Covered Entity Details

CH03270AD KEYSTONE RURAL HEALTH CENTER (Approved) - information as of 4/30/2025 10:56:24 PM

Main Details

Name

KEYSTONE RURAL HEALTH CENTER

Subdivision Name

Keystone Medical Associates - Waynesboro

Type

HRSA-Funded Health Center

Site ID

BPS-H80-039895

340B ID

CH03270AD

Grant Number

H80CS00076

Additional Details

Current Program Status

Approved

Registration Date

4/2/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/3/2025

Last Recertification Date

Contacts

Authorizing Official

Keystone Rural Health Center
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906

Primary Contact

Keystone Rural Health Center
Suzanne Barnhart, 340B Director
(717) 709-7957

Addresses

Street Address

12104 Buchanan Trl E
Waynesboro, PA 17268-9429

Billing Address

Keystone Rural Health Center
111 Chambers Hill Dr, Suite 200
Chambersburg, PA 17201

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	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	WAYNESBORO APOTHECARY	604 E MAIN ST		WAYNESBORO	PA	17268	04/04/2025	07/01/2025			04/04/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH032700	Active	BPS-H80-027860	KEYSTONE RURAL HEALTH CENTER	ADMINISTRATION	111 Chambers Hill Drive, Suite 200		CHAMBERSBURG	PA
CH03270A	Active	BPS-H80-004379	KEYSTONE RURAL HEALTH CENTER	KEYSTONE DENTAL CARE	767 5TH AVE STE B-3A		CHAMBERSBURG	PA
CH03270AA	Active	BPS-H80-027665	Keystone Rural Health Center	Keystone Foot and Ankle Center Waynesboro	1905 Market Square Blvd		Waynesboro	PA
CH03270AB	Active	BPS-H80-027891	Keystone Rural Health Center	Keystone Pediatric Dental	111 Chambers Hill Dr Ste 202		Chambersburg	PA
CH03270AC	Active	BPS-H80-039546	KEYSTONE RURAL HEALTH CENTER	Keystone Internal Medicine - Waynesboro	1051 E Main St, Ste 2		Waynesboro	PA
CH03270AD	Approved	BPS-H80-039895	KEYSTONE RURAL HEALTH CENTER	Keystone Medical Associates - Waynesboro	12104 Buchanan Trl E		Waynesboro	PA
CH03270D	Active	BPS-H80-000650	KEYSTONE RURAL HEALTH CENTER	KEYSTONE FAMILY MEDICINE	820 5th Ave		Chambersburg	PA
CH03270F	Active	BPS-H80-010694	KEYSTONE RURAL HEALTH CENTER	Keystone Women's Care	830 5th Ave STE 202		Chambersburg	PA
CH03270G	Active	BPS-H80-010894	KEYSTONE RURAL HEALTH CENTER	Keystone Internal Medicine	830 Fifth Avenue STE 201		Chambersburg	PA
CH03270I	Active	BPS-H80-010693	KEYSTONE RURAL HEALTH CENTER	Keystone Pediatrics	830 Fifth Avenue STE 103		Chambersburg	PA
CH03270J	Active	BPS-H80-032391	KEYSTONE RURAL HEALTH CENTER	Keystone Agricultural Worker Program - Adams Co.	3375 Carlisle Rd		Gardners	PA
CH03270K	Active	BPS-H80-007428	KEYSTONE RURAL HEALTH CENTER	Keystone Agricultural Worker Program - Franklin Co.	820 5th Ave		Chambersburg	PA
CH03270L	Active	BPS-H80-006507	KEYSTONE RURAL HEALTH CENTER	Keystone Agricultural Worker Program - Columbia	301 W 3rd St		Berwick	PA
CH03270M	Active	BPS-H80-034066	KEYSTONE RURAL HEALTH CENTER	Keystone Agricultural Worker Program - Berks Co.	1981 State Hill Rd Ste 1		Wyomissing	PA
CH03270N	Terminated	BPS-H80-004398	KEYSTONE RURAL HEALTH CENTER	Keystone Crisis Intervention Program	112 N 7th St		Chambersburg	PA
CH03270R	Active	BPS-H80-033769	KEYSTONE RURAL HEALTH CENTER	KEYSTONE BEHAVIORAL HEALTH	100 Chambers Hill Dr Ste 200		Chambersburg	PA
CH03270S	Terminated	BPS-H80-010064	KEYSTONE RURAL HEALTH CENTER	Keystone Cardiology	755 Norland Avenue, Suite 201		Chambersburg	PA
CH03270T	Active	BPS-H80-027890	KEYSTONE RURAL HEALTH CENTER	Keystone Urgent Care	111 Chambers Hill Dr		Chambersburg	PA
CH03270U	Terminated	BPS-H80-018035	KEYSTONE RURAL HEALTH CENTER	Keystone Pediatric Therapies	3583 Scotland Road		Scotland	PA
CH03270V	Active	BPS-H80-018036	KEYSTONE RURAL HEALTH CENTER	Keystone Pediatrics Waynesboro	45 Roadside Avenue, Lowr level		Waynesboro	PA
