Covered Entity Details

CH04278A CAROLINA HEALTH CENTERS, INC. (Active) - information as of 6/27/2025 12:28:57 AM

Main Details

Name

CAROLINA HEALTH CENTERS, INC.

Subdivision Name

MCCORMICK FAMILY PRACTICE

Type

HRSA-Funded Health Center

Site ID

BPS-H80-015233

340B ID

CH04278A

Grant Number

H80CS00785

Additional Details

Current Program Status

Active

Registration Date

1/1/2004

Participating Start Date

1/1/2004

Participating Approval Date

12/13/2003

Last Recertification Date

2/26/2025

Contacts

Authorizing Official

Carolina Health Centers, Inc.
SUE VEER, CEO
(864) 388-0301 Ext: 68207

Primary Contact

Carolina Health Centers, Inc.
Dominic Mellette, DIRECTOR OF PHARMACY
(864) 554-7102

Addresses

Street Address

1319 S. Main Street
MCCORMICK, SC 29835

Billing Address

Carolina Health Centers, Inc.
313 MAIN ST.
Suite B
GREENWOOD, SC 29646

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
3/29/12-Changed authorizing official and primary contact was (DONALD G. BOONE) ADDED ADDITIONAL SHIPPING ADDRESS; 7/23/09 SHIPPING ADDED - NEW ADD 1/04	03/29/2012
3/29/12-Changed authorizing official and primary contact was (DONALD G. BOONE); 7/23/09 SHIPPING ADDED - NEW ADD 1/04	03/29/2012
7/23/09 SHIPPING ADDED - NEW ADD 1/04	07/23/2009

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
SC	FQC002	1063545119

Shipping Addresses

Shipping Address 1

Carolina Health Centers, Inc. DBA Carolina Community Pharmacy at Carolina Village
420 EPTING AVEUNE
GREENWOOD, SC 29646-4040

