Covered Entity Details

CH09534A Altura Centers for Health (Terminated) - information as of 5/13/2025 1:30:47 AM

Main Details

Name

Altura Centers for Health

Subdivision Name

Altura Centers for Health Pediatrics

Type

HRSA-Funded Health Center

Site ID

BPS-H80-004719

340B ID

CH09534A

Grant Number

H80CS00338

Additional Details

Current Program Status

Terminated

Registration Date

3/1/2008

Participating Start Date

4/1/2008

Participating Approval Date

3/3/2008

Last Recertification Date

2/2/2024

Termination Date
Termination Reason

10/1/2024
Other

Contacts

Authorizing Official

Altura Centers for Health
GRACIELA Soto Perez, CEO
(559) 685-4601

Primary Contact

Altura Centers for Health
Dawn Wells, Grants Specialist
(559) 816-3612

Addresses

Street Address

1186 Leland Ave
Tulare, CA 93274-7811

Billing Address

Altura Centers for Health
1134 E Cartmill Avenue
Tulare, CA 93274

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
CA	1568827210	1568827210

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
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH095340	Active	BPS-H80-038449	Altura Centers for Health	Altura Centers for Health Cartmill Campus	1134 E Cartmill Avenue	TULARE	CA
CH09534A	Terminated	BPS-H80-004719	Altura Centers for Health	Altura Centers for Health Pediatrics	1186 Leland Ave	Tulare	CA
CH09534B	Active	BPS-H80-005500	Altura Centers for Health	Altura Centers for Health Main Clinic	1101 N Cherry St	Tulare	CA
CH09534C	Active	BPS-H80-009841	Altura Centers for Health	Altura Centers for Health Multi Services	1203 N Cherry St	Tulare	CA
CH09534D	Active	BPS-H80-000986	Altura Centers for Health	Altura Centers for Health Mobile Clinic 1	1134 E Cartmill Avenue	Tulare	CA
CH09534E	Active	BPS-H80-012664	Altura Centers for Health	Altura Centers for Health South Tulare	3035 E Bardsley Ave	Tulare	CA
CH09534F	Terminated	BPS-H80-005585	Altura Centers for Health	Altura Centers for Health Administration	1201 N Cherry St	Tulare	CA
CH09534G	Active	BPS-H80-013798	Altura Centers for Health	Altura Centers for Health Woodville	16686 ROAD 168	WOODVILLE	CA
CH09534H	Active	BPS-H80-017458	ALTURA CENTERS FOR HEALTH	Altura Centers for Health West Tulare	1500 West Tulare Drive	Tulare	CA
CH09534J	Active	BPS-H80-014014	Altura Centers for Health	Altura Centers for Health Mobile Clinic 2	1134 E Cartmill Avenue	TULARE	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH095340	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2023
CH095340	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2023
CH095340	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2023
CH095340	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2023
CH095340	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2023
CH095340	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2023
CH095340	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2023
CH095340	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2023
CH095340	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2023
CH095340	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2023
CH095340	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/01/2023
CH095340	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/01/2023
CH095340	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2023
CH095340	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/01/2023
CH095340	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2019
CH095340	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	07/01/2021
CH09534B	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00035	800 N. WESTWOOD ST.	PORTERVILLE	CA	93257	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 00912	2175 E. BARDSLEY AVE.	TULARE	CA	93274	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02541	1102 N. DEMAREE ST.	VISALIA	CA	93291	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 02944	53 E. OLIVE AVE.	PORTERVILLE	CA	93257	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05551	109 SOUTH WEST ST.	TULARE	CA	93274	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16928	4247 S MOONEY BLVD	VISALIA	CA	93277	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17025	140 N 12TH AVE	HANFORD	CA	93230	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17414	2195 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17520	3308 N DINUBA BLVD	VISALIA	CA	93291	10/01/2024
CH09534B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534F	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534H	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17477	1363 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH095340	GKN RX	GKN RX INC.	7072 N CEDAR AVE GKN RX INC	FRESNO	CA	93720	10/01/2023	07/06/2023
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 04652	590 W PUTNAM AVE	PORTERVILLE	CA	93257	10/01/2019	06/29/2022
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2019
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2019
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2019
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2019
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2019
CH095340	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2019
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09176	1395 E PROSPERITY AVE	TULARE	CA	93274	10/01/2024
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09271	3619 W. CALDWELL AVE	VISALIA	CA	93277	10/01/2024
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09500	1455 E NOBLE AVE	VISALIA	CA	93292	10/01/2024
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09828	574 W LACEY BLVD	HANFORD	CA	93230	10/01/2024
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09845	1155 W HENDERSON AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534F	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024	10/01/2024
