Covered Entity Details

CHC28980-03 Harmony Health Medical Clinic And Family Resource Center (Terminated) - information as of 6/12/2025 6:04:27 AM

Main Details

Name

Harmony Health Medical Clinic And Family Resource Center

Subdivision Name

Harmony Health Medical Clinic and Family Resource Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-022114

340B ID

CHC28980-03

Grant Number

H80CS28980

Additional Details

Current Program Status

Terminated

Registration Date

1/8/2019

Participating Start Date

4/1/2019

Participating Approval Date

1/9/2019

Last Recertification Date

1/29/2024

Termination Date
Termination Reason

4/1/2025
Site closure

Contacts

Authorizing Official

Harmony Health Medical Clinic and Family Resource Center
Jennifer Hunter, CFO
(530) 743-6888 Ext: 5307436888

Primary Contact

Harmony Health Medical Clinic and Family Resource Center
Rachel Linda Farrell, CEO
(530) 743-6888

Addresses

Street Address

1215 Plumas Street, Suite 1400
Yuba City, CA 95991-3493

Billing Address

Harmony Health Medical Clinic and Family Resource Center
1908 North Beale Road, Suite E
Marysville, CA 95901

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
CA	1124130620	1124130620

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	01/11/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	04/01/2022	07/01/2022	04/01/2025	04/01/2025
Contract Detail	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	01/10/2024	04/01/2024	04/01/2025	04/01/2025
Contract Detail	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	10/12/2023	01/01/2024	04/01/2025	04/01/2025
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/13/2023	04/01/2023	04/01/2025	04/01/2025
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/11/2023	01/01/2024	04/01/2025	04/01/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CHC28980-00	Active	BPS-H80-015720	HARMONY HEALTH MEDICAL CLINIC AND FAMILY RESOURCE CENTER	Harmony Health Medical Clinic and Family Resource Center	1908 N BEALE RD	Suite E	MARYSVILLE	CA
CHC28980-02	Active	BPS-H80-038384	Harmony Health Medical Clinic And Family Resource Center	Harmony Health Medical Clinic and Family Resource Center	920 Chestnut Street		Yuba City	CA
CHC28980-03	Terminated	BPS-H80-022114	Harmony Health Medical Clinic And Family Resource Center	Harmony Health Medical Clinic and Family Resource Center	1215 Plumas Street, Suite 1400		Yuba City	CA
CHC28980-04	Active	BPS-H80-031365	Harmony Health Medical Clinic And Family Resource Center	Harmony Health Medical Clinic and Family Resource Center	1930 N Beale Rd		Marysville	CA
CHC28980-05	Terminated	BPS-H80-027745	Harmony Health Medical Clinic And Family Resource Center	Harmony Health Medical Clinic and Family Resource Center	1215 Plumas St Ste 1400		Yuba City	CA
CHC28980-06	Active	BPS-H80-032878	Harmony Health Medical Clinic And Family Resource Center	Mobile Medical Unit	1976 N Beale Rd		Marysville	CA
CHC28980-07	Active	BPS-H80-036537	Harmony Health Medical Clinic And Family Resource Center	Harmony Health Medical Clinic and Family Resource Center	114 D St		Wheatland	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28980-00	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	01/31/2025
CHC28980-02	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	02/28/2025
CHC28980-03	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	04/01/2025
CHC28980-04	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	02/28/2025
CHC28980-06	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	02/28/2025
CHC28980-07	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/01/2024	02/28/2025
CHC28980-00	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	01/31/2025
CHC28980-02	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	02/28/2025
CHC28980-03	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	04/01/2025
CHC28980-04	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	02/28/2025
CHC28980-06	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	02/28/2025
CHC28980-07	ACARIAHEALTH PHARMACY #14, INC.	4151 E COMMERCE WAY # 1041		SACRAMENTO	CA	95834-9679	04/01/2024	02/28/2025
CHC28980-00	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	10/01/2023	01/31/2025
CHC28980-02	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2024	01/31/2025
CHC28980-03	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2024	04/01/2025
CHC28980-04	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2024	01/31/2025
CHC28980-06	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2024	01/31/2025
CHC28980-07	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2024	01/31/2025
CHC28980-00	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	10/01/2023	01/31/2025
CHC28980-02	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	01/01/2024	01/31/2025
CHC28980-03	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	01/01/2024	04/01/2025
CHC28980-04	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	01/01/2024	01/31/2025
CHC28980-06	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	01/01/2024	01/31/2025
