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FQHC638524 Colusa Indian Health Clinic (Active)
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Main Details
Name
Colusa Indian Health Clinic
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638524
Additional Details
Current Program Status
Active
Registration Date
10/15/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
3/12/2025
Contacts
Authorizing Official
Colusa Indian Health Clinic
Catrina Ross, Director of Clinic Operations
(530) 458-5501 Ext: 6542
Primary Contact
Colusa Indian Health Clinic
Daisy Franco, Clinic Coordinator
(530) 458-6548
Addresses
Street Address
3710 Highway 45
Colusa, CA 95932
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (07/01/2019) until terminated effective date: (04/01/2022); reinstatement effective date: (01/1/2025)
10/21/2024
Participating from effective date (1/1/2012) until terminated effective date (4/1/2017), reinstatement effective date (07/01/2019)
05/01/2019
May 2025
May 2025
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