Covered Entity Details

CHC28995-10 Unicare Community Health Center (Active) - information as of 6/15/2025 6:04:58 AM

Main Details

Name

Unicare Community Health Center

Subdivision Name

Unicare Community Health Center, Inc. - Fontana #2

Type

HRSA-Funded Health Center

Site ID

BPS-H80-027703

340B ID

CHC28995-10

Grant Number

H80CS28995

Additional Details

Current Program Status

Active

Registration Date

10/7/2019

Participating Start Date

1/1/2020

Participating Approval Date

10/8/2019

Last Recertification Date

2/12/2025

Contacts

Authorizing Official

Unicare Community Health Center
Avetik Machkalyan, CEO
(909) 623-3600

Primary Contact

Unicare Community Health Center
Kelly Hong Vo, Executive Vice President
(909) 988-2555

Addresses

Street Address

17500 Foothill Blvd # A2
FONTANA, CA 92335-3736

Billing Address

Unicare Community Health Center, Inc
437 N. Euclid Ave.
Ontario, CA 91762

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?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC28995-00	Active	BPS-H80-015523	UNICARE COMMUNITY HEALTH CENTER	Unicare Community Health Center, Inc.	437 N EUCLID AVE	ONTARIO	CA
CHC28995-01	Active	BPS-H80-015515	UNICARE COMMUNITY HEALTH CENTER	Unicare Community Health Center, Inc.	570 S MOUNT VERNON AVE. STE. G	SAN BERNARDINO	CA
CHC28995-02	Active	BPS-H80-015517	UNICARE COMMUNITY HEALTH CENTER	Unicare Community Health Center, Inc.	1501 E HOLT AVE., STE. A	POMONA	CA
CHC28995-03	Active	BPS-H80-017982	Unicare Community Health Center	Unicare Community Health Center - Fontana	16127 FOOTHILL BLVD	FONTANA	CA
CHC28995-04	Active	BPS-H80-027676	Unicare Community Health Center	Unicare Community Health Center, Inc. - Riverside	5549 Van Buren Blvd	Riverside	CA
CHC28995-05	Active	BPS-H80-027632	Unicare Community Health Center	Unicare Community Health Center - Moreno Valley	24853 Alessandro Blvd	Moreno Valley	CA
CHC28995-06	Active	BPS-H80-027704	Unicare Community Health Center	Unicare Community Health Center - Ontario 1151	1151 E Walnut St	Ontario	CA
CHC28995-07	Active	BPS-H80-027635	Unicare Community Health Center	Unicare Community Health Center - Corona	107 N Mckinley St	Corona	CA
CHC28995-08	Active	BPS-H80-027634	Unicare Community Health Center	Unicare Community Health Center, Inc. - San Bernardino 190	190 E Highland Ave	San Bernardino	CA
CHC28995-09	Active	BPS-H80-027633	Unicare Community Health Center	Unicare Community Health Center, Inc. - Westlake 2.0	741 S Alvarado St	Los Angeles	CA
CHC28995-10	Active	BPS-H80-027703	Unicare Community Health Center	Unicare Community Health Center, Inc. - Fontana #2	17500 Foothill Blvd # A2	FONTANA	CA
CHC28995-11	Active	BPS-H80-020771	Unicare Community Health Center	Unicare Community Health Center, Inc. - Lincoln Heights	2409 N BROADWAY	Los Angeles	CA
CHC28995-12	Active	BPS-H80-017993	Unicare Community Health Center	Unicare Community Health Center - Colton	308 N. La Cadena Drive	Colton	CA
CHC28995-13	Active	BPS-H80-036269	UNICARE COMMUNITY HEALTH CENTER, INC	Unicare Community Health Center Hesperia	11919 Hesperia Rd.	Hesperia	CA
CHC28995-14	Active	BPS-H80-036270	UNICARE COMMUNITY HEALTH CENTER, INC	Unicare Community Health Center Kasota	15863 Kasota Road	Apple Valley	CA
CHC28995-15	Active	BPS-H80-031731	UNICARE COMMUNITY HEALTH CENTER, INC	Unicare Community Health Center, Inc. - San Bernardino 184	184 E Highland Ave	San Bernardino	CA
CHC28995-16	Active	BPS-H80-028029	UNICARE COMMUNITY HEALTH CENTER, INC	Unicare-Ontario HQ expanded	123 W E St	Ontario	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28995-00	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	04/01/2025
CHC28995-00	BESTCARE PHARMACY	BESTCARE HEALTH SERVICES LLC	570 S MOUNT VERNON AVE STE F-2	SAN BERNARDINO	CA	92410	04/01/2025
CHC28995-00	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/01/2025
CHC28995-00	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/01/2025
CHC28995-00	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/01/2025
CHC28995-00	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/01/2025
CHC28995-00	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/01/2025
CHC28995-00	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/01/2025
CHC28995-00	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/01/2025
CHC28995-00	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/01/2025
CHC28995-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2025
CHC28995-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2025
CHC28995-00	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	04/01/2025
