340B Drug Pricing Program Database


OPTUM PHARMACY 806, INC. - information as of 5/29/2025 2:42:21 AM


OPTUM PHARMACY 806, INC.

2288 AUBURN BLVD
STE. 102
SACRAMENTO, CA 95821-1618



  • Contracts
  • History
Contracts
Contract Detail340B IDEntity NameSub NameEntity TypeAddressAddress Cont.CityStateBegin DateTerm DateEdit Date
DetailsCAH041324-00CHI St. Vincent Morrilton Critical Access Hospital4 HOSPITAL DRIVE
MORRILTONAR10/01/201901/31/20215/4/2021 11:24 AM
DetailsCAH051328-00TAHOE FOREST HOSPITAL Critical Access Hospital10121 PINE AVENUE
TRUCKEECA07/15/202006/28/20216/28/2021 3:45 PM
DetailsCAH051333-00Ridgecrest Regional Hospital Critical Access Hospital1081 N. China Lake Blvd.
RidgecrestCA04/19/202108/13/20219/1/2021 1:40 PM
DetailsCAH061325-00PIONEERS MEDICAL CENTER Critical Access Hospital100 PIONEERS MEDICAL CENTER DRIVE
MEEKERCO01/01/202204/13/20224/28/2022 2:05 PM
DetailsCAH191312-00CHRISTUS Health Central Louisiana DBA CHRISTUS Coushatta Health Care Center Critical Access Hospital1635 Marvel Street
CoushattaLA06/08/202007/01/20229/7/2022 1:04 PM
DetailsCAH191325-00LAFOURCHE HOSPITAL SERVICE DISTRICT #1 DBA LADY OF THE SEA GENERAL HOSPITAL Critical Access Hospital200 WEST 134TH PLACE
CUT OFFLA01/01/202106/18/20216/23/2021 3:50 PM
DetailsCAH361302-00TRINITY HOSPITAL TWIN CITY Critical Access Hospital819 N 1st STREET
DENNISONOH10/01/201901/31/20212/24/2021 4:31 AM
DetailsCAH381308-00Salem Health West Valley Critical Access Hospital525 SE WASHINGTON STREET
DALLASOR07/01/2020 7/1/2020 12:01 AM
DetailsCAH381315-00ST. ALPHONSUS MEDICAL CENTER BAKER CITY Critical Access Hospital3325 POCAHONTAS ROAD
BAKER CITYOR04/01/202011/01/20214/14/2022 11:49 AM
DetailsCAH451319-00MOTHER FRANCES HOSPITAL-JACKSONVILLE Critical Access Hospital2026 S.JACKSON ST.
JACKSONVILLETX06/08/202007/01/20229/7/2022 11:37 AM
DetailsCAH451381-00MOTHER FRANCES HOSPITAL-WINNSBORO Critical Access Hospital719 WEST COKE ROAD
WINNSBOROTX06/08/202004/01/20229/1/2022 1:10 PM
DetailsCAH501321-01NORTH VALLEY HOSPITALOKANOGAN COUNTY PUBLIC HOSPITAL DIS - Tonasket Family Medical ClinicCritical Access Hospital118 N WHITCOMB AVE
TONASKETWA10/01/202107/08/20217/8/2021 11:18 AM
DetailsCAN050660-00USC Norris Cancer Hospital Free Standing Cancer Hospital1441 Eastlake Avenue
Los AngelesCA01/01/202112/10/20211/13/2022 1:49 PM
DetailsCH058470COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.CNHC dba PrimaryOne HealthHRSA-Funded Health Center2780 Airport Drive, Suite 100
ColumbusOH07/01/202107/22/20211/18/2022 9:51 AM
DetailsCH090160EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTEREL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTERHRSA-Funded Health Center839 WEST CONGRESS ST
TUCSONAZ10/01/202010/15/202110/18/2021 5:01 PM
DetailsCH090250CLINICAS DE SALUD DEL PUEBLO,Inc.Innercare K StreetHRSA-Funded Health Center1166 K St
BrawleyCA09/09/202010/10/202310/13/2023 6:52 PM
DetailsCH090470GOLDEN VALLEY HEALTH CENTERSGVHC - MERCED SUITESHRSA-Funded Health Center847 W. CHILDS AVE
MERCEDCA07/15/202006/30/20227/22/2022 8:06 PM
DetailsCH090780Community Medical Centers, Inc.Community Medical Centers, ChannelHRSA-Funded Health Center701 E Channel St.
StocktonCA05/11/202002/02/20222/25/2022 3:39 PM
DetailsCH090850AMPLA HEALTHAmpla Health Lindhurst Medical, Dental, & Xpress CareHRSA-Funded Health Center4941 Olivehurst Ave
OlivehurstCA01/01/202201/01/20221/24/2022 5:41 PM
DetailsCH091540OPEN DOOR COMMUNITY HEALTH CENTERSArcata Community Health CenterHRSA-Funded Health Center1150 Foster Avenue
ArcataCA07/01/202111/19/202112/3/2021 3:33 PM
DetailsCH091670VISTA COMMUNITY CLINICVCC: VALE TERRACEHRSA-Funded Health Center1000 Vale Terrace Dr.
VistaCA04/01/202106/18/20216/18/2021 12:01 AM
DetailsCH093030ADELANTE HEALTHCARE, INC.Adelante HealthcareHRSA-Funded Health Center3033 N. Central Ave.
