Covered Entity Details

CHC29048-00 BEHAVIORAL HEALTH SERVICES INC (Active) - information as of 4/25/2025 6:33:44 PM

Main Details

Name

BEHAVIORAL HEALTH SERVICES INC

Subdivision Name

Behavioral Health Services - Family Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-018189

340B ID

CHC29048-00

Grant Number

H80CS29048

Additional Details

Current Program Status

Active

Registration Date

7/11/2016

Participating Start Date

10/1/2016

Participating Approval Date

7/27/2016

Last Recertification Date

2/24/2025

Contacts

Authorizing Official

Behavioral Health Services, Inc.
Denise Shook, President/CEO
(310) 679-9126 Ext: 1293

Primary Contact

BHS- Family Health Center
Michelle Venable, Director of Health Center Operations
(310) 679-9126 Ext: 1233

Addresses

Street Address

2501 W. El Segundo Blvd. Suite B
Hawthorne, CA 90250

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ALBERTSONS LLC	SAV-ON PHARMACY #2935	110 E CARSON ST	CARSON	CA	90745	04/16/2018	07/01/2018	01/15/2019	01/15/2019
Contract Detail	ALBERTSONS LLC	SAV-ON PHARMACY #3859	200 E SEPULVEDA BLVD	CARSON	CA	90745	04/16/2018	07/01/2018	01/15/2019	01/15/2019
Contract Detail	AVALON PHARMACY	AVALON PHARMACY	1203 N AVALON BLVD SUITE A	WILMINGTON	CA	90744-9074	07/17/2017	10/01/2017	07/12/2018	07/12/2018
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK PUERTO RICO SPECIALTY PHARMACY,	CAREMARK PUERTO RICO SPECIALTY PHARMACY	6020 AVE ROBERTO SANCHEZ VILELLA	CAROLINA	PR	00982	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/05/2020	01/01/2021		01/01/2021
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/05/2020	01/01/2021	04/12/2021	04/12/2021
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/05/2020	01/01/2021		01/01/2021
Contract Detail	FARMACIA BRISTOL	1155 W. CENTRAL AVE SUITE#112		SANTA ANA	CA	92707	04/16/2018	07/01/2018	01/05/2021	01/08/2021
Contract Detail	FARMACIA BRISTOL	1155 W. CENTRAL AVE.	STE. 112	SANTA ANA	CA	92707	01/17/2021	04/01/2021		04/01/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09578	3120 W. IMPERIAL HWY.	INGLEWOOD	CA	90303	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08860	11831 HAWTHORNE BOULEVARD	HAWTHORNE	CA	90250	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09123	3800 MARTIN LUTHER KING JR. BOULEVARD	LYNWOOD	CA	90262	07/12/2019	10/01/2019	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08831	3880 W. ROSECRANS AVE.	HAWTHORNE	CA	90250	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08837	222 N. MARKET ST.	INGLEWOOD	CA	90301	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS/PHARMACY #10292	4030 SOUTH WESTERN AVE.	LOS ANGELES	CA	90062	07/12/2019	10/01/2019	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17354	2700 W 120TH ST	HAWTHORNE	CA	90250	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05012	23806 MAIN STREET	CARSON	CA	90745	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05809	4775 W. ROSECRANS AVE.	HAWTHORNE	CA	90250	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09584	4345 WEST CENTURY BOULEVARD	INGLEWOOD	CA	90304	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 4524	5176 E. WHITTIER BLVD.	LOS ANGELES	CA	90022	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10509	3627 EAST CESAR EAST CHAVEZ AVENUE	LOS ANGELES	CA	90063	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09582	3741 CRENSHAW BOULEVARD	LOS ANGELES	CA	90016	07/12/2019	10/01/2019	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08839	150 WEST CARSON STREET	CARSON	CA	90745	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09572	5117 LAKEWOOD BOULEVARD	LAKEWOOD	CA	90712	07/12/2019	10/01/2019	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09564	15700 SOUTH WESTERN AVENUE	GARDENA	CA	90247	07/12/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 01176	25829 NARBONNE AVE.	