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FQHCLA328J COUNTY OF SAN JOAQUIN (Active)
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Main Details
Name
COUNTY OF SAN JOAQUIN
Subdivision Name
Manteca Clinic
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-035785
340B ID
FQHCLA328J
Grant Number
LALCS00158
Additional Details
Current Program Status
Active
Registration Date
5/26/2023
Participating Start Date
7/1/2023
Participating Approval Date
6/7/2023
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
San Joaquin County Clinics
Rachna Sharma, Controller
(209) 953-3738
Primary Contact
San Joaquin County Clinics
STACY FERREIRA, INTERIM CEO
(209) 953-3700 Ext: 33719
Addresses
Street Address
283 Spreckels Ave
Manteca, CA 95336-6005
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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