340B Drug Pricing Program Database


CH09085AG AMPLA HEALTH (Active) - information as of 4/30/2025 10:57:46 PM

Main Details
AMPLA HEALTH
Ampla Health South Chico Medical
HRSA-Funded Health Center
BPS-H80-037250
CH09085AG
H80CS00765


Additional Details
Active
11/28/2023
1/1/2024
11/28/2023
2/14/2025

Contacts

Ampla Health
Benjamin H. Flores, President & CEO
(530) 674-4261 Ext: 1155

Ampla Health
Jessica Barber, Pharmacy Administrator
(530) 520-6042

Addresses

2216 Fair Street
Chico, CA 95928

Ampla Health
935 Market Street
Yuba City, CA 95991


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

No
Shipping Addresses

Ampla Health South Chico Medical
2216 Fair Street
Chico, CA 95928

Ampla Health Chico Pharmacy
680 Cohasset RD
Chico, CA 95926

Ampla Health
355 Samuel Drive
Yuba City, CA 95991

Ampla Health Cannery Pharmacy
614 J Street
Marysville, CA 95901

Ampla Health d/b/a Nofel Pharmacy
4941 Olivehurst Ave.
Olivehurst, CA 95961

Ampla Health d/b/a/ Madison Home Pharmacy
2800 Lincoln St
Oroville, CA 95966

Ampla Health d/b/a RE Community Pharmacy
1000 Sutter Street
Yuba City, CA 95991
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH090850ActiveBPS-H80-000154AMPLA HEALTHAmpla Health Lindhurst Medical, Dental, & Xpress Care4941 Olivehurst Ave OlivehurstCA
CH09085AActiveBPS-H80-004416AMPLA HEALTHAmpla Health Oroville Medical & Dental2800 Lincoln Blvd OrovilleCA
CH09085AAActiveBPS-H80-013998AMPLA HEALTHAmpla Health Los Molinos Medical7981 STATE HIGHWAY 99E LOS MOLINOSCA
CH09085ABActiveBPS-H80-018620AMPLA HEALTHAmpla Health Magalia Medical Clinic14137 Lakeridge Court MagaliaCA
CH09085ACActiveBPS-H80-032418AMPLA HEALTHThe Cannery Building614 J St MarysvilleCA
CH09085ADActiveBPS-H80-036382AMPLA HEALTHAmpla Health Yuba City Plumas Medical481 Plumas Street STE 101 Yuba CityCA
CH09085AEActiveBPS-H80-030378AMPLA HEALTHAmpla Health Mobile Unit2800 Lincoln Blvd. OrovilleCA
CH09085AFActiveBPS-H80-036345AMPLA HEALTHAmpla Health Test to Treat Mobile Unit355 Samuel Dr Yuba CityCA
CH09085AGActiveBPS-H80-037250AMPLA HEALTHAmpla Health South Chico Medical2216 Fair Street ChicoCA
CH09085AHActiveBPS-H80-038075AMPLA HEALTHAmpla Health Marysville Medical at the Cannery608 J Street MarysvilleCA
CH09085AJActiveBPS-H80-038076AMPLA HEALTHAmpla Health North Plumas Medical1231 Plumas St Yuba CityCA
CH09085AKActiveBPS-H80-038172AMPLA HEALTHAmpla Health North Chico Medical100 Independence Circle ChicoCA
CH09085ALActiveBPS-H80-033886AMPLA HEALTHAmpla Health Family Dental and Medical285 Cohasset Rd ChicoCA
CH09085BActiveBPS-H80-001827AMPLA HEALTHAmpla Health Colusa Medical & Dental555 Fremont Street ColusaCA
CH09085CActiveBPS-H80-032558AMPLA HEALTHAmpla Health Richland Medical355 Samuel Drive Yuba CityCA
CH09085DActiveBPS-H80-010583AMPLA HEALTHAmpla Health Yuba City Medical & Xpress1000 SUTTER STREET YUBA CITYCA
CH09085EActiveBPS-H80-002697AMPLA HEALTHAmpla Health Orland Medical & Dental1211 Cortina Drive OrlandCA
CH09085FActiveBPS-H80-004958AMPLA HEALTHAmpla Health Gridley Medical520 Kentucky Street GridleyCA
CH09085GActiveBPS-H80-011481AMPLA HEALTHAmpla Health Hamilton City Medical278 MAIN ST. HAMILTON CITYCA
CH09085HActiveBPS-H80-003382AMPLA HEALTHAmpla Health Chico Medical, Pediatrics, & Xpress Care680 COHASSET ROAD CHICOCA
CH09085JActiveBPS-H80-000261AMPLA HEALTHAmpla Health Yuba City Pediatrics931 MARKET ST YUBA CITYCA
CH09085UActiveBPS-H80-004492AMPLA HEALTHAmpla Health Corporate Office935 Market Street Yuba CityCA
CH09085WActiveBPS-H80-009944AMPLA HEALTHAmpla Health Arbuckle Medical & Dental89 Putnam Way ArbuckleCA
CH09085XTerminatedBPS-H80-010970AMPLA HEALTHAmpla Health Chico Dental236 WEST EAST AVENUE CHICOCA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090850ACARIAHEALTH PHARMACY #14, INC.4151 E COMMERCE WAY # 1041
SACRAMENTOCA95834-967904/01/2018  
