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CH09879W SANTA ROSA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Van #1 (Tiburcio)
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021513
340B ID
CH09879W
Grant Number
H80CS00259
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/15/2020
Last Recertification Date
2/3/2022
Termination Date
Termination Reason
4/1/2023
Site closure
Contacts
Authorizing Official
Santa Rosa Community Health
Gabriela Bernal Leroi, Chief Executive Officer
(415) 312-9646
Primary Contact
Santa Rosa Community Health
Steven Ghidinelli, CAO
(707) 303-3600
Addresses
Street Address
1110 N Dutton Ave
Santa Rosa, CA 95401-4606
Billing Address
Santa Rosa Community Health Centers
Van #1 (Tiburcio)
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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Participated starting 12/13/2017, terminated 10/1/2019. Reinstated 7/1/2020.
04/15/2020
April 2025
April 2025
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