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FQHCLA106 SIERRA FAMILY MEDICAL CLINIC, INC. (Terminated)
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Main Details
Name
SIERRA FAMILY MEDICAL CLINIC, INC.
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-009787
340B ID
FQHCLA106
Grant Number
LALCS00058
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2002
Participating Start Date
4/1/2002
Participating Approval Date
3/3/2010
Last Recertification Date
2/2/2015
Termination Date
Termination Reason
4/1/2016
Change of covered entity type
Contacts
Authorizing Official
Steve Weber, CEO
(530) 292-3478 Ext: 230
Primary Contact
Sierra Family Medical Clinic
Gary Graeber, Senior Accountant
(530) 292-3478 Ext: 219
Addresses
Street Address
15301 TYLER FOOTE ROAD
NEVADA CITY, CA 95959
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
April 2025
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