Covered Entity Details

STD87747 New Mexico Corrections Department (Active) - information as of 6/28/2025 12:22:41 AM

Main Details

Name

New Mexico Corrections Department

Subdivision Name

Springer Women's Correctional Center

Type

Sexually Transmitted Diseases

340B ID

STD87747

Grant Number

NH25PS005180

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

Direct Funding (dollars received from CDC or an intermediate organization)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.

1/1/2019

Additional Details

Current Program Status

Active

Registration Date

4/15/2020

Participating Start Date

7/1/2020

Participating Approval Date

5/1/2020

Last Recertification Date

5/6/2025

Notice of Funding Opportunity (NOFO) Number

CDC-RFA-PS19-1901

Contacts

Authorizing Official

New Mexico Corrections Department
Wence J Asonganyi, Health Services Administrator
(505) 629-7753

Primary Contact

New Mexico Corrections Department
Edmundo Barraza, Compliance Administrator
(505) 584-7628

Addresses

Street Address

201 Highway 468
Springer, NM 87747

Billing Address

New Mexico Corrections Department (NMCD)
Health Services Bureau
Santa Fe, NM 87508

Comments
Medicaid Billing
Shipping Addresses
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?
No

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	BOSWELL PHARMACY SERVICES, LLC	131 SCHOOLHOUSE ROAD	P O BOX 266	JENNERSTOWN	PA	15547	07/01/2020	07/09/2020			07/09/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/6/2024 5:10:59 PM	5/6/2025 11:04:06 AM	5/6/2025 11:04 AM
Contacts	Primary Contact	Update	Group Change Request	Martinez, Ariana Executive assistant NMCD 5052524095	Barraza, Edmundo Compliance Administrator New Mexico Corrections Department 5055847628	5/7/2024 6:22 AM
Details	Nature of Support: Support Received To Date	Update	Recertification	12/31/2023 12:00:00 AM		5/6/2024 5:10 PM
Details	Last Recertification Date	Update	Recertification	5/8/2023 11:01:53 AM	5/6/2024 5:10:59 PM	5/6/2024 5:10 PM
Details	Last Recertification Date	Update	Recertification	5/10/2022 5:34:26 PM	5/8/2023 11:01:53 AM	5/8/2023 11:01 AM
Contacts	Primary Contact	Update	Group Change Request	Trujillo, Natasha Executive Assistant - Health Services Bureau NMCD 5052524163	Martinez, Ariana Executive assistant NMCD 5052524095	5/3/2023 4:24 PM
Contacts	Primary Contact	Update	Recertification	Meehan, Matthew Quality Assurance Nurse NMCD 5052524095	Trujillo, Natasha Executive Assistant - Health Services Bureau NMCD 5052524163	5/10/2022 5:34 PM
Details	Last Recertification Date	Update	Recertification	5/12/2021 4:16:24 PM	5/10/2022 5:34:26 PM	5/10/2022 5:34 PM
Contacts	Primary Contact	Update	Group Change Request	Mondragon, Pauline S. Clinicial Nurse Specialist New Mexico Corrections Department 5058278659	Meehan, Matthew Quality Assurance Nurse NMCD 5052524095	12/8/2021 9:48 AM
Details	Nature of Support: Support Received From Date	Update	Recertification		1/1/2019 12:00:00 AM	5/12/2021 4:16 PM
Details	Nature of Support: Support Received To Date	Update	Recertification		12/31/2023 12:00:00 AM	5/12/2021 4:16 PM
Details	Last Recertification Date	Update	Recertification		5/12/2021 4:16:24 PM	5/12/2021 4:16 PM
Details	NOFO Number	Update	Recertification		CDC-RFA-PS19-1901	5/12/2021 4:16 PM
Addresses	Billing Address	Insert	Change Request		New Mexico Corrections Department (NMCD) Health Services Bureau Santa Fe, NM 87508	7/1/2020 4:52 PM
Details	State	Update		Approved	Active	7/1/2020 12:00 AM
Contacts	Authorizing Official	Update	Change Request	Price, Wendy Behavioral Health Bureau Chief New Mexico Corrections Department 5053832857	Asonganyi, Wence J Health Services Administrator New Mexico Corrections Department 5056297753	6/30/2020 9:25 AM
Contacts	Signed By	Insert	New Registration		Price, Wendy Behavioral Health Bureau Chief New Mexico Corrections Department 5053832857	5/1/2020 3:52 PM
Details	340B ID	Update	New Registration		STD87747	5/1/2020 3:52 PM
Dates	Participating Approval Date	Update	New Registration		5/1/2020 3:52:46 PM	5/1/2020 3:52 PM
Details	State	Update	New Registration	Pending	Approved	5/1/2020 3:52 PM
Dates	Signed By Date	Update	New Registration		4/15/2020 12:25:35 PM	5/1/2020 3:52 PM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	5/1/2020 3:52 PM
Addresses	Main Address	Insert	New Registration		201 Highway 468 Springer, NM 87747	4/15/2020 12:05 PM
Details	Nature Of Support	Insert	New Registration		Direct Funding (dollars received from CDC or an intermediate organization)	4/15/2020 12:05 PM
Contacts	Primary Contact	Insert	New Registration		Mondragon, Pauline S. Clinicial Nurse Specialist New Mexico Corrections Department 5058278659	4/15/2020 12:05 PM
Contacts	Authorizing Official	Insert	New Registration		Price, Wendy Behavioral Health Bureau Chief New Mexico Corrections Department 5053832857	4/15/2020 12:05 PM
Details	Last Recertification Date	Insert	New Registration			4/15/2020 12:05 PM
Details	Grant Number	Insert	New Registration		NH25PS005180	4/15/2020 12:05 PM
Details	340B ID	Insert	New Registration			4/15/2020 12:05 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2020 12:05 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2020 12:05 PM
Details	Medicare Provider Number	Insert	New Registration			4/15/2020 12:05 PM
Details	Entity Name	Insert	New Registration		New Mexico Corrections Department	4/15/2020 12:05 PM
Details	Program Code	Insert	New Registration		STD	4/15/2020 12:05 PM
Details	Entity Subname	Insert	New Registration		Springer Women's Correctional Center	4/15/2020 12:05 PM
Dates	Participating Approval Date	Insert	New Registration			4/15/2020 12:05 PM
Details	State	Insert	New Registration		Pending	4/15/2020 12:05 PM
Dates	Registration Date	Insert	New Registration		4/15/2020 12:05:45 PM	4/15/2020 12:05 PM
Dates	Signed By Date	Insert	New Registration			4/15/2020 12:05 PM
Dates	Start Date	Insert	New Registration			4/15/2020 12:05 PM
Terminations	Termination Comments	Insert	New Registration			4/15/2020 12:05 PM
Terminations	Termination Date	Insert	New Registration			4/15/2020 12:05 PM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2020 12:05 PM
Terminations	Termination Reason	Insert	New Registration			4/15/2020 12:05 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History