340B Drug Pricing Program Database


CH09047O GOLDEN VALLEY HEALTH CENTER (Terminated) - information as of 4/30/2025 10:49:59 PM

Main Details
GOLDEN VALLEY HEALTH CENTER
GVHC - O'Banion
HRSA-Funded Health Center
BPS-H80-004876
CH09047O
H80CS00742


Additional Details
Terminated
12/7/2006
1/1/2007
12/8/2006
2/7/2023

10/1/2023
Site closure

Contacts

Golden Valley Health Centers
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516

Golden Valley Health Centers
Trisha Ramirez, Director of Finance
(209) 384-6524

Addresses

401 LESHER DR.
MERCED, CA 95341

GOLDEN VALLEY HEALTH CENTER ADMIN OFFICE
737 WEST CHILDS AVENUE
MERCED, CA 95341


  • 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
CH090470ActiveBPS-H80-005643GOLDEN VALLEY HEALTH CENTERSGVHC - MERCED SUITES847 W. CHILDS AVE MERCEDCA
CH09047AActiveBPS-H80-004226GOLDEN VALLEY HEALTH CENTERGVHC - West Modesto1114 6th St ModestoCA
CH09047AAActiveBPS-H80-018263GOLDEN VALLEY HEALTH CENTERSGVHC - Empire198 N. G Street EmpireCA
CH09047ABActiveBPS-H80-018262GOLDEN VALLEY HEALTH CENTERSGVHC - Hanshaw Dental1717 Las Vegas Street, Suite A ModestoCA
CH09047ACActiveBPS-H80-017811GOLDEN VALLEY HEALTH CENTERSGVHC - CERES EAST1920 MEMORIAL DR CERESCA
CH09047ADActiveBPS-H80-019526GOLDEN VALLEY HEALTH CENTERSGVHC - MANTECA250 Northgate Drive MantecaCA
CH09047AEActiveBPS-H80-021563Golden Valley Health CentersGVHC - TURLOCK MONTE VISTA2240 W Monte Vista Ave TurlockCA
CH09047AFActiveBPS-H80-021564Golden Valley Health CentersGVHC - TURLOCK PEDIATRIC HEALTH CENTER 1199 Suite 31199 Delbon Ave Ste 3 TurlockCA
CH09047AGActiveBPS-H80-021842Golden Valley Health CentersGVHC - TURLOCK PEDIATRIC HEALTH CENTER 11001100 Delbon Ave TurlockCA
CH09047AHActiveBPS-H80-021843Golden Valley Health CentersGVHC - TURLOCK PEDIATRIC HEALTH CENTER 11201120 Delbon Ave TurlockCA
CH09047AJActiveBPS-H80-021840Golden Valley Health CentersGVHC - TURLOCK PEDIATRIC HEALTH CENTER 1199 Suite 21199 Delbon Ave Ste 2 TurlockCA
CH09047AKActiveBPS-H80-021841Golden Valley Health CentersGVHC - TURLOCK PEDIATRIC HEALTH CENTER 1199 Suite 51199 Delbon Ave Ste 5 TurlockCA
CH09047ALActiveBPS-H80-027744Golden Valley Health CentersGVHC - Modesto Mission Health Center209 Kerr Ave ModestoCA
CH09047AMActiveBPS-H80-027683Golden Valley Health CentersGVHC – Manteca Northgate West302 Northgate Dr MantecaCA
CH09047ANActiveBPS-H80-028076Golden Valley Health CentersGVHC - Merced Northview3940 Sandpiper Avenue MercedCA
CH09047APActiveBPS-H80-030070Golden Valley Health CentersGVHC - Ceres Whitmore Avenue3109 East Whitmore Avenue CeresCA
CH09047AQTerminatedBPS-H80-029860Golden Valley Health CentersGVHC Mobile Unit - Hanshaw1717 LAS VEGAS ST MODESTOCA
CH09047ARActiveBPS-H80-029460Golden Valley Health CentersGVHC - Modesto Tully Road1801 Tully Rd Ste F ModestoCA
CH09047ASTerminatedBPS-H80-029859Golden Valley Health CentersGVHC Mobile Unit - Northview3940 Sandpiper Avenue MercedCA
CH09047ATActiveBPS-H80-030930Golden Valley Health CentersCentral Valley PACE2401 E Orangeburg Ave Ste 330 ModestoCA
CH09047AUActiveBPS-H80-032188Golden Valley Health CentersGVHC - McHenry Suite 5601524 Mchenry Ave Ste 560 ModestoCA
CH09047AVActiveBPS-H80-032187Golden Valley Health CentersGVHC - McHenry Suite 5701524 Mchenry Ave Ste 570 ModestoCA
