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CH06033H EL CENTRO FAMILY HEALTH (Active)
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Main Details
Name
EL CENTRO FAMILY HEALTH
Subdivision Name
PENASCO MEDICAL & DDS CLINICS
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005126
340B ID
CH06033H
Grant Number
H80CS00605
Additional Details
Current Program Status
Active
Registration Date
8/1/1993
Participating Start Date
8/1/1993
Participating Approval Date
8/1/1993
Last Recertification Date
2/14/2025
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
15136 STATE HIGHWAY 75
PENASCO, NM 87553-0238
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)
12/20/2005
June 2025
June 2025
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