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CHC24202-01 WILMINGTON COMMUNITY CLINIC (Active)
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Main Details
Name
WILMINGTON COMMUNITY CLINIC
Subdivision Name
Wilmington Community Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011803
340B ID
CHC24202-01
Grant Number
H80CS24202
Additional Details
Current Program Status
Active
Registration Date
1/31/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/1/2013
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Wilmington Community Clinic
Benjamin Alvarez, COO
(310) 722-5852
Primary Contact
Wilmington Community Clinic
Noemi Martinez, Project Coordinator
(310) 549-5760
Addresses
Street Address
1009 N Avalon Blvd
Wilmington, CA 90744-4505
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/1/13 formerly enrolled in 340B as FQHCLA164
02/01/2013
May 2025
May 2025
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