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CH08146J PEAK VISTA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Health Center at Printers Parkway, 350
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005383
340B ID
CH08146J
Grant Number
H80CS00212
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2004
Participating Start Date
10/1/2004
Participating Approval Date
9/15/2004
Last Recertification Date
2/1/2022
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
PVCHC
Lisa Ramey, CMDO
(719) 344-6455
Primary Contact
Peak Vista Community Health Centers
Katie Boudreaux, Vice President of Pharmacy Services
(719) 344-6269
Addresses
Street Address
350 Printers Pkwy
Colorado Springs, CO 80910-3190
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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4/16/2008-UPDATED SHIPPING ADDRESS (WAS 2828 INTERNATIONAL CIRCLE);NEW SITE 10/01/2004
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