340B Drug Pricing Program Database


CHC29048-01 BEHAVIORAL HEALTH SERVICES INC (Active) - information as of 4/28/2025 12:42:07 AM

Main Details
BEHAVIORAL HEALTH SERVICES INC
BHS - El Puerto Family Health Center
HRSA-Funded Health Center
BPS-H80-020995
CHC29048-01
H80CS29048


Additional Details
Active
10/16/2017
1/1/2018
10/17/2017
2/24/2025

Contacts

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

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

Addresses

1334 N Avalon Blvd
Wilmington, CA 90744

Behavioral Health Services, Inc.
15519 Crenshaw Blvd.
Gardena, CA 90249


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

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09122 700 S. GAFFEY ST.
SAN PEDROCA9073107/12/201910/01/2019 07/01/201907/15/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08840 311W. PACIFIC COAST HWY. SUITE C
WILMINGTONCA9074407/12/201910/01/2019 07/01/201907/15/2019
Contract DetailGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17394 651 W SEPULVEDA BLVD
CARSONCA9074507/12/201910/01/2019 07/01/201907/15/2019
Contract DetailTHE MEDICINE CABINET228 E ANAHEIM ST
WILMINGTONCA9074404/16/201807/01/2018  04/16/2018
Contract DetailTOWERS PHARMACY INCDBA TOWERS PHARMACY 5451 LA PALMA AVE STE 17
LA PALMACA9062310/17/202201/01/2023  01/01/2023
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC29048-00ActiveBPS-H80-018189BEHAVIORAL HEALTH SERVICES INCBehavioral Health Services - Family Health Center2501 W. El Segundo Blvd. Suite B HawthorneCA
CHC29048-01ActiveBPS-H80-020995BEHAVIORAL HEALTH SERVICES INCBHS - El Puerto Family Health Center1334 N Avalon Blvd WilmingtonCA
CHC29048-02ActiveBPS-H80-036008BEHAVIORAL HEALTH SERVICES INCBHS - Carson Health Center1000 E. Dominguez Street CarsonCA
CHC29048-03ActiveBPS-H80-021788BEHAVIORAL HEALTH SERVICES INCBHS Adelante Health Center2015 W 1st St Ste L Santa AnaCA
CHC29048-04ActiveBPS-H80-036998BEHAVIORAL HEALTH SERVICES INCBHS - Nuestra Health Center4511 Whittier Blvd Los AngelesCA
CHC29048-05ActiveBPS-H80-031303BEHAVIORAL HEALTH SERVICES INCBHS - Crenshaw Health Center3850 Crenshaw Blvd Los AngelesCA
CHC29048-06ActiveBPS-H80-030885BEHAVIORAL HEALTH SERVICES INCBHS - Health Center for Women12954 Hawthorne Blvd Ste 100 HawthorneCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC29048-00ALBERTSONS LLCSAV-ON PHARMACY #2935 110 E CARSON ST
CARSONCA9074507/01/2018 01/15/2019
CHC29048-00ALBERTSONS LLCSAV-ON PHARMACY #3859 200 E SEPULVEDA BLVD
CARSONCA9074507/01/2018 01/15/2019
CHC29048-00AVALON PHARMACYAVALON PHARMACY 1203 N AVALON BLVD
SUITE A 		WILMINGTONCA90744-907410/01/2017 07/12/2018
CHC29048-00CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2021  
CHC29048-00CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2021  
CHC29048-00CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2021  
CHC29048-00CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2021  
CHC29048-00CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2021  
CHC29048-00CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2021  
CHC29048-00CAREMARK PUERTO RICO SPECIALTY PHARMACY,CAREMARK PUERTO RICO SPECIALTY PHARMACY 6020 AVE ROBERTO SANCHEZ VILELLA
CAROLINAPR0098201/01/2021  
CHC29048-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/01/2021  
CHC29048-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/01/2021  
CHC29048-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2021  
CHC29048-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2021 04/12/2021
CHC29048-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2021  
CHC29048-00FARMACIA BRISTOL1155 W. CENTRAL AVE SUITE#112
SANTA ANACA9270707/01/2018 01/05/2021
CHC29048-00FARMACIA BRISTOL1155 W. CENTRAL AVE. STE. 112
