340B Drug Pricing Program Database


CH09167S VISTA COMMUNITY CLINIC (Approved) - information as of 6/5/2025 2:37:38 PM

Main Details
VISTA COMMUNITY CLINIC
VCC: Vista Village Pediatrics
HRSA-Funded Health Center
BPS-H80-039549
CH09167S
H80CS00282


Additional Details
Approved
4/10/2025
7/1/2025
5/6/2025

Contacts

Vista Community Clinic
Michele Lambert, CFO
(760) 216-5803

Vista Community Clinic
Debra debra.l.jones@vcc.org Jones, Accountant
(760) 631-5000 Ext: 8173

Addresses

950 Civic Center Dr
Vista, CA 92083-5208

Vista Community Clinic
1000 VALE TERRACE
Vista, CA 92084


  • 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
StateMedicaid NumberNPI Number
CA1295822658,14972035411295822658,1497203541,1629296041
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH091670ActiveBPS-H80-000220VISTA COMMUNITY CLINICVCC: VALE TERRACE1000 Vale Terrace Dr. VistaCA
CH09167BActiveBPS-H80-004581VISTA COMMUNITY CLINICVCC: North River4700 N RIVER RD OCEANSIDECA
CH09167CActiveBPS-H80-008480VISTA COMMUNITY CLINICVCC: GRAPEVINE 134 GRAPEVINE RD. VISTACA
CH09167DActiveBPS-H80-003251VISTA COMMUNITY CLINICVCC: PIER VIEW818 PIER VIEW WAY OCEANSIDECA
CH09167EActiveBPS-H80-001981VISTA COMMUNITY CLINICVCC: Horne517 N HORNE STREET OCEANSIDECA
CH09167FActiveBPS-H80-014107VISTA COMMUNITY CLINICVISTA COMMUNITY CLINIC MOBILE VAN1000 Vale Terrace Dr VistaCA
CH09167GActiveBPS-H80-017331VISTA COMMUNITY CLINICVCC: Lake Elsinore30195 FRASER DR LAKE ELSINORECA
CH09167HActiveBPS-H80-018719VISTA COMMUNITY CLINICVCC: Durian105 Durian St Ste A VistaCA
CH09167JActiveBPS-H80-017793VISTA COMMUNITY CLINICVCC: The Gary Center201 S. Harbor Blvd. La HabraCA
CH09167KActiveBPS-H80-018146VISTA COMMUNITY CLINICMobile Dental Clinic 230195 Fraser Drive Lake ElsinoreCA
CH09167LActiveBPS-H80-030101VISTA COMMUNITY CLINICVCC: Mission Dental1910 Mission Ave OceansideCA
CH09167MActiveBPS-H80-031377VISTA COMMUNITY CLINICVCC Mobile Medical Clinic517 N Horne St OceansideCA
CH09167NActiveBPS-H80-033960VISTA COMMUNITY CLINICVCC Mobile Wellness Unit1000 Vale Terrace Dr VistaCA
CH09167PActiveBPS-H80-035235VISTA COMMUNITY CLINICVCC: Durian Senior Adult Care105 Durian St STE B VistaCA
CH09167QActiveBPS-H80-035173VISTA COMMUNITY CLINICVCC: Fallbrook Pediatrics321 E Alvarado St FallbrookCA
CH09167RActiveBPS-H80-033793VISTA COMMUNITY CLINICVCC: Lake Elsinore Health Center31361 Riverside Dr Lake ElsinoreCA
CH09167SApprovedBPS-H80-039549VISTA COMMUNITY CLINICVCC: Vista Village Pediatrics950 Civic Center Dr VistaCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH091670ACARIAHEALTH PHARMACY #11, INC1311 W SAM HOUSTON PKWY N STE 130
HOUSTONTX77043-401510/01/2019 10/01/2021
CH091670ACARIAHEALTH PHARMACY #11, INC1311 W SAM HOUSTON PKWY N STE 130
HOUSTONTX77043-401510/01/2022 06/01/2023
CH091670ACARIAHEALTH PHARMACY #13, INC3302 GARFIELD AVE.
COMMERCECA90040-310210/01/2019 10/01/2021
CH091670ACARIAHEALTH PHARMACY #13, INC3302 GARFIELD AVE.
