Page 1
Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
1. AAA COMMUNITY PHARMACY
7921 WESTMINSTER BLVD. WESTMINSTER, CA 92683 Independent Y007817 Change of Ownership
PING ON HOLDINGS LLC MICHAEL DEPADUA CARLOS
2. Accredo Health Group 3000 Ericsson Drive, Ste 100 Warrendale, PA 15086 Chain Y007907 Change of Ownership
Accredo Health Inc. Joseph Montgomery
3. Accredo Health Group Inc. 41 Rachel Drive, Suite 1 Nashville, TN 37214 Chain Y007902 Change of Ownership
Accredo Health Inc. Vincent Fayette
4. Accredo Health Group Inc. 1620 Century Center PKWY Ste 109 Memphis, TN 38134 Chain Y007903 Change of Ownership
Accredo Health Inc. Lynette Washington
5. Accredo Health Group Inc. 361 Inverness Drive South, Suite F Englewood, CO 80112 Chain Y007901 Change of Ownership
Accredo Health Inc. Rachel Thompson
6. Accredo Health Group Inc. 2 Boulden Circle, Suite 1 New Castle, DE 19720 Chain Y007905 Change of Ownership
Accredo Health Inc. Ann M. Campagna
7. Accredo Health Group Inc. 1335 E. Sunset Road, Suite J Las Vegas, NV 89119 Chain Y007906 Change of Ownership
Accredo Health Inc. Stephen Wright
8. Accredo Health Group Inc. 6272 Lee Vista Blvd. Orlando, FL 32822 Chain Y007908
Accredo Health Inc. Joseph Casaccia
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
Change of Ownership
9. Accredo Health Group Inc. 2825 W. Perimeter Rd. Indianapolis, IN 46241 Chain Y007904 Change of Ownership
Accredo Health Inc. Tera Teachout
10. Aetna Rx Home Delivery LLC 1600 SW 80th Terrace 2nd Floor Plantation, FL 33324 Independent Y007823 Change of Ownership
Aetna Rx Home Delivery LLC Tokunbo Toks Kassim
11. Aetna Rx Home Delivery LLC 10991 NW Airworld Drive Kansas City, MO 64153 Independent Y007822 Change of Ownership
Aetna Rx Home Delivery LLC John P. DeHaemers
12. Aetna Specialty Pharmacy LLC 503 Sunport Lane Orlando, FL 32809 Independent Y007821 Change of Ownership
Aetna Specialty Pharmacy LLC Nereida Padilla
13. Affinity RX 11003 Antoine Dr, Suite F Houston, TX 77086 Independent Y007855
KB Empire LLC Carlton Oden
14. Amber Enterprises Inc d/b/a Amber Pharmacy 328 East Commercial Road Units 102 & 103 San Bernardino, CA 92408 Independent Y007837
Amber Acquisition LLC Quratul A Hasan
15. Amber Enterprises Inc d/b/a Amber Pharmacy 1301 East Arapaho Road Suite 103 Richardson, TX 75091 Independent Y007836
Amber Acquisition LLC Donna B Filo
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
16. Amber Enterprises Inc d/b/a
Amber Pharmacy 10 Medical Parkway Plaza 3 Suite 107 Farmers Branch, TX 75234 Independent Y007839
Amber Acquisition LLC Muataz Noffel
17. Amber Enterprises Inc d/b/a/ Amber Pharmacy 323 Norristown Road, Suite 100 Ambler, PA 19002 Independent Y007844
Amber Acquisition LLC Michael A Caruso
18. Amber Enterprises Inc. d/b/a Amber Pharmacy 8924 Kirby Drive Houston, TX 77054 Independent Y007838
Amber Acquisition LLC Melinda F Hargrove
19. American Pharmacy Services Inc. 4113 Birney Ave Moosic, PA 18507 Independent Y007873
Richard Para THOMAS CHARLES STEFANOSKI
20. America's Pharmacy Source 947 W. Waterloo Road Akron, OH 44314 Independent Y007808
Douglas Behrens Joseph Chimienti
21. AON Pharmacy LLC 12631 Westlinks Dr Suite 1 Fort Myers, FL 33913 Independent Y007856
American Oncology Partners PA Douglas Braun
22. ASAP Pharmacy Inc. 1361 Main St. Dunedin, FL 36498 Independent Y007866
ASAP Pharmacy Inc. Erica Lestini
23. ASPN Pharmacies LLC 200 Park Ave, Suite 300 Florham Park, NJ 7932 Limited Service Y007863
Lawrence Irene Shivani Patel
