Covered Entity Details

CHC26623-03 OPERATION SAMAHAN (Terminated) - information as of 5/13/2025 1:28:38 AM

Main Details

Name

OPERATION SAMAHAN

Subdivision Name

Rancho Penasquitos Community Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-013107

340B ID

CHC26623-03

Grant Number

H80CS26623

Additional Details

Current Program Status

Terminated

Registration Date

2/28/2014

Participating Start Date

4/1/2014

Participating Approval Date

2/28/2014

Last Recertification Date

1/26/2017

Termination Date
Termination Reason

4/1/2017
Site closure

Contacts

Authorizing Official

Operation Samahan
Dirk Darwin Zirbel, CEO
(310) 699-0998

Primary Contact

Operation Samahan, Inc.
Fe Seligman, Grant Director
(844) 200-2426 Ext: 1016

Addresses

Street Address

9955 Carmel Mt. Road STE F2
San Diego, CA 92129-2815

Billing Address
Same as Street Address

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
CHC26623-00	Active	BPS-H80-013135	OPERATION SAMAHAN, INC.	OPSAM HEALTH: 2835 Highland	2835 Highland Ave		National City	CA
CHC26623-01	Active	BPS-H80-013234	OPERATION SAMAHAN, INC.	OPSAM HEALTH: 2743 Highland	2743 Highland Ave		National City	CA
CHC26623-02	Active	BPS-H80-013246	OPERATION SAMAHAN	OPSAM HEALTH: 10737 Camino Ruiz Ste. 235	10737 Camino Ruiz STE 235		San Diego	CA
CHC26623-03	Terminated	BPS-H80-013107	OPERATION SAMAHAN	Rancho Penasquitos Community Health Center	9955 Carmel Mt. Road STE F2		San Diego	CA
CHC26623-04	Active	BPS-H80-013093	OPERATION SAMAHAN	Granger School based Health Center	2101 Granger Ave STE 101A		National City	CA
CHC26623-05	Terminated	BPS-H80-013228	OPERATION SAMAHAN	Operation Samahan-Pacific American Academy School based Health Center	4260 54th St		San Diego	CA
CHC26623-06	Active	BPS-H80-018226	OPERATION SAMAHAN, INC.	OPSAM HEALTH: 9855 Erma Road	9855 Erma Road Suite 105		San Diego	CA
CHC26623-07	Active	BPS-H80-019611	OPERATION SAMAHAN, INC.	OPSAM HEALTH: Rancho Penasquitos	9995 Carmel Mountain Road	Suite B10 & B11	San Diego	CA
CHC26623-08	Active	BPS-H80-039621	OPERATION SAMAHAN, INC	Opsam Health Mid-City Health Center	5296 University Ave, Ste F1		San Diego	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC26623-00	COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY	STE A - E	SAN DIEGO	CA	92102-4548	07/01/2017
CHC26623-00	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05773	69-80 GRAND AVE.	MASPETH	NY	11378	07/01/2020
CHC26623-00	GALLOWAY'S MEDICAL CENTER PHARMACY	2995 NATIONAL AVENUE		SAN DIEGO	CA	92113	07/01/2017
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09195	8831 VILLA LA JOLLA DR.	LA JOLLA	CA	92037	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09524	3350 PALM AVE.	SAN DIEGO	CA	92154	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08859	16 3RD AVENUE EXT.	CHULA VISTA	CA	91910	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09114	1299 BROADWAY	EL CAJON	CA	92021	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09196	1376 3RD AVE	CHULA VISTA	CA	91911	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09177	8260 MIRA MESA BLVD.	SAN DIEGO	CA	92126	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09113	645 E. PALOMAR ST.	CHULA VISTA	CA	91911	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09140	555 BROADWAY STE 1054	CHULA VISTA	CA	91910	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09103	318 W EL NORTE PARKWAY	ESCONDIDO	CA	92026	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09138	1201 E. PLAZA BLVD	NATIONAL CITY	CA	91950	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09115	645 SATURN BLVD	SAN DIEGO	CA	92154	04/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08833	3332 SANDROCK ROAD	SAN DIEGO	CA	92123	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09148	313 WASHINGTON ST.	