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CH09194C MENDOCINO COMMUNITY HEALTH CLINIC, INC. (Active)
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Main Details
Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
Dora Street Health Center, Suite B1
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021194
340B ID
CH09194C
Grant Number
H80CS00628
Additional Details
Current Program Status
Active
Registration Date
4/10/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/13/2018
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Mendocino Community Health Clinic
Rod Grainger, CEO
(707) 472-4667
Primary Contact
Mendocino Community Health Clinic
Oscar Murrillo, 340B Program Analyst
(707) 472-4518
Addresses
Street Address
1165 S Dora St Ste B1
Ukiah, CA 95482-6353
Billing Address
Mendocino Community Health Clinic, Inc.
333 Laws Avenue
Ukiah, CA 95482
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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