COMMERCECA90040-310210/01/2022 06/01/2023
CH091670ACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967910/01/2019 10/01/2021
CH091670ACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967910/01/2022 06/01/2023
CH091670ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/01/2021 12/12/2024
CH091670ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/01/2021 12/12/2024
CH091670ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/01/2021 06/01/2023
CH09167HACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2024 12/12/2024
CH091670ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624104/01/2021 06/01/2023
CH091670ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/01/2021 06/01/2023
CH091670ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349204/01/2021 06/01/2023
CH091670ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280901/01/2025  
CH091670AHF PHARMACYAIDS HEALTHCARE FOUNDATION 1988 HACIENDA DR
VISTACA92081-602612/31/2020  
CH091670AHF PHARMACYAIDS HEALTHCARE FOUNDATION 4630 BORDER VILLAGE RD STE K
SAN YSIDROCA92173-312112/31/2020 06/01/2023
CH091670AHF PHARMACYAIDS HEALTHCARE FOUNDATION 120 UNIVERSITY AVE
SAN DIEGOCA92103-300712/31/2020  
CH09167FAHF PHARMACYAIDS HEALTHCARE FOUNDATION 1988 HACIENDA DR
VISTACA92081-602601/12/2023  
CH091670AIDS HEALTHCARE FOUNDATIONDBA AHF PHARMACY 19300 S. HAMILTON AVE #170/180
GARDENACA90248-440010/01/2013 09/27/2017
CH091670AIDS HEALTHCARE FOUNDATIONAHF PHARMACY 3580 5TH AVE STE 200
SAN DIEGOCA9210310/01/2013 06/17/2016
CH091670AIDS HEALTHCARE FOUNDATIONDBA AHF PHARMACY 5417 E. WHITTIER BLVD
LOS ANGELESCA90022-410110/01/2013 09/27/2017
CH091670AIDS HEALTHCARE FOUNDATIONAHF PHARMACY 3580 5TH AVE STE 200
SAN DIEGOCA9210312/31/2020 06/01/2023
CH091670AIDS HEALTHCARE FOUNDATIONDBA AHF PHARMACY 19300 S. HAMILTON AVE #170/180
GARDENACA90248-440012/31/2020 06/01/2023
CH091670ALBERTSONS LLCSAV-ON PHARMACY # 2767 3925 MISSION AVE
OCEANSIDECA9205807/01/2017  
CH091670ALBERTSONS LLCSAV-ON PHARMACY # 0733 3450 MARRON RD
OCEANSIDECA9205607/01/2017  
CH09167RALBERTSONS LLCSAV-ON PHARMACY # 2767 3925 MISSION AVE
OCEANSIDECA9205801/01/2024  
CH09167NALBERTSONS LLCSAV-ON PHARMACY # 0733 3450 MARRON RD
OCEANSIDECA9205610/01/2024  
CH09167GALBERTSONS LLCSAV-ON PHARMACY # 2767 3925 MISSION AVE
OCEANSIDECA9205801/01/2025  
CH091670AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291104/01/2020 12/31/2022
CH091670ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09270 2033 W WICKENBURG WAY
WICKENBURGAZ8539007/01/2019  
CH091670AVITA PHARMACY 1025PHARMEDQUEST PHARMACY SERVICES DBA AVITA 3020 SATURN ST STE 100
BREACA9282110/01/2019 06/01/2023
CH091670AVITA PHARMACY 1040AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10 6100 CORPORATE BLVD STE 250
BATON ROUGELA7080807/01/2022 06/01/2023
CH091670AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2020 12/31/2022
CH091670BI-RITE QUALITY PHARMACIES340 NORTH HARBOR BLVD
LA HABRACA90631-489207/01/2017 10/01/2021
CH091670BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771307/01/2020 12/31/2022
CH091670BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526107/01/2020 12/31/2022
CH091670CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2025  
CH091670CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2025  
CH091670CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2025  
CH091670CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2025  
CH091670CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2025  
CH091670CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2025  
CH091670CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2025  
CH091670CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813301/01/2025  
CH091670CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237401/01/2025  
CH091670CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2025  
CH091670CEDAR PARK PHARMACY130 CEDAR RD
VISTACA9208310/01/2014 04/01/2022
CH091670COMMUNITY MEDICAL CENTER PHARMACY610 GATEWAY CENTER WAY STE A - E
SAN DIEGOCA92102-454807/01/2013 07/01/2018
CH091670COMMUNITY MEDICAL CENTER PHARMACY  750 MEDICAL CENTER CRT
STE. 1
CHULA VISTACA91911-663407/01/2013 01/27/2017
CH091670CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2025  
CH091670DOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K
GREENVILLESC29607-654007/01/2020 12/31/2022
CH091670ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111204/01/2021 06/01/2023
CH091670EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313404/01/2021 06/01/2023
CH091670EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801604/01/2021 06/01/2023
CH091670EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607504/01/2021 06/01/2023
CH091670FOUNDATION CARE LLC111 CHESTERFIELD INDUSTRIAL BLVD STE 115
CHESTERFIELDMO6300510/01/2022 06/01/2023
CH091670GALLOWAY'S MEDICAL CENTER PHARMACY2995 NATIONAL AVENUE
SAN DIEGOCA9211307/01/2013 07/01/2018
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08866 1706 OCEANSIDE BLVD
OCEANSIDECA9205401/01/2016  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08857 1441 N SANTA FE
VISTACA9208401/01/2016  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09574 883 S. SANTA FE AVENUE
VISTACA9208301/01/2016  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09585 3925 N. RIVER RD.
