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TURQUOISE
CH060330 EL CENTRO FAMILY HEALTH
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Covered Entity Details
Entity Name
EL CENTRO FAMILY HEALTH
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH060330
Entity Address
620 CORONADO STREET
ESPANOLA, NM 87532
Grant Number
H80CS00605
Participating Start Date
8/1/1993
Last Recertification Date
3/8/2016
Entity Termination Date
4/1/2016
Pharmacy Details
Pharmacy Name
TURQUOISE
Pharmacy Address
DBA: DEL NORTE PHARMACY
615 GRAND AVE
LAS VEGAS, NM 87701
Pharmacy Comments
Contract Details
Approval Date
9/9/2011
Contract Begin Date
9/9/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Contacts
Covered Entity Signing Official
Christine Vigil, Director of Pharmacy Services
(505) 753-7395
Contract Pharmacy Representative
Brookshire Grocery
John Stogner, CFO
(903) 893-0677
Signed By Date
7/5/2011
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