Page 4
Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
24. ASPN Pharmacies 2 LLC
4850 E Street Rd, Suite 400 Trevose, PA 19053 Limited Service Y007815
Lawrence Irene Alberto Silva
25. BioPartners in Care Inc. 11411 Strang Line Road Lenexa, KS 66215 Chain Y007860 Change of Ownership
Accredo Health Inc. Janel A. Potter
26. Blink Health Pharmacy 100 Chesterfield Bus Pkwy, Room 268 Chesterfield, MO 63005 Independent Y007824
Blink Health Pharmacy Lee Trotter RPh PIC
27. CARE PLUS PHARMACY 10301 CLUB CREEK RD HOUSTON, TX 77036 Independent Y007832 Change of Ownership
Care Plus Pharmacy LLC Sholeh Karsten
28. Chewy Pharmacy LLC 3621 Fern Valley Rd. Louisville, KY 40219 Independent Y007929
Chewy Pharmacy LLC Ryan Murphy
29. Cigna Home Delivery Pharmacy 4901 N. 4th Avenue Sioux Falls, SD 57104 Limited Service Y007859 Change of Ownership
Tel-Drug Inc. Alyssa Jordanger
30. Comprehensive Care Pharmacy 910 North Charles G. Seivers Blvd. Clinton, TN 37716 Independent Y007811
Todd Antrobus Chris Helms
31. CORNELL PHARMACY LLC 17000 DALLAS PKWY, SUITE 229 DALLAS, TX 75248 Independent Y007828 Change of Ownership
Cornell Pharmacy LLC Ijeoma Shirley Onyekere
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
32. Cure Stat Rx Home Infusion And
Specialty Pharmacy Inc 6725 Mesa Ridge RD #230 #202 San Diego, CA 92121 Independent Y007851
Ramesh Chigurupati Ramesh Chigurupati
33. DermaTran Health Solutions LLC 85 Technology parkway NW Rome, GA 30165 Independent Y007850 Change of Ownership
DermaTran Health Solutions LLC Michael A. Ball
34. Eagle Lake Pharmacy Inc 5245 US Hwy 98N Lakeland, FL 33809 Independent Y007932
Tony Tran Anthony Bethune
35. ESI Mail Pharmacy Service Inc. dba Express Scripts 4700 N. Hanley Road Suite C St. Louis, MO 63134 Chain Y007912 Change of Ownership
ESI Mail Pharmacy Service Inc. Christine Poling
36. ESI Mail Pharmacy Service Inc. dba Express Scripts 4600 N. Hanley Rd. St. Louis, MO 63134 Chain Y007909 Change of Ownership
ESI Mail Pharmacy Service Inc. Susan Lanctot
37. ESI Mail Pharmacy Service Inc. dba Express Scripts 4500 Alexander Blvd. NE Albuquerque, NM 87107 Chain Y007910 Change of Ownership
ESI Mail Pharmacy Service Inc. BJ Cobb
38. ESI Mail Pharmacy Service Inc. dba Express Scripts 433 River St. Suite 800 Troy, NY 12180 Chain Y007911 Change of Ownership
ESI Mail Pharmacy Service Inc. Patrick Marks
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
39. Express Scripts Pharmacy Inc. dba
Express Scripts 13051 N. Telecom Parkway Suite 150 Temple Terrance, FL 33637 Chain Y007914 Change of Ownership
Express Scripts Pharmacy Inc. Jennifer Backhus
40. Express Scripts Pharmacy Inc. dba Express Scripts 4750 E. 450 South Whitestown, IN 46075 Chain Y007917 Change of Ownership
Express Scripts Pharmacy Inc. Rhonda A. Yates
41. Express Scripts Pharmacy Inc. dba Express Scripts 2040 Route 130 North Burlington, NJ 8016 Chain Y007918 Change of Ownership
Express Scripts Pharmacy Inc. Piotr Cymbalski
42. Express Scripts Pharmacy Inc. dba Express Scripts 5151 Blazer Pkwy Suite B Dublin, OH 43017 Chain Y007916 Change of Ownership
Express Scripts Pharmacy Inc. Joanne Colegrove
43. Express Scripts Pharmacy Inc. dba Express Scripts 4865 Dixie Highway Fairfield, OH 45014 Chain Y007913 Change of Ownership
Express Scripts Pharmacy Inc. Christopher Bracale
44. Express Scripts Pharmacy Inc. dba Express Scripts 501 Ronda Court North Huntingdon, PA 15642 Chain Y007915 Change of Ownership
Express Scripts Pharmacy Inc. Thomas Edinger
