340B Drug Pricing Program Database


CH09085AK AMPLA HEALTH (Active) - information as of 5/20/2025 12:38:21 AM

Main Details
AMPLA HEALTH
Ampla Health North Chico Medical
HRSA-Funded Health Center
BPS-H80-038172
CH09085AK
H80CS00765


Additional Details
Active
7/9/2024
10/1/2024
7/15/2024
2/14/2025

Contacts

Ampla Health
Benjamin H. Flores, President & CEO
(530) 674-4261 Ext: 1155

Ampla Health
Jessica Barber, Pharmacy Administrator
(530) 520-6042

Addresses

100 Independence Circle
Chico, CA 95973-0258

Ampla Health
935 Market Street
Yuba City, CA 95991


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH090850ActiveBPS-H80-000154AMPLA HEALTHAmpla Health Lindhurst Medical, Dental, & Xpress Care4941 Olivehurst Ave OlivehurstCA
CH09085AActiveBPS-H80-004416AMPLA HEALTHAmpla Health Oroville Medical & Dental2800 Lincoln Blvd OrovilleCA
CH09085AAActiveBPS-H80-013998AMPLA HEALTHAmpla Health Los Molinos Medical7981 STATE HIGHWAY 99E LOS MOLINOSCA
CH09085ABActiveBPS-H80-018620AMPLA HEALTHAmpla Health Magalia Medical Clinic14137 Lakeridge Court MagaliaCA
CH09085ACActiveBPS-H80-032418AMPLA HEALTHThe Cannery Building614 J St MarysvilleCA
CH09085ADActiveBPS-H80-036382AMPLA HEALTHAmpla Health Yuba City Plumas Medical481 Plumas Street STE 101 Yuba CityCA
CH09085AEActiveBPS-H80-030378AMPLA HEALTHAmpla Health Mobile Unit2800 Lincoln Blvd. OrovilleCA
CH09085AFActiveBPS-H80-036345AMPLA HEALTHAmpla Health Test to Treat Mobile Unit355 Samuel Dr Yuba CityCA
CH09085AGActiveBPS-H80-037250AMPLA HEALTHAmpla Health South Chico Medical2216 Fair Street ChicoCA
CH09085AHActiveBPS-H80-038075AMPLA HEALTHAmpla Health Marysville Medical at the Cannery608 J Street MarysvilleCA
CH09085AJActiveBPS-H80-038076AMPLA HEALTHAmpla Health North Plumas Medical1231 Plumas St Yuba CityCA
CH09085AKActiveBPS-H80-038172AMPLA HEALTHAmpla Health North Chico Medical100 Independence Circle ChicoCA
CH09085ALActiveBPS-H80-033886AMPLA HEALTHAmpla Health Family Dental and Medical285 Cohasset Rd ChicoCA
CH09085BActiveBPS-H80-001827AMPLA HEALTHAmpla Health Colusa Medical & Dental555 Fremont Street ColusaCA
CH09085CActiveBPS-H80-032558AMPLA HEALTHAmpla Health Richland Medical355 Samuel Drive Yuba CityCA
CH09085DActiveBPS-H80-010583AMPLA HEALTHAmpla Health Yuba City Medical & Xpress1000 SUTTER STREET YUBA CITYCA
CH09085EActiveBPS-H80-002697AMPLA HEALTHAmpla Health Orland Medical & Dental1211 Cortina Drive OrlandCA
CH09085FActiveBPS-H80-004958AMPLA HEALTHAmpla Health Gridley Medical520 Kentucky Street GridleyCA
CH09085GActiveBPS-H80-011481AMPLA HEALTHAmpla Health Hamilton City Medical278 MAIN ST. HAMILTON CITYCA
CH09085HActiveBPS-H80-003382AMPLA HEALTHAmpla Health Chico Medical, Pediatrics, & Xpress Care680 COHASSET ROAD CHICOCA
CH09085JActiveBPS-H80-000261AMPLA HEALTHAmpla Health Yuba City Pediatrics931 MARKET ST YUBA CITYCA
CH09085UActiveBPS-H80-004492AMPLA HEALTHAmpla Health Corporate Office935 Market Street Yuba CityCA
CH09085WActiveBPS-H80-009944AMPLA HEALTHAmpla Health Arbuckle Medical & Dental89 Putnam Way ArbuckleCA
CH09085XTerminatedBPS-H80-010970AMPLA HEALTHAmpla Health Chico Dental236 WEST EAST AVENUE CHICOCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090850ACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967904/01/2018  
CH090850ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750207/01/2022  
CH090850ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2022  
CH090850ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/01/2022  
CH090850ACCREDO HEALTH GROUP INC4343 W ROYAL LN STE 124
IRVINGTX75063-229907/01/2025  
CH090850ACCREDO HEALTH GROUP INC2410 WARDLOW RD STE 101
CORONACA9287807/01/2025  
CH090850ACCREDO HEALTH GROUP INC22623 68TH AVE S
KENTWA98032-198107/01/2025  
CH090850ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607507/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624107/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282207/01/2022  
