340B Drug Pricing Program Database


DSH050599 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER (Active) - information as of 4/24/2025 10:13:50 PM

Main Details
UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
Disproportionate Share Hospital
No
DSH050599
050599


Additional Details
Active
10/30/2007
1/1/1999
10/30/2007
8/22/2024

Contacts

UC Davis Health
Jennifer L Doll, Chief Financial Officer
(916) 708-2708

UC Davis Medical Center
Mark Riggle, Assistant Chief Pharmacist
(916) 734-3309

Addresses

2315 STOCKTON BLVD
SACRAMENTO, CA 95817

UC Davis Medical Center Accounts Payable
PO Box 168016
Sacramento, CA 95816


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
9/2/10 MEDI ID ADDED10/30/2007
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
CA 1114932712,1336487685,1427396779,1518205863,1578639308,1710918545,1396498580
NV 1578639308,1710918545,1518205863
Shipping Addresses

UC Davis Medical Center Placer Center for Health Pharmacy (PHE 51004)
550 W. Ranch View Drive
Suite 1600
Rocklin, CA 95765

U.C. Davis Medical Center (PHE 37804)
Cancer Center Pharmacy
4501 X Street
Room 1008
Sacramento, CA 95817

Pavilion Pharmacy at UC Davis Medical Center (PHE 50265)
2315 Stockton Blvd
Room 1P175
Sacramento, CA 95817

Ambulatory Care Center Pharmacy (PHE 43732)
4860 Y Street
Room 1210
Sacramento, CA 95817

UC Davis Medical Center Infusion Pharmacy (PHE 51003)
2279 45th Street
Room 3262
Sacramento, CA 95817

U.C. Davis Medical Center
Pharmacy Receiving
2315 Stockton Blvd
Room 0762
Sacramento, CA 95817

UC Davis Discharge Pharmacy (PHE 59440)
2221 Stockton Blvd
Room 1130
Sacramento, CA 95817

SAFECOR
4060 BUSINESS PARK DR
STE B
COLUMBUS, OH 43204

UC Davis Medical Center
Hospital Receiving
7301 14th Ave
Sacramento, CA 95820

UC Davis Clinic Pharmacy in Davis (PHE 40255)
2660 W Covell Blvd
Davis, CA 95616

UC Davis Medical Center
Pharmacy Receiving
2315 Stockton Blvd.
Room 0761
Sacramento, CA 95817

Health Physics (Radiopharmaceutical Receiving for Main Hospital - DSH050599)
4800 2nd Ave.
FSSB Room 2500
Sacramento, CA 95817

Radiopharmaceutical Lab (Receiving for ACC PET - DSH050599BW)
ACC Lawrence J Ellison Bldg
4860 Y Street
Room 0603
Sacramento, CA 95817

HPC Laboratory (Cellular Therapy Receiving)
UC Davis Institute for Regenerative Cures
2921 Stockton Blvd
Sacramento, CA 95817

Nexus Pharmacy Solutions (WLE 8411)
3575 Business Dr
Suite 1404
Sacramento, CA 95820

UC Davis Health Solutions Pharmacy (PHE 59398)
3575 Business Dr
Suite 1702
Sacramento, CA 95820

UC Davis Health at Home (PHE 59397)
3575 Business Dr
Suite 1601
Sacramento, CA 95820

UC Davis C Street Infusion Pharmacy
3301 C Street
Suite 800C
Sacramento, CA 95816

