340B Drug Pricing Program Database


CH041279T RURAL HEALTH SERVICES CONSORTIUM, INC (Active) - information as of 4/29/2025 1:40:30 AM

Main Details
RURAL HEALTH SERVICES CONSORTIUM, INC
RHSC Medical Complex at Kingsport
HRSA-Funded Health Center
BPS-H80-033837
CH041279T
H80CS00421


Additional Details
Active
2/4/2025
4/1/2025
2/6/2025

Contacts

Rural Health Services Consortium, Inc.
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901

Rural Health Services Consortium
Tara Worley, Pharmacist
(423) 921-1621

Addresses

1000 E Center St
Kingsport, TN 37660-4973

Rural Health Services Consortium
4966 Hwy 11 W PO Box 850
Rogersville, TN 37857


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
TNQ098781,3703860,444-80701619649753,1730189549
Shipping Addresses

RHSC Medical Complex at Kingsport Pharmacy
1000 E Center Street
Kingsport, TN 37660

Rural Health Services Pharmacy
4307 Hwy 66 S
Rogersville, TN 37857
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH0412790ActiveBPS-H80-004665RURAL HEALTH SERVICES CONSORTIUMHAWKINS MEDICAL CENTER4966 HIGHWAY 11 WEST ROGERSVILLETN
CH041279AActiveBPS-H80-002977RURAL HEALTH SERVICES CONSORTIUMROAN MOUNTAIN MEDICAL CENTER152 HIGHWAY 143 ROAN MOUNTAINTN
CH041279BActiveBPS-H80-004522RURAL HEALTH SERVICES CONSORTIUMBULLS GAP MEDICAL CENTER260HWY 11-E BULLS GAPTN
CH041279CActiveBPS-H80-004627RURAL HEALTH SERVICES CONSORTIUM, INC.BLUFF CITY MEDICAL CENTER229 Highway 19 E Bluff CityTN
CH041279DActiveBPS-H80-009027RURAL HEALTH SERVICES CONSORTIUMSNEEDVILLE MEDICAL CENTER1861 MAIN STREET SNEEDVILLETN
CH041279EActiveBPS-H80-002358RURAL HEALTH SERVICES CONSORTIUM, INC.BAILEYTON MEDICAL CENTER580 Van Hill Rd GreenevilleTN
CH041279HActiveBPS-H80-002814RURAL HEALTH SERVICES CONSORTIUMMOUNTAIN CITY MEDICAL CENTER222 OAK STREET MOUNTAIN CITYTN
CH041279IActiveBPS-H80-003447RURAL HEALTH SERVICES CONSORTIUM, INC.DRY CREEK MEDICAL CENTER1826 N Main Ave ErwinTN
CH041279JActiveBPS-H80-000455RURAL HEALTH SERVICES CONSORTIUM, INC.KINGSPORT MEDICAL CENTER737 E Sevier Ave KingsportTN
CH041279KActiveBPS-H80-000513RURAL HEALTH SERVICES CONSORTIUMLIMESTONE MEDICAL CENTER105 LIMESTONE RURITAN RD. LIMESTONETN
CH041279NActiveBPS-H80-008682RURAL HEALTH SERVICES CONSORTIUM, INC.Rogersville Medical Complex4307 Hwy 66S RogersvilleTN
CH041279PActiveBPS-H80-021040Rural Health Services Consortium, Inc.Camp Creek Medical Center2994 Camp Creek Rd GreenevilleTN
CH041279QActiveBPS-H80-017968Rural Health Services Consortium, Inc.Mobile Unit 24966 Highway 11w RogersvilleTN
CH041279RActiveBPS-H80-008658Rural Health Services Consortium, Inc.H.C. Mobile Unit #14966 Hwy 11 W RogersvilleTN
CH041279SActiveBPS-H80-035807Rural Health Services Consortium, Inc.RHSC Medical Center at Jonesborough600 Boones Creek Rd JonesboroughTN
CH041279TActiveBPS-H80-033837RURAL HEALTH SERVICES CONSORTIUM, INCRHSC Medical Complex at Kingsport1000 E Center St KingsportTN
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH0412790ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/01/2022  
CH0412790ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/01/2022  
CH0412790ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2022  
CH0412790ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/01/2022  
CH0412790ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624110/01/2022  
CH0412790ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/01/2022  
CH0412790ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607510/01/2022  
CH0412790ADAMS PHARMACY LLC851 S SHADY ST
MOUNTAIN CITYTN3768304/01/2020 12/01/2021
CH0412790AHSSHCEXPEDIEN RX PHARMACY 5050 WESLEY RD STE 120