PhoenixAZ07/17/202003/29/20224/4/2022 2:37 AM
DetailsCH093110ALTAMED Health Services CorporationAltaMed Health Services Corporation HeadquartersHRSA-Funded Health Center2040 CAMFIELD AVENUE
CommerceCA04/17/202007/01/20217/14/2021 4:50 PM
DetailsCH093640FAMILY HEALTHCARE NETWORKFAMILY HEALTHCARE NETWORK - Porterville Health CenterHRSA-Funded Health Center1107 W Poplar Ave
PortervilleCA07/15/202010/01/202110/14/2021 12:30 PM
DetailsCH103100UMPQUA COMMUNITY HEALTH CENTER, INC., dba Aviva HealthUmpqua Community Health CenterHRSA-Funded Health Center150 NE Kenneth Ford Drive
RoseburgOR10/27/2020 10/27/2020 7:58 AM
DetailsCH108170Dirne Health Centers, Inc.Heritage Health CDAHRSA-Funded Health Center1090 W Park Pl
Coeur D AleneID10/14/202003/15/20219/12/2022 5:32 PM
DetailsCHC28973-00GENESIS HEALTHCARE, INCOlanta Family CareHRSA-Funded Health Center211 S Jones Rd
OlantaSC10/01/202004/19/20214/19/2021 12:01 AM
DetailsCHC28973-00GENESIS HEALTHCARE, INCOlanta Family CareHRSA-Funded Health Center211 S Jones Rd
OlantaSC10/01/202102/13/20252/13/2025 11:20 AM
DetailsCHC33644-00MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICTValleywise Health Administrative BuildingHRSA-Funded Health Center2601 E Roosevelt St
PhoenixAZ07/01/202004/15/20206/17/2020 3:09 PM
DetailsCHC33644-00MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICTValleywise Health Administrative BuildingHRSA-Funded Health Center2601 E Roosevelt St
PhoenixAZ07/14/202007/12/20217/13/2021 3:02 PM
DetailsDSH010092DCH REGIONAL MEDICAL CENTER Disproportionate Share Hospital809 UNIVERSITY BOULEVARD EAST
TUSCALOOSAAL10/01/202004/01/20214/15/2021 11:22 AM
DetailsDSH030013YUMA REGIONAL MEDICAL CENTER Disproportionate Share Hospital2400 S Avenue A
YumaAZ10/01/202006/18/20216/18/2021 12:01 AM
DetailsDSH030014HONORHEALTH JOHN C. LINCOLN MED CTR Disproportionate Share Hospital250 E Dunlap Ave
PhoenixAZ07/01/202010/15/202110/15/2021 10:37 PM
DetailsDSH030022MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT Disproportionate Share HospitalMARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH 2601 EAST ROOSEVELT STREET
PHOENIXAZ07/01/202004/15/20206/17/2020 3:03 PM
DetailsDSH030022MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT Disproportionate Share HospitalMARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH 2601 EAST ROOSEVELT STREET
PHOENIXAZ07/14/202007/12/20217/13/2021 3:11 PM
DetailsDSH030024ST JOSEPH'S HOSPITAL AND MEDICAL CENTER Disproportionate Share Hospital350 W THOMAS ROAD
PHOENIXAZ01/01/2020 1/1/2020 12:05 AM
DetailsDSH030036CHANDLER REGIONAL MEDICAL CENTERCHANDLER REGIONAL MEDICAL CENTERDisproportionate Share Hospital1955 W. Frye Road
CHANDLERAZ01/01/202010/05/202110/5/2021 7:55 AM
DetailsDSH040007ST VINCENT INFIRMARY Disproportionate Share Hospital#2 ST. VINCENT CIRCLE ATTN: PHARMACY
LITTLE ROCKAR10/01/2019 10/1/2019 12:05 AM
DetailsDSH040029CONWAY REGIONAL MEDICAL CENTER INC Disproportionate Share Hospital2302 COLLEGE AVENUE
CONWAYAR10/01/202110/01/202110/1/2021 12:01 AM
DetailsDSH050006St. Joseph Health Northern California, LLC-DBA St. Joseph Hospital Disproportionate Share Hospital2700 DOLBEER STREET
EUREKACA07/07/202006/18/20216/23/2021 12:50 PM
DetailsDSH050009ST Joseph Health Northern California LLC-DBA Queen of the Valley Medical Center Disproportionate Share Hospital1000 TRANCAS STREET
NAPACA04/01/202006/18/20216/23/2021 12:50 PM
DetailsDSH050013St. Helena Hospital, DBA Adventist Health St. Helena Disproportionate Share Hospital10 WOODLAND ROAD
ST. HELENACA07/14/202007/01/202210/6/2022 7:48 PM
DetailsDSH050017MERCY GENERAL HOSPITAL Disproportionate Share Hospital4001 J STREET
SACRAMENTOCA01/01/202005/30/20228/10/2023 2:14 PM
DetailsDSH050025UCSD MEDICAL CENTER Disproportionate Share Hospital200 WEST ARBOR DRIVE
SAN DIEGOCA10/01/201908/31/202110/4/2021 2:25 PM
DetailsDSH050030OROVILLE HOSPITAL Disproportionate Share Hospital2767 OLIVE HIGHWAY
OROVILLECA07/15/202007/01/20217/13/2021 8:17 PM
DetailsDSH050039ENLOE MEDICAL CENTER Disproportionate Share Hospital1531 ESPLANADE
CHICOCA01/01/202006/19/202110/11/2021 11:12 AM
DetailsDSH050045EL CENTRO REGIONAL MEDICAL CENTER Disproportionate Share Hospital1415 ROSS AVENUE
