Covered Entity Details

CH09008N MARANA HEALTH CENTER, INC. (Active) - information as of 5/29/2025 2:01:01 AM

Main Details

Name

MARANA HEALTH CENTER, INC.

Subdivision Name

CLINICA DEL ALMA

Type

HRSA-Funded Health Center

Site ID

BPS-H80-003690

340B ID

CH09008N

Grant Number

H80CS00231

Additional Details

Current Program Status

Active

Registration Date

11/26/2007

Participating Start Date

1/1/2008

Participating Approval Date

11/27/2007

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Marana Health Center
Heidi Kurgat, Director of Compliance and Risk
(573) 578-1344

Primary Contact

MHC Health Care
Greg Redding, Pharmacy Director
(520) 682-4111

Addresses

Street Address

3690 S Park Ave STE 805
Tucson, AZ 85713-5042

Billing Address

Marana Health Center
P.O. Box 188
Marana, AZ 85653

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

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

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

State	Medicaid Number	NPI Number
AZ	929554,369853,914568	1972662294,1326417270,1154584977

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09274	615 N. ALVERNON	TUCSON	AZ	85711	10/13/2023	01/01/2024			01/01/2024
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/13/2023	01/01/2024			01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH090080	Active	BPS-H80-010850	MARANA HEALTH CENTER, INC.	Marana Health Center, Inc.	13395 N. Marana Main Street		MARANA	AZ
CH09008A	Active	BPS-H80-014118	MARANA HEALTH CENTER, INC.	SANTA CATALINA HEALTH CENTER	16701 N ORACLE RD		TUCSON	AZ
CH09008AA	Active	BPS-H80-027559	Marana Health Center, Inc.	MHC Integrated Care	2325 N Wyatt Dr		Tucson	AZ
CH09008AB	Active	BPS-H80-031802	Marana Health Center, Inc.	West Side Health Center	1707 W Saint Marys Rd Ste 175 # 39S		Tucson	AZ
CH09008AC	Active	BPS-H80-037989	MARANA HEALTH CENTER, INC	MHC Healthcare Ronald McDonald Mobile	13395 North Marana Main Street		Marana	AZ
CH09008AD	Active	BPS-H80-038434	MARANA HEALTH CENTER, INC	Ina Health Center	2945 West Ina Road		Tucson	AZ
CH09008C	Terminated	BPS-H80-007185	MARANA HEALTH CENTER, INC.	Keeling Health Center	435 EAST GLENN STREET		TUCSON	AZ
CH09008H	Active	BPS-H80-001123	MARANA HEALTH CENTER, INC.	Ortiz Community Health Center	12635 W. RUDASILL ROAD		TUCSON	AZ
CH09008I	Terminated	BPS-H80-002978	MARANA HEALTH CENTER, INC.	DBA FREEDOM PARK HEALTH CENTER	5000 EAST 29TH STREET		TUCSON	AZ
CH09008J	Active	BPS-H80-004395	MARANA HEALTH CENTER, INC.	MARANA HEALTH CENTER OBSTETRICS AND GYNECOLOGY	2055 W Hospital Dr STE 115		Tucson	AZ
CH09008N	Active	BPS-H80-003690	MARANA HEALTH CENTER, INC.	CLINICA DEL ALMA	3690 S Park Ave STE 805		Tucson	AZ
CH09008P	Active	BPS-H80-014818	MARANA HEALTH CENTER, INC.	Wilmot Community Health Center	899 N. Wilmot Road	Building B	Tucson	AZ
CH09008Q	Active	BPS-H80-011480	MARANA HEALTH CENTER, INC.	MHC Primary Care Health Center	2355 N Wyatt Dr STE 101		Tucson	AZ
CH09008R	Active	BPS-H80-011160	MARANA HEALTH CENTER, INC.	MHC Counseling and Wellness Center	13395 N. Marana Main Street Bldg B		Marana	AZ
CH09008S	Terminated	BPS-H80-007525	MARANA HEALTH CENTER, INC.	East Side Health Center	8181 E Irvington Rd		Tucson	AZ
CH09008U	Terminated	BPS-H80-001568	MARANA HEALTH CENTER, INC.	West Side Health Center	2202 W. Anklam		Tucson	AZ
CH09008V	Active	BPS-H80-000242	MARANA HEALTH CENTER, INC.	FLOWING WELLS FAMILY PRACTICE	1323 W Prince Rd		Tucson	AZ
CH09008W	Terminated	BPS-H80-014781	MARANA HEALTH CENTER, INC.	Ellie Towne Health Center	1670 W Ruthrauff Rd		Tucson	AZ
CH09008X	Terminated	BPS-H80-018227	MARANA HEALTH CENTER, INC.	Marana Cares Mobile	11279 W. Grier Rd.		Marana	AZ
CH09008Y	Active	BPS-H80-018514	MARANA HEALTH CENTER, INC.	Dove Mountain Health Center	5224 W. Dove Centre Road		Marana	AZ
CH09008Z	Active	BPS-H80-024812	Marana Health Center, Inc.	Oro Valley Pediatrics	1856 E Innovation Park Dr		Oro Valley	AZ

