Covered Entity Details

CH05157BF THE CINCINNATI HEALTH NETWORK, INC. (Approved) - information as of 5/6/2025 12:03:40 AM

Main Details

Name

THE CINCINNATI HEALTH NETWORK, INC.

Subdivision Name

Bethany House

Type

HRSA-Funded Health Center

Site ID

BPS-H80-038746

340B ID

CH05157BF

Grant Number

H80CS00189

Additional Details

Current Program Status

Approved

Registration Date

4/1/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/2/2025

Last Recertification Date

Contacts

Authorizing Official

Cincinnati Health Network
Brian VanderHorst, Chief Executive Officer
(513) 961-0600 Ext: 309

Primary Contact

Cincinnati Health Network
Charity Gutierrez, Chief Operating Officer
(513) 961-0600 Ext: 305

Addresses

Street Address

4769 Reading Rd
Cincinnati, OH 45237-6107

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?
Yes

State	Medicaid Number	NPI Number
OH	0089409	1255155388

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
CH05157BB	Active	BPS-H80-021697	CINCINNATI HEALTH NETWORK INC, THE	CENTER FOR RESPITE CARE	1615 Republic St	CINCINNATI	OH
CH05157BC	Active	BPS-H80-001132	CINCINNATI HEALTH NETWORK INC, THE	MCMICKEN HEALTH COLLABORATIVE	40 E MCMICKEN AVE	CINCINNATI	OH
CH05157BD	Active	BPS-H80-017607	CINCINNATI HEALTH NETWORK INC, THE	SHELTERHOUSE	411 Gest Street	Cincinnati	OH
CH05157BE	Active	BPS-H80-021354	CINCINNATI HEALTH NETWORK INC, THE	SHELTERHOUSE-Hatton Center for Women	2499 Reading Rd	Cincinnati	OH
CH05157BF	Approved	BPS-H80-038746	THE CINCINNATI HEALTH NETWORK, INC.	Bethany House	4769 Reading Rd	Cincinnati	OH
CH05157BG	Active	BPS-H80-021696	CINCINNATI HEALTH NETWORK INC, THE	CARACOLE CLINIC	4138 Hamilton Ave	Cincinnati	OH

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH05157BB	CINCINNATI HEALTH DEPARTMENT	D.B.A ELM STREET HEALTH CENTER PHARMACY	1525 ELM ST ELM STREET HEALTH CENTER PHARMACY	CINCINNATI	OH	45202	10/01/2015
CH05157BC	CINCINNATI HEALTH DEPARTMENT	D.B.A ELM STREET HEALTH CENTER PHARMACY	1525 ELM ST ELM STREET HEALTH CENTER PHARMACY	CINCINNATI	OH	45202	10/01/2015
CH05157BD	CINCINNATI HEALTH DEPARTMENT	D.B.A ELM STREET HEALTH CENTER PHARMACY	1525 ELM ST ELM STREET HEALTH CENTER PHARMACY	CINCINNATI	OH	45202	10/01/2018
CH05157BE	CINCINNATI HEALTH DEPARTMENT	D.B.A ELM STREET HEALTH CENTER PHARMACY	1525 ELM ST ELM STREET HEALTH CENTER PHARMACY	CINCINNATI	OH	45202	10/01/2018
CH05157BG	CINCINNATI HEALTH DEPARTMENT	D.B.A ELM STREET HEALTH CENTER PHARMACY	1525 ELM ST ELM STREET HEALTH CENTER PHARMACY	CINCINNATI	OH	45202	10/01/2018
CH05157BB	PHARMACY OVER THE RHINE	PHARMACY OVER THE RHINE	5 E LIBERTY ST STE 1	CINCINNATI	OH	45202	01/05/2010	10/01/2015

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		VanderHorst, Brian Chief Executive Officer Cincinnati Health Network 5139610600-309	4/2/2025 11:42 AM
Details	340B ID	Update	New Registration		CH05157BF	4/2/2025 11:42 AM
Dates	Participating Approval Date	Update	New Registration		4/2/2025 11:42:04 AM	4/2/2025 11:42 AM
Details	State	Update	New Registration	Pending	Approved	4/2/2025 11:42 AM
Dates	Signed By Date	Update	New Registration		4/1/2025 9:48:42 AM	4/2/2025 11:42 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/2/2025 11:42 AM
Addresses	Main Address	Insert	New Registration		4769 Reading Rd Cincinnati, OH 45237-6107	4/1/2025 9:48 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2025 9:48 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0089409	4/1/2025 9:48 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		OH	4/1/2025 9:48 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1255155388	4/1/2025 9:48 AM
Medicaid Billing	NPI: State	Insert	New Registration		OH	4/1/2025 9:48 AM
Contacts	Authorizing Official	Insert	New Registration		VanderHorst, Brian Chief Executive Officer Cincinnati Health Network 5139610600-309	4/1/2025 9:48 AM
Contacts	Primary Contact	Insert	New Registration		Gutierrez, Charity Chief Operating Officer Cincinnati Health Network 5139610600-305	4/1/2025 9:48 AM
Details	Assistance Received From Date	Insert	New Registration			4/1/2025 9:48 AM
Details	Assistance Received To Date	Insert	New Registration			4/1/2025 9:48 AM
Details	Last Recertification Date	Insert	New Registration			4/1/2025 9:48 AM
Details	Grant Number	Insert	New Registration		H80CS00189	4/1/2025 9:48 AM
Details	340B ID	Insert	New Registration			4/1/2025 9:48 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/1/2025 9:48 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/1/2025 9:48 AM
Details	Medicare Provider Number	Insert	New Registration			4/1/2025 9:48 AM
Details	Entity Name	Insert	New Registration		THE CINCINNATI HEALTH NETWORK, INC.	4/1/2025 9:48 AM
Details	NOFO Number	Insert	New Registration			4/1/2025 9:48 AM
Details	Program Code	Insert	New Registration		CH	4/1/2025 9:48 AM
Details	Entity Subname	Insert	New Registration		Bethany House	4/1/2025 9:48 AM
Dates	Participating Approval Date	Insert	New Registration			4/1/2025 9:48 AM
Details	State	Insert	New Registration		Pending	4/1/2025 9:48 AM
Dates	Registration Date	Insert	New Registration		4/1/2025 9:48:42 AM	4/1/2025 9:48 AM
Dates	Signed By Date	Insert	New Registration			4/1/2025 9:48 AM
Dates	Start Date	Insert	New Registration			4/1/2025 9:48 AM
Terminations	Termination Comments	Insert	New Registration			4/1/2025 9:48 AM
Terminations	Termination Date	Insert	New Registration			4/1/2025 9:48 AM
Terminations	Termination Effective Date	Insert	New Registration			4/1/2025 9:48 AM
Terminations	Termination Reason	Insert	New Registration			4/1/2025 9:48 AM

340B Drug Pricing Program Database