340B Drug Pricing Program Database


CH03089A PRESTON TAYLOR COMMUNITY HEALTH CENTER (Active) - information as of 4/23/2025 10:51:05 PM

Main Details
PRESTON TAYLOR COMMUNITY HEALTH CENTER
EGLON CLINIC
HRSA-Funded Health Center
BPS-H80-001077
CH03089A
H80CS00617


Additional Details
Active
7/1/2004
7/1/2004
6/10/2004
2/26/2025

Contacts

Preston-Taylor Community Health Centers, Inc.
June Griffith, COO
(304) 265-0312

PTCHC
Charles Michael Dickey, Pharmacist
(304) 265-7400

Addresses

2604 Grange Hall Rd
Eglon, WV 26716-0008

PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC. - MAIN SITE/ADMINISTRATIVE OFFICE
25 W Bluemont St
PO Box 399
Grafton, WV 26354


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
NEW SITE 07/01/200408/12/2005
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
WV38100089481538277231,1578549879,1578996310,1760601850
Shipping Addresses

Preston-Taylor Pharmacy
25 W Bluemont St
Grafton, WV 26354
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH030890ActiveBPS-H80-000768PRESTON TAYLOR COMMUNITY HEALTH CENTERPreston-Taylor Community Health725 N Pike St GraftonWV
CH03089AActiveBPS-H80-001077PRESTON TAYLOR COMMUNITY HEALTH CENTEREGLON CLINIC2604 Grange Hall Rd EglonWV
CH03089DActiveBPS-H80-004584PRESTON TAYLOR COMMUNITY HEALTH CENTERMT. STORM HEALTH CENTER14311 George Washington Highway MT. STORMWV
CH03089EActiveBPS-H80-002449PRESTON TAYLOR COMMUNITY HEALTH CENTERROWLESBURG CLINIC83 Poplar St. RowlesburgWV
CH03089GActiveBPS-H80-012063PRESTON TAYLOR COMMUNITY HEALTH CENTERMountaintop Health Center30 Cortland Acres Ln ThomasWV
CH03089HActiveBPS-H80-008190PRESTON TAYLOR COMMUNITY HEALTH CENTERNewburg Clinic1231 N Mountaineer Highway NewburgWV
CH03089JActiveBPS-H80-003532PRESTON TAYLOR COMMUNITY HEALTH CENTERDENTAL CENTER OF TAYLOR COUNTY711 N Pike Street GraftonWV
CH03089KActiveBPS-H80-035324Preston Taylor Community Health CenterMountaintop Dental Center132 Cortland Acres Lane ThomasWV
CH03089LActiveBPS-H80-037034PRESTON TAYLOR COMMUNITY HEALTH CENTERS INCCommunity Eyecare216 Lincoln St GraftonWV
CH03089MActiveBPS-H80-037667PRESTON TAYLOR COMMUNITY HEALTH CENTERS INCTaylor County Middle School - SBHC670 Spring Hills Rd GraftonWV
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH030890CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2023  
CH030890CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2023  
CH030890CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2024  
CH030890MARYLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04102 220 NORTH 3RD ST.
OAKLANDMD2155007/01/2023  
CH030890WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738607/01/2020  
CH030890WAL-MART PHARMACY 10-28331 WAL-MART LANE
GRAFTONWV2635407/01/2020  
CH030890WAL-MART PHARMACY 10-289413164 GARRETT HIGHWAY
OAKLANDMD2155007/01/2020  
CH030890WAL-MART PHARMACY 10-4372100 WAL-MART DRIVE
KINGWOODWV2653707/01/2020  
CH030890WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283707/01/2020  
CH030890WALGREEN CO.DBA: WALGREENS #12277 38 VICTORY AVE.
GRAFTONWV2635407/01/2020  
CH030890WALGREEN CO.DBA: WALGREENS #12266 209 N 3RD ST