CHC28980-07	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	01/01/2024	01/31/2025
CHC28980-00	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	10/01/2023	01/31/2025
CHC28980-02	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2024	01/31/2025
CHC28980-03	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2024	04/01/2025
CHC28980-04	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2024	01/31/2025
CHC28980-06	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2024	01/31/2025
CHC28980-07	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2024	01/31/2025
CHC28980-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28980-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28980-03	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024	04/01/2025
CHC28980-04	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28980-06	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28980-07	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28980-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28980-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28980-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28980-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28980-03	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024	04/01/2025
CHC28980-03	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024	04/01/2025
CHC28980-04	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28980-04	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28980-06	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28980-06	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28980-07	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28980-07	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28980-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024
CHC28980-02	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024
CHC28980-03	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024	04/01/2025
CHC28980-04	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024
CHC28980-06	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024
CHC28980-07	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2024
CHC28980-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024
CHC28980-02	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024
CHC28980-03	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024	04/01/2025
CHC28980-04	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024
CHC28980-06	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024
CHC28980-07	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2024
CHC28980-00	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28980-02	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28980-03	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024	04/01/2025
CHC28980-04	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28980-06	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28980-07	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28980-00	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024
CHC28980-02	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024
CHC28980-03	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024	04/01/2025
CHC28980-04	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024
CHC28980-06	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024
CHC28980-07	EVERGREEN PHARMACEUTICAL OF CALIFORNIA,	OMNICARE OF SACRAMENTO	3630 BUSINESS DR. SUITE D	SACRAMENTO	CA	95820	04/01/2024
CHC28980-00	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	12/31/2024
CHC28980-02	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	12/31/2024
CHC28980-03	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	04/01/2025
CHC28980-04	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	12/31/2024
CHC28980-06	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	12/31/2024
CHC28980-07	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/01/2024	12/31/2024
CHC28980-00	FRANKLIN PHARMACY	SCRIPT DEPOT LP DBA	1619 FRANKLIN RD BLDG A	YUBA CITY	CA	95993	04/01/2019	02/28/2021
CHC28980-00	FRANKLIN PHARMACY	SCRIPT DEPOT LP DBA	1619 FRANKLIN RD BLDG A	YUBA CITY	CA	95993	04/01/2019	02/28/2021
CHC28980-00	FRANKLIN PHARMACY	SCRIPT DEPOT LP DBA	1619 FRANKLIN RD BLDG A	YUBA CITY	CA	95993	04/01/2019	02/28/2021
CHC28980-00	FRANKLIN PHARMACY	SCRIPT DEPOT LP DBA	1619 FRANKLIN RD BLDG A	YUBA CITY	CA	95993	04/01/2019	02/28/2021
CHC28980-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16109	1153 BUTTE HOUSE RD	YUBA CITY	CA	95991	04/01/2020
CHC28980-00	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022
CHC28980-02	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022
CHC28980-03	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022	04/01/2025
CHC28980-04	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022
CHC28980-05	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022	01/01/2024
CHC28980-06	LINDHURST PHARMACY	LINDHURST PHARMACY SERVICES INC	5991 LINDHURST AVE	MARYSVILLE	CA	95901	07/01/2022