EL CENTROCA07/06/202006/18/202110/4/2021 2:11 PM
DetailsDSH050057Kaweah Delta Health Care District DBA Kaweah Health Disproportionate Share Hospital400 West Mineral King Avenue
VisaliaCA07/27/2020 8/20/2020 3:42 PM
DetailsDSH050093SAINT AGNES MEDICAL CENTER Disproportionate Share Hospital1303 E HERNDON AVE
FRESNOCA10/01/2021 10/1/2021 12:01 AM
DetailsDSH050126Valley Presbyterian Hospital Disproportionate Share Hospital15107 Vanowen Street
Van NuysCA10/01/2019 10/1/2019 12:05 AM
DetailsDSH050127WOODLAND MEMORIAL HOSPITAL Disproportionate Share Hospital1325 COTTONWOOD ST
WOODLANDCA01/01/202007/16/20238/11/2023 4:06 PM
DetailsDSH050133RIDEOUT MEMORIAL HOSPITAL DBA Adventist Health and Rideout Disproportionate Share Hospital726 4TH STREET
MARYSVILLECA07/13/202004/15/20224/18/2022 8:31 PM
DetailsDSH050136NorCal HealthConnect LLC, DBA Petaluma Valley Hospital Disproportionate Share Hospital400 N. MCDOWELL BLVD
PETALUMACA04/01/202001/15/20201/30/2020 5:25 PM
DetailsDSH050150SIERRA NEVADA MEMORIAL HOSPITAL Disproportionate Share Hospital155 GLASSON WAY
GRASS VALLEYCA01/01/202007/16/20238/1/2023 2:18 PM
DetailsDSH050174ST Joseph Health Northern California LLC-DBA Santa Rosa Memorial Hospital Disproportionate Share Hospital1165 MONTGOMERY DRIVE
Santa RosaCA07/07/202006/18/20216/23/2021 12:49 PM
DetailsDSH050231POMONA VALLEY HOSPITAL MEDICAL CENTER Disproportionate Share Hospital1798 NORTH GAREY AVENUE
POMONACA07/14/202007/15/20217/15/2021 10:21 PM
DetailsDSH050254MARSHALL HOSPITAL Disproportionate Share Hospital1100 MARSHALL WAY
PLACERVILLECA07/01/202107/12/20217/16/2021 5:02 PM
DetailsDSH050262RONALD REAGAN UCLA MEDICAL CENTER Disproportionate Share Hospital757 WESTWOOD PLAZA
LOS ANGELESCA07/01/202006/18/202110/4/2021 12:34 PM
DetailsDSH050280MERCY MEDICAL CENTER, REDDING Disproportionate Share Hospital2175 ROSALINE AVENUE
REDDINGCA01/01/202110/01/202310/4/2023 4:03 PM
DetailsDSH050301ADVENTIST HEALTH UKIAH VALLEY Disproportionate Share Hospital275 HOSPITAL DRIVE
UKIAHCA07/14/202007/01/20219/30/2022 3:06 PM
DetailsDSH050334SALINAS VALLEY HEALTH MEDICAL CENTER Disproportionate Share Hospital450 EAST ROMIE LANE
SALINASCA07/01/202010/01/20212/21/2023 1:21 PM
DetailsDSH050335Sonora Community Hospital DBA Adventist Health Sonora Disproportionate Share Hospital1000 Greenley Road
SonoraCA10/09/202007/01/202210/3/2022 2:27 PM
DetailsDSH050348UCI MEDICAL CENTERUNIVERSITY OF CALIFORNIA, IRVINEDisproportionate Share Hospital101 THE CITY DR. S RT32
ORANGECA07/12/202006/18/20216/30/2021 8:40 PM
DetailsDSH050360MARIN GENERAL HOSPITAL Disproportionate Share Hospital250 BON AIR ROAD
GREENBRAECA01/01/202106/18/202110/7/2021 12:12 PM
DetailsDSH050367NorthBay Healthcare GroupNORTH BAY MEDICAL CENTERDisproportionate Share Hospital1200 B GALE WILSON BLVD
FAIRFIELDCA07/13/2020 7/22/2020 5:57 PM
DetailsDSH050438HUNTINGTON HOSPITAL Disproportionate Share Hospital100 W. California Blvd
PasadenaCA07/01/202005/18/20225/18/2022 6:52 PM
DetailsDSH050441STANFORD HEALTH CARE Disproportionate Share Hospital300 PASTEUR DRIVE
StanfordCA07/08/202006/18/202110/13/2021 5:10 PM
DetailsDSH050454UCSF-MEDICAL CENTER Disproportionate Share Hospital505 PARNASSUS AVE.
SAN FRANCISCOCA04/14/202007/01/20217/1/2021 12:01 AM
DetailsDSH050455Adventist Health Bakersfield Disproportionate Share Hospital2615 Chester Avenue
BAKERSFIELDCA10/06/202010/01/20221/9/2023 3:48 PM
DetailsDSH050516MERCY SAN JUAN MEDICAL CENTER Disproportionate Share Hospital6501 COYLE AVENUE
CARMICHAELCA01/01/202007/16/20238/16/2023 1:49 PM
DetailsDSH050590METHODIST HOSPITAL OF SACRAMENTO Disproportionate Share Hospital7500 HOSPITAL DRIVE
SACRAMENTOCA01/01/202007/16/20238/17/2023 2:35 PM
DetailsDSH050599UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER Disproportionate Share Hospital2315 STOCKTON BLVD
SACRAMENTOCA07/15/202006/18/20217/15/2021 4:56 PM
DetailsDSH050696Keck Hospital of USC Disproportionate Share Hospital1500 SAN PABLO STREET
LOS ANGELESCA04/01/202012/10/20211/13/2022 1:48 PM
DetailsDSH060012St. Mary-Corwin Hospital Disproportionate Share Hospital1008 Minnequa Avenue
PuebloCO01/01/2020 1/1/2020 12:05 AM
DetailsDSH060013Mercy Hospital Disproportionate Share Hospital1010 THREE SPRINGS BLVD.
