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BOULDER HEALTH CENTER PHARMACY
CH08165M Clinica Campesina Family Health Services
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Covered Entity Details
Entity Name
Clinica Campesina Family Health Services
Subdivision Name
Clinica Family Health - People's
Type
HRSA-Funded Health Center
340B ID
CH08165M
Entity Address
2525 13th St
Boulder, CO 80304
Grant Number
H80CS00690
Participating Start Date
4/1/2008
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BOULDER HEALTH CENTER PHARMACY
Pharmacy Address
5495 ARAPAHOE AVE
SUITE 101
BOULDER, CO 80303-1260
Pharmacy Comments
Contract Details
Approval Date
3/11/2009
Contract Begin Date
3/11/2009
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/3/2009
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