CH090850ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750207/01/2022  
CH090850ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2022  
CH090850ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/01/2022  
CH090850ACCREDO HEALTH GROUP INC4343 W ROYAL LN STE 124
IRVINGTX75063-229907/01/2025  
CH090850ACCREDO HEALTH GROUP INC2410 WARDLOW RD STE 101
CORONACA9287807/01/2025  
CH090850ACCREDO HEALTH GROUP INC22623 68TH AVE S
KENTWA98032-198107/01/2025  
CH090850ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607507/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624107/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/01/2022  
CH090850ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282207/01/2022  
CH090850ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280904/01/2025  
CH090850AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291104/01/2018  
CH090850AMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700304/01/2025  
CH090850AMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287904/01/2025  
CH090850AVELLA OF COLUMBUS4830 KNIGHTSBRIDGE BLVD STE C
COLUMBUSOH43214-230001/01/2020 10/15/2021
CH090850AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062112/06/2017 10/15/2021
CH090850AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508507/01/2017 10/06/2017
CH090850AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508504/01/2018 10/03/2019
CH090850AVELLA OF SACRAMENTO, INC.2288 AUBURN BLVD #102
SACRAMENTOCA9582107/01/2017 10/15/2021
CH090850AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2019 04/01/2019
CH090850AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503410/01/2019  
CH090850BIDWELL PHARMACY & MEDICAL SUPPLYBIDWELL PHARMACY & MEDICAL SUPPLY 1200 MANGROVE AVE STE A
CHICOCA9592607/01/2015 06/01/2017
CH090850BIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/01/2024  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526101/01/2020  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771301/01/2020  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620310/01/2024 10/01/2024
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522610/01/2024 10/01/2024
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522601/01/2025  
CH090850BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620301/01/2025  
CH090850CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2023  
CH090850CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2023  
CH090850CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2023  
CH090850CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2023  
CH090850CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2023  
CH090850CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2023  
CH090850CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2023  
CH090850CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813307/01/2023  
CH090850CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237407/01/2023  
CH090850CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2023  
CH090850CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506910/01/2022 09/07/2022
CH090850CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506901/01/2024  
CH090850CENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282401/01/2024  
CH090850CHICO PHARMACY251 COHASSET RD STE 100
CHICOCA95926-223507/01/2015 06/01/2017
CH090850COMMUNITY MEDICAL CENTER PHARMACY610 GATEWAY CENTER WAY STE A - E
SAN DIEGOCA92102-454804/01/2017 05/16/2018
CH090850CORNERSTONE PHARMACY SERVSDBA LATIMERS PHARMACY 7885 HIGHWAY 99E
P.O. BOX 117
LOS MOLINOSCA9605507/01/2015 06/01/2017
CH090850CRYSTAL MEDICAL CENTERPHARMACY, INC. 2809 OLIVE HIGHWAY
SUITE 160
OROVILLECA9596610/01/2015 03/22/2019
CH090850CRYSTAL MEDICAL CENTER PHARMACYODEDRA ENTERPRISES, INC. DBA 2809 OLIVE HWY STE 160
OROVILLECA95966-613301/01/2020  
CH090850CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2023  
