Covered Entity Details

CH04285N RURAL HEALTH MEDICAL PROGRAM INC (Approved) - information as of 6/17/2025 2:32:20 AM

Main Details

Name

RURAL HEALTH MEDICAL PROGRAM INC

Subdivision Name

Rural Health Medical Program, Inc. - Dallas County Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-001139

340B ID

CH04285N

Grant Number

H80CS00794

Additional Details

Current Program Status

Approved

Registration Date

5/28/2025

Participating Start Date

7/1/2025

Participating Approval Date

5/29/2025

Last Recertification Date

Contacts

Authorizing Official

Rural Health Medical Program, Inc.
KESHEE Danee DOZIER-SMITH, CEO
(334) 874-7428 Ext: 121

Primary Contact

Rural Health Medical Program Inc.
Jasmine Williams, Corporate Compliance Officer
(334) 874-7428

Addresses

Street Address

228 Selma Ave
Selma, AL 36701-5825

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	City	State
CH042850	Active	BPS-H80-024401	RURAL HEALTH MEDICAL PROGRAM, INC.	Rural Health Medical Program, Inc.-Selma Health Center & Administrative Office	101 PARK PLACE	SELMA	AL
CH04285B	Active	BPS-H80-004587	RURAL HEALTH MEDICAL PROGRAM, INC.	UNIONTOWN HEALTH CENTER	330 OLD HAMBURG ROAD	UNIONTOWN	AL
CH04285C	Active	BPS-H80-004037	RURAL HEALTH MEDICAL PROGRAM, INC.	Rural Health Medical Program, Inc.- PINE APPLE HEALTH CENTER	867 COUNTY ROAD 59	PINE APPLE	AL
CH04285D	Active	BPS-H80-013667	RURAL HEALTH MEDICAL PROGRAM, INC.	Rural Health Medical Program, Inc. - Yellow Bluff - Camden Health Center	2210 Hwy 221	Camden	AL
CH04285G	Active	BPS-H80-003479	RURAL HEALTH MEDICAL PROGRAM, INC.	Rural Health Medical Program, Inc.- MARION HEALTH CENTER	1310 WASHINGTON STREET	MARION	AL
CH04285H	Active	BPS-H80-019237	RURAL HEALTH MEDICAL PROGRAM, INC.	Rural Health Medical Program, Inc.- Thomaston Health Center	111 Main Street	Thomaston	AL
CH04285J	Active	BPS-H80-024485	Rural Health Medical Program, Inc.	Rural Health Medical Program, Inc.- Demopolis Health Center	1502 US Highway 80	Demopolis	AL
CH04285K	Active	BPS-H80-029880	Rural Health Medical Program, Inc.	Rural Health Medical Program, Inc.- Monroeville Health Center	3040 S Alabama Ave	Monroeville	AL
CH04285L	Active	BPS-H80-034201	Rural Health Medical Program, Inc.	Rural Health Medical Program, Inc.- Thomasville Health Center	411 Wilson Ave W	Thomasville	AL
CH04285M	Approved	BPS-H80-029791	RURAL HEALTH MEDICAL PROGRAM INC	RHMPI Selma Mobile Unit Health Center	101 Park Pl	Selma	AL
CH04285N	Approved	BPS-H80-001139	RURAL HEALTH MEDICAL PROGRAM INC	Rural Health Medical Program, Inc. - Dallas County Health Center	228 Selma Ave	Selma	AL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH042850	ALABAMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04973	7 CAMDEN BYPASS	CAMDEN	AL	36726	01/01/2021
CH042850	ALABAMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04853	520 HIGHLAND AVENUE	SELMA	AL	36701	10/01/2022
CH04285J	ALABAMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04957	312 HWY 80 EAST	DEMOPOLIS	AL	36732	10/01/2022
CH042850	ALABAMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04957	312 HWY 80 EAST	DEMOPOLIS	AL	36732	01/01/2023
CH042850	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2018	05/08/2025
CH042850	COLLEGE CITY DRUG CO	BRADFORD R STURGIS	304 WASHINGTON ST PO BOX 220	MARION	AL	36756	04/01/2018	05/08/2025
CH042850	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	04/01/2018
CH042850	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	04/01/2018
CH042850	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/01/2018	05/08/2025
CH042850	FREDS PHARMACY #1356	24 CAMDEN BYPASS		CAMDEN	AL	36726	04/01/2018	09/06/2019
CH042850	INVERNESS APOTHECARY TRINITY	24333 GORDON TERRY PARKWAY	SUITE B	TRINITY	AL	35673	07/01/2018	03/07/2019
CH042850	MONROE DRUGS, LLC	360 S ALABAMA AVE		MONROEVILLE	AL	36460	01/01/2021	01/01/2021
CH042850	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2018	05/08/2025
CH042850	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2018	05/08/2025
CH042850	SPECIALTY CARE RX, LLC	150 COLLINS ST		MEMPHIS	TN	38112	07/01/2018	07/01/2018
CH042850	UNION DRUGS	A DIVISION OF BROWN DRUG CO INC	P.O. BOX 1220 117 WATER ST	UNIONTOWN	AL	36786-1220	01/01/2021	01/01/2021
