340B Drug Pricing Program Database


FQHC638494A Rolling Hills Clinic (Active) - information as of 4/28/2025 12:44:09 AM

Main Details
Rolling Hills Clinic
Tribal Contract/Compact with IHS (P.L. 93-638)
FQHC638494A


Additional Details
Active
9/6/2011
1/1/2012
12/29/2011
2/13/2025

Contacts

Rolling Hills Clinic
Stephen Stake, Executive Director
(530) 900-7547

Rolling Hills Clinic
Torey Lam, 340B Program Manager
(808) 499-5491

Addresses

2526 Sister Mary Columba Drive
Red Bluff, CA 96080

Rolling Hills Clinic
PO Box 908
Corning, CA 96021


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailCHICO PHARMACY251 COHASSET RD STE 100
CHICOCA95926-223508/02/201208/02/2012 02/07/202302/07/2023
Contract DetailCLARK'S DRUG STORE PHARMACY  2126 SOLANO STREET
CORNINGCA9602108/02/201208/02/2012 02/07/202302/07/2023
Contract DetailCORNERSTONE PHARMACY SERVSDBA LATIMERS PHARMACY 7885 HIGHWAY 99E
P.O. BOX 117 		LOS MOLINOSCA9605509/05/201209/05/2012 12/31/202307/09/2024
Contract DetailCURANT HEALTH FLORIDA, LLC11001 ROOSEVELT BLVD STE 1400
ST PETERSBURGFL33716-233804/11/202407/01/2024 07/01/202407/09/2024
Contract DetailCURANT HEALTH GEORGIA LLCCURANT HEALTH 200 TECHNOLOGY CT SE BLDG 200
SUITE B 		SMYRNAGA30082-525004/11/202407/01/2024 07/01/202407/09/2024
Contract DetailELMORE PHARMACYTEHAMA PHARMACY AND TRADING COMPANY, INC 401 WALNUT ST
RED BLUFFCA9608007/09/202410/01/2024  10/01/2024
Contract DetailORLANDCARE PHARMACY AND MEDICAL SUPPLYORLANDCARE PHARMACY AND MEDICAL SUPPLY 21 E WALKER ST
ORLANDCA9596307/09/202410/01/2024  10/01/2024
Contract DetailTIN RX1322 SOLANO ST.
CORNINGCA9602104/12/201807/01/2018 12/31/202307/09/2024
Contract DetailWEST-END PHARMACY965 99W STE 127
CORNINGCA96021-274207/09/202410/01/2024 07/01/202407/17/2024
Contract DetailWEST-END PHARMACY965 99W STE 127
CORNINGCA96021-274210/11/202401/01/2025  01/01/2025
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsAuthorizing OfficialUpdateAO Change RequestDeuchars, Elizabeth Controller Rolling Hills Clinic 5306902790Stake, Stephen Executive Director Rolling Hills Clinic 53090075472/23/2025 8:28 AM
DetailsLast Recertification DateUpdateRecertification2/20/2024 3:51:49 PM2/13/2025 12:32:05 PM2/13/2025 12:32 PM
ContactsPrimary ContactUpdateProfile Change RequestLam, Torey 340B Contractor Rolling Hills Clinic 8084995491Lam, Torey 340B Program Manager Rolling Hills Clinic 808499549110/11/2024 6:47 PM
ContactsPrimary ContactUpdateGroup Change RequestCiciliot, Suzanne Director of TMS Rolling Hills Clinic 5306902877Lam, Torey 340B Contractor Rolling Hills Clinic 808499549110/11/2024 12:41 PM
ContactsPrimary ContactUpdateChange RequestSamaniego, Guadalupe Medical manager Rolling Hills Clinic 5306902786Ciciliot, Suzanne Director of TMS Rolling Hills Clinic 53069028777/10/2024 7:23 AM
ContactsPrimary ContactUpdateRecertificationKoch, Erich Executive Director Rolling Hills Clinic 5306902800-1305Samaniego, Guadalupe Medical manager Rolling Hills Clinic 53069027862/20/2024 3:51 PM
DetailsLast Recertification DateUpdateRecertification2/1/2023 3:30:40 PM2/20/2024 3:51:49 PM2/20/2024 3:51 PM
ContactsPrimary ContactUpdateRecertificationBoomgarden, Kati FNP, Director of Clinical Operations Rolling Hills Clinic 5306902827Koch, Erich Executive Director Rolling Hills Clinic 5306902800-13052/1/2023 3:30 PM
DetailsLast Recertification DateUpdateRecertification2/3/2022 8:24:37 AM2/1/2023 3:30:40 PM2/1/2023 3:30 PM
ContactsAuthorizing OfficialUpdateAO Change RequestKoch, Erich Executive Director Rolling Hills Clinic 5306902800-1305Deuchars, Elizabeth Controller Rolling Hills Clinic 53069027901/27/2023 5:56 PM
ContactsAuthorizing OfficialUpdateAO Change RequestVeloso, Carol Executive Director Rolling Hills Clinic 2016554878Koch, Erich Executive Director Rolling Hills Clinic 5306902800-130512/6/2022 6:44 AM
AddressesMain AddressUpdateChange Request 2540 Sister Mary Columba Drive Red Bluff, CA 96080 2526 Sister Mary Columba Drive Red Bluff, CA 960805/12/2022 7:11 AM
ContactsPrimary ContactUpdatePC Change RequestDeuchars, Elizabeth Controller Rolling Hills Clinic 5306302800Boomgarden, Kati FNP, Director of Clinical Operations Rolling Hills Clinic 53069028275/4/2022 7:23 AM
