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CH09901E BORREGO COMMUNITY HEALTH FOUNDATION (Terminated)
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Main Details
Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
JULIAN MEDICAL CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007051
340B ID
CH09901E
Grant Number
H80CS00287
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/14/2012
Last Recertification Date
2/24/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Borrego Community Health Foundation
Edgar Bulloch, Interim CEO
(760) 767-6641
Primary Contact
Borrego Community Health Foundation
Mark Connelly, COO
(760) 767-6422
Addresses
Street Address
2721 WASHINGTON STREET
JULIAN, CA 92036
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/16/12 - Reviewed and forwarded to IS for processing.
05/16/2012
June 2025
June 2025
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