CHC28980-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09525	260 SPRUCE ST	GRIDLEY	CA	95948	04/01/2020
CHC28980-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09691	906 E ST.	MARYSVILLE	CA	95901	04/01/2020
CHC28980-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09932	1274 STABLER LN	YUBA CITY	CA	95993	04/01/2020
CHC28980-00	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	10/01/2023	01/31/2025
CHC28980-02	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2024	01/31/2025
CHC28980-03	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2024	04/01/2025
CHC28980-04	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2024	01/31/2025
CHC28980-06	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2024	01/31/2025
CHC28980-07	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2024	01/31/2025
CHC28980-00	MISSION PHARMACY SERVICES INC	400 PLUMAS BOULEVARD	SUITE 100	YUBA CITY	CA	95991	01/01/2017	01/19/2024
CHC28980-00	OLIVEHURST DRUG STORE, INC	4897 OLIVEHURST AVE		OLIVEHURST	CA	95961-4225	01/01/2017	12/31/2021
CHC28980-00	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	10/01/2023	01/31/2025
CHC28980-02	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2024	01/31/2025
CHC28980-03	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2024	04/01/2025
CHC28980-04	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2024	01/31/2025
CHC28980-06	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2024	01/31/2025
CHC28980-07	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2024	01/31/2025
CHC28980-00	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28980-02	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28980-03	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024	04/01/2025
CHC28980-04	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28980-06	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28980-07	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28980-00	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28980-02	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28980-03	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024	04/01/2025
CHC28980-04	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28980-06	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28980-07	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28980-00	RIVERSIDE PHARMACY	SCRIPT DEPOT LP DBA	866 PLUMAS ST STE C	YUBA CITY	CA	95991	04/01/2019	02/28/2021
CHC28980-00	RIVERSIDE PHARMACY	SCRIPT DEPOT LP DBA	866 PLUMAS ST STE C	YUBA CITY	CA	95991	04/01/2019	02/28/2021
CHC28980-00	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28980-02	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28980-03	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024	04/01/2025
CHC28980-04	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28980-06	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28980-07	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28980-00	SUN SCRIPTS INC	DB/A THE MEDICINE SHOPPE	812 FIFTH STREET	MARYSVILLE	CA	95901	01/01/2017	10/02/2017
CHC28980-00	SUTTER PHARMACY	470 PLUMAS BLVD.	STE. 103	YUBA CITY	CA	95991	04/01/2020
CHC28980-00	THE MEDICINE SHOPPE PHARMACY	812 5TH ST.		MARYSVILLE	CA	95901	01/01/2018	05/12/2020
CHC28980-00	THRIFTY PAYLESS, INC.	RITE AID #6557	5075 OLIVEHURST AVENUE	OLIVEHURST	CA	95961	04/01/2017
CHC28980-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CHC28980-00	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024
CHC28980-02	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024
CHC28980-03	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024	04/01/2025
CHC28980-04	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024
CHC28980-06	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024
CHC28980-07	WAL-MART PHARMACY 10-1575	465 CAL OAK RD		OROVILLE	CA	95965	01/01/2024
CHC28980-00	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024
CHC28980-02	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024
CHC28980-03	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024	04/01/2025
CHC28980-04	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024
CHC28980-06	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024
CHC28980-07	WAL-MART PHARMACY 10-1903	1150 HARTER ROAD		YUBA CITY	CA	95993	01/01/2024
CHC28980-00	WAL-MART PHARMACY 10-5136	1131 N BEALE RD		MARYSVILLE	CA	95901	01/01/2017
CHC28980-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CHC28980-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC28980-02	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC28980-03	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023	04/01/2025
CHC28980-04	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC28980-05	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023	01/01/2024
CHC28980-06	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC28980-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC28980-02	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC28980-03	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024	04/01/2025
