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SMITH'S MANAGEMENT CORP
CH06033T El Centro Family Health
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Covered Entity Details
Entity Name
El Centro Family Health
Subdivision Name
TAOS CLINIC
Type
HRSA-Funded Health Center
340B ID
CH06033T
Entity Address
1331 Gusdorf Road
Taos, NM 87571-6282
Grant Number
H80CS00605
Participating Start Date
10/1/2012
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SMITH'S MANAGEMENT CORP
Pharmacy Address
SMITH'S FOOD & DRUG #426
ATTN: PHARMACY
224 PASEO PUEBLO SUR
TAOS, NM 87571
Pharmacy Comments
Contract Details
Approval Date
4/9/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lore Pease, CEO
(505) 753-7218
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/9/2021
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