CH09047AWActiveBPS-H80-032190Golden Valley Health CentersGVHC - McHenry Suite 5651524 Mchenry Ave Ste 565 ModestoCA
CH09047AXActiveBPS-H80-032189Golden Valley Health CentersGVHC - McHenry Suite 5351524 Mchenry Ave Ste 535 ModestoCA
CH09047AYActiveBPS-H80-032192Golden Valley Health CentersGVHC - McHenry Suite 5501524 Mchenry Ave Ste 550 ModestoCA
CH09047AZActiveBPS-H80-034380GOLDEN VALLEY HEALTH CENTERS INCGVHC - Modesto Coolidge208 W Coolidge Ave ModestoCA
CH09047BActiveBPS-H80-004639GOLDEN VALLEY HEALTH CENTERGVHC - Merced Women's Clinic797 WEST CHILDS AVENUE MERCEDCA
CH09047BAActiveBPS-H80-038615GOLDEN VALLEY HEALTH CENTERSGVHC - McHenry Suite 3301524 McHenry Ave, Ste 330 ModestoCA
CH09047BBActiveBPS-H80-038687GOLDEN VALLEY HEALTH CENTERSGolden Valley Health Centers - Modesto Paradise Suite E103401 Paradise Rd. STE E103 ModestoCA
CH09047BCActiveBPS-H80-038670GOLDEN VALLEY HEALTH CENTERSGolden Valley Health Centers - Modesto Paradise Suite E102401 Paradise Rd STE E102 ModestoCA
CH09047BDActiveBPS-H80-038618GOLDEN VALLEY HEALTH CENTERSGVHC - McHenry Suite 3001524 McHenry Ave, Ste 300 ModestoCA
CH09047BEActiveBPS-H80-038872GOLDEN VALLEY HEALTH CENTERSCentral Valley PACE - Merced727 W Childs Ave MercedCA
CH09047BFActiveBPS-H80-038669GOLDEN VALLEY HEALTH CENTERSGVHC - Modesto Paradise E101401 Paradise Rd. STE E101 ModestoCA
CH09047BGActiveBPS-H80-036438GOLDEN VALLEY HEALTH CENTERSGVHC Mobile Unit - Tenaya2101 Tenaya Dr. ModestoCA
CH09047BHActiveBPS-H80-038740GOLDEN VALLEY HEALTH CENTERSGolden Valley Health Centers - Modesto Paradise Suite E104401 Paradise Rd STE E104 ModestoCA
CH09047BJActiveBPS-H80-035382GOLDEN VALLEY HEALTH CENTERSGVHC - Merced Ranchero2752 Ranchero Ln. MercedCA
CH09047BKApprovedBPS-H80-039594GOLDEN VALLEY HEALTH CENTERSGVHC - West Modesto Dental1008 6th St, Ste A ModestoCA
CH09047CActiveBPS-H80-002002GOLDEN VALLEY HEALTH CENTERGVHC- Los Banos821 TEXAS AVE LOS BANOSCA
CH09047DActiveBPS-H80-002365GOLDEN VALLEY HEALTH CENTERGHVC - Planada9235 WEST BROADWAY PLANADACA
CH09047EActiveBPS-H80-005535GOLDEN VALLEY HEALTH CENTERGVHC - Patterson200 C STREET PATTERSONCA
CH09047FActiveBPS-H80-001671GOLDEN VALLEY HEALTH CENTERGVHC - Dos Palos1405 CALIFORNIA AVENUE DOS PALOSCA
CH09047HActiveBPS-H80-004480GOLDEN VALLEY HEALTH CENTERSGVHC-NEWMAN SITE637 Merced St NewmanCA
CH09047IActiveBPS-H80-000246GOLDEN VALLEY HEALTH CENTERGVHC - Robertson Road1121 HAMMOND ST MODESTOCA
CH09047JTerminatedBPS-H80-002672GOLDEN VALLEY HEALTH CENTERGVHC - Turlock Health Center1141 NORTH OLIVE TURLOCKCA
CH09047KActiveBPS-H80-004207GOLDEN VALLEY HEALTH CENTERGVHC - Hanshaw1717 LAS VEGAS ST MODESTOCA
CH09047LActiveBPS-H80-005428GOLDEN VALLEY HEALTH CENTERSGHVC - MODESTO FLORIDA SUITES1510 Florida Ave ModestoCA
CH09047MActiveBPS-H80-001553GOLDEN VALLEY HEALTH CENTERGVHC - WESTLEY301 HOWARD ROAD WESTLEYCA
CH09047NTerminatedBPS-H80-001538GOLDEN VALLEY HEALTH CENTERSGVHC - NORTH MERCED127 W. EL PORTAL DR. STE B MERCEDCA
CH09047OTerminatedBPS-H80-004876GOLDEN VALLEY HEALTH CENTERGVHC - O'Banion401 LESHER DR. MERCEDCA
CH09047PTerminatedBPS-H80-003455GOLDEN VALLEY HEALTH CENTERSGVHC - MODESTO CORNER OF HOPE1130 6th St ModestoCA
CH09047QTerminatedBPS-H80-005155GOLDEN VALLEY HEALTH CENTERGVHC - Ceres2760 THIRD STREET CERESCA
CH09047RActiveBPS-H80-005192GOLDEN VALLEY HEALTH CENTERGVHC - Le Grand13161 JEFFERSON STREET LEGRANDCA
