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CH09175A MOUNTAIN VALLEYS HEALTH CENTERS (Active)
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Main Details
Name
MOUNTAIN VALLEYS HEALTH CENTERS
Subdivision Name
TULELAKE HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002648
340B ID
CH09175A
Grant Number
H80CS00260
Additional Details
Current Program Status
Active
Registration Date
4/1/2002
Participating Start Date
4/1/2002
Participating Approval Date
5/9/2005
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Mountain Valleys Health Centers
Shannon Gerig, CEO
(530) 999-9010
Primary Contact
Mountain Valleys Health Centers
Brandon Watkins, Chief Financial Officer
(530) 249-6857
Addresses
Street Address
498 MAIN STREET
TULELAKE, CA 96134-0725
Billing Address
MOUNTAIN VALLEYS HEALTH CENTERS, INC.
PO BOX 277
BIEBER, CA 96009
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/21/04 - ADMIN CORRECTION - WAS 340B ID FQHCLA078C, 5/9/05 NEW EMAIL, BILL TO
08/28/2006
April 2025
April 2025
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