340B Drug Pricing Program Database


CH09016AK EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CE (Active) - information as of 6/4/2025 1:21:15 PM

Main Details
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CE
El Rio Health - Grant Health Center
HRSA-Funded Health Center
BPS-H80-033565
CH09016AK
H80CS00230


Additional Details
Active
4/15/2022
7/1/2022
4/18/2022
2/11/2025

Contacts

El RIo Health
Clinton Kuntz, CEO
(520) 670-3909

El Rio Santa Cruz Neighborhood Health Center
Ocie Wilson, Pharmacy Director
(520) 309-3923

Addresses

3655 E Grant Rd
Tucson, AZ 85716-2933

EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
450 W Paseo Redondo
TUCSON, AZ, AZ 85701


  • 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
AZ1215531477204485
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailWALGREEN ARIZONA DRUG CO.WALGREENS SPECIALTY PHARMACY #16500 1830 E. BROADWAY BLVD.
SUITE 136
TUCSONAZ8571910/11/202301/01/2024  01/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH090160ActiveBPS-H80-001464EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER839 WEST CONGRESS ST TUCSONAZ
CH09016AActiveBPS-H80-003194EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO SOUTHWEST MEDICAL1500 W COMMERCE CT TUCSONAZ
CH09016ACActiveBPS-H80-003194EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO SOUTHWEST DENTAL1500 W COMMERCE CT TUCSONAZ
CH09016ADActiveBPS-H80-014116EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO NORTHWEST DENTAL340 W Prince Rd TUCSONAZ
CH09016AETerminatedBPS-H80-013833EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.EL RIO CLINIC AT CODAC BEHAVIORAL HEALTH EAST630 N ALVERNON WAY TUCSONAZ
CH09016AFTerminatedBPS-H80-014393EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.St. Elizabeth's Health Center140 W SPEEDWAY BLVD TUCSONAZ
CH09016AGActiveBPS-H80-018677EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.Health On Broadway1 W. Broadway Blvd TucsonAZ
CH09016AHActiveBPS-H80-029634EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.HealthOn University434 E University Blvd TucsonAZ
CH09016AJActiveBPS-H80-032792EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CEEl Rio Health Center of Opportunity4550 S Palo Verde Rd TucsonAZ
CH09016AKActiveBPS-H80-033565EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CEEl Rio Health - Grant Health Center3655 E Grant Rd TucsonAZ
CH09016ALActiveBPS-H80-035301EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CEEl Rio Health Abrams Health Center3950 S Country Club Rd STE 130 TucsonAZ
CH09016AMActiveBPS-H80-036016EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CEUniversity Health Center434 E. University Blvd. STE 200 TucsonAZ
CH09016BActiveBPS-H80-001850EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO OB/GYN ASSOCIATES225 WEST IRVINGTON RD TUCSONAZ
CH09016EActiveBPS-H80-027263EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO CHERRYBELL Health Center1230 S. Cherrybell Stravenue TUCSONAZ
CH09016FActiveBPS-H80-013831EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.El Rio Pascua Yaqui7490 S CAMINO DE OESTE TUCSONAZ
CH09016OTerminatedBPS-H80-003978EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL Rio Broadway Clinic1101 EAST BROADWAY BLVD TUCSONAZ
CH09016PActiveBPS-H80-001347EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO NORTHWEST CLINIC320 W. PRINCE RD TUCSONAZ
CH09016STerminatedBPS-H80-004706EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTERST. MARY'S HOSPITAL WOUND CLINIC1802 W SAINT MARYS RD TUCSONAZ
CH09016T1ActiveBPS-H80-000328EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL PUEBLO HEALTH CENTER101 WEST IRVINGTON ROAD TUCSONAZ
CH09016UTerminatedBPS-H80-010541EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTERTUCSON BIRTH AND WOMEN'S HEALTH CENTER5979 East Grant Road TUCSONAZ
CH09016YActiveBPS-H80-009093EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTERSOUTHEAST CLINIC6950 E. GOLFLINKS ROAD TUCSONAZ
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090160ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2025  
CH090160ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2025  
CH090160ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2025  
CH090160ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2025  
CH090160ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607501/01/2025  
CH090160ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2025  
CH090160ALBERTSON'S LLCOSCO DRUG #2988 5085 N LA CANADA DRIVE
TUCSONAZ8570404/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09254 240 W CONTINENTAL RD
GREEN VALLEYAZ8562204/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09272 7499 E. BROADWAY
TUCSONAZ8571004/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09277 6895 E. SUNRISE
TUCSONAZ8575004/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09273 3785 WEST INA RD.