UC Davis 48X Outpatient Pharmacy
4686 X Street
Suite 1500
Sacramento, CA 95817

UC Davis 48X OR Pharmacy
4868 X Street
Suite 2535
Sacramento, CA 95817

UC Davis Folsom Infusion Pharmacy
14264 Innovation Drive
Folsom, CA 95630
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACARIAHEALTH PHARMACY #11, INC1311 W SAM HOUSTON PKWY N STE 130
HOUSTONTX77043-401501/15/201904/01/2019 12/31/202404/10/2025
Contract DetailACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967901/15/201904/01/2019 12/31/202404/10/2025
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/17/201601/01/2017  07/13/2017
Contract DetailACCREDO HEALTH GROUP INC201 GREAT CIRCLE ROAD
NASHVILLETN3722810/17/201601/01/2017 04/06/201804/06/2018
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/17/201601/01/2017  07/13/2017
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/07/201710/01/2017  07/13/2017
Contract DetailACCREDO HEALTH GROUP INC2410 WARDLOW RD STE 101
CORONACA9287810/06/202001/01/2021  01/01/2021
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624110/17/201601/01/2017 06/30/202310/10/2023
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/17/201601/01/2017  07/13/2017
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/17/201601/01/2017  07/13/2017
Contract DetailACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607501/14/202204/01/2022  04/01/2022
Contract DetailADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280907/18/201710/01/2017  08/24/2021
Contract DetailAETNA SPECIALTY PHARMACY, LLC503 SUNPORT LN
ORLANDOFL32809-787407/01/201910/01/2019 02/18/202104/21/2023
Contract DetailANDERSON BROS FLORIN SQUARE PHCY2374 FLORIN RD
SACRAMENTOCA9582210/22/201210/22/2012  07/13/2017
Contract DetailANDERSON BROS TOWN & COUNTRY PHARMACYANDERSON BROS PHARMACY 2900 FULTON AVE
SACRAMENTOCA95821-491010/22/201210/22/2012 02/05/202012/19/2022
Contract DetailAVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582110/22/201210/22/2012 07/15/202007/28/2020
Contract DetailBEL AIR PHARMACY #5091039 SUNRISE AVENUE
ROSEVILLECA9566104/13/202207/01/2022  07/01/2022
Contract DetailBEL AIR PHARMACY #5165100 LAGUNA BLVD.
ELK GROVECA9575804/13/202207/01/2022  07/01/2022
Contract DetailBEL AIR PHARMACY #5172222 GRASS VALLEY HWY.
AUBURNCA9560310/10/201210/10/2012  08/24/2021
Contract DetailBEL AIR PHARMACY #5259435 ELK GROVE BLVD.
ELK GROVECA9562404/13/202207/01/2022  07/01/2022
Contract DetailBIOLOGICS, INC.BIOLOGICS BY MCKESSON 11800 WESTON PARKWAY
CARYNC2751301/13/202304/01/2023  04/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284101/08/201504/01/2015 02/15/201710/06/2017
Contract DetailBIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284110/12/202101/01/2022 03/02/202304/11/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526104/11/202307/01/2023  07/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267004/11/202307/01/2023  07/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771304/11/202307/01/2023  07/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620307/12/202410/01/2024  10/01/2024
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522607/12/202410/01/2024  10/01/2024
Contract DetailBIOPLUS SPECIALTY PHARMACY, INC3200 LAKE EMMA RD UNIT 1000
LAKE MARYFL3274610/12/202101/01/2022 03/02/202304/11/2023
Contract DetailBRIOVARX MRPBRIOVARX OF CALIFORNIA, INC. D/B/A BRIOV 1902-1910 MARENGO ST
LOS ANGELESCA9003307/18/201710/01/2017 10/26/201804/03/2019
Contract DetailBRIOVARX OF MAINE INCDBA BRIOVARX 53 DARLING AVE
SOUTH PORTLANDME0410607/18/201710/01/2017 01/14/202001/14/2020
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/03/201704/01/2017  08/24/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/12/202107/01/2021  07/01/2021
Contract DetailCENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506910/13/202101/01/2022  01/01/2022
Contract DetailCENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302510/13/202101/01/2022 07/07/202307/14/2024
Contract DetailCENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282407/14/202410/01/2024  10/01/2024
Contract DetailCORAM HEALTHCARE CORP OF NORTHERN CALIFODBA CORAM CVS/SPECIALTY INFUSION SERVICE 9332 TECH CENTER DRIVE SUITE 100
SACRAMENTOCA9582610/14/201901/01/2020 07/21/202204/11/2023
Contract DetailCRESCENT HEALTHCARE INC11980 TELEGRAPH RD SUITE 102
SANTA FE SPRINGSCA90670-608901/11/201804/01/2018 10/10/201910/18/2019
Contract DetailCRESCENT HEALTHCARE, INC.11980 TELEGRAPH RD. SUITE 100
SANTA FE SPRINGSCA90670-608907/07/201710/01/2017 12/31/201701/11/2018
Contract DetailCRESCENT HEALTHCARE, INC.25901 INDUSTRIAL BLVD BLDG E
HAYWARDCA94545-299501/10/201904/01/2019 10/10/201910/18/2019
Contract DetailCRESCENT HEALTHCARE, INC.CRESCENT HEALTHCARE 11980 TELEGRAPH RD STE 102
SANTA FE SPRINGSCA90670-608710/10/201910/10/2019  08/24/2021
Contract DetailCRESCENT HEALTHCARE, INC.DBA CRESCENT HEALTHCARE 25901 INDUSTRIAL BLVD BLDG E
HAYWARDCA94545-299510/10/201910/10/2019  08/24/2021
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/13/202101/01/2022  01/01/2022
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/13/202101/01/2022  01/01/2022
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/12/202107/01/2021  07/01/2021
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503304/15/202007/01/2020  07/01/2020
Contract DetailDIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268304/03/201907/01/2019 01/24/202201/25/2022
Contract DetailDIPLOMAT SPECIALTY PHARMACYG3320 BEECHER RD
FLINTMI48532-361404/03/201907/01/2019 12/31/201901/08/2020
Contract DetailDIPLOMAT SPECIALTY PHARMACY OF PHOENIX,DIPLOMAT SPECIALTY PHARMACY 485 N. JUNIPER DR
CHANDLERAZ8522607/01/201910/01/2019 07/14/202010/06/2020
Contract DetailDIPLOMAT SPECIALTY PHARMACY OF SOUTHERNDIPLOMAT SPECIALTY PHARMACY 1809 EXCISE AVENUE
SUITE 204-208 		ONTARIOCA9176104/03/201907/01/2019 07/02/201907/10/2019
Contract DetailESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/14/201901/01/2020  01/01/2020
Contract DetailEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/14/201901/01/2020  01/01/2020
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/14/201901/01/2020  01/01/2020
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/14/201901/01/2020  01/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 04950 3301 ZINFANDEL DR.
RANCHO CORDOVACA9567004/15/201507/01/2015  07/13/2017
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 5091 1771 PLEASANT GROVE BLVD.
SUITE 100 		ROSEVILLECA9574704/15/201507/01/2015  07/13/2017
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY# 2881 1120 FOREST AVE.
CHICOCA9592804/12/201907/01/2019  07/01/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16294 2355 W KETTLEMAN LN
LODICA9524204/12/201907/01/2019  07/01/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #7136 3710 FRANKLIN BLVD
SACRAMENTOCA9582004/12/201907/01/2019  07/01/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16856 280 SPRECKELS AVE
MANTECACA9533604/12/201907/01/2019 07/13/202007/15/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10005 6401 MACK RD.
SACRAMENTOCA9582304/12/201907/01/2019  07/01/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16857 8101 COSUMNES RIVER BLVD
SACRAMENTOCA9582304/12/201907/01/2019  07/01/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 5225 2636 MARCONI AVE.
SACRAMENTOCA9582101/08/202004/01/2020  04/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17342 2005 TOWN CENTER PLZ
WEST SACRAMENTOCA9569101/08/202004/01/2020  04/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00182 8400 BRADSHAW RD.
ELK GROVECA9562407/15/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17516 10881 OLSON DR
RANCHO CORDOVACA9567007/15/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17538 6507 4TH AVE
SACRAMENTOCA9581707/15/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16413 7505 LAGUNA BLVD
ELK GROVECA9575807/15/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS/PHARMACY #11342 2975 EAST ST
ANDERSONCA96007-348104/12/202107/01/2021  07/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.CVSPHARMACY # 16161 1280 DANA DR
REDDINGCA9600304/12/202107/01/2021  07/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17508 4601 2ND ST
DAVISCA9561810/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17344 4400 TOWN CENTER BLVD
EL DORADO HILLSCA9576210/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17292 950 GROVELAND LN
LINCOLNCA9564810/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17468 2185 BRONZE STAR DR
WOODLANDCA9577610/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16474 430 BLUE RAVINE RD
FOLSOMCA9563010/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16109 1153 BUTTE HOUSE RD
YUBA CITYCA9599110/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16833 10451 FAIRWAY DR
ROSEVILLECA9567810/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16473 2700 BELL RD
AUBURNCA9560310/12/202101/01/2022  01/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16106 1919 FULTON AVE
SACRAMENTOCA9582507/05/202210/01/2022  10/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17200 3601 N FREEWAY BLVD
SACRAMENTOCA9583407/05/202210/01/2022  10/01/2022
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16199 2059 CADENASSO DR
FAIRFIELDCA9453310/17/202201/01/2023  01/01/2023
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #17822 1707 J STREET
SACRAMENTOCA9581107/11/202310/01/2023 02/27/202411/06/2024
Contract DetailJCH LTC PHARMACY LLCDBA PUCCI'S LTC PHARMACY 1428 33RD ST
SACRAMENTOCA9581610/10/202301/01/2024  01/01/2024
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 01825 5040 LAGUNA BLVD
