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CH06301K LA CLINICA DE FAMILIA, INC. (Active)
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Main Details
Name
LA CLINICA DE FAMILIA, INC.
Subdivision Name
CHAPARRAL MEDICAL CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004170
340B ID
CH06301K
Grant Number
H80CS00316
Additional Details
Current Program Status
Active
Registration Date
1/1/2002
Participating Start Date
1/1/2002
Participating Approval Date
2/27/2009
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
La Clinica de Familia, Inc.
Virgil Medina, CEO
(575) 526-1105
Primary Contact
La Clinica de Familia, Inc.
Rosemary Melendez Acosta, Pharmacist
(575) 526-1105
Addresses
Street Address
510 E LISA DR
CHAPARRAL, NM 88081
Billing Address
LA CLINICA DE FAMILIA, INC
385 Calle de Alegra
Bldg. A
LAS CRUCES, NM 88005
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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04/09/09 UPDATED ADDR (WAS ZIP: 88021); 2/27/09 ADDED BILL TO; 1/2/08 UPDATED ADDR (WAS 317 MCCOMBS) 3/7/12-Changed Authorizing Official (was HARRIET BRANDSTETTER)
03/07/2012
04/09/09 UPDATED ADDR (WAS ZIP: 88021); 2/27/09 ADDED BILL TO; 1/2/08 UPDATED ADDR (WAS 317 MCCOMBS)
01/08/2010
June 2025
June 2025
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