OCEANSIDECA9205801/01/2016  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09479 2510 EL CAMINO REAL
CARLSBADCA9200804/01/2017  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09532 4615 FRAZEE ROAD
OCEANSIDECA9205704/01/2017  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09549 1980 COLLEGE BLVD
OCEANSIDECA9205604/01/2017  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09110 1101 S. MISSION RD.
FALLBROOKCA9202804/01/2018  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08836 1631 S MELROSE DR
VISTACA9208104/01/2018 05/01/2025
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09103 318 W EL NORTE PARKWAY
ESCONDIDOCA9202601/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09181 455 ENCINITAS BLVD.
ENCINITASCA9202401/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09166 734 S. RANCHO SANTA FE RD.
SAN MARCOSCA9207801/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 07127 1302 WEST MISSION RD.
SAN MARCOSCA9206901/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09528 7740 RANCHO SANTA FE ROAD
CARLSBADCA9200904/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09104 2427 E. VALLEY PKWY
ESCONDIDOCA9202704/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16425 1751 UNIVERSITY DR
VISTACA9208304/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17274 18287 COLLIER AVE
LAKE ELSINORECA9253004/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16108 3173 E SHIELDS AVE
FRESNOCA9372604/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09108 1655 S. CENTRE CITY PKWY.
ESCONDIDOCA9202504/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09148 313 WASHINGTON ST.
SAN DIEGOCA9210307/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09524 3350 PALM AVE.
SAN DIEGOCA9215407/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09177 8260 MIRA MESA BLVD.
SAN DIEGOCA9212607/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09112 7100 BROADWAY
LEMON GROVECA9194507/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08818 997 WOODLAND PKWY.
SAN MARCOSCA9206907/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16416 1010 N EL CAMINO REAL
ENCINITASCA9202407/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09187 683 LOMAS SANTA FE DR.
SOLANA BEACHCA9207507/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09193 1380 43RD ST.
SAN DIEGOCA9211307/01/2019  
CH091670GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16101 2255 S EL CAMINO REAL
OCEANSIDECA9205410/01/2020  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09569 17136 MAGNOLIA ST.
FOUNTAIN VALLEYCA9270807/01/2022  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09654 2091 E LAKESHORE DR
LAKE ELSINORECA9253007/01/2022  
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09194 1810 MAIN ST.
RAMONACA9206507/01/2022  
CH091670GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 11339 777 S. HARBOR BLVD., SUITE E-164
LA HABRACA9063107/01/2022 02/26/2024
CH091670GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09606 29610 RANCHO CALIFORNIA RD
TEMECULACA9259107/01/2022  
CH091670GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 17725 443 COLLEGE BLVD
OCEANSIDECA9205707/01/2022  
CH09167CGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08857 1441 N SANTA FE
VISTACA9208401/12/2023  
CH09167EGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09585 3925 N. RIVER RD.
OCEANSIDECA9205801/12/2023  
CH09167PGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09574 883 S. SANTA FE AVENUE
VISTACA9208301/12/2023  
CH09167MGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08866 1706 OCEANSIDE BLVD
OCEANSIDECA9205401/12/2023  
CH09167KGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09104 2427 E. VALLEY PKWY
ESCONDIDOCA9202701/12/2023 10/04/2024
CH09167NGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09549 1980 COLLEGE BLVD
OCEANSIDECA9205601/12/2023  
CH09167BGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09103 318 W EL NORTE PARKWAY
ESCONDIDOCA9202610/01/2023  
CH09167GGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17274 18287 COLLIER AVE
LAKE ELSINORECA9253004/01/2024  
CH09167QGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09166 734 S. RANCHO SANTA FE RD.
