Covered Entity Details

CH06236Q BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC. (Terminated) - information as of 4/25/2025 8:34:17 PM

Main Details

Name

BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.

Subdivision Name

CommuniCare Health Centers - Simon Middle School

Type

HRSA-Funded Health Center

Site ID

BPS-H80-014546

340B ID

CH06236Q

Grant Number

H80CS00672

Additional Details

Current Program Status

Terminated

Registration Date

7/9/2015

Participating Start Date

10/1/2015

Participating Approval Date

7/14/2015

Last Recertification Date

1/25/2017

Termination Date
Termination Reason

4/1/2018
Site closure

Contacts

Authorizing Official

Barrio Comprehensive Family Health Care Center, Inc.
Paul Nguyen, President & CEO
(210) 233-7070 Ext: 7886

Primary Contact

Bob Milks, COO
(210) 233-7070

Addresses

Street Address

3839 E FM 150
KYLE, TX 78640-6072

Billing Address

CommuniCare Health Centers
3066 E. Commerce
San Antonio, TX 78220

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	City	State
CH062360	Active	BPS-H80-003849	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - West	1102 Barclay St	San Antonio	TX
CH06236AA	Active	BPS-H80-035550	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	San Antonio Specialty Health & Sports Medicine	1200 Brooklyn Ave. STE 320	San Antonio	TX
CH06236AB	Active	BPS-H80-034235	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Encino Park	20306 Encino Ledge Ste 101	San Antonio	TX
CH06236AC	Active	BPS-H80-033954	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Alamo Ranch	6838 Alamo Pkwy Ste 5	San Antonio	TX
CH06236AD	Active	BPS-H80-034420	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Stone Oak	20642 Stone Oak Pkwy STE 105	San Antonio	TX
CH06236AE	Active	BPS-H80-035311	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare at The MAC	5210 Thousand Oaks Dr STE 1203	San Antonio	TX
CH06236AF	Active	BPS-H80-036067	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Hallmark University	9855 Westover Hills Blvd. STE 156	San Antonio	TX
CH06236AG	Active	BPS-H80-036685	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - South	7355 Barlite Blvd, Ste 101	San Antonio	TX
CH06236AH	Active	BPS-H80-037168	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Westover Hills	9022 Culebra Rd STE 101	San Antonio	TX
CH06236AJ	Active	BPS-H80-036840	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	Apollo Wellness	6511 West FM 1604 North STE 105	San Antonio	TX
CH06236AK	Terminated	BPS-H80-037168	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Westover Hills	9022 Culebra Rd STE 101	San Antonio	TX
CH06236AL	Active	BPS-H80-037563	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Town & Country	10350 Bandera Rd, Ste 210	San Antonio	TX
CH06236AM	Active	BPS-H80-039004	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - Mobile Health Unit	3066 E Commerce St	San Antonio	TX
CH06236AN	Active	BPS-H80-039005	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - Allergy Institute	4456 Lockhill Selma Rd, Ste 103	San Antonio	TX
CH06236AP	Active	BPS-H80-039301	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - Vital Life Wellness Broadway	2520 Broadway St, Ste 100	San Antonio	TX
CH06236AQ	Active	BPS-H80-039302	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - Vital Life Wellness Stone Oak	418 N Loop 1604 W	San Antonio	TX
CH06236AR	Approved	BPS-H80-039796	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - South	2316 SE Military Dr	San Antonio	TX
CH06236AS	Approved	BPS-H80-039657	Barrio Comprehensive Family Health Care Center, Inc.	CommuniCare Health Centers - Roosevelt	3727 Roosevelt Ave	San Antonio	TX
CH06236D	Active	BPS-H80-024792	BARRIO COMPREHENSIVE HEALTH CARE CENTER, INC	CommuniCare Health Centers - San Marcos	1941 S Interstate 35, Ste 101	San Marcos	TX
CH06236I	Active	BPS-H80-001887	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - East	3066 E Commerce St	San Antonio	TX
CH06236J	Active	BPS-H80-008672	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Kyle	2810 Dacy Ln	Kyle	TX
CH06236K	Active	BPS-H80-010104	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Northwest	8210 Callaghan	San Antonio	TX
CH06236L	Active	BPS-H80-018765	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Potranco	10002 Westover Blf	San Antonio	TX
CH06236M	Terminated	BPS-H80-012854	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers-Downtown Campus	311 Camden St. Suite #601	San Antonio	TX
CH06236N	Active	BPS-H80-014110	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Metropolitan	1200 Brooklyn Ave, Ste 300	San Antonio	TX
CH06236P	Active	BPS-H80-029941	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Wimberley	203 Stillwater, Ste 6	Wimberley	TX
CH06236Q	Terminated	BPS-H80-014546	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Simon Middle School	3839 E FM 150	KYLE	TX
CH06236R	Active	BPS-H80-015210	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Boerne	430 W. Bandera, Suite 9	Boerne	TX
CH06236S	Active	BPS-H80-017399	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Hill Country Village	14811 San Pedro Ave	San Antonio	TX
CH06236T	Active	BPS-H80-034876	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	Health Outcomes Centers	4751 Hamilton Wolfe Rd, Ste 200	San Antonio	TX
CH06236U	Active	BPS-H80-027024	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Medical Center	7220 Louis Pasteur Dr, Ste 140	San Antonio	TX
CH06236V	Active	BPS-H80-027437	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Leon Springs	21195 W. Interstate 10 STE 2101	San Antonio	TX
CH06236W	Active	BPS-H80-028110	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Helotes	12850 Bandera Rd Ste 106	Helotes	TX
CH06236X	Active	BPS-H80-030098	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Blvd Dental	5138 Utsa Blvd Ste 116	San Antonio	TX
CH06236Y	Active	BPS-H80-031315	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Luckey Ranch	11930 W US Highway 90 Ste 110	San Antonio	TX
CH06236Z	Active	BPS-H80-020855	BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	CommuniCare Health Centers - Navigation Center	7420 Blanco Rd Ste 210	San Antonio	TX