LOMITA	CA	90717	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08849	1545 WEST 17TH STREET	SANTA ANA	CA	92706	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08864	3575 ATLANTIC AVENUE	LONG BEACH	CA	90807	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08858	7101 ATLANTIC AVENUE	BELL	CA	90201	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08840	311W. PACIFIC COAST HWY. SUITE C	WILMINGTON	CA	90744	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08876	233 EAST WILLOW STREET	LONG BEACH	CA	90806	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08886	8601 SOUTH SEPULVEDA BOULEVARD	LOS ANGELES	CA	90045	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07191	15718 HAWTHORNE BLVD (NEC)	LAWNDALE	CA	90260	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09496	2900 N. SEPULVEDA BLVD.	MANHATTAN BEACH	CA	90266	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09477	5399 WEST CENTINELA AVENUE	LOS ANGELES	CA	90045	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09495	220 EAST COMPTON BOULEVARD	COMPTON	CA	90220	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08855	228 NORTH HARBOR BOULEVARD	SANTA ANA	CA	92703	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09507	650 EAST EL SEGUNDO BOULEVARD	LOS ANGELES	CA	90059	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09122	700 S. GAFFEY ST.	SAN PEDRO	CA	90731	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 03968	816 E. MAIN STREET	ALHAMBRA	CA	91801	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08875	3644 EAST OLYMPIC BOULEVARD	LOS ANGELES	CA	90023	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09475	4320 REDONDO BEACH BOULEVARD	TORRANCE	CA	90504	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09583	102 NORTH MAIN STREET	SANTA ANA	CA	92701	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09771	9256 SLAUSON AVENUE	PICO RIVERA	CA	90660	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09679	1485 E. VALLEY BLVD.	ALHAMBRA	CA	91801	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09588	15103 HAWTHORNE BOULEVARD	LAWNDALE	CA	90260	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17394	651 W SEPULVEDA BLVD	CARSON	CA	90745	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09571	950 NORTH WESTERN AVENUE	SAN PEDRO	CA	90732	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16670	3471 W CENTURY BLVD	INGLEWOOD	CA	90303	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16041	2120 W MAIN ST	ALHAMBRA	CA	91801	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16093	2169 W REDONDO BEACH BLVD	GARDENA	CA	90247	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17521	1701 N GAFFEY ST	SAN PEDRO	CA	90731	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17096	1601 KINGSDALE AVE	REDONDO BEACH	CA	90278	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09579	4570 ATLANTIC AVENUE	LONG BEACH	CA	90807	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16750	3600 ROSEMEAD BLVD	ROSEMEAD	CA	91770	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16043	5600 WHITTIER BLVD	COMMERCE	CA	90022	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09769	8580 WHITTIER BLVD.	PICO RIVERA	CA	90660	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09798	313 SOUTH GARFIELD AVENUE	MONTEREY PARK	CA	91754	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17119	20700 S AVALON BLVD STE 700	CARSON	CA	90746	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16049	1200 N SEPULVEDA BLVD	MANHATTAN BEACH	CA	90266	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09557	1250 E.PACIFIC COAST HIGHWAY	LONG BEACH	CA	90806	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 10022	1303 SEPULVEDA BLVD.	TORRANCE	CA	90501	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09617	2103 SOUTH ATLANTIC BOULEVARD	MONTEREY PARK	CA	91754	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09645	8225 GARVEY AVENUE	ROSEMEAD	CA	91770	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09791	2532 W. VALLEY BLVD.	ALHAMBRA	CA	91803	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17349	1621 S ALAMEDA ST	COMPTON	CA	90220	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09566	596 LONG BEACH BOULEVARD	LONG BEACH	CA	90802	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09594	901 S. CENTRAL AVENUE	COMPTON	CA	90220	07/15/2019	10/01/2019		10/01/2019
