Covered Entity Details

CH04431AB MANATEE COUNTY RURAL HEALTH SERVICES, INC. (Terminated) - information as of 4/28/2025 1:48:55 AM

Main Details

Name

MANATEE COUNTY RURAL HEALTH SERVICES, INC.

Subdivision Name

Manatee General Surgery/GI

Type

HRSA-Funded Health Center

Site ID

BPS-H80-007907

340B ID

CH04431AB

Grant Number

H80CS00097

Additional Details

Current Program Status

Terminated

Registration Date

1/14/2013

Participating Start Date

4/1/2013

Participating Approval Date

2/13/2013

Last Recertification Date

3/1/2016

Termination Date
Termination Reason

4/1/2016
Site closure

Contacts

Authorizing Official

WALTER L. PRESHA, CEO
(941) 776-4000

Primary Contact

Tuesday Fredricks, Pharmacy Director
(941) 708-7672 Ext: 300

Addresses

Street Address

250 2nd St E STE 4G
Bradenton, FL 34208-1028

Billing Address

MANATEE COUNTY RURAL HEALTH SERVICES, INC
ADMINISTRATION OFFICE
700 8TH AVE WEST SUITE 101
PALMETTO, FL 34221

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
FL	029561230
		1053509950

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
CH044310	Active	BPS-H80-000856	MCR Health, Inc.	EDGAR J. PRICE FAMILY & CHILDREN HEALTHCARE CENTER	12271 US HIGHWAY 301 NORTH		Parrish	FL
CH04431A	Active	BPS-H80-005444	MCR Health, Inc.	LAWTON CHILES CHILDREN & FAM HCC	1515 26th Ave E		Bradenton	FL
CH04431AA	Active	BPS-H80-011253	MCR Health, Inc.	Bradenton Family Medical Center	4805 26th St W		Bradenton	FL
CH04431AB	Terminated	BPS-H80-007907	MANATEE COUNTY RURAL HEALTH SERVICES, INC.	Manatee General Surgery/GI	250 2nd St E STE 4G		Bradenton	FL
CH04431AC	Terminated	BPS-H80-008891	MCR Health, Inc.	North Sarasota Walk-In	1945 Northgate Blvd		Sarasota	FL
CH04431AD	Active	BPS-H80-007652	MCR Health, Inc.	Arcadia Family Optometry Center	122 N Brevard Ave		Arcadia	FL
CH04431AE	Active	BPS-H80-008632	MCR Health, Inc.	Community Care Family Healthcare Center Building C	1148 E Gibson St		Arcadia	FL
CH04431AF	Active	BPS-H80-000352	MCR Health, Inc.	PALMETTO FAMILY HEALTHCARE CTR	404 7TH St W		Palmetto	FL
CH04431AG	Active	BPS-H80-008420	MCR Health, INC.	Community Care Family Healthcare Center Building E	709 N 12th Ave		Arcadia	FL
CH04431AH	Active	BPS-H80-010153	MCR Health, Inc.	Lawton Chiles Administration	1505 26th Ave E		Bradenton	FL
CH04431AJ	Active	BPS-H80-012974	MCR Health, Inc.	Mobile Eye Care	12271 Us Highway 301 N		Parrish	FL
CH04431AK	Active	BPS-H80-011499	MCR Health, Inc.	Riverside MEDICAL SERVICES	300 Riverside Dr E	Ste 2010	Bradenton	FL
CH04431AL	Active	BPS-H80-012970	MCR Health, Inc.	Health Express	12271 Us Highway 301 N		Parrish	FL
CH04431AM	Active	BPS-H80-012795	MCR Health, Inc.	Palmetto Administrative Offices	700 8th Avenue W	Suite 101	Palmetto	FL
CH04431AN	Active	BPS-H80-001544	MCR Health, Inc.	RIVERVIEW	212 2nd Ave E		Bradenton	FL
CH04431AP	Terminated	BPS-H80-015331	MCR Health, Inc.	Twin Rivers Medical Center	888 N ROBERT AVE		ARCADIA	FL
CH04431AQ	Active	BPS-H80-008635	MCR Health, Inc.	Community Care Family Healthcare Center Building B	725 N 12th Ave		Arcadia	FL
CH04431AR	Active	BPS-H80-008634	MCR Health, Inc.	Community Care Family Healthcare Center Building D	707 N 12th Ave		Arcadia	FL
CH04431AS	Active	BPS-H80-008935	MCR Health, Inc.	Southeast Administration	5223 9th St E		Bradenton	FL
CH04431AT	Active	BPS-H80-016999	MCR Health, Inc.	South County Medical Center	579 A South Indiana Avenue		Englewood	FL
CH04431AU	Terminated	BPS-H80-017572	MCR Health, Inc.	North Tuttle Family Health Center	220 North Tuttle Avenue		Sarasota	FL
CH04431AV	Active	BPS-H80-018513	MCR Health, Inc.	Whole Child Pediatrics	6040B State Road 70 East		Bradenton	FL
CH04431AW	Terminated	BPS-H80-021634	MCR Health, Inc.	South Manatee Pediatrics	6326 15th St E		Sarasota	FL
CH04431AX	Terminated	BPS-H80-026009	MCR Health, Inc.	AMA University	2415 University Parkway, Bldg 3 STE 111		Sarasota	FL
CH04431AY	Terminated	BPS-H80-026006	MCR Health, Inc.	Nursing Home Drive	425 Nursing Home Dr		Arcadia	FL
CH04431AZ	Terminated	BPS-H80-027112	MCR Health, Inc.	AMA Manatee	701 Manatee Ave W		Bradenton	FL
CH04431B	Active	BPS-H80-001908	MCR Health, Inc.	NORTH MANATEE HEALTHCARE CENTER	5600 Bayshore Rd		Palmetto	FL
CH04431BA	Terminated	BPS-H80-027113	MCR Health, Inc.	AMA Wachula	508 S 6th Ave		Wauchula	FL
CH04431BB	Terminated	BPS-H80-027933	MCR Health, Inc.	AMA Family	5309 E State Road 64		Bradenton	FL
CH04431BC	Terminated	BPS-H80-027913	MCR Health, Inc.	AMA Health	5305 E State Road 64		Bradenton	FL
CH04431BD	Terminated	BPS-H80-028105	MCR Health, Inc.	MCR Health Centennial Middle School	38503 Centennial Rd		Dade City	FL
CH04431BE	Terminated	BPS-H80-028104	MCR Health, Inc.	MCR Health Wesley Chapel High School	30833 Wells Road		Wesley Chapel	FL
CH04431BF	Terminated	BPS-H80-028103	MCR Health, Inc.	MCR Health Gulf High School	5117 Madison St		New Port Richey	FL
CH04431BG	Terminated	BPS-H80-028200	MCR Health, Inc.	Health and Welness Land O&Lakes	20360 Gator Lane BLDG 14		Land O Lakes	FL
CH04431BH	Terminated	BPS-H80-028199	MCR Health, Inc.	MCR Health Hudson High School	14730 Cobra Way		Hudson	FL
CH04431BJ	Active	BPS-H80-030093	MCR Health, Inc.	MCR Health Medical Express Mobile Unit	12271 US Highway 301 N		Parrish	FL
CH04431BK	Active	BPS-H80-028332	MCR Health, Inc.	MCR Health Southeast High School	1200 37th Ave E		Bradenton	FL