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH062360	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/01/2019
CH062360	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/01/2019
CH062360	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/01/2019
CH062360	ACCREDO HEALTH GROUP INC	4343 W ROYAL LN STE 124		IRVING	TX	75063-2299	07/01/2024
CH062360	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/01/2019
CH062360	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	10/01/2019	06/14/2023
CH062360	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/01/2019
CH062360	ACCREDO HEALTH GROUP, INC.	11411 STRANG LINE RD	STE A	LENEXA	KS	66215	04/01/2020	12/01/2023
CH062360	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	10/01/2024
CH062360	AETNA SPECIALTY PHARMACY, LLC	503 SUNPORT LN		ORLANDO	FL	32809-7874	07/01/2019	10/05/2022
CH062360	ASPCARES	120 W ASHBY PL		SAN ANTONIO	TX	78212	07/01/2019	10/11/2023
CH062360	ASPCARES	2414 BABCOCK RD STE 111		SAN ANTONIO	TX	78229	07/01/2019	10/11/2023
CH062360	BEST CARE PHARMACY INC.	D/B/A ASPCARES	2657 NW 20TH ST	MIAMI	FL	33142	07/01/2019	10/11/2023
CH062360	BIOPLUS SPECIALTY PHARMACY LA, LLC	2731 MANHATTAN BLVD STE B17		HARVEY	LA	70058	10/01/2024
CH062360	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2016
CH062360	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	07/01/2022
CH062360	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	07/01/2022
CH062360	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	07/01/2024
CH062360	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	07/01/2024
CH062360	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	10/01/2024
CH062360	CANYON MEDICAL PHARMACY, INC.	7265 S REVERE PARKWAY, SUITE 902		CENTENNIAL	CO	80112	10/01/2017
CH062360	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/01/2017
CH062360	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/01/2017
CH062360	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/01/2017
CH062360	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/01/2017
CH062360	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/01/2017
CH062360	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2017
CH062360	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2017
CH062360	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2017
CH062360	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/01/2017
CH062360	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/01/2021
CH062360	CRAWFORD PHARMACY	145 W HART AVE STE 104		SAN ANTONIO	TX	78214-1491	10/01/2018	12/07/2022
CH062360	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD STE 1400		ST PETERSBURG	FL	33716-2338	07/01/2015
CH062360	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	07/01/2015
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07301	3027 NACOGDOCHES RD	SAN ANTONIO	TX	78217	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07460	14900 JONES MALTSBERGER RD	SAN ANTONIO	TX	78247	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01201	4730 FREDRICKSBURG RD.	SAN ANTONIO	TX	78229	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07551	2801 NOGALITOS	SAN ANTONIO	TX	78225	04/01/2020	06/14/2023
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07832	9838 POTRANCO RD	SAN ANTONIO	TX	78251	04/01/2020	06/21/2023
