Covered Entity Details

FQHCLA420K COMMUNITY HEALTH CENTERS OF AMERICA (Active) - information as of 6/9/2025 12:00:33 AM

Main Details

Name

COMMUNITY HEALTH CENTERS OF AMERICA

Subdivision Name

CHCA Merced

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-038227

340B ID

FQHCLA420K

Grant Number

LALCS40180

Additional Details

Current Program Status

Active

Registration Date

1/7/2025

Participating Start Date

4/1/2025

Participating Approval Date

1/29/2025

Last Recertification Date

Contacts

Authorizing Official

Community Health Centers of America
Naresh Channaveerappa, CEO
(209) 678-0990

Primary Contact

Community Health Centers of America
Vinay Channaveerappa, Clinics Director
(209) 441-8383

Addresses

Street Address

850 W Olive Ave
Merced, CA 95348-2427

Billing Address

Community Health Centers of America
5200 Pirrone Ct.
A
Salida, CA 95368

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
FQHCLA420	Active	BPS-LAL-031793	COMMUNITY HEALTH CENTERS OF AMERICA	CHCA Mariposa	5320 State Highway 49 N Ste 1	Mariposa	CA
FQHCLA420A	Active	BPS-LAL-032487	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America Administrative Site	5200 Pirrone Ct STE A&B	Salida	CA
FQHCLA420B	Terminated	BPS-LAL-034273	Community Health Centers of America	Community Health centers of America Carmichael	5723 Marconi Ave	Carmichael	CA
FQHCLA420C	Active	BPS-LAL-033601	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America Gustine	554 5th St	Gustine	CA
FQHCLA420D	Active	BPS-LAL-032823	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America Livingston	517 Main St	Livingston	CA
FQHCLA420E	Active	BPS-LAL-035590	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America McFarland Health Center	733 3rd St	Mc Farland	CA
FQHCLA420F	Active	BPS-LAL-035757	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America Gustine Primary Care	489 5th St	Gustine	CA
FQHCLA420G	Active	BPS-LAL-037013	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America-Chowchilla	101 N Front St	Chowchilla	CA
FQHCLA420H	Active	BPS-LAL-037010	COMMUNITY HEALTH CENTERS OF AMERICA	Community Health Centers of America-Fair Oaks	6608 Mercy Ct	Fair Oaks	CA
FQHCLA420J	Active	BPS-LAL-036521	COMMUNITY HEALTH CENTERS OF AMERICA	Comunity Health Centers of America Sacramento	2928 Eastern Ave.	Sacramento	CA
FQHCLA420K	Active	BPS-LAL-038227	COMMUNITY HEALTH CENTERS OF AMERICA	CHCA Merced	850 W Olive Ave	Merced	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA420	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/01/2024
FQHCLA420	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/01/2024
FQHCLA420	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/01/2024
FQHCLA420	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/01/2024
FQHCLA420	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/01/2024
FQHCLA420	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/01/2024
FQHCLA420	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	07/01/2024
FQHCLA420	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	07/01/2024
FQHCLA420	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	07/01/2024
FQHCLA420	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	07/01/2024
FQHCLA420	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	07/01/2024
FQHCLA420	COMMUNITY HEALTH CENTERS OF AMERICA	517 W MAIN ST STE B		LIVINGSTON	CA	95334-1427	01/01/2022	06/01/2022
FQHCLA420	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	07/01/2024
FQHCLA420	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/01/2024
FQHCLA420	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/01/2024
FQHCLA420	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/01/2024
