Covered Entity Details

CH09359AA UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC. (Active) - information as of 5/29/2025 1:59:00 AM

Main Details

Name

UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.

Subdivision Name

United Community Health Center at Amado

Type

HRSA-Funded Health Center

Site ID

BPS-H80-010044

340B ID

CH09359AA

Grant Number

H80CS00416

Additional Details

Current Program Status

Active

Registration Date

10/27/2010

Participating Start Date

1/1/2011

Participating Approval Date

11/22/2010

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

United Community Health Center Maria Auxiliadora, Inc
Tamie Olson, Chief Financial Officer
(520) 407-5600

Primary Contact

United Community Health Center
Liberty Bruss, 340B Analyst
(520) 975-2166

Addresses

Street Address

28720 S Nogales Hwy
Amado, AZ 85645

Billing Address

UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC.
1260 S CAMPBELL AVE
BLDG 2
GREEN VALLEY, AZ 85614-0503

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?
No

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	Address Cont.	City	State
CH093590	Active	BPS-H80-001561	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	CONTINENTAL FAMILY MEDICAL CTR	1260 S. CAMPBELL RD	BLDG 1	GREEN VALLEY	AZ
CH09359AA	Active	BPS-H80-010044	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Center at Amado	28720 S Nogales Hwy		Amado	AZ
CH09359AC	Active	BPS-H80-010326	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Center at Sahuarita Heights	2875 E. Sahuarita Rd.		Sahuarita	AZ
CH09359AE	Active	BPS-H80-005934	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	UCHC Dental	1260 S Campbell Ave BLDG 1, STE 2		Green Valley	AZ
CH09359AG	Active	BPS-H80-012235	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Center at Old Vail Middle School	13299 E Colossal Cave Rd		Vail	AZ
CH09359AH	Active	BPS-H80-036362	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Center at Green Valley	4475 S I-19 Frontage Rd STE 139		Green Valley	AZ
CH09359AJ	Terminated	BPS-H80-027543	United Community Health Center-Maria Auxiliadora, Inc.	United Community Health Center at La Posada	670 S Park Centre Avenue		Green Valley	AZ
CH09359AK	Active	BPS-H80-024666	United Community Health Center-Maria Auxiliadora, Inc.	United Community Health Center at La Canada Pediatrics	18857 S La Canada Dr.		Sahuarita	AZ
CH09359B	Active	BPS-H80-006539	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Cener at Arivaca Clinic	17388 W. 3rd Street		Arivaca	AZ
CH09359C	Terminated	BPS-H80-006844	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	ALTAR VALLEY HLTH & WELLNESS CTR	9875 S. SASABE ROAD		TUCSON	AZ
CH09359D	Active	BPS-H80-000467	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Comminity Health Center at Three Points	15921 W. Ajo Way		Tucson	AZ
CH09359I	Active	BPS-H80-001561	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	Continental Family Medical Center	1260 S Campbell Ave BLDG 1, STE 1		Green Valley	AZ
CH09359K	Active	BPS-H80-001561	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	CONTINENTAL FAMILY MEDICAL CTR	1260 S. CAMPBELL RD		GREEN VALLEY	AZ
CH09359Z	Active	BPS-H80-012499	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	United Community Health Center at Freeport McMoRan Copper & Gold Building	1260 S Campbell Ave	BLDG 2	Green Valley	AZ

