Covered Entity Details

CH05315D COMMUNITY HEALTH IMPROVEMENT CENTER (Terminated) - information as of 5/5/2025 11:57:28 PM

Main Details

Name

COMMUNITY HEALTH IMPROVEMENT CENTER

Subdivision Name

URBANA SCHOOL HEALTH CENTER

Type

HRSA-Funded Health Center

Site ID

BPS-H80-002287

340B ID

CH05315D

Grant Number

H80CS00681

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2004

Participating Start Date

10/1/2004

Participating Approval Date

9/14/2004

Last Recertification Date

3/2/2018

Termination Date
Termination Reason

4/1/2019
Other

Contacts

Authorizing Official

Crossing Healthcare
Tanya Renee Andricks, CEO
(217) 877-6111

Primary Contact

Crossing Healthcare
Lois Tanner, CFO
(217) 877-6127

Addresses

Street Address

1002 S RACE ST
URBANA, IL 61801-4957

Billing Address

COMMUNITY HEALTH IMPROVEMENT CENTER
1314 NORTH MAIN STREET
DECATUR, IL 62526-4438

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

Comments

Comment	Last Updated On
NEW SITE 10/01/2004	08/11/2005

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
IL	370961830003
		1023083227

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
CH053150	Active	BPS-H80-017030	COMMUNITY HEALTH IMPROVEMENT CENTER	COMMUNITY HEALTH IMPROVEMENT CENTER	320 East Central Avenue	Decatur	IL
CH05315C	Terminated	BPS-H80-002597	COMMUNITY HEALTH IMPROVEMENT CENTER	Frances Nelson Health Center	819 BLOOMINGTON RD.	CHAMPAIGN	IL
CH05315D	Terminated	BPS-H80-002287	COMMUNITY HEALTH IMPROVEMENT CENTER	URBANA SCHOOL HEALTH CENTER	1002 S RACE ST	URBANA	IL
CH05315E	Terminated	BPS-H80-007233	COMMUNITY HEALTH IMPROVEMENT CENTER	Oasis Drop In Center	243 W. Cerro Gordo	Decatur	IL
CH05315F	Terminated	BPS-H80-011930	COMMUNITY HEALTH IMPROVEMENT CENTER	Heritage Behavioral Health Center, Inc.	151 N Main St	Decatur	IL
CH05315G	Active	BPS-H80-006564	COMMUNITY HEALTH IMPROVEMENT CENTER	MACON COUNTY HEALTH DEPARTMENT	1221 E. CONDIT	DECATUR	IL
CH05315H	Terminated	BPS-H80-013678	COMMUNITY HEALTH IMPROVEMENT CENTER	Community Health Improvement Center at Decatur Memorial Hospital	2300 N EDWARD ST	DECATUR	IL
CH05315J	Terminated	BPS-H80-014147	COMMUNITY HEALTH IMPROVEMENT CENTER	Promise Healthcare at the Community Resource Center	1400 W PARK ST, Building 3	URBANA	IL
CH05315K	Terminated	BPS-H80-013433	COMMUNITY HEALTH IMPROVEMENT CENTER	Promise Healthcare at Community Elements	801 N WALNUT ST	CHAMPAIGN	IL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH053150	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05545	225 E. ASH	DECATUR	IL	62526	04/01/2024
CH053150	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05388	1311 N STATE ROUTE 48	DECATUR	IL	62526	04/01/2024
CH053150	DALE'S SOUTHLAKE PHARMACY	245 W 1ST DR STE B	LAKE OF DECATUR, INC.	DECATUR	IL	62521-5381	09/19/2011	06/30/2024
CH053150	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 04857	570 N. FAIRVIEW AVE.	DECATUR	IL	62522	04/01/2020
CH053150	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 08632	1595 E CANTRELL ST	DECATUR	IL	62521	04/01/2020
