Covered Entity Details

CH04813D VALLEY HEALTHCARE SYSTEM, INC. (Active) - information as of 6/21/2025 10:42:40 PM

Main Details

Name

VALLEY HEALTHCARE SYSTEM, INC.

Subdivision Name

Talbot County Medical/Dental Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-008481

340B ID

CH04813D

Grant Number

H80CS00678

Additional Details

Current Program Status

Active

Registration Date

6/13/2006

Participating Start Date

7/1/2006

Participating Approval Date

6/14/2006

Last Recertification Date

3/3/2025

Contacts

Authorizing Official

Valley Healthcare System INC
Asante Hilts, CEO
(706) 987-8343

Primary Contact

Valley Healthcare System Inc.
Donna Bellamy, Interim Pharmacy Director
(706) 507-1850

Addresses

Street Address

341 N Washington Ave
Talbotton, GA 31827-2037

Billing Address

VALLEY HEALTHCARE SYSTEM, INC.
1600 Fort Benning Road
COLUMBUS, GA 31903

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

Comments

Comment	Last Updated On
THIS ORG IS PART OF THE ALTERNATIVE METHOD DEMO PROJECT FOR COLUMBUS REGIONAL COMMUNITY HEALTHCARE NETWORK	04/07/2010

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
GA	003132691A,000617196I	1922601467,1013951706

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
Contract Detail	MANIFEST PHARMACY, LLC	1018 S BATESVILLE RD	STE 4A	GREER	SC	29650-5203	04/12/2013	07/01/2013			04/12/2013