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH090080	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/01/2023
CH090080	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/01/2023
CH090080	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/01/2023
CH090080	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/01/2023
CH090080	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/01/2023
CH090080	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/01/2023
CH090080	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2023
CH090080	ADVANCED PHARMACY, LLC	ADVANCED PHARMACY	350 FEASTER ROAD SUITE D	GREENVILLE	SC	29615-6176	10/01/2016	04/02/2018
CH090080	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	07/01/2016
CH090080	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/01/2018
CH09008A	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	10/01/2024
CH090080	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	10/01/2024
CH090080	AMAZON PHARMACY #008	408 TECHNOLOGY PARKWAY	BUILDING B, STE 101	COLLEGE STATION	TX	77845	10/01/2024
CH090080	AMAZON PHARMACY #009	7469 KINGSPOINTE PKWY STE 400		ORLANDO	FL	32819	10/01/2024
CH090080	AMAZON PHARMACY #010	1331 E 6TH ST		CORONA	CA	92879	10/01/2024
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09207	865 E. GRANT	TUCSON	AZ	85719	01/01/2020	06/23/2022
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09232	4748 E. SUNRISE DRIVE	TUCSON	AZ	85718	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09272	7499 E. BROADWAY	TUCSON	AZ	85710	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09273	3785 WEST INA RD.	TUCSON	AZ	85741	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09274	615 N. ALVERNON	TUCSON	AZ	85711	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09277	6895 E. SUNRISE	TUCSON	AZ	85750	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09302	8920 E TANQUE VERDE	TUCSON	AZ	85749	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09336	7901 E. GOLF LINKS ROAD	TUCSON	AZ	85730	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09211	6488 N. ORACLE ROAD	TUCSON	AZ	85704	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09374	1900 W. VALENCIA RD.	TUCSON	AZ	85746	01/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09254	240 W CONTINENTAL RD	GREEN VALLEY	AZ	85622	10/01/2020
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 08828	2090 EAST FRY BLVD.	SIERRA VISTA	AZ	85635	04/01/2022
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09293	325 W APACHE TRAIL	APACHE JUNCTION	AZ	85120	04/01/2022
CH090080	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09347	1525 NORTH CENTRAL AVENUE	PHOENIX	AZ	85004	04/01/2022
CH09008AA	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09273	3785 WEST INA RD.	TUCSON	AZ	85741	01/01/2024
CH09008H	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09336	7901 E. GOLF LINKS ROAD	TUCSON	AZ	85730	01/01/2024
CH09008N	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09274	615 N. ALVERNON	TUCSON	AZ	85711	01/01/2024
CH090080	AVELLA OF DEER VALLEY	23620 N 20TH DR #12		PHOENIX	AZ	85085-0621	07/01/2016	10/07/2022
CH090080	AVELLA OF DEER VALLEY, INC. #38	DBA AVELLA SPECIALTY PHARMACY	24416 N. 19TH AVE	PHOENIX	AZ	85085	07/01/2018	10/07/2022
CH090080	AVELLA OF DEER VALLEY, INC. #38	24416 N. 19TH AVE		PHOENIX	AZ	85085-1887	10/01/2018	10/07/2022
CH090080	AVELLA OF ORLANDO	100 TECHNOLOGY PARK STE 155		LAKE MARY	FL	32746-6205	07/01/2016	10/01/2017
CH090080	AVELLA OF TUCSON	4512 E CAMP LOWELL DR		TUCSON	AZ	85712-1282	01/01/2018	04/02/2018
CH090080	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019
CH09008A	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	10/01/2024
CH090080	BASHAS' #52	RALEY'S ARIZONA LLC	15310 N. ORACLE RD	TUCSON	AZ	85739	07/01/2024
CH090080	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/01/2024
CH090080	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/01/2024
CH090080	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/01/2024
CH09008W	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/01/2024	04/01/2025
CH09008Y	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/01/2024