CH053150	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 08648	2990 N. MONROE STREET	DECATUR	IL	62526	04/01/2020
CH053150	HIGHLAND PARK CVS, L.L.C.	CVS PHARMACY # 17068	355 W MOUND RD	DECATUR	IL	62526	04/01/2020
CH05315C	INDEPENDENCE HOLDING CO LLC	DBA COMPLETE CARE PHARMACY	14 E WASHINGTON ST. SUITE C	CHAMPAIGN	IL	61820	10/01/2013	10/01/2016
CH053150	KROGER PHARMACY	#250	1401 W. KING	DECATUR	IL	62522	04/01/2017
CH053150	KROGER PHARMACY 946	1818 AIRPORT PLZ		DECATUR	IL	62521-9717	04/01/2017
CH053150	KROGER PHARMACY J-924	255 W FIRST DR		DECATUR	IL	62521	04/01/2017
CH053150	KROGER SAV-ON PHARMACY #J-922	3070 N WATER STREET		DECATUR	IL	62526	04/01/2017
CH053150	LAKE OF DECATUR INC	DBA - COLEE'S COMMUNITY PHARMACY	320 E CENTRAL AVE	DECATUR	IL	62521	01/01/2017	06/30/2024
CH053150	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2017
CH053150	WAL-MART PHARMACY 10-1690	4224 NORTH PROSPECT		DECATUR	IL	62526	04/01/2017
CH053150	WAL-MART PHARMACY 10-2728	4625 EAST MARYLAND AVENUE		DECATUR (S)	IL	62521	04/01/2017
CH053150	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2017
CH053150	WALGREEN CO	DBA: WALGREENS #10800	424 W VAN BUREN ST	CLINTON	IL	61727-2130	04/01/2024
CH053150	Walgreen CO	DBA Walgreens Central Fill #21417	599 S Schmidt Rd Ste A	Bolingbrook	IL	60440-9405	04/01/2024
CH053150	WALGREEN CO.	DBA: WALGREENS # 05719	4995 E US ROUTE 36	DECATUR	IL	62521	04/01/2024
CH053150	WALGREEN CO.	DBA: WALGREENS # 09792	625 W PERSHING RD	DECATUR	IL	62526	04/01/2024
CH053150	WALGREEN CO.	DBA: WALGREENS #13921	420 W. FIRST DR.	DECATUR	IL	62521	04/01/2024
CH053150	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #21190	1150 N 5TH ST STE B	SPRINGFIELD	IL	62702	04/01/2024
CH053150	WALGREEN CO.	DBA: WALGREENS SPECIALTY PHARMACY #10843	747 N RUTLEDGE ST STE 100	SPRINGFIELD	IL	62702	04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Recertification	West, Tom CFO Crossing Healthcare 2178776127	Tanner, Lois CFO Crossing Healthcare 2178776127	1/31/2022 10:14 AM
Details	State	Update		To Be Terminated	Terminated	4/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		6/30/2018 12:00:00 AM	1/30/2019 9:58 AM
Details	State	Update	Recertification	Active	To Be Terminated	1/30/2019 9:58 AM
Terminations	Termination Comments	Update	Recertification		This location is no longer operated by Community Health Improvement Center. It is now operated by Promise Healthcare which is an eligible 340B organization thru the Consolidated Health Center Program. This transition was done with the approval of HRSA and was completed on July 1, 2018.	1/30/2019 9:58 AM
Terminations	Termination Date	Update	Recertification		4/1/2019 12:00:00 AM	1/30/2019 9:58 AM
Terminations	Termination Effective Date	Update	Recertification		6/30/2018 12:00:00 AM	1/30/2019 9:58 AM
Terminations	Termination Reason	Update	Recertification		Other	1/30/2019 9:58 AM
Details	Last Recertification Date	Update	Recertification	2/14/2017 12:00:00 AM	3/2/2018 9:43:13 AM	3/2/2018 9:43 AM
