Covered Entity Details

CHC26516-05 FREE CLINIC OF NEW RIVER VALLEY INC (Approved) - information as of 5/20/2025 12:50:51 AM

Main Details

Name

FREE CLINIC OF NEW RIVER VALLEY INC

Subdivision Name

Pulaski County High School Service Site

Type

HRSA-Funded Health Center

Site ID

BPS-H80-035861

340B ID

CHC26516-05

Grant Number

H80CS26516

Additional Details

Current Program Status

Approved

Registration Date

4/10/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/29/2025

Last Recertification Date

Contacts

Authorizing Official

CHC NRV
Albert Brogan, CFO
(540) 525-0623

Primary Contact

Free Clinic of the New River Valley, Inc.
Michelle Brauns, CEO
(540) 381-0820 Ext: 806

Addresses

Street Address

5414 Cougar Trail Rd BLDG 2
Dublin, VA 24084-3841

Billing Address

Free Clinic of the New River Valley Inc
215 Roanoke St.
Christiansburg, VA 24073

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	Last Updated On
Contract Detail	BLACKSBURG PHARMACY	1445 N MAIN ST		BLACKSBURG	VA	24060	04/29/2025	07/01/2025	04/29/2025
Contract Detail	GILES PHARMACY INC	1615 WENONAH AVE		PEARISBURG	VA	24134	04/29/2025	07/01/2025	04/29/2025
Contract Detail	WAL-MART PHARMACY 10-1292	2400 N FRANKLIN ST		CHRISTIANSBURG	VA	24073	04/29/2025	07/01/2025	04/29/2025
Contract Detail	WAL-MART PHARMACY 10-1652	5225 ALEXANDER ROAD		DUBLIN	VA	24084	04/29/2025	07/01/2025	04/29/2025
Contract Detail	WAL-MART PHARMACY 10-2646	160 KINTER WAY		PEARISBURG	VA	24134	04/29/2025	07/01/2025	04/29/2025
Contract Detail	WAL-MART PHARMACY 10-2762	7373 PEPPERS FERRY BLVD.		FAIRLAWN	VA	24141	04/29/2025	07/01/2025	04/29/2025
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/29/2025	07/01/2025	04/29/2025
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/29/2025	07/01/2025	04/29/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC26516-00	Active	BPS-H80-012919	Free Clinic Of The New River Valley Inc	Montgomery Clinic	215 Roanoke St	Christiansburg	VA
CHC26516-01	Active	BPS-H80-012913	Free Clinic Of The New River Valley Inc	Giles Clinic	219 Buchanan St	Pearisburg	VA
CHC26516-02	Active	BPS-H80-018952	Free Clinic Of The New River Valley Inc	Pulaski/Radford Clinic	5826 RUEBUSH RD STE B	Dublin	VA
CHC26516-03	Approved	BPS-H80-032430	FREE CLINIC OF NEW RIVER VALLEY INC	Montgomery Admin Annex	211 Roanoke St	Christiansburg	VA
CHC26516-04	Approved	BPS-H80-032338	FREE CLINIC OF NEW RIVER VALLEY INC	Clinical Annex Montgomery	209 Roanoke St Ste 4	Christiansburg	VA
CHC26516-05	Approved	BPS-H80-035861	FREE CLINIC OF NEW RIVER VALLEY INC	Pulaski County High School Service Site	5414 Cougar Trail Rd BLDG 2	Dublin	VA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC26516-00	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	04/01/2025
CHC26516-00	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	04/01/2025
CHC26516-00	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	04/01/2025
CHC26516-00	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	04/01/2025
CHC26516-00	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	04/01/2025
CHC26516-00	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY CA	7373 LINCOLN WAY		GARDEN GROVE	CA	92841	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY LA, LLC	2731 MANHATTAN BLVD STE B17		HARVEY	LA	70058	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2025
CHC26516-00	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	04/01/2025
CHC26516-00	BLACKSBURG PHARMACY	1445 N MAIN ST		BLACKSBURG	VA	24060	07/01/2020
CHC26516-05	BLACKSBURG PHARMACY	1445 N MAIN ST		BLACKSBURG	VA	24060	07/01/2025
CHC26516-00	CHRISTIANSBURG PHARMACY	CHRISTIANSBURG PHARMACY	470 N FRANKLIN ST	CHRISTIANSBURG	VA	24073-2940	07/01/2020
CHC26516-00	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2025
CHC26516-00	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2025
CHC26516-00	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2025
CHC26516-00	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	04/01/2025
