Covered Entity Details

CH02016B SYRACUSE COMMUNITY HEALTH CENTER, INC. (Active) - information as of 6/5/2025 2:39:46 PM

Main Details

Name

SYRACUSE COMMUNITY HEALTH CENTER, INC.

Subdivision Name

SCHC - EAST HEALTH CENTER

Type

HRSA-Funded Health Center

Site ID

BPS-H80-003830

340B ID

CH02016B

Grant Number

H80CS00434

Additional Details

Current Program Status

Active

Registration Date

4/11/2017

Participating Start Date

7/1/2017

Participating Approval Date

4/24/2017

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Syracuse Community Health Center
Ofrona Reid, President & CEO
(315) 476-7921

Primary Contact

Syracuse Community Health Center
Kerri Devere Warner, Director of Revenue Cycle Management
(315) 476-7921 Ext: 2357

Addresses

Street Address

1938 E Fayette St
Syracuse, NY 13210-1339

Billing Address

Syracuse Community Health Center
819 South Salina Street
Syracuse, NY 13202

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
NY	03003876,00474204	1497796353,1184886988

Shipping Addresses

Shipping Address 1

Syracuse Community Health Center
819 S Salina Street
Syracuse, NY 13202

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
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	07/15/2019	10/01/2019		08/25/2019	08/25/2019
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/14/2020	04/01/2020		01/20/2021	02/25/2021
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/14/2020	04/01/2020		01/20/2021	02/25/2021
Contract Detail	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	07/12/2019	10/01/2019	10/01/2019	06/21/2022	02/26/2024
Contract Detail	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	07/12/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	07/12/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	07/15/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	07/15/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	07/15/2019	10/01/2019	10/01/2019	07/23/2021	02/26/2024
Contract Detail	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	07/15/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/15/2019	01/01/2020			01/01/2020
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/15/2019	01/01/2020			01/01/2020
Contract Detail	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	07/15/2019	10/01/2019		08/25/2019	08/25/2019
Contract Detail	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	01/14/2020	04/01/2020		01/20/2021	02/25/2021
Contract Detail	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	04/15/2019	07/01/2019		08/25/2019	08/25/2019
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	07/15/2019	10/01/2019		08/25/2019	08/25/2019
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	01/14/2020	04/01/2020		01/20/2021	02/25/2021
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	07/15/2019	10/01/2019		08/25/2019	08/25/2019
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	01/14/2020	04/01/2020		01/20/2021	02/25/2021
Contract Detail	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	04/15/2019	07/01/2019		08/25/2019	08/25/2019
Contract Detail	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	04/15/2019	07/01/2019		08/25/2019	08/25/2019
Contract Detail	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	04/15/2019	07/01/2019		08/25/2019	08/25/2019
Contract Detail	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	04/15/2019	07/01/2019		04/15/2019	04/15/2019
Contract Detail	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	04/15/2019	07/01/2019	07/01/2019	02/18/2021	02/25/2021
Contract Detail	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	07/11/2019	10/01/2019	10/01/2019		10/01/2019
Contract Detail	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	04/15/2019	07/01/2019	10/01/2019	02/06/2023	02/26/2024
Contract Detail	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	07/15/2019	10/01/2019			10/01/2019
Contract Detail	WALGREEN EASTERN CO., INC	WALGREENS #19977	104 GENESEE ST	ONEIDA	NY	13421	07/15/2020	10/01/2020			10/01/2020
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	07/15/2019	10/01/2019			10/01/2019
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS 17213	423 S PETERBORO ST	CANASTOTA	NY	13032	07/15/2020	10/01/2020		11/09/2022	02/26/2024
Contract Detail	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	04/15/2019	07/01/2019	10/01/2019		09/30/2019