CH090850CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2023  
CH090850CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2023  
CH090850CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2019  
CH090850DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200
MT PROSPECTIL6005604/01/2017  
CH090850DIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268301/01/2020 10/15/2021
CH090850DIPLOMAT SPECIALTY PHARMACY OF PHOENIX,DIPLOMAT SPECIALTY PHARMACY 485 N. JUNIPER DR
CHANDLERAZ8522601/01/2020 10/15/2021
CH090850DIPLOMAT SPECIALTY PHARMACY OF SOUTHERNDIPLOMAT SPECIALTY PHARMACY 1809 EXCISE AVENUE
SUITE 204-208
ONTARIOCA9176110/01/2019 09/27/2019
CH090850DOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K
GREENVILLESC29607-654001/01/2020  
CH090850DOVES LANDING PHARMACY  2450 ORO DAM BLVD.
SUITE B
OROVILLECA9596607/01/2015 06/01/2017
CH090850ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/01/2022  
CH090850EVERGREEN PHARMACEUTICAL OF CALIFORNIA,DBA OMNICARE OF SACRAMENTO 3630 BUSINESS DR STE D
SACRAMENTOCA9582004/01/2025  
CH090850EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/01/2022  
CH090850EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/01/2022  
CH090850EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/01/2022  
CH090850FOUCH AND SON PHARMACY692 E ST PO BOX 39
WILLIAMSCA9598701/01/2020  
CH090850FRANKLIN PHARMACY  1619 FRANKLIN ROAD BUILDING A
YUBA CITYCA9599307/01/2015 01/01/2017
CH090850FRANKLIN PHARMACYSCRIPT DEPOT LP DBA 1619 FRANKLIN RD
BLDG A
YUBA CITYCA9599301/01/2017  
CH090850GALLOWAY'S MEDICAL CENTER PHARMACY2995 NATIONAL AVENUE
SAN DIEGOCA9211312/06/2017 05/16/2018
CH090850GARDEN GROVE COMMUNITY PHARMACY12665 GARDEN GROVE BLVD STE 108
GARDEN GROVECA92843-191501/01/2019 08/31/2022
CH090850GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY# 2881 1120 FOREST AVE.
CHICOCA9592807/01/2023  
CH090850GARFIELD BEACH CVS, L.L.C.DBA CVS/PHARMACY # 5225 2636 MARCONI AVE.
SACRAMENTOCA9582107/01/2023  
CH090850GARFIELD BEACH CVS, L.L.C.CVS PHARMACY # 16109 1153 BUTTE HOUSE RD
YUBA CITYCA9599107/01/2023  
CH090850GENOA HEALTHCARE LLC245 11TH ST STE P1
SAN FRANCISCOCA9410301/01/2022  
CH090850GENOA HEALTHCARE LLC17782 COWAN ST STE G
IRVINECA9261401/01/2022  
CH090850GENOA HEALTHCARE LLC1850 W FLORIDA AVE
HEMETCA9254501/01/2022  
CH090850GENOA HEALTHCARE LLC1701 MISSION AVE STE 230 RM P1
OCEANSIDECA9205801/01/2022  
CH090850GENOA HEALTHCARE LLC11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGSCA9067001/01/2022  
CH090850GENOA HEALTHCARE LLC560 COHASSET RD STE 110
CHICOCA9592601/01/2024  
CH090850GENOA HEALTHCARE LLC474 W VERMONT AVE, STE 104
ESCONDIDOCA9202504/01/2025  
CH090850LINDHURST PHARMACYLINDHURST PHARMACY SERVICES INC 5991 LINDHURST AVE
MARYSVILLECA9590101/01/2017 06/01/2017
CH090850LIVE OAK PHARMACY  9970 LIVE OAK BOULEVARD
LIVE OAKCA9595307/01/2015 10/01/2018
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07506 1496 EAST AVE
CHICOCA9592607/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09932 1274 STABLER LN
YUBA CITYCA9599307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09158 850 ORO DAM BLVD E
OROVILLECA9596507/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09691 906 E ST.
MARYSVILLECA9590107/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09525 260 SPRUCE ST
GRIDLEYCA9594807/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 07128 2780 ESPLANADE
CHICOCA9597307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09188 869 NEWVILLE RD
ORLANDCA9596307/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 03937 455 SOUTH MAIN STREET
RED BLUFFCA9608007/01/2023  
CH090850LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: CVS/PHARMACY # 09535 63 LINCOLN BLVD
LINCOLNCA9564807/01/2023  
CH090850M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312604/01/2018  
