340B Drug Pricing Program Database


CH09160W OMNI FAMILY HEALTH (Active) - information as of 5/3/2025 11:31:39 PM

Main Details
OMNI FAMILY HEALTH
Omni Family Health
HRSA-Funded Health Center
BPS-H80-016979
CH09160W
H80CS00615


Additional Details
Active
1/4/2017
4/1/2017
1/13/2017
2/11/2025

Contacts

Omni Family Health
Joseph Hayes, Chief medical officer
(661) 630-7039

Omni Family health
Peter Nabil Tawfik, Senior Director of Pharmacy
(661) 805-8397

Addresses

4151 Mexicali Dr
Bakersfield, CA 93313-2065

Omni Family Health
4900 California Ave
400B
Bakersfield, CA 93309


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

Yes
Shipping Addresses

Omni Family Health - Pharmacy
1701 Stine Rd
Bakersfield, CA 93309
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH091600ActiveBPS-H80-002979Omni Family HealthOmni Family Health277 East Front Street ButtonwillowCA
CH09160AAActiveBPS-H80-021278Omni Family HealthOmni Family Health355 Campus Drive, #E HanfordCA
CH09160ABActiveBPS-H80-021529Omni Family HealthOmni Family Health2505 Merced St FresnoCA
CH09160ACActiveBPS-H80-022203Omni Family HealthOmni Family Health3748 E Shields Ave FresnoCA
CH09160ADTerminatedBPS-H80-022202Omni Family HealthOmni Family Health1900 N Gateway Blvd Ste 116 FresnoCA
CH09160AEActiveBPS-H80-024745Omni Family HealthOmni Family Health4900 California Ave STE 100B BakersfieldCA
CH09160AFActiveBPS-H80-024715Omni Family HealthOmni Family Health6107 N 1st St FresnoCA
CH09160AGActiveBPS-H80-024647Omni Family HealthOmni Family Health311 W Noble Ave VisaliaCA
CH09160AHActiveBPS-H80-024642Omni Family HealthOmni Family Health860 Sequoia Ave LindsayCA
CH09160AJActiveBPS-H80-021038Omni Family HealthOmni Family Health912 Fremont St DelanoCA
CH09160AKActiveBPS-H80-024989Omni Family HealthOmni Family Health1701 Stine Rd BakersfieldCA
CH09160ALActiveBPS-H80-027601Omni Family HealthOmni Family Health4646 N 1st St FresnoCA
CH09160AMActiveBPS-H80-029807Omni Family HealthOmni Family Health2811 H St BakersfieldCA
CH09160ANActiveBPS-H80-029806Omni Family HealthOmni Family Health1451 White Ln BakersfieldCA
CH09160APActiveBPS-H80-028031Omni Family HealthOmni Family Health1110 W Visalia Rd Ste 102 ExeterCA
CH09160AQTerminatedBPS-H80-032869Omni Family HealthOmni Family Health141 S Mirage Ave LindsayCA
CH09160ARActiveBPS-H80-035524Omni Family HealthOmni Family Health - Mobile #14900 California Ave Ste 400B BakersfieldCA
CH09160ASActiveBPS-H80-034035Omni Family HealthOmni Family Health3800 Mall View Rd BakersfieldCA
CH09160ATActiveBPS-H80-036093Omni Family HealthOmni Family Health6700 Niles Street STE 185 BakersfieldCA
CH09160AUActiveBPS-H80-037502OMNI FAMILY HEALTHOmni Family Health6700 Niles Street STE 155 BakersfieldCA
CH09160AVActiveBPS-H80-037777OMNI FAMILY HEALTHOmni Family Health2107 7th St WascoCA
CH09160AWActiveBPS-H80-038399OMNI FAMILY HEALTHOmni Family Health667 S Central Valley Hwy ShafterCA
CH09160AXActiveBPS-H80-038603OMNI FAMILY HEALTHOmni Family Health1507 Panama Lane STE G101 BakersfieldCA
CH09160AYActiveBPS-H80-038192OMNI FAMILY HEALTHOmni Family Health1507 Panama Lane STE G100 BakersfieldCA
CH09160AZApprovedBPS-H80-039924OMNI FAMILY HEALTHOmni Family Health2688 Oswell St BakersfieldCA
CH09160BActiveBPS-H80-001133OMNI FAMILY HEALTHOmni Family Health21138 PASO ROBLES HWY LOST HILLSCA
CH09160CActiveBPS-H80-001563Omni Family HealthOmni Family Health2101 7th St WascoCA
CH09160DActiveBPS-H80-004758Omni Family HealthOmni Family Health1100 4th St TaftCA
CH09160GActiveBPS-H80-004337Omni Family HealthOmni Family Health1215 Jefferson St DelanoCA