ELK GROVECA9575804/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 02290 1587 W EL CAMINO AVE
SACRAMENTOCA9583304/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 02661 4785 GRANITE DR
ROCKLINCA9567704/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03862 1030 PLEASANT GROVE BLVD
ROSEVILLECA9567804/15/201507/01/2015 08/16/202311/06/2024
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03943 5039 FOLSOM BLVD
SACRAMENTOCA9581904/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03945 1701 K ST
SACRAMENTOCA9581104/15/201507/01/2015 04/25/202311/06/2024
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 04151 2050 CLUB CENTER DR
SACRAMENTOCA9583504/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09142 1550 E COVELL BLVD
DAVISCA9561604/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09199 5420 DEWEY DR
FAIR OAKSCA9562804/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09282 1471 W COVELL BLVD
DAVISCA9561604/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09322 2085 FAIR OAKS BLVD
SACRAMENTOCA9582504/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09535 63 LINCOLN BLVD
LINCOLNCA9564804/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09546 3251 STANFORD RANCH RD
ROCKLINCA9576504/15/201507/01/2015 01/26/202304/21/2023
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09814 8101 GREENBACK LANE
FAIR OAKSCA9562804/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09823 1350 FLORIN ROAD
SACRAMENTOCA9582204/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09826 5333 ELKHORN BLVD
SACRAMENTOCA9584204/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09958 5090 FOOTHILLS BLVD
ROSEVILLECA9574704/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09992 3338 ARDEN WAY
SACRAMENTOCA9582504/15/201507/01/2015 01/18/202411/06/2024
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09993 9280 SIERRA COLLEGE BLVD
ROSEVILLECA9566104/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03066 8351 ELK GROVE FLORIN RD
SACRAMENTOCA9582904/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09972 7465 RUSH RIVER DR STE 500
SACRAMENTOCA9583104/15/201507/01/2015  07/13/2017
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09917 625 ELMIRA RD
VACAVILLECA9568704/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09819 191 DEPOT STREET
VACAVILLECA9568804/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07128 2780 ESPLANADE
CHICOCA9597304/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09932 1274 STABLER LN
YUBA CITYCA9599304/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03022 1063 C ST
GALTCA9563204/12/201907/01/2019 04/12/201905/31/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09691 906 E ST.
MARYSVILLECA9590104/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09713 1043 EMERALD BAY RD
SOUTH LAKE TAHOECA9615004/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09233 515 S STATE HIGHWAY 49
JACKSONCA9564204/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09943 949 11TH ST
LAKEPORTCA9545304/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 06793 3020 GREEN VALLEY RD STE B
CAMERON PARKCA9568204/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03937 455 SOUTH MAIN STREET
RED BLUFFCA9608004/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09490 6450 PONY EXPRESS TRL
POLLOCK PINESCA9572604/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09158 850 ORO DAM BLVD E
OROVILLECA9596504/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03022 1063 C ST
GALTCA9563204/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09147 2605 WEST MARCH LANE
STOCKTONCA9520704/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09184 3964 MISSOURI FLAT RD STE A
PLACERVILLECA9566704/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07506 1496 EAST AVE
CHICOCA9592604/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09243 1000 W KETTLEMAN LN
LODICA9524004/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09830 6632 PACIFIC AVENUE
STOCKTONCA9520704/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03908 1885 W 11TH ST
TRACYCA9537604/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09539 41 N MAIN ST
ANGELS CAMPCA9522204/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09174 11411 DEERFIELD DR
TRUCKEECA9616104/12/201907/01/2019  07/01/2019
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09526 8455 AUBURN FOLSOM RD
GRANITE BAYCA9574610/14/201901/01/2020  01/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09155 1005 SUTTON WAY
GRASS VALLEYCA9594501/08/202004/01/2020  04/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03009 3500 PALMER DR
CAMERON PARKCA9568201/08/202004/01/2020  04/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09390 200 E HIGHWAY 12 STE D
VALLEY SPRINGSCA9525201/08/202004/01/2020  04/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03947 10045 COMBIE RD
AUBURNCA9560201/08/202004/01/2020  04/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03911 1060 E CYPRESS AVE
REDDINGCA9600201/08/202004/01/2020  04/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09950 1057 N 1ST ST
DIXONCA9562007/15/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09809 4959 MARCONI AVE
CARMICHAELCA9560807/15/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09866 1190 N MAIN ST
MANTECACA9533604/12/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09208 13763 MONO WAY
SONORACA9537004/12/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09180 7 W MAIN ST
WOODLANDCA9569504/12/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09150 388 ELM ST.
AUBURNCA9560310/12/202101/01/2022  01/01/2022
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03909 4330 LATROBE RD
EL DORADO HILLSCA9576210/12/202101/01/2022  01/01/2022
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09132 9285 ELK GROVE BLVD
ELK GROVECA9562410/12/202101/01/2022  01/01/2022
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 02124 8585 ELK GROVE BLVD
ELK GROVECA9562410/12/202101/01/2022 05/08/202504/10/2025
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09487 8861 GREENBACK LN
ORANGEVALECA9566207/05/202210/01/2022 01/18/202304/21/2023
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09980 9479 MADISON AVE
FOLSOMCA9563007/05/202210/01/2022  10/01/2022
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03950 2790 E BIDWELL ST
FOLSOMCA9563010/17/202201/01/2023  01/01/2023
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09923 1005 E BIDWELL ST
FOLSOMCA9563004/21/202307/01/2023  07/01/2023
Contract DetailOPTION CAREOPTION CARE ENTERPRISES, INC. 132 MISSION RANCH BLVD.
CHICOCA95926-218610/10/201910/10/2019 04/09/202108/24/2021
Contract DetailOPTION CARE ENTERPRISES, INC.D/B/A OPTION CARE 11403 BLUEGRASS PARKWAY
SUITE 400 		LOUISVILLEKY40299-239804/11/201607/01/2016  08/24/2021
Contract DetailOPTION CARE ENTERPRISES, INC.OPTION CARE 132 MISSION RANCH BLVD.
CHICOCA95926-218607/07/201710/01/2017 10/10/201910/18/2019
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191307/18/201710/01/2017 10/23/202011/23/2020
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191310/10/202301/01/2024  01/01/2024
Contract DetailOPTUM FRONTIER THERAPIES, LLC325 W ATHERTON RD SUITE 1
FLINTMI48507-260110/10/202301/01/2024  01/01/2024
Contract DetailOPTUM INFUSION SERVICES 401, LLC4610 NORTHGATE BLVD. STE. 130
SACRAMENTOCA95834-115401/14/202004/01/2020  08/24/2021
Contract DetailOPTUM INFUSION SERVICES 401, LLC455 RESERVATION RD STE G
MARINACA93933-332807/15/202110/01/2021 08/02/202210/17/2022
Contract DetailOPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502904/12/202107/01/2021  07/01/2021
Contract DetailOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850701/20/202201/24/2022  01/24/2022
Contract DetailOPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520410/10/202301/01/2024  01/01/2024
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713007/18/201710/01/2017  08/24/2021
Contract DetailOPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824904/12/202107/01/2021  07/01/2021
Contract DetailOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729807/18/201710/01/2017  08/24/2021
Contract DetailOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140107/18/201710/01/2017  08/24/2021
Contract DetailOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/15/202110/01/2021  10/01/2021
Contract DetailOPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161807/15/202007/15/2020 06/18/202107/15/2021
Contract DetailOPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660801/14/202004/01/2020 05/27/202207/05/2022
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983807/15/202110/01/2021  10/01/2021
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999204/15/202007/01/2020 06/28/202207/05/2022
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/03/201704/01/2017  08/24/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 445 CASTRO STREET
SAN FRANCISCOCA9411407/07/201710/01/2017  07/13/2017
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/12/202107/01/2021  07/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/12/202107/01/2021  07/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681304/12/202107/01/2021  07/01/2021
Contract DetailPUCCI'S PHARMACY  TOMLIN INC
2821 J STREET 		SACRAMENTOCA9581610/22/201210/22/2012 08/26/201607/13/2017
Contract DetailPUCCI'S PHARMACYJCH PHARMACY HOLDINGS INC 3257 FOLSOM BLVD
SACRAMENTOCA95816-522008/23/201608/26/2016  07/13/2017
Contract DetailRALEY'S PHARMACY #22913384 LINCOLN WAY