CH03270W	Active	BPS-H80-018439	KEYSTONE RURAL HEALTH CENTER	Keystone School Health Center	511 S 6th St Health Center Suite		Chambersburg	PA
CH03270X	Active	BPS-H80-027888	KEYSTONE RURAL HEALTH CENTER	Keystone Community Health Services	111 Chambers Hill Dr		Chambersburg	PA
CH03270Y	Terminated	BPS-H80-019300	KEYSTONE RURAL HEALTH CENTER	Keystone Dental Mont Alto	6155 Anthony Highway Suite C		Waynesboro	PA
CH03270Z	Active	BPS-H80-037605	Keystone Rural Health Center	Keystone Foot and Ankle Center Chambersburg	100 Chambers Hill Dr.	STE 101	Chambersburg	PA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH032700	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2021
CH032700	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2021
CH032700	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2021
CH032700	ACCREDO HEALTH GROUP INC	520 ELMWOOD PARK BLVD STE 100		NEW ORLEANS	LA	70123-6826	01/01/2025
CH032700	ACCREDO HEALTH GROUP INC	190 TECHNOLOGY PKWY STE 120		NORCROSS	GA	30092-2914	04/01/2025
CH032700	ACCREDO HEALTH GROUP INC	212 CARPENTERS UNION WAY	SUITE 500	LAS VEGAS	NV	89119-4231	04/01/2025
CH032700	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2021
CH032700	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2021
CH032700	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	01/01/2021	07/01/2023
CH032700	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2024
CH032700	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	04/01/2024
CH032700	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/01/2023
CH032700	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/01/2023
CH032700	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/01/2023
CH032700	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/01/2023
CH032700	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/01/2023
CH032700	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/01/2023
CH032700	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/01/2023
CH032700	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/01/2023
CH032700	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/01/2023
CH032700	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/01/2023
CH032700	CENTERWELL PHARMACY, INC.	10737 MARKS WAY		MIRAMAR	FL	33025	04/01/2021	12/06/2023
CH032700	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	04/01/2021	12/06/2023
CH032700	CHAMBERS APOTHECARY	278 LINCOLN WAY E		CHAMBERSBURG	PA	17201	10/01/2018
CH03270Z	CHAMBERS APOTHECARY	278 LINCOLN WAY E		CHAMBERSBURG	PA	17201	04/01/2023
CH032700	CRITICAL CARE SYSTEMS, INC.	OPTION CARE	6380 FLANK DRIVE SUITE 600	HARRISBURG	PA	17112	10/01/2019	03/24/2020
CH032700	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2023
CH03270A	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2024
CH032700	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2023
CH032700	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	04/01/2023
CH032700	CYSTIC FIBROSIS SERVICES	CYSTIC FIBROSIS SERVICES, INC	10530 JOHN W ELLIOTT DR, STE 200	FRISCO	TX	75033	07/01/2017	08/09/2017
CH032700	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2017	04/21/2024
CH032700	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	04/01/2021
CH032700	EAST GOSHEN PHARMACY, LLC	DBA BIOSCRIP INFUSION SERVICES	3419 CONCORD RD	YORK	PA	17402	01/01/2020
CH032700	EAST GOSHEN PHARMACY, LLC	DBA BIOSCRIP INFUSION SERVICES	970 RITTENHOUSE RD STE 200	AUDUBON	PA	19403	10/01/2021
CH032700	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2021
CH032700	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2021
CH032700	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2021