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07808	4805 MEDICAL DR	SAN ANTONIO	TX	78229	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 10264	1118 SOUTH WW WHITE RD.	SAN ANTONIO	TX	78220	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 05512	7208 FM 78	SAN ANTONIO	TX	78244	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07306	6915 W AVE	CASTLE HILLS	TX	78213	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07307	2018 CULEBRA ROAD	SAN ANTONIO	TX	78201	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07403	103 S.W. MILITARY DR.	SAN ANTONIO	TX	78221	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 2391	15607 CHASE HILL BLVD.	SAN ANTONIO	TX	78256	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 08389	8602 HUEBNER RD	SAN ANTONIO	TX	78240	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07724	10225 WURZBACH RD	SAN ANTONIO	TX	78230	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07341	9285 CULEBRA AVE	SAN ANTONIO	TX	78251	04/01/2020
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 10051	2920 EAST SOUTHCROSS BLVD.	SAN ANTONIO	TX	78211	07/01/2020	10/09/2023
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01057	9140 GUILBEAU	SAN ANTONIO	TX	78250	07/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06986	1240 SOUTH PORT AVE	CORPUS CHRISTI	TX	78405	07/01/2020	08/30/2023
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10347	9686 MARBACH ROAD	SAN ANTONIO	TX	78245	07/01/2020
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 10141	5975 OLD PEARSALL RD.	SAN ANTONIO	TX	78242	07/01/2020
CH062360	CVS PHARMACY, INC.	CVS/PHARMACY # 10179	300 EAST COMMERCE ST.	SAN ANTONIO	TX	78205	07/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 08990	12980 BANDERA RD	HELOTES	TX	78023	07/01/2020
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 03505	102 NORTH US 81	KYLE	TX	78640	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10540	9089 FAIR OAKS PKWY	FAIR OAKS RANCH	TX	78015	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10579	4600 BROADWAY STREET	ALAMO HEIGHTS	TX	78209	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07829	16580 HUEBNER RD	SAN ANTONIO	TX	78248	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10905	13343 CULEBRA ROAD	SAN ANTONIO	TX	78253	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 05776	105 WONDERWORLD DRIVE	SAN MARCOS	TX	78666	10/01/2021
CH062360	CVS PHARMACY, INC.	CVS PHARMACY # 17606	5188 KYLE CENTER DR	KYLE	TX	78640	10/01/2021
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02263	22202 BULVERDE RD.	SAN ANTONIO	TX	78261	01/01/2022
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 7000	5301 ALAMO PARKWAY	SAN ANTONIO	TX	78253	01/01/2022
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 5872	22135 IH-10 W	SAN ANTONIO	TX	78257	01/01/2022
CH062360	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 4109	12835 POTRANCO RD	SAN ANTONIO	TX	78253	01/01/2022
CH062360	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 05857	7603 CULEBRA	SAN ANTONIO	TX	78251	01/01/2022
CH062360	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/01/2021
CH062360	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/01/2020
CH062360	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2017
CH062360	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/01/2019	12/01/2023
CH062360	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/01/2019	12/01/2023
CH062360	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/01/2019	12/01/2023
CH062360	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/01/2019	12/01/2023
CH062360	H E B FULFILLMENT CENTER		6520 FRATT ROAD	SAN ANTONIO	TX	78218	07/01/2017	07/10/2023
CH062360	H-E-B, LP	H-E-B PHARMACY WAREHOUSE	6520 FRATT RD	SAN ANTONIO	TX	78218	05/10/2023	07/10/2023
CH06236I	HEB PHARMACY #014	5401 SOUTH FM 1626		KYLE	TX	78640	01/01/2014	12/13/2019