TUCSONAZ8574104/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09232 4748 E. SUNRISE DRIVE
TUCSONAZ8571804/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09211 6488 N. ORACLE ROAD
TUCSONAZ8570404/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09274 615 N. ALVERNON
TUCSONAZ8571104/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09336 7901 E. GOLF LINKS ROAD
TUCSONAZ8573004/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09302 8920 E TANQUE VERDE
TUCSONAZ8574904/01/2020  
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09207 865 E. GRANT
TUCSONAZ8571904/01/2020 06/22/2022
CH090160ARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09374 1900 W. VALENCIA RD.
TUCSONAZ8574607/01/2020  
CH09016AARIZONA CVS STORES, L.L.C.DBA: CVS/PHARMACY # 09374 1900 W. VALENCIA RD.
TUCSONAZ8574601/01/2024  
CH090160AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062110/01/2015 02/01/2021
CH090160AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508504/01/2017 02/01/2021
CH090160AVELLA OF PHOENIX III1101 N CENTRAL AVE., STE. 102
PHOENIXAZ8500407/01/2018 02/01/2021
CH090160AVELLA OF TUCSON4512 E CAMP LOWELL DR
TUCSONAZ85712-128210/01/2015 01/26/2018
CH090160BIOPLUS SPECIALTY PHARMACY, INC3200 LAKE EMMA RD UNIT 1000
LAKE MARYFL3274607/01/2022  
CH090160CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2021  
CH090160CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2021  
CH090160CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2021  
CH090160CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2021  
CH090160CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2021  
CH090160CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2021  
CH090160CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2021  
CH090160CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813307/01/2021  
CH090160CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237407/01/2021  
CH09016AGCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237401/01/2024  
CH090160CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2021  
CH09016ACCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2024  
CH090160CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2021  
CH090160CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2021  
CH090160CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2021  
CH090160CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2020  
CH090160FRY'S PHARMACY #0831795 W VALENCIA RD
TUCSONAZ8574604/01/2020  
CH090160GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 11339 777 S. HARBOR BLVD., SUITE E-164
LA HABRACA9063101/01/2023 01/01/2023
CH090160GARFIELD BEACH CVS, L.L.C.CVS/PHARMACY # 11339 777 S. HARBOR BLVD., SUITE E-164
LA HABRACA9063110/01/2023  
CH090160GENOA HEALTHCARE LLC1075 E FORT LOWELL RD
TUCSONAZ8571907/01/2021  
CH090160GENOA HEALTHCARE LLC4631 S POWER ROAD BUILDING A, SUITE 105
MESAAZ8521207/01/2021  
CH090160GENOA HEALTHCARE LLC1642 S PRIEST DR BLDG 6, STE 101
TEMPEAZ8528107/01/2021  
CH090160GENOA HEALTHCARE LLC1101 NORTH CENTRAL AVE STE 102
PHOENIXAZ8500412/20/2021  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07867 5100 E. GRANT RD.
TUCSONAZ8571204/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07841 4365 N ORACLE RD
TUCSONAZ8570504/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07876 3832 EAST SPEEDWAY
TUCSONAZ8571604/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07855 2601 S. HOUGHTON RD.