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09543	2001 PACIFIC COAST HIGHWAY	LOMITA	CA	90717	10/07/2019	01/01/2020		01/01/2020
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09665	5944 N FIGUEROA ST	LOS ANGELES	CA	90042	04/06/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07079	2200 N. HARBOR BLVD. (NEC)	FULLERTON	CA	92835	04/06/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09501	2655 SANTA ANA STREET	SOUTH GATE	CA	90280	04/06/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16206	39440 10TH ST W	PALMDALE	CA	93551	04/07/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09510	15421 BROOKHURST STREET	WESTMINSTER	CA	92683	04/07/2020	07/01/2020	06/21/2021	06/24/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09141	3151 UNIVERSITY AVE.	SAN DIEGO	CA	92104	04/07/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16045	12100 HARBOR BLVD	GARDEN GROVE	CA	92840	04/10/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09576	10889 WELLWORTH AVENUE	LOS ANGELES	CA	90024	04/10/2020	07/01/2020	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09568	4625 TORRANCE BOULEVARD	TORRANCE	CA	90503	10/05/2020	01/01/2021		01/01/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09610	12280 PERRIS BLVD	MORENO VALLEY	CA	92557	10/05/2020	01/01/2021		01/01/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09613	23357 MULHOLLAND DRIVE	WOODLAND HILLS	CA	91364	10/05/2020	01/01/2021	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16046	13831 BROOKHURST ST	GARDEN GROVE	CA	92843	10/05/2020	01/01/2021		01/01/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08841	11623 ROSECRANS AVE.	NORWALK	CA	90650	10/05/2020	01/01/2021	04/12/2021	04/12/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #4019	5837 S. CENTRAL AVE.	LOS ANGELES	CA	90001	10/05/2020	01/01/2021		01/01/2021
Contract Detail	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09580	5101 OBAMA BLVD	LOS ANGELES	CA	90016	10/05/2020	01/01/2021	04/12/2021	04/12/2021
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09513	1570 ROSECRANS AVE	MANHATTAN BEACH	CA	90266	07/15/2019	10/01/2019		10/01/2019
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09985	8900 SEPULVEDA WESTWAY	LOS ANGELES	CA	90045	07/15/2019	10/01/2019		10/01/2019
Contract Detail	MCCARTHY PHARMACY INC	MCCARTHY DRUGS	12025 SAN VICENTE BLVD	LOS ANGELES	CA	90049	10/17/2016	01/01/2017	04/30/2018	04/30/2018
Contract Detail	MCCARTHY PHARMACY INC	DBA FREEMAN MEDICAL PHARMACY	301 N PRAIRIE AVE STE 110	INGLEWOOD	CA	90301	10/17/2016	01/01/2017	01/15/2019	01/15/2019
Contract Detail	MEDIMPACT DIRECT, LLC	8060 S KYRENE RD		TEMPE	AZ	85284-2109	04/17/2020	07/01/2020	04/15/2021	04/19/2021
Contract Detail	NEW JERSEY CVS PHARMACY, L.L.C.	CVS PHARMACY # 16533	632 ROUTE 46 E	FAIRFIELD	NJ	07004	10/05/2020	01/01/2021	04/12/2021	04/12/2021
Contract Detail	NOVIXUS PHARMACY SERVICES	43159 W 9 MILE RD.		NOVI	MI	48375-4117	04/17/2020	07/01/2020	04/15/2021	04/19/2021
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/05/2020	01/01/2021		01/01/2021
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/05/2020	01/01/2021		01/01/2021
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/05/2020	01/01/2021		01/01/2021
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/05/2020	01/01/2021		01/01/2021
Contract Detail	RAMI INC	DBA AALPHA PHARMACY	174 S ALVARADO ST	LOS ANGELES	CA	90057-2211	04/15/2019	07/01/2019		07/01/2019
Contract Detail	SOUTH GATE PHARMACY INC	8200 LONG BEACH BLVD UNIT D-2		SOUTH GATE	CA	90280	01/17/2023	04/01/2023		04/01/2023
Contract Detail	THE MEDICINE CABINET	228 E ANAHEIM ST		WILMINGTON	CA	90744	04/16/2018	07/01/2018		04/16/2018
Contract Detail	THE MEDICINE CABINET #5	7037 ATLANTIC AVE		BELL	CA	90201	01/15/2019	04/01/2019		04/01/2019
Contract Detail	TOWERS PHARMACY INC	DBA TOWERS PHARMACY	5451 LA PALMA AVE STE 17	LA PALMA	CA	90623	01/17/2023	04/01/2023		04/01/2023

