Covered Entity Details

CH09072R NORTH COUNTY HEALTH PROJECT INCORPORATED (Terminated) - information as of 5/27/2025 11:40:14 PM

Main Details

Name

NORTH COUNTY HEALTH PROJECT INCORPORATED

Subdivision Name

Novata Behavioral Health (Oceanside); An Affiliate of NCHS

Type

HRSA-Funded Health Center

Site ID

BPS-H80-015289

340B ID

CH09072R

Grant Number

H80CS00228

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2015

Participating Start Date

1/1/2016

Participating Approval Date

10/22/2015

Last Recertification Date

2/17/2017

Termination Date
Termination Reason

4/1/2017
Site closure

Contacts

Authorizing Official

IRMA COTA, CEO
(760) 736-6755

Primary Contact

NCHS
Kory Hernandez, Director of Operations
(760) 736-1722

Addresses

Street Address

1100 Sportfisher Drive
Oceanside, CA 92054-2550

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
		1639185317

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
CH090720	Active	BPS-H80-001768	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	150 Valpreda Road		San Marcos	CA
CH09072B	Active	BPS-H80-027631	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	220 Rotanzi St		Ramona	CA
CH09072BA	Active	BPS-H80-036032	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	1595 Grand Ave. suite 100		San Marcos	CA
CH09072BB	Active	BPS-H80-036031	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare Mobile Unit 3	150 Valpreda Road		San Marcos	CA
CH09072BC	Active	BPS-H80-038544	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare Vista Way Health Center Ste 204	3998 Vista Way		Oceanside	CA
CH09072BD	Active	BPS-H80-039620	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare Rancho Sante Fe QuickCare	295 S Rancho Santa Fe Rd		San Marcos	CA
CH09072BE	Active	BPS-H80-039793	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare Vista Way Health Center Ste B/C	3998 Vista Way, Suite C		Oceanside	CA
CH09072D	Active	BPS-H80-001425	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	1130 2nd St		Encinitas	CA
CH09072E	Active	BPS-H80-002730	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	2210 Mesa Dr Suite 100		Oceanside	CA
CH09072F	Active	BPS-H80-009187	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	605 Crouch St	Building C	Oceanside	CA
CH09072G	Terminated	BPS-H80-008082	NORTH COUNTY HEALTH PROJECT, INC	North County Health Services -Grand Avenue	727 West San Marcos Blvd. Sute 112		San Marcos	CA
CH09072H	Active	BPS-H80-014232	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	1295 CARLSBAD VILLAGE DR, SUITE 100		CARLSBAD	CA
CH09072J	Active	BPS-H80-008463	NORTH COUNTY HEALTH PROJECT, INC	TrueCare	3220 Mission Ave Suite 1		Oceanside	CA
CH09072K	Active	BPS-H80-003996	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	2210 Mesa Drive Suite 5		OCEANSIDE	CA
CH09072L	Active	BPS-H80-008948	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	2216 S El Camino Real Suite 121		Oceanside	CA
CH09072M	Active	BPS-H80-014759	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	2210 Mesa Drive, Suite 300		Oceanside	CA
CH09072N	Terminated	BPS-H80-015068	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	161 Thunder Drive Suite 210		Vista	CA
CH09072P	Terminated	BPS-H80-015288	NORTH COUNTY HEALTH PROJECT INCORPORATED	Novata Behavioral Health (Escondido); An Affiliate of NCHS	940 E. Valley Parkway		Escondido	CA
CH09072Q	Terminated	BPS-H80-015290	NORTH COUNTY HEALTH PROJECT INCORPORATED	California Pediatrics an Affiliate of NCHS	1595 Grand Ave #102		San Marcos	CA
CH09072R	Terminated	BPS-H80-015289	NORTH COUNTY HEALTH PROJECT INCORPORATED	Novata Behavioral Health (Oceanside); An Affiliate of NCHS	1100 Sportfisher Drive		Oceanside	CA
CH09072S	Terminated	BPS-H80-015383	NORTH COUNTY HEALTH PROJECT INCORPORATED	Mark Ventocilla OD Inc. an Affiliate of NCHS	613 East Grand Ave.		Escondido	CA
CH09072T	Active	BPS-H80-017635	NORTH COUNTY HEALTH PROJECT INCORPORATED	TrueCare	1675 N. Perris Blvd. Suite G1		Perris	CA
CH09072U	Terminated	BPS-H80-018215	NORTH COUNTY HEALTH PROJECT INCORPORATED	Cognitive Health Science Centers (San Marcos); An Affiliate of NCHS	960 W. San Marcos Blvd., San Marcos, CA 92078		San Marcos	CA
