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CH080900 PEAK VISTA COMMUNITY HEALTH CENTERS (Active)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Health Center at Limon
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014122
340B ID
CH080900
Grant Number
H80CS00212
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
2/25/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PVCHC
Joel Tanaka, Chief Medical Officer
(719) 344-6530
Primary Contact
Peak Vista Community Health Centers
Katie Boudreaux, Vice President of Pharmacy Services
(719) 344-6269
Addresses
Street Address
820 1st St
Limon, CO 80828
Billing Address
PEAK VISTA COMMUNITY HEALTH CENTERS
3205 N. Academy Blvd, Suite 130
Colorado Springs, CO 80917
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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8/7/14 PLAINS MEDICAL CENTER merged with PEAK VISTA COMMUNITY HEALTH CENTERS, 340B IDs remain the same but organization name, EIN, grant number, and AO have changed
08/07/2014
NEW SITE 04/01/2004
08/12/2005
April 2025
April 2025
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