Covered Entity Details

HV01713 MetroHealth (Terminated) - information as of 5/3/2025 11:30:20 PM

Main Details

Name

MetroHealth

Subdivision Name

Type

Ryan White Part C

340B ID

HV01713

Grant Number

H89HA00012

Additional Details

Current Program Status

Terminated

Registration Date

5/13/2009

Participating Start Date

7/1/2009

Participating Approval Date

5/22/2009

Last Recertification Date

1/29/2019

Time Period the Assistance was Received

Termination Date
Termination Reason

1/1/2020
Other

Contacts

Authorizing Official

Metro Health
Miguel McInnis, CEO
(202) 838-9271

Primary Contact

MetroHealth
Amandeep Dhindsa, Finance Manager
(202) 638-0750

Addresses

Street Address

1012 14TH STREET, NW
SUITE 700
WASHINGTON, DC 20005

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

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	AHF PHARMACY	AIDS HEALTHCARE FOUNDATION	2141 K ST NW STE 707	WASHINGTON	DC	20037-1810	05/11/2010	05/11/2010	01/01/2020	01/01/2020
Contract Detail	AIDS HEALTHCARE FOUNDATION	DBA AHF PHARMACY	700 SE 3RD AVENUE SUITE 100	FT LAUDERDALE	FL	33316	10/15/2014	01/01/2015	01/01/2020	01/01/2020
Contract Detail	ALEX PHARM, LLC DBA PALISADES PHARMACY	5185 MACARTHUR BLVD NW, STE 107		WASHINGTON	DC	20016-3341	10/16/2014	01/01/2015	07/12/2019	07/12/2019
Contract Detail	APEX CARE PHARMACY	3839 MINNESOTA AVE NE		WASHINGTON	DC	20019	10/16/2014	01/01/2015	06/25/2015	10/17/2016
Contract Detail	BRIOVARX OF MAINE INC	DBA BRIOVARX	53 DARLING AVE	SOUTH PORTLAND	ME	04106	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	BRIOVARX OF MASSACHUSETTS, LLC	D/B/A BRIOVARX	BLDG 2 - UNIT A 145 BODWELL STREET	AVON	MA	02322	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01341	1199 VERMONT AVENUE NW	WASHINGTON	DC	20005	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 00021	1117 10TH ST., UNIT C-1	WASHINGTON	DC	20001	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 00022	320 40TH STREET NE	WASHINGTON	DC	20019	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01334	717 14TH STREET NW	WASHINGTON	DC	20005	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01338	661 PENNSYLVANIA AVENUE SE	WASHINGTON	DC	20003	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01344	500 12TH STREET SE	WASHINGTON	DC	20003	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01347	6-7 DUPONT CIRCLE NW	WASHINGTON	DC	20036	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01348	1100 4TH STREET SW	WASHINGTON	DC	20024	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01351	1755 COLUMBIA ROAD NW	WASHINGTON	DC	20009	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01360	2724 GOOD HOPE RD SE	WASHINGTON	DC	20020-3014	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01363	2350 WASHINGTON PLACE SUITE 101-N	WASHINGTON	DC	20018	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 01364	6514 GEORGIA AVENUE NW	WASHINGTON	DC	20012	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 02527	1025 CONNECTICUT AVENUE NW	WASHINGTON	DC	20036	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 02787	3642 GEORGIA AVE.	WASHINGTON	DC	20010	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 02817	1418 P STREET NW	WASHINGTON	DC	20005	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 02834	3031 14TH ST., NW	WASHINGTON	DC	20009	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 04546	2129 14TH STREET NW	WASHINGTON	DC	20009	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA: CVS/PHARMACY # 07102	1100 NEW JERSEY AVE., S.E.	WASHINGTON	DC	20003	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C	DBA CVS/PHARMACY # 10287	645 H STREET, NE	WASHINGTON	DC	20002	04/01/2019	07/01/2019	01/01/2020	01/01/2020