CH09160IActiveBPS-H80-005432Omni Family HealthOmni Family Health655 S Central Valley Hwy ShafterCA
CH09160JActiveBPS-H80-000142Omni Family HealthOmni Family Health525 Roberts Ln BakersfieldCA
CH09160KTerminatedBPS-H80-004770Omni Family HealthOmni Family Health320 James St ShafterCA
CH09160LActiveBPS-H80-000343Omni Family HealthOmni Family Health3409 Calloway Dr UNIT 300 BakersfieldCA
CH09160MActiveBPS-H80-000301Omni Family HealthOmni Family Health161 N Mill St TehachapiCA
CH09160NActiveBPS-H80-009002Omni Family HealthOmni Family Health1133 N. Chelsea Street RidgecrestCA
CH09160PActiveBPS-H80-004251Omni Family HealthOmni Family Health1001 Main St DelanoCA
CH09160QActiveBPS-H80-009456Omni Family HealthOmni Family Health1014 Calloway Dr BLDG F BakersfieldCA
CH09160RActiveBPS-H80-011389OMNI FAMILY HEALTHOmni Family Health210 N Chester Ave BakersfieldCA
CH09160SActiveBPS-H80-013258OMNI FAMILY HEALTHOmni Family Health4131 Ming Ave BakersfieldCA
CH09160TActiveBPS-H80-012508OMNI FAMILY HEALTHOmni Family Health4600 Panama Lane STE 102B BakersfieldCA
CH09160UActiveBPS-H80-018186OMNI FAMILY HEALTHOmni Family Health1022 Calloway Dr BakersfieldCA
CH09160VActiveBPS-H80-017587OMNI FAMILY HEALTHOmni Family Health659 S Central Valley Hwy ShafterCA
CH09160WActiveBPS-H80-016979OMNI FAMILY HEALTHOmni Family Health4151 Mexicali Dr BakersfieldCA
CH09160XActiveBPS-H80-018932OMNI FAMILY HEALTHOmni Family Health925 G St ReedleyCA
CH09160YActiveBPS-H80-019349OMNI FAMILY HEALTHOmni Family Health4844 N 1st St Ste 104 FresnoCA
CH09160ZActiveBPS-H80-021360Omni Family HealthOmni Family Health1530 E Manning Ave ReedleyCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH091600CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361410/01/2023  
CH091600CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/01/2023  
CH091600CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621910/01/2023  
CH091600CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175710/01/2023  
CH091600CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808310/01/2023  
CH091600CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700410/01/2023  
CH091600CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761710/01/2023  
CH091600CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813310/01/2023  
CH091600CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237410/01/2023  
CH091600CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911910/01/2023  
CH091600COLE'S MEDICAL ARTS PHARMACY  1205 GARCES HWY
SUITE 107
DELANOCA9321501/01/2016 01/01/2016
CH091600CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/01/2022  
CH091600CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2022  
CH091600CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502810/01/2023  
CH091600CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2023  
CH091600EXPRESS DRUGSDBA EXPRESS PHARMACY #8 9902 BRIMHALL RD STE 100
BAKERSFIELDCA93312-280101/01/2016 01/01/2016
CH091600EXPRESS DRUGSDBA EXPRESS PHARMACY #8 9902 BRIMHALL RD STE 100
BAKERSFIELDCA93312-280107/01/2018 11/11/2019
CH091600EXPRESS DRUGS900 KERN ST STE A DBA EXPRESS PHARMACY 9
TAFTCA93268-276607/01/2018 11/11/2019
CH091600EXPRESS PHARMACYHANFORD EXPRESS PHARMACY 365 CAMPUS DR
HANFORDCA93230-437407/01/2018 11/11/2019
CH09160AAEXPRESS PHARMACY #39802 STOCKDALE HWY STE 106B
BAKERSFIELDCA93311-365307/01/2018  
CH091600EXPRESS PHARMACY #39802 STOCKDALE HWY STE 106B
BAKERSFIELDCA93311-365310/01/2019 11/11/2019
CH091600EXPRESS PHARMACY #4650 F ST
