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CH06033AD EL CENTRO FAMILY HEALTH (Terminated)
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Main Details
Name
EL CENTRO FAMILY HEALTH
Subdivision Name
Memorial Middle School Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018576
340B ID
CH06033AD
Grant Number
H80CS00605
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/24/2016
Last Recertification Date
1/31/2017
Termination Date
Termination Reason
4/1/2018
Site closure
Contacts
Authorizing Official
El Centro Family Health
Lore Pease, CEO
(505) 753-7218
Primary Contact
El Centro Family Health
Christine Vigil, Director of Pharmacy Services
(505) 753-7395
Addresses
Street Address
947 Old National Road
Las Vegas, NM 87701
Billing Address
El Centro Family Health
PO Box 158
Espanola, NM 87532
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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