TUCSONAZ8573004/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07859 6370 N. CAMPBELL AVE., #120
TUCSONAZ8571804/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 17223 4040 N ORACLE RD
TUCSONAZ8570504/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 08420 7740 N CORTARO RD
TUCSONAZ8574304/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 00091 8705 E SPEEDWAY BLVD
TUCSONAZ8571004/01/2020 08/11/2022
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16217 10555 N ORACLE RD
ORO VALLEYAZ8573704/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA CVS/PHARMACY # 10307 6310 E. BROADWAY BLVD.
TUCSONAZ8571004/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16772 3699 E BROADWAY BLVD
TUCSONAZ8571604/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16659 1225 W IRVINGTON RD
TUCSONAZ8571404/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16296 6500 E GRANT RD
TUCSONAZ8571504/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS/PHARMACY #10742 2385 N. SILVERBELL ROAD
TUCSONAZ8574504/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA CVS/PHARMACY # 10184 825 EAST UNIVERSITY BLVD., SUITE 101
TUCSONAZ8571904/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16983 9615 E OLD SPANISH TRL
TUCSONAZ8574804/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA CVS/PHARMACY # 10006 10650 NORTH ORACLE RD
ORO VALLEYAZ8573704/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16295 3901 W INA RD
TUCSONAZ8574104/01/2020  
CH090160GERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 05026 1212 S. GREENFIELD RD.
MESAAZ8520607/01/2021  
CH090160GERMAN DOBSON CVS, L.L.C.CVS/PHARMACY #10616 7547 E. SOUTHERN AVE.
MESAAZ8520901/01/2023 01/01/2023
CH090160GERMAN DOBSON CVS, L.L.C.CVS PHARMACY # 16220 4151 E HIGHWAY 90
SIERRA VISTAAZ8563510/01/2023  
CH090160GERMAN DOBSON CVS, L.L.C.CVS/PHARMACY #10616 7547 E. SOUTHERN AVE.
MESAAZ8520910/01/2023  
CH09016AHGERMAN DOBSON CVS, L.L.C.CVS/PHARMACY #10742 2385 N. SILVERBELL ROAD
TUCSONAZ8574501/01/2024  
CH09016AJGERMAN DOBSON CVS, L.L.C.DBA: CVS/PHARMACY # 07841 4365 N ORACLE RD
TUCSONAZ8570501/01/2024  
CH090160HOLIDAY CVS, L.L.C.DBA: CVS/PHARMACY # 03662 5357 EHRLICH RD
TAMPAFL3362504/01/2024  
CH090160OHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 03174 1370 WEST MAIN STREET
NEWARKOH4305507/01/2021  
CH090160OHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 03314 4240 PEARL RD
CLEVELANDOH4410901/01/2023 01/01/2023
CH090160OHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 03314 4240 PEARL RD
CLEVELANDOH4410910/01/2023 01/11/2024
CH090160OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191301/01/2020 10/23/2020
CH090160OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2020  
CH090160OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824901/01/2022  
CH090160OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2022  
CH090160OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/24/2020  
CH090160OPTUM PHARMACY 805, INC1101 N CENTRAL AVE, STE 102
PHOENIXAZ85004-182907/24/2020  
CH090160OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161810/01/2020 10/15/2021
CH090160PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDOFL32819-999201/01/2020 10/01/2022
CH090160PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2021  