APOPKAFL3271204/01/2016  
CH0412790AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291104/01/2019  
CH0412790AMAZON PHARMACY #0063620 PLAINFIELD RD
INDIANAPOLISIN46231-700310/01/2024  
CH0412790AMAZON PHARMACY #008408 TECHNOLOGY PARKWAY BUILDING B, STE 101
COLLEGE STATIONTX7784510/01/2024  
CH0412790AMAZON PHARMACY #0097469 KINGSPOINTE PKWY STE 400
ORLANDOFL3281910/01/2024  
CH0412790AMAZON PHARMACY #0101331 E 6TH ST
CORONACA9287910/01/2024  
CH0412790APPALACHIAN SPECIALTY PHARMACY932 HENDERSONVILLE RD STE 106
ASHEVILLENC28803-661907/01/2020 05/21/2024
CH0412790AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062104/01/2016 09/24/2024
CH041279NAVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508501/01/2018  
CH0412790AVELLA OF ORLANDO100 TECHNOLOGY PARK STE 155
LAKE MARYFL32746-620504/01/2016 09/24/2024
CH0412790AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2019  
CH0412790BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526104/01/2024  
CH0412790BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771304/01/2024  
CH0412790BIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267004/01/2024  
CH0412790BISE PLLCD/B/A SURGOINSVILLE PHARMACY 114 BELLAMY AVE
SURGOINSVILLETN37873-270011/14/2014 05/21/2024
CH0412790BULLS GAP DRUGS412 HWY 11E
BULLS GAPTN3771101/01/2013  
CH041279BBULLS GAP DRUGS412 HWY 11E
BULLS GAPTN3771109/08/2010  
CH0412790CHURCH HILL DRUG STOREP.O. BOX 208 104 EAST MAIN STREET
CHURCH HILLTN3764201/01/2021  
CH0412790CORLEY'S PHARMACY INC1004 SNAPPS FERRY RD PO BOX 874
GREENEVILLETN37744-087401/01/2015 05/21/2024
CH041279ECORLEY'S PHARMACY INC1004 SNAPPS FERRY RD PO BOX 874
GREENEVILLETN37744-087410/06/2010  
CH041279KCORLEY'S PHARMACY INC1004 SNAPPS FERRY RD PO BOX 874
GREENEVILLETN37744-087409/30/2010  
CH0412790CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2022  
CH0412790CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2022  
CH0412790DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200
MT PROSPECTIL6005601/01/2017 03/05/2020
CH0412790DOGWOOD PHARMACY LLCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER RD
STE K
GREENVILLESC29607-654104/01/2024  
CH0412790ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/01/2022  
CH0412790EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/01/2022  
CH0412790EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2022  
CH0412790EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2022  
CH0412790FOOD CITY PHARMACY #603731 HIGHWAY 11 W
CHURCH HILLTN3764201/01/2016  
CH0412790FOOD CITY PHARMACY #657300 CLINCHFIELD STREET
KINGSPORTTN3766010/15/2012  
CH0412790GENOA HEALTHCARE LLC310 W 3RD NORTH ST SUITE PHARM
MORRISTOWNTN3781401/01/2024  
CH0412790GENOA HEALTHCARE LLC205 W. SPRINGDALE AVE.
KNOXVILLETN3791701/01/2024  
CH0412790IC PHARMACY LLCAMAZON PHARMACY #004 34 35TH STREET
STE 4BSW, UNIT 28
BROOKLYNNY1123210/01/2024  
CH0412790M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2019  
CH0412790MED CENTER PHARMACY900 WEST MAIN STREET SUITE 2
ROGERSVILLETN37857-378510/12/2012 06/28/2019
CH041279HMOUNTAIN CITY PHARMACY1641 S SHADY ST
MOUNTAIN CITYTN3768309/30/2010  
CH0412790MOUNTAIN CITY PHARMACY1641 S SHADY ST
MOUNTAIN CITYTN3768304/12/2011  
CH041279KMOUNTAIN CITY PHARMACY1641 S SHADY ST
MOUNTAIN CITYTN3768305/04/2023  
CH0412790NORTH CAROLINA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05558 325 PINEOLA STREET/PO BOX 552
NEWLANDNC2865710/01/2022  
CH0412790OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276501/01/2024  
CH0412790OPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302501/01/2024  
