340B Drug Pricing Program Database

Effective Sunday, September 1, OPA is implementing a change to the export format for Medicaid and NPI numbers. This change affects covered entity exports that include Medicaid and/or NPI billing numbers, and the CE Daily Report in Excel format. If the number is associated with more than one state, all the states will be listed between one set of parentheses following the number - for example, 1275575227 (IN,MI,OH). This change is necessary to ensure that the exported data does not exceed Excel’s limit for field length.

CH093640 FAMILY HEALTHCARE NETWORK (Active) - information as of 9/29/2024 5:32:42 PM

Main Details
FAMILY HEALTHCARE NETWORK
FHCN - PORTERVILLE CENTER
HRSA-Funded Health Center
BPS-H80-002499
CH093640
H80CS00786


Additional Details
Active
4/1/1997
4/1/1997
12/19/2003
2/16/2024

Contacts

Family HealthCare Network
Kerry Hydash, President and CEO
(559) 737-4700

Family HealthCare Network
Chad Vawter, CFO
(559) 737-4700

Addresses

1107 W Poplar Ave
Porterville, CA 93257-5839

FAMILY HEALTHCARE NETWORK
305 East Center Ave
Visalia, CA 93291


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
ADD BILL TO/NEW CONTACT08/12/2005
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
CA 1083611156,1316257959,1154772705,1619302031,1932613536,1386295350,1871144329,1699423814
Shipping Addresses

Same as Street Address
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
HOUSTONTX77043-401510/17/202201/01/2023  01/01/2023
Contract DetailACARIAHEALTH PHARMACY #13, INC3302 GARFIELD AVE.
COMMERCECA90040-310210/17/202201/01/2023  01/01/2023
Contract DetailACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967910/17/202201/01/2023  01/01/2023
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/15/201801/01/2019  01/01/2019
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/15/201801/01/2019 08/01/202002/19/2021
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/15/201801/01/2019  01/01/2019
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/15/201801/01/2019 08/01/202002/19/2021
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624110/15/201801/01/2019 08/01/202002/19/2021
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/15/201801/01/2019 08/01/202002/19/2021
Contract DetailALTO PHARMACY LLCDBA ALTO PHARMACY 2360 QUME DR
STE A 		SAN JOSECA9513110/17/202201/01/2023  01/01/2023
Contract DetailALTO PHARMACY, LLCDBA ALTO PHARMACY 1400 TENNESSEE ST UNIT 2
SAN FRANCISCOCA94107-342110/17/202201/01/2023  01/01/2023
Contract DetailAMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/09/202004/01/2020  04/01/2020
Contract DetailAMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700307/13/202410/01/2024  07/13/2024
Contract DetailAMAZON PHARMACY #008408 TECHNOLOGY PARKWAY BUILDING B, STE 101
COLLEGE STATIONTX7784507/13/202410/01/2024  07/13/2024
Contract DetailAMAZON PHARMACY #0097469 KINGSPOINTE PKWY STE 400
ORLANDOFL3281907/13/202410/01/2024  07/13/2024
Contract DetailAMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287907/13/202410/01/2024  07/13/2024
Contract DetailAVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508504/12/201807/01/2018 07/15/202002/19/2021
Contract DetailAVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582104/12/201807/01/2018 07/15/202002/19/2021
Contract DetailAZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503401/09/202004/01/2020  04/01/2020
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526110/14/201901/01/2020  01/01/2020
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771310/14/201901/01/2020  01/01/2020
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267007/13/202410/01/2024  07/13/2024
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522607/13/202410/01/2024  07/13/2024
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620307/13/202410/01/2024  07/13/2024
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361410/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621910/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175710/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808310/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700410/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761710/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DRIVE
SUITE 107 		BARTLETTTN3813310/15/201801/01/2019  01/01/2019
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237410/15/201801/01/2019  01/01/2019
Contract DetailCAREPLUS HEALTHCARE INCD/B/A VALLEY PHARMACY 560 W PUTNAM AVE STE 2
PORTERVILLECA93257-326907/12/202110/01/2021  10/01/2021
Contract DetailCENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506904/05/202204/07/2022  04/07/2022
Contract DetailCENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302504/05/202204/07/2022 07/07/202301/08/2024
Contract DetailCENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282407/13/202410/01/2024  07/13/2024
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CARELONRX MAIL OR CF 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/12/202110/01/2021  10/01/2021
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK OR CARELONRX MAIL 1780 WALL ST
MT PROSPECTIL6005607/12/202110/01/2021  10/01/2021
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/15/201801/01/2019  01/01/2019
Contract DetailDINUBA PHARMACYDINUBA PHARMACY 172 N L ST.
DINUBACA9361804/15/201907/01/2019  07/01/2019
Contract DetailDIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268310/14/202101/01/2022  01/01/2022
Contract DetailDOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K 		GREENVILLESC29607-654010/14/201901/01/2020  01/01/2020
Contract DetailESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/15/202207/19/2022  07/19/2022
Contract DetailEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/15/202207/19/2022  07/19/2022
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/15/202207/19/2022  07/19/2022
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/15/202207/19/2022  07/19/2022
Contract DetailFOUNDATION CARE LLC111 CHESTERFIELD INDUSTRIAL BLVD STE 115
CHESTERFIELDMO6300510/17/202201/01/2023  01/01/2023
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00035 800 N. WESTWOOD ST.
PORTERVILLECA9325707/09/201510/01/2015  07/09/2015
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02711 2135 N. DINUBA BLVD.
VISALIACA9329107/09/201510/01/2015 02/14/201704/30/2018
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02944 53 E. OLIVE AVE.
PORTERVILLECA9325707/09/201510/01/2015  07/09/2015
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05551 109 SOUTH WEST ST.
TULARECA9327407/09/201510/01/2015  07/09/2015
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17477 1363 W HENDERSON AVE
PORTERVILLECA9325704/03/201707/01/2017  04/03/2017
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17520 3308 N DINUBA BLVD
VISALIACA9329104/03/201707/01/2017  04/03/2017
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16928 4247 S MOONEY BLVD
VISALIACA9327704/07/202004/09/2020  04/09/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00912 2175 E. BARDSLEY AVE.
TULARECA9327404/07/202004/09/2020  04/09/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17025 140 N 12TH AVE
HANFORDCA9323004/07/202004/09/2020  04/09/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17414 2195 E PROSPERITY AVE
TULARECA9327404/07/202004/09/2020  04/09/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02541 1102 N. DEMAREE ST.
VISALIACA9329104/07/202004/09/2020  04/09/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10074 5995 EAST KINGS CANYON RD
FRESNOCA9372707/14/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16108 3173 E SHIELDS AVE
FRESNOCA9372607/14/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 06772 4987 N. FRESNO ST.
FRESNOCA9372607/14/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16084 3150 W SHAW AVE
FRESNOCA9371107/14/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05422 5180 E. KINGS CANYON ROAD
FRESNOCA9372707/14/202010/01/2020  10/01/2020
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16136 900 SHAW AVE
CLOVISCA9361204/08/202107/01/2021  07/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10801 6720 N. FRESNO ST.
FRESNOCA9371007/12/202110/01/2021  10/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 11339 777 S. HARBOR BLVD., SUITE E-164
LA HABRACA9063107/12/202110/01/2021  10/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16337 7600 N BLACKSTONE AVE
FRESNOCA9372007/12/202110/01/2021  10/01/2021
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08895 775 E. FOOTHILL BOULEVARD
POMONACA9176707/12/202110/01/2021  10/01/2021
Contract DetailGENOA HEALTHCARE LLC11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGSCA9067010/14/202101/01/2022  01/01/2022
Contract DetailGENOA HEALTHCARE LLC1850 W FLORIDA AVE
HEMETCA9254510/14/202101/01/2022  01/01/2022
Contract DetailGENOA HEALTHCARE LLC17782 COWAN ST STE G
IRVINECA9261410/14/202101/01/2022  01/01/2022
Contract DetailGENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205810/14/202101/01/2022  01/01/2022
Contract DetailGENOA HEALTHCARE LLC245 11TH ST STE P1
SAN FRANCISCOCA9410310/14/202101/01/2022  01/01/2022
Contract DetailGENOA HEALTHCARE LLC1393 BAILEY DR STE 149
HANFORDCA9323001/08/202404/01/2024  04/01/2024
Contract DetailGENOA HEALTHCARE LLC2550 WEST CLINTON AVE STE 123
FRESNOCA9370501/08/202404/01/2024  04/01/2024
Contract DetailIC PHARMACY LLCAMAZON PHARMACY #004 34 35TH STREET
STE 4BSW, UNIT 28 		BROOKLYNNY1123207/13/202410/01/2024  07/13/2024
Contract DetailIVANHOE PHARMACY  33060 RD 159
IVANHOECA93235-123501/16/201404/01/2014 01/31/201601/16/2017
Contract DetailKROGER SPECIALTY INFUSION CA19110 VAN NESS AVE.