CH09534G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534H	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH09534J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09893	2539 N 11TH AVE	HANFORD	CA	93230	10/01/2024
CH095340	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2023
CH095340	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2023
CH095340	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2023
CH095340	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2023
CH095340	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	07/01/2020
CH095340	THRIFTY PAYLESS, INC.	RITE AID #5805	2727 SOUTH MOONEY BLVD.	VISALIA	CA	93277	07/01/2020	02/10/2022
CH095340	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	07/01/2020
CH095340	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	07/01/2020
CH095340	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	07/01/2020
CH095340	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2020
CH09534B	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534C	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534D	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534E	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534F	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024	10/01/2024
CH09534G	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534H	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534J	THRIFTY PAYLESS, INC.	RITE AID #5798	262 NORTH HIGHWAY 65	LINDSAY	CA	93247	10/01/2024
CH09534B	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534C	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534D	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534E	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534F	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024	10/01/2024
CH09534G	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534H	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534J	THRIFTY PAYLESS, INC.	RITE AID #5806	5212 WEST WALNUT AVENUE	VISALIA	CA	93277	10/01/2024
CH09534B	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534C	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534D	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534E	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534F	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534H	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534J	THRIFTY PAYLESS, INC.	RITE AID #6454	1645 E TULARE AVENUE	TULARE	CA	93274	10/01/2024
CH09534B	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534C	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534D	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534E	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534F	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024	10/01/2024
CH09534G	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534H	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534J	THRIFTY PAYLESS, INC.	RITE AID #6459	1735 E WALNUT AVENUE	VISALIA	CA	93292	10/01/2024
CH09534B	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534C	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534D	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534E	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534F	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534H	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH09534J	THRIFTY PAYLESS, INC.	RITE AID #5799	66 WEST MORTON AVENUE	PORTERVILLE	CA	93257	10/01/2024
CH095340	THRIFTY PAYLESS, INC.	RITE AID #6764	1710 N FARMERSVILLE BLVD	FARMERSVILLE	CA	93223	01/01/2025
CH095340	VISALIA HEALTH CENTER PHARMACY		2611 NORTH DINUBA BLVD.	VISALIA	CA	93291	07/01/2013	03/23/2018
CH09534B	VISALIA HEALTH CENTER PHARMACY		2611 NORTH DINUBA BLVD.	VISALIA	CA	93291	07/01/2013	03/28/2018
CH09534C	VISALIA HEALTH CENTER PHARMACY		2611 NORTH DINUBA BLVD.	VISALIA	CA	93291	07/01/2013	03/28/2018
CH095340	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2020
CH095340	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	07/01/2020
CH09534B	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534C	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534D	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534E	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534F	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024	10/01/2024
CH09534G	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534H	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH09534J	WAL-MART PHARMACY 10-1645	250 S 12TH AVE		HANFORD	CA	93230	10/01/2024
CH095340	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2020
CH09534B	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534C	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534D	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534E	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534F	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534H	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH09534J	WAL-MART PHARMACY 10-1877	1250 WEST HENDERSON AVE		PORTERVILLE	CA	93257	10/01/2024
CH095340	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	07/01/2020
CH09534B	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534C	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534D	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534E	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534F	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024	10/01/2024
CH09534G	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534H	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH09534J	WAL-MART PHARMACY 10-2536	1110 EAST PROSPERITY AVE		TULARE	CA	93274	10/01/2024