SAN DIEGO	CA	92103	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09112	7100 BROADWAY	LEMON GROVE	CA	91945	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09560	611 S. BROOKHURST ST.	ANAHEIM	CA	92804	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09751	5623 KANAN RD.	AGOURA HILLS	CA	91301	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09193	1380 43RD ST.	SAN DIEGO	CA	92113	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09110	1101 S. MISSION RD.	FALLBROOK	CA	92028	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09109	6265 EL CAJON BLVD	SAN DIEGO	CA	92115	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09120	800 PALM AVE.	IMPERIAL BEACH	CA	91932	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09173	2760 FLETCHER PKY	EL CAJON	CA	92020	07/01/2020
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09175	4829 CLAIREMONT DR	SAN DIEGO	CA	92117	07/01/2020
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09104	2427 E. VALLEY PKWY	ESCONDIDO	CA	92027	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09197	9225 TWIN TRAILS DRIVE	SAN DIEGO	CA	92129	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09105	12358 POWAY ROAD	POWAY	CA	92064	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09102	10575 SCRIPPS POWAY PRKY	SAN DIEGO	CA	92131	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09197	9225 TWIN TRAILS DRIVE	SAN DIEGO	CA	92129	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09111	16773 BERNARDO CENTER DR	RANCHO BERNARDO	CA	92128	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08848	30736 BENTON RD.	WINCHESTER	CA	92596	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09165	3327 ROSECRANS ST.	SAN DIEGO	CA	92110	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09131	10560-4S COMMONS DR.	SAN DIEGO	CA	92127	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09197	9225 TWIN TRAILS DRIVE	SAN DIEGO	CA	92129	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09165	3327 ROSECRANS ST.	SAN DIEGO	CA	92110	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09104	2427 E. VALLEY PKWY	ESCONDIDO	CA	92027	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09111	16773 BERNARDO CENTER DR	RANCHO BERNARDO	CA	92128	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09131	10560-4S COMMONS DR.	SAN DIEGO	CA	92127	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09131	10560-4S COMMONS DR.	SAN DIEGO	CA	92127	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09102	10575 SCRIPPS POWAY PRKY	SAN DIEGO	CA	92131	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09105	12358 POWAY ROAD	POWAY	CA	92064	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08848	30736 BENTON RD.	WINCHESTER	CA	92596	07/01/2022
CHC26623-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09105	12358 POWAY ROAD	POWAY	CA	92064	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09102	10575 SCRIPPS POWAY PRKY	SAN DIEGO	CA	92131	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08848	30736 BENTON RD.	WINCHESTER	CA	92596	07/01/2022
CHC26623-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09111	16773 BERNARDO CENTER DR	RANCHO BERNARDO	CA	92128	07/01/2022
CHC26623-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09165	3327 ROSECRANS ST.	SAN DIEGO	CA	92110	07/01/2022
CHC26623-00	HILLCREST PHARMACY	120 UNIVERSITY AVE		SAN DIEGO	CA	92103	07/01/2020	02/02/2022
CHC26623-00	HILLCREST PHARMACY INC	HILLCREST PHARMACY	1988 HACIENDA DR	VISTA	CA	92081-6026	07/01/2020	02/02/2022
