340B Drug Pricing Program Database


CHC26614-01 APLA HEALTH & WELLNESS (Active) - information as of 5/20/2025 12:45:52 AM

Main Details
APLA HEALTH & WELLNESS
APLA Health & Wellness Dental Clinic
HRSA-Funded Health Center
BPS-H80-013372
CHC26614-01
H80CS26614


Additional Details
Active
10/10/2014
1/1/2015
10/17/2014
3/3/2025

Contacts

APLA Health & Wellness
Craig E. Thompson, Chief Executive Officer
(213) 201-1456

APLA Health & Wellness
Joseph Moldovan, Chief Financial Officer
(213) 201-1411

Addresses

1127 Wilshire Blvd. STE 1504
Los Angeles, CA 90017-4006

APLA Health & Wellness
611 S. Kingsley Drive
c/o Joseph Moldovan
Los Angeles, CA 90005-2319


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

Yes
Shipping Addresses

APLA Health & Wellness
1127 Wilshire Blvd
STE 1504
Los Angeles, CA 90017

APLA Health & Wellness
7531 Santa Monica Blvd
Suite 201
West Hollywood, CA 90046
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC26614-00ActiveBPS-H80-013374APLA HEALTH & WELLNESSAPLA Health & Wellness Center3743 S. La Brea Ave. Los AngelesCA
CHC26614-01ActiveBPS-H80-013372APLA HEALTH & WELLNESSAPLA Health & Wellness Dental Clinic1127 Wilshire Blvd. STE 1504 Los AngelesCA
CHC26614-02TerminatedBPS-H80-016813APLA HEALTH & WELLNESSAPLA Health & Wellness - S. Mark Taper Center1741 E 120TH ST LOS ANGELESCA
CHC26614-03ActiveBPS-H80-016812APLA HEALTH & WELLNESSAPLA Health & Wellness - Long Beach Center1043 Elm Avenue, Suite 302 Long BeachCA
CHC26614-04ActiveBPS-H80-027008APLA HEALTH & WELLNESSAPLA Health-Olympic5901 W. Olympic Blvd. Suite 310 Los AngelesCA
CHC26614-05ActiveBPS-H80-033537APLA HEALTH & WELLNESSAPLA Health - CDU / MLK Medical Campus1679 E. 120th St. suites 101 & 102 Los AngelesCA
CHC26614-06ActiveBPS-H80-030909APLA HEALTH & WELLNESSAPLA Health - 3741 S. La Brea3741 S La Brea Ave Los AngelesCA
CHC26614-07ActiveBPS-H80-038191APLA HEALTH & WELLNESSAPLA Health - Michael Gottlieb Health Center7531 Santa Monica Blvd, Ste 100 West HollywoodCA
CHC26614-08ActiveBPS-H80-013340APLA HEALTH & WELLNESSAPLA Health-David Geffen Center611 S Kingsley Dr Los AngelesCA
CHC26614-09ActiveBPS-H80-020960APLA HEALTH & WELLNESSAPLA Health-Olympic5901 W Olympic Blvd Ste 500 Los AngelesCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC26614-00ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2023  
CHC26614-00ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2023  
CHC26614-00ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2023  
CHC26614-00ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2023  
CHC26614-00ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/01/2023  
CHC26614-00ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2023  
CHC26614-00ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607501/01/2023  
CHC26614-00ALTO PHARMACY5916 BOWCROFT ST
LOS ANGELESCA9001610/01/2022  
CHC26614-00ALTO PHARMACY LLCDBA ALTO PHARMACY 20 FAIRBANKS STE 187
IRVINECA9261810/01/2022  
CHC26614-00ALTO PHARMACY, LLCDBA ALTO PHARMACY 1400 TENNESSEE ST UNIT 2
SAN FRANCISCOCA94107-342110/01/2022  
CHC26614-00BIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/01/2018  
CHC26614-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526101/09/2024  
CHC26614-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267001/09/2024  
CHC26614-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771301/09/2024  
CHC26614-00CAPITOL DRUGS - SHERMAN OAKS4454 VAN NUYS BLVD STE J
SHERMAN OAKSCA9140301/01/2018  
CHC26614-00CAPITOL DRUGS - WEST HOLLYWOOD8578 SANTA MONICA BLVD
WEST HOLLYWOODCA9006901/01/2018  
CHC26614-00CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2021  
CHC26614-00CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2021  
CHC26614-00CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2021  