CH090160PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2021  
CH090160PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2021  
CH090160PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681307/01/2021  
CH090160PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #3129 1002 EAST MCDOWELL ROAD
PHOENIXAZ8500604/01/2024  
CH090160SAFEWAY INCSAFEWAY PHARMACY #0267 2940 W. VALENCIA ROAD
TUCSONAZ8574604/01/2020  
CH090160SAFEWAY INCSAFEWAY PHARMACY #0255 1551 W ST MARYS RD
TUCSONAZ8574504/01/2020  
CH090160SAFEWAY INCSAFEWAY PHARMACY #1684 1940 E BROADWAY BLVD
TUCSONAZ8571904/01/2020  
CH090160SMITH'S FOOD & DRUGDBA FRY'S FOOD & DRUG #17 4150 E. 22ND STREET
TUCSONAZ8571104/01/2020  
CH090160SMITH'S FOOD & DRUG CTRSDBA FRY'S FOOD AND DRUG #131 2480 NORTH SWAN ROAD
TUCSONAZ8571204/01/2020  
CH090160SMITH'S FOOD & DRUG CTRSFRY'S FOOD AND DRUG #137 7050 EAST 22ND STREET
TUCSONAZ8571004/01/2020  
CH090160SMITH'S FOOD AND DRUGDBA FRY'S FOOD AND DRUG #138 4036 N. 1ST STREET
TUCSONAZ8571904/01/2020  
CH090160SMITHS FOOD & DRUG CENTERDBA FRYS FOOD & DRUG #20 3640 S 16 AVENUE
TUCSONAZ8571304/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #21 555 E GRANT ROAD
TUCSONAZ8570504/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #34 7812 E. SPEEDWAY
TUCSONAZ8571004/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #57 7870 N SILVERBELL ROAD
MARANAAZ8574304/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #42 9401 E 22 STREET
TUCSONAZ8571004/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #58 2001 E IRVINGTON ROAD
TUCSONAZ8571404/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS PHARMACY #36 3770 W INA ROAD
TUCSONAZ8574104/01/2020  
CH090160SMITHS FOOD & DRUG CENTERSDBA FRYS FOOD & DRUG #33 7050 E GOLF LINKS
TUCSONAZ8573004/01/2020  
CH090160SMITHS FOOD AND DRUG CENTERS INC.DBA: FRY'S FOOD STRORES OF AZ #679 15950 SOUTH RANCHO SAHUARITA BLVD
SAHUARITAAZ8562904/01/2020  
CH090160SMITHS FOOD AND DRUG CENTERS INC.DBA:FRY'S FOOD STORES OF AZ #689 12100 N THORNYDALE RD
MARANAAZ8565304/01/2020  
CH090160THOMAS PHOENIX CVS, L.L.C.DBA: CVS/PHARMACY # 03625 8245 W. THOMAS RD.
PHOENIXAZ8503307/01/2022  
CH090160WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738604/01/2020  
CH090160WAL-MART PHARMACY # 10-44732175 WEST RUTHRAUFF ROAD
TUCSONAZ8570504/01/2020  
CH090160WAL-MART PHARMACY 10-12917150 EAST SPEEDWAY
TUCSON (E)AZ8571004/01/2020  
CH090160WAL-MART PHARMACY 10-1325455 EAST WETMORE
TUCSON (N)AZ8570504/01/2020  
CH090160WAL-MART PHARMACY 10-16121650 WEST VALENCIA
TUCSONAZ8574604/01/2020  
CH090160WAL-MART PHARMACY 10-30492550 S. KOLB RD.
TUCSONAZ8571004/01/2020  
CH090160WAL-MART PHARMACY 10-31438640 E BROADWAY
TUCSONAZ8571004/01/2020  
CH090160WAL-MART PHARMACY 10-33573925 EAST GRANT ROAD
TUCSON(ALVERNON)AZ8571204/01/2020  
CH090160WAL-MART PHARMACY 10-33772823 WEST VALENCIA ROAD
TUSCON (CARDINAL)AZ8574604/01/2020  
CH090160WAL-MART PHARMACY 10-38843435 E. BROADWAY BLVD
TUCSONAZ8571604/01/2020  
CH090160WAL-MART PHARMACY 10-46035500 E. 22ND ST.
TUCSONAZ8571104/01/2020  
CH090160WAL-MART PHARMACY 10-56261260 E. TUSCON MKT
TUSCONAZ8571304/01/2020  
CH090160WAL-MART PHARMACY 10-58589260 S. HOUGHTON RD
TUCSONAZ8574704/01/2020  
CH090160WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283704/01/2020  
CH090160WALGREEN ARIZONA DRUG CODBA:WALGREENS #15363 4655 E. SUNRISE DR.
