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CH08017N PUEBLO COMMUNITY HEALTH CENTER, INC. (Active)
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Main Details
Name
PUEBLO COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Pueblo Community College Student Health Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021004
340B ID
CH08017N
Grant Number
H80CS00692
Additional Details
Current Program Status
Active
Registration Date
10/5/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/6/2017
Last Recertification Date
3/2/2025
Contacts
Authorizing Official
Pueblo Community Health Center, Inc.
Donald Moore, CEO
(719) 543-8718 Ext: 139
Primary Contact
Pueblo Community Health Center
Phillip L Davis, CFO
(719) 543-8718 Ext: 295
Addresses
Street Address
900 W Orman Ave MT Building, Room 118
Pueblo, CO 81004
Billing Address
Pueblo Community Health Center, Inc.
110 East Routt Avenue
Pueblo, CO 81004-2117
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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