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FQHC638558 Coyote Valley Band of Pomo Indians (Terminated)
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Main Details
Name
Coyote Valley Band of Pomo Indians
Subdivision Name
Tribal Health and Human Services
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638558
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/15/2019
Last Recertification Date
Termination Date
Termination Reason
4/1/2020
Never implemented the 340B Program
Contacts
Authorizing Official
Coyote Valley Band of Pomo Indians
Bernadette Mora, Tribal Administrator
(707) 485-8723
Primary Contact
Coyote Valley Tribal Health Department
Leah Sautelet, Health & Human Services Director
(707) 472-2202
Addresses
Street Address
7601 North State Street
Redwood Valley, CA 95470-9492
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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June 2025
June 2025
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