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH020160	Active	BPS-H80-001414	SYRACUSE COMMUNITY HEALTH CENTER, INC.	SYRACUSE COMMUNITY HEALTH CENTER, INC.	819 S Salina St	Syracuse	NY
CH02016A	Active	BPS-H80-000613	SYRACUSE COMMUNITY HEALTH CENTER, INC.	DELAWARE ELEMENTARY SBHC	900 S Geddes St	Syracuse	NY
CH02016B	Active	BPS-H80-003830	SYRACUSE COMMUNITY HEALTH CENTER, INC.	SCHC - EAST HEALTH CENTER	1938 E Fayette St	Syracuse	NY
CH02016C	Active	BPS-H80-000922	SYRACUSE COMMUNITY HEALTH CENTER, INC.	SCHC WEST HEALTH CENTER	603 Oswego St	Syracuse	NY
CH02016D	Active	BPS-H80-013610	SYRACUSE COMMUNITY HEALTH CENTER, INC.	HW Smith	1130 Salt Springs Rd	Syracuse	NY
CH02016E	Active	BPS-H80-013558	SYRACUSE COMMUNITY HEALTH CENTER, INC.	Grant Middle School	2400 Grant Blvd.	Syracuse	NY
CH02016F	Active	BPS-H80-013557	SYRACUSE COMMUNITY HEALTH CENTER, INC.	Westside Academy at Blodgett 312 Oswego Street	312 Oswego Street	Syracuse	NY
CH02016G	Active	BPS-H80-013556	SYRACUSE COMMUNITY HEALTH CENTER, INC.	Franklin Elementary School	428 S Alvord St	Syracuse	NY
CH02016H	Active	BPS-H80-003784	SYRACUSE COMMUNITY HEALTH CENTER, INC.	DR. WEEKS ELEMENTARY SBHC	710 HAWLEY AVE	SYRACUSE	NY
CH02016J	Terminated	BPS-H80-006364	SYRACUSE COMMUNITY HEALTH CENTER, INC.	SCHC SOUTH SITE	1701 SOUTH AVE	SYRACUSE	NY
CH02016K	Active	BPS-H80-002296	SYRACUSE COMMUNITY HEALTH CENTER, INC.	FOWLER HIGH SCHOOL SBHC	227 Magnolia St	Syracuse	NY
CH02016L	Active	BPS-H80-001273	SYRACUSE COMMUNITY HEALTH CENTER, INC.	DR. KING ELEMENTARY SBHC	416 E RAYNOR AVE	SYRACUSE	NY
CH02016M	Active	BPS-H80-030940	SYRACUSE COMMUNITY HEALTH CENTER, INC.	Onondaga Community College	4585 W Seneca Tpke	Syracuse	NY
CH02016N	Terminated	BPS-H80-030700	SYRACUSE COMMUNITY HEALTH CENTER, INC.	Temporary Site - Catholic Charities Mens Shelter	1074 S Clinton St	Syracuse	NY
CH02016P	Active	BPS-H80-038431	SYRACUSE COMMUNITY HEALTH CENTER INC	SCHC - 930 South Salina St.	930 South Salina St. BLDG 930	Syracuse	NY