SANTA ANACA9270704/01/2021  
CHC29048-02GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09122 700 S. GAFFEY ST.
SAN PEDROCA9073110/01/2019 07/01/2019
CHC29048-02GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05012 23806 MAIN STREET
CARSONCA9074510/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09578 3120 W. IMPERIAL HWY.
INGLEWOODCA9030310/01/2019  
CHC29048-02GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08840 311W. PACIFIC COAST HWY. SUITE C
WILMINGTONCA9074410/01/2019 07/01/2019
CHC29048-02GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17119 20700 S AVALON BLVD STE 700
CARSONCA9074610/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08860 11831 HAWTHORNE BOULEVARD
HAWTHORNECA9025010/01/2019  
CHC29048-03GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08849 1545 WEST 17TH STREET
SANTA ANACA9270610/01/2019 07/01/2019
CHC29048-01GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09122 700 S. GAFFEY ST.
SAN PEDROCA9073110/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09123 3800 MARTIN LUTHER KING JR. BOULEVARD
LYNWOODCA9026210/01/2019 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08831 3880 W. ROSECRANS AVE.
HAWTHORNECA9025010/01/2019  
CHC29048-02GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17394 651 W SEPULVEDA BLVD
CARSONCA9074510/01/2019 07/01/2019
CHC29048-03GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08855 228 NORTH HARBOR BOULEVARD
SANTA ANACA9270310/01/2019 07/01/2019
CHC29048-01GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08840 311W. PACIFIC COAST HWY. SUITE C
WILMINGTONCA9074410/01/2019 07/01/2019
CHC29048-02GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08839 150 WEST CARSON STREET
CARSONCA9074510/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08837 222 N. MARKET ST.
INGLEWOODCA9030110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY #10292 4030 SOUTH WESTERN AVE.
LOS ANGELESCA9006210/01/2019 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17354 2700 W 120TH ST
HAWTHORNECA9025010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05012 23806 MAIN STREET
CARSONCA9074510/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 05809 4775 W. ROSECRANS AVE.
HAWTHORNECA9025010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09584 4345 WEST CENTURY BOULEVARD
INGLEWOODCA9030410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 4524 5176 E. WHITTIER BLVD.
LOS ANGELESCA9002210/01/2019  
CHC29048-01GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17394 651 W SEPULVEDA BLVD
CARSONCA9074510/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #10509 3627 EAST CESAR EAST CHAVEZ AVENUE
LOS ANGELESCA9006310/01/2019  
CHC29048-03GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09583 102 NORTH MAIN STREET
SANTA ANACA9270110/01/2019 07/01/2019
CHC29048-02GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 10022 1303 SEPULVEDA BLVD.
TORRANCECA9050110/01/2019 07/01/2019
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09582 3741 CRENSHAW BOULEVARD
LOS ANGELESCA9001610/01/2019 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08839 150 WEST CARSON STREET
CARSONCA9074510/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09572 5117 LAKEWOOD BOULEVARD
LAKEWOODCA9071210/01/2019 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09564 15700 SOUTH WESTERN AVENUE
GARDENACA9024710/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 01176 25829 NARBONNE AVE.
LOMITACA9071710/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08849 1545 WEST 17TH STREET
SANTA ANACA9270610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08864 3575 ATLANTIC AVENUE
LONG BEACHCA9080710/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08858 7101 ATLANTIC AVENUE