Shipping Address 2

CAROLINA HEALTH CENTERS, INC. DBA CAROLINA COMMUNITY PHARMACY NW
577 BYPASS 72 NW
GREENWOOD, SC 29649

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
CH042780	Active	BPS-H80-002333	CAROLINA HEALTH CENTERS, INC.		313 MAIN STREET	SUITE B	GREENWOOD	SC
CH04278A	Active	BPS-H80-015233	CAROLINA HEALTH CENTERS, INC.	MCCORMICK FAMILY PRACTICE	1319 S. Main Street		MCCORMICK	SC
CH04278B	Active	BPS-H80-002111	CAROLINA HEALTH CENTERS, INC.	SALUDA FAMILY PRACTICE CENTER	219 GREENWOOD HIGHWAY		SALUDA	SC
CH04278C	Active	BPS-H80-005484	CAROLINA HEALTH CENTERS, INC.	The Pendergrass Family Health Center	93 SOUTH GREENWOOD AVENUE		WARE SHOALS	SC
CH04278F	Active	BPS-H80-000417	CAROLINA HEALTH CENTERS, INC.	CALHOUN FALLS FAMILY PRACTICE CENTER	535 JACKSON STREET		CALHOUN FALLS	SC
CH04278G	Active	BPS-H80-004413	CAROLINA HEALTH CENTERS, INC.	RIDGE SPRING FAMILY PRACTICE CENTER	201 AIKEN ROAD		RIDGE SPRING	SC
CH04278H	Active	BPS-H80-003974	CAROLINA HEALTH CENTERS, INC.	UPTOWN FAMILY PRACTICE	313 MAIN STREET	Suite A	GREENWOOD	SC
CH04278I	Active	BPS-H80-002822	CAROLINA HEALTH CENTERS, INC.	THE CHILDRENS CENTER	113 LINER DRIVE		GREENWOOD	SC
CH04278J	Terminated	BPS-H80-007235	CAROLINA HEALTH CENTERS, INC.	MCCORMICK ELEMENTARY SCHOOL	6977 HIGHWAY 28 SOUTH		MCCORMICK	SC
CH04278K	Active	BPS-H80-000210	CAROLINA HEALTH CENTERS, INC.	LAKELANDS FAMILY PRACTICE AND PEDIATRIC CENTER	17124 HIGHWAY 72 W		WATERLOO	SC
CH04278P	Terminated	BPS-H80-013711	CAROLINA HEALTH CENTERS, INC.	HomeTown Pediatrics	500 Plaza Circle, Suite J		CLINTON	SC
CH04278Q	Active	BPS-H80-011836	CAROLINA HEALTH CENTERS, INC.	Laurens Community Care Medical Home Referral Center	22725 Highway 76 E		Clinton	SC
CH04278R	Active	BPS-H80-033499	CAROLINA HEALTH CENTERS, INC.	The Bethany Center	355 Cambridge Ave. W		Greenwood	SC
CH04278S	Active	BPS-H80-016917	CAROLINA HEALTH CENTERS, INC.	Village Family Practice	420 Epting Avenue, Suite B		Greenwood	SC
CH04278T	Active	BPS-H80-021965	CAROLINA HEALTH CENTERS, INC.	HomeTown Pediatrics	23265 Hwy 76 E		Clinton	SC
CH04278U	Active	BPS-H80-037637	CAROLINA HEALTH CENTERS INC	Carolina Health Centers at Laurens MHC	442 Professional Park Rd		Clinton	SC
CH04278V	Active	BPS-H80-037847	CAROLINA HEALTH CENTERS INC	Carolina Health Centers at Newberry MHC	2043 Medical Park Drive RM 114, 131		Newberry	SC
CH04278W	Active	BPS-H80-037848	CAROLINA HEALTH CENTERS INC	Carolina Health Centers at Greenwood MHC	1547 Parkway, Suite 200 RM 306, 302		Grenwood	SC
CH04278X	Active	BPS-H80-037846	CAROLINA HEALTH CENTERS INC	Carolina Health Centers at Abbeville MHC	101 Commercial Drive RM 8, 11		Abbeville	SC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH042780	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2025
CH042780	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2025
CH042780	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2025
CH042780	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2025
CH042780	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2025
CH042780	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2025
CH042780	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2025
CH042780	AVITA PHARMACY 1058	MEDEXPRESS PHARMACY, LTD. DBA AVITA PHAR	1431 W. INNES ST.	SALISBURY	NC	28144	01/01/2025
CH042780	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CH042780	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CH042780	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CH042780	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	10/01/2024
CH042780	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	10/01/2024
CH042780	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	07/01/2018
CH042780	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	07/01/2018
CH042780	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CH042780	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2025
CH042780	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2025
CH042780	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2025
CH042780	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2025
CH042780	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2025