SAN MARCOSCA9207804/01/2024  
CH09167RGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09479 2510 EL CAMINO REAL
CARLSBADCA9200804/01/2024  
CH09167RGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09654 2091 E LAKESHORE DR
LAKE ELSINORECA9253010/01/2024  
CH09167FGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09532 4615 FRAZEE ROAD
OCEANSIDECA9205710/01/2024  
CH09167FGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09110 1101 S. MISSION RD.
FALLBROOKCA9202810/01/2024  
CH09167NGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09104 2427 E. VALLEY PKWY
ESCONDIDOCA9202710/01/2024  
CH09167JGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16425 1751 UNIVERSITY DR
VISTACA9208310/01/2024  
CH09167GGARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 17725 443 COLLEGE BLVD
OCEANSIDECA9205710/01/2024 01/01/2025
CH09167GGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09181 455 ENCINITAS BLVD.
ENCINITASCA9202401/01/2025  
CH09167GGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 07127 1302 WEST MISSION RD.
SAN MARCOSCA9206901/01/2025  
CH091670GEN RX PHARMACYGEN RX 16800 LAKESHORE DR.
LAKE ELSINORECA92530-491607/01/2016  
CH09167KGEN RX PHARMACYGEN RX 16800 LAKESHORE DR.
LAKE ELSINORECA92530-491610/01/2023  
CH091670GENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205801/01/2022  
CH091670HAGGEN OPCO SOUTH, LLCHAGGEN PHARMACY #2191 671 RANCHO SANTA FE ROAD
SAN MARCOSCA9207810/01/2015 10/02/2015
CH091670HILLCREST PHARMACY120 UNIVERSITY AVE
SAN DIEGOCA9210312/16/2011 11/24/2020
CH091670HILLCREST PHARMACY INCHILLCREST PHARMACY 1988 HACIENDA DR
VISTACA92081-602610/01/2015 11/24/2020
CH091670LAGUNA DRUGS239 BROADWAY ST
LAGUNA BEACHCA92651-180601/01/2014 09/27/2017
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 06368 635 S MELROSE DR
VISTACA9208104/01/2018  
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09558 320 S TWIN OAKS VALLEY RD
SAN MARCOSCA9207801/01/2019  
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09961 191 WOODLAND PKWY
SAN MARCOSCA9206904/01/2019  
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09959 1560 W VALLEY PKWY
ESCONDIDOCA9202904/01/2019  
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09135 129 N EL CAMINO REAL
ENCINITASCA9202404/01/2019  
CH091670LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07553 3011 E SHIELDS AVE
FRESNOCA9372604/01/2019  
CH09167JLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 06368 635 S MELROSE DR
VISTACA9208110/01/2024 01/01/2025
CH091670LONGS DRUGS OF LEXINGTOND/B/A AVITA PHARMACY 1051 1216 W MAIN ST
STE D
LEXINGTONSC29072-245307/01/2022 06/01/2023
CH091670M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312604/01/2020 12/31/2022
CH091670MED CARE PHARMACYASBAC PHARMACY, INC. 161 THUNDER DR.
STE 100
VISTACA9208311/10/2011 10/06/2022
CH091670MED CARE PHARMACYMED MATRIX PHARMACY , INC 161 THUNDER DR STE 100
VISTACA9208311/07/2022  
CH09167CMED CARE PHARMACYMED MATRIX PHARMACY , INC 161 THUNDER DR STE 100
VISTACA9208310/01/2023  
CH09167JMED CARE PHARMACYMED MATRIX PHARMACY , INC 161 THUNDER DR STE 100
VISTACA9208310/01/2023 05/01/2024
CH091670MED-RX PHARMACY AND COMPOUNDING1031 E VISTA WAY
VISTACA92084-460611/10/2011 07/23/2020
CH091670MEDICAL CENTER PHARMACY340 4TH AVENUE SUITE 1
CHULA VISTACA9191007/01/2013 12/31/2017
CH091670MEDICAL CENTER PHARMACYPARK MEDICAL PHARMACY 480 4TH AVE STE 100
CHULA VISTACA9191007/01/2013 07/01/2018
CH091670MEDICAL CENTER PHARMACYMEDICAL CENTER PHARMACY 855 THIRD AVENUE
SUITE 1102
CHULA VISTACA91911-921007/01/2013 01/27/2017
CH091670MEDICAL CENTER PHARMACY  7910 FROST STREET
SUITE 130
SAN DIEGOCA9212307/01/2013 07/05/2016
CH091670MEDICAL CENTER PHARMACY3904 PARK BLVD
SAN DIEGOCA9210307/01/2013 12/31/2017
CH091670MEDICAL CENTER PHARMACY  765 MEDICAL CENTER CRT.
