340B Drug Pricing Program Database


CH09071BA Community Health Centers Of The Central Coast, Inc. (Active) - information as of 4/25/2025 5:37:18 PM

Main Details
Community Health Centers Of The Central Coast, Inc.
COMMUNITY HEALTH CENTERS - PRADO
HRSA-Funded Health Center
BPS-H80-027327
CH09071BA
H80CS00621


Additional Details
Active
7/30/2019
10/1/2019
8/29/2019
2/11/2025

Contacts

community health centers of the central coast, inc
RONALD E. CASTLE, CEO
(805) 459-1835

Community Health Centers of the Central Coast, Inc.
Derek Yip, 340B Director
(805) 346-3923

Addresses

40 Prado Rd
San Luis Obispo, CA 93401-7313

Community Health Centers of the Central Coast, Inc
150 Tejas Place
Nipomo, CA 93444


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

Yes
StateMedicaid NumberNPI Number
CAPHA4679801275553257,1952390254
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 # 09782 610 WEST TEFFT STREET
NIPOMOCA9344406/09/202306/09/2023  06/14/2023
Contract DetailTHRIFTY PAYLESS, INC.RITE AID #5821 1110 LOS OSOS VALLEY ROAD
LOS OSOSCA9340205/04/202305/05/2023 01/01/202401/10/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH090710ActiveBPS-H80-002350COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.NIPOMO COMMUNITY MEDICAL CENTER150 TEJAS PL NIPOMOCA
CH09071AActiveBPS-H80-000088COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS SANTA MARIA2801 SANTA MARIA WAY SANTA MARIACA
CH09071ABActiveBPS-H80-014306COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS - SANTA MARIA II1835 N BROADWAY SANTA MARIACA
CH09071ADActiveBPS-H80-005121COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS WOMENS HEALTH1551 BISHOP ST STE 240 SAN LUIS OBISPOCA
CH09071AGActiveBPS-H80-009341COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS ARBOR 1418 E MAIN ST, STE 210 SANTA MARIACA
CH09071AHActiveBPS-H80-010524COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS ARROYO GRANDE260 STATION WAY ARROYO GRANDECA
CH09071AJTerminatedBPS-H80-013689COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC PALISADE WOMEN'S HEALTH210 S Palisade Dr STE 102 Santa MariaCA
CH09071AKActiveBPS-H80-010764COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.Community Health Centers - New Cuyama4711 Highway 166 New CuyamaCA
CH09071ALTerminatedBPS-H80-013651COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC GROVER BEACH555 S 13TH ST GROVER BEACHCA
CH09071AMActiveBPS-H80-006403COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC SLO HOMELESS MOBILE MEDICAL 32801 SANTA MARIA WAY SANTA MARIACA
CH09071ANActiveBPS-H80-007147COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC - MOBILE MEDICAL VAN 2200 W. WILLIAMS ST SANTA MARIACA
CH09071APActiveBPS-H80-014465COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS DEL VALLE430 S BLOSSER RD SANTA MARIACA
CH09071AQActiveBPS-H80-010989COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS BROADWAY DENTAL210 N Broadway Santa MariaCA
CH09071ARActiveBPS-H80-017291COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS SAN LUIS OBISPO II1551 Bishop St., Ste B-260 San Luis ObispoCA
CH09071ASActiveBPS-H80-032247COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.Community Health Centers Los Alamos490 Bell St Los AlamosCA
CH09071ATTerminatedBPS-H80-017973 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC - SANTA MARIA HIGH SCHOOL829 S LINCOLN ST, SPC 908 SANTA MARIACA
CH09071AUActiveBPS-H80-017292COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.CHC - TEMPLETON WOMEN'S HEALTH292 Posada Ln Ste A TempletonCA
CH09071AVActiveBPS-H80-017983COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS - SAN MIGUEL1385 Mission St San MiguelCA
CH09071AWActiveBPS-H80-019701Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS - DEL MAR2120 Cienaga St OceanoCA
CH09071AXActiveBPS-H80-021791Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS - ARROYO GRANDE1205 E. Grand Ave., Ste H Arroyo GrandeCA
CH09071AYActiveBPS-H80-021327Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS COASTAL DENTAL1304 South Miller St. Santa MariaCA
CH09071AZTerminatedBPS-H80-021648Community Health Centers Of The Central Coast, Inc.Community Health Centers - Advanced Women's Health1510 E. Main Street, Suite 104B Santa MariaCA
CH09071BAActiveBPS-H80-027327Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS - PRADO40 Prado Rd San Luis ObispoCA
CH09071BBActiveBPS-H80-028330Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS LOS ROBLES2800 Riverside Avenue # 101 Paso RoblesCA
