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CH081460Z PEAK VISTA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Moreno Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010560
340B ID
CH081460Z
Grant Number
H80CS00212
Additional Details
Current Program Status
Terminated
Registration Date
8/11/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/2/2011
Last Recertification Date
2/26/2016
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
Peak Vista CHC
PAMELA J. MCMANUS, PRESIDENT AND CEO
(719) 344-6453
Primary Contact
Peak Vista Community Health Centers
Paul Reilly, Pharmacy Director
(719) 344-6269
Addresses
Street Address
875 W Moreno Ave
Colorado Springs, CO 80905-1731
Billing Address
Peak Vista Community Health Center
3205 N. Academy Blvd, Suite 130
Colorado Springs, CO 80917
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW ENTITY NAME, CONTACT, ADDRESS (FORMERLY 2828 INTERNATIONAL CIRCLE) 7/13/11 - CHANGED AO FROM BJ SCOTT AND CONTACT FROM PAMELA J. MCMANUS.
08/11/2011
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