AUBURNCA9560310/10/201210/10/2012  08/24/2021
Contract DetailRALEY'S PHARMACY #4154690 FREEPORT BLVD
SACRAMENTOCA9582204/13/202207/01/2022  07/01/2022
Contract DetailRALEY'S PHARMACY #4208391 FOLSOM BLVD.
SACRAMENTOCA9582610/10/201210/10/2012  08/24/2021
Contract DetailRALEY'S PHARMACY #4218870 MADISON AVENUE
FAIR OAKSCA9562810/10/201210/10/2012  08/24/2021
Contract DetailRALEY'S PHARMACY #4243935 PARK DRIVE SUITE B
EL DORADO HILLSCA9576210/10/201210/10/2012  08/24/2021
Contract DetailRALEY'S PHARMACY #4315159 FAIR OAKS BLVD.
CARMICHAELCA9560804/13/202207/01/2022  07/01/2022
Contract DetailRALEY'S PHARMACY #4434900 ELK GROVE BLVD.
ELK GROVECA9575804/13/202207/01/2022  07/01/2022
Contract DetailRALEY'S PHARMACY #4474650 NATOMAS BLVD.
SACRAMENTOCA9583510/10/201210/10/2012  08/24/2021
Contract DetailRIVER CITY PHARMACY, INC.OPTION CARE 3301 C ST., STE 450
SACRAMENTOCA95816-339304/11/201607/01/2016  08/24/2021
Contract DetailRIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500204/11/202307/01/2023  07/01/2023
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1794 1850 PRAIRIE CITY ROAD
FOLSOMCA9563010/22/201210/22/2012 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1746 10635 FOLSOM BLVD
RANCHO CORDOVACA9567010/22/201210/22/2012 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2684 1814 19TH STREET
SACRAMENTOCA9581112/21/201201/01/2013 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2697 2851 DEL PASO ROAD
SACRAMENTOCA9583512/21/201201/01/2013 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2242 1025 ALHAMBRA BLVD
SACRAMENTOCA9581612/21/201201/01/2013 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1258 1235 STRATFORD AVENUE
DIXONCA9562001/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1530 3320 ARDEN WAY
SACRAMENTOCA9582501/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1531 7301 GREENBACK LANE
CITRUS HEIGHTSCA9562101/15/201504/01/2015 01/02/202001/08/2020
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1617 8640 SIERRA COLLEGE BLVD.
ROSEVILLECA9566101/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1647 5021 LAGUNA BLVD
ELK GROVECA9575801/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1761 67 LINCOLN BLVD
LINCOLNCA9564801/15/201504/01/2015 07/11/201710/06/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1866 2220 SUNSET BLVD.
ROCKLINCA9576501/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1890 1080 PLEASANT GROVE BLVD
ROSEVILLECA9567801/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1895 5450 DEWEY DR
FAIR OAKSCA9562801/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1899 989 SUNRISE AVENUE
ROSEVILLECA9566101/15/201504/01/2015 01/02/202001/08/2020
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2620 9045 WOODCREEK OAKS BLVD
ROSEVILLECA9574701/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2683 2207 FRANCISCO DRIVE
EL DORADO HILLSCA9576201/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2778 12110 INDUSTRY BLVD.
JACKSONCA9564201/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #3122 2550 BELL ROAD
AUBURNCA9560301/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1618 3380 COACH LANE
CAMERON PARKCA9568201/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1846 8925 MADISON AVENUE
FAIR OAKSCA9562801/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #2707 6445 N PACIFIC AVE
STOCKTONCA9520701/15/201504/01/2015 02/12/201902/27/2019
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1109 2090 HARBISON DRIVE
VACAVILLECA9568701/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1648 2449 W KETTLEMAN LANE
LODICA9524201/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1769 2808 COUNTRY CLUB BLVD
STOCKTONCA9520401/15/201504/01/2015 12/29/201507/13/2017
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1724 3955 MISSOURI FLAT ROAD
PLACERVILLECA9566701/15/201504/01/2015 11/18/202401/14/2025
Contract DetailSANTA BARBARA SPECIALTY PHARMACY LLC4690 CARPINTERIA AVE STE B
CARPINTERIACA9301307/12/202410/01/2024  10/01/2024
Contract DetailSENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
PLANOTX7507401/08/202004/01/2020 08/15/202310/10/2023
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6264 8368 ELK GROVE FLORIN ROAD
SACRAMENTOCA9582907/11/201610/01/2016 02/05/201902/27/2019
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6077 4020 FLORIN ROAD
SACRAMENTOCA9582307/11/201610/01/2016 02/01/201803/06/2018
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6046 7900 ARCADIA DRIVE
CITRUS HEIGHTSCA9561007/11/201610/01/2016 06/14/201807/16/2018
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6457 2101 S STREET
SACRAMENTOCA9581607/11/201610/01/2016 02/05/201902/27/2019
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6070 2419 DEL PASO BOULEVARD
SACRAMENTOCA9581507/11/201610/01/2016 02/13/201803/06/2018
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6082 7900 FLORIN ROAD SUITE 5
SACRAMENTOCA9582807/11/201610/01/2016 02/05/201902/27/2019
Contract DetailTHRIFTY PAYLESS INC.RITE AID #6075 2214 EL CAMINO AVENUE
SACRAMENTOCA9582107/15/201610/01/2016 06/14/201807/16/2018
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6074 5610 STOCKTON BOULEVARD
SACRAMENTOCA9582407/12/201610/01/2016 04/23/202405/05/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6054 6639 WATT AVENUE
NORTH HIGHLANDSCA9566007/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6084 980 FLORIN ROAD
SACRAMENTOCA9583107/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6081 9133 KIEFER BOULEVARD
SACRAMENTOCA9582607/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6073 5712 FOLSOM BOULEVARD
SACRAMENTOCA9581907/12/201610/01/2016 03/28/202205/11/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6071 1125 ALHAMBRA BOULEVARD
SACRAMENTOCA9581607/12/201610/01/2016 05/03/202205/11/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6044 4010 MANZANITA AVENUE
CARMICHAELCA9560807/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6448 2751 DEL PASO ROAD
SACRAMENTOCA9583507/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6432 7211 ELK GROVE BOULEVARD
ELK GROVECA9575807/12/201610/01/2016 04/17/202405/05/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6086 4300 ELVERTA ROAD
ANTELOPECA9584307/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6059 2111 GOLDEN CENTRE LANE
RANCHO CORDOVACA9567007/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6266 526 EAST BIDWELL STREET
FOLSOMCA9563007/12/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6505 2211 F STREET
SACRAMENTOCA9581607/12/201610/01/2016 03/03/202203/09/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6049 6661 AUBURN BOULEVARD
CITRUS HEIGHTSCA9562107/11/201610/01/2016 05/08/202307/11/2023
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6403 4241 MARCONI AVENUE
SACRAMENTOCA9582107/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6076 4980 FREEPORT BOULEVARD
SACRAMENTOCA9582207/11/201610/01/2016 12/14/202301/11/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6083 7860 GERBER ROAD
SACRAMENTOCA9582807/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6065 1260 WEST CAPITOL AVENUE
WEST SACRAMENTOCA9569107/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6228 4221 NORWOOD AVENUE
SACRAMENTOCA9583807/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6079 1730 WATT AVENUE
SACRAMENTOCA9582507/11/201610/01/2016 10/05/202310/10/2023
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6520 4830 J STREET
SACRAMENTOCA9581907/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6080 1309 FULTON AVENUE
SACRAMENTOCA9582507/11/201610/01/2016 10/18/202301/11/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6069 831 K STREET
SACRAMENTOCA9581407/11/201610/01/2016 02/28/202203/09/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6458 990 PLEASANT GROVE BLVD
ROSEVILLECA9567807/11/201610/01/2016 05/05/202205/11/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6560 446 ROSEVILLE SQUARE
ROSEVILLECA9567807/11/201610/01/2016  10/17/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6045 5409 SUNRISE BOULEVARD
CITRUSHEIGHTSCA9561007/11/201610/01/2016 11/01/202301/11/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #4062 900 SUNRISE AVENUE
ROSEVILLECA9566107/11/201610/01/2016 09/12/202209/14/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6062 4004 FOOTHILLS BOULEVARD
ROSEVILLECA9574707/15/201610/01/2016 12/05/202301/11/2024
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6072 2801 K STREET STE 100
SACRAMENTOCA9581607/15/201610/01/2016 08/20/202110/26/2021
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/12/201704/01/2017 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-16978465 ELK GROVE BLVD
ELK GROVECA9575802/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-17601018 RILEY STREET
FOLSOMCA9563002/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-1988900 PLEASANT GROVE BLVD
ROSEVILLECA9567802/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-245710655 FOLSOM BLVD.
RANCHO CORDOVACA9567002/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-25983661 TRUXEL ROAD
SACRAMENTO (NW)CA9583302/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-27356051 FLORIN ROAD
SACRAMENTOCA9582302/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-35875454 CROSSING DR.
ROCKLINCA9567702/26/201304/01/2013 05/31/202307/11/2023
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/12/201704/01/2017 05/31/202307/11/2023
Contract DetailWALGREEN CODBA: WALGREENS #10482 7850 WEST LANE
STOCKTONCA9521011/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CODBA: WALGREENS #07191 6199 SUNRISE BOULEVARD