CHC26614-00CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2021  
CHC26614-00CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2021  
CHC26614-00CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2021  
CHC26614-00CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2021  
CHC26614-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/01/2021  
CHC26614-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/01/2019  
CHC26614-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2021  
CHC26614-03COUNTY OF LOS ANGELES - AUDITOR CONTROLL313 N FIGUEROA ST STE 1225 HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELESCA90012-260204/01/2018  
CHC26614-00COUNTY OF LOS ANGELES - AUDITOR CONTROLL313 N FIGUEROA ST STE 1225 HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELESCA90012-260207/01/2018  
CHC26614-00CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/01/2023  
CHC26614-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2023  
CHC26614-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2021  
CHC26614-00DISCOUNT MEDICAL PHARMACY2716 GRIFFITH PARK BLVD
LOS ANGELESCA9002704/01/2021  
CHC26614-00DOGWOOD PHARMACY LLCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER RD
STE K 		GREENVILLESC29607-654101/09/2024  
CHC26614-00EDDIE'S PHARMACYGOLDEN STATE RX PARTNERS LLC DBA 8408 BEVERLY BLVD
LOS ANGELESCA9004810/01/2021 04/10/2023
CHC26614-00EDDIE'S PHARMACY8408 BEVERLY BLVD
LOS ANGELESCA9004804/29/2023  
CHC26614-00ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111201/01/2023  
CHC26614-00EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313401/01/2023  
CHC26614-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801601/01/2023  
CHC26614-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607501/01/2023  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09767 9045 WILSHIRE BOULEVARD
BEVERLY HILLSCA9021101/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09566 596 LONG BEACH BOULEVARD
LONG BEACHCA9080201/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09661 6360 WEST THIRD STREET
LOS ANGELESCA9003601/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09660 3751 WILSHIRE BOULEVARD
LOS ANGELESCA9001001/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09732 861 NORTH VINE STREET
HOLLYWOODCA9003801/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17004 7100 SANTA MONICA BLVD
WEST HOLLYWOODCA9004601/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09580 5101 OBAMA BLVD
LOS ANGELESCA9001601/01/2020 02/21/2025
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09669 2530 GLENDALE BOULEVARD
LOS ANGELESCA9003901/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09652 8491 SANTA MONICA BLVD
WEST HOLLYWOODCA9006901/01/2020  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09686 4707 VENICE BLVD
LOS ANGELESCA9001901/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09590 6000 ATLANTIC AVENUE
LONG BEACHCA9080501/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08876 233 EAST WILLOW STREET
LONG BEACHCA9080601/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09531 4501 WEST SLAUSON AVENUE
LOS ANGELESCA9004301/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09481 12444 BEACH BOULEVARD
STANTONCA9068001/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08870 8859 ALONDRA BLVD.
PARAMOUNTCA9072301/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05809 4775 W. ROSECRANS AVE.
HAWTHORNECA9025001/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10614 812 S GRAND AVE
LOS ANGELESCA9001707/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY #10791 8000 WEST SUNSET BLVD,
LOS ANGELESCA9004607/01/2021  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09505 4400 EAST LOS COYOTES DIAGONAL
LONG BEACHCA9081507/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05837 7065 LA PALMA AVE.