CH09047SActiveBPS-H80-004387GOLDEN VALLEY HEALTH CENTERGVHC - TENAYA2101 TENAYA DRIVE MODESTOCA
CH09047TActiveBPS-H80-008705GOLDEN VALLEY HEALTH CENTERSGVHC - Riverbank4150 Patterson Road RiverbankCA
CH09047UActiveBPS-H80-007779Golden Valley Health CenterGVHC - Turlock West1200 West Main St. TurlockCA
CH09047VActiveBPS-H80-003145GOLDEN VALLEY HEALTH CENTERSGVHC - LOS BANOS DENTAL725 W I St Los BanosCA
CH09047WTerminatedBPS-H80-014047GOLDEN VALLEY HEALTH CENTERSGVHC-Florida North1540 FLORIDA AVE MODESTOCA
CH09047XActiveBPS-H80-007760GOLDEN VALLEY HEALTH CENTERSGVHC- Modesto Womens and Florida1500 Florida Avenue ModestoCA
CH09047YActiveBPS-H80-014425GOLDEN VALLEY HEALTH CENTERSGVHC - Senior Health and Wellness Center857 W Childs Ave MercedCA
CH09047ZTerminatedBPS-H80-001725GOLDEN VALLEY HEALTH CENTERSGVHC Mobile Unit - Le Grand13161 JEFFERSON ST LE GRANDCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090470AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/01/2019  
CH090470AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508507/01/2018 06/30/2022
CH090470AVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582107/01/2018 06/30/2022
CH090470AVITA PHARMACY 1019PHARMEDQUEST PHARMACY SERVICES DBA AVITA 857 W CHILDS AVE.
SUITE 101 		MERCEDCA95341-686209/27/2016 03/31/2023
CH090470AVITA PHARMACY 1020PHARMEDQUEST PHARMACY SERVICES DBA AVITA 1114 6TH ST STE A
MODESTOCA95354-220309/27/2016 04/30/2022
CH090470AVITA PHARMACY 1024PHARMEDQUEST PHARMACY SERVICES DBA AVITA 330 E LAMBERT RD STE 120
BREACA92821-410001/01/2022 03/31/2023
CH090470AVITA PHARMACY 1025PHARMEDQUEST PHARMACY SERVICES DBA AVITA 3020 SATURN ST STE 100
BREACA9282104/01/2021 03/31/2023
CH090470CAREKINESIS228 STRAWBRIDGE DR STE 200
MOORESTOWNNJ08057-460004/01/2020  
CH090470CAREKINESISSUITE 100 5303 SPINE RD
BOULDERCO80301-330004/01/2020  
CH090470CAREKINESIS401 S CANAL ST
SOUTH SAN FRANCISCOCA94080-460604/01/2020  
CH09047KCAREKINESISSUITE 100 5303 SPINE RD
BOULDERCO80301-330001/01/2024  
CH09047ATCAREKINESIS228 STRAWBRIDGE DR STE 200
MOORESTOWNNJ08057-460001/01/2024  
CH090470CARRANZA PHARMACY(MODESTO) 1739 CROWS LANDING ROAD
SUITE A 		MODESTOCA9535806/21/2012 10/12/2018
CH090470COMMUNITY MEDICAL CENTER PHARMACY610 GATEWAY CENTER WAY STE A - E
SAN DIEGOCA92102-454807/01/2017 03/29/2018
CH090470CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2022  
CH090470CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2022  
CH090470DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200 		MT PROSPECTIL6005607/01/2017  
CH090470DIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268308/12/2020 06/30/2022
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16357 3900 SISK RD
MODESTOCA9535610/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17449 1000 COMMERCE AVE
ATWATERCA9530110/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10360 474 WINTON PKWY
LIVINGSTONCA9533410/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16856 280 SPRECKELS AVE
MANTECACA9533610/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17423 1405 W PACHECO BLVD
LOS BANOSCA9363510/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16082 3405 MCHENRY AVE
MODESTOCA9535010/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 01467 2020 W. BRIGGSMORE AVE.