TORRANCECA9050107/15/202207/19/2022  07/19/2022
Contract DetailKROGER SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/15/202207/19/2022  07/19/2022
Contract DetailKROGER SPECIALTY PHARMACY INC.3200 LAKE EMMA RD UNIT 1000
LAKE MARYFL32746-335807/15/202207/19/2022  07/19/2022
Contract DetailLA PHARMACY LLC1048 S GARFIELD AVE STE 101
ALHAMBRACA9180104/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09271 3619 W. CALDWELL AVE
VISALIACA9327707/09/201510/01/2015  07/09/2015
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09500 1455 E NOBLE AVE
VISALIACA9329207/09/201510/01/2015  07/09/2015
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09845 1155 W HENDERSON AVE
PORTERVILLECA9325707/09/201510/01/2015  07/09/2015
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09176 1395 E PROSPERITY AVE
TULARECA9327404/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09893 2539 N 11TH AVE
HANFORDCA9323004/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09171 2900 STANDIFORD AVE
MODESTOCA9535004/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09377 1065 W MANNING AVE
REEDLEYCA9365404/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09828 574 W LACEY BLVD
HANFORDCA9323004/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 04652 590 W PUTNAM AVE
PORTERVILLECA9325704/07/202004/09/2020  04/09/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09983 929 SIERRA ST
KINGSBURGCA9363107/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09149 6750 N CEDAR AVE
FRESNOCA9371007/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09592 1435 E GRAND AVE
ARROYO GRANDECA9342007/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09846 6800 N MILBURN AVE
FRESNOCA9372207/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07553 3011 E SHIELDS AVE
FRESNOCA9372607/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09129 1302 FULTON MALL
FRESNOCA9372107/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03034 333 ACADEMY AVE
SANGERCA9365707/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09537 1325 W SHIELDS AVENUE
FRESNOCA9370507/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09971 4077 W CLINTON AVE
FRESNOCA9372207/14/202010/01/2020  10/01/2020
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09994 728 W SHAW AVE
FRESNOCA9370404/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09159 1109 COUNTRY CLUB DR
MADERACA9363804/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09801 10 SHAW AVE
CLOVISCA9361204/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07910 1794 ASHLAN AVE
CLOVISCA9361104/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09865 7096 N WEST AVE
FRESNOCA9371104/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09933 1405 HERNDON AVENUE
CLOVISCA9361104/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09320 686 LIGHTHOUSE AVE
MONTEREYCA9394004/08/202107/01/2021  07/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534807/12/202110/01/2021  10/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09935 40044 HIGHWAY 49
OAKHURSTCA9364407/12/202110/01/2021  10/01/2021
Contract DetailM.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312604/12/201807/01/2018  04/12/2018
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191304/07/202004/09/2020  04/09/2020
Contract DetailOPTUM INFUSION SERVICES 401, LLC4610 NORTHGATE BLVD. STE. 130
SACRAMENTOCA95834-115404/14/202307/01/2023  07/01/2023
Contract DetailOPTUM INFUSION SERVICES 550, LLC1819 ASTON AVE STE 104
CARLSBADCA9200801/08/202404/01/2024  04/01/2024
Contract DetailOPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502910/15/202101/01/2022  01/01/2022
Contract DetailOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/05/202204/07/2022  04/07/2022
Contract DetailOPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520401/08/202404/01/2024  04/01/2024
Contract DetailOPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302501/08/202404/01/2024  04/01/2024
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/07/202004/09/2020  04/09/2020
Contract DetailOPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824904/14/202307/01/2023  07/01/2023
Contract DetailOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729804/14/202307/01/2023  07/01/2023
Contract DetailOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140104/07/202004/09/2020 10/01/202110/14/2021
Contract DetailOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140104/14/202307/01/2023  07/01/2023
Contract DetailOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/15/202007/15/2020  07/22/2020
Contract DetailOPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161807/15/202007/15/2020 10/01/202110/14/2021
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/14/202101/01/2022  01/01/2022
Contract DetailOPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660810/14/202101/01/2022 05/27/202202/24/2023
Contract DetailOVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805204/07/202004/09/2020 07/01/202407/13/2024
Contract DetailPILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310104/12/201807/01/2018  04/12/2018
Contract DetailPILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231907/13/202410/01/2024  07/13/2024
Contract DetailPORTERVILLE PHARMACY406 W PUTNAM AVE
PORTERVILLECA9325710/16/201701/01/2018  10/16/2017
Contract DetailPORTERVILLE PHARMACY #21270 W HENDERSON AVE
PORTERVILLECA9325707/16/201810/01/2018  10/01/2018
Contract DetailPREMIER PHARMACY SERVICES410 CLOVERLEAF DR
BALDWIN PARKCA9170604/14/202007/01/2020  07/01/2020
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999210/15/201801/01/2019 10/01/202210/17/2022
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514610/15/201801/01/2019  01/01/2019
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 445 CASTRO STREET
SAN FRANCISCOCA9411404/08/202107/01/2021  07/01/2021
Contract DetailRAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103 		NEWBURGHNY1255010/14/201901/01/2020  01/01/2020
Contract DetailRALEY'S PHARMACY #34040041 HIGHWAY 49
OAKHURSTCA9364407/12/202410/01/2024  07/12/2024
Contract DetailRIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500210/14/201901/01/2020  01/01/2020
Contract DetailSAVE MART PHARMACY # 657  3615 W. NOBLE AVENUE
VISALIACA9327710/14/201301/01/2014 09/30/202204/14/2023
Contract DetailSAVE MART PHARMACY #45  900 WEST HENDERSON
PORTERVILLECA9325710/14/201301/01/2014 09/30/202204/14/2023
Contract DetailSAVE MART PHARMACY #522179 SHAW AVE
CLOVISCA93611-893707/14/202010/01/2020 09/30/202204/14/2023
Contract DetailSAVE MART PHARMACY #83  5203 WEST WALNUT AVE
VISALIACA9327701/16/201404/01/2014 09/30/202204/14/2023
Contract DetailSAVE MART PHARMACY #89  5201 W. GOSHEN AVE
VISALIACA9329107/05/201610/01/2016 09/30/202204/14/2023
Contract DetailSENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
PLANOTX7507404/05/202204/07/2022  04/07/2022
Contract DetailSIERRA VISTA PHARMACY, INC.650 E VISALIA RD
FARMERSVILLECA9322307/14/202010/01/2020  10/01/2020
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #1756 1650 HERNDON AVENUE
CLOVISCA9361101/08/202404/01/2024  04/01/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #2188 8949 NORTH CEDAR AVENUE
FRESNOCA9372001/08/202404/01/2024  04/01/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #2701 3100 FOWLER AVENUE
CLOVISCA9361101/08/202404/01/2024  04/01/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #1754 5638 EAST KINGS CANYON RD
FRESNOCA9372707/13/202410/01/2024  07/13/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #2409 40044 HIGHWAY 49
STE D 		OAKHURSTCA9364407/13/202410/01/2024  07/13/2024
Contract DetailTHRIFTY PAYLESS INC.RITE AID #5852 2200 EAST EL MONTE WAY
DINUBACA9361810/15/201301/01/2014 02/05/201903/22/2019
Contract DetailTHRIFTY PAYLESS INC.RITE AID #5803 110 EAST CROSS AVENUE
TULARECA9327404/19/201607/01/2016 04/03/201807/16/2018
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5795 1051 W VISALIA RD
EXETERCA9322110/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5796 707 WEST LACEY BOULEVARD
HANFORDCA9323010/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5798 262 NORTH HIGHWAY 65
LINDSAYCA9324710/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5799 66 WEST MORTON AVENUE
PORTERVILLECA9325710/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5805 2727 SOUTH MOONEY BLVD.
