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CHC08229-06 FIRST NATIONS COMMUNITY HEALTH SOURCE INC (Active)
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Main Details
Name
FIRST NATIONS COMMUNITY HEALTH SOURCE INC
Subdivision Name
Grant Middle School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020872
340B ID
CHC08229-06
Grant Number
H80CS08229
Additional Details
Current Program Status
Active
Registration Date
10/4/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/9/2019
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
First Nations Community HealthSource
Linda Son-Stone, CEO
(505) 262-6546
Primary Contact
First Nations Community HealthSource
Jane Anne Burak, CFO
(505) 262-2481
Addresses
Street Address
1111 Easterday Dr NE
Albuquerque, NM 87112-5115
Billing Address
First Nations Community HealthSource
5608 Zuni SE
Albuquerque, NM 87108
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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