MODESTOCA9535010/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02994 3100 GEER RD.
TURLOCKCA9538210/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17412 16858 GOLDEN VALLEY PKWY
LATHROPCA9533010/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 03117 1651 BELLEVUE RD
ATWATERCA9530110/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05403 1175 W. LATHROP RD.
MANTECACA9533610/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17183 2425 CLARIBEL RD
RIVERBANKCA9536710/01/2022  
CH090470GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16647 3000 COUNTRYSIDE DR
TURLOCKCA9538010/01/2022  
CH09047AFGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 03117 1651 BELLEVUE RD
ATWATERCA9530101/01/2024  
CH09047AYGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02994 3100 GEER RD.
TURLOCKCA9538201/01/2024  
CH09047VGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17423 1405 W PACHECO BLVD
LOS BANOSCA9363501/01/2024  
CH09047AMGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16357 3900 SISK RD
MODESTOCA9535601/01/2024  
CH090470GV PMQ NORTHVIEW PHARMACYPHARMEDQUEST PHARMACY SERVICES 3940 SANDPIPER AVENUE, PHARMACY 181
MERCEDCA9534003/26/2020 03/31/2021
CH090470GVHC PMQ FS PHARMACY1510 FLORIDA AVE STE E
MODESTOCA95350-443707/01/2019 03/31/2021
CH090470LA PHARMACY LLC1048 S GARFIELD AVE STE 101
ALHAMBRACA9180110/23/2020  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07206 1970 YOSEMITE PARKWAY
MERCEDCA9534101/01/2015 10/12/2018
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534801/01/2015 10/12/2018
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03944 1520 E F ST
OAKDALECA9536110/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09248 1700 MCHENRY AVE.
MODESTOCA9535010/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03077 801 OAKDALE RD STE F
MODESTOCA9535510/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09171 2900 STANDIFORD AVE
MODESTOCA9535010/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09919 1621 LANDER AVE
TURLOCKCA9538010/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09874 2075 E HATCH ROAD
MODESTOCA9535110/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09233 515 S STATE HIGHWAY 49
JACKSONCA9564210/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09308 901 N CARPENTER RD STE 30
MODESTOCA9535110/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09884 2601 OAKDALE RD STE E
MODESTOCA9535510/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09763 1080 SPERRY AVE
PATTERSONCA9536310/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09866 1190 N MAIN ST
MANTECACA9533610/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03079 2224 PATTERSON RD
RIVERBANKCA9536710/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534810/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09949 1201 W MAIN ST STE 14
RIPONCA9536610/01/2022  
CH090470LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07206 1970 YOSEMITE PARKWAY
MERCEDCA9534110/01/2022  
CH09047FLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07206 1970 YOSEMITE PARKWAY
MERCEDCA9534101/01/2024  
CH09047AHLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03077 801 OAKDALE RD STE F
MODESTOCA9535501/01/2024  
CH09047ALLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09763 1080 SPERRY AVE
PATTERSONCA9536301/01/2024  
CH09047ABLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09248 1700 MCHENRY AVE.
