Covered Entity Details

CH09083AF SANTA BARBARA, COUNTY OF (Active) - information as of 6/26/2025 2:58:24 AM

Main Details

Name

SANTA BARBARA, COUNTY OF

Subdivision Name

GOOD SAMARITAN SHELTER

Type

HRSA-Funded Health Center

Site ID

BPS-H80-000108

340B ID

CH09083AF

Grant Number

H80CS00046

Additional Details

Current Program Status

Active

Registration Date

4/1/2014

Participating Start Date

7/1/2014

Participating Approval Date

4/11/2014

Last Recertification Date

2/27/2025

Contacts

Authorizing Official

Santa Barbara County Public Health Dept
Paola Hurtado, Assistant Deputy Director PCFH
(805) 698-2418

Primary Contact

County of Santa Barbara
Trang Ngo, Pharmacist
(805) 737-6094

Addresses

Street Address

401 W. MORRISON
SANTA MARIA, CA 93458-6124

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?
Yes

State	Medicaid Number	NPI Number
CA	PHA463810,PHB454770,PHA467130,FHC12098F	1245337773,1881786333,1952324980,1265599732

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH090830	Active	BPS-H80-000471	SANTA BARBARA COUNTY HEALTH CARE	SANTA BARBARA COUNTY PUBLIC HEALTH DEPARTMENT	345 Camino del Remedio	SANTA BARBARA	CA
CH09083A	Active	BPS-H80-004431	SANTA BARBARA, COUNTY OF	COUNTY HEALTH CLINIC-SANTA MARIA	2115 Centerpointe Pkwy	Santa Maria	CA
CH09083AA	Active	BPS-H80-000456	SANTA BARBARA COUNTY HEALTH CARE	COUNTY HLTH CLINIC - CARPINTERIA	931 Walnut Ave	Carpinteria	CA
CH09083AF	Active	BPS-H80-000108	SANTA BARBARA, COUNTY OF	GOOD SAMARITAN SHELTER	401 W. MORRISON	SANTA MARIA	CA
CH09083AG	Active	BPS-H80-006654	SANTA BARBARA, COUNTY OF	PATH (People Assisting the Homeless)	816 CACIQUE ST	SANTA BARBARA	CA
CH09083AH	Active	BPS-H80-007107	SANTA BARBARA, COUNTY OF	SANTA BARBARA RESCUE MISSION	535 E. YANONALI ST	SANTA BARBARA	CA
CH09083AJ	Active	BPS-H80-022356	SANTA BARBARA, COUNTY OF	Franklin Elementary School Health Care Center	1111 E Mason St	Santa Barbara	CA
CH09083D	Active	BPS-H80-000209	SANTA BARBARA COUNTY HEALTH CARE	COUNTY HEALTH CLINIC - LOMPOC	301 N R ST	LOMPOC	CA
CH09083Z	Active	BPS-H80-001169	SANTA BARBARA COUNTY HEALTH CARE	COUNTY HEALTH CLINIC FRANKLIN	1136 E. Montecito St	Santa Barbara	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH090830	ALBERTSONS LLC	SAV-ON PHARMACY #3171	1500 NORTH H STREET	LOMPOC	CA	93436	01/01/2023
CH090830	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	08/29/2012	01/01/2022
CH090830	DIPLOMAT SPECIALTY PHARMACY	15211 VANOWEN ST	STE 301	VAN NUYS	CA	91405	10/01/2019	02/01/2021
CH090830	DIPLOMAT SPECIALTY PHARMACY OF PHOENIX,	DIPLOMAT SPECIALTY PHARMACY	485 N. JUNIPER DR	CHANDLER	AZ	85226	10/01/2019	02/01/2021
CH090830	DIPLOMAT SPECIALTY PHARMACY OF SOUTHERN	DIPLOMAT SPECIALTY PHARMACY	1809 EXCISE AVENUE SUITE 204-208	ONTARIO	CA	91761	07/01/2013	07/31/2019
CH090830	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09737	189 SOUTH TURNPIKE ROAD	GOLETA	CA	93111	04/01/2017	06/30/2022
CH090830	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09750	1830 NORTH BROADWAY	SANTA MARIA	CA	93454	04/01/2017	06/30/2022
CH090830	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09860	222 W. CARRILLO ST.	SANTA BARBARA	CA	93101	04/01/2017	06/30/2022
