Covered Entity Details

CH10002A ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC. (Active) - information as of 4/24/2025 11:08:11 PM

Main Details

Name

ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.

Subdivision Name

Anchorage Neighborhood Health Center, Inc.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-010139

340B ID

CH10002A

Grant Number

H80CS00146

Additional Details

Current Program Status

Active

Registration Date

4/1/1999

Participating Start Date

4/1/1999

Participating Approval Date

3/4/2005

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

Anchorage Neighborhood Health Center
Lisa DH Aquino, CEO
(907) 743-7305

Primary Contact

Anchorage Neighborhood Health Center Pharmacy
Stephen Russell Woodard, Director of Pharmacy
(907) 743-7203

Addresses

Street Address

4951 Business Park Blvd
Anchorage, AK 99503-7174

Billing Address
Same as Street Address

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

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
AK	1028568,1004346,1581033,1003895	1316952013,1669475166,1811170210,1407030026

Shipping Addresses

Shipping Address 1

Anchorage Neighborhood Health Center
4951 Business Park Blvd #106
Anchorage, AK 99503

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ALASKA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17435	1200 NO MULDOON RD	ANCHORAGE	AK	99504	01/10/2020	04/01/2020		04/01/2020
Contract Detail	ALASKA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17436	150 W 100TH AVE	ANCHORAGE	AK	99515	01/10/2020	04/01/2020		04/01/2020
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1802	1340 GAMBELL ST	ANCHORAGE	AK	99501	07/19/2016	10/01/2016	05/10/2025	04/14/2025
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1813	1501 HUFFMAN RD	ANCHORAGE	AK	99515-3596	07/19/2016	10/01/2016		07/19/2016
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1812	4000 W DIMOND BLVD	ANCHORAGE	AK	99502-1475	07/19/2016	10/01/2016		07/19/2016
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1817	7731 E NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99504	07/19/2016	10/01/2016		07/19/2016
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1809	5600 DEBARR RD	ANCHORAGE	AK	99504	07/19/2016	10/01/2016		07/19/2016
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1805	1650 W NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99517	07/19/2016	10/01/2016		07/19/2016
Contract Detail	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1807	11431 BUSINESS BLVD	EAGLE RIVER	AK	99577	07/20/2017	10/01/2017		10/01/2017
Contract Detail	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/09/2023	04/01/2023		04/01/2023
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/09/2023	04/01/2023		04/01/2023
Contract Detail	FRED MEYER STORES	DBA: FRED MEYER	7701 DEBARR RD	ANCHORAGE	AK	99504-1872	10/20/2016	01/01/2017		10/20/2016
Contract Detail	FRED MEYER STORES	DBA: FRED MEYER	1000 E NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99508	10/20/2016	01/01/2017		10/20/2016
Contract Detail	FRED MEYER STORES	DBA: FRED MEYER	2300 ABBOTT RD	ANCHORAGE	AK	99507	10/20/2016	01/01/2017		10/20/2016
Contract Detail	FRED MEYER STORES, INC	DBA FRED MEYER #071	2000 W DIMOND BLVD	ANCHORAGE	AK	99515	10/20/2016	01/01/2017		10/20/2016
Contract Detail	GENOA HEALTHCARE LLC	4020 FOLKER ST	SUITE 5	ANCHORAGE	AK	99508	07/13/2022	10/01/2022	02/09/2023	03/21/2023
Contract Detail	GENOA HEALTHCARE LLC	4120 LAUREL STREET, SUITE 102		ANCHORAGE	AK	99508	02/07/2023	02/09/2023		07/18/2024
Contract Detail	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/20/2016	01/01/2017		10/20/2016
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03526	306 EAST WOODLAWN RD	CHARLOTTE	NC	28217	10/05/2021	01/01/2022		01/01/2022
