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CH09879T SANTA ROSA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
TEMPORARY SITE-Santa Rosa Community Health Center Mobile Clinic 2
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021334
340B ID
CH09879T
Grant Number
H80CS00259
Additional Details
Current Program Status
Terminated
Registration Date
11/2/2017
Participating Start Date
11/3/2017
Participating Approval Date
11/3/2017
Last Recertification Date
2/11/2018
Termination Date
Termination Reason
4/1/2019
Other
Contacts
Authorizing Official
Santa Rosa Community Health Centers
Naomi Fuchs, CEO
(707) 303-3600 Ext: 3111
Primary Contact
Santa Rosa Community Health Centers
Noeleen Farrell, Director of Corporate Compliance and Assurance
(707) 387-3265
Addresses
Street Address
751 Lombardi Ct
Santa Rosa, CA 95407-6798
Billing Address
Santa Rosa Community Health
Accounts Payable-Mobile Van 2 Lombardi Campus
3569 Round Barn Circle
Santa Rosa, CA 95403
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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