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CH06033I EL CENTRO FAMILY HEALTH (Active)
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Main Details
Name
EL CENTRO FAMILY HEALTH
Subdivision Name
COYOTE CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005688
340B ID
CH06033I
Grant Number
H80CS00605
Additional Details
Current Program Status
Active
Registration Date
8/1/1993
Participating Start Date
8/1/1993
Participating Approval Date
7/14/2011
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
El Centro Family Health
Darren Deyapp, CEO
(505) 753-7218
Primary Contact
El Centro Family Health
Christine Vigil, Director of Pharmacy Services
(505) 753-7395
Addresses
Street Address
STATE ROAD 96 #3396
COYOTE, NM 87012-9998
Billing Address
EL CENTRO FAMILY HEALTH
PO BOX 158
ESPANOLA, NM 87532
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/6/2012 THIS RECORD WAS INADVERTENTLY DELETED ON 9/30/2011; THE CORRECT VALUES WERE RESTORED ON 6/1/2012. THE ENTITY WAS CONTINUOUSLY ELIGIBLE FOR 340B DISCOUNTS DESPITE NOT BEING LISTED IN THE 340B DATABASE DURING THIS PERIOD. 7/14/11 - CHANGED PHYSICAL ADDRESS FROM GENERAL DELIVERY-STATE ROAD 96; 3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM)
06/06/2012
3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM) 7/14/11 - CHANGED PHYSICAL ADDRESS FROM GENERAL DELIVERY-STATE ROAD 96
07/14/2011
3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM) 7/14/11 - CHANGED PHYSICAL ADDRESS FROM GENERAL DELIVERY-STATE ROAD 96
07/14/2011
June 2025
June 2025
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