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CH08017P PUEBLO COMMUNITY HEALTH CENTER, INC. (Active)
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Main Details
Name
PUEBLO COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Chavez/Huerta K-12 Preparatory Academy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027849
340B ID
CH08017P
Grant Number
H80CS00692
Additional Details
Current Program Status
Active
Registration Date
8/26/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/27/2019
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
2727 W 18th St
Pueblo, CO 81003-1185
Billing Address
Pueblo Community Health Center
110 East Routt Avenue
Pueblo, CO 81004
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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