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CH06033G EL CENTRO FAMILY HEALTH (Active)
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Main Details
Name
EL CENTRO FAMILY HEALTH
Subdivision Name
ROY CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007045
340B ID
CH06033G
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
555 Wagon Mound Hwy
Roy, NM 87743
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 ADMIN ADDRESS FROM PO BOX 148, STATE ROAD 120, WEST OF TOWN. ADDED BILL ADDRESS.
07/14/2011
3/23/07 - UPDATED ENTITY NAME (WAS HEALTH CENTERS OF NORTHERN NM) 7/14/11 - CHANGE ADMIN ADDRESS FROM PO BOX 148, STATE ROAD 120, WEST OF TOWN. ADDED BILL ADDRESS.
07/14/2011
June 2025
June 2025
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