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH093590	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	04/01/2025
CH093590	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	04/01/2025
CH093590	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	04/01/2025
CH093590	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	04/01/2025
CH093590	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	04/01/2025
CH093590	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/01/2025
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09254	240 W CONTINENTAL RD	GREEN VALLEY	AZ	85622	04/01/2020
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09272	7499 E. BROADWAY	TUCSON	AZ	85710	04/01/2020	08/10/2021
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09274	615 N. ALVERNON	TUCSON	AZ	85711	04/01/2020	08/10/2021
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09277	6895 E. SUNRISE	TUCSON	AZ	85750	04/01/2020	08/10/2021
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09302	8920 E TANQUE VERDE	TUCSON	AZ	85749	04/01/2020
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09336	7901 E. GOLF LINKS ROAD	TUCSON	AZ	85730	04/01/2020
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09374	1900 W. VALENCIA RD.	TUCSON	AZ	85746	04/01/2020
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09207	865 E. GRANT	TUCSON	AZ	85719	04/01/2020	06/23/2022
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09211	6488 N. ORACLE ROAD	TUCSON	AZ	85704	04/01/2020
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09232	4748 E. SUNRISE DRIVE	TUCSON	AZ	85718	04/01/2020	08/10/2021
CH093590	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 09273	3785 WEST INA RD.	TUCSON	AZ	85741	04/01/2020	08/10/2021
CH093590	AVITA PHARMACY 1024	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	330 E LAMBERT RD STE 120	BREA	CA	92821-4100	10/01/2021
CH093590	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	10/01/2021
CH093590	AVITA PHARMACY 1026	PHARMBLUE ARIZONA LLC	1260 S CAMPBELL AVE STE 1152	GREEN VALLEY	AZ	85614-0504	04/01/2016
CH093590	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	10/01/2021
CH093590	AVITA PHARMACY 1060	RX BLUE STAR SOLUTIONS, LLC DBA AVITA PH	40 PENNWOOD PL STE 200	WARRENDALE	PA	15086-6625	10/01/2014
CH093590	FRY'S PHARMACY #083	1795 W VALENCIA RD		TUCSON	AZ	85746	10/01/2022
CH093590	GENOA HEALTHCARE LLC	1075 E FORT LOWELL RD		TUCSON	AZ	85719	04/01/2025
CH093590	GENOA HEALTHCARE LLC	4585 E SPEEDWAY BLVD	BLDG 2 STE P	TUCSON	AZ	85712	04/01/2025
CH093590	GENOA HEALTHCARE LLC	1501 W COMMERCE CT STE P		TUCSON	AZ	85746	04/01/2025
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 00091	8705 E SPEEDWAY BLVD	TUCSON	AZ	85710	04/01/2020	08/11/2022
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07855	2601 S. HOUGHTON RD.	TUCSON	AZ	85730	04/01/2020
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07867	5100 E. GRANT RD.	TUCSON	AZ	85712	04/01/2020
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07876	3832 EAST SPEEDWAY	TUCSON	AZ	85716	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10184	825 EAST UNIVERSITY BLVD., SUITE 101	TUCSON	AZ	85719	04/01/2020
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10307	6310 E. BROADWAY BLVD.	TUCSON	AZ	85710	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16296	6500 E GRANT RD	TUCSON	AZ	85715	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16659	1225 W IRVINGTON RD	TUCSON	AZ	85714	04/01/2020
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16772	3699 E BROADWAY BLVD	TUCSON	AZ	85716	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16983	9615 E OLD SPANISH TRL	TUCSON	AZ	85748	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07841	4365 N ORACLE RD	TUCSON	AZ	85705	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 07859	6370 N. CAMPBELL AVE., #120	TUCSON	AZ	85718	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA: CVS/PHARMACY # 08420	7740 N CORTARO RD	TUCSON	AZ	85743	04/01/2020
CH093590	GERMAN DOBSON CVS, L.L.C.	DBA CVS/PHARMACY # 10006	10650 NORTH ORACLE RD	ORO VALLEY	AZ	85737	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS/PHARMACY #10742	2385 N. SILVERBELL ROAD	TUCSON	AZ	85745	04/01/2020	08/10/2021
