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CH09152J MOUNTAIN HEALTH & COMMUNITY SERVICES, INC. (Terminated)
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Main Details
Name
MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.
Subdivision Name
North Inland Family Medicine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017649
340B ID
CH09152J
Grant Number
H80CS00284
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/13/2017
Last Recertification Date
2/23/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Mountain Health & Community Services, Inc
Amy Weisiger, CFO
(619) 478-5254 Ext: 229
Primary Contact
Mountain Health and Community Services, Inc.
Maria Ramirez, Credentialing Coordinator
(619) 478-5254 Ext: 238
Addresses
Street Address
125 West Mission Avenue, Suite 105
Escondido, CA 92025-1721
Billing Address
Mountain Health & Community Services, Inc
31115 Highway 94
Campo, CA 91906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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