Covered Entity Details

CH09154S OPEN DOOR COMMUNITY HEALTH CENTERS (Active) - information as of 6/26/2025 12:24:19 AM

Main Details

Name

OPEN DOOR COMMUNITY HEALTH CENTERS

Subdivision Name

Open Door Gynecology Services

Type

HRSA-Funded Health Center

Site ID

BPS-H80-032996

340B ID

CH09154S

Grant Number

H80CS00225

Additional Details

Current Program Status

Active

Registration Date

6/8/2020

Participating Start Date

6/8/2020

Participating Approval Date

6/8/2020

Last Recertification Date

2/24/2025

Contacts

Authorizing Official

Open Door Community Health Centers
Natasha Wood, Chief Financial Officer
(707) 616-6927

Primary Contact

Open Door Community Health Centers
Adriana R Campbell, 340B Program Manager
(210) 834-1173

Addresses

Street Address

3770 Janes Road
Arcata, CA 95521-4745

Billing Address

OPEN DOOR COMMUNITY HEALTH CENTER
1275 8th St
ARCATA, CA 95521-6249

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		1689206252

Shipping Addresses

Shipping Address 1

OPEN DOOR COMMUNITY HEALTH CENTERS
Open Door Rx
2515 Harrison Avenue
Eureka, CA 95501-3220

