Covered Entity Details

FQHCLA189 MON VALLEY COMMUNITY HEALTH SERVICES, INC. (Terminated) - information as of 6/27/2025 12:34:03 AM

Main Details

Name

MON VALLEY COMMUNITY HEALTH SERVICES, INC.

Subdivision Name

SPHS FAMILY HEALTH COMPLEX

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-009796

340B ID

FQHCLA189

Grant Number

LALCS00065

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2005

Participating Start Date

9/9/2005

Participating Approval Date

8/8/2005

Last Recertification Date

2/8/2019

Termination Date
Termination Reason

10/1/2019
Change of covered entity type (non-hospital)

Contacts

Authorizing Official

Mon Valley Community Health Services Inc.
LUTHER SHEETS, COO
(724) 489-3100 Ext: 4114

Primary Contact

Mon Valley Community Health Services Inc.
Kellie McKevitt, Executive Director
(724) 489-9100 Ext: 3180

Addresses

Street Address

2 EASTGATE AVENUE
MONESSEN, PA 15062

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
7/27/07 ADDR CHANGE (WAS EASTGATE #8)	08/05/2009

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	Termination Date	Last Updated On
Contract Detail	DIERKEN'S PHARMACY		100 EAST MAIN STREET	MONONGAHELA	PA	15063	10/15/2013	01/01/2014	10/01/2019	10/01/2019
Contract Detail	DONORA UNION PHARMACY	601 MCKEAN AVE		DONORA	PA	15033-1020	01/11/2017	04/01/2017	10/01/2019	10/01/2019
Contract Detail	GIANT EAGLE PHARMACY #0012	1300 COUNTRY CLUB ROAD		MONONGAHELA	PA	15063	01/09/2017	04/01/2017	10/01/2019	10/01/2019
Contract Detail	GIANT EAGLE PHARMACY #0053	300 TRI-COUNTY LANE		BELLE VERNON	PA	15012	01/09/2017	04/01/2017	10/01/2019	10/01/2019
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #2466	10 DONNER AVENUE	MONESSEN	PA	15062	04/07/2015	07/01/2015	10/01/2019	10/01/2019
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4083	101 5TH STREET	CHARLEROI	PA	15022	04/07/2015	07/01/2015	10/01/2019	10/01/2019
Contract Detail	WAL-MART PHARMACY 10-2420	100 SARA WAY/ ROSTRAVER SQUARE		BELLE VERNON	PA	15012	01/05/2017	04/01/2017	10/01/2019	10/01/2019