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Carve-In Effective Date	Termination Date
CH020160	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	10/01/2017		04/05/2018
CH020160	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016D	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016G	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016E	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016J	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016K	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016A	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016B	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016C	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016F	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016H	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2019		08/25/2019
CH02016C	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2020		01/20/2021
CH02016B	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2020		01/20/2021
CH02016B	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2020		01/20/2021
CH02016C	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2020		01/20/2021
CH020160	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2020		01/20/2021
CH020160	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2020		01/20/2021
CH02016M	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	10/01/2020		01/20/2021
CH02016M	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	10/01/2020		01/20/2021
CH020160	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	10/01/2019	10/01/2019
CH020160	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH020160	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	10/01/2019	10/01/2019
CH02016G	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016F	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016J	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019	01/01/2022
CH020160	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	10/01/2019	10/01/2019
CH02016K	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016D	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH020160	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	10/01/2019	10/01/2019
CH02016E	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016L	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016D	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016A	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016G	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016J	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	01/01/2022
CH02016K	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016F	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016B	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016E	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016B	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016L	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH020160	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH02016A	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019	10/01/2019
CH020160	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	10/01/2019	10/01/2019	07/23/2021
CH02016C	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	10/01/2019	10/01/2019
CH02016B	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	10/01/2019	10/01/2019
CH02016F	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	10/01/2019	10/01/2019
CH02016H	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	10/01/2019	10/01/2019
CH02016B	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	10/01/2019	10/01/2019
CH02016B	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	10/01/2019	10/01/2019
CH02016C	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2019	10/01/2019	06/21/2022
CH02016C	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	10/01/2019	10/01/2019	07/23/2021
CH02016B	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	10/01/2019	10/01/2019	07/23/2021
CH02016B	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	10/01/2019	10/01/2019
CH02016C	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	10/01/2019	10/01/2019
CH02016C	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	10/01/2019	10/01/2019
CH02016C	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	10/01/2019	10/01/2019
CH02016C	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2019
CH02016D	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016E	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016A	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016A	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016E	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016A	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016D	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016F	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016D	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016D	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016A	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016E	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016F	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016D	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016F	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016E	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016F	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016E	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016A	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016H	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016L	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016G	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016G	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016G	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016K	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016H	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	01/01/2020		06/21/2022
CH02016H	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016L	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016J	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020		01/01/2022
CH02016K	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020
CH02016J	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	01/01/2020		01/01/2022
CH02016J	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		01/01/2022
CH02016J	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020		01/01/2022
CH02016K	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016K	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016H	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	01/01/2020
