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CH09788A PETALUMA HEALTH CENTER, INC. (Active)
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Main Details
Name
PETALUMA HEALTH CENTER, INC.
Subdivision Name
Rohnert Park Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015298
340B ID
CH09788A
Grant Number
H80CS00587
Additional Details
Current Program Status
Active
Registration Date
10/2/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/23/2015
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Petaluma Health Center
Molly Jouaneh, Chief Financial Officer
(707) 559-7500
Primary Contact
Petaluma Health Center
Pedro Toledo, Chief Executive Officer
(707) 326-7551
Addresses
Street Address
5900 State Farm Dr., Suite 200
Rohnert Park, CA 94928-2149
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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