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COMMUNITY MEDICAL CENTER PHARMACY
CH08126B Mountain Family Health Centers
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Covered Entity Details
Entity Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Glenwood Springs
Type
HRSA-Funded Health Center
340B ID
CH08126B
Entity Address
1905 BLAKE AVE
STE 101
GLENWOOD SPRINGS, CO 81601-4206
Grant Number
H80CS00830
Participating Start Date
10/1/1999
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
COMMUNITY MEDICAL CENTER PHARMACY
Pharmacy Address
610 GATEWAY CENTER WAY
STE A - E
SAN DIEGO, CA 92102-4548
Pharmacy Comments
Contract Details
Approval Date
6/4/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Art M Fernandez, Chief Operating Officer
(970) 945-2840 Ext: 7205
Contract Pharmacy Representative
Western Pharmacy Group LLC
KEVIN FARIS, CEO
(360) 685-4263
Signed By Date
6/4/2018
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