340B Drug Pricing Program Database


CH091963N LIVINGSTON COMMUNITY HEALTH (Approved) - information as of 6/24/2025 12:06:24 AM

Main Details
LIVINGSTON COMMUNITY HEALTH
Modesto Health Center - Florida Ave
HRSA-Funded Health Center
BPS-H80-039813
CH091963N
H80CS02588


Additional Details
Approved
4/8/2025
7/1/2025
5/6/2025

Contacts

Livingston Community Health
Leslie Abasta-Cummings, Chief Executive Officer
(209) 850-3545

Livingston Community Health
Erin Pilot, Chief Financial Officer
(209) 850-3500 Ext: 1362

Addresses

1444 Florida Ave, Suite 202
Modesto, CA 95350-4400

Livingston Community Health
600 B Street, Bldg A
Livingston, CA 95334


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

Yes
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH0919630TerminatedBPS-H80-003882LIVINGSTON COMMUNITY HEALTH LIVINGSTON HEALTH CENTER1140 MAIN STREET LIVINGSTONCA
CH091963AActiveBPS-H80-012658LIVINGSTON COMMUNITY HEALTHHilmar Health Center7970 Lander Ave STE A/B HilmarCA
CH091963BActiveBPS-H80-016845LIVINGSTON COMMUNITY HEALTHBentley Health Center12633 BENTLEY ST WATERFORDCA
CH091963CActiveBPS-H80-016843LIVINGSTON COMMUNITY HEALTHBentley Health Center12619 BENTLEY ST WATERFORDCA
CH091963DActiveBPS-H80-018443LIVINGSTON COMMUNITY HEALTHWolves Wellness Center1617 Main St. RM 200 & 201 LivingstonCA
CH091963ETerminatedBPS-H80-018376LIVINGSTON COMMUNITY HEALTHLas Palmas1010 W. Las Palmas Avenue, Suite E PattersonCA
CH091963FActiveBPS-H80-019273LIVINGSTON COMMUNITY HEALTHDelhi Health Center16233 W King Street DelhiCA
CH091963GActiveBPS-H80-024902LIVINGSTON COMMUNITY HEALTHLivingston Community Health Campus, B Street, Buildings A, B, C600 B Street BLDG A, B, C LivingstonCA
CH091963HActiveBPS-H80-038382LIVINGSTON COMMUNITY HEALTHTurlock Health Center2141 Colorado Ave TurlockCA
CH091963JActiveBPS-H80-030330LIVINGSTON COMMUNITY HEALTHHughson Health Center2412 3rd St Ste B HughsonCA
CH091963KActiveBPS-H80-035552LIVINGSTON COMMUNITY HEALTHModesto Health Center2116 E. Orangeburg Avenue ModestoCA
CH091963LActiveBPS-H80-037411LIVINGSTON COMMUNITY HEALTHMUHSD East Campus Health Center125 E 18th St MercedCA
CH091963MToBeTerminatedBPS-H80-039164LIVINGSTON COMMUNITY HEALTHModesto Health Center - Florida Ave1444 Florida Ave ModestoCA
CH091963NApprovedBPS-H80-039813LIVINGSTON COMMUNITY HEALTHModesto Health Center - Florida Ave1444 Florida Ave, Suite 202 ModestoCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH091963GACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/01/2024  
CH091963GACCREDO HEALTH GROUP INC2410 WARDLOW RD STE 101
CORONACA9287807/01/2024  
CH091963GACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750207/01/2024  
CH091963GACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2024  
CH091963GACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282207/01/2024  
CH091963GACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607507/01/2024  
CH091963GACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/01/2024  
CH091963GADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280901/01/2025  
CH091963GCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2025  
CH091963GCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2025  
CH091963GCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2025  
CH091963GCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2025  
CH091963GCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2025  
CH091963GCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2025  
CH091963GCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2025  
