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FQHC638290A PASCUA YAQUI HEALTH SERVICES DIVISION (Active)
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Main Details
Name
PASCUA YAQUI HEALTH SERVICES DIVISION
Subdivision Name
PASCUA YAQUI HEALTH SERVICES DIVISION GUADALUPE
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638290A
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/27/2016
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Pascua Yaqui Tribe
JULIAN HERNANDEZ, Tribal Council Chairman
(520) 879-5110
Primary Contact
Pascua Yaqui Tribe
Serena Felix, Pharmacy Director
(520) 879-6373
Addresses
Street Address
9405 S AVENIDA DEL YAQUI
GUADALUPE, AZ 85283-2529
Billing Address
PASCUA YAQUI HEALTH SERVICES DIVISION
7490 S CAMINO DE OESTE
TUCSON, AZ 85746-9308
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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