,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Park%20Falls%20Center
WI-012002,FHC Park Falls Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,75 Sherry Ave,,Park Falls,WI,54552-1468,Price,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Park%20Falls%20Dental%20Center
WI-012003,Flambeau Hospital,Flambeau Hospital,1700963048,Inpatient Hospitals (other than children's hospitals),98 Sherry Ave,,Park Falls,WI,54552-1467,Price,98 Sherry Ave,,Park Falls,WI,54552,Price,Thomas William Kaster,Director of Quality and Financial Oversight,715-762-7505,,kaster.thomas@marshfieldclinic.org,,,,,,http://ministryhealth.org/FH/home.nws
WI-012004,Price County Health and Human Services,PRICE COUNTY HEALTH DEPARTMENT,1902028541,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",104 S Eyder Ave,,Phillips,WI,54555-1342,Price,104 S. Eyder,PO Box 88,Phillips,WI,54555,Price,Michelle Edwards,Health Officer/Public Health Supervisor,715-339-3054,5310,michelle.edwards@co.price.wi.us,Keri Nelson,Program Coordinator,715-339-3054,5322,keri.nelson@co.price.wi.us,https://co.price.wi.us/190/Health-Human-Services
WI-012005,Marshfield Clinic Phillips Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,104 Trinity Dr,,Phillips,WI,54555-1524,Price,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Phillips%20Center
WI-012006,ASPIRUS PHILLIPS CLINIC,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1891971768,Rural Health Clinics,625 Peterson Ave,,Phillips,WI,54555-1452,Price,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-012007,Plain Clinic,"Sauk Prairie Memorial Hospital, Inc.",1134194004,Ryan White Providers,825 Main St,,Plain,WI,53577-9668,Sauk,260 26th Street,,Prairie du Sac,WI,53578,Sauk,Carol J May,VP/CFO,608-643-7173,,carol.may@saukprairiehealthcare.org,Nadia Hookham,Clinic Operations-Priimary Care Svc Director,608-643-7625,,nadia.hookham@saukprairiehealthcare.org,www.saukprairiehealthcare.org
WI-012008,SOUTHWEST BEHAVIORAL SERVICES,SOUTHWEST HEALTH,1548345150,Inpatient Hospitals (other than children's hospitals),1185 N Elm St,,Platteville,WI,53818-1207,Grant,1400 Eastside Rd,,Platteville,WI,53818,Grant,Jesse Sookochoff,CFO,608-342-4705,,sookochoff@southwesthealth.org,,,,,,www.southwesthealth.org
WI-012009,Southwest Health Center,SOUTHWEST HEALTH,1831279793,Inpatient Hospitals (other than children's hospitals),1400 Eastside Rd,,Platteville,WI,53818-9800,Grant,1400 Eastside Rd,,Platteville,WI,53818,Grant,Jesse Sookochoff,CFO,608-342-4705,,sookochoff@southwesthealth.org,,,,,,www.southwesthealth.org
WI-012010,SOUTHWEST HEALTH PLATTEVILLE CLINIC,SOUTHWEST HEALTH,1669871620,Rural Health Clinics,1450 Eastside Rd,,Platteville,WI,53818-9800,Grant,1400 Eastside Road,,Platteville,WI,53818-9800,Grant,Jesse William Sookochoff,CFO,608-342-4705,,sookochoff@southwesthealth.org,,,,,,
WI-012011,SWCAP Neighborhood Health Partners-Platteville,SWCAP Neighborhood Health Partners,1679572788,Family Planning Providers,5 West Mineral St,PO Box 704,Platteville,WI,53818-0704,Grant,5 West Mineral St,PO Box 704,Platteville,WI,53818,Grant,Jacquelyne Bodden,Program Director/Nurse Practitioner,608-348-9766,506,j.bodden@swcap.org,Trisha Farrey,Administrative Assistant 3,608-348-9766,501,t.farrey@swcap.org,www.swnhp.org
WI-012012,Portage Health Center,"Planned Parenthood of Wisconsin, Inc.",1871767400,Family Planning Providers,132 W Cook St,,Portage,WI,53901-2104,Columbia,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012013,Divine Savior Healthcare,"Divine Savior Healthcare, Inc.",1124083894,Inpatient Hospitals (other than children's hospitals),2817 New Pinery Rd,Suite 202,Portage,WI,53901-9296,Columbia,2817 New Pinery Road,,Portage,WI,53901,Columbia,Marlin Nelson,VP of Finance,608-745-5610,,mdnelson@dshealthcare.com,Jennifer Fitzpatrick,Director of Finance,608-745-5655,,jfitzpat@dshealthcare.com,
WI-012014,Crossing Rivers Health Clinic - Prairie du Chien,"Prairie du Chien Memorial Hospital Association, Inc. dba Crossing Rivers Health",1659709830,"Other ECP Providers, Outpatient Hospital Clinics",37822 US Highway 18,,Prairie du Chien,WI,53821-8416,Crawford,37868 US Hwy 18,,Prairie du Chien,WI,53821,Crawford,William Sexton,Chief Executive Officer,608-357-2236,,william.sexton@crossingrivers.org,Dave Breitbach,Chief Financial Officer,608-357-2405,,dave.breitbach@crossingrivers.org,
WI-012015,Crossing Rivers Health Medical Center,"Prairie du Chien Memorial Hospital Association, Inc. dba Crossing Rivers Health",1619024197,Inpatient Hospitals (other than children's hospitals),37868 US Highway 18,,Prairie du Chien,WI,53821-8416,Crawford,37868 US Hwy 18,,Prairie du Chien,WI,53821,Crawford,William Sexton,Chief Executive Officer,608-357-2236,,william.sexton@crossingrivers.org,Dave Breitbach,Chief Financial Officer,608-357-2405,,dave.breitbach@crossingrivers.org,
WI-012016,Crossing Rivers Health Center for Behavioral Health,"Prairie du Chien Memorial Hospital Association, Inc. dba Crossing Rivers Health",1659709830,"Other ECP Providers, Outpatient Hospital Clinics",705 S Buchanan St,,Prairie du Chien,WI,53821-2344,Crawford,37868 US Hwy. 18,,Prairie du Chien,WI,53821,Crawford,William Sexton,Chief Executive Officer,608-357-2236,,william.sexton@crossingrivers.org,Dave Breitbach,Chief Financial Officer,608-357-2405,,dave.breitbach@crossingrivers.org,
WI-012017,ASPIRUS PRENTICE CLINIC,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1710066584,Rural Health Clinics,1511 Railroad Ave,,Prentice,WI,54556-1155,Price,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-012018,Racine Health Center,"Planned Parenthood of Wisconsin, Inc.",1295909836,Family Planning Providers,834 Main St,,Racine,WI,53403-1523,Racine,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012019,REEDSBURG AREA MEDICAL CTR,REEDBURG AREA MEDICAL CENTER,1891796710,Inpatient Hospitals (other than children's hospitals),2000 N Dewey Ave,,Reedsburg,WI,53959-1049,Sauk,2000 N Dewey Ave,,Reedsburg,WI,53959-1049,Sauk,Marianne Baumgarten,Director of Business Office,608-768-6232,,mbaumgartern@ramchealth.org,,,,,,www.ramchealth.com
WI-012020,Reproductive Health Clinic,ONEIDA COUNTY HEALTH DEPARTMENT,1225175128,"Family Planning Providers, Sexually Transmitted Disease Clinics",100 W Keenan St,,Rhinelander,WI,54501-3365,Oneida,100 W. Keenan Street,,Rhinelander,WI,54501-3365,Oneida,Linda Conlon,Health Director,715-369-6111,,lconlon@co.oneida.wi.us,Anne Cirilli,Program Lead,715-369-6142,,acirilli@co.oneida.wi.us,http://oneidacountypublichealth.org
WI-012021,ASCENSION ST MARYS HOSPITAL,Ascension Wisconsin,1356391247,Inpatient Hospitals (other than children's hospitals),2251 N Shore Dr,Suite 100,Rhinelander,WI,54501-6710,Oneida,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012022,FHC Rhinelander Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,2268 N Shore Dr,,Rhinelander,WI,54501-8888,Oneida,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Rhinelander%20Dental%20Center
WI-012023,ASPIRUS RIB LAKE CLINIC,"ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC.",1265502173,Rural Health Clinics,1121 Highway 102,,Rib Lake,WI,54470,Taylor,135 SOUTH GIBSON STREET,,Medford,WI,54451,Taylor,TYLER HACK,Director of Finance,715-748-8144,,TYLER.HACK@ASPIRUS.ORG,GREG SHAW,VP OF FINANCE/CFO,715-748-8159,,GREG.SHAW@ASPIRUS.ORG,
WI-012024,Marshfield Clinic Lakewoods Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,1215 W Knapp St,,Rice Lake,WI,54868-1307,Barron,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Rice%20Lake%20Lakewoods%20Center
WI-012025,FHC Rice Lake Dental Center,"Family Health Center of Marshfield, Inc.",1437264140,Federally Qualified Health Centers - Dental Services,1501 W Stout St,,Rice Lake,WI,54868-5001,Barron,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Rice%20Lake%20Dental%20Center
WI-012026,Marshfield Medical Center - Rice Lake,"MCHS Hospitals, Inc.",1154415024,Inpatient Hospitals (other than children's hospitals),1700 W Stout St,,Rice Lake,WI,54868-5000,Barron,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/locations/centers/Rice%20Lake%20-%20Marshfield%20Medical%20Center
WI-012027,Mayo Clinic Health System - Northland Rice Lake,"Mayo Clinic Health System - Northland, Inc",1740239557,Outpatient Hospital Clinics,331 S Main St,Suite H,Rice Lake,WI,54868-2253,Barron,1222 Woodland Ave,,Barron,WI,54812,Barron,Jean Lehman,Assistant Administrator,715-597-8621,,lehman.jean@mayo.edu,Christina Gerdes,Director,608-392-9461,,gerdes.Christina1@mayo.edu,
WI-012028,Essential Health Clinic - Richland Center,Options In Reproductive Care Inc. DBA Essential Health Clinic,1326086976,"Family Planning Providers, Sexually Transmitted Disease Clinics",175 E Mill St,,Richland Center,WI,53581-2200,Richland,1201 Caledonia Street,,La Crosse,WI,54603-2514,La Crosse,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,
WI-012029,RICHLAND HOSPITAL,RICHLAND HOSPITAL,1659301273,Inpatient Hospitals (other than children's hospitals),333 E 2nd St,,Richland Center,WI,53581-1914,Richland,333 E 2nd Street,,Richland Center,WI,53581-1914,Richland,Karen Traynor,Chief Financial Officer,608-647-6321,2205,karen.traynor@richlandhospital.com,Bruce Roesler,Chief Executive Officer,608-647-6321,2200,bruce.roesler@richlandhospital.com,www.richlandhospital.com
WI-012030,Ripon Medical Center,"Agnesian HealthCare, Inc.",1053362624,Inpatient Hospitals (other than children's hospitals),845 Parkside St,,Ripon,WI,54971-8505,Fond du Lac,430 E Division Street,,Fond du Lac,WI,54935-4560,Fond Du Lac,Barb Faber,"Director, Managed Care & Professional Billing",920-926-8333,,faberb@agnesian.com,Penny Claggett,System Accreditation/Risk Management/Safety Coordinator,920-745-3363,,claggettp@agnesian.com,www.agnesian.com
WI-012031,Pierce County Reproductive Health,Pierce County Public Health Department,1952349573,"Family Planning Providers, Sexually Transmitted Disease Clinics",1234 S Wasson Ln,Suite A,River Falls,WI,54022-2741,Pierce,412 W. Kinne St.,,Ellsworth,WI,54011,Pierce,AZ SYNDER,Director Health Officer,715-273-6782,6569,AZSYNDER@CO.PIERCE.WI.US,Dianne H-Robinson,Nursing Manager,715-273-6755,6563,dhrobins@co.pierce.wi.us,www.co.pierce.wi.us
WI-012032,RIVER FALLS AREA HOSPITAL,Allina Health System,1285691725,Inpatient Hospitals (other than children's hospitals),1629 E Division St,,River Falls,WI,54022-1571,Saint Croix,2925 Chicago Ave,,Minneapolis,MN,55407,Hennepin,Bruce Craven,Contract Manager,715-307-6022,,bruce.craven@allina.com,Jon Tranby,Contract Manager,715-307-6022,,jon.tranby@allina.com,
WI-012033,St. Croix Regional Medical Center,St. Croix Regional Medical Center,1043240922,Inpatient Hospitals (other than children's hospitals),235 E State St,,Saint Croix Falls,WI,54024-4117,Polk,235 State Street,,St. Croix Falls,WI,54024,Polk,Sally Bajak,Chief Financial Officer,715-483-0556,,sally.bajak@scrmc.org,,,,,,www.scrmc.org
WI-012034,Schofield,AIDS Resource Center of Wisconsin,1770721607,"Community Mental Health Centers, Ryan White Providers",1105 Grand Ave,Suite 1,Schofield,WI,54476-1168,Marathon,820 N Plankinton Avenue,,Milwaukee,WI,53203,Milwaukee,Brian Van Den Heuvel,Director,414-225-1568,,brian.vandenheuvel@arcw.org,,,,,,
WI-012035,Lakeshore Community Health Care Medical/Behavioral Health Clinic,"LAKESHORE COMMUNITY HEALTH CARE, INC",1144698549,"Dental Providers, Federally Qualified Health Centers - Medical Services",1721 Saemann Ave,,Sheboygan,WI,53081-2342,Sheboygan,P.O. Box 959,,Sheboygan,WI,53082-0959,Sheboygan,Kristin Stearns,CEO,920-783-6633,204,kstearns@lakeshorechc.org,Marty Schaller,CFO/COO,920-783-6633,201,mschaller@lakeshorechc.org,
WI-012036,Sheboygan Health Center,"Planned Parenthood of Wisconsin, Inc.",1578737136,Family Planning Providers,5934 S Business Dr,,Sheboygan,WI,53081-8914,Sheboygan,302 N Jackson St,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012037,"Shell Lake Clinic, Ltd","Shell Lake Clinic, Ltd",1083722805,Other ECP Providers,105 4th Ave,,Shell Lake,WI,54871-4457,Washburn,"Shell Lake Clinic, Ltd",PO Box 336,Shell Lake,WI,54871,Washburn,Jodi Gregoire,CLINIC MANAGER,715-468-2711,407,jgregoire.slclinic@centurylink.net,Carrie Thompson,biller,715-468-2711,415,jgregoire.slclinic@centurylink.net,
WI-012038,"Indianhead Medical Center Shell Lake, Inc.","Indianhead Medical Center Shell Lake, Inc.",1568438125,Inpatient Hospitals (other than children's hospitals),113 4th Ave,,Shell Lake,WI,54871-4457,Washburn,113 4th Ave PO Box 300,,Shell Lake,WI,54871,Washburn,Shannon James Jack,Executive Vise President,715-468-7833,201,sjack@indianheadmedicalcenter.com,Doris Laursen,Director of Nursing,715-468-7833,201,dorisimc@yahoo.com,
WI-012039,Department of Health & Human Services,Burnett County,1598765125,"Family Planning Providers, Other ECP Providers",7410 County Road K,Suite 280,Siren,WI,54872-9070,Burnett,7410 County Road K,,Siren,WI,54872,Burnett,Judy L Cornelison,Fiscal Specialist,715-349-7600,1232,jcornelison@burnettcounty.org,Katherine M Peterson,Director,715-349-7600,1231,kmpeterson@burnettcounty.org,www.burnettcounty.com
WI-012040,Kickapoo Valley Medical Clinic-VMH,"Vernon Memorial Healthcare, Inc.",1376549824,Rural Health Clinics,102 Sunset Ave,,Soldiers Grove,WI,54655-1400,Crawford,507 S. Main St.,,Viroqua,WI,54665,Vernon,Ashley Lagerquist,Manager-Patient Accounts,608-637-4769,,alagerquist@vmh.org,Mary Koenig,CFO,608-637-4230,,mkoenig@vmh.org,vmh.org
WI-012041,Mayo Clinic Health System-Franciscan Healthcare in Sparta,"Mayo Clinic Health System-Franciscan Medical Center, Inc.",1366420788,Rural Health Clinics,310 W Main St,,Sparta,WI,54656-2170,Monroe,700 West Avenue South,,La Crosse,WI,54601,La Crosse,Justin Offord,Regulatory Specialist,507-266-4850,,offord.justin@mayo.edu,Kim Hawthorne,Administrator,608-366-5223,,hawthorne.kimberly@mayo.edu,
WI-012042,Mayo Clinic Health System-Franciscan Healthcare in Sparta,"Mayo Clinic Health System-Franciscan Medical Center, Inc.",1841278637,Inpatient Hospitals (other than children's hospitals),310 W Main St,,Sparta,WI,54656-2170,Monroe,700 West Avenue South,,La Crosse,WI,54601,La Crosse,Justin Offord,Regulatory Specialist,507-266-4850,,offord.justin@mayo.edu,Kim Hawthorne,Administrator,608-366-5223,,hawthorne.kimberly@mayo.edu,
WI-012043,Essential Health Clinic - Sparta,Options In Reproductive Care Inc. DBA Essential Health Clinic,1326086976,"Family Planning Providers, Sexually Transmitted Disease Clinics",415 W Wisconsin St,,Sparta,WI,54656-2492,Monroe,1201 Caledonia Street,,La Crosse,WI,54603-2514,La Crosse,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,
