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CH080170A PUEBLO COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
PUEBLO COMMUNITY HEALTH CENTER
Subdivision Name
Colorado Avenue Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008656
340B ID
CH080170A
Grant Number
H80CS00692
Additional Details
Current Program Status
Active
Registration Date
1/1/2000
Participating Start Date
1/1/2000
Participating Approval Date
5/11/2005
Last Recertification Date
3/2/2025
Contacts
Authorizing Official
Pueblo Community Health Center, Inc.
Donald Moore, CEO
(719) 543-8718 Ext: 139
Primary Contact
Pueblo Community Health Center
Phillip L Davis, CFO
(719) 543-8718 Ext: 295
Addresses
Street Address
300 Colorado Ave
Pueblo, CO 81004-2006
Billing Address
PUEBLO COMMUNITY HEALTH CENTER, INC.
110 EAST ROUTT
PUEBLO, CO 81004
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/24/11 ADDED SHIP TO AND BILL TO; 1/8/10 - UPDATED PHYS ADD (WAS 110 EAST ROUTT AVE, PUEBLO)
05/26/2011
April 2025
April 2025
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