340B Drug Pricing Program Database


CH051833Q HEARTLAND COMMUNITY HEALTH CLINIC INC (Approved) - information as of 5/3/2025 11:33:06 PM

Main Details
HEARTLAND COMMUNITY HEALTH CLINIC INC
Heartland Health Services - East Bluff Community Center
HRSA-Funded Health Center
BPS-H80-039884
CH051833Q
H80CS02457


Additional Details
Approved
4/7/2025
7/1/2025
4/8/2025

Contacts

Heartland Health Services
Dewitt Harrell, CEO
(309) 680-7657

Heartland Health Services
Tony Bartlett, CFO
(309) 680-7612

Addresses

512 E Kansas St
Peoria, IL 61603-2554

Heartland Community Health Clinic DBA: Heartland Health Services
2214 N. University St
Peoria, IL 61604


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

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH051833AActiveBPS-H80-001864Heartland Community Health Clinic DBA: Heartland Health ServicesGarden1701 W Garden St PeoriaIL
CH051833BActiveBPS-H80-007249Heartland Community Health Clinic DBA: Heartland Health ServicesHuman Service Center228 NE Jefferson Avenue PeoriaIL
CH051833DActiveBPS-H80-000960Heartland Community Health Clinic DBA: Heartland Health ServicesCarver711 W. John H Gwynn Jr. Ave PeoriaIL
CH051833GActiveBPS-H80-000578Heartland Community Health Clinic DBA: Heartland Health ServicesEast Bluff2321 N Wisconsin Ave PeoriaIL
CH051833JActiveBPS-H80-031043Heartland Community Health Clinic DBA: Heartland Health ServicesKnoxville1800 N Knoxville Ave Ste A PeoriaIL
CH051833KTerminatedBPS-H80-019669Heartland Community Health Clinic DBA Heartland Health ServicesHeartland Health Services East Court3422 Court St PekinIL
CH051833LActiveBPS-H80-029878Heartland Community Health Clinic DBA Heartland Health Services - OltHeartland Health Services - Olt19 Olt Ave PekinIL
CH051833MTerminatedBPS-H80-013947Heartland Community Health ClinicHeartland Community Health Clinic DBA: Heartland Health Services - University2214 N UNIVERSITY ST PEORIAIL
CH051833NActiveBPS-H80-024953Heartland Community Health Clinic DBA Heartland Health ServicesTazwood3248 Vandever Ave Ste B PekinIL
CH051833PApprovedBPS-H80-027598HEARTLAND COMMUNITY HEALTH CLINIC INCHeartland Community Health Clinic DBA: Heartland Health Services - Sheridan2116 N Sheridan Rd Rm 104 PeoriaIL
CH051833QApprovedBPS-H80-039884HEARTLAND COMMUNITY HEALTH CLINIC INCHeartland Health Services - East Bluff Community Center512 E Kansas St PeoriaIL
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH051833AACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2025  
CH051833AACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750207/01/2025  
CH051833AACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/01/2025  
CH051833LACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2025  
CH051833AACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/01/2025  
CH051833AACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282207/01/2025  
CH051833AACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607507/01/2025  
CH051833AADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101
ORLANDOFL3280907/01/2025  
CH051833AAMERICAN PHARMACY OF IL INCDBA: ALWAN PHARMACY AND COMPOUNDING CENT 311 N WESTERN AVE
PEORIAIL6160410/01/2017  
CH051833ABIOPLUS SPECIALTY PHARMACY CA7373 LINCOLN WAY
GARDEN GROVECA9284107/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY LA, LLC2731 MANHATTAN BLVD STE B17
HARVEYLA7005807/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620307/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522607/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526107/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771307/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267007/01/2025  
CH051833ABIOPLUS SPECIALTY PHARMACY, INC3200 LAKE EMMA RD UNIT 1000
LAKE MARYFL3274607/01/2025  
CH051833BBOGARD DRUGS INC #5  1102 S WESTERN AVE
PEORIAIL6160512/12/2011 09/25/2017
CH051833DBOGARD DRUGS INC #5  1102 S WESTERN AVE
PEORIAIL6160507/07/2006 09/25/2017
CH051833GBOGARD DRUGS INC #5  1102 S WESTERN AVE
PEORIAIL6160504/09/2010 09/25/2017
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03181 2515 N. KNOXVILLE AVE
PEORIAIL6160412/28/2011 01/22/2025
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02166 3524 N UNIVERSITY
