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CH063920 LA FAMILIA MEDICAL CENTER INC (Active)
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Main Details
Name
LA FAMILIA MEDICAL CENTER INC
Subdivision Name
La Famila Medical Center Dental Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009241
340B ID
CH063920
Grant Number
H80CS00606
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
2/25/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
La Familia Medical Center
Brandon Vanessa Van Pelt, Interim CEO
(505) 982-4425 Ext: 1067
Primary Contact
La Familia Medical Center
Maya Hardman, Pharmacy Manager
(505) 479-3800
Addresses
Street Address
6401 S Richards Ave
Santa Fe, NM 87508-4887
Billing Address
LA FAMILIA MEDICAL CENTER
P O BOX 5395
SANTA FE, NM 87502-5395
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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ADDED CONTACT TITLE
05/09/2011
April 2025
April 2025
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