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CH09108W CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. (Terminated)
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Main Details
Name
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Subdivision Name
Chula Vista Medical Plaza
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013436
340B ID
CH09108W
Grant Number
H80CS10748
Additional Details
Current Program Status
Terminated
Registration Date
1/6/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/25/2014
Last Recertification Date
3/2/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Centro de Salud de la Comunidad de San Ysidro, Inc.,
Kevin Mattson, President & CEO
(619) 662-6322
Primary Contact
Centro de Salud de la Comunidad de San Ysidro, Inc.
Gilbert Fimbres, CFO
(619) 662-6331
Addresses
Street Address
678 3rd Ave
Chula Vista, CA 91910-5736
Billing Address
Chula Vista Medical Plaza
1275 30th Street
San Diego, CA 92154
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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