Covered Entity Details

RRC340023-06 ADVENTHEALTH HENDERSONVILLE (Terminated) - information as of 5/1/2025 11:50:42 PM

Main Details

Name

ADVENTHEALTH HENDERSONVILLE

Subdivision Name

AdventHealth Hematology Oncology Infusion Services Weaverville - clinic - Oncology Infusion

Type

Rural Referral Center

Rural

340B ID

RRC340023-06

Medicare Provider Number

340023

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/4/2024

Participating Start Date

7/1/2024

Participating Approval Date

4/22/2024

Last Recertification Date

8/16/2024

Termination Date
Termination Reason

4/1/2025
Change of covered entity type

Contacts

Authorizing Official

AdventHealth Hendersonville
Steven Burroughs, VP of Finance / CFO
(828) 681-2102

Primary Contact

Adventhealth
Rafael Kirkpatrick, SE Region 340B Coordinator
(956) 466-8487

Addresses

Street Address

179 North Buncombe School Road
Suite 102
Weaverville, NC 28787

Billing Address

AdventHealth Hendersonville
c/o AdventHealth
902 Inspiration Ave.
Suite 9100
Altamonte Springs, FL 32714

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
NC	3400023,3400023S,3407195	1427075027,1265466452,1992740468

Shipping Addresses

Shipping Address 1

AdventHealth Hendersonville
100 Hospital Drive
Hendersonville, NC 28792

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
RRC340023-01	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Sleep Center Hendersonville - sleep center	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-02	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Ear, Nose & Throat at Hendersonville - ENT	80 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-03	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Hendersonville - Infusion	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-04	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Haywood - Infusion	49 Spicewood Drive	Clyde	NC	Terminated
RRC340023-05	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Weaverville - Infusion	179 North Buncombe School Road	Weaverville	NC	Terminated
RRC340023-06	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Weaverville - clinic - Oncology Infusion	179 North Buncombe School Road	Weaverville	NC	Terminated
RRC340023-07	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Haywood - clinic - Oncology Infusion	49 Spicewood Drive	Clyde	NC	Terminated
RRC340023-08	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Cardiac Rehabilitation Hendersonville - Cardiac Rehabilitaion	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-09	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Wound Care Hendersonville - HyperBaric - HyperBaric	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-10	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Hendersonville - clinic - Oncology Clinic	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-11	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Urology at Medical Office Building - Urology	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-12	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Cardiology at Medical Office Building - Cardiology	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-13	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Multispecialty at South Asheville - Multispecialty	15 Skyland Inn Drive	Arden	NC	Terminated
RRC340023-14	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Endocrinology at Hendersonville - Endocrinology	81 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-15	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Integrative Medicine at Medical Office Building - Integrative Medicine	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-16	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Forge Mountain - Family Medicine	127 Vance Hill Drive	Mills River	NC	Terminated
RRC340023-17	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Neurology at Hendersonville - Neurology	50 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-18	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Behavioral Health Medical Office Building - Behavioral Health	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-19	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Black Mountain - Family Medicine	15 Jane Jacobs Road	Black Mountain	NC	Terminated
RRC340023-20	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Parkway - Family Medicine	333 Gashes Creek Rd.	Asheville	NC	Terminated
RRC340023-21	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Rheumatology at Hendersonville - Rheumatology	80 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-22	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Internal Medicine at Hendersonville - Internal Medicine	50 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-23	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Multispecialty at Medical Office Building - Multispecialty	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-24	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Biltmore Park - Family Medicine	1 Town Square	Asheville	NC	Terminated
RRC340023-25	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Multispecialty at Candler - Multispecialty	1388 Sand Hill Rd	Candler	NC	Terminated
RRC340023-26	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Surgery Specialists at Hendersonville - Surgery Specialists	80 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-27	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Multispecialty at Laurel Park - Multispecialty	1881 Pisgah Drive	Hendersonville	NC	Terminated
RRC340023-28	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Breast Center at Hendersonville - Breast Center	80 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-29	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Audiology at Hendersonville - Audiology	80 Doctors Drive	Hendersonville	NC	Terminated
RRC340023-30	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Hendersonville - Family Medicine	207 Linda Vista Drive	Hendersonville	NC	Terminated