WASCOCA93280-201807/01/2018 11/11/2019
CH091600EXPRESS PHARMACY #73400 CALLOWAY DR SUITE 302
BAKERSFIELDCA9331207/01/2018 11/11/2019
CH091600GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10921 6601 STINE ROAD
BAKERSFIELDCA9331301/01/2018  
CH091600GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 4221 11300 MING AVE
BAKERSFIELDCA9331101/01/2018 07/31/2019
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05495 5184 STOCKDALE HWY.
BAKERSFIELDCA9330901/01/2018  
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 06772 4987 N. FRESNO ST.
FRESNOCA9372601/01/2020 11/04/2022
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08913 9628 ROSEDALE HWY.
BAKERSFIELDCA9331201/01/2020 08/01/2024
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 07001 6500 NILES STREET
BAKERSFIELDCA9330601/01/2020  
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05422 5180 E. KINGS CANYON ROAD
FRESNOCA9372701/01/2020  
CH091600GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 02768 6500 S. UNION AVE.
BAKERSFIELDCA9330707/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16084 3150 W SHAW AVE
FRESNOCA9371107/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 10813 8929 PANAMA RD SUITE B
LAMONTCA9324107/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17552 2901 MING AVE
BAKERSFIELDCA9330407/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16108 3173 E SHIELDS AVE
FRESNOCA9372607/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 10810 505 BEAR MOUNTAIN BLVD, SUITE B
ARVINCA9320307/01/2020 10/01/2020
CH091600GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17025 140 N 12TH AVE
HANFORDCA9323001/01/2022  
CH091600GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16723 9100 ROSEDALE HWY
BAKERSFIELDCA9331201/01/2022 11/04/2022
CH091600GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 4221 11300 MING AVE
BAKERSFIELDCA9331101/01/2022 11/04/2022
CH091600GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 4221 11300 MING AVE
BAKERSFIELDCA9331110/01/2024 01/25/2025
CH091600KOMOTO PHARMACYKOMOTO PHARMACY 1017 ELLINGTON ST
DELANOCA93215-262101/01/2019  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09204 3500 STINE RD
BAKERSFIELDCA9330901/01/2018 09/18/2023
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07553 3011 E SHIELDS AVE
FRESNOCA9372601/01/2020  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09377 1065 W MANNING AVE
REEDLEYCA9365401/01/2020  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09537 1325 W SHIELDS AVENUE
FRESNOCA9370501/01/2020  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09828 574 W LACEY BLVD
HANFORDCA9323001/01/2020 11/04/2022
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09129 1302 FULTON MALL
FRESNOCA9372101/01/2020 09/13/2022
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09900 2690 MOUNT VERNON AVE
BAKERSFIELDCA9330601/01/2020  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09149 6750 N CEDAR AVE
FRESNOCA9371007/01/2020 10/01/2020
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09500 1455 E NOBLE AVE
VISALIACA9329207/01/2020 10/01/2020
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09971 4077 W CLINTON AVE
FRESNOCA9372207/01/2020 10/01/2020
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09801 10 SHAW AVE
CLOVISCA9361207/01/2020 10/01/2020
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09975 4400 COFFEE RD
BAKERSFIELDCA9330801/01/2022  
CH091600LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09878 8200 STOCKDALE HWY STE G
BAKERSFIELDCA9331101/01/2022 04/24/2023
