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CH08003R VALLEY WIDE HEALTH SYSTEMS, INC. (Terminated)
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Main Details
Name
VALLEY WIDE HEALTH SYSTEMS, INC.
Subdivision Name
FREMONT FAMILY MEDICAL CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005434
340B ID
CH08003R
Grant Number
H80CS00134
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2001
Participating Start Date
7/1/2001
Participating Approval Date
3/16/2009
Last Recertification Date
2/23/2018
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Valley-Wide Health Systems, Inc.
JEANNE DARRICADES, PRESIDENT/CEO
(719) 589-5161
Primary Contact
Valley-Wide Health Systems, Inc.
Justin Hanel, Director of Pharmacy
(719) 589-3633
Addresses
Street Address
602 Yale Place
Canon City, CO 81212-4611
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/16/09 ADDR CHANGE (WAS 3225B INDEPENDENCE RD)2/26/07 - UPDATED ENTITY NAME (WAS VALLEY WIDE HEALTH SERVICES)
03/16/2009
May 2025
May 2025
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