DURANGOCO01/01/202007/01/20237/25/2023 11:45 PM
DetailsDSH060103AdventHealth Avista Disproportionate Share Hospital100 Health Park Drive
LouisvilleCO07/13/202010/12/20214/10/2024 5:13 PM
DetailsDSH070006THE STAMFORD HOSPITAL Disproportionate Share HospitalOne Hospital Plaza
STAMFORDCT07/14/202007/01/20217/19/2021 1:13 PM
DetailsDSH070022YALE NEW HAVEN HOSPITAL Disproportionate Share Hospital20 York Street
New HavenCT10/01/202007/14/20207/14/2020 3:23 PM
DetailsDSH110091Piedmont Rockdale Hospital, Inc. Disproportionate Share Hospital1412 Milstead Ave NE
CONYERSGA07/01/202104/12/20224/13/2022 3:40 PM
DetailsDSH130006ST LUKES REGIONAL MEDICAL CENTER, LTD. Disproportionate Share Hospital190 EAST BANNOCK
BOISEID10/29/202007/01/20217/12/2021 5:56 PM
DetailsDSH130013Saint Alphonsus Medical Center Nampa Disproportionate Share Hospital4300 East Flamingo Ave
NAMPAID07/01/202011/01/20214/14/2022 11:48 AM
DetailsDSH140046SSM HEALTH GOOD SAMARITAN HOSPITAL Disproportionate Share Hospital1 GOOD SAMARITAN WAY
MT. VERNONIL07/01/202310/10/202410/17/2024 9:53 AM
DetailsDSH140182ADVOCATE NORTH SIDE HEALTH NETWORKDBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)Disproportionate Share Hospital836 West Wellington Ave.
CHICAGOIL07/01/202007/15/20217/27/2021 2:06 PM
DetailsDSH140208ADVOCATE CHRIST MEDICAL CENTER Disproportionate Share Hospital4440 W 95TH ST
OAK LAWNIL07/01/202007/15/20217/26/2021 10:42 AM
DetailsDSH140228SWEDISH AMERICAN HOSPITAL Disproportionate Share Hospital1401 E STATE ST
ROCKFORDIL08/26/202011/29/202211/29/2022 10:47 AM
DetailsDSH160083CATHOLIC HEALTH INITIATIVES - IOWA, CORPMERCYONE DES MOINES MEDICAL CENTERDisproportionate Share Hospital1111 6th Avenue
DES MOINESIA10/01/2019 10/1/2019 12:05 AM
DetailsDSH180011SAINT JOSEPH HEALTH SYSTEMDBA SAINT JOSEPH - LONDONDisproportionate Share Hospital1001 SAINT JOSEPH LANE
LONDONKY07/01/2019 7/1/2019 12:05 AM
DetailsDSH180025ST. JOE. - FLAGET Disproportionate Share Hospital4305 NEW SHEPHERDSVILLE RD
BARDSTOWNKY07/01/2019 7/1/2019 12:05 AM
DetailsDSH180040UofL Health -- Louisville Disproportionate Share Hospital200 ABRAHAM FLEXNER WAY
LOUISVILLEKY07/15/202004/01/20224/12/2022 9:15 AM
DetailsDSH180143SAINT JOSEPH EAST Disproportionate Share Hospital150 NORTH EAGLE CREEK DRIVE
LEXINGTONKY07/17/2020 7/23/2020 1:45 PM
DetailsDSH190006UNIVERSITY HOSPITAL AND CLINICS Disproportionate Share Hospital2390 W CONGRESS ST.
LAFAYETTELA01/01/2022 1/1/2022 12:01 AM
DetailsDSH190019CHRISTUS ST FRANCES CABRINI HOSPITAL Disproportionate Share Hospital3330 MASONIC DRIVE
ALEXANDRIALA06/08/202007/01/20229/7/2022 1:07 PM
DetailsDSH190041CHRISTUS Shreveport-Bossier Health System Disproportionate Share Hospital1453 E. Bert Kouns Industrial Loop
ShreveportLA06/08/202007/01/20229/7/2022 1:56 PM
DetailsDSH190201CHRISTUS Lake Area Hospital Disproportionate Share Hospital4200 NELSON RD
LAKE CHARLESLA06/11/202007/01/20229/7/2022 11:49 AM
DetailsDSH200039MAINEGENERAL MEDICAL CENTER Disproportionate Share Hospital35 Medical Center Parkway
AugustaME09/09/202012/15/202312/20/2023 6:52 AM
DetailsDSH230236METROPOLITAN HOSPITAL Disproportionate Share Hospital5900 BYRON CENTER AVE SW
WYOMINGMI10/15/202009/30/202110/11/2021 8:35 AM
DetailsDSH260005SSM HEALTH ST. JOSEPH HOSPITAL- SC Disproportionate Share Hospital300 FIRST CAPITOL DRIVE
ST. CHARLESMO10/01/202004/10/20234/18/2023 12:47 AM
DetailsDSH260091SSM HEALTH ST MARY'S HOSPITAL-STL Disproportionate Share Hospital6420 CLAYTON ROAD
ST. LOUISMO10/01/202004/10/20234/18/2023 12:48 AM
DetailsDSH260104SSM HEALTH DEPAUL HOSPITAL Disproportionate Share Hospital12303 DePaul Dr
BRIDGETONMO10/01/202004/10/20234/18/2023 12:48 AM
DetailsDSH260105SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL Disproportionate Share Hospital1201 South Grand Blvd.