TUCSONAZ8571801/01/2024  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 02851 7000 N 16TH ST
PHOENIXAZ8502010/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 02232 313 W ESPERANZA BLVD
GREEN VALLEYAZ8561410/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05312 375 W CONTINENTAL RD
GREEN VALLEYAZ8562210/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 09186 18600 S NOGALES HWY
GREEN VALLEYAZ8561410/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07623 1959 N GRAND AVE
NOGALESAZ85621-134110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05027 1950 E FRY BLVD
SIERRA VISTAAZ8563510/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS #10684 13542 E COLOSSAL CAVE RD
VAILAZ8564110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 02372 7114 NORTH ORACLE
TUCSONAZ8570410/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03463 1415 W RIVER RD
TUCSONAZ8570410/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 02451 4220 N ORACLE RD
TUCSONAZ85705-163210/12/2012 11/10/2022
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04104 2411 N. ORACLE ROAD
TUCSONAZ8570510/12/2012 08/20/2015
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06491 1351 W PRINCE ROAD
TUCSONAZ8570510/12/2012 02/24/2025
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07463 525 W VALENCIA ROAD
TUCSONAZ85706-763610/12/2012 11/07/2024
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 02910 8730 E BROADWAY BLVD
TUCSONAZ8571010/12/2012 02/28/2024
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04102 6767 E. BROADWAY BLVD.
TUCSONAZ8571010/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 09953 7885 E SPEEDWAY BLVD
TUCSONAZ85710-162610/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03856 5480 E 22ND STREET
TUCSONAZ85711-540610/12/2012 03/09/2020
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05892 3910 E 22ND STREET
TUCSONAZ8571110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06244 4700 E BROADWAY BLVD
TUCSONAZ8571110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04045 4685 E GRANT RD
TUCSONAZ8571210/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04764 5455 E SPEEDWAY BLVD
TUCSONAZ8571210/12/2012 02/21/2024
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07203 2415 N ALVERNON WAY
TUCSONAZ85712-250110/12/2012 08/20/2015
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03377 1900 S 6TH AVE
TUCSONAZ8571310/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06953 605 W AJO WAY
TUCSONAZ85713-604710/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06766 1880 E IRVINGTON ROAD
TUCSONAZ85714-175410/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 11183 3200 E SPEEDWAY
TUCSONAZ8571610/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03249 4910 NORTH FIRST AVE
TUCSONAZ8571810/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS #15030 730 E GRANT ROAD
TUCSONAZ8571910/12/2012 03/09/2020
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05209 3180 N CAMPBELL AVE
TUCSONAZ8571910/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03007 9470 E GOLF LINKS RD
TUCSONAZ8573010/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 10879 7111 E. GOLF LINKS RD.
TUCSONAZ8573010/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04103 10405 N. LA CANADA DR.
ORO VALLEYAZ8573710/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06411 11951 N 1ST AVE
ORO VALLEYAZ85737-878710/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03447 12965 N ORACLE RD
TUCSONAZ8573910/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 04266 2150 W ORANGE GROVE RD
TUCSONAZ8574110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07209 3800 W INA RD
TUCSONAZ8574110/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07304 2175 W INA ROAD
TUCSONAZ85741-264810/12/2012 11/10/2022
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03630 9220 N. THORNYDALE RD
TUCSONAZ8574210/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05156 7800 N. CORTARO RD.
TUCSONAZ8574310/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07232 9250 N COACHLINE BLVD
TUCSONAZ8574310/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 13822 550 N. SILVERBELL RD
TUCSONAZ85745-310710/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06571 2180 W GRANT ROAD
TUCSONAZ85745-114210/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03837 1550 W VALENCIA
TUCSONAZ8574610/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05532 2929 W VALENCIA ROAD
TUCSONAZ8574610/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07041 9184 E VALENCIA ROAD
TUCSONAZ85747-490210/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05750 10315 E BROADWAY BLVD
TUCSONAZ85748-340910/12/2012 03/09/2020
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07104 1145 S HARRISON ROAD
TUCSONAZ85748-664010/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS #15502 8980 E TANQUE VERDE ROAD
TUCSONAZ8574910/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06645 5525 E RIVER RD
TUCSONAZ85750-194910/12/2012  
CH090160WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 01899 9495 EAST SPEEDWAY BLVD
TUCSONAZ8571007/01/2016 04/21/2025
CH090160WALGREEN ARIZONA DRUG CO.WALGREENS SPECIALTY PHARMACY #16500 1830 E. BROADWAY BLVD.