45. Express Scripts Specialty Distribution Services Inc. 8931 Springdale Avenue, Suite A St. Louis, MO 63134 Chain Y007920
Express Scripts Inc. Daniel White
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
Change of Ownership
46. Express Scripts Specialty Distribution Services Inc. 4700 N. Hanley Suite A St. Louis, MO 63134 Chain Y007919 Change of Ownership
Express Scripts Inc. Carolyn Bast
47. FAIRVIEW PHARMACY CBCD 2512 SOUTH 7TH STREET SUITE 105 MINNEAPOLIS, MN 55454 Chain Y007927
FAIRVIEW PHARMACY SERVICES LLC TIMOTHY BOONSTRA
48. Forte Rx Pharmacy 651 Via Alondra #708 & 709 Camarillo, CA 93012 Independent Y007819
Haleh Khatami Haleh Khatami
49. Hopewell Pharmacy 1 W. Broad Street Hopewell, NJ 8525 Independent Y007841 Change of Ownership
Drugs Are Us JoAnn Hobson
50. Humble & Pacific Pharmacy 211 FM 1960 East Bypass Humble, TX 77338 Independent Y007935
Dougherty's Pharmacy Humble LLC Antony Kalleeny
51. KYLE CARE PHARMACY 575 E FM 150 STE L KYLE, TX 78640 Independent Y007834 Change of Ownership
SVS Health & Wellness Partners II LLC Kathleen Garcia
52. Lincare Pharmacy Services Inc. dba Med 4 Home 10800 North Congress Avenue Kansas City, MO 64153 Independent Y007816 Change of Ownership
Lincare Pharmacy Services Inc. Evan Weight
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
53. LINCOLN PHARMACY LLC
8329 BEECHNUT ST HOUSTON, TX 77036 Independent Y007829 Change of Ownership
Lincoln Pharmacy LLC Christina Nguyen
54. Lynnfield Compounding Center Inc. dba Freedom Fertility Pharmacy 12 Kent Way Ste. 120F Byfield, MA 1922 Independent Y007922 Change of Ownership
Lynnfield Compounding Center Inc. Hilary Thibault
55. Lynnfield Compounding Center Inc. dba Freedom FP Fertility Pharmacy 12 Kent Way Suite 120 E Byfield, MA 1922 Independent Y007923 Change of Ownership
Lynnfield Compounding Center Inc. Philip D'Antonio
56. MAH Pharmacy LLC dba CHD Pharmacy 4600 N. Hanley Rd. Suite C St. Louis, MO 63134 Independent Y007921 Change of Ownership
MAH Pharmacy LLC Richard Kruse
57. MAH Pharmacy LLC dba CHD Pharmacy 4867 Dixie Highway Fairfield, OH 45014 Independent Y007924 Change of Ownership
MAH Pharmacy LLC Lana DeLong
58. Medication Review Inc. 104 S. Freya St Ste 225 Turquoise Flag Bldg Spokane, WA 99202 Independent Y007852
K Douglas Crafton majority shareholder Nathan Wende
59. Med-Pharm LLC 1717 W. University Dr. Suite # 412 Mckinney, TX 75069 Independent Y007862
Mahdi Al Hallaq Mahdi Al Hallaq
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
60. MedRx Specialty Pharmacy LLC.4726 East Texas St., Suite 230Bossier City, TX 71111IndependentY007877
Jermaine Allen Kimberly Gilbreath
61. NH Enterprises llc. d/b/a CSIPharmacy1201 east 35th streettexarkana, AR 71854IndependentY007853
NH enterprises llc Dale Pickard
62. NP Pharmacy LLC7644 Park BoulevardPinellas Park, FL 33781IndependentY007826
Thinh Nguyen Thinh Nguyen
63. OAK PHARMACY17000 DALLAS PKWY, STE 101DALLAS, TX 75248IndependentY007831Change of Ownership
Oak Pharmacy LLC Ebere Rachael Enebeli
64. Option Care Home Care Inc.4374 Alexander Blvd NE Suites A-CAlbuquerque, NM 87107Limited ServiceY007868
Option Care Enterprises Inc. Raymond Martinez
65. Pensacola Apothecary dbaEverwell Specialty Pharmacy6506 N. Davis HwyPensacola, FL 32504IndependentY007842
Christopher Schulte Casey Trest
66. perfection rx llc3248 Lantana RdLake Worth, FL 33462IndependentY007846
peter bigley Mohammad Rizwan
67. Phantastic Pharmacy4347 Van Nuys BlvdSherman Oaks, CA 91403IndependentY007820
