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CH09152L Mountain Health & Community Services, Inc. (Terminated)
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Main Details
Name
Mountain Health & Community Services, Inc.
Subdivision Name
Community Heights Family Medicine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019538
340B ID
CH09152L
Grant Number
H80CS00284
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/7/2020
Termination Date
Termination Reason
7/1/2020
Other
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
4690 El Cajon Boulevard
San Diego, CA 92115
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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