Covered Entity Details

CH05848D NEIGHBORHOOD HEALTH CLINICS (Active) - information as of 6/14/2025 10:09:50 AM

Main Details

Name

NEIGHBORHOOD HEALTH CLINICS

Subdivision Name

Neighborhood Health Family Medicine Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-038193

340B ID

CH05848D

Grant Number

H80CS00548

Additional Details

Current Program Status

Active

Registration Date

5/29/2024

Participating Start Date

7/1/2024

Participating Approval Date

6/11/2024

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

Neighborhood Health Clinics, Inc.
Angela Zaegel, CEO
(260) 458-2641 Ext: 3634

Primary Contact

Neighborhood Health Clinic
Andrea Mekonnen, Pharmacy Director
(260) 458-2641 Ext: 3775

Addresses

Street Address

750 Broadway STE 350
Fort Wayne, IN 46802-1412

Billing Address

Neighborhood Health Clinics, Inc
PO Box 11949
Fort Wayne, IN 46862

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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?
No

Shipping Addresses

Shipping Address 1

Neighborhood Health Pharmacy
1721 S Calhoun Street
Fort Wayne, IN 46802

Shipping Address 2

Neighborhood Health Clinics, Inc
1717 S. Calhoun Street
Fort Wayne, IN 46802

Shipping Address 3

Neighborhood Health Clinics, Inc
3350 E. Paulding Rd
Fort Wayne, IN 46816

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06509	2802 EAST STATE BOULEVARD	FORT WAYNE	IN	46805	07/11/2024	10/01/2024	10/01/2024
Contract Detail	HOOK-SUPERX, L.L.C.	CVS/PHARMACY # 5369	6279 E. STATE BLVD.	FORT WAYNE	IN	46815	07/11/2024	10/01/2024	10/01/2024
Contract Detail	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06520	3918 SOUTH CALHOUN ST.	FORT WAYNE	IN	46807	01/10/2025	04/01/2025	04/01/2025
Contract Detail	WAL-MART PHARMACY 10-4231	7502 SOUTHTOWN CROSSING		FORT WAYNE	IN	46816	07/11/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03722	110 E. CREIGHTON AVE.	FT WAYNE	IN	46803	07/11/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05940	5830 N CLINTON ST	FT WAYNE	IN	46825	07/11/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06868	330 W STATE BLVD	FT WAYNE	IN	46808-3135	07/11/2024	10/01/2024	10/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH058480	Active	BPS-H80-004669	NEIGHBORHOOD HEALTH CLINICS, INC.	Neighborhood Health - Calhoun Site	1717 S. Calhoun st	FORT WAYNE	IN
CH05848A	Terminated	BPS-H80-006771	NEIGHBORHOOD HEALTH CLINICS, INC.	PARK CENTER SITE	909 E STATE BLVD.	FORT WAYNE	IN
CH05848B	Active	BPS-H80-013629	NEIGHBORHOOD HEALTH CLINICS INC.	Southeast Clinic	3350 E PAULDING RD	FORT WAYNE	IN
CH05848C	Active	BPS-H80-010034	NEIGHBORHOOD HEALTH CLINICS INC.	1721 S Calhoun	1721 S Calhoun St	Fort Wayne	IN
CH05848D	Active	BPS-H80-038193	NEIGHBORHOOD HEALTH CLINICS	Neighborhood Health Family Medicine Center	750 Broadway STE 350	Fort Wayne	IN