CH0412790OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520401/01/2025  
CH0412790OPTUM PHARMACY 705, LLC3539 BLUECUTT RD
COLUMBUSMS3970510/01/2023  
CH0412790OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729810/01/2023  
CH0412790OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265501/01/2025  
CH0412790OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983801/01/2024  
CH0412790P&S PHARMACY INCDBA U-SAVE DRUGS & HOSPICE 4017 HIGHWAY 66 S STE 7
HIGHWAY 66 SHOPPING CENTER
ROGERSVILLETN37857-319609/08/2010  
CH041279DP&S PHARMACY INCDBA U-SAVE DRUGS & HOSPICE 4017 HIGHWAY 66 S STE 7
HIGHWAY 66 SHOPPING CENTER
ROGERSVILLETN37857-319601/01/2024  
CH0412790PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310107/01/2018 08/14/2018
CH0412790PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2019  
CH0412790PILLPACK LLCAMAZON PHARMACY #005 20416 72ND AVE S
KENTWA98032-231910/01/2024  
CH0412790PREMIER PHARMACY INC.107 ESTATOA AVE PO BOX 580
NEWLANDNC2865704/01/2021  
CH0412790RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255004/01/2024  
CH0412790RITE AID OF TENNESSEE, INC.RITE AID #114 1252 NORTH MAIN STREET
ERWINTN3765009/07/2012 01/03/2018
CH0412790RITE AID OF TENNESSEE, INC.RITE AID #3344 1267 MAIN STREET
P.O. BOX 95
SNEEDVILLETN3786909/07/2012 01/03/2018
CH0412790RITE AID OF TENNESSEE, INC.RITE AID #3418 1255 HIGHWAY 11 WEST
BEAN STATIONTN3770809/07/2012 01/03/2018
CH0412790RITE AID OF TENNESSEE, INC.RITE AID #1297 103 NORTH SHADY STREET
MOUNTAIN CITYTN3768309/07/2012 01/03/2018
CH0412790RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500204/01/2024  
CH0412790ROAN MOUNTAIN PHARMACY8251 HWY 19E
ROAN MOUNTAINTN37687-334304/12/2011 08/12/2019
CH041279AROAN MOUNTAIN PHARMACY8251 HWY 19E
ROAN MOUNTAINTN37687-334310/27/2010 08/12/2019
CH0412790ROAN MOUNTAIN PHARMACY8251 HIGHWAY 19 E
ROAN MOUNTAINTN3768708/12/2019  
CH041279AROAN MOUNTAIN PHARMACY8251 HIGHWAY 19 E
ROAN MOUNTAINTN3768705/04/2023  
CH0412790ROLLER PHARMACY INC109 N. MAIN AVE
ERWINTN3765010/12/2012  
CH041279NRURAL HEALTH SERVICES PHCY4307 HIGHWAY 66 S
ROGERSVILLETN3785707/01/2014 11/09/2015
CH0412790SANTA BARBARA SPECIALTY PHARMACY LLC4690 CARPINTERIA AVE STE B
CARPINTERIACA9301304/01/2024  
CH041279DSMITH-TURNER DRUG STORE INC140 CHURCH ST
SNEEDVILLETN3786909/30/2010  
CH0412790SMITH-TURNER DRUG STORE INC140 CHURCH ST
SNEEDVILLETN3786904/08/2011  
CH041279RSMITH-TURNER DRUG STORE INC140 CHURCH ST
SNEEDVILLETN3786905/04/2023  
CH041279ESMITH-TURNER DRUG STORE INC140 CHURCH ST
SNEEDVILLETN3786901/01/2024  
CH0412790SNAPPS FERRY PHARMACY, INC. DBA CORLEY'S1004 SNAPPS FERRY RD
GREENEVILLETN3774504/01/2017  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07276 917 N. MAIN ST.
ERWINTN3765010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07738 506 ASHEVILLE HWY
GREENEVILLETN3774310/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04240 4400 W. STONE DRIVE
KINGSPORTTN3766010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06357 1379 VOLUNTEER PKWY
BRISTOLTN3762010/01/2022 06/13/2023
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07280 1100 WEST ELK AVE.
ELIZABETHTONTN3764310/01/2022 11/07/2024
CH0412790TENNESSEE CVS PHARMACY, L.L.C.CVS PHARMACY # 17398 2626 E STONE DR SUITE 90
KINGSPORTTN3766010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07655 1161 US HWY 19 E
ELIZABETHTONTN3764310/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03726 3030 WEST STATE STREET
BRISTOLTN3762010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07639 5215 MEMORIAL BLVD., SUITE 20
KINGSPORTTN3766410/01/2022 02/22/2024