PEORIAIL6160412/28/2011  
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04732 2020 COURT STREET
PEKINIL6155412/28/2011  
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 11493 1400 BROADWAY ST
PEKINIL6155412/28/2011  
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05544 1200 E WAR MEMORIAL DR
PEORIA HEIGHTSIL6161612/28/2011  
CH051833ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05088 300 N MAIN ST
EAST PEORIAIL6161112/28/2011  
CH051833JBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03181 2515 N. KNOXVILLE AVE
PEORIAIL6160401/01/2024 01/22/2025
CH051833QBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04732 2020 COURT STREET
PEKINIL6155407/01/2025  
CH051833ACAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2025  
CH051833ACAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2025  
CH051833ACAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2025  
CH051833ACAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2025  
CH051833ACAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2025  
CH051833NCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2025  
CH051833ACAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2025  
CH051833ACAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2025  
CH051833ACAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813307/01/2025  
CH051833ACAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237407/01/2025  
CH051833ACAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2025  
CH051833ACENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506907/01/2025  
CH051833ACENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282407/01/2025  
CH051833ACVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2025  
CH051833ACVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2025  
CH051833JCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2025  
CH051833ACVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2025  
CH051833ACYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2018  
CH051833ADOGWOOD PHARMACY LLCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER RD
STE K
GREENVILLESC29607-654107/01/2025  
CH051833AESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/01/2025  
CH051833AEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/01/2025  
CH051833AEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/01/2025  
CH051833AEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/01/2025  
CH051833AGENOA HEALTHCARE LLC228 NE JEFFERSON AVE STE 207
PEORIAIL6160310/01/2019  
CH051833AGENOA HEALTHCARE LLC2321 N WISCONSIN AVE STE A
PEORIAIL6160304/01/2023  
CH051833LGENOA HEALTHCARE LLC228 NE JEFFERSON AVE STE 207
PEORIAIL6160301/01/2024  
CH051833AGENOA HEALTHCARE LLC702 W CHESTNUT ST STE 103
BLOOMINGTONIL6170110/01/2024  
CH051833AGENOA HEALTHCARE LLC3010 GRAND AVE RM 1104
WAUKEGANIL6008510/01/2024  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06455 1200 W. MAIN ST.
PEORIAIL6160604/01/2018  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07798 3034 WEST LINCOLN
PEORIAIL6160407/01/2018 10/01/2021
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06446 1008 W. GARFIELD ST
BARTONVILLEIL6160701/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06453 200 NORTH MAIN STREET
EAST PEORIAIL6161101/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07800 2540 EAST WASHINGTON ST.
EAST PEORIAIL6161107/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06444 1773 E. CHESTNUT ST.
CANTONIL6152007/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06447 9315 N. LINDBERGH DR.
PEORIAIL6161507/01/2019 02/20/2025
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06452 1005 W JACKSON ST
MORTONIL6155007/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07797 6820 NORTH PEAR TREE LANE
PEORIAIL6161507/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY #10656 808 UNIVERSITY AVENUE
HENRYIL6153707/01/2019  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06450 603 S. FOURTH ST.
CHILLICOTHEIL6152301/01/2021  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06451 910 COURT STREET
PEKINIL6155401/01/2021  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07799 4521 N PROSPECT RD
PEORIA HEIGHTSIL6161601/01/2021  