CH04431BL	Terminated	BPS-H80-030636	MCR Health, Inc.	Temporary Site-MCR Health. Inc.	119 Shamrock Blvd		Venice	FL
CH04431BM	Terminated	BPS-H80-030717	MCR Health, Inc.	Temporary Site- AMA Health Medical Services	6001 21st Ave W		Bradenton	FL
CH04431BN	Active	BPS-H80-030896	MCR Health, Inc.	Manatee Elementary School Based Health Center	1609 6th Ave E		Bradenton	FL
CH04431BP	Active	BPS-H80-031276	MCR Health, Inc.	South Manatee Pediatrics	5108 15th St E Ste 111		Bradenton	FL
CH04431BQ	Terminated	BPS-H80-030897	MCR Health, Inc.	MCR Health Venice Pediatrics	119 Shamrock Blvd		Venice	FL
CH04431BR	Terminated	BPS-H80-030953	MCR Health, Inc.	AMA Heart and Vascular	6001 21st Ave W		Bradenton	FL
CH04431BS	Active	BPS-H80-031651	MCR Health, Inc.	MCR Health Fruitville	170 N Lime Ave		Sarasota	FL
CH04431BT	Active	BPS-H80-032031	MCR Health, Inc.	Riverside Specialty	300 Riverside Dr E Ste 2600		Bradenton	FL
CH04431BU	Active	BPS-H80-032620	MCR Health, Inc.	MCR Health Cortez OB/GYN and Pediatrics	3501 Cortez Rd W Ste 1		Bradenton	FL
CH04431BV	Terminated	BPS-H80-034285	MCR Health, Inc.	Riverside Medical Services 3300	300 Riverside Dr E Ste 3300		Bradenton	FL
CH04431BW	Active	BPS-H80-034346	MCR Health, Inc.	MCR Health, Inc. Corporate Office	101 Riverfront Blvd		Bradenton	FL
CH04431BX	Active	BPS-H80-035960	MCR HEALTH INC	Advanced Specialty Institute Pointe West	6015 Pointe West Blvd.		Bradenton	FL
CH04431BY	Active	BPS-H80-035934	MCR HEALTH INC	Riverside Medical Services 2400	300 Riverside Dr. East STE 2400		Bradenton	FL
CH04431BZ	Active	BPS-H80-037932	MCR HEALTH INC	MCR Health Blanche H Daughtrey	515 63rd Ave E		Bradenton	FL
CH04431E	Active	BPS-H80-003630	MCR Health, Inc.	EAST MANATEE HEALTH AND WELLNESS CENTER	1312 Manatee Ave E		Bradenton	FL
CH04431H	Active	BPS-H80-002187	MCR Health, Inc.	SOUTHEAST FAMILY HEALTH CARE CTR	919 53rd Ave E		Bradenton	FL
CH04431O	Active	BPS-H80-005472	MCR Health, Inc.	Community Care Family Healthcare Center Building A	1110 E Gibson St		Arcadia	FL
CH04431R	Terminated	BPS-H80-007915	MCR Health, Inc.	North County Healthcare Center	1949 Northgate Blvd		Sarasota	FL
CH04431S	Active	BPS-H80-009458	MCR Health, Inc.	West Manatee Health Center	2318 Manatee Ave W		Bradenton	FL
CH04431T	Active	BPS-H80-001763	MCR Health, Inc.	George Van Buren Health Center	712 39th St W		Bradenton	FL
CH04431U	Terminated	BPS-H80-003802	MCR Health, Inc.	MYAKKA CITY FAMILY MEDICAL CTR	37220 GLENWOOD AVE		MYAKKA CITY	FL
CH04431V	Terminated	BPS-H80-001687	MANATEE COUNTY RURAL HEALTH SERVICES, INC.	WHOLE CHILD PEDIATRICS	8936 77th Ter E		Lakewood Ranch	FL
CH04431W	Terminated	BPS-H80-009097	MCR Health, Inc.	River Landings OB/GYN	5460 63rd St E		Bradenton	FL
CH04431X	Active	BPS-H80-011498	MCR Health, Inc.	MCR Dermatology by Luminary	300 Riverside Dr E STE 1500		Bradenton	FL
CH04431Y	Active	BPS-H80-011899	MCR Health, Inc.	MCR Health Arcadia	250 North Brevard Avenue		Arcadia	FL
CH04431Z	Active	BPS-H80-011898	MCR Health, Inc.	Southwest Health Center	5325 26th St W		Bradenton	FL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH044310	AADESH RX LLC	ECKERDS PHARMACY	907 10TH ST E	PALMETTO	FL	34221	10/01/2013	01/16/2018
CH044310	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/01/2022
CH044310	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/01/2022
CH044310	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/01/2022
CH044310	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	10/01/2022
CH044310	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/01/2022
CH044310	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/01/2022
CH044310	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/01/2022
CH044310	ADVANCE PHARMACY SERVICE, LLC	NORA PHARMACY	7926 W HILLSBOROUGH AVE, STE E	TAMPA	FL	33615	07/01/2015	01/16/2018
CH044310	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	07/01/2024
CH044310	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	04/01/2014	01/16/2018
CH04431A	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	04/01/2014	06/30/2019
CH04431E	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	04/01/2014	06/30/2019
CH04431AA	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	04/01/2014	06/30/2019
CH044310	BIOPLUS SPECIALTY PHARMACY CA	7373 LINCOLN WAY		GARDEN GROVE	CA	92841	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY LA, LLC	2731 MANHATTAN BLVD STE B17		HARVEY	LA	70058	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	04/01/2025
CH044310	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	04/01/2025
CH044310	BISHT LLC	DBA DESOTO PHARMACY	301 N BREVARD AVENUE STE # E	ARCADIA	FL	34266	04/01/2013	06/17/2019
CH044310	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2023
CH04431AJ	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2024
CH044310	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/01/2023
CH044310	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/01/2023
CH044310	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/01/2023
CH044310	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/01/2023
CH044310	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2023
CH044310	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2023
CH044310	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2023