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04130 128 W. STONE DR.
KINGSPORTTN3766010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03489 5674 HWY 11-E SUITE F
PINEY FLATSTN3768610/01/2022 07/01/2024
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07714 308 E. CEDAR ST
BRISTOLTN3762010/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03792 420 PARK BLVD., #5
ROGERSVILLETN3785710/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03791 1510 E. ANDREW JOHNSON HWY.
GREENEVILLETN3774510/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07226 2114 E. ANDREW JOHNSON HWY.
MORRISTOWNTN3781410/01/2022  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05664 4106 FT. HENRY DR.
KINGSPORTTN3766310/01/2022  
CH041279BTENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03489 5674 HWY 11-E SUITE F
PINEY FLATSTN3768605/04/2023  
CH041279ITENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03792 420 PARK BLVD., #5
ROGERSVILLETN3785705/04/2023  
CH041279BTENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03792 420 PARK BLVD., #5
ROGERSVILLETN3785701/01/2024  
CH041279STENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04130 128 W. STONE DR.
KINGSPORTTN3766004/01/2024  
CH0412790TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07235 4209 N ROAN ST.,
JOHNSON CITYTN3760110/01/2024  
CH0412790VALUE RX SNEEDVILLE LLC. #41400 MAIN ST.
SNEEDVILLETN3786907/01/2017  
CH041279JVALUE RX SNEEDVILLE LLC. #41400 MAIN ST.
SNEEDVILLETN3786905/04/2023  
CH0412790WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2018  
CH0412790WAL-MART PHARMACY 10-05993200 FORT HENRY DR
KINGSPORTTN3766410/01/2018  
CH041279QWAL-MART PHARMACY 10-05993200 FORT HENRY DR
KINGSPORTTN3766405/04/2023  
CH0412790WAL-MART PHARMACY 10-0620220 CENTURY BLVD
BRISTOLTN3762004/01/2013  
CH0412790WAL-MART PHARMACY 10-06803755 E. ANDREW JOHNSON HWY
GREENVILLETN3774504/01/2013  
CH0412790WAL-MART PHARMACY 10-0685475 SO. DAVY CROCKETT PKWY.
MORRISTOWNTN3781310/01/2018  
CH0412790WAL-MART PHARMACY 10-06901001 OVER MOUNTAIN AVENUE
ELIZABETHTONTN3764304/01/2013  
CH0412790WAL-MART PHARMACY 10-07422500 WEST STONE DRIVE
KINGSPORTTN3766010/01/2018  
CH0412790WAL-MART PHARMACY 10-32344331 HIGHWAY 66
ROGERSVILLETN3785709/21/2012  
CH041279AWAL-MART PHARMACY 10-32344331 HIGHWAY 66
ROGERSVILLETN3785701/01/2024  
CH0412790WAL-MART PHARMACY 10-3852110 ROCKY BOTTOM RD.
UNICOITN3769210/01/2018  
CH0412790WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2018  
CH0412790WALGREEN CO.DBA: WALGREENS # 04330 121 N. NORTHSHORE DRIVE
KNOXVILLETN3791904/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 05347 2412 W. STATE STREET
BRISTOLTN3762004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 05597 2200 MEMORIAL BLVD.
KINGSPORTTN3766404/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 05828 1420 W STONE DR
KINGSPORTTN3766004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 06256 1430 S ROAN ST
JOHNSON CITYTN3760104/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 06788 1959 W ANDREW JOHNSON HWY
MORRISTOWNTN3781404/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 07049 1650 E ANDREW JOHNSON HWY
GREENEVILLETN37745-427404/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 07285 2240 N ROAN STREET
JOHNSON CITYTN37601-252104/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 09046 1560 LEE HWY
BRISTOLVA2420104/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 09306 3900 FORT HENRY DRIVE
COLONIAL HEIGHTSTN37663-202604/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 09428 4500 W STONE DRIVE
KINGSPORTTN3766004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 09429 214 BROAD ST
