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CH09311AW ALTAMED HEALTH SERVICES CORPORATION (Terminated)
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Main Details
Name
ALTAMED HEALTH SERVICES CORPORATION
Subdivision Name
AltaMed Medical Group - Santa Ana, Broadway
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014589
340B ID
CH09311AW
Grant Number
H80CS00142
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/15/2016
Last Recertification Date
2/2/2021
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
AltaMed Health Services Corporation
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Primary Contact
AltaMed Health Services Corporation
Israel Espinoza, Care Management Coordinator
(323) 889-7886
Addresses
Street Address
1515 S Broadway Street
Santa Ana, CA 92707-2253
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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