VISALIACA9327710/15/201301/01/2014 01/19/202202/24/2023
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5806 5212 WEST WALNUT AVENUE
VISALIACA9327710/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6459 1735 E WALNUT AVENUE
VISALIACA9329210/15/201301/01/2014  10/15/2013
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6764 1710 N FARMERSVILLE BLVD
FARMERSVILLECA9322304/19/201607/01/2016  04/19/2016
Contract DetailTHRIFTY PAYLESS, INC.DBA RITE AID #6723 160 E ANTELOPE AVE
WOODLAKECA9328604/19/201607/01/2016  04/19/2016
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5861 4224 EAST SHIELDS AVENUE
FRESNOCA9372604/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5794 1809 CECIL AVENUE
DELANOCA9321504/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5865 2011 WEST SHAW AVENUE
FRESNOCA9371104/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6295 1101 FRESNO STREET
FRESNOCA9370604/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5869 3795 WEST SHIELDS AVENUE
FRESNOCA9372204/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #4072 2020 E COPPER AVENUE
FRESNOCA9373004/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5863 6074 NORTH 1ST AVE.
FRESNOCA9371004/15/201907/01/2019 03/15/202202/24/2023
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6476 2990 EAST NEES AVENUE
FRESNOCA9372004/15/201907/01/2019 03/31/202205/24/2022
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6289 4593 NORTH CEDAR AVENUE
FRESNOCA9372604/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6454 1645 E TULARE AVENUE
TULARECA9327404/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6378 8027 NORTH CEDAR AVENUE
FRESNOCA9372004/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5862 1210 NORTH BLACKSTONE AVENUE
FRESNOCA9370304/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6475 820 N LEMOORE AVENUE
LEMOORECA9324504/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6243 2500 NORTH 10TH AVENUE
HANFORDCA9323004/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6395 1500 WHITLEY AVENUE
CORCORANCA9321204/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5872 5574 EAST KINGS CANYON
FRESNOCA9372704/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6522 875 NORTH ALTA AVENUE
DINUBACA9361804/15/201907/01/2019  07/01/2019
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #6475 820 N LEMOORE AVENUE
LEMOORECA9324504/15/201907/01/2019 02/10/202002/11/2020
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5858 1721 EAST MANNING AVENUE
REEDLEYCA9365407/13/202310/01/2023  10/01/2023
Contract DetailTRUEPILL3121 DIABLO AVE
HAYWARDCA9454504/07/202004/09/2020 07/01/202407/13/2024
Contract DetailTRUXTUN PHARMACY DELANO1228 JEFFERSON ST
DELANOCA9321504/12/202407/01/2024  07/01/2024
Contract DetailUNIVERSITY MEDICAL CENTER PHARMACY290 N WAYTE LN FL 1
FRESNOCA93701-212407/16/201810/01/2018  10/01/2018
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738607/17/201710/01/2017  10/01/2017
Contract DetailWAL-MART PHARMACY 10-1645250 S 12TH AVE
HANFORDCA9323001/10/201404/01/2014 05/29/201601/16/2017
Contract DetailWAL-MART PHARMACY 10-1645250 S 12TH AVE
HANFORDCA9323007/16/201810/01/2018  10/01/2018
Contract DetailWAL-MART PHARMACY 10-18154080 W SHAW AVE
FRESNOCA9372207/13/202410/01/2024  07/13/2024
Contract DetailWAL-MART PHARMACY 10-18261819 EAST NOBLE AVE.
VISALIACA9329201/10/201404/01/2014  01/10/2014
Contract DetailWAL-MART PHARMACY 10-18771250 WEST HENDERSON AVE
PORTERVILLECA9325701/10/201404/01/2014  01/10/2014
Contract DetailWAL-MART PHARMACY 10-18823400 FLORAL AVE
SELMACA9366207/14/202010/01/2020  10/01/2020
Contract DetailWAL-MART PHARMACY 10-20015125 EAST KINGS CANYON
FRESNOCA9372707/13/202410/01/2024  07/13/2024
Contract DetailWAL-MART PHARMACY 10-25361110 EAST PROSPERITY AVE
TULARECA9327401/10/201404/01/2014  01/10/2014
Contract DetailWAL-MART PHARMACY 10-5215530 WOOLLOMES AVE
DELANOCA9321507/14/202010/01/2020  10/01/2020
Contract DetailWAL-MART PHARMACY 10-5394770 WEST EL MONTE WAY
DINUBACA9361801/10/201404/01/2014  01/10/2014
Contract DetailWAL-MART PHARMACY 10-56351320 N DEMAREE ST
VISALIACA9329104/19/201607/01/2016  04/19/2016
Contract DetailWAL-MART PHARMACY 10-59563750 S MOONEY BLVD.
VISALIACA9327701/10/201404/01/2014  01/10/2014
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283707/17/201710/01/2017  10/01/2017
Contract DetailWAL-MART PHARMACY WHSE #452250 NORTH 8TH STREET SUITE 102-A
ROGERSAR7275607/13/202410/01/2024  07/13/2024
Contract DetailWALGREEN CODBA: WALGREENS #11612 12 W HANFORD ARMONA RD
LEMOORECA93245-232007/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CODBA: WALGREENS #10243 2420 N BLACKSTONE AVE
FRESNOCA93703-174710/06/202001/01/2021 12/14/202012/14/2020
Contract DetailWALGREEN CODBA: WALGREENS #10243 2420 N BLACKSTONE AVE
FRESNOCA93703-174704/08/202107/01/2021  07/01/2021
Contract DetailWALGREEN CODBA: WALGREENS #10335 2424 N BRAWLEY AVE
FRESNOCA9372204/08/202107/01/2021  07/01/2021
Contract DetailWALGREEN CODBA: WALGREENS #09702 5785 N FIRST ST
FRESNOCA93710-620307/12/202110/01/2021  10/01/2021
Contract DetailWALGREEN CODBA: WALGREENS #11242 2020 W CLEVELAND AVE
MADERACA9363710/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 02869 1407 N DINUBA BLVD
VISALIACA9329107/17/201310/01/2013 05/30/201806/11/2018
Contract DetailWALGREEN CO.DBA: WALGREENS # 03476 100 W WALNUT AVE
VISALIACA9327707/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 05411 710 W GRANGEVILLE BLVD
HANFORDCA9323007/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 06298 49 W TULARE AVE
TULARECA9327407/17/201310/01/2013 07/27/202008/28/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 06683 5328 W CYPRESS AVENUE
VISALIACA9327707/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS #09844 416 W. OLIVE AVE
PORTERVILLECA9325707/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 10002 1418 EAST PROSPERITY AVENUE
TULARECA93274-805407/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 10201 170 W EL MONTE WAY
DINUBACA93618-156107/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS #11407 3010 N DEMAREE ST
VISALIACA93291-714707/17/201310/01/2013  07/17/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 06082 626 S CLOVIS AVE
FRESNOCA9372707/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA: WALGREENS #12574 1219 N CEDAR AVE
FRESNOCA9370307/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA: WALGREENS # 06942 6010 N FIGARDEN DRIVE
FRESNOCA93722-603007/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA WALGREENS #06386 4810 E KINGS CANYON RD
FRESNOCA93727-380907/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA: WALGREENS # 07266 8975 N CHESTNUT AVE
FRESNOCA9372007/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA: WALGREENS #11877 4771 W ASHLAN AVE
FRESNOCA9372207/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA: WALGREENS # 13871 1016 W SHAW AVE
FRESNOCA9371107/16/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA WALGREENS #16382 2323 16TH ST., SUITE 100
BAKERSFIELDCA9330110/15/201801/01/2019  01/01/2019
Contract DetailWALGREEN CO.DBA: WALGREENS #12761 41169 GOODWIN WAY SUITE 110
MADERACA93636-876610/15/201801/01/2019  01/01/2019
Contract DetailWALGREEN CO.DBA: WALGREENS #12298 852 E MANNING AVE
REEDLEYCA9365404/08/202004/09/2020  04/09/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 07830 205 W SHAW AVENUE
CLOVISCA93612-360210/06/202001/01/2021  01/01/2021
Contract DetailWALGREEN CO.DBA: WALGREENS # 09815 988 SIERRA STREET
KINGSBURGCA9363110/06/202001/01/2021  01/01/2021
Contract DetailWALGREEN CO.DBA: WALGREENS # 05847 610 E NEES AVENUE
FRESNOCA9372004/08/202107/01/2021  07/01/2021
Contract DetailWALGREEN CO.DBA: WALGREENS #12282 2589 JENSEN AVE
SANGERCA9365710/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS #12337 2795 FLORAL AVE
SELMACA93662-260310/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 06453 1300 W YOSEMITE AVE
MADERACA9363710/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 12707 4172 N. 1ST STREET
FRESNOCA9372610/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 07204 7015 N WEST AVE
FRESNOCA93711-046110/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 06387 1815 HERNDON AVE
CLOVISCA9361110/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA WALGREENS #10827 1435 HIGH ST.