CH042780	LONGS DRUGSTORES OF SOUTH CAROLINA	D/B/A AVITA PHARMACY 1055	811 PENDLETON ST STE 10	GREENVILLE	SC	29601-3232	01/01/2025
CH042780	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2025
CH042780	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	10/01/2019	08/23/2021
CH042780	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	10/01/2019	08/23/2021
CH042780	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1464	479 BYPASS 72 NORTHWEST SUITE 100	GREENWOOD	SC	29649	10/01/2019	08/23/2021
CH042780	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CH042780	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CH042780	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05579	1337 SOUTH MAIN STREET	GREENWOOD	SC	29646	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03543	902 W. GREENWOOD ST.	ABBEVILLE	SC	29620	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03557	194 JACOBS HIGHWAY	CLINTON	SC	29325	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03869	321 N. MAIN ST.	SALUDA	SC	29138	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04173	1302 HWY 72-221 EAST	GREENWOOD	SC	29649	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07318	230 APPLE SQUARE PLAZA	EDGEFIELD	SC	29824	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07388	1942 MONTAGUE AVENUE EXT.	GREENWOOD	SC	29649	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07538	408-B EAST GREER STREET	HONEA PATH	SC	29654	07/01/2019
CH042780	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03578	120 WEST COLUMBIA AVENUE	BATESBURG	SC	29006	01/01/2020
CH042780	STROM'S DRUG STORE #2	124 S MAIN ST		MC CORMICK	SC	29835-8345	07/01/2021
CH042780	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2019
CH042780	WAL-MART PHARMACY 10-1130	922 E MAIN STREET		LAURENS	SC	29360	10/01/2019
CH042780	WAL-MART PHARMACY 10-1382	508 BYPASS 72 NW		GREENWOOD	SC	29649	10/01/2019
CH042780	WAL-MART PHARMACY 10-4420	115 EAST CHURCH STREET		LEESVILLE	SC	29070	10/01/2019
CH042780	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2019
CH042780	WALGREEN CO.	DBA: WALGREENS # 02681	6057 WHITE HORSE ROAD	GREENVILLE	SC	29611-3842	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS # 07446	1014 MONTAGUE AVE	GREENWOOD	SC	29649-1450	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS #10229	1376 S. MAIN ST.	GREENWOOD	SC	29646-3932	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS #12163	127 W. COLUMBIA AVE.	BATESBURG	SC	29006	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS #12568	814 E. MAIN ST.	LAURENS	SC	29360-3535	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS #12795	3510 RICHLAND AVE. W	AIKEN	SC	29801	04/01/2013	10/01/2015
CH042780	WALGREEN CO.	DBA: WALGREENS # 07446	1014 MONTAGUE AVE	GREENWOOD	SC	29649-1450	07/01/2020
CH042780	WALGREEN CO.	DBA: WALGREENS #10229	1376 S. MAIN ST.	GREENWOOD	SC	29646-3932	07/01/2020
CH042780	WALGREEN CO.	DBA: WALGREENS #12568	814 E. MAIN ST.	LAURENS	SC	29360-3535	07/01/2020
CH042780	WALGREEN CO.	DBA: WALGREENS #17512	571 N HARPER ST	LAURENS	SC	29360	07/01/2020
CH042780	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH042780	WALMART PHARMACY 10-6887	300 BYPASS 25 NE		GREENWOOD	SC	29646	10/01/2019
CH042780	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/10/2024 3:45:09 PM	2/26/2025 12:50:53 AM	2/26/2025 12:50 AM
Details	Last Recertification Date	Update	Recertification	2/10/2023 3:04:21 PM	2/10/2024 3:45:09 PM	2/10/2024 3:45 PM
Details	Last Recertification Date	Update	Recertification	2/15/2022 11:47:23 AM	2/10/2023 3:04:21 PM	2/10/2023 3:04 PM
Details	Last Recertification Date	Update	Recertification	2/25/2021 8:48:47 AM	2/15/2022 11:47:23 AM	2/15/2022 11:47 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1063545119	2/25/2021 8:48 AM
Medicaid Billing	NPI: State	Insert	Recertification		SC	2/25/2021 8:48 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1063545119 ( )		2/25/2021 8:48 AM
Details	Last Recertification Date	Update	Recertification	2/6/2020 5:49:53 PM	2/25/2021 8:48:47 AM	2/25/2021 8:48 AM
Details	Last Recertification Date	Update	Recertification	2/19/2019 4:00:25 PM	2/6/2020 5:49:53 PM	2/6/2020 5:49 PM
