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CH09307T Mountain Park Health Center (Active)
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Main Details
Name
Mountain Park Health Center
Subdivision Name
Mountain Park Health Center - Goodyear Suite 100
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021358
340B ID
CH09307T
Grant Number
H80CS00141
Additional Details
Current Program Status
Active
Registration Date
4/4/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/6/2022
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Mountain Park Health Center
John R. Swagert, CEO
(602) 323-3470
Primary Contact
Mountain Park Health Center
Maegan Anne Burris, Associate Director of Pharmacy
(602) 323-8180
Addresses
Street Address
140 N Litchfield Rd Ste 100
Goodyear, AZ 85338-1269
Billing Address
Mountain Park Health Center - Central Office
3003 N Central Ave
Ste 1600
Phoenix, AZ 85012-2908
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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