CH09071BCActiveBPS-H80-032248Community Health Centers Of The Central Coast, Inc.Community Health Centers - Advanced Primary Care1510 E. Main Street, Suite 104B Santa MariaCA
CH09071BDActiveBPS-H80-035364Community Health Centers Of The Central Coast, Inc.COMMUNITY HEALTH CENTERS PALISADE PRIMARY CARE210 S Palisade Dr STE 202A Santa MariaCA
CH09071BEActiveBPS-H80-035739Community Health Centers Of The Central Coast, Inc.Community Health Centers Santa Maria Women's Health A116 S Palisade Dr STE 301 Santa MariaCA
CH09071BFActiveBPS-H80-035740Community Health Centers Of The Central Coast, Inc.Community Health Centers Santa Maria Women's Health B116 S Palisade Dr STE 306 Santa MariaCA
CH09071CActiveBPS-H80-001009COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.DOCTORS OFFICE/FAIR OAKS COMMUNITY HEALTH CENTERS1057 E GRAND AVE ARROYO GRANDECA
CH09071DActiveBPS-H80-011138COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS PASO416A Spring St. PASO ROBLESCA
CH09071IActiveBPS-H80-028033COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS TEMPLETON1330 Las Tablas Rd TempletonCA
CH09071LActiveBPS-H80-019432COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS GUADALUPE4723 W MAIN ST, STE H. GUADALUPECA
CH09071STerminatedBPS-H80-003883COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS SAN LUIS OBISPO1551 BISHOP ST. SAN LUIS OBISPOCA
CH09071TActiveBPS-H80-017501COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS ATASCADERO7512 MORRO ROAD #7516, STE 7512, 7520, 7524 ATASCADEROCA
CH09071UActiveBPS-H80-018283COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS CASA77 CASA ST. #201 SAN LUIS OBISPOCA
CH09071VTerminatedBPS-H80-017208COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS SANTA MARIA III1414 S. MILLER ST. STE 8 SANTA MARIACA
CH09071WActiveBPS-H80-034143COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS CAMBRIA1276 Tamsen St CAMBRIACA
CH09071XActiveBPS-H80-032198COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS LOMPOC1300 W Ocean Ave LOMPOCCA
CH09071ZTerminatedBPS-H80-001155COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.COMMUNITY HEALTH CENTERS OCEANO1981 Cienaga St OceanoCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090710ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2021  
CH090710ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2021  
CH090710ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2021  
CH090710ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2021  
CH090710ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/01/2021 02/28/2024
CH090710ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2021  
CH090710ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607504/19/2023  
CH090710ALBERTSONS LLCSAV-ON PHARMACY #0314 189 NIBLICK ROAD
PASO ROBLESCA9344607/01/2017  
CH090710ALBERTSONS LLCSAV-ON PHARMACY #1394 1120 E CLARK AVE
ORCUTTCA9345507/01/2017  
CH090710ALBERTSONS LLCSAV-ON PHARMACY #1348 2320 S BROADWAY
SANTA MARIACA9345407/01/2017  
CH090710ALBERTSONS LLCSAV-ON PHARMACY #3171 1500 NORTH H STREET
LOMPOCCA9343604/14/2021  
CH09071AALBERTSONS LLCSAV-ON PHARMACY #3171 1500 NORTH H STREET
LOMPOCCA9343604/17/2023 01/01/2024
CH09071CALBERTSONS LLCSAV-ON PHARMACY #0314 189 NIBLICK ROAD
PASO ROBLESCA9344604/17/2023 01/01/2024
CH09071LALBERTSONS LLCSAV-ON PHARMACY #1348 2320 S BROADWAY
SANTA MARIACA9345404/17/2023 01/01/2024
CH09071AALBERTSONS LLCSAV-ON PHARMACY #3171 1500 NORTH H STREET
LOMPOCCA9343610/01/2024  
CH09071AMALBERTSONS LLCSAV-ON PHARMACY #1348 2320 S BROADWAY
SANTA MARIACA9345410/01/2024  
CH09071IALBERTSONS LLCSAV-ON PHARMACY #0314 189 NIBLICK ROAD
PASO ROBLESCA9344610/01/2024  
CH09071LALBERTSONS LLCSAV-ON PHARMACY #1394 1120 E CLARK AVE
ORCUTTCA9345510/01/2024  
CH090710BESTCARE PHARMACY1051 E GRAND AVE
ARROYO GRANDECA93420-250407/01/2013 12/31/2021
CH090710CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361410/01/2023  
CH090710CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/01/2023  
CH090710CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621910/01/2023  
CH090710CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175710/01/2023  
CH090710CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808310/01/2023  
CH090710CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700410/01/2023  
CH090710CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761710/01/2023  
CH090710CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2023  
CH090710CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237410/01/2023  
CH090710CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911910/01/2023  
CH090710CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506904/01/2021  
