340B Drug Pricing Program Database
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CH08073Z METRO COMMUNITY PROVIDER NETWORK, INC. (Terminated)
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Main Details
Name
METRO COMMUNITY PROVIDER NETWORK, INC.
Subdivision Name
STRIDE CHC- Parker
Type
HRSA-Funded Health Center
Site ID
BPS-H80-022098
340B ID
CH08073Z
Grant Number
H80CS00217
Additional Details
Current Program Status
Terminated
Registration Date
11/13/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/14/2014
Last Recertification Date
2/13/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Metro Community Provider Network, Inc
Santos vera, President/CEO
(949) 572-0958
Primary Contact
Stride CHC
Richard David Dziallo, Pharmacy Manager
(720) 473-7212
Addresses
Street Address
17866 Cottonwood Dr
Parker, CO 80134-3924
Billing Address
STRIDE CHC- Wheat Ridge
7495 W 29th Ave
Wheat Ridge, CO 80033-8002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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