CH095340	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	07/01/2020
CH09534B	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534C	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534D	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534E	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534F	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024	10/01/2024
CH09534G	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534H	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH09534J	WAL-MART PHARMACY 10-5215	530 WOOLLOMES AVE		DELANO	CA	93215	10/01/2024
CH095340	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	07/01/2020
CH09534B	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534C	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534D	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534E	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534F	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024	10/01/2024
CH09534G	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534H	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH09534J	WAL-MART PHARMACY 10-5635	1320 N DEMAREE ST		VISALIA	CA	93291	10/01/2024
CH095340	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2020
CH095340	WALGREEN CO.	DBA: WALGREENS # 02869	1407 N DINUBA BLVD	VISALIA	CA	93291	07/01/2013	07/23/2018
CH095340	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	07/01/2013
CH095340	WALGREEN CO.	DBA: WALGREENS # 06298	49 W TULARE AVE	TULARE	CA	93274	07/01/2013	07/27/2020
CH095340	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	07/01/2013
CH095340	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	07/01/2013
CH095340	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	07/01/2013
CH095340	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	07/01/2013
CH09534B	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534C	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534D	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534E	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534F	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024	10/01/2024
CH09534G	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534H	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534J	WALGREEN CO.	DBA: WALGREENS # 03476	100 W WALNUT AVE	VISALIA	CA	93277	10/01/2024
CH09534B	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534C	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534D	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534E	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534F	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024	10/01/2024
CH09534G	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534H	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534J	WALGREEN CO.	DBA: WALGREENS # 06683	5328 W CYPRESS AVENUE	VISALIA	CA	93277	10/01/2024
CH09534B	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534C	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534D	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534E	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534F	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024	10/01/2024
CH09534G	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534H	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534J	WALGREEN CO.	DBA: WALGREENS #09844	416 W. OLIVE AVE	PORTERVILLE	CA	93257	10/01/2024
CH09534B	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534C	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534D	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534E	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534F	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024	10/01/2024
CH09534G	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534H	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534J	WALGREEN CO.	DBA: WALGREENS # 10002	1418 EAST PROSPERITY AVENUE	TULARE	CA	93274-8054	10/01/2024
CH09534B	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534C	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534D	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534E	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534F	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024	10/01/2024
CH09534G	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534H	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH09534J	WALGREEN CO.	DBA: WALGREENS #11407	3010 N DEMAREE ST	VISALIA	CA	93291-7147	10/01/2024
CH095340	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/01/2023
CH095340	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/01/2023
CH095340	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/01/2023
CH095340	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH095340	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH095340	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2023
CH09534B	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534C	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534D	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534E	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534F	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024	10/01/2024
CH09534G	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534H	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024
CH09534J	WALNUT PHARMACY LLC	10331 W GOSHEN AVE UNIT B		VISALIA	CA	93291	10/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2024 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		6/21/2024 12:00:00 AM	7/1/2024 5:39 PM
Details	State	Update	Termination Request	Active	To Be Terminated	7/1/2024 5:39 PM
Terminations	Termination Comments	Update	Termination Request		Closed location.	7/1/2024 5:39 PM
