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CHC12875-02 HURTT FAMILY HEALTH CLINIC, INC. (Active)
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Main Details
Name
HURTT FAMILY HEALTH CLINIC, INC.
Subdivision Name
Hurtt Family Health Clinic - Santa Ana BH
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018395
340B ID
CHC12875-02
Grant Number
H80CS12875
Additional Details
Current Program Status
Active
Registration Date
7/14/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/13/2024
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Hurtt Family Health Clinic
Jina 714-914-6551 Lawler, President & CEO
(714) 247-8044
Primary Contact
Hurtt Family Health Clinic
Mercedes Wagner, Pharmacist
(714) 397-1224
Addresses
Street Address
1100 N Tustin Ave Ste F
Santa Ana, CA 92705-3509
Billing Address
Hurtt Family Health Clinic
1 Hope Drive
Tustin, CA 92782
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participated starting 1/1/2017; Terminated 4/1/2023; Reinstated 10/1/2024.
08/13/2024
June 2025
June 2025
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