CITRUS HEIGHTSCA9561011/14/201211/14/2012 02/20/202404/03/2024
Contract DetailWALGREEN CODBA: WALGREENS #10693 6819 WATT AVE
NORTH HIGHLANDSCA95660-320311/14/201211/14/2012 02/20/202404/03/2024
Contract DetailWALGREEN CODBA: WALGREENS #10716 250 FLORIN RD
SACRAMENTOCA9583111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CODBA: WALGREENS #10114 3521 DEL PASO ROAD
SACRAMENTOCA9583511/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 01940 1955 W TEXAS STREET
FAIRFIELDCA9453311/14/201211/14/2012 02/28/202202/28/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 02680 15 W HARDING WAY
STOCKTONCA9520411/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 02770 7929 LOWER SACRAMENTO RD.
STOCKTONCA9521011/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 02961 75 NORTH HAM LANE
LODICA9524211/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #02170 12120 NEW AIRPORT RD
AUBURNCA9560311/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06658 6325 FAIR OAKS BLVD
CARMICHAELCA9560811/14/201211/14/2012 04/30/202504/10/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 05774 7787 SUNRISE BLVD
CITRUS HEIGHTSCA9561011/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05152 6144 DEWEY DRIVE
CITRUS HEIGHTSCA9562111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06142 9200 ELK GROVE FLORIN RD
ELK GROVECA9562411/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06612 8400 ELK GROVE FLORIN ROAD
ELK GROVECA95624-945011/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06417 1100 RILEY ST
FOLSOMCA9563011/14/201211/14/2012 10/09/202310/10/2023
Contract DetailWALGREEN CO.DBA: WALGREENS # 09048 2595 E BIDWELL ST
FOLSOMCA9563011/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12525 700 TWELVE BRIDGES DR
LINCOLNCA9564811/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04414 8900 GREENBACK LANE
ORANGEVALECA9566211/14/201211/14/2012 04/14/201707/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #11823 4220 MISSOURI FLAT RD
PLACERVILLECA9566711/14/201211/14/2012 04/09/202405/05/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 02644 2010 ALAMO DRIVE
VACAVILLECA9568711/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04198 1351 W CAPITOL AVE
WEST SACRAMENTOCA9569111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04107 10 WEST MAIN ST.
WOODLANDCA9569511/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #09532 4050 SUNRISE BLVD
RANCHO CORDOVACA9574211/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06036 4051 DOUGLAS BLVD
GRANITE BAYCA95746-590111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05501 3999 FOOTHILLS BLVD
ROSEVILLECA9574711/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06419 9180 FRANKLIN BLVD
ELK GROVECA9575811/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05499 7299 LAGUNA BLVD
ELK GROVECA9575811/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12840 8230 SARATOGA WAY
EL DORADO HILLSCA9576211/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06915 2177 SUNSET BLVD
ROCKLINCA95765-474311/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #11262 840 EL CAMINO AVE
SACRAMENTOCA95815-251311/14/201211/14/2012 11/08/202301/11/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05374 2900 STOCKTON BLVD
SACRAMENTOCA9581711/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06613 1401 BROADWAY
SACRAMENTOCA9581811/14/201211/14/2012 01/23/202502/11/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 04136 1919 FRUITRIDGE RD.
SACRAMENTOCA9582211/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06706 7155 24TH STREET
SACRAMENTOCA9582211/14/201211/14/2012 01/29/202502/11/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 05036 4495 MACK RD
SACRAMENTOCA9582311/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12365 8275 BRUCEVILLE RD
SACRAMENTOCA9582311/14/201211/14/2012 04/14/201707/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06193 2201 ARDEN WAY
SACRAMENTOCA9582511/14/201211/14/2012 04/09/202405/05/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #13597 1420 MEADOWVIEW RD
SACRAMENTOCA9583211/14/201211/14/2012 11/07/201912/19/2019
Contract DetailWALGREEN CO.DBA: WALGREENS # 06807 5020 MADISON AVE
SACRAMENTOCA95841-260511/14/201211/14/2012 11/06/201912/19/2019
Contract DetailWALGREEN CO.DBA: WALGREENS # 05500 4331 ANTELOPE ROAD
SACRAMENTOCA9584311/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04170 4200 ARDEN WAY
SACRAMENTOCA9586411/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 02277 602 10TH STREET
MARYSVILLECA9590111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12527 2293 RIVER OAKS BLVD
PLUMAS LAKECA9596111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 00993 855 COLUSA AVE
YUBA CITYCA9599111/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA; WALGREENS #12259 1640 LINCOLN RD
YUBA CITYCA9599311/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07433 1781 COLUSA HWY
YUBA CITYCA95993-909611/14/201211/14/2012  07/13/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #15195 10701 FOLSOM BLVD.
RANCHO CORDOVACA9567004/12/201707/01/2017 06/01/202006/01/2020
Contract DetailWALGREEN CO.DBA: WALGREENS #15602 4195 NORWOOD AVE
SACRAMENTOCA9583804/12/201707/01/2017 11/06/201912/19/2019
Contract DetailWALGREEN CO.DBA: WALGREENS #16058 1492 BLUE OAKS BLVD
ROSEVILLECA9574704/12/201707/01/2017  07/13/2017
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #04318 4129 18TH STREET
SAN FRANCISCOCA9411404/13/202207/01/2022  07/01/2022
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #21141 217 ALMA ST STE 200
PALO ALTOCA9430104/13/202207/01/2022  07/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS #10599 4014 PLAZA GOLDORADO CIR.
CAMERON PARKCA9568207/05/202210/01/2022 01/27/202501/27/2025
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15987 1020 29TH ST STE 140
SACRAMENTOCA9581604/21/202307/01/2023  07/01/2023
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528404/08/201307/01/2013 12/31/201701/11/2018
Contract DetailWALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904904/08/201307/01/2013 08/24/201507/13/2017
Contract DetailWALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528410/16/201701/01/2018  10/16/2017
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818804/15/202007/01/2020  07/01/2020
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527504/15/202007/01/2020  07/01/2020
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700804/15/202007/01/2020 10/11/202110/12/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503304/15/202007/01/2020  07/01/2020
Contract DetailWALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528610/16/201701/01/2018  10/16/2017
Contract DetailWELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706204/11/201407/01/2014 07/04/201807/20/2018
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH050599AAChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSPINE CLINIC AT C STREET3301 C STREETSacramentoCAActive
DSH050599ABChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICIAL MEDICINE AND REHABILITATION OCCUPATIONAL THERAPY CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599ACChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERVASCULAR CENTER LAB AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599ADChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERHBC-RADIOLOGY-ELLISON ACC4860 Y STREETSacramentoCAActive
DSH050599AEChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERRADIOLOGY ULTRASOUND AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599AFChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERMRI AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599AGChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERNEUROLOGY CLINIC3160 Folsom BlvdSacramentoCAActive
DSH050599AHChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERNEUROSURGERY CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599AJChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERENT SPEECH CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCAActive
DSH050599AKChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION SPEECH THERAPY CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCATerminated
DSH050599ALChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION OCCUPATIONAL THERAPY CLINIC2825 J STREETSacramentoCATerminated
DSH050599AMChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION CLINIC2825 J STREETSacramentoCATerminated
DSH050599ANChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROPHTHALMOLOGY CLINIC AT UCDMG ROSEVILLE2261 Douglas BlvdRosevilleCATerminated
DSH050599APChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUCDMC HOME HEALTH10850 White Rock RoadRancho CordovaCAActive
DSH050599AQChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUCDMC HOSPICE10850 White Rock RoadRancho CordovaCAActive
DSH050599AUChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERFAMILY PRACTICE CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599AXChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCARDIAC REHABILITATION CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599AYChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCARDIOLOGY CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599AZChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCT HEAD AND BODY SCANNING CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599BChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCANCER CENTER4501 X STREETSACRAMENTOCATerminated
DSH050599BBChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERDERMATOLOGY CLINIC AT FOLSOM1370 Prairie City RoadFolsomCATerminated
