Covered Entity Details

CH039840 WALNUT STREET COMMUNITY HEALTH CENTER (Active) - information as of 6/27/2025 12:30:34 AM

Main Details

Name

WALNUT STREET COMMUNITY HEALTH CENTER

Subdivision Name

Walnut Street Community Heath Center, Inc. DBA: FAMILY HEALTHCARE OF HAGERSTOWN

Type

HRSA-Funded Health Center

Site ID

BPS-H80-015268

340B ID

CH039840

Grant Number

H80CS00857

Additional Details

Current Program Status

Active

Registration Date

10/1/2003

Participating Start Date

10/1/2003

Participating Approval Date

9/30/2003

Last Recertification Date

2/27/2025

Contacts

Authorizing Official

Walnut Street Community Health Center
David F. Becker, CFO
(301) 745-3777 Ext: 1080

Primary Contact

Walnut Street Community Health Center, Inc., DBA Family Healthcare of Hagerstown
Nicole Houser, CEO
(301) 745-3777 Ext: 1079

Addresses

Street Address

201 South Cleveland Avenue
HAGERSTOWN, MD 21740-4738

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
NEW ADD 10/1/03	10/01/2003

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
MD	425035400	1871234294

Shipping Addresses

Shipping Address 1

Walnut Street Community Health Center Inc
DBA Family Healthcare Pharmacy
201 S Cleveland Ave
Ste 101
Hagerstown, MD 21740-5758

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	07/13/2023	10/01/2023	03/31/2025	04/02/2025
Contract Detail	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	07/13/2023	10/01/2023	03/31/2025	04/02/2025
Contract Detail	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	07/13/2023	10/01/2023	03/31/2025	04/02/2025
Contract Detail	HOPE-WELL PHARMACY CLEVELAND LLC	DBA EXPRESS PHARMACY #5	201 S CLEVELAND AVE STE 101	HAGERSTOWN	MD	21740-5758	04/01/2016	07/01/2016	04/01/2022	04/07/2022
Contract Detail	HOPE-WELL PHARMACY HAGERSTOWN LLC	DBA EXPRESS PHARMACY	25 N. CANNON AVE	HAGERSTOWN	MD	21740	07/15/2013	10/01/2013	03/31/2022	04/07/2022
Contract Detail	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	07/13/2023	10/01/2023	03/31/2025	04/02/2025
Contract Detail	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04199	34 N. CANNON AVE.	HAGERSTOWN	MD	21740	01/04/2019	04/01/2019	06/26/2025	06/26/2025
Contract Detail	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01442	10 EAST WILSON BOULEVARD	HAGERSTOWN	MD	21740	01/04/2019	04/01/2019		04/01/2019
Contract Detail	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01435	1503 POTOMAC AVE.	HAGERSTOWN	MD	21742	04/02/2025	07/01/2025		04/02/2025
Contract Detail	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03166	1731 DUAL HWY	HAGERSTOWN	MD	21740	04/02/2025	07/01/2025		04/02/2025
Contract Detail	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	07/13/2023	10/01/2023	03/31/2025	04/02/2025
Contract Detail	SCHINDEL'S PHARMACY INC	642 OAK HILL AVE		HAGERSTOWN	MD	21740-3870	07/15/2013	10/01/2013	12/11/2019	01/13/2020
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/09/2019	01/01/2020		01/01/2020
Contract Detail	WAL-MART PHARMACY 10-1674	17850 GARLAND GROH BLVD.		HAGERSTOWN	MD	21740	04/14/2014	07/01/2014		11/19/2015
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/09/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13892	17703 VIRGINIA AVENUE	HAGERSTOWN	MD	21740	10/24/2014	01/01/2015		11/19/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13893	1631 DUAL HIGHWAY	HAGERSTOWN	MD	21740	10/24/2014	01/01/2015		11/19/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15978	324 E. ANTIETAM STREET SUITE 202	HAGERSTOWN	MD	21740	10/24/2014	01/01/2015		11/19/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #21369	13415 PENNSYLVANIA AVE	HAGERSTOWN	MD	21742	10/24/2014	01/01/2015		11/19/2015
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15980	11110 MEDICAL CAMPUS ROAD SUITE 105	HAGERSTOWN	MD	21742	10/24/2014	01/01/2015	08/23/2023	08/23/2023
Contract Detail	WALGREEN CO.	WALGREENS #17174	901 N BURHANS BLVD	HAGERSTOWN	MD	21742	04/06/2021	07/01/2021	07/13/2022	07/13/2022
Contract Detail	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	07/06/2023	10/01/2023		10/01/2023
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	10/24/2014	01/01/2015	08/19/2015	11/19/2015
Contract Detail	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	10/24/2014	01/01/2015	08/19/2015	11/19/2015
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/05/2023	07/01/2023		07/01/2023
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/09/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH039840	Active	BPS-H80-015268	WALNUT STREET COMMUNITY HEALTH CENTER	Walnut Street Community Heath Center, Inc. DBA: FAMILY HEALTHCARE OF HAGERSTOWN	201 South Cleveland Avenue	HAGERSTOWN	MD
CH03984A	Terminated	BPS-H80-012631	WALNUT STREET COMMUNITY HEALTH CENTER, INC.	Walnut Street Community Health Center at Way Station	328 N Potomac St	Hagerstown	MD
CH03984B	Terminated	BPS-H80-024759	Walnut Street Community Health Center, Inc.	Family Healthcare of Hagerstown at Wells House	221 E Baltimore St	Hagerstown	MD
CH03984C	Active	BPS-H80-038158	WALNUT STREET COMMUNITY HEALTH CENTER, INC	FHH Behavioral Health Clinic - RAMPS	1311 Yale Dr	Hagerstown	MD