BELLCA9020110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08840 311W. PACIFIC COAST HWY. SUITE C
WILMINGTONCA9074410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08876 233 EAST WILLOW STREET
LONG BEACHCA9080610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08886 8601 SOUTH SEPULVEDA BOULEVARD
LOS ANGELESCA9004510/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 07191 15718 HAWTHORNE BLVD (NEC)
LAWNDALECA9026010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08892 5822 SOUTH VERMONT AVENUE
LOS ANGELESCA9004410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09496 2900 N. SEPULVEDA BLVD.
MANHATTAN BEACHCA9026610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09477 5399 WEST CENTINELA AVENUE
LOS ANGELESCA9004510/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09495 220 EAST COMPTON BOULEVARD
COMPTONCA9022010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08855 228 NORTH HARBOR BOULEVARD
SANTA ANACA9270310/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09507 650 EAST EL SEGUNDO BOULEVARD
LOS ANGELESCA9005910/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09122 700 S. GAFFEY ST.
SAN PEDROCA9073110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 03968 816 E. MAIN STREET
ALHAMBRACA9180110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08875 3644 EAST OLYMPIC BOULEVARD
LOS ANGELESCA9002310/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09475 4320 REDONDO BEACH BOULEVARD
TORRANCECA9050410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09583 102 NORTH MAIN STREET
SANTA ANACA9270110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09771 9256 SLAUSON AVENUE
PICO RIVERACA9066010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09679 1485 E. VALLEY BLVD.
ALHAMBRACA9180110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09588 15103 HAWTHORNE BOULEVARD
LAWNDALECA9026010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17394 651 W SEPULVEDA BLVD
CARSONCA9074510/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09571 950 NORTH WESTERN AVENUE
SAN PEDROCA9073210/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16670 3471 W CENTURY BLVD
INGLEWOODCA9030310/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16041 2120 W MAIN ST
ALHAMBRACA9180110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16093 2169 W REDONDO BEACH BLVD
GARDENACA9024710/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17521 1701 N GAFFEY ST
SAN PEDROCA9073110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17096 1601 KINGSDALE AVE
REDONDO BEACHCA9027810/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09579 4570 ATLANTIC AVENUE
LONG BEACHCA9080710/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16750 3600 ROSEMEAD BLVD
ROSEMEADCA9177010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16043 5600 WHITTIER BLVD
COMMERCECA9002210/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09769 8580 WHITTIER BLVD.
PICO RIVERACA9066010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09798 313 SOUTH GARFIELD AVENUE
MONTEREY PARKCA9175410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17119 20700 S AVALON BLVD STE 700
CARSONCA9074610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16049 1200 N SEPULVEDA BLVD
MANHATTAN BEACHCA9026610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09557 1250 E.PACIFIC COAST HIGHWAY
LONG BEACHCA9080610/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 10022 1303 SEPULVEDA BLVD.
TORRANCECA9050110/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09617 2103 SOUTH ATLANTIC BOULEVARD
MONTEREY PARKCA9175410/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09645 8225 GARVEY AVENUE
ROSEMEADCA9177010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09791 2532 W. VALLEY BLVD.
