Covered Entity Details

CH062376A JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC (Terminated) - information as of 4/23/2025 10:54:05 PM

Main Details

Name

JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC

Subdivision Name

JCHCC River Ridge Clinic

Type

HRSA-Funded Health Center

Site ID

BPS-H80-008237

340B ID

CH062376A

Grant Number

H80CS06716

Additional Details

Current Program Status

Terminated

Registration Date

5/20/2009

Participating Start Date

7/1/2009

Participating Approval Date

6/8/2009

Last Recertification Date

2/20/2018

Termination Date
Termination Reason

4/1/2019
Site closure

Contacts

Authorizing Official

Jefferson Community Health Care Centers
Shondra Williams, CEO
(504) 762-8931

Primary Contact

Jefferson Community Health Care Centers, Inc.
Wanda Rose, CFO
(504) 206-7738

Addresses

Street Address

11312 Jefferson Hwy
River Ridge, LA 70123-1709

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
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	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	10/14/2018	01/01/2019		04/01/2019	04/01/2019
Contract Detail	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	11/01/2017	01/01/2018		04/01/2019	04/01/2019

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH0623760	Active	BPS-H80-012634	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	Jefferson Community Health Care Centers-Avondale	3932 U.S. Hwy 90	Avondale	LA
CH062376A	Terminated	BPS-H80-008237	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	JCHCC River Ridge Clinic	11312 Jefferson Hwy	River Ridge	LA
CH062376B	Terminated	BPS-H80-001446	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	MARRERO FAMILY CLINIC	1855 AMES BLVD	MARRERO	LA
CH062376C	Active	BPS-H80-012611	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	Jefferson Community Health Care Centers-RFK Lafitte Medical Clinic	5140 Church St	Lafitte	LA
CH062376D	Terminated	BPS-H80-015626	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	Jefferson Community Health Care Centers-Grand Isle	3101 HIGHWAY 1	GRAND ISLE	LA
CH062376E	Active	BPS-H80-014705	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC.	4028 U.S. HIGHWAY 90	AVONDALE	LA
CH062376F	Terminated	BPS-H80-018669	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	JCHCC-Satellite Lapalco	7017 Lapalco Blvd.	Marrero	LA
CH062376G	Active	BPS-H80-021588	Jefferson Community Health Care Centers, Inc	JCHCC-Your Dental Mobile Home	4028 Highway 90 W	Avondale	LA
CH062376H	Active	BPS-H80-022288	Jefferson Community Health Care Centers, Inc	Jefferson Community Health Care Centers,Inc.-Kenner	2552 Williams Blvd	Kenner	LA
CH062376J	Active	BPS-H80-032150	Jefferson Community Health Care Centers, Inc	InclusivCare-Marrero	7001 Lapalco Blvd	Marrero	LA
CH062376K	Active	BPS-H80-029888	Jefferson Community Health Care Centers, Inc	LW Higgins High School SBHC	7201 Lapalco Blvd	Marrero	LA
CH062376L	Active	BPS-H80-036940	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	Emmett Gilbert Elementary School	435 S Jamie Blvd	Westwego	LA
CH062376M	Active	BPS-H80-036941	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	Lincoln Elementary School for the Arts	1429 Ames Blvd	Marrero	LA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH0623760	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	04/01/2017	11/27/2019
CH0623760	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	01/01/2019
CH062376C	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	01/01/2019
CH062376G	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	01/01/2019
CH0623760	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	01/01/2019	06/01/2024
CH062376A	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	01/01/2019	04/01/2019
CH062376C	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	01/01/2019	07/01/2024
