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CH09312CG FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Elm Street Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010752
340B ID
CH09312CG
Grant Number
H80CS00224
Additional Details
Current Program Status
Active
Registration Date
6/13/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/14/2012
Last Recertification Date
3/1/2025
Contacts
Authorizing Official
Family Health Centers of San Diego
Ricardo Roman, CFO
(619) 906-4603
Primary Contact
Family Health Centers of San Diego, Inc.
Nichole M Laferriere, Business Analyst II
(619) 255-7313
Addresses
Street Address
140 Elm St
San Diego, CA 92101-2602
Billing Address
Family Health Centers of San Diego, Inc.
823 Gateway Center Way
San Diego, CA 92102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/14/12 wet ink signature by Fran Butler-Cohen on paper registration
06/14/2012
April 2025
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