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CH09538H Marin Community Clinic (Active)
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Main Details
Name
Marin Community Clinic
Subdivision Name
Marin Community Clinic - 4th Street Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011038
340B ID
CH09538H
Grant Number
H80CS00343
Additional Details
Current Program Status
Active
Registration Date
10/9/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/16/2020
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Marin Community Clinics
Kathryn E Powell, Interim Chief Executive Officer
(415) 448-1500
Primary Contact
Marin Community Clinic
Sheri Dunham, Compliance Coordinator
(415) 376-3255
Addresses
Street Address
411 4th St STE A
San Rafael, CA 94901-5716
Billing Address
Marin Community Clinic
9 Commercial Blvd, Ste 100
Novato, CA 94949
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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