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CH09718H PEACH TREE CLINIC, THE, INC. (Terminated)
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Main Details
Name
PEACH TREE CLINIC, THE, INC.
Subdivision Name
Peach Tree Norwood
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017564
340B ID
CH09718H
Grant Number
H80CS06629
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/12/2016
Last Recertification Date
1/31/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
Peach Tree Healthcare
Greg Stone, CEO
(530) 741-6245 Ext: 1363
Primary Contact
Peach Tree Healthcare
Kay Sidhu, CFO
(530) 300-0308 Ext: 1360
Addresses
Street Address
3911 Norwood Avenue
Sacramento, CA 95838
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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