CH090850ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280904/01/2025  
CH090850AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291104/01/2018  
CH090850AMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700304/01/2025  
CH090850AMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287904/01/2025  
CH090850AVELLA OF COLUMBUS4830 KNIGHTSBRIDGE BLVD STE C
COLUMBUSOH43214-230001/01/2020 10/15/2021
CH090850AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062112/06/2017 10/15/2021
CH090850AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508507/01/2017 10/06/2017
CH090850AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508504/01/2018 10/03/2019
CH090850AVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582107/01/2017 10/15/2021
CH090850AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2019 04/01/2019
CH090850AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503410/01/2019  
CH090850BIDWELL PHARMACY & MEDICAL SUPPLYBIDWELL PHARMACY & MEDICAL SUPPLY 1200 MANGROVE AVE STE A
CHICOCA9592607/01/2015 06/01/2017
CH090850BIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/01/2024  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526101/01/2020  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771301/01/2020  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620310/01/2024 10/01/2024
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522610/01/2024 10/01/2024
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522601/01/2025  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620301/01/2025  
CH090850CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2023  
CH090850CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2023  
CH090850CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2023  
CH090850CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2023  
CH090850CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2023  
CH090850CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2023  
CH090850CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2023  
CH090850CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813307/01/2023  
CH090850CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237407/01/2023  
CH090850CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2023  
CH090850CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506910/01/2022 09/07/2022
CH090850CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506901/01/2024  
CH090850CENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282401/01/2024  
CH090850CHICO PHARMACY251 COHASSET RD STE 100
CHICOCA95926-223507/01/2015 06/01/2017
CH090850COMMUNITY MEDICAL CENTER PHARMACY610 GATEWAY CENTER WAY STE A - E
SAN DIEGOCA92102-454804/01/2017 05/16/2018
CH090850CORNERSTONE PHARMACY SERVSDBA LATIMERS PHARMACY 7885 HIGHWAY 99E
P.O. BOX 117
LOS MOLINOSCA9605507/01/2015 06/01/2017
CH090850CRYSTAL MEDICAL CENTERPHARMACY, INC. 2809 OLIVE HIGHWAY
SUITE 160
OROVILLECA9596610/01/2015 03/22/2019
CH090850CRYSTAL MEDICAL CENTER PHARMACYODEDRA ENTERPRISES, INC. DBA 2809 OLIVE HWY STE 160
OROVILLECA95966-613301/01/2020  
CH090850CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2023  
CH090850CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2023  
CH090850CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2023  
CH090850CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2019  
CH090850DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200
MT PROSPECTIL6005604/01/2017  
CH090850DIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268301/01/2020 10/15/2021
CH090850DIPLOMAT SPECIALTY PHARMACY OF PHOENIX,DIPLOMAT SPECIALTY PHARMACY 485 N. JUNIPER DR
CHANDLERAZ8522601/01/2020 10/15/2021
CH090850DIPLOMAT SPECIALTY PHARMACY OF SOUTHERNDIPLOMAT SPECIALTY PHARMACY 1809 EXCISE AVENUE
SUITE 204-208
ONTARIOCA9176110/01/2019 09/27/2019
CH090850DOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K
GREENVILLESC29607-654001/01/2020  
CH090850DOVES LANDING PHARMACY  2450 ORO DAM BLVD.
