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CH08126K Mountain Family Health Centers (Terminated)
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Main Details
Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Basalt Middle School SBHC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-031880
340B ID
CH08126K
Grant Number
H80CS00830
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/6/2021
Last Recertification Date
2/7/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Mountain Family Health Centers
Art M Fernandez, Chief Operating Officer
(970) 945-2840 Ext: 7205
Primary Contact
Mountain Family Health Centers
Shiela Kendall, Provider Relations and Credentialing Manager
(970) 945-2840 Ext: 7369
Addresses
Street Address
51 School St Rm E114
Basalt, CO 81621-8223
Billing Address
Mountain Family Health Centers
PO Box 339
Glenwood Springs, CO 81602
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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