WI-012044,Gundersen Sparta Clinic,Gundersen Sparta Clinic,1467404483,"Community Mental Health Centers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics",620 Industrial Dr,,Sparta,WI,54656-4221,Monroe,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,Monroe,Kari Adank,CCO,608-782-7300,27300,questions@gundersenhealth.org,,,,,,
WI-012045,Scenic Bluffs Health Center Inc - Sparta,"Scenic Bluffs Health Center, Inc",1366844003,Federally Qualified Health Centers - Medical Services,620 Industrial Dr,,Sparta,WI,54656-4221,Monroe,238 Front St,,Cashton,WI,54619-2002,Monroe,Mari Freiberg,CEO,608-654-5100,270,mfreiberg@scenicbluffs.org,Sheryl Barker,CFO,608-654-5100,267,sbarker@scenicbluffs.org,scenicbluffs.org
WI-012046,SPOONER HEALTH SYSTEM,"Spooner Health System, Inc.",1518982628,Inpatient Hospitals (other than children's hospitals),819 Ash St,,Spooner,WI,54801-1201,Washburn,819 Ash St,,Spooner,WI,54801-1201,Washburn,Rebecca Busch,CFO,715-635-1225,,bbusch@spoonerhealthsystem.com,Glynis Evans,Director of Patient Accounts/HIS,715-635-1433,,gevans@spoonerhealthsystem.com,www.spoonerhealthsystem.com
WI-012047,Spring Green Medical Center,"The Richland Hospital, Inc.",1063404341,Rural Health Clinics,150 E Jefferson St,,Spring Green,WI,53588-8000,Sauk,333 E 2nd Street,,Richland Center,WI,53581,Richland,Karen L Traynor,Chief Financial Officer,608-647-6321,2205,karen.traynor@richlandhospital.com,Bruce Roesler,Chief Executive Officer,608-647-6321,2200,bruce.roesler@richlandhospital.com,www.richlandhospital.com
WI-012048,Upland Hills Health Clinic - Spring Green,Upland Hills Health,1265767966,Rural Health Clinics,156 W Jefferson St,,Spring Green,WI,53588-8005,Sauk,800 Compassion Way,,Dodgeville,WI,53533,Iowa,A Karl Pustina,VP of Finance,608-930-7200,4102,pustinak@uplandhillshealth.org,Patty Ramsden,Clinic Manager,608-588-2600,,ramsdenp@uplandhillshealth.org,www.uplandhillshealth.org
WI-012049,River Valley Clinic,"Sauk Prairie Memorial Hospital, Inc.",1609841568,Ryan White Providers,436 Sunrise Dr,,Spring Green,WI,53588-9286,Sauk,260 26th Street,,Prairie du Sac,WI,53588,Sauk,Carol J May,VP/CFO,608-643-7173,,carol.may@saukprairiehealthcare.org,Nadia Hookham,Clinic Operations-Primary Care Svc Director,608-643-7625,,nadia.hookham@saukprairiehealthcare.org,www.saukprairiehealthcare.org
WI-012050,Ascension Our Lady of Victory at Stanley,Ascension Wisconsin,1356311252,Rural Health Clinics,1120 Pine St,,Stanley,WI,54768-1297,Clark,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012051,Ascension Our Lady of Victory Hospital,Ascension Wisconsin,1053391730,Inpatient Hospitals (other than children's hospitals),1120 Pine St,,Stanley,WI,54768-1297,Clark,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012052,FPHS Portage County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Sexually Transmitted Disease Clinics",200 Division St,Suite K,Stevens Point,WI,54481-1843,Portage,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-012053,ASCENSION ST MICHAELS HOSPITAL,Ascension Wisconsin,1538112230,Inpatient Hospitals (other than children's hospitals),900 Illinois Ave,,Stevens Point,WI,54481-3114,Portage,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012054,STOUGHTON HOSPITAL,Stoughton Hospital Association,1679558647,Inpatient Hospitals (other than children's hospitals),900 Ridge St,,Stoughton,WI,53589-1864,Dane,900 Ridge Street,,Stoughton,WI,53589,Dane,Karen Myers,Chief Financial Officer,608-873-2247,,kmyers@stohosp.com,Michelle Abey,Director of Finance,608-873-2267,,mabey@stohosp.com,www.stoughtonhospital.com
WI-012055,FAMILY HEALTH CENTER/MARSHFIELD CLINIC-STRATFORD CENTER,FAMILY HEALTH CENTER OF A MARSHFIELD INC,1851632111,Federally Qualified Health Centers - Medical Services,101 S Wisconsin Ave,,Stratford,WI,54484-9692,Marathon,1000 N Oak Ave,,Marshfield,WI,54449-5703,Wood,Greg Nycz,Executive Director,715-387-9137,,nycz.greg@marshfieldclinic.org,Mary Dorsch,Assistant Director,715-389-4574,,dorsch.mary@marshfieldclinic.org,
WI-012431,Marshfield Clinic Stratford Center,"Family Health Center of Marshfield, Inc.",1851632111,Federally Qualified Health Centers - Medical Services,212800 Stainless Ave,,Stratford,WI,54484-4325,Marathon,1000 N Oak Ave,PO BOX 7900,Marshfield,WI,54449-7900,Wood,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.marshfieldclinic.org/Locations/Centers/Stratford%20Center
WI-012056,Door County Memorial Hospital,Door County Memorial Hospital,1093743874,Inpatient Hospitals (other than children's hospitals),323 S 18th Ave,,Sturgeon Bay,WI,54235-1401,Door,323 S. 18TH AVE,,STURGEON BAY,WI,54235,Door,Adam Gingery,Director of Finance,920-746-3743,,adam.gingery@ministryhealth.org,Brian Stephens,CFO,920-746-3737,,brian.stephens@ministryhealth.org,http://ministryhealth.org/DCMH/home.nws
WI-012057,NORTH SHORE MED CLINIC STURGEON BAY,MINISTRY DOOR COUNTY MEDICAL CENTER,1578892857,Rural Health Clinics,323 S 18th Ave,,Sturgeon Bay,WI,54235-1401,Door,323 S. 18TH AVE,,STURGEON BAY,WI,54235,Door,BRIAN STEPHENS,CHIEF FINANCIAL OFFICER,920-746-3737,,BRIAN.STEPHENS@ministryhealth.org,,,,,,
WI-012058,Sun Prairie Clinic,"Access Community Health Centers, Inc.",1417055617,Dental Providers,1270 W Main St,,Sun Prairie,WI,53590-1930,Dane,2901 W Beltline Hwy Ste 120,,Madison,WI,53713-4231,Dane,Judy Keel,Grants Manager,608-663-5109,,judy.keel@accesshealthwi.org,,,,,,
WI-012059,ESSENTIA HEALTH ST MARYS HOSPITAL OF SUPERIOR,Essentia Health,1083657886,Inpatient Hospitals (other than children's hospitals),3500 Tower Ave,,Superior,WI,54880-4491,Douglas,421 N. 6th Avenue E.,,Duluth,MN,55805,Saint Louis,Catherine VonRueden,Vice President Payor Contracting & Strategy,218-786-6611,66611,catherine.vonrueden@essentiahealth.org,Terry Jacobson,Administrator,715-817-7014,,terry.jacobson@essentiahealth.org,http://www.essentiahealth.org/Main/home.aspx
WI-012060,LAKE SUPERIOR COMMUNITY HEALTH CENTER,LAKE SUPERIOR COMMUNITY HEALTH CENTER,1578781639,"Dental Providers, Federally Qualified Health Centers - Medical Services",3600 Tower Ave,,Superior,WI,54880-5589,Douglas,4325 Grand Avenue,,Duluth,MN,55803,Saint Louis,Dayle Patterson,CEO,218-336-3580,,dpatterson@lschc.org,Mike Elling,CFO/COO,715-395-5386,,melling@lschc.org,
WI-012061,Health Care Clinic,"Douglas County Community Health Clinic, Inc",1396889259,"Family Planning Providers, Sexually Transmitted Disease Clinics",69 N 28th St E,Suite 9,Superior,WI,54880-6525,Douglas,69 N. 28th St. E.,Suite 9,Superior,WI,54880,Douglas,Hillary R Peterson,Executive Director,715-394-4117,,hpeterson@hcclinic.org,Heather Willcoxon,Patient Services Coordinator,715-394-4117,,hwillcoxon@hcclinic.org,www.hcclinic.org
WI-012062,HSHS St Clare Memorial Hospital Suring Health Center,HSHS St Clare Memorial Hospital,1750412292,Rural Health Clinics,913 Main St,,Suring,WI,54174-9012,Oconto,855 S Main Street,,Oconto Falls,WI,54154,Oconto,Nicole Stapleton,Director of Clinic Services,920-848-6380,36380,nicole.stapleton@hshs.org,,,,,,
WI-012063,Ascension Our Lady of Victory Thorp,Ascension Wisconsin,1780663989,Rural Health Clinics,704 S Clark St,,Thorp,WI,54771-7624,Clark,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012064,Gundersen Tomah Clinic,Gundersen Tomah Clinic,1497708044,"Community Mental Health Centers, Rural Health Clinics",1330 N Superior Ave,,Tomah,WI,54660-1130,Monroe,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
WI-012065,Tomah Memorial Hospital,Tomah Memorial Hospital,1184765240,Inpatient Hospitals (other than children's hospitals),321 Butts Ave,,Tomah,WI,54660-1412,Monroe,321 Butts Avenue,,Tomah,WI,54660,Monroe,Joseph Zeps,CFO,608-374-0307,,jzeps@tomahhospital.org,Philip Stuart,CEO,608-374-0301,,pstuart@tomahhospital.org,www.tomahhospital.org
WI-012066,FPHS Lincoln County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",318 N 7th St,,Tomahawk,WI,54487-1435,Lincoln,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-012067,ASCENSION SACRED HEART HOSPITAL,Ascension Wisconsin,1598715401,Inpatient Hospitals (other than children's hospitals),401 W Mohawk Dr,Suite 100,Tomahawk,WI,54487-2273,Lincoln,400 W. RIVER WOODS PARKWAY,,Glendale,WI,53212-1060,Milwaukee,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ascension.org,Tracy Litzen,Enrollment Specialist,715-361-4872,,tracy.litzen@ascension.org,
WI-012068,NorthLakes Community Clinic -Turtle Lake,Lakes Community Health Center,1811178825,"Dental Providers, Federally Qualified Health Centers - Medical Services, Other ECP Providers",212 Maple St S,,Turtle Lake,WI,54889-8003,Barron,7665 US Hwy 2,,Iron River,WI,54847,Bayfield,Jason Akl,COO,715-372-5001,1211,jakl@northlakesclinic.org,Breanna Popp,Operations Assistant,715-372-5001,1258,bpopp@northlakesclinic.org,
WI-012069,Turtle Lake Clinic,Amery Regional Medical Center,1538384466,Rural Health Clinics,550 Martin Ave W,,Turtle Lake,WI,54889-9069,Barron,265 Griffin St. East,,Amery,WI,54001,Polk,Alex Holsman,Clinic Director,715-268-0595,595,alexander.j.holsman@amerymedical.com,Sandi Reed,Vice-President of Ambulatory Operations,715-268-0304,304,sandi.m.reed@amerymedical.com,
WI-012070,Cumberland Healthcare Turtle Lake Center,"Cumberland Memorial Hospital Extended Care Unit, Inc.",1952737264,Rural Health Clinics,632 US Highway 8 W,,Turtle Lake,WI,54889-4411,Polk,1110 7th Ave,,Cumberland,WI,54829,Barron,Angela J Martens,CFO,715-822-6196,6196,amartens@cumberlandhealthcare.com,Mike Gutsch,CEO,715-822-6194,6194,mgutsch@cumberlandhealthcare.com,
WI-012071,Essential Health Clinic - Viroqua,"Options in Reproducitve Care, Inc. DBA Essential Health Clinic",1326086976,"Family Planning Providers, Sexually Transmitted Disease Clinics",210 S Main St Unit C,,Viroqua,WI,54665-1650,Vernon,1201 Caledonia Street,,La Crosse,WI,54603-2514,Vernon,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,www.essentialclinic.org
WI-012072,Gundersen Viroqua Clinic,Gundersen Viroqua Clinic,1376588376,Rural Health Clinics,407 S Main St,Suite 200,Viroqua,WI,54665-4002,Vernon,Gundersen Health System,1900 South Ave,LaCrosse,WI,54601,La Crosse,Harvey Miller,Contract Specialist,608-775-8722,58722,mchotline@gundersenhealth.org,,,,,,
WI-012073,Hirsch Clinic-VMH,"Vernon Memorial Healthcare, Inc.",1144226507,Rural Health Clinics,407 S Main St,Suite 400,Viroqua,WI,54665-4000,Vernon,507 S. Main St.,,Viroqua,WI,54665,Vernon,Ashley Lagerquist,Manager-Patient Accounts,608-637-4769,,alagerquist@vmh.org,Mary Koenig,CFO,608-637-4230,,mkoenig@vmh.org,www.vmh.org
WI-012074,Scenic Bluffs Health Center - Viroqua,"Scenic Bluffs Health Center, Inc",1255733994,Dental Providers,407 S Main St,,Viroqua,WI,54665-2100,Vernon,238 Front St,,Cashton,WI,54619,Monroe,Mari Freiberg,CEO,608-654-5100,270,mfreiberg@scenicbluffs.org,Sheryl Barker,CFO,608-654-5100,267,sbarker@scenicbluffs.org,scenicbluffs.org
WI-012075,Vernon Memorial Hospital,"Vernon Memorial Healthcare, Inc.",1497750921,Inpatient Hospitals (other than children's hospitals),507 S Main St,,Viroqua,WI,54665-2059,Vernon,507 S. Main St.,,Viroqua,WI,54665,Vernon,Ashley Lagerquist,Manager-Patient Accounts,608-637-4769,,alagerquist@vmh.org,Mary Koenig,CFO,608-637-4230,,mkoenig@vmh.org,vmh.org
WI-012076,NORTH SHORE MED CLINIC WASHINGTON ISLAND,Ministry Health Care,1174627483,Rural Health Clinics,910 Main Rd,,Washington Island,WI,54246-9004,Door,"222 W. College Ave., Suite 3B",,Appleton,WI,54911-5863,Outagamie,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,,,,,,
WI-012077,16th St Comm Hlth Ctr-Waukesha,"16TH STREET COMMUNITY HEALTH CENTER, INC.",1144593815,Federally Qualified Health Centers - Medical Services,309 E North St,,Waukesha,WI,53188-3718,Waukesha,1337 S Cesar E Chavez Dr,,Milwaukee,WI,53204-2712,Milwaukee,Wina M Zorro,Director: Grants and Program Development,414-672-1315,,wina.zorro@sschc.org,,,,,,
WI-012078,Waukesha Health Center,"Planned Parenthood of Wisconsin, Inc.",1730353392,Family Planning Providers,426 W Main St,,Waukesha,WI,53186-4636,Waukesha,302 N. Jackson Street,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012432,"BDCH, Inc. Medical Clinics - Waupun","Beaver Dam Community Hospitals, Inc.",1023187416,Outpatient Hospital Clinics,180 Gateway Dr,,Waupun,WI,53963-2276,Fond du Lac,707 S University Ave,,Beaver Dam,WI,53916-3027,Dodge,Jennifer F. Nelson,Provider Enrollment Coordinator,715-389-0785,,nelson.jennifer.f@marshfieldclinic.org,Vicki Brostowitz,Manager - Revenue Integrity Services,715-389-0609,,brostowitz.vicki@marshfieldclinc.org,https://www.bdch.com/Waupun-Clinic
WI-012080,Waupun Memorial Hospital,"Agnesian HealthCare, Inc.",1548248644,Inpatient Hospitals (other than children's hospitals),620 W Brown St,,Waupun,WI,53963-1702,Dodge,430 E Division Street,,Fond du Lac,WI,54935-4560,Fond Du Lac,Barb Faber,"Director, Managed Care & Professonal Billing",920-926-8333,,faberb@agnesian.com,Penny Claggett,System Accreditation/Risk Managment/Safety Coordinator,920-745-3363,,claggettp@agnesian.com,www.agnesian.com
WI-012081,Bridge Community Health Clinic Wausau,"PRIMARY CONNECTION HEALTHCARE, INC",1457370744,"Dental Providers, Federally Qualified Health Centers - Medical Services",1810 N 2nd St,,Wausau,WI,54403-3492,Marathon,1810 N 2nd St,,Wausau,WI,54403-3492,Marathon,Roger Rego,Co-Transitional Executive Director,715-848-4884,,rogerr@bridgeclinic.org,,,,,,
WI-012082,Family Planning Health Services Marathon,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-012083,Wausaukee Medical Center,Dickinson County Healthcare System,1699719310,Rural Health Clinics,536 Kenny Dr,,Wausaukee,WI,54177-9627,Marinette,1721 S Stephenson Ave.,,Iron Mountain,MI,49801,Dickinson,Peg Freeman,Chief Officer Physician Services,906-776-5313,,peggy.freeman@dchs.org,Kim Kowalkowski,Physician Services Manager,906-776-5437,,kim.kowalkowski@dchs.org,
WI-012084,Waushara County Health Department,Waushara County Health Department,1528232832,"Family Planning Providers, Sexually Transmitted Disease Clinics",230 Park St,,Wautoma,WI,54982-9031,Waushara,PO Box 837,,Wautoma,WI,54982,Waushara,Patti Wohlfeil,"Director, Health Officer",920-787-6544,,patti.wohlfeil@co.waushara.wi.us,Jennifer Pulvermacher,Financial Office Manager,920-787-6538,,jennifer.pulvermacher@co.waushara.wi.us,
WI-012085,FAMILY HEALTH / LA CLINICA - Wautoma,"LA CLINICA DE LOS CAMPESINOS, INC.",1790786929,"Dental Providers, Federally Qualified Health Centers - Medical Services",400 S Townline Rd,,Wautoma,WI,54982-6922,Waushara,400 S Townline Rd,,Wautoma,WI,54982-6922,Waushara,Laura Waldvogel,CEO,920-787-5514,,Laura.Waldvogel@famhealth.com,Brian Sullivan,CFO,920-787-5514,270,Laura.Waldvogel@famhealth.com,www.famhealth.com
WI-012086,Ingalls Clinic,St. Croix Regional Medical Center,1851652374,Rural Health Clinics,7456 Main St W,,Webster,WI,54893-8205,Burnett,235 State Street,,St. Croix Falls,WI,54024,Polk,Wendy Young,Vice President Clinic and Ancillary Services,715-483-0497,,wendy.young@scrmc.org,Sally Bajak,CFO,715-483-0556,,sally.bajak@scrmc.org,
