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CH091026D SOUTH BAY FAMILY HEALTH CARE CENTER INC (Terminated)
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Main Details
Name
SOUTH BAY FAMILY HEALTH CARE CENTER INC
Subdivision Name
SBFHC - INGLEWOOD
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000869
340B ID
CH091026D
Grant Number
H80CS00877
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2005
Participating Start Date
4/1/2005
Participating Approval Date
3/4/2005
Last Recertification Date
2/4/2021
Termination Date
Termination Reason
1/1/2022
Other
Contacts
Authorizing Official
SBFHC
JANN HAMILTON LEE, CHIEF EXECUTIVE OFFICER
(310) 802-6177 Ext: 1105
Primary Contact
South Bay Family Health Care
Bertha Becerra, QA/QI Director
(310) 802-6177 Ext: 1116
Addresses
Street Address
1091 S. LA BREA AVE
INGLEWOOD, CA 90301-3817
Billing Address
SOUTH BAY FAMILY HEALTHCARE CENTER
23430 HAWTHORNE BLVD., SUITE 210
TORRANCE, CA 90505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW SITE 4/01/05
08/12/2005
April 2025
April 2025
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