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CH09130M Canyonlands Community Health Care (Terminated)
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Main Details
Name
Canyonlands Community Health Care
Subdivision Name
Canyonlands Healthcare - Globe Integrated
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019547
340B ID
CH09130M
Grant Number
H80CS00448
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/10/2018
Last Recertification Date
2/5/2019
Termination Date
Termination Reason
10/1/2019
Site closure
Contacts
Authorizing Official
Canyonlands Community Health Care
Christopher Hansen, CEO
(928) 645-6600
Primary Contact
Canyonlands Healthcare
Andrew J Lewandowski, Director of Pharmacy
(928) 645-9675 Ext: 2205
Addresses
Street Address
111 West Blake Street
Globe, AZ 85501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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