CH09072V	Active	BPS-H80-019132	North County Health Project Incorporated	TrueCare	619 Crouch St. Suite 100		Oceanside	CA
CH09072W	Active	BPS-H80-000939	North County Health Project Incorporated	TrueCare Mobile Unit	150 VALPREDA RD		SAN MARCOS	CA
CH09072X	Active	BPS-H80-034338	North County Health Project Incorporated	TrueCare - Casa de Amparo	325 Buena Creek Rd BLDG A		San Marcos	CA
CH09072Y	Active	BPS-H80-035455	North County Health Project Incorporated	TrueCare	1595 Grand Ave Suite106		San Marcos	CA
CH09072Z	Active	BPS-H80-035631	North County Health Project Incorporated	TrueCare Mobile Unit 2	150 Valpreda Road		San Marcos	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH090720	AHF PHARMACY	AIDS HEALTHCARE FOUNDATION	120 UNIVERSITY AVE	SAN DIEGO	CA	92103-3007	07/01/2021
CH090720	AHF PHARMACY	AIDS HEALTHCARE FOUNDATION	1988 HACIENDA DR	VISTA	CA	92081-6026	07/01/2021
CH09072Z	AHF PHARMACY	AIDS HEALTHCARE FOUNDATION	1988 HACIENDA DR	VISTA	CA	92081-6026	01/01/2024
CH090720	AIDS HEALTHCARE FOUNDATION	AHF PHARMACY	3580 5TH AVE STE 200	SAN DIEGO	CA	92103	07/01/2021
CH090720	ALBERTSONS LLC	SAV-ON PHARMACY #0725	1459 MAIN ST	RAMONA	CA	92065	07/01/2017
CH09072Y	ALBERTSONS LLC	SAV-ON PHARMACY #0725	1459 MAIN ST	RAMONA	CA	92065	01/01/2024
CH09072B	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072D	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072L	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072W	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072H	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH090720	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072K	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072F	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072E	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072M	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072T	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072V	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072Y	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072X	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072J	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	01/01/2023
CH09072E	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072F	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072X	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072J	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072T	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072M	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072Y	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072H	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH090720	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072W	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072L	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072V	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072D	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072B	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH09072K	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2023
CH090720	COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY	STE A - E	SAN DIEGO	CA	92102-4548	07/01/2013	03/29/2018
CH09072F	FALLBROOK PHARMACY		343 E. ALVARADO ST.	FALLBROOK	CA	92028	08/23/2012	07/13/2015
CH09072B	FALLBROOK PHARMACY		343 E. ALVARADO ST.	FALLBROOK	CA	92028	08/23/2012	07/13/2015
CH09072E	FALLBROOK PHARMACY		343 E. ALVARADO ST.	FALLBROOK	CA	92028	08/23/2012	07/13/2015
CH09072D	FALLBROOK PHARMACY		343 E. ALVARADO ST.	FALLBROOK	CA	92028	08/23/2012	07/13/2015
CH090720	GALLOWAY'S MEDICAL CENTER PHARMACY	2995 NATIONAL AVENUE		SAN DIEGO	CA	92113	07/01/2013	01/12/2016
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07127	1302 WEST MISSION RD.	SAN MARCOS	CA	92069	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08866	1706 OCEANSIDE BLVD	OCEANSIDE	CA	92054	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09103	318 W EL NORTE PARKWAY	ESCONDIDO	CA	92026	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09166	734 S. RANCHO SANTA FE RD.	SAN MARCOS	CA	92078	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09194	1810 MAIN ST.	RAMONA	CA	92065	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09479	2510 EL CAMINO REAL	CARLSBAD	CA	92008	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09585	3925 N. RIVER RD.	OCEANSIDE	CA	92058	04/01/2017
