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CH10103AH YAKIMA VALLEY FARM WORKERS CLINIC (Terminated)
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Main Details
Name
YAKIMA VALLEY FARM WORKERS CLINIC
Subdivision Name
Toppenish Medical-Dental Clinic Pharmacy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010886
340B ID
CH10103AH
Grant Number
H80CS00639
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2015
Participating Start Date
4/1/2015
Participating Approval Date
1/20/2015
Last Recertification Date
2/13/2017
Termination Date
Termination Reason
4/1/2018
Other
Contacts
Authorizing Official
Yakima Valley Farm Workers Clinic
JUAN CARLOS OLIVARES, CEO
(509) 865-5898 Ext: 2101
Primary Contact
Yakima Valley Farm Workers Clinic
Glen Davis, COO
(509) 865-6175 Ext: 2618
Addresses
Street Address
602 W 1st Ave
Toppenish, WA 98948-1566
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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