Contract Detail	FLEXCARE PHARMACY LLC	FLEXCARE PHARMACY	3861 ALABAMA AVE SE	WASHINGTON	DC	20020-2002	01/08/2018	04/01/2018	01/01/2020	01/01/2020
Contract Detail	GENOA HEALTHCARE LLC	801 PENNSYLVANIA AVENUE SE	SUITE 120	WASHINGTON	DC	20003-2167	01/13/2017	04/01/2017	01/01/2020	01/01/2020
Contract Detail	GOOD HOPE CARE PHARMACY, LLC	1343 GOOD HOPE ROAD, SE		WASHINGTON	DC	20020	10/16/2014	01/01/2015	03/01/2018	03/01/2018
Contract Detail	GOODCARE PHARMACY 11 INC.		1328 SOUTHERN AVE SE	WASHINGTON	DC	20032	10/16/2014	01/01/2015	04/08/2016	10/17/2016
Contract Detail	GOODCARE PHARMACY INC.	2910 MARTIN LUTHER KING JR AVE SE		WASHINGTON	DC	20032-2522	10/16/2014	01/01/2015	01/01/2020	01/01/2020
Contract Detail	GRUBB'S PHARMACY SE, INC.	GRUBBS PHARMACY SE, INC.	1800 MARTIN LUTHER KING JR AVE SE	WASHINGTON	DC	20020-6900	10/16/2014	01/01/2015	01/01/2020	01/01/2020
Contract Detail	GRUBBS CARE PHARMACY NW INC.	GRUBB'S NW SPECIALTY PHARMACY	1517 17TH ST NW FL 1	WASHINGTON	DC	20036-6230	10/16/2014	01/01/2015	06/25/2015	10/17/2016
Contract Detail	GRUBBS CARE PHARMACY NW INC.	GRUBB'S NW SPECIALTY PHARMACY	1517 17TH ST NW FL 1	WASHINGTON	DC	20036-6230	01/09/2018	04/01/2018	01/01/2020	01/01/2020
Contract Detail	GRUBBS PHARMACY OF D C INC	GRUBBS CARE PHARMACY	326 E CAPITOL ST NE	WASHINGTON	DC	20003-3809	10/16/2014	01/01/2015	01/01/2020	01/01/2020
Contract Detail	H STREET CARE PHARMACY AND WELLNESS CENT	812 H STREET, NE		WASHINGTON	DC	20002	10/16/2014	01/01/2015	06/25/2015	10/17/2016
Contract Detail	JANILCAR INC		T/A NEW HAMPSHIRE PHARMACY 5000 1ST ST NW	WASHINGTON	DC	20011	10/16/2014	01/01/2015	03/01/2018	07/18/2019
Contract Detail	MATRIX CORP	DBA APEX CARE SPECIALTY PHARMACY	210 MICHIGAN AVE NE	WASHINGTON	DC	20017	10/16/2014	01/01/2015	06/25/2015	10/17/2016
Contract Detail	OPTUM FRONTIER THERAPIES II, LLC	6425 SANTA MARGARITA ST UNIT 110		LAS VEGAS	NV	89118-1913	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	PRIME	DBA STERLING PHARMACY	1647 BENNING RD NE STE 101	WASHINGTON	DC	20002-4571	10/16/2014	01/01/2015	06/25/2015	10/17/2016
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/13/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY#2733	1601 17TH STREET NW	WASHINGTON	DC	20009	07/17/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO	COMMUNITY A WALGREENS PHARMACY #15298	1325 14TH STREET NW	WASHINGTON	DC	20005	07/01/2014	10/01/2014	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	COMMUNITY, A WALGREENS PHARMACY #16419	1117 GOOD HOPE RD. SE	WASHINGTON	DC	20020	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	RITE AID #03676	1671 CRYSTAL SQUARE ARCADE	ARLINGTON	VA	22202	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #18419	1301 S JOYCE ST	ARLINGTON	VA	22202-2079	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19419	4720B LANGSTON BLVD	ARLINGTON	VA	22207	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19650	2820 COLUMBIA PIKE	ARLINGTON	VA	22204-4412	04/02/2018	07/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	RITE AID #11222	8416 LEE HIGHWAY	FAIRFAX	VA	22031	04/02/2018	07/01/2018	07/18/2019	07/18/2019