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC29048-00	Active	BPS-H80-018189	BEHAVIORAL HEALTH SERVICES INC	Behavioral Health Services - Family Health Center	2501 W. El Segundo Blvd. Suite B	Hawthorne	CA
CHC29048-01	Active	BPS-H80-020995	BEHAVIORAL HEALTH SERVICES INC	BHS - El Puerto Family Health Center	1334 N Avalon Blvd	Wilmington	CA
CHC29048-02	Active	BPS-H80-036008	BEHAVIORAL HEALTH SERVICES INC	BHS - Carson Health Center	1000 E. Dominguez Street	Carson	CA
CHC29048-03	Active	BPS-H80-021788	BEHAVIORAL HEALTH SERVICES INC	BHS Adelante Health Center	2015 W 1st St Ste L	Santa Ana	CA
CHC29048-04	Active	BPS-H80-036998	BEHAVIORAL HEALTH SERVICES INC	BHS - Nuestra Health Center	4511 Whittier Blvd	Los Angeles	CA
CHC29048-05	Active	BPS-H80-031303	BEHAVIORAL HEALTH SERVICES INC	BHS - Crenshaw Health Center	3850 Crenshaw Blvd	Los Angeles	CA
CHC29048-06	Active	BPS-H80-030885	BEHAVIORAL HEALTH SERVICES INC	BHS - Health Center for Women	12954 Hawthorne Blvd Ste 100	Hawthorne	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC29048-00	ALBERTSONS LLC	SAV-ON PHARMACY #2935	110 E CARSON ST	CARSON	CA	90745	07/01/2018	01/15/2019
CHC29048-00	ALBERTSONS LLC	SAV-ON PHARMACY #3859	200 E SEPULVEDA BLVD	CARSON	CA	90745	07/01/2018	01/15/2019
CHC29048-00	AVALON PHARMACY	AVALON PHARMACY	1203 N AVALON BLVD SUITE A	WILMINGTON	CA	90744-9074	10/01/2017	07/12/2018
CHC29048-00	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2021
CHC29048-00	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/01/2021
CHC29048-00	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/01/2021
CHC29048-00	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/01/2021
CHC29048-00	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/01/2021
CHC29048-00	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/01/2021
CHC29048-00	CAREMARK PUERTO RICO SPECIALTY PHARMACY,	CAREMARK PUERTO RICO SPECIALTY PHARMACY	6020 AVE ROBERTO SANCHEZ VILELLA	CAROLINA	PR	00982	01/01/2021
CHC29048-00	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/01/2021
CHC29048-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/01/2021
CHC29048-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/01/2021
CHC29048-00	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2021	04/12/2021
CHC29048-00	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/01/2021
CHC29048-00	FARMACIA BRISTOL	1155 W. CENTRAL AVE SUITE#112		SANTA ANA	CA	92707	07/01/2018	01/05/2021
CHC29048-00	FARMACIA BRISTOL	1155 W. CENTRAL AVE.	STE. 112	SANTA ANA	CA	92707	04/01/2021
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09122	700 S. GAFFEY ST.	SAN PEDRO	CA	90731	10/01/2019	07/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05012	23806 MAIN STREET	CARSON	CA	90745	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09578	3120 W. IMPERIAL HWY.	INGLEWOOD	CA	90303	10/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08840	311W. PACIFIC COAST HWY. SUITE C	WILMINGTON	CA	90744	10/01/2019	07/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17119	20700 S AVALON BLVD STE 700	CARSON	CA	90746	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08860	11831 HAWTHORNE BOULEVARD	HAWTHORNE	CA	90250	10/01/2019
CHC29048-03	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08849	1545 WEST 17TH STREET	SANTA ANA	CA	92706	10/01/2019	07/01/2019
CHC29048-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09122	700 S. GAFFEY ST.	SAN PEDRO	CA	90731	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09123	3800 MARTIN LUTHER KING JR. BOULEVARD	LYNWOOD	CA	90262	10/01/2019	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08831	3880 W. ROSECRANS AVE.	HAWTHORNE	CA	90250	10/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17394	651 W SEPULVEDA BLVD	CARSON	CA	90745	10/01/2019	07/01/2019
