Covered Entity Details

FQHCLA484C UPTOWN COMMUNITY HEALTH CENTER INC (Approved) - information as of 6/19/2025 11:45:13 PM

Main Details

Name

UPTOWN COMMUNITY HEALTH CENTER INC

Subdivision Name

Uptown Community Health Center, Inc. Bruner Family Medicine

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-039882

340B ID

FQHCLA484C

Grant Number

LALCS54746

Additional Details

Current Program Status

Approved

Registration Date

4/3/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/4/2025

Last Recertification Date

Contacts

Authorizing Official

Uptown Community Health Center
Cherise Callighan, CEO
(303) 318-2505

Primary Contact

Uptown Community Health Center
Jonathan Burdick, CMO
(303) 318-3255

Addresses

Street Address

1960 N Ogden St, Ste 460
Denver, CO 80218-3670

Billing Address

Uptown Community Health Center, Inc
1960 N Ogden Street
Suite 300
Denver, CO 80218

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
CO	9000242852	1487432019

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
FQHCLA484	Approved	BPS-LAL-039878	UPTOWN COMMUNITY HEALTH CENTER INC	Uptown Community Health Center, Inc. Administration	1960 N Ogden St, Ste 300	Denver	CO
FQHCLA484A	Approved	BPS-LAL-039880	UPTOWN COMMUNITY HEALTH CENTER INC	Uptown Community Health Center, Inc. Seton Women's Center	1960 N Ogden St, Ste 340	Denver	CO
FQHCLA484B	Approved	BPS-LAL-039879	UPTOWN COMMUNITY HEALTH CENTER INC	Uptown Community Health Center, Inc. Caritas Internal Medicine	1960 N Ogden St, Ste 400	Denver	CO
FQHCLA484C	Approved	BPS-LAL-039882	UPTOWN COMMUNITY HEALTH CENTER INC	Uptown Community Health Center, Inc. Bruner Family Medicine	1960 N Ogden St, Ste 460	Denver	CO

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA484	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/01/2025
FQHCLA484	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/01/2025
FQHCLA484	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/01/2025
FQHCLA484	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/01/2025
FQHCLA484	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/01/2025
FQHCLA484	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2025
FQHCLA484	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/01/2025
FQHCLA484	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/01/2025
FQHCLA484	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/01/2025
FQHCLA484	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/01/2025
FQHCLA484	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	07/01/2025
FQHCLA484	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	07/01/2025
FQHCLA484	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/01/2025
FQHCLA484	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	07/01/2025
FQHCLA484	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2025
FQHCLA484	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/01/2025
FQHCLA484	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2025
FQHCLA484	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
FQHCLA484	WAL-MART PHARMACY 10-3533	7800 EAST SMITH ROAD		DENVER	CO	80207	07/01/2025
FQHCLA484	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
FQHCLA484	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	07/01/2025	04/15/2025
FQHCLA484	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
FQHCLA484	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Callighan, Cherise CEO Uptown Community Health Center 3033182505	4/4/2025 9:33 AM
Details	340B ID	Update	New Registration		FQHCLA484C	4/4/2025 9:33 AM
Dates	Participating Approval Date	Update	New Registration		4/4/2025 9:33:46 AM	4/4/2025 9:33 AM
Details	State	Update	New Registration	Pending	Approved	4/4/2025 9:33 AM
Dates	Signed By Date	Update	New Registration		4/3/2025 3:32:50 PM	4/4/2025 9:33 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/4/2025 9:33 AM
Addresses	Main Address	Insert	New Registration		1960 N Ogden St, Ste 460 Denver, CO 80218-3670	4/3/2025 3:32 PM
Addresses	Billing Address	Insert	New Registration		Uptown Community Health Center, Inc 1960 N Ogden Street Suite 300 Denver, CO 80218	4/3/2025 3:32 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/3/2025 3:32 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		9000242852	4/3/2025 3:32 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		CO	4/3/2025 3:32 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1487432019	4/3/2025 3:32 PM
Medicaid Billing	NPI: State	Insert	New Registration		CO	4/3/2025 3:32 PM
Contacts	Authorizing Official	Insert	New Registration		Callighan, Cherise CEO Uptown Community Health Center 3033182505	4/3/2025 3:32 PM
Contacts	Primary Contact	Insert	New Registration		Burdick, Jonathan CMO Uptown Community Health Center 3033183255	4/3/2025 3:32 PM
Details	Assistance Received From Date	Insert	New Registration			4/3/2025 3:32 PM
Details	Assistance Received To Date	Insert	New Registration			4/3/2025 3:32 PM
Details	Last Recertification Date	Insert	New Registration			4/3/2025 3:32 PM
Details	Grant Number	Insert	New Registration		LALCS54746	4/3/2025 3:32 PM
Details	340B ID	Insert	New Registration			4/3/2025 3:32 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/3/2025 3:32 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/3/2025 3:32 PM
Details	Medicare Provider Number	Insert	New Registration			4/3/2025 3:32 PM
Details	Entity Name	Insert	New Registration		UPTOWN COMMUNITY HEALTH CENTER INC	4/3/2025 3:32 PM
Details	NOFO Number	Insert	New Registration			4/3/2025 3:32 PM
Details	Program Code	Insert	New Registration		FQHCLA	4/3/2025 3:32 PM
Details	Entity Subname	Insert	New Registration		Uptown Community Health Center, Inc. Bruner Family Medicine	4/3/2025 3:32 PM
Dates	Participating Approval Date	Insert	New Registration			4/3/2025 3:32 PM
Details	State	Insert	New Registration		Pending	4/3/2025 3:32 PM
Dates	Registration Date	Insert	New Registration		4/3/2025 3:32:49 PM	4/3/2025 3:32 PM
Dates	Signed By Date	Insert	New Registration			4/3/2025 3:32 PM
Dates	Start Date	Insert	New Registration			4/3/2025 3:32 PM
Terminations	Termination Comments	Insert	New Registration			4/3/2025 3:32 PM
Terminations	Termination Date	Insert	New Registration			4/3/2025 3:32 PM
Terminations	Termination Effective Date	Insert	New Registration			4/3/2025 3:32 PM
Terminations	Termination Reason	Insert	New Registration			4/3/2025 3:32 PM

340B Drug Pricing Program Database