NO 208
CHULA VISTACA9191107/01/2013 12/31/2017
CH091670MEDICAL CENTER PHARMACY4074 FAIRMONT AVENUE
SAN DIEGOCA9210507/01/2013 12/31/2017
CH091670MEDICAL CENTER PHARMACYMCP16 286 EUCLID AVE, #206
SAN DIEGOCA9211404/01/2015 12/31/2017
CH091670MISSION PARK PHARMACY2201 MISSION AVE
OCEANSIDECA9205810/01/2014 06/17/2016
CH091670MISSION PLAZA PHARMACY26800 CROWN VALLEY PKWY STE 185
MISSION VIEJOCA92691-730407/01/2015 04/18/2022
CH091670OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502904/01/2021 06/01/2023
CH091670OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/01/2021 06/01/2023
CH091670OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140104/01/2021 06/01/2023
CH091670OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161804/01/2021 06/18/2021
CH091670OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983804/01/2021 06/01/2023
CH091670OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660804/01/2021 12/12/2022
CH091670OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805204/01/2020 12/31/2022
CH091670PHARMEDQUEST PHARMACYPHARMEDQUEST PHARMACY SERVICES 451 W. LAMBERT RD STE 209
BREACA92821-928210/01/2019 04/01/2022
CH091670PHARMEDQUEST PHARMACY SERVICESDBA AVITA PHARMACY 1072 26800 CROWN VALLEY PKWY STE 185
MISSION VIEJOCA9269105/06/2022  
CH09167JPHARMEDQUEST PHARMACY SERVICESDBA AVITA PHARMACY 1072 26800 CROWN VALLEY PKWY STE 185
MISSION VIEJOCA9269110/01/2024  
CH091670PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310104/01/2020 12/31/2022
CH091670PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2025  
CH091670PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 1010 UNIVERSITY AVENUE
SAN DIEGOCA9210310/01/2023  
CH091670PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2025  
CH091670PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2025  
CH091670QC PHARMACY CORP727 W SAN MARCOS BLVD STE 113
SAN MARCOSCA9207810/12/2022  
CH091670QUALITY-CARE PHARMACY727 W SAN MARCOS BLVD STE 113
SAN MARCOSCA92078-124401/01/2015 10/12/2022
CH09167JQUALITY-CARE PHARMACY727 W SAN MARCOS BLVD STE 113
SAN MARCOSCA92078-124401/01/2025  
CH091670RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255007/01/2020 12/31/2022
CH091670RALPHS GROCERY CODBA RALPHS #108 8657 VILLA LA JOLLA DR
#108
LA JOLLACA9203710/01/2013 12/31/2017
CH091670RALPHS GROCERY CODBA RALPHS #123 101 G ST.
