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CH09307E MOUNTAIN PARK HEALTH CENTER (Terminated)
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Main Details
Name
MOUNTAIN PARK HEALTH CENTER
Subdivision Name
MOUNTAIN PARK HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005333
340B ID
CH09307E
Grant Number
H80CS00141
Additional Details
Current Program Status
Terminated
Registration Date
3/10/2006
Participating Start Date
4/1/2006
Participating Approval Date
3/14/2006
Last Recertification Date
2/14/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Mountain Park Health Center
John R. Swagert, CEO
(602) 323-3470
Primary Contact
Mountain Park Health Center
Mary Soto, Associate Director of Pharmacy
(602) 586-3026
Addresses
Street Address
2702 N. 3rd St.
Suite 4020
Phoenix, AZ 85004-4608
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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