DELANOCA9321510/14/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 10334 1790 SHAW AVE
CLOVISCA9361110/14/202101/01/2022  01/01/2022
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/17/201310/01/2013 07/08/201507/09/2015
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700810/15/201801/01/2019 10/01/202110/17/2022
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PHARMACY #15438 41460 HAGGERTY CIRCLE SOUTH
CANTONMI4818810/15/201801/01/2019  01/01/2019
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/15/201801/01/2019  01/01/2019
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/15/201801/01/2019  01/01/2019
Contract DetailWALMART PHARMACY 10-26893131 N CEDAR AVENUE
FRESNOCA9370307/13/202410/01/2024  07/13/2024
Contract DetailWALMART PHARMACY 10-56321804 EAST ASHLAN AVE.
FRESNOCA9372607/13/202410/01/2024  07/13/2024
Contract DetailWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616807/13/202410/01/2024  07/13/2024
Contract DetailWESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E 		SAN DIEGOCA9210204/12/201807/01/2018  04/12/2018
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH093640ActiveBPS-H80-002499FAMILY HEALTHCARE NETWORKFHCN - PORTERVILLE CENTER1107 W Poplar Ave PortervilleCA
CH09364AActiveBPS-H80-001686FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - IVANHOE HEALTH CENTER33025 Road 159 IvanhoeCA
CH09364AAActiveBPS-H80-022256Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 2100FresnoCA
CH09364ABActiveBPS-H80-022250Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 2500FresnoCA
CH09364ACActiveBPS-H80-022249Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 2300FresnoCA
CH09364ADActiveBPS-H80-022150Family Healthcare NetworkFamily HealthCare Network - Surgical Consultation Center255 N. Herwaldt Drive FresnoCA
CH09364AEActiveBPS-H80-022147Family Healthcare NetworkFamily HealthCare Network - ACC290 N. Wayte Lane,Suite 1700FresnoCA
CH09364AFActiveBPS-H80-022151Family Healthcare NetworkFamily HealthCare Network - Dinuba Health Center324 N Vermont Ave. DinubaCA
CH09364AGActiveBPS-H80-021676Family Healthcare NetworkFamily HealthCare Network - Mobile Van #231180 Road 72 VisaliaCA
CH09364AHActiveBPS-H80-022358Family Healthcare NetworkFamily HealthCare Network - ACC290 N. Wayte Lane, Suite 1300 FresnoCA
CH09364AJActiveBPS-H80-024962Family Healthcare NetworkFamily HealthCare Network - Fresno Illinois2210 E. Illinois Ave. STE 206 FresnoCA
CH09364AKTerminatedBPS-H80-022125Family Healthcare NetworkFamily HealthCare Network - Chronic Care Management Center2315 E. Illinois Avenue FresnoCA
CH09364ALActiveBPS-H80-027045Family Healthcare NetworkFamily HealthCare Network - Visalia Mooney2333 S Mooney Blvd VisaliaCA
CH09364AMActiveBPS-H80-027365Family Healthcare NetworkFamily HealthCare Network - Porterville Downtown65 N Hockett St PortervilleCA
CH09364ANActiveBPS-H80-027708Family Healthcare NetworkFamily HealthCare Network - Selma1850 Whitson St. SelmaCA
CH09364APActiveBPS-H80-028327Family Healthcare NetworkFamily HealthCare Network - Reedley826 E Manning Ave ReedleyCA
CH09364AQActiveBPS-H80-028329Family Healthcare NetworkFamily HealthCare Network - Exeter330 E Pine St ExeterCA
CH09364ARActiveBPS-H80-028328Family Healthcare NetworkFamily HealthCare Network - Squaw Valley30924 E Kings Canyon Rd Squaw ValleyCA
CH09364ASActiveBPS-H80-028326Family Healthcare NetworkFamily HealthCare Network - Farmersville East682 E Visalia Rd FarmersvilleCA
CH09364ATActiveBPS-H80-030043Family Healthcare NetworkFamily HealthCare Network - Fresno Shields3505 E Shields Ave FresnoCA
CH09364AUActiveBPS-H80-030476Family Healthcare NetworkFamily HealthCare Network - Fresno Recreation7060 N Recreation Ave Ste 101 FresnoCA
CH09364AVActiveBPS-H80-031049Family Healthcare NetworkFamily HealthCare Network - Tulare Hillman1062 S K St, Ste 100 TulareCA
CH09364AWActiveBPS-H80-034916Family Healthcare NetworkFamily HealthCare Network - City Center3837 N Clark St FresnoCA
CH09364AXActiveBPS-H80-033479FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Fresno First3425 N First St FresnoCA
CH09364AYActiveBPS-H80-035759FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Fresno Clinton1344 W Clinton Ave FresnoCA
CH09364AZActiveBPS-H80-037882FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Hanford 12th Avenue Health Center939 S. 12th Avenue HanfordCA
CH09364BActiveBPS-H80-002896FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - VISALIA BRIDGE HEALTH CENTER501 N Bridge St VisaliaCA
CH09364BAActiveBPS-H80-038241FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Delano1230 Jefferson St DelanoCA
CH09364CActiveBPS-H80-011869FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - WOODLAKE HEALTH CENTER201 E. Lakeview Avenue WoodlakeCA
CH09364DActiveBPS-H80-000346FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - CUTLER/OROSI HEALTH CENTER12586 Avenue 408 OrosiCA
CH09364EActiveBPS-H80-004257FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - THREE RIVERS HEALTH CENTER41651 SIERRA DR. STE A THREE RIVERSCA
CH09364FActiveBPS-H80-004184FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - SPRINGVILLE HEALTH CENTER35800 Highway 190 SpringvilleCA
CH09364GActiveBPS-H80-002463FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - VISALIA OAK HEALTH CENTER400 E Oak Ave VisaliaCA
CH09364JActiveBPS-H80-013841FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - GOSHEN HEALTH CENTER31180 Road 72 GOSHENCA
CH09364KActiveBPS-H80-021390FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - HANFORD 5TH STREET HEALTH CENTER250 W Fifth Street HanfordCA
CH09364LActiveBPS-H80-011508FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Farmersville Health Center730 N. Farmersville Blvd FarmersvilleCA
CH09364MActiveBPS-H80-013067FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Terra Bella Health Center9416 Road 238 Terra BellaCA
CH09364NActiveBPS-H80-011365FAMILY HEALTHCARE NETWORKFamily HealthCare Network Visalia-School Avenue Health Center401 E SCHOOL AVE VisaliaCA
CH09364PActiveBPS-H80-011876FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Porterville Dental Center1133 W Poplar Ave PortervilleCA
CH09364QActiveBPS-H80-015799FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Tulare West Health Center263 S. West Street TulareCA
CH09364RActiveBPS-H80-015566FAMILY HEALTHCARE NETWORKFamily HealthCare Network-Traver Health Center4177 Avenue 368 TraverCA
CH09364SActiveBPS-H80-018019FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Tulare Cherry Street Health Center1008 North Cherry Street TulareCA
CH09364TActiveBPS-H80-018753FAMILY HEALTHCARE NETWORKFamily HealthCare Network - Pixley Health Center927 Center Street PixleyCA
CH09364UActiveBPS-H80-019392Family Healthcare NetworkFamily HealthCare Network - Mobile Van #131180 Road 72 VisaliaCA
CH09364VActiveBPS-H80-021433Family Healthcare NetworkFamily HealthCare Network - Strathmore Health Center22817 Avenue 196 StrathmoreCA
CH09364WActiveBPS-H80-022272Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 1200FresnoCA
CH09364XActiveBPS-H80-022252Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 2200FresnoCA
CH09364YActiveBPS-H80-022254Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 1600FresnoCA
CH09364ZActiveBPS-H80-022257Family Healthcare NetworkFamily HealthCare Network - ACC290 N Wayte LaneSuite 1800FresnoCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH093640ACARIAHEALTH PHARMACY #11, INC1311 W SAM HOUSTON PKWY N STE 130
HOUSTONTX77043-401501/01/2023  
CH093640ACARIAHEALTH PHARMACY #13, INC3302 GARFIELD AVE.
