340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CH097880 PETALUMA HEALTH CENTER, INC (Active)
Print
Main Details
Name
PETALUMA HEALTH CENTER, INC
Subdivision Name
Petaluma Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008799
340B ID
CH097880
Grant Number
H80CS00587
Additional Details
Current Program Status
Active
Registration Date
2/24/2006
Participating Start Date
7/1/2000
Participating Approval Date
2/24/2006
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Petaluma Health Center
Molly Jouaneh, Chief Financial Officer
(707) 559-7500
Primary Contact
Petaluma Health Center
Pedro Toledo, Chief Executive Officer
(707) 326-7551
Addresses
Street Address
1179 N. McDowell Blvd.
Petaluma, CA 94954-6559
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
2/24/06 - REPLACES FQHCLA116. 7/8/11 - CHANGED PHYSICAL ADDRESS FROM 1301 SOUTHPOINT BLVD, CHANGED AO FROM KATHRYN POWELL AND CONTACT FROM NURIT LICHT, MD.
07/08/2011
2/24/06 - REPLACES FQHCLA116. 7/8/11 - CHANGED PHYSICAL ADDRESS FROM 1301 SOUTHPOINT BLVD, CHANGED AO FROM KATHRYN POWELL AND CONTACT FROM NURIT LICHT, MD.
07/08/2011
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session