SUITE B
OROVILLECA9596607/01/2015 06/01/2017
CH090850ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/01/2022  
CH090850EVERGREEN PHARMACEUTICAL OF CALIFORNIA,DBA OMNICARE OF SACRAMENTO 3630 BUSINESS DR STE D
SACRAMENTOCA9582004/01/2025  
CH090850EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/01/2022  
CH090850EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/01/2022  
CH090850EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/01/2022  
CH090850FOUCH AND SON PHARMACY692 E ST PO BOX 39
WILLIAMSCA9598701/01/2020  
CH090850FRANKLIN PHARMACY  1619 FRANKLIN ROAD BUILDING A
YUBA CITYCA9599307/01/2015 01/01/2017
CH090850FRANKLIN PHARMACYSCRIPT DEPOT LP DBA 1619 FRANKLIN RD
BLDG A
YUBA CITYCA9599301/01/2017  
CH090850GALLOWAY'S MEDICAL CENTER PHARMACY2995 NATIONAL AVENUE
SAN DIEGOCA9211312/06/2017 05/16/2018
CH090850GARDEN GROVE COMMUNITY PHARMACY12665 GARDEN GROVE BLVD STE 108
GARDEN GROVECA92843-191501/01/2019 08/31/2022
CH090850GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY# 2881 1120 FOREST AVE.
CHICOCA9592807/01/2023  
CH090850GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 5225 2636 MARCONI AVE.
SACRAMENTOCA9582107/01/2023  
CH090850GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16109 1153 BUTTE HOUSE RD
YUBA CITYCA9599107/01/2023  
CH090850GENOA HEALTHCARE LLC245 11TH ST STE P1
SAN FRANCISCOCA9410301/01/2022  
CH090850GENOA HEALTHCARE LLC17782 COWAN ST STE G
IRVINECA9261401/01/2022  
CH090850GENOA HEALTHCARE LLC1850 W FLORIDA AVE
HEMETCA9254501/01/2022  
CH090850GENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205801/01/2022  
CH090850GENOA HEALTHCARE LLC11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGSCA9067001/01/2022  
CH090850GENOA HEALTHCARE LLC560 COHASSET RD STE 110
CHICOCA9592601/01/2024  
CH090850GENOA HEALTHCARE LLC474 W VERMONT AVE, STE 104
ESCONDIDOCA9202504/01/2025  
CH090850LINDHURST PHARMACYLINDHURST PHARMACY SERVICES INC 5991 LINDHURST AVE
MARYSVILLECA9590101/01/2017 06/01/2017
CH090850LIVE OAK PHARMACY  9970 LIVE OAK BOULEVARD
LIVE OAKCA9595307/01/2015 10/01/2018
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07506 1496 EAST AVE
CHICOCA9592607/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09932 1274 STABLER LN
YUBA CITYCA9599307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09158 850 ORO DAM BLVD E
OROVILLECA9596507/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09691 906 E ST.
