Covered Entity Details

CH03296E WESTSIDE FAMILY HEALTHCARE, INC. (Active) - information as of 5/9/2025 10:51:19 PM

Main Details

Name

WESTSIDE FAMILY HEALTHCARE, INC.

Subdivision Name

Westside Family Healthcare - Newark

Type

HRSA-Funded Health Center

Site ID

BPS-H80-005541

340B ID

CH03296E

Grant Number

H80CS00789

Additional Details

Current Program Status

Active

Registration Date

4/1/2004

Participating Start Date

4/1/2004

Participating Approval Date

3/10/2004

Last Recertification Date

2/25/2025

Contacts

Authorizing Official

Westside Family Healthcare
Chris Fraser, President & CEO
(302) 656-8292 Ext: 1008

Primary Contact

Westside Family Healthcare
Phillippa Jane Walmsley, Compliance Manager / Corporate Compliance Officer
(302) 656-8292 Ext: 1019

Addresses

Street Address

27 Marrows Road
Newark, DE 19713-3701

Billing Address

Westside Family Healthcare, Inc.
300 Water Street
Suite 200
Wilmington, DE 19801-5043

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

Comments

Comment	Last Updated On
5/2/12 - Changed contacts name from LENETTA ROBERTS. 8/13/10 UPDATED ENTITY NAME (WAS WESTSIDE HEALTH CENTER, INC.), ADDED SUBDIV NAME,(NORTHEAST HEALTH) AND BILL TO (WAS 1802 W. 4TH STREET, WILMINGTON, 19805);	05/02/2012
8/13/10 UPDATED ENTITY NAME (WAS WESTSIDE HEALTH CENTER, INC.), ADDED SUBDIV NAME,(NORTHEAST HEALTH) AND BILL TO (WAS 1802 W. 4TH STREET, WILMINGTON, 19805);	08/13/2010

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
DE	200157964,200172123,250536603,250749834	1669479929,1801898556,1861537821

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010	10/01/2010	10/13/2023	10/13/2023
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010	10/01/2010	10/13/2023	10/13/2023
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/17/2006	10/17/2006		03/28/2013
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010	10/01/2010	10/13/2023	10/13/2023
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010	10/01/2010	10/13/2023	10/13/2023
Contract Detail	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	10/01/2010	10/13/2023	10/13/2023

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH032960	Active	BPS-H80-008512	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Administration Office	300 Water Street	Suite 200	Wilmington	DE
CH03296D	Active	BPS-H80-004557	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Northeast	908 East 16th Street	Suite B	Wilmington	DE
CH03296E	Active	BPS-H80-005541	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Newark	27 Marrows Road		Newark	DE
CH03296F	Active	BPS-H80-008566	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Bear / New Castle	404 Fox Hunt Drive		Bear	DE
CH03296G	Active	BPS-H80-005405	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Wilmington	1802 West 4th Street		Wilmington	DE
CH03296H	Active	BPS-H80-010446	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Dover	1020 Forrest Avenue		Dover	DE
CH03296J	Terminated	BPS-H80-011752	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Middletown	306 E Main St		Middletown	DE
CH03296K	Active	BPS-H80-011904	WESTSIDE FAMILY HEALTHCARE, INC.	Westside Family Healthcare - Mobile Health Unit #1	120 Holly Oak Lane		Dover	DE