MODESTOCA9535001/01/2024  
CH09047AALONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09308 901 N CARPENTER RD STE 30
MODESTOCA9535101/01/2024  
CH09047TLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03079 2224 PATTERSON RD
RIVERBANKCA9536701/01/2024  
CH09047RLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534801/01/2024  
CH09047QLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09884 2601 OAKDALE RD STE E
MODESTOCA9535501/01/2024 04/01/2025
CH09047AJLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09171 2900 STANDIFORD AVE
MODESTOCA9535001/01/2024  
CH09047ILONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09874 2075 E HATCH ROAD
MODESTOCA9535101/01/2024  
CH090470LONGS DRUG STORES CALIFORNIA, LLCD.B.A. CVS DISTRIBUTION CENTER 2400 KEYSTONE PACIFIC PKWY
SUITE B 		PATTERSONCA9536301/01/2015 10/12/2018
CH090470M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2019  
CH090470NEWMAN PIONEER DRUG INC1261 MAIN ST
NEWMANCA9536004/01/2017  
CH09047HNEWMAN PIONEER DRUG INC1261 MAIN ST
NEWMANCA9536009/10/2009  
CH090470OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191308/12/2020  
CH090470OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850711/07/2022  
CH090470OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713008/12/2020  
CH090470OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2023  
CH090470OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/15/2020  
CH090470OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161807/15/2020 06/30/2022
CH090470OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660810/23/2020 06/30/2022
CH090470OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983812/29/2020 10/01/2022
CH090470OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805210/23/2020  
CH090470PATTERSON FAMILY PHARMACYPATTERSON FAMILY PHARMACY INC 101 S DEL PUERTO AVE
PATTERSONCA9536304/01/2017 06/30/2024
CH09047EPATTERSON FAMILY PHARMACY  47 SOUTH DEL PUERTO AVENUE
PATTERSONCA9536305/29/2009  
CH09047MPATTERSON FAMILY PHARMACY  47 SOUTH DEL PUERTO AVENUE
PATTERSONCA9536306/03/2009  
CH090470PHARMEDQUEST PHARMACYPHARMEDQUEST PHARMACY SERVICES 451 W. LAMBERT RD STE 209
BREACA92821-928204/01/2021 09/01/2021
CH090470PHARMEDQUEST PHARMACY SERVICES451 W LAMBERT RD STE 208
BREACA92821-392004/01/2021 09/01/2021
CH090470PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310107/01/2018  
CH09047AKPILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2024  
CH090470PIONEER DRUGDOS PALOS DRUG INC 1428 CENTER AVE
DOS PALOSCA93620-232007/01/2017 01/31/2022
CH090470PIONEER DRUG #2397 5TH ST
GUSTINECA95322-123604/01/2017 07/06/2017
CH09047ARODERICK PHARMACY GROUP INCDBA GOLDEN VALLEY PHARMACY 1114 6TH STREET
MODESTOCA9535408/01/2002 09/10/2016
CH09047PRODERICK PHARMACY GROUP INCDBA GOLDEN VALLEY PHARMACY 1114 6TH STREET
MODESTOCA9535408/27/2008 10/12/2018
CH090470RODERICK PHARMACY GROUP INC DBADBA:GOLDEN VALLEY PHARMACY 857 W. CHILDS AVE
SUITE 101 		MERCEDCA95341-680508/01/2002 09/10/2016
CH090470ROGERS DRUG STORE402 H ST
MODESTOCA9535107/01/2015 10/31/2016
CH090470SAFEWAY INCSAFEWAY PHARMACY #1661 2001 MCHENRY AVENUE
MODESTOCA9535007/01/2014  
CH09047LSAFEWAY INCSAFEWAY PHARMACY #1661 2001 MCHENRY AVENUE
MODESTOCA9535012/31/2009  
CH09047APSAFEWAY INCSAFEWAY PHARMACY #1661 2001 MCHENRY AVENUE
MODESTOCA9535001/01/2024  
CH090470SAN JOAQUIN DRUG9215 EAST HIGHWAY 140 P.O. BOX 1636
PLANADACA9536501/01/2015 11/30/2024
CH09047DSAN JOAQUIN DRUG9215 EAST HIGHWAY 140 P.O. BOX 1636
PLANADACA9536503/24/2009  
CH09047RSAN JOAQUIN DRUG9215 EAST HIGHWAY 140 P.O. BOX 1636
PLANADACA9536504/17/2009  
CH090470THRIFTY PAYLESS, INC.RITE AID #6003 1830 MITCHELL ROAD