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH039840	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	10/01/2023	03/31/2025
CH039840	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	10/01/2023	03/31/2025
CH039840	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	10/01/2023	03/31/2025
CH039840	HOPE-WELL PHARMACY CLEVELAND LLC	DBA EXPRESS PHARMACY #5	201 S CLEVELAND AVE STE 101	HAGERSTOWN	MD	21740-5758	07/01/2016	04/01/2022
CH039840	HOPE-WELL PHARMACY HAGERSTOWN LLC	DBA EXPRESS PHARMACY	25 N. CANNON AVE	HAGERSTOWN	MD	21740	10/01/2013	03/31/2022
CH039840	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	10/01/2023	03/31/2025
CH039840	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04199	34 N. CANNON AVE.	HAGERSTOWN	MD	21740	04/01/2019	06/26/2025
CH039840	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01442	10 EAST WILSON BOULEVARD	HAGERSTOWN	MD	21740	04/01/2019
CH039840	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01435	1503 POTOMAC AVE.	HAGERSTOWN	MD	21742	07/01/2025
CH039840	MARYLAND CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03166	1731 DUAL HWY	HAGERSTOWN	MD	21740	07/01/2025
CH039840	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	10/01/2023	03/31/2025
CH039840	SCHINDEL'S PHARMACY INC	642 OAK HILL AVE		HAGERSTOWN	MD	21740-3870	10/01/2013	12/11/2019
CH039840	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2020
CH039840	WAL-MART PHARMACY 10-1674	17850 GARLAND GROH BLVD.		HAGERSTOWN	MD	21740	07/01/2014
CH039840	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2020
CH039840	WALGREEN CO.	DBA: WALGREENS #13892	17703 VIRGINIA AVENUE	HAGERSTOWN	MD	21740	01/01/2015
CH039840	WALGREEN CO.	DBA: WALGREENS #13893	1631 DUAL HIGHWAY	HAGERSTOWN	MD	21740	01/01/2015
CH039840	WALGREEN CO.	DBA: WALGREENS #15978	324 E. ANTIETAM STREET SUITE 202	HAGERSTOWN	MD	21740	01/01/2015
CH039840	WALGREEN CO.	DBA: WALGREENS #21369	13415 PENNSYLVANIA AVE	HAGERSTOWN	MD	21742	01/01/2015
CH039840	WALGREEN CO.	DBA: WALGREENS #15980	11110 MEDICAL CAMPUS ROAD SUITE 105	HAGERSTOWN	MD	21742	01/01/2015	08/23/2023
CH039840	WALGREEN CO.	WALGREENS #17174	901 N BURHANS BLVD	HAGERSTOWN	MD	21742	07/01/2021	07/13/2022
CH039840	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CH039840	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2015	08/19/2015
CH039840	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	01/01/2015	08/19/2015
CH039840	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH039840	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Recertification	Carter, Lynda K Operations Manager WALNUT STREET COMMUNITY HEALTH CENTER, INC. 3017453777-1078	Houser, Nicole CEO Walnut Street Community Health Center, Inc., DBA Family Healthcare of Hagerstown 3017453777-1079	2/27/2025 10:36 AM
Details	Last Recertification Date	Update	Recertification	1/29/2024 9:57:30 AM	2/27/2025 10:36:00 AM	2/27/2025 10:36 AM