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/13/2022	10/01/2022	10/01/2024	10/08/2024
Contract Detail	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	07/13/2022	10/01/2022		07/18/2024
Contract Detail	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	10/11/2024	01/01/2025		01/01/2025
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/13/2022	10/01/2022	10/01/2024	10/08/2024
Contract Detail	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/13/2022	10/01/2022		07/18/2024
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/13/2022	10/01/2022	10/01/2024	10/08/2024
Contract Detail	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	07/13/2022	10/01/2022	10/01/2024	10/08/2024
Contract Detail	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	07/13/2022	10/01/2022	01/01/2023	06/01/2023
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/04/2023	04/01/2023		07/18/2024
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/09/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/09/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/09/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	01/09/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2926	1001 MADISON ST.	SEATTLE	WA	98104	01/15/2024	04/01/2024		04/01/2024
Contract Detail	SAFEWAY INC	CARRS PHARMACY #2628	1725 ABBOTT ROAD	ANCHORAGE	AK	99507	07/19/2016	10/01/2016		07/19/2016
Contract Detail	SAFEWAY INC	CARRS PHARMACY #0520	3101 PENLAND PARKWAY	ANCHORAGE	AK	99508	07/19/2016	10/01/2016	09/19/2020	03/02/2021
Contract Detail	SAFEWAY, INC	CARRS PHARMACY #720	2920 SEWARD HWY	ANCHORAGE	AK	99503	04/15/2021	07/01/2021		07/01/2021
Contract Detail	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05596	4627 NORTH MAIN STREET	COLUMBIA	SC	29203	01/09/2023	04/01/2023		04/01/2023
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/20/2017	10/01/2017		10/01/2017
Contract Detail	WAL-MART PHARMACY 10-2070	3101 A STREET		ANCHORAGE	AK	99503	10/20/2016	01/01/2017		10/20/2016
Contract Detail	WAL-MART PHARMACY 10-2071	8900 OLD SEWARD HWY		ANCHORAGE (S)	AK	99515	10/20/2016	01/01/2017		10/20/2016
Contract Detail	WAL-MART PHARMACY 10-4359	7405 DEBARR ROAD		ANCHORAGE	AK	99504	10/20/2016	01/01/2017		10/20/2016
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/20/2017	10/01/2017		10/01/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12680	2197 W DIMOND BLVD	ANCHORAGE	AK	99515	01/12/2012	01/12/2012		02/11/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12681	1721 E PARKS HWY	WASILLA	AK	99654	01/12/2012	01/12/2012		02/11/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13449	12405 BRANDON ST	ANCHORAGE	AK	99515-3589	01/12/2012	01/12/2012		02/11/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13656	725 E. NORTHERN LIGHTS BLVD.	ANCHORAGE	AK	99503	01/12/2012	01/12/2012		02/11/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12679	7600 DEBARR RD	ANCHORAGE	AK	99504	01/12/2012	01/12/2012	12/05/2024	12/10/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15092	1470 W. NORTHERN LIGHTS BLVD.	ANCHORAGE	AK	99503-3663	03/08/2013	04/01/2013	12/17/2024	12/26/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15653	4353 LAKE OTIS PKWY	ANCHORAGE	AK	99508	01/27/2017	04/01/2017		01/27/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15654	2550 EAST 88TH AVENUE	ANCHORAGE	AK	99507	01/27/2017	04/01/2017		01/27/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15362	12051 OLD GLENN HIGHWAY	EAGLE RIVER	AK	99577	01/18/2022	04/01/2022		04/01/2022
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/19/2023	04/01/2023		04/01/2023
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/11/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH10002A	Active	BPS-H80-010139	ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.	Anchorage Neighborhood Health Center, Inc.	4951 Business Park Blvd		Anchorage	AK

