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CHC08229-08 FIRST NATIONS COMMUNITY HEALTH SOURCE INC (Terminated)
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Main Details
Name
FIRST NATIONS COMMUNITY HEALTH SOURCE INC
Subdivision Name
FNCH Outpatient Services
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020946
340B ID
CHC08229-08
Grant Number
H80CS08229
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/28/2020
Last Recertification Date
Termination Date
Termination Reason
4/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
First Nations Community HealthSource
Linda Son-Stone, CEO
(505) 262-6546
Primary Contact
First Nations Community HealthSource
Leon Paboucek, Chief Financial Officer
(505) 262-6069
Addresses
Street Address
634 Manzano Street NE
Albuquerque, NM 87110-6443
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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