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COMPLIANCE INFO_1996-2009
EnvironmentalHealth
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4500 - Medical Waste Program
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PR0506192
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COMPLIANCE INFO_1996-2009
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Entry Properties
Last modified
7/14/2025 2:23:06 PM
Creation date
7/3/2020 10:20:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1996-2009
RECORD_ID
PR0506192
PE
4530 - LG QUANITY GENERATOR
FACILITY_ID
FA0007263
FACILITY_NAME
DEUEL VOCATIONAL INSTITUTION
STREET_NUMBER
23500
STREET_NAME
KASSON
STREET_TYPE
RD
City
TRACY
Zip
95378
CURRENT_STATUS
Inactive, non-billable
SITE_LOCATION
23500 KASSON RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4530_PR0506192_23500 KASSON_FILE 1.tif
Site Address
23500 KASSON RD TRACY 95378
Tags
EHD - Public
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gr_whtrn-storlasr <br />DEVOS LTD., DBA GUARANTEED RETURNS <br />10 <br />100 <br />Colin Drive Holbrook, NY 11741-4306 <br />Page: <br />242 <br />Cust. #: 15152 <br />(DEA#: RD0188311 EPA#: NY0000997692 ) <br />� � 1i <br />Store #: 5793 <br />1 <br />NON-RETURNABLES MANIFEST <br />-tch # 157 <br />t. #: 805663 <br />Print Date <br />Sep 7, 2005 <br />r: DEUEL VOCATIONAL INSTITUTION <br />Phone: <br />(209) 835-4141 <br />Adc. 23500 KASSON <br />ROAD <br />P.O. BOX <br />400 - PHARMACY DEPT. <br />Credits <br />passed through: 15152 Wholesaler: MCKESSON-26 <br />TRACY, CA <br />95376 <br />Cust <br />Ref #/Debit#: GRX15152157 <br />Address: 3775 <br />SEAPORT <br />BLVD. <br />Contact VINCENT <br />Service <br />Date: 08/19/05 <br />182-W. <br />SACRAMENTO, <br />CA 94403 <br />Dea # AV3309831 <br />QUANTITY <br />DEA <br />REASON <br />VENDOR <br />F P <br />SIZE <br />STRENGTH <br />DRUG NAME <br />NDCNO <br />CLASS <br />EXPIRES <br />PRICE <br />CODE <br />HOSPIRA WORLDWIDE <br />.300 <br />10.00 <br />50% <br />DEXTROSE <br />74751716 <br />R <br />9.93 <br />02 <br />HOSPIRA WORLDWIDE <br />.900 <br />10.00 <br />.2MG/ML <br />ISUPREL <br />74141005 <br />R <br />41.04 <br />02 <br />HOSPIRA WORLDWIDE <br />.020 <br />50.00 <br />400 MG <br />DOPAMINE HCL <br />74910420 <br />R <br />.61 <br />02 <br />HOSPIRA WORLDWIDE <br />.400 <br />25.00 <br />1:1,000 <br />EPINEPHRINE HCL <br />74724101 <br />R <br />5.10 <br />02 <br />HOSPIRA WORLDWIDE <br />.100 <br />100.00 <br />2.5 MG/M <br />DROPERIDOL <br />74118701 <br />R <br />04/05 <br />1.31 <br />01 <br />-iOSPIRA WORLDWIDE <br />.050 <br />100.00 <br />48 <br />LIDOCAINE HCL <br />74428301 <br />R <br />2.31 <br />02 <br />HOSPIRA WORLDWIDE <br />.020 <br />100.00 <br />100 U/ML <br />HEPARIN LOCK FLUSH <br />74115270 <br />R <br />.25 <br />02 <br />-JOSPIRA WORLDWIDE <br />.020 <br />50.00 <br />1% <br />LIDOCAINE HCL <br />74427602 <br />R <br />.35 <br />02 <br />iOSPIRA WORLDWIDE <br />.600 <br />10.00 <br />50 MG <br />PHENYTOIN SODIUM INJECTION, USP <br />74184402 <br />R <br />04/05 <br />7.26 <br />01 <br />iOSPIRA WORLDWIDE <br />.090 <br />10.00 <br />50 MG <br />PHENYTOIN SODIUM INJECTION, USP <br />74184402 <br />R <br />04/05 <br />1.09 <br />01 <br />iOSPIRA WORLDWIDE <br />.020 <br />50.00 <br />18 <br />LIDOCAINE HCL <br />74427602 <br />R <br />.35 <br />23 <br />iOSPIRA WORLDWIDE <br />.200 <br />50.00 <br />400 MG <br />DOPAMINE HCL <br />74910420 <br />R <br />6.10 <br />23 <br />40SPIRA WORLDWIDE <br />.040 <br />10.00 <br />50% <br />DEXTROSE <br />74751716 <br />R <br />1.32 <br />23 <br />iOSPIRA WORLDWIDE <br />.010 <br />10.00 <br />0.1 MG/M <br />EPINEPHRINE HCL <br />74490118 <br />R <br />.28 <br />23 <br />40SPIPA WORLDWIDE <br />.040 <br />10.00 <br />500 MG/M <br />MAGNESIUM SULFATE <br />74175410 <br />R <br />1.14 <br />23 <br />iUMCO LAB <br />2.000 <br />- 1.00 <br />3% <br />HYDROGEN PEROXIDE <br />395111316 <br />R <br />05/03 <br />.79 <br />01 <br />:VAX <br />.490 <br />100.00 <br />200 MG <br />LABETALOL HYDROCHLORIDE <br />172436560 <br />R <br />11.70 <br />02 <br />:VAX <br />.840 <br />100.00 <br />500 MG <br />SALICYLSALICYLIC ACID <br />182180289 <br />R <br />9.52 <br />02 <br />:VAX <br />.520 <br />100.00 <br />50 MG <br />NITROFURANTOIN MACROCRYSTALS <br />172213060 <br />R <br />44.67 <br />02 <br />:VAX <br />.200 <br />100.00 <br />10MG <br />FLUOXETINE <br />172436360 <br />R <br />3.22 <br />02 <br />:VAX <br />.200 <br />100.00 <br />20 MG <br />FLUOXETINE HCL <br />172435660 <br />R <br />3.36 <br />02 <br />.100 <br />100.00 <br />200 MG <br />LABETALOL HYDROCHLORIDE <br />172436560 <br />R <br />2.39 <br />02 <br />1.0001.001 <br />MG <br />RISPERDAL <br />5045830503 <br />R <br />09/03 <br />104.70 <br />O1 <br />#/ORTHO/MCNEIL <br />1.000 <br />60.00 <br />5 MG <br />ZYPREXA <br />2411560 <br />R <br />08/03 <br />344.34 <br />01 <br />2M. <br />1.000 <br />1.00 <br />1% <br />PILOCARPINE HCL OPTH SOLUTION <br />820010125 <br />R <br />3.39 <br />06 <br />1AJOR <br />.520 <br />100.00 <br />100 MG <br />DOXYCYCLINE HYCLATE <br />904042861 <br />R <br />17.07 <br />02 <br />1AJOR <br />..250 <br />100.00 <br />100 MG <br />DOXYCYCLINE HYCLATE <br />904042861 <br />R <br />8.21 <br />02 <br />1AJOR <br />.200 <br />100.00 <br />4 MG <br />DOXAZOSIN MESYLATE <br />904552460 <br />R <br />1.53 <br />02 <br />1AJOR <br />.100 <br />100.00 <br />1MG <br />DOXAZOSIN MESYLATE <br />904552260 <br />R <br />.68 <br />02 <br />IONARCH PHARM <br />1.000 <br />10.00 <br />600,000 <br />BICILLIN L-A <br />61570014710 <br />R <br />342.53 <br />21 <br />IONARCH PHARM <br />1.000 <br />1.00 <br />3.5MG <br />CORTISPORIN OTIC <br />6157003410 <br />R <br />11/03 <br />51.37 <br />01 <br />IORTON GROVE PHARM <br />.750 <br />1.00 <br />118 ML <br />DOXEPIN HCL ORAL SOLUTION <br />6043265104 <br />R <br />6.67 <br />02 <br />IYLAN <br />.433 <br />30.00 <br />4MG <br />NITROGLYCERIN <br />378911293 <br />R <br />15.59 <br />05 <br />IYLAN <br />.200 <br />100.00 <br />1 MG <br />HALOPERIDOL <br />378025701 <br />R <br />4.57 <br />05 <br />IYLAN <br />.050 <br />100.00 <br />0.175 MG <br />LEVOTHYROXINE SODIUM <br />378181701 <br />R <br />1.42 <br />05 <br />,AR PHARM <br />.200 <br />100.00 <br />4 MG <br />CYPROHEPTADINE HCL <br />49684004301 <br />R <br />2.00 <br />02 <br />1AR PHARM <br />.200 <br />100.00 <br />10 MG <br />DOXEPIN HCL <br />49884021701 <br />R <br />B0 <br />02 <br />'AR PHARM <br />.200 <br />100.00 <br />25 MG <br />IMIPRAMINE HCL <br />49884005501 <br />R <br />2.10 <br />02 <br />AR PHARM <br />.500 <br />100.00 <br />20MG <br />FLUOXETINE <br />4968473501 <br />R <br />08/03 <br />140.03 <br />01 <br />,AR PHARM <br />.500 <br />1000.00 <br />'1 MG <br />BENZTROPINE MESYLATE <br />49884016510 <br />R <br />06/04 <br />7.67 <br />01 <br />'AR PHARM <br />.500 <br />100.00 <br />20MG <br />FLUOXETINE <br />4988473501 <br />R <br />08/03 <br />140.03 <br />01 <br />,FIZER <br />1.000 <br />100.00 <br />150 MG <br />MYCOBUTIN <br />13530117 <br />R <br />598.78 <br />23 <br />'FIZER <br />.200 <br />100.00 <br />100 <br />NEURONTIN <br />71080324 <br />R <br />05/04 <br />9.94 <br />01 <br />'FIZER <br />.600 <br />500.00 <br />100 MG <br />ZOLOFT <br />49491073 <br />R <br />12/03 <br />724.08 <br />01 <br />LIVA INC <br />.200 <br />1000.00 <br />20 MG <br />PROPRANOLOL HCL <br />50111046803 <br />R <br />7.99 <br />05 <br />UREPAC <br />.100 <br />100.00 <br />400 MG <br />ETODOLAC TABLET <br />228259911 <br />R <br />3.16 <br />02 <br />,UALITEST <br />.450 <br />100.00 <br />50 MG <br />PRIMIDONE <br />603536921 <br />R <br />8.37 <br />02 <br />,UALITEST <br />.100 <br />100.00 <br />50 MG <br />PRIMIDONE <br />603536921 <br />R <br />1.86 <br />02 <br />'UALITEST <br />.500 <br />100.00 <br />5 MG <br />TRIHEXYPHENIDYL HCL <br />603624121 <br />R <br />7.28 <br />02 <br />UALITEST <br />.200 <br />100.00 <br />75 MG <br />AMITRIPTYLINE HCL <br />603221521 <br />R <br />7.05 <br />02 <br />UALITEST <br />.500 <br />100.00 <br />5 MG <br />TRIHEXYPHENIDYL HCL <br />603624121 <br />R <br />7.28 <br />02 <br />OX.ANE <br />.500 <br />1000.00 <br />300 MG <br />LITHIUM CARBONATE <br />54452731 <br />R <br />09/03 <br />107.52 <br />01 <br />'EVA PHARM. <br />8i0 <br />500.00 <br />250 MG <br />METRONIDAZOLE <br />93085105 <br />R <br />133.55 <br />02 <br />DL <br />.650 <br />80.00 <br />120 MG <br />DILTIAZEM HCL <br />51079094708 <br />R <br />27.33 <br />02 <br />DL <br />.280 <br />100.00 <br />120 MG <br />VERAPAMIL HCL <br />51079068320 <br />R <br />3.28 <br />02 <br />' <br />.625 <br />80.00 <br />120 MG <br />DILTIAZEM HCL <br />51079094708 <br />R <br />26.28 <br />C2 <br />.500 <br />100.00 <br />100 <br />METOPROLOL TAP,TRATE <br />51079BC220 <br />R <br />01/04 <br />5.67 <br />0_ <br />'SEARCH <br />.510 <br />100.00 <br />2.5 MG <br />NITROGLYCERIN <br />677048501 <br />R <br />4.07 <br />C2 <br />ARRIC <br />.100 <br />1.00 <br />17G <br />ALBUTEROL <br />5993015601 <br />R <br />08/02 <br />2.14 <br />01 <br />EST-WA,.- <br />.300 <br />100.00 <br />25 MG-15 <br />HYDRALAZINE COMPLEX <br />143126701 <br />R <br />7.86 <br />C2 <br />EST-WARD <br />.500 <br />1000.00 <br />1 MG <br />FOLIC ACID <br />143124810 <br />R <br />32.25 <br />02 <br />EST-WARD <br />.010 <br />100.00 <br />2.5 MG <br />ISOSORBIDE DINITRATE <br />143176501 <br />R <br />12/04 <br />.05 <br />01 <br />YETF/AYERST/LEDERLE <br />.200 <br />100.00 <br />75 MG <br />EFFEXOR <br />8070401 <br />R <br />11/04 <br />32.92 <br />01 <br />
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