Covered Entity Details

CHC26636-07 ROCKBRIDGE AREA FREE CLINIC (Active) - information as of 5/5/2025 11:56:03 PM

Main Details

Name

ROCKBRIDGE AREA FREE CLINIC

Subdivision Name

Rockbridge County High School Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-037633

340B ID

CHC26636-07

Grant Number

H80CS26636

Additional Details

Current Program Status

Active

Registration Date

7/9/2024

Participating Start Date

10/1/2024

Participating Approval Date

9/4/2024

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

Rockbridge Area Health Center
Suzanne Sheridan, Chief Executive Officer
(540) 464-8700 Ext: 7111

Primary Contact

Rockbridge Area Health Center
Jessica Ferguson, Clinical Director
(540) 464-8700 Ext: 7214

Addresses

Street Address

143 Greenhouse Rd
Lexington, VA 24450-3718

Billing Address
Same as Street Address

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

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	01/03/2025	04/01/2025	04/01/2025
Contract Detail	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	01/03/2025	04/01/2025	04/01/2025
Contract Detail	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	01/03/2025	04/01/2025	04/01/2025
Contract Detail	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	01/03/2025	04/01/2025	04/01/2025
Contract Detail	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	01/03/2025	04/01/2025	04/01/2025
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/03/2025	04/01/2025	04/01/2025
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/03/2025	04/01/2025	04/01/2025
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/03/2025	04/01/2025	04/01/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC26636-00	Active	BPS-H80-013054	ROCKBRIDGE AREA FREE CLINIC	Rockbridge Area Health Center	25 Northridge Ln	Lexington	VA
CHC26636-01	Active	BPS-H80-020969	ROCKBRIDGE AREA FREE CLINIC	Mountain View Family Dentistry	2131 Magnolia Avenue	Buena Vista	VA
CHC26636-02	Active	BPS-H80-034514	Rockbridge Area Free Clinic	RAHC Kendal Drive	170A Kendal Dr	Lexington	VA
CHC26636-03	Active	BPS-H80-034515	Rockbridge Area Free Clinic	RAHC - Buena Vista	2127 Magnolia Ave	Buena Vista	VA
CHC26636-04	Active	BPS-H80-035300	ROCKBRIDGE AREA FREE CLINIC	RAHC Mobile Dental Unit	25 Northridge Ln	Lexington	VA
CHC26636-05	Active	BPS-H80-034797	ROCKBRIDGE AREA FREE CLINIC	Mobile Medical Unit #1	25 Northridge Ln	Lexington	VA
CHC26636-06	Active	BPS-H80-037632	ROCKBRIDGE AREA FREE CLINIC	Maury River Middle School Health Center	600 Waddell St	Lexington	VA
CHC26636-07	Active	BPS-H80-037633	ROCKBRIDGE AREA FREE CLINIC	Rockbridge County High School Health Center	143 Greenhouse Rd	Lexington	VA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date
CHC26636-00	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	01/01/2015
CHC26636-01	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2023
CHC26636-02	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2023
CHC26636-03	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2023
CHC26636-04	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2025
CHC26636-05	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2025
CHC26636-06	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2025
CHC26636-07	LEXINGTON PRESCRIPTION CENTER	LEXINGTON PRESCRIPTION CENTER	800 S MAIN ST	LEXINGTON	VA	24450-2445	04/01/2025
CHC26636-00	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	10/01/2024
CHC26636-01	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	10/01/2024
CHC26636-02	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	10/01/2024
CHC26636-03	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	10/01/2024
CHC26636-04	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	04/01/2025
CHC26636-05	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	04/01/2025
CHC26636-06	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	04/01/2025
CHC26636-07	UNCHAINED RX INC DBA BUENA VISTA FAM PHA	2263 MAGNOLIA AVE		BUENA VISTA	VA	24416	04/01/2025
CHC26636-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	10/01/2024
CHC26636-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	10/01/2024
CHC26636-01	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	10/01/2024
CHC26636-01	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	10/01/2024
CHC26636-02	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	10/01/2024
CHC26636-02	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	10/01/2024
CHC26636-03	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	10/01/2024
CHC26636-03	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	10/01/2024
CHC26636-04	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	04/01/2025
CHC26636-04	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	04/01/2025
CHC26636-05	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	04/01/2025
CHC26636-05	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	04/01/2025
CHC26636-06	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	04/01/2025
CHC26636-07	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05514	2148 EAST MIDLAND TRAIL	BUENA VISTA	VA	24416	04/01/2025
CHC26636-07	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	04/01/2025