CH02016G	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016H	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016L	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	01/01/2020
CH02016J	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020		01/01/2022
CH02016L	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	01/01/2020
CH02016G	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016L	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	01/01/2020
CH02016H	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016K	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	01/01/2020		07/23/2021
CH02016M	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16807	3857 STATE ROUTE 31	LIVERPOOL	NY	13090	10/01/2020
CH02016M	CVS ALBANY, L.L.C.	CVS/PHARMACY # 17365	8061 BREWERTON RD	CICERO	NY	13039	10/01/2020
CH02016M	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 05024	27 FENNELL ST.	SKANEATELES	NY	13152	10/01/2020
CH02016M	CVS ALBANY, L.L.C.	CVS PHARMACY # 17390	3657 W GENESEE ST	SYRACUSE	NY	13219	10/01/2020
CH02016M	CVS ALBANY, L.L.C.	DBA CVS/PHARMACY #11238	300 GIFFORD ST.	SYRACUSE	NY	13204	10/01/2020		06/21/2023
CH02016M	CVS ALBANY, L.L.C.	DBA: CVS/PHARMACY # 07617	312 FAYETTE STREET	MANLIUS	NY	13104	10/01/2020
CH02016M	CVS ALBANY, L.L.C.	CVS/PHARMACY # 16808	340 TOWNE DR	FAYETTEVILLE	NY	13066	10/01/2020		07/23/2021
CH020160	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016C	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016A	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016B	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016D	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016F	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016L	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016H	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016E	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016K	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016G	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020
CH02016J	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2020		01/01/2022
CH02016M	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/01/2020
CH02016C	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH020160	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016B	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016E	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016A	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016K	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016G	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016H	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016F	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016J	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020		01/01/2022
CH02016D	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016L	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2020
CH02016M	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/01/2020
CH020160	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2022
CH020160	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	10/01/2017		04/05/2018
CH020160	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016B	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016A	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016C	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016D	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016F	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016H	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016E	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016J	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016K	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH02016L	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2019		08/25/2019
CH020160	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/01/2020		01/20/2021
CH02016B	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/01/2020		01/20/2021
CH02016C	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/01/2020		01/20/2021
CH02016M	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	10/01/2020		01/20/2021
CH020160	ECKERD CORPORATION	RITE AID #10766	4751 ONONDAGA BLVD.	SYRACUSE	NY	13219	07/01/2017		04/05/2018
CH020160	ECKERD CORPORATION	RITE AID #10756	1820 TEALL AVE	SYRACUSE	NY	13206	04/01/2020
CH020160	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS AT THE SYRACUSE COMMUNITY H	819 SOUTH SALINA STREET	SYRACUSE	NY	13202	03/09/2009		08/25/2019
CH020160	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #85	104 LAFAYETTE ROAD	SYRACUSE	NY	13205	07/01/2018
CH020160	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #87	406 BUTTERNUT STREET	SYRACUSE	NY	13208	07/01/2018
CH020160	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	10/01/2024
CH020160	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2018	10/01/2018	08/13/2019
CH02016B	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016A	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016D	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016C	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016F	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016G	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016E	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016F	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016H	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016H	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016K	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH02016L	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	07/01/2019		08/25/2019
CH020160	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	07/01/2022		10/01/2022
CH020160	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016A	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016B	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016C	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016D	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016E	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016H	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016G	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016J	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016K	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016L	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2019		08/25/2019
CH02016C	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2020		01/20/2021