OAKLANDMD2155007/01/2020  
CH030890WALGREEN CO.WALGREENS #18187 150 MAIN ST.
PARSONSWV26287-014807/01/2020 12/14/2023
CH030890WALGREEN CO.WALGREENS #19666 415 E MAIN ST.
KINGWOODWV26537-170107/01/2022  
CH030890Walgreens #21423Walgreens Central Fill #21423 6275 Winchester Blvd
Canal WInchesterOH43110-653701/01/2024  
CH030890WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2024  
CH030890WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/01/2024  
CH030890WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2024  
CH030890WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/01/2024  
CH030890Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
CH030890WEST VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03475 300 FAIRMONT AVENUE
FAIRMONTWV2655407/01/2023  
CH030890WEST VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06280 1601 EARL L CORE RD.
MORGANTOWNWV2650507/01/2023  
CH030890WHITE HALL PHARMACY, LLC.177 MIDDLETOWN RD STE 2
FAIRMONTWV26554-825407/01/2020 12/29/2023
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/16/2024 2:22:30 PM2/26/2025 7:38:26 AM2/26/2025 7:38 AM
DetailsLast Recertification DateUpdateRecertification2/13/2023 11:24:35 AM2/16/2024 2:22:30 PM2/16/2024 2:22 PM
AddressesBilling AddressUpdateRecertificationPRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC. - MAIN SITE/ADMINISTRATIVE OFFICE 725 NORTH PIKE STREET, PO BOX 399 GRAFTON, WV 26354PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC. - MAIN SITE/ADMINISTRATIVE OFFICE 25 W Bluemont St PO Box 399 Grafton, WV 263542/13/2023 11:24 AM
Medicaid BillingNPI: NumberDeleteRecertification1962876110 (WV) 2/13/2023 11:24 AM
DetailsLast Recertification DateUpdateRecertification2/23/2022 3:48:35 PM2/13/2023 11:24:35 AM2/13/2023 11:24 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestShriver, Linda M. CEO Preston-Taylor Community Health Centers, Inc. 3042650312Griffith, June COO Preston-Taylor Community Health Centers, Inc. 30426503122/28/2022 9:11 PM
ContactsPrimary ContactUpdateGroup Change RequestGriffith, June COO Preston-Taylor Community Health Centers, Inc. 3042650312Dickey, Charles Michael Pharmacist PTCHC 30426574002/28/2022 9:11 PM
DetailsLast Recertification DateUpdateRecertification2/25/2021 11:06:33 AM2/23/2022 3:48:35 PM2/23/2022 3:48 PM
AddressesShipping AddressInsertChange Request Preston-Taylor Pharmacy 25 W Bluemont St Grafton, WV 263545/18/2021 4:54 PM
Medicaid BillingNPI: StateUpdateRecertification WV2/25/2021 11:06 AM
Medicaid BillingNPI: StateUpdateRecertification WV2/25/2021 11:06 AM
Medicaid BillingNPI: StateUpdateRecertification WV2/25/2021 11:06 AM
Medicaid BillingNPI: StateUpdateRecertification WV2/25/2021 11:06 AM
Medicaid BillingNPI: StateUpdateRecertification WV2/25/2021 11:06 AM
DetailsLast Recertification DateUpdateRecertification2/21/2020 10:49:57 AM2/25/2021 11:06:33 AM2/25/2021 11:06 AM
DetailsLast Recertification DateUpdateRecertification2/22/2019 3:51:13 PM2/21/2020 10:49:57 AM2/21/2020 10:49 AM
DetailsLast Recertification DateUpdateRecertification2/20/2018 10:31:20 AM2/22/2019 3:51:13 PM2/22/2019 3:51 PM