WI-012087,Lincoln Plaza Health Center,"Planned Parenthood of Wisconsin, Inc.",1346414158,Family Planning Providers,2239 S 108th St,,West Allis,WI,53227-1107,Milwaukee,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012088,West Bend Health Center,"Planned Parenthood of Wisconsin, Inc.",1104090778,Family Planning Providers,532 Shepherds Dr,,West Bend,WI,53090-8488,Washington,302 N. Jackson Street,,Milwaukee,WI,53202,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012089,Bland Clinic-VMH,"Vernon Memorial Healthcare, Inc.",1215933767,Rural Health Clinics,100 Melby St,,Westby,WI,54667-1012,Vernon,507 S. Main St.,,Viroqua,WI,54665,Vernon,Ashley Lagerquist,Manager-Patient Accounts,608-637-4769,,alagerquist@vmh.org,Mary Koenig,CFO,608-637-4230,,mkoenig@vmh.org,vmh.org
WI-012090,Moundview Family Clinic at Westfield,"Moundview Memorial Hospital & Clinics, Inc",1861829194,Rural Health Clinics,207 N Pioneer Park Rd Unit 8,,Westfield,WI,53964-9092,Marquette,402 W Lake St,,Friendship,WI,53934-9699,Adams,Lori Wittig,Director of Clinic Operations,608-339-8318,,lwittig@moundview.org,Don Heinz,CEO,608-339-6814,,dheinz@moundview.org,
WI-012091,Bridge Community Health Clinic Weston,"PRIMARY CONNECTION HEALTHCARE, INC",1457370744,Federally Qualified Health Centers - Medical Services,4005 Community Center Dr,,Weston,WI,54476-4139,Marathon,1810 N 2nd St,,Wausau,WI,54403-3492,Marathon,Roger Rego,Co-Transitional Executive Director,715-848-4884,,rogerr@bridgeclinic.org,,,,,,
WI-012092,White Lake Clinic,"NORTHERN HEALTH CENTERS, INC.",1699778233,Federally Qualified Health Centers - Medical Services,524 Bissell St,,White Lake,WI,54491,Langlade,15397 State Highway 32,,Lakewood,WI,54138-9702,Langlade,Michele White,CEO,715-276-6321,229,shellyw@nhcmedden.com,Holly Liptack,CFO,715-276-6321,224,hollyl@nhcmedden.com,www.nhcmedden.com
WI-012093,Essential Health Clinic - Whitehall,Options In Reproductive Care Inc. DBA Essential Health Clinic,1326086976,"Family Planning Providers, Sexually Transmitted Disease Clinics",18520 Scranton St,,Whitehall,WI,54773-8521,Trempealeau,1201 Caledonia Street,,La Crosse,WI,54603-2514,La Crosse,Chrissy Feine,Executive Director,608-775-8383,,cmfeine@essentialclinic.org,,,,,,www.essentialclinic.org
WI-012094,TRI COUNTY MEMORIAL HOSPITAL (inpatient hospital),Gundersen Tri County Hospital,1124063573,Inpatient Hospitals (other than children's hospitals),18601 Lincoln St,,Whitehall,WI,54773-8605,Trempealeau,"Tri-County Memorial Hospital, Inc.",18601 Lincoln Street,Whitehall,WI,54773,Trempealeau,Joni D. Olson,CEO,715-538-4361,64120,BJTheile@gundersenhealth.org,,,,,,
WI-012095,TRI COUNTY MEMORIAL HOSPITAL (outpatient hospital clinics),Gundersen Tri County Hospital,1124063573,Outpatient Hospital Clinics,18601 Lincoln St,,Whitehall,WI,54773-8605,Trempealeau,"Tri-County Memorial Hospital, Inc.",18601 Lincoln Street,Whitehall,WI,54773,Trempealeau,Joni D. Olson,CEO,715-538-4361,64120,jdolson@gundersenhealth.org,,,,,,
WI-012096,Gundersen Tri County Hospital and Clinic - Whitehall,Gundersen Tri County Hospital and Clinic - Whitehall,1417201864,Rural Health Clinics,18606 Ervin St,,Whitehall,WI,54773-8613,Trempealeau,"Tri-County Memorial Hospital, Inc.",18601 Lincoln Street,Whitehall,WI,54773,Trempealeau,Joni D. Olson,CEO,715-538-4361,64120,jdolson@gundersenhealth.org,,,,,,
WI-012097,FPHS Sauk County,"FAMILY PLANNING HEALTH SERVICES, INC.",1538152491,"Family Planning Providers, Rural Health Clinics, Sexually Transmitted Disease Clinics",1425 Wisconsin Dells Pkwy,Suite 7,Wisconsin Dells,WI,53965-8308,Sauk,719 N 3rd Ave,,Wausau,WI,54401-2965,Marathon,Ruth Dayton,Finance Director,800-246-5743,1251,daytonr@fphs.org,Jessica Scharfenberg,Executive Director,800-246-5743,1250,scharfenbergj@fphs.org,
WI-012098,Wisconsin Rapids Health Center,"Planned Parenthood of Wisconsin, Inc.",1720252307,Family Planning Providers,1355 8th St S,,Wisconsin Rapids,WI,54494-5265,Wood,302 N Jackson St,,Milwaukee,WI,53202-5904,Milwaukee,Brian Tollakson,Chief Financial Officer,414-289-3728,,brian.tollakson@ppwi.org,,,,,,
WI-012099,Aspirus Riverview Clinic - Wisconsin Rapids,"Aspirus Riverview Hospital and Clinics, Inc.",1568821122,Outpatient Hospital Clinics,410 Dewey St,East Medical Building,Wisconsin Rapids,WI,54494-4715,Wood,PO Box 8080,,Wisconsin Rapids,WI,54495,Wood,Brian Schmick,Reimbursement Analyst,715-422-9331,,brian.schmick@aspirus.org,,,,,,www.aspirus.org
WI-012100,Aspirus Riverview Hospital,"Aspirus Riverview Hospital and Clinics, Inc.",1295754844,Inpatient Hospitals (other than children's hospitals),410 Dewey St,,Wisconsin Rapids,WI,54494-4715,Wood,PO Box 8080,,Wisconsin Rapids,WI,54495,Wood,Brian Schmick,Reimbursement Analyst,715-422-9331,,brian.schmick@aspirus.org,,,,,,www.aspirus.org
WI-012101,Gundersen St. Joseph's Wonewoc Clinic,"St. Joseph's Health Services, Inc",1881607463,Rural Health Clinics,301 Railroad Rd,,Wonewoc,WI,53968-9425,Juneau,Gundersen St. Joseph's Hospital and Clinics,400 Water Ave,Hillsboro,WI,54634,Vernon,Kristie McCoic,Clinical Operations Officer,608-489-8106,,kjmccoic@gundersenhealth.org,,,,,,
WI-012102,HOWARD YOUNG MEDICAL CTR,Ministry Health Care,1134183171,Inpatient Hospitals (other than children's hospitals),240 Maple St,,Woodruff,WI,54568-9190,Oneida,"222 W. College Ave., Suite 3B",,Appleton,WI,54911-5863,Outagamie,Michael S. Ballinger,Dir. - Man. Care Contracting,715-340-9699,,michael.ballinger@ministryhealth.org,,,,,,
WV-012103,Alderson Medical Center,Rainelle Medical Center,1740589746,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",101 Railroad Ave,,Alderson,WV,24910-7000,Greenbrier,176 Medical Center Drive,,Rainelle,WV,25962,Greenbrier,Sabrina McKinney,"BSN-RN, DON",304-438-6188,1041,smckinney@rmchealth.org,Joseph Godbey,BSN-RN,304-445-3140,,jgodbey@rmchealth.org,
WV-012104,Mustang Health Center,Southern WV Health System,1003274580,Federally Qualified Health Centers - Medical Services,267 Midway Rd,,Alum Creek,WV,25003-9591,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012105,Athens Medical Center,Athens Medical Center,1972610863,Rural Health Clinics,401 Vermillion St,,Athens,WV,24712,Mercer,PO Box 697,,Athens,WV,24712,Mercer,Dawn Lester,Office Manager,304-384-7325,,dawn.lester@pchonline.org,,,,,,
WV-012106,E. A. HAWSE HEALTH CENTER INC.,E A HAWSE HEALTH CENTER,1851359251,"Dental Providers, Federally Qualified Health Centers - Medical Services",17978 SR 55,,Baker,WV,26801,Hardy,45 SR 259,,Baker,WV,26801,Hardy,Gary T Johnson,CEO,304-897-5915,230,gjohnson@hawsehealth.com,,,,,,https://www.hawsehealth.com
WV-012107,Access Health Rural Acres,"COMMUNITY HEALTH SYSTEMS, INC.",1588738538,Federally Qualified Health Centers - Medical Services,252 Rural Acres Dr,,Beckley,WV,25801-3503,Raleigh,252 Rural Acres Dr,,Beckley,WV,25801-3503,Raleigh,Charles Hunt,CEO,304-252-8324,164,chunt@accesshealthwv.com,April Smith,Director of Billing,304-252-8324,175,asmith@accesshealthwv.com,
WV-012108,Belington Medical Clinic,BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION,1053347328,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",70 N Sturmer St,,Belington,WV,26250-7403,Barbour,70 N Sturmer St,,Belington,WV,26250-7403,Barbour,Connie Williams,Certified Applications Counselor,304-823-2800,146,cwilliams@bcmsa.org,,,,,,
WV-012109,Tri-State Community Health Center - Berkeley Springs,Tri-State Community Health Center,1083055081,Federally Qualified Health Centers - Medical Services,261 Berkmore Pl,Suite 1A,Berkeley Springs,WV,25411-6247,Morgan,109 Rayloc Drive,,Hancock,MD,21750,Washington,Sheila DeShong,COO,301-678-5187,226,sdeshong@tschc.com,,,,,,
WV-012110,Clay-Battelle Community Health Center,Clay-Battelle Health Services Association,1699830752,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",5861 Mason Dixon Hwy,,Blacksville,WV,26521,Monongalia,PO Box 72,,Blacksville,WV,26521,Monongalia,Janice Morris,Chief Executive Officer,304-432-8211,237,janice.morris@cbhealthwv.org,Jason Whipkey,Chief Information Officer,304-432-8211,227,jason.whipkey@cbhealthwv.org,http://cbhealthwv.org/
WV-012111,Bluestone Family Practice,"Bluestone Health Association, Inc.",1770950396,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3016 E Cumberland Rd,,Bluefield,WV,24701-4858,Mercer,3997 Beckley Road,,Princeton,WV,24740-7660,Mercer,Sharon Kay Brim,COO,304-431-5499,126,kbrim@bluestonewv.org,,,,,,
WV-012112,Mercer County Board of Health,"West Virginia Department Health and Human Resources, Family Planning Program",1861696601,Family Planning Providers,978 Blue Prince Rd,,Bluefield,WV,24701-5074,Mercer,978 Blue Prince Rd,,Bluefield,WV,24701-5074,Mercer,Ethel Yopp,Family Planning,304-356-4456,,Ethel.M.Yopp@wv.gov,,,,,,
WV-012113,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1811366248,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",501 Bomont Rd,H.E. White Elementary School Wellness Center,Bomont,WV,25030-9666,Clay,78 Queens Alley Rd.,,Rock Cave,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012114,Bradshaw Medical Clinic,Bradshaw Medical Clinic,1912963869,Rural Health Clinics,9981 Marshall Highway,,Bradshaw,WV,24817,McDowell,PO Box 240,,Bradshaw,WV,24817,Mcdowell,Jennifer Sparks,Office Manager,304-875-2302,,ymcbmc@gmail.com,Mahesh Patel,Owner,304-875-2302,,mbpatel101@gmail.com,
WV-012115,Guyan Valley Wellness Center,Southern WV Health System,1255521027,Federally Qualified Health Centers - Medical Services,5322 McClellan Hwy,,Branchland,WV,25506-8725,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephanie Belford,COO,304-824-5806,1289,Stephanie.Belford@swvhs.org,www.swvhs.org
WV-012116,Pendleton Community Care,"Pendleton Community Care, Inc",1912314667,Federally Qualified Health Centers - Medical Services,11480 Blue Gray Trail,Brandywine Elementary School Based Health Center,Brandywine,WV,26802,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012117,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1700252764,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",250 Worthington Dr,SIMPSON ELEMENTARY SCHOOL WELLNESS CENTER,Bridgeport,WV,26330-1449,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012118,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1669868931,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",413 Johnson Ave,Bridgeport Middle School Wellness Center,Bridgeport,WV,26330-1309,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012119,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1326434846,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",515 Johnson Ave,Bridgeport High School Wellness Center,Bridgeport,WV,26330-1311,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012120,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1912392358,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",531 Johnson Ave,Johnson Elementary School Wellness Center,Bridgeport,WV,26330-1311,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012121,COMMUNITY CARE OF BRIDGEPORT,COMMUNITY CARE OF WEST VIRGINIA,1619348844,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",65 Professional Pl,,Bridgeport,WV,26330-1889,Harrison,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012122,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1386083673,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Copperhead Way,Marlinton Middle School Wellness Center,Buckeye,WV,24924,Pocahontas,78 Queens Alley Rd,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012123,POCAHONTAS MEMORIAL HOSPITAL RURAL HEALTH CLINIC,Pocahontas Memorial Rural Health Clinic,1346523206,Inpatient Hospitals (other than children's hospitals),150 Duncan Rd,,Buckeye,WV,24924-9037,Pocahontas,150 Duncan Rd,,Buckeye,WV,24924-9037,Pocahontas,Rebecca Hammer,CFO,304-799-7400,1024,rhammer@pmhwv.org,Wanessa Cassell,Business Office Manager,304-799-7400,1030,wcassell@pmhwv.org,pmhwv.org
WV-012124,CARE XPRESS AND PEDIATRICS,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1255507810,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",11 N Locust St,,Buckhannon,WV,26201-2231,Upshur,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012125,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1578811857,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",16 College Ave,Buckhannon Academy Elementary School Wellness Center,Buckhannon,WV,26201-2628,Upshur,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012126,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1104177674,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",50 Bu Dr,Buckhannon-Upshur High School Wellness Center,Buckhannon,WV,26201-9689,Upshur,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012127,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1992144273,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",553 Route 20 South Rd,Buckhannon-Upshur Middle School Wellness Center,Buckhannon,WV,26201,Upshur,78 Queens Alley Rd,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012128,Community Health Center of NE Wetzel County,Clay-Battelle Health Services Association,1437214509,"Family Planning Providers, Federally Qualified Health Centers - Medical Services","Kenova, WV 25530",,Burton,WV,26562-9669,Wetzel,PO Box 72,,Blacksville,WV,26521,Monongalia,Janice Morris,Chief Executive Officer,304-432-8211,237,janice.morris@cbhealthwv.org,Jason Whipkey,Chief Information Officer,304-432-8211,227,jason.whipkey@cbhealthwv.org,http://cbhealthwv.org/
WV-012129,Camden Family Health,"Camden on Gauley Medical Center, Inc",1598749244,"Dental Providers, Federally Qualified Health Centers - Medical Services",10003 Webster Rd,,Camden on Gauley,WV,26208-7713,Webster,10003 Webster Road,,Camden on Gauley,WV,26208,Nicholas,Margaret E Groves,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-742-5725,117,mrogers@cog-wv.org,
WV-012130,Valley Health Upper Kanawha,"Valley Health Systems, Inc.",1699740472,"Black Lung Clinics, Dental Providers, Federally Qualified Health Centers - Medical Services",408 Alexander Street,,Cedar Grove,WV,25039,Kanawha,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/upper-kanawha/
WV-012131,CRHS Tiger Center for Health,Southern WV Health System,1396052528,Federally Qualified Health Centers - Medical Services,200 Vance St,,Chapmanville,WV,25508,Logan,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephanie Belford,COO,304-824-5806,1289,Stephanie.Belford@swvhs.org,www.swvhs.org
WV-012132,FamilyCare HealthCenter - Mary C. Snow West Side Elementary,"WOMENCARE, INC.",1871872184,Federally Qualified Health Centers - Medical Services,100 Florida St,,Charleston,WV,25302-1131,Kanawha,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,,,,,,www.familycarewv.org