CH09008Z	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/01/2024
CH090080	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	04/01/2024
CH090080	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2021
CH09008V	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2024
CH090080	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/01/2021
CH09008S	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/01/2024	10/01/2024
CH090080	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/01/2021
CH09008R	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/01/2024
CH090080	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/01/2021
CH09008Q	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/01/2024
CH090080	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/01/2021
CH09008P	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/01/2024
CH090080	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/01/2021
CH09008N	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/01/2024
CH090080	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/01/2021
CH09008J	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/01/2024
CH090080	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/01/2021
CH09008H	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/01/2024
CH090080	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/01/2021
CH090080	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/01/2021
CH090080	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	04/01/2023
CH090080	CENTERWELL PHARMACY, INC.	11010 FLORIDA CROWN DRIVE, SUITE 200		ORLANDO	FL	32824	01/01/2024
CH090080	COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY	STE A - E	SAN DIEGO	CA	92102-4548	10/01/2016	04/20/2018
CH090080	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2021
CH090080	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2021
CH090080	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/01/2021
CH090080	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2019
CH090080	DESERT LIFE PHARMACY	63675 E SADDLEBROOKE BLVD		TUCSON	AZ	85739-1297	07/01/2023
CH090080	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	01/01/2024
CH090080	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/01/2023
CH090080	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/01/2023
CH090080	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/01/2023
CH090080	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/01/2023
CH090080	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08896	33205 TEMECULA PARKWAY	TEMECULA	CA	92592	10/01/2020
CH090080	GENOA HEALTHCARE LLC	1101 NORTH CENTRAL AVE	STE 102	PHOENIX	AZ	85004	01/01/2023
CH090080	GENOA HEALTHCARE LLC	1075 E FORT LOWELL RD		TUCSON	AZ	85719	04/01/2024
CH090080	GENOA HEALTHCARE LLC	1210 E. PENNSYLVANIA ST.		TUCSON	AZ	85714	07/01/2025
CH090080	GENOA HEALTHCARE LLC	1501 W COMMERCE CT STE P		TUCSON	AZ	85746	07/01/2025
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 00091	8705 E SPEEDWAY BLVD	TUCSON	AZ	85710	01/01/2020	08/11/2022
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07841	4365 N ORACLE RD	TUCSON	AZ	85705	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07855	2601 S. HOUGHTON RD.	TUCSON	AZ	85730	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07859	6370 N. CAMPBELL AVE., #120	TUCSON	AZ	85718	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07867	5100 E. GRANT RD.	TUCSON	AZ	85712	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07876	3832 EAST SPEEDWAY	TUCSON	AZ	85716	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 08420	7740 N CORTARO RD	TUCSON	AZ	85743	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10006	10650 NORTH ORACLE RD	ORO VALLEY	AZ	85737	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10184	825 EAST UNIVERSITY BLVD., SUITE 101	TUCSON	AZ	85719	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS/PHARMACY #10742	2385 N. SILVERBELL ROAD	TUCSON	AZ	85745	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16295	3901 W INA RD	TUCSON	AZ	85741	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16296	6500 E GRANT RD	TUCSON	AZ	85715	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16772	3699 E BROADWAY BLVD	TUCSON	AZ	85716	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16983	9615 E OLD SPANISH TRL	TUCSON	AZ	85748	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 17223	4040 N ORACLE RD	TUCSON	AZ	85705	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10307	6310 E. BROADWAY BLVD.	