Covered Entity Details

FQHCLA002C COUNTY OF MONTEREY (Terminated) - information as of 6/9/2025 11:03:19 PM

Main Details

Name

COUNTY OF MONTEREY

Subdivision Name

Alisal Health Center

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-009966

340B ID

FQHCLA002C

Grant Number

LALCS00049

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2001

Participating Start Date

10/1/2001

Participating Approval Date

10/1/2001

Last Recertification Date

1/31/2019

Termination Date
Termination Reason

4/1/2020
Failure to recertify

Contacts

Authorizing Official

Monterey County HEalth Department
Julia C. Edgcomb, Clinic Services Bureau Chief/Director
(831) 796-1386

Primary Contact

Monterey County Health Department
Prisca Segovia, Management Analyst II - Clinic Service Bureau
(831) 755-4939

Addresses

Street Address

559 E Alisal Street, Suite 201
Salinas, CA 93905

Billing Address

Monterey County Health Department FQHC Look Alike Clinics
1441 Schilling Place
South Building, First Floor
Salinas, CA 93901

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	Termination Date	Last Updated On
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	10/08/2019	01/01/2020	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03446	575 N SANBORN RD	SALINAS	CA	93905	04/11/2014	07/01/2014	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02867	1055 FREMONT BLVD	SEASIDE	CA	93955	04/11/2014	07/01/2014	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02606	1532 N MAIN ST	SALINAS	CA	93906	04/11/2014	07/01/2014	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04997	226 RESERVATION RD.	MARINA	CA	93933	04/11/2014	07/01/2014	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07081	416 ALVARADO ST	MONTEREY	CA	93940	04/11/2014	07/01/2014	04/01/2020	04/01/2020
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/11/2014	07/01/2014	01/04/2017	01/09/2017

