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CH091181B SANTA CLARA, COUNTY OF (Active)
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Main Details
Name
SANTA CLARA, COUNTY OF
Subdivision Name
Valley Health Center Tully
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002441
340B ID
CH091181B
Grant Number
H80CS01442
Additional Details
Current Program Status
Active
Registration Date
7/1/2001
Participating Start Date
7/1/2001
Participating Approval Date
7/19/2005
Last Recertification Date
2/20/2025
Contacts
Authorizing Official
SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300
Primary Contact
Santa Clara Valley Health and Hospital System
Jennefer Yoon, Assistant Director of Pharmacy
(408) 885-7636
Addresses
Street Address
500 Tully Rd
San Jose, CA 95111-1917
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/5/09 MEDICAID NUMBER REMOVED (WAS FHC80070F);3/8/06 - NAME CHANGE, 7/19/05 - ADDR CHANGE (WAS 2410 SENTER ROAD), 4/22/05 - ADMIN CORRECTION REPLACES FQ113A 3/9/12-Changed the authorizing official (was Michael Lipman, CEO) and the contact person (was Phoebe Li, Assistant Director of Pharmacy) added Medicaid #
03/09/2012
5/5/09 MEDICAID NUMBER REMOVED (WAS FHC80070F);3/8/06 - NAME CHANGE, 7/19/05 - ADDR CHANGE (WAS 2410 SENTER ROAD), 4/22/05 - ADMIN CORRECTION REPLACES FQ113A
08/06/2009
May 2025
May 2025
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