TUCSON	AZ	85710	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16217	10555 N ORACLE RD	ORO VALLEY	AZ	85737	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16659	1225 W IRVINGTON RD	TUCSON	AZ	85714	01/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 00086	1686 E FLORENCE BLVD	CASA GRANDE	AZ	85122	10/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 2412	60 E DEUCE OF CLUBS DR.	SHOW LOW	AZ	85901	10/01/2020
CH090080	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 09205	802 S. MILL AVE.	TEMPE	AZ	85281	07/01/2021
CH090080	GERMAN DOBSON CVS, L.L.C.	CVS/PHARMACY # 10859	286 E 7TH ST	DOUGLAS	AZ	85607	04/01/2022
CH09008A	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 08420	7740 N CORTARO RD	TUCSON	AZ	85743	01/01/2024
CH09008AB	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10006	10650 NORTH ORACLE RD	ORO VALLEY	AZ	85737	01/01/2024
CH09008C	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07867	5100 E. GRANT RD.	TUCSON	AZ	85712	01/01/2024	10/01/2024
CH09008J	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 17223	4040 N ORACLE RD	TUCSON	AZ	85705	01/01/2024
CH090080	IC PHARMACY LLC	AMAZON PHARMACY #004	34 35TH STREET STE 4BSW, UNIT 28	BROOKLYN	NY	11232	10/01/2024
CH090080	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	07/01/2021
CH090080	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09979	3375 PLACER ST	REDDING	CA	96001	07/01/2021
CH090080	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/01/2018
CH09008A	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	10/01/2024
CH090080	OPTUM INFUSION SERVICES 308, LLC	485 N JUNIPER DR	STE 2	CHANDLER	AZ	85226	04/01/2024
CH090080	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	10/01/2021	10/07/2022
CH090080	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/01/2021	10/07/2022
CH090080	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/01/2023
CH090080	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2023
CH090080	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	10/01/2021
CH090080	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	10/01/2021	10/07/2022
CH090080	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/01/2022
CH090080	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	01/01/2023
CH090080	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/01/2024
CH090080	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/01/2021
CH090080	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	10/01/2021
CH090080	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2024
CH090080	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	10/01/2021
CH090080	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	10/01/2021
CH090080	OPTUM PHARMACY 805, INC	1101 N CENTRAL AVE, STE 102		PHOENIX	AZ	85004-1829	10/01/2021	10/07/2022
CH090080	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	10/01/2021	10/13/2022
CH090080	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	10/01/2021
CH090080	OVERLAKE PHARMACY, LLC	4124 148TH AVE NE STE JA		REDMOND	WA	98052	04/01/2020	01/08/2024
CH090080	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/01/2018
CH090080	PILLPACK LLC	AMAZON PHARMACY #005	20416 72ND AVE S	KENT	WA	98032-2319	10/01/2024
CH09008A	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	10/01/2024
CH090080	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	10/01/2019	10/05/2022
CH090080	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/01/2021
CH090080	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/01/2021
CH090080	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	01/01/2021
CH090080	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/01/2021
CH090080	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	01/01/2024
CH090080	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	01/01/2024
