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CH06301G LA CLINICA DE FAMILIA, INC (Active)
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Main Details
Name
LA CLINICA DE FAMILIA, INC
Subdivision Name
EAST MESA MEDICAL AND DENTAL CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005627
340B ID
CH06301G
Grant Number
H80CS00316
Additional Details
Current Program Status
Active
Registration Date
7/1/2002
Participating Start Date
7/1/2002
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
8600 BATAAN MEMORIAL E
LAS CRUCES, NM 88011-6016
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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2/27/09-ADDED BILLING ADDR. 12/3/07- UPDATED ADD. & NAME (WAS8780 HIGHWAY 70 & NAME WAS MEDICAL EAST) 3/7/12-Changed Authorizing Official (was HARRIET BRANDSTETTER)
03/07/2012
2/27/09-ADDED BILLING ADDR. 12/3/07- UPDATED ADD. & NAME (WAS8780 HIGHWAY 70 & NAME WAS MEDICAL EAST)
03/04/2009
June 2025
June 2025
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