CH02016B	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2020		01/20/2021
CH020160	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2020		01/20/2021
CH02016M	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	10/01/2020		01/20/2021
CH020160	RITE AID OF NEW YORK, INC.	RITE AID #636	519 BUTTERNUT STREET	SYRACUSE	NY	13208	07/01/2017
CH020160	RITE AID OF NEW YORK, INC.	RITE AID #631	4001 SOUTH SALINA STREET	SYRACUSE	NY	13205	07/01/2017		04/05/2018
CH020160	RITE AID OF NEW YORK, INC.	RITE AID #3623	522 W. ONONDAGA ST.	SYRACUSE	NY	13204	07/01/2017		04/05/2018
CH020160	RITE AID OF NEW YORK, INC.	RITE AID #632	1405 EAST GENESEE STREET	SYRACUSE	NY	13210	07/01/2017		04/05/2018
CH020160	RITE AID OF NEW YORK, INC.	RITE AID #546	301 SOUTH SALINA STREET	SYRACUSE	NY	13202	07/01/2017		04/05/2018
CH020160	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016A	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016C	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016B	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016D	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016E	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016G	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016F	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016H	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016J	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016L	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH02016K	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2019		08/25/2019
CH020160	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2020		01/20/2021
CH02016B	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2020		01/20/2021
CH02016C	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2020		01/20/2021
CH02016M	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	10/01/2020		01/20/2021
CH020160	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2018	10/01/2018	08/13/2019
CH020160	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2018	10/01/2018	08/13/2019
CH02016A	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016A	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016B	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016C	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016C	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016D	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016D	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016F	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016H	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016H	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016E	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016F	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016F	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016F	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016E	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016G	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016G	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016K	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016K	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016L	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016L	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	07/01/2019		08/25/2019
CH02016B	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH02016G	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	07/01/2019		08/25/2019
CH020160	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2018	10/01/2018	08/13/2019
CH02016A	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016B	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016B	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		04/15/2019
CH02016D	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016C	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016F	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016E	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016G	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016F	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016H	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016H	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016L	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH02016K	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	07/01/2019		08/25/2019
CH020160	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	04/01/2019		02/15/2019
CH020160	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016A	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016B	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016C	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016D	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016F	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019		02/18/2021
CH02016F	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016E	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016G	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016H	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016L	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016K	STATE UNIVERSITY OF NEW YORK	OUTPATIENT PHARMACY	750 E ADAMS ST LOBBY	SYRACUSE	NY	13210	07/01/2019	07/01/2019	02/18/2021
CH02016F	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016B	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016K	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016D	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016C	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016L	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016G	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016A	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016E	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH02016J	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019	01/01/2022
CH02016H	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	10/01/2019	10/01/2019
CH020160	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	09/01/2019	10/01/2019
CH02016M	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	08/20/2020
CH02016N	SYRACUSE COMMUNITY HEALTH PHARMACY LLC	819 S SALINA ST STE B		SYRACUSE	NY	13202-3527	09/03/2020		04/01/2024
CH020160	TOPS MARKETS	700 FIRST NORTH STREET		SYRACUSE	NY	13208	10/01/2021
CH020160	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	10/01/2018	10/01/2018	02/06/2023
