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CHC10608-18 CENTRAL CITY COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Central City Community Health Center - San Pedro
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017374
340B ID
CHC10608-18
Grant Number
H80CS10608
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/17/2016
Last Recertification Date
3/6/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Central City Community Health Center Inc.
Sommer R Kaskowitz, Chief Nursing Officer
(323) 724-0019 Ext: 1026
Primary Contact
Central City Community Health Center
Franklin Gonzalez, Chief Executive Officer
(323) 724-0019 Ext: 1014
Addresses
Street Address
928 S PALOS VERDES ST
SAN PEDRO, CA 90731-3721
Billing Address
Central City Community Health Center, Inc
1000 San Gabriel Blvd
Ste. 200
Rosemead, CA 91770
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Grantee Sites Contract Pharmacies
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