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH032960	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/01/2023
CH032960	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/01/2023
CH032960	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/01/2023
CH032960	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/01/2023
CH032960	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2023
CH032960	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/01/2023
CH032960	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/01/2023
CH032960	ADVANCED PHARMACY, LLC	ADVANCED PHARMACY	350 FEASTER ROAD SUITE D	GREENVILLE	SC	29615-6176	07/01/2016	05/02/2017
CH032960	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	01/01/2016
CH032960	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/01/2019	01/15/2025
CH032960	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	04/01/2025
CH032960	AVELLA OF DEER VALLEY	23620 N 20TH DR #12		PHOENIX	AZ	85085-0621	01/01/2016
CH032960	AVELLA OF ORLANDO	100 TECHNOLOGY PARK STE 155		LAKE MARY	FL	32746-6205	01/01/2016
CH032960	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019
CH032960	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2020
CH032960	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	10/01/2020
CH032960	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2022
CH032960	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2022
CH032960	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2022
CH032960	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2022
CH032960	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2022
CH032960	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2022
CH032960	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2022
CH032960	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2022
CH032960	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2022
CH032960	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2022
CH032960	CORAM ALTERNATE SITE SERVICES, INC.	DBA CORAM CVS/SPECIALTY INFUSION SERVICE	6 SPRING MILL DR	MALVERN	PA	19355	04/01/2025
CH032960	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2025
CH032960	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2025
CH032960	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2022
CH032960	CYSTIC FIBROSIS SERVICES	CYSTIC FIBROSIS SERVICES, INC	10530 JOHN W ELLIOTT DR, STE 200	FRISCO	TX	75033	04/01/2017	08/09/2017
CH032960	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2017
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00088	1005 DELAWARE AVE.	WILMINGTON	DE	19806	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01911	11 NORTH DUPONT HWY	DOVER	DE	19901	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02069	988 FORREST ST.	DOVER	DE	19904	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 3038	1605 TELEGRAPH RD.	WILMINGTON	DE	19804	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #3042	1545 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #6869	8 LANDERS LANE	NEW CASTLE	DE	19720	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10103	366 E. CHESTNUT HILL RD.	NEWARK	DE	19713	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10222	601 N DUPONT BLVD	MILFORD	DE	19963	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10238	702 NAAMANS RD.	CLAYMONT	DE	19703	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10375	674 MIDDLETOWN ODESSA ROAD	MIDDLETOWN	DE	19709	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10609	4020 CONCORD PIKE	WILMINGTON	DE	19803	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	CVS PHARMACY # 16509	1050 BRANDYWINE PKWY	WILMINGTON	DE	19803	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	CVS PHARMACY # 16655	148 JOHN HUNN BROWN RD	DOVER	DE	19901	10/01/2019
CH032960	DELAWARE CVS PHARMACY, L.L.C.	CVS PHARMACY # 17621	800 CHRISTIANA MALL	NEWARK	DE	19702	10/01/2019
CH032960	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	01/01/2017
CH032960	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2020
