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CH09160AQ Omni Family Health (Terminated)
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Main Details
Name
Omni Family Health
Subdivision Name
Omni Family Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032869
340B ID
CH09160AQ
Grant Number
H80CS00615
Additional Details
Current Program Status
Terminated
Registration Date
10/18/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/25/2021
Last Recertification Date
1/29/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Omni Family Health
Joseph Hayes, Chief medical officer
(661) 630-7039
Primary Contact
Omni Family health
Peter Nabil Tawfik, Senior Director of Pharmacy
(661) 805-8397
Addresses
Street Address
141 S Mirage Ave
Lindsay, CA 93247-2541
Billing Address
Omni Family Health
4900 California Ave
400B
Bakersfield, CA 93309
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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