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CH06033L EL CENTRO FAMILY HEALTH (Active)
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Main Details
Name
EL CENTRO FAMILY HEALTH
Subdivision Name
LA LOMA CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030407
340B ID
CH06033L
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
1044 La Loma Rd
Anton Chico, NM 87711
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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3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM) 7/14/11 - CHANGE PHYSICAL ADDRESS FROM PO BOX I, 1/2 MILES SOUTH OF HWY 119 AND ADDED BILL ADDRESS.
07/14/2011
3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM) 7/14/11 - CHANGE PHYSICAL ADDRESS FROM PO BOX I, 1/2 MILES SOUTH OF HWY 119 AND ADDED BILL ADDRESS.
07/14/2011
June 2025
June 2025
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