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CH08126D Mountain Family Health Centers (Active)
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Main Details
Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Basalt
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027305
340B ID
CH08126D
Grant Number
H80CS00830
Additional Details
Current Program Status
Active
Registration Date
8/11/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/5/2011
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Mountain Family Health Centers
Art M Fernandez, Chief Operating Officer
(970) 945-2840 Ext: 7205
Primary Contact
Mountain Family Health Centers
Shiela Kendall, Provider Relations and Credentialing Manager
(970) 945-2840 Ext: 7369
Addresses
Street Address
123 Emma Rd, Ste 106
Basalt, CO 81621-9169
Billing Address
Mountain Family Health Centers
PO Box 339
Glenwood Springs, CO 81602-0339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW NAME/CONTACT 9/15/05 NEW CONTACT
08/11/2011
April 2025
April 2025
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