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CH06345AV PRESBYTERIAN MEDICAL SERVICES, INC. (Terminated)
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Main Details
Name
PRESBYTERIAN MEDICAL SERVICES, INC.
Subdivision Name
PMS - Farmington Community Health Center Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009414
340B ID
CH06345AV
Grant Number
H80CS00205
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/28/2013
Last Recertification Date
2/7/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
Presbyterian Medical Services
Steven C. Hansen, CEO
(505) 982-5565 Ext: 3470
Primary Contact
Presbyterian Medical Services
Stephen M. Quesada, DIRECTOR OF PHARMACY
(505) 443-2634
Addresses
Street Address
2700 Farmington Ave, BLDG C, STE 1
Farmington, NM 87401-4550
Billing Address
Presbyterian Medical Services
1422 Paseo de Peralta
Santa Fe, NM 87501
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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