MARYSVILLECA9590107/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09525 260 SPRUCE ST
GRIDLEYCA9594807/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07128 2780 ESPLANADE
CHICOCA9597307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09188 869 NEWVILLE RD
ORLANDCA9596307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03937 455 SOUTH MAIN STREET
RED BLUFFCA9608007/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09535 63 LINCOLN BLVD
LINCOLNCA9564807/01/2023  
CH090850M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312604/01/2018  
CH090850MADISON HOME PHARMACY2800 LINCOLN ST STE B
OROVILLECA95966-596110/15/2018 02/01/2022
CH090850MADISON HOME PHARMACY CORPDBA MADISON HOME PHARMACY 1811 W KATELLA AVE SUITE 229
ANAHEIMCA9280407/01/2018 10/15/2018
CH090850MEDI-MART PHARMACY  5993 LINDHURST AVENUE
MARYSVILLECA9590110/01/2015 10/01/2015
CH090850MISSION PHARMACY SERVICES INC400 PLUMAS BOULEVARD SUITE 100
YUBA CITYCA9599107/01/2015 10/20/2017
CH090850NEXT DOOR PHARMACYNEXT DOOR PHARMACY INC 285 COHASSET RD
STE 110, 140, 150
CHICOCA9592607/01/2015 01/19/2016
CH090850OLIVEHURST DRUG STORE, INC4897 OLIVEHURST AVE
OLIVEHURSTCA95961-422507/01/2015 01/21/2021
CH090850OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191301/01/2020 01/01/2020
CH090850OPTUM INFUSION SERVICES 305, LLC15529 COLLEGE BLVD.
LENEXAKS66219-135107/01/2024  
CH090850OPTUM INFUSION SERVICES 401, LLC4610 NORTHGATE BLVD. STE. 130
SACRAMENTOCA95834-115407/01/2024  
CH090850OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276507/01/2024  
CH090850OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502904/01/2022  
CH090850OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850707/25/2022  
CH090850OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520407/01/2024  
CH090850OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2020  
CH090850OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824904/01/2022  
CH090850OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729804/01/2022  
CH090850OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2020  
CH090850OPTUM PHARMACY 800, INC.3016 GUADALUPE ST STE A
AUSTINTX78705-286101/01/2020 01/01/2022
CH090850OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508501/01/2024  
CH090850OPTUM PHARMACY 803, INC.701 SHADOW LN #110
LAS VEGASNV89106-413201/01/2020 01/01/2022
CH090850OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161801/01/2022 01/01/2022
CH090850OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983804/01/2022  
CH090850OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660804/01/2022 06/30/2022
CH090850ORLANDCARE PHARMACY AND MEDICAL SUPPLYORLANDCARE PHARMACY AND MEDICAL SUPPLY 21 E WALKER ST
ORLANDCA9596307/01/2015 06/01/2017
CH090850OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805204/01/2020  
CH090850PEACH TREE PHARMACY  5730 PACKARD AVENUE
SUITE 620
MARYSVILLECA9590107/01/2015 06/01/2017
CH090850PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310104/01/2018  
CH090850PILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231904/01/2025  
CH090850PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDOFL32819-999210/01/2019 10/01/2023
CH090850PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 445 CASTRO STREET
SAN FRANCISCOCA9411407/01/2025  
CH090850RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255001/01/2020  
CH090850RE COMMUNITY PHARMACY32241 CAMINO CAPISTRANO STE A-102
SAN JUAN CAPISTRANOCA9267510/01/2019 04/14/2020
CH090850RE COMMUNITY PHARMACY1000 SUTTER ST., STE. B
YUBA CITYCA9599104/15/2020 04/01/2022
CH090850RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500201/01/2020  
CH090850RIVERSIDE PHARMACYSCRIPT DEPOT LP DBA 866 PLUMAS ST STE C
YUBA CITYCA9599101/01/2017  
CH090850SAFEWAY INCSAFEWAY PHARMACY #1125 1366 EAST AVE
CHICOCA9592607/01/2015  
CH090850SAFEWAY INCSAFEWAY PHARMACY #2287 1596 STATE HWY 99
GRIDLEYCA9594807/01/2015  
CH090850SAFEWAY INCSAFEWAY PHARMACY #0302 6020 CLARK ROAD
PARADISECA9596907/01/2015 11/09/2018
CH090850SOLVENCY HEALTH PHARMACY7 BALA AVE STE 100
BALA CYNWYDPA1900410/01/2016 08/27/2020
CH090850STELLAR SCRIPTS INCDBA RIVERSIDE PHARMACY 866 PLUMAS STREET
SUITE #C
YUBA CITYCA9599107/01/2015 12/31/2016
CH090850SUN SCRIPTS INCDB/A THE MEDICINE SHOPPE 812 FIFTH STREET
MARYSVILLECA9590101/01/2016 05/10/2020
CH090850SUTTER PHARMACY470 PLUMAS BOULEVARD SUITE 103
YUBA CITYCA9599107/01/2015 12/01/2019
CH090850SUTTER PHARMACY470 PLUMAS BLVD. STE. 103
YUBA CITYCA9599104/01/2020  
CH090850THE MEDICINE SHOPPE PHARMACY812 5TH ST.
