Yes
| Details | Last Recertification Date | Update | Recertification | | 2/26/2025 5:54:35 PM | 2/26/2025 5:54 PM |
| Details | State | Update | | Approved | Active | 7/1/2024 12:01 AM |
| Contacts | Signed By | Insert | New Registration | | Page, Zettie D
CEO
Bay Area Community Health
7609025249 | 5/6/2024 2:37 PM |
| Details | 340B ID | Update | New Registration | | CH09122AE | 5/6/2024 2:37 PM |
| Dates | Participating Approval Date | Update | New Registration | | 5/6/2024 2:37:36 PM | 5/6/2024 2:37 PM |
| Details | State | Update | New Registration | Pending | Approved | 5/6/2024 2:37 PM |
| Dates | Signed By Date | Update | New Registration | | 4/2/2024 3:25:15 PM | 5/6/2024 2:37 PM |
| Dates | Start Date | Update | New Registration | | 7/1/2024 12:00:00 AM | 5/6/2024 2:37 PM |
| Addresses | Main Address | Insert | New Registration | |
40910 Fremont Blvd
Fremont, CA 94538-4375 | 4/2/2024 12:01 AM |
| Medicaid Billing | Medicaid: Is Primary | Insert | New Registration | | False | 4/2/2024 12:01 AM |
| Medicaid Billing | Medicaid: Number | Insert | New Registration | | 1184791998 | 4/2/2024 12:01 AM |
| Medicaid Billing | Medicaid: State | Insert | New Registration | | CA | 4/2/2024 12:01 AM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1184791998 | 4/2/2024 12:01 AM |
| Medicaid Billing | NPI: State | Insert | New Registration | | CA | 4/2/2024 12:01 AM |
| Contacts | Primary Contact | Insert | New Registration | | Monterola, Trina
Director of Finance and Controller
Bay Area Community Health
5103045360 | 4/2/2024 12:01 AM |
| Contacts | Authorizing Official | Insert | New Registration | | Page, Zettie D
CEO
Bay Area Community Health
7609025249 | 4/2/2024 12:01 AM |
| Details | Assistance Received From Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Assistance Received To Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Last Recertification Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Grant Number | Insert | New Registration | | H80CS02326 | 4/2/2024 12:01 AM |
| Details | 340B ID | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Medicare Provider Number | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Entity Name | Insert | New Registration | | BAY AREA COMMUNITY HEALTH | 4/2/2024 12:01 AM |
| Details | NOFO Number | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | Program Code | Insert | New Registration | | CH | 4/2/2024 12:01 AM |
| Details | Entity Subname | Insert | New Registration | | Mobile Health Clinic #1 | 4/2/2024 12:01 AM |
| Dates | Participating Approval Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Details | State | Insert | New Registration | | Pending | 4/2/2024 12:01 AM |
| Dates | Registration Date | Insert | New Registration | | 4/2/2024 12:01:02 AM | 4/2/2024 12:01 AM |
| Dates | Signed By Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Dates | Start Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Terminations | Termination Comments | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Terminations | Termination Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 4/2/2024 12:01 AM |
| Terminations | Termination Reason | Insert | New Registration | | | 4/2/2024 12:01 AM |