340B Drug Pricing Program Database

Name

FIRST PERSON CARE CLINIC

Subdivision Name

First Person Care Clinic

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-017460

340B ID

FQHCLA345

Grant Number

LALCS00177

Current Program Status

Terminated

Registration Date

10/4/2016

Participating Start Date

1/1/2017

Participating Approval Date

10/31/2016

Last Recertification Date

2/25/2019

Termination Date
Termination Reason

7/1/2019
Change of covered entity type (non-hospital)

Authorizing Official

First Person Care Clinic
Roxana Valeton, CEO
(305) 303-8108

Primary Contact

First Person Care Clinic
Ryan Jacob, Clinic Director
(702) 380-8118

Street Address

1200 S 4TH ST
LAS VEGAS, NV 89104-1046

Billing Address
Same as Street Address