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FQHC638022 TULE RIVER INDIAN HEALTH CENTER, INC. (Active)
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Main Details
Name
TULE RIVER INDIAN HEALTH CENTER, INC.
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638022
Additional Details
Current Program Status
Active
Registration Date
4/12/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/20/2024
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
TRIHCI
Elizabeth Medrano, Executive Office Manager
(559) 784-2316 Ext: 276
Primary Contact
TRIHCI
Sylvia Jimenez, Staff Accountant
(559) 784-2316 Ext: 268
Addresses
Street Address
380 NORTH RESERVATION ROAD
PORTERVILLE, CA 93257
Billing Address
Tule River Indian Health Center, Inc.
PO Box 768
Porterville, CA 93258
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (01/01/1995) until terminated effective date: (04/01/2024); reinstatement effective date: (07/1/2024)
04/18/2024
12/01/04 UPDATED ADDR(WAS 340 INDIAN RESERVATION ROAD); 9/27/05 UPDATED ADDR (WAS 370 INDIAN RESERVATION ROAD)
01/14/2010
June 2025
June 2025
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