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CH091026E SOUTH BAY FAMILY HEALTH CARE CENTER INC (Terminated)
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Main Details
Name
SOUTH BAY FAMILY HEALTH CARE CENTER INC
Subdivision Name
SOUTH BAY HEALTHCARE CTR - OBGYN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006759
340B ID
CH091026E
Grant Number
H80CS00877
Additional Details
Current Program Status
Terminated
Registration Date
7/2/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/20/2013
Last Recertification Date
2/4/2021
Termination Date
Termination Reason
1/1/2022
Other
Contacts
Authorizing Official
SBFHC
JANN HAMILTON LEE, CHIEF EXECUTIVE OFFICER
(310) 802-6177 Ext: 1105
Primary Contact
South Bay Family Health Care
Bertha Becerra, QA/QI Director
(310) 802-6177 Ext: 1116
Addresses
Street Address
323 N. PRAIRIE AVE
INGLEWOOD, CA 90301-4502
Billing Address
South Bay Family Health Care
23430 Hawthorne Blvd.
Suite 210
Torrance, CA 90505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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