CH044310	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/01/2023
CH044310	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	07/01/2023
CH044310	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2023
CH04431BV	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/01/2024	01/15/2025
CH044310	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2023
CH044310	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2023
CH044310	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/01/2025
CH044310	DIPLOMAT SPECIALTY INFUSION GROUP	311 POMONA DRIVE	SUITE B & C	GREENSBORO	NC	27407-1693	07/26/2021	07/30/2022
CH044310	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	07/26/2021	10/01/2022
CH044310	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2025
CH044310	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/01/2022
CH044310	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/01/2022
CH044310	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/01/2022
CH044310	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/01/2022
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	01/01/2017
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03107	24 S. BREVARD AVE.	ARCADIA	FL	34266	01/01/2017
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	01/01/2017
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05245	520 FIRST ST W	BRADENTON	FL	34208	01/01/2017
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00368	3709 N TAMIAMI TRL	SARASOTA	FL	34234	10/01/2018
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05780	4302 CORTEZ RD. WEST	BRADENTON	FL	34210	10/01/2018
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00312	2773 FRUITVILLE RD	SARASOTA	FL	34237	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07892	1520 LAKEWOOD RANCH BLVD.	BRADENTON	FL	34211	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07938	3724 84TH AVE., CIRCLE EAST	SARASOTA	FL	34243	01/01/2019	05/21/2024
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00319	4301 BEE RIDGE RD	SARASOTA	FL	34233	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16264	6150 14TH ST W	BRADENTON	FL	34207	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05110	105 S PEBBLE BEACH BLVD	SUN CITY CENTER	FL	33573	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05823	5310 45TH ST., EAST	BRADENTON	FL	34203	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01013	1760 S MCCALL RD	ENGLEWOOD	FL	34223	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01863	3800 TAMIAMI TRL SOUTH	SARASOTA	FL	34239	01/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03258	14998 S. TAMIAMI TRAIL	NORTH PORT	FL	34287	04/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04616	7195 SR 70	BRADENTON	FL	34203	04/01/2019
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02030	301 S. 6TH AVE.	WAUCHULA	FL	33873	01/01/2020
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03122	2480 TAMIAMI TRL	PORT CHARLOTTE	FL	33952	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00411	500 S 11TH ST	LAKE WALES	FL	33853	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03399	6105 US HWY 98 N	LAKELAND	FL	33809	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03638	10623 GIBSONTON DR	RIVERVIEW	FL	33578	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16211	1400A TAMIAMI TRL	PORT CHARLOTTE	FL	33948	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00149	294 37TH AVE N	SAINT PETERSBURG	FL	33704	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03520	6202 US HWY 41 N	APOLLO BEACH	FL	33572	04/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01120	215 JACARANDA BLVD.	VENICE	FL	34292	10/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04266	100 US HIGHWAY 41 BYP N	VENICE	FL	34285	10/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA CVS/PHARMACY #11239	11521 SR 70 E	BRADENTON	FL	34202	10/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05229	5403 UNIVERSITY PKWY	UNIVERSITY PARK	FL	34201	10/01/2021
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01810	2811 CLARK RD	SARASOTA	FL	34231	10/01/2021
CH044310	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 17127	101 N CATTLEMEN RD	SARASOTA	FL	34243	01/01/2023
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03953	611 MANATEE AVE	HOLMES BEACH	FL	34217	01/01/2023
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05211	5250 CLARK RD	SARASOTA	FL	34233	01/01/2023
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03532	5361 FRUITVILLE RD	SARASOTA	FL	34232	01/01/2023
CH044310	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02444	1105 W MAIN ST	AVON PARK	FL	33825	01/01/2023
CH04431AD	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	10/01/2024
CH04431O	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00319	4301 BEE RIDGE RD	SARASOTA	FL	34233	10/01/2024
CH04431AD	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03107	24 S. BREVARD AVE.	ARCADIA	FL	34266	10/01/2024
CH04431O	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02030	301 S. 6TH AVE.	WAUCHULA	FL	33873	10/01/2024
CH04431AD	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05245	520 FIRST ST W	BRADENTON	FL	34208	10/01/2024
CH04431AK	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07892	1520 LAKEWOOD RANCH BLVD.	BRADENTON	FL	34211	10/01/2024	01/15/2025
