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CH09901AR BORREGO COMMUNITY HEALTH FOUNDATION (Terminated)
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Main Details
Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
Stanley H Schwartz, M.D., Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027629
340B ID
CH09901AR
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
Termination Date
Termination Reason
4/1/2021
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
264 N Highland Springs Avenue STE 1-A, 1-B
Banning, CA 92220-3045
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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