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FQHCLA308 Universal Community Health Center (Terminated)
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Main Details
Name
Universal Community Health Center
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-011293
340B ID
FQHCLA308
Grant Number
H80CS30722
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/27/2013
Last Recertification Date
1/30/2019
Termination Date
Termination Reason
7/1/2019
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Universal Community Health Center
Edgar Alexander Chavez, CEO
(323) 485-0467
Primary Contact
Universal Community Health Center
Alfredo 3233135588 Reynoso, Chief Operations Officer
(323) 233-3100 Ext: 144
Addresses
Street Address
1005 E. Washington Blvd.
Suite A
Los Angeles, CA 90021
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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