CERESCA9530701/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6006 1158 WEST MAIN STREET
MERCEDCA9534001/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6007 3142 G STREET
MERCEDCA9534001/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6008 1707 MCHENRY AVENUE
MODESTOCA9535001/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6010 1032 OAKDALE ROAD
MODESTOCA9535501/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6013 1935 N STREET
NEWMAMCA9536001/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #6019 653 N GOLDEN STATE BLVD
TURLOCKCA95380-395201/01/2014 01/01/2017
CH090470THRIFTY PAYLESS, INC.RITE AID #5855 1317 EAST PACHECO BOULEVARD
LOS BANOSCA9363501/01/2014 01/01/2017
CH090470TRUEPILL3121 DIABLO AVE
HAYWARDCA9454510/23/2020  
CH090470TRUEPILL NY LLC850 3RD AVE STE 404
BROOKLYNNY11232-152310/23/2020  
CH090470WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH090470WAL-MART PHARMACY 10-15872225 PLAZA PARKWAY
MODESTOCA9535007/01/2014  
CH09047ARWAL-MART PHARMACY 10-15872225 PLAZA PARKWAY
MODESTOCA9535001/01/2024  
CH090470WAL-MART PHARMACY 10-19632111 FULKERTH RD
TURLOCKCA9538007/01/2015  
CH09047AEWAL-MART PHARMACY 10-19632111 FULKERTH RD
TURLOCKCA9538001/01/2024  
CH090470WAL-MART PHARMACY 10-19833960 MITCHELL RD
CERESCA9530707/01/2014  
CH09047ACWAL-MART PHARMACY 10-19833960 MITCHELL RD
CERESCA9530701/01/2024  
CH090470WAL-MART PHARMACY 10-20393055 LOUGHBOROUGH DRIVE
MERCEDCA9534807/01/2014  
CH09047YWAL-MART PHARMACY 10-20393055 LOUGHBOROUGH DRIVE
MERCEDCA9534801/01/2024  
CH090470WAL-MART PHARMACY 10-58431030 SPERRY AVE
PATTERSONCA9536304/01/2018  
CH09047AGWAL-MART PHARMACY 10-58431030 SPERRY AVE
PATTERSONCA9536301/01/2024  
CH090470WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH090470WALGREEN CO.DBA: WALGREENS # 02865 1101 MCHENRY AVE
MODESTOCA9535001/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 04331 401 PARADISE RD UNIT 3
MODESTOCA9535101/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 02902 2101 E HATCH RD
MODESTOCA9535101/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 03330 1640 R STREET
MERCEDCA9534001/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 02842 840 OAKDALE ROAD
MODESTOCA9535501/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 03030 1591 GEER ROAD
TURLOCKCA9538001/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 05498 3500 COFFEE ROAD
MODESTOCA9535501/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 07313 1700 STANDIFORD AVE STE #4
MODESTOCA9535001/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 04415 3098 G STREET
MERCEDCA9534001/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 06355 4201 DALE ROAD
MODESTOCA9535601/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 06418 1360 E PACHECO BLVD
LOS BANOSCA9363501/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS #09955 995 SPERRY AVE
PATTERSONCA9536301/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS #11705 3019 FLOYD AVE
MODESTOCA9535501/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 06718 2730 SHAFFER ROAD
ATWATERCA9530101/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS #11934 444 W. F ST
OAKDALECA9536101/01/2015  
CH090470WALGREEN CO.DBA: WALGREENS # 10454 1071 N MAIN ST
MANTECACA9533601/01/2020  
CH090470WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16527 1801 N MAIN ST
JACKSONVILLEFL3220610/01/2023  
CH090470WALGREEN CO.DBA: WALGREENS #15986 8298 LANDER AVE
HILMARCA9532410/01/2023  
CH090470WALGREEN CO.DBA: WALGREENS # 09716 102 N JACK TONE RD
RIPONCA95366-951410/01/2023  
CH09047BWALGREEN CO.DBA: WALGREENS # 04415 3098 G STREET
MERCEDCA9534001/01/2024  
CH09047AUWALGREEN CO.DBA: WALGREENS # 02842 840 OAKDALE ROAD