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09783	1730 SWEETWATER RD	NATIONAL CITY	CA	91950	04/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09538	1792 GARNET AVE	SAN DIEGO	CA	92109	04/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 07962	5685 BALBOA AVE	SAN DIEGO	CA	92111	04/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09632	691 3RD AVE	CHULA VISTA	CA	91910	04/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09900	2690 MOUNT VERNON AVE	BAKERSFIELD	CA	93306	07/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 06332	645 MARKET ST	SAN DIEGO	CA	92101	07/01/2020
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09926	7525 EADS AVE	LA JOLLA	CA	92037	07/01/2020
CHC26623-01	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09251	3999 SANTA RITA ROAD	PLEASANTON	CA	94588	07/01/2022
CHC26623-01	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09961	191 WOODLAND PKWY	SAN MARCOS	CA	92069	07/01/2022
CHC26623-02	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09961	191 WOODLAND PKWY	SAN MARCOS	CA	92069	07/01/2022
CHC26623-02	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03068	10776 WESTVIEW PKWY	SAN DIEGO	CA	92126	07/01/2022
CHC26623-02	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09251	3999 SANTA RITA ROAD	PLEASANTON	CA	94588	07/01/2022
CHC26623-02	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09162	3749 AVOCADO BLVD	LA MESA	CA	91941	07/01/2022
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09961	191 WOODLAND PKWY	SAN MARCOS	CA	92069	07/01/2022
CHC26623-01	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03068	10776 WESTVIEW PKWY	SAN DIEGO	CA	92126	07/01/2022
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09251	3999 SANTA RITA ROAD	PLEASANTON	CA	94588	07/01/2022
CHC26623-01	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09162	3749 AVOCADO BLVD	LA MESA	CA	91941	07/01/2022
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09162	3749 AVOCADO BLVD	LA MESA	CA	91941	07/01/2022
CHC26623-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03068	10776 WESTVIEW PKWY	SAN DIEGO	CA	92126	07/01/2022
CHC26623-00	MAJESTIC PHARMACY	4456 VANDEVER AVENUE	SUITE 5	SAN DIEGO	CA	92120-3325	04/01/2014	02/16/2017
CHC26623-00	MEDICAL CENTER PHARMACY	340 4TH AVENUE	SUITE 1	CHULA VISTA	CA	91910	07/01/2017
CHC26623-00	MEDICAL CENTER PHARMACY	PARK MEDICAL PHARMACY	480 4TH AVE STE 100	CHULA VISTA	CA	91910	07/01/2017
CHC26623-00	MEDICAL CENTER PHARMACY	4074 FAIRMONT AVENUE		SAN DIEGO	CA	92105	07/01/2017
CHC26623-00	MEDICAL CENTER PHARMACY	MCP16	286 EUCLID AVE, #206	SAN DIEGO	CA	92114	07/01/2017	09/13/2021
CHC26623-00	MEDICAL CENTER PHARMACY	3904 PARK BLVD		SAN DIEGO	CA	92103	07/01/2020
CHC26623-00	MEDICAL CENTER PHARMACY AT FATHER JOE'S	CONDUCTED BY MCP/SVDPV LLC	16 15TH STREET	SAN DIEGO	CA	92101	07/01/2020	09/13/2021
CHC26623-00	MEDICAL CENTER PHARMACY LTC	CONDUCTED BY WESTERN PHARMACY GROUP LLC	610 GATEWAY CENTER WAY STE H-I	SAN DIEGO	CA	92102-4533	07/01/2020
CHC26623-00	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023	06/22/2023
CHC26623-06	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023
CHC26623-02	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023
CHC26623-01	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023
CHC26623-04	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023
CHC26623-07	MEDPILOT PHARMACY INCORPORATED	9323 CHESAPEAKE DR STE C1		SAN DIEGO	CA	92123-1034	01/01/2023
CHC26623-00	MI FARMACIA SAN YSIDRO	4630 BORDER VILLAGE RD STE K-L		SAN YSIDRO	CA	92173-3121	04/01/2020	02/02/2022
CHC26623-04	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-01	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-02	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-07	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-00	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-06	PALM CARE PHARMACY	505 N MOLLISON AVE STE 102		EL CAJON	CA	92021-6159	01/01/2022