CH091600PREMIER PHARMACY SERVICES410 CLOVERLEAF DR
BALDWIN PARKCA9170601/01/2019  
CH091600PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514610/01/2023  
CH091600PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920310/01/2023  
CH091600PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523310/01/2023  
CH091600PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 1010 UNIVERSITY AVENUE
SAN DIEGOCA9210301/01/2025  
CH091600SHAFTER MEDICAL PHARMACY825 CENTRAL VALLEY HWY
SHAFTERCA93263-207807/01/2018 11/11/2019
CH091600THRIFTY PAYLESS INCRITE AID #6768 150 W KERN AVE
MC FARLANDCA9325001/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5807 2501 HIGHWAY 46
WASCOCA9328001/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #5794 1809 CECIL AVENUE
DELANOCA9321501/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #6303 3225 PANAMA LANE
BAKERSFIELDCA9331301/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #5800 1076 WEST KERN STREET
TAFTCA9326801/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #6302 150 EAST LERDO HIGHWAY
SHAFTERCA9326301/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #6294 2646 ALLEN ROAD
BAKERSFIELDCA9331401/01/2018  
CH091600THRIFTY PAYLESS, INC.RITE AID #5814 2505 MT VERNON AVENUE
BAKERSFIELDCA9330601/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #6451 1107 CALLOWAY DRIVE
BAKERSFIELDCA9331201/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5847 811 TUCKER ROAD
TEHACHAPICA9356101/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #6549 11200 OLIVE DRIVE
BAKERSFIELDCA9331201/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5816 715 AIRPORT DRIVE
BAKERSFIELDCA9330801/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5845 101 NORTH CHINA LAKE BLVD
RIDGECRESTCA9355501/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5798 262 NORTH HIGHWAY 65
LINDSAYCA9324701/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #6459 1735 E WALNUT AVENUE
VISALIACA9329201/01/2019 06/20/2019
CH091600THRIFTY PAYLESS, INC.RITE AID #5796 707 WEST LACEY BOULEVARD
HANFORDCA9323001/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5815 100 CHINA GRADE LOOP
BAKERSFIELDCA9330801/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #6295 1101 FRESNO STREET
FRESNOCA9370601/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #6366 6001 COFFEE ROAD
BAKERSFIELDCA9330801/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5809 1601 23RD STREET
BAKERSFIELDCA9330101/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5811 1425 SOUTH H STREET
BAKERSFIELDCA9330401/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5817 8000 WHITE LANE
BAKERSFIELDCA9330907/01/2019 12/04/2023
CH091600THRIFTY PAYLESS, INC.DBA RITE AID 6716 9700 PANAMA LANE
BAKERSFIELDCA9331107/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5858 1721 EAST MANNING AVENUE
REEDLEYCA9365410/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5862 1210 NORTH BLACKSTONE AVENUE
FRESNOCA9370310/01/2019  
CH091600THRIFTY PAYLESS, INC.RITE AID #5837 9482 CALIFORNIA CITY BOULEVARD
CALIFORNIA CITYCA9350510/01/2019  
CH091600WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2019  
CH091600WAL-MART PHARMACY 10-15746225 COLONY STREET
BAKERSFIELDCA9330701/01/2018  
CH091600WAL-MART PHARMACY 10-1600201 EAST BOWMAN RD.
RIDGECRESTCA9355501/01/2018  
CH091600WAL-MART PHARMACY 10-1645250 S 12TH AVE
HANFORDCA9323001/01/2019  
CH091600WAL-MART PHARMACY 10-20015125 EAST KINGS CANYON
FRESNOCA9372701/01/2019  
CH091600WAL-MART PHARMACY 10-25578400 ROSEDALE HWY.