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1749	9100 N SILVERBELL RD	TUCSON	AZ	85743	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #0272	650 N BISBEE AVENUE	WILLCOX	AZ	85643	01/01/2015	04/02/2018
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1521	12122 N. RANCHO VISTOSO BLVD.	ORO VALLEY	AZ	85755	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1874	6360 E. GOLF LINKS RD	TUCSON	AZ	85730	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1986	9050 E. VALENCIA ROAD	TUCSON	AZ	85747-4900	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #0267	2940 W. VALENCIA ROAD	TUCSON	AZ	85746	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #0255	1551 W ST MARYS RD	TUCSON	AZ	85745	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1255	7110 N ORACLE RD.	TUCSON	AZ	85704	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1684	1940 E BROADWAY BLVD	TUCSON	AZ	85719	01/01/2015
CH090080	SAFEWAY INC	SAFEWAY PHARMACY #1983	2140 W. GRANT ROAD	TUCSON	AZ	85745-1142	01/01/2015
CH090080	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	01/01/2024
CH09008C	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	01/01/2024	10/01/2024
CH090080	SMITH'S FOOD & DRUG	DBA FRY'S FOOD & DRUG #17	4150 E. 22ND STREET	TUCSON	AZ	85711	07/01/2020
CH090080	SMITH'S FOOD & DRUG CTRS	FRY'S FOOD AND DRUG #137	7050 EAST 22ND STREET	TUCSON	AZ	85710	04/01/2015
CH090080	SMITH'S FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #131	2480 NORTH SWAN ROAD	TUCSON	AZ	85712	07/01/2020
CH090080	SMITH'S FOOD AND DRUG	DBA FRY'S FOOD AND DRUG #138	4036 N. 1ST STREET	TUCSON	AZ	85719	04/01/2015
CH090080	SMITH'S FOOD AND DRUG	DBA FRY'S FOOD AND DRUG #117	10450 N. LA CANADA DRIVE	ORO VALLEY	AZ	85737	04/01/2024
CH090080	SMITHS FOOD & DRUG CENTER	DBA FRYS FOOD & DRUG #20	3640 S 16 AVENUE	TUCSON	AZ	85713	04/01/2024
CH090080	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #57	7870 N SILVERBELL ROAD	MARANA	AZ	85743	04/01/2015
CH090080	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #21	555 E GRANT ROAD	TUCSON	AZ	85705	07/01/2020
CH090080	SMITHS FOOD & DRUG CENTERS	DBA FRYS PHARMACY #36	3770 W INA ROAD	TUCSON	AZ	85741	07/01/2020
CH090080	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #58	2001 E IRVINGTON ROAD	TUCSON	AZ	85714	07/01/2020
CH090080	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #18	10661 N ORACLE ROAD	ORO VALLEY	AZ	85737	04/01/2024
CH090080	SMITHS FOOD AND DRUG CENTERS INC.	DBA: FRY'S FOOD STRORES OF AZ #679	15950 SOUTH RANCHO SAHUARITA BLVD	SAHUARITA	AZ	85629	04/01/2015
CH090080	SMITHS FOOD AND DRUG CENTERS INC.	DBA:FRY'S FOOD STORES OF AZ #689	12100 N THORNYDALE RD	MARANA	AZ	85653	07/01/2020
CH090080	TRUEPILL	3121 DIABLO AVE		HAYWARD	CA	94545	04/01/2020	01/08/2024
CH090080	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2018
CH090080	WAL-MART PHARMACY # 10-3379	2150 EAST TANGERINE RD		ORO VALLEY	AZ	85755	10/01/2015
CH09008P	WAL-MART PHARMACY # 10-3379	2150 EAST TANGERINE RD		ORO VALLEY	AZ	85755	01/01/2024
CH090080	WAL-MART PHARMACY # 10-4473	2175 WEST RUTHRAUFF ROAD		TUCSON	AZ	85705	10/01/2015
CH090080	WAL-MART PHARMACY 10-1291	7150 EAST SPEEDWAY		TUCSON (E)	AZ	85710	04/01/2015
CH090080	WAL-MART PHARMACY 10-1325	455 EAST WETMORE		TUCSON (N)	AZ	85705	04/01/2015
CH090080	WAL-MART PHARMACY 10-1411	18680 SOUTH NOGALES HIGHWAY		GREEN VALLEY	AZ	85614	04/01/2015
CH090080	WAL-MART PHARMACY 10-1612	1650 WEST VALENCIA		TUCSON	AZ	85746	04/01/2015
CH090080	WAL-MART PHARMACY 10-2922	7635 NO. LA CHOLLA BLVD		TUCSON (FOOTHILLS)	AZ	85741	10/01/2015
CH090080	WAL-MART PHARMACY 10-3049	2550 S. KOLB RD.		TUCSON	AZ	85710	10/01/2015
CH090080	WAL-MART PHARMACY 10-3142	3900 W. INA ROAD		MARANA	AZ	85653	10/01/2015
CH090080	WAL-MART PHARMACY 10-3143	8640 E BROADWAY		TUCSON	AZ	85710	07/01/2019
CH090080	WAL-MART PHARMACY 10-3357	3925 EAST GRANT ROAD		TUCSON(ALVERNON)	AZ	85712	10/01/2015
CH090080	WAL-MART PHARMACY 10-3377	2823 WEST VALENCIA ROAD		TUSCON (CARDINAL)	AZ	85746	10/01/2015
CH090080	WAL-MART PHARMACY 10-4603	5500 E. 22ND ST.		TUCSON	AZ	85711	04/01/2015
CH090080	WAL-MART PHARMACY 10-5031	8280 NORTH CORTARO		TUCSON	AZ	85743	10/01/2015