SUITE 136
TUCSONAZ8571901/01/2021  
CH090160WALGREEN ARIZONA DRUG CO.WALGREENS CENTRAL FILL #21372 120 N 83RD AVE
STE 200
TOLLESONAZ8535310/01/2021  
CH090160Walgreen Arizona Drug Co.Walgreens Central Fill #21372 120 N 83rd Ave
200
TollesonAZ8535307/01/2022 09/30/2022
CH090160WALGREEN ARIZONA DRUG CO.DBA WALGREENS SPECIALTY PHARMACY #21393 3627 N CAMPBELL AVE
TUCSONAZ8571901/01/2024  
CH09016EWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05532 2929 W VALENCIA ROAD
TUCSONAZ8574601/01/2024  
CH09016FWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 07463 525 W VALENCIA ROAD
TUCSONAZ85706-763601/01/2024  
CH09016AMWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06953 605 W AJO WAY
TUCSONAZ85713-604701/01/2024  
CH09016AKWALGREEN ARIZONA DRUG CO.WALGREENS SPECIALTY PHARMACY #16500 1830 E. BROADWAY BLVD.
SUITE 136
TUCSONAZ8571901/01/2024  
CH09016BWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 06766 1880 E IRVINGTON ROAD
TUCSONAZ85714-175401/01/2024  
CH09016YWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05209 3180 N CAMPBELL AVE
TUCSONAZ8571901/01/2024  
CH09016ADWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 05892 3910 E 22ND STREET
TUCSONAZ8571101/01/2024  
CH09016PWALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 13822 550 N. SILVERBELL RD
TUCSONAZ85745-310701/01/2024  
CH09016T1WALGREEN ARIZONA DRUG CO.DBA: WALGREENS # 03837 1550 W VALENCIA
TUCSONAZ8574601/01/2024  
CH090160WALGREEN CODBA: WALGREENS 17500 PERRIS BLVD
MORENO VALLEYCA92551-954710/12/2012 08/20/2015
CH090160WALGREEN CODBA: WALGREENS 2370 E MAIN STREET
WOODLANDCA9577610/12/2012 08/20/2015
CH090160WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/12/2012 02/14/2020
CH090160WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904907/01/2013 08/20/2015
CH090160WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/01/2020 12/01/2021
CH090160WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/01/2020  
CH090160WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2020  
CH090160WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2020  
CH090160WALMART PHARMACY 10-44902565 E COMMERCE CENTER PLACE
TUCSONAZ8570604/01/2020  
CH090160WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2025  
CH090160WALMART PHARMACY 10-5725831 E. FORT LOWELL RD.