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
FQHCLA002A	Terminated	BPS-LAL-009965	COUNTY OF MONTEREY	MARINA CLINIC	3155 DEFOREST ROAD	MARINA	CA
FQHCLA002B	Terminated	BPS-LAL-020829	COUNTY OF MONTEREY	Seaside Family Health Center	1156 Fremont Street	Seaside	CA
FQHCLA002C	Terminated	BPS-LAL-009966	COUNTY OF MONTEREY	Alisal Health Center	559 E Alisal Street, Suite 201	Salinas	CA
FQHCLA002D	Terminated	BPS-LAL-009967	COUNTY OF MONTEREY	LAUREL INTERNAL MEDICINE	1441 CONSTITUTION BLVD, BLDG 151, SUITE 16	SALINAS	CA
FQHCLA002E	Terminated	BPS-LAL-015148	COUNTY OF MONTEREY	Laurel Family Practice	1441 Constitution Blvd, Bldg. 400, STE 300	Salinas	CA
FQHCLA002F	Terminated	BPS-LAL-009968	MONTEREY COUNTY DEPT OF HEALTH	LAUREL WOMEN'S HEALTH	1441 CONSTITUTION BLVD, BLDG 200, SUITE 105	SALINAS	CA
FQHCLA002G	Terminated	BPS-LAL-009962	MONTEREY COUNTY DEPT OF HEALTH	LAUREL PEDIATRIC CLINIC	1441 CONSTITUTION BLVD, BLDG 200, SUITE 101	SALINAS	CA
FQHCLA002H	Terminated	BPS-LAL-014094	COUNTY OF MONTEREY	Rancho Cielo Inc	710 Old Stage Rd	Salinas	CA
FQHCLA002J	Terminated	BPS-LAL-013955	COUNTY OF MONTEREY	Bienestar	1441 Constitution Blvd BLDG 400 STE 201	Salinas	CA
FQHCLA002K	Terminated	BPS-LAL-013954	COUNTY OF MONTEREY	County of Monterey Integrated Health Care Services I Condado de Monterey Servicios Integrados de Salud	299 12th St	Marina	CA
FQHCLA002L	Terminated	BPS-LAL-014641	COUNTY OF MONTEREY	Bienestar-King City	200 BROADWAY ST, STE 70	KING CITY	CA
FQHCLA002M	Terminated	BPS-LAL-015147	COUNTY OF MONTEREY	Laurel Vista	1441 Constitution Blvd. Bldg. 400, Ste. 301	Salinas	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA002C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002C	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002A	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002D	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002G	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002A	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002K	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002K	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002E	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002M	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002M	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16447	2040 CALIFORNIA AVE	SAND CITY	CA	93955	01/01/2020	04/01/2020
FQHCLA002J	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002B	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16200	1640 N MAIN ST	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002D	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002C	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002J	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002K	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002A	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09506	1140 S MAIN ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09349	347 E ALISAL ST	SALINAS	CA	93901	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 03050	268 RESERVATION RD	MARINA	CA	93933	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002G	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09186	110 E LAUREL DR	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002M	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09320	686 LIGHTHOUSE AVE	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002E	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 01300	662 E BORONDA RD	SALINAS	CA	93906	01/01/2020	04/01/2020
FQHCLA002B	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09802	2170 FREMONT ST	MONTEREY	CA	93940	01/01/2020	04/01/2020
FQHCLA002B	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	04/01/2013	04/01/2020
FQHCLA002A	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	04/01/2013	04/01/2020
FQHCLA002D	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	12/31/2007	04/01/2020
FQHCLA002E	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	12/31/2007	04/01/2020
FQHCLA002F	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	12/31/2007	04/01/2016
FQHCLA002G	NATIVIDAD	MEDICAL CENTER PHCY	1441 CONSTITUTION BLVD	SALINAS	CA	93906-3100	12/31/2007	04/01/2020
FQHCLA002A	WALGREEN CO.	DBA: WALGREENS # 03446	575 N SANBORN RD	SALINAS	CA	93905	07/01/2014	04/01/2020
FQHCLA002A	WALGREEN CO.	DBA: WALGREENS # 02867	1055 FREMONT BLVD	SEASIDE	CA	93955	07/01/2014	04/01/2020
FQHCLA002A	WALGREEN CO.	DBA: WALGREENS # 02606	1532 N MAIN ST	SALINAS	CA	93906	07/01/2014	04/01/2020
FQHCLA002A	WALGREEN CO.	DBA: WALGREENS # 04997	226 RESERVATION RD.	MARINA	CA	93933	07/01/2014	04/01/2020
FQHCLA002A	WALGREEN CO.	DBA: WALGREENS # 07081	416 ALVARADO ST	MONTEREY	CA	93940	07/01/2014	04/01/2020
FQHCLA002C	WALGREEN CO.	DBA: WALGREENS # 03446	575 N SANBORN RD	SALINAS	CA	93905	07/01/2014	04/01/2020
FQHCLA002C	WALGREEN CO.	DBA: WALGREENS # 02867	1055 FREMONT BLVD	SEASIDE	CA	93955	07/01/2014	04/01/2020
FQHCLA002C	WALGREEN CO.	DBA: WALGREENS # 02606	1532 N MAIN ST	SALINAS	CA	93906	07/01/2014	04/01/2020
FQHCLA002C	WALGREEN CO.	DBA: WALGREENS # 04997	226 RESERVATION RD.	MARINA	CA	93933	07/01/2014	04/01/2020
FQHCLA002C	WALGREEN CO.	DBA: WALGREENS # 07081	416 ALVARADO ST	MONTEREY	CA	93940	07/01/2014	04/01/2020
FQHCLA002A	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2014	04/01/2020
FQHCLA002C	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2014	01/04/2017

