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CH095380 Marin Community Clinic (Active)
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Main Details
Name
Marin Community Clinic
Subdivision Name
Marin Community Clinic - Larkspur
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014015
340B ID
CH095380
Grant Number
H80CS00343
Additional Details
Current Program Status
Active
Registration Date
10/1/2001
Participating Start Date
10/1/2001
Participating Approval Date
4/15/2004
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Marin Community Clinics
Kathryn E Powell, Interim Chief Executive Officer
(415) 448-1500
Primary Contact
Marin Community Clinic
Sheri Dunham, Compliance Coordinator
(415) 376-3255
Addresses
Street Address
5 Bon Air Road, Suite 117
Larkspur, CA 94939-1138
Billing Address
MARIN COMMUNITY CLINIC
9 Commercial Blvd
Suite 100
NOVATO, CA 94949
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/28/11 - Changed AO title from interim executive director. 4/10/09-BILL TO CHANGE(WAS PO BOX 760) 4/15/04 ID CORRECTION - REPLACES FQ78/CH095380; 7/20/07 MOVED ADDR LINE 2 TO BILL TO
10/28/2011
4/10/09-BILL TO CHANGE(WAS PO BOX 760) 4/15/04 ID CORRECTION - REPLACES FQ78/CH095380; 7/20/07 MOVED ADDR LINE 2 TO BILL TO
04/10/2009
June 2025
June 2025
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