CH09008Q	WAL-MART PHARMACY 10-5031	8280 NORTH CORTARO		TUCSON	AZ	85743	01/01/2024
CH090080	WAL-MART PHARMACY 10-5626	1260 E. TUSCON MKT		TUSCON	AZ	85713	10/01/2015
CH090080	WAL-MART PHARMACY 10-5858	9260 S. HOUGHTON RD		TUCSON	AZ	85747	07/01/2019
CH090080	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018
CH090080	WALGREEN ARIZONA DRUG CO	WALGREENS SPECIALTY PHARMACY #21213	5149 W THUNDERBIRD RD.	GLENDALE	AZ	85306	04/01/2024
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #15030	730 E GRANT ROAD	TUCSON	AZ	85719	10/01/2013	03/03/2020
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 01899	9495 EAST SPEEDWAY BLVD	TUCSON	AZ	85710	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #15502	8980 E TANQUE VERDE ROAD	TUCSON	AZ	85749	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02372	7114 NORTH ORACLE	TUCSON	AZ	85704	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02451	4220 N ORACLE RD	TUCSON	AZ	85705-1632	10/01/2013	11/09/2022
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02910	8730 E BROADWAY BLVD	TUCSON	AZ	85710	10/01/2013	02/28/2024
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03007	9470 E GOLF LINKS RD	TUCSON	AZ	85730	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03097	7115 E.TANQUE VERDE	TUCSON	AZ	85715	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03249	4910 NORTH FIRST AVE	TUCSON	AZ	85718	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03377	1900 S 6TH AVE	TUCSON	AZ	85713	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03447	12965 N ORACLE RD	TUCSON	AZ	85739	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03463	1415 W RIVER RD	TUCSON	AZ	85704	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03630	9220 N. THORNYDALE RD	TUCSON	AZ	85742	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03837	1550 W VALENCIA	TUCSON	AZ	85746	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03856	5480 E 22ND STREET	TUCSON	AZ	85711-5406	10/01/2013	03/02/2020
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04045	4685 E GRANT RD	TUCSON	AZ	85712	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04102	6767 E. BROADWAY BLVD.	TUCSON	AZ	85710	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04103	10405 N. LA CANADA DR.	ORO VALLEY	AZ	85737	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04104	2411 N. ORACLE ROAD	TUCSON	AZ	85705	10/01/2013	11/16/2015
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04266	2150 W ORANGE GROVE RD	TUCSON	AZ	85741	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04764	5455 E SPEEDWAY BLVD	TUCSON	AZ	85712	10/01/2013	02/21/2024
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05156	7800 N. CORTARO RD.	TUCSON	AZ	85743	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05209	3180 N CAMPBELL AVE	TUCSON	AZ	85719	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05532	2929 W VALENCIA ROAD	TUCSON	AZ	85746	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05750	10315 E BROADWAY BLVD	TUCSON	AZ	85748-3409	10/01/2013	03/09/2020
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05892	3910 E 22ND STREET	TUCSON	AZ	85711	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06244	4700 E BROADWAY BLVD	TUCSON	AZ	85711	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06245	7877 E SNYDER RD	TUCSON	AZ	85750	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06411	11951 N 1ST AVE	ORO VALLEY	AZ	85737-8787	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06491	1351 W PRINCE ROAD	TUCSON	AZ	85705	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06571	2180 W GRANT ROAD	TUCSON	AZ	85745-1142	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06645	5525 E RIVER RD	TUCSON	AZ	85750-1949	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06766	1880 E IRVINGTON ROAD	TUCSON	AZ	85714-1754	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06953	605 W AJO WAY	TUCSON	AZ	85713-6047	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07041	9184 E VALENCIA ROAD	TUCSON	AZ	85747-4902	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07104	1145 S HARRISON ROAD	TUCSON	AZ	85748-6640	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07203	2415 N ALVERNON WAY	TUCSON	AZ	85712-2501	10/01/2013	11/16/2015
