340B Drug Pricing Program Database


CH07117G COMMUNITY HEALTH CARE, INC. (Active) - information as of 5/20/2025 12:45:55 AM

Main Details
COMMUNITY HEALTH CARE, INC.
Community Health Care, Inc. Rock Island Clinic
HRSA-Funded Health Center
BPS-H80-000222
CH07117G
H80CS00670


Additional Details
Active
5/25/2007
7/1/2007
5/29/2007
2/27/2025

Contacts

Community Health Care Inc
Tom Bowman, CEO
(563) 336-3000 Ext: 3112

Community Health Care, Inc.
Sarah Brondyke, Pharmacy Coordinator
(563) 336-3059

Addresses

2750 11th St
Rock Island, IL 61201

COMMUNITY HEALTH CARE INC.
500 WEST RIVER DRIVE
DAVENPORT, IA 52801


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
IL4210607240051598759292
IA15987592921598759292
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH071170ActiveBPS-H80-004273COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. River Drive Clinic500 W River Dr DavenportIA
CH07117AActiveBPS-H80-008204COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. Moline1106 4th Avenue MolineIL
CH07117AAActiveBPS-H80-033697Community Health Care, Inc.Community Health Care, Inc. Muscatine2925 Cedar St MuscatineIA
CH07117ABActiveBPS-H80-037807Community Health Care, Inc.Community Health Care, Inc. - The Project4101 John Deere Rd MolineIL
CH07117ACTerminatedBPS-H80-037332COMMUNITY HEALTH CARE, INC.Humility530 Vine St DavenportIA
CH07117ADActiveBPS-H80-038438COMMUNITY HEALTH CARE, INC.Community Health Care Inc. Outreach Clinic902 W 4th St DavenportIA
CH07117BActiveBPS-H80-003939COMMUNITY HEALTH CARE, INC.Community Health Care Inc. Dental Clinic125 Scott St DavenportIA
CH07117DTerminatedBPS-H80-006060COMMUNITY HEALTH CARE, INC.Adult Rehabilitation Center4001 N Brady St DavenportIA
CH07117FTerminatedBPS-H80-006812COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. Iowa Homeless Drop-In Clinic303 W 6th St DavenportIA
CH07117GActiveBPS-H80-000222COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. Rock Island Clinic2750 11th St Rock IslandIL
CH07117HTerminatedBPS-H80-009125COMMUNITY HEALTH CARE, INC.Illinois Drop-In MLK Center - Homeless630 9th St Rock IslandIL
CH07117VActiveBPS-H80-012284COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. East Moline Clinic708 15th Ave East MolineIL
CH07117WActiveBPS-H80-009584COMMUNITY HEALTH CARE, INC.Community Health Care, Inc. - Robert Young Center2200 3rd Ave Rock IslandIL
CH07117XActiveBPS-H80-015375COMMUNITY HEALTH CARE, INC.Community Health Care Inc. Clinton Clinic925 S 4th St ClintonIA
CH07117YActiveBPS-H80-017681COMMUNITY HEALTH CARE, INC.Edgerton Women's Health Center1510 E Rusholme St DavenportIA
CH07117ZActiveBPS-H80-029818Community Health Care, Inc.Community Health Care, Inc. MCSA Muscatine312 Iowa Ave MuscatineIA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH071170AMERICAN DRUG STORES LLCOSCO DRUG 1118 1309 N 2ND ST
CLINTONIA5273204/01/2021  
CH071170AMERICAN DRUG STORES LLCDBA OSCO DRUG 3088 1312 JOHN DEERE EXPWY
SILVISIL6128204/01/2021  
CH071170AMERICAN DRUG STORES LLCDBA OSCO DRUG 3770 107 AVENUE OF THE CITIES
EAST MOLINEIL6124404/01/2021  
CH071170AMERICAN DRUG STORES LLCDBA OSCO DRUG 122 2010 1ST ST STE A
MOLINEIL6126510/01/2023 10/09/2024
CH071170BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526110/01/2019  
CH071170BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771310/01/2019  
CH071170BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03991 3100 11TH ST
ROCK ISLANDIL6120105/11/2012 03/29/2023
CH071170BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04332 2955 18TH AVE.
ROCK ISLANDIL6120105/11/2012  
CH071170BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04333 301 30TH AVE.
EAST MOLINEIL6124405/11/2012  
CH07117WBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04332 2955 18TH AVE.