CH090830	HOMETOWN PHARMACY		1414 S MILLER STREET SUITES E & F	SANTA MARIA	CA	93454	09/04/2012	06/14/2016
CH090830	L M CALDWELL PHARMACIST		1509 STATE ST	SANTA BARBARA	CA	93101-2513	09/12/2012	01/18/2017
CH090830	L M CALDWELL PHARMACIST		235 WEST PUEBLO ST	SANTA BARBARA	CA	93105	09/12/2012	01/18/2017
CH090830	LA JOYA PHARMACY	1115 WEST MAIN STREET STE E-1		SANTA MARIA	CA	93458-9345	09/04/2012	09/25/2018
CH090830	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03153	733 E MAIN ST	SANTA MARIA	CA	93454	04/01/2017	06/30/2022
CH090830	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09235	1036 CASITAS PASS RD	CARPINTERIA	CA	93013	04/01/2017	06/30/2022
CH090830	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09824	2973 STATE ST	SANTA BARBARA	CA	93105	04/01/2017	10/31/2018
CH090830	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09871	1317 N H ST	LOMPOC	CA	93436	04/01/2017	06/30/2022
CH090830	RALPHS GROCERY CO	DBA RALPH'S #680	100 W. CARRILLO STREET	SANTA BARBARA	CA	93101	10/11/2012	07/13/2018
CH090830	THE VONS COMPANIES INC	VONS PHARMACY #1738	729 NORTH H STREET	LOMPOC	CA	93436	10/11/2012	05/11/2021
CH090830	THRIFTY PAYLESS, INC.	RITE AID #5835	345 TOWN CENTER WEST	SANTA MARIA	CA	93458	04/01/2020
CH090830	THRIFTY PAYLESS, INC.	RITE AID #5788	35 SOUTH MILPAS STREET	SANTA BARBARA	CA	93103	04/01/2020
CH090830	THRIFTY PAYLESS, INC.	RITE AID #5836	2405 SOUTH BROADWAY	SANTA MARIA	CA	93454	04/01/2020
CH090830	THRIFTY PAYLESS, INC.	RITE AID #5790	1976 CLIFF DRIVE	SANTA BARBARA	CA	93109	04/01/2024
CH090830	THRIFTY PAYLESS, INC.	RITE AID #5791	199 NORTH FAIRVIEW AVENUE	GOLETA	CA	93117	04/01/2024
CH090830	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	01/01/2017	12/05/2017
CH090830	US BIOSERVICES	PHARM PLUS ACQUISITION, INC.	5100 E HUNTER AVE SUITE 101	ANAHEIM	CA	92807-2049	01/01/2017	12/05/2017
CH090830	VALLEY MEDICAL PHARMACY	DBA JDX PHARMACY	1504 S BROADWAY	SANTA MARIA	CA	93454-7214	08/27/2012	02/01/2022
CH090830	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2017
CH090830	WAL-MART PHARMACY 10-1989	701 WEST CENTRAL AVE		LOMPOC	CA	93436	08/23/2012
CH090830	WAL-MART PHARMACY 10-2507	2220 SOUTH BRADLEY		SANTA MARIA	CA	93455	10/01/2016
CH090830	WAL-MART PHARMACY 10-5658	2240 S BRADLEY RD		SANTA MARIA	CA	93454	07/01/2015	07/20/2018
CH090830	WAL-MART PHARMACY 10-5659	500 SOUTH BLOSSER RD		SANTA MARIA	CA	93454	07/01/2015
CH090830	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2017
CH090830	WALGREEN CO.	DBA: WALGREENS # 06287	2399 S BROADWAY	SANTA MARIA	CA	93454-7832	04/01/2014
CH090830	WALGREEN CO.	DBA: WALGREENS # 06288	707 N BROADWAY	SANTA MARIA	CA	93454	04/01/2014
CH090830	WALGREEN CO.	DBA: WALGREENS # 06290	937 NORTH H STREET	LOMPOC	CA	93436-4148	04/01/2014
CH090830	WALGREEN CO.	DBA: WALGREENS # 06289	5900 CALLE REAL	GOLETA	CA	93117-2312	04/01/2015
CH090830	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/12/2024 3:35:25 PM	2/27/2025 6:29:09 PM	2/27/2025 6:29 PM
