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CH08146D PEAK VISTA COMMUNITY HEALTH CENTERS (Active)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Health Center at Wahsatch, Enrichment & Counseling Center at Wahsatch
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001678
340B ID
CH08146D
Grant Number
H80CS00212
Additional Details
Current Program Status
Active
Registration Date
10/1/2004
Participating Start Date
10/1/2004
Participating Approval Date
9/15/2004
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
722 S Wahsatch Ave
Colorado Springs, CO 80903
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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2/18/10 UPDATED PHYS ADD (WAS 2840 INTERNATIONAL CIRCLE, 80910), UPDATED SUB-DIV NAME (WAS FAMILY HEALTH AND SENIOR HEALTH CENTER); 4/16/2008- UPDATED SHIPPING ADDRESS (WAS 2828 INTERNATIONAL CIRCLE); NEW SITE 10/01/2004
02/18/2010
April 2025
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