ROCK ISLANDIL6120110/01/2023  
CH071170CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503307/01/2024  
CH071170DOGWOOD PHARMACY, INCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER ROAD
SUITE K
GREENVILLESC29607-654010/01/2019  
CH071170EXACT CARE PHARMACYDDCRX, LLC 2701 HIGHPOINT OAKS DR STE 100
LEWISVILLETX75067-389610/01/2021 03/31/2024
CH071170EXACT CARE PHARMACY, LLC8333 ROCKSIDE RD
CLEVELANDOH4412510/01/2021 03/31/2024
CH071170HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08656 2617 18TH AVE.
ROCK ISLANDIL6120110/01/2018  
CH071170HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 00484 2250 41ST ST.
MOLINEIL6126510/01/2019 11/29/2023
CH071170HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08634 910 W. 4TH ST.
MILANIL6126410/01/2019  
CH071170HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16348 900 42ND AVENUE DR
MOLINEIL6126504/01/2023  
CH07117AAHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08656 2617 18TH AVE.
ROCK ISLANDIL6120110/01/2024  
CH07117ZHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 00484 2250 41ST ST.
MOLINEIL6126510/01/2024 07/15/2024
CH071170HY-VEE DRUGSTORE PHCY #7060510 EAST 6TH STREET
MUSCATINEIA5276110/01/2020  
CH071170HY-VEE FOOD STORESDBA HY-VEE FOOD STORE#1 3019 ROCKINGHAM RD
DAVENPORTIA5280204/01/2019 10/09/2024
CH071170HY-VEE PHARMACY2001 5TH ST
SILVISIL6128204/01/2019  
CH071170HY-VEE PHARMACY #5 (1109)2351 W LOCUST
DAVENPORTIA5280410/01/2020  
CH071170HY-VEE PHARMACY (1075)901 SOUTH 4TH ST
CLINTONIA5273204/01/2019  
CH07117XHY-VEE PHARMACY (1075)901 SOUTH 4TH ST
CLINTONIA5273204/01/2023  
CH071170HY-VEE PHARMACY (1415)201 WEST 10TH AVENUE
MILANIL6126410/01/2020  
CH071170HY-VEE PHARMACY (1416)4218 AVENUE OF THE CITIES
MOLINEIL6126510/01/2020  
CH071170Hy-Vee Pharmacy Fulfillment Center #4016Hy-Vee Inc 4707 Fleur Dr
Des MoinesIA5032104/01/2019  
CH071170HY-VEE PHCY1823 E KIMBERLY
DAVENPORTIA5280710/01/2020  
CH071170HY-VEE PHRM CLINIC 15492930 18TH AVE
ROCK ISLANDIL6120104/01/2019  
CH07117WHY-VEE PHRM CLINIC 15492930 18TH AVE
ROCK ISLANDIL6120104/01/2023  
CH071170IOWA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08659 1777 DIVISION ST.
DAVENPORTIA5280401/01/2019 12/07/2023
CH071170IOWA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08658 1655 WEST KIMBERLY ROAD
DAVENPORTIA5280610/01/2019 11/07/2023
CH071170IOWA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08658 1655 WEST KIMBERLY ROAD
DAVENPORTIA5280607/31/2024  
CH071170RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103
NEWBURGHNY1255010/01/2019  
CH071170RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500210/01/2019  
CH071170WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2018  
CH071170WAL-MART PHARMACY 10-05593003 N HIGHWAY 61
MUSCATINEIA5276104/01/2021  
CH071170WAL-MART PHARMACY 10-12415811 ELMORE AVENUE
DAVENPORTIA5280710/01/2018  
CH071170WAL-MART PHARMACY 10-1509103 E. CARLISLE
MAQUOKETAIA5206004/01/2021  
CH071170WAL-MART PHARMACY 10-22313930 44TH AVENUE DRIVE
MOLINEIL6126510/01/2018  
CH071170WAL-MART PHARMACY 10-28892715 SO. 25TH STREET
CLINTONIA5273210/01/2018  
CH07117ADWAL-MART PHARMACY 10-28892715 SO. 25TH STREET
CLINTONIA5273210/01/2024  
CH071170WAL-MART PHARMACY 10-45111601 18TH STREET
SILVISIL6128210/01/2018  
CH071170WAL-MART PHARMACY 10-51153101 W KIMBERLY RD
DAVENPORT (W)IA5280610/01/2018  
CH071170WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2018  
CH071170WAL-MART PHARMACY WHSE #452250 NORTH 8TH STREET SUITE 102-A
ROGERSAR7275607/01/2023 04/05/2024
CH071170Walgreen CODBA Walgreens Central Fill #21417 599 S Schmidt Rd
Ste A
BolingbrookIL60440-940504/01/2023  
CH071170WALGREEN CO.DBA: WALGREENS # 03633 4000 AVENUE OF THE CITIES
MOLINEIL6126509/21/2011  
