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CH09039AK CLINICA SIERRA VISTA (Active)
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Main Details
Name
CLINICA SIERRA VISTA
Subdivision Name
DENTAL: CLINICA SIERRA VISTA - Elm Dental Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010017
340B ID
CH09039AK
Grant Number
H80CS00540
Additional Details
Current Program Status
Active
Registration Date
4/9/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/14/2012
Last Recertification Date
3/3/2025
Contacts
Authorizing Official
Clinica Sierra Vista
Dixit Bhakta, Director of Pharmacy
(661) 779-3118
Primary Contact
Clinica Sierra Vista
Diane Marin-Gonzalez, 340B Analyst
(954) 686-5823
Addresses
Street Address
2756 S. Elm Ave
Fresno, CA 93706
Billing Address
Clinica Sierra Vista
1430 Truxtun Ave, STE 400
PO BOX 1559
Bakersfield, CA 93301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/18/12 - Reviewed registration and submitted to IS.
05/18/2012
May 2025
May 2025
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