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00319	4301 BEE RIDGE RD	SARASOTA	FL	34233	10/01/2024
CH04431BJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01013	1760 S MCCALL RD	ENGLEWOOD	FL	34223	10/01/2024
CH04431AT	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05823	5310 45TH ST., EAST	BRADENTON	FL	34203	10/01/2024
CH04431BN	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024
CH04431AQ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05780	4302 CORTEZ RD. WEST	BRADENTON	FL	34210	10/01/2024
CH04431AL	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05780	4302 CORTEZ RD. WEST	BRADENTON	FL	34210	10/01/2024
CH04431BK	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07892	1520 LAKEWOOD RANCH BLVD.	BRADENTON	FL	34211	10/01/2024
CH04431BY	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024	01/15/2025
CH04431BY	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04616	7195 SR 70	BRADENTON	FL	34203	10/01/2024	01/15/2025
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024
CH04431AT	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07938	3724 84TH AVE., CIRCLE EAST	SARASOTA	FL	34243	10/01/2024
CH04431BV	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	10/01/2024	01/15/2025
CH04431U	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	10/01/2024	01/15/2025
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04616	7195 SR 70	BRADENTON	FL	34203	10/01/2024
CH04431BY	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16264	6150 14TH ST W	BRADENTON	FL	34207	10/01/2024	01/15/2025
CH04431BN	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05245	520 FIRST ST W	BRADENTON	FL	34208	10/01/2024
CH04431BJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05229	5403 UNIVERSITY PKWY	UNIVERSITY PARK	FL	34201	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	10/01/2024
CH04431AJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00368	3709 N TAMIAMI TRL	SARASOTA	FL	34234	10/01/2024
CH04431AQ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024
CH04431U	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024	01/15/2025
CH04431BV	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05823	5310 45TH ST., EAST	BRADENTON	FL	34203	10/01/2024	01/15/2025
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05823	5310 45TH ST., EAST	BRADENTON	FL	34203	10/01/2024
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03953	611 MANATEE AVE	HOLMES BEACH	FL	34217	10/01/2024
CH04431AF	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02030	301 S. 6TH AVE.	WAUCHULA	FL	33873	10/01/2024
CH04431AF	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00312	2773 FRUITVILLE RD	SARASOTA	FL	34237	10/01/2024
CH04431BN	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05823	5310 45TH ST., EAST	BRADENTON	FL	34203	10/01/2024
CH04431BJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024
CH04431BK	HOLIDAY CVS, L.L.C.	DBA CVS/PHARMACY #11239	11521 SR 70 E	BRADENTON	FL	34202	10/01/2024
CH04431BP	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07892	1520 LAKEWOOD RANCH BLVD.	BRADENTON	FL	34211	10/01/2024
CH04431U	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	10/01/2024	01/15/2025
CH04431AJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024
CH04431AF	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024
CH04431BP	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00319	4301 BEE RIDGE RD	SARASOTA	FL	34233	10/01/2024
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03520	6202 US HWY 41 N	APOLLO BEACH	FL	33572	10/01/2024
CH04431BY	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05110	105 S PEBBLE BEACH BLVD	SUN CITY CENTER	FL	33573	10/01/2024	01/15/2025
CH04431AL	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03520	6202 US HWY 41 N	APOLLO BEACH	FL	33572	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	10/01/2024
CH04431AF	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07938	3724 84TH AVE., CIRCLE EAST	SARASOTA	FL	34243	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024
CH04431BJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01863	3800 TAMIAMI TRL SOUTH	SARASOTA	FL	34239	10/01/2024
CH04431BV	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00368	3709 N TAMIAMI TRL	SARASOTA	FL	34234	10/01/2024	01/15/2025
CH04431AL	HOLIDAY CVS, L.L.C.	DBA CVS/PHARMACY #11239	11521 SR 70 E	BRADENTON	FL	34202	10/01/2024
CH04431BK	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	10/01/2024
CH04431BP	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05245	520 FIRST ST W	BRADENTON	FL	34208	10/01/2024
CH04431X	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07937	8700 US HIGHWAY, 301 NORTH	PARRISH	FL	34219	10/01/2024
CH04431AT	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00312	2773 FRUITVILLE RD	SARASOTA	FL	34237	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05245	520 FIRST ST W	BRADENTON	FL	34208	10/01/2024
CH04431BY	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05780	4302 CORTEZ RD. WEST	BRADENTON	FL	34210	10/01/2024	01/15/2025
CH04431AK	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07938	3724 84TH AVE., CIRCLE EAST	SARASOTA	FL	34243	10/01/2024	01/15/2025
CH04431AT	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05859	3813 MANATEE AVE. WEST	BRADENTON	FL	34205	10/01/2024