Details	Last Recertification Date	Update	Recertification	2/27/2018 3:26:20 PM	2/19/2019 4:00:25 PM	2/19/2019 4:00 PM
Details	Last Recertification Date	Update	Recertification	2/20/2017 12:00:00 AM	2/27/2018 3:26:20 PM	2/27/2018 3:26 PM
Contacts	Primary Contact	Update	Recertification	Mellette, Dominic DIRECTOR OF PHARMACY 8648899304	Mellette, Dominic DIRECTOR OF PHARMACY Carolina Health Centers, Inc. 8645547102	2/27/2018 3:24 PM
Contacts	Authorizing Official	Update		VEER, SUE CEO 8643880301-68207	VEER, SUE CEO Carolina Health Centers, Inc. 8643880301-68207	10/3/2017 1:51 PM
Addresses	Main Address	Insert			1319 S. Main Street MCCORMICK, SC 29835	2/20/2017 4:08 PM
Contacts	Authorizing Official	Update		BOONE, DONALD G. CEO 8643880301-200	VEER, SUE CEO 8643880301-68207	2/20/2017 4:08 PM
Contacts	Primary Contact	Update		BROWN, LOUIE DIRECTOR OF PHARMACY 8648899304	Mellette, Dominic DIRECTOR OF PHARMACY 8648899304	2/20/2017 4:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/20/2017 4:08 PM
Medicaid Billing	Medicaid: Number	Insert			FQC002	2/20/2017 4:08 PM
Medicaid Billing	Medicaid: State	Insert			SC	2/20/2017 4:08 PM
Medicaid Billing	NPI: Number	Insert			1063545119	2/20/2017 4:08 PM
Details	Last Recertification Date	Update		2/15/2016 12:00:00 AM	2/20/2017 12:00:00 AM	2/20/2017 4:08 PM
Contacts	Primary Contact	Update		BOONE, DONALD G. CEO 8643880301-200	BROWN, LOUIE DIRECTOR OF PHARMACY 8648899304	2/16/2016 1:52 PM
Details	Last Recertification Date	Update		3/10/2015 12:00:00 AM	2/15/2016 12:00:00 AM	2/15/2016 2:29 PM
Addresses	Billing Address	Insert			Carolina Health Centers, Inc. 313 MAIN ST. Suite B GREENWOOD, SC 29646	10/27/2015 3:35 PM
Addresses	Shipping Address	Insert			CAROLINA HEALTH CENTERS, INC. DBA CAROLINA COMMUNITY PHARMACY NW 577 BYPASS 72 NW GREENWOOD, SC 29649	10/27/2015 3:35 PM
Addresses	Shipping Address	Insert			Carolina Health Centers, Inc. DBA Carolina Community Pharmacy at Carolina Village 420 EPTING AVEUNE GREENWOOD, SC 29646-4040	10/27/2015 3:35 PM
Details	Last Recertification Date	Update		3/7/2014 12:00:00 AM	3/10/2015 12:00:00 AM	3/10/2015 6:03 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/7/2014 12:00:00 AM	3/7/2014 9:50 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/20/2013 9:42 AM
Details	Comments Public	Insert			3/29/12-Changed authorizing official and primary contact was (DONALD G. BOONE) ADDED ADDITIONAL SHIPPING ADDRESS; 7/23/09 SHIPPING ADDED - NEW ADD 1/04	3/29/2012 3:26 PM
Details	Comments Public	Insert			3/29/12-Changed authorizing official and primary contact was (DONALD G. BOONE); 7/23/09 SHIPPING ADDED - NEW ADD 1/04	3/29/2012 11:30 AM
Contacts	Authorizing Official	Insert			BOONE, DONALD G. CEO 8643880301-200	7/23/2009 3:48 PM
Contacts	Primary Contact	Insert			BOONE, DONALD G. CEO 8643880301-200	7/23/2009 3:48 PM
Details	Last Recertification Date	Insert				7/23/2009 3:01 PM
Details	Grant Number	Insert			H80CS00785	7/23/2009 3:01 PM
Details	340B ID	Insert			CH04278A	7/23/2009 3:01 PM
Details	Is Authorizing Official EHB Data	Insert				7/23/2009 3:01 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/23/2009 3:01 PM
Details	Medicare Provider Number	Insert				7/23/2009 3:01 PM
Details	Entity Name	Insert			CAROLINA HEALTH CENTERS, INC.	7/23/2009 3:01 PM
Details	Program Code	Insert			CH	7/23/2009 3:01 PM
Details	Entity Subname	Insert			MCCORMICK FAMILY PRACTICE	7/23/2009 3:01 PM
Dates	Participating Approval Date	Insert			12/13/2003 12:00:00 AM	7/23/2009 3:01 PM
Details	State	Insert			Active	7/23/2009 3:01 PM
Dates	Registration Date	Insert			1/1/2004 12:00:00 AM	7/23/2009 3:01 PM
Dates	Signed By Date	Insert				7/23/2009 3:01 PM
Dates	Start Date	Insert			1/1/2004 12:00:00 AM	7/23/2009 3:01 PM
Terminations	Termination Comments	Insert				7/23/2009 3:01 PM
Terminations	Termination Date	Insert				7/23/2009 3:01 PM
Terminations	Termination Effective Date	Insert				7/23/2009 3:01 PM
Terminations	Termination Reason	Insert				7/23/2009 3:01 PM
Details	Comments Public	Insert			7/23/09 SHIPPING ADDED - NEW ADD 1/04	7/23/2009 3:01 PM

340B Drug Pricing Program Database