DSH050599BCChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERGENERAL INTERNAL MEDICINE CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599BDChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERJ STREET MEDICAL SPECIALTY CLINIC2825 J StreetSacramentoCAActive
DSH050599BFChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROPHTHALMOLOGY CLINIC AT CADILLAC DRIVE77 Cadillac DriveSacramentoCATerminated
DSH050599BGChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERMIND INSTITUTE CLINIC2825 50th StreetSacramentoCAActive
DSH050599BHChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERNEUROSCIENCE CLINIC AT AMBULATORY CARE CENTER4860 Y StreetSacramentoCATerminated
DSH050599BJChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERNON-INVASIVE VASCULAR LAB AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599BKChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROBSTETRICS AND GYNECOLOGY CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599BLChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERORTHOPEDICS CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599BMChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPAIN CLINIC AT AMBULATORY CARE CENTER4860 Y StreetSacramentoCAActive
DSH050599BNChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION CLINIC4860 Y STREETSacramentoCAActive
DSH050599BPChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION HAND THERAPY CLINIC4860 Y STREETSacramentoCATerminated
DSH050599BQChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPHYSICAL MEDICINE AND REHABILITATION PHYSICAL THERAPY CLINIC4860 Y STREETSacramentoCATerminated
DSH050599BRChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERRADIOLOGY DIAGNOSTICS AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCATerminated
DSH050599BTChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROPHTHALMOLOGY CLINIC4860 Y STREETSacramentoCAActive
DSH050599BUChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUROLOGY CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599BVChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERENT Procedures2521 Stockton BlvdSacramentoCAActive
DSH050599BWChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPET Radiology Clinic (ACC)4860 Y StreetSacramentoCATerminated
DSH050599BXChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERANESTHESIOLOGY / ANESTHESIOLOGY GLASSROCK2521 STOCKTON BLVD, STE 5200SACRAMENTOCATerminated
DSH050599BYChildDSHUC DAVIS MEDICAL CENTERUNIVERSITY WOMENS CLINIC / BREAST HEALTH CENTER4860 Y STREET, STE 0540SACRAMENTOCATerminated
DSH050599BZChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPLACER CENTER FOR HEALTH / ROCKLIN INFUSION550 WEST RANCH VIEW DRROCKLINCAActive
DSH050599CAChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPM&R SPINE CENTER / PHYSICAL THERAPY3301 C STSACRAMENTOCAActive
DSH050599CBChildDSHUC DAVIS MEDICAL CENTEROphthalmology Clinic / Ophthalmology251 Turnpike Dr, Ste 1070FolsomCATerminated
DSH050599CCChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSpeech Pathology / PM&R Speech Therapy4860 Y StreetSacramentoCATerminated
DSH050599CDChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERAdult IV Infusion Center 3rd Floor2279 45th StSacramentoCAActive
DSH050599CEChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPediatric IV Infusion Center2279 45th StSacramentoCAActive
DSH050599CFChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center Clinic / BMT Transplant Program2279 45th StSacramentoCATerminated
DSH050599CGChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center Clinic / Pediatrics Cancer Center Clinic2279 45th StSacramentoCATerminated
DSH050599CHChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center / Cancer Center Clinics2279 45th StSacramentoCAActive
DSH050599CJChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center / Radiation Oncology4501 X StSacramentoCAActive
DSH050599CKChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUC DAVIS MEDICAL CENTER / CT Head and Body Scanning at Glassrock2521 Stockton BlvdSACRAMENTOCAActive
DSH050599CLChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUC DAVIS MEDICAL CENTER / RADIOLOGY SPINE CLINIC3301 C STSACRAMENTOCAActive
DSH050599CMChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUC DAVIS MEDICAL CENTER / PM&R EMG LABORATORY4860 Y STREETSACRAMENTOCAActive
DSH050599CNChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCANCER CENTER CLINIC / ADULT IV INFUSION CENTER4501 X STREETSACRAMENTOCAActive
DSH050599CPChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERADULT INFUSION / GLASSROCK INFUSION2521 STOCKTON BLVDSACRAMENTOCATerminated
DSH050599CQChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERMEDICAL GI SPECIALTY CLINIC - SACTO CLINIC / GI3160 Folsom BlvdSACRAMENTOCAActive
DSH050599CRChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPEDIATRIC NEUROLOGY3160 Folsom BlvdSACRAMENTOCAActive
DSH050599CSChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSLEEP LAB3160 Folsom BlvdSACRAMENTOCAActive
DSH050599CTChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERELECTROMYOGRAPHY3160 Folsom BlvdSACRAMENTOCAActive
DSH050599CUChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERELECTROENCEPHALOGRAPHY3160 Folsom BlvdSACRAMENTOCAActive
DSH050599CVChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERGastroenterology Glassrock / GLASSROCK NON-CHEMOTHERAPY INFUSION2521 STOCKTON BLVDSACRAMENTOCATerminated
DSH050599CWChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROTOLARYGOLOGY GLASSROCK / REFLUX CLINIC 2521 STOCKTON BLVDSACRAMENTOCATerminated
DSH050599CXChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center / BMT Transplant Program4501 X StSACRAMENTOCATerminated
DSH050599CYChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center Clinic4501 X StreetSACRAMENTOCAActive
DSH050599CZChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERNEUROSCIENCES CLINIC / NEUROSURGERY CLINIC3160 FOLSOM BLVDSACRAMENTOCAActive
DSH050599DAChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERALZHEIMERS DISEASE AND DIAGNOSTIC TREATMENT CENTER4860 Y STSACRAMENTOCATerminated
DSH050599DBChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSPORTS MEDICINE CLINIC3301 C STSACRAMENTOCAActive
DSH050599DCChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSURGERY PEDIATRIC GLASSROCK2521 STOCKTON BLVDSACRAMENTOCATerminated
DSH050599DEChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERMidtown Multispecialty Clinic - Multispecialty3160 Folsom BlvdSacramentoCATerminated
DSH050599DFChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERMIDTOWN GI LAB - GI3160 Folsom BlvdSacramentoCAActive
DSH050599DGChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERRadiology Midtown Imaging - Radiology3160 Folsom BlvdSacramentoCAActive
DSH050599DHChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUC DAVIS MEDICAL CENTER - PAIN SERVICE CLINIC3301 C STSACRAMENTOCAActive
DSH050599DJChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERGYNECOLOGY CLINIC - Midtown OB3160 Folsom BlvdSacramentoCATerminated
DSH050599DKChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPEDIATRIC CANCER CENTER - Pediatric Oncology2279 45th StreetSacramentoCAActive
DSH050599DLChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERENT PEDIATRICS - OTOLARYNGOLOGY CLINIC PEDIATRICS2521 STOCKTON BLVDSACRAMENTOCATerminated
DSH050599DMChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERUC DAVIS MEDICAL CENTER - PULMONARY REHAB J ST2825 J StreetSacramentoCAActive
DSH050599DNChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERApheresis/Vascular Access - Apheresis Services2521 Stockton BlvdSacramentoCAActive
DSH050599DPChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROperating Room - Surgical Admission Center4860 Y StreetSacramentoCAActive
DSH050599DQChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCardiac Cath Lab - PHC Echocardiography Lab4860 Y StreetSacramentoCAActive
DSH050599DRChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center Clinic - Supportive Oncology Services4501 X StSacramentoCAActive
DSH050599DSChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERCancer Center Clinic - Supportive Oncology Services2279 45th StSacramentoCAActive
DSH050599DTChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPain Service Clinic - Pain Clinic at TEI4860 Y StreetSacramentoCAActive
DSH050599DUChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPain Service Clinic - AIM Services Glassrock2521 Stockton BlvdSacramentoCATerminated
DSH050599DVChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERHBC Wound Care Ellison - HBC Wound Care Clinic Ellison4860 Y StreetSacramentoCAActive
DSH050599DWChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPediatric Specialist Clinic - Pediatric Ambulatory Service Clinic77 Cadillac DrSacramentoCAActive
DSH050599DXChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERElectrocardiology - Cardiac Cath Lab - PHC Echocardiography Lab77 Cadillac DrSacramentoCAActive
DSH050599DYChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPAIN SERVICE CLINIC - AIM SERVICES2279 45th StreetSacramentoCAActive
DSH050599DZChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERBone Marrow Transplant - Cancer Center Clinics -Benign Hematology3301 C StreetSacramentoCATerminated
DSH050599FChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSURGERY CLINIC2221 Stockton BlvdSacramentoCAActive
DSH050599FAChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPhysical Therapy - PM&R TRAUMATC BRAIN INJURY4860 Y StreetSacramentoCAActive