CH090710CENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302504/01/2021 07/07/2023
CH090710CENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282404/01/2024  
CH090710CHC TEMPLETON PHARMACY1330 LAS TABLAS ROAD SUITE 140
TEMPLETONCA9346509/29/2020  
CH09071AXCHC TEMPLETON PHARMACY1330 LAS TABLAS ROAD SUITE 140
TEMPLETONCA9346501/01/2024  
CH090710CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2024  
CH090710CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2024  
CH090710CVS PHARMACY INC777 S HARBOR BLVD STE D-152
LA HABRACA90631-688201/01/2015 06/22/2020
CH090710CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502810/01/2023  
CH090710DIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268308/17/2012 04/04/2022
CH090710DIPLOMAT SPECIALTY PHARMACYG3320 BEECHER RD
FLINTMI48532-361407/01/2013 07/11/2018
CH090710DIPLOMAT SPECIALTY PHARMACY1370 BUSCH PKWY
BUFFALO GROVEIL60089-450507/01/2013 07/11/2018
CH090710DIPLOMAT SPECIALTY PHARMACY15211 VANOWEN ST STE 301
VAN NUYSCA9140510/01/2019 10/01/2020
CH090710DIPLOMAT SPECIALTY PHARMACY OF FT LAUDERDIPLOMAT SPECIALTY PHARMACY 15471 SW 12TH ST
STE 207 		SUNRISEFL3332607/01/2013 07/11/2018
CH090710DIPLOMAT SPECIALTY PHARMACY OF PHOENIX,DIPLOMAT SPECIALTY PHARMACY 485 N. JUNIPER DR
CHANDLERAZ8522610/01/2019 02/10/2021
CH090710DIPLOMAT SPECIALTY PHARMACY OF SOUTHERNDIPLOMAT SPECIALTY PHARMACY 1809 EXCISE AVENUE
SUITE 204-208 		ONTARIOCA9176107/01/2013 07/31/2019
CH090710GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340107/01/2013  
CH090710GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09750 1830 NORTH BROADWAY
SANTA MARIACA9345407/01/2013  
CH090710GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09782 610 WEST TEFFT STREET
NIPOMOCA9344407/01/2013  
CH09071UGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09750 1830 NORTH BROADWAY
SANTA MARIACA9345403/19/2010 06/08/2020
CH09071ABGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09782 610 WEST TEFFT STREET
NIPOMOCA9344412/04/2009 06/08/2020
CH09071ADGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340112/11/2009 06/08/2020
CH090710GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17619 11990 LOS OSOS VALLEY RD
SAN LUIS OBISPOCA9340501/01/2018  
CH090710GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16488 2305 THEATRE DR
PASO ROBLESCA9344601/01/2018  
CH090710GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16105 223 E BETTERAVIA RD
SANTA MARIACA9345401/01/2018  
CH09071XGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09782 610 WEST TEFFT STREET
NIPOMOCA9344407/01/2023 05/05/2023
CH09071LGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09750 1830 NORTH BROADWAY
SANTA MARIACA9345407/01/2023 05/05/2023
CH09071IGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16488 2305 THEATRE DR
PASO ROBLESCA9344605/05/2023 01/01/2024
CH09071AMGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340105/05/2023 01/01/2024
CH09071AQGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09782 610 WEST TEFFT STREET
NIPOMOCA9344405/08/2023 01/01/2024
CH09071ASGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09750 1830 NORTH BROADWAY
SANTA MARIACA9345405/08/2023  
CH09071BAGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09782 610 WEST TEFFT STREET
NIPOMOCA9344406/09/2023  
CH09071IGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340106/09/2023  
CH09071LGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340106/09/2023 01/01/2024
CH09071UGARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09662 3960 BROAD STREET
SAN LUIS OBISPOCA9340106/09/2023 01/01/2024
CH09071XGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16105 223 E BETTERAVIA RD
SANTA MARIACA9345406/09/2023  
CH09071DGARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 17619 11990 LOS OSOS VALLEY RD
SAN LUIS OBISPOCA9340510/01/2024  
CH090710HOMETOWN LTC PHARMACYHOMETOWN LTC PHARMACY 1450 W MCCOY LN STE B
SANTA MARIACA93455-105907/01/2014 06/01/2019
CH090710HOMETOWN PHARMACY  1414 S MILLER STREET
SUITES E & F 		SANTA MARIACA9345407/01/2013 07/21/2017
CH09071VHOMETOWN PHARMACY  1414 S MILLER STREET
SUITES E & F 		SANTA MARIACA9345402/17/2010 04/01/2016
CH090710IMGRX SLO INCDBA CHC PHARMACY ATASCADERO 7524 MORRO RD
ATASCADEROCA9342210/01/2016 01/09/2019
CH090710IMGRX SLO INCDBA CHC PHARMACY PASO ROBLES 416 SPRING ST
PASO ROBLESCA9344607/01/2017 01/09/2019
CH090710IMGRX SLO INCDBA CHC PHARMACY SLO 77 CASA ST STE 205
SAN LUIS OBISPOCA9340507/01/2017 01/09/2019
CH090710IMGRX SLO, INC. DBACHC PHARMACY ATASCADERO 7524 MORRO ROAD