CH04431BK	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05780	4302 CORTEZ RD. WEST	BRADENTON	FL	34210	10/01/2024
CH04431X	HOLIDAY CVS, L.L.C.	DBA CVS/PHARMACY #11239	11521 SR 70 E	BRADENTON	FL	34202	10/01/2024
CH04431AQ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01013	1760 S MCCALL RD	ENGLEWOOD	FL	34223	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	10/01/2024
CH04431BX	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16264	6150 14TH ST W	BRADENTON	FL	34207	10/01/2024
CH04431BV	HOLIDAY CVS, L.L.C.	DBA CVS/PHARMACY #11239	11521 SR 70 E	BRADENTON	FL	34202	10/01/2024	01/15/2025
CH04431AQ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02030	301 S. 6TH AVE.	WAUCHULA	FL	33873	10/01/2024
CH04431BY	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00368	3709 N TAMIAMI TRL	SARASOTA	FL	34234	10/01/2024	01/15/2025
CH04431BJ	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16264	6150 14TH ST W	BRADENTON	FL	34207	04/01/2025
CH04431BJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	04/01/2025
CH04431AJ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01047	6204 14TH ST WEST	BRADENTON	FL	34207	04/01/2025
CH04431AQ	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03111	945 8TH AVE W	PALMETTO	FL	34221	04/01/2025
CH044310	MEDPRO RX, INC.	DBA DIPLOMAT SPECIALTY INFUSION GROUP	140 NORTHWAY CT	RALEIGH	NC	27615-4916	07/26/2021	10/01/2022
CH044310	OPTUM INFUSION SERVICES 200, INC	5895 CORE RD	STE 417	NORTH CHARLESTON	SC	29406	07/26/2021
CH044310	OPTUM INFUSION SERVICES 204, INC	8509 BENJAMIN RD STE A		TAMPA	FL	33634-1224	10/01/2022
CH044310	OPTUM INFUSION SERVICES 208, INC.	556 ARBOR HILL RD STE F		KERNERSVILLE	NC	27284-3321	07/26/2021	07/30/2022
CH044310	OPTUM INFUSION SERVICES 305, LLC	15529 COLLEGE BLVD.		LENEXA	KS	66219-1351	07/26/2021
CH044310	OPTUM INFUSION SERVICES 500, INC	8400 ESTERS BLVD STE 185		IRVING	TX	75063-2864	07/26/2021
CH044310	OPTUM INFUSION SERVICES 550, LLC	20 COMMERCE WAY	SUITE 2	WOBURN	MA	01801	07/26/2021
CH044310	OPTUM INFUSION SERVICES 550, LLC	7167 E. KEMPER RD.		CINCINNATI	OH	45249	07/26/2021
CH044310	OPTUM INFUSION SERVICES 550, LLC	9045 E PIMA CENTER PKWY STE 1		SCOTTSDALE	AZ	85258-4621	10/01/2022
CH044310	OPTUM INFUSION SERVICES 553, LLC	6531 MERIDIEN DR	SUITE 113	RALEIGH	NC	27616	10/01/2022
CH044310	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	07/26/2021
CH044310	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	07/26/2021
CH04431AK	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/01/2024	01/15/2025
CH04431O	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/01/2024
CH044310	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	07/26/2021
CH044310	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	07/26/2021
CH044310	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/13/2022
CH044310	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/26/2021
CH044310	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/26/2021
CH044310	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/26/2021
CH044310	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	07/26/2021
CH044310	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	07/26/2021
CH044310	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	10/01/2022
CH044310	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/26/2021
CH044310	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	07/26/2021	05/27/2022
CH044310	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01600	88 BROOKLYN ST.	CARBONDALE	PA	18407	04/01/2021
CH044310	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/01/2023
CH044310	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/01/2023
CH044310	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	07/01/2023
CH044310	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	07/01/2023
CH044310	PUBLIX SUPER MARKETS	PUBLIC PHARMACY #0780	3913 MANATEE AVENUE WEST	BRADENTON	FL	34205	07/01/2023
CH044310	PUBLIX SUPER MARKETS INC	PUBLIX PHARMACY #0417	6030 14TH STREET W	BRADENTON	FL	34207-4104	07/01/2023	04/27/2024
CH044310	PUBLIX SUPER MARKETS INC	PUBLIX PHARMACY #0798	1755 LAKEWOOD RANCH BLVD.	BRADENTON	FL	34211	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1342	1101 8TH AVENUE WEST	PALMETTO	FL	34221	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1528	2551 SE HIGHWAY 70	ARCADIA	FL	34266	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1447	4240 53RD AVE. E	BRADENTON	FL	34203	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1666	9520 BUFFALO RD	PALMETTO	FL	34221	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1326	4651 CORTEZ ROAD WEST	BRADENTON	FL	34210	07/01/2023
CH044310	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1152	11245 NORTH US 301	PARRISH	FL	34219	07/01/2023
CH044310	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2025
CH044310	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2025
CH044310	ROYAL RX PHARMACY	4941 E BUSCH BLVD	SUITE 240	TAMPA	FL	33617-6056	01/01/2017	06/30/2019
CH044310	SAMSON MERGER SUB, LLC	WINN DIXIE #2444	1023 N. TAMIAMI TR.	RUSKIN	FL	33570	07/01/2018	06/30/2021
CH044310	SAMSON MERGER SUB, LLC	WINN DIXIE #2448	515 7TH STREET WEST	PALMETTO	FL	34221	07/01/2018	06/30/2021
