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COMPLIANCE INFO_1996-2009
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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
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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 />Cust. #: 15152cR�7 <br />Store #: 5793 <br />Bacch #: 161 <br />loco. #: 805663 <br />Omer: DEUEL VOCATIONAL INSTITUTION <br />cess 23500 KASSON ROAD <br />P.O. BOX 400 - PHARMACY DEPT. <br />TRACY, CA 95376 <br />Contact VINCENT <br />Dea # AV3309831 <br />UVI UJIJ <br />DEVOS LTD., DHA GUARANTEED RETURNS <br />100 Colin Drive Holbrook, NY 11741-4306 <br />(DEA#: RD0186311 EPA#: NY0000997692 ) <br />NON-RETURNABLES MANIFEST <br />Credits passed through: 15152 <br />Cust Ref #/Debit#: GRX15152161 <br />Service Date: 12/29/05 <br />Page: 282 <br />Print Date : Jan 19, 2006 <br />Phone: (209) 835-4141 <br />Wholesaler: MCKESSON-26 <br />Address: 3775 SEAPORT BLVD. <br />182-W. SACRAMENTO, CA 944.03 <br />QUANTITY <br />DEA <br />RE ASO: <br />VENDOR <br />F P <br />SIZE <br />STRENGTH <br />DRUG NAME <br />NDCNO <br />CLASS <br />EXPIRES <br />PRICE <br />CODE <br />ADVANCE PHARMA <br />.900 <br />100.00 <br />325 MG <br />ACETAMINOPHEN <br />17714001201 <br />1.25 <br />23 <br />BECTON -DICKINSON <br />.500 <br />6.00 <br />GLUCOSE TABLETS <br />8290823000 <br />.38 <br />06 <br />CONSUMER HLTH PFIZER <br />.333 <br />36.00 <br />88ML <br />KAOPECTATE -NOT FOR RETAIL <br />9521399 <br />- <br />6.82 <br />21 <br />CONSUMER HLTH PFIZER <br />.150 <br />36.00 <br />88ML <br />KAOPECTATE -NOT FOR RETAIL <br />9521399 <br />3.07 <br />21 <br />FLEET <br />1.000 <br />1.00 <br />N/A <br />FLEET PREP KIT #1 W/PHOSPHO-SODA <br />132021101 <br />03/05 <br />4.36 <br />01 <br />NOVARTIS CONSUMER <br />.800 <br />1.00 <br />225 MG -2 <br />MAALOX SUSPENSION <br />67033062 <br />1.55 <br />20 <br />NOVO-NORDISK <br />1.000 <br />1.00 <br />100 U/ML <br />NOVOLIN N <br />169183411 <br />27.67 <br />04 <br />NOVO-NORDISK <br />1.000 <br />1.00 <br />100 U/ML <br />NOVOLIN R <br />169183311 <br />27.67 <br />04 <br />P&G,RICHARDSON-VICKS <br />.905 <br />42.00 <br />20 MG <br />PRILOSEC OTC <br />37000045504 <br />21.84 <br />06 <br />SI< BEECHAM/CONS <br />.480 <br />100.00 <br />N/A <br />FEOSOL <br />4969294220 <br />01/04 <br />2.98 <br />01 <br />TEVA PHARM. <br />.750 <br />12.00 <br />2 <br />LOPERAMIDE HCL <br />55953001712 <br />2.34 <br />02 <br />UDL <br />.900 <br />100.00 <br />325 MG <br />ASPIRIN <br />51079000540 <br />.74 <br />23 <br />ABBOTT PHARM <br />.500 <br />100.00 <br />250 MG <br />DEPAKOTE ER <br />74382613 <br />R <br />55.37 <br />02 <br />AMERICAN PHARM. INC. <br />.120 <br />25.00 <br />25MG <br />FLUPHENAZINE DECANOATE <br />6332327205 <br />R <br />06/05 <br />6.65 <br />Ol <br />AMERICAN PHARM. INC. <br />.080 <br />25.00 <br />50MG <br />PROTAMINE SULFATE <br />6332322905 <br />R <br />06/05 <br />.43 <br />01 <br />AMERICAN PHARM. INC. <br />.280 <br />25.00 <br />20MG/ML <br />FUROSEMIDE <br />6332328002 <br />R <br />07/05 <br />.23 <br />01 <br />AMERICAN RED CROSS <br />1.000 <br />1.00 <br />N/A <br />IMMUNE GLOBULIN (HUMAN) USP <br />5276901152 <br />R <br />7.72 <br />06 <br />AMERICAN REGENT LABS <br />1.000 <br />25.00 <br />4 MG/ML <br />DEXAMETHASONE SODIUM PHOSPHATE - <br />517490125 <br />R <br />09/05 <br />21.75 <br />01 <br />AMERICAN REGENT LABS <br />.960 <br />25.00 <br />250MG/10 <br />AMINOPHYLLINE <br />517381025 <br />R <br />08/05 <br />15.12 <br />01 <br />AMERICAN REGENT LABS <br />.120 <br />25.00 <br />50 MG/ML <br />HYDROXYZINE HCL <br />517560125 <br />R <br />02/05 <br />2.13 <br />01 <br />AMERICAN REGENT LABS <br />.720 <br />25.00 <br />20 U/ML <br />VASOPRESSIN <br />517102025 <br />R <br />08/05 <br />77.76 <br />01 <br />AMGEN <br />.700 <br />10.00 <br />10 <br />EPOGEN <br />5551314410 <br />R <br />823.55 <br />20 <br />.100 <br />10.00 <br />480MCG <br />FILGRASTRIM NEUPOGEN <br />5551354601 <br />R <br />30.34 <br />26 <br />OEN <br />IS/PASTEUR <br />1.000 <br />1.00 <br />45 MCG/0 <br />FLUZONE <br />49281037415 <br />R <br />71.15 <br />21 <br />SCANDIPHARM <br />.670 <br />1.00 <br />1 GM/10 <br />CARAFATE <br />58914017014 <br />R <br />28.94 <br />20 <br />BAu-_H LOMB PHARM. <br />1.000 <br />1.00 <br />10% <br />SULFACETAMIDE SODIUM W/PREDNISOLONE <br />2420831705 <br />R <br />09/04 <br />12.03 <br />Ol <br />BAXTER ANESTHESIA -CC <br />.200 <br />25.00 <br />50MG/ML <br />DIPHENHYDRAMINE HCL INJECTION <br />641037621 <br />R <br />.19 <br />02 <br />BAXTER ANESTHESIA -CC <br />.400 <br />10.00 <br />150MG/3 <br />AMIODARONE HCI <br />1001913185 <br />R <br />12.05 <br />02 <br />BRISTOL/SQUIBB/NOVO <br />.020 <br />100.00 <br />5 MG <br />COUMADIN <br />56017275 <br />R <br />1.47 <br />BRI STOL/SQUI-BB/NOVO <br />.0_0 <br />100.00 <br />2 MG <br />COUMAD?N <br />56017070 <br />R <br />3.42 <br />05 <br />BRISTOL/SQUIBB/NOVO <br />.020 <br />100-00 <br />5 MG <br />COUMADIN <br />-05 <br />BRISTOL/SQUIBB/NOVO <br />.030 <br />100.00 <br />1 MG <br />COUMADIN <br />56017270 <br />56016975 <br />R <br />R <br />1.47 <br />1.97 <br />05 <br />05 <br />DEY <br />1.000 <br />25.00 <br />0.6% <br />METAPROTERENOL SULFATE <br />49502067603 <br />R <br />06/05 <br />8.90 <br />- Ol <br />ETHEX <br />.250 <br />100.00 <br />0.4MG <br />NITROQUICK <br />5817732418 <br />R <br />11/03 <br />3.18 <br />01 <br />G & W <br />.500 <br />12.00 <br />25 MG <br />PROMETHEGAN <br />713052612 <br />R <br />02/05 <br />16.48 <br />01 <br />GENEVA PHARM <br />.850 <br />100.00 <br />2 MG <br />HALOPERIDOL <br />761139301 <br />R <br />12.27 <br />02 <br />GENEVA PHARM <br />.500 <br />100.00 <br />1MG <br />TERAZOSIN HYDROCHLORIDE <br />781205101 <br />R <br />20.00 <br />02 <br />GENEVA PHARM <br />.170 <br />100.00 <br />5 MG <br />PROCHLORPERAZINE MALEATE <br />781502001 <br />R <br />5.43 <br />02 <br />GENEVA PHARM <br />.350 <br />100.00 <br />25 MG <br />THIORIDAZINE HCL <br />781162401 <br />R <br />9.00 <br />02 <br />GENSIA <br />.080 <br />25.00 <br />N/A <br />PROCHLORPERAZINE EDISYLATE INJ <br />703717101 <br />R <br />.30 <br />02 <br />HOSPIRA WORLDWIDE <br />.400 <br />10.00 <br />1:10,000 <br />EPINEPHRINE HCL <br />74490101 <br />R <br />02/03 <br />30.86 <br />01 <br />HOSPIRA WORLDWIDE <br />.100 <br />10.00 <br />0.1 MG/M <br />EPINEPHRINE HCL <br />74490118 <br />R <br />08/05 <br />3.70 <br />01 <br />HOSPIRA WORLDWIDE <br />.500 <br />10.00 <br />100MG <br />LIDOCANE <br />74132305 <br />R <br />8.35 <br />02 <br />HOSPIRA WORLDWIDE <br />.400 <br />10.00 <br />100MG <br />LIDOCANE <br />74132305 <br />R <br />09/05 <br />6.68 <br />01 <br />HOSPIRA WORLDWIDE <br />.040 <br />25.00 <br />2.5 MG/M <br />VERAPAMIL HCL <br />74114401 <br />R <br />.16 <br />02 <br />HOSPIRA WORLDWIDE <br />.150 <br />100.00 <br />4% <br />LIDOCAINE HCL <br />74428301 <br />R <br />07/05 <br />6.94 <br />01 <br />HOSPIRA WORLDWIDE <br />..600 <br />10.00 <br />250 MG <br />DOBUTAMINE HCL <br />74234401 <br />R <br />1.89 <br />02 <br />HOSPIRA WORLDWIDE <br />.010 <br />100.00 <br />100 U/ML <br />HEPARIN LOCK FLUSH <br />74115270 <br />R <br />06/05 <br />.11 <br />01 <br />HOSPIRA WORLDWIDE <br />.160 <br />25.00 <br />25% <br />MANNITOL <br />744031_01 <br />R <br />09/05 <br />6.48 <br />01 <br />HOSPIRA WORLDWIDE <br />.100 <br />10.00 <br />100MG <br />LIDOCANE <br />74132305 <br />R <br />1.67 <br />02 <br />HOSPIRA WORLDWIDE <br />.200 <br />10.00 <br />.2MG/ML <br />ISUPREL <br />74/41005 <br />R <br />06/05 <br />7.90 <br />01 <br />HOSPIRA WORLDWIDE <br />.440 <br />25.00 <br />1:1,000 <br />EPINEPHRINE HCL <br />74724101 <br />R <br />07/05 <br />4.84 <br />01 <br />HOSPIRA WORLDWIDE <br />.050 <br />100.001 <br />4% <br />LIDOCAINE HCL <br />74428301 <br />R <br />07/05 <br />2.31 <br />01 <br />IVAX <br />.100 <br />100.00 <br />10 MG <br />CYCLOBENZAPRINE HCL <br />182/91901 <br />R <br />6.02 <br />02 <br />!VAX. <br />.060 <br />100.00 <br />500 MG <br />TETRACYCLINE <br />18206790/ <br />R <br />46 <br />02 <br />IVAX <br />.010 <br />100.00 <br />25 MG <br />HYDROCHLOROTHIAZIDE <br />182055601 <br />R <br />.01 <br />02 <br />.050 <br />100.00 <br />40 MG <br />FUROSEMIDE <br />18211610'_ <br />R <br />.22 <br />02 <br />1.000 <br />1.00 <br />0.1% <br />TRIAMCINOLONF ACETONIDE <br />182139545 <br />R <br />14.25 <br />04 <br />7VA <br />.300 <br />100.00 <br />100I4G <br />LABETAL HCL <br />172436460 <br />R <br />16.02 <br />02 <br />VAX <br />.350 <br />100.00 <br />10M1G <br />FLUOXETINE <br />172436360 <br />R <br />5.64 <br />02 <br />--50 <br />100.00 <br />20 MG <br />BACLOFEN <br />172409760 <br />R <br />19.69 <br />02 <br />=VAX <br />.'450 <br />100.00 <br />180 <br />VER_*-,PAMI-L HCL <br />172428660 <br />R <br />16.65 <br />02 <br />- 'A -X <br />.450 <br />100.00 <br />20 MG <br />FLUOXETINE _-CL <br />172435660 <br />R <br />7.56 <br />02 <br />
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