Covered Entity Details

CH04700N Health Care Partners of South Carolina, Inc. (Active) - information as of 4/25/2025 6:34:49 PM

Main Details

Name

Health Care Partners of South Carolina, Inc.

Subdivision Name

Health Care Partners of South Carolina Mobile Eye Care Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-038921

340B ID

CH04700N

Grant Number

H80CS00411

Additional Details

Current Program Status

Active

Registration Date

1/7/2025

Participating Start Date

4/1/2025

Participating Approval Date

1/24/2025

Last Recertification Date

Contacts

Authorizing Official

Health Care Partners of SC
Santina Mayo, Chief Executive Officer
(843) 488-6034

Primary Contact

Health Care Partners of South Carolina, Inc. - Conway Office Pharmacy
Joseph Hamilton Odom, Director of Pharmacy
(843) 438-8399

Addresses

Street Address

1606 Main Street UNIT B
Conway, SC 29526-2952

Billing Address

HEALTH CARE PARTNERS OF S.C. INC.
1708 OAK STREET
CONWAY, SC 29526

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?
Yes

State	Medicaid Number	NPI Number
SC	758617,FQC010,FQC128,FQC150	1457436628,1043395346,1639255631,1770668824

Shipping Addresses

Same as Street Address

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.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH047000	Active	BPS-H80-002223	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of South Carolina, Inc. - Conway Administrative Office	1708 Oak Street	Conway	SC
CH04700A	Active	BPS-H80-003461	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of South Carolina, Inc. - Conway Office	1608 Main St	Conway	SC
CH04700B	Active	BPS-H80-002857	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of South Carolina, Inc. - Johnsonville Office	123 East Broadway Street	Johnsonville	SC
CH04700F	Terminated	BPS-H80-002223	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of South Carolina, Inc. - Conway Office	1708 Oak St	Conway	SC
CH04700G	Active	BPS-H80-011364	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of South Carolina, Inc. - Marion Office	145 Palmetto Pointe Rd.	Marion	SC
CH04700H	Active	BPS-H80-027989	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of SC Women's Care	243 Singleton Ridge Rd	Conway	SC
CH04700J	Active	BPS-H80-031109	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	HCPSC School Based Health at Johnsonville High School	237 S Georgetown Hwy	Johnsonville	SC
CH04700K	Active	BPS-H80-036394	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners Brittons Neck Health Center	6874 Highway 908	Gresham	SC
CH04700L	Active	BPS-H80-036273	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners Mobile Dental Unit	145 PALMETTO POINTE RD	MARION	SC
CH04700M	Active	BPS-H80-036505	HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.	Health Care Partners of SC Optometry Office	1606 Main UNIT B	Conway	SC
CH04700N	Active	BPS-H80-038921	Health Care Partners of South Carolina, Inc.	Health Care Partners of South Carolina Mobile Eye Care Center	1606 Main Street UNIT B	Conway	SC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH047000	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	10/01/2018
CH047000	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	10/01/2024
CH047000	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	10/01/2024
CH047000	AMAZON PHARMACY #008	408 TECHNOLOGY PARKWAY	BUILDING B, STE 101	COLLEGE STATION	TX	77845	10/01/2024
CH047000	AMAZON PHARMACY #009	7469 KINGSPOINTE PKWY STE 400		ORLANDO	FL	32819	10/01/2024
CH047000	AMAZON PHARMACY #010	1331 E 6TH ST		CORONA	CA	92879	10/01/2024
CH047000	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019
CH047000	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	07/01/2023
CH047000	CENTERWELL PHARMACY, INC.	11010 FLORIDA CROWN DRIVE, SUITE 200		ORLANDO	FL	32824	01/01/2024
CH047000	CONNECTICUT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02018	540 WEST MAIN STREET	MERIDEN	CT	06451	04/01/2022	07/07/2024
CH047000	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2022	07/07/2024
CH047000	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2022	07/07/2024
CH047000	IC PHARMACY LLC	AMAZON PHARMACY #004	34 35TH STREET STE 4BSW, UNIT 28	BROOKLYN	NY	11232	10/01/2024
CH047000	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	10/01/2018