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH048130	Active	BPS-H80-010111	VALLEY HEALTHCARE SYSTEM, INC.	Fort Benning Road Health Center	1600 Fort Benning Road	Columbus	GA
CH04813D	Active	BPS-H80-008481	VALLEY HEALTHCARE SYSTEM, INC.	Talbot County Medical/Dental Center	341 N Washington Ave	Talbotton	GA
CH04813E	Active	BPS-H80-012586	VALLEY HEALTHCARE SYSTEM, INC.	VHcS Fortson Medical/Dental Center	94 Mccrary Rd	Fortson	GA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH048130	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/01/2022	05/01/2025
CH048130	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/01/2022	05/01/2025
CH048130	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	10/01/2014
CH048130	ALABAMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04934	2514 CRAWFORD RD	PHENIX CITY	AL	36867	04/01/2022
CH048130	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2022
CH048130	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2022
CH048130	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2022
CH048130	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2022
CH048130	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2022
CH048130	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2022
CH048130	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2022
CH048130	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2022
CH048130	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2022
CH048130	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2022
CH048130	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	01/01/2017
CH048130	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	01/01/2017
CH048130	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2023
CH048130	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2023
CH048130	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2022
CH048130	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/01/2022	05/01/2025
CH048130	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/01/2022	05/01/2025
CH048130	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/01/2022
CH048130	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/01/2022	05/01/2025
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04579	1622 SOUTH LUMPKIN RD.	COLUMBUS	GA	31903	04/01/2022
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04671	3127 MACON RD	COLUMBUS	GA	31906	04/01/2022
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04677	3617 HILTON AVE.	COLUMBUS	GA	31904	04/01/2022
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04679	4561 RIVER RD	COLUMBUS	GA	31904-5828	04/01/2022
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02946	1367 DOUBLE CHURCHES RD.	COLUMBUS	GA	31904	10/01/2022
CH048130	GEORGIA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 10358	503 WEST MAIN ST.	MANCHESTER	GA	31816	10/01/2022
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04579	1622 SOUTH LUMPKIN RD.	COLUMBUS	GA	31903	04/01/2024
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04671	3127 MACON RD	COLUMBUS	GA	31906	04/01/2024
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02946	1367 DOUBLE CHURCHES RD.	COLUMBUS	GA	31904	04/01/2024
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04677	3617 HILTON AVE.	COLUMBUS	GA	31904	04/01/2024
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04679	4561 RIVER RD	COLUMBUS	GA	31904-5828	04/01/2024
CH04813E	GEORGIA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 10358	503 WEST MAIN ST.	MANCHESTER	GA	31816	04/01/2024
CH048130	MANIFEST PHARMACY, LLC	1018 S BATESVILLE RD	STE 4A	GREER	SC	29650-5203	07/01/2013	10/21/2015
CH04813D	MANIFEST PHARMACY, LLC	1018 S BATESVILLE RD	STE 4A	GREER	SC	29650-5203	07/01/2013
CH04813E	MANIFEST PHARMACY, LLC	1018 S BATESVILLE RD	STE 4A	GREER	SC	29650-5203	07/01/2013	10/21/2015
CH048130	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/01/2018
CH048130	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2022
CH048130	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2022
CH048130	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2022
CH048130	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2022
CH048130	PUBLIX PHARMACY #0562	5435 WOODRUFF FARMS ROAD		COLUMBUS	GA	31907	04/01/2020
CH04813E	PUBLIX PHARMACY #0562	5435 WOODRUFF FARMS ROAD		COLUMBUS	GA	31907	04/01/2024
CH048130	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1390	3201 MACON RD. SUITE 201	COLUMBUS	GA	31906	04/01/2020
CH048130	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	04/01/2020
