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CH092535K SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC (Terminated)
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Main Details
Name
SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC
Subdivision Name
Gilroy Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014719
340B ID
CH092535K
Grant Number
H80CS06646
Additional Details
Current Program Status
Terminated
Registration Date
1/7/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
1/27/2020
Termination Date
Termination Reason
1/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Foothill Community Health Center
Salvador Chavarin, Chief Executive Officer
(408) 729-4290
Primary Contact
Bay Area Community Health
NEIL KOZUMA, Development Director
(408) 729-4290 Ext: 4087294290
Addresses
Street Address
9460 NO NAME UNO
Gilroy, CA 95020-3536
Billing Address
San Jose Foothill Family Community Clinic
2670 S. White Road, Suite 200
San Jose, CA 95148
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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