Contacts	Authorizing Official	Update	AO Change Request	West, Tom CFO Crossing Healthcare 2178776127	Andricks, Tanya Renee CEO Crossing Healthcare 2178776111	3/1/2018 10:45 AM
Contacts	Authorizing Official	Update	Recertification	Andricks, Tanya CEO 2178776111	West, Tom CFO Crossing Healthcare 2178776127	2/13/2018 9:51 AM
Contacts	Primary Contact	Update	Recertification	Andricks, Tanya CEO 2178776111	West, Tom CFO Crossing Healthcare 2178776127	2/13/2018 9:51 AM
Addresses	Main Address	Insert			1002 S RACE ST URBANA, IL 61801-4957	2/14/2017 10:03 AM
Contacts	Authorizing Official	Update		Mitchell, Rhonda Interim CEO 2178773290	Andricks, Tanya CEO 2178776111	2/14/2017 10:03 AM
Contacts	Primary Contact	Update		Mitchell, Rhonda Interim CEO 2178773290	Andricks, Tanya CEO 2178776111	2/14/2017 10:03 AM
Details	Last Recertification Date	Update		2/12/2016 12:00:00 AM	2/14/2017 12:00:00 AM	2/14/2017 10:03 AM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/12/2016 12:00:00 AM	2/12/2016 3:23 PM
Details	Last Recertification Date	Update		3/21/2014 12:00:00 AM	2/12/2015 12:00:00 AM	2/12/2015 10:23 AM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/21/2014 12:00:00 AM	3/21/2014 9:39 PM
Contacts	Authorizing Official	Insert			Mitchell, Rhonda Interim CEO 2178773290	2/14/2014 1:35 PM
Contacts	Primary Contact	Insert			Mitchell, Rhonda Interim CEO 2178773290	2/14/2014 1:35 PM
Addresses	Billing Address	Insert			COMMUNITY HEALTH IMPROVEMENT CENTER 1314 NORTH MAIN STREET DECATUR, IL 62526-4438	8/21/2013 2:58 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/4/2013 7:45 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/15/2013 3:57 PM
Medicaid Billing	Medicaid: Number	Insert			370961830003	1/15/2013 3:57 PM
Medicaid Billing	Medicaid: State	Insert			IL	1/15/2013 3:57 PM
Medicaid Billing	NPI: Number	Insert			1023083227	1/15/2013 3:57 PM
Details	Last Recertification Date	Insert				8/11/2005 2:50 PM
Details	Grant Number	Insert			H80CS00681	8/11/2005 2:50 PM
Details	340B ID	Insert			CH05315D	8/11/2005 2:50 PM
Details	Is Authorizing Official EHB Data	Insert				8/11/2005 2:50 PM
Dates	Last Date That 340B Drugs Purchased	Insert				8/11/2005 2:50 PM
Details	Medicare Provider Number	Insert				8/11/2005 2:50 PM
Details	Entity Name	Insert			COMMUNITY HEALTH IMPROVEMENT CENTER	8/11/2005 2:50 PM
Details	Program Code	Insert			CH	8/11/2005 2:50 PM
Details	Entity Subname	Insert			URBANA SCHOOL HEALTH CENTER	8/11/2005 2:50 PM
Dates	Participating Approval Date	Insert			9/14/2004 12:00:00 AM	8/11/2005 2:50 PM
Details	State	Insert			Active	8/11/2005 2:50 PM
Dates	Registration Date	Insert			10/1/2004 12:00:00 AM	8/11/2005 2:50 PM
Dates	Signed By Date	Insert				8/11/2005 2:50 PM
Dates	Start Date	Insert			10/1/2004 12:00:00 AM	8/11/2005 2:50 PM
Terminations	Termination Comments	Insert				8/11/2005 2:50 PM
Terminations	Termination Date	Insert				8/11/2005 2:50 PM
Terminations	Termination Effective Date	Insert				8/11/2005 2:50 PM
Terminations	Termination Reason	Insert				8/11/2005 2:50 PM
Details	Comments Public	Insert			NEW SITE 10/01/2004	8/11/2005 2:50 PM

340B Drug Pricing Program Database