CH044310	SAMSON MERGER SUB, LLC	WINN DIXIE #2404	5805 MANATEE AVENUE	BRADENTON	FL	34209	07/01/2018	06/30/2021
CH044310	SAMSON MERGER SUB, LLC	WINN DIXIE #2519	5802 14TH STREET W.	BRADENTON	FL	34207	07/01/2018	06/30/2021
CH044310	SAMSON MERGER SUB, LLC	WINN DIXIE #2491	1737 EAST OAK STREET	ARCADIA	FL	34266	07/01/2018	06/30/2021
CH044310	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2025
CH044310	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH044310	WAL-MART PHARMACY 10-0528	2911 53RD AVENUE EAST		BRADENTON	FL	34203	04/01/2013
CH04431BX	WAL-MART PHARMACY 10-0528	2911 53RD AVENUE EAST		BRADENTON	FL	34203	10/01/2024
CH04431AK	WAL-MART PHARMACY 10-0528	2911 53RD AVENUE EAST		BRADENTON	FL	34203	10/01/2024	01/15/2025
CH04431AL	WAL-MART PHARMACY 10-0528	2911 53RD AVENUE EAST		BRADENTON	FL	34203	10/01/2024
CH04431BJ	WAL-MART PHARMACY 10-0528	2911 53RD AVENUE EAST		BRADENTON	FL	34203	10/01/2024
CH044310	WAL-MART PHARMACY 10-0759	1480 HIGHWAY 17 NORTH		WAUCHULA	FL	33873	04/01/2020	01/15/2025
CH044310	WAL-MART PHARMACY 10-0811	2725 SOUTHEAST HWY 70		ARCADIA	FL	34266	04/01/2013
CH04431O	WAL-MART PHARMACY 10-0811	2725 SOUTHEAST HWY 70		ARCADIA	FL	34266	10/01/2024
CH04431U	WAL-MART PHARMACY 10-0811	2725 SOUTHEAST HWY 70		ARCADIA	FL	34266	10/01/2024	01/15/2025
CH04431AQ	WAL-MART PHARMACY 10-0811	2725 SOUTHEAST HWY 70		ARCADIA	FL	34266	10/01/2024
CH04431BJ	WAL-MART PHARMACY 10-0811	2725 SOUTHEAST HWY 70		ARCADIA	FL	34266	10/01/2024
CH044310	WAL-MART PHARMACY 10-1004	5315 CORTEZ RD WEST		BRADENTON	FL	34210	04/01/2013
CH04431BN	WAL-MART PHARMACY 10-1004	5315 CORTEZ RD WEST		BRADENTON	FL	34210	10/01/2024
CH04431BJ	WAL-MART PHARMACY 10-1004	5315 CORTEZ RD WEST		BRADENTON	FL	34210	10/01/2024
CH04431AF	WAL-MART PHARMACY 10-1004	5315 CORTEZ RD WEST		BRADENTON	FL	34210	10/01/2024
CH04431AJ	WAL-MART PHARMACY 10-1004	5315 CORTEZ RD WEST		BRADENTON	FL	34210	10/01/2024
CH044310	WAL-MART PHARMACY 10-1171	8320 LOCKWOOD RIDGE		SARASOTA	FL	34243	04/01/2013
CH04431AL	WAL-MART PHARMACY 10-1171	8320 LOCKWOOD RIDGE		SARASOTA	FL	34243	10/01/2024
CH04431AT	WAL-MART PHARMACY 10-1171	8320 LOCKWOOD RIDGE		SARASOTA	FL	34243	10/01/2024
CH04431BP	WAL-MART PHARMACY 10-1171	8320 LOCKWOOD RIDGE		SARASOTA	FL	34243	10/01/2024
CH04431X	WAL-MART PHARMACY 10-1171	8320 LOCKWOOD RIDGE		SARASOTA	FL	34243	10/01/2024
CH044310	WAL-MART PHARMACY 10-1874	2931 S. MCCALL RD		ENGLEWOOD	FL	34224	04/01/2025
CH044310	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	04/01/2013
CH04431BP	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	10/01/2024
CH04431BK	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	10/01/2024
CH04431AF	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	10/01/2024
CH04431AL	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	10/01/2024
CH04431AJ	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	10/01/2024
CH04431AT	WAL-MART PHARMACY 10-3370	508 10TH ST. E.		PALMETTO	FL	34221	04/01/2025
CH044310	WAL-MART PHARMACY 10-3474	6225 E STATE RD 64		BRADENTON(NE)	FL	34208	04/01/2013	01/15/2025
CH04431BJ	WAL-MART PHARMACY 10-3474	6225 E STATE RD 64		BRADENTON(NE)	FL	34208	10/01/2024
CH04431BP	WAL-MART PHARMACY 10-3474	6225 E STATE RD 64		BRADENTON(NE)	FL	34208	10/01/2024
CH04431AF	WAL-MART PHARMACY 10-3474	6225 E STATE RD 64		BRADENTON(NE)	FL	34208	10/01/2024
CH044310	WAL-MART PHARMACY 10-5727	5810 RANCH LAKE BLVD		BRADENTON	FL	34202	07/01/2023	01/15/2025
CH044310	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH044310	WALGREEN CO	DBA: WALGREENS #12102	14415 ARBOR GREEN TRAIL	LAKEWOOD RANCH	FL	34202	09/14/2012
CH044310	WALGREEN CO	DBA: WALGREENS #10668	2575 NE HWY 70	ARCADIA	FL	34266	09/14/2012
CH044310	WALGREEN CO	DBA: WALGREENS #09098	2 US 27 S	LAKE PLACID	FL	33852	04/01/2019
CH044310	WALGREEN CO	DBA: WALGREENS #10145	1063 N TOLEDO BLADE BLVD	NORTH PORT	FL	34288	04/01/2019
CH04431AL	WALGREEN CO	DBA: WALGREENS #10668	2575 NE HWY 70	ARCADIA	FL	34266	10/01/2024
CH04431AQ	WALGREEN CO	DBA: WALGREENS #10668	2575 NE HWY 70	ARCADIA	FL	34266	10/01/2024
CH044310	WALGREEN CO.	DBA: WALGREENS # 02083	3155 UNIVERSITY PARKWAY	SARASOTA	FL	34243	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03613	4220 MANATEE AVENUE W	BRADENTON	FL	34205	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03963	6003 14TH ST W	BRADENTON	FL	34207-4105	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 04282	1504 53RD AVE. E	BRADENTON	FL	34203	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 04379	4320 26TH STREET W.	BRADENTON	FL	34205	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 04812	930 8TH AVE WEST	PALMETTO	FL	34221	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 04841	4210 STATE ROAD 64 EAST	BRADENTON	FL	34208	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 05641	3425 53RD AVE WEST	BRADENTON	FL	34210	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 06156	3535 N TAMIAMI TRAIL	SARASOTA	FL	34234-5310	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 06515	5945 US HIGHWAY 301 N	ELLENTON	FL	34222	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 07106	5896 CORTEZ ROAD WEST	BRADENTON	FL	34210	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 07177	705 N PEBBLE BEACH BLVD	SUN CITY CENTER	FL	33573-5350	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 06135	