MARYSVILLECA9590104/01/2018 05/10/2020
CH090850THRIFTY PAYLESS, INC.RITE AID #6087 650 MANGROVE AVENUE
CHICOCA9592604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6088 1021 BRIDGE STREET
COLUSACA9593204/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6090 1583 HIGHWAY 99
GRIDLEYCA9594804/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6091 2700 ORO DAM BOULEVARD EAST
OROVILLECA9596604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6092 6007 CLARK ROAD
PARADISECA9596904/01/2017 12/03/2023
CH090850THRIFTY PAYLESS, INC.RITE AID #6094 220 WEST EAST AVENUE
CHICOCA9592604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6188 640 EDITH AVENUE
CORNINGCA9602104/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6342 1590 BUTTE HOUSE ROAD
YUBA CITYCA9599304/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6557 5075 OLIVEHURST AVENUE
OLIVEHURSTCA9596104/01/2017  
CH090850TRUEPILL3121 DIABLO AVE
HAYWARDCA9454504/01/2020  
CH090850WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2018  
CH090850WAL-MART PHARMACY 10-1575465 CAL OAK RD
OROVILLECA9596510/01/2015  
CH090850WAL-MART PHARMACY 10-19031150 HARTER ROAD
YUBA CITYCA9599310/01/2015  
CH090850WAL-MART PHARMACY 10-20442044 FOREST AVENUE
CHICOCA9592810/01/2015  
CH090850WAL-MART PHARMACY 10-2053470 N AIRPORT ROAD
WILLOWSCA9598810/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-21901720 EAST MAIN STREET
WOODLANDCA9577610/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-51361131 N BEALE RD
MARYSVILLECA9590110/01/2015  
CH090850WAL-MART PHARMACY 10-56061250 E GIBSON ROAD
WOODLANDCA9577610/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2018  
CH090850WALGREEN CO.DBA: WALGREENS # 06141 2703 ORO DAM BLVD E
OROVILLECA9596610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS #12527 2293 RIVER OAKS BLVD
PLUMAS LAKECA9596110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 00993 855 COLUSA AVE
YUBA CITYCA9599110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS #13001 828 NEWVILLE RD
ORLANDCA9596310/01/2019  
CH090850WALGREEN CO.DBA; WALGREENS #12259 1640 LINCOLN RD
YUBA CITYCA9599310/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 13000 860 EAST AVENUE
CHICOCA9592610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 05207 1042 NORD AVE
CHICOCA9592610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 07433 1781 COLUSA HWY
YUBA CITYCA95993-909610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 02277 602 10TH STREET
MARYSVILLECA9590110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 07653 1145 S MAIN ST
RED BLUFFCA96080-273810/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 03877 7576 SKYWAY
PARADISECA9596910/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700810/01/2019 10/01/2023
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2019  
CH090850WALMART PHARMACY 10-4127215 CALIFORNIA ST.