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
FQHCLA189	Terminated	BPS-LAL-009796	MON VALLEY COMMUNITY HEALTH SERVICES, INC.	SPHS FAMILY HEALTH COMPLEX	2 EASTGATE AVENUE		MONESSEN	PA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA189	DIERKEN'S PHARMACY		100 EAST MAIN STREET	MONONGAHELA	PA	15063	01/01/2014	10/01/2019
FQHCLA189	DONORA UNION PHARMACY	601 MCKEAN AVE		DONORA	PA	15033-1020	04/01/2017	10/01/2019
FQHCLA189	GIANT EAGLE PHARMACY #0012	1300 COUNTRY CLUB ROAD		MONONGAHELA	PA	15063	04/01/2017	10/01/2019
FQHCLA189	GIANT EAGLE PHARMACY #0053	300 TRI-COUNTY LANE		BELLE VERNON	PA	15012	04/01/2017	10/01/2019
FQHCLA189	RITE AID OF PENNSYLVANIA, LLC	RITE AID #2466	10 DONNER AVENUE	MONESSEN	PA	15062	07/01/2015	10/01/2019
FQHCLA189	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4083	101 5TH STREET	CHARLEROI	PA	15022	07/01/2015	10/01/2019
FQHCLA189	WAL-MART PHARMACY 10-2420	100 SARA WAY/ ROSTRAVER SQUARE		BELLE VERNON	PA	15012	04/01/2017	10/01/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		6/28/2019 12:00:00 AM	9/19/2019 9:37 AM
Details	State	Update	Termination Request	Active	To Be Terminated	9/19/2019 9:37 AM
Terminations	Termination Date	Update	Termination Request		10/1/2019 12:00:00 AM	9/19/2019 9:37 AM
Terminations	Termination Effective Date	Update	Termination Request		7/1/2019 12:00:00 AM	9/19/2019 9:37 AM
Terminations	Termination Reason	Update	Termination Request		Change of covered entity type (non-hospital)	9/19/2019 9:37 AM
Contacts	Primary Contact	Update	Recertification	Jackson, Raelynn Director Mon Valley Community Health Services Inc. 7246848999-4510	McKevitt, Kellie Executive Director Mon Valley Community Health Services Inc. 7244899100-3180	2/8/2019 10:32 AM
Details	Last Recertification Date	Update	Recertification	2/12/2018 7:50:59 AM	2/8/2019 10:32:16 AM	2/8/2019 10:32 AM
Details	Last Recertification Date	Update	Recertification	1/25/2017 12:00:00 AM	2/12/2018 7:50:59 AM	2/12/2018 7:50 AM
Details	Grant Number	Update	Recertification	LAL000065	LALCS00065	2/12/2018 7:50 AM
Contacts	Authorizing Official	Update		SHEETS, LUTHER COO 7244893100-4114	SHEETS, LUTHER COO Mon Valley Community Health Services Inc. 7244893100-4114	2/12/2018 7:43 AM
Contacts	Primary Contact	Update		Jackson, Raelynn Director 7246848999-4510	Jackson, Raelynn Director Mon Valley Community Health Services Inc. 7246848999-4510	9/29/2017 4:01 PM
Contacts	Authorizing Official	Insert			SHEETS, LUTHER COO 7244893100-4114	6/22/2017 2:46 PM
Addresses	Main Address	Insert			2 EASTGATE AVENUE MONESSEN, PA 15062	1/25/2017 7:26 AM
Contacts	Primary Contact	Insert			Jackson, Raelynn Director 7246848999-4510	1/25/2017 7:26 AM
Details	Last Recertification Date	Update		2/15/2016 12:00:00 AM	1/25/2017 12:00:00 AM	1/25/2017 7:26 AM
Details	Last Recertification Date	Update		3/4/2015 12:00:00 AM	2/15/2016 12:00:00 AM	2/15/2016 7:27 AM
Terminations	Termination Comments	Update		3/31/14 this was unterminated because it was terminated in error because it moved and OPA was not notified; 3/17/14 not able to find this address associated with the Look-alike project information in HRSA's Electronic Handbooks		3/23/2015 2:43 PM
Details	Last Recertification Date	Update		3/17/2014 12:00:00 AM	3/4/2015 12:00:00 AM	3/4/2015 8:07 AM
Dates	Last Date That 340B Drugs Purchased	Update		3/31/2014 12:00:00 AM		3/31/2014 4:29 PM
Details	State	Update		Terminated	Active	3/31/2014 4:29 PM
Terminations	Termination Comments	Update		3/17/14 not able to find this address associated with the Look-alike project information in HRSA's Electronic Handbooks	3/31/14 this was unterminated because it was terminated in error because it moved and OPA was not notified; 3/17/14 not able to find this address associated with the Look-alike project information in HRSA's Electronic Handbooks	3/31/2014 4:29 PM
Terminations	Termination Date	Update		4/1/2014 12:00:00 AM		3/31/2014 4:29 PM
Terminations	Termination Effective Date	Update		4/1/2014 12:00:00 AM		3/31/2014 4:29 PM
Terminations	Termination Reason	Update		Other		3/31/2014 4:29 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/17/2014 12:00:00 AM	3/17/2014 4:45 PM
Dates	Last Date That 340B Drugs Purchased	Update			3/31/2014 12:00:00 AM	3/17/2014 4:45 PM
Details	State	Update		Active	Terminated	3/17/2014 4:45 PM
Terminations	Termination Comments	Update			3/17/14 not able to find this address associated with the Look-alike project information in HRSA's Electronic Handbooks	3/17/2014 4:45 PM
Terminations	Termination Date	Update			4/1/2014 12:00:00 AM	3/17/2014 4:45 PM
Terminations	Termination Effective Date	Update			4/1/2014 12:00:00 AM	3/17/2014 4:45 PM
Terminations	Termination Reason	Update			Other	3/17/2014 4:45 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/5/2013 12:56 PM
Details	Grant Number	Update			LAL000065	1/17/2012 2:59 PM
Details	Last Recertification Date	Insert				8/5/2009 10:52 AM
Details	Grant Number	Insert				8/5/2009 10:52 AM
Details	340B ID	Insert			FQHCLA189	8/5/2009 10:52 AM
Details	Is Authorizing Official EHB Data	Insert				8/5/2009 10:52 AM
Dates	Last Date That 340B Drugs Purchased	Insert				8/5/2009 10:52 AM
Details	Medicare Provider Number	Insert				8/5/2009 10:52 AM
Details	Entity Name	Insert			MON VALLEY COMMUNITY HEALTH SERVICES, INC.	8/5/2009 10:52 AM
Details	Program Code	Insert			FQHCLA	8/5/2009 10:52 AM
Details	Entity Subname	Insert			SPHS FAMILY HEALTH COMPLEX	8/5/2009 10:52 AM
Dates	Participating Approval Date	Insert			8/8/2005 12:00:00 AM	8/5/2009 10:52 AM
Details	State	Insert			Active	8/5/2009 10:52 AM
Dates	Registration Date	Insert			10/1/2005 12:00:00 AM	8/5/2009 10:52 AM
Dates	Signed By Date	Insert			7/19/2009 12:00:00 AM	8/5/2009 10:52 AM
Dates	Start Date	Insert			9/9/2005 12:00:00 AM	8/5/2009 10:52 AM
Terminations	Termination Comments	Insert				8/5/2009 10:52 AM
Terminations	Termination Date	Insert				8/5/2009 10:52 AM
Terminations	Termination Effective Date	Insert				8/5/2009 10:52 AM
Terminations	Termination Reason	Insert				8/5/2009 10:52 AM
Details	Comments Public	Insert			7/27/07 ADDR CHANGE (WAS EASTGATE #8)	8/5/2009 10:52 AM

340B Drug Pricing Program Database