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CH09130N Canyonlands Community Health Care (Active)
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Main Details
Name
Canyonlands Community Health Care
Subdivision Name
Canyonlands Healthcare - Mobile Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032623
340B ID
CH09130N
Grant Number
H80CS00448
Additional Details
Current Program Status
Active
Registration Date
10/14/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/18/2021
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Canyonlands Community Health Care
Christopher Hansen, CEO
(928) 645-6600
Primary Contact
Canyonlands Healthcare
Andrew J Lewandowski, Director of Pharmacy
(928) 645-9675 Ext: 2205
Addresses
Street Address
827 Vista Ave.
Page, AZ 86040-1625
Billing Address
Canyonlands Healthcare - Mobile Clinic
PO Box 1625
Page, AZ 86040
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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