WV-012133,FamilyCare HealthCenter - Patrick Street,"WOMENCARE, INC.",1972773224,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",116 Hills Plz,,Charleston,WV,25387-2438,Kanawha,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,Kathy Howell,Family Planning Specialist,304-356-4456,,,www.familycarewv.org
WV-012134,CAMC Memorial Hospital (inpatient hospital),Charleston Area Medical Center,1952390239,Inpatient Hospitals (other than children's hospitals),3200 Maccorkle Ave SE,,Charleston,WV,25304-1227,Kanawha,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP Finance,304-388-6251,,stephen.bell@camc.org,
WV-012135,CAMC Memorial Hospital (multiple outpatient ECP categories),Charleston Area Medical Center,1952390239,"Dental Providers, Hemophilia Treatment Centers, Outpatient Hospital Clinics, Ryan White Providers",3200 Maccorkle Ave SE,,Charleston,WV,25304-1227,Kanawha,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP Finance,304-388-6251,,stephen.bell@camc.org,
WV-012136,CAMC General Hospital,Charleston Area Medical Center,1952390239,Outpatient Hospital Clinics,501 Morris St,,Charleston,WV,25301-1326,Kanawha,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP Finance,304-388-6251,,stephen.bell@camc.org,
WV-012137,CHARLESTON AREA MEDICAL CENTER,Charleston Area Medical Center,1952390239,Inpatient Hospitals (other than children's hospitals),501 Morris St,,Charleston,WV,25301-1326,Kanawha,501 Morris St.,,Charleston,WV,25301-1326,Kanawha,Stephen Bell,VP of Finance,304-388-6265,,billy.comer@camc.org,Billy Comer,Reimbursement Manager,304-388-6265,,billy.comer@camc.org,
WV-012138,"Women's Health Center of West Virginia, Inc.","Women's Health Center of West Virginia, Inc.",1073679254,Family Planning Providers,510 Washington St W,,Charleston,WV,25302-2036,Kanawha,"510 Washington Street, West",,Charleston,WV,25302,Kanawha,Sharon Lewis,Executive Director,304-344-9841,,salewis@suddenlinkmail.com,Vania Riddle,Office Manager,304-344-9841,,vaniariddlewhc@suddenlinkmail.com,http://www.whcwva.com
WV-012139,CAMC Women and Children's Hospital (inpatient hospital),Charleston Area Medical Center,1952390239,Inpatient Hospitals (other than children's hospitals),800 Pennsylvania Ave,,Charleston,WV,25302-3351,Kanawha,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimbursement Manager,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP - Finance,304-388-6251,,stephen.bell@camc.org,
WV-012140,CAMC Women and Children's Hospital (outpatient hospital clinics),Charleston Area Medical Center,1952390239,Outpatient Hospital Clinics,800 Pennsylvania Ave,,Charleston,WV,25302-3351,Kanawha,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,,304-388-6251,,stephen.bell@camc.org,
WV-012141,FamilyCare HealthCenter - Children's Medicine Center,"WOMENCARE, INC.",1265792055,Federally Qualified Health Centers - Medical Services,800 Pennsylvania Ave,,Charleston,WV,25302-3351,Kanawha,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,,,,,,www.familycarewv.org
WV-012142,Pendleton Community Care,"Pendleton Community Care, Inc",1386051035,Federally Qualified Health Centers - Medical Services,1 School Ln,NORTH FORK ELEMENTARY SCHOOL CLINIC,Circleville,WV,26804,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012143,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1356780639,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Eagle Way,Robert C Byrd High School Wellness Center,Clarksburg,WV,26301-9784,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012144,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1194111468,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Mountaineer Dr,Liberty High School Wellness Center,Clarksburg,WV,26301-5511,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012145,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1538555891,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1040 Wilsonburg Rd,Wilsonburg Elementary School Wellness Center,Clarksburg,WV,26301-6511,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012146,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1346636792,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1400 N 19th St,North View Elementary School Wellness Center,Clarksburg,WV,26301-1644,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012147,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1851787121,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1636 W Pike St,Adamston Elementary School Wellness Center,Clarksburg,WV,26301-2361,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-881-1190,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012148,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1164809802,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",2 Mountaineer Dr,Mountaineer Middle School Wellness Center,Clarksburg,WV,26301-5511,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012149,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1619316999,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",443 Lee Ave,Washington Irving Middle School Wellness Center,Clarksburg,WV,26301-3648,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012150,Community Care of Clarksburg,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1053742668,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",700 Oakmound Rd,,Clarksburg,WV,26301-9398,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012151,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1992755789,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Panther Dr,Clay High School Wellness Center,Clay,WV,25043,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012152,Primary Care Systems,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1073562641,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",122 Center St,,Clay,WV,25043-7046,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012153,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1669422432,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",168 Church St,Clay Elementary School Wellness Center,Clay,WV,25043-9420,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012154,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1093765869,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",236 Church St,Clay Middle School Wellness Center,Clay,WV,25043-9412,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012155,Sherman Elementary Wellness Center,"Hygeia Facilities Foundation, Inc.",1669819637,Federally Qualified Health Centers - Medical Services,7487 Coal River Road,,Comfort,WV,25049,Boone,37456 Coal River Road,,Whitesville,WV,25209,Boone,Terri L Grandstaff,CFO,304-854-1323,,terri@myhygeia.org,Margaret L Martin,CEO,304-854-1323,,margmartin@frontier.com,
WV-012156,Camden Family Health,"Camden on Gauley Medical Center, Inc.",1639418361,Federally Qualified Health Centers - Medical Services,56 Park St,,Cowen,WV,26206-3302,Webster,10003 Webster Road,,Camden on Gauley,WV,26208,Webster,Margaret E Hickey,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012157,Camden Family Health,"Camden on Gauley Medical Center, Inc",1528491537,Federally Qualified Health Centers - Medical Services,1 School St,,Craigsville,WV,26205,Nicholas,10003 Webster Road,,Camden on Gauley,WV,26208,Webster,Margaret E Hickey,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012158,Camden Family Health,"Camden on Gauley Medical Center, Inc.",1215394648,Federally Qualified Health Centers - Medical Services,46 Red Oak Dr,,Craigsville,WV,26205-3102,Nicholas,10003 Webster Road,,Camden on Gauley,WV,26208,Webster,Margaret E Hickey,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012159,Southern WV Health System at Delbarton,Southern WV Health System,1033490149,Federally Qualified Health Centers - Medical Services,5027 Helena Ave,,Delbarton,WV,25670-1301,Mingo,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012160,Big Otter Elementary Wellness Center,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1619103041,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",59 Ossia Rd,,Duck,WV,25063-8500,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012161,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1043567456,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",271 Warrior Way,Pocahontas County High School Wellness Center,Dunmore,WV,24934-9048,Pocahontas,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012162,EGLON CLINIC,PRESTON TAYLOR COMMUNITY HEALTH CENTER,1538277231,Federally Qualified Health Centers - Medical Services,2604 Grange Hall Rd,,Eglon,WV,26716-8774,Preston,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012163,FamilyCare HealthCenter - Putnam Career Technical Center,"WOMENCARE, INC.",1457783367,Federally Qualified Health Centers - Medical Services,300 Roosevelt Blvd,,Eleanor,WV,25070,Putnam,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,,,,,,www.familycarewv.org
WV-012164,FamilyCare HealthCenter - Eleanor,"WOMENCARE, INC.",1255660056,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",503 Roosevelt Blvd,,Eleanor,WV,25070,Putnam,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,Kathy Howell,Family Planning Specialist,304-356-4456,,,http://www.familycarewv.org/locations_eleanor.html
WV-012165,Coplin Memorial Community Health Center,Coplin Health Systems,1518962232,"Community Mental Health Centers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",483 Court St,PO Box 609,Elizabeth,WV,26143-0609,Wirt,483 Court St,P.O> Box 609,"Elizabeth,",WV,26143,Wirt,Cheryl Davis,HR Coordinator,304-275-3301,206,cdavis@wchsa.com,Derek Snyder,CEO,304-275-3301,207,dsnyder@wchsa.com,
WV-012166,Arbor Community Health Center,"Valley Health Care, Inc.",1710270954,Federally Qualified Health Centers - Medical Services,105 Nathan St,,Elkins,WV,26241-3331,Randolph,PO BOX 247,,Mill Creek,WV,26280,Randolph,Robert Douglas Haddix,Grants Management,304-335-2050,107,haddixr@vhcwv.org,,,,,,
WV-012167,Ritchie Regional Health Center Ellenboro Campus,"Ritchie County Primary Care Association, Inc.",1518083070,Federally Qualified Health Centers - Medical Services,107 School Road,,Ellenboro,WV,26346,Ritchie,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012168,MVA Fairmont Clinic,"MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC",1770697278,Federally Qualified Health Centers - Medical Services,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,Eric Pulice,Administrator,304-367-8740,,contactus@mvahealth.org,,,,,,mvahealth.org
WV-012169,MVA Pediatric Center,"MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC",1770697278,Federally Qualified Health Centers - Medical Services,1338 Locust Ave,,Fairmont,WV,26554-1436,Marion,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,Eric Pulice,Administrator,304-367-8740,,contactus@mvahealth.org,,,,,,mvahealth.org
WV-012170,"MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC","MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC",1770697278,Federally Qualified Health Centers - Medical Services,1993 Airport Rd,East Fairmont High School,Fairmont,WV,26554-9138,Marion,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,Eric Pulice,Administrator,304-367-8740,,contactus@mvahealth.org,,,,,,https://mvahealth.org/school-based-health-care/
WV-012171,North Marion Campus Wellness Center,"MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC",1770697278,Federally Qualified Health Centers - Medical Services,1 North Marion Dr,,Farmington,WV,26571-9717,Marion,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,Eric Pulice,Administrator,304-367-8740,,contactus@mvahealth.org,,,,,,mvahealth.org
WV-012172,Valley Health Fort Gay,Valley Health Systems Inc.,1083694756,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",71 Wayne St,,Fort Gay,WV,25514-8518,Wayne,3377 US Route 60,,Huntington,WV,25514,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/fort-gay/
WV-012173,"Community Care Of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1790110047,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",HC 61 PO Box 14,Frametown Elementary School Wellness Center,Frametown,WV,26623-9802,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012174,Pendleton Community Care,"Pendleton Community Care, Inc",1205243961,Federally Qualified Health Centers - Medical Services,147 Maple Ave,PENDLETON County HIGH/MIDDLE SCHOOL CLINIC,Franklin,WV,26807,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012175,Pendleton Community Care,"Pendleton Community Care, Inc",1932516697,Federally Qualified Health Centers - Medical Services,67 S Branch St,Franklin Elementary School Based Health Clinic,Franklin,WV,26807,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012176,Pendleton Community Care,"Pendleton Community Care, Inc",1417936535,Federally Qualified Health Centers - Medical Services,82 Pine St,,Franklin,WV,26807,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012177,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1689921082,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7619 Route 20 South Rd,French Creek Elementary School Wellness Center,French Creek,WV,26218,Upshur,78 Queens Alley Rd,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012178,Valley Health Gallipolis Ferry,Valley Health Systems Inc,1194020677,Federally Qualified Health Centers - Medical Services,15167 Huntington Rd,,Gallipolis Ferry,WV,25515-6615,Mason,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/gallipolis-ferry/
WV-012179,Braxton Community Health Center,Braxton Community Health Center,1639278518,Rural Health Clinics,100 Hoylman Dr,,Gassaway,WV,26624-9318,Braxton,100 Hoylman Drive,,Gassaway,WV,26624,Braxton,Linda K Davis,Business Office Manager,304-364-1095,,linda.davis@braxtonmemorial.org,Kimber Knight,CFO,304-364-1128,,kimber.knight@braxtonmemorial.org,
WV-012180,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1447699723,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",113 5th St,Davis Elementary School Wellness Center,Gassaway,WV,26624-1224,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012181,Family Healthcare Associates,Family Healthcare Associates,1376572479,Rural Health Clinics,113 3rd Ave,,Gilbert,WV,25621,Mingo,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing manager,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012182,Southern WV Health System at Gilbert,Southern WV Health System,1942523931,Federally Qualified Health Centers - Medical Services,202 Larry Joe Harless Dr,,Gilbert,WV,25621,Mingo,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012183,TYGART VALLEY TOTAL CARE CENTER,Grafton City Hospital,1336200344,Rural Health Clinics,500 Market St,,Grafton,WV,26354-1283,Taylor,1 Hospital Plaza,,Grafton,WV,26354,Taylor,Tammy Barcus,Director of Quality & Patient Safety,304-265-0400,7156,tbarcus@graftonhospital.com,Pat Shaw,CEO,304-265-0400,7151,pshaw@graftonhospital.com,www.graftonhospital.com