CH032700	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2021
CH032700	MODNURX INC PHARMACY	SVM2 PHARMA INC DBA MODNURX INC PHARMACY	4495 LINCOLN WAY WEST	SAINT THOMAS	PA	17252	10/01/2019	03/20/2023
CH032700	NORLAND AVENUE PHARMACY	NORLAND AVENUE PHARMACY LLC	12 ST PAUL DR STE 105	CHAMBERSBURG	PA	17201	08/29/2000
CH03270V	NORLAND AVENUE PHARMACY	NORLAND AVENUE PHARMACY LLC	12 ST PAUL DR STE 105	CHAMBERSBURG	PA	17201	04/01/2023
CH032700	OPTION CARE ENTERPRISES, INC.	D/B/A OPTION CARE	11403 BLUEGRASS PARKWAY SUITE 400	LOUISVILLE	KY	40299-2398	10/01/2019
CH032700	OPTION CARE ENTERPRISES, INC.	OPTION CARE	4000 CHEMICAL ROAD SUITE 100	PLYMOUTH MEETING	PA	19462-1708	10/01/2019	06/01/2021
CH032700	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	04/01/2021	04/01/2024
CH032700	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	04/01/2022	04/01/2024
CH032700	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	04/01/2022	04/01/2024
CH032700	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/24/2022
CH032700	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2021
CH032700	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	04/01/2021	04/01/2024
CH032700	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	04/01/2021
CH032700	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2021
CH032700	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	04/01/2022	04/01/2024
CH032700	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	04/01/2021
CH032700	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	04/01/2022	04/01/2024
CH032700	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	04/01/2021
CH032700	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2022
CH032700	PARK AVENUE PHARMACY	220 PARK AVE		CHAMBERSBURG	PA	17201	12/05/2011
CH03270K	PARK AVENUE PHARMACY	220 PARK AVE		CHAMBERSBURG	PA	17201	08/26/2010	12/09/2022
CH03270AA	PARK AVENUE PHARMACY	220 PARK AVE		CHAMBERSBURG	PA	17201	04/01/2023
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00142	305 W. BALTIMORE ST.	GREENCASTLE	PA	17225	07/01/2016
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01642	406 E. MAIN ST.	WAYNESBORO	PA	17268	07/01/2016
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01649	125 WEST WASHINGTON ST.	CHAMBERSBURG	PA	17201	07/01/2016
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01918	840 WAYNE AVENUE	CHAMBERSBURG	PA	17201	07/01/2016
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05726	701 E. KING ST.	SHIPPENSBURG	PA	17257	07/01/2016
CH032700	PENNSYLVANIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17317	913 NORLAND AVE	CHAMBERSBURG	PA	17201	04/01/2017
CH03270T	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00142	305 W. BALTIMORE ST.	GREENCASTLE	PA	17225	04/01/2023
CH03270R	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01649	125 WEST WASHINGTON ST.	CHAMBERSBURG	PA	17201	04/01/2023
CH03270X	PENNSYLVANIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17317	913 NORLAND AVE	CHAMBERSBURG	PA	17201	04/01/2023
CH03270M	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01918	840 WAYNE AVENUE	CHAMBERSBURG	PA	17201	04/01/2023
CH03270AB	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05726	701 E. KING ST.	SHIPPENSBURG	PA	17257	04/01/2023
CH03270I	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01642	406 E. MAIN ST.	WAYNESBORO	PA	17268	01/01/2024
CH032700	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	10/01/2017	10/01/2022
CH032700	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/01/2023
CH032700	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	04/01/2023
CH032700	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	04/01/2023