CH051833AHIGHLAND PARK CVS, L.L.C.DBA CVS/PHARMACY #18084 4800 N UNIVERSITY ST
PEORIAIL6161401/01/2021  
CH051833GHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06455 1200 W. MAIN ST.
PEORIAIL6160601/01/2024  
CH051833AKROGER COLUMBUS CENTRAL FILL #0192270 RICKENBACKER PKWY W
COLUMBUSOH4321701/01/2020  
CH051833AKROGER PHARMACY#863 2321 W. WISCONSIN
PEORIAIL6160305/20/2010 02/04/2018
CH051833DKROGER PHARMACY#863 2321 W. WISCONSIN
PEORIAIL6160305/20/2010 02/04/2018
CH051833GKROGER PHARMACY#863 2321 W. WISCONSIN
PEORIAIL6160307/01/2007 02/04/2018
CH051833AKROGER PHARMACY#917 801 WEST LAKE STREET
PEORIAIL6161404/01/2018  
CH051833AKROGER PHARMACY #5311405 W. GARFIELD
BARTONVILLEIL6160704/01/2022  
CH051833AKROGER PHARMACY J-677603 S 4TH STREET
CHILLICOTHEIL6152304/01/2022  
CH051833AKROGER PHARMACY J7673103 W. HARMON HIGHWAY
PEORIAIL6160404/01/2017 02/04/2018
CH051833AKROGER SAV-ON #705201 S MAIN
EAST PEORIAIL6161104/01/2017  
CH051833AMEDI-PARK PHARMACY420 NE GLEN OAK AVE STE 102 HILLCREST PLAZA
PEORIAIL61603-317110/01/2018  
CH051833NMEDI-PARK PHARMACY420 NE GLEN OAK AVE STE 102 HILLCREST PLAZA
PEORIAIL61603-317101/01/2024  
CH051833AOPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276507/01/2025  
CH051833AOPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705807/01/2025  
CH051833AOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850707/01/2025  
CH051833AOPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502907/01/2025  
CH051833AOPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302507/01/2025  
CH051833AOPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520407/01/2025  
CH051833AOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713007/01/2025  
CH051833GOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713007/01/2025  
CH051833AOPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824907/01/2025  
CH051833AOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729807/01/2025  
CH051833AOPTUM PHARMACY 705, LLC3539 BLUECUTT RD
COLUMBUSMS3970507/01/2025  
CH051833AOPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265507/01/2025  
CH051833AOPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110107/01/2025  
CH051833BOPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110107/01/2025  
CH051833AOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140107/01/2025  
CH051833AOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/01/2025  
CH051833AOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983807/01/2025  
CH051833APOINTCORE INCDBA OSF PHARMACY 1800 N KNOXVILLE AVE
STE G
PEORIAIL61603-302801/01/2021  
CH051833JPOINTCORE INCDBA OSF PHARMACY 1800 N KNOXVILLE AVE
STE G
PEORIAIL61603-302807/01/2024  
CH051833APRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDOFL32819-999210/01/2018 10/01/2022
CH051833DPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2025  
CH051833APROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2025  
CH051833APROCARE PHARMACY, L.L.C.CVS/PHARMACY #48637 2700 NORTHEAST EXPY NE STE B800
BUILDING B
ATLANTAGA3034507/01/2025  
CH051833APROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #48611 141 PREBLE STREET
PORTLANDME0410107/01/2025  
CH051833APROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2025  
CH051833APROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681307/01/2025  
CH051833APROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2025  
CH051833ARAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255007/01/2025  
CH051833ARIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500207/01/2025  
CH051833ASANTA BARBARA SPECIALTY PHARMACY LLC4690 CARPINTERIA AVE STE B
CARPINTERIACA9301307/01/2025  
CH051833ATHE KROGER PHARMACY #9423311 N STERLING AVENUE
PEORIAIL6160404/01/2017  
CH051833BTHE KROGER PHARMACY #9423311 N STERLING AVENUE
PEORIAIL6160401/01/2024  
CH051833ATHE KROGER PHARMACY J9231607 BROADWAY
PEKINIL6155404/01/2017  
CH051833AWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH051833AWAL-MART PHARMACY 10-06033320 VETERANS DRIVE
PEKINIL6155407/01/2017  
CH051833AWAL-MART PHARMACY 10-1028401 RIVER ROAD
EAST PEORIAIL6161107/01/2017  
CH051833BWAL-MART PHARMACY 10-1028401 RIVER ROAD
EAST PEORIAIL6161107/01/2024  
CH051833PWAL-MART PHARMACY 10-1028401 RIVER ROAD