Phantastic Pharmacy Inc. Kenneth Bruce Asarch
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
68. PHARMA SELECT TEXAS
17000 DALLAS PKWY, STE 121 DALLAS, TX 75248 Independent Y007825 Change of Ownership
Sabzi Holdings LLC Sindya Varghese
69. PHARMACY 45 10547 SOUTH POST OAK HOUSTON, TX 77035 Independent Y007830 Change of Ownership
Pharmaceutical Care Solutions LLC Tameya Geraldine Sam
70. Pharmaneek 7345 Woodland Dr., Suite A Indianapolis, IN 46278 Independent Y007818
Prithvi S. Dhani Annadurai Kuppusamy
71. PREMIER SPECIALTY INFUSION LLC 2401 Hassell Road Street Suite 1525 Hoffman Estates, IL 60169 Independent Y007840
Ambreen Jafri Scott Luckow
72. PRO SCRIPT SOLUTIONS PHARMACY 6730 ATASCOCITA RD SUITE 111 HUMBLE, TX 77346 Independent Y007865
PRO SCRIPT SOLUTIONS PHARMACY LLC KIETRICH JOHNSON
73. Procure Pharmaceutical Services 264 SMITH TOWNSHIP STATE RD SUITE 5 BURGETTSTOWN, PA 15021 Independent Y007809
Andrew J Mihalyo Michelle J Mikus
74. RAVENS PHARMACY 820 N ZANG BLVD STE 120 Dallas, TX 75208 Independent Y007835 Change of Ownership
Shri Jagannath Drugs II LLC Danielle Teresa Mercier
75. Revive Rx LLC 3831 Golf Dr A A Houston, TX 77018 Independent Y007864
Aaron Schneider Aaron Schneider
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
76. SCL Health Pharmacy Services -
Franklin Pharmacy 1830 Franklin Street, Suite 190 Denver, CO 80218 Independent Y007867
Sisters of Charity of Leavenworth Health System Inc.
Christopher Wilson
77. SIENNA COMPOUNDING PHARMACY 9029 HWY 6, STE 190 Missouri City, TX 77459 Independent Y007833 Change of Ownership
SIENNA COMPOUNDING PHARMACY LLC Ryann Bardwell
78. SinfoniaRx Inc. 1812 Center Creek Drive, Suite 115 Austin, TX 78754 Limited Service Y007930
SinfoniaRx Inc. Saul Ortega
79. Sofie Co 5900-B Obata Way Gilroy, CA 95020 Chain Y007933
GRD US Pet Operations Inc. Hai Vu
80. South Bend Specialty Pharmacy LLC 54590 N. Ironwood Rd South Bend, IN 46635 Independent Y007931
FIGHTING IRISH HOLDINGS LLC Jeffrey Lee Huff
81. Tel-Drug of Pennsylvania LLC dba Cigna Home Delivery Pharmacy 206 Welsh Rd Horsham, PA 19044 Limited Service Y007872 Change of Ownership
Tel-Drug of Pennsylvania LLC David Dessender
82. The Generic Pharmacy - Dothan LLC 2115 East Main St., Suite 4 Dothan, AL 36301 Independent Y007812
Richard Allen Strickland Richard Allen Strickland
83. TPC Pharmacy 2212 Sam Rayburn Hwy, Ste 100 Melissa, TX 75454 Independent Y007874
Roger Wu Yaneya Hall
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Non-Resident Pharmacy Permit Applications NON-RESIDENT PHARMACY PERMITS OWNER PHARMACIST IN CHARGE
84. Tri-Unity Infusion Services
447 S Whittaker St New Buffalo, MI 49117 Independent Y007882
Devin Barrett Elias Ayoub
85. UBC Pharmacy 4700 N Hanley Rd, Suite B Saint Louis, MO 63130 Independent Y007845
UBC Pharmacy LLC Katherine Therese Twomey
86. University of Wisconsin Hospitals and Clinics 3185 Deming Way Middletown, WI 53562 Government Y007926
Public Authority Designation- University of Wisconsin
Annie Baeten
87. VC Pharmacy Inc dba Rite Care Pharmacy V 3403 Louetta Rd, Ste D Spring, TX 77388 Independent Y007861 Change of Ownership
Syed Zulfiqar Pinky Choksi
88. Westover Hills Pharmacy 9793 Culebra Rd, Suite 101 San Antonio, TX 78251 Independent Y007854
Westover Hills Pharmacy Inc. Randy Nemecek
89. Wilshire Pharmcare Inc 26611 Cabot Road, Suite B Laguna Hills, CA 92653 Independent Y007878
Samuel Lee John Jackson
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