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09528	7740 RANCHO SANTA FE ROAD	CARLSBAD	CA	92009	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08818	997 WOODLAND PKWY.	SAN MARCOS	CA	92069	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09110	1101 S. MISSION RD.	FALLBROOK	CA	92028	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09181	455 ENCINITAS BLVD.	ENCINITAS	CA	92024	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16416	1010 N EL CAMINO REAL	ENCINITAS	CA	92024	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09104	2427 E. VALLEY PKWY	ESCONDIDO	CA	92027	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09574	883 S. SANTA FE AVENUE	VISTA	CA	92083	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09187	683 LOMAS SANTA FE DR.	SOLANA BEACH	CA	92075	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08857	1441 N SANTA FE	VISTA	CA	92084	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09549	1980 COLLEGE BLVD	OCEANSIDE	CA	92056	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09532	4615 FRAZEE ROAD	OCEANSIDE	CA	92057	01/01/2019
CH090720	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09108	1655 S. CENTRE CITY PKWY.	ESCONDIDO	CA	92025	01/01/2019
CH09072L	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09549	1980 COLLEGE BLVD	OCEANSIDE	CA	92056	01/01/2024
CH09072X	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09103	318 W EL NORTE PARKWAY	ESCONDIDO	CA	92026	01/01/2024
CH09072J	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09585	3925 N. RIVER RD.	OCEANSIDE	CA	92058	01/01/2024
CH09072V	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09166	734 S. RANCHO SANTA FE RD.	SAN MARCOS	CA	92078	01/01/2024
CH09072H	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08866	1706 OCEANSIDE BLVD	OCEANSIDE	CA	92054	01/01/2024
CH09072BA	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07127	1302 WEST MISSION RD.	SAN MARCOS	CA	92069	01/01/2024
CH090720	HILLCREST PHARMACY	120 UNIVERSITY AVE		SAN DIEGO	CA	92103	06/21/2012	04/01/2021
CH090720	HILLCREST PHARMACY INC	HILLCREST PHARMACY	1988 HACIENDA DR	VISTA	CA	92081-6026	10/01/2015	04/01/2021
CH090720	LAGUNA DRUGS	239 BROADWAY ST		LAGUNA BEACH	CA	92651-1806	04/01/2014	06/30/2019
CH090720	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09558	320 S TWIN OAKS VALLEY RD	SAN MARCOS	CA	92078	04/01/2017
CH090720	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09961	191 WOODLAND PKWY	SAN MARCOS	CA	92069	04/01/2017
CH09072B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09961	191 WOODLAND PKWY	SAN MARCOS	CA	92069	01/01/2024
CH09072BB	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09558	320 S TWIN OAKS VALLEY RD	SAN MARCOS	CA	92078	01/01/2024
CH09072L	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072V	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072E	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072F	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072X	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072W	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072J	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072B	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH090720	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072M	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072K	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072D	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072Y	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072T	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH09072H	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2023
CH090720	MEDICAL CENTER PHARMACY		7910 FROST STREET SUITE 130	SAN DIEGO	CA	92123	07/01/2013	06/17/2016
CH090720	MEDICAL CENTER PHARMACY	3904 PARK BLVD		SAN DIEGO	CA	92103	07/01/2013	03/29/2018
CH09072Y	NEW ALBERTSON'S INC.		DBA SAVON PHARMACY #6725 1459 MAIN STREET	RAMONA	CA	92065	01/01/2024
CH090720	NUEVO PHARMACY	75 W. NUEVO RD SUITE H		PERRIS	CA	92571	07/01/2016	03/01/2020
