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CH09039AH CLINICA SIERRA VISTA (Terminated)
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Main Details
Name
CLINICA SIERRA VISTA
Subdivision Name
DEATH VALLEY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003076
340B ID
CH09039AH
Grant Number
H80CS00540
Additional Details
Current Program Status
Terminated
Registration Date
9/15/2010
Participating Start Date
10/1/2010
Participating Approval Date
9/15/2010
Last Recertification Date
2/14/2019
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
Clinica Sierra Vista
Brian Harris, CEO
(661) 635-3050 Ext: 2152
Primary Contact
Clinica Sierra Vista
Pam Bookout, Director of Pharmacy
(661) 635-3050 Ext: 2147
Addresses
Street Address
140 N. State Highway 127
SHOSHONE, CA 92384-0158
Billing Address
CLINICA SIERRA VISTA
1430 TRUXTUN AVENUE, SUITE 400
P.O. BOX 1559
BAKERSFIELD, CA 93301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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