ATASCADEROCA93422-440401/10/2019 03/05/2019
CH090710IMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344601/10/2019  
CH090710IMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340501/10/2019  
CH09071ABIMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344607/01/2023 05/05/2023
CH09071AYIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340507/01/2023 05/05/2023
CH09071AWIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340505/08/2023 01/01/2024
CH09071AVIMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344605/08/2023  
CH09071BDIMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344606/09/2023 01/01/2024
CH09071DIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340506/09/2023 01/01/2024
CH09071XIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340506/09/2023 01/01/2024
CH09071ADIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340510/01/2023 01/01/2024
CH09071BBIMGRX SLO, INC. DBACHC PHARMACY SLO 77 CASA STREET, SUITE 205
SAN LUIS OBISPOCA9340510/01/2023  
CH09071BBIMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344610/01/2023 01/01/2024
CH09071WIMGRX SLO, INC. DBACHC PHARMACY PASO ROBLES 2800 RIVERSIDE AVENUE
SUITE 150 		PASO ROBLESCA9344610/01/2023 01/01/2024
CH090710LA JOYA PHARMACY1115 WEST MAIN STREET STE E-1
SANTA MARIACA93458-934507/01/2013 11/11/2018
CH09071ULA JOYA PHARMACY1115 WEST MAIN STREET STE E-1
SANTA MARIACA93458-934505/11/2010 11/11/2018
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340107/01/2013  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09592 1435 E GRAND AVE
ARROYO GRANDECA9342007/01/2013  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09873 1300 MADONNA RD
SAN LUIS OBISPOCA9340507/01/2013  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09909 8320 EL CAMINO REAL
ATASCADEROCA9342207/01/2013  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09925 187 NIBLICK RD
PASO ROBLESCA9344607/01/2013  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09871 1317 N H ST
LOMPOCCA9343601/01/2014  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344901/01/2014  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03153 733 E MAIN ST
SANTA MARIACA9345404/01/2017  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09394 4852 S BRADLEY RD
SANTA MARIACA9345504/01/2017  
CH090710LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09821 2116 S BROADWAY
SANTA MARIACA9345404/01/2017  
CH09071ALONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09592 1435 E GRAND AVE
ARROYO GRANDECA9342012/04/2009 06/08/2020
CH09071DLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09925 187 NIBLICK RD
PASO ROBLESCA9344612/04/2009 06/08/2020
CH09071TLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09909 8320 EL CAMINO REAL
ATASCADEROCA9342212/04/2009 06/08/2020
CH09071SLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340112/04/2009 04/01/2016
CH09071AGLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09592 1435 E GRAND AVE
ARROYO GRANDECA9342005/05/2023  
CH09071ADLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09909 8320 EL CAMINO REAL
ATASCADEROCA9342205/05/2023  
CH09071AHLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09873 1300 MADONNA RD
SAN LUIS OBISPOCA9340505/05/2023 01/01/2024
CH09071AULONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09925 187 NIBLICK RD
PASO ROBLESCA9344605/05/2023  
CH09071ATLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340107/01/2023 05/05/2023
CH09071AQLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09871 1317 N H ST
LOMPOCCA9343607/01/2023 05/05/2023
CH09071AKLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09394 4852 S BRADLEY RD
SANTA MARIACA9345505/05/2023  
CH09071ASLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344907/01/2023 05/05/2023
CH09071ANLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03153 733 E MAIN ST
SANTA MARIACA9345405/05/2023 01/01/2024
CH09071BCLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344905/08/2023 01/01/2024
CH09071CLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340105/08/2023 01/01/2024
CH09071XLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09871 1317 N H ST
LOMPOCCA9343605/08/2023 01/01/2024
CH09071AHLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03153 733 E MAIN ST
SANTA MARIACA9345406/09/2023  
CH09071AMLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09873 1300 MADONNA RD
SAN LUIS OBISPOCA9340506/09/2023  
CH09071ANLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09821 2116 S BROADWAY
SANTA MARIACA9345406/09/2023 01/01/2024