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH10002A	ALASKA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17435	1200 NO MULDOON RD	ANCHORAGE	AK	99504	04/01/2020
CH10002A	ALASKA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17436	150 W 100TH AVE	ANCHORAGE	AK	99515	04/01/2020
CH10002A	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/01/2023
CH10002A	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/01/2023
CH10002A	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/01/2023
CH10002A	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/01/2023
CH10002A	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/01/2023
CH10002A	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/01/2023
CH10002A	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/01/2023
CH10002A	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/01/2023
CH10002A	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2023
CH10002A	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2023
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1802	1340 GAMBELL ST	ANCHORAGE	AK	99501	10/01/2016	05/10/2025
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1813	1501 HUFFMAN RD	ANCHORAGE	AK	99515-3596	10/01/2016
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1812	4000 W DIMOND BLVD	ANCHORAGE	AK	99502-1475	10/01/2016
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1817	7731 E NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99504	10/01/2016
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1809	5600 DEBARR RD	ANCHORAGE	AK	99504	10/01/2016
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1805	1650 W NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99517	10/01/2016
CH10002A	CARR-GOTTSTEIN FOODS, CO.	CARRS PHARMACY #1807	11431 BUSINESS BLVD	EAGLE RIVER	AK	99577	10/01/2017
CH10002A	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2023
CH10002A	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2023
CH10002A	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	04/01/2023
CH10002A	FRED MEYER STORES	DBA: FRED MEYER	7701 DEBARR RD	ANCHORAGE	AK	99504-1872	01/01/2017
CH10002A	FRED MEYER STORES	DBA: FRED MEYER	1000 E NORTHERN LIGHTS BLVD	ANCHORAGE	AK	99508	01/01/2017
CH10002A	FRED MEYER STORES	DBA: FRED MEYER	2300 ABBOTT RD	ANCHORAGE	AK	99507	01/01/2017
CH10002A	FRED MEYER STORES, INC	DBA FRED MEYER #071	2000 W DIMOND BLVD	ANCHORAGE	AK	99515	01/01/2017
CH10002A	GENOA HEALTHCARE LLC	4020 FOLKER ST	SUITE 5	ANCHORAGE	AK	99508	10/01/2022	02/09/2023
CH10002A	GENOA HEALTHCARE LLC	4120 LAUREL STREET, SUITE 102		ANCHORAGE	AK	99508	02/09/2023
CH10002A	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	01/01/2017
CH10002A	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03526	306 EAST WOODLAWN RD	CHARLOTTE	NC	28217	01/01/2022
CH10002A	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	10/01/2022	10/01/2024
CH10002A	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	10/01/2022
CH10002A	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH10002A	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/01/2022	10/01/2024
CH10002A	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	10/01/2022
CH10002A	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	10/01/2022	10/01/2024
CH10002A	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	10/01/2022	10/01/2024
CH10002A	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	10/01/2022	01/01/2023
CH10002A	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2023
CH10002A	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/01/2023
CH10002A	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	04/01/2023
CH10002A	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	04/01/2023
CH10002A	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	04/01/2023
CH10002A	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2926	1001 MADISON ST.	SEATTLE	WA	98104	04/01/2024
CH10002A	SAFEWAY INC	CARRS PHARMACY #2628	1725 ABBOTT ROAD	ANCHORAGE	AK	99507	10/01/2016