BUENA PARKCA9062007/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09781 5985 WEST PICO BOULEVARD
LOS ANGELESCA9003507/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 3825 303 S. LA BREA AVE
LOS ANGELESCA9003607/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09624 1747 NORTH CAHUENGA BOULEVARD
HOLLYWOODCA9002807/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09707 14735 VENTURA BLVD.
SHERMAN OAKSCA9140307/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09608 2505 SANTA MONICA BOULEVARD
SANTA MONICACA9040407/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09726 1411 LINCOLN BOULEVARD
SANTA MONICACA9040107/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10433 6201 HOLLYWOOD BLVD, STE 126
LOS ANGELESCA9002807/01/2022  
CHC26614-00GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 17719 4211 EAGLE ROCK BLVD
LOS ANGELESCA9006501/01/2023  
CHC26614-00GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY #10916 7500 MELROSE AVE
LOS ANGELESCA9004601/01/2023  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09674 1050 W. SUNSET BOULEVARD
LOS ANGELESCA9001201/01/2023  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08879 8985 VENICE BOULEVARD
LOS ANGELESCA9003407/01/2025  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09582 3741 CRENSHAW BOULEVARD
LOS ANGELESCA9001607/01/2025  
CHC26614-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09804 425 S. SUNRISE WAY
PALM SPRINGSCA9226207/01/2025  
CHC26614-00GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 17794 5500 W. SUNSET BLVD.
LOS ANGELESCA9002807/01/2025  
CHC26614-00GENOA HEALTHCARE LLC11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGSCA9067007/01/2021 07/01/2022
CHC26614-00GENOA HEALTHCARE LLC17782 COWAN ST STE G
IRVINECA9261407/01/2021 07/01/2022
CHC26614-00GENOA HEALTHCARE LLC245 11TH ST STE P1
SAN FRANCISCOCA9410307/01/2021 07/01/2022
CHC26614-00GENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205807/01/2021 07/01/2022
CHC26614-00GENOA HEALTHCARE LLC1850 W FLORIDA AVE
HEMETCA9254507/01/2021 07/01/2022
CHC26614-00GOOD DRUGS1864 E WASHINGTON STE 105
PASADENACA9110404/01/2022 09/01/2022
CHC26614-00KROGER SPECIALTY PHARMACY CA 26240 WILSHIRE BLVD.
LOS ANGELESCA9004807/01/2018 06/30/2020
CHC26614-00LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09527 12100 VENTURA BLVD
STUDIO CITYCA9160401/01/2021  
CHC26614-00LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09144 7021 HOLLYWOOD BLVD
LOS ANGELESCA9002801/01/2021  
CHC26614-00LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03931 650 N BELLFLOWER BLVD
LONG BEACHCA9081401/01/2023  
CHC26614-00LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY313 N FIGUEROA STREET SUITE 1225
LOS ANGELESCA9001207/01/2015 06/30/2018
CHC26614-00NTEGROUS CORE CORPORATIONANDERSON PHARMACY 1864 E. WASHINGTON BLVD.
STE. 105 		PASADENACA9110408/31/2022  
CHC26614-00OLYMPIA PLAZA PHARMACY INC5901 W. OLYMPIC BLVD STE 103
LOS ANGELESCA90036-465901/01/2018  
CHC26614-00OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191307/20/2020 04/01/2021
CHC26614-00OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713007/20/2020  
CHC26614-00OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729807/20/2020  
CHC26614-00OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140107/20/2020  
CHC26614-00OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983807/20/2020  
CHC26614-00OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660807/20/2020 07/01/2022
CHC26614-00POLARIS SPECIALTY RX410 CLOVERLEAF DR
BALDWIN PARKCA9170606/02/2023 01/01/2025
CHC26614-00POLARIS SPECIALTY RX1010 E ARROW HWY
COVINACA9172403/19/2025  
CHC26614-00PREMIER PHARMACY SERVICES410 CLOVERLEAF DR
BALDWIN PARKCA9170601/01/2018 12/31/2023
