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CH08146AU Peak Vista Community Health Centers (Terminated)
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Main Details
Name
Peak Vista Community Health Centers
Subdivision Name
Temporary Site - Springs Rescue Mission
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030616
340B ID
CH08146AU
Grant Number
H80CS00212
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2020
Participating Start Date
4/17/2020
Participating Approval Date
4/17/2020
Last Recertification Date
2/10/2021
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
PVCHC
Lisa Ramey, CMDO
(719) 344-6455
Primary Contact
Peak Vista Community Health Centers
Paul Reilly, Pharmacy Director
(719) 344-6269
Addresses
Street Address
5 W Las Vegas St
Colorado Springs, CO 80903-4217
Billing Address
Peak Vista Community Health Centers
3205 N. Academy Blvd
Suite 130
Colorado Springs, CO 80917
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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