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COMMUNITY MEDICAL CENTER PHARMACY
CH081260E Mountain Family Health Centers
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Covered Entity Details
Entity Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Rifle
Type
HRSA-Funded Health Center
340B ID
CH081260E
Entity Address
195 W. 14th St., Bldg C
Rifle, CO 81650-4717
Grant Number
H80CS00830
Participating Start Date
10/1/2011
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
2/1/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2018
Ownership change
Contacts
Covered Entity Signing Official
Bart Carnoali, DON
(970) 945-2840
Contract Pharmacy Representative
Community Medical Center Pharmacy
Michelle Darnelle, Operations / Business Development Manager
(619) 206-0117
Signed By Date
2/1/2017
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