CHC26636-06	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06325	506 EAST NELSON STREET	LEXINGTON	VA	24450	04/01/2025
CHC26636-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2021
CHC26636-01	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CHC26636-02	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CHC26636-03	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CHC26636-00	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	10/01/2021
CHC26636-01	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2023
CHC26636-02	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2023
CHC26636-03	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2023
CHC26636-04	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2025
CHC26636-05	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2025
CHC26636-06	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2025
CHC26636-07	WAL-MART PHARMACY 10-1335	1233 N. LEE HWY.		LEXINGTON	VA	24450	04/01/2025
CHC26636-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2021
CHC26636-01	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CHC26636-02	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CHC26636-03	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CHC26636-04	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2025
CHC26636-05	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2025
CHC26636-06	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2025
CHC26636-07	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2025
CHC26636-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC26636-01	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC26636-02	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC26636-03	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC26636-04	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2025
CHC26636-05	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2025
CHC26636-06	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2025
CHC26636-07	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2025
CHC26636-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26636-01	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-02	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-03	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-04	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-05	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-06	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025
CHC26636-07	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/11/2025 8:58:40 AM	2/11/2025 8:58 AM
Details	State	Update		Approved	Active	10/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Sheridan, Suzanne Chief Executive Officer Rockbridge Area Health Center 5404648700-7111	9/4/2024 12:45 PM
Details	340B ID	Update	New Registration		CHC26636-07	9/4/2024 12:45 PM
Dates	Participating Approval Date	Update	New Registration		9/4/2024 12:45:23 PM	9/4/2024 12:45 PM
Details	State	Update	New Registration	Pending	Approved	9/4/2024 12:45 PM
Dates	Signed By Date	Update	New Registration		7/9/2024 3:48:08 PM	9/4/2024 12:45 PM
Dates	Start Date	Update	New Registration		10/1/2024 12:00:00 AM	9/4/2024 12:45 PM
Addresses	Main Address	Insert	New Registration		143 Greenhouse Rd Lexington, VA 24450-3718	7/9/2024 3:48 PM
Contacts	Authorizing Official	Insert	New Registration		Sheridan, Suzanne Chief Executive Officer Rockbridge Area Health Center 5404648700-7111	7/9/2024 3:48 PM
Contacts	Primary Contact	Insert	New Registration		Ferguson, Jessica Clinical Director Rockbridge Area Health Center 5404648700-7214	7/9/2024 3:48 PM
Details	Assistance Received From Date	Insert	New Registration			7/9/2024 3:48 PM
Details	Assistance Received To Date	Insert	New Registration			7/9/2024 3:48 PM
Details	Last Recertification Date	Insert	New Registration			7/9/2024 3:48 PM
Details	Grant Number	Insert	New Registration		H80CS26636	7/9/2024 3:48 PM
Details	340B ID	Insert	New Registration			7/9/2024 3:48 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/9/2024 3:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/9/2024 3:48 PM
Details	Medicare Provider Number	Insert	New Registration			7/9/2024 3:48 PM
Details	Entity Name	Insert	New Registration		ROCKBRIDGE AREA FREE CLINIC	7/9/2024 3:48 PM
Details	NOFO Number	Insert	New Registration			7/9/2024 3:48 PM
Details	Program Code	Insert	New Registration		CH	7/9/2024 3:48 PM
Details	Entity Subname	Insert	New Registration		Rockbridge County High School Health Center	7/9/2024 3:48 PM
Dates	Participating Approval Date	Insert	New Registration			7/9/2024 3:48 PM
Details	State	Insert	New Registration		Pending	7/9/2024 3:48 PM
Dates	Registration Date	Insert	New Registration		7/9/2024 3:48:05 PM	7/9/2024 3:48 PM
Dates	Signed By Date	Insert	New Registration			7/9/2024 3:48 PM
Dates	Start Date	Insert	New Registration			7/9/2024 3:48 PM
Terminations	Termination Comments	Insert	New Registration			7/9/2024 3:48 PM
Terminations	Termination Date	Insert	New Registration			7/9/2024 3:48 PM
Terminations	Termination Effective Date	Insert	New Registration			7/9/2024 3:48 PM
Terminations	Termination Reason	Insert	New Registration			7/9/2024 3:48 PM

340B Drug Pricing Program Database