CH090850MADISON HOME PHARMACY2800 LINCOLN ST STE B
OROVILLECA95966-596110/15/2018 02/01/2022
CH090850MADISON HOME PHARMACY CORPDBA MADISON HOME PHARMACY 1811 W KATELLA AVE SUITE 229
ANAHEIMCA9280407/01/2018 10/15/2018
CH090850MEDI-MART PHARMACY  5993 LINDHURST AVENUE
MARYSVILLECA9590110/01/2015 10/01/2015
CH090850MISSION PHARMACY SERVICES INC400 PLUMAS BOULEVARD SUITE 100
YUBA CITYCA9599107/01/2015 10/20/2017
CH090850NEXT DOOR PHARMACYNEXT DOOR PHARMACY INC 285 COHASSET RD
STE 110, 140, 150
CHICOCA9592607/01/2015 01/19/2016
CH090850OLIVEHURST DRUG STORE, INC4897 OLIVEHURST AVE
OLIVEHURSTCA95961-422507/01/2015 01/21/2021
CH090850OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191301/01/2020 01/01/2020
CH090850OPTUM INFUSION SERVICES 305, LLC15529 COLLEGE BLVD.
LENEXAKS66219-135107/01/2024  
CH090850OPTUM INFUSION SERVICES 401, LLC4610 NORTHGATE BLVD. STE. 130
SACRAMENTOCA95834-115407/01/2024  
CH090850OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276507/01/2024  
CH090850OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502904/01/2022  
CH090850OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850707/25/2022  
CH090850OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520407/01/2024  
CH090850OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2020  
CH090850OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824904/01/2022  
CH090850OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729804/01/2022  
CH090850OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2020  
CH090850OPTUM PHARMACY 800, INC.3016 GUADALUPE ST STE A
AUSTINTX78705-286101/01/2020 01/01/2022
CH090850OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508501/01/2024  
CH090850OPTUM PHARMACY 803, INC.701 SHADOW LN #110
LAS VEGASNV89106-413201/01/2020 01/01/2022
CH090850OPTUM PHARMACY 806, INC.2288 AUBURN BLVD STE. 102
SACRAMENTOCA95821-161801/01/2022 01/01/2022
CH090850OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983804/01/2022  
CH090850OPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660804/01/2022 06/30/2022
CH090850ORLANDCARE PHARMACY AND MEDICAL SUPPLYORLANDCARE PHARMACY AND MEDICAL SUPPLY 21 E WALKER ST
ORLANDCA9596307/01/2015 06/01/2017
CH090850OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
REDMONDWA9805204/01/2020  
CH090850PEACH TREE PHARMACY  5730 PACKARD AVENUE
SUITE 620
MARYSVILLECA9590107/01/2015 06/01/2017
CH090850PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310104/01/2018  
CH090850PILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231904/01/2025  
CH090850PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDOFL32819-999210/01/2019 10/01/2023
CH090850PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2023  
CH090850PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY 445 CASTRO STREET
SAN FRANCISCOCA9411407/01/2025  
CH090850RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255001/01/2020  
CH090850RE COMMUNITY PHARMACY32241 CAMINO CAPISTRANO STE A-102
SAN JUAN CAPISTRANOCA9267510/01/2019 04/14/2020
CH090850RE COMMUNITY PHARMACY1000 SUTTER ST., STE. B
YUBA CITYCA9599104/15/2020 04/01/2022
CH090850RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500201/01/2020  
CH090850RIVERSIDE PHARMACYSCRIPT DEPOT LP DBA 866 PLUMAS ST STE C
YUBA CITYCA9599101/01/2017  
CH090850SAFEWAY INCSAFEWAY PHARMACY #1125 1366 EAST AVE
CHICOCA9592607/01/2015  
CH090850SAFEWAY INCSAFEWAY PHARMACY #2287 1596 STATE HWY 99
GRIDLEYCA9594807/01/2015  
CH090850SAFEWAY INCSAFEWAY PHARMACY #0302 6020 CLARK ROAD
PARADISECA9596907/01/2015 11/09/2018
CH090850SOLVENCY HEALTH PHARMACY7 BALA AVE STE 100
BALA CYNWYDPA1900410/01/2016 08/27/2020
CH090850STELLAR SCRIPTS INCDBA RIVERSIDE PHARMACY 866 PLUMAS STREET
SUITE #C
YUBA CITYCA9599107/01/2015 12/31/2016
CH090850SUN SCRIPTS INCDB/A THE MEDICINE SHOPPE 812 FIFTH STREET
MARYSVILLECA9590101/01/2016 05/10/2020
