Covered Entity Details

CH06024C FIRST CHOICE COMMUNITY HEALTHCARE, INC. (Active) - information as of 5/6/2025 12:00:06 AM

Main Details

Name

FIRST CHOICE COMMUNITY HEALTHCARE, INC.

Subdivision Name

MOUNTAIN AND VALLEY REGIONAL HEALTH CENTER

Type

HRSA-Funded Health Center

Site ID

BPS-H80-018336

340B ID

CH06024C

Grant Number

H80CS00202

Additional Details

Current Program Status

Active

Registration Date

10/1/2003

Participating Start Date

10/1/2003

Participating Approval Date

8/29/2003

Last Recertification Date

2/24/2025

Contacts

Authorizing Official

First Choice Community Healthcare
Shawna R Gonzales, CFO
(505) 873-7414

Primary Contact

First Choice Community Healthcare
Dane Tortalita, Financial Analyst
(505) 873-7400 Ext: 9053

Addresses

Street Address

7 MUNICIPAL WAY
EDGEWOOD, NM 87015

Billing Address
Same as Street Address

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

Comments

Comment	Last Updated On
4/10/12 - Changed contact information from John Denslow, R.Ph, added INC to entity name.	04/10/2012

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
NM	54905737	1962663153

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
Contract Detail	SMITH'S PHARMACY	02-B HIGHWAY 344		EDGEWOOD	NM	87015	10/01/2003	10/01/2003			03/28/2013

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH060240	Active	BPS-H80-000395	FIRST CHOICE COMMUNITY HEALTHCARE	FIRST CHOICE COMMUNITY HEALTH CARE	2001 NORTH CENTRO FAMILIAR BOU	ALBUQUERQUE	NM
CH06024A	Active	BPS-H80-010148	FIRST CHOICE COMMUNITY HEALTHCARE	1ST CHOICE/LOS LUNAS	145 Don Pasqual NW	Los Lunas	NM
CH06024C	Active	BPS-H80-018336	FIRST CHOICE COMMUNITY HEALTHCARE, INC.	MOUNTAIN AND VALLEY REGIONAL HEALTH CENTER	7 MUNICIPAL WAY	EDGEWOOD	NM
CH06024D	Active	BPS-H80-005069	FIRST CHOICE COMMUNITY HEALTHCARE	NORTH VALLEY HEALTH CENTER	1231 Candelaria Rd NW	Albuquerque	NM
CH06024E	Active	BPS-H80-008628	FIRST CHOICE COMMUNITY HEALTHCARE	South Broadway / William Street	1401 William St SE	Albuquerque	NM
CH06024F	Active	BPS-H80-005262	FIRST CHOICE COMMUNITY HEALTHCARE	ALAMEDA CENTER	7704 2nd St NW	Albuquerque	NM
CH06024G	Active	BPS-H80-001338	FIRST CHOICE COMMUNITY HEALTHCARE	ALAMOSA COMMUNITY CENTER	6900 GONZALES RD SW	ALBUQUERQUE	NM
CH06024H	Terminated	BPS-H80-003462	FIRST CHOICE COMMUNITY HEALTHCARE	BELEN CENTER	120 S 9th St	Belen	NM
CH06024I	Active	BPS-H80-007471	FIRST CHOICE COMMUNITY HEALTHCARE	RIO GRANDE HIGH SCHOOL CLINIC	2300 ARENAL RD SW	ALBUQUERQUE	NM