ALHAMBRACA9180310/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17349 1621 S ALAMEDA ST
COMPTONCA9022010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09566 596 LONG BEACH BOULEVARD
LONG BEACHCA9080210/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09594 901 S. CENTRAL AVENUE
COMPTONCA9022010/01/2019  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09543 2001 PACIFIC COAST HIGHWAY
LOMITACA9071701/01/2020  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09665 5944 N FIGUEROA ST
LOS ANGELESCA9004207/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 07079 2200 N. HARBOR BLVD. (NEC)
FULLERTONCA9283507/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09501 2655 SANTA ANA STREET
SOUTH GATECA9028007/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16206 39440 10TH ST W
PALMDALECA9355107/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09510 15421 BROOKHURST STREET
WESTMINSTERCA9268307/01/2020 06/21/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09141 3151 UNIVERSITY AVE.
SAN DIEGOCA9210407/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16045 12100 HARBOR BLVD
GARDEN GROVECA9284007/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09576 10889 WELLWORTH AVENUE
LOS ANGELESCA9002407/01/2020 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09568 4625 TORRANCE BOULEVARD
TORRANCECA9050301/01/2021  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09610 12280 PERRIS BLVD
MORENO VALLEYCA9255701/01/2021  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09613 23357 MULHOLLAND DRIVE
WOODLAND HILLSCA9136401/01/2021 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16046 13831 BROOKHURST ST
GARDEN GROVECA9284301/01/2021  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 08841 11623 ROSECRANS AVE.
NORWALKCA9065001/01/2021 04/12/2021
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY #4019 5837 S. CENTRAL AVE.
LOS ANGELESCA9000101/01/2021  
CHC29048-00GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09580 5101 OBAMA BLVD
LOS ANGELESCA9001601/01/2021 04/12/2021
CHC29048-00LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09513 1570 ROSECRANS AVE
MANHATTAN BEACHCA9026610/01/2019  
CHC29048-00LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09985 8900 SEPULVEDA WESTWAY
LOS ANGELESCA9004510/01/2019  
CHC29048-00MCCARTHY PHARMACY INCMCCARTHY DRUGS 12025 SAN VICENTE BLVD
LOS ANGELESCA9004901/01/2017 04/30/2018
CHC29048-00MCCARTHY PHARMACY INCDBA FREEMAN MEDICAL PHARMACY 301 N PRAIRIE AVE STE 110
INGLEWOODCA9030101/01/2017 01/15/2019
CHC29048-00MEDIMPACT DIRECT, LLC8060 S KYRENE RD
TEMPEAZ85284-210907/01/2020 04/15/2021
CHC29048-00NEW JERSEY CVS PHARMACY, L.L.C.CVS PHARMACY # 16533 632 ROUTE 46 E
FAIRFIELDNJ0700401/01/2021 04/12/2021
CHC29048-00NOVIXUS PHARMACY SERVICES43159 W 9 MILE RD.
NOVIMI48375-411707/01/2020 04/15/2021
CHC29048-00PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2021  
CHC29048-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/01/2021  
CHC29048-00PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2021  
CHC29048-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2021  
CHC29048-00RAMI INCDBA AALPHA PHARMACY 174 S ALVARADO ST
LOS ANGELESCA90057-221107/01/2019  
CHC29048-00SOUTH GATE PHARMACY INC8200 LONG BEACH BLVD UNIT D-2
SOUTH GATECA9028004/01/2023  
CHC29048-01THE MEDICINE CABINET228 E ANAHEIM ST
WILMINGTONCA9074407/01/2018  
CHC29048-00THE MEDICINE CABINET228 E ANAHEIM ST
WILMINGTONCA9074407/01/2018  
CHC29048-02THE MEDICINE CABINET228 E ANAHEIM ST
WILMINGTONCA9074401/01/2020  
CHC29048-00THE MEDICINE CABINET #57037 ATLANTIC AVE
BELLCA9020104/01/2019  
CHC29048-04THE MEDICINE CABINET #57037 ATLANTIC AVE
