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CH09489D VENICE FAMILY CLINIC (Active)
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Main Details
Name
VENICE FAMILY CLINIC
Subdivision Name
Venice Family Clinic - Simms/Mann Health and Wellness Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014381
340B ID
CH09489D
Grant Number
H80CS04217
Additional Details
Current Program Status
Active
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
1/22/2015
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Venice Family Clinic
Mitesh G Popat, CEO
(310) 664-7901
Primary Contact
Venice Family Clinic
Isabela Mihai, Chief Compliance Officer
(310) 593-9594
Addresses
Street Address
2509 Pico Blvd
Santa Monica, CA 90405-1828
Billing Address
Venice Family Clinic Store 2
2509 Pico Blvd Fl 2
Santa Monica, CA 90405
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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