CH032960	ECKERD CORPORATION	RITE AID #11175	1999 PULASKI HWY (RT 40)	BEAR	DE	19701	07/01/2018
CH032960	ECKERD CORPORATION	RITE AID #11181	4607 STANTON OGLETOWN ROAD	NEWARK	DE	19713	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11183	501 EAST BASIN ROAD	NEW CASTLE	DE	19720	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11190	3004 SOUTH DUPONT HIGHWAY	CAMDEN	DE	19934	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11186	4609 KIRKWOOD HIGHWAY	WILMINGTON	DE	19808	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11195	66 E GLENWOOD AVENUE	SMYRNA	DE	19977	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11186	4609 KIRKWOOD HIGHWAY	WILMINGTON	DE	19808	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11188	3209 KIRKWOOD HIGHWAY	WILMINGTON	DE	19808	07/01/2019
CH032960	ECKERD CORPORATION	RITE AID #11182	25 CHESTNUT HILL PLAZA	NEWARK	DE	19713	07/01/2019
CH032960	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/01/2023
CH032960	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/01/2023
CH032960	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/01/2023
CH032960	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/01/2023
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/01/2010
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010	02/21/2024
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #09687	1001 FORREST AVE	DOVER	DE	19904-3306	07/01/2011
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11061	STATE STREET 1215 SOUTH STATE STREET	DOVER	DE	19901	07/01/2011
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11016	30182 SUSSEX HWY UNIT 1	LAUREL	DE	19956	08/01/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11055	SUMMIT BRIDGE 4465 SUMMIT BRIDGE ROAD	MIDDLETOWN	DE	19709	10/24/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11067	MIDDLETOWN CROSSING 396 E MAIN STREET	MIDDLETOWN	DE	19709	10/24/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11075	2470 N DUPONT PKWY	MIDDLETOWN	DE	19709	10/24/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11135	5999 SUMMIT BRIDGE ROAD	TOWNSEND	DE	19734	10/24/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #12462	700 S RIDGE AVE	MIDDLETOWN	DE	19709	10/24/2012
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11006	FAIRFAX SHOPPING CENTER 2119 CONCORD PIKE	WILMINGTON	DE	19803-2911	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11009	1413 NORTH DUPONT HWY	NEW CASTLE	DE	19720-1843	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11010	CANNERY 3301 LANCASTER PIKE	WILMINGTON	DE	19805-1436	07/01/2013	11/13/2023
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11014	1A TROLLEY SQ	WILMINGTON	DE	19806	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11020	839 N MARKET ST FL1	WILMINGTON	DE	19801	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11051	STANTON 536 MAIN STREET	STANTON	DE	19804	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11058	287 CHRISTIANA RD STE 17A	NEW CASTLE	DE	19720	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11069	CHESTNUT RUN 1710 FAULKLAND ROAD	WILMINGTON	DE	19805	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11070	UNION STREET 1313 N UNION STREET	WILMINGTON	DE	19806	07/01/2013
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11003	UNIVERSITY PLAZA SHOPPING CTR 15 UNIVERSITY PLAZA	NEWARK	DE	19702-1549	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11028	SUBURBAN PLAZA 216 SUBURBAN DRIVE	NEWARK	DE	19711-3596	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11032	1508 PHILADELPHIA PIKE	WILMINGTON	DE	19809-1826	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11035	HARMONY PLAZA 4114 STANTON-OGLETOWN RD	NEWARK	DE	19713	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11050	500 PLAZA DR	NEWARK	DE	19702	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #21382	20 N DUPONT HWY STE 3	DOVER	DE	19901	07/01/2015
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11078	BEAVER BROOK 1500 BEAVER BROOK PLAZA	NEW CASTLE	DE	19720	04/01/2016	11/04/2019