SAN DIEGOCA9210110/01/2013 12/31/2017
CH091670RALPHS GROCERY CO  DBA RALPHS #138
3533 CANNON RD
OCEANSIDECA9205610/01/2013 09/09/2016
CH091670RALPHS GROCERY CODBA RALPHS #201 3345 SPORTS ARENA BLVD
SAN DIEGOCA9211010/01/2013 12/31/2017
CH091670RALPHS GROCERY CODBA RALPHS #207 4315 MISSION BLVD
SAN DIEGOCA9210910/01/2013 02/16/2019
CH091670RALPHS GROCERY CODBA RALPHS #235 659 E. PALOMAR STREET
CHULA VISTACA9191110/01/2013 12/31/2017
CH091670RALPHS GROCERY CODBA RALPHS #298 4251 OCEANSIDE BLVD
OCEANSIDECA9205610/01/2013 02/16/2019
CH091670RALPHS GROCERY CODBA RALPHS #54 101 OLD GROVE RD
OCEANSIDECA9205710/01/2013  
CH091670RALPHS GROCERY CODBA RALPHS #683 306 TWIN OAKS VALLEY RD
SAN MARCOSCA9207810/01/2013 12/31/2017
CH09167MRALPHS GROCERY CODBA RALPHS #54 101 OLD GROVE RD
OCEANSIDECA9205710/01/2023  
CH091670RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500207/01/2020 12/31/2022
CH091670THE VONS COMPANIES INCVONS PHARMACY #2360 845 COLLEGE BOULEVARD
OCEANSIDECA9205709/10/2012 04/19/2024
CH09167PTHE VONS COMPANIES INCVONS PHARMACY #2360 845 COLLEGE BOULEVARD
OCEANSIDECA9205710/01/2023 04/19/2024
CH091670THRIFTY PAYLESS, INC.RITE AID #5642 1363 EAST VISTA WAY
VISTACA9208410/01/2016  
CH091670THRIFTY PAYLESS, INC.RITE AID #5634 1201 SOUTH COAST HIGHWAY
OCEANSIDECA9205410/01/2016  
CH091670THRIFTY PAYLESS, INC.RITE AID #5635 3813 PLAZA DRIVE
OCEANSIDECA9205610/01/2016 10/24/2023
CH091670THRIFTY PAYLESS, INC.RITE AID #5622 7100 AVENIDA ENCINAS
CARLSBADCA9201110/01/2016 02/11/2019
CH091670THRIFTY PAYLESS, INC.RITE AID #5631 1331 SOUTH MISSION ROAD
FALLBROOKCA9202810/01/2016 02/11/2019
CH091670THRIFTY PAYLESS, INC.RITE AID #5621 955 TAMARACK AVENUE
CARLSBADCA9200810/01/2016 02/11/2019
CH09167GTHRIFTY PAYLESS, INC.RITE AID #5642 1363 EAST VISTA WAY
VISTACA9208401/12/2023 10/04/2024
CH09167PTHRIFTY PAYLESS, INC.RITE AID #5635 3813 PLAZA DRIVE
OCEANSIDECA9205610/01/2023 10/24/2023
CH09167ETHRIFTY PAYLESS, INC.RITE AID #5634 1201 SOUTH COAST HIGHWAY
OCEANSIDECA9205410/01/2023  
CH09167GTHRIFTY PAYLESS, INC.RITE AID #5635 3813 PLAZA DRIVE
OCEANSIDECA9205610/01/2023 10/24/2023
CH091670THRIFTY PAYLESS, INC.RITE AID #6509 16491 LAKESHORE DRIVE
LAKE ELSINORECA9253001/01/2024 04/18/2024
CH091670THRIFTY PAYLESS, INC.RITE AID #5621 955 TAMARACK AVENUE
CARLSBADCA9200801/01/2024  
CH09167HTHRIFTY PAYLESS, INC.RITE AID #5634 1201 SOUTH COAST HIGHWAY
OCEANSIDECA9205404/01/2024 05/01/2024
CH09167PTHRIFTY PAYLESS, INC.RITE AID #5642 1363 EAST VISTA WAY
VISTACA9208410/01/2024  
CH091670TRUEPILL3121 DIABLO AVE
HAYWARDCA9454504/01/2020 12/31/2022
CH091670US BIOSERVICESPHARM PLUS ACQUISITION, INC. 5100 E HUNTER AVE
SUITE 101
ANAHEIMCA92807-204907/01/2019 08/24/2022
CH091670US BIOSERVICESUS BIOSERVICE CORPORATION 5025 PLANO PARKWAY
STE 100
CARROLLTONTX7501007/01/2019 09/16/2022
CH091670WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738604/01/2017  
CH091670WAL-MART PHARMACY 10-170013425 COMMUNITY ROAD
POWAYCA9206407/01/2022  
CH09167JWAL-MART PHARMACY 10-170013425 COMMUNITY ROAD
POWAYCA9206401/12/2023  
CH091670WAL-MART PHARMACY 10-20941800 UNIVERSITY DR
VISTACA9208310/01/2014  
CH09167HWAL-MART PHARMACY 10-20941800 UNIVERSITY DR
VISTACA9208301/12/2023  
CH091670WAL-MART PHARMACY 10-2245705 COLLEGE BLVD
OCEANSIDECA9205710/12/2012  
CH09167BWAL-MART PHARMACY 10-2245705 COLLEGE BLVD
OCEANSIDECA9205701/12/2023  
CH091670WAL-MART PHARMACY 10-24942100 VISTA WAY
OCEANSIDECA9205410/12/2012  
CH09167NWAL-MART PHARMACY 10-24942100 VISTA WAY
OCEANSIDECA9205410/01/2023 10/04/2024
CH09167JWAL-MART PHARMACY 10-24942100 VISTA WAY
OCEANSIDECA9205401/01/2025  
CH091670WAL-MART PHARMACY 10-32481340 SOUTH BEACH BLVD.
