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CHC28992-12 Sac Health System (Terminated)
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Main Details
Name
Sac Health System
Subdivision Name
SAC Barstow
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033961
340B ID
CHC28992-12
Grant Number
H80CS28992
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2022
Participating Start Date
4/1/2022
Participating Approval Date
2/8/2022
Last Recertification Date
1/30/2023
Termination Date
Termination Reason
1/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
SACHS
bonnie inquinn chi-lum, CMO
(951) 235-0642
Primary Contact
SAC Health
Tasha Amick, Director of Billing
(909) 219-8665 Ext: 4230
Addresses
Street Address
801 E Mountain View St
Barstow, CA 92311-3053
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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