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11133	2651 CAPITOL TRL	NEWARK	DE	19711	04/01/2016
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11048	DEER PARK 2719 PULASKI HIGHWAY	NEWARK	DE	19702	04/01/2016
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11063	LINKSIDE 52 WEST BIRDIE LANE	MAGNOLIA	DE	19962	07/01/2016
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #15632	2480 S DUPONT HWY	CAMDEN	DE	19934	07/01/2016
CH032960	HAPPY HARRY'S INC.	WALGREENS SPECIALTY PHARMACY #11322	200 BANNING ST, SUITE 100	DOVER	DE	19904	04/01/2017
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS #11134	700 JIMMY DR	SMYRNA	DE	19977	04/01/2017
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11060	WOODSIDE 5506 SOUTH DUPONT HIGHWAY	DOVER	DE	19901	04/01/2017
CH032960	HAPPY HARRY'S INC.	DBA: WALGREENS # 11034	NEW CASTLE 740 FERRY CUT-OFF	NEW CASTLE	DE	19720	04/01/2017
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/01/2010	10/13/2023
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010	10/13/2023
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010	10/13/2023
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010	10/13/2023
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010	10/13/2023
CH03296E	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010	10/13/2023
CH03296E	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010	10/13/2023
CH03296E	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/17/2006
CH03296E	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010	10/13/2023
CH03296E	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010	10/13/2023
CH03296F	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010	10/13/2023
CH03296F	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010	10/13/2023
CH03296F	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010
CH03296F	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010
CH03296F	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/01/2010	10/13/2023
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	10/01/2010	10/13/2023
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	10/01/2010
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	10/01/2010	10/13/2023
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	10/01/2010	10/13/2023
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	10/01/2010	10/13/2023
CH03296H	HAPPY HARRY'S INC.	DBA: WALGREENS #09687	1001 FORREST AVE	DOVER	DE	19904-3306	01/01/2024
CH03296D	HAPPY HARRY'S INC.	DBA: WALGREENS # 11020	839 N MARKET ST FL1	WILMINGTON	DE	19801	01/01/2024
CH03296G	HAPPY HARRY'S INC.	DBA: WALGREENS #13823	2121 KIRKWOOD HIGHWAY	WILMINGTON	DE	19805-4921	07/01/2024
CH03296K	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	07/01/2024
CH03296K	HAPPY HARRY'S INC.	DBA: WALGREENS # 11022	FOX RUN 128 FOX HUNT DR	BEAR	DE	19701-2535	07/01/2024
CH032960	HAPPY HARRY'S, INC.	DBA: WALGREENS #11132	648 NW FRONT ST.	MILFORD	DE	19963-1033	07/01/2013
CH032960	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2019
CH032960	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2019
CH032960	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2022
CH032960	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2022
CH032960	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2022
CH032960	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2022
CH032960	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2020
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1658	800 WEST 4TH STREET	WILMINGTON	DE	19801	01/01/2015
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #814	801 MARKET STREET	WILMINGTON	DE	19801	01/01/2015	09/26/2018
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #172	2034 NEW CASTLE AVENUE	NEW CASTLE	DE	19720	01/01/2015
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1411	1698 PULASKI HIGHWAY	BEAR	DE	19701	01/01/2015
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1782	3801 N. MARKET STREET	WILMINGTON	DE	19802	01/01/2015
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #3756	41 GREENTREE DR	DOVER	DE	19904-2685	07/01/2018
