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CHC33644-11 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT (Terminated)
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Main Details
Name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Subdivision Name
Valleywise Community Health Center - Glendale
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029514
340B ID
CHC33644-11
Grant Number
H80CS33644
Additional Details
Current Program Status
Terminated
Registration Date
11/5/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/6/2019
Last Recertification Date
1/28/2020
Termination Date
Termination Reason
4/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Maricopa County Special Health Care District
Michael White, Executive Vice President, Chief Clinical Officer
(602) 344-5503
Primary Contact
Maricopa County Special Health Care District
Anna Sogard, Director of Pharmacy
(602) 344-5253
Addresses
Street Address
5141 W Lamar Rd
Glendale, AZ 85301-3423
Billing Address
Maricopa County Special Health Care District
Valleywise Health Medical Center
2601 E Roosevelt St
Phoenix, AZ 85008
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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