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CH09901AL BORREGO COMMUNITY HEALTH FOUNDATION (Terminated)
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Main Details
Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
METROPOLITAN FAMILY MEDICAL CLINIC- RIVERSIDE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030154
340B ID
CH09901AL
Grant Number
H80CS00287
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/21/2020
Last Recertification Date
2/24/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Borrego Community Health Foundation
Edgar Bulloch, Interim CEO
(760) 767-6641
Primary Contact
Borrego Community Health Foundation
Mark Connelly, COO
(760) 767-6422
Addresses
Street Address
4990 ARLINGTON AVE # D
RIVERSIDE, CA 92504-2757
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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