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CH06031D LAS CLINICA DEL NORTE INCORPORATED (Active)
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Main Details
Name
LAS CLINICA DEL NORTE INCORPORATED
Subdivision Name
LAS CLINICAS DEL NORTE SCH CLN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006584
340B ID
CH06031D
Grant Number
H80CS00607
Additional Details
Current Program Status
Active
Registration Date
7/1/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/27/2013
Last Recertification Date
2/26/2025
Contacts
Authorizing Official
Las Clinicas del Norte
Andrea Sandoval, CEO
(575) 581-4728 Ext: 253
Primary Contact
LCDN
Roxanne Rodriguez, CPhT
(575) 581-4728 Ext: 6250
Addresses
Street Address
BLDG. K ON SR 554
OJO CALIENTE, NM 87510-0307
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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