CH071170WALGREEN CO.DBA: WALGREENS # 03595 1720 W. KIMBERLY RD.
DAVENPORTIA5280605/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 04041 1525 E KIMBERLY RD
DAVENPORTIA5280705/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 09515 1301 AVENUE OF THE CITIES
EAST MOLINEIL6124405/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 05239 1660 W LOCUST ST
DAVENPORTIA5280405/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 05512 3425 MIDDLE ROAD
BETTENDORFIA5272205/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 05720 3601 16TH ST
MOLINEIL6126505/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 05885 1703 PARK AVE
MUSCATINEIA5276105/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 06067 555 19TH AVE
MOLINEIL61265-376105/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 06186 4011 E 53RD ST
DAVENPORTIA5280705/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 06553 830 MIDDLE ROAD
BETTENDORFIA52722-410105/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 09267 440 W 10TH AVE
MILANIL6126405/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 11709 1805 BRADY ST
DAVENPORTIA5280305/11/2012 04/03/2024
CH071170WALGREEN CO.DBA: WALGREENS #11881 600 N MAIN ST
MONMOUTHIL6146205/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS #12305 1009 S OAKWOOD AVE
GENESEOIL61254-193705/11/2012  
CH071170WALGREEN CO.DBA: WALGREENS # 05119 806 S. 4TH ST
CLINTONIA5273204/01/2016  
CH07117AAWALGREEN CO.DBA: WALGREENS # 05885 1703 PARK AVE
MUSCATINEIA5276104/01/2023  
CH07117AWALGREEN CO.DBA: WALGREENS # 03633 4000 AVENUE OF THE CITIES
MOLINEIL6126510/01/2023  
CH07117YWALGREEN CO.DBA: WALGREENS # 04041 1525 E KIMBERLY RD
DAVENPORTIA5280710/01/2023  
CH07117VWALGREEN CO.DBA: WALGREENS # 09515 1301 AVENUE OF THE CITIES
EAST MOLINEIL6124410/01/2023  
CH07117XWALGREEN CO.DBA: WALGREENS # 05119 806 S. 4TH ST
CLINTONIA5273210/01/2023  
CH07117BWALGREEN CO.DBA: WALGREENS # 05239 1660 W LOCUST ST
DAVENPORTIA5280410/01/2023  
CH07117ABWALGREEN CO.DBA: WALGREENS # 06067 555 19TH AVE
MOLINEIL61265-376110/01/2023  
CH071170WALGREEN CO.DBA: WALGREENS # 05144 1905 N 2ND ST
CLINTONIA5273207/01/2024  
CH07117YWALGREEN CO.DBA: WALGREENS # 03633 4000 AVENUE OF THE CITIES
MOLINEIL6126510/01/2024  
CH07117ZWALGREEN CO.DBA: WALGREENS # 04041 1525 E KIMBERLY RD
DAVENPORTIA5280704/01/2025  
CH071170WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/01/2013 07/06/2015
CH071170WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503307/01/2024  
CH071170WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527507/01/2024  
CH071170WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818807/01/2024  
CH071170WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2024  
CH071170Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesMain AddressUpdateRecertification 2750 11th St Rock Island, IL 61201-5216 2750 11th St Rock Island, IL 612012/27/2025 8:20 AM
DetailsLast Recertification DateUpdateRecertification2/7/2024 5:07:01 PM2/27/2025 8:20:21 AM2/27/2025 8:20 AM
DetailsLast Recertification DateUpdateRecertification1/31/2023 12:38:54 PM2/7/2024 5:07:01 PM2/7/2024 5:07 PM
ContactsAuthorizing OfficialUpdateAO Change RequestBowman, Thomas CEO Community Health Care, Inc. 5633363112Bowman, Tom CEO Community Health Care Inc 5633363000-311211/9/2023 1:09 PM
DetailsLast Recertification DateUpdateRecertification2/7/2022 5:56:59 PM1/31/2023 12:38:54 PM1/31/2023 12:38 PM
DetailsLast Recertification DateUpdateRecertification2/4/2021 9:01:42 AM2/7/2022 5:56:59 PM2/7/2022 5:56 PM
Medicaid BillingNPI: StateUpdateRecertification IA2/4/2021 9:01 AM
Medicaid BillingNPI: NumberInsertRecertification 15987592922/4/2021 9:01 AM
Medicaid BillingNPI: StateInsertRecertification IL2/4/2021 9:01 AM