CH09071ATLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344906/09/2023 04/01/2024
CH09071AWLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09871 1317 N H ST
LOMPOCCA9343606/09/2023  
CH09071BCLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09871 1317 N H ST
LOMPOCCA9343606/09/2023 01/01/2024
CH09071BELONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09873 1300 MADONNA RD
SAN LUIS OBISPOCA9340506/09/2023 01/01/2024
CH09071BFLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340106/09/2023  
CH09071DLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344906/09/2023 01/01/2024
CH09071APLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09394 4852 S BRADLEY RD
SANTA MARIACA9345510/01/2023 01/01/2024
CH09071APLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340110/01/2023 01/01/2024
CH09071AVLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340110/01/2023 01/01/2024
CH09071CLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09821 2116 S BROADWAY
SANTA MARIACA9345410/01/2023  
CH09071ILONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09873 1300 MADONNA RD
SAN LUIS OBISPOCA9340510/01/2023 01/01/2024
CH09071ILONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09345 717 MARSH ST
SAN LUIS OBISPOCA9340110/01/2023 01/01/2024
CH09071LLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09821 2116 S BROADWAY
SANTA MARIACA9345410/01/2023 01/01/2024
CH09071LLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09394 4852 S BRADLEY RD
SANTA MARIACA9345510/01/2023 01/01/2024
CH09071LLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03153 733 E MAIN ST
SANTA MARIACA9345410/01/2023 01/01/2024
CH09071ANLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09892 827 OAK PARK BLVD
PISMO BEACHCA9344901/01/2024  
CH090710MORRO BAY DRUG AND GIFT600 MORRO BAY BLVD STE B
MORRO BAYCA93442-196507/01/2013 09/23/2019
CH090710MORRO BAY DRUG AND GIFT600 MORRO BAY BLVD. STE. B
MORRO BAYCA9344209/20/2019 03/31/2022
CH090710NIPOMO PHARMACY INCDBA NIPOMO REXALL DRUGS 695 W TEFFT ST STE A
NIPOMOCA93444-939501/01/2017 03/28/2022
CH090710OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502908/03/2021  
CH090710OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/04/2022  
CH090710OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713008/03/2021  
CH090710OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824908/03/2021  
CH090710OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729808/03/2021  
CH090710OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140108/03/2021  
CH090710OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2022  
CH090710PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999210/01/2017 08/31/2022
CH090710PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514610/01/2023  
CH090710PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523310/01/2023  
CH090710PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920310/01/2023  
CH090710RALPHS GROCERY CODBA RALPHS #271 1240 LOS OSOS VALLEY RD
LOS OSOSCA9340207/01/2013  
CH09071ADRALPHS GROCERY CODBA RALPHS #271 1240 LOS OSOS VALLEY RD
LOS OSOSCA9340210/01/2023 01/01/2024
CH09071TRALPHS GROCERY CODBA RALPHS #271 1240 LOS OSOS VALLEY RD
LOS OSOSCA9340210/01/2024  
CH090710SENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
PLANOTX7507401/01/2021  
CH090710STARS PHARMACYSTAR PHARMACY RX, INC. 830 GUADALUPE ST
GUADALUPECA9343404/01/2016 05/31/2022
CH090710THE VONS COMPANIES INCVONS PHARMACY #1621 520 WEST TEFFT STREET
NIPOMOCA9344411/21/2009  
CH090710THE VONS COMPANIES INCVONS PHARMACY #1738 729 NORTH H STREET
LOMPOCCA9343607/01/2013 04/27/2021
CH090710THE VONS COMPANIES INCVONS PHARMACY #2560 1758 GRAND AVENUE
GROVER BEACHCA9343307/01/2013  
CH090710THE VONS COMPANIES INCVONS PHARMACY #2306 3900 BROAD STREET
SAN LUIS OBISPOCA9340101/01/2017  
CH09071XTHE VONS COMPANIES INCVONS PHARMACY #1738 729 NORTH H STREET
LOMPOCCA9343603/19/2010 06/08/2020
CH09071BDTHE VONS COMPANIES INCVONS PHARMACY #1621 520 WEST TEFFT STREET
NIPOMOCA9344404/17/2023 01/01/2024
CH09071BETHE VONS COMPANIES INCVONS PHARMACY #2306 3900 BROAD STREET
SAN LUIS OBISPOCA9340104/17/2023 01/01/2024
CH09071BCTHE VONS COMPANIES INCVONS PHARMACY #2560 1758 GRAND AVENUE
GROVER BEACHCA9343304/17/2023 01/01/2024
CH09071AHTHE VONS COMPANIES INCVONS PHARMACY #2306 3900 BROAD STREET
SAN LUIS OBISPOCA9340110/01/2024  
CH09071CTHE VONS COMPANIES INCVONS PHARMACY #1621 520 WEST TEFFT STREET
NIPOMOCA9344410/01/2024  
CH09071UTHE VONS COMPANIES INCVONS PHARMACY #2560 1758 GRAND AVENUE