CHC26614-00PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/01/2019  
CHC26614-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/01/2021  
CHC26614-00PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2021  
CHC26614-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2021  
CHC26614-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 8607 SANTA MONICA BOULEVARD
WEST HOLLYWOODCA9006901/01/2021  
CHC26614-00RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103 		NEWBURGHNY1255001/09/2024  
CHC26614-00RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500201/09/2024  
CHC26614-00RX E-FILL SOLUTIONS28341 CONSTELLATION RD
SANTA CLARITACA9135504/01/2016 06/30/2018
CHC26614-03RX E-FILL SOLUTIONSCARDINAL HEALTH PHARMACY SERVICES, LLC 27680 AVENUE MENTRY STE 100
VALENCIACA9135504/01/2018  
CHC26614-00RX E-FILL SOLUTIONSCARDINAL HEALTH PHARMACY SERVICES, LLC 27680 AVENUE MENTRY STE 100
VALENCIACA9135507/01/2018  
CHC26614-00SANTA BARBARA SPECIALTY PHARMACY LLC4690 CARPINTERIA AVE STE B
CARPINTERIACA9301301/09/2024  
CHC26614-00ST MARY HEALTH VENTURESDBA MEDICAL MALL PHARMACY 1040 ELM AVE STE 104
LONG BEACHCA9081307/01/2016  
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5537 531 NORTH GLENDALE AVENUE
GLENDALECA9120607/01/2022 04/01/2023
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5435 1637 NORTH VERMONT AVENUE
LOS ANGELESCA9002707/01/2022  
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5526 735 EAST ALTADENA DRIVE
ALTADENACA9100107/01/2022 04/01/2023
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5520 3300 EAST ANAHEIM STREET
LONG BEACHCA9080407/01/2022 04/01/2023
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #6288 959 CRENSHAW BOULEVARD
LOS ANGELESCA9001907/01/2022 10/18/2023
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5446 1130 NORTH LA BREA AVENUE
WEST HOLLYWOODCA9003807/01/2022 05/03/2022
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5519 5670 EAST 2ND STREET
LONG BEACHCA9080307/01/2022 07/11/2022
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5485 888 LINCOLN BOULEVARD
VENICECA9029107/01/2022  
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5683 366 SOUTH PALM CANYON DRIVE
PALM SPRINGSCA9226207/01/2022 04/01/2023
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5508 15924 BELLFLOWER BOULEVARD
BELLFLOWERCA9070607/01/2022 04/01/2033
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #6346 211 CHERRY AVENUE
LONG BEACHCA9080207/01/2022  
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5455 11750 WILMINGTON AVENUE
LOS ANGELESCA9005907/01/2022 03/14/2024
CHC26614-00THRIFTY PAYLESS, INC.RITE AID #5452 7900 WEST SUNSET BOULEVARD
LOS ANGELESCA9004610/17/2022  
CHC26614-00WALGREEN CODBA: WALGREENS # 09136 1625 W SUNSET BLVD
LOS ANGELESCA9002607/01/2015 04/15/2018
CHC26614-00WALGREEN CODBA: WALGREENS #11785 6100 PACIFIC BLVD
HUNTINGTON PARKCA9025507/01/2016 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS # 07016 3724 CRENSHAW BLVD
LOS ANGELESCA9001610/01/2014  
CHC26614-00WALGREEN CO.DBA: WALGREENS # 05879 3201 WEST 6TH ST
LOS ANGELESCA9002007/01/2015 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS #12913 1500 E GAGE AVE
LOS ANGELESCA9000107/01/2015 04/15/2018
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15190 1399 ROXBURY DR
LOS ANGELESCA9003507/01/2015 04/15/2018
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15294 8490 SANTA MONICA BLVD STE 1
WEST HOLLYWOODCA9006907/01/2015  
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16368 3745 S LA BREA AVE STE C & D
LOS ANGELESCA9001601/01/2016  
CHC26614-00WALGREEN CO.DBA: WALGREENS # 07870 600 LONG BEACH BLVD
LONG BEACHCA9080204/01/2016 11/13/2023
CHC26614-00WALGREEN CO.DBA: WALGREENS # 05650 2627 PACIFIC AVENUE