CH10002A	SAFEWAY INC	CARRS PHARMACY #0520	3101 PENLAND PARKWAY	ANCHORAGE	AK	99508	10/01/2016	09/19/2020
CH10002A	SAFEWAY, INC	CARRS PHARMACY #720	2920 SEWARD HWY	ANCHORAGE	AK	99503	07/01/2021
CH10002A	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05596	4627 NORTH MAIN STREET	COLUMBIA	SC	29203	04/01/2023
CH10002A	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH10002A	WAL-MART PHARMACY 10-2070	3101 A STREET		ANCHORAGE	AK	99503	01/01/2017
CH10002A	WAL-MART PHARMACY 10-2071	8900 OLD SEWARD HWY		ANCHORAGE (S)	AK	99515	01/01/2017
CH10002A	WAL-MART PHARMACY 10-4359	7405 DEBARR ROAD		ANCHORAGE	AK	99504	01/01/2017
CH10002A	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH10002A	WALGREEN CO.	DBA: WALGREENS #12680	2197 W DIMOND BLVD	ANCHORAGE	AK	99515	01/12/2012
CH10002A	WALGREEN CO.	DBA: WALGREENS #12681	1721 E PARKS HWY	WASILLA	AK	99654	01/12/2012
CH10002A	WALGREEN CO.	DBA: WALGREENS #13449	12405 BRANDON ST	ANCHORAGE	AK	99515-3589	01/12/2012
CH10002A	WALGREEN CO.	DBA: WALGREENS #13656	725 E. NORTHERN LIGHTS BLVD.	ANCHORAGE	AK	99503	01/12/2012
CH10002A	WALGREEN CO.	DBA: WALGREENS #12679	7600 DEBARR RD	ANCHORAGE	AK	99504	01/12/2012	12/05/2024
CH10002A	WALGREEN CO.	DBA: WALGREENS #15092	1470 W. NORTHERN LIGHTS BLVD.	ANCHORAGE	AK	99503-3663	04/01/2013	12/17/2024
CH10002A	WALGREEN CO.	DBA: WALGREENS #15653	4353 LAKE OTIS PKWY	ANCHORAGE	AK	99508	04/01/2017
CH10002A	WALGREEN CO.	DBA: WALGREENS #15654	2550 EAST 88TH AVENUE	ANCHORAGE	AK	99507	04/01/2017
CH10002A	WALGREEN CO.	DBA: WALGREENS #15362	12051 OLD GLENN HIGHWAY	EAGLE RIVER	AK	99577	04/01/2022
CH10002A	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH10002A	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 2:46:55 PM	2/11/2025 1:56:23 PM	2/11/2025 1:56 PM
Details	Last Recertification Date	Update	Recertification	1/31/2023 8:43:25 PM	1/29/2024 2:46:55 PM	1/29/2024 2:46 PM
Details	Last Recertification Date	Update	Recertification	2/2/2022 6:01:27 PM	1/31/2023 8:43:25 PM	1/31/2023 8:43 PM
Contacts	Primary Contact	Update	PC Change Request	Muffoletto, Chantele Pharmacist Anchorage Neighborhood Health Center Pharmacy 9077437203	Woodard, Stephen Russell Director of Pharmacy Anchorage Neighborhood Health Center Pharmacy 9077437203	11/7/2022 8:32 AM
Contacts	Primary Contact	Update	PC Change Request	Harrison, Jonathon Pharmacy Director Anchorage Neighborhood Health Center Inc. 9077437203	Muffoletto, Chantele Pharmacist Anchorage Neighborhood Health Center Pharmacy 9077437203	9/20/2022 6:32 AM
Details	Last Recertification Date	Update	Recertification	2/1/2021 10:28:51 PM	2/2/2022 6:01:27 PM	2/2/2022 6:01 PM
Contacts	Authorizing Official	Update	AO Change Request	Green, Tammy Chief Executive Officer Anchorage Neighborhood Health Center 9077437305	Aquino, Lisa DH CEO Anchorage Neighborhood Health Center 9077437305	1/18/2022 7:02 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1003895 (AK)		2/1/2021 10:28 PM
Medicaid Billing	NPI: State	Update	Recertification		AK	2/1/2021 10:28 PM
Medicaid Billing	NPI: State	Update	Recertification		AK	2/1/2021 10:28 PM
Medicaid Billing	NPI: State	Update	Recertification		AK	2/1/2021 10:28 PM
Medicaid Billing	NPI: State	Update	Recertification		AK	2/1/2021 10:28 PM
Details	Last Recertification Date	Update	Recertification	1/30/2020 6:31:11 PM	2/1/2021 10:28:51 PM	2/1/2021 10:28 PM
Contacts	Primary Contact	Update	Change Request	Ruggles, Ryan P. Pharmacy Director ANHC 9077437352	Harrison, Jonathon Pharmacy Director Anchorage Neighborhood Health Center Inc. 9077437203	10/28/2020 12:34 PM
Details	Last Recertification Date	Update	Recertification	2/14/2019 7:04:58 PM	1/30/2020 6:31:11 PM	1/30/2020 6:31 PM
Addresses	Shipping Address	Insert	Change Request		Anchorage Neighborhood Health Center 4951 Business Park Blvd #106 Anchorage, AK 99503	4/3/2019 2:55 PM