ELIZABETHTONTN37643-271404/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 09459 6740 BRISTOL HWY
PINEY FLATSTN3768604/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #10192 1388 VOLUNTEER PKWY.
BRISTOLTN37620-570004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 10299 401 N MAIN AVE
ERWINTN37650-120704/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS # 10330 2340 HWY 394
BLOUNTVILLETN3761704/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #10918 4210 N. ROAN ST.
JOHNSON CITYTN37601-113004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #10960 4325 HIGHWAY 66 S
ROGERSVILLETN37857-315504/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #11113 5104 BOBBY HICKS HWY.
GRAYTN37615-621704/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #11813 251 S CUMBERLAND ST
MORRISTOWNTN3781304/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #11907 104 ASHEVILLE HWY.
GREENEVILLETN37743-460204/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #12373 606 N. BROADWAY ST.
JOHNSON CITYTN37601-353504/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #12858 2103 E. ANDREW JOHNSON HWY.
MORRISTOWNTN37814-541104/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #12934 2790 E. STONE DR.
KINGSPORTTN3766004/01/2013  
CH0412790WALGREEN CO.DBA: WALGREENS #13891 429 N. STATE OF FRANKLIN RD.
JOHNSON CITYTN3760404/01/2013  
CH0412790WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #13980 130 W. RAVINE STE #101
KINGSPORTTN3766004/01/2013  
CH0412790WALGREEN CO.WALGREENS #18327 103 NORTH SHADY STREET
MOUNTAIN CITYTN3768301/04/2018  
CH0412790WALGREEN CO.DBA: WALGREENS #17991 1267 MAIN STREET
P.O. BOX 95
SNEEDVILLETN3786901/04/2018 11/07/2022
CH0412790WALGREEN CO.DBA: WALGREENS #17569 1149 HIGHWAY 11W
BEAN STATIONTN3770801/04/2018  
CH0412790WALGREEN CO.RITE AID #00114 1252 NORTH MAIN STREET
ERWINTN3765001/04/2018 08/09/2018
CH0412790WALGREEN CO.DBA: WALGREENS #13660 531 E. JACKSON BLVD.
JONESBOROUGHTN3765904/01/2021  
CH041279HWALGREEN CO.DBA: WALGREENS # 07049 1650 E ANDREW JOHNSON HWY
GREENEVILLETN37745-427405/04/2023  
CH041279CWALGREEN CO.DBA: WALGREENS # 09459 6740 BRISTOL HWY
PINEY FLATSTN3768607/01/2023 05/08/2023
CH041279PWALGREEN CO.DBA: WALGREENS #10960 4325 HIGHWAY 66 S
ROGERSVILLETN37857-315505/04/2023  
CH041279DWALGREEN CO.DBA: WALGREENS # 10330 2340 HWY 394
BLOUNTVILLETN3761707/01/2023 05/04/2023
CH041279EWALGREEN CO.DBA: WALGREENS # 05828 1420 W STONE DR
KINGSPORTTN3766005/04/2023  
CH041279DWALGREEN CO.DBA: WALGREENS # 10330 2340 HWY 394
BLOUNTVILLETN3761705/04/2023  
CH041279CWALGREEN CO.DBA: WALGREENS # 09459 6740 BRISTOL HWY
PINEY FLATSTN3768605/09/2023  
CH041279CWALGREEN CO.DBA: WALGREENS #10960 4325 HIGHWAY 66 S
ROGERSVILLETN37857-315501/01/2024  
CH041279RWALGREEN CO.DBA: WALGREENS #17569 1149 HIGHWAY 11W
BEAN STATIONTN3770804/01/2024  
CH041279CWALGREEN CO.DBA: WALGREENS # 09429 214 BROAD ST
ELIZABETHTONTN37643-271404/01/2024  
CH041279KWALGREEN CO.WALGREENS #18327 103 NORTH SHADY STREET
MOUNTAIN CITYTN3768304/01/2024  
CH041279BWALGREEN CO.DBA: WALGREENS # 05828 1420 W STONE DR
KINGSPORTTN3766004/01/2024  
CH0412790WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528404/01/2013 07/07/2015
CH0412790WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275604/01/2023  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate ApprovedActive4/1/2025 12:01 AM
AddressesBilling AddressInsertChange Request Rural Health Services Consortium 4966 Hwy 11 W PO Box 850 Rogersville, TN 378572/7/2025 12:47 PM
