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CHC12849-00 AXIS COMMUNITY HEALTH, INC. (Active)
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Main Details
Name
AXIS COMMUNITY HEALTH, INC.
Subdivision Name
Axis Community Health - Pleasanton Site
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008405
340B ID
CHC12849-00
Grant Number
H80CS12849
Additional Details
Current Program Status
Active
Registration Date
6/10/2010
Participating Start Date
4/1/2003
Participating Approval Date
8/24/2005
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Axis Community Health
Liz Perez-Howe, CEO
(925) 201-6005
Primary Contact
Axis Community Health
Amit Pabla, Chief Operating Officer
(925) 201-6052
Addresses
Street Address
4361 Railroad Avenue
Pleasanton, CA 94566-6611
Billing Address
Axis Community Health
5925 W. Las Positas Blvd. UNIT 100
PLEASANTON, CA 94588-8537
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/22/09 CONTR PHARM NAME CHANGE (WAS THE MEDICINE SHOPPE #1068) 8/24/05 - REPLACES FQ100 (ADMIN CORRECTION)
06/11/2010
May 2025
May 2025
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