FQHCLA420	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 01467	2020 W. BRIGGSMORE AVE.	MODESTO	CA	95350	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02768	6500 S. UNION AVE.	BAKERSFIELD	CA	93307	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS/PHARMACY # 4221	11300 MING AVE	BAKERSFIELD	CA	93311	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 5225	2636 MARCONI AVE.	SACRAMENTO	CA	95821	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05403	1175 W. LATHROP RD.	MANTECA	CA	95336	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05495	5184 STOCKDALE HWY.	BAKERSFIELD	CA	93309	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07001	6500 NILES STREET	BAKERSFIELD	CA	93306	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08913	9628 ROSEDALE HWY.	BAKERSFIELD	CA	93312	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10360	474 WINTON PKWY	LIVINGSTON	CA	95334	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10921	6601 STINE ROAD	BAKERSFIELD	CA	93313	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16082	3405 MCHENRY AVE	MODESTO	CA	95350	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16106	1919 FULTON AVE	SACRAMENTO	CA	95825	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16160	3401 MALL VIEW RD	BAKERSFIELD	CA	93306	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16357	3900 SISK RD	MODESTO	CA	95356	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16723	9100 ROSEDALE HWY	BAKERSFIELD	CA	93312	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16856	280 SPRECKELS AVE	MANTECA	CA	95336	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17423	1405 W PACHECO BLVD	LOS BANOS	CA	93635	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17552	2901 MING AVE	BAKERSFIELD	CA	93304	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17602	11000 STOCKDALE HWY	BAKERSFIELD	CA	93311	04/01/2023	04/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02768	6500 S. UNION AVE.	BAKERSFIELD	CA	93307	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS/PHARMACY # 4221	11300 MING AVE	BAKERSFIELD	CA	93311	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 5225	2636 MARCONI AVE.	SACRAMENTO	CA	95821	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05403	1175 W. LATHROP RD.	MANTECA	CA	95336	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05495	5184 STOCKDALE HWY.	BAKERSFIELD	CA	93309	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07001	6500 NILES STREET	BAKERSFIELD	CA	93306	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08913	9628 ROSEDALE HWY.	BAKERSFIELD	CA	93312	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10360	474 WINTON PKWY	LIVINGSTON	CA	95334	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10921	6601 STINE ROAD	BAKERSFIELD	CA	93313	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16082	3405 MCHENRY AVE	MODESTO	CA	95350	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16106	1919 FULTON AVE	SACRAMENTO	CA	95825	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16160	3401 MALL VIEW RD	BAKERSFIELD	CA	93306	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16357	3900 SISK RD	MODESTO	CA	95356	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16723	9100 ROSEDALE HWY	BAKERSFIELD	CA	93312	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16856	280 SPRECKELS AVE	MANTECA	CA	95336	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17423	1405 W PACHECO BLVD	LOS BANOS	CA	93635	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17552	2901 MING AVE	BAKERSFIELD	CA	93304	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17602	11000 STOCKDALE HWY	BAKERSFIELD	CA	93311	07/01/2024
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 04950	3301 ZINFANDEL DR.	RANCHO CORDOVA	CA	95670	07/01/2025
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 03117	1651 BELLEVUE RD	ATWATER	CA	95301	07/01/2025
FQHCLA420	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17449	1000 COMMERCE AVE	ATWATER	CA	95301	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03077	801 OAKDALE RD STE F	MODESTO	CA	95355	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09171	2900 STANDIFORD AVE	MODESTO	CA	95350	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09248	1700 MCHENRY AVE.	