CH048130	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	04/01/2020
CH04813E	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1390	3201 MACON RD. SUITE 201	COLUMBUS	GA	31906	04/01/2024
CH048130	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2020
CH048130	WAL-MART PHARMACY 10-1284	3700 HWY 280/431 NORTH		PHENIX CITY	AL	36867	04/01/2020
CH04813E	WAL-MART PHARMACY 10-1284	3700 HWY 280/431 NORTH		PHENIX CITY	AL	36867	04/01/2024
CH048130	WAL-MART PHARMACY 10-1338	3515 VICTORY DRIVE		COLUMBUS	GA	31903	04/01/2020
CH04813E	WAL-MART PHARMACY 10-1338	3515 VICTORY DRIVE		COLUMBUS	GA	31903	04/01/2024
CH048130	WAL-MART PHARMACY 10-4200	6475 GATEWAY ROAD		COLUMBUS	GA	31909	10/01/2024
CH048130	WAL-MART PHARMACY 10-4283	2801 AIRPORT THRUWAY		COLUMBUS	GA	31909	10/01/2024
CH048130	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2020
CH048130	WALGREEN CO.	DBA: WALGREENS #02454	3116 HWY 34 EAST	NEWNAN	GA	30265	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS # 06326	3700 MACON ROAD	COLUMBUS	GA	31907-2248	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS # 06327	4808 BUENA VISTA ROAD	COLUMBUS	GA	31907	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS # 06328	2510 WYNNTON ROAD	COLUMBUS	GA	31906	10/03/2011	04/08/2024
CH048130	WALGREEN CO.	DBA: WALGREENS # 06373	5707 VETERANS PKWY	COLUMBUS	GA	31904	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS # 06483	2515 CRAWFORD ROAD	PHENIX CITY	AL	36867	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS #11704	5301 SUMMERVILLE RD	PHENIX CITY	AL	36867	10/03/2011
CH048130	WALGREEN CO.	DBA: WALGREENS #12754	7869 VETERANS PKWY	COLUMBUS	GA	31909	10/03/2011
CH048130	WALGREEN CO.	WALGREENS #18178	6950 BEAVER RUN RD	MIDLAND	GA	31820	04/01/2022
CH048130	WALGREEN CO.	WALGREENS #19828	305 W MAIN ST	MANCHESTER	GA	31816	04/01/2022
CH048130	WALGREEN CO.	WALGREENS #15433	600 TRES PINOS RD	HOLLISTER	CA	95023	10/01/2023
CH04813E	WALGREEN CO.	DBA: WALGREENS #11704	5301 SUMMERVILLE RD	PHENIX CITY	AL	36867	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS # 06326	3700 MACON ROAD	COLUMBUS	GA	31907-2248	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS # 06327	4808 BUENA VISTA ROAD	COLUMBUS	GA	31907	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS # 06328	2510 WYNNTON ROAD	COLUMBUS	GA	31906	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS # 06373	5707 VETERANS PKWY	COLUMBUS	GA	31904	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS #12754	7869 VETERANS PKWY	COLUMBUS	GA	31909	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS #02454	3116 HWY 34 EAST	NEWNAN	GA	30265	04/01/2024
CH04813E	WALGREEN CO.	WALGREENS #19828	305 W MAIN ST	MANCHESTER	GA	31816	04/01/2024
CH04813E	WALGREEN CO.	WALGREENS #18178	6950 BEAVER RUN RD	MIDLAND	GA	31820	04/01/2024
CH04813E	WALGREEN CO.	DBA: WALGREENS # 06483	2515 CRAWFORD ROAD	PHENIX CITY	AL	36867	04/01/2024
CH048130	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2023
CH048130	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2023
CH048130	WALMART PHARMACY #10-5907	4909 BUENA VISTA ROAD		COLUMBUS	GA	31907-7271	10/01/2022
CH04813E	WALMART PHARMACY #10-5907	4909 BUENA VISTA ROAD		COLUMBUS	GA	31907-7271	04/01/2024
CH048130	WALMART PHARMACY 10-4421	7400 BLACKMON ROAD		COLUMBUS	GA	31909	10/01/2024	05/01/2025
CH048130	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH048130	WALMART PHARMACY 10-5903	3864 US HIGHWAY 80 W		PHENIX CITY	AL	36870	10/01/2024
CH048130	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	2/26/2024 4:03:36 PM	3/3/2025 9:29:59 AM	3/3/2025 9:29 AM
Contacts	Primary Contact	Update	Change Request	Cobb, Ashley Pharmacy Director Valley Healthcare System, Inc. 7065071850	Bellamy, Donna Interim Pharmacy Director Valley Healthcare System Inc. 7065071850	1/13/2025 7:16 AM
Details	Last Recertification Date	Update	Recertification	2/6/2023 8:55:04 AM	2/26/2024 4:03:36 PM	2/26/2024 4:03 PM
Details	Last Recertification Date	Update	Recertification	2/9/2022 12:32:40 PM	2/6/2023 8:55:04 AM	2/6/2023 8:55 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	1/23/2023 1:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		000617196I	1/23/2023 1:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		GA	1/23/2023 1:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1013951706	1/23/2023 1:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		GA	1/23/2023 1:42 PM