WV-012184,DENTAL CENTER OF TAYLOR COUNTY,PRESTON TAYLOR COMMUNITY HEALTH CENTER,1841308541,Dental Providers,711 N Pike St,,Grafton,WV,26354-1221,Taylor,725 North Pike Street,PO Box 399,Grafton,WV,26354,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012185,MEDICAL CENTER OF TAYLOR COUNTY,"PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC",1992813604,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",725 N Pike St,,Grafton,WV,26354-1270,Taylor,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,ceo,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012186,Community Care of Green Bank,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1164557237,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",4498 Potomac Highlands Trl,,Green Bank,WV,24944,Pocahontas,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012187,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1194073486,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",5917 Potomac Highlands Trl,Green Bank Elementary-Middle School Wellness Center,Green Bank,WV,24944-9099,Pocahontas,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012188,Community Dental Care of Green Bank,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1427305911,Dental Providers,6404 Potomac Highlands Trl,,Green Bank,WV,24944,Pocahontas,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012189,Duval Yellowjacket Center for Health,Southern WV Health System,1457541229,Federally Qualified Health Centers - Medical Services,5304 Straight Frk,,Griffithsville,WV,25521-9504,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephanie Belford,COO,304-824-5806,1289,Stephanie.Belford@swvhs.org,www.swvhs.org
WV-012190,"Lincoln Primary Care Center, Inc.",Southern WV Health System,1942274543,Federally Qualified Health Centers - Medical Services,7400 Lynn Ave,,Hamlin,WV,25523-1138,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012191,LCHS Panther Center for Health,Southern WV Health System,1962583054,Federally Qualified Health Centers - Medical Services,81 Lincoln Panther Way,,Hamlin,WV,25523-1169,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012192,HARMAN HEALTH CENTER,"Pendleton Community Care, Inc",1427307222,Federally Qualified Health Centers - Medical Services,15 Mott St,,Harman,WV,26270,Randolph,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012193,Harpers Ferry Family Medicine,University Healthcare Physicians,1659625739,Ryan White Providers,171 Taylor St,,Harpers Ferry,WV,25425-3641,Jefferson,2500 Foundation Way,,Martinsburg,WV,25401,Berkeley,Aaron Henry,CFO,304-264-9202,2,henrya@wvumedicine.org,,,,,,
WV-012194,Ritchie Regional Health Center,"Ritchie County Primary Care Association, Inc.",1265404230,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",135 S Penn Ave,,Harrisville,WV,26362-1371,Ritchie,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012195,Valley Health - Harts Intermediate,"Valley Health Systems, Inc.",1154697431,Federally Qualified Health Centers - Medical Services,1246 McClellan Hwy,,Harts,WV,25524-9524,Lincoln,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/harts-intermediate/
WV-012196,Valley Health Harts,"Valley Health Systems, Inc.",1649250309,"Black Lung Clinics, Dental Providers, Federally Qualified Health Centers - Medical Services",22 Fleming Dr,,Harts,WV,25524-9788,Lincoln,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shatlls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Director,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/harts/
WV-012197,LITTLE MEADOW HEALTH CENTER,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1740310663,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",100 Pickens Rd,,Helvetia,WV,26224,Randolph,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012198,Community Care of Hillsboro,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1134538762,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",7576 Seneca Trail,,Hillsboro,WV,24946,Pocahontas,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012199,ARH Summers County Rural Health Clinic,"Appalachian Regional Healthcare, Inc.",1730196049,"Outpatient Hospital Clinics, Rural Health Clinics",115 Summers Hospital Rd,,Hinton,WV,25951-5172,Summers,100 Airport Gardens Road,ATTN: Roy Milwee,Hazard,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
WV-012200,Summers County ARH Family Care Clinic,"Appalachian Regional Healthcare, Inc.",1417317397,"Outpatient Hospital Clinics, Rural Health Clinics",197 Pleasant St,,Hinton,WV,25951-2540,Summers,100 Airport Gardens Road,ATTN: Roy Milwee,Hazarad,KY,41701,Perry,Roy Milwee,System Administrator Ambulatory Services,606-487-7766,,rmilwee@arh.org,,,,,,
WV-012201,S K Shammaa MD Inc,S K Shammaa MD Inc,1881856516,Rural Health Clinics,623 Temple St,,Hinton,WV,25951-2230,Summers,623 Temple St,POB 370,Hinton,WV,25951,Summers,Royce Ann Martin,Office Manager,304-466-1243,303,sahibshammaamd@yahoo.com,Gayle Bugg,Office Manager,304-466-1243,305,skshammaamd@suddenlinkmail.com,
WV-012202,Valley Health Huntington High,"Valley Health Systems, Inc.",1659346757,Federally Qualified Health Centers - Medical Services,1 Highlander Way,,Huntington,WV,25701-5261,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/huntington-high/
WV-012203,Valley Health Mountwest,"Valley Health Systems, Inc.",1477926350,Federally Qualified Health Centers - Medical Services,1 Mountwest Way,,Huntington,WV,25701-9804,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/mountwest/
WV-012204,Valley Health Spring Valley,"Valley Health Systems, Inc.",1760458350,Federally Qualified Health Centers - Medical Services,1 Timberwolfe Drive,,Huntington,WV,25704,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/spring-valley/
WV-012205,Valley Health Huntington,Valley Health Systems Inc.,1710952056,Federally Qualified Health Centers - Medical Services,1301 Hal Greer Blvd,,Huntington,WV,25701-3803,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/huntington/
WV-012206,Cabell Huntington Hospital,Cabell Huntington Hospital,1073518007,Inpatient Hospitals (other than children's hospitals),1340 Hal Greer Blvd,,Huntington,WV,25701-3800,Cabell,1340 Hal Greer Boulevard,,Huntington,WV,25701-3800,Cabell,Greg Wageman,"Director Managed Care, Budgeting and Decision Support",304-526-2170,,greg.wageman@chhi.org,,,,,,
WV-012207,Hoops Family Children's Hospital at Cabell Huntington Hospital,Cabell Huntington Hospital,1073518007,Children's Hospitals (inpatient only),1340 Hal Greer Blvd,,Huntington,WV,25701-3800,Cabell,1340 Hal Greer Boulevard,,Huntington,WV,25701-3800,Cabell,Greg Wageman,"Director Managed Care, Budgeting, and Decision Support",304-526-2170,,greg.wageman@chhi.org,,,,,,
WV-012208,Valley Health A Woman's Place,"Valley Health Systems, Inc.",1194790089,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1630 13th Ave,,Huntington,WV,25701-3812,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/a-womans-place/
WV-012209,Valley Health Westmoreland,"Valley Health Systems, Inc.",1205801396,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",2908 Auburn Rd,,Huntington,WV,25704-2715,Wayne,3377 US Route 60,,Huntington,WV,25705,Cabell,Steve Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/westmoreland/
WV-012210,"Valley Health Ear, Nose, and Throat","Valley Health Systems, Inc.",1366897720,Federally Qualified Health Centers - Medical Services,3 Stonecrest Dr,,Huntington,WV,25701-9392,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/ear-nose-and-throat-location/
WV-012211,Valley Health at Prestera,"Valley Health Systems, Inc.",1164604633,Federally Qualified Health Centers - Medical Services,3375 US Route 60,,Huntington,WV,25705-2837,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/valley-health-at-prestera/
WV-012212,Valley Health East Huntington,Valley Health Systems Inc.,1720333461,"Community Mental Health Centers, Dental Providers, Federally Qualified Health Centers - Medical Services",3377 US Route 60,,Huntington,WV,25705-2837,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Richard Weinberger,CFO,304-525-3334,5104,rweinberger@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/
WV-012213,Valley Health 10th Street,Valley Health Systems Inc.,1881054476,Federally Qualified Health Centers - Medical Services,540 10th St,Suite 1,Huntington,WV,25701-2217,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Richard Weinberger,CFO,304-525-3334,5104,rweinberger@valleyhealth.org,Mandi,Pitsenbarger,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/
WV-012214,Valley Health Southside,"Valley Health Systems, Inc.",1710952031,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",723 9th Ave,,Huntington,WV,25701-2718,Cabell,3377 US Route 60,,Huntington,WV,25701,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Director,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/southside/
WV-012215,Valley Health Huntington Middle,"Valley Health Systems, Inc.",1174831275,Federally Qualified Health Centers - Medical Services,930 2nd St,,Huntington,WV,25701-3146,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/huntington-middle-school/
WV-012216,CAMC Teays Valley Hospital (inpatient hospital),Charleston Area Medical Center,1952390239,Inpatient Hospitals (other than children's hospitals),1400 Hospital Dr,,Hurricane,WV,25526-9202,Putnam,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP Finance,304-388-6251,,stephen.bell@camc.org,
WV-012217,CAMC Teays Valley Hospital (outpatient hospital clinics),Charleston Area Medical Center,1952390239,Outpatient Hospital Clinics,1400 Hospital Dr,,Hurricane,WV,25526-9202,Putnam,501 Morris Street,,Charleston,WV,25301,Kanawha,Billy Comer,Reimb Mgr,304-388-6265,,billy.comer@camc.org,Stephen Bell,VP Finance,304-388-6251,,stephen.bell@camc.org,
WV-012218,FamilyCare Women's Health & BirthCenter,"WOMENCARE, INC.",1003085903,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3911 Teays Valley Rd,,Hurricane,WV,25526-9604,Putnam,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,Kathy Howell,Family Planning Specialist,304-356-4456,,,www.familycarewv.org
WV-012219,Big Otter Clinic,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1992754592,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",797 Clinic Dr,,Ivydale,WV,25113-8263,Clay,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012220,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1851767818,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",6536 Main St,JANE LEW ELEMENTARY SCHOOL WELLNESS CENTER,Jane Lew,WV,26378-8505,Lewis,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012221,Valley Health Stepptwon,"Valley Health Systems, Inc.",1720054489,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",3 Adena Dr,,Kermit,WV,25674-8063,Wayne,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/stepptown/
WV-012222,Southern Roane Medical Clinic,Roane General Hospital,1790745677,Rural Health Clinics,1 Library Ln,Suite 2,Left Hand,WV,25251-9745,Roane,Roane General Hospital,,Spencer,WV,25251,Roane,Mariana G. Massey,Vice President Ambulatory Care,304-927-4444,820,mgmassey@rghwv.org,,,,,,
WV-012223,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1194191676,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1 Lizemore Lion Rd,LIZEMORE ELEMENTARY SCHOOL WELLNESS CENTER,Lizemores,WV,25125,Clay,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012224,Logan Wildcat Center for Health,Southern WV Health System,1023331220,"Dental Providers, Federally Qualified Health Centers - Medical Services",1 Wildcat Way,,Logan,WV,25601-3474,Logan,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012225,Logan Regional Medical Center,LifePoint Health,1750332565,Inpatient Hospitals (other than children's hospitals),20 Hospital Dr,,Logan,WV,25601-3452,Logan,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Walter Franz,Sr. Director Managed Care,615-920-7361,,Walter.Franz@LPNT.net,Timothy Matney,CFO,304-831-1537,,,
WV-012226,Lisa Elliott Health Center,"New River Health Association, Inc",1346426103,"Dental Providers, Federally Qualified Health Centers - Medical Services",79 Spyrock Loop Rd,,Lookout,WV,25868-1100,Fayette,908 Scarbro Road,,Scarbro,WV,25917,Fayette,Linda Hopkins-Carey,Credentialing Officer,304-469-2905,4117,linda.hopkins@nrhawv.org,,,,,,
WV-012227,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1114277050,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",128 College St,Lost Creek Elementary School Wellness Center,Lost Creek,WV,26385,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012228,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1699024547,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3003 Hawk Hwy,SOUTH HARRISON MIDDLE SCHOOL WELLNESS CENTER,Lost Creek,WV,26385,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012229,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1912258492,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",3073 Hawk Hwy,South Harrison High School Wellness Center,Lost Creek,WV,26385,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234,Harrison,RICHARD SIMON,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012230,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1649610445,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",38 E Lyndon St,Lumberport Elementary School Wellness Center,Lumberport,WV,26386,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-1065,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012231,FamilyCare HealthCenter - Madison,"WOMENCARE, INC.",1740450089,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",515 Main St,,Madison,WV,25130-1417,Boone,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Boone,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,Kathy Howell,Family Planning Specialist,304-356-4456,,,www.familycarewv.org
WV-012232,Pioneer Health Center,Southern WV Health System,1447619416,Federally Qualified Health Centers - Medical Services,1 Pioneer Path,,Man,WV,25635-1235,Logan,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012233,Family Healthcare Associates,Family Healthcare Associates,1902835010,Rural Health Clinics,114 Main St,,Man,WV,25635-1212,Logan,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing clerk,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012234,MVA Mannington,"Monongahela Valley Association of Health Centers, Inc.",1083162796,Federally Qualified Health Centers - Medical Services,118 Market St,,Mannington,WV,26582-1131,Marion,1322 Locust Avenue,,Fairmont,WV,26554,Marion,Nancy L. Vandergrift,President,304-367-8740,,nancy.vandergrift@mvahealth.org,,,,,,