LONG BEACHCA90806-261004/01/2016 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS # 07832 3339 E ANAHEIM ST
LONGBEACHCA90804-403204/01/2016  
CHC26614-00WALGREEN CO.DBA: WALGREENS # 07244 3570 ATLANTIC AVE
LONG BEACHCA90807-451604/01/2016 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS #11082 5400 CHERRY AVE
LONG BEACHCA90805-550204/01/2016 03/20/2017
CHC26614-00WALGREEN CO.DBA: WALGREENS # 10262 9830 LONG BEACH BLVD
SOUTH GATECA9028007/01/2016 04/15/2018
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16482 1902 MARENGO ST
UNITS 105 AND 106 		LOS ANGELESCA9003301/01/2017 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS # 06903 5829 LAKEWOOD BLVD
LAKEWOODCA90712-100107/01/2017 04/15/2018
CHC26614-00WALGREEN CO.DBA: WALGREENS # 06516 5467 WILSHIRE BLVD
LOS ANGELESCA9003604/01/2019  
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #21154 730-740 LONG BEACH BLVD
#A & #C 		LONG BEACHCA9081307/01/2019  
CHC26614-00WALGREEN CO.DBA WALGREENS #12057 1050 N. HIGHLAND AVE.
LOS ANGELESCA9003804/01/2020  
CHC26614-00WALGREEN CO.W002 DBA: WALGREENS #15278 1501 VINE ST.
LOS ANGELESCA90028-730407/01/2020 02/04/2022
CHC26614-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15293 4940 VAN NUYS BLVD STE 104
SHERMAN OAKSCA9140301/01/2021  
CHC26614-00WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/01/2014 04/15/2018
CHC26614-00WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904910/01/2014 04/15/2018
CHC26614-00WALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2018  
CHC26614-00WALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528601/01/2018 04/15/2018
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingNPI: NumberInsertChange Request 17404909373/12/2025 1:28 PM
Medicaid BillingNPI: StateInsertChange Request CA3/12/2025 1:28 PM
DetailsLast Recertification DateUpdateRecertification2/1/2024 9:52:50 PM3/3/2025 2:32:41 PM3/3/2025 2:32 PM
ContactsPrimary ContactUpdateProfile Change RequestMoldovan, Joseph Chief Clinical Operations Officer APLA Health & Wellness 2132011411Moldovan, Joseph Chief Financial Officer APLA Health & Wellness 213201141111/1/2024 6:22 PM
AddressesShipping AddressInsertChange Request APLA Health & Wellness 1127 Wilshire Blvd STE 1504 Los Angeles, CA 900174/26/2024 10:41 AM
AddressesShipping AddressInsertChange Request APLA Health & Wellness 7531 Santa Monica Blvd Suite 201 West Hollywood, CA 900464/26/2024 10:41 AM
AddressesBilling AddressUpdateChange RequestAPLA Health & Wellness 611 S. Kingsley Drive Los Angeles, CA 90005-2319APLA Health & Wellness 611 S. Kingsley Drive c/o Joseph Moldovan Los Angeles, CA 90005-23194/26/2024 10:41 AM
ContactsPrimary ContactUpdateGroup Change RequestGoldman, Robyn Chief Financial Officer APLA Health & Wellness 2132011546Moldovan, Joseph Chief Clinical Operations Officer APLA Health & Wellness 21320114113/1/2024 9:33 AM
DetailsLast Recertification DateUpdateRecertification2/9/2023 12:46:32 PM2/1/2024 9:52:50 PM2/1/2024 9:52 PM
DetailsLast Recertification DateUpdateRecertification2/1/2022 1:12:13 PM2/9/2023 12:46:32 PM2/9/2023 12:46 PM
DetailsLast Recertification DateUpdateRecertification2/5/2021 3:39:20 PM2/1/2022 1:12:13 PM2/1/2022 1:12 PM
ContactsPrimary ContactUpdateProfile Change RequestGoldman, Robyn Chief Operating Officer APLA Health & Wellness 2132011546Goldman, Robyn Chief Financial Officer APLA Health & Wellness 21320115461/26/2022 12:19 PM
DetailsLast Recertification DateUpdateRecertification2/3/2020 11:32:42 AM2/5/2021 3:39:20 PM2/5/2021 3:39 PM
DetailsLast Recertification DateUpdateRecertification1/28/2019 6:52:56 PM2/3/2020 11:32:42 AM2/3/2020 11:32 AM
ContactsPrimary ContactUpdateProfile Change RequestGoldman, Robyn CFO APLA Health & Wellness 2132011546Goldman, Robyn Chief Operating Officer APLA Health & Wellness 21320115462/1/2020 6:22 PM
