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CH06658B Homeless Clinic (Active)
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Main Details
Name
Homeless Clinic
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004650
340B ID
CH06658B
Grant Number
H80CS00637
Additional Details
Current Program Status
Active
Registration Date
1/1/2002
Participating Start Date
1/1/2002
Participating Approval Date
6/14/2005
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Centro San Vicente
Christina Ilene Paz, CEO
(915) 859-7545 Ext: 1232
Primary Contact
Centro San Vicente
Ana Nicoletto, Director of Pharmacy
(915) 859-7545 Ext: 1241
Addresses
Street Address
1208 Myrtle Ave
El Paso, TX 79901-1602
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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