LA HABRACA9063110/01/2016 12/29/2017
CH091670WAL-MART PHARMACY 10-3494732 CENTER DR
SAN MARCOSCA9206910/01/2015 02/15/2019
CH091670WAL-MART PHARMACY 10-50753405 MARRON RD
OCEANSIDECA9205610/12/2012  
CH09167QWAL-MART PHARMACY 10-50753405 MARRON RD
OCEANSIDECA9205610/01/2023  
CH091670WAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
ORLANDOFL3281901/01/2017 12/31/2017
CH091670WAL-MART PHARMACY 10-56411000 E IMPERIAL HWY
LA HABRACA9063110/01/2016 12/29/2017
CH091670WAL-MART PHARMACY 10-566114865 TELEGRAPH ROAD
LA MIRADACA9063801/01/2017 12/29/2017
CH091670WAL-MART PHARMACY 10-59961330 EAST GRAND AVE
ESCONDIDOCA9202710/01/2015 12/29/2017
CH091670WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283704/01/2017 12/29/2017
CH091670WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283707/01/2022  
CH091670WALGREEN CODBA: WALGREENS #07751 3507 CANNON RD
OCEANSIDECA92056-497712/29/2011  
CH091670WALGREEN CODBA: WALGREENS #09433 3752 MISSION AVE
OCEANSIDECA9205812/29/2011  
CH091670WALGREEN CODBA: WALGREENS #11081 1285 S MISSION RD
FALLBROOKCA9202804/01/2015  
CH09167MWALGREEN CODBA: WALGREENS #09433 3752 MISSION AVE
OCEANSIDECA9205810/01/2024  
CH091670WALGREEN CO.DBA: WALGREENS # 05455 111 W WASHINGTON AVE
ESCONDIDOCA9202512/29/2011  
CH091670WALGREEN CO.DBA: WALGREENS # 05456 1510 N SANTA FE AVE
VISTACA9208312/29/2011  
CH091670WALGREEN CO.DBA: WALGREENS # 05700 1574 E VALLEY PKWY
ESCONDIDOCA9202712/29/2011  
CH091670WALGREEN CO.DBA: WALGREENS # 06222 802 S SANTA FE AVE
VISTACA92084-610712/29/2011 01/03/2017
CH091670WALGREEN CO.DBA: WALGREENS # 09389 310 SYCAMORE AVENUE
VISTACA92083-770212/29/2011 04/08/2024
CH091670WALGREEN CO.DBA: WALGREENS #13052 4181 OCEANSIDE BLVD.
OCEANSIDECA9205612/29/2011 11/04/2019
CH091670WALGREEN CO.DBA: WALGREENS #11653 1320 ENCINITAS BLVD
ENCINITASCA9202404/01/2015  
CH091670WALGREEN CO.DBA: WALGREENS # 03747 101 W. IMPERIAL HWY.
LA HABRACA9063101/01/2016 10/10/2023
CH091670WALGREEN CO.DBA: WALGREENS # 05672 2000 W WHITTIER BLVD
LA HABRACA9063101/01/2016  
CH091670WALGREEN CO.DBA: WALGREENS # 09486 18296 COLLIER AVENUE
LAKE ELSINORECA92530-275401/01/2016  
CH091670WALGREEN CO.DBA: WALGREENS #13813 160 DIAMOND DR.