CH090850SUTTER PHARMACY470 PLUMAS BOULEVARD SUITE 103
YUBA CITYCA9599107/01/2015 12/01/2019
CH090850SUTTER PHARMACY470 PLUMAS BLVD. STE. 103
YUBA CITYCA9599104/01/2020  
CH090850THE MEDICINE SHOPPE PHARMACY812 5TH ST.
MARYSVILLECA9590104/01/2018 05/10/2020
CH090850THRIFTY PAYLESS, INC.RITE AID #6087 650 MANGROVE AVENUE
CHICOCA9592604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6088 1021 BRIDGE STREET
COLUSACA9593204/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6090 1583 HIGHWAY 99
GRIDLEYCA9594804/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6091 2700 ORO DAM BOULEVARD EAST
OROVILLECA9596604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6092 6007 CLARK ROAD
PARADISECA9596904/01/2017 12/03/2023
CH090850THRIFTY PAYLESS, INC.RITE AID #6094 220 WEST EAST AVENUE
CHICOCA9592604/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6188 640 EDITH AVENUE
CORNINGCA9602104/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6342 1590 BUTTE HOUSE ROAD
YUBA CITYCA9599304/01/2017  
CH090850THRIFTY PAYLESS, INC.RITE AID #6557 5075 OLIVEHURST AVENUE
OLIVEHURSTCA9596104/01/2017  
CH090850TRUEPILL3121 DIABLO AVE
HAYWARDCA9454504/01/2020  
CH090850WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2018  
CH090850WAL-MART PHARMACY 10-1575465 CAL OAK RD
OROVILLECA9596510/01/2015  
CH090850WAL-MART PHARMACY 10-19031150 HARTER ROAD
YUBA CITYCA9599310/01/2015  
CH090850WAL-MART PHARMACY 10-20442044 FOREST AVENUE
CHICOCA9592810/01/2015  
CH090850WAL-MART PHARMACY 10-2053470 N AIRPORT ROAD
WILLOWSCA9598810/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-21901720 EAST MAIN STREET
WOODLANDCA9577610/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-51361131 N BEALE RD
MARYSVILLECA9590110/01/2015  
CH090850WAL-MART PHARMACY 10-56061250 E GIBSON ROAD
WOODLANDCA9577610/01/2015 10/20/2015
CH090850WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2018  
CH090850WALGREEN CO.DBA: WALGREENS # 06141 2703 ORO DAM BLVD E
OROVILLECA9596610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS #12527 2293 RIVER OAKS BLVD
PLUMAS LAKECA9596110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 00993 855 COLUSA AVE
YUBA CITYCA9599110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS #13001 828 NEWVILLE RD
ORLANDCA9596310/01/2019  
CH090850WALGREEN CO.DBA; WALGREENS #12259 1640 LINCOLN RD
YUBA CITYCA9599310/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 13000 860 EAST AVENUE
CHICOCA9592610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 05207 1042 NORD AVE
CHICOCA9592610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 07433 1781 COLUSA HWY
YUBA CITYCA95993-909610/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 02277 602 10TH STREET
MARYSVILLECA9590110/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 07653 1145 S MAIN ST
RED BLUFFCA96080-273810/01/2019  
CH090850WALGREEN CO.DBA: WALGREENS # 03877 7576 SKYWAY
PARADISECA9596910/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700810/01/2019 10/01/2023
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2019  
CH090850WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2019  
CH090850WALMART PHARMACY 10-4127215 CALIFORNIA ST.
WOODLANDCA9569510/01/2015  
CH090850WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2023  
CH090850Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616807/01/2025  
CH090850WESTERN PHARMACY GROUP LLCDBA COMMUNITY MEDICAL CENTER PHARMACY 610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGOCA9210205/17/2018  
CH09085AAWESTERN PHARMACY GROUP LLCDBA GALLOWAY'S MEDICAL CENTER PHARMACY 2995 NATIONAL AVE
SAN DIEGOCA92113-241907/01/2018 04/13/2018
CH090850WESTERN PHARMACY GROUP LLCDBA GALLOWAY'S MEDICAL CENTER PHARMACY 2995 NATIONAL AVE
SAN DIEGOCA92113-241905/17/2018  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdatePC Change RequestSnelgrove, Cindy Anne Chief Clinical Services Officer Ampla Health 5307513755Barber, Jessica Pharmacy Administrator Ampla Health 53052060424/25/2025 6:42 AM