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07209	3800 W INA RD	TUCSON	AZ	85741	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07232	9250 N COACHLINE BLVD	TUCSON	AZ	85743	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07304	2175 W INA ROAD	TUCSON	AZ	85741-2648	10/01/2013	11/08/2022
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07463	525 W VALENCIA ROAD	TUCSON	AZ	85706-7636	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09186	18600 S NOGALES HWY	GREEN VALLEY	AZ	85614	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA; WALGREENS #09952	12050 N DOVE MOUNTAIN BLVD	MARANA	AZ	85658-4211	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09953	7885 E SPEEDWAY BLVD	TUCSON	AZ	85710-1626	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #10684	13542 E COLOSSAL CAVE RD	VAIL	AZ	85641	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 10879	7111 E. GOLF LINKS RD.	TUCSON	AZ	85730	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 11183	3200 E SPEEDWAY	TUCSON	AZ	85716	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 13822	550 N. SILVERBELL RD	TUCSON	AZ	85745-3107	10/01/2013
CH090080	WALGREEN ARIZONA DRUG CO.	DBA WALGREENS SPECIALTY PHARMACY #21393	3627 N CAMPBELL AVE	TUCSON	AZ	85719	10/01/2018
CH090080	WALGREEN ARIZONA DRUG CO.	WALGREENS SPECIALTY PHARMACY #16500	1830 E. BROADWAY BLVD. SUITE 136	TUCSON	AZ	85719	10/01/2018
CH090080	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	10/01/2021
CH09008R	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02372	7114 NORTH ORACLE	TUCSON	AZ	85704	01/01/2024
CH09008S	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03463	1415 W RIVER RD	TUCSON	AZ	85704	01/01/2024	10/01/2024
CH09008V	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05156	7800 N. CORTARO RD.	TUCSON	AZ	85743	01/01/2024
CH09008W	WALGREEN ARIZONA DRUG CO.	WALGREENS SPECIALTY PHARMACY #16500	1830 E. BROADWAY BLVD. SUITE 136	TUCSON	AZ	85719	01/01/2024	04/01/2025
CH09008Y	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07209	3800 W INA RD	TUCSON	AZ	85741	01/01/2024
CH09008Z	WALGREEN ARIZONA DRUG CO.	DBA WALGREENS SPECIALTY PHARMACY #21393	3627 N CAMPBELL AVE	TUCSON	AZ	85719	01/01/2024
CH090080	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	10/01/2013	01/01/2018
CH090080	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	01/01/2018
CH090080	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	10/01/2019	10/01/2021
CH090080	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2019
CH090080	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/01/2019
CH090080	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2019
CH09008A	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/01/2024
CH09008AA	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/01/2024
CH09008AB	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/01/2024
CH090080	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	01/01/2018
CH090080	WALMART PHARMACY 10-4490	2565 E COMMERCE CENTER PLACE		TUCSON	AZ	85706	07/01/2019
CH090080	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH090080	WALMART PHARMACY 10-5725	831 E. FORT LOWELL RD.		TUCSON	AZ	85719	07/01/2019
CH090080	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH090080	WESTERN PHARMACY GROUP LLC	DBA COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY SUITES A--E	SAN DIEGO	CA	92102	04/20/2018	01/08/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/31/2024 8:57:00 AM	2/10/2025 9:43:17 AM	2/10/2025 9:43 AM
Contacts	Authorizing Official	Update	AO Change Request	Olson, Tamie Chief Financial Officer Marana Health Center, Inc. 5206824111-6221	Kurgat, Heidi Director of Compliance and Risk Marana Health Center 5735781344	3/27/2024 2:22 PM
Details	Last Recertification Date	Update	Recertification	1/31/2023 4:19:16 PM	1/31/2024 8:57:00 AM	1/31/2024 8:57 AM
Details	Last Recertification Date	Update	Recertification	1/31/2022 9:23:33 AM	1/31/2023 4:19:16 PM	1/31/2023 4:19 PM