DetailsLast Recertification DateUpdateRecertification2/17/2020 4:38:11 PM2/4/2021 9:01:42 AM2/4/2021 9:01 AM
ContactsPrimary ContactUpdateChange RequestLOBB, TIM CHIEF PHARMACIST Community Health Care, Inc. 5633363041Brondyke, Sarah Pharmacy Coordinator Community Health Care, Inc. 56333630591/29/2021 10:15 AM
DetailsLast Recertification DateUpdateRecertification2/11/2019 4:14:39 PM2/17/2020 4:38:11 PM2/17/2020 4:38 PM
DetailsLast Recertification DateUpdateRecertification2/12/2018 4:27:39 PM2/11/2019 4:14:39 PM2/11/2019 4:14 PM
DetailsLast Recertification DateUpdateRecertification2/9/2017 12:00:00 AM2/12/2018 4:27:39 PM2/12/2018 4:27 PM
ContactsPrimary ContactUpdateRecertificationLOBB, TIM CHIEF PHARMACIST 5633363041LOBB, TIM CHIEF PHARMACIST Community Health Care, Inc. 56333630412/12/2018 4:26 PM
ContactsAuthorizing OfficialUpdate Bowman, Thomas CEO 5633363112Bowman, Thomas CEO Community Health Care, Inc. 56333631121/12/2018 3:43 PM
AddressesMain AddressInsert   2750 11th St Rock Island, IL 61201-52162/9/2017 11:53 AM
ContactsAuthorizing OfficialInsert  Bowman, Thomas CEO 56333631122/9/2017 11:53 AM
ContactsPrimary ContactInsert  LOBB, TIM CHIEF PHARMACIST 56333630412/9/2017 11:53 AM
DetailsLast Recertification DateUpdate 2/12/2016 12:00:00 AM2/9/2017 12:00:00 AM2/9/2017 11:53 AM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse3/3/2016 9:30 AM
Medicaid BillingMedicaid: NumberUpdate 4210607240014210607240053/3/2016 9:30 AM
Medicaid BillingMedicaid: NumberUpdate 014046715987592923/3/2016 9:30 AM
DetailsLast Recertification DateUpdate 3/10/2015 12:00:00 AM2/12/2016 12:00:00 AM3/3/2016 9:30 AM
DetailsLast Recertification DateUpdate 3/13/2014 12:00:00 AM3/10/2015 12:00:00 AM3/10/2015 10:47 AM
Medicaid BillingNPI: NumberInsert  15987592923/13/2014 3:41 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM3/13/2014 12:00:00 AM3/13/2014 3:41 PM
DetailsEntity NameUpdate COMMUNITY HEALTH CARE INCCOMMUNITY HEALTH CARE, INC.3/13/2014 3:41 PM
DetailsEntity SubnameUpdate ROCK ISLAND CLINICCommunity Health Care, Inc. Rock Island Clinic3/13/2014 3:41 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/25/2013 8:46 AM
AddressesBilling AddressInsert  COMMUNITY HEALTH CARE INC. 500 WEST RIVER DRIVE DAVENPORT, IA 5280110/15/2012 12:01 PM
DetailsLast Recertification DateInsert   5/29/2007 5:45 AM
DetailsGrant NumberInsert  H80CS006705/29/2007 5:45 AM
Details340B IDInsert  CH07117G5/29/2007 5:45 AM
DetailsIs Authorizing Official EHB DataInsert   5/29/2007 5:45 AM
DatesLast Date That 340B Drugs PurchasedInsert   5/29/2007 5:45 AM
DetailsMedicare Provider NumberInsert   5/29/2007 5:45 AM
DetailsEntity NameInsert  COMMUNITY HEALTH CARE INC5/29/2007 5:45 AM
DetailsProgram CodeInsert  CH5/29/2007 5:45 AM
DetailsEntity SubnameInsert  ROCK ISLAND CLINIC5/29/2007 5:45 AM
DatesParticipating Approval DateInsert  5/29/2007 12:00:00 AM5/29/2007 5:45 AM
DetailsStateInsert  Active5/29/2007 5:45 AM
DatesRegistration DateInsert  5/25/2007 12:00:00 AM5/29/2007 5:45 AM
DatesSigned By DateInsert  5/7/2007 12:00:00 AM5/29/2007 5:45 AM
DatesStart DateInsert  7/1/2007 12:00:00 AM5/29/2007 5:45 AM
TerminationsTermination CommentsInsert   5/29/2007 5:45 AM
TerminationsTermination DateInsert   5/29/2007 5:45 AM
TerminationsTermination Effective DateInsert   5/29/2007 5:45 AM
TerminationsTermination ReasonInsert   5/29/2007 5:45 AM
Medicaid BillingMedicaid: Is PrimaryInsert  True5/25/2007 2:47 PM
Medicaid BillingMedicaid: NumberInsert  4210607240015/25/2007 2:47 PM
Medicaid BillingMedicaid: StateInsert  IL5/25/2007 2:47 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False5/25/2007 2:47 PM
Medicaid BillingMedicaid: NumberInsert  01404675/25/2007 2:47 PM
Medicaid BillingMedicaid: StateInsert  IA5/25/2007 2:47 PM