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CH09901Y BORREGO COMMUNITY HEALTH FOUNDATION (Terminated)
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Main Details
Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
D STREET MEDICAL CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017459
340B ID
CH09901Y
Grant Number
H80CS00287
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/5/2016
Last Recertification Date
2/24/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Borrego Community Health Foundation
Edgar Bulloch, Interim CEO
(760) 767-6641
Primary Contact
Borrego Community Health Foundation
Mark Connelly, COO
(760) 767-6422
Addresses
Street Address
590 NORTH D STREET
SAN BERNARDINO, CA 92401-1352
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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