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CH03682B LA CLINICA DEL PUEBLO, INC (Active)
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Main Details
Name
LA CLINICA DEL PUEBLO, INC
Subdivision Name
University Park Elementary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037524
340B ID
CH03682B
Grant Number
H80CS08244
Additional Details
Current Program Status
Active
Registration Date
5/13/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/16/2024
Last Recertification Date
2/20/2025
Contacts
Authorizing Official
La Clinica del Pueblo
Carlos Plazas, CFO/COO
(202) 464-0141
Primary Contact
La Clinica
Altinay D Kayani, Accounting Manager
(443) 360-8309
Addresses
Street Address
4315 Underwood Street
University Park, MD 20782-1199
Billing Address
La Clinica del Pueblo
2831 15th St NW
Washington, DC 20009
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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