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CH08146AS Peak Vista Community Health Centers (Active)
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Main Details
Name
Peak Vista Community Health Centers
Subdivision Name
Family Health Center at Mitchell High School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029887
340B ID
CH08146AS
Grant Number
H80CS00212
Additional Details
Current Program Status
Active
Registration Date
11/26/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/3/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PVCHC
Joel Tanaka, Chief Medical Officer
(719) 344-6530
Primary Contact
Peak Vista Community Health Centers
Katie Boudreaux, Vice President of Pharmacy Services
(719) 344-6269
Addresses
Street Address
4041 E San Miguel St
Colorado Springs, CO 80909
Billing Address
Peak Vista Community Health Centers
3205 N. Academy Blvd, Ste 130
Colorado Springs, CO 80917
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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