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
CH091540	Active	BPS-H80-034810	OPEN DOOR COMMUNITY HEALTH CENTERS	Arcata Community Health Center	1150 Foster Avenue	Arcata	CA
CH09154A	Active	BPS-H80-000400	OPEN DOOR COMMUNITY HEALTH CENTERS	EUREKA COMMUNITY HEALTH CENTER	2200 Tydd St	Eureka	CA
CH09154B	Active	BPS-H80-000666	OPEN DOOR COMMUNITY HEALTH CENTERS	DEL NORTE COMMUNITY HEALTH CENTER	550 E WASHINGTON BLVD.	CRESCENT CITY	CA
CH09154D	Active	BPS-H80-005238	OPEN DOOR COMMUNITY HEALTH CENTERS	NORTH COUNTRY CLINIC	785 18TH ST	ARCATA	CA
CH09154F	Active	BPS-H80-003356	OPEN DOOR COMMUNITY HEALTH CENTERS	MCKINLEYVILLE COMMUNITY HEALTH CENTER	1644 CENTRAL AVE	MCKINLEYVILLE	CA
CH09154H	Active	BPS-H80-007791	OPEN DOOR COMMUNITY HEALTH CENTERS	WILLOW CREEK COMMUNITY HEALTH CENTER	38883 HIGHWAY 299	WILLOW CREEK	CA
CH09154I	Active	BPS-H80-001665	OPEN DOOR COMMUNITY HEALTH CENTERS	BURRE DENTAL CENTER	959 MYRTLE AVE	EUREKA	CA
CH09154J	Active	BPS-H80-010274	OPEN DOOR COMMUNITY HEALTH CENTERS	PERINATAL SERVICES OF NORTHCOUNTRY CLINIC	3800 JANES RD	ARCATA	CA
CH09154K	Active	BPS-H80-004228	OPEN DOOR COMMUNITY HEALTH CENTERS	Telehealth & Visiting Specialist Center	2426 Buhne St	Eureka	CA
CH09154L	Active	BPS-H80-014318	OPEN DOOR COMMUNITY HEALTH CENTERS	Ferndale Community Health Center	638 Main St	Ferndale	CA
CH09154M	Active	BPS-H80-027289	OPEN DOOR COMMUNITY HEALTH CENTERS	Fortuna Community Health and Wellness Center	3750 Rohnerville Rd	FORTUNA	CA
CH09154N	Terminated	BPS-H80-014662	OPEN DOOR COMMUNITY HEALTH CENTERS	Fortuna Community Health Center (3304)	3304 RENNER DR	FORTUNA	CA
CH09154P	Terminated	BPS-H80-014659	OPEN DOOR COMMUNITY HEALTH CENTERS	Fortuna Community Health Center (3307)	3307 RENNER DR	FORTUNA	CA
CH09154Q	Active	BPS-H80-012781	OPEN DOOR COMMUNITY HEALTH CENTERS	Mobile Health Services Van #1	2412 Buhne St	Eureka	CA
CH09154R	Active	BPS-H80-019114	OPEN DOOR COMMUNITY HEALTH CENTERS	Redwood Community Health Center	2350 Buhne St	Eureka	CA
CH09154S	Active	BPS-H80-032996	OPEN DOOR COMMUNITY HEALTH CENTERS	Open Door Gynecology Services	3770 Janes Road	Arcata	CA
CH09154T	Active	BPS-H80-019351	OPEN DOOR COMMUNITY HEALTH CENTERS	Harding Street Clinic	833 W Washington Blvd	Crescent City	CA
CH09154U	Active	BPS-H80-006394	OPEN DOOR COMMUNITY HEALTH CENTERS	Burre Mobile Dental	959 Myrtle Ave	Eureka	CA
CH09154V	ToBeTerminated	BPS-H80-031035	OPEN DOOR COMMUNITY HEALTH CENTERS	Open Door Downtown	622 H St	Eureka	CA
CH09154W	Active	BPS-H80-039514	OPEN DOOR COMMUNITY HEALTH CENTERS	Plaza Community Health Center	770 10th St	Arcata	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH091540	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/19/2021
CH091540	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/19/2021
CH091540	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/19/2021
CH091540	ACCREDO HEALTH GROUP INC	2410 WARDLOW RD	STE 101	CORONA	CA	92878	07/01/2025
CH091540	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/19/2021
CH091540	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/19/2021
CH091540	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/19/2021
CH091540	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2025
CH091540	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	01/01/2018
CH091540	AETNA SPECIALTY PHARMACY, LLC	503 SUNPORT LN		ORLANDO	FL	32809-7874	10/01/2019
CH091540	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	07/19/2021
CH091540	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	07/19/2021
CH091540	BARNES ARCATA FAMILY DRUG	1080 G ST		ARCATA	CA	95521	08/09/2011
CH091540	BIOPLUS SPECIALTY PHARMACY CA	7373 LINCOLN WAY		GARDEN GROVE	CA	92841	07/01/2024
CH091540	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	07/19/2021
CH091540	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	07/19/2021
CH091540	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	07/19/2021
CH091540	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	10/01/2024
