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FQHCLA225J Maricopa County Special Health Care District (Terminated)
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Main Details
Name
Maricopa County Special Health Care District
Subdivision Name
7th Avenue Walk In Clinic
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-009885
340B ID
FQHCLA225J
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
10/1/2019
Site closure
Contacts
Authorizing Official
Maricopa Integrated Health Center
Kris Gaw, Chief Operating Officer
(602) 344-1258
Primary Contact
Maricopa County Special Health Care District
Anna Sogard, Director of Pharmacy
(602) 344-5253
Addresses
Street Address
1201 S. 7th Avenue
Phoenix, AZ 85007
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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