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1294	636 SOUTH MARYLAND AVENUE	WILMINGTON	DE	19804	01/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1751	400 PEOPLES PLAZA	NEWARK	DE	19702	01/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #3748	1580 SOUTH DUPONT HIGHWAY	DOVER	DE	19901	01/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #1600	1602 CAPITOL TRAIL	NEWARK	DE	19711	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #839	1718 MARSH RD	WILMINGTON	DE	19810-4606	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #129	263 S MAIN STREET	NEWARK	DE	19711	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #4926	455 WEST MAIN STREET	MIDDLETOWN	DE	19709	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #7891	200 PHARMACY DRIVE	SMYRNA	DE	19977	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #4924	17069 SOUTH DUPONT HIGHWAY	HARRINGTON	DE	19952	07/01/2019
CH032960	RITE AID OF DELAWARE, INC.	RITE AID #3749	677 NORTH DUPONT BLVD	MILFORD	DE	19963	07/01/2019
CH032960	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2020
CH032960	SHOP RITE PHARMACY #558	1300 ROCKY RUN PARKWAY		WILMINGTON	DE	19803	07/01/2019
CH032960	SHOP-RITE PHARMACY	1600 WEST NEWPORT PIKE		WILMINGTON	DE	19804-3500	07/01/2019
CH032960	SHOPRITE OF CHRISTINA LANDING CENTER, LL	SHOPRITE PHARMACY #589	501 S. WALNUT ST	WILMINGTON	DE	19801-5286	07/01/2019
CH032960	SHOPRITE PHARMACY #588	DELAWARE SUPERMARKETS, INC	1101 GOVERNORS PLACE	BEAR	DE	19701-6024	07/01/2019
CH032960	THRIFT DRUG, INC.	RITE AID #11176	701 GOVERNORS PLACE	BEAR	DE	19701	07/01/2018
CH032960	THRIFT DRUG, INC.	RITE AID #11189	245 NORTH DUPONT HIGHWAY	DOVER	DE	19901	07/01/2019
CH032960	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH032960	WAL-MART PHARMACY 10-1736	36 JEROME DRIVE		DOVER	DE	19901	01/01/2017
CH032960	WAL-MART PHARMACY 10-1860	1000 EAST PULASKI HWY		ELKTON	MD	21921	01/01/2017
CH032960	WAL-MART PHARMACY 10-2555	117 WILTON BLVD		NEW CASTLE	DE	19720	01/01/2016
CH032960	WAL-MART PHARMACY 10-3802	705 MIDDLETOWN WARWICK RD.		MIDDLETOWN	DE	19709	04/01/2019
CH032960	WAL-MART PHARMACY 10-5039	263 WAL-MART DR		CAMDEN	DE	19934	04/01/2019
CH032960	WAL-MART PHARMACY 10-5436	1251 CENTERVILLE ROAD		WILMINGTON,	DE	19808	01/01/2016
CH032960	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH032960	WALGREEN CO	DBA: WALGREENS	28727 OREGON ROAD	PERRYSBURG	OH	43551	10/24/2012	06/23/2015
CH032960	WALGREEN EASTERN CO INC		DBA WALGREENS WAREHOUSE 125 N COMMERCE WAY	BETHLEHEM	PA	18017	10/24/2012	06/23/2015
CH032960	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	11/07/2019
CH032960	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #11756	17248 S DUPONT HIGHWAY	HARRINGTON	DE	19952	07/01/2013
CH032960	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12695	1601 NAAMANS RD	WILMINGTON	DE	19810	07/01/2016
CH03296D	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	10/13/2023
CH03296E	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	10/13/2023
CH03296F	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	10/13/2023
CH03296G	WALGREEN EASTERN CO., INC.	DBA; WALGREENS #12040	3513 NORTH MARKET STREET	WILMINGTON	DE	19802	10/01/2010	10/13/2023
CH032960	WALGREEN EASTERN CO., INC.	WALGREENS SPECIALTY PHARMACY #16532	1201 N MARKET ST STE 101	WILMINGTON	DE	19801	01/01/2019
CH03296G	WALGREEN EASTERN CO., INC.	WALGREENS SPECIALTY PHARMACY #16532	1201 N MARKET ST STE 101	WILMINGTON	DE	19801	01/01/2024
CH03296D	WALGREEN EASTERN CO., INC.	WALGREENS SPECIALTY PHARMACY #16532	1201 N MARKET ST STE 101	WILMINGTON	DE	19801	01/01/2024
CH032960	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2013	06/23/2015
CH032960	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2013	06/23/2015
CH032960	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/01/2017
CH032960	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	04/01/2017
CH032960	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/01/2017
CH032960	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/01/2017