DetailsLast Recertification DateUpdateRecertification2/11/2018 1:38:58 PM1/28/2019 6:52:56 PM1/28/2019 6:52 PM
ContactsPrimary ContactUpdateRecertificationWagner, Vallerie D. Director - Health Center Operations - Los Angeles APLA Health & Wellness 3233299920Goldman, Robyn CFO APLA Health & Wellness 21320115462/11/2018 1:38 PM
DetailsLast Recertification DateUpdateRecertification2/7/2017 12:00:00 AM2/11/2018 1:38:58 PM2/11/2018 1:38 PM
DetailsIs Authorizing Official EHB DataUpdateRecertificationFalse 2/11/2018 1:38 PM
ContactsPrimary ContactUpdateProfile Change RequestWagner, Vallerie D. Director - Health Center Operations - Los Angeles APLA Health & Wellness 2132011543Wagner, Vallerie D. Director - Health Center Operations - Los Angeles APLA Health & Wellness 323329992010/10/2017 12:56 PM
ContactsPrimary ContactUpdate Wagner, Vallerie D. Director - Health Center Operations - Los Angeles 2132011543Wagner, Vallerie D. Director - Health Center Operations - Los Angeles APLA Health & Wellness 213201154310/10/2017 12:10 PM
ContactsAuthorizing OfficialUpdate Thompson, Craig E. Chief Executive Officer 2132011456Thompson, Craig E. Chief Executive Officer APLA Health & Wellness 213201145610/2/2017 5:26 PM
ContactsSigned ByUpdate Thompson, Craig E. Chief Executive Officer 2132011456Thompson, Craig E. Chief Executive Officer APLA Health & Wellness 213201145610/2/2017 5:26 PM
ContactsPrimary ContactInsert  Wagner, Vallerie D. Director - Health Center Operations - Los Angeles 21320115435/10/2017 7:41 AM
ContactsAuthorizing OfficialInsert  Thompson, Craig E. Chief Executive Officer 21320114565/10/2017 7:41 AM
ContactsSigned ByInsert  Thompson, Craig E. Chief Executive Officer 21320114565/10/2017 7:41 AM
AddressesMain AddressInsert   1127 Wilshire Blvd. STE 1504 Los Angeles, CA 90017-40062/7/2017 4:42 PM
DetailsLast Recertification DateUpdate 2/26/2016 12:00:00 AM2/7/2017 12:00:00 AM2/7/2017 4:42 PM
DetailsLast Recertification DateUpdate 3/4/2015 12:00:00 AM2/26/2016 12:00:00 AM2/26/2016 2:16 PM
DetailsLast Recertification DateUpdate  3/4/2015 12:00:00 AM3/4/2015 1:01 PM
AddressesBilling AddressInsert  APLA Health & Wellness 611 S. Kingsley Drive Los Angeles, CA 90005-231910/17/2014 10:05 AM
DetailsEntity SubnameUpdate APLA Health &lness Dental ClinicAPLA Health & Wellness Dental Clinic10/17/2014 10:05 AM
DatesParticipating Approval DateUpdate  10/17/2014 12:00:00 AM10/17/2014 10:05 AM
DetailsStateUpdate PendingActive10/17/2014 10:05 AM
DatesStart DateUpdate  1/1/2015 12:00:00 AM10/17/2014 10:05 AM
Details340B IDUpdate ONLINE_REG_46990CHC26614-0110/10/2014 1:33 PM
Details340B IDUpdate ONLINE_REGONLINE_REG_4699010/10/2014 12:18 PM
DetailsLast Recertification DateInsert   10/10/2014 12:18 PM
DetailsGrant NumberInsert  H80CS2661410/10/2014 12:18 PM
Details340B IDInsert  ONLINE_REG10/10/2014 12:18 PM
DetailsIs Authorizing Official EHB DataInsert  False10/10/2014 12:18 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/10/2014 12:18 PM
DetailsMedicare Provider NumberInsert   10/10/2014 12:18 PM
DetailsEntity NameInsert  APLA HEALTH & WELLNESS10/10/2014 12:18 PM
DetailsProgram CodeInsert  CH10/10/2014 12:18 PM
DetailsEntity SubnameInsert  APLA Health &lness Dental Clinic10/10/2014 12:18 PM
DatesParticipating Approval DateInsert   10/10/2014 12:18 PM
DetailsStateInsert  Pending10/10/2014 12:18 PM
DatesRegistration DateInsert  10/10/2014 12:00:00 AM10/10/2014 12:18 PM
DatesSigned By DateInsert  10/10/2014 12:00:00 AM10/10/2014 12:18 PM
DatesStart DateInsert   10/10/2014 12:18 PM
TerminationsTermination CommentsInsert   10/10/2014 12:18 PM
TerminationsTermination DateInsert   10/10/2014 12:18 PM
TerminationsTermination Effective DateInsert   10/10/2014 12:18 PM
TerminationsTermination ReasonInsert   10/10/2014 12:18 PM