WOODLANDCA9569510/01/2015  
CH090850WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2023  
CH090850Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616807/01/2025  
CH090850WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGOCA9210205/17/2018  
CH09085AAWESTERN PHARMACY GROUP LLCDBA GALLOWAY'S MEDICAL CENTER PHARMACY 2995 NATIONAL AVE
SAN DIEGOCA92113-241907/01/2018 04/13/2018
CH090850WESTERN PHARMACY GROUP LLCDBA GALLOWAY'S MEDICAL CENTER PHARMACY 2995 NATIONAL AVE
SAN DIEGOCA92113-241905/17/2018  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdatePC Change RequestSnelgrove, Cindy Anne Chief Clinical Services Officer Ampla Health 5307513755Barber, Jessica Pharmacy Administrator Ampla Health 53052060424/25/2025 6:42 AM
DetailsLast Recertification DateUpdateRecertification 2/14/2025 6:41:07 PM2/14/2025 6:41 PM
DetailsStateUpdate ApprovedActive10/1/2024 12:01 AM
ContactsSigned ByInsertNew Registration Flores, Benjamin H. President & CEO Ampla Health 5306744261-11557/15/2024 7:27 AM
Details340B IDUpdateNew Registration CH09085AK7/15/2024 7:27 AM
DatesParticipating Approval DateUpdateNew Registration 7/15/2024 7:27:16 AM7/15/2024 7:27 AM
DetailsStateUpdateNew RegistrationPendingApproved7/15/2024 7:27 AM
DatesSigned By DateUpdateNew Registration 7/11/2024 12:00:08 PM7/15/2024 7:27 AM
DatesStart DateUpdateNew Registration 10/1/2024 12:00:00 AM7/15/2024 7:27 AM
AddressesMain AddressInsertNew Registration  100 Independence Circle Chico, CA 95973-02587/9/2024 6:08 PM
AddressesBilling AddressInsertNew Registration Ampla Health 935 Market Street Yuba City, CA 959917/9/2024 6:08 PM
ContactsAuthorizing OfficialInsertNew Registration Flores, Benjamin H. President & CEO Ampla Health 5306744261-11557/9/2024 6:08 PM
ContactsPrimary ContactInsertNew Registration Snelgrove, Cindy Anne Chief Clinical Services Officer Ampla Health 53075137557/9/2024 6:08 PM
DetailsAssistance Received From DateInsertNew Registration  7/9/2024 6:08 PM
DetailsAssistance Received To DateInsertNew Registration  7/9/2024 6:08 PM
DetailsLast Recertification DateInsertNew Registration  7/9/2024 6:08 PM
DetailsGrant NumberInsertNew Registration H80CS007657/9/2024 6:08 PM
Details340B IDInsertNew Registration  7/9/2024 6:08 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  7/9/2024 6:08 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  7/9/2024 6:08 PM
DetailsMedicare Provider NumberInsertNew Registration  7/9/2024 6:08 PM
DetailsEntity NameInsertNew Registration AMPLA HEALTH7/9/2024 6:08 PM
DetailsNOFO NumberInsertNew Registration  7/9/2024 6:08 PM
DetailsProgram CodeInsertNew Registration CH7/9/2024 6:08 PM
DetailsEntity SubnameInsertNew Registration Ampla Health North Chico Medical7/9/2024 6:08 PM
DatesParticipating Approval DateInsertNew Registration  7/9/2024 6:08 PM
DetailsStateInsertNew Registration Pending7/9/2024 6:08 PM
DatesRegistration DateInsertNew Registration 7/9/2024 6:08:49 PM7/9/2024 6:08 PM
DatesSigned By DateInsertNew Registration  7/9/2024 6:08 PM
DatesStart DateInsertNew Registration  7/9/2024 6:08 PM
TerminationsTermination CommentsInsertNew Registration  7/9/2024 6:08 PM
TerminationsTermination DateInsertNew Registration  7/9/2024 6:08 PM
TerminationsTermination Effective DateInsertNew Registration  7/9/2024 6:08 PM
TerminationsTermination ReasonInsertNew Registration  7/9/2024 6:08 PM