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CHC12875-06 HURTT FAMILY HEALTH CLINIC, INC. (Active)
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Main Details
Name
HURTT FAMILY HEALTH CLINIC, INC.
Subdivision Name
Hurtt Family Health Clinic - Medical and Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032292
340B ID
CHC12875-06
Grant Number
H80CS12875
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/19/2023
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
14642 Newport Ave
suite 200
Tustin, CA 92780-6058
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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June 2025
June 2025
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