COMMERCECA90040-310201/01/2023  
CH093640ACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967901/01/2023  
CH093640ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2019  
CH093640ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2019 08/01/2020
CH093640ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2019  
CH093640ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2019 08/01/2020
CH093640ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/01/2019 08/01/2020
CH093640ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2019 08/01/2020
CH093640ALTO PHARMACY LLCDBA ALTO PHARMACY 2360 QUME DR
STE A 		SAN JOSECA9513101/01/2023  
CH093640ALTO PHARMACY, LLCDBA ALTO PHARMACY 1400 TENNESSEE ST UNIT 2
SAN FRANCISCOCA94107-342101/01/2023  
CH093640AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291104/01/2020  
CH093640AMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700310/01/2024  
CH093640AMAZON PHARMACY #008408 TECHNOLOGY PARKWAY BUILDING B, STE 101
COLLEGE STATIONTX7784510/01/2024  
CH093640AMAZON PHARMACY #0097469 KINGSPOINTE PKWY STE 400
ORLANDOFL3281910/01/2024  
CH093640AMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287910/01/2024  
CH093640AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508507/01/2018 07/15/2020
CH093640AVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582107/01/2018 07/15/2020
CH093640AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2020  
CH093640BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526101/01/2020  
CH093640BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771301/01/2020  
CH093640BIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267010/01/2024  
CH093640BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522610/01/2024  
CH093640BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620310/01/2024  
CH093640CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2019  
CH093640CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2019  
CH093640CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2019  
CH093640CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2019  
CH093640CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2019  
CH093640CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2019  
CH093640CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2019  
CH093640CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DRIVE
SUITE 107 		BARTLETTTN3813301/01/2019  
CH093640CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/01/2019  
CH093640CAREPLUS HEALTHCARE INCD/B/A VALLEY PHARMACY 560 W PUTNAM AVE STE 2
PORTERVILLECA93257-326910/01/2021  
CH093640CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506904/07/2022  
CH093640CENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302504/07/2022 07/07/2023
CH093640CENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282410/01/2024  
CH093640CVS CAREMARKDBA CVS/CAREMARK OR CARELONRX MAIL OR CF 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2021  
CH093640CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK OR CARELONRX MAIL 1780 WALL ST
MT PROSPECTIL6005610/01/2021  
CH093640CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2019  
CH093640DINUBA PHARMACYDINUBA PHARMACY 172 N L ST.
DINUBACA9361807/01/2019  
CH09364AWDINUBA PHARMACYDINUBA PHARMACY 172 N L ST.
DINUBACA9361810/01/2024  
CH093640DIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268301/01/2022  
CH093640DOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K 		GREENVILLESC29607-654001/01/2020  
CH093640ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/19/2022  
CH093640EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/19/2022  
CH093640EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/19/2022  
CH093640EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/19/2022  
CH093640FOUNDATION CARE LLC111 CHESTERFIELD INDUSTRIAL BLVD STE 115
CHESTERFIELDMO6300501/01/2023  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00035 800 N. WESTWOOD ST.
PORTERVILLECA9325710/01/2015  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02711 2135 N. DINUBA BLVD.
VISALIACA9329110/01/2015 02/14/2017
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02944 53 E. OLIVE AVE.
PORTERVILLECA9325710/01/2015  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05551 109 SOUTH WEST ST.
TULARECA9327410/01/2015  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17477 1363 W HENDERSON AVE
PORTERVILLECA9325707/01/2017  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17520 3308 N DINUBA BLVD
VISALIACA9329107/01/2017  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16928 4247 S MOONEY BLVD
VISALIACA9327704/09/2020  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00912 2175 E. BARDSLEY AVE.
TULARECA9327404/09/2020  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17025 140 N 12TH AVE
HANFORDCA9323004/09/2020  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17414 2195 E PROSPERITY AVE
TULARECA9327404/09/2020  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02541 1102 N. DEMAREE ST.
VISALIACA9329104/09/2020  
CH093640GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10074 5995 EAST KINGS CANYON RD
FRESNOCA9372710/01/2020  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16108 3173 E SHIELDS AVE
FRESNOCA9372610/01/2020  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 06772 4987 N. FRESNO ST.
FRESNOCA9372610/01/2020  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16084 3150 W SHAW AVE
FRESNOCA9371110/01/2020  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05422 5180 E. KINGS CANYON ROAD
FRESNOCA9372710/01/2020  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16136 900 SHAW AVE
CLOVISCA9361207/01/2021  
CH093640GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10801 6720 N. FRESNO ST.
FRESNOCA9371010/01/2021  
CH093640GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 11339 777 S. HARBOR BLVD., SUITE E-164
LA HABRACA9063110/01/2021  
CH093640GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16337 7600 N BLACKSTONE AVE
FRESNOCA9372010/01/2021  
CH093640GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08895 775 E. FOOTHILL BOULEVARD
POMONACA9176710/01/2021  
CH09364APGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02541 1102 N. DEMAREE ST.
VISALIACA9329110/01/2024  
CH09364JGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17520 3308 N DINUBA BLVD
VISALIACA9329110/01/2024  
CH09364VGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17477 1363 W HENDERSON AVE
PORTERVILLECA9325710/01/2024  
CH09364ARGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 06772 4987 N. FRESNO ST.
FRESNOCA9372610/01/2024  
CH09364QGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05551 109 SOUTH WEST ST.
TULARECA9327410/01/2024  
CH09364WGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00912 2175 E. BARDSLEY AVE.
TULARECA9327410/01/2024  
CH09364UGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02944 53 E. OLIVE AVE.
PORTERVILLECA9325710/01/2024  
CH09364ZGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05422 5180 E. KINGS CANYON ROAD
FRESNOCA9372710/01/2024  
CH09364AEGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17414 2195 E PROSPERITY AVE
TULARECA9327410/01/2024  
CH09364EGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 00035 800 N. WESTWOOD ST.
PORTERVILLECA9325710/01/2024  
CH093640GENOA HEALTHCARE LLC11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGSCA9067001/01/2022  
CH093640GENOA HEALTHCARE LLC1850 W FLORIDA AVE
HEMETCA9254501/01/2022  
CH093640GENOA HEALTHCARE LLC17782 COWAN ST STE G
IRVINECA9261401/01/2022  
CH093640GENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205801/01/2022  
CH093640GENOA HEALTHCARE LLC245 11TH ST STE P1
SAN FRANCISCOCA9410301/01/2022  
CH093640GENOA HEALTHCARE LLC1393 BAILEY DR STE 149
HANFORDCA9323004/01/2024  
CH093640GENOA HEALTHCARE LLC2550 WEST CLINTON AVE STE 123
FRESNOCA9370504/01/2024  
CH093640IC PHARMACY LLCAMAZON PHARMACY #004 34 35TH STREET
STE 4BSW, UNIT 28 		BROOKLYNNY1123210/01/2024  
CH093640IVANHOE PHARMACY  33060 RD 159
IVANHOECA93235-123504/01/2014 01/31/2016
CH093640KROGER SPECIALTY INFUSION CA19110 VAN NESS AVE.