Details	Last Recertification Date	Update	Recertification	2/11/2023 1:59:54 PM	1/29/2024 9:57:30 AM	1/29/2024 9:57 AM
Details	Last Recertification Date	Update	Recertification	2/16/2022 6:48:50 AM	2/11/2023 1:59:54 PM	2/11/2023 1:59 PM
Contacts	Authorizing Official	Update	Change Request	Murdaugh, Kimberly Z. Executive Director CHO39840 3017453777-1079	Becker, David F. CFO Walnut Street Community Health Center 3017453777-1080	6/16/2022 9:34 AM
Contacts	Primary Contact	Update	Change Request	Becker, David F. CFO Walnut Street Community Health Center 3017453777-1080	Carter, Lynda K Operations Manager WALNUT STREET COMMUNITY HEALTH CENTER, INC. 3017453777-1078	6/16/2022 9:34 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	6/14/2022 6:03 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		425035400	6/14/2022 6:03 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MD	6/14/2022 6:03 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1871234294	6/14/2022 6:03 PM
Medicaid Billing	NPI: State	Insert	Change Request		MD	6/14/2022 6:03 PM
Addresses	Shipping Address	Update	Change Request	Hope-Well Pharmacy Cleveland LLC DBA Express Pharmacy #5 201 S Cleveland Ave STE 101 Hagerstown, MD 21740-5758	Walnut Street Community Health Center Inc DBA Family Healthcare Pharmacy 201 S Cleveland Ave Ste 101 Hagerstown, MD 21740-5758	5/24/2022 10:46 AM
Addresses	Shipping Address	Insert	Change Request		Hope-Well Pharmacy Cleveland LLC DBA Express Pharmacy #5 201 S Cleveland Ave STE 101 Hagerstown, MD 21740-5758	4/11/2022 12:44 PM
Details	Last Recertification Date	Update	Recertification	2/26/2021 9:17:40 AM	2/16/2022 6:48:50 AM	2/16/2022 6:48 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	401662900 (MD)		2/26/2021 9:17 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1366425266 ( )		2/26/2021 9:17 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 5:59:14 PM	2/26/2021 9:17:40 AM	2/26/2021 9:17 AM
Details	Last Recertification Date	Update	Recertification	1/30/2019 8:52:12 AM	1/28/2020 5:59:14 PM	1/28/2020 5:59 PM
Details	Last Recertification Date	Update	Recertification	2/12/2018 10:03:48 AM	1/30/2019 8:52:12 AM	1/30/2019 8:52 AM
Details	Last Recertification Date	Update	Recertification	2/3/2017 12:00:00 AM	2/12/2018 10:03:48 AM	2/12/2018 10:03 AM
Contacts	Primary Contact	Update	Change Request	Murdaugh, Kimberly Z. Executive Director 3017453777-1079	Becker, David F. CFO Walnut Street Community Health Center 3017453777-1080	10/12/2017 5:06 PM
Contacts	Authorizing Official	Update		Murdaugh, Kimberly Z. Executive Director 3017453777-1079	Murdaugh, Kimberly Z. Executive Director CHO39840 3017453777-1079	10/12/2017 3:33 PM
Addresses	Main Address	Insert			201 South Cleveland Avenue HAGERSTOWN, MD 21740-4738	2/3/2017 2:21 PM
Contacts	Authorizing Official	Update		MURDAUGH, KIMBERLY Z. Executive Director 3013933419	Murdaugh, Kimberly Z. Executive Director 3017453777-1079	2/3/2017 2:21 PM
