340B Drug Pricing Program Database
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CH09078AF COMMUNITY MEDICAL CENTERS, INC. (Terminated)
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Main Details
Name
COMMUNITY MEDICAL CENTERS, INC.
Subdivision Name
Community Medical Centers, Vine Suite 105
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027907
340B ID
CH09078AF
Grant Number
H80CS00138
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/11/2019
Last Recertification Date
2/23/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Community Medical Centers, inc.
Greg Diederich, CEO
(209) 373-2826
Primary Contact
Community Medical Centers, Inc.
Pak Hui, Director of Pharmacy
(209) 940-4677
Addresses
Street Address
2415 W Vine St.
Suite 105
Lodi, CA 95242-3731
Billing Address
Community Medical Centers, Inc.
PO Box 779
Stockton, CA 95201-0779
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
May 2025
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