CH091963GCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813301/01/2025  
CH091963GCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237401/01/2025  
CH091963GCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2025  
CH091963GCARRANZA PHARMACY HUGHSON2431 3RD ST SUITE A
HUGHSONCA9532604/01/2024  
CH091963GCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2022  
CH091963GCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2022  
CH091963GCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2025  
CH091963GCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2024  
CH091963GESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/01/2024  
CH091963GEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/01/2024  
CH091963GEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/01/2024  
CH091963GEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/01/2024  
CH0919630GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10360 474 WINTON PKWY
LIVINGSTONCA9533401/01/2017 04/01/2021
CH0919630GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 03117 1651 BELLEVUE RD
ATWATERCA9530101/01/2019 04/01/2021
CH0919630GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17449 1000 COMMERCE AVE
ATWATERCA9530101/01/2019 04/01/2021
CH091963GGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16647 3000 COUNTRYSIDE DR
TURLOCKCA9538004/23/2021  
CH091963GGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17449 1000 COMMERCE AVE
ATWATERCA9530104/23/2021  
CH091963GGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02994 3100 GEER RD.
TURLOCKCA9538204/23/2021 04/23/2021
CH091963GGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10360 474 WINTON PKWY
LIVINGSTONCA9533404/23/2021  
CH091963GGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 03117 1651 BELLEVUE RD
ATWATERCA9530104/23/2021  
CH091963GGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02994 3100 GEER RD.
TURLOCKCA9538204/01/2025  
CH091963GGENOA HEALTHCARE LLC2550 WEST CLINTON AVE STE 123
FRESNOCA9370501/01/2025  
CH091963GGILL PHARMACY WATERFORDGILL PHARMACY INC 12648 BENTLEY ST
WATERFORDCA9538604/01/2024  
CH0919630GKN RX INC1471 B ST STE R
LIVINGSTONCA95334-142607/01/2017 04/16/2019
CH091963GLCH PHARMACY600 B ST BLDG B ROOM 100
LIVINGSTONCA9533404/23/2021 04/23/2021
CH0919630LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09919 1621 LANDER AVE
TURLOCKCA9538001/01/2017 04/01/2021
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09919 1621 LANDER AVE
TURLOCKCA9538004/23/2021  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09248 1700 MCHENRY AVE.
MODESTOCA9535007/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09884 2601 OAKDALE RD STE E
MODESTOCA9535507/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09874 2075 E HATCH ROAD
MODESTOCA9535107/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09171 2900 STANDIFORD AVE
MODESTOCA9535007/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03079 2224 PATTERSON RD
RIVERBANKCA9536707/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03944 1520 E F ST
OAKDALECA9536107/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07206 1970 YOSEMITE PARKWAY
MERCEDCA9534107/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09308 901 N CARPENTER RD STE 30
MODESTOCA9535107/01/2022  
CH091963GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534807/01/2022  
CH091963GOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850701/01/2025  
CH091963GOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2025  
CH091963GOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2025  