MODESTO	CA	95350	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09308	901 N CARPENTER RD STE 30	MODESTO	CA	95351	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09763	1080 SPERRY AVE	PATTERSON	CA	95363	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09809	4959 MARCONI AVE	CARMICHAEL	CA	95608	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09866	1190 N MAIN ST	MANTECA	CA	95336	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09874	2075 E HATCH ROAD	MODESTO	CA	95351	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09878	8200 STOCKDALE HWY STE G	BAKERSFIELD	CA	93311	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09884	2601 OAKDALE RD STE E	MODESTO	CA	95355	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09900	2690 MOUNT VERNON AVE	BAKERSFIELD	CA	93306	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09949	1201 W MAIN ST STE 14	RIPON	CA	95366	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09975	4400 COFFEE RD	BAKERSFIELD	CA	93308	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09992	3338 ARDEN WAY	SACRAMENTO	CA	95825	04/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09204	3500 STINE RD	BAKERSFIELD	CA	93309	07/01/2023	04/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03077	801 OAKDALE RD STE F	MODESTO	CA	95355	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09171	2900 STANDIFORD AVE	MODESTO	CA	95350	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09248	1700 MCHENRY AVE.	MODESTO	CA	95350	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09308	901 N CARPENTER RD STE 30	MODESTO	CA	95351	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09809	4959 MARCONI AVE	CARMICHAEL	CA	95608	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09866	1190 N MAIN ST	MANTECA	CA	95336	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09884	2601 OAKDALE RD STE E	MODESTO	CA	95355	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09874	2075 E HATCH ROAD	MODESTO	CA	95351	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09900	2690 MOUNT VERNON AVE	BAKERSFIELD	CA	93306	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09949	1201 W MAIN ST STE 14	RIPON	CA	95366	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09975	4400 COFFEE RD	BAKERSFIELD	CA	93308	07/01/2024
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09919	1621 LANDER AVE	TURLOCK	CA	95380	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09623	649 W. OLIVE AVENUE	MERCED	CA	95348	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 07206	1970 YOSEMITE PARKWAY	MERCED	CA	95341	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09159	1109 COUNTRY CLUB DR	MADERA	CA	93638	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09935	40044 HIGHWAY 49	OAKHURST	CA	93644	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09199	5420 DEWEY DR	FAIR OAKS	CA	95628	07/01/2025
FQHCLA420	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09814	8101 GREENBACK LANE	FAIR OAKS	CA	95628	07/01/2025
FQHCLA420	MAXOR SPECIALTY PHARMACY	216 S POLK ST		AMARILLO	TX	79101-1407	04/01/2024	04/01/2024
FQHCLA420	MAXOR SPECIALTY PHARMACY	6101 43RD ST, STE C		LUBBOCK	TX	79407	04/01/2024	04/01/2024
FQHCLA420	MAXOR SPECIALTY PHARMACY	150 CLEVELAND RD	SUITE B	BOGART	GA	30622-1701	04/01/2024	04/01/2024
FQHCLA420	MAXOR SPECIALTY PHARMACY	216 S POLK ST		AMARILLO	TX	79101-1407	07/01/2024
FQHCLA420	MAXOR SPECIALTY PHARMACY	6101 43RD ST, STE C		LUBBOCK	TX	79407	07/01/2024
FQHCLA420	MAXOR SPECIALTY PHARMACY	150 CLEVELAND RD	SUITE B	BOGART	GA	30622-1701	07/01/2024
FQHCLA420	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/01/2025
FQHCLA420	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2025
FQHCLA420	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/01/2025
FQHCLA420	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2025
FQHCLA420	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	07/01/2025
FQHCLA420	PACIFIC WEST PHARMACY	4363 PACIFIC ST		ROCKLIN	CA	95677-2117	07/01/2025
FQHCLA420	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	03/01/2023	07/05/2023
FQHCLA420B	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	03/01/2023	04/01/2024
FQHCLA420C	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	03/01/2023	04/01/2024
FQHCLA420D	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	03/01/2023	04/01/2024
FQHCLA420	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	10/01/2023	04/01/2024
FQHCLA420	PIONEER DRUG #2	397 5TH ST		GUSTINE	CA	95322-1236	07/01/2025
FQHCLA420	PIONEER MARKET PHARMACY	5034 COAKLEY CIR STE 200	P.O. BOX 2128	MARIPOSA	CA	95338-8519	01/01/2022	04/01/2024
