340B Drug Pricing Program Database

Name

Maricopa County Special Health Care District

Subdivision Name

Whole Health Home Clinic POCN Comunidad

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-011993

340B ID

FQHCLA225Q

Grant Number

LALCS00037

Current Program Status

Terminated

Registration Date

1/9/2013

Participating Start Date

4/1/2013

Participating Approval Date

2/27/2013

Last Recertification Date

2/8/2018

Termination Date
Termination Reason

4/1/2019
Business decision by the Covered Entity

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

Street Address

1035 E. Jefferson Street
STE B
Phoenix, AZ 85034

Billing Address

Maricopa Medical Center
2601 E. Roosevelt
Phoenix, AZ 85008