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CH09242N OLE HEALTH (Active)
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Main Details
Name
OLE HEALTH
Subdivision Name
OLE Health American Canyon
Type
HRSA-Funded Health Center
Site ID
BPS-H80-035917
340B ID
CH09242N
Grant Number
H80CS04219
Additional Details
Current Program Status
Active
Registration Date
4/1/2023
Participating Start Date
4/4/2023
Participating Approval Date
4/3/2023
Last Recertification Date
2/21/2025
Contacts
Authorizing Official
OLE Health
Kevin E. Moses, Legal Officer
(707) 254-1774 Ext: 8222
Primary Contact
OLE Health
Antonio Olea, Director of Pharmacy
(619) 756-9987
Addresses
Street Address
3431 Broadway STE A8-A9
American Canyon, CA 94503-1228
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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