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CH08126H Mountain Family Health Centers (Terminated)
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Main Details
Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Riverside Administration
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027260
340B ID
CH08126H
Grant Number
H80CS00830
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/8/2020
Last Recertification Date
2/3/2021
Termination Date
Termination Reason
4/1/2022
Other
Contacts
Authorizing Official
Mountain Family Health Centers
Art M Fernandez, Chief Operating Officer
(970) 945-2840 Ext: 7205
Primary Contact
Mountain Family Health Centers
Jackie Marie Marshall, Compliance Coordinator
(970) 945-2840 Ext: 7212
Addresses
Street Address
2700 Gilstrap Ct Ste 100
Glenwood Springs, CO 81601-8735
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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