FQHCLA420	PIONEER MARKET PHARMACY	5034 COAKLEY CIR STE 200	P.O. BOX 2128	MARIPOSA	CA	95338-8519	07/01/2024
FQHCLA420	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	07/01/2024
FQHCLA420	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	07/01/2024
FQHCLA420	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	07/01/2024
FQHCLA420	SCRIPTCO PHARMACY	6916 WOODWAY DR.		WOODWAY	TX	76712	10/01/2024
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6006	1158 WEST MAIN STREET	MERCED	CA	95340	01/01/2022	01/01/2022
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #5848	48 ROBERTSON BLVD	CHOWCHILLA	CA	93610	01/01/2022	09/12/2022
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6007	3142 G STREET	MERCED	CA	95340	01/01/2022	09/12/2022
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6013	1935 N STREET	NEWMAM	CA	95360	01/01/2022	09/12/2022
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6019	653 N GOLDEN STATE BLVD	TURLOCK	CA	95380-3952	01/01/2022	09/12/2022
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6443	4994 JOE HOWARD STREET PO BOX 1159	MARIPOSA	CA	95338	01/01/2022	04/01/2024
FQHCLA420	THRIFTY PAYLESS, INC.	RITE AID #6443	4994 JOE HOWARD STREET PO BOX 1159	MARIPOSA	CA	95338	07/01/2024
FQHCLA420	TIN RX AT THE TOWER, INC.	1801 COLORADO AVE STE 300		TURLOCK	CA	95382-2708	05/20/2022	04/01/2024
FQHCLA420	VIBRANT CARE PHARMACY, INC.	7400 MACARTHUR BLVD STE B		OAKLAND	CA	94605-2939	01/01/2022	04/01/2024
FQHCLA420	VIBRANT CARE PHARMACY, INC.	7400 MACARTHUR BLVD STE B		OAKLAND	CA	94605-2939	07/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Channaveerappa, Naresh CEO Community Health Centers of America 2096780990	1/29/2025 8:15 AM
Details	340B ID	Update	New Registration		FQHCLA420K	1/29/2025 8:15 AM
Dates	Participating Approval Date	Update	New Registration		1/29/2025 8:15:10 AM	1/29/2025 8:15 AM
Details	State	Update	New Registration	Pending	Approved	1/29/2025 8:15 AM
Dates	Signed By Date	Update	New Registration		1/7/2025 12:57:57 PM	1/29/2025 8:15 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/29/2025 8:15 AM
Addresses	Main Address	Insert	New Registration		850 W Olive Ave Merced, CA 95348-2427	1/7/2025 12:57 PM
Addresses	Billing Address	Insert	New Registration		Community Health Centers of America 5200 Pirrone Ct. A Salida, CA 95368	1/7/2025 12:57 PM
Contacts	Authorizing Official	Insert	New Registration		Channaveerappa, Naresh CEO Community Health Centers of America 2096780990	1/7/2025 12:57 PM
Contacts	Primary Contact	Insert	New Registration		Channaveerappa, Vinay Clinics Director Community Health Centers of America 2094418383	1/7/2025 12:57 PM
Details	Assistance Received From Date	Insert	New Registration			1/7/2025 12:57 PM
Details	Assistance Received To Date	Insert	New Registration			1/7/2025 12:57 PM
Details	Last Recertification Date	Insert	New Registration			1/7/2025 12:57 PM
Details	Grant Number	Insert	New Registration		LALCS40180	1/7/2025 12:57 PM
Details	340B ID	Insert	New Registration			1/7/2025 12:57 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/7/2025 12:57 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/7/2025 12:57 PM
Details	Medicare Provider Number	Insert	New Registration			1/7/2025 12:57 PM
Details	Entity Name	Insert	New Registration		COMMUNITY HEALTH CENTERS OF AMERICA	1/7/2025 12:57 PM
Details	NOFO Number	Insert	New Registration			1/7/2025 12:57 PM
Details	Program Code	Insert	New Registration		FQHCLA	1/7/2025 12:57 PM
Details	Entity Subname	Insert	New Registration		CHCA Merced	1/7/2025 12:57 PM
Dates	Participating Approval Date	Insert	New Registration			1/7/2025 12:57 PM
Details	State	Insert	New Registration		Pending	1/7/2025 12:57 PM
Dates	Registration Date	Insert	New Registration		1/7/2025 12:57:54 PM	1/7/2025 12:57 PM
Dates	Signed By Date	Insert	New Registration			1/7/2025 12:57 PM
Dates	Start Date	Insert	New Registration			1/7/2025 12:57 PM
Terminations	Termination Comments	Insert	New Registration			1/7/2025 12:57 PM
Terminations	Termination Date	Insert	New Registration			1/7/2025 12:57 PM
Terminations	Termination Effective Date	Insert	New Registration			1/7/2025 12:57 PM
Terminations	Termination Reason	Insert	New Registration			1/7/2025 12:57 PM

340B Drug Pricing Program Database