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CH08165E CLINICA CAMPESINA FAMILY HEALTH SERVICES (Terminated)
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Main Details
Name
CLINICA CAMPESINA FAMILY HEALTH SERVICES
Subdivision Name
Clinica Family Health Services- Lafayette
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000858
340B ID
CH08165E
Grant Number
H80CS00690
Additional Details
Current Program Status
Terminated
Registration Date
2/20/2008
Participating Start Date
4/1/2008
Participating Approval Date
2/25/2008
Last Recertification Date
3/6/2018
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
Clinica Campesina Family Health Services
Simon Smith, CEO
(303) 665-3036 Ext: 1003
Primary Contact
Clinica Campesina/Family Health Services
Justin Wheeler, VP of Clinical Services
(303) 665-3036 Ext: 1002
Addresses
Street Address
2000 W SOUTH BOULDER
LAFAYETTE, CO 80026-1389
Billing Address
CLINICA FAMILY HEALTH
1345 PLAZA CT N
LAFAYETTE, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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