TORRANCECA9050107/19/2022  
CH093640KROGER SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/19/2022  
CH093640KROGER SPECIALTY PHARMACY INC.3200 LAKE EMMA RD UNIT 1000
LAKE MARYFL32746-335807/19/2022  
CH093640LA PHARMACY LLC1048 S GARFIELD AVE STE 101
ALHAMBRACA9180104/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09271 3619 W. CALDWELL AVE
VISALIACA9327710/01/2015  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09500 1455 E NOBLE AVE
VISALIACA9329210/01/2015  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09845 1155 W HENDERSON AVE
PORTERVILLECA9325710/01/2015  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09176 1395 E PROSPERITY AVE
TULARECA9327404/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09893 2539 N 11TH AVE
HANFORDCA9323004/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09171 2900 STANDIFORD AVE
MODESTOCA9535004/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09377 1065 W MANNING AVE
REEDLEYCA9365404/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09828 574 W LACEY BLVD
HANFORDCA9323004/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 04652 590 W PUTNAM AVE
PORTERVILLECA9325704/09/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09983 929 SIERRA ST
KINGSBURGCA9363110/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09149 6750 N CEDAR AVE
FRESNOCA9371010/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09592 1435 E GRAND AVE
ARROYO GRANDECA9342010/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09846 6800 N MILBURN AVE
FRESNOCA9372210/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07553 3011 E SHIELDS AVE
FRESNOCA9372610/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09129 1302 FULTON MALL
FRESNOCA9372110/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03034 333 ACADEMY AVE
SANGERCA9365710/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09537 1325 W SHIELDS AVENUE
FRESNOCA9370510/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09971 4077 W CLINTON AVE
FRESNOCA9372210/01/2020  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09994 728 W SHAW AVE
FRESNOCA9370407/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09159 1109 COUNTRY CLUB DR
MADERACA9363807/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09801 10 SHAW AVE
CLOVISCA9361207/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07910 1794 ASHLAN AVE
CLOVISCA9361107/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09865 7096 N WEST AVE
FRESNOCA9371107/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09933 1405 HERNDON AVENUE
CLOVISCA9361107/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09320 686 LIGHTHOUSE AVE
MONTEREYCA9394007/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09623 649 W. OLIVE AVENUE
MERCEDCA9534810/01/2021  
CH093640LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09935 40044 HIGHWAY 49
OAKHURSTCA9364410/01/2021  
CH09364BLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09500 1455 E NOBLE AVE
VISALIACA9329210/01/2024  
CH09364RLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09176 1395 E PROSPERITY AVE
TULARECA9327410/01/2024  
CH09364ATLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09893 2539 N 11TH AVE
HANFORDCA9323010/01/2024  
CH09364AJLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09828 574 W LACEY BLVD
HANFORDCA9323010/01/2024  
CH09364AALONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09271 3619 W. CALDWELL AVE
VISALIACA9327710/01/2024  
CH09364AXLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09377 1065 W MANNING AVE
REEDLEYCA9365410/01/2024  
CH09364TLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09845 1155 W HENDERSON AVE
PORTERVILLECA9325710/01/2024  
CH09364AYLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09537 1325 W SHIELDS AVENUE
FRESNOCA9370510/01/2024  
CH093640M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312607/01/2018  
CH093640OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191304/09/2020  
CH093640OPTUM INFUSION SERVICES 401, LLC4610 NORTHGATE BLVD. STE. 130
SACRAMENTOCA95834-115407/01/2023  
CH093640OPTUM INFUSION SERVICES 550, LLC1819 ASTON AVE STE 104
CARLSBADCA9200804/01/2024  
CH093640OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502901/01/2022  
CH093640OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/07/2022  
CH093640OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520404/01/2024  
CH093640OPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302504/01/2024  
CH093640OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/09/2020  
CH093640OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824907/01/2023  
CH093640OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729807/01/2023  
CH093640OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140104/09/2020 10/01/2021
CH093640OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140107/01/2023  
CH093640OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/15/2020  
CH093640OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161807/15/2020 10/01/2021
CH093640OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983801/01/2022  
CH093640OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660801/01/2022 05/27/2022
CH093640OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805204/09/2020 07/01/2024
CH093640PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310107/01/2018  
CH093640PILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231910/01/2024  
CH093640PORTERVILLE PHARMACY406 W PUTNAM AVE
PORTERVILLECA9325701/01/2018  
CH093640PORTERVILLE PHARMACY #21270 W HENDERSON AVE
PORTERVILLECA9325710/01/2018  
CH09364FPORTERVILLE PHARMACY #21270 W HENDERSON AVE
PORTERVILLECA9325710/01/2024  
CH093640PREMIER PHARMACY SERVICES410 CLOVERLEAF DR
BALDWIN PARKCA9170607/01/2020  
CH093640PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999201/01/2019 10/01/2022
CH093640PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2019  
CH093640PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 445 CASTRO STREET
SAN FRANCISCOCA9411407/01/2021  
CH093640RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103 		NEWBURGHNY1255001/01/2020  
CH093640RALEY'S PHARMACY #34040041 HIGHWAY 49
OAKHURSTCA9364410/01/2024  
CH093640RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500201/01/2020  
CH093640SAVE MART PHARMACY # 657  3615 W. NOBLE AVENUE
VISALIACA9327701/01/2014 09/30/2022
CH093640SAVE MART PHARMACY #45  900 WEST HENDERSON
PORTERVILLECA9325701/01/2014 09/30/2022
CH093640SAVE MART PHARMACY #522179 SHAW AVE
CLOVISCA93611-893710/01/2020 09/30/2022
CH093640SAVE MART PHARMACY #83  5203 WEST WALNUT AVE
VISALIACA9327704/01/2014 09/30/2022
CH093640SAVE MART PHARMACY #89  5201 W. GOSHEN AVE
VISALIACA9329110/01/2016 09/30/2022
CH093640SENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
PLANOTX7507404/07/2022  
CH093640SIERRA VISTA PHARMACY, INC.650 E VISALIA RD
FARMERSVILLECA9322310/01/2020  
CH09364CSIERRA VISTA PHARMACY, INC.650 E VISALIA RD
FARMERSVILLECA9322310/01/2024  
CH093640THE VONS COMPANIES INCVONS PHARMACY #1756 1650 HERNDON AVENUE
CLOVISCA9361104/01/2024  
CH093640THE VONS COMPANIES INCVONS PHARMACY #2188 8949 NORTH CEDAR AVENUE
FRESNOCA9372004/01/2024  
CH093640THE VONS COMPANIES INCVONS PHARMACY #2701 3100 FOWLER AVENUE
CLOVISCA9361104/01/2024  
CH093640THE VONS COMPANIES INCVONS PHARMACY #1754 5638 EAST KINGS CANYON RD
FRESNOCA9372710/01/2024  
CH093640THE VONS COMPANIES INCVONS PHARMACY #2409 40044 HIGHWAY 49
STE D 		OAKHURSTCA9364410/01/2024  
CH093640THRIFTY PAYLESS INC.RITE AID #5852 2200 EAST EL MONTE WAY
DINUBACA9361801/01/2014 02/05/2019
CH093640THRIFTY PAYLESS INC.RITE AID #5803 110 EAST CROSS AVENUE
TULARECA9327407/01/2016 04/03/2018
CH093640THRIFTY PAYLESS, INC.RITE AID #5795 1051 W VISALIA RD
EXETERCA9322101/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #5796 707 WEST LACEY BOULEVARD
HANFORDCA9323001/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #5798 262 NORTH HIGHWAY 65
LINDSAYCA9324701/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #5799 66 WEST MORTON AVENUE
PORTERVILLECA9325701/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #5805 2727 SOUTH MOONEY BLVD.
VISALIACA9327701/01/2014 01/19/2022
CH093640THRIFTY PAYLESS, INC.RITE AID #5806 5212 WEST WALNUT AVENUE
VISALIACA9327701/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #6459 1735 E WALNUT AVENUE
VISALIACA9329201/01/2014  
CH093640THRIFTY PAYLESS, INC.RITE AID #6764 1710 N FARMERSVILLE BLVD
FARMERSVILLECA9322307/01/2016  
CH093640THRIFTY PAYLESS, INC.DBA RITE AID #6723 160 E ANTELOPE AVE
WOODLAKECA9328607/01/2016  
CH093640THRIFTY PAYLESS, INC.RITE AID #5861 4224 EAST SHIELDS AVENUE
FRESNOCA9372607/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5794 1809 CECIL AVENUE
DELANOCA9321507/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5865 2011 WEST SHAW AVENUE
FRESNOCA9371107/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6295 1101 FRESNO STREET
FRESNOCA9370607/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5869 3795 WEST SHIELDS AVENUE
FRESNOCA9372207/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #4072 2020 E COPPER AVENUE
FRESNOCA9373007/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5863 6074 NORTH 1ST AVE.