ST. LOUISMO10/01/202004/10/20234/18/2023 12:47 AM
DetailsDSH270012BENEFIS HOSPITALS INC. Disproportionate Share Hospital1101 26TH STREET SOUTH
GREAT FALLSMT10/01/202007/20/20218/2/2021 7:45 PM
DetailsDSH270051KALISPELL REGIONAL MEDICAL CENTER d/b/a LOGAN HEALTH MEDICAL CENTER Disproportionate Share Hospital310 SUNNYVIEW LANE
KALISPELLMT01/01/202109/01/202110/4/2021 3:09 PM
DetailsDSH290001RENOWN REGIONAL MEDICAL CENTER Disproportionate Share Hospital1155 MILL STREET
RENONV10/01/202006/18/20216/18/2021 12:01 AM
DetailsDSH290019CARSON TAHOE REGIONAL HEALTHCARE Disproportionate Share Hospital1600 MEDICAL PARKWAY
CARSON CITYNV01/01/202310/14/202210/17/2022 10:14 AM
DetailsDSH320002ST. VINCENT HOSPITAL Disproportionate Share Hospital455 ST. MICHAELS DRIVE
SANTA FENM06/08/202007/01/20229/9/2022 12:51 PM
DetailsDSH330221WYCKOFF HEIGHTS MEDICAL CENTER Disproportionate Share Hospital374 STOCKHOLM STREET
BROOKLYNNY10/01/202008/11/20238/14/2023 1:06 PM
DetailsDSH340047NORTH CAROLINA BAPTIST HOSPITAL Disproportionate Share HospitalMEDICAL CENTER BOULEVARD
WINSTON-SALEMNC07/15/202007/15/20208/6/2020 9:03 AM
DetailsDSH350011SANFORD MEDICAL CENTER FARGO Disproportionate Share Hospital801 BROADWAY NORTH
FARGOND01/01/202007/12/20217/13/2021 8:24 AM
DetailsDSH350015SANFORD BISMARCK Disproportionate Share Hospital300 N 7TH ST
BISMARCKND01/01/202006/18/20217/14/2021 11:03 PM
DetailsDSH360134THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO Disproportionate Share Hospital375 DIXMYTH AVE
CINCINNATIOH10/01/202007/15/20207/27/2020 10:33 AM
DetailsDSH360211TRINITY HOSPITAL HOLDING COMPANY Disproportionate Share Hospital4000 JOHNSON ROAD
STEUBENVILLEOH10/01/2022 10/1/2022 12:01 AM
DetailsDSH370056COMANCHE COUNTY MEMORIAL HOSPITAL Disproportionate Share Hospital3401 W Gore Blvd
LAWTONOK10/01/202007/07/20207/7/2020 9:50 AM
DetailsDSH380007LEGACY EMANUEL HOSPITAL & HEALTH CENTER Disproportionate Share Hospital2801 N GANTENBEIN AVE
PORTLANDOR01/01/202104/15/20244/15/2024 3:38 PM
DetailsDSH380009OREGON HLTH SCIENCE CENTERUNIVERSITY HOSPITALDisproportionate Share Hospital3181 SW SAM JACKSON PARK RD
PORTLANDOR01/01/202007/15/20217/16/2021 10:48 AM
DetailsDSH380017LEGACY GOOD SAMARITAN HOSPITAL Disproportionate Share Hospital1015 NW 22ND AVENUE
PORTLANDOR01/01/202104/15/20244/15/2024 3:42 PM
DetailsDSH380047St. Charles Health System, Inc., d/b/a St. Charles Bend Disproportionate Share Hospital2500 NE NEFF ROAD
BENDOR04/01/202007/01/20219/23/2021 7:02 PM
DetailsDSH380051Salem Health Disproportionate Share Hospital890 Oak Street SE
SalemOR07/01/2020 7/1/2020 12:01 AM
DetailsDSH380075PROVIDENCE MEDFORD MEDICAL CENTER Disproportionate Share Hospital1111 CRATER LAKE AVENUE
MEDFORDOR04/01/2021 4/1/2021 12:01 AM
DetailsDSH390044READING HOSPITAL Disproportionate Share Hospital420 South 5th Avenue
West ReadingPA05/12/202111/08/20225/9/2023 10:21 AM
DetailsDSH390090West Penn Hospital Disproportionate Share Hospital4800 FRIENDSHIP AVE
PITTSBURGHPA07/15/202010/01/202310/19/2023 4:11 PM
DetailsDSH390174THOMAS JEFFERSON UNIVERSITY HOSPITAL Disproportionate Share Hospital111 South 11th Street
PhiladelphiaPA10/01/202007/15/20216/2/2022 8:04 AM
DetailsDSH450032GOOD SHEPHERD MEDICAL CENTER Disproportionate Share Hospital700 E. MARSHALL AVENUE
LONGVIEWTX06/08/202001/01/20211/1/2021 12:01 AM
DetailsDSH450032GOOD SHEPHERD MEDICAL CENTER Disproportionate Share Hospital700 E. MARSHALL AVENUE
LONGVIEWTX07/01/202207/01/20228/25/2022 1:23 PM
DetailsDSH450034CHRISTUS HOSPITAL Disproportionate Share Hospital2830 CALDER STREET
BEAUMONTTX05/28/202107/01/20214/7/2022 3:16 PM
DetailsDSH450046CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE Disproportionate Share Hospital600 Elizabeth St.