CH09072H	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072X	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072V	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072J	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072W	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072Y	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072K	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072D	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072E	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072T	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072L	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072B	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072F	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH090720	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH09072M	PHARMEDQUEST PHARMACY SERVICES	DBA AVITA PHARMACY 1072	26800 CROWN VALLEY PKWY STE 185	MISSION VIEJO	CA	92691	01/01/2023
CH090720	QUALITY-CARE PHARMACY	727 W SAN MARCOS BLVD STE 113		SAN MARCOS	CA	92078-1244	10/01/2013	05/07/2019
CH090720	RALPHS GROCERY CO	DBA RALPHS #683	306 TWIN OAKS VALLEY RD	SAN MARCOS	CA	92078	10/01/2013	05/29/2015
CH090720	RANCHO PUEBLO PHARMACY	31515 RANCHO PUEBLO RD	SUITE 105	TEMECULA	CA	92592	07/01/2016	03/08/2017
CH090720	THRIFTY PAYLESS INC.	RITE AID #5628	315 WEST WASHINGTON AVENUE	ESCONDIDO	CA	92025	10/01/2017	02/05/2019
CH090720	THRIFTY PAYLESS INC.	RITE AID #5643	427 C STREET SUITE 100	SAN DIEGO	CA	92101	10/01/2017	06/19/2018
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5627	439 SANTA FE DRIVE 439 SANTA FE DRIVE	ENCINITAS	CA	92024	10/01/2017	04/16/2024
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5621	955 TAMARACK AVENUE	CARLSBAD	CA	92008	10/01/2017
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5642	1363 EAST VISTA WAY	VISTA	CA	92084	10/01/2017
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5622	7100 AVENIDA ENCINAS	CARLSBAD	CA	92011	10/01/2017
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5635	3813 PLAZA DRIVE	OCEANSIDE	CA	92056	10/01/2017	02/09/2024
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5638	1670 MAIN STREET	RAMONA	CA	92065	10/01/2017	02/09/2024
CH090720	THRIFTY PAYLESS, INC.	RITE AID #5634	1201 SOUTH COAST HIGHWAY	OCEANSIDE	CA	92054	10/01/2017
CH090720	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2018
CH090720	WAL-MART PHARMACY 10-2094	1800 UNIVERSITY DR		VISTA	CA	92083	01/01/2018
CH090720	WAL-MART PHARMACY 10-2245	705 COLLEGE BLVD		OCEANSIDE	CA	92057	01/01/2018
CH090720	WAL-MART PHARMACY 10-2494	2100 VISTA WAY		OCEANSIDE	CA	92054	01/01/2018
CH09072D	WAL-MART PHARMACY 10-2494	2100 VISTA WAY		OCEANSIDE	CA	92054	01/01/2024
CH090720	WAL-MART PHARMACY 10-3494	732 CENTER DR		SAN MARCOS	CA	92069	01/01/2018
CH090720	WAL-MART PHARMACY 10-5075	3405 MARRON RD		OCEANSIDE	CA	92056	01/01/2018
CH09072E	WAL-MART PHARMACY 10-5075	3405 MARRON RD		OCEANSIDE	CA	92056	01/01/2024
CH09072M	WAL-MART PHARMACY 10-5075	3405 MARRON RD		OCEANSIDE	CA	92056	01/01/2024
CH090720	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	01/01/2018
CH090720	WAL-MART PHARMACY 10-5638	2121 IMPERIAL AVE		SAN DIEGO	CA	92102	01/01/2018
CH090720	WAL-MART PHARMACY 10-5886	1550 LEUCADIA BLVD		ENCINITAS	CA	92024	01/01/2018
CH090720	WAL-MART PHARMACY 10-5996	1330 EAST GRAND AVE		ESCONDIDO	CA	92027	01/01/2018
CH090720	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2018
CH090720	WALGREEN CO	DBA: WALGREENS #07751	3507 CANNON RD	OCEANSIDE	CA	92056-4977	03/23/2012
CH090720	WALGREEN CO	DBA: WALGREENS #09433	3752 MISSION AVE	OCEANSIDE	CA	92058	03/23/2012
CH09072K	WALGREEN CO	DBA: WALGREENS #09433	3752 MISSION AVE	OCEANSIDE	CA	92058	01/01/2024
CH090720	WALGREEN CO.	DBA: WALGREENS # 05455	111 W WASHINGTON AVE	ESCONDIDO	CA	92025	03/23/2012
CH090720	WALGREEN CO.	DBA: WALGREENS # 05456	1510 N SANTA FE AVE	VISTA	CA	92083	03/23/2012
CH090720	WALGREEN CO.	DBA: WALGREENS # 05700	1574 E VALLEY PKWY	ESCONDIDO	CA	92027	03/23/2012
CH090720	WALGREEN CO.	DBA: WALGREENS # 06222	802 S SANTA FE AVE	VISTA	CA	92084-6107	03/23/2012	04/14/2017
CH090720	WALGREEN CO.	DBA: WALGREENS # 09389	310 SYCAMORE AVENUE	VISTA	CA	92083-7702	03/23/2012	04/08/2024
CH090720	WALGREEN CO.	DBA: WALGREENS # 10142	460 W FELICITA AVENUE	ESCONDIDO	CA	92025-6518	03/23/2012	04/22/2025