Medicaid BillingNPI: NumberInsertRecertification 19628761102/20/2018 10:31 AM
DetailsLast Recertification DateUpdateRecertification2/22/2017 12:00:00 AM2/20/2018 10:31:20 AM2/20/2018 10:31 AM
ContactsAuthorizing OfficialUpdate Shriver, Linda M. CEO 3042650312Shriver, Linda M. CEO Preston-Taylor Community Health Centers, Inc. 30426503122/20/2018 10:16 AM
ContactsPrimary ContactUpdate Griffith, June COO 3042650312Griffith, June COO Preston-Taylor Community Health Centers, Inc. 30426503122/20/2018 9:35 AM
AddressesMain AddressInsert   2604 Grange Hall Rd EGLON, WV 26716-00082/22/2017 12:00 PM
ContactsPrimary ContactInsert  Griffith, June COO 30426503122/22/2017 12:00 PM
ContactsAuthorizing OfficialInsert  Shriver, Linda M. CEO 30426503122/22/2017 12:00 PM
Medicaid BillingNPI: NumberInsert  17606018502/22/2017 12:00 PM
DetailsLast Recertification DateUpdate 3/9/2016 12:00:00 AM2/22/2017 12:00:00 AM2/22/2017 12:00 PM
Medicaid BillingNPI: NumberInsert  15382772313/9/2016 1:46 PM
Medicaid BillingNPI: NumberInsert  15785498793/9/2016 1:46 PM
Medicaid BillingNPI: NumberInsert  15789963103/9/2016 1:46 PM
DetailsLast Recertification DateUpdate 3/3/2015 12:00:00 AM3/9/2016 12:00:00 AM3/9/2016 1:46 PM
DetailsLast Recertification DateUpdate 3/19/2014 12:00:00 AM3/3/2015 12:00:00 AM3/3/2015 9:05 AM
AddressesBilling AddressInsert  PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC. - MAIN SITE/ADMINISTRATIVE OFFICE 725 NORTH PIKE STREET, PO BOX 399 GRAFTON, WV 263548/19/2014 4:27 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False3/19/2014 9:12 AM
Medicaid BillingMedicaid: NumberInsert  38100089483/19/2014 9:12 AM
Medicaid BillingMedicaid: StateInsert  WV3/19/2014 9:12 AM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM3/19/2014 12:00:00 AM3/19/2014 9:12 AM
DetailsEntity NameUpdate PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC.PRESTON TAYLOR COMMUNITY HEALTH CENTER3/19/2014 9:12 AM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/11/2013 9:15 AM
DetailsLast Recertification DateInsert   8/12/2005 4:08 PM
DetailsGrant NumberInsert  H80CS006178/12/2005 4:08 PM
Details340B IDInsert  CH03089A8/12/2005 4:08 PM
DetailsIs Authorizing Official EHB DataInsert   8/12/2005 4:08 PM
DatesLast Date That 340B Drugs PurchasedInsert   8/12/2005 4:08 PM
DetailsMedicare Provider NumberInsert   8/12/2005 4:08 PM
DetailsEntity NameInsert  PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INC.8/12/2005 4:08 PM
DetailsProgram CodeInsert  CH8/12/2005 4:08 PM
DetailsEntity SubnameInsert  EGLON CLINIC8/12/2005 4:08 PM
DatesParticipating Approval DateInsert  6/10/2004 12:00:00 AM8/12/2005 4:08 PM
DetailsStateInsert  Active8/12/2005 4:08 PM
DatesRegistration DateInsert  7/1/2004 12:00:00 AM8/12/2005 4:08 PM
DatesSigned By DateInsert   8/12/2005 4:08 PM
DatesStart DateInsert  7/1/2004 12:00:00 AM8/12/2005 4:08 PM
TerminationsTermination CommentsInsert   8/12/2005 4:08 PM
TerminationsTermination DateInsert   8/12/2005 4:08 PM
TerminationsTermination Effective DateInsert   8/12/2005 4:08 PM
TerminationsTermination ReasonInsert   8/12/2005 4:08 PM
DetailsComments PublicInsert  NEW SITE 07/01/20048/12/2005 4:08 PM