RRC340023-31	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Obstetrics & Gynecology at Medical Office Building - Obstetrics & Gynecology	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-32	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Dermatology at Medical Office Building - Dermatology	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-33	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Pediatrics at Medical Office Building - Pediatrics	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-34	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Psychiatry at Medical Office Building - Psychiatry	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-35	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Pulmonology & Sleep Medicine at Medical Office Building - Pulmonology & Sleep Medicine	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-36	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Wound Care & Hyperbaric Medicine at Medical Office Building - Wound Care Clinic	50 Hospital Drive	Hendersonville	NC	Terminated
RRC340023-37	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Medical Group Family Medicine at Mills River - Family Medicine	125 Vance Hill Drive	Mills River	NC	Terminated
RRC340023-38	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Asheville - clinic - Oncology Infusion	20 Medical Park Drive	Asheville	NC	Terminated
RRC340023-39	Child	RRC	ADVENTHEALTH HENDERSONVILLE	AdventHealth Hematology Oncology Infusion Services Asheville - Infusion	20 Medical Park Drive	Asheville	NC	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2025 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/6/2025 6:39 AM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	2/6/2025 6:39 AM
Terminations	Termination Date	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/6/2025 6:39 AM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/6/2025 6:39 AM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	2/6/2025 6:39 AM
Details	Last Recertification Date	Update	Recertification		8/16/2024 1:06:46 PM	8/16/2024 1:06 PM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Contacts	Primary Contact	Update	Group Change Request	Phillips, Larry D Director Supply Chain and 340B Pharmacy Adventhealth Hendersonville 8286812720	Kirkpatrick, Rafael SE Region 340B Coordinator Adventhealth 9564668487	6/13/2024 10:37 AM
Contacts	Signed By	Insert	New Registration		Burroughs, Steven VP of Finance / CFO AdventHealth Hendersonville 8286812102	4/22/2024 2:54 PM
Details	340B ID	Update	New Registration		RRC340023-06	4/22/2024 2:54 PM
Details	Entity Subname	Update	New Registration	AdventHealth Hematology Oncology Infusion Services Weaverville - clinic	AdventHealth Hematology Oncology Infusion Services Weaverville - clinic - Oncology Infusion	4/22/2024 2:54 PM
Dates	Participating Approval Date	Update	New Registration		4/22/2024 2:54:28 PM	4/22/2024 2:54 PM
Details	State	Update	New Registration	Pending	Approved	4/22/2024 2:54 PM
Dates	Signed By Date	Update	New Registration		4/15/2024 8:14:21 AM	4/22/2024 2:54 PM
Dates	Start Date	Update	New Registration		7/1/2024 12:00:00 AM	4/22/2024 2:54 PM
Addresses	Main Address	Insert	New Registration		179 North Buncombe School Road Suite 102 Weaverville, NC 28787	4/4/2024 2:36 PM
Addresses	Billing Address	Insert	New Registration		AdventHealth Hendersonville c/o AdventHealth 902 Inspiration Ave. Suite 9100 Altamonte Springs, FL 32714	4/4/2024 2:36 PM
Addresses	Shipping Address	Insert	New Registration		AdventHealth Hendersonville 100 Hospital Drive Hendersonville, NC 28792	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		3400023	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		3400023S	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		3407195	4/4/2024 2:36 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1427075027	4/4/2024 2:36 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1265466452	4/4/2024 2:36 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1992740468	4/4/2024 2:36 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	4/4/2024 2:36 PM
Contacts	Primary Contact	Insert	New Registration		Phillips, Larry D Director Supply Chain and 340B Pharmacy Adventhealth Hendersonville 8286812720	4/4/2024 2:36 PM
Contacts	Authorizing Official	Insert	New Registration		Burroughs, Steven VP of Finance / CFO AdventHealth Hendersonville 8286812102	4/4/2024 2:36 PM
Details	Assistance Received From Date	Insert	New Registration			4/4/2024 2:36 PM
Details	Assistance Received To Date	Insert	New Registration			4/4/2024 2:36 PM
Details	Last Recertification Date	Insert	New Registration			4/4/2024 2:36 PM
Details	Grant Number	Insert	New Registration			4/4/2024 2:36 PM
Details	340B ID	Insert	New Registration			4/4/2024 2:36 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/4/2024 2:36 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/4/2024 2:36 PM
Details	Medicare Provider Number	Insert	New Registration		340023	4/4/2024 2:36 PM
Details	Entity Name	Insert	New Registration		ADVENTHEALTH HENDERSONVILLE	4/4/2024 2:36 PM
Details	NOFO Number	Insert	New Registration			4/4/2024 2:36 PM
Details	Program Code	Insert	New Registration		RRC	4/4/2024 2:36 PM
Details	Entity Subname	Insert	New Registration		AdventHealth Hematology Oncology Infusion Services Weaverville - clinic	4/4/2024 2:36 PM
Dates	Participating Approval Date	Insert	New Registration			4/4/2024 2:36 PM
Details	State	Insert	New Registration		Pending	4/4/2024 2:36 PM
Dates	Registration Date	Insert	New Registration		4/4/2024 2:36:22 PM	4/4/2024 2:36 PM
Dates	Signed By Date	Insert	New Registration			4/4/2024 2:36 PM
Dates	Start Date	Insert	New Registration			4/4/2024 2:36 PM
Terminations	Termination Comments	Insert	New Registration			4/4/2024 2:36 PM
Terminations	Termination Date	Insert	New Registration			4/4/2024 2:36 PM
Terminations	Termination Effective Date	Insert	New Registration			4/4/2024 2:36 PM
Terminations	Termination Reason	Insert	New Registration			4/4/2024 2:36 PM