CH0623760	AVITA PHARMACY 1039	1631 ELYSIAN FIELDS AVE STE 200		NEW ORLEANS	LA	70117-8208	07/01/2020
CH0623760	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	11/02/2017
CH062376A	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2018	04/01/2019
CH062376B	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2018	04/01/2019
CH062376C	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2018
CH062376D	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2018	04/01/2019
CH062376E	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2018
CH0623760	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	04/01/2017	11/27/2019
CH0623760	TEWELDE'S LAFITTE DRUGS	2695 JEAN LAFITTE BLVD	PO BOX 10	LAFITTE	LA	70067-5205	01/01/2015	11/27/2019
CH0623760	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2019
CH0623760	WAL-MART PHARMACY 10-0911	4810 LAPALCO BLVD		MARRERO	LA	70072	01/01/2019
CH0623760	WAL-MART PHARMACY 10-0989	8912 VETERANS MEMORIAL BLVD		METAIRIE	LA	70003	07/01/2019	10/06/2024
CH0623760	WAL-MART PHARMACY 10-1353	5110 JEFFERSON HWY		HARAHAN	LA	70123	01/01/2019
CH062376K	WAL-MART PHARMACY 10-1353	5110 JEFFERSON HWY		HARAHAN	LA	70123	04/01/2024
CH0623760	WAL-MART PHARMACY 10-2706	1501 MANHATTAN BLVD		HARVEY	LA	70058	07/01/2019
CH0623760	WAL-MART PHARMACY 10-5722	3265 MANHATTAN BLVD.		HARVEY	LA	70058	04/01/2024
CH062376L	WAL-MART PHARMACY 10-5722	3265 MANHATTAN BLVD.		HARVEY	LA	70058	04/01/2024
CH0623760	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2019
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03199	1891 BARATARIA BLVD.	MARRERO	LA	70072	01/01/2014
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 05230	818 WESTBANK EXPY	WESTWEGO	LA	70094	01/01/2014
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 05516	4600 WESTBANK EXPRESSWAY	MARRERO	LA	70072-3065	01/01/2014
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 13658	9705 JEFFERSON HWY	RIVER RIDGE	LA	70123	01/01/2014
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 05633	2570 BARATARIA BLVD	MARRERO	LA	70072	01/01/2015
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 06506	89 WESTBANK EXPRESSWAY	GRETNA	LA	70053-3662	01/01/2015
CH0623760	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS SPECIALTY PHARMACY #15198	1111 MEDICAL CENTER BLVD STE 116N	MARRERO	LA	70072	07/01/2019
CH062376H	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03199	1891 BARATARIA BLVD.	MARRERO	LA	70072	04/01/2024
CH0623760	Walgreens #21389	Walgreens Central Fill #21389	3299 Tchulatech Dr Suite 101	Memphis	TN	38118	10/01/2023
CH0623760	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2014	07/01/2015
CH0623760	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	01/01/2015	07/01/2015
CH062376M	WALMART PHARMACY 10-5102	99 WESTBANK EXPY		GRETNA	LA	70053	04/01/2024	03/31/2025
CH0623760	WALMART PHARMACY 10-5102	99 WESTBANK EXPY		GRETNA	LA	70053	04/01/2024	03/31/2025
CH0623760	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH0623760	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		12/3/2018 12:00:00 AM	1/30/2019 9:07 AM
Details	State	Update	Recertification	Active	To Be Terminated	1/30/2019 9:07 AM
Terminations	Termination Date	Update	Recertification		4/1/2019 12:00:00 AM	1/30/2019 9:07 AM
Terminations	Termination Effective Date	Update	Recertification		12/3/2018 12:00:00 AM	1/30/2019 9:07 AM
Terminations	Termination Reason	Update	Recertification		Site closure	1/30/2019 9:07 AM
Contacts	Primary Contact	Update	Change Request	Young, Annette Director of Nursing Jefferson Community Health Care Center 5044008256	Rose, Wanda CFO Jefferson Community Health Care Centers, Inc. 5042067738	10/14/2018 8:25 PM
Contacts	Primary Contact	Update	Recertification	Williams, Shondra CEO Jefferson Community Health Care Centers 5047628931	Young, Annette Director of Nursing Jefferson Community Health Care Center 5044008256	2/20/2018 8:56 AM