CH090720	WALGREEN CO.	DBA: WALGREENS #11653	1320 ENCINITAS BLVD	ENCINITAS	CA	92024	03/23/2012
CH090720	WALGREEN CO.	DBA: WALGREENS #13052	4181 OCEANSIDE BLVD.	OCEANSIDE	CA	92056	03/23/2012	11/01/2019
CH090720	WALGREEN CO.	DBA: WALGREENS #12421	13390 POWAY RD	POWAY	CA	92064	10/01/2013
CH090720	WALGREEN CO.	DBA: DOMINGUEZ, A WALGREENS PHARMACY	2055 N PERRIS BLVD SUITE A1	PERRIS	CA	92571	07/01/2016
CH09072F	WALGREEN CO.	DBA: WALGREENS # 10142	460 W FELICITA AVENUE	ESCONDIDO	CA	92025-6518	01/01/2024
CH09072T	WALGREEN CO.	DBA: DOMINGUEZ, A WALGREENS PHARMACY	2055 N PERRIS BLVD SUITE A1	PERRIS	CA	92571	01/01/2024
CH090720	WALMART PHARMACY 10-3084	1266 E VALLEY PKWY		ESCONDIDO	CA	92027	01/01/2018
CH090720	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2024
CH090720	WALMART PHARMACY 10-5637	1046 MISSION AVE		OCEANSIDE	CA	92054	01/01/2018
CH09072W	WALMART PHARMACY 10-5637	1046 MISSION AVE		OCEANSIDE	CA	92054	01/01/2024
CH090720	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Torres, Irene Director of Operations NCHS 7607361722	Hernandez, Kory Director of Operations NCHS 7607361722	1/30/2019 5:26 PM
Contacts	Primary Contact	Update	Profile Change Request	Hernandez, Kory Director of Operations for Pharmacy and Dental Services NCHS 7607367061	Torres, Irene Director of Operations NCHS 7607361722	1/30/2019 5:04 PM
Contacts	Primary Contact	Update		Hernandez, Kory Director of Operations for Pharmacy and Dental Services 7607367061	Hernandez, Kory Director of Operations for Pharmacy and Dental Services NCHS 7607367061	9/18/2017 5:47 PM
Contacts	Authorizing Official	Insert			COTA, IRMA CEO 7607366755	8/4/2017 7:27 PM
Contacts	Signed By	Insert			COTA, IRMA CEO 7607366755	8/4/2017 7:27 PM
Addresses	Main Address	Insert			1100 Sportfisher Drive Oceanside, CA 92054-2550	2/17/2017 1:38 PM
Contacts	Primary Contact	Insert			Hernandez, Kory Director of Operations for Pharmacy and Dental Services 7607367061	2/17/2017 1:38 PM
Details	Last Recertification Date	Update		3/1/2016 12:00:00 AM	2/17/2017 12:00:00 AM	2/17/2017 1:38 PM
Dates	Last Date That 340B Drugs Purchased	Update			5/5/2016 12:00:00 AM	1/23/2017 8:16 AM
Details	State	Update		Active	Terminated	1/23/2017 8:16 AM
Terminations	Termination Comments	Update			Business decision	1/23/2017 8:16 AM
Terminations	Termination Date	Update			4/1/2017 12:00:00 AM	1/23/2017 8:16 AM
Terminations	Termination Effective Date	Update			5/5/2016 12:00:00 AM	1/23/2017 8:16 AM
Terminations	Termination Reason	Update			Site closure	1/23/2017 8:16 AM
Details	Last Recertification Date	Update			3/1/2016 12:00:00 AM	3/4/2016 5:44 PM
Dates	Participating Approval Date	Update			10/22/2015 12:00:00 AM	10/22/2015 10:14 AM
Details	State	Update		Pending	Active	10/22/2015 10:14 AM
Dates	Start Date	Update			1/1/2016 12:00:00 AM	10/22/2015 10:14 AM
Details	340B ID	Update		ONLINE_REG_54322	CH09072R	10/7/2015 11:14 AM
Medicaid Billing	NPI: Number	Insert			1639185317	10/1/2015 8:03 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_54322	10/1/2015 8:03 PM
Details	Last Recertification Date	Insert				10/1/2015 8:03 PM
Details	Grant Number	Insert			H80CS00228	10/1/2015 8:03 PM
Details	340B ID	Insert			ONLINE_REG	10/1/2015 8:03 PM
Details	Is Authorizing Official EHB Data	Insert			False	10/1/2015 8:03 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/1/2015 8:03 PM
Details	Medicare Provider Number	Insert				10/1/2015 8:03 PM
Details	Entity Name	Insert			NORTH COUNTY HEALTH PROJECT INCORPORATED	10/1/2015 8:03 PM
Details	Program Code	Insert			CH	10/1/2015 8:03 PM
Details	Entity Subname	Insert			Novata Behavioral Health (Oceanside); An Affiliate of NCHS	10/1/2015 8:03 PM
Dates	Participating Approval Date	Insert				10/1/2015 8:03 PM
Details	State	Insert			Pending	10/1/2015 8:03 PM
Dates	Registration Date	Insert			10/1/2015 12:00:00 AM	10/1/2015 8:03 PM
Dates	Signed By Date	Insert			10/1/2015 12:00:00 AM	10/1/2015 8:03 PM
Dates	Start Date	Insert				10/1/2015 8:03 PM
Terminations	Termination Comments	Insert				10/1/2015 8:03 PM
Terminations	Termination Date	Insert				10/1/2015 8:03 PM
Terminations	Termination Effective Date	Insert				10/1/2015 8:03 PM
Terminations	Termination Reason	Insert				10/1/2015 8:03 PM

340B Drug Pricing Program Database