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CH066580 Centro San Vicente (Active)
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Main Details
Name
Centro San Vicente
Subdivision Name
None
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002813
340B ID
CH066580
Grant Number
H80CS00637
Additional Details
Current Program Status
Active
Registration Date
10/1/1995
Participating Start Date
10/1/1995
Participating Approval Date
6/15/2005
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Centro San Vicente
Christina Ilene Paz, CEO
(915) 859-7545 Ext: 1232
Primary Contact
Centro San Vicente
Ana Nicoletto, Director of Pharmacy
(915) 859-7545 Ext: 1241
Addresses
Street Address
8061 Alameda Ave
El Paso, TX 79915-4705
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/13/05 - ADDR CORR (WAS 13017 PERICO, SAN ELIZARIO, TX 79849), CORRECTED ADD DATE (WAS 01/01/99)
06/15/2005
April 2025
April 2025
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