DSH050599FBChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPsychiatry BHC - ADV PSYCH THRPY CLINIC-ACC4860 Y StreetSacramentoCAActive
DSH050599HChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERTRANSPLANT CLINIC2221 Stockton BlvdSacramentoCAActive
DSH050599KChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSPECIALTY INTERNAL MEDICINE CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599LChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTEROBSTETRICS AND GYNECOLOGY CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCATerminated
DSH050599MChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERHBC - Otolaryngology Clinic - Glassrock2521 Stockton BlvdSacramentoCAActive
DSH050599NChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERDENTAL CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCAActive
DSH050599PChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPEDIATRIC INFUSION CENTER AT GLASSROCK2521 Stockton BlvdSacramentoCATerminated
DSH050599RChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERENT AUDIOLOGY CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCAActive
DSH050599SChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPEDIATRIC CARDIOLOGY CLINIC2521 Stockton BlvdSacramentoCATerminated
DSH050599TChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPEDIATRIC AMBULATORY SERVICE CLINIC AT GLASSROCK2521 Stockton BlvdSacramentoCAActive
DSH050599UChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERSAME DAY SURGERY CENTER4845 2ND AVESACRAMENTOCAActive
DSH050599VChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERGI OUTREACH AT PLACER CENTER FOR HEALTH550 W. Ranch View Dr.ROCKLINCAActive
DSH050599WChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERVASCULAR CENTER CLINIC AT AMBULATORY CARE CENTER4860 Y STREETSacramentoCAActive
DSH050599XChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERRADIOLOGY AT PLACER CENTER FOR HEALTH550 W. Ranch View Dr.RocklinCAActive
DSH050599YChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERDERMATOLOGY CLINIC AT C STREET3301 C StreetSacramentoCAActive
DSH050599ZChildDSHUNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTERPLASTIC SURGERY CLINIC AT C STREET3301 C STREETSacramentoCAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingNPI: NumberInsertChange Request 15182058634/8/2025 10:47 AM
Medicaid BillingNPI: StateInsertChange Request NV4/8/2025 10:47 AM
AddressesShipping AddressInsertChange Request UC Davis C Street Infusion Pharmacy 3301 C Street Suite 800C Sacramento, CA 958163/25/2025 7:41 AM
AddressesShipping AddressInsertChange Request UC Davis 48X Outpatient Pharmacy 4686 X Street Suite 1500 Sacramento, CA 958173/25/2025 7:41 AM
AddressesShipping AddressInsertChange Request UC Davis 48X OR Pharmacy 4868 X Street Suite 2535 Sacramento, CA 958173/25/2025 7:41 AM
AddressesShipping AddressInsertChange Request UC Davis Folsom Infusion Pharmacy 14264 Innovation Drive Folsom, CA 956303/25/2025 7:41 AM
Medicaid BillingNPI: NumberDeleteGroup Change Request1700804200 (CA) 11/4/2024 6:22 PM
Medicaid BillingNPI: NumberDeleteGroup Change Request1700804200 (NV) 11/4/2024 6:22 PM
AddressesShipping AddressUpdateChange RequestHPC Laboratory aka Progenitor Cell Lab (Cellular Therapy Receiving) 4501 X Street Room 1011 Sacramento, CA 95817HPC Laboratory (Cellular Therapy Receiving) UC Davis Institute for Regenerative Cures 2921 Stockton Blvd Sacramento, CA 9581710/7/2024 7:09 AM
ContactsAuthorizing OfficialUpdateAO Change RequestSousa, Noel Interim CFO UC Davis Health 9164967593Doll, Jennifer L Chief Financial Officer UC Davis Health 91670827089/12/2024 7:19 AM
DetailsLast Recertification DateUpdateRecertification8/22/2023 12:50:15 AM8/22/2024 1:36:08 PM8/22/2024 1:36 PM
AddressesShipping AddressUpdateChange RequestUC Davis Clinic Pharmacy in Davis 2660 W Covell Blvd Davis, CA 95616UC Davis Clinic Pharmacy in Davis (PHE 40255) 2660 W Covell Blvd Davis, CA 956166/28/2024 8:24 AM
AddressesShipping AddressDeleteChange RequestUC Davis Health at Home - Home Infusion Pharmacy 550 W. Ranch View Drive Suite 1600 Rocklin, CA 95765 6/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestPAVILION PHARMACY AT UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD ROOM 1P175 SACRAMENTO, CA 95817Pavilion Pharmacy at UC Davis Medical Center (PHE 50265) 2315 Stockton Blvd Room 1P175 Sacramento, CA 958176/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestUC Davis Medical Center Placer Center for Health Pharmacy 550 W. Ranch View Drive Suite 1600 Rocklin, CA 95765UC Davis Medical Center Placer Center for Health Pharmacy (PHE 51004) 550 W. Ranch View Drive Suite 1600 Rocklin, CA 957656/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestU.C. Davis Medical Center Cypress Pharmacy 2221 Stockton Blvd Room 1130 Sacramento, CA 95817UC Davis Discharge Pharmacy (PHE 59440) 2221 Stockton Blvd Room 1130 Sacramento, CA 958176/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestAmbulatory Care Center Pharmacy 4860 Y Street Room 1210 Sacramento, CA 95817Ambulatory Care Center Pharmacy (PHE 43732) 4860 Y Street Room 1210 Sacramento, CA 958176/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestU.C. Davis Medical Center Cancer Center Pharmacy 4501 X Street Room 1008 Sacramento, CA 95817U.C. Davis Medical Center (PHE 37804) Cancer Center Pharmacy 4501 X Street Room 1008 Sacramento, CA 958176/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestUC Davis Medical Center Infusion Pharmacy 2279 45th Street Room 3262 Sacramento, CA 95817UC Davis Medical Center Infusion Pharmacy (PHE 51003) 2279 45th Street Room 3262 Sacramento, CA 958176/28/2024 8:24 AM
AddressesShipping AddressUpdateChange RequestUC Davis Medical Center 3575 Business Dr. Ste 1404 Sacramento, CA 95820Nexus Pharmacy Solutions (WLE 8411) 3575 Business Dr Suite 1404 Sacramento, CA 958202/1/2024 6:47 AM
AddressesShipping AddressInsertChange Request UC Davis Medical Center 3575 Business Dr. Ste 1404 Sacramento, CA 958201/29/2024 7:50 AM
AddressesShipping AddressInsertChange Request UC Davis Health Solutions Pharmacy (PHE 59398) 3575 Business Dr Suite 1702 Sacramento, CA 958201/29/2024 7:50 AM
AddressesShipping AddressInsertChange Request UC Davis Health at Home (PHE 59397) 3575 Business Dr Suite 1601 Sacramento, CA 958201/29/2024 7:50 AM
ContactsAuthorizing OfficialUpdateAO Change RequestSadro, Cheryl Ann Chief Financial Officer UC Davis Health 9167035009Sousa, Noel Interim CFO UC Davis Health 91649675931/8/2024 7:02 AM
DetailsLast Recertification DateUpdateRecertification9/15/2022 10:35:23 AM8/22/2023 12:50:15 AM8/22/2023 12:50 AM
AddressesShipping AddressUpdateChange RequestUC Davis Medical Center 7301 14th Ave Sacramento, CA 95820UC Davis Medical Center Hospital Receiving 7301 14th Ave Sacramento, CA 958207/12/2023 7:38 AM
AddressesShipping AddressInsertChange Request Health Physics (Radiopharmaceutical Receiving for Main Hospital - DSH050599) 4800 2nd Ave. FSSB Room 2500 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressInsertChange Request Radiopharmaceutical Lab (Receiving for ACC PET - DSH050599BW) ACC Lawrence J Ellison Bldg 4860 Y Street Room 0603 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressInsertChange Request HPC Laboratory aka Progenitor Cell Lab (Cellular Therapy Receiving) 4501 X Street Room 1011 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressUpdateChange RequestU.C. Davis Medical Center 2221 Stockton Boulevard Room 1130 Sacramento, CA 95817U.C. Davis Medical Center Cypress Pharmacy 2221 Stockton Blvd Room 1130 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressUpdateChange RequestAmbulatory Care Center Pharmacy 4860 Y Street Sacramento, CA 95817Ambulatory Care Center Pharmacy 4860 Y Street Room 1210 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressUpdateChange RequestU.C. Davis Medical Center 4501 X STREET ROOM 1008 SACRAMENTO, CA 95817U.C. Davis Medical Center Cancer Center Pharmacy 4501 X Street Room 1008 Sacramento, CA 958177/12/2023 7:38 AM
AddressesShipping AddressUpdateChange RequestU.C. Davis Medical Center 2315 Stockton Blvd Room 0762 Sacramento, CA 95817U.C. Davis Medical Center Pharmacy Receiving 2315 Stockton Blvd Room 0762 Sacramento, CA 958177/12/2023 7:38 AM
ContactsPrimary ContactUpdateProfile Change RequestRiggle, Mark Assistant Chief Pharmacist UC Davis Medical Center 9167343305Riggle, Mark Assistant Chief Pharmacist UC Davis Medical Center 91673433091/10/2023 4:45 PM
Medicaid BillingMedicaid: NumberDeleteRecertification1114932712 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1700804200 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1578639308 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1710918545 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1578639308 (NV) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1396498580 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1710918545 (NV) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1700804200 (NV) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1336487685 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1427396779 (CA) 9/15/2022 10:35 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1518205863 (CA) 9/15/2022 10:35 AM
DetailsLast Recertification DateUpdateRecertification9/15/2021 1:01:09 PM9/15/2022 10:35:23 AM9/15/2022 10:35 AM
AddressesShipping AddressInsertChange Request UC Davis Health at Home - Home Infusion Pharmacy 550 W. Ranch View Drive Suite 1600 Rocklin, CA 957659/13/2022 2:25 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False9/13/2022 2:25 PM
