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FQHC638366 Riverside - San Bernardino County Indian Health, Inc. (Active)
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Main Details
Name
Riverside - San Bernardino County Indian Health, Inc.
Subdivision Name
SAN MANUEL INDIAN HEALTH CLINIC
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638366
Additional Details
Current Program Status
Active
Registration Date
7/1/1996
Participating Start Date
7/1/1996
Participating Approval Date
1/11/2010
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Riverside-San Bernardino County Indian Health, Inc.
Bill Thomsen, CEO
(909) 864-1097 Ext: 4703
Primary Contact
Riverside-San Bernardino County Indian Health, Inc.
Jeevan s Dhouni, Pharmacy Director
(909) 864-1097 Ext: 4776
Addresses
Street Address
11980 Mt. Vernon Ave
Grand Terrace, CA 92313
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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10/1/99 UPDATED ADDR(WAS 5771 NORTH VICTORIA, HIGHLANDS, CA 92348)
01/11/2010
April 2025
April 2025
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