CHC26623-00	RALPHS GROCERY CO	DBA RALPHS #235	659 E. PALOMAR STREET	CHULA VISTA	CA	91911	07/01/2017	04/26/2023
CHC26623-00	RALPHS GROCERY CO.	DBA: RALPHS #105	10525 4S COMMONS DRIVE	SAN DIEGO	CA	92127	07/01/2017	04/26/2023
CHC26623-00	RANCHO PHARMACY	9912 CARMEL MOUNTAIN RD	STE E	SAN DIEGO	CA	92129	10/01/2017	06/26/2018
CHC26623-06	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-02	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-00	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-01	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-07	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-04	TALAMI HEALTH CARE LLC	DBA: PALM CARE PHARMACY	101 N HIGHLAND AVE SUITE EFG	NATIONAL CITY	CA	91950-1400	01/01/2022
CHC26623-00	TCY PHARMACY INC	DBA SUITECARE PHARMACY	1120 E. 8TH STREET	NATIONAL CITY	CA	91950	10/01/2017	10/12/2023
CHC26623-00	THE VONS COMPANIES INC	VONS PHARMACY #2081	13255 BLACK MOUNTAIN ROAD	SAN DIEGO	CA	92129	07/01/2017	05/02/2023
CHC26623-00	THRIFTY PAYLESS INC.	RITE AID #5637	12666 POWAY ROAD	POWAY	CA	92064	07/01/2017	05/05/2017
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5661	8985 MIRA MESA BOULEVARD	SAN DIEGO	CA	92126	07/01/2017
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5620	661 SWEETWATER ROAD	SPRING VALLEY	CA	91977	07/01/2017	07/14/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5662	11845 CARMEL MOUNTAIN RD.	SAN DIEGO	CA	92128	07/01/2017	06/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5665	13167 BLACK MOUNTAIN ROAD	SAN DIEGO	CA	92129	07/01/2017	10/14/2022
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5617	2230 OTAY LAKES ROAD	CHULA VISTA	CA	91915	07/01/2017	05/09/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023	06/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #6256	25710 BARTON ROAD	LOMA LINDA	CA	92354	01/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #6256	25710 BARTON ROAD	LOMA LINDA	CA	92354	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023	06/01/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #6256	25710 BARTON ROAD	LOMA LINDA	CA	92354	01/01/2023	06/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023
CHC26623-06	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #6256	25710 BARTON ROAD	LOMA LINDA	CA	92354	01/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023	06/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #6256	25710 BARTON ROAD	LOMA LINDA	CA	92354	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023
CHC26623-01	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023
CHC26623-06	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023
CHC26623-07	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023
CHC26623-02	THRIFTY PAYLESS, INC.	RITE AID #5701	700 EAST REDLANDS BLVD SUITE A	REDLANDS	CA	92373	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5668	1854 CORONADO AVENUE	SAN DIEGO	CA	92154	01/01/2023	06/12/2023
CHC26623-06	THRIFTY PAYLESS, INC.	RITE AID #5666	3515 DELMAR HEIGHTS ROAD	SAN DIEGO	CA	92130	01/01/2023
CHC26623-00	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023	06/12/2023
CHC26623-06	THRIFTY PAYLESS, INC.	RITE AID #5646	1735 EUCLID AVENUE	SAN DIEGO	CA	92105	01/01/2023
CHC26623-04	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023
CHC26623-06	THRIFTY PAYLESS, INC.	RITE AID #6711	13460 HIGHLANDS PL	SAN DIEGO	CA	92130-2401	01/01/2023
CHC26623-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2017
CHC26623-00	WAL-MART PHARMACY 10-1700	13425 COMMUNITY ROAD		POWAY	CA	92064	07/01/2017