CH091963GPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2025  
CH091963GPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2025  
CH091963GPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2025  
CH0919630ROL'S DELHI DRUG STORE  9724 STEPHENS STREET
DELHICA9531502/10/2006 07/20/2016
CH091963GTARGET STORES A DIV. OF TARGET CORP.ATTN PHARMACY TARGET STORE T-2386
1000 COMMERCE AVE
ATWATERCA9530104/23/2021 04/23/2021
CH091963GTARGET STORES A DIV.OF TARGET CORP.TARGET STORE T-1304 ATTN: PHARMACY
3000 COUNTRYSIDE DRIVE
TURLOCKCA9538004/23/2021 04/23/2021
CH0919630THRIFTY PAYLESS, INC.RITE AID #6379 500 MAIN STREET
LIVINGSTONCA9533401/01/2017 04/01/2021
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6379 500 MAIN STREET
LIVINGSTONCA9533404/23/2021  
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6019 653 N GOLDEN STATE BLVD
TURLOCKCA95380-395204/23/2021 04/23/2021
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6001 571 BELLEVUE ROAD
ATWATERCA9530104/23/2021 04/23/2021
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6512 1000 W MONTE VISTA AVENUE
TURLOCKCA9538204/23/2021 04/23/2021
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6019 653 N GOLDEN STATE BLVD
TURLOCKCA95380-395204/01/2025  
CH091963GTHRIFTY PAYLESS, INC.RITE AID #6512 1000 W MONTE VISTA AVENUE
TURLOCKCA9538204/01/2025  
CH0919630WAL-MART PHARMACY 10-19632111 FULKERTH RD
TURLOCKCA9538001/01/2017 04/01/2021
CH091963GWAL-MART PHARMACY 10-19632111 FULKERTH RD
TURLOCKCA9538004/23/2021  
CH0919630WAL-MART PHARMACY 10-30472480 GEER RD
TURLOCKCA9538001/01/2017 04/01/2021
CH091963GWAL-MART PHARMACY 10-30472480 GEER RD
TURLOCKCA9538004/23/2021  
CH0919630WAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
ORLANDOFL3281901/01/2017 04/01/2021
CH091963GWAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
ORLANDOFL3281904/23/2021  
CH0919630WAL-MART PHARMACY 10-5394770 WEST EL MONTE WAY
DINUBACA9361801/01/2017 01/24/2017
CH0919630WAL-MART PHARMACY 10-58431030 SPERRY AVE
PATTERSONCA9536304/01/2018 04/01/2021
CH091963GWAL-MART PHARMACY 10-58431030 SPERRY AVE
PATTERSONCA9536304/23/2021  
CH0919630WAL-MART PHARMACY 10-5890800 COMMERCE AVE.
ATWATERCA9530101/01/2017 04/01/2021
CH091963GWAL-MART PHARMACY 10-5890800 COMMERCE AVE.
ATWATERCA9530104/23/2021  
CH0919630WALGREEN CO.DBA: WALGREENS # 03030 1591 GEER ROAD
TURLOCKCA9538010/01/2014 04/01/2021
CH0919630WALGREEN CO.DBA: WALGREENS # 06718 2730 SHAFFER ROAD
ATWATERCA9530110/01/2014 04/01/2021
CH0919630WALGREEN CO.DBA: WALGREENS #15986 8298 LANDER AVE
HILMARCA9532410/01/2014 04/01/2021
CH0919630WALGREEN CO.DBA: WALGREENS # 03330 1640 R STREET
MERCEDCA9534004/01/2018 04/01/2021
CH0919630WALGREEN CO.DBA: WALGREENS #09955 995 SPERRY AVE
PATTERSONCA9536304/01/2018 04/01/2021
CH091963GWALGREEN CO.DBA: WALGREENS #09955 995 SPERRY AVE
PATTERSONCA9536304/23/2021  
CH091963GWALGREEN CO.DBA: WALGREENS # 06718 2730 SHAFFER ROAD
ATWATERCA9530104/23/2021  
CH091963GWALGREEN CO.DBA: WALGREENS # 03330 1640 R STREET
MERCEDCA9534004/23/2021  
CH091963GWALGREEN CO.DBA: WALGREENS #15986 8298 LANDER AVE
HILMARCA9532404/23/2021  
CH091963GWALGREEN CO.DBA: WALGREENS # 03030 1591 GEER ROAD
TURLOCKCA9538007/01/2021  
CH091963GWALGREEN CO.DBA: WALGREENS # 02902 2101 E HATCH RD
MODESTOCA9535104/01/2022  
CH0919630WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/01/2014 07/09/2015
CH0919630WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904910/01/2014 07/09/2015
CH091963GWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2024  