CH042850	VITAL RX LLC	237 CAHABA VALLEY PARKWAY		PELHAM	AL	35124	07/01/2018	03/07/2019
CH042850	VITAL RX OF LOUISIANA	6200 LESLIE LN		LAKE CHARLES	LA	70615	07/01/2018	03/07/2019
CH042850	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2018
CH042850	WAL-MART PHARMACY 10-0700	1501 HWY 14 EAST		SELMA	AL	36703	04/01/2018
CH04285J	WAL-MART PHARMACY 10-0731	969 US HWY 80 WEST		DEMOPOLIS	AL	36732	10/01/2022
CH042850	WAL-MART PHARMACY 10-0731	969 US HWY 80 WEST		DEMOPOLIS	AL	36732	04/01/2025
CH042850	WAL-MART PHARMACY 10-1174	34301 HIGHWAY 43		THOMASVILLE	AL	36784	01/01/2019
CH042850	WAL-MART PHARMACY 10-1462	501 WILLOW LN		GREENVILLE	AL	36037	04/01/2018
CH042850	WAL-MART PHARMACY 10-1493	3371 SOUTH ALABAMA AVENUE		MONROEVILLE	AL	36460	07/01/2020
CH042850	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2018
CH042850	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	04/01/2024
CH042850	WALGREEN CO	DBA: WALGREENS #11468	101 GREENVILLE BYP	GREENVILLE	AL	36037-3724	04/01/2025
CH042850	WALGREEN CO.	DBA: WALGREENS # 10524	1111 HIGHLAND AVE	SELMA	AL	36703-4129	04/01/2025
CH042850	WALGREEN CO.	DBA: WALGREENS #12879	1772 S ALABAMA AVE	MONROEVILLE	AL	36460	04/01/2025
CH042850	WALGREEN CO.	DBA: WALGREENS #11115	33495 HIGHWAY 43	THOMASVILLE	AL	36784-3425	04/01/2025
CH042850	Walgreens #21389	Walgreens Central Fill #21389	3299 Tchulatech Dr Suite 101	Memphis	TN	38118	04/01/2025
CH042850	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024
CH042850	WHITAKER DRUGS	20 CAMDEN BYP		CAMDEN	AL	36726	01/01/2019
CH042850	WINN-DIXIE #543	1952 W. DALLAS AVE		SELMA	AL	36701	04/01/2018	10/19/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		DOZIER-SMITH, KESHEE Danee CEO Rural Health Medical Program, Inc. 3348747428-121	5/29/2025 7:48 AM
Details	340B ID	Update	New Registration		CH04285N	5/29/2025 7:48 AM
Dates	Participating Approval Date	Update	New Registration		5/29/2025 7:48:29 AM	5/29/2025 7:48 AM
Details	State	Update	New Registration	Pending	Approved	5/29/2025 7:48 AM
Dates	Signed By Date	Update	New Registration		5/28/2025 5:29:25 PM	5/29/2025 7:48 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	5/29/2025 7:48 AM
Addresses	Main Address	Insert	New Registration		228 Selma Ave Selma, AL 36701-5825	5/28/2025 10:36 AM
Contacts	Primary Contact	Insert	New Registration		Williams, Jasmine Corporate Compliance Officer Rural Health Medical Program Inc. 3348747428	5/28/2025 10:36 AM
Contacts	Authorizing Official	Insert	New Registration		DOZIER-SMITH, KESHEE Danee CEO Rural Health Medical Program, Inc. 3348747428-121	5/28/2025 10:36 AM
Details	Assistance Received From Date	Insert	New Registration			5/28/2025 10:36 AM
Details	Assistance Received To Date	Insert	New Registration			5/28/2025 10:36 AM
Details	Last Recertification Date	Insert	New Registration			5/28/2025 10:36 AM
Details	Grant Number	Insert	New Registration		H80CS00794	5/28/2025 10:36 AM
Details	340B ID	Insert	New Registration			5/28/2025 10:36 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			5/28/2025 10:36 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			5/28/2025 10:36 AM
Details	Medicare Provider Number	Insert	New Registration			5/28/2025 10:36 AM
Details	Entity Name	Insert	New Registration		RURAL HEALTH MEDICAL PROGRAM INC	5/28/2025 10:36 AM
Details	NOFO Number	Insert	New Registration			5/28/2025 10:36 AM
Details	Program Code	Insert	New Registration		CH	5/28/2025 10:36 AM
Details	Entity Subname	Insert	New Registration		Rural Health Medical Program, Inc. - Dallas County Health Center	5/28/2025 10:36 AM
Dates	Participating Approval Date	Insert	New Registration			5/28/2025 10:36 AM
Details	State	Insert	New Registration		Pending	5/28/2025 10:36 AM
Dates	Registration Date	Insert	New Registration		5/28/2025 10:36:56 AM	5/28/2025 10:36 AM
Dates	Signed By Date	Insert	New Registration			5/28/2025 10:36 AM
Dates	Start Date	Insert	New Registration			5/28/2025 10:36 AM
Terminations	Termination Comments	Insert	New Registration			5/28/2025 10:36 AM
Terminations	Termination Date	Insert	New Registration			5/28/2025 10:36 AM
Terminations	Termination Effective Date	Insert	New Registration			5/28/2025 10:36 AM
Terminations	Termination Reason	Insert	New Registration			5/28/2025 10:36 AM

340B Drug Pricing Program Database