CH062360	HEB PHARMACY #014	5401 SOUTH FM 1626		KYLE	TX	78640	01/01/2019
CH062360	HEB PHARMACY #025	925 10TH STREET		FLORESVILLE	TX	78114	10/01/2024
CH062360	HEB PHARMACY #026	4100 S. NEW BRAUNFELS		SAN ANTONIO	TX	78223	04/01/2022
CH062360	HEB PHARMACY #084	6818 S. ZARZAMORA		SAN ANTONIO	TX	78224	10/01/2024
CH062360	HEB PHARMACY #085	10718 POTRANCO RD.		SAN ANTONIO	TX	78251	07/01/2022
CH062360	HEB PHARMACY #106	1015 S. WW WHITE ROAD		SAN ANTONIO	TX	78220	04/01/2016
CH062360	HEB PHARMACY #108	20935 US HIGHWAY 281 N		SAN ANTONIO	TX	78258	10/01/2024
CH062360	HEB PHARMACY #189	2130 CULEBRA RD		SAN ANTONIO	TX	78228	10/01/2017
CH06236I	HEB PHARMACY #205	721 CASTROVILLE ROAD		SAN ANTONIO	TX	78237	01/01/2014	12/13/2019
CH062360	HEB PHARMACY #205	721 CASTROVILLE ROAD		SAN ANTONIO	TX	78237	01/01/2019
CH062360	HEB PHARMACY #211	415 N. NEW BRAUNFELS		SAN ANTONIO	TX	78202	10/01/2019
CH062360	HEB PHARMACY #243	641 E. HOPKINS		SAN MARCOS	TX	78666	10/01/2017
CH062360	HEB PHARMACY #262	5601 BANDERA RD, STE 11		SAN ANTONIO	TX	78238	04/01/2022
CH062360	HEB PHARMACY #444	3323 SE MILITARY DR.		SAN ANTONIO	TX	78223	04/01/2022
CH062360	HEB PHARMACY #466	108 ROSILLO		SAN ANTONIO	TX	78207	10/01/2017
CH062360	HEB PHARMACY #480	9900 WURZBACH ROAD		SAN ANTONIO	TX	78230	04/01/2022
CH062360	HEB PHARMACY #556	2118 FREDERICKSBURG RD		SAN ANTONIO	TX	78201	07/01/2019
CH062360	HEB PHARMACY #613	8219 MARBACH RD		SAN ANTONIO	TX	78227	07/01/2019
CH062360	HEB PHARMACY #618	5910 BABCOCK		SAN ANTONIO	TX	78240	10/01/2024
CH062360	HEB PHARMACY #621	420 WEST BANDERA		BOERNE	TX	78006	07/01/2019
CH062360	HEB PHARMACY #623	9238 NORTH LOOP 1604 WEST		SAN ANTONIO	TX	78249	10/01/2024
CH062360	HEB PHARMACY #678	302 VALLEY HI DR		SAN ANTONIO	TX	78227	07/01/2019
CH062360	HEB PHARMACY #699	1601 NOGALITOS ST.		SAN ANTONIO	TX	78204	10/01/2024
CH062360	HEB Pharmacy #701	6520 Fratt Road		San Antonio	TX	78218	07/27/2017	01/12/2022
CH062360	HEB PHARMACY #708	14501 RANCH RD. 12		WIMBERLEY	TX	78676	07/01/2019
CH062360	HEB PHARMACY #733	12125 ALAMO RANCH PKWY		SAN ANTONIO	TX	78253	07/01/2022
CH062360	HEB PHARMACY #771	14325 POTRANCO RD		SAN ANTONIO	TX	78253	07/01/2022
CH062360	HEB PHARMACY WAREHOUSE 208	H-E-B, LP	5311 DIETRICH RD STE 100	SAN ANTONIO	TX	78219	07/03/2023
CH062360	HEB SPECIALTY PHARMACY #701	3503 FREDERICKSBURG RD	STE 450	SAN ANTONIO	TX	78201	10/01/2020
CH06236I	MEDPARK PHARMACY	MED-TVZ PHARMACIES INC	2004 MEDICAL PKWY STE A	SAN MARCOS	TX	78666-7585	01/19/2008	10/15/2018
CH062360	OPTUM FRONTIER THERAPIES II, LLC	6425 SANTA MARGARITA ST UNIT 110		LAS VEGAS	NV	89118-1913	07/06/2020	10/14/2021
CH062360	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/01/2022
CH062360	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2025
CH062360	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	10/01/2022
CH062360	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	07/01/2023
CH062360	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH062360	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/01/2020
CH062360	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	01/01/2020
CH062360	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/01/2020
CH062360	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	07/06/2020
CH062360	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	07/06/2020
CH062360	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	10/01/2022
CH062360	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	07/01/2023
CH062360	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	10/01/2022
CH062360	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2022
