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CH09152S Mountain Health & Community Services, Inc. (Terminated)
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Main Details
Name
Mountain Health & Community Services, Inc.
Subdivision Name
Alpine Family Medicine Suite 114
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019535
340B ID
CH09152S
Grant Number
H80CS00284
Additional Details
Current Program Status
Terminated
Registration Date
4/16/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/19/2018
Last Recertification Date
2/7/2020
Termination Date
Termination Reason
7/1/2020
Other
Contacts
Authorizing Official
Mountain Health & Community Services, Inc
Amy Weisiger, CFO
(619) 478-5254 Ext: 229
Primary Contact
Mountain Health and Community Services, Inc.
Maria Ramirez, Credentialing Coordinator
(619) 478-5254 Ext: 238
Addresses
Street Address
1620 Alpine Boulevard Suite 114
Alpine, CA 91901-1103
Billing Address
Mountain Health & Community Services, Inc.
31115 Hwy 94
Campo, CA 91906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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