CHC29048-03	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08855	228 NORTH HARBOR BOULEVARD	SANTA ANA	CA	92703	10/01/2019	07/01/2019
CHC29048-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08840	311W. PACIFIC COAST HWY. SUITE C	WILMINGTON	CA	90744	10/01/2019	07/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08839	150 WEST CARSON STREET	CARSON	CA	90745	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08837	222 N. MARKET ST.	INGLEWOOD	CA	90301	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS/PHARMACY #10292	4030 SOUTH WESTERN AVE.	LOS ANGELES	CA	90062	10/01/2019	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17354	2700 W 120TH ST	HAWTHORNE	CA	90250	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05012	23806 MAIN STREET	CARSON	CA	90745	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 05809	4775 W. ROSECRANS AVE.	HAWTHORNE	CA	90250	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09584	4345 WEST CENTURY BOULEVARD	INGLEWOOD	CA	90304	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 4524	5176 E. WHITTIER BLVD.	LOS ANGELES	CA	90022	10/01/2019
CHC29048-01	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17394	651 W SEPULVEDA BLVD	CARSON	CA	90745	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10509	3627 EAST CESAR EAST CHAVEZ AVENUE	LOS ANGELES	CA	90063	10/01/2019
CHC29048-03	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09583	102 NORTH MAIN STREET	SANTA ANA	CA	92701	10/01/2019	07/01/2019
CHC29048-02	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 10022	1303 SEPULVEDA BLVD.	TORRANCE	CA	90501	10/01/2019	07/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09582	3741 CRENSHAW BOULEVARD	LOS ANGELES	CA	90016	10/01/2019	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08839	150 WEST CARSON STREET	CARSON	CA	90745	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09572	5117 LAKEWOOD BOULEVARD	LAKEWOOD	CA	90712	10/01/2019	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09564	15700 SOUTH WESTERN AVENUE	GARDENA	CA	90247	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 01176	25829 NARBONNE AVE.	LOMITA	CA	90717	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08849	1545 WEST 17TH STREET	SANTA ANA	CA	92706	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08864	3575 ATLANTIC AVENUE	LONG BEACH	CA	90807	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08858	7101 ATLANTIC AVENUE	BELL	CA	90201	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08840	311W. PACIFIC COAST HWY. SUITE C	WILMINGTON	CA	90744	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08876	233 EAST WILLOW STREET	LONG BEACH	CA	90806	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08886	8601 SOUTH SEPULVEDA BOULEVARD	LOS ANGELES	CA	90045	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07191	15718 HAWTHORNE BLVD (NEC)	LAWNDALE	CA	90260	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09496	2900 N. SEPULVEDA BLVD.	MANHATTAN BEACH	CA	90266	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09477	5399 WEST CENTINELA AVENUE	LOS ANGELES	CA	90045	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09495	220 EAST COMPTON BOULEVARD	COMPTON	CA	90220	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08855	228 NORTH HARBOR BOULEVARD	SANTA ANA	CA	92703	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09507	650 EAST EL SEGUNDO BOULEVARD	LOS ANGELES	CA	90059	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09122	700 S. GAFFEY ST.	