8315 MARKET STREET	LAKEWOOD RANCH	FL	34202	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 13850	3200 E BAY DRIVE	HOLMES BEACH	FL	34217	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS #09980	1455 UPPER MANATEE RIVER RD	BRADENTON	FL	34212	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS #02085	1700 N LOCKWOOD RIDGE RD	SARASOTA	FL	34234	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03332	3601 BEE RIDGE ROAD	SARASOTA	FL	34233	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03830	1947 FRUITVILLE RD	SARASOTA	FL	34236	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 05575	5800 BEE RIDGE ROAD	SARASOTA	FL	34233-5067	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03606	6465 SOUTH TAMIAMI TRAIL	SARASOTA	FL	34231	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 04979	3901 S TAMIAMI TRAIL	SARASOTA	FL	34231	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 05660	5281 CLARK RD	SARASOTA	FL	34233	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 01077	3550 FRUITVILLE RD	SARASOTA	FL	34237-9026	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 03264	1224 S. TAMIAMI TRAIL	SARASOTA	FL	34239	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 01921	3506 CLARK ROAD	SARASOTA	FL	34231-8408	09/14/2012	04/21/2022
CH044310	WALGREEN CO.	DBA: WALGREENS # 09031	3851 4TH ST NORTH	ST PETERSBURG	FL	33703	09/14/2012
CH044310	WALGREEN CO.	DBA: WALGREENS # 07496	2940 SOUTH MCCALL RD	ENGLEWOOD	FL	34224-8638	07/01/2018
CH044310	WALGREEN CO.	DBA: WALGREENS #13578	1921 WALDEMERE ST STE 201	SARASOTA	FL	34239	10/01/2018
CH044310	WALGREEN CO.	DBA: WALGREENS # 05859	15 S INDIANA AVE	ENGLEWOOD	FL	34223	10/01/2018
CH044310	WALGREEN CO.	DBA: WALGREENS #11535	3501 UNIQUE CIRCLE	FORT MYERS	FL	33908	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 05016	1930 KINGS HIGHWAY	PORT CHARLOTTE	FL	33980	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 03862	4774 S SEMORAN BLVD	ORLANDO	FL	32822-2412	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 07875	1800 TAMIAMI TRAIL	PORT CHARLOTTE	FL	33948-1043	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 09219	17065 PINE RIDGE RD	FORT MYERS BEACH	FL	33931	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 05017	3795 TAMIAMI TRAIL	PUNTA GORDA	FL	33950	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 04380	1903 STATE ROAD 60 E	LAKE WALES	FL	33853	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 03778	1801 GULF TO BAY BLVD	CLEARWATER	FL	33765	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 09219	17065 PINE RIDGE RD	FORT MYERS BEACH	FL	33931	04/01/2019	04/01/2021
CH044310	WALGREEN CO.	DBA: WALGREENS # 05946	93 US HIGHWAY 27 S	AVON PARK	FL	33825	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 05947	3027 US HWY 27 SOUTH	SEBRING	FL	33870	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 06164	15180 TAMIAMI TRAILS	NORTH PORT	FL	34287	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS #12698	3001 TAMIAMI TRAIL	PORT CHARLOTTE	FL	33952	04/01/2019
CH044310	WALGREEN CO.	DBA: WALGREENS # 05017	3795 TAMIAMI TRAIL	PUNTA GORDA	FL	33950	04/01/2019	02/12/2020
CH044310	WALGREEN CO.	DBA: WALGREENS # 05947	3027 US HWY 27 SOUTH	SEBRING	FL	33870	04/01/2019	02/12/2020
CH044310	WALGREEN CO.	DBA: WALGREENS # 01339	3077 54TH AVE S	ST PETERSBURG	FL	33712-4613	04/01/2019
CH044310	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15301	3030 1ST AVE N	ST PETERSBURG	FL	33713	04/01/2021
CH04431O	WALGREEN CO.	DBA: WALGREENS # 06135	8315 MARKET STREET	LAKEWOOD RANCH	FL	34202	10/01/2024
CH04431AD	WALGREEN CO.	DBA: WALGREENS # 07106	5896 CORTEZ ROAD WEST	BRADENTON	FL	34210	10/01/2024
CH04431AK	WALGREEN CO.	DBA: WALGREENS # 04841	4210 STATE ROAD 64 EAST	BRADENTON	FL	34208	10/01/2024	01/15/2025
CH04431BV	WALGREEN CO.	DBA: WALGREENS # 04282	1504 53RD AVE. E	BRADENTON	FL	34203	10/01/2024	01/15/2025
CH04431BK	WALGREEN CO.	DBA: WALGREENS # 02083	3155 UNIVERSITY PARKWAY	SARASOTA	FL	34243	10/01/2024
CH04431BK	WALGREEN CO.	DBA: WALGREENS # 04282	1504 53RD AVE. E	BRADENTON	FL	34203	10/01/2024
CH04431AJ	WALGREEN CO.	DBA: WALGREENS # 03963	6003 14TH ST W	BRADENTON	FL	34207-4105	10/01/2024
CH044310	Walgreens #21395	Walgreens Central Fill #21395	5710 Young Pine Rd	Orlando	FL	32829	01/01/2023
CH044310	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	09/14/2012	08/10/2015
CH044310	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/01/2025
CH044310	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/01/2025
CH044310	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/01/2025
CH044310	WALMART PHARMACY 10-3066	3500 N. TAMIAMI TRAIL		SARASOTA	FL	34234	07/01/2023	01/15/2025
CH044310	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2024
CH044310	WALMART PHARMACY 10-7221	1100 S MAIN STREET		NORTH PORT	FL	34287	04/01/2025
CH044310	WALMART PHARMACY 10-7307	4536 53RD AVENUE EAST		BRADENTON	FL	34203	04/01/2025
CH044310	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH044310	WINN DIXIE STORES	WINN DIXIE PHARMACY #657	5400 FRUITVILLE ROAD	SARASOTA	FL	34232	07/01/2018	06/30/2021
CH044310	WINN-DIXIE STORES	WINN-DIXIE STORE #656	7400 44TH AVENUE WEST	BRADENTON	FL	34210	07/01/2018	06/30/2021
CH044310	WINN-DIXIE STORES	WINN-DIXIE PHARMACY #630	1010 53RD AVE. EAST	BRADENTON	FL	34203	07/01/2018	06/30/2021