BELLCA9020101/01/2020  
CHC29048-01TOWERS PHARMACY INCDBA TOWERS PHARMACY 5451 LA PALMA AVE STE 17
LA PALMACA9062301/01/2023  
CHC29048-00TOWERS PHARMACY INCDBA TOWERS PHARMACY 5451 LA PALMA AVE STE 17
LA PALMACA9062304/01/2023  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/26/2024 1:55:10 PM2/24/2025 6:27:51 PM2/24/2025 6:27 PM
DetailsLast Recertification DateUpdateRecertification1/30/2023 12:30:51 PM2/26/2024 1:55:10 PM2/26/2024 1:55 PM
ContactsAuthorizing OfficialUpdateAO Change RequestSummers, Shirley President/CEO Behavioral Health Services, Inc. 3106799126Shook, Denise President/CEO Behavioral Health Services, Inc. 3106799126-12932/25/2024 7:47 AM
DetailsLast Recertification DateUpdateRecertification2/7/2022 5:45:27 PM1/30/2023 12:30:51 PM1/30/2023 12:30 PM
ContactsPrimary ContactInsertPC Change Request Venable, Michelle Director of Health Center Operations BHS- Family Health Center 3106799126-123310/18/2022 9:18 AM
DetailsLast Recertification DateUpdateRecertification2/2/2021 5:43:40 PM2/7/2022 5:45:27 PM2/7/2022 5:45 PM
DetailsLast Recertification DateUpdateRecertification2/3/2020 6:35:41 PM2/2/2021 5:43:40 PM2/2/2021 5:43 PM
DetailsLast Recertification DateUpdateRecertification2/11/2019 1:01:32 PM2/3/2020 6:35:41 PM2/3/2020 6:35 PM
DetailsLast Recertification DateUpdateRecertification2/9/2018 4:26:26 PM2/11/2019 1:01:32 PM2/11/2019 1:01 PM
DetailsLast Recertification DateUpdateRecertification 2/9/2018 4:26:26 PM2/9/2018 4:26 PM
DetailsStateUpdate ApprovedActive1/1/2018 12:00 AM
ContactsSigned ByInsertNew Registration Summers, Shirley President/CEO Behavioral Health Services, Inc. 310679912610/17/2017 12:37 PM
Details340B IDUpdateNew Registration CHC29048-0110/17/2017 12:37 PM
DatesParticipating Approval DateUpdateNew Registration 10/17/2017 12:37:29 PM10/17/2017 12:37 PM
DetailsStateUpdateNew RegistrationPendingApproved10/17/2017 12:37 PM
DatesSigned By DateUpdateNew Registration 10/16/2017 2:49:13 PM10/17/2017 12:37 PM
DatesStart DateUpdateNew Registration 1/1/2018 12:00:00 AM10/17/2017 12:37 PM
AddressesMain AddressInsertNew Registration  1334 N Avalon Blvd Wilmington, CA 9074410/16/2017 2:49 PM
AddressesBilling AddressInsertNew Registration Behavioral Health Services, Inc. 15519 Crenshaw Blvd. Gardena, CA 9024910/16/2017 2:49 PM
ContactsAuthorizing OfficialInsertNew Registration Summers, Shirley President/CEO Behavioral Health Services, Inc. 310679912610/16/2017 2:49 PM
DetailsLast Recertification DateInsertNew Registration  10/16/2017 2:49 PM
DetailsGrant NumberInsertNew Registration H80CS2904810/16/2017 2:49 PM
Details340B IDInsertNew Registration  10/16/2017 2:49 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/16/2017 2:49 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/16/2017 2:49 PM
DetailsMedicare Provider NumberInsertNew Registration  10/16/2017 2:49 PM
DetailsEntity NameInsertNew Registration BEHAVIORAL HEALTH SERVICES INC10/16/2017 2:49 PM
DetailsProgram CodeInsertNew Registration CH10/16/2017 2:49 PM
DetailsEntity SubnameInsertNew Registration BHS - El Puerto Family Health Center10/16/2017 2:49 PM
DatesParticipating Approval DateInsertNew Registration  10/16/2017 2:49 PM
DetailsStateInsertNew Registration Pending10/16/2017 2:49 PM
DatesRegistration DateInsertNew Registration 10/16/2017 2:49:10 PM10/16/2017 2:49 PM
DatesSigned By DateInsertNew Registration  10/16/2017 2:49 PM
DatesStart DateInsertNew Registration  10/16/2017 2:49 PM
TerminationsTermination CommentsInsertNew Registration  10/16/2017 2:49 PM
TerminationsTermination DateInsertNew Registration  10/16/2017 2:49 PM
TerminationsTermination Effective DateInsertNew Registration  10/16/2017 2:49 PM
TerminationsTermination ReasonInsertNew Registration  10/16/2017 2:49 PM