Contacts	Authorizing Official	Update	Change Request	LANG, SARAH E. CEO Valley Healthcare System, Inc. 7063229599-1011	Hilts, Asante CEO Valley Healthcare System INC 7069878343	1/23/2023 1:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/9/2022 12:32 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		003132691A	2/9/2022 12:32 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		GA	2/9/2022 12:32 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1922601467	2/9/2022 12:32 PM
Medicaid Billing	NPI: State	Insert	Recertification		GA	2/9/2022 12:32 PM
Details	Last Recertification Date	Update	Recertification	2/4/2021 12:01:02 PM	2/9/2022 12:32:40 PM	2/9/2022 12:32 PM
Contacts	Primary Contact	Update	Group Change Request	Calhoun, Charity E Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	Cobb, Ashley Pharmacy Director Valley Healthcare System, Inc. 7065071850	7/7/2021 8:17 AM
Details	Last Recertification Date	Update	Recertification	2/5/2020 2:44:44 PM	2/4/2021 12:01:02 PM	2/4/2021 12:01 PM
Details	Last Recertification Date	Update	Recertification	1/31/2019 1:34:39 PM	2/5/2020 2:44:44 PM	2/5/2020 2:44 PM
Details	Last Recertification Date	Update	Recertification	2/13/2018 12:48:18 PM	1/31/2019 1:34:39 PM	1/31/2019 1:34 PM
Contacts	Primary Contact	Update	Change Request	Turner, PHARM.D., Kati Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	Calhoun, Charity E Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	8/21/2018 2:55 PM
Contacts	Primary Contact	Update	Recertification	Turner, Kati Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	Turner, PHARM.D., Kati Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	2/13/2018 12:51 PM
Contacts	Primary Contact	Update	Recertification	LANG, SARAH E. CEO Valley Healthcare System, Inc. 7063229599-1011	Turner, Kati Pharmacy Director Valley Healthcare System, Inc. 7065071850-1604	2/13/2018 12:48 PM
Details	Last Recertification Date	Update	Recertification	1/30/2017 12:00:00 AM	2/13/2018 12:48:18 PM	2/13/2018 12:48 PM
Contacts	Authorizing Official	Update		LANG, SARAH E. CEO 7063229599-1011	LANG, SARAH E. CEO Valley Healthcare System, Inc. 7063229599-1011	1/10/2018 4:03 PM
Contacts	Primary Contact	Update		LANG, SARAH E. CEO 7063229599-1011	LANG, SARAH E. CEO Valley Healthcare System, Inc. 7063229599-1011	1/10/2018 4:03 PM
Contacts	Authorizing Official	Insert			LANG, SARAH E. CEO 7063229599-1011	1/31/2017 2:33 PM
Contacts	Primary Contact	Insert			LANG, SARAH E. CEO 7063229599-1011	1/31/2017 2:33 PM
Addresses	Main Address	Insert			341 N Washington Ave Talbotton, GA 31827-2037	1/30/2017 4:16 PM
Details	Last Recertification Date	Update		2/12/2016 12:00:00 AM	1/30/2017 12:00:00 AM	1/30/2017 4:16 PM
Details	Last Recertification Date	Update		2/10/2015 12:00:00 AM	2/12/2016 12:00:00 AM	2/12/2016 8:44 PM
Details	Last Recertification Date	Update		3/17/2014 12:00:00 AM	2/10/2015 12:00:00 AM	2/10/2015 3:27 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/17/2014 12:00:00 AM	3/17/2014 3:43 AM
Details	Entity Subname	Update		TALBOT COUNTY MEDICAL/DENTAL CENTER	Talbot County Medical/Dental Center	3/17/2014 3:43 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/12/2013 11:31 AM
Addresses	Billing Address	Insert			VALLEY HEALTHCARE SYSTEM, INC. 1600 Fort Benning Road COLUMBUS, GA 31903	2/1/2013 7:11 PM
Details	Last Recertification Date	Insert				4/7/2010 2:46 PM
Details	Grant Number	Insert			H80CS00678	4/7/2010 2:46 PM
Details	340B ID	Insert			CH04813D	4/7/2010 2:46 PM
Details	Is Authorizing Official EHB Data	Insert				4/7/2010 2:46 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/7/2010 2:46 PM
Details	Medicare Provider Number	Insert				4/7/2010 2:46 PM
Details	Entity Name	Insert			VALLEY HEALTHCARE SYSTEM, INC.	4/7/2010 2:46 PM
Details	Program Code	Insert			CH	4/7/2010 2:46 PM
Details	Entity Subname	Insert			TALBOT COUNTY MEDICAL/DENTAL CENTER	4/7/2010 2:46 PM
Dates	Participating Approval Date	Insert			6/14/2006 12:00:00 AM	4/7/2010 2:46 PM
Details	State	Insert			Active	4/7/2010 2:46 PM
Dates	Registration Date	Insert			6/13/2006 12:00:00 AM	4/7/2010 2:46 PM
Dates	Signed By Date	Insert			5/23/2006 12:00:00 AM	4/7/2010 2:46 PM
Dates	Start Date	Insert			7/1/2006 12:00:00 AM	4/7/2010 2:46 PM
Terminations	Termination Comments	Insert				4/7/2010 2:46 PM
Terminations	Termination Date	Insert				4/7/2010 2:46 PM
Terminations	Termination Effective Date	Insert				4/7/2010 2:46 PM
Terminations	Termination Reason	Insert				4/7/2010 2:46 PM
Details	Comments Public	Insert			THIS ORG IS PART OF THE ALTERNATIVE METHOD DEMO PROJECT FOR COLUMBUS REGIONAL COMMUNITY HEALTHCARE NETWORK	4/7/2010 2:46 PM

340B Drug Pricing Program Database