WV-012235,Community Care of Marlinton,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1164653457,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",821 3rd Ave,,Marlinton,WV,24954-1015,Pocahontas,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012236,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1790033082,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",926 5th Ave Suite A,Marlinton Elementary School Wellness Center,Marlinton,WV,24954-1264,Pocahontas,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012237,"SHENANDOAH VALLEY MEDICAL SYSTEM, INC.","SHENANDOAH VALLEY MEDICAL SYSTEM, INCORPORATED",1083617823,"Community Mental Health Centers, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Ryan White Providers, Sexually Transmitted Disease Clinics",99 Tavern Rd,,Martinsburg,WV,25401-2890,Berkeley,99 Tavern Rd,,Martinsburg,WV,25401-2890,Berkeley,David Fant,CEO,304-596-2610,1062,dfant@svms.net,,,,,,www.shencommhealth.com
WV-012238,Meadow Bridge Clinic,Rainelle Medical Center,1093883324,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",1502 Meadow Bridge Rd,,Meadow Bridge,WV,25976-9655,Fayette,Rainelle Medcial Center,176 Medical Center Drive,Rainelle,WV,25962,Greenbrier,Sabrina McKinney,"BSN-RN, DON",304-438-6188,1041,smckinney@rmchealth.org,Crystal Fox,LPN,304-484-7755,,cfox@rmchealth.org,
WV-012239,Sistersville General Medical Center,Sistersville General Hospital,1710203419,Rural Health Clinics,100 Fair St,,Middlebourne,WV,26149-9525,Tyler,314 South Wells Street,,Sistersville,WV,26175,Tyler,Brandon Chadock,Interim CEO,304-447-2420,,b.chadock@sistersvillegeneral.com,Trisha O'Neil,QA Director/ Clinic Director,304-447-2503,,toneil@sistersvillegeneral.com,
WV-012240,"Valley Health Care, Inc","VALLEY HEALTH CARE, INC",1801861083,Federally Qualified Health Centers - Medical Services,US Rt 219/250,,Mill Creek,WV,26280,Randolph,PO BOX 247,,Mill Creek,WV,26280,Randolph,Vevica L Gray,Administrative Assistant,304-335-2050,124,grayv@vhcwv.org,Robert,Haddix,304-335-2050,107,haddixr@vhcwv.org,
WV-012241,"Monongahela Valley Association of Health Centers, Inc.","Monongahela Valley Association of Health Centers, Inc.",1376902122,Federally Qualified Health Centers - Medical Services,550 Camden Ave,Monongah Middle School Wellness Center,Monongah,WV,26554-1105,Marion,1322 Locust Avenue,,Fairmont,WV,26554,Marion,Nancy L. Vandergrift,President,304-367-8740,,nancy.vandergrift@mvahealth.org,,,,,,
WV-012242,"Monongahela Valley Association of Health Centers, Inc.","Monongahela Valley Association of Health Centers, Inc.",1285093039,Federally Qualified Health Centers - Medical Services,628 Walnut St,Monongah Elementary School Wellness Center,Monongah,WV,26554-1136,Marion,1322 Locust Avenue,,Fairmont,WV,26554,Marion,Nancy L. Vandergrift,President,304-367-8740,,nancy.vandergrift@mvahealth.org,,,,,,
WV-012243,Prudich Medical Center,"Bluestone Health Association, Inc.",1043387327,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",541 Simmons River Rd,,Montcalm,WV,24737,Mercer,3997 Beckley Road,,Princeton,WV,24740,Mercer,Sharon Kay Brim,COO,304-431-5499,126,kbrim@bluestonewv.org,,,,,,
WV-012244,Hardy County Medical Services,Hardy County Medical Services,1083606230,Rural Health Clinics,422 S Main St,,Moorefield,WV,26836-1238,Hardy,422 South Main Street,,Moorefield,WV,26836,Hardy,Christopher Hahn,Administrator,304-822-3838,6614,chris@hahnmedical.com,,,,,,http://www.hahnmedical.com
WV-012245,West Virginia University Hospitals Inc.,West Virginia University Hospitals Inc.,1841271459,Inpatient Hospitals (other than children's hospitals),1 Medical Center Dr,,Morgantown,WV,26506-1200,Monongalia,One Medical Center Drive,,Morgantown,WV,26508,Monongalia,Justin Gibson,VP of Finance,304-598-4256,,gibsonju@wvumedicine.org,Amy Stephens,Director of Finance & Reimbursement,304-598-4877,,stephensa@wvumedicine.org,
WV-012246,MT. STORM HEALTH CENTER,Mt Storm Health Center (PT),1700819471,Federally Qualified Health Centers - Medical Services,14311 George Washington Hwy,,Mt Storm,WV,26739,Grant,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012247,Family Healthcare Associates,Family Healthcare Associates,1700815800,Rural Health Clinics,205 Howard Ave,,Mullens,WV,25882-1420,Wyoming,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing manager,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012248,Wetzel Internal Medicine,"Wetzel County Hospital, Inc.",1548893068,Rural Health Clinics,150 Paducah Dr,,New Martinsville,WV,26155-2710,Wetzel,150 Paducah Drive,,New Martinsville,WV,26155-2710,Wetzel,Sarah Cumberledge,Practice Manager,304-455-8134,,sarah.cumberledge@wvumedicine.org,Kitty Jo Lloyd,Accountant/Revenue Cycle Analyst,304-455-8230,,kitty.lloyd@wvumedicine.org,https://wvumedicine.org/wetzel/
WV-012249,"Wetzel County Hospital, Inc.","Wetzel County Hospital, Inc.",1376175240,Inpatient Hospitals (other than children's hospitals),3 E Benjamin Dr,,New Martinsville,WV,26155-2705,Wetzel,3 East Benjamin Drive,,New Martinsville,WV,26155-2705,Wetzel,Kitty Jo Lloyd,Accountant/Revenue Cycle Analyst,304-455-8052,,kitty.lloyd@wvumedicine.org,Vincent Tad Greene,Director of Operations,304-455-8195,,vincent.greene@wvumedicine.org,https://wvumedicine.org/wetzel/
WV-012250,Wetzel Primary Care,"Wetzel County Hospital, Inc.",1255963120,Rural Health Clinics,3 E Benjamin Dr,Suite B,New Martinsville,WV,26155-2705,Wetzel,3 East Benjamin Drive,,New Martinsville,WV,26155-2705,Wetzel,Kitty Jo Lloyd,Accountant/Revenue Cycle Analyst,304-455-8052,,kitty.lloyd@wvumedicine.org,Vincent Tad Greene,Director of Operations,304-455-8195,,vincent.greene@wvumedicine.org,https://wvumedicine.org/wetzel/
WV-012251,Newburg Clinic,PRESTON TAYLOR COMMUNITY HEALTH CENTER,1154439859,Federally Qualified Health Centers - Medical Services,2060 N Mountaineer Hwy,,Newburg,WV,26410-8994,Preston,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012252,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1003256801,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1302 Buckhannon Pike,Nutter Fort Intermediate School Wellness Center,Nutter Fort,WV,26301-4406,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012253,Oceana Medical Center,"Hygeia Facilities Foundation, Inc.",1366502254,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services",26 Trinity Lane,,Oceana,WV,24870-0400,Wyoming,37456 Coal River Road,,Whitesville,WV,25209,Boone,Terri L Grandstaff,CFO,304-854-1323,,terri@myhygeia.org,Margaret L Martin,CEO,304-854-1323,,margmartin@frontier.com,
WV-012254,Family Healthcare Associates,Family Healthcare Associates,1275562373,Rural Health Clinics,926 Cook Parkway,,Oceana,WV,24870,Wyoming,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing manager,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012255,Valley Health Cabell Midland,"Valley Health Systems, Inc.",1417923236,Federally Qualified Health Centers - Medical Services,2300 US Route 60,,Ona,WV,25545-9712,Cabell,3377 US Route 60,,Huntington,WV,25705,Cabell,Steve Shattls,Executive Director,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Director/CEO,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/cabell-midland-high-school/
WV-012256,Ritchie Regional Health Center Jefferson Campus,"Ritchie County Primary Care Association, Inc.",1700900818,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1200 Stephenson Ave,,Parkersburg,WV,26101-4889,Wood,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012257,Ritchie Regional Health Center South Parkersburg Campus,"Ritchie County Primary Care Association, Inc.",1568719458,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1513 Blizzard Dr,,Parkersburg,WV,26101-6424,Wood,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012258,Parkersburg Family Care,Coplin Health Systems,1760733984,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Rural Health Clinics, Sexually Transmitted Disease Clinics",2610 Camden Ave,,Parkersburg,WV,26101-5652,Wood,483 Court St,P.O. Box 609,Elizabeth,WV,26143,Wirt,Cheryl J. Davis,HR Coordinator,304-275-8780,206,cdavis@wchsa.com,,,,,,
WV-012259,Camden Clark Medical Center,Camden Clark Medical Center,1699704254,Inpatient Hospitals (other than children's hospitals),800 Garfield Ave,,Parkersburg,WV,26101-5340,Wood,800 Garfield Ave,,Parkersburg,WV,26101,Wood,Carolyn Allen,CFO,304-424-2202,,cballen@camdenclark.org,David McClure,CEO,304-424-2204,,dkmcclure@ccmh.org,
WV-012260,Mountaineer Community Health Center,Mountaineer Community Health Center,1033299862,"Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",783 Winchester St,,Paw Paw,WV,25434,Morgan,PO Box 2,,Paw Paw,WV,25434,Morgan,Chad Hott,CEO,304-947-5500,,chad.hott.fnp@gmail.com,,,,,,
WV-012261,PETERSTOWN WELLNESS CENTER,Monroe County Health Department,1962696682,Federally Qualified Health Centers - Medical Services,108 College Dr,,Peterstown,WV,24963-1500,Monroe,200 Health Center Dr,,Union,WV,24983-8442,Monroe,Michelle Ballard,COO,304-772-3065,,mballard@monroehealthcenter.com,Rebekah Stone,CFO,,,rstone@monroehealthcenter.com,
WV-012262,Peterstown Clinic,Monroe Health Center,1174725188,Federally Qualified Health Centers - Medical Services,591 US Hwy 219,,Peterstown,WV,24963,Monroe,PO Box 580,,Peterstown,WV,24963-0580,Monroe,Michelle Ballard,COO,304-772-3064,,mballard@monroehealthcenter.com,Rebekah Stone,CFO,304-772-3065,,rstone@monroehealthcenter.com,http://www.monroehealthcenter.com
WV-012263,"The Myers Clinic, Inc","The Myers Clinic, Inc",1366446015,Rural Health Clinics,3 Health Care Drive,PO Box 900,Philippi,WV,26416-0900,Barbour,3 Health Care Drive,Po Box 900,Philippi,WV,26416,Barbour,Christina Collins,Office Manager,304-457-2800,223,ccollins@myersclinic.org,Kelly Holbert,Administrator,304-457-2800,222,kholbert@myersclinic.org,
WV-012264,Pine Grove Health Care RHC,Pine Grove Health Care RHC,1326186586,Rural Health Clinics,12960 Shortline Hwy,,Pine Grove,WV,26419-8221,Wetzel,PO Box 418,,Pine Grove,WV,26419-0418,Wetzel,Sarah Cumberledge,Practice Manager,304-455-8134,,scumberledge@wetzelhealth.org,Kitty Jo Lloyd,Accountant/Revenue Cycle Analyst,304-455-8052,,klloyd@wetzelhealth.org,wetzelcountyhospital.com
WV-012265,Family Healthcare Associates,Family Healthcare Associates,1225067317,Rural Health Clinics,113 Main Ave,,Pineville,WV,24874,Wyoming,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing manager,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012266,Valley Health Milton,"Valley Health Systems, Inc.",1124323340,Federally Qualified Health Centers - Medical Services,2801 Jackson Ave,,Point Pleasant,WV,25550-1713,Mason,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Director/CEO,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/point-pleasant-pediatrics/
WV-012267,Jana Peters,Jana Peters,1396875746,Rural Health Clinics,365 Courthouse Rd,,Princeton,WV,24740-2431,Mercer,365 Courthouse Road,,Princeton,WV,24740,Mercer,Lillie Poole,Office Manager,304-425-3922,,lilliepoole@janapeters.com,Jana Peters,Owner,304-425-3922,,drjanapeters@janapeters.com,
WV-012268,"Bluestone Health Association, Inc.","Bluestone Health Association, Inc.",1346266848,"Black Lung Clinics, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",3997 Beckley Rd,,Princeton,WV,24740-7660,Mercer,3997 Beckley Rd,,Princeton,WV,24740-7660,Mercer,Sharon Kay Brim,COO,304-431-5499,126,kbrim@bluestonewv.org,,,,,,
WV-012269,Rainelle Medical Center,Rainelle Medical Center,1437227766,"Black Lung Clinics, Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",176 Medical Center Dr,,Rainelle,WV,25962-1064,Greenbrier,176 Medical Center Drive,,Rainelle,WV,25962,Greenbrier,Sabrina McKinney,"BSN-RN, DON",304-438-6188,1041,smckinney@rmchealth.org,,,,,,
WV-012270,Ranger Health Center,Southern WV Health System,1801254388,Federally Qualified Health Centers - Medical Services,59 Vanatters Crk,,Ranger,WV,25557-9719,Lincoln,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012271,Camden Family Health,"Camden on Gauley Medical Center, Inc",1396119343,Federally Qualified Health Centers - Medical Services,58 E Main St,,Richwood,WV,26261-1122,Nicholas,10003 Webster Road,,Camden on Gauley,WV,26208,Webster,Margaret E Groves,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012272,Jackson General Hospital,Community Health Association,1649277476,Inpatient Hospitals (other than children's hospitals),122 Pinnell St,,Ripley,WV,25271-9101,Jackson,122 Pinnell Street,,Ripley,WV,25271,Jackson,Brenda Greene,Medical Staff Coordinator,304-373-1507,,bgreene@jacksongeneral.com,Stephanie McCoy,Chief Executive Officer,304-373-1475,,smccoy@jacksongeneral.com,
WV-012273,Morad-Hughes Health Center,Community Health Association,1871606517,Rural Health Clinics,122 Pinnell St,,Ripley,WV,25271-9101,Jackson,122 Pinnell Street,,Ripley,WV,25271,Jackson,Brenda Greene,Medical Staff Coordinator,304-373-1507,,bgreene@jacksongeneral.com,Dee Scritchfield,Practice Manager,304-373-1494,,dscritchfield@jacksongeneral.com,
WV-012274,Jackson General Clinic,Community Health Association,1134417975,Other ECP Providers,200 Academy Dr,,Ripley,WV,25271-1157,Jackson,122 Pinnell Street,,Ripley,WV,25271,Jackson,Brenda Greene,Medical Staff Coordinator,304-373-1507,,bgreene@jacksongeneral.com,Dee Scritchfield,Practice Manager,304-373-1494,,dscritchfield@jacksongeneral.com,
WV-012275,NORTH FORK PRIMARY CARE,"Pendleton Community Care, Inc",1417931379,Federally Qualified Health Centers - Medical Services,16921 Mountaineer Dr,,Riverton,WV,26814-7521,Pendleton,PO BOX 100,,Franklin,WV,26807,Pendleton,Jamie Hudson,CEO,304-358-2355,,jhudson@pcc-nfc.org,Rebecca Eason,CFO,304-358-2355,,reason@pcc-nfc.org,pccnfc.org
WV-012276,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1104292168,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",1176 Oil Creek Rd,ROANOKE ELEMENTARY SCHOOL WELLNESS SCHOOL,Roanoke,WV,26447-8263,Lewis,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012277,TRI-COUNTY HEALTH CLINIC,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1912932526,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,78 Queens Alley Rd.,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012278,Romney Medical Associates,Romney Medical Associates,1497747398,Rural Health Clinics,22347 Northwestern Pike,,Romney,WV,26757-6343,Hampshire,22347 Northwestern Pike,,Romney,WV,26757,Hampshire,Christopher Hahn,Administrator,304-822-3838,6614,chris@hahnmedical.com,,,,,,http://www.hahnmedical.com
