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CH08146R PEAK VISTA COMMUNITY HEALTH CENTERS (Active)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Lane Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013493
340B ID
CH08146R
Grant Number
H80CS00212
Additional Details
Current Program Status
Active
Registration Date
1/1/2005
Participating Start Date
1/1/2005
Participating Approval Date
12/13/2004
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
4863 N. Nevada
Colorado Springs, CO 80918
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 01/01/2005
04/16/2008
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