ContactsPrimary ContactUpdateRecertificationRypka, Alyssa Accountant Rolling Hills Clinic 5306902827-1303Deuchars, Elizabeth Controller Rolling Hills Clinic 53063028002/3/2022 8:24 AM
DetailsLast Recertification DateUpdateRecertification2/23/2021 12:54:18 PM2/3/2022 8:24:37 AM2/3/2022 8:24 AM
DetailsLast Recertification DateUpdateRecertification2/24/2020 7:22:42 PM2/23/2021 12:54:18 PM2/23/2021 12:54 PM
ContactsPrimary ContactUpdateRecertificationSanderson, Susie CFO Rolling Hills Clinic 5306902827-217Rypka, Alyssa Accountant Rolling Hills Clinic 5306902827-13032/24/2020 7:22 PM
DetailsLast Recertification DateUpdateRecertification1/29/2019 9:54:15 AM2/24/2020 7:22:42 PM2/24/2020 7:22 PM
ContactsAuthorizing OfficialUpdateAO Change RequestMarioneaux-Ibanitoru, Lona Executive Director Rolling Hills Clinic 5306902800Veloso, Carol Executive Director Rolling Hills Clinic 20165548782/24/2020 11:26 AM
DetailsLast Recertification DateUpdateRecertification2/7/2018 6:37:12 PM1/29/2019 9:54:15 AM1/29/2019 9:54 AM
DetailsLast Recertification DateUpdateRecertification1/25/2017 12:00:00 AM2/7/2018 6:37:12 PM2/7/2018 6:37 PM
ContactsPrimary ContactUpdateRecertificationSanderson, Susie CFO 5306902827Sanderson, Susie CFO Rolling Hills Clinic 5306902827-2172/7/2018 6:36 PM
ContactsAuthorizing OfficialUpdate Marioneaux-Ibanitoru, Lona Executive Director 5306902800Marioneaux-Ibanitoru, Lona Executive Director Rolling Hills Clinic 53069028002/7/2018 6:26 PM
AddressesMain AddressInsert   2540 Sister Mary Columba Drive Red Bluff, CA 960801/25/2017 11:36 AM
ContactsSigned ByInsert  Crosby, Ines Boardchair 53086520101/25/2017 11:36 AM
ContactsAuthorizing OfficialUpdate Contreras, Terry Executive Director 5306902827Marioneaux-Ibanitoru, Lona Executive Director 53069028001/25/2017 11:36 AM
ContactsPrimary ContactUpdate Jenson, Steven Executive Director 5306902800Sanderson, Susie CFO 53069028271/25/2017 11:36 AM
DetailsLast Recertification DateUpdate 2/12/2016 12:00:00 AM1/25/2017 12:00:00 AM1/25/2017 11:36 AM
DetailsLast Recertification DateUpdate 3/2/2015 12:00:00 AM2/12/2016 12:00:00 AM2/12/2016 11:34 AM
AddressesBilling AddressInsert  Rolling Hills Clinic PO Box 908 Corning, CA 960219/1/2015 3:42 PM
ContactsAuthorizing OfficialInsert  Contreras, Terry Executive Director 53069028274/8/2015 12:55 PM
DetailsLast Recertification DateUpdate 2/14/2014 12:00:00 AM3/2/2015 12:00:00 AM3/2/2015 12:58 PM
ContactsPrimary ContactUpdate Gonczeruk, Amy Operations Manager 5306902781Jenson, Steven Executive Director 53069028003/2/2015 9:25 AM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/14/2014 12:00:00 AM2/14/2014 11:05 AM
ContactsPrimary ContactInsert  Gonczeruk, Amy Operations Manager 53069027812/11/2013 7:15 AM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM2/11/2013 7:15 AM
Details340B IDUpdate FQHC638525FQHC638494A12/29/2011 10:00 AM
DatesParticipating Approval DateUpdate  12/29/2011 12:00:00 AM12/29/2011 10:00 AM
DetailsStateUpdate PendingActive12/29/2011 10:00 AM
Details340B IDUpdate NEXTQTR6FQHC63852512/9/2011 11:23 AM
Details340B IDUpdate ONLINE_REGNEXTQTR69/7/2011 10:40 AM
DatesStart DateUpdate  1/1/2012 12:00:00 AM9/7/2011 10:40 AM
DetailsLast Recertification DateInsert   9/6/2011 7:14 PM
DetailsGrant NumberInsert   9/6/2011 7:14 PM
Details340B IDInsert  ONLINE_REG9/6/2011 7:14 PM
DetailsIs Authorizing Official EHB DataInsert   9/6/2011 7:14 PM
DatesLast Date That 340B Drugs PurchasedInsert   9/6/2011 7:14 PM
DetailsMedicare Provider NumberInsert   9/6/2011 7:14 PM
DetailsEntity NameInsert  Rolling Hills Clinic9/6/2011 7:14 PM
DetailsProgram CodeInsert  FQHC6389/6/2011 7:14 PM
DetailsEntity SubnameInsert   9/6/2011 7:14 PM
DatesParticipating Approval DateInsert   9/6/2011 7:14 PM
DetailsStateInsert  Pending9/6/2011 7:14 PM
DatesRegistration DateInsert  9/6/2011 12:00:00 AM9/6/2011 7:14 PM
DatesSigned By DateInsert  9/6/2011 12:00:00 AM9/6/2011 7:14 PM
DatesStart DateInsert   9/6/2011 7:14 PM
TerminationsTermination CommentsInsert   9/6/2011 7:14 PM
TerminationsTermination DateInsert   9/6/2011 7:14 PM
TerminationsTermination Effective DateInsert   9/6/2011 7:14 PM
TerminationsTermination ReasonInsert   9/6/2011 7:14 PM