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CH08090D PEAK VISTA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Health Center at Kiowa
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014124
340B ID
CH08090D
Grant Number
H80CS00212
Additional Details
Current Program Status
Terminated
Registration Date
9/18/2012
Participating Start Date
1/1/2013
Participating Approval Date
11/16/2012
Last Recertification Date
2/1/2022
Termination Date
Termination Reason
7/1/2022
Site closure
Contacts
Authorizing Official
PVCHC
Lisa Ramey, CMDO
(719) 344-6455
Primary Contact
Peak Vista Community Health Centers
Katie Boudreaux, Vice President of Pharmacy Services
(719) 344-6269
Addresses
Street Address
320 Comanche Street
Kiowa, CO 80117
Billing Address
PEAK VISTA COMMUNITY HEALTH CENTERS
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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8/7/14 PLAINS MEDICAL CENTER merged with PEAK VISTA COMMUNITY HEALTH CENTERS, 340B IDs remain the same but organization name, EIN, grant number, AO and billing organization have changed
08/07/2014
April 2025
April 2025
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