Medicaid BillingMedicaid: NumberInsertChange Request 13964985809/13/2022 2:25 PM
Medicaid BillingMedicaid: StateInsertChange Request CA9/13/2022 2:25 PM
Medicaid BillingNPI: NumberInsertChange Request 13964985809/13/2022 2:25 PM
Medicaid BillingNPI: StateInsertChange Request CA9/13/2022 2:25 PM
AddressesShipping AddressDeleteChange RequestCentral Admixture Pharmacy Services Inc 48006 Fremont Blvd Fremont, CA 94538 4/14/2022 8:17 AM
AddressesShipping AddressInsertChange Request UC Davis Medical Center Pharmacy Receiving 2315 Stockton Blvd. Room 0761 Sacramento, CA 958174/14/2022 8:17 AM
ContactsAuthorizing OfficialUpdateAO Change RequestMAURICE, TIMOTHY CHIEF FINANCIAL OFFICER University of California, Davis 9167344055Sadro, Cheryl Ann Chief Financial Officer UC Davis Health 91670350094/8/2022 8:09 AM
DetailsLast Recertification DateUpdateRecertification9/14/2020 4:50:06 PM9/15/2021 1:01:09 PM9/15/2021 1:01 PM
AddressesBilling AddressInsertGroup Change Request UC Davis Medical Center Accounts Payable PO Box 168016 Sacramento, CA 958167/15/2021 4:56 PM
Medicaid BillingMedicaid: NumberUpdate 1700804200 170080420012/10/2020 4:18 PM
AddressesShipping AddressInsertRecertification UC Davis Clinic Pharmacy in Davis 2660 W Covell Blvd Davis, CA 956169/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1578639308 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1114932712 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1710918545 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1700804200 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 11149327129/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 13364876859/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 14273967799/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 15182058639/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 15786393089/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 17008042009/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 17109185459/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification CA9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 15786393089/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification NV9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 17008042009/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification NV9/14/2020 4:50 PM
Medicaid BillingNPI: NumberInsertRecertification 17109185459/14/2020 4:50 PM
Medicaid BillingNPI: StateInsertRecertification NV9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1336487685 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1427396779 ( ) 9/14/2020 4:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1518205863 ( ) 9/14/2020 4:50 PM
DetailsLast Recertification DateUpdateRecertification8/26/2019 5:07:49 PM9/14/2020 4:50:06 PM9/14/2020 4:50 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/2/2020 7:09 PM
Medicaid BillingMedicaid: NumberInsertChange Request 11149327126/2/2020 7:09 PM
Medicaid BillingMedicaid: StateInsertChange Request CA6/2/2020 7:09 PM
Medicaid BillingNPI: NumberInsertChange Request 11149327126/2/2020 7:09 PM
DetailsLast Recertification DateUpdateRecertification8/27/2018 10:28:10 AM8/26/2019 5:07:49 PM8/26/2019 5:07 PM
AddressesShipping AddressInsertChange Request UC Davis Medical Center 7301 14th Ave Sacramento, CA 958204/26/2019 2:43 PM
ContactsAuthorizing OfficialUpdateChange RequestMAURICE, TIMOTHY CHIEF FINANCIAL OFFICER UC Davis Medical Center 9167344055MAURICE, TIMOTHY CHIEF FINANCIAL OFFICER University of California, Davis 916734405512/4/2018 7:41 AM
DetailsLast Recertification DateUpdateRecertification11/29/2017 1:44:30 PM8/27/2018 10:28:10 AM8/27/2018 10:28 AM
AddressesShipping AddressInsertChange Request Central Admixture Pharmacy Services Inc 48006 Fremont Blvd Fremont, CA 945383/12/2018 7:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/22/2018 12:50 PM
Medicaid BillingMedicaid: NumberInsertChange Request 13364876851/22/2018 12:50 PM
Medicaid BillingMedicaid: StateInsertChange Request CA1/22/2018 12:50 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/22/2018 12:50 PM
Medicaid BillingMedicaid: NumberInsertChange Request 14273967791/22/2018 12:50 PM
Medicaid BillingMedicaid: StateInsertChange Request CA1/22/2018 12:50 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/22/2018 12:50 PM
Medicaid BillingMedicaid: NumberInsertChange Request 15182058631/22/2018 12:50 PM
Medicaid BillingMedicaid: StateInsertChange Request CA1/22/2018 12:50 PM
Medicaid BillingNPI: NumberInsertChange Request 13364876851/22/2018 12:50 PM
Medicaid BillingNPI: NumberInsertChange Request 14273967791/22/2018 12:50 PM
Medicaid BillingNPI: NumberInsertChange Request 15182058631/22/2018 12:50 PM
AddressesShipping AddressInsertChange Request SAFECOR 4060 BUSINESS PARK DR STE B COLUMBUS, OH 4320412/14/2017 11:00 AM
DetailsLast Recertification DateUpdateRecertification8/17/2016 12:00:00 AM11/29/2017 1:44:30 PM11/29/2017 1:44 PM
ContactsPrimary ContactInsertChange Request Riggle, Mark Assistant Chief Pharmacist UC Davis Medical Center 91673433059/29/2017 6:44 PM
ContactsAuthorizing OfficialUpdateChange RequestMAURICE, TIMOTHY CHIEF FINANCIAL OFFICER 9167344055MAURICE, TIMOTHY CHIEF FINANCIAL OFFICER UC Davis Medical Center 91673440559/29/2017 4:05 PM
ContactsAuthorizing OfficialUpdate MCGOWAN, WILLIAM CFO 9167349129MAURICE, TIMOTHY CHIEF FINANCIAL OFFICER 91673440557/18/2017 10:19 AM
AddressesMain AddressInsert   2315 STOCKTON BLVD SACRAMENTO, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  PAVILION PHARMACY AT UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD ROOM 1P175 SACRAMENTO, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  UC Davis Medical Center Placer Center for Health Pharmacy 550 W. Ranch View Drive Suite 1600 Rocklin, CA 957657/13/2017 10:01 AM
AddressesShipping AddressInsert  U.C. Davis Medical Center 2221 Stockton Boulevard Room 1130 Sacramento, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  Ambulatory Care Center Pharmacy 4860 Y Street Sacramento, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  U.C. Davis Medical Center 4501 X STREET ROOM 1008 SACRAMENTO, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  U.C. Davis Medical Center 2315 Stockton Blvd Room 0762 Sacramento, CA 958177/13/2017 10:01 AM
AddressesShipping AddressInsert  UC Davis Medical Center Infusion Pharmacy 2279 45th Street Room 3262 Sacramento, CA 958177/13/2017 10:01 AM
DetailsLast Recertification DateUpdate 8/28/2015 12:00:00 AM8/17/2016 12:00:00 AM8/17/2016 1:03 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False10/9/2015 2:25 PM
Medicaid BillingMedicaid: NumberInsert  171091854510/9/2015 2:25 PM
Medicaid BillingMedicaid: StateInsert  NV10/9/2015 2:25 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False10/9/2015 2:25 PM
Medicaid BillingMedicaid: NumberInsert  1700804200 10/9/2015 2:25 PM
Medicaid BillingMedicaid: StateInsert  NV10/9/2015 2:25 PM
DetailsLast Recertification DateUpdate 8/26/2014 12:00:00 AM8/28/2015 12:00:00 AM8/28/2015 12:40 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False12/10/2014 7:27 AM
Medicaid BillingMedicaid: NumberInsert  157863930812/10/2014 7:27 AM
Medicaid BillingMedicaid: StateInsert  NV12/10/2014 7:27 AM
DetailsLast Recertification DateUpdate 8/28/2013 12:00:00 AM8/26/2014 12:00:00 AM8/26/2014 6:33 AM
Medicaid BillingNPI: NumberInsert  171091854510/18/2013 12:39 PM
Medicaid BillingNPI: NumberInsert  170080420010/18/2013 12:39 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False8/28/2013 6:57 AM
Medicaid BillingMedicaid: NumberInsert  17008042008/28/2013 6:57 AM
Medicaid BillingMedicaid: StateInsert  CA8/28/2013 6:57 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False8/28/2013 6:57 AM
Medicaid BillingMedicaid: NumberInsert  15786393088/28/2013 6:57 AM
Medicaid BillingMedicaid: StateInsert  CA8/28/2013 6:57 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False8/28/2013 6:57 AM
Medicaid BillingMedicaid: NumberInsert  17109185458/28/2013 6:57 AM
Medicaid BillingMedicaid: StateInsert  CA8/28/2013 6:57 AM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM8/28/2013 12:00:00 AM8/28/2013 6:57 AM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/23/2012 8:34 AM
ContactsAuthorizing OfficialInsert  MCGOWAN, WILLIAM CFO 91673491299/2/2010 11:44 AM
Medicaid BillingNPI: NumberInsert  157863930810/30/2007 1:52 PM
DetailsLast Recertification DateInsert   10/30/2007 1:52 PM
DetailsGrant NumberInsert   10/30/2007 1:52 PM
Details340B IDInsert  DSH05059910/30/2007 1:52 PM
DetailsIs Authorizing Official EHB DataInsert   10/30/2007 1:52 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/30/2007 1:52 PM
DetailsMedicare Provider NumberInsert  05059910/30/2007 1:52 PM
DetailsEntity NameInsert  UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER10/30/2007 1:52 PM
DetailsProgram CodeInsert  DSH10/30/2007 1:52 PM
DetailsEntity SubnameInsert   10/30/2007 1:52 PM
DatesParticipating Approval DateInsert  10/30/2007 12:00:00 AM10/30/2007 1:52 PM
DetailsStateInsert  Active10/30/2007 1:52 PM
DatesRegistration DateInsert  10/30/2007 12:00:00 AM10/30/2007 1:52 PM
DatesSigned By DateInsert   10/30/2007 1:52 PM
DatesStart DateInsert  1/1/1999 12:00:00 AM10/30/2007 1:52 PM
TerminationsTermination CommentsInsert   10/30/2007 1:52 PM
TerminationsTermination DateInsert   10/30/2007 1:52 PM
TerminationsTermination Effective DateInsert   10/30/2007 1:52 PM
TerminationsTermination ReasonInsert   10/30/2007 1:52 PM
DetailsComments PublicInsert  9/2/10 MEDI ID ADDED10/30/2007 1:52 PM