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FQHC638005 GREENVILLE RANCHERIA TRIBAL HEALTH (Active)
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Main Details
Name
GREENVILLE RANCHERIA TRIBAL HEALTH
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638005
Additional Details
Current Program Status
Active
Registration Date
4/1/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/27/2016
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Greenville Rancheria
Tracy Remick, CEO
(530) 528-8600 Ext: 242
Primary Contact
Greenville Rancheria
Jason David Libbee, PRC Supervisor
(530) 528-8600 Ext: 215
Addresses
Street Address
410 MAIN STREET
GREENVILLE, CA 95947
Billing Address
Greenville Rancheria
PO Box 279
Greenville, CA 95947
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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5/27/16 Previously participated 1/1/95 through 3/31/16, reinstatement effective 7/1/16;
05/27/2016
April 2025
April 2025
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