BAKERSFIELD (NW)CA9331201/01/2018  
CH091600WAL-MART PHARMACY 10-42382761 JENSEN AVE
SANGERCA9365701/01/2019  
CH091600WAL-MART PHARMACY 10-51345075 GOSFORD ROAD
BAKERSFIELDCA9331301/01/2018  
CH091600WAL-MART PHARMACY 10-5215530 WOOLLOMES AVE
DELANOCA9321501/01/2018  
CH091600WAL-MART PHARMACY 10-5394770 WEST EL MONTE WAY
DINUBACA9361801/01/2018  
CH091600WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2019  
CH091600WALGREEN CODBA: WALGREENS #09702 5785 N FIRST ST
FRESNOCA93710-620307/01/2017 05/31/2018
CH091600WALGREEN CODBA: WALGREENS #10243 2420 N BLACKSTONE AVE
FRESNOCA93703-174707/01/2017 01/25/2025
CH091600WALGREEN CO.DBA: WALGREENS # 01816 3301 PANAMA LANE
BAKERSFIELDCA93313-363110/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 03222 40 CHESTER AVENUE
BAKERSFIELDCA9330110/24/2012 04/04/2023
CH091600WALGREEN CO.DBA: WALGREENS # 03272 3315 SOUTH H STREET
BAKERSFIELDCA9330410/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 03282 3815 NILES STREET
BAKERSFIELDCA9330610/24/2012 07/01/2015
CH091600WALGREEN CO.DBA: WALGREENS # 03294 2628 MOUNT VERNON AVENUE
BAKERSFIELDCA9330610/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 06526 9550 HAGEMAN ROAD
BAKERSFIELDCA9331210/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 06756 4306 MING AVE
BAKERSFIELDCA93309-480210/24/2012 01/28/2025
CH091600WALGREEN CO.DBA: WALGREENS # 07555 1101 W TEHACHAPI BLVD
TEHACHAPICA9356110/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 07909 4949 GOSFORD ROAD
BAKERSFIELDCA93313-499210/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS # 09030 101 W DRUMMOND AVE
RIDGECRESTCA9355510/24/2012  
CH091600WALGREEN CO.DBA WALGREENS #10827 1435 HIGH ST.
DELANOCA9321510/24/2012  
CH091600WALGREEN CO.DBA: WALGREENS #11532 3300 BUENA VISTA RD BLDG A
BAKERSFIELDCA9331110/24/2012  
CH091600WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16382 2323 16TH ST STE 100
BAKERSFIELDCA9330101/01/2016  
CH091600WALGREEN CO.DBA: WALGREENS # 02702 1344 W CLINTON AVE
FRESNOCA9370504/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS #12298 852 E MANNING AVE
REEDLEYCA9365404/01/2017 03/19/2025
CH091600WALGREEN CO.DBA: WALGREENS # 10201 170 W EL MONTE WAY
DINUBACA93618-156104/01/2017 03/19/2025
CH091600WALGREEN CO.DBA: WALGREENS # 09815 988 SIERRA STREET
KINGSBURGCA9363104/01/2017  
CH091600WALGREEN CO.DBA: WALGREENS #12337 2795 FLORAL AVE
SELMACA93662-260304/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS #12282 2589 JENSEN AVE
SANGERCA9365704/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS # 06082 626 S CLOVIS AVE
FRESNOCA9372704/01/2017 05/31/2018
CH091600WALGREEN CO.DBA WALGREENS #06386 4810 E CESAR CHAVEZ BLVD
FRESNOCA9372704/01/2017  
CH091600WALGREEN CO.DBA: WALGREENS # 10334 1790 SHAW AVE
CLOVISCA9361104/01/2017  
CH091600WALGREEN CO.DBA: WALGREENS # 12707 4172 N. 1ST STREET
FRESNOCA9372607/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS # 13871 1016 W SHAW AVE