CH091963GWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2024  
CH091963GWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2024  
CH091963GWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275610/01/2023  
CH0919630WELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706201/01/2017 02/05/2019
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsSigned ByInsertNew Registration Abasta-Cummings, Leslie Chief Executive Officer Livingston Community Health 20985035455/6/2025 2:09 PM
Details340B IDUpdateNew Registration CH091963N5/6/2025 2:09 PM
DatesParticipating Approval DateUpdateNew Registration 5/6/2025 2:09:00 PM5/6/2025 2:09 PM
DetailsStateUpdateNew RegistrationPendingApproved5/6/2025 2:09 PM
DatesSigned By DateUpdateNew Registration 4/10/2025 4:44:51 PM5/6/2025 2:09 PM
DatesStart DateUpdateNew Registration 7/1/2025 12:00:00 AM5/6/2025 2:09 PM
Medicaid BillingMedicaid: NumberDeleteNew Registration1427110329 (CA) 4/10/2025 4:44 PM
ContactsPrimary ContactUpdateProfile Change RequestPilot, Erin Chief Financial Officer Livingston Community Health 2098501362Pilot, Erin Chief Financial Officer Livingston Community Health 2098503500-13624/8/2025 6:32 PM
AddressesMain AddressInsertNew Registration  1444 Florida Ave, Suite 202 Modesto, CA 95350-44004/8/2025 6:13 PM
AddressesBilling AddressInsertNew Registration Livingston Community Health 600 B Street, Bldg A Livingston, CA 953344/8/2025 6:13 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False4/8/2025 6:13 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 14271103294/8/2025 6:13 PM
Medicaid BillingMedicaid: StateInsertNew Registration CA4/8/2025 6:13 PM
Medicaid BillingNPI: NumberInsertNew Registration 14271103294/8/2025 6:13 PM
Medicaid BillingNPI: StateInsertNew Registration CA4/8/2025 6:13 PM
ContactsAuthorizing OfficialInsertNew Registration Abasta-Cummings, Leslie Chief Executive Officer Livingston Community Health 20985035454/8/2025 6:13 PM
ContactsPrimary ContactInsertNew Registration Pilot, Erin Chief Financial Officer Livingston Community Health 20985013624/8/2025 6:13 PM
DetailsAssistance Received From DateInsertNew Registration  4/8/2025 6:13 PM
DetailsAssistance Received To DateInsertNew Registration  4/8/2025 6:13 PM
DetailsLast Recertification DateInsertNew Registration  4/8/2025 6:13 PM
DetailsGrant NumberInsertNew Registration H80CS025884/8/2025 6:13 PM
Details340B IDInsertNew Registration  4/8/2025 6:13 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/8/2025 6:13 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/8/2025 6:13 PM
DetailsMedicare Provider NumberInsertNew Registration  4/8/2025 6:13 PM
DetailsEntity NameInsertNew Registration LIVINGSTON COMMUNITY HEALTH4/8/2025 6:13 PM
DetailsNOFO NumberInsertNew Registration  4/8/2025 6:13 PM
DetailsProgram CodeInsertNew Registration CH4/8/2025 6:13 PM
DetailsEntity SubnameInsertNew Registration Modesto Health Center - Florida Ave4/8/2025 6:13 PM
DatesParticipating Approval DateInsertNew Registration  4/8/2025 6:13 PM
DetailsStateInsertNew Registration Pending4/8/2025 6:13 PM
DatesRegistration DateInsertNew Registration 4/8/2025 6:13:24 PM4/8/2025 6:13 PM
DatesSigned By DateInsertNew Registration  4/8/2025 6:13 PM
DatesStart DateInsertNew Registration  4/8/2025 6:13 PM
TerminationsTermination CommentsInsertNew Registration  4/8/2025 6:13 PM
TerminationsTermination DateInsertNew Registration  4/8/2025 6:13 PM
TerminationsTermination Effective DateInsertNew Registration  4/8/2025 6:13 PM
TerminationsTermination ReasonInsertNew Registration  4/8/2025 6:13 PM