GROVER BEACHCA9343310/01/2024  
CH090710THRIFTY PAYLESS, INC.RITE AID #5820 1251 JOHNSON AVENUE
SAN LUIS OBISPOCA9340107/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5821 1110 LOS OSOS VALLEY ROAD
LOS OSOSCA9340207/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5824 1207 GRAND AVENUE
ARROYO GRANDECA9342007/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342007/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5827 7025 EL CAMINO REAL
ATASCADEROCA9342207/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5830 740 QUINTANA ROAD
MORRO BAYCA9344207/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5831 1151 CRESTON ROAD
PASO ROBLESCA9344607/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5832 2424 SPRING STREET
PASO ROBLESCA9344607/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5835 345 TOWN CENTER WEST
SANTA MARIACA9345807/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5836 2405 SOUTH BROADWAY
SANTA MARIACA9345407/01/2013  
CH090710THRIFTY PAYLESS, INC.RITE AID #5833 531 FIVE CITIES DRIVE
PISMO BEACHCA9344907/01/2017  
CH090710THRIFTY PAYLESS, INC.RITE AID #5822 956 E FOOTHILL BLVD
SAN LUIS OBISPOCA9340507/01/2017  
CH09071BFTHRIFTY PAYLESS, INC.RITE AID #5822 956 E FOOTHILL BLVD
SAN LUIS OBISPOCA9340504/17/2023 01/01/2024
CH09071AWTHRIFTY PAYLESS, INC.RITE AID #5827 7025 EL CAMINO REAL
ATASCADEROCA9342207/01/2023 05/05/2023
CH09071ATHRIFTY PAYLESS, INC.RITE AID #5824 1207 GRAND AVENUE
ARROYO GRANDECA9342005/05/2023 01/01/2024
CH09071BDTHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342005/05/2023  
CH09071WTHRIFTY PAYLESS, INC.RITE AID #5830 740 QUINTANA ROAD
MORRO BAYCA9344205/05/2023  
CH09071DTHRIFTY PAYLESS, INC.RITE AID #5832 2424 SPRING STREET
PASO ROBLESCA9344605/05/2023  
CH09071AXTHRIFTY PAYLESS, INC.RITE AID #5820 1251 JOHNSON AVENUE
SAN LUIS OBISPOCA9340105/05/2023  
CH09071CTHRIFTY PAYLESS, INC.RITE AID #5835 345 TOWN CENTER WEST
SANTA MARIACA9345807/01/2023 05/05/2023
CH09071BATHRIFTY PAYLESS, INC.RITE AID #5821 1110 LOS OSOS VALLEY ROAD
LOS OSOSCA9340205/05/2023 01/01/2024
CH09071ARTHRIFTY PAYLESS, INC.RITE AID #5836 2405 SOUTH BROADWAY
SANTA MARIACA9345407/01/2023 05/05/2023
CH09071BBTHRIFTY PAYLESS, INC.RITE AID #5831 1151 CRESTON ROAD
PASO ROBLESCA9344605/05/2023 01/01/2024
CH09071ARTHRIFTY PAYLESS, INC.RITE AID #5827 7025 EL CAMINO REAL
ATASCADEROCA9342205/08/2023  
CH09071ATTHRIFTY PAYLESS, INC.RITE AID #5835 345 TOWN CENTER WEST
SANTA MARIACA9345805/08/2023 04/01/2024
CH09071AYTHRIFTY PAYLESS, INC.RITE AID #5836 2405 SOUTH BROADWAY
SANTA MARIACA9345405/08/2023  
CH09071AMTHRIFTY PAYLESS, INC.RITE AID #5820 1251 JOHNSON AVENUE
SAN LUIS OBISPOCA9340106/09/2023 01/01/2024
CH09071ATHRIFTY PAYLESS, INC.RITE AID #5822 956 E FOOTHILL BLVD
SAN LUIS OBISPOCA9340506/09/2023 01/01/2024
CH09071AWTHRIFTY PAYLESS, INC.RITE AID #5835 345 TOWN CENTER WEST
SANTA MARIACA9345806/09/2023 01/01/2024
CH09071BETHRIFTY PAYLESS, INC.RITE AID #5824 1207 GRAND AVENUE
ARROYO GRANDECA9342006/09/2023  
CH09071CTHRIFTY PAYLESS, INC.RITE AID #5832 2424 SPRING STREET
PASO ROBLESCA9344606/09/2023 01/01/2024
CH09071ADTHRIFTY PAYLESS, INC.RITE AID #5833 531 FIVE CITIES DRIVE
PISMO BEACHCA9344910/01/2023 01/01/2024
CH09071ADTHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071AUTHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071AUTHRIFTY PAYLESS, INC.RITE AID #5836 2405 SOUTH BROADWAY
SANTA MARIACA9345410/01/2023 01/01/2024
CH09071AVTHRIFTY PAYLESS, INC.RITE AID #5827 7025 EL CAMINO REAL
ATASCADEROCA9342210/01/2023 01/01/2024
CH09071AXTHRIFTY PAYLESS, INC.RITE AID #5824 1207 GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071BBTHRIFTY PAYLESS, INC.RITE AID #5822 956 E FOOTHILL BLVD
SAN LUIS OBISPOCA9340510/01/2023 01/01/2024
CH09071BBTHRIFTY PAYLESS, INC.RITE AID #5820 1251 JOHNSON AVENUE
SAN LUIS OBISPOCA9340110/01/2023 01/01/2024
CH09071ITHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071ITHRIFTY PAYLESS, INC.RITE AID #5821 1110 LOS OSOS VALLEY ROAD
LOS OSOSCA9340210/01/2023 01/01/2024
CH09071LTHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071TTHRIFTY PAYLESS, INC.RITE AID #5825 1690 EAST GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071UTHRIFTY PAYLESS, INC.RITE AID #5824 1207 GRAND AVENUE
ARROYO GRANDECA9342010/01/2023 01/01/2024
CH09071AWTHRIFTY PAYLESS, INC.RITE AID #5833 531 FIVE CITIES DRIVE
PISMO BEACHCA9344910/01/2024  
CH09071AUTHRIFTY PAYLESS, INC.RITE AID #5822 956 E FOOTHILL BLVD
SAN LUIS OBISPOCA9340510/01/2024  
CH09071BBTHRIFTY PAYLESS, INC.RITE AID #5831 1151 CRESTON ROAD
PASO ROBLESCA9344610/01/2024  