CHC28995-00	DEV PHARMA INC	DBA EZRX PHARMACY	731 INDIAN HILL BLVD	POMONA	CA	91767	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09666	2419 WORKMAN STREET	LOS ANGELES	CA	90031	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09644	16975 BEAR VALLEY RD.	HESPERIA	CA	92345	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09849	8280 MAGNOLIA AVE.	RIVERSIDE	CA	92504	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16042	499 W ORANGE SHOW RD	SAN BERNARDINO	CA	92408	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09727	2456 S GROVE AVE	ONTARIO	CA	91761	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09698	100 W. FOOTHILL BLVD.	UPLAND	CA	91786	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 17334	20288 US HWY 18	APPLE VALLEY	CA	92307	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #11035	16049 BASELINE AVENUE #1	FONTANA	CA	92336	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09745	4535 HOLT BLVD	MONTCLAIR	CA	91763	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09746	6840 LINCOLN AVENUE	RIVERSIDE	CA	92506	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09778	12101 CENTRAL AVE.	CHINO	CA	91710	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09664	1564 W. BASE LINE ST.	SAN BERNARDINO	CA	92411	04/01/2025
CHC28995-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09619	9840 SIERRA AVE.	FONTANA	CA	92335	04/01/2025
CHC28995-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09910	3440 LA SIERRA AVE	RIVERSIDE	CA	92503	04/01/2025
CHC28995-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 04291	12058 PALMDALE RD	ADELANTO	CA	92301	04/01/2025
CHC28995-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09190	1299 E ONTARIO AVE	CORONA	CA	92881	04/01/2025
CHC28995-00	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03058	26180 IRIS AVE	MORENO VALLEY	CA	92555	04/01/2025
CHC28995-00	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/01/2025
CHC28995-00	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	04/01/2025
CHC28995-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	04/01/2025
CHC28995-00	VIDA DRUG STORE AND PHARMACY	TDSM INC	437 N. EUCLID AVE SUIT B	ONTARIO	CA	91762	07/01/2018	06/30/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 2:28:32 PM	2/12/2025 4:03:26 PM	2/12/2025 4:03 PM
Details	Last Recertification Date	Update	Recertification	2/14/2023 5:22:30 PM	1/29/2024 2:28:32 PM	1/29/2024 2:28 PM
Details	Last Recertification Date	Update	Recertification	2/1/2022 2:18:17 PM	2/14/2023 5:22:30 PM	2/14/2023 5:22 PM
Details	Last Recertification Date	Update	Recertification	2/3/2021 2:20:45 PM	2/1/2022 2:18:17 PM	2/1/2022 2:18 PM
Details	Last Recertification Date	Update	Recertification	1/31/2020 2:15:44 PM	2/3/2021 2:20:45 PM	2/3/2021 2:20 PM
Details	Last Recertification Date	Update	Recertification		1/31/2020 2:15:44 PM	1/31/2020 2:15 PM
Details	State	Update		Approved	Active	1/1/2020 12:04 AM
Contacts	Signed By	Insert	New Registration		Machkalyan, Avetik CEO Unicare Community Health Center 9096233600	10/8/2019 9:36 AM
Details	340B ID	Update	New Registration		CHC28995-10	10/8/2019 9:36 AM
Dates	Participating Approval Date	Update	New Registration		10/8/2019 9:36:42 AM	10/8/2019 9:36 AM
Details	State	Update	New Registration	Pending	Approved	10/8/2019 9:36 AM
Dates	Signed By Date	Update	New Registration		10/7/2019 1:32:46 PM	10/8/2019 9:36 AM
Dates	Start Date	Update	New Registration		1/1/2020 12:00:00 AM	10/8/2019 9:36 AM
Addresses	Main Address	Insert	New Registration		17500 Foothill Blvd # A2 FONTANA, CA 92335-3736	10/7/2019 1:08 PM
Addresses	Billing Address	Insert	New Registration		Unicare Community Health Center, Inc 437 N. Euclid Ave. Ontario, CA 91762	10/7/2019 1:08 PM
Contacts	Primary Contact	Insert	New Registration		Vo, Kelly Hong Executive Vice President Unicare Community Health Center 9099882555	10/7/2019 1:08 PM
Contacts	Authorizing Official	Insert	New Registration		Machkalyan, Avetik CEO Unicare Community Health Center 9096233600	10/7/2019 1:08 PM
Details	Last Recertification Date	Insert	New Registration			10/7/2019 1:08 PM
Details	Grant Number	Insert	New Registration		H80CS28995	10/7/2019 1:08 PM
Details	340B ID	Insert	New Registration			10/7/2019 1:08 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/7/2019 1:08 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/7/2019 1:08 PM
Details	Medicare Provider Number	Insert	New Registration			10/7/2019 1:08 PM
Details	Entity Name	Insert	New Registration		Unicare Community Health Center	10/7/2019 1:08 PM
Details	Program Code	Insert	New Registration		CH	10/7/2019 1:08 PM
Details	Entity Subname	Insert	New Registration		Unicare Community Health Center, Inc. - Fontana #2	10/7/2019 1:08 PM
Dates	Participating Approval Date	Insert	New Registration			10/7/2019 1:08 PM
Details	State	Insert	New Registration		Pending	10/7/2019 1:08 PM
Dates	Registration Date	Insert	New Registration		10/7/2019 1:08:41 PM	10/7/2019 1:08 PM
Dates	Signed By Date	Insert	New Registration			10/7/2019 1:08 PM
Dates	Start Date	Insert	New Registration			10/7/2019 1:08 PM
Terminations	Termination Comments	Insert	New Registration			10/7/2019 1:08 PM
Terminations	Termination Date	Insert	New Registration			10/7/2019 1:08 PM
Terminations	Termination Effective Date	Insert	New Registration			10/7/2019 1:08 PM
Terminations	Termination Reason	Insert	New Registration			10/7/2019 1:08 PM

340B Drug Pricing Program Database