CH091540	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	10/01/2024
CH091540	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	07/01/2024
CH091540	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2018
CH091540	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/01/2018
CH091540	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/01/2018
CH091540	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/01/2018
CH091540	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/01/2018
CH091540	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/01/2018
CH091540	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/01/2018
CH091540	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/01/2018
CH091540	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/01/2018
CH091540	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	07/19/2021
CH091540	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	05/23/2023
CH091540	CENTERWELL PHARMACY, INC.	11010 FLORIDA CROWN DRIVE, SUITE 200		ORLANDO	FL	32824	01/01/2024
CH091540	CLONEY'S PHARMACY INC	DBA CLONEY'S MCKINLEYVILLE PHARMACY	1567 CITY CENTER ROAD #35	MCKINLEYVILLE	CA	95519	10/01/2014	03/01/2021
CH091540	CLONEY'S PRESCRIPTION PHARMACY		2515 HARRISON AVENUE	EUREKA	CA	95501-3220	09/12/2011	03/01/2021
CH09154D	CLONEY'S RED CROSS PHARMACY		525 5TH STREET	EUREKA	CA	95501-1032	10/01/2014	03/01/2021
CH091540	CLONEY'S RED CROSS PHARMACY		525 5TH STREET	EUREKA	CA	95501-1032	07/01/2014	03/01/2021
CH091540	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2021
CH091540	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2021
CH091540	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2020
CH091540	CYSTIC FIBROSIS SERVICES	CYSTIC FIBROSIS SERVICES, INC	10530 JOHN W ELLIOTT DR, STE 200	FRISCO	TX	75033	01/01/2018	10/16/2017
CH091540	DIPLOMAT SPECIALTY PHARMACY OF SOUTHERN	DIPLOMAT SPECIALTY PHARMACY	1809 EXCISE AVENUE SUITE 204-208	ONTARIO	CA	91761	01/01/2018	07/01/2019
CH091540	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	07/19/2021
CH091540	ENCORE PHARMACY #1	800 8TH AVE STE 130		FORT WORTH	TX	76104	05/04/2022
CH091540	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/19/2021
CH091540	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/19/2021
CH091540	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/19/2021
CH091540	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/19/2021
CH091540	FRED MEYER	1301 CENTER DRIVE		MEDFORD	OR	97501	07/01/2024	05/21/2025
CH091540	FRED MEYER	ATTN: PHARMACY	325 5TH STREET	BROOKINGS	OR	97415	07/01/2024
CH091540	FRED MEYER PHARMACY #126	1101 GRANTS PASS PKWY		GRANTS PASS	OR	97526-2333	07/01/2024	05/21/2025
CH091540	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY # 10513	1720 CENTRAL AVE	MCKINLEYVILLE	CA	95519	10/01/2015
CH091540	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #10478	657 US HIGHWAY 101 N.	CRESCENT CITY	CA	95531	01/01/2018
CH091540	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16759	2525 4TH ST	EUREKA	CA	95501	01/01/2018
CH091540	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09141	3151 UNIVERSITY AVE.	SAN DIEGO	CA	92104	01/01/2021
CH091540	GENOA HEALTHCARE LLC	1701 MISSION AVE STE 230 RM P1		OCEANSIDE	CA	92058	07/19/2021
CH091540	GENOA HEALTHCARE LLC	245 11TH ST STE P1		SAN FRANCISCO	CA	94103	07/19/2021
CH091540	GENOA HEALTHCARE LLC	17782 COWAN ST STE G		IRVINE	CA	92614	07/19/2021
CH091540	GENOA HEALTHCARE LLC	11721 E TELEGRAPH RD UNIT I		SANTA FE SPRINGS	CA	90670	07/19/2021
CH091540	GENOA HEALTHCARE LLC	1850 W FLORIDA AVE		HEMET	CA	92545	07/19/2021
CH091540	GENOA HEALTHCARE LLC	1500 S WHITE MOUNTAIN ROAD BLDG 3	SUITE 302	SHOW LOW	AZ	85901	01/25/2022
CH091540	GENOA HEALTHCARE LLC	1545 HARBECK RD STE P1		GRANTS PASS	OR	97527	01/25/2022
CH091540	GREEN'S FORTUNA PHARMACY	1058 MAIN ST		FORTUNA	CA	95540	10/01/2013
CH091540	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	07/01/2024
CH091540	LA PHARMACY LLC	1048 S GARFIELD AVE	STE 101	ALHAMBRA	CA	91801	07/19/2021