CH09071WTHRIFTY PAYLESS, INC.RITE AID #5821 1110 LOS OSOS VALLEY ROAD
LOS OSOSCA9340210/01/2024  
CH090710US BIOSERVICESUS BIOSERVICE CORPORATION 5025 PLANO PARKWAY
STE 100 		CARROLLTONTX7501001/01/2017 12/05/2017
CH090710US BIOSERVICESPHARM PLUS ACQUISITION, INC. 5100 E HUNTER AVE
SUITE 101 		ANAHEIMCA92807-204901/01/2017 12/05/2017
CH090710US BIOSERVICESUS BIOSERVICE CORPORATION 5025 PLANO PARKWAY
STE 100 		CARROLLTONTX7501010/01/2021 09/30/2022
CH090710US BIOSERVICESPHARM PLUS ACQUISITION, INC. 5100 E HUNTER AVE
SUITE 101 		ANAHEIMCA92807-204910/01/2021 09/30/2022
CH090710VALLEY MEDICAL PHARMACYDBA JDX PHARMACY 1504 S BROADWAY
SANTA MARIACA93454-721401/01/2014 03/01/2022
CH090710WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738604/01/2017  
CH090710WAL-MART PHARMACY 10-1989701 WEST CENTRAL AVE
LOMPOCCA9343604/01/2014  
CH09071AHWAL-MART PHARMACY 10-1989701 WEST CENTRAL AVE
LOMPOCCA9343606/09/2023 01/01/2024
CH09071APWAL-MART PHARMACY 10-1989701 WEST CENTRAL AVE
LOMPOCCA9343606/09/2023  
CH090710WAL-MART PHARMACY 10-2099180 NIBLICK RD
PASO ROBLESCA9344608/22/2012  
CH09071TWAL-MART PHARMACY 10-2099180 NIBLICK RD
PASO ROBLESCA9344605/05/2023  
CH090710WAL-MART PHARMACY 10-25072220 SOUTH BRADLEY
SANTA MARIACA9345508/22/2012  
CH09071BFWAL-MART PHARMACY 10-25072220 SOUTH BRADLEY
SANTA MARIACA9345505/05/2023 01/01/2024
CH09071ABWAL-MART PHARMACY 10-25072220 SOUTH BRADLEY
SANTA MARIACA9345507/01/2023 05/05/2023
CH09071BCWAL-MART PHARMACY 10-25072220 SOUTH BRADLEY
SANTA MARIACA9345506/09/2023  
CH09071CWAL-MART PHARMACY 10-25072220 SOUTH BRADLEY
SANTA MARIACA9345506/09/2023 01/01/2024
CH090710WAL-MART PHARMACY 10-25561168 WEST BRANCH STREET
ARROYO GRANDECA9342004/01/2014  
CH09071APWAL-MART PHARMACY 10-25561168 WEST BRANCH STREET
ARROYO GRANDECA9342005/05/2023 01/01/2024
CH09071AQWAL-MART PHARMACY 10-25561168 WEST BRANCH STREET
ARROYO GRANDECA9342006/09/2023  
CH090710WAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
ORLANDOFL3281910/01/2020  
CH090710WAL-MART PHARMACY 10-56582240 S BRADLEY RD
SANTA MARIACA9345410/01/2016  
CH09071BFWAL-MART PHARMACY 10-56582240 S BRADLEY RD
SANTA MARIACA9345406/09/2023 01/01/2024
CH09071AGWAL-MART PHARMACY 10-56582240 S BRADLEY RD
SANTA MARIACA9345410/01/2024  
CH090710WAL-MART PHARMACY 10-5659500 SOUTH BLOSSER RD
SANTA MARIACA9345407/01/2014  
CH09071BCWAL-MART PHARMACY 10-5659500 SOUTH BLOSSER RD
SANTA MARIACA9345407/01/2023 05/05/2023
CH09071LWAL-MART PHARMACY 10-5659500 SOUTH BLOSSER RD
SANTA MARIACA9345405/08/2023  
CH090710WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283704/01/2017  
CH090710WALGREEN CODBA: WALGREENS 17500 PERRIS BLVD
MORENO VALLEYCA92551-954704/01/2013 08/20/2015
CH090710WALGREEN CODBA: WALGREENS 2370 E MAIN STREET
WOODLANDCA9577604/01/2013 08/20/2015
CH090710WALGREEN CO.DBA: WALGREENS # 06287 2399 S BROADWAY
SANTA MARIACA93454-783204/01/2013  
CH090710WALGREEN CO.DBA: WALGREENS # 06288 707 N BROADWAY
SANTA MARIACA9345404/01/2013  
CH090710WALGREEN CO.DBA: WALGREENS # 06290 937 NORTH H STREET
LOMPOCCA93436-414804/01/2013  
CH090710WALGREEN CO.DBA: WALGREENS # 07210 8005 EL CAMINO REAL
ATASCADEROCA93422-521104/01/2013  
CH090710WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15293 4940 VAN NUYS BLVD STE 104
SHERMAN OAKSCA9140301/01/2020  
CH09071UWALGREEN CO.DBA: WALGREENS # 07210 8005 EL CAMINO REAL
ATASCADEROCA93422-521105/05/2023  
CH09071AVWALGREEN CO.DBA: WALGREENS # 06287 2399 S BROADWAY
SANTA MARIACA93454-783207/01/2023 05/05/2023
CH09071BEWALGREEN CO.DBA: WALGREENS # 06288 707 N BROADWAY
SANTA MARIACA9345405/05/2023 01/01/2024
CH09071ABWALGREEN CO.DBA: WALGREENS # 06287 2399 S BROADWAY
SANTA MARIACA93454-783205/08/2023  
CH09071AWALGREEN CO.DBA: WALGREENS # 06288 707 N BROADWAY
SANTA MARIACA9345406/09/2023  
CH09071AXWALGREEN CO.DBA: WALGREENS # 06290 937 NORTH H STREET
LOMPOCCA93436-414806/09/2023 01/01/2024
CH09071APWALGREEN CO.DBA: WALGREENS # 06287 2399 S BROADWAY
SANTA MARIACA93454-783210/01/2023 01/01/2024
CH09071APWALGREEN CO.DBA: WALGREENS # 06288 707 N BROADWAY
SANTA MARIACA9345410/01/2023 01/01/2024
CH09071CWALGREEN CO.DBA: WALGREENS # 06287 2399 S BROADWAY
SANTA MARIACA93454-783210/01/2023 01/01/2024
CH09071BFWALGREEN CO.DBA: WALGREENS # 06290 937 NORTH H STREET
LOMPOCCA93436-414810/01/2024  
CH090710WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/01/2013 01/02/2018
CH090710WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904907/01/2013 08/20/2015
CH090710WALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2018  
