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CH09194B MENDOCINO COMMUNITY HEALTH CLINIC, INC. (Active)
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Main Details
Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
LAKEVIEW HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005336
340B ID
CH09194B
Grant Number
H80CS00628
Additional Details
Current Program Status
Active
Registration Date
2/16/2011
Participating Start Date
4/1/2011
Participating Approval Date
2/22/2011
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Mendocino Community Health Clinic
Rod Grainger, CEO
(707) 472-4667
Primary Contact
Mendocino Community Health Clinic
Oscar Murrillo, 340B Program Analyst
(707) 472-4518
Addresses
Street Address
5335 Lakeshore Blvd
Lakeport, CA 95453-6123
Billing Address
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
333 LAWS AVENUE
UKIAH, CA 95482
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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