Contacts	Primary Contact	Update		MURDAUGH, KIMBERLY Z. Executive Director 3013933419	Murdaugh, Kimberly Z. Executive Director 3017453777-1079	2/3/2017 2:21 PM
Details	Last Recertification Date	Update		2/24/2016 12:00:00 AM	2/3/2017 12:00:00 AM	2/3/2017 2:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/12/2016 1:06 PM
Medicaid Billing	Medicaid: Number	Insert			401662900	8/12/2016 1:06 PM
Medicaid Billing	Medicaid: State	Insert			MD	8/12/2016 1:06 PM
Medicaid Billing	NPI: Number	Insert			1366425266	8/12/2016 1:06 PM
Details	Entity Subname	Update			Walnut Street Community Heath Center, Inc. DBA: FAMILY HEALTHCARE OF HAGERSTOWN	6/1/2016 3:38 PM
Details	Last Recertification Date	Update		3/10/2015 12:00:00 AM	2/24/2016 12:00:00 AM	2/24/2016 8:59 AM
Contacts	Authorizing Official	Update		MURDAUGH, KIMBERLY Z. CEO 3013933419	MURDAUGH, KIMBERLY Z. Executive Director 3013933419	11/19/2015 4:05 PM
Contacts	Primary Contact	Update		MURDAUGH, KIMBERLY 3013933419	MURDAUGH, KIMBERLY Z. Executive Director 3013933419	11/19/2015 4:05 PM
Details	Last Recertification Date	Update		3/11/2014 12:00:00 AM	3/10/2015 12:00:00 AM	3/10/2015 11:17 AM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/11/2014 12:00:00 AM	3/11/2014 2:45 PM
Dates	Participating Approval Date	Update		9/30/2003 11:45:07 AM	9/30/2003 12:00:00 AM	4/16/2013 4:22 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/18/2013 2:10 PM
Contacts	Primary Contact	Insert			MURDAUGH, KIMBERLY 3013933419	10/1/2003 12:00 AM
Contacts	Authorizing Official	Insert			MURDAUGH, KIMBERLY Z. CEO 3013933419	10/1/2003 12:00 AM
Details	Last Recertification Date	Insert				10/1/2003 12:00 AM
Details	Grant Number	Insert			H80CS00857	10/1/2003 12:00 AM
Details	340B ID	Insert			CH039840	10/1/2003 12:00 AM
Details	Is Authorizing Official EHB Data	Insert				10/1/2003 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Insert				10/1/2003 12:00 AM
Details	Medicare Provider Number	Insert				10/1/2003 12:00 AM
Details	Entity Name	Insert			WALNUT STREET COMMUNITY HEALTH CENTER	10/1/2003 12:00 AM
Details	Program Code	Insert			CH	10/1/2003 12:00 AM
Details	Entity Subname	Insert				10/1/2003 12:00 AM
Dates	Participating Approval Date	Insert			9/30/2003 11:45:07 AM	10/1/2003 12:00 AM
Details	State	Insert			Active	10/1/2003 12:00 AM
Dates	Registration Date	Insert			10/1/2003 12:00:00 AM	10/1/2003 12:00 AM
Dates	Signed By Date	Insert				10/1/2003 12:00 AM
Dates	Start Date	Insert			10/1/2003 12:00:00 AM	10/1/2003 12:00 AM
Terminations	Termination Comments	Insert				10/1/2003 12:00 AM
Terminations	Termination Date	Insert				10/1/2003 12:00 AM
Terminations	Termination Effective Date	Insert				10/1/2003 12:00 AM
Terminations	Termination Reason	Insert				10/1/2003 12:00 AM
Details	Comments Public	Insert			NEW ADD 10/1/03	10/1/2003 12:00 AM

340B Drug Pricing Program Database