CH090710WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527504/01/2015 09/06/2023
CH090710WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700804/01/2015 11/05/2021
CH090710WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818804/01/2015 09/06/2023
CH090710WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503304/01/2015 09/06/2023
CH090710WALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528601/01/2018  
CH090710WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275607/01/2023  
CH090710Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616804/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/6/2024 12:45:06 PM2/11/2025 4:24:21 PM2/11/2025 4:24 PM
DetailsLast Recertification DateUpdateRecertification1/30/2023 1:15:24 PM2/6/2024 12:45:06 PM2/6/2024 12:45 PM
ContactsPrimary ContactUpdateGroup Change RequestYip, Ada Director of 340B Program Community Health Centers of Central Coast, Inc 8053463987Yip, Derek 340B Director Community Health Centers of the Central Coast, Inc. 805346392311/7/2023 4:30 PM
DetailsLast Recertification DateUpdateRecertification2/7/2022 11:22:06 AM1/30/2023 1:15:24 PM1/30/2023 1:15 PM
DetailsLast Recertification DateUpdateRecertification2/1/2021 5:11:17 PM2/7/2022 11:22:06 AM2/7/2022 11:22 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/17/2021 7:46 PM
Medicaid BillingMedicaid: NumberInsertChange Request PHA4679806/17/2021 7:46 PM
Medicaid BillingMedicaid: StateInsertChange Request CA6/17/2021 7:46 PM
Medicaid BillingNPI: NumberInsertChange Request 19523902546/17/2021 7:46 PM
Medicaid BillingNPI: StateInsertChange Request CA6/17/2021 7:46 PM
DetailsLast Recertification DateUpdateRecertification1/27/2020 5:31:37 PM2/1/2021 5:11:17 PM2/1/2021 5:11 PM
Medicaid BillingNPI: StateUpdateChange Request CA1/28/2021 5:09 PM
DetailsLast Recertification DateUpdateRecertification 1/27/2020 5:31:37 PM1/27/2020 5:31 PM
DetailsStateUpdate ApprovedActive10/1/2019 12:04 AM
Medicaid BillingNPI: NumberDeleteNew Registration1336166248 ( ) 8/29/2019 9:04 AM
ContactsSigned ByInsertNew Registration CASTLE, RONALD E. CEO community health centers of the central coast, inc 80545918358/29/2019 9:04 AM
Details340B IDUpdateNew Registration CH09071BA8/29/2019 9:04 AM
DatesParticipating Approval DateUpdateNew Registration 8/29/2019 9:04:48 AM8/29/2019 9:04 AM
DetailsStateUpdateNew RegistrationPendingApproved8/29/2019 9:04 AM
DatesSigned By DateUpdateNew Registration 7/30/2019 12:07:46 PM8/29/2019 9:04 AM
DatesStart DateUpdateNew Registration 10/1/2019 12:00:00 AM8/29/2019 9:04 AM
Medicaid BillingNPI: NumberInsertNew Registration 12755532577/30/2019 3:52 PM
AddressesMain AddressInsertNew Registration  40 Prado Rd San Luis Obispo, CA 93401-73137/30/2019 11:28 AM
AddressesBilling AddressInsertNew Registration Community Health Centers of the Central Coast, Inc 150 Tejas Place Nipomo, CA 934447/30/2019 11:28 AM
Medicaid BillingNPI: NumberInsertNew Registration 13361662487/30/2019 11:28 AM
ContactsPrimary ContactInsertNew Registration Yip, Ada Director of 340B Program Community Health Centers of Central Coast, Inc 80534639877/30/2019 11:28 AM
ContactsAuthorizing OfficialInsertNew Registration CASTLE, RONALD E. CEO community health centers of the central coast, inc 80545918357/30/2019 11:28 AM
DetailsLast Recertification DateInsertNew Registration  7/30/2019 11:28 AM
DetailsGrant NumberInsertNew Registration H80CS006217/30/2019 11:28 AM
Details340B IDInsertNew Registration  7/30/2019 11:28 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  7/30/2019 11:28 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  7/30/2019 11:28 AM
DetailsMedicare Provider NumberInsertNew Registration  7/30/2019 11:28 AM
DetailsEntity NameInsertNew Registration Community Health Centers Of The Central Coast, Inc.7/30/2019 11:28 AM
DetailsProgram CodeInsertNew Registration CH7/30/2019 11:28 AM
DetailsEntity SubnameInsertNew Registration COMMUNITY HEALTH CENTERS - PRADO7/30/2019 11:28 AM
DatesParticipating Approval DateInsertNew Registration  7/30/2019 11:28 AM
DetailsStateInsertNew Registration Pending7/30/2019 11:28 AM
DatesRegistration DateInsertNew Registration 7/30/2019 11:28:45 AM7/30/2019 11:28 AM
DatesSigned By DateInsertNew Registration  7/30/2019 11:28 AM
DatesStart DateInsertNew Registration  7/30/2019 11:28 AM
TerminationsTermination CommentsInsertNew Registration  7/30/2019 11:28 AM
TerminationsTermination DateInsertNew Registration  7/30/2019 11:28 AM
TerminationsTermination Effective DateInsertNew Registration  7/30/2019 11:28 AM
TerminationsTermination ReasonInsertNew Registration  7/30/2019 11:28 AM