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CH09312CM FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Ibarra Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014590
340B ID
CH09312CM
Grant Number
H80CS00224
Additional Details
Current Program Status
Active
Registration Date
4/7/2015
Participating Start Date
7/1/2015
Participating Approval Date
4/14/2015
Last Recertification Date
3/1/2025
Contacts
Authorizing Official
Family Health Centers of San Diego
Ricardo Roman, CFO
(619) 906-4603
Primary Contact
Family Health Centers of San Diego, Inc.
Nichole M Laferriere, Business Analyst II
(619) 255-7313
Addresses
Street Address
4874 Polk Ave
San Diego, CA 92105
Billing Address
Family Health Centers of San Diego, Inc.
823 Gateway Center Way
San Diego, CA 92102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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