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CH09307C MOUNTAIN PARK HEALTH CENTER (Active)
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Main Details
Name
MOUNTAIN PARK HEALTH CENTER
Subdivision Name
Mountain Park Health Center - Goodyear
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010170
340B ID
CH09307C
Grant Number
H80CS00141
Additional Details
Current Program Status
Active
Registration Date
3/10/2006
Participating Start Date
4/1/2006
Participating Approval Date
3/14/2006
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Mountain Park Health Center
John R. Swagert, CEO
(602) 323-3470
Primary Contact
Mountain Park Health Center
Maegan Anne Burris, Associate Director of Pharmacy
(602) 323-8180
Addresses
Street Address
140 N Litchfield Rd
Ste 200
Goodyear, AZ 85338-1226
Billing Address
Mountain Park Health Center - Central Office
3003 N Central Ave
Ste 1600
Phoenix, AZ 85012-2908
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/11/11 UPDATE PHYS ADD (WAS 9169 W. VAN BUREN, TOLLESON, AZ 85353)
02/11/2011
April 2025
April 2025
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