Details	Last Recertification Date	Update	Recertification	2/8/2021 11:08:52 AM	1/31/2022 9:23:33 AM	1/31/2022 9:23 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/8/2021 11:08 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		929554	2/8/2021 11:08 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		AZ	2/8/2021 11:08 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/8/2021 11:08 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		369853	2/8/2021 11:08 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		AZ	2/8/2021 11:08 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1972662294 ( )		2/8/2021 11:08 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1972662294	2/8/2021 11:08 AM
Medicaid Billing	NPI: State	Insert	Recertification		AZ	2/8/2021 11:08 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1326417270	2/8/2021 11:08 AM
Medicaid Billing	NPI: State	Insert	Recertification		AZ	2/8/2021 11:08 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1154584977	2/8/2021 11:08 AM
Medicaid Billing	NPI: State	Insert	Recertification		AZ	2/8/2021 11:08 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 10:08:46 AM	2/8/2021 11:08:52 AM	2/8/2021 11:08 AM
Details	Last Recertification Date	Update	Recertification	2/15/2019 12:27:06 PM	1/28/2020 10:08:46 AM	1/28/2020 10:08 AM
Details	Last Recertification Date	Update	Recertification	2/21/2018 1:38:54 PM	2/15/2019 12:27:06 PM	2/15/2019 12:27 PM
Details	Last Recertification Date	Update	Recertification	2/1/2017 12:00:00 AM	2/21/2018 1:38:54 PM	2/21/2018 1:38 PM
Contacts	Authorizing Official	Update	AO Change Request	Arnoldi, Jania Chief Financial Officer 5206824111-6221	Olson, Tamie Chief Financial Officer Marana Health Center, Inc. 5206824111-6221	2/21/2018 1:13 PM
Contacts	Primary Contact	Update		Redding, Greg Pharmacy Director 5206824111	Redding, Greg Pharmacy Director MHC Health Care 5206824111	9/27/2017 12:11 PM
Contacts	Primary Contact	Insert			Redding, Greg Pharmacy Director 5206824111	2/1/2017 8:52 AM
Contacts	Authorizing Official	Insert			Arnoldi, Jania Chief Financial Officer 5206824111-6221	2/1/2017 8:52 AM
Addresses	Main Address	Insert			3690 S Park Ave STE 805 Tucson, AZ 85713-5042	2/1/2017 8:51 AM
Details	Last Recertification Date	Update		3/2/2016 12:00:00 AM	2/1/2017 12:00:00 AM	2/1/2017 8:51 AM
Details	Last Recertification Date	Update		3/10/2015 12:00:00 AM	3/2/2016 12:00:00 AM	3/2/2016 10:45 AM
Details	Last Recertification Date	Update		3/13/2014 12:00:00 AM	3/10/2015 12:00:00 AM	3/10/2015 10:52 AM
Addresses	Billing Address	Insert			Marana Health Center P.O. Box 188 Marana, AZ 85653	12/10/2014 12:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	12/10/2014 12:35 PM
Medicaid Billing	Medicaid: Number	Insert			914568	12/10/2014 12:35 PM
Medicaid Billing	Medicaid: State	Insert			AZ	12/10/2014 12:35 PM
Medicaid Billing	NPI: Number	Insert			1972662294	12/10/2014 12:35 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/13/2014 12:00:00 AM	3/13/2014 9:47 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/12/2013 7:55 AM
Details	Last Recertification Date	Insert				11/27/2007 12:32 PM
Details	Grant Number	Insert			H80CS00231	11/27/2007 12:32 PM
Details	340B ID	Insert			CH09008N	11/27/2007 12:32 PM
Details	Is Authorizing Official EHB Data	Insert				11/27/2007 12:32 PM
Dates	Last Date That 340B Drugs Purchased	Insert				11/27/2007 12:32 PM
Details	Medicare Provider Number	Insert				11/27/2007 12:32 PM
Details	Entity Name	Insert			MARANA HEALTH CENTER, INC.	11/27/2007 12:32 PM
Details	Program Code	Insert			CH	11/27/2007 12:32 PM
Details	Entity Subname	Insert			CLINICA DEL ALMA	11/27/2007 12:32 PM
Dates	Participating Approval Date	Insert			11/27/2007 12:00:00 AM	11/27/2007 12:32 PM
Details	State	Insert			Active	11/27/2007 12:32 PM
Dates	Registration Date	Insert			11/26/2007 12:00:00 AM	11/27/2007 12:32 PM
Dates	Signed By Date	Insert			11/14/2007 12:00:00 AM	11/27/2007 12:32 PM
Dates	Start Date	Insert			1/1/2008 12:00:00 AM	11/27/2007 12:32 PM
Terminations	Termination Comments	Insert				11/27/2007 12:32 PM
Terminations	Termination Date	Insert				11/27/2007 12:32 PM
Terminations	Termination Effective Date	Insert				11/27/2007 12:32 PM
Terminations	Termination Reason	Insert				11/27/2007 12:32 PM

340B Drug Pricing Program Database