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH06024E	DURAN CENTRAL PHARMACY INC	1815 CENTRAL AVE NW		ALBUQUERQUE	NM	87104	05/01/2000	05/23/2018
CH06024H	SHARE N' CARE PHARMACY LTC	SHARE 'N CARE PHARMACY	701 DALIES AVE STE B	BELEN	NM	87002	10/01/1999	05/23/2018
CH060240	SMITH MANAGEMENT CORP DBA	SMITH'S PHARMACY #414	2580 MAIN ST NE	LOS LUNAS	NM	87031	01/01/2017
CH06024A	SMITH MANAGEMENT CORP DBA	SMITH'S PHARMACY #414	2580 MAIN ST NE	LOS LUNAS	NM	87031	05/01/2000
CH060240	SMITH'S FOOD & DRUG CTRS	SMITH'S PHARMACY #496	3701 CONSTITUTION NE	ALBUQUERQUE	NM	87110	01/01/2017
CH060240	SMITH'S FOOD & DRUG CTRS	SMITH'S PHARMACY #498	111 COOR ROAD N.W.	ALBUQUERQUE	NM	87121	01/01/2017
CH06024D	SMITH'S FOOD & DRUG CTRS	SMITH'S PHARMACY #496	3701 CONSTITUTION NE	ALBUQUERQUE	NM	87110	05/02/2011
CH06024G	SMITH'S FOOD & DRUG CTRS	SMITH'S PHARMACY #498	111 COOR ROAD N.W.	ALBUQUERQUE	NM	87121	09/15/2009
CH060240	SMITH'S PHARMACY	02-B HIGHWAY 344		EDGEWOOD	NM	87015	01/01/2017
CH06024C	SMITH'S PHARMACY	02-B HIGHWAY 344		EDGEWOOD	NM	87015	10/01/2003
CH06024F	SMITHS FOOD & DRUG CTRS	SMITHS PHARMACY # 423	6125 4TH ST NW ATTENTION: PHARMACY	ALBUQUERQUE	NM	87107	07/01/2000
CH060240	SMITHS FOOD & DRUG CTRS	SMITH'S FOOD & DRUG #571	1601 ARENAL SW ATTN PHARMACY	ALBUQUERQUE	NM	87105	05/01/2000
CH060240	SMITHS FOOD & DRUG CTRS	SMITHS PHARMACY # 423	6125 4TH ST NW ATTENTION: PHARMACY	ALBUQUERQUE	NM	87107	01/01/2017
CH06024D	SMITHS FOOD AND DRUG CENTERS, INC. - #429	2620 Carlisle Blvd. NE		Albuquerque	NM	87110	05/01/2000	05/23/2018
CH060240	SW MESA CENTER FOR FAMILY AND COMMUNITY	301 UNSER BLVD NW	STE 106	ALBUQUERQUE	NM	87121-1927	07/01/2015
CH060240	UNIV HOSP OUTPATIENT PHARMACY	1209 UNIVERSITY BLVD NE		ALBUQUERQUE	NM	87102	07/01/2015
CH060240	UNM HOSPITAL SE HEIGHTS CLINIC	8200 CENTRAL AVE SE	UNM HEALTH SCIENCES	ALBUQUERQUE	NM	87108-2408	07/01/2015
CH06024D	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2018
CH060240	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2019
CH060240	WAL-MART PHARMACY # 5491	2266 WYOMING BLVD NE		ALBUQUERQUE	NM	87112	10/01/2019	01/07/2024
CH060240	WAL-MART PHARMACY 10-0831	301 SAN MATEO BLV SE		ALBUQUERQUE	NM	87108	10/01/2019	01/07/2024
CH060240	WAL-MART PHARMACY 10-0850	2701 CARLISLE BLVD NE		ALBUQUERQUE(C)	NM	87110	10/01/2019
CH06024H	WAL-MART PHARMACY 10-1414	1 I-25 BYPASS		BELEN	NM	87002	10/01/2018	04/01/2025
CH060240	WAL-MART PHARMACY 10-1414	1 I-25 BYPASS		BELEN	NM	87002	04/01/2019
CH060240	WAL-MART PHARMACY 10-2451	4700 CUTLER AVE NE		ALBUQUERQUE	NM	87110	10/01/2019	01/07/2024
CH06024D	WAL-MART PHARMACY 10-2924	2550 COORS BLVD., N.W.		ALBUQUERQUE (W)	NM	87120	10/01/2018
CH060240	WAL-MART PHARMACY 10-2924	2550 COORS BLVD., N.W.		ALBUQUERQUE (W)	NM	87120	04/01/2019	01/07/2024
CH06024D	WAL-MART PHARMACY 10-3385	9600 SAGE RD SW		ALBUQUERQUE	NM	87121	10/01/2018
CH060240	WAL-MART PHARMACY 10-3385	9600 SAGE RD SW		ALBUQUERQUE	NM	87121	04/01/2019
CH06024A	WAL-MART PHARMACY 10-3596	2250 MAIN STREET NW		LOS LUNAS	NM	87031	10/01/2018
CH060240	WAL-MART PHARMACY 10-3596	2250 MAIN STREET NW		LOS LUNAS	NM	87031	04/01/2019	01/07/2024
CH060240	WAL-MART PHARMACY 10-4201	66 STATE ROUTE #344		EDGEWOOD	NM	87015	10/01/2019