EAST PEORIAIL6161107/01/2025  
CH051833AWAL-MART PHARMACY 10-13233315 N. UNIVERSITY STREET
PEORIAIL6160407/01/2017  
CH051833AWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH051833AWalgreen CODBA Walgreens Central Fill #21417 599 S Schmidt Rd
Ste A
BolingbrookIL60440-940504/01/2023  
CH051833AWALGREEN CO.DBA: WALGREENS # 06604 1919 WEST PIONEER PKWY
PEORIAIL61615-182512/28/2011  
CH051833AWALGREEN CO.DBA: WALGREENS # 06079 4814 N SHERIDAN RD
PEORIAIL6161412/28/2011  
CH051833AWALGREEN CO.DBA: WALGREENS # 09508 221 N WESTERN AVE
WEST PEORIAIL61604-564012/28/2011  
CH051833AWALGREEN CO.DBA: WALGREENS # 03763 1011 PEORIA ST
WASHINGTONIL61571-248712/28/2011  
CH051833AWALGREEN CO.DBA: WALGREENS # 06408 2324 W WAR MEMORIAL DRIVE
PEORIAIL6161412/28/2011  
CH051833AWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15636 221 NE GLEN OAK AVE STE A
PEORIAIL6163604/01/2018  
CH051833AWALGREEN CO.DBA: WALGREENS #12367 10613 N. KNOXVILLE AVE.
PEORIAIL6161504/01/2023  
CH051833DWALGREEN CO.DBA: WALGREENS # 09508 221 N WESTERN AVE
WEST PEORIAIL61604-564001/01/2024  
CH051833NWALGREEN CO.DBA: WALGREENS # 09508 221 N WESTERN AVE
WEST PEORIAIL61604-564001/01/2025  
CH051833AWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2018  
CH051833AWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2018  
CH051833AWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2018  
CH051833AWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700810/01/2018 10/01/2021
CH051833AWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275601/01/2024  
CH051833AWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616807/01/2025  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsSigned ByInsertNew Registration Harrell, Dewitt CEO Heartland Health Services 30968076574/8/2025 8:51 AM
Details340B IDUpdateNew Registration CH051833Q4/8/2025 8:51 AM
DatesParticipating Approval DateUpdateNew Registration 4/8/2025 8:51:36 AM4/8/2025 8:51 AM
DetailsStateUpdateNew RegistrationPendingApproved4/8/2025 8:51 AM
DatesSigned By DateUpdateNew Registration 4/7/2025 4:26:19 PM4/8/2025 8:51 AM
DatesStart DateUpdateNew Registration 7/1/2025 12:00:00 AM4/8/2025 8:51 AM
AddressesMain AddressInsertNew Registration  512 E Kansas St Peoria, IL 61603-25544/7/2025 12:45 PM
AddressesBilling AddressInsertNew Registration Heartland Community Health Clinic DBA: Heartland Health Services 2214 N. University St Peoria, IL 616044/7/2025 12:45 PM
ContactsPrimary ContactInsertNew Registration Bartlett, Tony CFO Heartland Health Services 30968076124/7/2025 12:45 PM
ContactsAuthorizing OfficialInsertNew Registration Harrell, Dewitt CEO Heartland Health Services 30968076574/7/2025 12:45 PM
DetailsAssistance Received From DateInsertNew Registration  4/7/2025 12:45 PM
DetailsAssistance Received To DateInsertNew Registration  4/7/2025 12:45 PM
DetailsLast Recertification DateInsertNew Registration  4/7/2025 12:45 PM
DetailsGrant NumberInsertNew Registration H80CS024574/7/2025 12:45 PM
Details340B IDInsertNew Registration  4/7/2025 12:45 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/7/2025 12:45 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/7/2025 12:45 PM
DetailsMedicare Provider NumberInsertNew Registration  4/7/2025 12:45 PM
DetailsEntity NameInsertNew Registration HEARTLAND COMMUNITY HEALTH CLINIC INC4/7/2025 12:45 PM
DetailsNOFO NumberInsertNew Registration  4/7/2025 12:45 PM
DetailsProgram CodeInsertNew Registration CH4/7/2025 12:45 PM
DetailsEntity SubnameInsertNew Registration Heartland Health Services - East Bluff Community Center4/7/2025 12:45 PM
DatesParticipating Approval DateInsertNew Registration  4/7/2025 12:45 PM
DetailsStateInsertNew Registration Pending4/7/2025 12:45 PM
DatesRegistration DateInsertNew Registration 4/7/2025 12:45:49 PM4/7/2025 12:45 PM
DatesSigned By DateInsertNew Registration  4/7/2025 12:45 PM
DatesStart DateInsertNew Registration  4/7/2025 12:45 PM
TerminationsTermination CommentsInsertNew Registration  4/7/2025 12:45 PM
TerminationsTermination DateInsertNew Registration  4/7/2025 12:45 PM
TerminationsTermination Effective DateInsertNew Registration  4/7/2025 12:45 PM
TerminationsTermination ReasonInsertNew Registration  4/7/2025 12:45 PM