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CH09879U SANTA ROSA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Santa Rosa Community Health Center Mobile Clinic 3-TEMPORARY
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021336
340B ID
CH09879U
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
Attn Accounts Payable 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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