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CH06345R PRESBYTERIAN MEDICAL SERVICES (Active)
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Main Details
Name
PRESBYTERIAN MEDICAL SERVICES
Subdivision Name
ORTIZ MOUNTAIN HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001226
340B ID
CH06345R
Grant Number
H80CS00205
Additional Details
Current Program Status
Active
Registration Date
10/1/1996
Participating Start Date
10/1/1996
Participating Approval Date
8/26/2004
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Presbyterian Medical Services
Stephen M. Quesada, DIRECTOR OF PHARMACY
(505) 443-2634
Primary Contact
Presbyterian Medical Services - Santa Fe, NM
Julie Georgia Lucero, 340B Coordinator
(505) 231-4028
Addresses
Street Address
06B MAIN STREET
CERRILLOS, NM 87010
Billing Address
PRESBYTERIAN MEDICAL SERVICES
1422 PASEO DE PERALTA
SANTA FE, NM 87501
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/7/08 UPDATED ADDR. (WAS 8 MAIN STREET, SUITE A); 9/24/08 UPDATED BILL TO (WAS PO BOX 2267)
01/13/2010
June 2025
June 2025
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