Contacts	Primary Contact	Update	Group Change Request	Walker, Frank Perry Pharmacy Director Santa Barbara County Public Health Department 8056987586	Ngo, Trang Pharmacist County of Santa Barbara 8057376094	6/7/2024 9:43 AM
Details	Last Recertification Date	Update	Recertification	2/13/2023 9:13:30 AM	2/12/2024 3:35:25 PM	2/12/2024 3:35 PM
Contacts	Primary Contact	Update	Group Change Request	Cumber, Jessica Interim Pharmacy Director Santa Barbara County Public Health Dept 8056814017	Walker, Frank Perry Pharmacy Director Santa Barbara County Public Health Department 8056987586	11/22/2023 2:35 PM
Contacts	Authorizing Official	Update	Profile Change Request	Hurtado, Paola Assistant Deputy Director PCFH Santa Barbara County Public Health Dept 8056815423	Hurtado, Paola Assistant Deputy Director PCFH Santa Barbara County Public Health Dept 8056982418	11/22/2023 2:05 PM
Contacts	Authorizing Official	Update	Group Change Request	Gamble, Dana Deputy Director County of Santa Barbara 8056815171	Hurtado, Paola Assistant Deputy Director PCFH Santa Barbara County Public Health Dept 8056815423	4/10/2023 4:48 PM
Details	Last Recertification Date	Update	Recertification	2/3/2022 11:27:37 AM	2/13/2023 9:13:30 AM	2/13/2023 9:13 AM
Contacts	Primary Contact	Update	Change Request	Cobian, Miguel Pharmacy Director Santa Barbara County Health Care 8056815164	Cumber, Jessica Interim Pharmacy Director Santa Barbara County Public Health Dept 8056814017	1/27/2023 11:35 AM
Contacts	Primary Contact	Update	Group Change Request	Millage, Carol Pharmacy Director County of Santa Barbara 8056815164	Cobian, Miguel Pharmacy Director Santa Barbara County Health Care 8056815164	4/27/2022 1:06 PM
Contacts	Authorizing Official	Update	Profile Change Request	Gamble, Dana Assistant Deputy Director County of Santa Barbara 8056815171	Gamble, Dana Deputy Director County of Santa Barbara 8056815171	2/8/2022 10:15 AM
Details	Last Recertification Date	Update	Recertification	2/8/2021 5:01:38 PM	2/3/2022 11:27:37 AM	2/3/2022 11:27 AM
Medicaid Billing	NPI: State	Update	Recertification		CA	2/8/2021 5:01 PM
Medicaid Billing	NPI: State	Update	Recertification		CA	2/8/2021 5:01 PM
Medicaid Billing	NPI: State	Update	Recertification		CA	2/8/2021 5:01 PM
Medicaid Billing	NPI: State	Update	Recertification		CA	2/8/2021 5:01 PM
Details	Last Recertification Date	Update	Recertification	2/7/2020 7:22:17 PM	2/8/2021 5:01:38 PM	2/8/2021 5:01 PM
Details	Last Recertification Date	Update	Recertification	2/16/2019 6:13:07 PM	2/7/2020 7:22:17 PM	2/7/2020 7:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		PHA463810	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CA	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		PHB454770	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CA	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		PHA467130	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CA	9/11/2019 5:09 PM
Medicaid Billing	Medicaid: Number	Update	Change Request	1265599732	FHC12098F	9/11/2019 5:09 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1881786333	9/11/2019 5:09 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1952324980	9/11/2019 5:09 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1265599732	9/11/2019 5:09 PM