CH062360	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	10/01/2022	04/11/2023
CH062360	PREMIER PHARMACY	2425 BABCOCK RD., STE. 108A		SAN ANTONIO	TX	78229	07/01/2023	03/19/2024
CH062360	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	10/01/2017	10/01/2022
CH062360	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2017
CH062360	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	07/01/2017
CH062360	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/01/2021
CH062360	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/01/2021
CH062360	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #3129	1002 EAST MCDOWELL ROAD	PHOENIX	AZ	85006	01/01/2025
CH062360	PROCARE PHARMACY, L.L.C.	CVS/PHARMACY #48637	2700 NORTHEAST EXPY NE STE B800 BUILDING B	ATLANTA	GA	30345	01/01/2025
CH062360	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2017
CH062360	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2017
CH062360	SOUTHSIDE INFUSION	7700 MAIN ST STE 210		HOUSTON	TX	77030-4457	07/01/2020	01/11/2023
CH062360	SOUTHSIDE PHARMACY 3	6330 WEST LOOP S STE 700C		BELLAIRE	TX	77401-2928	07/01/2020	01/11/2023
CH062360	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH062360	WAL-MART PHARMACY 10-0404	1015 HIGHWAY 80		SAN MARCOS	TX	78666	07/01/2017
CH062360	WAL-MART PHARMACY 10-5145	1603 VANCE JACKSON RD		SAN ANTONIO	TX	78213	07/01/2017
CH062360	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	01/01/2025
CH062360	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 04552	4703 W. COMMERCE ST.	SAN ANTONIO	TX	78237	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 04550	639 E. HOPKINS ST.	SAN MARCOS	TX	78666	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 04160	2200 E. HOUSTON ST	SAN ANTONIO	TX	78202	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #12517	5781 KYLE PKWY.	KYLE	TX	78640	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #12479	121 N. ZARZAMORA ST.	SAN ANTONIO	TX	78207-3739	10/11/2011	11/14/2023
CH062360	WALGREEN CO.	DBA: WALGREENS # 02755	3065 RIGSBY AVE	SAN ANTONIO	TX	78222	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 02943	2710 NOGALITOS	SAN ANTONIO	TX	78225	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03141	1105 GOLIAD ROAD	SAN ANTONIO	TX	78223	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03354	1106 CULEBRA	SAN ANTONIO	TX	78201	10/11/2011	06/27/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 03563	7103 MARBACH ROAD	SAN ANTONIO	TX	78227	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #11131	200 S. COLORADO ST.	LOCKHART	TX	78644-2733	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #12521	1700 RANCH ROAD 12	SAN MARCOS	TX	78666-2502	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #15461	1560 BANDERA ROAD	SAN ANTONIO	TX	78228	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 07371	7019 S ZARZAMORA ST	SAN ANTONIO	TX	78224-1141	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03224	6901 SAN PEDRO AVE	SAN ANTONIO	TX	78216-6206	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03634	3326 FREDERICKSBURG ROAD	SAN ANTONIO	TX	78201	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03996	5760 WALZEM RD	WINDCREST	TX	78218	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03506	6363 RITTIMAN RD	SAN ANTONIO	TX	78218	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03734	8202 CULEBRA RD	SAN ANTONIO	TX	78251	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 05424	138 SW MILITARY DRIVE	SAN ANTONIO	TX	78221	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS #10841	1660 MAIN ST.	BUDA	TX	78610	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 04934	6017 INGRAM ROAD	SAN ANTONIO	TX	78238	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 02458	7802 WURZBACH ROAD	SAN ANTONIO	TX	78229	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03562	9080 MARBACH ROAD	SAN ANTONIO	TX	78245	10/11/2011