CH093590	GERMAN DOBSON CVS, L.L.C.	CVS PHARMACY # 16217	10555 N ORACLE RD	ORO VALLEY	AZ	85737	04/01/2020	08/10/2021
CH093590	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	10/01/2021
CH093590	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	04/01/2025
CH093590	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	04/01/2025
CH093590	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/01/2025
CH093590	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2025
CH093590	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	04/01/2025
CH093590	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2025
CH093590	PHARMBLUE LLC DBA AVITA PHARMACY 1059	1226 CHESTNUT ST		PHILADELPHIA	PA	19107	10/01/2014
CH093590	SAFEWAY INC	SAFEWAY PHARMACY #1771	1305 W. DUVAL MINE ROAD	GREEN VALLEY	AZ	85614	01/01/2023
CH093590	SAFEWAY INC	SAFEWAY PHARMACY #2044	260 W CONTINENTAL RD	GREEN VALLEY	AZ	85622-3555	01/01/2023
CH093590	SAFEWAY INC	SAFEWAY PHARMACY #0267	2940 W. VALENCIA ROAD	TUCSON	AZ	85746	04/01/2025
CH093590	SAFEWAY INC.	SAFEWAY PHARMACY #2809	13380 E. MARY ANN CLEVELAND WAY	VAIL	AZ	85641	04/01/2025
CH093590	SMITHS FOOD AND DRUG CENTERS INC.	DBA: FRY'S FOOD STRORES OF AZ #679	15950 SOUTH RANCHO SAHUARITA BLVD	SAHUARITA	AZ	85629	10/01/2022
CH093590	SMITHS FOOD DRUG CTRS. INC	DBA FRYS FOOD DRUG #90	8080 S. HOUGHTON RD	TUCSON	AZ	85747-9791	10/01/2022
CH093590	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2022
CH093590	WAL-MART PHARMACY 10-1324	100 WEST WHITE PARK DR		NOGALES	AZ	85621	10/01/2022
CH093590	WAL-MART PHARMACY 10-1411	18680 SOUTH NOGALES HIGHWAY		GREEN VALLEY	AZ	85614	10/01/2022
CH093590	WAL-MART PHARMACY 10-1612	1650 WEST VALENCIA		TUCSON	AZ	85746	04/01/2025
CH093590	WAL-MART PHARMACY 10-3377	2823 WEST VALENCIA ROAD		TUSCON (CARDINAL)	AZ	85746	10/01/2022
CH093590	WAL-MART PHARMACY 10-5858	9260 S. HOUGHTON RD		TUCSON	AZ	85747	04/01/2025
CH093590	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2022
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05532	2929 W VALENCIA ROAD	TUCSON	AZ	85746	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02232	313 W ESPERANZA BLVD	GREEN VALLEY	AZ	85614	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07623	1959 N GRAND AVE	NOGALES	AZ	85621-1341	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06766	1880 E IRVINGTON ROAD	TUCSON	AZ	85714-1754	03/01/2011	07/14/2022
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07463	525 W VALENCIA ROAD	TUCSON	AZ	85706-7636	03/01/2011	11/07/2024
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06953	605 W AJO WAY	TUCSON	AZ	85713-6047	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05312	375 W CONTINENTAL RD	GREEN VALLEY	AZ	85622	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05892	3910 E 22ND STREET	TUCSON	AZ	85711	03/01/2011	07/14/2022
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03837	1550 W VALENCIA	TUCSON	AZ	85746	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09186	18600 S NOGALES HWY	GREEN VALLEY	AZ	85614	03/01/2011
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #10684	13542 E COLOSSAL CAVE RD	VAIL	AZ	85641	01/01/2013
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03463	1415 W RIVER RD	TUCSON	AZ	85704	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04104	2411 N. ORACLE ROAD	TUCSON	AZ	85705	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02451	4220 N ORACLE RD	TUCSON	AZ	85705-1632	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04102	6767 E. BROADWAY BLVD.	TUCSON	AZ	85710	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03856	5480 E 22ND STREET	TUCSON	AZ	85711-5406	01/01/2013	08/28/2020
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04045	4685 E GRANT RD	TUCSON	AZ	85712	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03377	1900 S 6TH AVE	TUCSON	AZ	85713	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 11183	3200 E SPEEDWAY	TUCSON	AZ	85716	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #15030	730 E GRANT ROAD	TUCSON	AZ	85719	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05209	3180 N CAMPBELL AVE	TUCSON	AZ	85719	01/01/2013