FRESNOCA9371007/01/2019 03/15/2022
CH093640THRIFTY PAYLESS, INC.RITE AID #6476 2990 EAST NEES AVENUE
FRESNOCA9372007/01/2019 03/31/2022
CH093640THRIFTY PAYLESS, INC.RITE AID #6289 4593 NORTH CEDAR AVENUE
FRESNOCA9372607/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6454 1645 E TULARE AVENUE
TULARECA9327407/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6378 8027 NORTH CEDAR AVENUE
FRESNOCA9372007/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5862 1210 NORTH BLACKSTONE AVENUE
FRESNOCA9370307/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6475 820 N LEMOORE AVENUE
LEMOORECA9324507/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6243 2500 NORTH 10TH AVENUE
HANFORDCA9323007/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6395 1500 WHITLEY AVENUE
CORCORANCA9321207/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #5872 5574 EAST KINGS CANYON
FRESNOCA9372707/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6522 875 NORTH ALTA AVENUE
DINUBACA9361807/01/2019  
CH093640THRIFTY PAYLESS, INC.RITE AID #6475 820 N LEMOORE AVENUE
LEMOORECA9324507/01/2019 02/10/2020
CH093640THRIFTY PAYLESS, INC.RITE AID #5858 1721 EAST MANNING AVENUE
REEDLEYCA9365410/01/2023  
CH09364ANTHRIFTY PAYLESS, INC.DBA RITE AID #6723 160 E ANTELOPE AVE
WOODLAKECA9328610/01/2024  
CH09364BATHRIFTY PAYLESS, INC.RITE AID #5794 1809 CECIL AVENUE
DELANOCA9321510/01/2024  
CH09364LTHRIFTY PAYLESS, INC.RITE AID #6764 1710 N FARMERSVILLE BLVD
FARMERSVILLECA9322310/01/2024  
CH09364ASTHRIFTY PAYLESS, INC.RITE AID #5795 1051 W VISALIA RD
EXETERCA9322110/01/2024  
CH09364AQTHRIFTY PAYLESS, INC.RITE AID #5798 262 NORTH HIGHWAY 65
LINDSAYCA9324710/01/2024  
CH09364AFTHRIFTY PAYLESS, INC.RITE AID #6459 1735 E WALNUT AVENUE
VISALIACA9329210/01/2024  
CH093640TRUEPILL3121 DIABLO AVE
HAYWARDCA9454504/09/2020 07/01/2024
CH093640TRUXTUN PHARMACY DELANO1228 JEFFERSON ST
DELANOCA9321507/01/2024  
CH09364YTRUXTUN PHARMACY DELANO1228 JEFFERSON ST
DELANOCA9321510/01/2024  
CH093640UNIVERSITY MEDICAL CENTER PHARMACY290 N WAYTE LN FL 1
FRESNOCA93701-212410/01/2018  
CH09364AHUNIVERSITY MEDICAL CENTER PHARMACY290 N WAYTE LN FL 1
FRESNOCA93701-212410/01/2024  
CH093640WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH093640WAL-MART PHARMACY 10-1645250 S 12TH AVE
HANFORDCA9323004/01/2014 05/29/2016
CH093640WAL-MART PHARMACY 10-1645250 S 12TH AVE
HANFORDCA9323010/01/2018  
CH093640WAL-MART PHARMACY 10-18154080 W SHAW AVE
FRESNOCA9372210/01/2024  
CH093640WAL-MART PHARMACY 10-18261819 EAST NOBLE AVE.
VISALIACA9329204/01/2014  
CH09364NWAL-MART PHARMACY 10-18261819 EAST NOBLE AVE.
VISALIACA9329210/01/2024  
CH09364AGWAL-MART PHARMACY 10-18261819 EAST NOBLE AVE.
VISALIACA9329210/01/2024  
CH093640WAL-MART PHARMACY 10-18771250 WEST HENDERSON AVE
PORTERVILLECA9325704/01/2014  
CH09364PWAL-MART PHARMACY 10-18771250 WEST HENDERSON AVE
PORTERVILLECA9325710/01/2024  
CH093640WAL-MART PHARMACY 10-18823400 FLORAL AVE
SELMACA9366210/01/2020  
CH093640WAL-MART PHARMACY 10-20015125 EAST KINGS CANYON
FRESNOCA9372710/01/2024  
CH093640WAL-MART PHARMACY 10-25361110 EAST PROSPERITY AVE
TULARECA9327404/01/2014  
CH09364SWAL-MART PHARMACY 10-25361110 EAST PROSPERITY AVE
TULARECA9327410/01/2024  
CH093640WAL-MART PHARMACY 10-5215530 WOOLLOMES AVE
DELANOCA9321510/01/2020  
CH09364MWAL-MART PHARMACY 10-5215530 WOOLLOMES AVE
DELANOCA9321510/01/2024  
CH093640WAL-MART PHARMACY 10-5394770 WEST EL MONTE WAY
DINUBACA9361804/01/2014  
CH09364AUWAL-MART PHARMACY 10-5394770 WEST EL MONTE WAY
DINUBACA9361810/01/2024  
CH093640WAL-MART PHARMACY 10-56351320 N DEMAREE ST
VISALIACA9329107/01/2016  
CH09364ADWAL-MART PHARMACY 10-56351320 N DEMAREE ST
VISALIACA9329110/01/2024  
CH093640WAL-MART PHARMACY 10-59563750 S MOONEY BLVD.
VISALIACA9327704/01/2014  
CH09364ABWAL-MART PHARMACY 10-59563750 S MOONEY BLVD.
VISALIACA9327710/01/2024  
CH093640WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH093640WAL-MART PHARMACY WHSE #452250 NORTH 8TH STREET SUITE 102-A
ROGERSAR7275610/01/2024  
CH093640WALGREEN CODBA: WALGREENS #11612 12 W HANFORD ARMONA RD
LEMOORECA93245-232010/01/2013  
CH093640WALGREEN CODBA: WALGREENS #10243 2420 N BLACKSTONE AVE
FRESNOCA93703-174701/01/2021 12/14/2020
CH093640WALGREEN CODBA: WALGREENS #10243 2420 N BLACKSTONE AVE
FRESNOCA93703-174707/01/2021  
CH093640WALGREEN CODBA: WALGREENS #10335 2424 N BRAWLEY AVE
FRESNOCA9372207/01/2021  
CH093640WALGREEN CODBA: WALGREENS #09702 5785 N FIRST ST
FRESNOCA93710-620310/01/2021  
CH093640WALGREEN CODBA: WALGREENS #11242 2020 W CLEVELAND AVE
MADERACA9363701/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 02869 1407 N DINUBA BLVD
VISALIACA9329110/01/2013 05/30/2018
CH093640WALGREEN CO.DBA: WALGREENS # 03476 100 W WALNUT AVE
VISALIACA9327710/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS # 05411 710 W GRANGEVILLE BLVD
HANFORDCA9323010/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS # 06298 49 W TULARE AVE
TULARECA9327410/01/2013 07/27/2020
CH093640WALGREEN CO.DBA: WALGREENS # 06683 5328 W CYPRESS AVENUE
VISALIACA9327710/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS #09844 416 W. OLIVE AVE
PORTERVILLECA9325710/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS # 10002 1418 EAST PROSPERITY AVENUE
TULARECA93274-805410/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS # 10201 170 W EL MONTE WAY
DINUBACA93618-156110/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS #11407 3010 N DEMAREE ST
VISALIACA93291-714710/01/2013  
CH093640WALGREEN CO.DBA: WALGREENS # 06082 626 S CLOVIS AVE
FRESNOCA9372710/01/2018  
CH093640WALGREEN CO.DBA: WALGREENS #12574 1219 N CEDAR AVE
FRESNOCA9370310/01/2018  
CH093640WALGREEN CO.DBA: WALGREENS # 06942 6010 N FIGARDEN DRIVE
FRESNOCA93722-603010/01/2018  
CH093640WALGREEN CO.DBA WALGREENS #06386 4810 E KINGS CANYON RD
FRESNOCA93727-380910/01/2018  
CH093640WALGREEN CO.DBA: WALGREENS # 07266 8975 N CHESTNUT AVE
FRESNOCA9372010/01/2018  
CH093640WALGREEN CO.DBA: WALGREENS #11877 4771 W ASHLAN AVE
FRESNOCA9372210/01/2018  
CH093640WALGREEN CO.DBA: WALGREENS # 13871 1016 W SHAW AVE
FRESNOCA9371110/01/2018  
CH093640WALGREEN CO.DBA WALGREENS #16382 2323 16TH ST., SUITE 100
BAKERSFIELDCA9330101/01/2019  
CH093640WALGREEN CO.DBA: WALGREENS #12761 41169 GOODWIN WAY SUITE 110
MADERACA93636-876601/01/2019  
CH093640WALGREEN CO.DBA: WALGREENS #12298 852 E MANNING AVE
REEDLEYCA9365404/09/2020  
CH093640WALGREEN CO.DBA: WALGREENS # 07830 205 W SHAW AVENUE
CLOVISCA93612-360201/01/2021  
CH093640WALGREEN CO.DBA: WALGREENS # 09815 988 SIERRA STREET
KINGSBURGCA9363101/01/2021  
CH093640WALGREEN CO.DBA: WALGREENS # 05847 610 E NEES AVENUE
FRESNOCA9372007/01/2021  
CH093640WALGREEN CO.DBA: WALGREENS #12282 2589 JENSEN AVE
SANGERCA9365701/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS #12337 2795 FLORAL AVE
SELMACA93662-260301/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 06453 1300 W YOSEMITE AVE
MADERACA9363701/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 12707 4172 N. 1ST STREET
FRESNOCA9372601/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 07204 7015 N WEST AVE
FRESNOCA93711-046101/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 06387 1815 HERNDON AVE
CLOVISCA9361101/01/2022  
CH093640WALGREEN CO.DBA WALGREENS #10827 1435 HIGH ST.
