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CHC28956-06 Valle Del Sol, Inc. (Terminated)
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Main Details
Name
Valle Del Sol, Inc.
Subdivision Name
Valle del Sol_4117
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032649
340B ID
CHC28956-06
Grant Number
H80CS28956
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/1/2021
Last Recertification Date
2/7/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
Valle Del Sol
Mike Renaud, President & Chief Executive Officer
(602) 258-6797 Ext: 1320
Primary Contact
Valle Del Sol
Rebecca Zelaya, Pharmacy Director
(602) 258-6797 Ext: 6213
Addresses
Street Address
4117 N 17th St
Phoenix, AZ 85016-5921
Billing Address
Valle del Sol
3877 North 7th Street
Suite 400
Phoenix, AZ 85014
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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