CH062360	WALGREEN CO.	DBA: WALGREENS # 03140	410 W. CYPRESS ST.	SAN ANTONIO	TX	78212	01/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS #12520	300 E. HOUSTON ST.	SAN ANTONIO	TX	78205-1816	01/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 07939	9903 POTRANCO RD	SAN ANTONIO	TX	78251	01/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 09180	11103 W MILITARY DR	SAN ANTONIO	TX	78251	01/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 01194	8530 FM 78	CONVERSE	TX	78109	07/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 05964	3401 SAN PEDRO	SAN ANTONIO	TX	78212	07/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS #11276	502 NEW VALLEY HI	SAN ANTONIO	TX	78227	07/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 03368	1581 AUSTIN HIGHWAY	SAN ANTONIO	TX	78218	07/01/2014
CH062360	WALGREEN CO.	DBA: WALGREENS # 07571	10673 CULEBRA RD	SAN ANTONIO	TX	78251-1346	07/01/2014	06/27/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 04551	11707 HUEBNER ROAD	SAN ANTONIO	TX	78230	07/01/2015
CH062360	WALGREEN CO.	DBA: WALGREENS # 09615	3030 GOLIAD RD	SAN ANTONIO	TX	78223-3959	07/01/2015
CH062360	WALGREEN CO.	DBA:WALGREENS #10787	12352 FM 1957	SAN ANTONIO	TX	78253	07/01/2015
CH062360	WALGREEN CO.	DBA: WALGREENS #11521	10858 WURZBACH RD.	SAN ANTONIO	TX	78230-2434	10/01/2015
CH062360	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21214	660 N MAIN AVE STE 101	SAN ANTONIO	TX	78205	10/01/2015
CH062360	WALGREEN CO.	DBA: WALGREENS # 03505	6635 BANDERA RD	SAN ANTONIO	TX	78238	01/01/2016
CH062360	WALGREEN CO.	DBA: WALGREENS # 05765	1223 S MAIN ST	BOERNE	TX	78006	01/01/2016
CH062360	WALGREEN CO.	DBA: WALGREENS # 03083	10650 TOEPPERWEIN RD	CONVERSE	TX	78109	07/01/2016
CH062360	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16485	7302 LOUIS PASTEUR DR STE 104	SAN ANTONIO	TX	78229	04/01/2017
CH062360	WALGREEN CO.	DBA:WALGREENS #15621	25215 INTERSTATE10 W	SAN ANTONIO	TX	78257	07/01/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 04274	2425 THOUSAND OAKS DRIVE	SAN ANTONIO	TX	78232	10/01/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 03804	7655 TEZEL RD	SAN ANTONIO	TX	78250	10/01/2017
CH062360	WALGREEN CO.	DBA: WALGREENS # 06335	14025 NACOGDOCHES RD	SAN ANTONIO	TX	78247-1918	01/01/2018
CH062360	WALGREEN CO.	DBA: WALGREENS #12716	12020 CULEBRA RD	SAN ANTONIO	TX	78253	07/01/2022
CH062360	WALGREEN CO.	DBA: WALGREENS # 07214	20800 US 281 NORTH	SAN ANTONIO	TX	78258	10/01/2024
CH062360	WALGREEN CO.	DBA: WALGREENS # 04838	19203 STONE OAK PKWY	SAN ANTONIO	TX	78258	10/01/2024
CH062360	WALGREEN CO.	DBA: WALGREENS # 07923	22114 BULVERDE ROAD	SAN ANTONIO	TX	78259	04/01/2025
CH062360	WALGREEN CO.	DBA: WALGREENS # 02944	7423 BROADWAY ST	SAN ANTONIO	TX	78209	07/01/2025
CH062360	WALGREEN CO.	DBA: WALGREENS #11971	20226 STONE OAK PKWY.	SAN ANTONIO	TX	78258	07/01/2025
CH062360	WALGREEN CO.	DBA: WALGREENS # 03571	14505 NW MILITARY HWY	SHAVANO PARK	TX	78231	07/01/2025
CH062360	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	07/01/2022
CH062360	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2014	06/24/2015
CH062360	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2015
CH062360	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	07/01/2015	10/04/2021
CH062360	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2015