CORPUS CHRISTITX06/10/202007/01/20229/7/2022 4:50 PM
DetailsDSH450082CHRISTUS SPOHN HOSPITAL BEEVILLE Disproportionate Share Hospital1500 E. HOUSTON
BEEVILLETX06/10/202007/01/20229/7/2022 4:54 PM
DetailsDSH450102CHRISTUS MOTHER FRANCES HOSP-TYLER Disproportionate Share Hospital800 EAST DAWSON
TYLERTX03/10/202203/10/20229/14/2022 3:50 PM
DetailsDSH450163CHRISTUS SPOHN HOSPITAL KLEBERG Disproportionate Share Hospital1311 E. GENERAL CAVAZOS BLVD
KINGSVILLETX06/10/202007/01/20229/7/2022 4:58 PM
DetailsDSH450236CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance Disproportionate Share Hospital115 AIRPORT ROAD
SULPHUR SPRINGSTX06/08/202007/01/20229/1/2022 1:34 PM
DetailsDSH450395Memorial Medical Center-Livingston Disproportionate Share Hospital1717 Hwy 59 Bypass
LivingstonTX10/01/201908/27/20219/17/2021 1:10 PM
DetailsDSH450573CHRISTUS JASPER MEMORIAL HOSPITAL Disproportionate Share Hospital1275 MARVIN HANCOCK DRIVE
JASPERTX06/08/202007/01/20229/9/2022 2:40 PM
DetailsDSH450801CHRISTUS ST MICHAEL Disproportionate Share Hospital2600 ST MICHAEL DRIVE
TEXARKANATX06/11/202007/01/20229/12/2022 12:12 PM
DetailsDSH450828CHRISTUS SPOHN HOSPITAL ALICE Disproportionate Share Hospital2500 EAST MAIN ST.
ALICETX06/10/202007/01/20229/7/2022 5:02 PM
DetailsDSH460009University of Utah Disproportionate Share Hospital50 North Medical Drive
Salt Lake CityUT01/01/202007/01/20217/14/2021 12:08 PM
DetailsDSH500003SKAGIT VALLEY HOSPITAL Disproportionate Share Hospital1415 EAST KINCAID
MOUNT VERNONWA07/13/202001/10/20231/13/2023 2:15 PM
DetailsDSH500015MULTICARE AUBURN MEDICAL CENTER Disproportionate Share Hospital202 NORTH DIVISION STREET
AUBURNWA07/01/201907/16/20207/19/2020 10:03 AM
DetailsDSH500027SWEDISH MEDICAL CENTER Disproportionate Share Hospital747 BROADWAY
SEATTLEWA07/01/202006/18/20212/9/2022 4:10 PM
DetailsDSH500030ST. JOSEPH MEDICAL CENTER Disproportionate Share Hospital2901 SQUALICUM PARKWAY
BELLINGHAMWA07/01/202007/15/20216/14/2022 11:50 AM
DetailsDSH500044DEACONESS MEDICAL CENTER Disproportionate Share Hospital800 W 5TH AVENUE
SPOKANEWA07/01/202007/05/20227/8/2022 2:15 AM
DetailsDSH500050PeaceHealth Southwest Medical Center Disproportionate Share Hospital400 NE Mother Joseph Place
VANCOUVERWA07/09/202007/15/20216/9/2022 11:16 AM
DetailsDSH500054PROVIDENCE HEALTH & SERVICES - WASHINGTONPROVIDENCE SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITALDisproportionate Share Hospital101 WEST 8TH AVENUE
SPOKANEWA01/01/2021 1/1/2021 12:01 AM
DetailsDSH500058Kadlec Regional Medical Center Disproportionate Share Hospital888 SWIFT BOULEVARD
RICHLANDWA10/15/202010/01/202210/1/2022 12:01 AM
DetailsDSH500077PROVIDENCE HEALTH & SERVICES-WASHINGTONPROVIDENCE HOLY FAMILY HOSPITALDisproportionate Share Hospital5633 NORTH LIDGERWOOD STREET
SPOKANEWA01/01/2021 1/1/2021 12:01 AM
DetailsDSH500079GOOD SAMARITAN HOSPITAL Disproportionate Share Hospital401 15th Avenue SE
PUYALLUPWA07/01/201907/01/20197/1/2019 12:05 AM
DetailsDSH500088PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER Disproportionate Share Hospital400 S 43RD STREET
RENTONWA07/01/202107/01/20217/9/2021 2:21 PM
DetailsDSH500119VALLEY HOSPITAL & MEDICAL CENTER Disproportionate Share Hospital12606 E MISSION Ave
SPOKANE ValleyWA07/01/2020 7/1/2020 12:01 AM
DetailsDSH500129TACOMA GENERAL/ALLENMORE HOSPITAL Disproportionate Share Hospital315 MARTIN LUTHER KING JR WAY
TACOMAWA01/01/202007/16/20207/19/2020 9:50 AM