CHC26623-00	WAL-MART PHARMACY 10-2150	710 DENNERY RD		SAN DIEGO	CA	92154	07/01/2017	05/26/2023
CHC26623-00	WAL-MART PHARMACY 10-5023	1200 HIGHLAND AVE		NATIONAL CITY	CA	91950	07/01/2017
CHC26623-00	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	07/01/2017	06/15/2023
CHC26623-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2017
CHC26623-00	WALGREEN CO	DBA: WALGREENS #12143	5504 BALBOA AVE	SAN DIEGO	CA	92111	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 05455	111 W WASHINGTON AVE	ESCONDIDO	CA	92025	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 05700	1574 E VALLEY PKWY	ESCONDIDO	CA	92027	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 05844	215 NORTH 2ND STREET	EL CAJON	CA	92021	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 07176	8766 NAVAJO RD	SAN DIEGO	CA	92119-2722	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 07869	885 EUCLID AVE	NATIONAL CITY	CA	91950	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS #11406	10512 MISSION GORGE RD	SANTEE	CA	92071-3146	04/01/2014	08/14/2017
CHC26623-00	WALGREEN CO.	DBA: WALGREENS #11654	10787 CAMINO RUIZ	SAN DIEGO	CA	92126-2304	04/01/2014
CHC26623-00	WALGREEN CO.	DBA: WALGREENS #12421	13390 POWAY RD	POWAY	CA	92064	04/01/2014
CHC26623-00	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #13434	640 UNIVERSITY AVE	SAN DIEGO	CA	92103	01/01/2017
CHC26623-00	WALGREEN CO.	DBA: WALGREENS # 07867	1430 EASTLAKE PKWY	CHULA VISTA	CA	91915	04/01/2017
CHC26623-00	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16490	4130 LA JOLLA VILLAGE DR STE 103	LA JOLLA	CA	92037	04/01/2017
CHC26623-00	WALGREEN CO.	DBA: WALGREENS #13834	602 EUCLID AVE	SAN DIEGO	CA	92114	10/01/2018	05/26/2023
CHC26623-00	WALGREEN CO.	DBA: WALGREENS #13834	602 EUCLID AVE	SAN DIEGO	CA	92114	10/01/2018	05/26/2023
CHC26623-00	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-07	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-04	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-07	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-01	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-04	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-06	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-02	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-02	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-01	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-00	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2023
CHC26623-06	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2023
CHC26623-06	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-07	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-01	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-02	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-04	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26623-00	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	07/01/2017	07/04/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA MEDICAL CENTER PHARMACY	3904 PARK BLVD	SAN DIEGO	CA	92103-3502	04/01/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA MEDICAL CENTER PHARMACY	340 4TH AVE STE 1	CHULA VISTA	CA	91910-3882	04/01/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA MEDICAL CENTER PHARMACY	4074 FAIRMOUNT AVE	SAN DIEGO	CA	92105-1608	03/12/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA GALLOWAY'S MEDICAL CENTER PHARMACY	2995 NATIONAL AVE	SAN DIEGO	CA	92113-2419	04/01/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY SUITES A--E	SAN DIEGO	CA	92102	04/01/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA MEDICAL CENTER PHARMACY	286 EUCLID AVE STE 206	SAN DIEGO	CA	92114-3612	04/01/2018
