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FQHCLA473 SAFE HARBOR MEDICAL, INC. (Active)
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Main Details
Name
SAFE HARBOR MEDICAL, INC.
Subdivision Name
SAFE HARBOR MEDICAL
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-038977
340B ID
FQHCLA473
Grant Number
LALCS53448
Additional Details
Current Program Status
Active
Registration Date
10/1/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/2/2024
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Safe Harbor Medical
TINA ALICEA, CEO
(702) 870-8852
Primary Contact
Safe Harbor Medical
Pauline Mah, COO
(702) 870-8852 Ext: 110
Addresses
Street Address
2901 N Tenaya Way Ste 100
Las Vegas, NV 89128-1404
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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