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH058480	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	10/01/2024
CH058480	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2024
CH058480	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2024
CH058480	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2024
CH058480	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2024
CH058480	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2024
CH058480	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2024
CH058480	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2024
CH058480	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2024
CH058480	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2024
CH058480	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2024
CH058480	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/01/2024
CH058480	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/01/2024
CH058480	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2024
CH058480	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	CVS/PHARMACY # 5369	6279 E. STATE BLVD.	FORT WAYNE	IN	46815	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06519	5802 SOUTH ANTHONY BLVD.	FORT WAYNE	IN	46816	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06520	3918 SOUTH CALHOUN ST.	FORT WAYNE	IN	46807	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06509	2802 EAST STATE BOULEVARD	FORT WAYNE	IN	46805	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06522	2811 GETZ ROAD	FORT WAYNE	IN	46804	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06515	1203 S. MAIN ST.	BLUFFTON	IN	46714	04/01/2023
CH058480	HOOK-SUPERX, L.L.C.	DBA CVS/PHARMACY #10190	770 E. DUPONT RD.	FORT WAYNE	IN	46825	04/01/2023
CH05848B	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06520	3918 SOUTH CALHOUN ST.	FORT WAYNE	IN	46807	07/01/2024
CH05848B	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06509	2802 EAST STATE BOULEVARD	FORT WAYNE	IN	46805	07/01/2024
CH05848D	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06509	2802 EAST STATE BOULEVARD	FORT WAYNE	IN	46805	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	CVS PHARMACY # 17051	6119 STELLHORN RD	FORT WAYNE	IN	46815	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA CVS/PHARMACY # 6737	4225 HOBSON RD	FORT WAYNE	IN	46815	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06516	1221 WEST MONROE ST.	DECATUR	IN	46733	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY #05696	10170 ILLINOIS ROAD	FORT WAYNE	IN	46804	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06527	6220 SAINT JOE CENTER RD.	FORT WAYNE	IN	46835	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	CVS PHARMACY # 17294	3801 COLDWATER RD	FORT WAYNE	IN	46805	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06510	7330 LIMA ROAD	FORT WAYNE	IN	46818	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06496	115 STATE ROAD #930 E	NEW HAVEN	IN	46774	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06479	1703 CARROLL RD.	FORT WAYNE	IN	46845	10/01/2024
CH058480	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06323	13821 LEO RD	LEO CEDARVILLE	IN	46765	10/01/2024
CH05848D	HOOK-SUPERX, L.L.C.	CVS/PHARMACY # 5369	6279 E. STATE BLVD.	FORT WAYNE	IN	46815	10/01/2024
CH05848D	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06520	3918 SOUTH CALHOUN ST.	FORT WAYNE	IN	46807	04/01/2025
CH058480	KROGER PHARMACY #412	1125 W STATE BLVD		FORT WAYNE	IN	46808-3185	10/01/2014	04/30/2016
CH058480	KROGER PHARMACY J-929	218 EAST PETTIT		FORT WAYNE	IN	46806	10/01/2014	04/30/2016
CH058480	NORTH ANTHONY PHARMACY & WELLNESS CENTER	3537 N. ANTHONY BLVD	STE A	FORT WAYNE	IN	46805	10/01/2014	04/30/2016
CH058480	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2024
CH058480	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2024
CH058480	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2024
CH058480	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CH058480	WAL-MART PHARMACY 10-4231	7502 SOUTHTOWN CROSSING		FORT WAYNE	IN	46816	04/01/2023
CH05848D	WAL-MART PHARMACY 10-4231	7502 SOUTHTOWN CROSSING		FORT WAYNE	IN	46816	10/01/2024
CH058480	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CH058480	WALGREEN CO	DBA: WALGREENS #12506	1610 W COOK ROAD	FORT WAYNE	IN	46825	07/01/2014	07/12/2016
CH058480	WALGREEN CO	DBA: WALGREENS #11494	124 E NORTH STREET	KENDALLVILLE	IN	46755	10/01/2024
CH058480	WALGREEN CO	DBA: WALGREENS #11945	11932 LIMA RD	FORT WAYNE	IN	46818	10/01/2024
CH058480	WALGREEN CO.	DBA: WALGREENS # 06868	330 W STATE BLVD	FT WAYNE	IN	46808-3135	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 03722	110 E. CREIGHTON AVE.	FT WAYNE	IN	46803	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 05452	2410 N COLISEUM BLVD	FT WAYNE	IN	46805	07/01/2014	03/25/2025
CH058480	WALGREEN CO.	DBA: WALGREENS # 02932	1701 EAST PAULDING ROAD	FORT WAYNE	IN	46816	07/01/2014	02/20/2024
CH058480	WALGREEN CO.	DBA: WALGREENS # 03129	6201 STELLHORN ROAD	FT WAYNE	IN	46815	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 03410	222 E PETTIT AVE	FT WAYNE	IN	46806	07/01/2014	02/24/2016