CH062360	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2015
CH062360	WALMART PHARMACY 10-3058	918 BANDERA RD.		SAN ANTONIO	TX	78228	07/01/2017
CH062360	WALMART PHARMACY 10-4130	5754 KYLE PARKWAY		KYLE	TX	78640	07/01/2017
CH062360	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH062360	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH062360	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	01/01/2014	01/06/2020
CH06236I	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	01/01/2014	10/15/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2018 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		1/19/2018 12:00:00 AM	2/7/2018 9:59 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/7/2018 9:59 AM
Terminations	Termination Date	Update	Recertification		4/1/2018 12:00:00 AM	2/7/2018 9:59 AM
Terminations	Termination Effective Date	Update	Recertification		1/19/2018 12:00:00 AM	2/7/2018 9:59 AM
Terminations	Termination Reason	Update	Recertification		Site closure	2/7/2018 9:59 AM
Contacts	Authorizing Official	Update		Nguyen, Paul President & CEO 2102337070-7886	Nguyen, Paul President & CEO Barrio Comprehensive Family Health Care Center, Inc. 2102337070-7886	10/13/2017 1:29 PM
Contacts	Signed By	Update		Nguyen, Paul President & CEO 2102337070-7886	Nguyen, Paul President & CEO Barrio Comprehensive Family Health Care Center, Inc. 2102337070-7886	10/13/2017 1:29 PM
Contacts	Authorizing Official	Insert			Nguyen, Paul President & CEO 2102337070-7886	7/27/2017 12:24 PM
Contacts	Signed By	Insert			Nguyen, Paul President & CEO 2102337070-7886	7/27/2017 12:24 PM
Addresses	Main Address	Insert			3839 E FM 150 KYLE, TX 78640-6072	1/25/2017 8:25 AM
Contacts	Primary Contact	Insert			Milks, Bob COO 2102337070	1/25/2017 8:25 AM
Details	Last Recertification Date	Update		2/12/2016 12:00:00 AM	1/25/2017 12:00:00 AM	1/25/2017 8:25 AM
Details	Last Recertification Date	Update			2/12/2016 12:00:00 AM	2/12/2016 10:15 AM
Addresses	Billing Address	Insert			CommuniCare Health Centers 3066 E. Commerce San Antonio, TX 78220	7/14/2015 5:43 PM
Dates	Participating Approval Date	Update			7/14/2015 12:00:00 AM	7/14/2015 5:43 PM
Details	State	Update		Pending	Active	7/14/2015 5:43 PM
Dates	Start Date	Update			10/1/2015 12:00:00 AM	7/14/2015 5:43 PM
Details	340B ID	Update		ONLINE_REG_52710	CH06236Q	7/10/2015 9:53 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_52710	7/9/2015 8:40 AM
Details	Last Recertification Date	Insert				7/9/2015 8:40 AM
Details	Grant Number	Insert			H80CS00672	7/9/2015 8:40 AM
Details	340B ID	Insert			ONLINE_REG	7/9/2015 8:40 AM
Details	Is Authorizing Official EHB Data	Insert			False	7/9/2015 8:40 AM
Dates	Last Date That 340B Drugs Purchased	Insert				7/9/2015 8:40 AM
Details	Medicare Provider Number	Insert				7/9/2015 8:40 AM
Details	Entity Name	Insert			BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.	7/9/2015 8:40 AM
Details	Program Code	Insert			CH	7/9/2015 8:40 AM
Details	Entity Subname	Insert			CommuniCare Health Centers - Simon Middle School	7/9/2015 8:40 AM
Dates	Participating Approval Date	Insert				7/9/2015 8:40 AM
Details	State	Insert			Pending	7/9/2015 8:40 AM
Dates	Registration Date	Insert			7/9/2015 12:00:00 AM	7/9/2015 8:40 AM
Dates	Signed By Date	Insert			7/9/2015 12:00:00 AM	7/9/2015 8:40 AM
Dates	Start Date	Insert				7/9/2015 8:40 AM
Terminations	Termination Comments	Insert				7/9/2015 8:40 AM
Terminations	Termination Date	Insert				7/9/2015 8:40 AM
Terminations	Termination Effective Date	Insert				7/9/2015 8:40 AM
Terminations	Termination Reason	Insert				7/9/2015 8:40 AM

340B Drug Pricing Program Database