CH060240	WAL-MART PHARMACY 10-5430	3500 COORS BLVD. SW		ALBUQUERQUE (S)	NM	87105	10/01/2019
CH06024D	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018
CH060240	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2019
CH060240	WALGREEN ARIZONA DRUG CO		DBA WALGREENS 2400 N WALGREEN STREET	FLAGSTAFF	AZ	86004	05/07/2012	05/23/2018
CH060240	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	01/01/2022
CH060240	WALGREEN CO	DBA: WALGREENS	2370 E MAIN STREET	WOODLAND	CA	95776	05/07/2012	05/23/2018
CH060240	WALGREEN CO.	DBA: WALGREENS # 00023	5001 MONTGOMERY BLVD NE STE A31	ALBUQUERQUE	NM	87109	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 01279	2950 CENTRAL AVENUE SE, SUITE A	ALBUQUERQUE	NM	87106	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 02026	100 E HWY 550	BERNALILLO	NM	87004-5967	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 02050	315 N MAIN ST	BELEN	NM	87002	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS #15033	3401 ISLETA BLVD. SW	ALBUQUERQUE	NM	87105	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 06587	9700 MENAUL BLVD NE	ALBUQUERQUE	NM	87112	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 06610	2500 MAIN STREET NE	LOS LUNAS	NM	87031	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 07351	4700 4TH STREET NW	ALBUQUERQUE	NM	87107-3902	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 07438	5850 EUBANK BLVD NE A101	ALBUQUERQUE	NM	87111	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 07442	1201 UNSER BLVD SW	ALBUQUERQUE	NM	87121	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 07735	6605 4TH ST NW	LOS RANCHOS DE ALBUQUERQUE	NM	87107-6112	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 07881	5 WALKER ROAD	EDGEWOOD	NM	87015-8740	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 09336	2011 12TH ST NW	ALBUQUERQUE	NM	87104	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 09608	6250 PASEO DEL NORTE NE	ALBUQUERQUE	NM	87113-1712	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 09773	10300 CENTRAL AVE SE	ALBUQUERQUE	NM	87123	05/07/2012	12/30/2024
CH060240	WALGREEN CO.	DBA: WALGREENS # 11360	11200 MONTGOMERY BLVD NE, #12	ALBUQUERQUE	NM	87111	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS #11361	1861 MAIN ST NW	LOS LUNAS	NM	87031	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS #11958	3632 MENAUL BLVD. NE	ALBUQUERQUE	NM	87110	05/07/2012	12/30/2024
CH060240	WALGREEN CO.	DBA: WALGREENS #11959	5201 CENTRAL AVE. NE	ALBUQUERQUE	NM	87108-1328	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS #13164	9601 GIBSON BLVD. SW	ALBUQUERQUE	NM	87121	05/07/2012
CH060240	WALGREEN CO.	DBA: WALGREENS # 06121	8400 MONTGOMERY BLVD NE	ALBUQUERQUE	NM	87111	04/01/2025
CH060240	WALGREEN CO.	DBA: WALGREENS #12407	10800 UNSER BLVD. NW	ALBUQUERQUE	NM	87114	04/01/2025
CH060240	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16544	933 SAN MATEO BLVD NE STE 501	ALBUQUERQUE	NM	87108	04/01/2025
CH060240	WALGREEN CO.	DBA: WALGREENS # 09213	1900 WYOMING BLVD NE	ALBUQUERQUE	NM	87112-2866	04/01/2025
CH060240	WALGREEN CO.	WALGREENS #04651	10236 COORS BYPASS NW	ALBUQUERQUE	NM	87114	04/01/2025