CH02016A	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016B	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016C	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016D	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016F	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016G	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016G	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019		02/06/2023
CH02016E	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016H	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016F	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019		02/06/2023
CH02016L	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016K	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	07/01/2019	10/01/2019	02/06/2023
CH02016J	TRILLIUM HEALTH, INC.	TRILLIUM HEALTH PHARMACY	259 MONROE AVE LOWER LEVEL	ROCHESTER	NY	14607-3632	01/01/2020		01/01/2022
CH020160	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2020		06/18/2021
CH020160	WAL-MART PHARMACY 10-2166	6438 BASILE ROWE		EAST SYRACUSE	NY	13057	01/01/2020		06/18/2021
CH020160	WAL-MART PHARMACY 10-2581	5399 WEST GENESEE STREET		CAMILLUS	NY	13031	01/01/2020		06/18/2021
CH020160	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2020		06/18/2021
CH020160	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	07/01/2019
CH020160	WALGREEN EASTERN CO., INC	WALGREENS	114 N MAIN ST	NORTH SYRACUSE	NY	13212	07/01/2019		11/10/2022
CH02016J	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019		01/01/2022
CH02016A	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016K	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016L	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016H	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016F	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016B	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH02016G	WALGREEN EASTERN CO., INC	WALGREENS #19542	7398 OSWEGO RD	LIVERPOOL	NY	13090	10/01/2019
CH020160	WALGREEN EASTERN CO., INC	WALGREENS #19049	2616 BREWERTON RD	MATTYDALE	NY	13211	01/01/2020		04/03/2024
CH02016C	WALGREEN EASTERN CO., INC	WALGREENS #19977	104 GENESEE ST	ONEIDA	NY	13421	10/01/2020
CH020160	WALGREEN EASTERN CO., INC	WALGREENS #19977	104 GENESEE ST	ONEIDA	NY	13421	10/01/2020
CH02016B	WALGREEN EASTERN CO., INC	WALGREENS #19977	104 GENESEE ST	ONEIDA	NY	13421	10/01/2020
CH020160	WALGREEN EASTERN CO., INC.	RITE AID #00546	301 S SALINA ST	SYRACUSE	NY	13202	04/13/2018		08/09/2019
CH020160	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #19377	4001 S SALINA ST	SYRACUSE	NY	13205	04/13/2018		01/27/2025
CH020160	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #19549	4751 ONONDAGA BLVD	SYRACUSE	NY	13219	04/13/2018
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS	1405 E GENESEE ST	SYRACUSE	NY	13210	04/13/2018		05/02/2023
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS	522 W ONONDAGA ST	SYRACUSE	NY	13204	04/13/2018		02/22/2022
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS	401 W SENECA TPKE	SYRACUSE	NY	13207	07/01/2019		11/10/2021
CH020160	WALGREEN EASTERN CO., INC.	RITE AID #04297	1900 GRANT BLVD	SYRACUSE	NY	13208-3022	07/01/2019		06/12/2019
CH020160	WALGREEN EASTERN CO., INC.	RITE AID #03424	300 W MANLIUS ST	EAST SYRACUSE	NY	13057	07/01/2019		02/10/2020
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS #19145	5942 SOUTH SALINA STREET	SYRACUSE	NY	13205-3326	07/01/2019
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS	1819 W GENESEE ST	SYRACUSE	NY	13204	07/01/2019
CH02016A	WALGREEN EASTERN CO., INC.	RITE AID #04297	1900 GRANT BLVD	SYRACUSE	NY	13208-3022	07/01/2019		06/12/2019
CH02016D	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016G	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016L	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016B	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016H	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016C	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016F	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016A	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016E	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016K	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH02016J	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019		01/01/2022
CH020160	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	2329 JAMES ST.	SYRACUSE	NY	13206	10/01/2019
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS #19349	602 NOTTINGHAM RD	SYRACUSE	NY	13224	01/01/2020
CH02016B	WALGREEN EASTERN CO., INC.	WALGREENS 17213	423 S PETERBORO ST	CANASTOTA	NY	13032	10/01/2020		11/09/2022
CH02016C	WALGREEN EASTERN CO., INC.	WALGREENS 17213	423 S PETERBORO ST	CANASTOTA	NY	13032	10/01/2020		11/09/2022
CH020160	WALGREEN EASTERN CO., INC.	WALGREENS 17213	423 S PETERBORO ST	CANASTOTA	NY	13032	10/01/2020		11/09/2022
CH020160	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2022
CH020160	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2022		11/05/2021
CH020160	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2022
CH020160	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	04/01/2019	04/01/2019
CH02016A	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016B	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016C	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016D	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016G	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016E	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016F	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016H	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016F	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019		02/27/2025
CH02016K	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016L	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	07/01/2019	10/01/2019
CH02016J	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	01/01/2020		01/01/2022
CH02016M	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	08/20/2020
CH02016N	WESTSIDE FAMILY PHARMACY LLC	216 SEYMOUR ST		SYRACUSE	NY	13204-3208	09/03/2020		04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Reid, Ofrona Interim CEO Syracuse Community Health Center 3154767921	Reid, Ofrona President & CEO Syracuse Community Health Center 3154767921	2/25/2025 3:22 PM
Contacts	Primary Contact	Update	Profile Change Request	Warner, Kerri Devere 340B Program Manager Syracuse Community Health Center 3154767921-2357	Warner, Kerri Devere Director of Revenue Cycle Management Syracuse Community Health Center 3154767921-2357	2/24/2025 6:58 PM
Details	Last Recertification Date	Update	Recertification	2/26/2024 3:53:20 PM	2/10/2025 12:16:26 PM	2/10/2025 12:16 PM