CH047000	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	04/01/2022
CH047000	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	04/01/2024
CH047000	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	10/01/2024
CH047000	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	10/01/2024
CH047000	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	04/01/2022
CH047000	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	04/01/2022	01/01/2023
CH047000	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2022
CH047000	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	10/01/2018
CH047000	PILLPACK LLC	AMAZON PHARMACY #005	20416 72ND AVE S	KENT	WA	98032-2319	10/01/2024
CH047000	RON GROUP	D/B/A BLUE SKY SPECIALTY PHARMACY	1501 BELLE ISLE AVE STE 150	MOUNT PLEASANT	SC	29464	01/01/2022	06/01/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03851	707 CHURCH STREET	CONWAY	SC	29526	01/01/2020	07/07/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07654	2996 E. HWY 501	CONWAY	SC	29526	01/01/2020	07/07/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03855	236 W. MCINTYRE ST.	MULLINS	SC	29574	01/01/2020	07/07/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07531	206 S. MAIN ST./PO BOX 901	HEMINGWAY	SC	29554	01/01/2020	07/07/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01140	101 FETLOCK DR.	MYRTLE BEACH	SC	29588	01/01/2020	03/13/2023
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04150	700 N. MAIN ST	MARION	SC	29571	01/01/2020	07/07/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07040	2492 HWY 9 EAST	LITTLE RIVER	SC	29566	04/01/2020	10/01/2023
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07386	512 SOUTH KINGS HWY	MYRTLE BEACH	SC	29577	04/01/2020	01/02/2021
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03863	301 WEST THOMAS ST.	LAKE CITY	SC	29560	04/01/2020	02/29/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04071	733 S. IRBY ST.	FLORENCE	SC	29501	04/01/2020	02/29/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07359	405 N. FRASER ST.	GEORGETOWN	SC	29440	04/01/2020	01/13/2022
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05515	601 HWY 17 NORTH	SURFSIDE BEACH	SC	29575	04/01/2020	01/13/2022
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01194	4767 BROAD ST.	LORIS	SC	29569	04/01/2020	10/01/2023
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07384	120 NORTH LONGSTREET ST.	KINGSTREE	SC	29556	04/01/2020	02/29/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07609	3306 WEST PALMETTO ST.	FLORENCE	SC	29501	07/01/2020	02/29/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05524	1370 HWY 17	LITTLE RIVER	SC	29566	07/01/2020	10/01/2023
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01540	3411 SOCASTEE BLVD.	MYRTLE BEACH	SC	29588	07/01/2020	01/13/2022
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02353	800 PAMPLICO HIGHWAY	FLORENCE	SC	29505	07/01/2020	01/13/2022
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07386	512 SOUTH KINGS HWY	MYRTLE BEACH	SC	29577	04/01/2022	01/18/2022
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05516	1303 38TH AVE. N.	MYRTLE BEACH	SC	29577	04/01/2022	02/29/2024
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03851	707 CHURCH STREET	CONWAY	SC	29526	01/01/2025
CH047000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04150	700 N. MAIN ST	MARION	SC	29571	01/01/2025
CH047000	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2019	06/01/2024
CH047000	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2025
CH047000	WAL-MART PHARMACY 10-0586	2709-A CHURCH STREET		CONWAY	SC	29526	10/01/2019	06/01/2024
CH047000	WAL-MART PHARMACY 10-0586	2709-A CHURCH STREET		CONWAY	SC	29526	01/01/2025
CH047000	WAL-MART PHARMACY 10-1829	305 COMMERCE DRIVE		MARION	SC	29571	10/01/2019	06/01/2024
CH047000	WAL-MART PHARMACY 10-1829	305 COMMERCE DRIVE		MARION	SC	29571	01/01/2025
CH047000	WAL-MART PHARMACY 10-5923	3650 WALTON DRIVE		MYRTLE BEACH	SC	29577	10/01/2019	10/01/2023
CH047000	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2019	06/01/2024
CH047000	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2025
CH047000	WALGREEN CO.	DBA: WALGREENS #09761	502 GAPWAY	MULLINS	SC	29574-3414	04/01/2020	06/11/2020