SAN PEDRO	CA	90731	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 03968	816 E. MAIN STREET	ALHAMBRA	CA	91801	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08875	3644 EAST OLYMPIC BOULEVARD	LOS ANGELES	CA	90023	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09475	4320 REDONDO BEACH BOULEVARD	TORRANCE	CA	90504	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09583	102 NORTH MAIN STREET	SANTA ANA	CA	92701	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09771	9256 SLAUSON AVENUE	PICO RIVERA	CA	90660	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09679	1485 E. VALLEY BLVD.	ALHAMBRA	CA	91801	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09588	15103 HAWTHORNE BOULEVARD	LAWNDALE	CA	90260	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17394	651 W SEPULVEDA BLVD	CARSON	CA	90745	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09571	950 NORTH WESTERN AVENUE	SAN PEDRO	CA	90732	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16670	3471 W CENTURY BLVD	INGLEWOOD	CA	90303	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16041	2120 W MAIN ST	ALHAMBRA	CA	91801	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16093	2169 W REDONDO BEACH BLVD	GARDENA	CA	90247	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17521	1701 N GAFFEY ST	SAN PEDRO	CA	90731	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17096	1601 KINGSDALE AVE	REDONDO BEACH	CA	90278	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09579	4570 ATLANTIC AVENUE	LONG BEACH	CA	90807	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16750	3600 ROSEMEAD BLVD	ROSEMEAD	CA	91770	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16043	5600 WHITTIER BLVD	COMMERCE	CA	90022	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09769	8580 WHITTIER BLVD.	PICO RIVERA	CA	90660	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09798	313 SOUTH GARFIELD AVENUE	MONTEREY PARK	CA	91754	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17119	20700 S AVALON BLVD STE 700	CARSON	CA	90746	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16049	1200 N SEPULVEDA BLVD	MANHATTAN BEACH	CA	90266	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09557	1250 E.PACIFIC COAST HIGHWAY	LONG BEACH	CA	90806	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 10022	1303 SEPULVEDA BLVD.	TORRANCE	CA	90501	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09617	2103 SOUTH ATLANTIC BOULEVARD	MONTEREY PARK	CA	91754	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09645	8225 GARVEY AVENUE	ROSEMEAD	CA	91770	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09791	2532 W. VALLEY BLVD.	ALHAMBRA	CA	91803	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17349	1621 S ALAMEDA ST	COMPTON	CA	90220	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09566	596 LONG BEACH BOULEVARD	LONG BEACH	CA	90802	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09594	901 S. CENTRAL AVENUE	COMPTON	CA	90220	10/01/2019
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09543	2001 PACIFIC COAST HIGHWAY	LOMITA	CA	90717	01/01/2020
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09665	5944 N FIGUEROA ST	LOS ANGELES	CA	90042	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 07079	2200 N. HARBOR BLVD. (NEC)	FULLERTON	CA	92835	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09501	2655 SANTA ANA STREET	SOUTH GATE	CA	90280	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16206	39440 10TH ST W	PALMDALE	CA	93551	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09510	15421 BROOKHURST STREET	WESTMINSTER	CA	92683	07/01/2020	06/21/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09141	3151 UNIVERSITY AVE.	