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FQHC638101 YSLETA DEL SUR PUEBLO COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
YSLETA DEL SUR PUEBLO COMMUNITY HEALTH CENTER
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638101
Additional Details
Current Program Status
Active
Registration Date
10/1/2004
Participating Start Date
10/1/2004
Participating Approval Date
7/27/2004
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Ysleta del Sur Pueblo
Martin Lopez Jr., HHS Director
(915) 860-6132
Primary Contact
Ysleta Del Sur Pueblo
Reasol Agustin Chino, Pharmacy Manager
(301) 717-1060
Addresses
Street Address
9473 Socorro Rd
EL PASO, TX 79907
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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NEW SITE 10/01/2004
07/27/2004
April 2025
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