FRESNOCA9371107/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS # 09655 6885 N WILLOW AVENUE
FRESNOCA9371007/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS # 07830 205 W SHAW AVENUE
CLOVISCA93612-360207/01/2017 05/31/2018
CH091600WALGREEN CO.DBA: WALGREENS # 05847 610 E NEES AVENUE
FRESNOCA9372007/01/2017  
CH091600WALGREEN CO.DBA: WALGREENS # 05411 710 W GRANGEVILLE BLVD
HANFORDCA9323001/01/2018  
CH091600WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2023  
CH091600WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2023  
CH091600WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2023  
CH091600WALMART PHARMACY 10-31385625 CALLOWAY DRIVE
BAKERSFIELDCA9331201/01/2019  
CH091600WALMART PHARMACY 10-31403111 NORTH CHESTER
BAKERSFIELDCA9330801/01/2018  
CH091600WALMART PHARMACY 10-5859401 N. CENTRAL AVENUE
WASCOCA9328001/01/2018  
CH091600ZOHA'S PHARMACY5458 CALIFORNIA AVE
BAKERSFIELDCA93309-161801/01/2016 01/01/2016
CH091600ZOHA'S PHARMACY5458 CALIFORNIA AVE
BAKERSFIELDCA93309-161807/01/2018 02/24/2019
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/29/2024 5:54:00 PM2/11/2025 8:26:17 PM2/11/2025 8:26 PM
ContactsPrimary ContactUpdateProfile Change RequestTawfik, Peter Nabil Pharmacy Director Omni Family health 6618058397Tawfik, Peter Nabil Senior Director of Pharmacy Omni Family health 66180583972/19/2024 12:17 PM
DetailsLast Recertification DateUpdateRecertification1/31/2023 5:25:33 PM1/29/2024 5:54:00 PM1/29/2024 5:54 PM
DetailsLast Recertification DateUpdateRecertification1/31/2022 1:09:31 PM1/31/2023 5:25:33 PM1/31/2023 5:25 PM
DetailsLast Recertification DateUpdateRecertification2/10/2021 3:20:30 PM1/31/2022 1:09:31 PM1/31/2022 1:09 PM
AddressesShipping AddressUpdateChange RequestOmni Family Health- Pharmacy 4600 panama lane STE 102b Bakersfield, CA 93313Omni Family Health - Pharmacy 1701 Stine Rd Bakersfield, CA 933091/31/2022 12:38 PM
AddressesBilling AddressUpdateChange RequestOmni Family Health 4900 California Ave. STE 400B Bakersfield, CA 93309Omni Family Health 4900 California Ave 400B Bakersfield, CA 933091/31/2022 12:38 PM
Medicaid BillingNPI: StateUpdateRecertification CA2/10/2021 3:20 PM
DetailsLast Recertification DateUpdateRecertification2/3/2020 11:48:02 AM2/10/2021 3:20:30 PM2/10/2021 3:20 PM
AddressesShipping AddressDeleteRecertificationOmni Family Health - Pharmacy 210 N. Chester Ave. Shafter, CA 93308 2/3/2020 11:48 AM
AddressesShipping AddressInsertRecertification Omni Family Health- Pharmacy 4600 panama lane STE 102b Bakersfield, CA 933132/3/2020 11:48 AM
AddressesMain AddressUpdateRecertification 4151 Mexicali Drive Bakersfield, CA 93313-9331 4151 Mexicali Dr Bakersfield, CA 93313-20652/3/2020 11:48 AM
DetailsLast Recertification DateUpdateRecertification2/1/2019 1:31:23 PM2/3/2020 11:48:02 AM2/3/2020 11:48 AM
DetailsLast Recertification DateUpdateRecertification2/9/2018 4:57:39 PM2/1/2019 1:31:23 PM2/1/2019 1:31 PM
