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FP86301 ARIZONA FAMILY HEALTH PARTNERSHIP (Terminated)
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Main Details
Name
ARIZONA FAMILY HEALTH PARTNERSHIP
Subdivision Name
COMMUNITY HEALTH CENTER OF YAVAPAI - PRESCOTT CLINIC
Type
Family Planning (Title X only)
340B ID
FP86301
Grant Number
FPHPA006520
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/23/2024
Last Recertification Date
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Yavapai, County of
Leslie Horton, Director, Health Officer
(928) 442-5303
Primary Contact
Yavapai County Community Health Services
Cody Schmidt, Pharmacy and 340b Section Manager
(928) 583-1038
Addresses
Street Address
1090 COMMERCE DRIVE
PRESCOTT, AZ 86305
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (07/1/2002) until terminated effective date: (07/1/2022); reinstatement effective date: (07/1/2024)
04/17/2024
April 2025
April 2025
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