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FQHCLA225N Maricopa County Special Health Care District (Terminated)
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Main Details
Name
Maricopa County Special Health Care District
Subdivision Name
McDowell Healthcare Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-013860
340B ID
FQHCLA225N
Grant Number
LALCS00037
Additional Details
Current Program Status
Terminated
Registration Date
12/16/2011
Participating Start Date
4/1/2012
Participating Approval Date
3/2/2012
Last Recertification Date
2/14/2019
Termination Date
Termination Reason
4/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Maricopa County Special Health Care District
Richard Mutarelli, Executive Vice President, Chief Financial Officer
(602) 344-8425
Primary Contact
Maricopa County Special Health Care District
Anna Sogard, Director of Pharmacy
(602) 344-5253
Addresses
Street Address
1101 N Central Ave
Phoenix, AZ 85004-1818
Billing Address
Maricopa Medical Center
2601 E. Roosevelt
Phoenix, AZ 85008
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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