DetailsDSH500150LEGACY SALMON CREEK HOSPITAL Disproportionate Share Hospital2211 NE 139TH ST
VANCOUVERWA01/01/202104/15/20244/15/2024 3:40 PM
DetailsDSH520138AURORA HEALTH CARE METRO, INC.Aurora St. Luke's Medical CenterDisproportionate Share Hospital2900 W OKLAHOMA AVE
MILWAUKEEWI07/01/201907/15/20217/27/2021 2:06 PM
DetailsFQHC638549mathiesen memorial Health Clinic Tribal Contract/Compact with IHS (P.L. 93-638)18144 Seco Street
JamestownCA07/06/202007/15/20217/15/2021 12:01 AM
DetailsFQHCLA270CASTLE FAMILY HEALTH CENTERS, INC.CASTLE FAMILY HEALTH CENTERS AT CASTLEHealth Center Program Look-Alike3605 HOSPITAL ROAD
ATWATERCA07/07/2020 7/23/2020 2:06 PM
DetailsFQHCLA347FAMILIES TOGETHER OF ORANGE COUNTYFamilies Together of Orange CountyHealth Center Program Look-Alike661 W. 1st St., Ste. G
TustinCA01/01/202110/01/202110/1/2021 12:01 AM
DetailsHV08949University of North Carolina at Chapel Hill Infectious Diseases Clinic Ryan White Part C100 Eastowne Drive Floors 5 and 6
Chapel HillNC10/01/202110/12/20211/11/2022 8:28 AM
DetailsPED053301-00CHILDRENS HOSP & RES CNTR OAKLAND Children's Hospital747 52ND STREET
OAKLANDCA10/01/202006/06/20217/14/2021 4:48 PM
DetailsPED453315-00CHRISTUS Children's Children's Hospital333 North Santa Rosa Street
San AntonioTX06/08/202007/01/20229/8/2022 12:13 PM
DetailsPED463301-00IHC HEALTH SERVICES, INC. INTERMOUNTAIN HEALTH PRIMARY CHILDREN'S HOSPITAL Children's Hospital100 NORTH MARIO CAPECCHI DRIVE
SALT LAKE CITYUT07/15/202006/18/20217/13/2021 6:46 PM
DetailsPED503301-00Mary Bridge Children's Hospital and Health Center Children's Hospital317 Martin Luther King Jr Way
TacomaWA07/01/201907/16/20207/19/2020 9:54 AM
DetailsRRC030119-00MERCY GILBERT MEDICAL CENTER Rural Referral Center3555 S. VAL VISTA DRIVE
GILBERTAZ01/01/202011/30/202112/3/2021 1:22 PM
DetailsRRC130049-00KOOTENAI HEALTH INC Rural Referral Center2003 KOOTENAI HEALTH WAY
COEUR DALENEID07/14/202007/01/20217/1/2021 12:01 AM
DetailsRRC140034-00ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS Rural Referral Center400 NORTH PLEASANT AVENUE
CENTRALIAIL10/01/202004/10/20234/18/2023 12:48 AM
DetailsRRC140046-00SSM HEALTH GOOD SAMARITAN HOSPITAL Rural Referral Center1 GOOD SAMARITAN WAY
MT. VERNONIL10/01/202004/10/20234/18/2023 12:48 AM
DetailsRRC140223-00ADVOCATE LUTHERAN GENERAL HOSPITAL Rural Referral Center1775 W. DEMPSTER STREET
PARK RIDGEIL07/01/202007/15/20217/27/2021 2:05 PM
DetailsRRC300003-00MARY HITCHCOCK MEMORIAL HOSPITAL Rural Referral CenterONE MEDICAL CENTER DRIVE
LEBANONNH07/13/202010/15/202110/18/2021 7:26 AM
DetailsRRC360147-00MARIETTA MEMORIAL HOSPITAL Rural Referral Center401 MATTHEW STREET
MARIETTAOH10/01/202012/22/202012/23/2020 4:43 PM
DetailsRRC360211-00TRINITY HOSPITAL HOLDING COMPANY Rural Referral Center4000 JOHNSON ROAD
STEUBENVILLEOH07/01/201904/01/20224/1/2022 12:01 AM
DetailsRRC380014-00GOOD SAMARITAN HOSPITAL CORVALLIS Rural Referral Center3600 NW SAMARITAN DRIVE
CORVALLISOR07/14/2020 7/23/2020 2:15 PM
DetailsRRC450011-00ST. JOSEPH REGIONAL HEALTH CENTER Rural Referral Center2801 FRANCISCAN DRIVE
BRYANTX10/01/2019 10/1/2019 12:05 AM
DetailsRRC450032-00GOOD SHEPHERD MEDICAL CENTER Rural Referral Center811 SOUTH WASHINGTON
MARSHALLTX12/02/202007/01/20227/1/2022 12:01 AM
DetailsRRC450034-00CHRISTUS HOSPITAL Rural Referral Center2830 CALDER STREET
BEAUMONTTX06/08/202005/25/20215/25/2021 12:01 AM
DetailsRRC450102-00CHRISTUS MOTHER FRANCES HOSP-TYLER Rural Referral Center800 EAST DAWSON ST.