Details	Is Authorizing Official EHB Data	Update	Change Request	False		9/11/2019 5:09 PM
Details	Last Recertification Date	Update	Recertification	3/2/2018 1:02:22 PM	2/16/2019 6:13:07 PM	2/16/2019 6:13 PM
Details	Last Recertification Date	Update	Recertification	2/15/2017 12:00:00 AM	3/2/2018 1:02:22 PM	3/2/2018 1:02 PM
Contacts	Authorizing Official	Update	Change Request	Gamble, Dana Assistant Deputy Director 8056815171	Gamble, Dana Assistant Deputy Director County of Santa Barbara 8056815171	3/2/2018 12:45 PM
Contacts	Primary Contact	Update		Millage, Carol Pharmacy Director 8056815164	Millage, Carol Pharmacy Director County of Santa Barbara 8056815164	9/19/2017 6:50 PM
Contacts	Signed By	Insert			Reid, Daniel Asst. Deputy Director 8056815173	3/23/2017 7:47 PM
Addresses	Main Address	Insert			401 W. MORRISON SANTA MARIA, CA 93458-6124	2/16/2017 6:41 PM
Contacts	Primary Contact	Insert			Millage, Carol Pharmacy Director 8056815164	2/16/2017 6:41 PM
Contacts	Authorizing Official	Insert			Gamble, Dana Assistant Deputy Director 8056815171	2/16/2017 6:41 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/16/2017 6:41 PM
Medicaid Billing	Medicaid: Number	Insert			1265599732	2/16/2017 6:41 PM
Medicaid Billing	Medicaid: State	Insert			CA	2/16/2017 6:41 PM
Details	Last Recertification Date	Update		2/23/2016 12:00:00 AM	2/15/2017 12:00:00 AM	2/16/2017 6:41 PM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/23/2016 12:00:00 AM	2/23/2016 7:54 AM
Details	Last Recertification Date	Update			2/12/2015 12:00:00 AM	2/12/2015 10:49 AM
Details	Is Authorizing Official EHB Data	Update			False	2/12/2015 10:49 AM
Details	340B ID	Update		ONLINE_REG	CH09083AF	4/11/2014 3:59 PM
Dates	Participating Approval Date	Update			4/11/2014 12:00:00 AM	4/11/2014 3:59 PM
Details	State	Update		Pending	Active	4/11/2014 3:59 PM
Dates	Start Date	Update			7/1/2014 12:00:00 AM	4/11/2014 3:59 PM
Medicaid Billing	NPI: Number	Insert			1245337773	4/1/2014 5:31 PM
Details	Last Recertification Date	Insert				4/1/2014 5:31 PM
Details	Grant Number	Insert			H80CS00046	4/1/2014 5:31 PM
Details	340B ID	Insert			ONLINE_REG	4/1/2014 5:31 PM
Details	Is Authorizing Official EHB Data	Insert				4/1/2014 5:31 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/1/2014 5:31 PM
Details	Medicare Provider Number	Insert				4/1/2014 5:31 PM
Details	Entity Name	Insert			SANTA BARBARA, COUNTY OF	4/1/2014 5:31 PM
Details	Program Code	Insert			CH	4/1/2014 5:31 PM
Details	Entity Subname	Insert			GOOD SAMARITAN SHELTER	4/1/2014 5:31 PM
Dates	Participating Approval Date	Insert				4/1/2014 5:31 PM
Details	State	Insert			Pending	4/1/2014 5:31 PM
Dates	Registration Date	Insert			4/1/2014 12:00:00 AM	4/1/2014 5:31 PM
Dates	Signed By Date	Insert			4/1/2014 12:00:00 AM	4/1/2014 5:31 PM
Dates	Start Date	Insert				4/1/2014 5:31 PM
Terminations	Termination Comments	Insert				4/1/2014 5:31 PM
Terminations	Termination Date	Insert				4/1/2014 5:31 PM
Terminations	Termination Effective Date	Insert				4/1/2014 5:31 PM
Terminations	Termination Reason	Insert				4/1/2014 5:31 PM

340B Drug Pricing Program Database