Terminations	Termination Date	Update	Termination Request		10/1/2024 12:00:00 AM	7/1/2024 5:39 PM
Terminations	Termination Effective Date	Update	Termination Request		6/21/2024 12:00:00 AM	7/1/2024 5:39 PM
Terminations	Termination Reason	Update	Termination Request		Other	7/1/2024 5:39 PM
Addresses	Billing Address	Update	Group Change Request	Altura Centers for Health 1201 N CHERRY STREET TULARE, CA 93274	Altura Centers for Health 1134 E Cartmill Avenue Tulare, CA 93274	6/6/2024 1:37 PM
Details	Last Recertification Date	Update	Recertification	1/30/2023 1:36:33 PM	2/2/2024 11:39:00 AM	2/2/2024 11:39 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	9/21/2023 2:51 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1568827210	9/21/2023 2:51 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CA	9/21/2023 2:51 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1811174725 (CA)		9/21/2023 2:51 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1568827210	9/21/2023 2:51 PM
Medicaid Billing	NPI: State	Insert	Change Request		CA	9/21/2023 2:51 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1811174725	1/30/2023 1:36 PM
Medicaid Billing	NPI: State	Insert	Recertification		CA	1/30/2023 1:36 PM
Details	Last Recertification Date	Update	Recertification	2/1/2022 3:09:21 PM	1/30/2023 1:36:33 PM	1/30/2023 1:36 PM
Details	Last Recertification Date	Update	Recertification	2/2/2021 4:38:15 PM	2/1/2022 3:09:21 PM	2/1/2022 3:09 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	FHC53895F (CA)		2/2/2021 4:38 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1811174725 ( )		2/2/2021 4:38 PM
Details	Last Recertification Date	Update	Recertification	1/29/2020 2:24:31 PM	2/2/2021 4:38:15 PM	2/2/2021 4:38 PM
Details	Last Recertification Date	Update	Recertification	1/31/2019 8:24:59 AM	1/29/2020 2:24:31 PM	1/29/2020 2:24 PM
Addresses	Billing Address	Update	Recertification	TULARE COMMUNITY HEALTH CLINIC 1201 N CHERRY STREET TULARE, CA 93274	Altura Centers for Health 1201 N CHERRY STREET TULARE, CA 93274	1/31/2019 8:24 AM
Details	Last Recertification Date	Update	Recertification	2/7/2018 10:40:26 AM	1/31/2019 8:24:59 AM	1/31/2019 8:24 AM
Details	Entity Name	Update	Recertification	TULARE COMMUNITY HEALTH CLINIC	Altura Centers for Health	1/31/2019 8:24 AM
Details	Entity Subname	Update	Recertification	TULARE COMM HEALTH PEDIATRICS SITE	Altura Centers for Health Pediatrics	1/31/2019 8:24 AM
Contacts	Authorizing Official	Update	Profile Change Request	PEREZ, GRACIELA SOTO CEO Altura Centers for Health 5596854601	Soto Perez, GRACIELA CEO Altura Centers for Health 5596854601	2/7/2018 10:43 AM
Contacts	Primary Contact	Update	Recertification	PEREZ, GRACIELA SOTO CEO Altura Centers for Health 5596854601	Wells, Dawn Grants Specialist Altura Centers for Health 5598163612	2/7/2018 10:40 AM
Details	Last Recertification Date	Update	Recertification	1/26/2017 12:00:00 AM	2/7/2018 10:40:26 AM	2/7/2018 10:40 AM
Contacts	Authorizing Official	Update		PEREZ, GRACIELA SOTO CEO 5596854601	PEREZ, GRACIELA SOTO CEO Altura Centers for Health 5596854601	1/8/2018 10:51 AM
Contacts	Primary Contact	Update		PEREZ, GRACIELA SOTO CEO 5596854601	PEREZ, GRACIELA SOTO CEO Altura Centers for Health 5596854601	1/8/2018 10:51 AM
Contacts	Authorizing Official	Insert			PEREZ, GRACIELA SOTO CEO 5596854601	1/28/2017 7:59 AM
Contacts	Primary Contact	Insert			PEREZ, GRACIELA SOTO CEO 5596854601	1/28/2017 7:59 AM
Addresses	Main Address	Insert			1186 Leland Ave Tulare, CA 93274-7811	1/26/2017 4:05 PM
Details	Last Recertification Date	Update		2/18/2016 12:00:00 AM	1/26/2017 12:00:00 AM	1/26/2017 4:05 PM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/18/2016 12:00:00 AM	2/18/2016 10:38 AM
Details	Last Recertification Date	Update		2/10/2014 12:00:00 AM	2/12/2015 12:00:00 AM	2/12/2015 12:55 PM
Details	Entity Subname	Update			TULARE COMM HEALTH PEDIATRICS SITE	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/10/2014 12:00:00 AM	2/10/2014 12:03 PM
Medicaid Billing	Medicaid: Is Primary	Update		True	False	2/14/2013 1:21 PM
Medicaid Billing	Medicaid: Number	Update		PENDING	FHC53895F	2/14/2013 1:21 PM
Medicaid Billing	NPI: Number	Insert			1811174725	2/14/2013 1:21 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/14/2013 1:21 PM
Addresses	Billing Address	Insert			TULARE COMMUNITY HEALTH CLINIC 1201 N CHERRY STREET TULARE, CA 93274	3/3/2008 11:21 AM
Details	Last Recertification Date	Insert				3/3/2008 11:21 AM
Details	Grant Number	Insert			H80CS00338	3/3/2008 11:21 AM
Details	340B ID	Insert			CH09534A	3/3/2008 11:21 AM
Details	Is Authorizing Official EHB Data	Insert				3/3/2008 11:21 AM
Dates	Last Date That 340B Drugs Purchased	Insert				3/3/2008 11:21 AM
Details	Medicare Provider Number	Insert				3/3/2008 11:21 AM
Details	Entity Name	Insert			TULARE COMMUNITY HEALTH CLINIC	3/3/2008 11:21 AM
Details	Program Code	Insert			CH	3/3/2008 11:21 AM
Details	Entity Subname	Insert				3/3/2008 11:21 AM
Dates	Participating Approval Date	Insert			3/3/2008 12:00:00 AM	3/3/2008 11:21 AM
Details	State	Insert			Active	3/3/2008 11:21 AM
Dates	Registration Date	Insert			3/1/2008 12:00:00 AM	3/3/2008 11:21 AM
Dates	Signed By Date	Insert			11/9/2007 12:00:00 AM	3/3/2008 11:21 AM
Dates	Start Date	Insert			4/1/2008 12:00:00 AM	3/3/2008 11:21 AM
Terminations	Termination Comments	Insert				3/3/2008 11:21 AM
Terminations	Termination Date	Insert				3/3/2008 11:21 AM
Terminations	Termination Effective Date	Insert				3/3/2008 11:21 AM
Terminations	Termination Reason	Insert				3/3/2008 11:21 AM
Medicaid Billing	Medicaid: Is Primary	Insert			True	3/1/2008 5:03 PM
Medicaid Billing	Medicaid: Number	Insert			PENDING	3/1/2008 5:03 PM
Medicaid Billing	Medicaid: State	Insert			CA	3/1/2008 5:03 PM

340B Drug Pricing Program Database