DetailsLast Recertification DateUpdateRecertification2/27/2024 2:27:01 PM2/14/2025 6:38:15 PM2/14/2025 6:38 PM
AddressesMain AddressUpdateRecertification 2216 Fair St Chico, CA 95928-6748 2216 Fair Street Chico, CA 959282/27/2024 2:27 PM
AddressesBilling AddressInsertRecertification Ampla Health 935 Market Street Yuba City, CA 959912/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health South Chico Medical 2216 Fair Street Chico, CA 959282/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health Chico Pharmacy 680 Cohasset RD Chico, CA 959262/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health 355 Samuel Drive Yuba City, CA 959912/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health Cannery Pharmacy 614 J Street Marysville, CA 959012/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health d/b/a Nofel Pharmacy 4941 Olivehurst Ave. Olivehurst, CA 959612/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health d/b/a/ Madison Home Pharmacy 2800 Lincoln St Oroville, CA 959662/27/2024 2:27 PM
AddressesShipping AddressInsertRecertification Ampla Health d/b/a RE Community Pharmacy 1000 Sutter Street Yuba City, CA 959912/27/2024 2:27 PM
DetailsLast Recertification DateUpdateRecertification 2/27/2024 2:27:01 PM2/27/2024 2:27 PM
DetailsStateUpdate ApprovedActive1/1/2024 12:01 AM
ContactsSigned ByInsertNew Registration Flores, Benjamin H. President & CEO Ampla Health 5306744261-115511/28/2023 1:18 PM
Details340B IDUpdateNew Registration CH09085AG11/28/2023 1:18 PM
DatesParticipating Approval DateUpdateNew Registration 11/28/2023 1:18:46 PM11/28/2023 1:18 PM
DetailsStateUpdateNew RegistrationPendingApproved11/28/2023 1:18 PM
DatesSigned By DateUpdateNew Registration 11/28/2023 12:28:43 PM11/28/2023 1:18 PM
DatesStart DateUpdateNew Registration 1/1/2024 12:00:00 AM11/28/2023 1:18 PM
AddressesMain AddressInsertNew Registration  2216 Fair St Chico, CA 95928-674811/28/2023 12:07 PM
ContactsAuthorizing OfficialInsertNew Registration Flores, Benjamin H. President & CEO Ampla Health 5306744261-115511/28/2023 12:07 PM
ContactsPrimary ContactInsertNew Registration Snelgrove, Cindy Anne Chief Clinical Services Officer Ampla Health 530751375511/28/2023 12:07 PM
DetailsAssistance Received From DateInsertNew Registration  11/28/2023 12:07 PM
DetailsAssistance Received To DateInsertNew Registration  11/28/2023 12:07 PM
DetailsLast Recertification DateInsertNew Registration  11/28/2023 12:07 PM
DetailsGrant NumberInsertNew Registration H80CS0076511/28/2023 12:07 PM
Details340B IDInsertNew Registration  11/28/2023 12:07 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  11/28/2023 12:07 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  11/28/2023 12:07 PM
DetailsMedicare Provider NumberInsertNew Registration  11/28/2023 12:07 PM
DetailsEntity NameInsertNew Registration AMPLA HEALTH11/28/2023 12:07 PM
DetailsNOFO NumberInsertNew Registration  11/28/2023 12:07 PM
DetailsProgram CodeInsertNew Registration CH11/28/2023 12:07 PM
DetailsEntity SubnameInsertNew Registration Ampla Health South Chico Medical11/28/2023 12:07 PM
DatesParticipating Approval DateInsertNew Registration  11/28/2023 12:07 PM
DetailsStateInsertNew Registration Pending11/28/2023 12:07 PM
DatesRegistration DateInsertNew Registration 11/28/2023 12:07:49 PM11/28/2023 12:07 PM
DatesSigned By DateInsertNew Registration  11/28/2023 12:07 PM
DatesStart DateInsertNew Registration  11/28/2023 12:07 PM
TerminationsTermination CommentsInsertNew Registration  11/28/2023 12:07 PM
TerminationsTermination DateInsertNew Registration  11/28/2023 12:07 PM
TerminationsTermination Effective DateInsertNew Registration  11/28/2023 12:07 PM
TerminationsTermination ReasonInsertNew Registration  11/28/2023 12:07 PM