WV-012279,Hampshire Rural Health Clinic,Hampshire Memorial Hospital,1881735660,Rural Health Clinics,329 Sunrise Blvd,,Romney,WV,26757-4607,Hampshire,363 Sunrise Blvd.,,Romney,WV,26757,Hampshire,Kathryn Morales,Director of Finance,304-822-4944,,kmorale2@valleyhealthllink.com,Mary Sas,Vice President of Nursing,304-822-4931,,msas@valleyhealthlink.com,
WV-012280,ROWLESBURG CLINIC,"PRESTON-TAYLOR COMMUNITY HEALTH CTRS, INC",1093729857,Federally Qualified Health Centers - Medical Services,1 Renaissance Square,,Rowlesburg,WV,26425,Preston,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,june Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012281,FamilyCare HealthCenter - St. Albans,"WOMENCARE, INC.",1902166945,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",12 Kanawha Ter,,Saint Albans,WV,25177-2750,Kanawha,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,,,,,,www.familycarewv.org
WV-012282,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1558752824,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",273 Education Way,Salem Elementary School Wellness Center,Salem,WV,26426,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012283,Salt Rock Medical Center,Southern WV Health System,1942509856,Federally Qualified Health Centers - Medical Services,5490 State Rt 10,,Salt Rock,WV,25559-9736,Cabell,7400 Lynn Avenue,,Hamlin,WV,25523,Lincoln,Tish Weaver,Credentialing Coordinator,304-824-5806,1235,Tish.Weaver@swvhs.org,Stephany Crist,Billing Specialist,304-824-5860,1508,Stephany.Crist@swvhs.org,www.swvhs.org
WV-012284,FamilyCare HealthCenter - Teays Valley,"WOMENCARE, INC.",1194759290,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",97 Great Teays Blvd,Suite 6,Scott Depot,WV,25560-9816,Putnam,97 Great Teays Blvd Ste 6,,Scott Depot,WV,25560-9816,Putnam,MARTHA CARTER,CEO,304-760-6316,,martha.cookcarter@familycarewv.org,,,,,,www.familycarewv.org
WV-012285,Sherman Jr/Sr High Wellness Center,"Hygeia Facilities Foundation, Inc.",1598102386,Federally Qualified Health Centers - Medical Services,10008 Coal River Road,,Seth,WV,25181,Boone,37456 Coal River Road,,Whitesville,WV,25209,Boone,Terri L Grandstaff,CFO,304-854-1323,,terri@myhygeia.org,Margaret L Martin,CEO,304-854-1323,,margmartin@frontier.com,
WV-012286,MVA Shinnston Medical Center,"MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC",1770697278,Federally Qualified Health Centers - Medical Services,1 Columbia Rd,,Shinnston,WV,26431-1016,Harrison,1322 Locust Ave,,Fairmont,WV,26554-1436,Marion,Eric Pulice,Administrator,304-367-8740,,contactus@mvahealth.org,,,,,,mvahealth.org
WV-012287,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1649610437,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 Tetrick Rd,Big Elm Elementary School Wellness Center,Shinnston,WV,26431-9704,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012288,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1861831323,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",78 Jerry Toth Dr,Lincoln Middle and High School Wellness Center,Shinnston,WV,26431-8502,Harrison,78 Queens Alley Rd.,,Rock Cave,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,rick.simon@ccwv.org,Brock Malcolm,COO,304-924-6262,,brock.malcolm@ccwv.org,ccwv.org
WV-012289,Sistersville Rural Health Clinic,Sistersville General Hospital,1538485230,Rural Health Clinics,305 Clay St,,Sistersville,WV,26175-1059,Tyler,314 South Wells Street,,Sistersville,WV,26175,Tyler,Brandon Chadock,Interim CEO,304-447-2420,,b.chadock@sistersvillegeneral.com,Trisha O'Neil,QA Director/Clinic Director,304-447-2503,,toneil@sistersvillegeneral.com,
WV-012290,Sistersville General Hospital,Sistersville General Hospital,1861495335,Inpatient Hospitals (other than children's hospitals),314 S Wells St,,Sistersville,WV,26175-1098,Tyler,314 South Wells Street,,Sistersville,WV,26175,Tyler,Jodie Nicole Neff,Credentialing Contact,304-447-2478,,jneff@sistersvillegeneral.com,Brandon Chadock,Director of Operations,304-447-2420,,b.chaddock@sistersvillegeneral.com,
WV-012291,ROANE COUNTY FAMILY HEALTH CARE,ROANE FAMILY HEALTH CARE,1861494528,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",146 Williams Dr,,Spencer,WV,25276-1826,Roane,146 Williams Dr,,Spencer,WV,25276-1826,Roane,Kip D Smith,CEO,304-927-2241,,ksmith@rcfhc.org,Lisa Webb,Family Planning Coordinator,304-927-8103,,lwebb@rcfhc.org,http://www.rcfhc.org
WV-012292,Roane General Medical Clinic,Roane General Hospital,1790745172,Rural Health Clinics,200 Hospital Dr,,Spencer,WV,25276-1050,Roane,200 Hospital Dr,,Spencer,WV,25276,Roane,Mariana G. Massey,Vice President Ambulatory Services,304-927-4444,820,mgmassey@rghwv.org,,,,,,
WV-012293,Roane General Medical Associates,Roane General Hospital,1922068469,Rural Health Clinics,300 Hospital Dr,,Spencer,WV,25276-1049,Roane,200 Hospital Dr,,Spencer,WV,25276,Roane,Mariana G. Massey,Vice President Ambulatory Services,304-927-4444,820,mgmassey@rghwv.org,,,,,,
WV-012294,Ritchie Regional Health Center St. Marys Campus,"Ritchie County Primary Care Association, Inc.",1720104219,Federally Qualified Health Centers - Medical Services,2330 North Pleasants Highway,,St. Marys,WV,26170,Pleasants,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012295,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1063808418,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",208 Kidd Ave,Norwood Elementary School Wellness Center,Stonewood,WV,26301-4833,Harrison,78 Queens Alley Rd,,Rock Cave,WV,26234-5890,Upshur,Richard G Simon,CEO,304-924-6262,,rick.simon@ccwv.org,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012296,RURAL HEALTH CLINIC,SRMC,1750378345,Rural Health Clinics,400 Fairview Heights Rd,,Summersville,WV,26651-9308,Nicholas,400 Fairview Heights Road,,Summersville,WV,26651,Nicholas,Jerri Kirkland,Risk Manager/Compliance,304-872-8470,,jkirkland@srmcwv.org,Debbie Kincell,Business Office Director,304-883-0220,,dkincell@srmcwv.org,
WV-012297,Camden Family Health,"Camden on Gauley Medical Center, Inc",1558340414,Federally Qualified Health Centers - Medical Services,55 Friends R Fun Dr,,Summersville,WV,26651-9514,Nicholas,10003 Webster Road,,Camden on Gauley,WV,26208,Nicholas,Margaret E Hickey,CEO,304-226-5725,131,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012298,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1104175058,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",100 Carter Braxton Dr,Braxton County Middle School Wellness Center,Sutton,WV,26601-9773,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012299,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1396096863,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",200 Jerry Burton Dr,Braxton County High School Wellness Center,Sutton,WV,26601-9768,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012300,Community Care of Flatwoods,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1770917577,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",266 Skidmore Ln,,Sutton,WV,26601-9271,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012301,COMMUNITY CARE OF FLATWOODS II,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1609042266,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",273 Skidmore Ln,,Sutton,WV,26601-9272,Braxton,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012302,Mountaintop Health Center,PRESTON TAYLOR COMMUNITY HEALTH CENTER,1245348945,Federally Qualified Health Centers - Medical Services,30 Cortland Acres Ln,,Thomas,WV,26292-8066,Tucker,725 N Pike St,,Grafton,WV,26354-1270,Taylor,Linda Shriver,CEO,304-265-0312,,lmshriver@mountain.net,June Griffith,COO,304-265-0312,,jgriffith@ptchc.com,
WV-012303,MONROE COUNTY HEALTH CENTER,Monroe County Health Department,1992734487,Federally Qualified Health Centers - Medical Services,200 Health Center Dr,,Union,WV,24983-8442,Monroe,200 Health Center Dr,,Union,WV,24983-8442,Monroe,Michelle Ballard,COO,304-772-3065,,mballard@monroehealthcenter.com,Rebekah Stone,CFO,304-772-3064,,rstone@monroehealthcenter.com,http://www.monroehealthcenter.com
WV-012304,MOUNTAIN VIEW WELLNESS CENTER,Monroe County Health Department,1346435906,Federally Qualified Health Centers - Medical Services,620 School St,,Union,WV,24983,Monroe,200 Health Center Dr,,Union,WV,24983-8442,Monroe,Michelle Ballard,COO,304-772-3065,,mballard@monroehealthcenter.com,Rebekah Stone,CFO,,,mballard@monroehealthcenter.com,
WV-012305,Planned Parenthood Vienna Health Center,Planned Parenthood South Atlantic,1801932199,Family Planning Providers,522 Grand Central Ave,,Vienna,WV,26105-2169,Wood,100 S Boylan Ave,,Raleigh,NC,27603-1802,Wake,Nancy Long,CFO,919-833-7526,6131,nancy.long@ppsat.org,Lisa Lowe-Hall,VP of Patient Servcies,919-833-7526,6170,lisa.lowe.hall@ppsat.org,https://www.plannedparenthood.org/health-center/west-virginia/vienna/26105/vienna-health-center-2893-90860
WV-012306,Walton Medical Clinic,Roane General Hospital,1639423411,Rural Health Clinics,90 School Dr,,Walton,WV,25286-9774,Roane,Roane General Hospital,200 Hospital Dr,Spencer,WV,25276,Roane,Mariana G. Massey,Vice President Ambulatory Services,304-927-4444,820,mgmassey@rghwv.org,,,,,,
WV-012307,Wardensville Medical Services,Wardensville Medical Services,1427040351,Rural Health Clinics,325 East Main St,,Wardensville,WV,26851,Hardy,325 East Main Street,,Wardensville,WV,26851,Hardy,Christopher Hahn,Administrator,304-822-3838,6614,chris@hahnmedical.com,,,,,,http://www.hahnmedical.com
WV-012308,Valley Health Wayne High,"Valley Health Systems, Inc.",1194790022,Federally Qualified Health Centers - Medical Services,100 Pioneer Rd,,Wayne,WV,25570-9504,Wayne,3377 US Route 60,,Huntington,WV,25705,Cabell,Steven Shattls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Assistant,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/wayne-high-middle/
WV-012309,Valley Health -Wayne,"Valley Health Systems, Inc.",1528038577,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",42 McGinnis Dr,,Wayne,WV,25570-9553,Wayne,3377 US Route 60,,Huntington,WV,25705,Cabell,Steve Shatttls,EXECUTIVE DIRECTOR/CEO,304-525-3334,5107,shattls@valleyhealth.org,Mandi Pitsenbarger,Executive Director,304-525-3334,5102,mpits@valleyhealth.org,http://valleyhealth.org/location/wayne/
WV-012310,Webster County Memorial Hospital,Webster County Memorial Hospital,1699778704,"Outpatient Hospital Clinics, Rural Health Clinics",324 Miller Mountain Dr,,Webster Springs,WV,26288-1065,Webster,PO Box 312,,Webster Springs,WV,26288,Webster,Julie Clutter,Director of Accounting & Finance,304-847-5682,3100,juliec@wcmhwv.org,Tina Riffle,Director of Clinical Operations/Quality/Risk,304-847-5682,5100,tinar@wcmhwv.org,
WV-012311,Family Medical Care Community Health Center,"CHANGE, Inc.",1245244367,"Dental Providers, Federally Qualified Health Centers - Medical Services",3136 West St,,Weirton,WV,26062-4637,Hancock,3158 West St.,,Weirton,WV,26062,Hancock,Judy Raveaux,CEO,304-797-7733,311,jraveaux@changeinc.org,Rita Coyne,COO,304-797-7733,324,rcoyne@changeinc.org,www.changeinc.org
WV-012312,"CHANGE, Inc","CHANGE, Inc",1245244367,"Dental Providers, Federally Qualified Health Centers - Medical Services",3428 Pennsylvania Ave,Weirton Elementary School Based Health Center,Weirton,WV,26062-3923,Hancock,3158 West ST,,Weirton,WV,26062,Hancock,Judy Raveaux,CEO,304-797-7733,311,jraveaux@changeinc.org,Rita Coyne,COO,304-797-7733,324,rcoyne@changeinc.org,www.changeinc.org
WV-012313,Family Healthcare Associates,Family Healthcare Associates,1215365028,Rural Health Clinics,19771 Coal Heritage Rd,,Welch,WV,24801-9825,McDowell,PO Box 1650,,Pineville,WV,24874,Wyoming,Stephanie Sizemore,Insurance billing manager,304-732-6735,,ssizemore@fhcawv.com,MIchael Muscari,DO,304-732-6735,,mmuscari@fhcawv.com,
WV-012314,"Community Care of West Virginia, Inc.","COMMUNITY CARE OF WEST VIRGINIA, INC.",1821349309,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",226 School St,West Milford Elementary School Wellness Center,West Milford,WV,26451-6815,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012315,WEST MILFORD COMMUNITY HLTH CTR,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1558563734,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",597 Liberty St,,West Milford,WV,26451-6801,Harrison,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-881-1190,,rick.simon@ccwv.org,BROCK.MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012316,Ritchie Regional Health Center West Union Campus,"Ritchie County Primary Care Association, Inc.",1790953412,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services",117 West Main Street,,West Union,WV,26456,Doddridge,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012317,"Ritchie County Primary Care Association, Inc.","Ritchie County Primary Care Association, Inc.",1982003786,"Dental Providers, Federally Qualified Health Centers - Medical Services",151 Doddridge School Road,Doddridge School Campus,West Union,WV,26456,Doddridge,P.O. Box 373,,Harrisville,WV,26362,Ritchie,"William H. Snider, II",CEO,304-643-4005,108,rcpcasnider@gmail.com,Lisa Leach,COO,304-643-4005,107,lleach@rcpca.org,http://ritchieregional.org/
WV-012318,Community Care of Weston,"COMMUNITY CARE OF WEST VIRGINIA, INC.",1073944658,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",149 Staunton Dr,,Weston,WV,26452-5604,Lewis,78 QUEENS ALLEY RD,,Rock Cave,WV,26234,Upshur,Richard G Simon,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012319,Camden Family Health,"Camden on Gauley Medical Center, Inc.",1861872541,Federally Qualified Health Centers - Medical Services,300 Minuteman Dr,,Weston,WV,26452-2200,Lewis,10003 Webster Road,,Camden on Gauley,WV,26208,Webster,Margaret E Hickey,CEO,304-226-5725,117,meg@cog-wv.org,Melissa D Rogers,COO,304-226-5725,117,mrogers@cog-wv.org,
WV-012320,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1043686553,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",358 Court Ave,ROBERT BLAND MIDDLE SCHOOL WELLNESS CENTER,Weston,WV,26452-2008,Lewis,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012321,"Community Care of West Virginia, Inc.",COMMUNITY CARE OF WEST VIRGINIA,1841666807,"Family Planning Providers, Federally Qualified Health Centers - Medical Services",509 Berlin Rd,PETERSON-CENTRAL ELEMENTARY SCHOOL WELLNESS CENTER,Weston,WV,26452-8323,Lewis,78 QUEENS ALLEY RD,,ROCK CAVE,WV,26234,Upshur,RICHARD SIMON,CEO,304-924-6262,,RICK.SIMON@CCWV.ORG,BROCK MALCOLM,COO,304-924-6262,,BROCK.MALCOLM@CCWV.ORG,CCWV.ORG
WV-012322,Wharton Medical Center,"Hygeia Facilities Foundation, Inc.",1144381302,"Black Lung Clinics, Federally Qualified Health Centers - Medical Services",35767 Pond Fork Road,,Wharton,WV,25208,Boone,37456 Coal River Road,,Whitesville,WV,25209,Boone,Terri L Grandstaff,CFO,304-854-1323,,terri@myhygeia.org,Margaret L Martin,CEO,304-854-1323,,margmartin@frontier.com,
