340B Drug Pricing Program Database


UI93710 Fresno American Indian Health Project (Active) - information as of 6/8/2025 12:59:57 AM

Main Details
Fresno American Indian Health Project
Urban Indian
UI93710


Additional Details
Active
1/3/2020
4/1/2020
3/5/2020
2/10/2025

Contacts

Fresno American Indian Health Project
Selina De La Pena, Chief Executive Officer
(559) 320-0490

Fresno American Indian Health Project
Bertha Ramirez, Director of Operations
(559) 320-0490 Ext: 104

Addresses

1551 E. Shaw Avenue
128 & 139
Fresno, CA 93710

Same as Street Address


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

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07553 3011 E SHIELDS AVE
FRESNOCA9372610/14/202001/01/2021  01/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09149 6750 N CEDAR AVE
FRESNOCA9371010/14/202001/01/2021  01/01/2021
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09537 1325 W SHIELDS AVENUE
FRESNOCA9370510/14/202001/01/2021  01/01/2021
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #1754 5638 EAST KINGS CANYON RD
FRESNOCA9372707/07/202310/01/2023 05/15/202405/15/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #1756 1650 HERNDON AVENUE
CLOVISCA9361107/07/202310/01/2023 05/15/202405/15/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #2701 3100 FOWLER AVENUE
CLOVISCA9361107/07/202310/01/2023 05/15/202405/15/2024
Contract DetailTHE VONS COMPANIES INCVONS PHARMACY #2188 8949 NORTH CEDAR AVENUE
FRESNOCA9372007/07/202310/01/2023 05/15/202405/15/2024
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/30/2024 12:50:04 PM2/10/2025 1:23:43 PM2/10/2025 1:23 PM
DetailsLast Recertification DateUpdateRecertification1/31/2023 3:01:03 PM1/30/2024 12:50:04 PM1/30/2024 12:50 PM
DetailsLast Recertification DateUpdateRecertification2/1/2022 12:45:17 PM1/31/2023 3:01:03 PM1/31/2023 3:01 PM
ContactsPrimary ContactUpdateChange RequestMcClindon, Delorise Director of Health Services Fresno American Indian Health Project 5593200490Ramirez, Bertha Director of Operations Fresno American Indian Health Project 5593200490-10410/27/2022 10:31 AM
ContactsPrimary ContactUpdateRecertificationRamirez, Bertha Director of Quality Improvment Fresno American Indian Health Project 5593200490-104McClindon, Delorise Director of Health Services Fresno American Indian Health Project 55932004902/1/2022 12:45 PM
DetailsLast Recertification DateUpdateRecertification2/3/2021 2:48:09 PM2/1/2022 12:45:17 PM2/1/2022 12:45 PM
DetailsLast Recertification DateUpdateRecertification 2/3/2021 2:48:09 PM2/3/2021 2:48 PM
AddressesMain AddressUpdateChange Request 1551 E. Shaw Avenue 139 Fresno, CA 93710 1551 E. Shaw Avenue 128 & 139 Fresno, CA 937101/31/2021 11:26 AM
DetailsStateUpdate ApprovedActive4/1/2020 12:05 AM
ContactsSigned ByInsertNew Registration De La Pena, Selina Chief Executive Officer Fresno American Indian Health Project 55932004903/5/2020 12:32 PM
Details340B IDUpdateNew Registration UI937103/5/2020 12:32 PM
DatesParticipating Approval DateUpdateNew Registration 3/5/2020 12:32:03 PM3/5/2020 12:32 PM
DetailsStateUpdateNew RegistrationPendingApproved3/5/2020 12:32 PM
DatesSigned By DateUpdateNew Registration 1/3/2020 11:58:25 AM3/5/2020 12:32 PM
DatesStart DateUpdateNew Registration 4/1/2020 12:00:00 AM3/5/2020 12:32 PM
ContactsPrimary ContactUpdate Ramirez, Bertha Director of Quality Improvment Fresno American Indian Health Project 5593200490Ramirez, Bertha Director of Quality Improvment Fresno American Indian Health Project 5593200490-1041/3/2020 12:49 PM
AddressesMain AddressInsertNew Registration  1551 E. Shaw Avenue 139 Fresno, CA 937101/3/2020 11:58 AM
ContactsAuthorizing OfficialInsertNew Registration De La Pena, Selina Chief Executive Officer Fresno American Indian Health Project 55932004901/3/2020 11:58 AM
ContactsPrimary ContactInsertNew Registration Ramirez, Bertha Director of Quality Improvment Fresno American Indian Health Project 55932004901/3/2020 11:58 AM
DetailsLast Recertification DateInsertNew Registration  1/3/2020 11:58 AM
DetailsGrant NumberInsertNew Registration  1/3/2020 11:58 AM
Details340B IDInsertNew Registration  1/3/2020 11:58 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  1/3/2020 11:58 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  1/3/2020 11:58 AM
DetailsMedicare Provider NumberInsertNew Registration  1/3/2020 11:58 AM
DetailsEntity NameInsertNew Registration Fresno American Indian Health Project1/3/2020 11:58 AM
DetailsProgram CodeInsertNew Registration UI1/3/2020 11:58 AM
DetailsEntity SubnameInsertNew Registration  1/3/2020 11:58 AM
DatesParticipating Approval DateInsertNew Registration  1/3/2020 11:58 AM
DetailsStateInsertNew Registration Pending1/3/2020 11:58 AM
DatesRegistration DateInsertNew Registration 1/3/2020 11:58:23 AM1/3/2020 11:58 AM
DatesSigned By DateInsertNew Registration  1/3/2020 11:58 AM
DatesStart DateInsertNew Registration  1/3/2020 11:58 AM
TerminationsTermination CommentsInsertNew Registration  1/3/2020 11:58 AM
TerminationsTermination DateInsertNew Registration  1/3/2020 11:58 AM
TerminationsTermination Effective DateInsertNew Registration  1/3/2020 11:58 AM
TerminationsTermination ReasonInsertNew Registration  1/3/2020 11:58 AM