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CH092080 ALLIANCE MEDICAL CENTER, INC. (Active)
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Main Details
Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
ALLIANCE MEDICAL CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005352
340B ID
CH092080
Grant Number
H80CS00249
Additional Details
Current Program Status
Active
Registration Date
4/1/1996
Participating Start Date
4/1/1996
Participating Approval Date
9/8/2004
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Alliance Medical Center
Susannah Labbe, CEO
(707) 480-3898
Primary Contact
Alliance Medical Center
Amy G Fawcett, CFO
(949) 923-9545
Addresses
Street Address
1381 UNIVERSITY AVENUE
HEALDSBURG, CA 95448-3314
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW ADDRESS
09/08/2004
May 2025
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