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 03366	3400 COORS BLVD NW	ALBUQUERQUE	NM	87120	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 03997	2105 CENTRAL AVE NW	ALBUQUERQUE	NM	87104	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 04047	101 COORS BOULEVARD NW	ALBUQUERQUE	NM	87121	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 04649	3501 LOMAS BLVD. NE	ALBUQUERQUE	NM	87106	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 04911	6000 COORS BLVD NW	ALBUQUERQUE	NM	87120	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 05158	4051 SOUTHERN BLVD SE	RIO RANCHO	NM	87124	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 05923	13000 INDIAN SCHOOL RD NE	ALBUQUERQUE	NM	87112	05/07/2012
CH060240	WALGREEN HASTINGS CO.	DBA: WALGREENS # 05997	2625 SAN PEDRO NE	ALBUQUERQUE	NM	87110	05/07/2012
CH060240	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2013	05/23/2018
CH060240	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2013	05/23/2018
CH060240	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	01/01/2018
CH060240	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	01/01/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/26/2024 8:23:13 PM	2/24/2025 3:21:57 PM	2/24/2025 3:21 PM
Contacts	Primary Contact	Update	Profile Change Request	Tortalita, Dane Financial Analyst First Choice Community Healthcare 5052204249	Tortalita, Dane Financial Analyst First Choice Community Healthcare 5058737400-9053	2/18/2025 4:08 PM
Contacts	Primary Contact	Update	PC Change Request	Briones, Monica E Medical Director First Choice Community Healthcare 5052248718	Tortalita, Dane Financial Analyst First Choice Community Healthcare 5052204249	11/25/2024 2:14 PM
Details	Last Recertification Date	Update	Recertification	2/9/2023 5:44:55 PM	2/26/2024 8:23:13 PM	2/26/2024 8:23 PM
Contacts	Primary Contact	Update	OPA Edit	Grasty, Christopher CFO FCCH 5058737457	Briones, Monica E Medical Director First Choice Community Healthcare 5052248718	2/26/2024 8:22 PM
Contacts	Authorizing Official	Update	OPA Edit	Edwards, Heather Interim -CEO First Choice Community Healthcarealthcare 2146165761	Gonzales, Shawna R CFO First Choice Community Healthcare 5058737414	2/26/2024 8:22 PM
Details	Last Recertification Date	Update	Recertification	2/10/2022 4:26:15 PM	2/9/2023 5:44:55 PM	2/9/2023 5:44 PM
Contacts	Authorizing Official	Update	AO Change Request	Thames, Marie Chief Executive Officer FIRST CHOICE COMMUNITY HEALTHCARE 5058737401	Edwards, Heather Interim -CEO First Choice Community Healthcarealthcare 2146165761	2/9/2023 5:23 PM
Details	Last Recertification Date	Update	Recertification	2/26/2021 2:44:35 PM	2/10/2022 4:26:15 PM	2/10/2022 4:26 PM
Contacts	Authorizing Official	Update	AO Change Request	DEFELICE, ROBERT CEO CH060240 5058737401	Thames, Marie Chief Executive Officer FIRST CHOICE COMMUNITY HEALTHCARE 5058737401	2/9/2022 7:15 AM
Medicaid Billing	NPI: State	Update	Recertification		NM	2/26/2021 2:44 PM
Details	Last Recertification Date	Update	Recertification	2/6/2020 2:54:49 PM	2/26/2021 2:44:35 PM	2/26/2021 2:44 PM
Details	Last Recertification Date	Update	Recertification	2/18/2019 1:14:11 PM	2/6/2020 2:54:49 PM	2/6/2020 2:54 PM