SAN DIEGO	CA	92104	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16045	12100 HARBOR BLVD	GARDEN GROVE	CA	92840	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09576	10889 WELLWORTH AVENUE	LOS ANGELES	CA	90024	07/01/2020	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09568	4625 TORRANCE BOULEVARD	TORRANCE	CA	90503	01/01/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09610	12280 PERRIS BLVD	MORENO VALLEY	CA	92557	01/01/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09613	23357 MULHOLLAND DRIVE	WOODLAND HILLS	CA	91364	01/01/2021	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16046	13831 BROOKHURST ST	GARDEN GROVE	CA	92843	01/01/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08841	11623 ROSECRANS AVE.	NORWALK	CA	90650	01/01/2021	04/12/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #4019	5837 S. CENTRAL AVE.	LOS ANGELES	CA	90001	01/01/2021
CHC29048-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09580	5101 OBAMA BLVD	LOS ANGELES	CA	90016	01/01/2021	04/12/2021
CHC29048-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09513	1570 ROSECRANS AVE	MANHATTAN BEACH	CA	90266	10/01/2019
CHC29048-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09985	8900 SEPULVEDA WESTWAY	LOS ANGELES	CA	90045	10/01/2019
CHC29048-00	MCCARTHY PHARMACY INC	MCCARTHY DRUGS	12025 SAN VICENTE BLVD	LOS ANGELES	CA	90049	01/01/2017	04/30/2018
CHC29048-00	MCCARTHY PHARMACY INC	DBA FREEMAN MEDICAL PHARMACY	301 N PRAIRIE AVE STE 110	INGLEWOOD	CA	90301	01/01/2017	01/15/2019
CHC29048-00	MEDIMPACT DIRECT, LLC	8060 S KYRENE RD		TEMPE	AZ	85284-2109	07/01/2020	04/15/2021
CHC29048-00	NEW JERSEY CVS PHARMACY, L.L.C.	CVS PHARMACY # 16533	632 ROUTE 46 E	FAIRFIELD	NJ	07004	01/01/2021	04/12/2021
CHC29048-00	NOVIXUS PHARMACY SERVICES	43159 W 9 MILE RD.		NOVI	MI	48375-4117	07/01/2020	04/15/2021
CHC29048-00	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/01/2021
CHC29048-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	01/01/2021
CHC29048-00	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/01/2021
CHC29048-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/01/2021
CHC29048-00	RAMI INC	DBA AALPHA PHARMACY	174 S ALVARADO ST	LOS ANGELES	CA	90057-2211	07/01/2019
CHC29048-00	SOUTH GATE PHARMACY INC	8200 LONG BEACH BLVD UNIT D-2		SOUTH GATE	CA	90280	04/01/2023
CHC29048-01	THE MEDICINE CABINET	228 E ANAHEIM ST		WILMINGTON	CA	90744	07/01/2018
CHC29048-00	THE MEDICINE CABINET	228 E ANAHEIM ST		WILMINGTON	CA	90744	07/01/2018
CHC29048-02	THE MEDICINE CABINET	228 E ANAHEIM ST		WILMINGTON	CA	90744	01/01/2020
CHC29048-00	THE MEDICINE CABINET #5	7037 ATLANTIC AVE		BELL	CA	90201	04/01/2019
CHC29048-04	THE MEDICINE CABINET #5	7037 ATLANTIC AVE		BELL	CA	90201	01/01/2020
CHC29048-01	TOWERS PHARMACY INC	DBA TOWERS PHARMACY	5451 LA PALMA AVE STE 17	LA PALMA	CA	90623	01/01/2023
CHC29048-00	TOWERS PHARMACY INC	DBA TOWERS PHARMACY	5451 LA PALMA AVE STE 17	LA PALMA	CA	90623	04/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/26/2024 1:53:53 PM	2/24/2025 6:28:48 PM	2/24/2025 6:28 PM
Details	Last Recertification Date	Update	Recertification	1/30/2023 12:32:30 PM	2/26/2024 1:53:53 PM	2/26/2024 1:53 PM
Contacts	Authorizing Official	Update	AO Change Request	Summers, Shirley President/CEO Behavioral Health Services, Inc. 3106799126	Shook, Denise President/CEO Behavioral Health Services, Inc. 3106799126-1293	2/25/2024 7:47 AM
Details	Last Recertification Date	Update	Recertification	2/7/2022 5:43:07 PM	1/30/2023 12:32:30 PM	1/30/2023 12:32 PM