History

Section	Field	Action	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Insert		PRESHA, WALTER L. CEO 9417764000	8/11/2017 2:26 PM
Contacts	Signed By	Insert		PRESHA, WALTER L. CEO 9417764000	8/11/2017 2:26 PM
Contacts	Primary Contact	Update	BEEBE, SHARON PHARMACY DIRECTOR 9417087672-302	Fredricks, Tuesday Pharmacy Director 9417087672-300	2/17/2017 1:51 PM
Details	Last Recertification Date	Update	2/11/2015 12:00:00 AM	3/1/2016 12:00:00 AM	3/1/2016 11:00 AM
Dates	Last Date That 340B Drugs Purchased	Update		12/31/2015 12:00:00 AM	3/1/2016 11:00 AM
Details	State	Update	Active	Terminated	3/1/2016 11:00 AM
Terminations	Termination Comments	Update		This location rarely used 340b drugs while in operation. Once determined to discontinue services, any and all 340b drugs were transferred to primary pharmacy location.	3/1/2016 11:00 AM
Terminations	Termination Date	Update		4/1/2016 12:00:00 AM	3/1/2016 11:00 AM
Terminations	Termination Effective Date	Update		2/22/2016 12:00:00 AM	3/1/2016 11:00 AM
Terminations	Termination Reason	Update		Site closure	3/1/2016 11:00 AM
Addresses	Main Address	Insert		250 2nd St E STE 4G Bradenton, FL 34208-1028	3/1/2016 11:00 AM
Addresses	Billing Address	Insert		MANATEE COUNTY RURAL HEALTH SERVICES, INC ADMINISTRATION OFFICE 700 8TH AVE WEST SUITE 101 PALMETTO, FL 34221	2/11/2015 8:34 AM
Details	Last Recertification Date	Update	3/22/2014 12:00:00 AM	2/11/2015 12:00:00 AM	2/11/2015 8:34 AM
Details	Last Recertification Date	Update		3/22/2014 12:00:00 AM	3/22/2014 8:45 PM
Details	Entity Name	Update	Manatee County Rural Health Services	MANATEE COUNTY RURAL HEALTH SERVICES, INC.	3/22/2014 8:45 PM
Contacts	Primary Contact	Insert		BEEBE, SHARON PHARMACY DIRECTOR 9417087672-302	3/20/2013 9:45 AM
Details	340B ID	Update	IS-FN-CH04431AB	CH04431AB	2/13/2013 5:15 PM
Dates	Participating Approval Date	Update		2/13/2013 12:00:00 AM	2/13/2013 5:15 PM
Details	State	Update	Pending	Active	2/13/2013 5:15 PM
Dates	Start Date	Update		4/1/2013 12:00:00 AM	2/13/2013 5:15 PM
Details	340B ID	Update	ONLINE_REG	IS-FN-CH04431AB	2/6/2013 12:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert		False	1/14/2013 3:29 PM
Medicaid Billing	Medicaid: Number	Insert		029561230	1/14/2013 3:29 PM
Medicaid Billing	Medicaid: State	Insert		FL	1/14/2013 3:29 PM
Medicaid Billing	NPI: Number	Insert		1053509950	1/14/2013 3:29 PM
Details	Last Recertification Date	Insert			1/14/2013 3:29 PM
Details	Grant Number	Insert		H80CS00097	1/14/2013 3:29 PM
Details	340B ID	Insert		ONLINE_REG	1/14/2013 3:29 PM
Details	Is Authorizing Official EHB Data	Insert			1/14/2013 3:29 PM
Dates	Last Date That 340B Drugs Purchased	Insert			1/14/2013 3:29 PM
Details	Medicare Provider Number	Insert			1/14/2013 3:29 PM
Details	Entity Name	Insert		Manatee County Rural Health Services	1/14/2013 3:29 PM
Details	Program Code	Insert		CH	1/14/2013 3:29 PM
Details	Entity Subname	Insert		Manatee General Surgery/GI	1/14/2013 3:29 PM
Dates	Participating Approval Date	Insert			1/14/2013 3:29 PM
Details	State	Insert		Pending	1/14/2013 3:29 PM
Dates	Registration Date	Insert		1/14/2013 12:00:00 AM	1/14/2013 3:29 PM
Dates	Signed By Date	Insert		1/14/2013 12:00:00 AM	1/14/2013 3:29 PM
Dates	Start Date	Insert			1/14/2013 3:29 PM
Terminations	Termination Comments	Insert			1/14/2013 3:29 PM
Terminations	Termination Date	Insert			1/14/2013 3:29 PM
Terminations	Termination Effective Date	Insert			1/14/2013 3:29 PM
Terminations	Termination Reason	Insert			1/14/2013 3:29 PM

340B Drug Pricing Program Database