CHC28980-04	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC28980-06	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC28980-07	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2025 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		12/31/2024 12:00:00 AM	2/11/2025 12:14 PM
Details	State	Update	Recertification	Active	To Be Terminated	2/11/2025 12:14 PM
Terminations	Termination Date	Update	Recertification		4/1/2025 12:00:00 AM	2/11/2025 12:14 PM
Terminations	Termination Effective Date	Update	Recertification		12/31/2024 12:00:00 AM	2/11/2025 12:14 PM
Terminations	Termination Reason	Update	Recertification		Site closure	2/11/2025 12:14 PM
Contacts	Primary Contact	Update	Change Request	Farrell, Rachel Chief Executive Officer Harmony Health Medical Clinic and Family Resource Center 5307436888	Farrell, Rachel Linda CEO Harmony Health Medical Clinic and Family Resource Center 5307436888	2/2/2024 10:59 AM
Details	Last Recertification Date	Update	Recertification	1/30/2023 12:12:14 PM	1/29/2024 6:28:52 PM	1/29/2024 6:28 PM
Details	Last Recertification Date	Update	Recertification	1/31/2022 12:42:31 PM	1/30/2023 12:12:14 PM	1/30/2023 12:12 PM
Details	Last Recertification Date	Update	Recertification	2/2/2021 5:21:48 PM	1/31/2022 12:42:31 PM	1/31/2022 12:42 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1124130620 ( )		2/2/2021 5:21 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1124130620	2/2/2021 5:21 PM
Medicaid Billing	NPI: State	Insert	Recertification		CA	2/2/2021 5:21 PM
Details	Last Recertification Date	Update	Recertification	1/27/2020 12:49:32 PM	2/2/2021 5:21:48 PM	2/2/2021 5:21 PM
Contacts	Authorizing Official	Update	Change Request	Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888	Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888-5307436888	10/1/2020 6:37 PM
Contacts	Signed By	Update	Change Request	Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888	Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888-5307436888	10/1/2020 6:37 PM
Details	Last Recertification Date	Update	Recertification		1/27/2020 12:49:32 PM	1/27/2020 12:49 PM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/19/2019 12:40 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1124130620	3/19/2019 12:40 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CA	3/19/2019 12:40 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1124130620	3/19/2019 12:40 PM
Addresses	Billing Address	Insert	Change Request		Harmony Health Medical Clinic and Family Resource Center 1908 North Beale Road, Suite E Marysville, CA 95901	1/9/2019 2:35 PM
Contacts	Signed By	Insert	New Registration		Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888	1/9/2019 7:23 AM
Details	340B ID	Update	New Registration		CHC28980-03	1/9/2019 7:23 AM
Dates	Participating Approval Date	Update	New Registration		1/9/2019 7:23:01 AM	1/9/2019 7:23 AM
Details	State	Update	New Registration	Pending	Approved	1/9/2019 7:23 AM
Dates	Signed By Date	Update	New Registration		1/8/2019 3:21:43 PM	1/9/2019 7:23 AM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	1/9/2019 7:23 AM
Addresses	Main Address	Insert	New Registration		1215 Plumas Street, Suite 1400 Yuba City, CA 95991-3493	1/8/2019 3:21 PM
Contacts	Primary Contact	Insert	New Registration		Farrell, Rachel Chief Executive Officer Harmony Health Medical Clinic and Family Resource Center 5307436888	1/8/2019 3:21 PM
Contacts	Authorizing Official	Insert	New Registration		Hunter, Jennifer CFO Harmony Health Medical Clinic and Family Resource Center 5307436888	1/8/2019 3:21 PM
Details	Last Recertification Date	Insert	New Registration			1/8/2019 3:21 PM
Details	Grant Number	Insert	New Registration		H80CS28980	1/8/2019 3:21 PM
Details	340B ID	Insert	New Registration			1/8/2019 3:21 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/8/2019 3:21 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/8/2019 3:21 PM
Details	Medicare Provider Number	Insert	New Registration			1/8/2019 3:21 PM
Details	Entity Name	Insert	New Registration		Harmony Health Medical Clinic And Family Resource Center	1/8/2019 3:21 PM
Details	Program Code	Insert	New Registration		CH	1/8/2019 3:21 PM
Details	Entity Subname	Insert	New Registration		Harmony Health Medical Clinic and Family Resource Center	1/8/2019 3:21 PM
Dates	Participating Approval Date	Insert	New Registration			1/8/2019 3:21 PM
Details	State	Insert	New Registration		Pending	1/8/2019 3:21 PM
Dates	Registration Date	Insert	New Registration		1/8/2019 3:21:40 PM	1/8/2019 3:21 PM
Dates	Signed By Date	Insert	New Registration			1/8/2019 3:21 PM
Dates	Start Date	Insert	New Registration			1/8/2019 3:21 PM
Terminations	Termination Comments	Insert	New Registration			1/8/2019 3:21 PM
Terminations	Termination Date	Insert	New Registration			1/8/2019 3:21 PM
Terminations	Termination Effective Date	Insert	New Registration			1/8/2019 3:21 PM
Terminations	Termination Reason	Insert	New Registration			1/8/2019 3:21 PM

340B Drug Pricing Program Database