CH032700	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3609	415 EAST QUEEN STREET	CHAMBERSBURG	PA	17201	01/01/2020
CH032700	RITE AID OF PENNSYLVANIA, LLC	RITE AID #232	5035 LINCOLN WAY EAST	FAYETTEVILLE	PA	17222	01/01/2020	08/29/2023
CH032700	RITE AID OF PENNSYLVANIA, LLC	RITE AID #230	200 NORTH ANTRIM WAY	GREENCASTLE	PA	17225	01/01/2020	02/05/2024
CH03270K	RITE AID OF PENNSYLVANIA, LLC	RITE AID #232	5035 LINCOLN WAY EAST	FAYETTEVILLE	PA	17222	04/01/2023	08/29/2023
CH03270W	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3609	415 EAST QUEEN STREET	CHAMBERSBURG	PA	17201	04/01/2023
CH03270A	SAVAGE FAMILY PHARMACY	604 E MAIN ST		WAYNESBORO	PA	17268	01/15/2010	05/04/2017
CH032700	SAVAGE FAMILY PHARMACY	604 E MAIN ST		WAYNESBORO	PA	17268	12/05/2011	05/04/2017
CH032700	SENDERRA RX PHARMACY	SENDERRA RX PARTNERS, LLC	3712 E PLANO PKWY STE 200	PLANO	TX	75074	10/01/2020	01/20/2023
CH032700	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	04/01/2021	06/09/2024
CH032700	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	04/01/2021	06/09/2024
CH032700	SORKIN'S RX LTD	D/B/A CAREMED PHARMACEUTICAL SERVICES	1985 MARCUS AVE STE 130	NEW HYDE PARK	NY	11042-2024	04/01/2021	06/09/2024
CH032700	ST THOMAS APOTHECARY	4495 LINCOLN WAY W		SAINT THOMAS	PA	17252	03/20/2023
CH03270G	ST THOMAS APOTHECARY	4495 LINCOLN WAY W		SAINT THOMAS	PA	17252	01/01/2024
CH032700	THRIFT DRUG, INC.	RITE AID #11023	300 S. FAYETTE STREET	SHIPPENSBURG	PA	17257	01/01/2020
CH03270K	THRIFT DRUG, INC.	RITE AID #11023	300 S. FAYETTE STREET	SHIPPENSBURG	PA	17257	01/01/2024
CH032700	THRIFT DRUG, INC.	RITE AID #11024	1513 EAST MAIN STREET	WAYNESBORO	PA	17268	07/01/2025
CH032700	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	10/01/2020	09/30/2022
CH032700	VALUE SPECIALTY PHARMACY	4200 INDUSTRIAL PARK DR		ALTOONA	PA	16602	04/01/2018
CH03270F	VALUE SPECIALTY PHARMACY	4200 INDUSTRIAL PARK DR		ALTOONA	PA	16602	04/01/2024
CH032700	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2017
CH032700	WAL-MART PHARMACY 10-1850	1730 LINCOLN WAY EAST		CHAMBERSBURG	PA	17201	02/24/2012
CH03270D	WAL-MART PHARMACY 10-1850	1730 LINCOLN WAY EAST		CHAMBERSBURG	PA	17201	04/01/2023
CH032700	WAL-MART PHARMACY 10-3633	12751 WASHINGTON TOWNSHIP BLVD		WAYNESBORO	PA	17268	04/06/2012	04/10/2017
CH032700	WAL-MART PHARMACY 10-3633	12751 WASHINGTON TOWNSHIP BLVD		WAYNESBORO	PA	17268	04/01/2025
CH03270AC	WAL-MART PHARMACY 10-3633	12751 WASHINGTON TOWNSHIP BLVD		WAYNESBORO	PA	17268	04/01/2025
CH032700	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	10/01/2020
CH032700	WAL-MART PHARMACY 10-5358	100 SOUTH CONESTOGA DRIVE		SHIPPENSBURG	PA	17257	02/24/2012
CH03270J	WAL-MART PHARMACY 10-5358	100 SOUTH CONESTOGA DRIVE		SHIPPENSBURG	PA	17257	04/01/2023
CH032700	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2017
CH032700	WALGREEN CO.	DBA: WALGREENS #21369	13415 PENNSYLVANIA AVE	HAGERSTOWN	MD	21742	07/01/2022	04/21/2024
CH032700	WALGREEN CO.	DBA: WALGREENS #15978	324 E. ANTIETAM STREET SUITE 202	HAGERSTOWN	MD	21740	07/01/2022	04/21/2024
CH032700	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	949 LINCOLN WAY E	CHAMBERSBURG	PA	17201-2817	02/09/2012	11/20/2023
CH03270D	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	949 LINCOLN WAY E	CHAMBERSBURG	PA	17201-2817	02/09/2012	12/09/2022
CH03270G	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	949 LINCOLN WAY E	CHAMBERSBURG	PA	17201-2817	02/09/2012	12/09/2022
CH03270A	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	949 LINCOLN WAY E	CHAMBERSBURG	PA	17201-2817	04/01/2023	11/20/2023
CH032700	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	07/01/2022	04/21/2024
CH032700	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	07/01/2017	10/01/2021