ContactsAuthorizing OfficialUpdateAO Change RequestMartinez, Diego Chief Operations Officer Omni Family health 6616307030Hayes, Joseph Chief medical officer Omni Family Health 66163070391/31/2019 8:04 AM
AddressesShipping AddressInsertChange Request Omni Family Health - Pharmacy 210 N. Chester Ave. Shafter, CA 933084/24/2018 2:21 PM
AddressesShipping AddressDeleteChange RequestOmni Family Health - Pharmacy 655 S Central Valley Hwy Shafter, CA 93263 4/24/2018 2:21 PM
DetailsLast Recertification DateUpdateRecertification 2/9/2018 4:57:39 PM2/9/2018 4:57 PM
ContactsPrimary ContactInsertChange Request Tawfik, Peter Nabil Pharmacy Director Omni Family health 661805839710/3/2017 1:58 PM
DetailsIs Authorizing Official EHB DataUpdateChange RequestFalse 10/3/2017 1:58 PM
ContactsAuthorizing OfficialUpdate Martinez, Diego Chief Operations Officer 6616307030Martinez, Diego Chief Operations Officer Omni Family health 661630703010/2/2017 12:46 PM
ContactsSigned ByUpdate Martinez, Diego Chief Operations Officer 6616307030Martinez, Diego Chief Operations Officer Omni Family health 661630703010/2/2017 12:46 PM
ContactsAuthorizing OfficialInsert  Martinez, Diego Chief Operations Officer 66163070305/1/2017 5:58 PM
ContactsSigned ByInsert  Martinez, Diego Chief Operations Officer 66163070305/1/2017 5:58 PM
AddressesMain AddressInsert   4151 Mexicali Drive Bakersfield, CA 93313-93313/16/2017 11:33 AM
AddressesBilling AddressInsert  Omni Family Health 4900 California Ave. STE 400B Bakersfield, CA 933091/13/2017 5:53 PM
AddressesShipping AddressInsert  Omni Family Health - Pharmacy 655 S Central Valley Hwy Shafter, CA 932631/13/2017 5:53 PM
DatesParticipating Approval DateUpdate  1/13/2017 12:00:00 AM1/13/2017 5:53 PM
DetailsStateUpdate PendingActive1/13/2017 5:53 PM
DatesStart DateUpdate  4/1/2017 12:00:00 AM1/13/2017 5:53 PM
Details340B IDUpdate ONLINE_REG_73762CH09160W1/12/2017 10:21 AM
Details340B IDUpdate ONLINE_REGONLINE_REG_737621/4/2017 5:28 PM
Medicaid BillingNPI: NumberInsert  10739973261/4/2017 5:28 PM
DetailsLast Recertification DateInsert   1/4/2017 5:28 PM
DetailsGrant NumberInsert  H80CS006151/4/2017 5:28 PM
Details340B IDInsert  ONLINE_REG1/4/2017 5:28 PM
DetailsIs Authorizing Official EHB DataInsert  False1/4/2017 5:28 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/4/2017 5:28 PM
DetailsMedicare Provider NumberInsert   1/4/2017 5:28 PM
DetailsEntity NameInsert  OMNI FAMILY HEALTH1/4/2017 5:28 PM
DetailsProgram CodeInsert  CH1/4/2017 5:28 PM
DetailsEntity SubnameInsert  Omni Family Health1/4/2017 5:28 PM
DatesParticipating Approval DateInsert   1/4/2017 5:28 PM
DetailsStateInsert  Pending1/4/2017 5:28 PM
DatesRegistration DateInsert  1/4/2017 12:00:00 AM1/4/2017 5:28 PM
DatesSigned By DateInsert  1/4/2017 12:00:00 AM1/4/2017 5:28 PM
DatesStart DateInsert   1/4/2017 5:28 PM
TerminationsTermination CommentsInsert   1/4/2017 5:28 PM
TerminationsTermination DateInsert   1/4/2017 5:28 PM
TerminationsTermination Effective DateInsert   1/4/2017 5:28 PM
TerminationsTermination ReasonInsert   1/4/2017 5:28 PM