Contract Detail	WALGREEN CO.	WALGREENS #17803	9139 RIGGS RD	ADELPHI	MD	20783	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #17712	1306 U ST NW	WASHINGTON	DC	20009-4445	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #17684	6100 ROSE HILL DR	ALEXANDRIA	VA	22310-1901	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #18330	3614 KING ST	ALEXANDRIA	VA	22302-1908	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	4515 DUKE ST		ALEXANDRIA	VA	22304-2591	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19804	7968 FORT HUNT RD	ALEXANDRIA	VA	22308-1249	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19265	5841 N. WASHINGTON BLVD	ARLINGTON	VA	22205-2923	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #18089	1312 CHAIN BRIDGE RD	MC LEAN	VA	22101-3966	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #17573	6224 OLD DOMINION DR	MC LEAN	VA	22101-4217	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	RITE AID #03794	6806 RIVERDALE RD	RIVERDALE	MD	20737	07/05/2018	10/01/2018	09/19/2018	09/25/2018
Contract Detail	WALGREEN CO.	WALGREENS #19851	10456 BALTIMORE AVE	BELTSVILLE	MD	20705	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #17262	6906 ARLINGTON RD	BETHESDA	MD	20814	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19368	12222 VEIRS MILL RD	SILVER SPRING	MD	20906	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19076	1815 CONNECTICUT AVE NW	WASHINGTON	DC	20009-5702	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19132	3301 NEW MEXICO AVE NW STE 127	WASHINGTON	DC	20016	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19546	4635 S CAPITOL ST SW	WASHINGTON	DC	20032-2717	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19268	1401 RHODE ISLAND AVE NE	WASHINGTON	DC	20018-3708	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19312	6130 BALTIMORE AVE	RIVERDALE	MD	20737	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	SUITE 1	2255 WISCONSIN AVE NW	WASHINGTON	DC	20007-4155	07/05/2018	10/01/2018	07/18/2019	07/18/2019
Contract Detail	WALGREEN CO.	WALGREENS #19619	8701 GEORGIA AVE STE 100	SILVER SPRING	MD	20910-3736	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #19336	9810 APOLLO DR	LARGO	MD	20774	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #17859	5741 SILVER HILL RD	DISTRICT HEIGHTS	MD	20747	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	WALGREENS #18162	6053 LEESBURG PIKE	FALLS CHURCH	VA	22041-2205	07/05/2018	10/01/2018	01/01/2020	01/01/2020
Contract Detail	WALGREEN CO.	RITE AID #11225	1003 WEST BROAD STREET	FALLS CHURCH	VA	22046	07/05/2018	10/01/2018	06/04/2019	06/04/2019
Contract Detail	WALGREEN CO.	RITE AID #03868	1823 E WEST HWY	ADELPHI	MD	20783	07/13/2018	10/01/2018	09/19/2018	09/25/2018
Contract Detail	WALGREEN CO.	WALGREENS #19080	5600 GEORGIA AVE NW	WASHINGTON	DC	20011-2927	10/11/2018	01/01/2019	01/01/2020	01/01/2020
Contract Detail	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2014	10/01/2014	07/01/2015	10/17/2016
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2014	10/01/2014	07/01/2015	10/17/2016