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 10879	7111 E. GOLF LINKS RD.	TUCSON	AZ	85730	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03007	9470 E GOLF LINKS RD	TUCSON	AZ	85730	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04266	2150 W ORANGE GROVE RD	TUCSON	AZ	85741	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03630	9220 N. THORNYDALE RD	TUCSON	AZ	85742	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05156	7800 N. CORTARO RD.	TUCSON	AZ	85743	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06571	2180 W GRANT ROAD	TUCSON	AZ	85745-1142	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 13822	550 N. SILVERBELL RD	TUCSON	AZ	85745-3107	01/01/2013	07/14/2022
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07041	9184 E VALENCIA ROAD	TUCSON	AZ	85747-4902	01/01/2013
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05750	10315 E BROADWAY BLVD	TUCSON	AZ	85748-3409	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06245	7877 E SNYDER RD	TUCSON	AZ	85750	01/01/2013	01/12/2016
CH093590	WALGREEN ARIZONA DRUG CO.	WALGREENS SPECIALTY PHARMACY #16500	1830 E. BROADWAY BLVD. SUITE 136	TUCSON	AZ	85719	10/01/2021
CH093590	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	10/01/2021
CH093590	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	01/01/2022	10/28/2021
CH093590	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2013	01/12/2016
CH093590	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2013	08/17/2015
CH093590	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH093590	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Change Request	Dixon, Dave Director of Accounting & Finance United Community Health Center 5204075600	Bruss, Liberty 340B Analyst United Community Health Center 5209752166	4/28/2025 1:55 PM
Contacts	Primary Contact	Update	Recertification	Hooker, Timothy Accounting Manager United Community Health Center Maria Auxiliadora, Inc 5204075615	Dixon, Dave Director of Accounting & Finance United Community Health Center 5204075600	2/11/2025 6:58 AM
Details	Last Recertification Date	Update	Recertification	2/14/2024 4:18:08 PM	2/11/2025 6:58:54 AM	2/11/2025 6:58 AM
Addresses	Billing Address	Update	Change Request	UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC. 1260 S. CAMPBELL ROAD BLDG 2 GREEN VALLEY, AZ 85614-0503	UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC. 1260 S CAMPBELL AVE BLDG 2 GREEN VALLEY, AZ 85614-0503	10/16/2024 10:43 AM
Contacts	Authorizing Official	Update	Group Change Request	Parnell, Brenda Chief Financial Officer United Community Health Center Maria Auxiliadora, Inc 5205372568	Olson, Tamie Chief Financial Officer United Community Health Center Maria Auxiliadora, Inc 5204075600	10/16/2024 7:19 AM
Contacts	Authorizing Official	Update	AO Change Request	Pippin, Claudette Chief Executive Officer - Interim United Community Health Center 5204075602	Parnell, Brenda Chief Financial Officer United Community Health Center Maria Auxiliadora, Inc 5205372568	2/15/2024 10:32 AM
Contacts	Primary Contact	Update	PC Change Request	Parnell, Brenda Chief Financial Officer United Community Health Center Maria Auxiliadora, Inc 5205372568	Hooker, Timothy Accounting Manager United Community Health Center Maria Auxiliadora, Inc 5204075615	2/14/2024 5:18 PM
Details	Last Recertification Date	Update	Recertification	2/14/2023 3:03:34 PM	2/14/2024 4:18:08 PM	2/14/2024 4:18 PM
Contacts	Authorizing Official	Update	Profile Change Request	Pippin, Claudette Chief Financial Officer United Community Health Center 5204075602	Pippin, Claudette Chief Executive Officer - Interim United Community Health Center 5204075602	2/15/2023 6:46 AM
Details	Last Recertification Date	Update	Recertification	2/8/2022 11:42:16 AM	2/14/2023 3:03:34 PM	2/14/2023 3:03 PM
Contacts	Primary Contact	Update	Group Change Request	Kibby, Wendy COO United Community Health Center 5204075606	Parnell, Brenda Chief Financial Officer United Community Health Center Maria Auxiliadora, Inc 5205372568	1/27/2023 5:26 PM
