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FP92102F FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (Terminated)
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Main Details
Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
LOGAN HEIGHTS FAMILY HEALTH CENTER
Type
Family Planning (Title X only)
340B ID
FP92102F
Grant Number
FPHPA006537
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2005
Participating Start Date
10/1/1999
Participating Approval Date
6/10/2005
Last Recertification Date
5/8/2024
Termination Date
Termination Reason
4/1/2025
Other
Contacts
Authorizing Official
Family Health Centers of San Diego
Ricardo Roman, CFO
(619) 906-4603
Primary Contact
Family Health Centers of San Diego, Inc.
Nichole M Laferriere, Business Analyst II
(619) 255-7313
Addresses
Street Address
1809 NATIONAL AVENUE
SAN DIEGO, CA 92113-2196
Billing Address
FAMILY HEALTH CENTERS OF SAN DIEGO, INC. - ADMINISTRATIVE OFFICES
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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2/19/10 DELETED MEDICAID# (WAS FHC 11890F);
02/19/2010
June 2025
June 2025
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