CH091540	LIMAS PROFESSIONAL PHARMACY 1	2097 HARRISON AVE		EUREKA	CA	95501-3211	06/16/2011	05/07/2021
CH091540	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03939	800 W HARRIS ST STE 20	EUREKA	CA	95503	10/01/2015
CH091540	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09482	600 F ST	ARCATA	CA	95521	10/01/2015
CH091540	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09681	1105 MYRTLE AVE	EUREKA	CA	95501	10/01/2015
CH091540	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09973	1595 MAIN STREET	WEAVERVILLE	CA	96093	10/01/2020
CH091540	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	07/19/2021
CH091540	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	07/19/2021
CH091540	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/25/2022
CH091540	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	07/01/2021
CH091540	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/24/2022
CH091540	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	07/01/2025
CH091540	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2021
CH091540	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/01/2021
CH091540	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2021
CH091540	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	07/01/2021
CH091540	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	07/01/2021
CH091540	OPTUM PHARMACY 806, INC.	2288 AUBURN BLVD	STE. 102	SACRAMENTO	CA	95821-1618	07/01/2021	11/19/2021
CH091540	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	07/19/2021
CH091540	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/19/2021
CH091540	OVERLAKE PHARMACY, LLC	4124 148TH AVE NE STE JA		REDMOND	WA	98052	07/19/2021
CH091540	PALCO PHARMACY	PO BOX 157	113 MAIN STREET SUITE D	SCOTIA	CA	95565-0157	01/01/2016	05/03/2023
CH091540	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	01/01/2018	12/01/2021
CH091540	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	02/28/2022	10/03/2022
CH091540	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/01/2018
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #11280	538 SW 4TH AVENUE	PORTLAND	OR	97204	10/01/2020	03/31/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY	445 CASTRO STREET	SAN FRANCISCO	CA	94114	10/01/2020	07/01/2020
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY	445 CASTRO STREET	SAN FRANCISCO	CA	94114	01/01/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2819	1309 NW 23RD AVE.	PORTLAND	OR	97210	07/01/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY	8607 SANTA MONICA BOULEVARD	WEST HOLLYWOOD	CA	90069	07/01/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY	1010 UNIVERSITY AVENUE	SAN DIEGO	CA	92103	07/01/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/19/2021
CH091540	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	07/19/2021
CH091540	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	07/19/2021
CH091540	RECEPT PHARMACY #1	800 8TH AVE STE 130		FORT WORTH	TX	76104	10/08/2021	05/03/2022
CH091540	REDWOOD COMMUNITY PHARMACY, LLC	1567 CITY CENTER RD.		MCKINLEYVILLE	CA	95519	01/01/2024
CH091540	RINGS PHARMACY	362 MAIN STREET	PO BOX 577	FERNDALE	CA	95536	01/01/2014
CH091540	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	07/19/2021
CH091540	SAFEWAY INC	SAFEWAY PHARMACY #2908	2555 HARRIS STREET	EUREKA	CA	95503	06/16/2011
CH091540	SAFEWAY INC	SAFEWAY PHARMACY #0954	475 M STREET	CRESCENT CITY	CA	95531	08/18/2011
CH091540	THRIFTY PAYLESS, INC.	RITE AID #6037	1500 ANNA SPARKS WAY SUITE D	MCKINLEYVILLE	CA	95519	09/05/2012
CH091540	THRIFTY PAYLESS, INC.	RITE AID #6040	575 M STREET	CRESCENT CITY	CA	95531	09/05/2012
CH091540	THRIFTY PAYLESS, INC.	RITE AID #6036	411 HARRIS STREET	EUREKA	CA	95503	09/05/2012
CH091540	THRIFTY PAYLESS, INC.	RITE AID #6041	725 SOUTH FORTUNA BOULEVARD	FORTUNA	CA	95540	01/01/2015
CH091540	TRUEPILL	3121 DIABLO AVE		HAYWARD	CA	94545	07/19/2021
CH091540	TRUEPILL NY LLC	850 3RD AVE STE 404		BROOKLYN	NY	11232-1523	07/19/2021