WV-012323,Raleigh-Boone Medical Center,"Hygeia Facilities Foundation, Inc.",1467512152,"Black Lung Clinics, Family Planning Providers, Federally Qualified Health Centers - Medical Services",37456 Coal River Rd,,Whitesville,WV,25209-9077,Raleigh,37456 Coal River Road,,Whitesville,WV,25209,Boone,Terri L Grandstaff,CFO,304-854-1323,,terri@myhygeia.org,Margaret L Martin,CEO,304-854-1323,,margmartin@frontier.com,
WV-012324,Yukon Medical Clinic,Yukon Medical Clinic,1942266887,Rural Health Clinics,402 Marshall Highway,,Yukon,WV,24892,McDowell,PO Box 400,,Bradshaw,WV,24817,Mcdowell,Jennifer Sparks,Office Manager,304-875-2302,,ymcbmc@gmail.com,Mahesh Patel,Owner,304-875-2302,,mbpatel101@gmail.com,
WY-012325,Arapahoe Health Center,Arapahoe Health Center,1104976372,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service",14 Great Plains Rd,,Arapahoe,WY,82510-9144,Fremont,PO Box 1310,,Arapahoe,WY,82510,Fremont,Richard Brannan,Chief Executive Officer,307-856-9281,,richardbrannan@outlook.com,,,,,,
WY-012326,Wind River Family & Community Health Care,Arapahoe/Wind River Family & Community Health Care,1285006379,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",14 Great Plains Rd,,Arapahoe,WY,82510-9144,Fremont,14 Great Plains Road,,Riverton,WY,82501,Fremont,Garland Stiffarm,"Tribal Director, Deputy Director, IHS",406-247-7076,,garland.stiffarm@ihs.gov,Richard Brannan,Tribal CEO,307-349-0868,,richardbrannan@outlook.com,www.ihs.gov
WY-012327,Outpatient and Prevention Center,White Buffalo Recovery Center,1902213093,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",24 Great Plains Rd,,Arapahoe,WY,82510-9144,Fremont,#24 Great Plains Rd,,Arapahoe,WY,82501,Fremont,Sunny Goggles,Director,307-856-0740,309,whitebuffalorecovery@gmail.com,,,,,,
WY-012328,South Big Horn County Hospital,South Big Horn County Hospital District,1013919794,Inpatient Hospitals (other than children's hospitals),388 US Highway 20 S,,Basin,WY,82410-8902,Big Horn,388 US Highway 20 S,,Basin,WY,82410,Big Horn,John Adlesich,Chief Executive Officer,307-568-3311,3311,jadlesich@midwayclinic.com,Beverly Bush,Director of Human Resources,307-568-3311,3311,bbush@midwayclinic.com,www.midwayclinic.com
WY-012329,University of Wyoming Family Medicine Residency Casper,UNIVERSITY OF WYOMING,1558657650,Federally Qualified Health Centers - Medical Services,1522 E A St,,Casper,WY,82601-2217,Natrona,1000 E University Ave Dept 3434,,Laramie,WY,82071-2001,Albany,Lyle David Svoboda,Clinic Director,307-232-6079,,lsvoboda@uwyo.edu,"Kevin F Murray, MD",Director of Medical Education,307-766-2113,,kmurra10@uwyo.edu,
WY-012330,Casper-Natrona County Health Department,Casper-Natrona County Health Department,1275674608,Other ECP Providers,475 S Spruce St,,Casper,WY,82601-1759,Natrona,475 S. Spruce St,,Casper,WY,826011759,Natrona,Rita Goehring,Disease Prevention Director,307-235-9340,750,rgoehring@cnchd.org,Kelly Weidenbach,Executive Direcctor,307-235-9340,722,kelly.weidenbach@cnchd.org,http://www.casperhealth.com/nursing-services/Family-planning/
WY-012331,Cheyenne-Laramie County Family Planning,Cheyenne-Laramie County Health Department,1235286634,Family Planning Providers,100 Central Ave,,Cheyenne,WY,82007-1330,Laramie,100 Central Ave,,Cheyenne,WY,82007,Laramie,Linda Thyfault,Clinic Administrator,307-633-4040,,lthyfault@laramiecounty.com,Linda Thyfautl,Nurse Practitioner,307-633-4051,,lthyfault@laramiecounty.com,
WY-012332,Crossroads Healthcare Clinic,COMMUNITY ACTION OF LARAMIE COUNTY INC,1043436983,Federally Qualified Health Centers - Medical Services,100 Central Ave,Suite 100,Cheyenne,WY,82007-1330,Laramie,200 W 17th St Ste 210,,Cheyenne,WY,82001-4479,Laramie,Melissa Ipsen,Program Director,307-632-8064,,melissa@calc.net,,,,,,
WY-012333,HealthWorks,HealthWorks (formerly Cheyenne Health and Wellness Center),1386632594,"Dental Providers, Federally Qualified Health Centers - Medical Services",2508 E Fox Farm Rd,,Cheyenne,WY,82007-2559,Laramie,2508 East Fox Farm Road,,Cheyenne,WY,82007,Laramie,Karim Tripodina,Development Director,307-635-3618,1016,ktripodina@wyhealthworks.org,Janet Marschner,Chief Financial Officer/Interim CEO,307-433-8060,,jmarschner@wyhealthworks.org,
WY-012334,University of Wyoming Family Medicine Residency Cheyenne,UNIVERSITY OF WYOMING,1770681439,Federally Qualified Health Centers - Medical Services,821 E 18th St,,Cheyenne,WY,82001-4775,Laramie,1000 E University Ave Dept 3434,"Associate Vice President, Research",Laramie,WY,82071-2001,Albany,Dorothy C Yates,"Associate Vice President, Research",307-766-5320,,dyates4@uwyo.edu,"Kevin F Murray, MD",Director Medical Education,307-766-2113,,kmurra10@uwyo.edu,
WY-012335,Northwest Wyoming Family Planning,Northwest Wyoming Family Planning,1063542090,Family Planning Providers,1231 Rumsey Ave,,Cody,WY,82414-3607,Park,1231 Rumsey Ave,,Cody,WY,82414-3607,Park,Michelle Gutierrez,Clinic Administrator,307-527-5174,,nwfp@tctwest.net,Christi Greaham,Office Manager,307-527-5174,,christi@tctwest.net,
WY-012336,Western Wyoming Family Health-Evanston,Western Wyoming Family Health,1922152826,Family Planning Providers,350 City View Dr,Room No. 102,Evanston,WY,82930-5327,Uinta,350 City View Dr,,Evanston,WY,82930-5327,Uinta,Kathleen Shipley,Bookkeeper/Assistant,307-362-6813,,shipleyk@sweet.wy.us,,,,,,
WY-012337,Wind River Dialysis Center,Eastern Shoshone Tribe,1790824530,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",11 Shipton Lane,,Fort Washakie,WY,82514,Fremont,14 North Fork Rd,PO Box 538,Fort Washakie,WY,82514,Fremont,Catherine E Keene,Executive Director Health Programs,307-332-6902,12,catherine@esthealth.org,Christine Williams,CEO,307-332-2998,,christine@esthealth.org,
WY-012338,Eastern Shoshone Tribal Health,Eastern Shoshone Tribe,1902240070,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",28 Black Coal Rd,PO Box 250,Fort Washakie,WY,82514-0250,Fremont,14 North Fork Rd,PO Box 538,Fort Washakie,WY,82514,Fremont,"Vernon Hill, Sr.",Tribal Chairman,307-335-2000,12,vhill@easternshoshone.org,DAVID MYERS,Director Tribal Health,307-332-6805,,DAVID@ESTHEALTH.ORG,
WY-012339,Fort Washakie Health Center (Wind River Service Unit),Fort Washakie Health Center (Wind River Service Unit),1023174299,"Dental Providers, Family Planning Providers, Federally Qualified Health Centers - Medical Services, Indian Health Service, Sexually Transmitted Disease Clinics",29 Black Coal Dr,PO Box 128,Fort Washakie,WY,82514-0128,Fremont,29 Black Coal Drive,PO Box 128,Fort Washakie,WY,82514,Fremont,"Alice Moore, MSW, PhD Cand.",Chief Executive Officer,307-332-7300,,Alice.Moore@ihs.gov,,,,,,
WY-012340,Morning Star Care Center,Eastern Shoshone Tribe,1851481634,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",4 North Fork Rd,PO Box 859,Fort Washakie,WY,82514-0859,Fremont,14 North Fork Rd,PO Box 538,Fort Washakie,WY,82514,Fremont,Catherine E Keene,Administrator,307-332-6902,12,catherine@esthealth.org,Carley Clausen,Director of Nursing,307-332-6902,,carley@esthealth.org,
WY-012341,Eastern Shoshone Recovery Program,Eastern Shoshone Tribe,1265751309,"Other ECP Providers, Tribal Health Program operated under P.L. 93-638",7 Shipton Lane,PO Box 638,Fort Washakie,WY,82514,Fremont,14 North Fork Rd,PO Box 538,Ft. Washakie,WY,82514,Fremont,"Kellie Webb, LAT",Program/Clinical Director,307-332-2203,,ers.director@gmail.com,Catherine E Keene,Administrator Tribal Health,307-332-6902,13,catherine@esthealth.org,
WY-012342,Gillette Reproductive Health,Gillette Reproductive Health,1962524504,Family Planning Providers,1304 W 4th St,,Gillette,WY,82716-3330,Campbell,1304 W 4th,,Gillette,WY,82716,Campbell,Julie Price,Clinic Administrator,307-682-8110,,julie@4grh.com,,,,,,
WY-012343,Glenrock Health Center,Glenrock Health Center,1093758161,Rural Health Clinics,925 West Brich,PO Box 786,Glenrock,WY,82637-0786,Converse,925 West Birch,PO Box 786,Glenrock,WY,82637,Converse,Melanie Cielinski,Administrator,307-436-9206,106,mcielinski@glenrockhealth.com,Terri Simon,Office Manager,307-436-9206,100,tsimon@glenrockhealth.com,www.glenrockhealthcenter.com
WY-012344,Castle Rock Hospital District,Castle Rock Hospital District,1740206382,Rural Health Clinics,1400 Uinta Dr,,Green River,WY,82935-5060,Sweetwater,Po Box 219,,Green River,WY,82935,Sweetwater,Todd Toolson,CFO,307-872-4530,,todd.toolson@crhd.org,,,,,,
WY-012345,Washakie Family Planning,Washakie Family Planning Services,1871731406,Family Planning Providers,417 S 2nd St,,Greybull,WY,82426-2235,Big Horn,417 S 2nd St,,Greybull,WY,82426-2235,Big Horn,Amanda Heinemeyer,Project Director,307-347-3866,,amanda.heinemeyer@wyo.gov,,,307-347-3278,,,http://www.washakiecounty.net/public-health
WY-012346,SageWest Health Care Lander,LifePoint Health,1245337286,Inpatient Hospitals (other than children's hospitals),1320 Bishop Randall Dr,,Lander,WY,82520-3939,Fremont,330 Seven Springs Way,,Brentwood,TN,37027,Davidson,Ian Andes,,615-920-7362,,Ian.Andes@LPNT.net,Jennifer Hamilton,CFO,307-335-6509,,,
WY-012347,Fremont County Family Planning,Wyoming Health Council,1134495195,Other ECP Providers,450 N 2nd St,Room 350,Lander,WY,82520-2306,Fremont,450 N 2nd St Rm. 350,,Lander,WY,82520-2302,Fremont,Julie Twist,Project Director,307-332-1073,,julie.twist@wyo.gov,Jamie Cardine,RN,307-349-0085,,jamie.cardine@wyo.gov,
WY-012348,Laramie Reproductive Health,Laramie Reproductive Health,1851410682,"Family Planning Providers, Ryan White Providers, Sexually Transmitted Disease Clinics",413 S 21st St,,Laramie,WY,82070-4323,Albany,413 S 21st St,,Laramie,WY,82070-4323,Albany,Richelle Keinath,Executive Director,307-745-5364,,richelle@laramiereproductivehealth.org,Scott Cheney,Outreach and Education Coordinator,307-745-5364,,scott@laramiereproductivehealth.org,www.laramiereproductivehealth.org
WY-012349,North Big Horn Hospital,North Big Horn Hospital,1952379547,Inpatient Hospitals (other than children's hospitals),1115 Lane 12,,Lovell,WY,82431-9537,Big Horn,1115 Lane 12,,Lovell,WY,82431,Big Horn,Lori Smith,CFO,307-548-5215,,lsmith2@nbhh.com,,,,,,
WY-012350,North Big Horn Hospital Clinic,North Big Horn Hospital,1750485793,"Family Planning Providers, Outpatient Hospital Clinics, Rural Health Clinics",1115 Lane 12,,Lovell,WY,82431-9537,Big Horn,1115 Lane 12,,Lovell,WY,82431,Big Horn,Lori Smith,CFO,307-548-5215,,lsmith2@nbhh.com,Lori Smith,CFO,307-548-5215,,lsmith2@nbhh.com,
WY-012351,Weston County Health Services,Weston County Hospital District,1154402972,Inpatient Hospitals (other than children's hospitals),1124 Washington Blvd,,Newcastle,WY,82701-2972,Weston,1124 Washington Blvd.,,Newcastle,WY,82701,Weston,Maureen Kay Cadwell,CEO,307-746-3733,,mcadwell@wchs-wy.org,Lynn Moller,CFO,307-746-3708,,lmoller@wchs-wy.org,
WY-012352,Pine Bluffs Clinic,UNIVERSITY OF WYOMING,1316340417,Federally Qualified Health Centers - Medical Services,215 E. Main,Suite A,Pine Bluffs,WY,82082,Laramie,1000 E University Ave Dept 3434,,Laramie,WY,82071-2001,Albany,Dorothy C Yates,"Associate Vice President, Research",307-766-5320,,dyates4@uwyo.edu,"Kevin F Murray, MD",Director Medical Education,307-766-2113,,kmurra10@uwyo.edu,
WY-012353,Western Wyoming Family Health-Pinedale,Western Wyoming Family Health,1922152826,Family Planning Providers,619 E Hennick St,,Pinedale,WY,82941,Sublette,619 E Hennick St,,Pinedale,WY,82941,Sublette,Kathleen Shipley,Bookkeeper/Assistant,307-362-6813,,shipleyk@sweet.wy.us,,,,,,
WY-012354,Heritage Health Center,Powell Health Care Coalition,1568846962,Federally Qualified Health Centers - Medical Services,128 N Bent St,,Powell,WY,82435-2712,Park,128 N Bent,,Powell,WY,82435-2712,Park,Colette Behrent,Chief Executive Officer,307-764-4135,1601,cbehrent@heritagehealthcenter.org,,,,,,
WY-012356,Ag Worker Health & Services - Powell,"Montana Migrant and Seasonal Farmworkers Council, Inc.",1558735308,"Federally Qualified Health Centers - Medical Services, Sexually Transmitted Disease Clinics",212 W 6th St,,Powell,WY,82435-1809,Park,3318 3rd Ave N,,Billings,MT,59101,Yellowstone,Claudia Stephens,Strategic Planning Specialist,406-248-3149,0,cstephens@mtmigrantcouncil.org,Carol Townsend,Executive Director,406-248-3149,0,ctownsend@mtmigrantcouncil.org,http://mtmigrantcouncil.org
WY-012357,"Powell Valley Healthcare, Inc.",Powell Valley Healthcare,1497753115,Inpatient Hospitals (other than children's hospitals),777 Avenue H,,Powell,WY,82435-2260,Park,777 Avenue H,,Powell,WY,82435,Park,Mike Long,CFO,307-754-2267,,mlong@pvhc.org,Joy Coulston,Controller,307-754-1115,,jCoulston@pvhc.org,
WY-012358,Western Wyoming Family Health-Rawlins,Western Wyoming Family Health,1922152826,Family Planning Providers,617 W Pine St,,Rawlins,WY,82301-5429,Carbon,617 W Pine St,,Rawlins,WY,82301-5429,Carbon,Kathleen Shipley,Bookkeeper/Assistant,307-362-6813,,shipleyk@sweet.wy.us,,,,,,
WY-012360,Western Wyoming Family Health,Western Wyoming Family Health,1922152826,Family Planning Providers,333 Broadway St,Suite 120,Rock Springs,WY,82901-6254,Sweetwater,333 Broadway,Suite 120,Rock Springs,WY,82901-7272,Sweetwater,Kathleen Shipley,Bookkeeper/Assistant,307-362-6813,,shipleyk@sweet.wy.us,,,,,,
WY-012361,Reproductive Healthcare of the Big Horns,Reproductive Healthcare of the Big Horns,1841313723,Family Planning Providers,128 S Thurmond St,,Sheridan,WY,82801-4145,Sheridan,128 S Thurmond ST,,Sheridan,WY,82801,Sheridan,Amanda Blish Alexander,Clinical Coordinator,307-672-7054,,rhbhexdir@gmail.com,,,,,,
WY-012362,Washakie Family Planning Services,Washakie Family Planning Services,1871731406,Family Planning Providers,117 N 4th St,,Thermopolis,WY,82443-2732,Hot Springs,1007 Robertson Ave,,Worland,WY,82401,Washakie,Amanda Heinemeyer,Project Director,307-347-3866,,amanda.heinemeyer@wyo.gov,,,307-347-3278,,,
WY-012363,Red Rock Family Practice,Red Rock Family Practice,1316914922,Rural Health Clinics,120 N C Ave,,Thermopolis,WY,82443-2410,Hot Springs,120 N C Ave,,Thermopolis,WY,82443-2410,Hot Springs,Jenifer Grimm,Billing,307-864-5534,208,jeni@rrfp.org,Stephanie Richert,Billing,307-864-5534,205,stephanie@rrfp.org,
WY-012364,Hot Springs County Counseling Services,Hot Springs County Counseling Services,1235350034,Community Mental Health Centers,121 S 4th St,,Thermopolis,WY,82443-2634,Hot Springs,121 S. 4th St,,Thermopolis,WY,82443,Hot Springs,Allan Braaten,Executive Director,307-864-3138,,allan.braaten@hsccs.com,Cheryl Stewart,Executive Admin Assistant,307-864-3138,,cheryl.stewart@hsccs.com,hsccs.com
WY-012365,Red Rock Family Practice,Red Rock Family Practice,1023247624,Rural Health Clinics,1125 Charles Ave,,Worland,WY,82401-4021,Washakie,120 N C Ave,,Thermopolois,WY,82443,Hot Springs,Jenifer Grimm,Billing,307-864-8208,,jeni@rrfp.org,Stephanie Richert,Billing,307-864-5534,205,stephanie@rrfp.org,