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CH09901AB BORREGO COMMUNITY HEALTH FOUNDATION (Terminated)
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Main Details
Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
MOBILE DENTAL UNIT #3
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018778
340B ID
CH09901AB
Grant Number
H80CS00287
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/11/2017
Last Recertification Date
2/22/2023
Termination Date
Termination Reason
4/1/2024
Failure to recertify
Contacts
Authorizing Official
BORREGO COMMUNITY HEALTH FOUNDATION
Rose MacIsaac, CEO
(760) 767-6684
Primary Contact
Borrego Community Health Foundation - Borrego Springs, CA
Guanzhong Yao Lo, Pharmacist
(760) 507-3300
Addresses
Street Address
69175 Ramon Road Bldg A
Cathedral City, CA 92234
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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