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CH06345AW PRESBYTERIAN MEDICAL SERVICES, INC. (Terminated)
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Main Details
Name
PRESBYTERIAN MEDICAL SERVICES, INC.
Subdivision Name
PMS - Lake Arthur School-Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010887
340B ID
CH06345AW
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
2/7/2018
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Presbyterian Medical Services
Stephen M. Quesada, DIRECTOR OF PHARMACY
(505) 443-2634
Primary Contact
Presbyterian Medical Services
Steven C. Hansen, CEO
(505) 982-5565 Ext: 3470
Addresses
Street Address
700 Broadway
Lake Arthur, NM 88253
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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June 2025
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