340B Drug Pricing Program Database
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CH08073AG METRO COMMUNITY PROVIDER NETWORK, INC. (Terminated)
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Main Details
Name
METRO COMMUNITY PROVIDER NETWORK, INC.
Subdivision Name
STRIDE CHC- Potomac Street
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030091
340B ID
CH08073AG
Grant Number
H80CS00217
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/10/2020
Last Recertification Date
2/2/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Metro Community Provider Network, Inc
Santos vera, President/CEO
(949) 572-0958
Primary Contact
Stride CHC
Richard David Dziallo, Pharmacy Manager
(720) 473-7212
Addresses
Street Address
750 Potomac St Ste L23
Aurora, CO 80011-6742
Billing Address
STRIDE CHC- Wheat Ridge
7495 W 29th Ave
Wheat Ridge, CO 80033-8002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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