Covered Entity Details

FQHCLA459A ONE CROSS COMMUNITY INC (Approved) - information as of 5/12/2025 10:18:02 PM

Main Details

Name

ONE CROSS COMMUNITY INC

Subdivision Name

One Cross Health

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-039932

340B ID

FQHCLA459A

Grant Number

LALCS52973

Additional Details

Current Program Status

Approved

Registration Date

4/8/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/16/2025

Last Recertification Date

Contacts

Authorizing Official

One Cross Community
Kim Mckenna, CEO
(270) 403-1106

Primary Contact

One Cross Community
Valeska Mckenna Craus, Executive Assistant
(270) 789-0034

Addresses

Street Address

106 Winston Way
Campbellsville, KY 42718

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?
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
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
FQHCLA459	Active	BPS-LAL-037970	ONE CROSS COMMUNITY INC	One Cross Community, Inc.	429 W Walnut St		Lebanon	KY
FQHCLA459A	Approved	BPS-LAL-039932	ONE CROSS COMMUNITY INC	One Cross Health	106 Winston Way		Campbellsville	KY

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date
FQHCLA459	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	10/01/2024
FQHCLA459	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2024
FQHCLA459	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2024
FQHCLA459	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2024
FQHCLA459	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2024
FQHCLA459	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2024
FQHCLA459	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2024
FQHCLA459	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2024
FQHCLA459	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2024
FQHCLA459	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2024
FQHCLA459	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2024
FQHCLA459	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2025
FQHCLA459	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2025
FQHCLA459	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2024
FQHCLA459	EASTRIDGE-PHELPS PHARMACY LLC	500 N BYPASS RD		CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	HOMETOWN PHARMACY OF CAMPBELLSVILLE, PLL	325 E BROADWAY ST		CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	HOMETOWN PHARMACY SPECIALTY SERVICES, PL	3200 NEW COLUMBIA RD		CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	KENTUCKY CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06338	101 EAST BROADWAY	CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	Kroger Pharmacy	Jeffersonville Central Fill Facility	301 Logistics Ave Suite 200	Jeffersonville	IN	47130	10/01/2024
FQHCLA459	KROGER PHARMACY L-369	399 CAMPBELLSVILLE BYPASS STE 100		CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2024
FQHCLA459	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2024
FQHCLA459	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2024
FQHCLA459	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
FQHCLA459	WAL-MART PHARMACY 10-0665	725 CAMPBELLSVILLE BYPASS		CAMPBELLSVILLE	KY	42718	10/01/2024
FQHCLA459	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
FQHCLA459	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
FQHCLA459	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Mckenna, Kim CEO One Cross Community 2704031106	4/16/2025 2:55 PM
Details	340B ID	Update	New Registration		FQHCLA459A	4/16/2025 2:55 PM
Dates	Participating Approval Date	Update	New Registration		4/16/2025 2:55:09 PM	4/16/2025 2:55 PM
Details	State	Update	New Registration	Pending	Approved	4/16/2025 2:55 PM
Dates	Signed By Date	Update	New Registration		4/8/2025 10:47:53 AM	4/16/2025 2:55 PM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/16/2025 2:55 PM
Addresses	Main Address	Insert	New Registration		106 Winston Way Campbellsville, KY 42718	4/8/2025 10:47 AM
Contacts	Authorizing Official	Insert	New Registration		Mckenna, Kim CEO One Cross Community 2704031106	4/8/2025 10:47 AM
Contacts	Primary Contact	Insert	New Registration		Craus, Valeska Mckenna Executive Assistant One Cross Community 2707890034	4/8/2025 10:47 AM
Details	Assistance Received From Date	Insert	New Registration			4/8/2025 10:47 AM
Details	Assistance Received To Date	Insert	New Registration			4/8/2025 10:47 AM
Details	Last Recertification Date	Insert	New Registration			4/8/2025 10:47 AM
Details	Grant Number	Insert	New Registration		LALCS52973	4/8/2025 10:47 AM
Details	340B ID	Insert	New Registration			4/8/2025 10:47 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/8/2025 10:47 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/8/2025 10:47 AM
Details	Medicare Provider Number	Insert	New Registration			4/8/2025 10:47 AM
Details	Entity Name	Insert	New Registration		ONE CROSS COMMUNITY INC	4/8/2025 10:47 AM
Details	NOFO Number	Insert	New Registration			4/8/2025 10:47 AM
Details	Program Code	Insert	New Registration		FQHCLA	4/8/2025 10:47 AM
Details	Entity Subname	Insert	New Registration		One Cross Health	4/8/2025 10:47 AM
Dates	Participating Approval Date	Insert	New Registration			4/8/2025 10:47 AM
Details	State	Insert	New Registration		Pending	4/8/2025 10:47 AM
Dates	Registration Date	Insert	New Registration		4/8/2025 10:47:52 AM	4/8/2025 10:47 AM
Dates	Signed By Date	Insert	New Registration			4/8/2025 10:47 AM
Dates	Start Date	Insert	New Registration			4/8/2025 10:47 AM
Terminations	Termination Comments	Insert	New Registration			4/8/2025 10:47 AM
Terminations	Termination Date	Insert	New Registration			4/8/2025 10:47 AM
Terminations	Termination Effective Date	Insert	New Registration			4/8/2025 10:47 AM
Terminations	Termination Reason	Insert	New Registration			4/8/2025 10:47 AM

340B Drug Pricing Program Database