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CH08146AD PEAK VISTA COMMUNITY HEALTH CENTERS (Active)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Dental Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009591
340B ID
CH08146AD
Grant Number
H80CS00212
Additional Details
Current Program Status
Active
Registration Date
10/8/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PVCHC
Joel Tanaka, Chief Medical Officer
(719) 344-6530
Primary Contact
Peak Vista Community Health Centers
Katie Boudreaux, Vice President of Pharmacy Services
(719) 344-6269
Addresses
Street Address
2828 International Circle STE 100
Colorado Springs, CO 80910
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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10/16/12 - Reviewed registration and forwarded to IS for approval.
10/16/2012
April 2025
April 2025
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