MODESTOCA9535501/01/2024  
CH09047AVWALGREEN CO.DBA: WALGREENS # 06355 4201 DALE ROAD
MODESTOCA9535601/01/2024  
CH09047CWALGREEN CO.DBA: WALGREENS # 06418 1360 E PACHECO BLVD
LOS BANOSCA9363501/01/2024  
CH09047LWALGREEN CO.DBA: WALGREENS # 05498 3500 COFFEE ROAD
MODESTOCA9535501/01/2024  
CH09047ANWALGREEN CO.DBA: WALGREENS # 06718 2730 SHAFFER ROAD
ATWATERCA9530101/01/2024  
CH09047MWALGREEN CO.DBA: WALGREENS #09955 995 SPERRY AVE
PATTERSONCA9536301/01/2024  
CH09047UWALGREEN CO.DBA: WALGREENS # 03030 1591 GEER ROAD
TURLOCKCA9538001/01/2024  
CH09047ADWALGREEN CO.DBA: WALGREENS # 10454 1071 N MAIN ST
MANTECACA9533601/01/2024  
CH09047AZWALGREEN CO.DBA: WALGREENS # 02865 1101 MCHENRY AVE
MODESTOCA9535001/01/2024  
CH09047AWALGREEN CO.DBA: WALGREENS # 04331 401 PARADISE RD UNIT 3
MODESTOCA9535101/01/2024  
CH09047SWALGREEN CO.DBA: WALGREENS # 02902 2101 E HATCH RD
MODESTOCA9535101/01/2024  
CH09047XWALGREEN CO.DBA: WALGREENS # 07313 1700 STANDIFORD AVE STE #4
MODESTOCA9535001/01/2024  
CH09047AXWALGREEN CO.DBA: WALGREENS #11705 3019 FLOYD AVE
MODESTOCA9535501/01/2024  
CH090470WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904901/01/2015 07/12/2016
CH090470WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2015 07/12/2016
CH090470WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700804/01/2020 12/08/2021
CH090470WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818804/01/2020  
CH090470WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503304/01/2020  
CH090470WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527504/01/2020  
CH090470WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E 		SAN DIEGOCA9210203/30/2018  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate To Be TerminatedTerminated10/1/2023 12:01 AM
DatesLast Date That 340B Drugs PurchasedUpdateTermination Request 6/30/2023 12:00:00 AM7/18/2023 9:23 AM
DetailsStateUpdateTermination RequestActiveTo Be Terminated7/18/2023 9:23 AM
TerminationsTermination DateUpdateTermination Request 10/1/2023 12:00:00 AM7/18/2023 9:23 AM
TerminationsTermination Effective DateUpdateTermination Request 6/30/2023 12:00:00 AM7/18/2023 9:23 AM
TerminationsTermination ReasonUpdateTermination Request Site closure7/18/2023 9:23 AM
AddressesBilling AddressUpdateRecertificationGOLDEN VALLEY HEALTH CENTER ADMIN OFFICE 737 WEST CHILDS MERCED, CA 95341GOLDEN VALLEY HEALTH CENTER ADMIN OFFICE 737 WEST CHILDS AVENUE MERCED, CA 953412/7/2023 7:33 PM
DetailsLast Recertification DateUpdateRecertification2/9/2022 5:51:57 PM2/7/2023 7:33:10 PM2/7/2023 7:33 PM
ContactsPrimary ContactUpdateProfile Change RequestRamirez, Trisha Accounting Manager Golden Valley Health Centers 2093846524Ramirez, Trisha Director of Finance Golden Valley Health Centers 20938465241/31/2023 1:37 PM
DetailsLast Recertification DateUpdateRecertification2/11/2021 7:30:07 AM2/9/2022 5:51:57 PM2/9/2022 5:51 PM
AddressesMain AddressUpdateRecertification 401 LESHER DR. MERCED, CA 95348 401 LESHER DR. MERCED, CA 953412/11/2021 7:30 AM
AddressesBilling AddressUpdateRecertificationGOLDEN VALLEY HEALTH CENTER ADMIN OFFICE 747 WEST CHILDS MERCED, CA 95341GOLDEN VALLEY HEALTH CENTER ADMIN OFFICE 737 WEST CHILDS MERCED, CA 953412/11/2021 7:30 AM
Medicaid BillingNPI: StateUpdateRecertification CA2/11/2021 7:30 AM
DetailsLast Recertification DateUpdateRecertification2/7/2020 7:12:13 PM2/11/2021 7:30:07 AM2/11/2021 7:30 AM
DetailsEntity SubnameUpdateRecertificationO'BanionGVHC - O'Banion2/11/2021 7:30 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestSandhu, Gurjeet Director of Finance Golden Valley Health Centers 2093846516Sandhu, Gurjeet Vice President and Chief Financial Officer Golden Valley Health Centers 20938465162/11/2021 6:51 AM