Details	Last Recertification Date	Update	Recertification	2/13/2018 5:48:28 PM	2/14/2019 7:04:58 PM	2/14/2019 7:04 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1003895	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AK	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1004346	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AK	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1581033	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AK	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1003895	7/23/2018 4:35 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AK	7/23/2018 4:35 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1669475166	7/23/2018 4:35 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1811170210	7/23/2018 4:35 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1407030026	7/23/2018 4:35 PM
Details	Last Recertification Date	Update	Recertification	1/27/2017 12:00:00 AM	2/13/2018 5:48:28 PM	2/13/2018 5:48 PM
Contacts	Authorizing Official	Update		Green, Tammy Chief Executive Officer 9077437305	Green, Tammy Chief Executive Officer Anchorage Neighborhood Health Center 9077437305	2/13/2018 5:37 PM
Contacts	Primary Contact	Update		Ruggles, Ryan P. Pharmacy Director 9077437352	Ruggles, Ryan P. Pharmacy Director ANHC 9077437352	1/16/2018 7:16 PM
Contacts	Authorizing Official	Update		Rodgers, William CEO 9077437353	Green, Tammy Chief Executive Officer 9077437305	7/20/2017 1:03 PM
Addresses	Main Address	Insert			4951 Business Park Blvd Anchorage, AK 99503-7174	1/27/2017 3:07 PM
Contacts	Primary Contact	Update		WETHINGTON, JASPER W. DIRECTOR OF PHARMACY 9077437352	Ruggles, Ryan P. Pharmacy Director 9077437352	1/27/2017 3:07 PM
Details	Last Recertification Date	Update		2/23/2016 12:00:00 AM	1/27/2017 12:00:00 AM	1/27/2017 3:06 PM
Medicaid Billing	Medicaid: Is Primary	Update		True	False	2/23/2016 7:55 AM
Medicaid Billing	Medicaid: Number	Update		PH 0311	1028568	2/23/2016 7:55 AM
Medicaid Billing	NPI: Number	Insert			1316952013	2/23/2016 7:55 AM
Details	Last Recertification Date	Update		2/19/2015 12:00:00 AM	2/23/2016 12:00:00 AM	2/23/2016 7:55 AM
Contacts	Primary Contact	Insert			WETHINGTON, JASPER W. DIRECTOR OF PHARMACY 9077437352	2/19/2015 5:48 PM
Contacts	Authorizing Official	Update		Cohen, Kimberly CEO 9077437353	Rodgers, William CEO 9077437353	2/19/2015 5:48 PM
Details	Last Recertification Date	Update		3/17/2014 12:00:00 AM	2/19/2015 12:00:00 AM	2/19/2015 5:48 PM
Contacts	Authorizing Official	Insert			Cohen, Kimberly CEO 9077437353	4/30/2014 10:39 AM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/17/2014 12:00:00 AM	3/17/2014 11:42 PM
Details	Entity Name	Update		ANCHORAGE NEIGHBORHOOD HLTH	ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.	3/17/2014 11:42 PM
Details	Entity Subname	Update			Anchorage Neighborhood Health Center, Inc.	3/17/2014 11:42 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/11/2013 10:27 AM
Details	Last Recertification Date	Insert				6/17/2011 2:00 PM
Details	Grant Number	Insert			H80CS00146	6/17/2011 2:00 PM
Details	340B ID	Insert			CH10002A	6/17/2011 2:00 PM
Details	Is Authorizing Official EHB Data	Insert				6/17/2011 2:00 PM
Dates	Last Date That 340B Drugs Purchased	Insert				6/17/2011 2:00 PM
Details	Medicare Provider Number	Insert				6/17/2011 2:00 PM
Details	Entity Name	Insert			ANCHORAGE NEIGHBORHOOD HLTH	6/17/2011 2:00 PM
Details	Program Code	Insert			CH	6/17/2011 2:00 PM
Details	Entity Subname	Insert				6/17/2011 2:00 PM
Dates	Participating Approval Date	Insert			3/4/2005 12:00:00 AM	6/17/2011 2:00 PM
Details	State	Insert			Active	6/17/2011 2:00 PM
Dates	Registration Date	Insert			4/1/1999 12:00:00 AM	6/17/2011 2:00 PM
Dates	Signed By Date	Insert				6/17/2011 2:00 PM
Dates	Start Date	Insert			4/1/1999 12:00:00 AM	6/17/2011 2:00 PM
Terminations	Termination Comments	Insert				6/17/2011 2:00 PM
Terminations	Termination Date	Insert				6/17/2011 2:00 PM
Terminations	Termination Effective Date	Insert				6/17/2011 2:00 PM
Terminations	Termination Reason	Insert				6/17/2011 2:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert			True	4/1/1999 12:00 AM
Medicaid Billing	Medicaid: Number	Insert			PH 0311	4/1/1999 12:00 AM
Medicaid Billing	Medicaid: State	Insert			AK	4/1/1999 12:00 AM

340B Drug Pricing Program Database