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/23/2024 2:34:25 PM	2/25/2025 11:17:14 AM	2/25/2025 11:17 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		200172123	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		DE	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250536603	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		DE	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250749834	2/23/2024 2:34 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		DE	2/23/2024 2:34 PM
Details	Last Recertification Date	Update	Recertification	2/15/2023 5:40:27 PM	2/23/2024 2:34:25 PM	2/23/2024 2:34 PM
Contacts	Authorizing Official	Update	Profile Change Request	Fraser, Chris Executive Vice President Westside Family Healthcare 3026568292-1008	Fraser, Chris President & CEO Westside Family Healthcare 3026568292-1008	10/16/2023 7:59 AM
Contacts	Authorizing Official	Update	Profile Change Request	Fraser, Chris Chief Operating Officer Westside Family Healthcare 3026568292-1008	Fraser, Chris Executive Vice President Westside Family Healthcare 3026568292-1008	6/2/2023 10:33 AM
Details	Last Recertification Date	Update	Recertification	2/18/2022 2:49:16 PM	2/15/2023 5:40:27 PM	2/15/2023 5:40 PM
Details	Last Recertification Date	Update	Recertification	2/25/2021 9:15:41 AM	2/18/2022 2:49:16 PM	2/18/2022 2:49 PM
Medicaid Billing	NPI: State	Update	Recertification		DE	2/25/2021 9:15 AM
Medicaid Billing	NPI: State	Update	Recertification		DE	2/25/2021 9:15 AM
Medicaid Billing	NPI: State	Update	Recertification		DE	2/25/2021 9:15 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 11:22:28 AM	2/25/2021 9:15:41 AM	2/25/2021 9:15 AM
Contacts	Authorizing Official	Update	AO Change Request	GOODMAN, DONNA M. VP AND CFO/COO Westside Family Healthcare 3026568292	Fraser, Chris Chief Operating Officer Westside Family Healthcare 3026568292-1008	2/24/2021 7:55 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	1/28/2020 11:22 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		200157964	1/28/2020 11:22 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		DE	1/28/2020 11:22 AM
Details	Last Recertification Date	Update	Recertification	2/11/2019 11:26:48 AM	1/28/2020 11:22:28 AM	1/28/2020 11:22 AM
Contacts	Primary Contact	Update	Profile Change Request	Walmsley, Phillippa Jane Compliance and Operations Specialist Westside Family Healthcare 3026568292-1019	Walmsley, Phillippa Jane Compliance Manager / Corporate Compliance Officer Westside Family Healthcare 3026568292-1019	1/27/2020 10:11 AM
Contacts	Authorizing Official	Update	Change Request	LOPEZ, LOLITA A. PRESIDENT AND CEO Westside Family Healthcare 3026568292	GOODMAN, DONNA M. VP AND CFO/COO Westside Family Healthcare 3026568292	2/11/2019 3:37 PM
Addresses	Main Address	Update	Recertification	27 Marrows Rd Newark, DE 19713-3701	27 Marrows Road Newark, DE 19713-3701	2/11/2019 11:26 AM
Addresses	Billing Address	Update	Recertification	WESTSIDE FAMILY HEALTHCARE, INC. 300 WATER STREET SUITE 200 WILMINGTON, DE 19801	Westside Family Healthcare, Inc. 300 Water Street Suite 200 Wilmington, DE 19801-5043	2/11/2019 11:26 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	261QF0400X (DE)		2/11/2019 11:26 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1801898556	2/11/2019 11:26 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1861537821	2/11/2019 11:26 AM
Contacts	Primary Contact	Update	Recertification	GOODMAN, DONNA M. VP AND CFO/COO Westside Family Healthcare 3026568292	Walmsley, Phillippa Jane Compliance and Operations Specialist Westside Family Healthcare 3026568292-1019	2/11/2019 11:26 AM
