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CH09879AA SANTA ROSA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Mobile Van #7 in use as a fixed site
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021715
340B ID
CH09879AA
Grant Number
H80CS00259
Additional Details
Current Program Status
Terminated
Registration Date
3/7/2018
Participating Start Date
3/8/2018
Participating Approval Date
3/8/2018
Last Recertification Date
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 Court; parked mobile van in parking lot
Santa Rosa, CA 95407
Billing Address
Santa Rosa Community Health
Lombardi Campus
3569 Round Barn Circle
Santa Rosa, CA 95407
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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