Details	Last Recertification Date	Update	Recertification	2/5/2021 1:39:05 PM	2/8/2022 11:42:16 AM	2/8/2022 11:42 AM
Details	Last Recertification Date	Update	Recertification	2/18/2020 5:10:33 PM	2/5/2021 1:39:05 PM	2/5/2021 1:39 PM
Details	Last Recertification Date	Update	Recertification	1/29/2019 12:20:53 PM	2/18/2020 5:10:33 PM	2/18/2020 5:10 PM
Contacts	Authorizing Official	Update	Change Request	DeSpain, Dustin W CFO CH093590 5204075602	Pippin, Claudette Chief Financial Officer United Community Health Center 5204075602	9/23/2019 3:18 PM
Details	Last Recertification Date	Update	Recertification	2/13/2018 5:05:41 PM	1/29/2019 12:20:53 PM	1/29/2019 12:20 PM
Contacts	Primary Contact	Update	Recertification	Woodworth, Thomas P. CFO CH093590 5204075602	Kibby, Wendy COO United Community Health Center 5204075606	2/13/2018 5:05 PM
Details	Last Recertification Date	Update	Recertification	1/25/2017 12:00:00 AM	2/13/2018 5:05:41 PM	2/13/2018 5:05 PM
Contacts	Authorizing Official	Update	AO Change Request	Woodworth, Thomas P. CFO 5204075602	DeSpain, Dustin W CFO CH093590 5204075602	11/20/2017 4:20 PM
Contacts	Primary Contact	Update		Woodworth, Thomas P. CFO 5204075602	Woodworth, Thomas P. CFO CH093590 5204075602	11/13/2017 11:37 AM
Addresses	Main Address	Insert			28720 S Nogales Hwy Amado, AZ 85645	1/25/2017 3:14 PM
Contacts	Authorizing Official	Insert			Woodworth, Thomas P. CFO 5204075602	1/25/2017 3:14 PM
Contacts	Primary Contact	Insert			Woodworth, Thomas P. CFO 5204075602	1/25/2017 3:14 PM
Details	Last Recertification Date	Update		2/12/2016 12:00:00 AM	1/25/2017 12:00:00 AM	1/25/2017 3:14 PM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/12/2016 12:00:00 AM	2/24/2016 10:55 AM
Details	Last Recertification Date	Update		2/12/2014 12:00:00 AM	2/12/2015 12:00:00 AM	2/12/2015 12:53 PM
Details	Entity Name	Update		UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC.	UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.	3/31/2014 4:25 PM
Details	Entity Subname	Update		UNITED COMMUNITY HEALTH CENTER AT AMADO	United Community Health Center at Amado	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/12/2014 12:00:00 AM	2/12/2014 11:17 AM
Addresses	Billing Address	Insert			UNITED COMMUNITY HEALTH CENTER, INC. 81 W ESPERANZA BLVD., SUITE 201 GREEN VALLEY, AZ 85614	12/6/2013 9:07 AM
Addresses	Billing Address	Update		UNITED COMMUNITY HEALTH CENTER, INC. 81 W ESPERANZA BLVD., SUITE 201 GREEN VALLEY, AZ 85614	UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC. 1260 S. CAMPBELL ROAD BLDG 2 GREEN VALLEY, AZ 85614-0503	12/6/2013 9:07 AM
Details	Entity Name	Update		UNITED COMMUNITY HEALTH CENTER, INC.	UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC.	12/6/2013 9:07 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/20/2013 9:36 AM
Details	Last Recertification Date	Insert				11/22/2010 12:03 PM
Details	Grant Number	Insert			H80CS00416	11/22/2010 12:03 PM
Details	340B ID	Insert			CH09359AA	11/22/2010 12:03 PM
Details	Is Authorizing Official EHB Data	Insert				11/22/2010 12:03 PM
Dates	Last Date That 340B Drugs Purchased	Insert				11/22/2010 12:03 PM
Details	Medicare Provider Number	Insert				11/22/2010 12:03 PM
Details	Entity Name	Insert			UNITED COMMUNITY HEALTH CENTER, INC.	11/22/2010 12:03 PM
Details	Program Code	Insert			CH	11/22/2010 12:03 PM
Details	Entity Subname	Insert			UNITED COMMUNITY HEALTH CENTER AT AMADO	11/22/2010 12:03 PM
Dates	Participating Approval Date	Insert			11/22/2010 12:00:00 AM	11/22/2010 12:03 PM
Details	State	Insert			Active	11/22/2010 12:03 PM
Dates	Registration Date	Insert			10/27/2010 12:00:00 AM	11/22/2010 12:03 PM
Dates	Signed By Date	Insert			10/7/2010 12:00:00 AM	11/22/2010 12:03 PM
Dates	Start Date	Insert			1/1/2011 12:00:00 AM	11/22/2010 12:03 PM
Terminations	Termination Comments	Insert				11/22/2010 12:03 PM
Terminations	Termination Date	Insert				11/22/2010 12:03 PM
Terminations	Termination Effective Date	Insert				11/22/2010 12:03 PM
Terminations	Termination Reason	Insert				11/22/2010 12:03 PM

340B Drug Pricing Program Database