Details	Last Recertification Date	Update	Recertification	2/15/2018 11:49:33 AM	2/11/2019 11:26:48 AM	2/11/2019 11:26 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/15/2018 11:49 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		261QF0400X	2/15/2018 11:49 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		DE	2/15/2018 11:49 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1669479929	2/15/2018 11:49 AM
Details	Last Recertification Date	Update	Recertification	1/25/2017 12:00:00 AM	2/15/2018 11:49:33 AM	2/15/2018 11:49 AM
Contacts	Authorizing Official	Update		LOPEZ, LOLITA A. PRESIDENT AND CEO 3026568292	LOPEZ, LOLITA A. PRESIDENT AND CEO Westside Family Healthcare 3026568292	11/3/2017 4:36 PM
Contacts	Primary Contact	Update		GOODMAN, DONNA M. VP AND CFO/COO 3026568292	GOODMAN, DONNA M. VP AND CFO/COO Westside Family Healthcare 3026568292	11/3/2017 11:12 AM
Contacts	Authorizing Official	Update		LOPEZ, LOLITA A. CEO 3026568292	LOPEZ, LOLITA A. PRESIDENT AND CEO 3026568292	8/9/2017 11:28 AM
Contacts	Primary Contact	Update		ROBERTS, LENETTA CHIEF NURSING OFFICER 3026568292	GOODMAN, DONNA M. VP AND CFO/COO 3026568292	5/3/2017 8:28 AM
Addresses	Main Address	Insert			27 Marrows Rd Newark, DE 19713-3701	1/25/2017 12:02 PM
Details	Last Recertification Date	Update		2/22/2016 12:00:00 AM	1/25/2017 12:00:00 AM	1/25/2017 12:02 PM
Details	Last Recertification Date	Update		2/10/2015 12:00:00 AM	2/22/2016 12:00:00 AM	2/22/2016 11:23 AM
Details	Last Recertification Date	Update		2/10/2014 12:00:00 AM	2/10/2015 12:00:00 AM	2/10/2015 1:56 PM
Details	Entity Subname	Update		Newark	Westside Family Healthcare - Newark	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/10/2014 12:00:00 AM	2/10/2014 1:45 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/15/2013 8:13 AM
Details	Entity Subname	Update		NEWARK	Newark	3/15/2013 8:13 AM
Addresses	Billing Address	Insert			WESTSIDE FAMILY HEALTHCARE, INC. 300 WATER STREET SUITE 200 WILMINGTON, DE 19801	1/31/2013 9:29 AM
Contacts	Authorizing Official	Insert			LOPEZ, LOLITA A. CEO 3026568292	1/31/2013 9:29 AM
Details	Comments Public	Insert			5/2/12 - Changed contacts name from LENETTA ROBERTS. 8/13/10 UPDATED ENTITY NAME (WAS WESTSIDE HEALTH CENTER, INC.), ADDED SUBDIV NAME,(NORTHEAST HEALTH) AND BILL TO (WAS 1802 W. 4TH STREET, WILMINGTON, 19805);	5/2/2012 3:32 PM
Contacts	Primary Contact	Insert			ROBERTS, LENETTA CHIEF NURSING OFFICER 3026568292	9/14/2010 8:44 AM
Details	Last Recertification Date	Insert				8/13/2010 3:10 PM
Details	Grant Number	Insert			H80CS00789	8/13/2010 3:10 PM
Details	340B ID	Insert			CH03296E	8/13/2010 3:10 PM
Details	Is Authorizing Official EHB Data	Insert				8/13/2010 3:10 PM
Dates	Last Date That 340B Drugs Purchased	Insert				8/13/2010 3:10 PM
Details	Medicare Provider Number	Insert				8/13/2010 3:10 PM
Details	Entity Name	Insert			WESTSIDE FAMILY HEALTHCARE, INC.	8/13/2010 3:10 PM
Details	Program Code	Insert			CH	8/13/2010 3:10 PM
Details	Entity Subname	Insert			NEWARK	8/13/2010 3:10 PM
Dates	Participating Approval Date	Insert			3/10/2004 12:00:00 AM	8/13/2010 3:10 PM
Details	State	Insert			Active	8/13/2010 3:10 PM
Dates	Registration Date	Insert			4/1/2004 12:00:00 AM	8/13/2010 3:10 PM
Dates	Signed By Date	Insert				8/13/2010 3:10 PM
Dates	Start Date	Insert			4/1/2004 12:00:00 AM	8/13/2010 3:10 PM
Terminations	Termination Comments	Insert				8/13/2010 3:10 PM
Terminations	Termination Date	Insert				8/13/2010 3:10 PM
Terminations	Termination Effective Date	Insert				8/13/2010 3:10 PM
Terminations	Termination Reason	Insert				8/13/2010 3:10 PM
Details	Comments Public	Insert			8/13/10 UPDATED ENTITY NAME (WAS WESTSIDE HEALTH CENTER, INC.), ADDED SUBDIV NAME,(NORTHEAST HEALTH) AND BILL TO (WAS 1802 W. 4TH STREET, WILMINGTON, 19805);	8/13/2010 3:10 PM

340B Drug Pricing Program Database