CHC26516-00	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	04/01/2025
CHC26516-00	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	04/01/2025
CHC26516-00	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	04/01/2025
CHC26516-00	GENOA HEALTHCARE LLC	700 UNIVERSITY CITY BLVD		BLACKSBURG	VA	24060	04/01/2025
CHC26516-00	GILES PHARMACY INC	1615 WENONAH AVE		PEARISBURG	VA	24134	07/01/2022
CHC26516-05	GILES PHARMACY INC	1615 WENONAH AVE		PEARISBURG	VA	24134	07/01/2025
CHC26516-00	KROGER PHARMACY #210	903 UNIVERSITY CITY BLVD		BLACKSBURG	VA	24060	10/01/2019
CHC26516-01	KROGER PHARMACY #210	903 UNIVERSITY CITY BLVD		BLACKSBURG	VA	24060	10/01/2019
CHC26516-02	KROGER PHARMACY #210	903 UNIVERSITY CITY BLVD		BLACKSBURG	VA	24060	10/01/2019
CHC26516-00	KROGER PHARMACY #215	7480 LEE HIGHWAY		FAIRLAWN	VA	24141	10/01/2019
CHC26516-01	KROGER PHARMACY #215	7480 LEE HIGHWAY		FAIRLAWN	VA	24141	10/01/2019
CHC26516-02	KROGER PHARMACY #215	7480 LEE HIGHWAY		FAIRLAWN	VA	24141	10/01/2019
CHC26516-00	KROGER PHARMACY #345	555 NORTH FRANKLIN ST., NE		CHRISTIANSBURG	VA	24073	10/01/2019
CHC26516-01	KROGER PHARMACY #345	555 NORTH FRANKLIN ST., NE		CHRISTIANSBURG	VA	24073	10/01/2019
CHC26516-02	KROGER PHARMACY #345	555 NORTH FRANKLIN ST., NE		CHRISTIANSBURG	VA	24073	10/01/2019
CHC26516-00	MARTIN'S PHARMACY	WILLIAM H HALE ET AL	400 N WASHINGTON AVE PO BOX 699	PULASKI	VA	24301	10/01/2022
CHC26516-02	MARTIN'S PHARMACY	WILLIAM H HALE ET AL	400 N WASHINGTON AVE PO BOX 699	PULASKI	VA	24301	04/24/2023
CHC26516-00	MARTINS PHARMACY OF DUBLIN	180 BROAD ST		DUBLIN	VA	24084	04/01/2023
CHC26516-00	OPTUM INFUSION SERVICES 305, LLC	15529 COLLEGE BLVD.		LENEXA	KS	66219-1351	04/01/2025
CHC26516-00	OPTUM INFUSION SERVICES 553, LLC	6531 MERIDIEN DR	SUITE 113	RALEIGH	NC	27616	04/01/2025
CHC26516-00	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	04/01/2025
CHC26516-00	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	04/01/2025
CHC26516-00	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	04/01/2025
CHC26516-00	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/01/2025
CHC26516-00	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2025
CHC26516-00	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	04/01/2025
CHC26516-00	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2025
CHC26516-00	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2025
CHC26516-00	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2025
CHC26516-00	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2025
CHC26516-00	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2025
CHC26516-00	SHAWSVILLE PHARMACY INC	250 ALLEGHANY SPRING RD		SHAWSVILLE	VA	24162	01/01/2022
CHC26516-01	SHAWSVILLE PHARMACY INC	250 ALLEGHANY SPRING RD		SHAWSVILLE	VA	24162	01/01/2022
CHC26516-02	SHAWSVILLE PHARMACY INC	250 ALLEGHANY SPRING RD		SHAWSVILLE	VA	24162	01/01/2022
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03503	1351 BOB WHITE BLVD.	PULASKI	VA	24301	04/01/2025
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06329	1775 SOUTH MAIN ST.	BLACKSBURG	VA	24060	04/01/2025
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07543	550 N. FRANKLIN ST.	CHRISTIANSBURG	VA	24073	04/01/2025
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07592	31 W. MAIN ST.	RADFORD	VA	24141	04/01/2025
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07658	100 GILES AVENUE	DUBLIN	VA	24084	04/01/2025
CHC26516-00	VIRGINIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16636	195 CONSTON AVE	CHRISTIANSBURG	VA	24073	04/01/2025
CHC26516-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2020
CHC26516-00	WAL-MART PHARMACY 10-1292	2400 N FRANKLIN ST		CHRISTIANSBURG	VA	24073	01/01/2025
CHC26516-05	WAL-MART PHARMACY 10-1292	2400 N FRANKLIN ST		CHRISTIANSBURG	VA	24073	07/01/2025
CHC26516-00	WAL-MART PHARMACY 10-1652	5225 ALEXANDER ROAD		DUBLIN	VA	24084	07/01/2020
CHC26516-05	WAL-MART PHARMACY 10-1652	5225 ALEXANDER ROAD		DUBLIN	VA	24084	07/01/2025
