340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RWII93291 Source LGBT Center, INC (Active)
Print
Main Details
Name
Source LGBT Center, INC
Subdivision Name
The Source LGBT+ Center
Type
Ryan White Part B
340B ID
RWII93291
Grant Number
X07HA12778
Additional Details
Current Program Status
Active
Registration Date
1/23/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/28/2022
Last Recertification Date
2/10/2025
Time Period the Assistance was Received
7/1/2020 - 6/30/2029
Contacts
Authorizing Official
The Source LGBT+ Center
Brian Poth, Executive Director
(559) 429-4277 Ext: 8
Primary Contact
The Source LGBT+ Center
Dean Jackson, Program Director, HIV Services
(559) 429-4277 Ext: 6
Addresses
Street Address
109 NW 2nd Avenue
Visalia, CA 93291
Billing Address
The Source LGBT+ Center
PO Box 188
Visalia, CA 93279
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating from effective date: (1/1/2021) until terminated effective date: (1/1/2022), reinstatement effective date: (4/1/2022)
01/28/2022
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session