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CH08073B Metro Community Provider Network, Inc. (Terminated)
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Main Details
Name
Metro Community Provider Network, Inc.
Subdivision Name
MCPN Lakewood Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003425
340B ID
CH08073B
Grant Number
H80CS00217
Additional Details
Current Program Status
Terminated
Registration Date
4/1/1997
Participating Start Date
4/1/1997
Participating Approval Date
4/8/2009
Last Recertification Date
1/29/2019
Termination Date
Termination Reason
1/1/2020
Site closure
Contacts
Authorizing Official
Metro Community Provider Network
Ben Wiederholt, CEO
(303) 761-1977 Ext: 1103
Primary Contact
Metro Community Provider Network
Jillian Anderson, 340B Program Manager
(303) 360-6276 Ext: 2163
Addresses
Street Address
8500 W. COLFAX AVE
LAKEWOOD, CO 80215-4011
Billing Address
Metro Community Provider Network, Inc.
3701 S Broadway
Englewood, CO 80113-3611
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/22/05 UPDATED ENTITY NAME
01/21/2010
May 2025
May 2025
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