CHC26623-00	WESTERN PHARMACY GROUP LLC	DBA MEDICAL CENTER PHARMACY	480 4TH AVE STE 100	CHULA VISTA	CA	91910-4411	04/01/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Seligman, Fe Grants & Programs Director Operation Samahan, Inc. 6194715433	Seligman, Fe Grant Director Operation Samahan, Inc. 8442002426-1016	1/29/2019 6:14 PM
Contacts	Authorizing Official	Update		Zirbel, Dirk CEO 3106990998	Zirbel, Dirk Darwin CEO Operation Samahan 3106990998	2/28/2018 11:13 AM
Contacts	Primary Contact	Update		Seligman, Fe Grants & Programs Director 6194715433	Seligman, Fe Grants & Programs Director Operation Samahan, Inc. 6194715433	2/8/2018 5:39 PM
Contacts	Signed By	Insert			San Juan, Joel CEO 6192749081	8/14/2017 12:22 PM
Contacts	Primary Contact	Update		Rahman, Mohammad COO of the North 6192741946	Seligman, Fe Grants & Programs Director 6194715433	7/26/2017 12:06 PM
Contacts	Authorizing Official	Insert			Zirbel, Dirk CEO 3106990998	7/26/2017 12:06 PM
Addresses	Main Address	Insert			9955 Carmel Mt. Road STE F2 San Diego, CA 92129-2815	2/17/2017 5:00 PM
Dates	Last Date That 340B Drugs Purchased	Update			4/1/2016 12:00:00 AM	2/17/2017 5:00 PM
Details	State	Update		Active	Terminated	2/17/2017 5:00 PM
Terminations	Termination Comments	Update			Site closure due to an expansion project at the Rancho Penasquitos facility. A change in scope request has been submitted to HRSA for the new Rancho Penasquitos facility (located within the same complex but with different suite numbers )and is currently under review by our HRSA officer.	2/17/2017 5:00 PM
Terminations	Termination Date	Update			4/1/2017 12:00:00 AM	2/17/2017 5:00 PM
Terminations	Termination Effective Date	Update			4/1/2016 12:00:00 AM	2/17/2017 5:00 PM
Terminations	Termination Reason	Update			Site closure	2/17/2017 5:00 PM
Details	Last Recertification Date	Update		3/1/2016 12:00:00 AM	1/26/2017 12:00:00 AM	1/26/2017 5:19 PM
Details	Last Recertification Date	Update		3/6/2015 12:00:00 AM	3/1/2016 12:00:00 AM	3/1/2016 10:50 AM
Contacts	Primary Contact	Insert			Rahman, Mohammad COO of the North 6192741946	2/9/2016 8:25 AM
Details	Last Recertification Date	Update			3/6/2015 12:00:00 AM	3/6/2015 10:57 AM
Details	Is Authorizing Official EHB Data	Update			False	3/6/2015 10:57 AM
Details	340B ID	Update		ONLINE_REG	CHC26623-03	2/28/2014 4:45 PM
Dates	Participating Approval Date	Update			2/28/2014 12:00:00 AM	2/28/2014 4:45 PM
Details	State	Update		Pending	Active	2/28/2014 4:45 PM
Dates	Start Date	Update			4/1/2014 12:00:00 AM	2/28/2014 4:45 PM
Details	Last Recertification Date	Insert				2/28/2014 2:54 PM
Details	Grant Number	Insert			H80CS26623	2/28/2014 2:54 PM
Details	340B ID	Insert			ONLINE_REG	2/28/2014 2:54 PM
Details	Is Authorizing Official EHB Data	Insert				2/28/2014 2:54 PM
Dates	Last Date That 340B Drugs Purchased	Insert				2/28/2014 2:54 PM
Details	Medicare Provider Number	Insert				2/28/2014 2:54 PM
Details	Entity Name	Insert			OPERATION SAMAHAN	2/28/2014 2:54 PM
Details	Program Code	Insert			CH	2/28/2014 2:54 PM
Details	Entity Subname	Insert			Rancho Penasquitos Community Health Center	2/28/2014 2:54 PM
Dates	Participating Approval Date	Insert				2/28/2014 2:54 PM
Details	State	Insert			Pending	2/28/2014 2:54 PM
Dates	Registration Date	Insert			2/28/2014 12:00:00 AM	2/28/2014 2:54 PM
Dates	Signed By Date	Insert			2/28/2014 12:00:00 AM	2/28/2014 2:54 PM
Dates	Start Date	Insert				2/28/2014 2:54 PM
Terminations	Termination Comments	Insert				2/28/2014 2:54 PM
Terminations	Termination Date	Insert				2/28/2014 2:54 PM
Terminations	Termination Effective Date	Insert				2/28/2014 2:54 PM
Terminations	Termination Reason	Insert				2/28/2014 2:54 PM

340B Drug Pricing Program Database