CH091540	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2017
CH091540	WAL-MART PHARMACY 10-1910	900 EAST WASHINGTON BLVD		CRESCENT CITY	CA	95531	09/21/2012
CH091540	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	04/01/2017	08/10/2022
CH091540	WAL-MART PHARMACY 10-5629	3300 BROADWAY BASHORE MALL		EUREKA	CA	95501	10/01/2017
CH091540	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2017
CH091540	WALGREEN CO	DBA: WALGREENS #11754	787 L ST	CRESCENT CITY	CA	95531-2882	10/01/2013	12/01/2021
CH091540	WALGREEN CO	DBA: WALGREENS #11754	787 L ST	CRESCENT CITY	CA	95531-2882	02/28/2022	04/03/2023
CH091540	WALGREEN CO.	DBA: WALGREENS # 09703	1065 S FORTUNA BLVD	FORTUNA	CA	95540	07/23/2012	12/01/2021
CH091540	WALGREEN CO.	DBA: WALGREENS # 04681	1424 BROADWAY STREET	EUREKA	CA	95501	10/01/2013	12/01/2021
CH091540	WALGREEN CO.	DBA: WALGREENS # 05863	2525 HARRIS STREET	EUREKA	CA	95503-4805	10/01/2013	12/01/2021
CH091540	WALGREEN CO.	DBA: WALGREENS # 04681	1424 BROADWAY STREET	EUREKA	CA	95501	02/28/2022
CH091540	WALGREEN CO.	DBA: WALGREENS # 09703	1065 S FORTUNA BLVD	FORTUNA	CA	95540	02/28/2022
CH091540	WALGREEN CO.	DBA: WALGREENS # 05863	2525 HARRIS STREET	EUREKA	CA	95503-4805	02/28/2022
CH091540	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	01/01/2018	12/01/2021
CH091540	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	02/28/2022
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	01/01/2018	12/01/2021
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/01/2018	12/01/2021
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/01/2018	12/01/2021
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/01/2018	12/01/2021
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	02/28/2022
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	02/28/2022
CH091540	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	02/28/2022
CH091540	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	01/01/2018	12/01/2021
CH091540	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	02/28/2022
CH091540	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH091540	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH091540	WILLOW CREEK PHARMACY		39050 HWY 299	WILLOW CREEK	CA	95573	06/29/2011	03/31/2019
CH091540	WILLOW CREEK PHARMACY	39050 HIGHWAY 299	PO BOX 112	WILLOW CREEK	CA	95573	04/24/2019	09/14/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Wood, Natasha Interim Vice President of Finance and Finance Officer Open Door Community Health Centers 7076166927	Wood, Natasha Chief Financial Officer Open Door Community Health Centers 7076166927	2/25/2025 6:11 AM
Details	Last Recertification Date	Update	Recertification	2/20/2024 6:56:07 PM	2/24/2025 2:06:18 PM	2/24/2025 2:06 PM
Details	Last Recertification Date	Update	Recertification	2/15/2023 3:57:24 PM	2/20/2024 6:56:07 PM	2/20/2024 6:56 PM
Details	Last Recertification Date	Update	Recertification	2/1/2022 7:37:32 PM	2/15/2023 3:57:24 PM	2/15/2023 3:57 PM
Contacts	Authorizing Official	Update	AO Change Request	Demont, Joseph Henry Chief Financial Officer Open Door Community Health Centers 7078268633-5106	Wood, Natasha Interim Vice President of Finance and Finance Officer Open Door Community Health Centers 7076166927	2/14/2023 9:51 AM
Details	Last Recertification Date	Update	Recertification	2/26/2021 2:01:08 PM	2/1/2022 7:37:32 PM	2/1/2022 7:37 PM
Details	Entity Subname	Update	Change Request	Open Door Women's Health	Open Door Gynecology Services	1/10/2022 8:31 AM
Contacts	Primary Contact	Update	Change Request	Johnston Schwab, Julie Ann 340B Program Manager Open Door Community Health Center 7078268633-5102	Campbell, Adriana R 340B Program Manager Open Door Community Health Centers 2108341173	10/12/2021 9:24 AM
Addresses	Main Address	Update	Change Request	3798 Janes Rd Ste 5 Arcata, CA 95521-4745	3770 Janes Road Arcata, CA 95521-4745	9/14/2021 8:41 AM
