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CH092176D WESTERN SIERRA MEDICAL CLINIC INC (Terminated)
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Main Details
Name
WESTERN SIERRA MEDICAL CLINIC INC
Subdivision Name
Western Sierra Medical Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018207
340B ID
CH092176D
Grant Number
H80CS08234
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/2/2017
Last Recertification Date
2/8/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Western Sierra Medical Clinic
Jennifer Malone, CEO
(530) 273-3819
Primary Contact
Western Sierra Medical Clinic
Francine Novak, Chief Planning and Development Officer
(530) 273-4984 Ext: 102
Addresses
Street Address
12183 Locksley Lane Suite #107
Auburn, CA 95602
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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