Medicaid BillingNPI: NumberUpdateRecertification145757125915485684212/7/2020 7:12 PM
DetailsLast Recertification DateUpdateRecertification2/15/2019 1:13:02 PM2/7/2020 7:12:13 PM2/7/2020 7:12 PM
DetailsLast Recertification DateUpdateRecertification3/5/2018 5:24:39 PM2/15/2019 1:13:02 PM2/15/2019 1:13 PM
ContactsAuthorizing OfficialUpdateChange RequestWeber, Tony CEO Golden Valley Health Centers 2093855551Sandhu, Gurjeet Director of Finance Golden Valley Health Centers 20938465167/11/2018 11:25 AM
ContactsPrimary ContactUpdateChange RequestSandhu, Gurjeet Director of Finance Golden Valley Health Centers 2093846516Ramirez, Trisha Accounting Manager Golden Valley Health Centers 20938465247/11/2018 11:25 AM
DetailsLast Recertification DateUpdateRecertification1/25/2017 12:00:00 AM3/5/2018 5:24:39 PM3/5/2018 5:24 PM
AddressesMain AddressUpdateChange Request 401 LESHER STREET MERCED, CA 95348 401 LESHER DR. MERCED, CA 953482/2/2018 7:16 AM
ContactsAuthorizing OfficialUpdate Weber, Tony CEO 2093855551Weber, Tony CEO Golden Valley Health Centers 209385555111/2/2017 1:57 PM
ContactsPrimary ContactUpdate Sandhu, Gurjeet Director of Finance 2093846516Sandhu, Gurjeet Director of Finance Golden Valley Health Centers 209384651610/5/2017 3:39 PM
ContactsPrimary ContactUpdate Ramirez, Trisha Financial Analyst 2093855201Sandhu, Gurjeet Director of Finance 20938465167/17/2017 11:08 AM
ContactsAuthorizing OfficialInsert  Weber, Tony CEO 20938555517/17/2017 11:08 AM
DetailsLast Recertification DateUpdate 3/7/2016 12:00:00 AM1/25/2017 12:00:00 AM2/1/2017 1:44 PM
AddressesMain AddressInsert   401 LESHER STREET MERCED, CA 953482/1/2017 1:44 PM
DetailsLast Recertification DateUpdate 3/4/2015 12:00:00 AM3/7/2016 12:00:00 AM3/8/2016 5:32 PM
ContactsPrimary ContactUpdate PENNER, SCOTT QI/CC/FACILITIES DIRECTOR 2093855456Ramirez, Trisha Financial Analyst 20938552015/29/2015 6:49 PM
DetailsLast Recertification DateUpdate 2/10/2014 12:00:00 AM3/4/2015 12:00:00 AM3/4/2015 2:00 PM
AddressesBilling AddressInsert  GOLDEN VALLEY HEALTH CENTER ADMIN OFFICE 747 WEST CHILDS MERCED, CA 953418/6/2014 6:12 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/10/2014 12:00:00 AM2/10/2014 12:37 PM
Medicaid BillingNPI: NumberInsert  14575712593/15/2013 12:09 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/15/2013 12:09 PM
DetailsEntity SubnameUpdate  O'Banion3/15/2013 12:09 PM
ContactsPrimary ContactInsert  PENNER, SCOTT QI/CC/FACILITIES DIRECTOR 209385545612/19/2011 5:13 PM
DetailsLast Recertification DateInsert   12/8/2006 10:14 AM
DetailsGrant NumberInsert  H80CS0074212/8/2006 10:14 AM
Details340B IDInsert  CH09047O12/8/2006 10:14 AM
DetailsIs Authorizing Official EHB DataInsert   12/8/2006 10:14 AM
DatesLast Date That 340B Drugs PurchasedInsert   12/8/2006 10:14 AM
DetailsMedicare Provider NumberInsert   12/8/2006 10:14 AM
DetailsEntity NameInsert  GOLDEN VALLEY HEALTH CENTER12/8/2006 10:14 AM
DetailsProgram CodeInsert  CH12/8/2006 10:14 AM
DetailsEntity SubnameInsert   12/8/2006 10:14 AM
DatesParticipating Approval DateInsert  12/8/2006 12:00:00 AM12/8/2006 10:14 AM
DetailsStateInsert  Active12/8/2006 10:14 AM
DatesRegistration DateInsert  12/7/2006 12:00:00 AM12/8/2006 10:14 AM
DatesSigned By DateInsert  10/26/2006 12:00:00 AM12/8/2006 10:14 AM
DatesStart DateInsert  1/1/2007 12:00:00 AM12/8/2006 10:14 AM
TerminationsTermination CommentsInsert   12/8/2006 10:14 AM
TerminationsTermination DateInsert   12/8/2006 10:14 AM
TerminationsTermination Effective DateInsert   12/8/2006 10:14 AM
TerminationsTermination ReasonInsert   12/8/2006 10:14 AM