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CH06658E Centro San Vicente at Pebble Hills (Active)
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Main Details
Name
Centro San Vicente at Pebble Hills
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018977
340B ID
CH06658E
Grant Number
H80CS00637
Additional Details
Current Program Status
Active
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/18/2017
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Centro San Vicente
Christina Ilene Paz, CEO
(915) 859-7545 Ext: 1232
Primary Contact
Centro San Vicente
Ana Nicoletto, Director of Pharmacy
(915) 859-7545 Ext: 1241
Addresses
Street Address
PEBBLE VILLAGE SHOPPING CENTER 10780 PEBBLE HILLS BLVD STE G1
EL PASO, TX 79935-2039
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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