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CH08146AF PEAK VISTA COMMUNITY HEALTH CENTERS (Terminated)
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Main Details
Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
RONALD MCDONALD CARE MOBILE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008227
340B ID
CH08146AF
Grant Number
H80CS00212
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
2/16/2018
Termination Date
Termination Reason
4/1/2019
Business decision by the Covered Entity
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
340 PRINTERS PARKWAY
COLORADO SPRINGS, CO 80910-3195
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
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