LAKE ELSINORECA9253001/01/2016  
CH091670WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #13434 640 UNIVERSITY AVE
SAN DIEGOCA9210301/01/2017  
CH09167FWALGREEN CO.DBA: WALGREENS # 05456 1510 N SANTA FE AVE
VISTACA9208310/01/2024  
CH09167RWALGREEN CO.DBA: WALGREENS # 09486 18296 COLLIER AVENUE
LAKE ELSINORECA92530-275410/01/2024  
CH09167GWALGREEN CO.DBA: WALGREENS #11653 1320 ENCINITAS BLVD
ENCINITASCA9202401/01/2025  
CH09167JWALGREEN CO.DBA: WALGREENS # 05455 111 W WASHINGTON AVE
ESCONDIDOCA9202501/01/2025 01/01/2025
CH091670WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2024  
CH091670WALMART PHARMACY 10-30841266 E VALLEY PKWY
ESCONDIDOCA9202710/01/2015 02/15/2019
CH091670WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2023  
CH091670WALMART PHARMACY 10-56371046 MISSION AVE
OCEANSIDECA9205410/01/2014  
CH09167LWALMART PHARMACY 10-56371046 MISSION AVE
OCEANSIDECA9205401/12/2023  
CH091670Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
CH091670WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGOCA9210207/01/2018 02/16/2019
CH091670WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGOCA9210204/01/2020 12/31/2022
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsSigned ByInsertNew Registration Lambert, Michele CFO Vista Community Clinic 76021658035/6/2025 1:50 PM
Details340B IDUpdateNew Registration CH09167S5/6/2025 1:50 PM
DatesParticipating Approval DateUpdateNew Registration 5/6/2025 1:50:28 PM5/6/2025 1:50 PM
DetailsStateUpdateNew RegistrationPendingApproved5/6/2025 1:50 PM
DatesSigned By DateUpdateNew Registration 4/10/2025 3:14:17 PM5/6/2025 1:50 PM
DatesStart DateUpdateNew Registration 7/1/2025 12:00:00 AM5/6/2025 1:50 PM
AddressesMain AddressInsertNew Registration  950 Civic Center Dr Vista, CA 92083-52084/10/2025 3:00 PM
AddressesBilling AddressInsertNew Registration Vista Community Clinic 1000 VALE TERRACE Vista, CA 920844/10/2025 3:00 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False4/10/2025 3:00 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 12958226584/10/2025 3:00 PM
Medicaid BillingMedicaid: StateInsertNew Registration CA4/10/2025 3:00 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False4/10/2025 3:00 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 14972035414/10/2025 3:00 PM
Medicaid BillingMedicaid: StateInsertNew Registration CA4/10/2025 3:00 PM
Medicaid BillingNPI: NumberInsertNew Registration 12958226584/10/2025 3:00 PM
Medicaid BillingNPI: StateInsertNew Registration CA4/10/2025 3:00 PM
Medicaid BillingNPI: NumberInsertNew Registration 14972035414/10/2025 3:00 PM
Medicaid BillingNPI: StateInsertNew Registration CA4/10/2025 3:00 PM
Medicaid BillingNPI: NumberInsertNew Registration 16292960414/10/2025 3:00 PM
Medicaid BillingNPI: StateInsertNew Registration CA4/10/2025 3:00 PM
ContactsAuthorizing OfficialInsertNew Registration Lambert, Michele CFO Vista Community Clinic 76021658034/10/2025 3:00 PM
ContactsPrimary ContactInsertNew Registration Jones, Debra debra.l.jones@vcc.org Accountant Vista Community Clinic 7606315000-81734/10/2025 3:00 PM
DetailsAssistance Received From DateInsertNew Registration  4/10/2025 3:00 PM
DetailsAssistance Received To DateInsertNew Registration  4/10/2025 3:00 PM
DetailsLast Recertification DateInsertNew Registration  4/10/2025 3:00 PM
DetailsGrant NumberInsertNew Registration H80CS002824/10/2025 3:00 PM
Details340B IDInsertNew Registration  4/10/2025 3:00 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/10/2025 3:00 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/10/2025 3:00 PM
DetailsMedicare Provider NumberInsertNew Registration  4/10/2025 3:00 PM
DetailsEntity NameInsertNew Registration VISTA COMMUNITY CLINIC4/10/2025 3:00 PM
DetailsNOFO NumberInsertNew Registration  4/10/2025 3:00 PM
DetailsProgram CodeInsertNew Registration CH4/10/2025 3:00 PM
DetailsEntity SubnameInsertNew Registration VCC: Vista Village Pediatrics4/10/2025 3:00 PM
DatesParticipating Approval DateInsertNew Registration  4/10/2025 3:00 PM
DetailsStateInsertNew Registration Pending4/10/2025 3:00 PM
DatesRegistration DateInsertNew Registration 4/10/2025 3:00:07 PM4/10/2025 3:00 PM
DatesSigned By DateInsertNew Registration  4/10/2025 3:00 PM
DatesStart DateInsertNew Registration  4/10/2025 3:00 PM
TerminationsTermination CommentsInsertNew Registration  4/10/2025 3:00 PM
TerminationsTermination DateInsertNew Registration  4/10/2025 3:00 PM
TerminationsTermination Effective DateInsertNew Registration  4/10/2025 3:00 PM
TerminationsTermination ReasonInsertNew Registration  4/10/2025 3:00 PM