CHC26516-04	WAL-MART PHARMACY 10-1652	5225 ALEXANDER ROAD		DUBLIN	VA	24084	07/01/2025
CHC26516-00	WAL-MART PHARMACY 10-2646	160 KINTER WAY		PEARISBURG	VA	24134	07/01/2020
CHC26516-01	WAL-MART PHARMACY 10-2646	160 KINTER WAY		PEARISBURG	VA	24134	04/24/2023
CHC26516-05	WAL-MART PHARMACY 10-2646	160 KINTER WAY		PEARISBURG	VA	24134	07/01/2025
CHC26516-00	WAL-MART PHARMACY 10-2762	7373 PEPPERS FERRY BLVD.		FAIRLAWN	VA	24141	07/01/2020
CHC26516-05	WAL-MART PHARMACY 10-2762	7373 PEPPERS FERRY BLVD.		FAIRLAWN	VA	24141	07/01/2025
CHC26516-03	WAL-MART PHARMACY 10-2762	7373 PEPPERS FERRY BLVD.		FAIRLAWN	VA	24141	07/01/2025
CHC26516-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2020
CHC26516-00	WALGREEN CO.	DBA: WALGREENS #11972	240 BROAD ST.	DUBLIN	VA	24084	04/01/2025	01/01/2025
CHC26516-00	WALGREEN CO.	WALGREENS #17869	121 N MAIN STREET	PEARISBURG	VA	24134-1624	04/01/2025
CHC26516-00	WALGREEN CO.	DBA: WALGREENS #10924	901 MEMORIAL DR.	PULASKI	VA	24301-2303	04/01/2025
CHC26516-00	WALGREEN CO.	DBA: WALGREENS # 07606	2460 N FRANKLIN STREET	CHRISTIANSBURG	VA	24073	04/01/2025
CHC26516-00	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	04/01/2025
CHC26516-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC26516-05	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CHC26516-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC26516-05	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Brogan, Albert CFO CHC NRV 5405250623	4/29/2025 10:51 AM
Details	340B ID	Update	New Registration		CHC26516-05	4/29/2025 10:51 AM
Dates	Participating Approval Date	Update	New Registration		4/29/2025 10:51:10 AM	4/29/2025 10:51 AM
Details	State	Update	New Registration	Pending	Approved	4/29/2025 10:51 AM
Dates	Signed By Date	Update	New Registration		4/10/2025 2:24:17 PM	4/29/2025 10:51 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/29/2025 10:51 AM
Addresses	Main Address	Insert	New Registration		5414 Cougar Trail Rd BLDG 2 Dublin, VA 24084-3841	4/10/2025 2:24 PM
Addresses	Billing Address	Insert	New Registration		Free Clinic of the New River Valley Inc 215 Roanoke St. Christiansburg, VA 24073	4/10/2025 2:24 PM
Contacts	Primary Contact	Insert	New Registration		Brauns, Michelle CEO Free Clinic of the New River Valley, Inc. 5403810820-806	4/10/2025 2:24 PM
Contacts	Authorizing Official	Insert	New Registration		Brogan, Albert CFO CHC NRV 5405250623	4/10/2025 2:24 PM
Details	Assistance Received From Date	Insert	New Registration			4/10/2025 2:24 PM
Details	Assistance Received To Date	Insert	New Registration			4/10/2025 2:24 PM
Details	Last Recertification Date	Insert	New Registration			4/10/2025 2:24 PM
Details	Grant Number	Insert	New Registration		H80CS26516	4/10/2025 2:24 PM
Details	340B ID	Insert	New Registration			4/10/2025 2:24 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/10/2025 2:24 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/10/2025 2:24 PM
Details	Medicare Provider Number	Insert	New Registration			4/10/2025 2:24 PM
Details	Entity Name	Insert	New Registration		FREE CLINIC OF NEW RIVER VALLEY INC	4/10/2025 2:24 PM
Details	NOFO Number	Insert	New Registration			4/10/2025 2:24 PM
Details	Program Code	Insert	New Registration		CH	4/10/2025 2:24 PM
Details	Entity Subname	Insert	New Registration		Pulaski County High School Service Site	4/10/2025 2:24 PM
Dates	Participating Approval Date	Insert	New Registration			4/10/2025 2:24 PM
Details	State	Insert	New Registration		Pending	4/10/2025 2:24 PM
Dates	Registration Date	Insert	New Registration		4/10/2025 2:24:17 PM	4/10/2025 2:24 PM
Dates	Signed By Date	Insert	New Registration			4/10/2025 2:24 PM
Dates	Start Date	Insert	New Registration			4/10/2025 2:24 PM
Terminations	Termination Comments	Insert	New Registration			4/10/2025 2:24 PM
Terminations	Termination Date	Insert	New Registration			4/10/2025 2:24 PM
Terminations	Termination Effective Date	Insert	New Registration			4/10/2025 2:24 PM
Terminations	Termination Reason	Insert	New Registration			4/10/2025 2:24 PM

340B Drug Pricing Program Database