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CH09107A SF COMMUNITY CLINIC CONSORTIUM (Terminated)
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Main Details
Name
SF COMMUNITY CLINIC CONSORTIUM
Subdivision Name
TOM WADDELL HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002543
340B ID
CH09107A
Grant Number
H80CS00049
Additional Details
Current Program Status
Terminated
Registration Date
7/1/1997
Participating Start Date
7/1/1997
Participating Approval Date
6/17/2005
Last Recertification Date
1/31/2023
Termination Date
Termination Reason
4/1/2023
Site closure
Contacts
Authorizing Official
ZSFG
Susan Ehrlich, CEO
(628) 206-8118
Primary Contact
ZSFG
David E Smith, Pharmacy Manager
(628) 206-2332
Addresses
Street Address
50 Dr Tom Waddell Pl
SAN FRANCISCO, CA 94102
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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ADMIN CORRECTION REPLACES HO09107A, 8/11/05 - ADDR CH (WAS 50 IVY STREET)
08/11/2005
May 2025
May 2025
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