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HV09311C AltaMed Health Services Corporation (Terminated)
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Main Details
Name
AltaMed Health Services Corporation
Subdivision Name
AltaMed Daniel Lara HIV - Pico Rivera
Type
Ryan White Part C
340B ID
HV09311C
Grant Number
H76HA00169
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2003
Participating Start Date
4/1/2003
Participating Approval Date
4/29/2005
Last Recertification Date
2/25/2019
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2020
Failure to recertify
Contacts
Authorizing Official
AltaMed Health Services Corporation
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Primary Contact
AltaMed Health Services Corporation
Nereyda Godinez Felix, Project Coordinator
(323) 201-9794
Addresses
Street Address
9436 SLAUSON AVE
PICO RIVERA, CA 90660
Billing Address
AltaMed Health Services Corporation
2040 Camfield Avenue
LOS ANGELES, CA 90040
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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NEW CONTACT, ENTITY NAME, ADDRESS CORRECTION, NEW BILL TO
08/12/2005
April 2025
April 2025
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