Details	Last Recertification Date	Update	Recertification	2/24/2023 1:46:56 PM	2/26/2024 3:53:20 PM	2/26/2024 3:53 PM
Contacts	Authorizing Official	Update	AO Change Request	Stoddard, Lois Director of Financial Operations & Grants Management Syracuse Community Health 3154767921	Reid, Ofrona Interim CEO Syracuse Community Health Center 3154767921	2/23/2024 4:20 PM
Details	Last Recertification Date	Update	Recertification	2/21/2022 10:05:41 AM	2/24/2023 1:46:56 PM	2/24/2023 1:46 PM
Contacts	Authorizing Official	Update	AO Change Request	Ellingworth, Amy C CFO SCHC 3154767921-2260	Stoddard, Lois Director of Financial Operations & Grants Management Syracuse Community Health 3154767921	2/24/2023 7:30 AM
Details	Last Recertification Date	Update	Recertification	3/1/2021 1:32:03 PM	2/21/2022 10:05:41 AM	2/21/2022 10:05 AM
Addresses	Shipping Address	Insert	Change Request		Syracuse Community Health Center 819 S Salina Street Syracuse, NY 13202	3/2/2021 7:50 AM
Medicaid Billing	NPI: State	Update	Recertification		NY	3/1/2021 1:32 PM
Medicaid Billing	NPI: State	Update	Recertification		NY	3/1/2021 1:32 PM
Details	Last Recertification Date	Update	Recertification	1/28/2020 8:24:30 AM	3/1/2021 1:32:03 PM	3/1/2021 1:32 PM
Contacts	Authorizing Official	Update	Change Request	Murry, Derrick Chief Operating Officer Syracuse Community Health Center, Inc. 3154767921-5942	Ellingworth, Amy C CFO SCHC 3154767921-2260	9/1/2020 1:04 PM
Contacts	Primary Contact	Update	Profile Change Request	Warner, Kerri Devere 340B Analyst Syracuse Community Health Center 3154767921-2357	Warner, Kerri Devere 340B Program Manager Syracuse Community Health Center 3154767921-2357	8/18/2020 10:16 AM
Details	Last Recertification Date	Update	Recertification	2/4/2019 8:52:55 AM	1/28/2020 8:24:30 AM	1/28/2020 8:24 AM
Contacts	Primary Contact	Update	Change Request	Albrigo, Gerald CHIEF FINANCIAL OFFICER SYRACUSE COMMUNITY HEALTH CENTER 3155305648	Warner, Kerri Devere 340B Analyst Syracuse Community Health Center 3154767921-2357	8/26/2019 8:08 AM
Details	Last Recertification Date	Update	Recertification	3/7/2018 10:51:52 AM	2/4/2019 8:52:55 AM	2/4/2019 8:52 AM
Contacts	Authorizing Official	Update	Change Request	HALL, MARK INTERIM PRESIDENT CEO SYRACUSE COMMUNITY HEALTH CENTER 3154767921-2426	Murry, Derrick Chief Operating Officer Syracuse Community Health Center, Inc. 3154767921-5942	1/18/2019 10:14 AM
Contacts	Primary Contact	Update	Change Request	DeMarche, Emily Chief Financial Officer Syracuse Community Health Center 3154767921-2260	Albrigo, Gerald CHIEF FINANCIAL OFFICER SYRACUSE COMMUNITY HEALTH CENTER 3155305648	4/3/2018 4:41 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/15/2018 3:00 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03003876	3/15/2018 3:00 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	3/15/2018 3:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/15/2018 3:00 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		00474204	3/15/2018 3:00 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	3/15/2018 3:00 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1497796353	3/15/2018 3:00 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1184886988	3/15/2018 3:00 PM
Contacts	Authorizing Official	Update	Change Request	Rodgers, Leola President and CEO Syracuse Community Health Center 3154767921-2427	HALL, MARK INTERIM PRESIDENT CEO SYRACUSE COMMUNITY HEALTH CENTER 3154767921-2426	3/15/2018 11:50 AM
Contacts	Primary Contact	Update	Recertification	Bolster, Jennifer R. Compliance Officer Syracuse Community Health Center 3154767921-2483	DeMarche, Emily Chief Financial Officer Syracuse Community Health Center 3154767921-2260	3/7/2018 10:51 AM
Details	Last Recertification Date	Update	Recertification		3/7/2018 10:51:52 AM	3/7/2018 10:51 AM
Details	Is Authorizing Official EHB Data	Update	Recertification	False		3/7/2018 10:51 AM
Contacts	Authorizing Official	Update		Rodgers, Leola President and CEO 3154767921-2427	Rodgers, Leola President and CEO Syracuse Community Health Center 3154767921-2427	3/7/2018 10:43 AM
Contacts	Signed By	Update		Rodgers, Leola President and CEO 3154767921-2427	Rodgers, Leola President and CEO Syracuse Community Health Center 3154767921-2427	3/7/2018 10:43 AM
Contacts	Primary Contact	Update		Bolster, Jennifer R. Compliance Officer 3154767921-2483	Bolster, Jennifer R. Compliance Officer Syracuse Community Health Center 3154767921-2483	2/27/2018 11:17 AM
Contacts	Authorizing Official	Insert			Rodgers, Leola President and CEO 3154767921-2427	7/28/2017 2:45 PM
Contacts	Signed By	Insert			Rodgers, Leola President and CEO 3154767921-2427	7/28/2017 2:45 PM
Contacts	Primary Contact	Insert			Bolster, Jennifer R. Compliance Officer 3154767921-2483	6/9/2017 1:14 PM
Addresses	Main Address	Insert			1938 E Fayette St Syracuse, NY 13210-1339	5/1/2017 5:53 PM
Addresses	Billing Address	Insert			Syracuse Community Health Center 819 South Salina Street Syracuse, NY 13202	4/24/2017 2:07 PM
Dates	Participating Approval Date	Update			4/24/2017 12:00:00 AM	4/24/2017 2:06 PM
Details	State	Update		Pending	Active	4/24/2017 2:06 PM
Dates	Start Date	Update			7/1/2017 12:00:00 AM	4/24/2017 2:06 PM
Details	340B ID	Update		ONLINE_REG_76585	CH02016B	4/12/2017 7:15 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_76585	4/11/2017 5:53 PM
Details	Last Recertification Date	Insert				4/11/2017 5:53 PM
Details	Grant Number	Insert			H80CS00434	4/11/2017 5:53 PM
Details	340B ID	Insert			ONLINE_REG	4/11/2017 5:53 PM
Details	Is Authorizing Official EHB Data	Insert			False	4/11/2017 5:53 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/11/2017 5:53 PM
Details	Medicare Provider Number	Insert				4/11/2017 5:53 PM
Details	Entity Name	Insert			SYRACUSE COMMUNITY HEALTH CENTER, INC.	4/11/2017 5:53 PM
Details	Program Code	Insert			CH	4/11/2017 5:53 PM
Details	Entity Subname	Insert			SCHC - EAST HEALTH CENTER	4/11/2017 5:53 PM
Dates	Participating Approval Date	Insert				4/11/2017 5:53 PM
Details	State	Insert			Pending	4/11/2017 5:53 PM
Dates	Registration Date	Insert			4/11/2017 12:00:00 AM	4/11/2017 5:53 PM
Dates	Signed By Date	Insert			4/11/2017 12:00:00 AM	4/11/2017 5:53 PM
Dates	Start Date	Insert				4/11/2017 5:53 PM
Terminations	Termination Comments	Insert				4/11/2017 5:53 PM
Terminations	Termination Date	Insert				4/11/2017 5:53 PM
Terminations	Termination Effective Date	Insert				4/11/2017 5:53 PM
Terminations	Termination Reason	Insert				4/11/2017 5:53 PM

340B Drug Pricing Program Database