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CH09114O SAN MATEO MEDICAL CENTER (Active)
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Main Details
Name
SAN MATEO MEDICAL CENTER
Subdivision Name
SOUTH SAN FRANCISCO HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001373
340B ID
CH09114O
Grant Number
H80CS00051
Additional Details
Current Program Status
Active
Registration Date
10/1/2001
Participating Start Date
10/1/2001
Participating Approval Date
11/9/2004
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
San Mateo Medical Center
CHESTER J. KUNNAPPILLY, CEO
(650) 573-2305
Primary Contact
San Mateo Medical Center
Victor Armendariz, Director of Pharmacy
(650) 573-2366
Addresses
Street Address
306 SPRUCE STREET
SOUTH SAN FRANCISCO, CA 94080
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/9/04 - ADMIN CORRECTION REPLACES HO091140E
10/01/2001
May 2025
May 2025
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