Contacts	Primary Contact	Update	PC Change Request	Ballue, Michael Director Family Health Services Behavioral Health Services, Inc. 3106799126	Venable, Michelle Director of Health Center Operations BHS- Family Health Center 3106799126-1233	10/18/2022 9:18 AM
Details	Last Recertification Date	Update	Recertification	2/2/2021 5:42:41 PM	2/7/2022 5:43:07 PM	2/7/2022 5:43 PM
Details	Last Recertification Date	Update	Recertification	2/3/2020 6:38:51 PM	2/2/2021 5:42:41 PM	2/2/2021 5:42 PM
Details	Last Recertification Date	Update	Recertification	2/11/2019 1:09:18 PM	2/3/2020 6:38:51 PM	2/3/2020 6:38 PM
Details	Last Recertification Date	Update	Recertification	2/9/2018 4:09:51 PM	2/11/2019 1:09:18 PM	2/11/2019 1:09 PM
Details	Last Recertification Date	Update	Recertification	1/27/2017 12:00:00 AM	2/9/2018 4:09:51 PM	2/9/2018 4:09 PM
Contacts	Primary Contact	Update	New Registration	Summers, Shirley Director Family Health Services Behavioral Health Services, Inc. 3106799126	Ballue, Michael Director Family Health Services Behavioral Health Services, Inc. 3106799126	1/3/2018 2:13 PM
Contacts	Primary Contact	Update	New Registration	Ballue, Michael Director Family Health Services 3106799126	Summers, Shirley Director Family Health Services Behavioral Health Services, Inc. 3106799126	10/16/2017 2:49 PM
Contacts	Authorizing Official	Update		Summers, Shirley President/CEO 3106799126	Summers, Shirley President/CEO Behavioral Health Services, Inc. 3106799126	10/16/2017 2:38 PM
Contacts	Signed By	Update		Summers, Shirley President/CEO 3106799126	Summers, Shirley President/CEO Behavioral Health Services, Inc. 3106799126	10/16/2017 2:38 PM
Contacts	Authorizing Official	Insert			Summers, Shirley President/CEO 3106799126	7/17/2017 1:41 PM
Contacts	Signed By	Insert			Summers, Shirley President/CEO 3106799126	7/17/2017 1:41 PM
Addresses	Main Address	Insert			2501 W. El Segundo Blvd. Suite B Hawthorne, CA 90250	1/27/2017 2:01 PM
Contacts	Primary Contact	Insert			Ballue, Michael Director Family Health Services 3106799126	1/27/2017 2:01 PM
Details	Last Recertification Date	Update			1/27/2017 12:00:00 AM	1/27/2017 2:01 PM
Dates	Participating Approval Date	Update			7/27/2016 12:00:00 AM	7/27/2016 1:47 PM
Details	State	Update		Pending	Active	7/27/2016 1:47 PM
Dates	Start Date	Update			10/1/2016 12:00:00 AM	7/27/2016 1:47 PM
Details	340B ID	Update		ONLINE_REG_71334	CHC29048-00	7/14/2016 11:00 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_71334	7/11/2016 2:26 PM
Details	Last Recertification Date	Insert				7/11/2016 2:26 PM
Details	Grant Number	Insert			H80CS29048	7/11/2016 2:26 PM
Details	340B ID	Insert			ONLINE_REG	7/11/2016 2:26 PM
Details	Is Authorizing Official EHB Data	Insert			False	7/11/2016 2:26 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/11/2016 2:26 PM
Details	Medicare Provider Number	Insert				7/11/2016 2:26 PM
Details	Entity Name	Insert			BEHAVIORAL HEALTH SERVICES INC	7/11/2016 2:26 PM
Details	Program Code	Insert			CH	7/11/2016 2:26 PM
Details	Entity Subname	Insert			Behavioral Health Services - Family Health Center	7/11/2016 2:26 PM
Dates	Participating Approval Date	Insert				7/11/2016 2:26 PM
Details	State	Insert			Pending	7/11/2016 2:26 PM
Dates	Registration Date	Insert			7/11/2016 12:00:00 AM	7/11/2016 2:26 PM
Dates	Signed By Date	Insert			7/11/2016 12:00:00 AM	7/11/2016 2:26 PM
Dates	Start Date	Insert				7/11/2016 2:26 PM
Terminations	Termination Comments	Insert				7/11/2016 2:26 PM
Terminations	Termination Date	Insert				7/11/2016 2:26 PM
Terminations	Termination Effective Date	Insert				7/11/2016 2:26 PM
Terminations	Termination Reason	Insert				7/11/2016 2:26 PM

340B Drug Pricing Program Database