CH032700	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2017	04/21/2024
CH032700	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2017	04/21/2024
CH032700	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2017	04/21/2024
CH032700	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	07/01/2022	04/21/2024
CH032700	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2023
CH032700	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024
CH032700	WAYNESBORO APOTHECARY	604 E MAIN ST		WAYNESBORO	PA	17268	07/01/2025
CH03270AD	WAYNESBORO APOTHECARY	604 E MAIN ST		WAYNESBORO	PA	17268	07/01/2025
CH032700	WEIS PHARMACY	1056 WAYNE AVENUE		CHAMBERSBURG	PA	17201	12/05/2011
CH03270L	WEIS PHARMACY	1056 WAYNE AVENUE		CHAMBERSBURG	PA	17201	04/01/2023
CH032700	WEIS PHARMACY 38	1075 WEST KING STREET		SHIPPENSBURG	PA	17257	12/05/2011
CH03270F	WEIS PHARMACY 38	1075 WEST KING STREET		SHIPPENSBURG	PA	17257	01/15/2010	12/09/2022
CH03270F	WEIS PHARMACY 38	1075 WEST KING STREET		SHIPPENSBURG	PA	17257	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		COCHRAN, JOANNE PRESIDENT AND CEO Keystone Rural Health Center 7177097906	4/3/2025 11:25 AM
Details	340B ID	Update	New Registration		CH03270AD	4/3/2025 11:25 AM
Dates	Participating Approval Date	Update	New Registration		4/3/2025 11:25:43 AM	4/3/2025 11:25 AM
Details	State	Update	New Registration	Pending	Approved	4/3/2025 11:25 AM
Dates	Signed By Date	Update	New Registration		4/2/2025 3:31:02 PM	4/3/2025 11:25 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/3/2025 11:25 AM
Addresses	Main Address	Insert	New Registration		12104 Buchanan Trl E Waynesboro, PA 17268-9429	4/2/2025 2:57 PM
Addresses	Billing Address	Insert	New Registration		Keystone Rural Health Center 111 Chambers Hill Dr, Suite 200 Chambersburg, PA 17201	4/2/2025 2:57 PM
Contacts	Authorizing Official	Insert	New Registration		COCHRAN, JOANNE PRESIDENT AND CEO Keystone Rural Health Center 7177097906	4/2/2025 2:57 PM
Contacts	Primary Contact	Insert	New Registration		Barnhart, Suzanne 340B Director Keystone Rural Health Center 7177097957	4/2/2025 2:57 PM
Details	Assistance Received From Date	Insert	New Registration			4/2/2025 2:57 PM
Details	Assistance Received To Date	Insert	New Registration			4/2/2025 2:57 PM
Details	Last Recertification Date	Insert	New Registration			4/2/2025 2:57 PM
Details	Grant Number	Insert	New Registration		H80CS00076	4/2/2025 2:57 PM
Details	340B ID	Insert	New Registration			4/2/2025 2:57 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/2/2025 2:57 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/2/2025 2:57 PM
Details	Medicare Provider Number	Insert	New Registration			4/2/2025 2:57 PM
Details	Entity Name	Insert	New Registration		KEYSTONE RURAL HEALTH CENTER	4/2/2025 2:57 PM
Details	NOFO Number	Insert	New Registration			4/2/2025 2:57 PM
Details	Program Code	Insert	New Registration		CH	4/2/2025 2:57 PM
Details	Entity Subname	Insert	New Registration		Keystone Medical Associates - Waynesboro	4/2/2025 2:57 PM
Dates	Participating Approval Date	Insert	New Registration			4/2/2025 2:57 PM
Details	State	Insert	New Registration		Pending	4/2/2025 2:57 PM
Dates	Registration Date	Insert	New Registration		4/2/2025 2:57:57 PM	4/2/2025 2:57 PM
Dates	Signed By Date	Insert	New Registration			4/2/2025 2:57 PM
Dates	Start Date	Insert	New Registration			4/2/2025 2:57 PM
Terminations	Termination Comments	Insert	New Registration			4/2/2025 2:57 PM
Terminations	Termination Date	Insert	New Registration			4/2/2025 2:57 PM
Terminations	Termination Effective Date	Insert	New Registration			4/2/2025 2:57 PM
Terminations	Termination Reason	Insert	New Registration			4/2/2025 2:57 PM

340B Drug Pricing Program Database