Addresses	Shipping Address	Insert	Change Request		OPEN DOOR COMMUNITY HEALTH CENTERS Open Door Rx 2515 Harrison Avenue Eureka, CA 95501-3220	8/5/2021 10:00 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1922318047 (CA)		8/5/2021 10:00 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1689206252	8/5/2021 10:00 AM
Medicaid Billing	NPI: State	Insert	Change Request		CA	8/5/2021 10:00 AM
Details	Last Recertification Date	Update	Recertification		2/26/2021 2:01:08 PM	2/26/2021 2:01 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1922318047 (CA)		10/9/2020 7:14 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1922318047	10/9/2020 7:14 AM
Medicaid Billing	NPI: State	Insert	Change Request		CA	10/9/2020 7:14 AM
Contacts	Authorizing Official	Update	Change Request	Bella, James CFO Open Door Community Health Centers 7078268633-5146	Demont, Joseph Henry Chief Financial Officer Open Door Community Health Centers 7078268633-5106	10/9/2020 7:14 AM
Details	Entity Subname	Update	Change Request	Open Door Women&s Health	Open Door Women's Health	10/9/2020 7:14 AM
Details	State	Update	OPA Edit	Approved	Active	6/8/2020 12:32 PM
Dates	Start Date	Update	OPA Edit	7/1/2020 12:00:00 AM	6/8/2020 12:00:00 AM	6/8/2020 12:32 PM
Contacts	Signed By	Insert	New Registration		Bella, James CFO Open Door Community Health Centers 7078268633-5146	6/8/2020 12:29 PM
Details	340B ID	Update	New Registration		CH09154S	6/8/2020 12:29 PM
Dates	Participating Approval Date	Update	New Registration		6/8/2020 12:29:54 PM	6/8/2020 12:29 PM
Details	State	Update	New Registration	Pending	Approved	6/8/2020 12:29 PM
Dates	Signed By Date	Update	New Registration		6/8/2020 11:26:54 AM	6/8/2020 12:29 PM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	6/8/2020 12:29 PM
Addresses	Main Address	Insert	New Registration		3798 Janes Rd Ste 5 Arcata, CA 95521-4745	6/8/2020 10:13 AM
Addresses	Billing Address	Insert	New Registration		OPEN DOOR COMMUNITY HEALTH CENTER 1275 8th St ARCATA, CA 95521-6249	6/8/2020 10:13 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	6/8/2020 10:13 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1922318047	6/8/2020 10:13 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		CA	6/8/2020 10:13 AM
Contacts	Authorizing Official	Insert	New Registration		Bella, James CFO Open Door Community Health Centers 7078268633-5146	6/8/2020 10:13 AM
Contacts	Primary Contact	Insert	New Registration		Johnston Schwab, Julie Ann 340B Program Manager Open Door Community Health Center 7078268633-5102	6/8/2020 10:13 AM
Details	Last Recertification Date	Insert	New Registration			6/8/2020 10:13 AM
Details	Grant Number	Insert	New Registration		H80CS00225	6/8/2020 10:13 AM
Details	340B ID	Insert	New Registration			6/8/2020 10:13 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			6/8/2020 10:13 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			6/8/2020 10:13 AM
Details	Medicare Provider Number	Insert	New Registration			6/8/2020 10:13 AM
Details	Entity Name	Insert	New Registration		OPEN DOOR COMMUNITY HEALTH CENTERS	6/8/2020 10:13 AM
Details	Program Code	Insert	New Registration		CH	6/8/2020 10:13 AM
Details	Entity Subname	Insert	New Registration		Open Door Women&s Health	6/8/2020 10:13 AM
Dates	Participating Approval Date	Insert	New Registration			6/8/2020 10:13 AM
Details	State	Insert	New Registration		Pending	6/8/2020 10:13 AM
Dates	Registration Date	Insert	New Registration		6/8/2020 10:13:04 AM	6/8/2020 10:13 AM
Dates	Signed By Date	Insert	New Registration			6/8/2020 10:13 AM
Dates	Start Date	Insert	New Registration			6/8/2020 10:13 AM
Terminations	Termination Comments	Insert	New Registration			6/8/2020 10:13 AM
Terminations	Termination Date	Insert	New Registration			6/8/2020 10:13 AM
Terminations	Termination Effective Date	Insert	New Registration			6/8/2020 10:13 AM
Terminations	Termination Reason	Insert	New Registration			6/8/2020 10:13 AM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

Grantee Sites

Grantee Sites Contract Pharmacies

History