DELANOCA9321501/01/2022  
CH093640WALGREEN CO.DBA: WALGREENS # 10334 1790 SHAW AVE
CLOVISCA9361101/01/2022  
CH09364ACWALGREEN CO.DBA: WALGREENS #11407 3010 N DEMAREE ST
VISALIACA93291-714710/01/2024  
CH09364AWALGREEN CO.DBA WALGREENS #10827 1435 HIGH ST.
DELANOCA9321510/01/2024  
CH09364XWALGREEN CO.DBA: WALGREENS #12298 852 E MANNING AVE
REEDLEYCA9365410/01/2024  
CH09364AZWALGREEN CO.DBA: WALGREENS # 03476 100 W WALNUT AVE
VISALIACA9327710/01/2024  
CH093640WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/01/2013 07/08/2015
CH093640WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/01/2019 10/01/2021
CH093640WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PHARMACY #15438 41460 HAGGERTY CIRCLE SOUTH
CANTONMI4818801/01/2019  
CH093640WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2019  
CH093640WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2019  
CH093640WALMART PHARMACY 10-26893131 N CEDAR AVENUE
FRESNOCA9370310/01/2024  
CH093640WALMART PHARMACY 10-56321804 EAST ASHLAN AVE.
FRESNOCA9372610/01/2024  
CH093640Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616810/01/2024  
CH093640WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E 		SAN DIEGOCA9210207/01/2018  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/24/2023 5:29:29 PM2/16/2024 8:20:14 AM2/16/2024 8:20 AM
DetailsLast Recertification DateUpdateRecertification2/17/2022 11:05:58 AM2/24/2023 5:29:29 PM2/24/2023 5:29 PM
Medicaid BillingNPI: NumberInsertChange Request 115477270511/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
Medicaid BillingNPI: NumberInsertChange Request 161930203111/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
Medicaid BillingNPI: NumberInsertChange Request 193261353611/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
Medicaid BillingNPI: NumberInsertChange Request 138629535011/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
Medicaid BillingNPI: NumberInsertChange Request 187114432911/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
Medicaid BillingNPI: NumberInsertChange Request 169942381411/28/2022 2:51 PM
Medicaid BillingNPI: StateInsertChange Request CA11/28/2022 2:51 PM
DetailsLast Recertification DateUpdateRecertification2/19/2021 9:25:59 AM2/17/2022 11:05:58 AM2/17/2022 11:05 AM
Medicaid BillingNPI: StateUpdateRecertification CA2/19/2021 9:25 AM
Medicaid BillingNPI: StateUpdateRecertification CA2/19/2021 9:25 AM
DetailsLast Recertification DateUpdateRecertification2/11/2020 3:49:55 PM2/19/2021 9:25:59 AM2/19/2021 9:25 AM
DetailsLast Recertification DateUpdateRecertification2/4/2019 2:46:11 PM2/11/2020 3:49:55 PM2/11/2020 3:49 PM
DetailsLast Recertification DateUpdateRecertification2/8/2018 12:49:21 PM2/4/2019 2:46:11 PM2/4/2019 2:46 PM
DetailsLast Recertification DateUpdateRecertification2/7/2017 12:00:00 AM2/8/2018 12:49:21 PM2/8/2018 12:49 PM
ContactsPrimary ContactUpdate Vawter, Chad CFO 5597374700Vawter, Chad CFO Family HealthCare Network 559737470010/6/2017 11:21 AM
ContactsAuthorizing OfficialUpdate Hydash, Kerry President and CEO 5597374700Hydash, Kerry President and CEO Family HealthCare Network 559737470010/6/2017 11:18 AM
ContactsAuthorizing OfficialInsert  Hydash, Kerry President and CEO 55973747007/17/2017 1:24 PM
ContactsPrimary ContactUpdate SOY, MARTIN CHIEF FINANCIAL OFFICER 5597374700Vawter, Chad CFO 55973747005/17/2017 1:05 PM
AddressesMain AddressInsert   1107 W Poplar Ave Porterville, CA 93257-58392/7/2017 4:59 PM
DetailsLast Recertification DateUpdate 2/24/2016 12:00:00 AM2/7/2017 12:00:00 AM2/7/2017 4:59 PM
DetailsLast Recertification DateUpdate 3/4/2015 12:00:00 AM2/24/2016 12:00:00 AM2/24/2016 5:41 PM
DetailsLast Recertification DateUpdate 2/14/2014 12:00:00 AM3/4/2015 12:00:00 AM3/4/2015 1:41 PM
AddressesBilling AddressInsert  FAMILY HEALTHCARE NETWORK 305 East Center Ave Visalia, CA 932915/30/2014 8:46 AM
Medicaid BillingNPI: NumberInsert  13162579595/30/2014 8:46 AM
DetailsEntity SubnameUpdate  FHCN - PORTERVILLE CENTER3/31/2014 4:25 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/14/2014 12:00:00 AM2/14/2014 12:47 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/15/2013 6:48 AM
Medicaid BillingNPI: NumberInsert  10836111561/22/2013 8:24 AM
ContactsPrimary ContactInsert  SOY, MARTIN CHIEF FINANCIAL OFFICER 55973747004/11/2012 3:17 PM
DetailsLast Recertification DateInsert   8/12/2005 8:45 AM
DetailsGrant NumberInsert  H80CS007868/12/2005 8:45 AM
Details340B IDInsert  CH0936408/12/2005 8:45 AM
DetailsIs Authorizing Official EHB DataInsert   8/12/2005 8:45 AM
DatesLast Date That 340B Drugs PurchasedInsert   8/12/2005 8:45 AM
DetailsMedicare Provider NumberInsert   8/12/2005 8:45 AM
DetailsEntity NameInsert  FAMILY HEALTHCARE NETWORK8/12/2005 8:45 AM
DetailsProgram CodeInsert  CH8/12/2005 8:45 AM
DetailsEntity SubnameInsert   8/12/2005 8:45 AM
DatesParticipating Approval DateInsert  12/19/2003 12:00:00 AM8/12/2005 8:45 AM
DetailsStateInsert  Active8/12/2005 8:45 AM
DatesRegistration DateInsert  4/1/1997 12:00:00 AM8/12/2005 8:45 AM
DatesSigned By DateInsert   8/12/2005 8:45 AM
DatesStart DateInsert  4/1/1997 12:00:00 AM8/12/2005 8:45 AM
TerminationsTermination CommentsInsert   8/12/2005 8:45 AM
TerminationsTermination DateInsert   8/12/2005 8:45 AM
TerminationsTermination Effective DateInsert   8/12/2005 8:45 AM
TerminationsTermination ReasonInsert   8/12/2005 8:45 AM
DetailsComments PublicInsert  ADD BILL TO/NEW CONTACT8/12/2005 8:45 AM