Details	Last Recertification Date	Update	Recertification	2/18/2017 12:00:00 AM	2/20/2018 8:56:56 AM	2/20/2018 8:56 AM
Details	Entity Subname	Update	Recertification	JCHCC River Edge Clinic	JCHCC River Ridge Clinic	2/20/2018 8:56 AM
Contacts	Authorizing Official	Update	OPA Edit Contract Pharmacy	Williams, Shondra CEO Jefferson Community Health Care Centers, Inc. 5047628931	Williams, Shondra CEO Jefferson Community Health Care Centers 5047628931	11/2/2017 7:07 AM
Contacts	Primary Contact	Update	OPA Edit Contract Pharmacy	Williams, Shondra CEO Jefferson Community Health Care Centers, Inc. 5047628931	Williams, Shondra CEO Jefferson Community Health Care Centers 5047628931	11/2/2017 7:07 AM
Contacts	Authorizing Official	Update		Williams, Shondra CEO 5047628931	Williams, Shondra CEO Jefferson Community Health Care Centers, Inc. 5047628931	10/26/2017 10:47 AM
Contacts	Primary Contact	Update		Williams, Shondra CEO 5047628931	Williams, Shondra CEO Jefferson Community Health Care Centers, Inc. 5047628931	10/26/2017 10:47 AM
Contacts	Authorizing Official	Update		ARDALAN, CYROUS INTERIM CEO 5043478347	Williams, Shondra CEO 5047628931	3/16/2017 11:00 AM
Contacts	Primary Contact	Update		DUNN, GAIL WILLIAMS CHIEF ADMINISTRATIVE OFFICER 5044378508	Williams, Shondra CEO 5047628931	3/16/2017 11:00 AM
Addresses	Main Address	Insert			11312 Jefferson Hwy River Ridge, LA 70123-1709	2/18/2017 10:08 AM
Details	Last Recertification Date	Update		2/17/2016 12:00:00 AM	2/18/2017 12:00:00 AM	2/18/2017 10:08 AM
Details	Last Recertification Date	Update		3/4/2015 12:00:00 AM	2/17/2016 12:00:00 AM	2/17/2016 7:23 PM
Details	Last Recertification Date	Update		3/13/2014 12:00:00 AM	3/4/2015 12:00:00 AM	3/4/2015 8:23 AM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/13/2014 12:00:00 AM	3/13/2014 12:51 PM
Details	Entity Name	Update		JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC.	JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC	3/13/2014 12:51 PM
Details	Entity Subname	Update			JCHCC River Edge Clinic	3/13/2014 12:51 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/4/2013 8:21 AM
Contacts	Primary Contact	Update		RUSSELL, DESHANNON C. PROJECT DIRECTOR 5044362223	DUNN, GAIL WILLIAMS CHIEF ADMINISTRATIVE OFFICER 5044378508	10/4/2012 4:02 PM
Contacts	Authorizing Official	Update		SMITH, CAROL CEO 5043669484	ARDALAN, CYROUS INTERIM CEO 5043478347	6/15/2012 4:09 PM
Contacts	Authorizing Official	Insert			SMITH, CAROL CEO 5043669484	2/16/2012 11:27 AM
Contacts	Primary Contact	Insert			RUSSELL, DESHANNON C. PROJECT DIRECTOR 5044362223	2/16/2012 11:27 AM
Details	Last Recertification Date	Insert				6/8/2009 1:48 PM
Details	Grant Number	Insert			H80CS06716	6/8/2009 1:48 PM
Details	340B ID	Insert			CH062376A	6/8/2009 1:48 PM
Details	Is Authorizing Official EHB Data	Insert				6/8/2009 1:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert				6/8/2009 1:48 PM
Details	Medicare Provider Number	Insert				6/8/2009 1:48 PM
Details	Entity Name	Insert			JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC.	6/8/2009 1:48 PM
Details	Program Code	Insert			CH	6/8/2009 1:48 PM
Details	Entity Subname	Insert				6/8/2009 1:48 PM
Dates	Participating Approval Date	Insert			6/8/2009 12:00:00 AM	6/8/2009 1:48 PM
Details	State	Insert			Active	6/8/2009 1:48 PM
Dates	Registration Date	Insert			5/20/2009 12:00:00 AM	6/8/2009 1:48 PM
Dates	Signed By Date	Insert			4/13/2009 12:00:00 AM	6/8/2009 1:48 PM
Dates	Start Date	Insert			7/1/2009 12:00:00 AM	6/8/2009 1:48 PM
Terminations	Termination Comments	Insert				6/8/2009 1:48 PM
Terminations	Termination Date	Insert				6/8/2009 1:48 PM
Terminations	Termination Effective Date	Insert				6/8/2009 1:48 PM
Terminations	Termination Reason	Insert				6/8/2009 1:48 PM

340B Drug Pricing Program Database