AddressesShipping AddressInsertChange Request RHSC Medical Complex at Kingsport Pharmacy 1000 E Center Street Kingsport, TN 376602/7/2025 12:47 PM
AddressesShipping AddressInsertChange Request Rural Health Services Pharmacy 4307 Hwy 66 S Rogersville, TN 378572/7/2025 12:47 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False2/7/2025 12:47 PM
Medicaid BillingMedicaid: NumberInsertChange Request 37038602/7/2025 12:47 PM
Medicaid BillingMedicaid: StateInsertChange Request TN2/7/2025 12:47 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False2/7/2025 12:47 PM
Medicaid BillingMedicaid: NumberInsertChange Request 444-80702/7/2025 12:47 PM
Medicaid BillingMedicaid: StateInsertChange Request TN2/7/2025 12:47 PM
ContactsSigned ByInsertNew Registration BUCK, LINDA W. CHIEF EXECUTIVE OFFICER Rural Health Services Consortium, Inc. 4232729163-89012/6/2025 8:04 AM
Details340B IDUpdateNew Registration CH041279T2/6/2025 8:04 AM
DatesParticipating Approval DateUpdateNew Registration 2/6/2025 8:04:13 AM2/6/2025 8:04 AM
DetailsStateUpdateNew RegistrationPendingApproved2/6/2025 8:04 AM
DatesSigned By DateUpdateNew Registration 2/4/2025 7:36:12 PM2/6/2025 8:04 AM
DatesStart DateUpdateNew Registration 4/1/2025 12:00:00 AM2/6/2025 8:04 AM
AddressesMain AddressInsertNew Registration  1000 E Center St Kingsport, TN 37660-49732/4/2025 11:09 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False2/4/2025 11:09 AM
Medicaid BillingMedicaid: NumberInsertNew Registration Q0987812/4/2025 11:09 AM
Medicaid BillingMedicaid: StateInsertNew Registration TN2/4/2025 11:09 AM
Medicaid BillingNPI: NumberInsertNew Registration 16196497532/4/2025 11:09 AM
Medicaid BillingNPI: StateInsertNew Registration TN2/4/2025 11:09 AM
Medicaid BillingNPI: NumberInsertNew Registration 17301895492/4/2025 11:09 AM
Medicaid BillingNPI: StateInsertNew Registration TN2/4/2025 11:09 AM
ContactsPrimary ContactInsertNew Registration Worley, Tara Pharmacist Rural Health Services Consortium 42392116212/4/2025 11:09 AM
ContactsAuthorizing OfficialInsertNew Registration BUCK, LINDA W. CHIEF EXECUTIVE OFFICER Rural Health Services Consortium, Inc. 4232729163-89012/4/2025 11:09 AM
DetailsAssistance Received From DateInsertNew Registration  2/4/2025 11:09 AM
DetailsAssistance Received To DateInsertNew Registration  2/4/2025 11:09 AM
DetailsLast Recertification DateInsertNew Registration  2/4/2025 11:09 AM
DetailsGrant NumberInsertNew Registration H80CS004212/4/2025 11:09 AM
Details340B IDInsertNew Registration  2/4/2025 11:09 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  2/4/2025 11:09 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  2/4/2025 11:09 AM
DetailsMedicare Provider NumberInsertNew Registration  2/4/2025 11:09 AM
DetailsEntity NameInsertNew Registration RURAL HEALTH SERVICES CONSORTIUM, INC2/4/2025 11:09 AM
DetailsNOFO NumberInsertNew Registration  2/4/2025 11:09 AM
DetailsProgram CodeInsertNew Registration CH2/4/2025 11:09 AM
DetailsEntity SubnameInsertNew Registration RHSC Medical Complex at Kingsport2/4/2025 11:09 AM
DatesParticipating Approval DateInsertNew Registration  2/4/2025 11:09 AM
DetailsStateInsertNew Registration Pending2/4/2025 11:09 AM
DatesRegistration DateInsertNew Registration 2/4/2025 11:09:46 AM2/4/2025 11:09 AM
DatesSigned By DateInsertNew Registration  2/4/2025 11:09 AM
DatesStart DateInsertNew Registration  2/4/2025 11:09 AM
TerminationsTermination CommentsInsertNew Registration  2/4/2025 11:09 AM
TerminationsTermination DateInsertNew Registration  2/4/2025 11:09 AM
TerminationsTermination Effective DateInsertNew Registration  2/4/2025 11:09 AM
TerminationsTermination ReasonInsertNew Registration  2/4/2025 11:09 AM