Addresses	Main Address	Update	Change Request	8 MEDICAL CENTER ROAD EDGEWOOD, NM 87015	7 MUNICIPAL WAY EDGEWOOD, NM 87015	7/17/2019 8:06 AM
Details	Last Recertification Date	Update	Recertification	2/19/2018 1:19:40 PM	2/18/2019 1:14:11 PM	2/18/2019 1:14 PM
Details	Last Recertification Date	Update	Recertification	2/20/2017 12:00:00 AM	2/19/2018 1:19:40 PM	2/19/2018 1:19 PM
Contacts	Authorizing Official	Update		DEFELICE, ROBERT CEO 5058737401	DEFELICE, ROBERT CEO CH060240 5058737401	10/13/2017 5:46 PM
Contacts	Primary Contact	Update		Grasty, Christopher CFO 5058737457	Grasty, Christopher CFO FCCH 5058737457	10/12/2017 5:34 PM
Addresses	Main Address	Insert			8 MEDICAL CENTER ROAD EDGEWOOD, NM 87015	2/20/2017 6:21 PM
Contacts	Authorizing Official	Insert			DEFELICE, ROBERT CEO 5058737401	2/20/2017 6:21 PM
Contacts	Primary Contact	Insert			Grasty, Christopher CFO 5058737457	2/20/2017 6:21 PM
Details	Last Recertification Date	Update		3/8/2016 12:00:00 AM	2/20/2017 12:00:00 AM	2/20/2017 6:21 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	3/8/2016 6:38 PM
Medicaid Billing	Medicaid: Number	Insert			54905737	3/8/2016 6:38 PM
Medicaid Billing	Medicaid: State	Insert			NM	3/8/2016 6:38 PM
Medicaid Billing	NPI: Number	Insert			1962663153	3/8/2016 6:38 PM
Details	Last Recertification Date	Update		3/10/2015 12:00:00 AM	3/8/2016 12:00:00 AM	3/8/2016 6:38 PM
Details	Last Recertification Date	Update		2/14/2014 12:00:00 AM	3/10/2015 12:00:00 AM	3/10/2015 4:13 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/14/2014 12:00:00 AM	2/14/2014 3:51 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/14/2013 3:05 PM
Details	Entity Name	Update		FIRST CHOICE COMMUNITY HEALTHCARE	FIRST CHOICE COMMUNITY HEALTHCARE, INC.	4/10/2012 8:15 AM
Details	Comments Public	Insert			4/10/12 - Changed contact information from John Denslow, R.Ph, added INC to entity name.	4/10/2012 8:15 AM
Details	Last Recertification Date	Insert				1/21/2010 1:17 PM
Details	Grant Number	Insert			H80CS00202	1/21/2010 1:17 PM
Details	340B ID	Insert			CH06024C	1/21/2010 1:17 PM
Details	Is Authorizing Official EHB Data	Insert				1/21/2010 1:17 PM
Dates	Last Date That 340B Drugs Purchased	Insert				1/21/2010 1:17 PM
Details	Medicare Provider Number	Insert				1/21/2010 1:17 PM
Details	Entity Name	Insert			FIRST CHOICE COMMUNITY HEALTHCARE	1/21/2010 1:17 PM
Details	Program Code	Insert			CH	1/21/2010 1:17 PM
Details	Entity Subname	Insert			MOUNTAIN AND VALLEY REGIONAL HEALTH CENTER	1/21/2010 1:17 PM
Dates	Participating Approval Date	Insert			8/29/2003 12:00:00 AM	1/21/2010 1:17 PM
Details	State	Insert			Active	1/21/2010 1:17 PM
Dates	Registration Date	Insert			10/1/2003 12:00:00 AM	1/21/2010 1:17 PM
Dates	Signed By Date	Insert				1/21/2010 1:17 PM
Dates	Start Date	Insert			10/1/2003 12:00:00 AM	1/21/2010 1:17 PM
Terminations	Termination Comments	Insert				1/21/2010 1:17 PM
Terminations	Termination Date	Insert				1/21/2010 1:17 PM
Terminations	Termination Effective Date	Insert				1/21/2010 1:17 PM
Terminations	Termination Reason	Insert				1/21/2010 1:17 PM

340B Drug Pricing Program Database