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2020 12:05 AM
Details	State	Update	Termination Request	Active	To Be Terminated	10/7/2019 12:29 PM
Terminations	Termination Date	Update	Termination Request		1/1/2020 12:00:00 AM	10/7/2019 12:29 PM
Terminations	Termination Effective Date	Update	Termination Request		10/1/2019 12:00:00 AM	10/7/2019 12:29 PM
Terminations	Termination Reason	Update	Termination Request		Other	10/7/2019 12:29 PM
Contacts	Authorizing Official	Update	AO Change Request	BUCKNER, LLOYD H. EXECUTIVE DIRECTOR MetroHealth 2026380750	McInnis, Miguel CEO Metro Health 2028389271	5/17/2019 3:15 PM
Details	Last Recertification Date	Update	Recertification	2/7/2018 2:48:53 PM	1/29/2019 11:59:35 AM	1/29/2019 11:59 AM
Contacts	Primary Contact	Update	Recertification	Dhindsa, Amandeep Finance Manager 2026380750	Dhindsa, Amandeep Finance Manager MetroHealth 2026380750	2/7/2018 2:48 PM
Details	Last Recertification Date	Update	Recertification	2/7/2017 12:00:00 AM	2/7/2018 2:48:53 PM	2/7/2018 2:48 PM
Contacts	Authorizing Official	Update		BUCKNER, LLOYD H. EXECUTIVE DIRECTOR 2026380750	BUCKNER, LLOYD H. EXECUTIVE DIRECTOR MetroHealth 2026380750	1/8/2018 2:57 PM
Addresses	Main Address	Insert			1012 14TH STREET, NW SUITE 700 WASHINGTON, DC 20005	2/7/2017 2:20 PM
Contacts	Authorizing Official	Update		BUCKNER, LLOYD H. EXECUTIVE DIRECTOR 2026380750	BUCKNER, LLOYD H. EXECUTIVE DIRECTOR 2026380750	2/7/2017 2:20 PM
Contacts	Primary Contact	Update		JONES, KATRINA OPERATIONS DIRECTOR 2026380750	Dhindsa, Amandeep Finance Manager 2026380750	2/7/2017 2:20 PM
Details	Last Recertification Date	Update		3/1/2016 12:00:00 AM	2/7/2017 12:00:00 AM	2/7/2017 2:20 PM
Details	Grant Number	Update		H76HA01713	H89HA00012	10/17/2016 7:49 AM
Details	Last Recertification Date	Update		1/29/2015 12:00:00 AM	3/1/2016 12:00:00 AM	3/1/2016 10:29 AM
Details	Last Recertification Date	Update		3/13/2014 12:00:00 AM	1/29/2015 12:00:00 AM	1/29/2015 1:20 PM
Details	Last Recertification Date	Update		1/1/2013 12:00:00 AM	3/13/2014 12:00:00 AM	3/13/2014 2:42 PM
Details	Entity Name	Update		CARL VOGEL FOUNDATION, INC.	MetroHealth	11/14/2013 9:43 AM
Contacts	Primary Contact	Insert			JONES, KATRINA OPERATIONS DIRECTOR 2026380750	11/28/2012 10:34 AM
Contacts	Authorizing Official	Insert			BUCKNER, LLOYD H. EXECUTIVE DIRECTOR 2026380750	11/28/2012 10:34 AM
Details	Last Recertification Date	Update			1/1/2013 12:00:00 AM	11/28/2012 10:34 AM
Details	Last Recertification Date	Insert				5/22/2009 1:48 PM
Details	Grant Number	Insert			H76HA01713	5/22/2009 1:48 PM
Details	340B ID	Insert			HV01713	5/22/2009 1:48 PM
Details	Is Authorizing Official EHB Data	Insert				5/22/2009 1:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert				5/22/2009 1:48 PM
Details	Medicare Provider Number	Insert				5/22/2009 1:48 PM
Details	Entity Name	Insert			CARL VOGEL FOUNDATION, INC.	5/22/2009 1:48 PM
Details	Program Code	Insert			HV	5/22/2009 1:48 PM
Details	Entity Subname	Insert				5/22/2009 1:48 PM
Dates	Participating Approval Date	Insert			5/22/2009 12:00:00 AM	5/22/2009 1:48 PM
Details	State	Insert			Active	5/22/2009 1:48 PM
Dates	Registration Date	Insert			5/13/2009 12:00:00 AM	5/22/2009 1:48 PM
Dates	Signed By Date	Insert			4/1/2009 12:00:00 AM	5/22/2009 1:48 PM
Dates	Start Date	Insert			7/1/2009 12:00:00 AM	5/22/2009 1:48 PM
Terminations	Termination Comments	Insert				5/22/2009 1:48 PM
Terminations	Termination Date	Insert				5/22/2009 1:48 PM
Terminations	Termination Effective Date	Insert				5/22/2009 1:48 PM
Terminations	Termination Reason	Insert				5/22/2009 1:48 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History