TUCSONAZ8571904/01/2020  
CH090160Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616807/01/2025  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/30/2024 5:11:38 PM2/11/2025 10:04:32 AM2/11/2025 10:04 AM
AddressesBilling AddressInsertChange Request EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER 450 W Paseo Redondo TUCSON, AZ, AZ 857011/28/2025 12:29 PM
DetailsLast Recertification DateUpdateRecertification2/3/2023 5:28:43 PM1/30/2024 5:11:38 PM1/30/2024 5:11 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False2/3/2023 5:28 PM
Medicaid BillingMedicaid: NumberInsertRecertification 1215532/3/2023 5:28 PM
Medicaid BillingMedicaid: StateInsertRecertification AZ2/3/2023 5:28 PM
DetailsLast Recertification DateUpdateRecertification 2/3/2023 5:28:43 PM2/3/2023 5:28 PM
ContactsPrimary ContactUpdateProfile Change RequestWilson, Ocie Pharmacy Director El Rio Santa Cruz Neighborhood Health Center 5202054906Wilson, Ocie Pharmacy Director El Rio Santa Cruz Neighborhood Health Center 520309392311/17/2022 10:37 AM
ContactsPrimary ContactUpdateGroup Change RequestCarzoli, Joshua Chief Operating Officer El RIo Health 5203093959Wilson, Ocie Pharmacy Director El Rio Santa Cruz Neighborhood Health Center 520205490611/17/2022 6:51 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestJohnson, Nancy CEO El Rio Health 5203092011Kuntz, Clinton CEO El RIo Health 520670390910/4/2022 6:32 AM
DetailsStateUpdate ApprovedActive7/1/2022 12:01 AM
ContactsSigned ByInsertNew Registration Johnson, Nancy CEO El Rio Health 52030920114/18/2022 1:08 PM
Details340B IDUpdateNew Registration CH09016AK4/18/2022 1:08 PM
DatesParticipating Approval DateUpdateNew Registration 4/18/2022 1:08:57 PM4/18/2022 1:08 PM
DetailsStateUpdateNew RegistrationPendingApproved4/18/2022 1:08 PM
DatesSigned By DateUpdateNew Registration 4/15/2022 7:10:48 PM4/18/2022 1:08 PM
DatesStart DateUpdateNew Registration 7/1/2022 12:00:00 AM4/18/2022 1:08 PM
AddressesMain AddressInsertNew Registration  3655 E Grant Rd Tucson, AZ 85716-29334/15/2022 1:08 PM
Medicaid BillingNPI: NumberInsertNew Registration 14772044854/15/2022 1:08 PM
Medicaid BillingNPI: StateInsertNew Registration AZ4/15/2022 1:08 PM
ContactsPrimary ContactInsertNew Registration Carzoli, Joshua Chief Operating Officer El RIo Health 52030939594/15/2022 1:08 PM
ContactsAuthorizing OfficialInsertNew Registration Johnson, Nancy CEO El Rio Health 52030920114/15/2022 1:08 PM
DetailsAssistance Received From DateInsertNew Registration  4/15/2022 1:08 PM
DetailsAssistance Received To DateInsertNew Registration  4/15/2022 1:08 PM
DetailsLast Recertification DateInsertNew Registration  4/15/2022 1:08 PM
DetailsGrant NumberInsertNew Registration H80CS002304/15/2022 1:08 PM
Details340B IDInsertNew Registration  4/15/2022 1:08 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/15/2022 1:08 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/15/2022 1:08 PM
DetailsMedicare Provider NumberInsertNew Registration  4/15/2022 1:08 PM
DetailsEntity NameInsertNew Registration EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CE4/15/2022 1:08 PM
DetailsNOFO NumberInsertNew Registration  4/15/2022 1:08 PM
DetailsProgram CodeInsertNew Registration CH4/15/2022 1:08 PM
DetailsEntity SubnameInsertNew Registration El Rio Health - Grant Health Center4/15/2022 1:08 PM
DatesParticipating Approval DateInsertNew Registration  4/15/2022 1:08 PM
DetailsStateInsertNew Registration Pending4/15/2022 1:08 PM
DatesRegistration DateInsertNew Registration 4/15/2022 1:08:46 PM4/15/2022 1:08 PM
DatesSigned By DateInsertNew Registration  4/15/2022 1:08 PM
DatesStart DateInsertNew Registration  4/15/2022 1:08 PM
TerminationsTermination CommentsInsertNew Registration  4/15/2022 1:08 PM
TerminationsTermination DateInsertNew Registration  4/15/2022 1:08 PM
TerminationsTermination Effective DateInsertNew Registration  4/15/2022 1:08 PM
TerminationsTermination ReasonInsertNew Registration  4/15/2022 1:08 PM