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FQHC638480 MACT Health Board, Inc. (Active)
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Main Details
Name
MACT Health Board, Inc.
Subdivision Name
MACT Medical, Sonora
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638480
Additional Details
Current Program Status
Active
Registration Date
1/1/2003
Participating Start Date
1/1/2003
Participating Approval Date
6/3/2009
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
MACT Health Board, Inc
John Shawver Alexander, Executive Director
(209) 754-6258
Primary Contact
MACT Health Board, Inc.
Mariela Contreras, Finance Director
(209) 754-6245
Addresses
Street Address
13975 MONO WAY
SUITE G,H, I, J
SONORA, CA 95370
Billing Address
MACT Health Board, Inc.
PO BOX 939
ANGELS CAMP, CA 95222
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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9/16/09 ADDED BILLING ADDR
06/03/2009
April 2025
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