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2020 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		3/31/2020 12:00:00 AM	2/28/2020 10:01 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/28/2020 10:01 AM
Terminations	Termination Date	Update	Recertification		4/1/2020 12:00:00 AM	2/28/2020 10:01 AM
Terminations	Termination Effective Date	Update	Recertification		4/1/2020 12:00:00 AM	2/28/2020 10:01 AM
Terminations	Termination Reason	Update	Recertification		Failure to recertify	2/28/2020 10:01 AM
Details	Last Recertification Date	Update	Recertification	2/12/2018 11:42:34 AM	1/31/2019 12:53:09 PM	1/31/2019 12:53 PM
Details	Last Recertification Date	Update	Recertification	2/12/2017 12:00:00 AM	2/12/2018 11:42:34 AM	2/12/2018 11:42 AM
Details	Grant Number	Update	Recertification	LAL000049	LALCS00049	2/12/2018 11:42 AM
Addresses	Main Address	Update	Change Request	559 E Alisal St STE Salinas, CA 93905	559 E Alisal Street, Suite 201 Salinas, CA 93905	12/29/2017 8:01 AM
Addresses	Main Address	Update	OPA Edit	599 E Alisal St STE 201 Salinas, CA 93905	559 E Alisal St STE Salinas, CA 93905	10/12/2017 9:51 AM
Addresses	Billing Address	Insert	Change Request		Monterey County Health Department FQHC Look Alike Clinics 1441 Schilling Place South Building, First Floor Salinas, CA 93901	10/6/2017 2:10 PM
Contacts	Primary Contact	Update	Change Request	CASPER, ART DIRECTOR OF CLINIC SERVICES 8317596522	Segovia, Prisca Management Analyst II - Clinic Service Bureau Monterey County Health Department 8317554939	10/2/2017 6:02 PM
Contacts	Authorizing Official	Update		Edgcomb, Julia C. Clinic Services Bureau Chief/Director 8317961386	Edgcomb, Julia C. Clinic Services Bureau Chief/Director Monterey County HEalth Department 8317961386	9/22/2017 11:03 AM
Contacts	Authorizing Official	Insert			Edgcomb, Julia C. Clinic Services Bureau Chief/Director 8317961386	2/12/2017 8:28 AM
Addresses	Main Address	Insert			599 E Alisal St STE 201 Salinas, CA 93905	2/12/2017 8:27 AM
Details	Last Recertification Date	Update		2/23/2016 12:00:00 AM	2/12/2017 12:00:00 AM	2/12/2017 8:27 AM
Details	Last Recertification Date	Update		2/2/2015 12:00:00 AM	2/23/2016 12:00:00 AM	2/23/2016 8:40 PM
Details	Last Recertification Date	Update		3/16/2014 12:00:00 AM	2/2/2015 12:00:00 AM	2/2/2015 8:46 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/16/2014 12:00:00 AM	3/16/2014 11:29 PM
Details	Entity Name	Update		MONTEREY COUNTY HEALTH DEPARTMENT	COUNTY OF MONTEREY	3/16/2014 11:29 PM
Details	Entity Subname	Update		ALISAL HEALTH CENTER	Alisal Health Center	3/16/2014 11:29 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/20/2013 6:47 AM
Details	Grant Number	Update			LAL000049	12/28/2012 3:36 PM
Contacts	Primary Contact	Insert			CASPER, ART DIRECTOR OF CLINIC SERVICES 8317596522	1/10/2011 9:01 AM
Details	Grant Number	Update		LAL000049		2/22/2006 2:45 PM
Details	Last Recertification Date	Insert				10/1/2001 12:00 AM
Details	Grant Number	Insert			LAL000049	10/1/2001 12:00 AM
Details	340B ID	Insert			FQHCLA002C	10/1/2001 12:00 AM
Details	Is Authorizing Official EHB Data	Insert				10/1/2001 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Insert				10/1/2001 12:00 AM
Details	Medicare Provider Number	Insert				10/1/2001 12:00 AM
Details	Entity Name	Insert			MONTEREY COUNTY HEALTH DEPARTMENT	10/1/2001 12:00 AM
Details	Program Code	Insert			FQHCLA	10/1/2001 12:00 AM
Details	Entity Subname	Insert			ALISAL HEALTH CENTER	10/1/2001 12:00 AM
Dates	Participating Approval Date	Insert			10/1/2001 12:00:00 AM	10/1/2001 12:00 AM
Details	State	Insert			Active	10/1/2001 12:00 AM
Dates	Registration Date	Insert			10/1/2001 12:00:00 AM	10/1/2001 12:00 AM
Dates	Signed By Date	Insert				10/1/2001 12:00 AM
Dates	Start Date	Insert			10/1/2001 12:00:00 AM	10/1/2001 12:00 AM
Terminations	Termination Comments	Insert				10/1/2001 12:00 AM
Terminations	Termination Date	Insert				10/1/2001 12:00 AM
Terminations	Termination Effective Date	Insert				10/1/2001 12:00 AM
Terminations	Termination Reason	Insert				10/1/2001 12:00 AM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

Grantee Sites

Grantee Sites Contract Pharmacies

History