CH047000	WALGREEN CO.	DBA: WALGREENS # 07154	1601 CHURCH STREET	CONWAY	SC	29526-2959	04/01/2020	07/07/2024
CH047000	WALGREEN CO.	DBA: WALGREENS # 07626	2498 2ND LOOP ROAD	FLORENCE	SC	29501-6162	10/01/2020	07/07/2024
CH047000	WALGREEN CO.	WALGREENS #17460	1905 HIGHWAY 544	CONWAY	SC	29526	10/01/2020	07/07/2024
CH047000	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023	06/01/2024
CH047000	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023	10/01/2023
CH047000	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2025
CH047000	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024	06/01/2024
CH047000	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Addresses	Billing Address	Insert	Change Request		HEALTH CARE PARTNERS OF S.C. INC. 1708 OAK STREET CONWAY, SC 29526	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC010	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC128	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC150	2/27/2025 4:56 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1043395346	2/27/2025 4:56 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1639255631	2/27/2025 4:56 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1770668824	2/27/2025 4:56 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	2/27/2025 4:56 PM
Contacts	Signed By	Insert	New Registration		Mayo, Santina Chief Executive Officer Health Care Partners of SC 8434886034	1/24/2025 6:28 AM
Details	340B ID	Update	New Registration		CH04700N	1/24/2025 6:28 AM
Dates	Participating Approval Date	Update	New Registration		1/24/2025 6:28:01 AM	1/24/2025 6:28 AM
Details	State	Update	New Registration	Pending	Approved	1/24/2025 6:28 AM
Dates	Signed By Date	Update	New Registration		1/13/2025 9:32:17 AM	1/24/2025 6:28 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/24/2025 6:28 AM
Addresses	Main Address	Insert	New Registration		1606 Main Street UNIT B Conway, SC 29526-2952	1/7/2025 3:59 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/7/2025 3:59 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		758617	1/7/2025 3:59 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		SC	1/7/2025 3:59 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1457436628	1/7/2025 3:59 PM
Medicaid Billing	NPI: State	Insert	New Registration		SC	1/7/2025 3:59 PM
Contacts	Primary Contact	Insert	New Registration		Odom, Joseph Hamilton Director of Pharmacy Health Care Partners of South Carolina, Inc. - Conway Office Pharmacy 8434388399	1/7/2025 3:59 PM
Contacts	Authorizing Official	Insert	New Registration		Mayo, Santina Chief Executive Officer Health Care Partners of SC 8434886034	1/7/2025 3:59 PM
Details	Assistance Received From Date	Insert	New Registration			1/7/2025 3:59 PM
Details	Assistance Received To Date	Insert	New Registration			1/7/2025 3:59 PM
Details	Last Recertification Date	Insert	New Registration			1/7/2025 3:59 PM
Details	Grant Number	Insert	New Registration		H80CS00411	1/7/2025 3:59 PM
Details	340B ID	Insert	New Registration			1/7/2025 3:59 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/7/2025 3:59 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/7/2025 3:59 PM
Details	Medicare Provider Number	Insert	New Registration			1/7/2025 3:59 PM
Details	Entity Name	Insert	New Registration		Health Care Partners of South Carolina, Inc.	1/7/2025 3:59 PM
Details	NOFO Number	Insert	New Registration			1/7/2025 3:59 PM
Details	Program Code	Insert	New Registration		CH	1/7/2025 3:59 PM
Details	Entity Subname	Insert	New Registration		Health Care Partners of South Carolina Mobile Eye Care Center	1/7/2025 3:59 PM
Dates	Participating Approval Date	Insert	New Registration			1/7/2025 3:59 PM
Details	State	Insert	New Registration		Pending	1/7/2025 3:59 PM
Dates	Registration Date	Insert	New Registration		1/7/2025 3:59:20 PM	1/7/2025 3:59 PM
Dates	Signed By Date	Insert	New Registration			1/7/2025 3:59 PM
Dates	Start Date	Insert	New Registration			1/7/2025 3:59 PM
Terminations	Termination Comments	Insert	New Registration			1/7/2025 3:59 PM
Terminations	Termination Date	Insert	New Registration			1/7/2025 3:59 PM
Terminations	Termination Effective Date	Insert	New Registration			1/7/2025 3:59 PM
Terminations	Termination Reason	Insert	New Registration			1/7/2025 3:59 PM

340B Drug Pricing Program Database