TYLERTX10/14/202001/01/20221/13/2022 6:27 PM
DetailsRRC450237-00CHRISTUS SANTA ROSA HEALTH SYSTEMCHRISTUS SANTA ROSA HOSPITAL MEDICAL CENTERRural Referral Center2827 BABCOCK ROAD
SAN ANTONIOTX06/08/202007/01/20229/8/2022 12:03 PM
DetailsRWI891041John Phoenix APRN PLLCHuntridge Family Clinic/CAN Community HealthRyan White Part A1820 E. Sahara Ave Suite 201
Las VegasNV07/13/202004/01/20214/1/2021 12:01 AM
DetailsRWI891041AJohn Phoenix APRN, PLLC Ryan White Part AThe Gay and Lesbian Center of Southern Nevada 401 S. Maryland Parkway
Las VegasNV07/13/202004/01/20214/1/2021 12:01 AM
DetailsRWI900151AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER DOWNTOWNRyan White Part A1400 South Grand Avenue SUITE 801
LOS ANGELESCA10/01/202007/01/20247/11/2024 6:05 PM
DetailsRWI900152BAIDS Healthcare FoundationAHF Healthcare Center - San DiegoRyan White Part A3580 5th Avenue
San DiegoCA10/01/202007/01/20247/11/2024 6:04 PM
DetailsRWI900152EAIDS Healthcare FoundationAHF Healthcare Center - RiversideRyan White Part A4510 Brockton Avenue
Suite 350
RiversideCA10/01/202007/01/20247/11/2024 6:05 PM
DetailsRWI900152FAIDS Healthcare FoundationAHF Healthcare Center - Long BeachRyan White Part A3500 E. Pacific Coast Highway
Long BeachCA10/01/202007/01/20247/11/2024 6:04 PM
DetailsRWI900283AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - CARL BEAN "MAGIC JOHNSON"Ryan White Part A2146 W. ADAMS BLVD
LOS ANGELESCA10/01/202001/01/20251/1/2025 12:01 AM
DetailsRWI900481AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - WESTSIDERyan White Part A8641 WILSHIRE BLVD SUITE 200
BEVERLY HILLSCA10/01/202007/01/20247/11/2024 6:06 PM
DetailsRWI90277AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - REDONDO BEACHRyan White Part A520 N. PROSPECT AVE., SUITE 209
REDONDO BEACHCA10/01/202001/01/20251/1/2025 12:01 AM
DetailsRWI90603AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - WHITTIERRyan White Part A15141 Whittier Blvd.
Suite 260
WHITTIERCA10/01/202001/01/20251/1/2025 12:01 AM
DetailsRWI914031AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - VALLEYRyan White Part A4940 VAN NUYS BLVD. SUITE 200
SHERMAN OAKSCA10/01/202007/01/20247/11/2024 6:06 PM
DetailsRWI917301AIDS HEALTHCARE FOUNDATIONAHF HEALTHCARE CENTER - UPLANDRyan White Part A8263 GROVE AVE SUITE 201
RANCHO CUCAMONGACA10/01/202007/01/20247/11/2024 6:06 PM
DetailsRWI93534AIDS HEALTHCARE FOUNDATIONAHF Healthcare Center - Antelope ValleyRyan White Part A1669 W Avenue J
Suite 301
LancasterCA10/01/202001/01/20251/1/2025 12:01 AM
DetailsSCH060013-00Mercy Regional Medical Center Sole Community Hospital1010 Three Springs Blvd
DurangoCO10/01/201901/01/20201/1/2020 12:05 AM
DetailsSCH170023-00St. Catherine Hospital - Garden City Sole Community Hospital401 E Spruce St
GARDEN CITYKS10/01/2019 10/1/2019 12:05 AM
DetailsSCH290019-00CARSON TAHOE REGIONAL HEALTHCARE Sole Community Hospital1600 MEDICAL PARKWAY
CARSON CITYNV01/01/202210/01/202210/1/2022 12:01 AM
DetailsSCH380001-00Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge Sole Community Hospital1700 E 19TH STREET
THE DALLESOR01/01/202011/08/202211/14/2022 3:14 PM
DetailsSTD89101The Gay and Lesbian Community Center of Southern NevadaSouthern Nevada Health DistrictSexually Transmitted Diseases401 S. Maryland Pkwy
Las VegasNV04/01/202107/01/20247/15/2024 6:40 PM
DetailsSTD891011John Phoenix APRN, PLLCHuntridge Family ClinicSexually Transmitted DiseasesThe Gay and Lesbian Center 401 S. Maryland Parkway
Las VegasNV07/13/202007/01/20227/1/2022 12:01 AM
DetailsSTD891042John Phoenix APRN, PLLCHuntridge Family ClinicSexually Transmitted Diseases1820 E Sahara Ave sUITE 201
Las VegasNV10/01/202007/01/20227/1/2022 12:01 AM
DetailsSTD891043The Gay and Lesbian Community Center of Southern NevadaHuntridge - The CenterSexually Transmitted Diseases1820 E. Sahara Avenue
Las VegasNV07/01/202107/01/20237/1/2023 12:01 AM
DetailsSTD9812231Gay City Health Project Sexually Transmitted Diseases400 E Pine St
100
SeattleWA10/01/2020 10/1/2020 12:01 AM
DetailsURB10414SACRAMENTO NATIVE AMERICAN HEALTH CENTER, INC. Urban Indian2020 J STREET
SACRAMENTOCA07/14/2020 7/23/2020 2:24 PM
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesPharmacy AddressInsert  OPTUM PHARMACY 806, INC. 2288 AUBURN BLVD STE. 102 SACRAMENTO, CA 95821-16186/11/2020 2:45 PM
DetailsNameUpdate AVELLA OF SACRAMENTO, INC.OPTUM PHARMACY 806, INC.6/11/2020 2:45 PM
DetailsCommentsInsert   10/29/2018 3:30 PM
DetailsIs DeletedInsert  False10/29/2018 3:30 PM
AddressesPharmacy AddressInsert  AVELLA OF SACRAMENTO, INC. 2288 AUBURN BLVD STE. 102 SACRAMENTO, CA 95821-161810/29/2018 3:30 PM
DetailsNameInsert  AVELLA OF SACRAMENTO, INC.10/29/2018 3:30 PM