CH058480	WALGREEN CO.	DBA: WALGREENS # 03502	907 LINCOLN HIGHWAY W	NEW HAVEN	IN	46774	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 04190	6730 BLUFFTON RD.	FT WAYNE	IN	46809	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 05940	5830 N CLINTON ST	FT WAYNE	IN	46825	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 06673	6202 WEST JEFFERSON BLVD	FT WAYNE	IN	46804	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 07472	1975 N MAIN ST	BLUFFTON	IN	46714-1182	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 09793	5435 E DUPONT ROAD	FORT WAYNE	IN	46825	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 05115	10412 COLDWATER ROAD	FT WAYNE	IN	46845	07/01/2014
CH058480	WALGREEN CO.	DBA: WALGREENS # 09893	123 N 13TH ST	DECATUR	IN	46733-1409	07/01/2014	10/15/2021
CH058480	WALGREEN CO.	DBA: WALGREENS # 05344	10211 CHESTNUT PLAZA DRIVE	FORT WAYNE	IN	46814	01/01/2022
CH058480	WALGREEN CO.	DBA: WALGREENS # 05510	9030 US HIGHWAY 24 W	FT WAYNE	IN	46804	01/01/2022
CH058480	WALGREEN CO.	DBA: WALGREENS # 09853	10170 MAYSVILLE RD	FT WAYNE	IN	46835-9589	01/01/2022	03/19/2025
CH058480	WALGREEN CO.	DBA: WALGREENS #15148	7950 W JEFFERSON BLVD STE 1B005	FORT WAYNE	IN	46804	04/01/2023
CH058480	WALGREEN CO.	DBA: WALGREENS # 07906	2400 E CENTER ST	WARSAW	IN	46580-3817	10/01/2024
CH05848D	WALGREEN CO.	DBA: WALGREENS # 03722	110 E. CREIGHTON AVE.	FT WAYNE	IN	46803	10/01/2024
CH058480	WALGREEN CO.	DBA: WALGREENS # 03437	1010 E IRELAND RD	SOUTH BEND	IN	46614	10/01/2024
CH05848D	WALGREEN CO.	DBA: WALGREENS # 05940	5830 N CLINTON ST	FT WAYNE	IN	46825	10/01/2024
CH058480	WALGREEN CO.	DBA: WALGREENS # 07907	535 N LINE ST	COLUMBIA CITY	IN	46725-1229	10/01/2024	01/28/2025
CH05848D	WALGREEN CO.	DBA: WALGREENS # 06868	330 W STATE BLVD	FT WAYNE	IN	46808-3135	10/01/2024
CH058480	WALGREEN CO.	DBA: WALGREENS # 06066	1804 N JEFFERSON	HUNTINGTON	IN	46750	10/01/2024
CH058480	Walgreens Central Fill #21399	4132Plainfield Rd	Ste 110	Indianapolis	IN	46231-7021	04/01/2023
CH058480	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2014	07/21/2015
CH058480	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/01/2024
CH058480	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2024
CH058480	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2024
CH058480	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH058480	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/11/2025 7:15:45 PM	2/11/2025 7:15 PM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Zaegel, Angela CEO Neighborhood Health Clinics, Inc. 2604582641-3634	6/11/2024 7:22 AM
Details	340B ID	Update	New Registration		CH05848D	6/11/2024 7:22 AM
Dates	Participating Approval Date	Update	New Registration		6/11/2024 7:22:57 AM	6/11/2024 7:22 AM
Details	State	Update	New Registration	Pending	Approved	6/11/2024 7:22 AM
Dates	Signed By Date	Update	New Registration		5/31/2024 11:05:10 AM	6/11/2024 7:22 AM
Dates	Start Date	Update	New Registration		7/1/2024 12:00:00 AM	6/11/2024 7:22 AM
Addresses	Main Address	Insert	New Registration		750 Broadway STE 350 Fort Wayne, IN 46802-1412	5/29/2024 1:02 PM
Addresses	Billing Address	Insert	New Registration		Neighborhood Health Clinics, Inc PO Box 11949 Fort Wayne, IN 46862	5/29/2024 1:02 PM
Addresses	Shipping Address	Insert	New Registration		Neighborhood Health Pharmacy 1721 S Calhoun Street Fort Wayne, IN 46802	5/29/2024 1:02 PM
Addresses	Shipping Address	Insert	New Registration		Neighborhood Health Clinics, Inc 1717 S. Calhoun Street Fort Wayne, IN 46802	5/29/2024 1:02 PM
Addresses	Shipping Address	Insert	New Registration		Neighborhood Health Clinics, Inc 3350 E. Paulding Rd Fort Wayne, IN 46816	5/29/2024 1:02 PM
Contacts	Authorizing Official	Insert	New Registration		Zaegel, Angela CEO Neighborhood Health Clinics, Inc. 2604582641-3634	5/29/2024 1:02 PM
Contacts	Primary Contact	Insert	New Registration		Mekonnen, Andrea Pharmacy Director Neighborhood Health Clinic 2604582641-3775	5/29/2024 1:02 PM
Details	Assistance Received From Date	Insert	New Registration			5/29/2024 1:02 PM
Details	Assistance Received To Date	Insert	New Registration			5/29/2024 1:02 PM
Details	Last Recertification Date	Insert	New Registration			5/29/2024 1:02 PM
Details	Grant Number	Insert	New Registration		H80CS00548	5/29/2024 1:02 PM
Details	340B ID	Insert	New Registration			5/29/2024 1:02 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			5/29/2024 1:02 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			5/29/2024 1:02 PM
Details	Medicare Provider Number	Insert	New Registration			5/29/2024 1:02 PM
Details	Entity Name	Insert	New Registration		NEIGHBORHOOD HEALTH CLINICS	5/29/2024 1:02 PM
Details	NOFO Number	Insert	New Registration			5/29/2024 1:02 PM
Details	Program Code	Insert	New Registration		CH	5/29/2024 1:02 PM
Details	Entity Subname	Insert	New Registration		Neighborhood Health Family Medicine Center	5/29/2024 1:02 PM
Dates	Participating Approval Date	Insert	New Registration			5/29/2024 1:02 PM
Details	State	Insert	New Registration		Pending	5/29/2024 1:02 PM
Dates	Registration Date	Insert	New Registration		5/29/2024 1:02:56 PM	5/29/2024 1:02 PM
Dates	Signed By Date	Insert	New Registration			5/29/2024 1:02 PM
Dates	Start Date	Insert	New Registration			5/29/2024 1:02 PM
Terminations	Termination Comments	Insert	New Registration			5/29/2024 1:02 PM
Terminations	Termination Date	Insert	New Registration			5/29/2024 1:02 PM
Terminations	Termination Effective Date	Insert	New Registration			5/29/2024 1:02 PM
Terminations	Termination Reason	Insert	New Registration			5/29/2024 1:02 PM

340B Drug Pricing Program Database