340B Drug Pricing Program Database


RWII27536 Warren-Vance Community Health Center (Active) - information as of 5/10/2025 10:57:11 PM

Main Details
Warren-Vance Community Health Center
Northern Outreach Clinic
Ryan White Part B
RWII27536
X07HA00051


Additional Details
Active
9/20/2011
1/1/2012
11/3/2011
2/25/2025
4/1/2022 - 3/31/2025

Contacts

Warren-Vance Community Health Center, Inc.
Michelle Collins Ogle, Medical Director
(252) 572-2610

Warren-Vance Community Health Center, Inc.
Wanda Henderson, Program Manager
(252) 572-2610

Addresses

120 Charles Rollins Rd. Suite 205
Henderson, NC 27536

Same as Street Address


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

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailCYSTIC FIBROSIS SERVICESCYSTIC FIBROSIS SERVICES, INC 10530 JOHN W ELLIOTT DR, STE 200
FRISCOTX7503307/12/201610/01/2016 08/09/201711/16/2017
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503307/07/201707/01/2017  07/07/2017
Contract DetailMEDEXPRESS PHARMACY LTD  1431 W INNES STREET
SALISBURYNC2814402/02/201202/02/2012  03/28/2013
Contract DetailMEDEXPRESS PHARMACY LTD  1431 W INNES STREET
SALISBURYNC2814402/02/201202/02/2012  03/28/2013
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999207/10/201710/01/2017 08/31/202202/25/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 05761 4701 SOUTH BLVD
CHARLOTTENC2821710/07/201301/01/2014  10/07/2013
Contract DetailWALGREEN CO.DBA: WALGREENS # 07398 1411 OXFORD ROAD
HENDERSONNC27536-496710/07/201301/01/2014  10/07/2013
Contract DetailWALGREEN CO.DBA: WALGREENS #11692 500 FINCHER ST.
MONROENC2811210/07/201301/01/2014  10/07/2013
Contract DetailWALGREEN CO.DBA: WALGREENS #11838 25 BURKE BLVD.
LOUISBURGNC2754910/07/201301/01/2014  10/07/2013
Contract DetailWALGREEN CO.DBA: WALGREENS #12630 201 HILLSBORO ST.
OXFORDNC2756510/07/201301/01/2014  10/07/2013
Contract DetailWALGREEN CO.WALGREENS #19096 201 TRADE ST
HENDERSONNC2753607/17/201810/01/2018  10/01/2018
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16405 1500 E 3RD ST STE A
CHARLOTTENC2820410/11/202001/01/2021  01/01/2021
Contract DetailWalgreens #21420Walgreens Central Fill #21420 8440 Times Dispatch Blvd
Ste. 400 		MechanicsvilleVA2311601/16/202404/01/2024  04/01/2024
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/07/201301/01/2014 07/27/201508/04/2015
Contract DetailWALGREENS OF NORTH CAROLINA INC.COMMUNITY, A WALGREENS PHARMACY #16313 2816 ERWIN ROAD
SUITE 105 		DURHAMNC2770501/08/201504/01/2015  01/08/2015
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/08/201504/01/2015  01/08/2015
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/08/201504/01/2015 10/01/202102/22/2022
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/08/201504/01/2015  01/08/2015
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/08/201504/01/2015  01/08/2015
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/9/2024 7:34:22 PM2/25/2025 11:17:28 AM2/25/2025 11:17 AM
DetailsAssistance Received To DateUpdateChange Request3/31/2024 12:00:00 AM3/31/2025 12:00:00 AM6/25/2024 1:31 AM
DetailsLast Recertification DateUpdateRecertification2/6/2023 1:35:15 AM2/9/2024 7:34:22 PM2/9/2024 7:34 PM
DetailsNOFO NumberUpdate HRSA-17- 036 12/16/2023 10:34 AM
DetailsLast Recertification DateUpdateRecertification2/25/2022 8:55:32 AM2/6/2023 1:35:15 AM2/6/2023 1:35 AM
DetailsAssistance Received From DateUpdateChange Request4/1/2021 12:00:00 AM4/1/2022 12:00:00 AM10/14/2022 2:11 AM
DetailsAssistance Received To DateUpdateChange Request3/31/2022 12:00:00 AM3/31/2024 12:00:00 AM10/14/2022 2:11 AM
AddressesMain AddressUpdateRecertification 511 Ruin Creek Road, Suite 105 Henderson, NC 27536 120 Charles Rollins Rd. Suite 205 Henderson, NC 275362/25/2022 8:55 AM
DetailsAssistance Received From DateUpdateRecertification4/1/2020 12:00:00 AM4/1/2021 12:00:00 AM2/25/2022 8:55 AM
DetailsAssistance Received To DateUpdateRecertification3/31/2021 12:00:00 AM3/31/2022 12:00:00 AM2/25/2022 8:55 AM
DetailsLast Recertification DateUpdateRecertification2/28/2021 9:21:48 AM2/25/2022 8:55:32 AM2/25/2022 8:55 AM
DetailsGrant NumberUpdateRecertificationT2-NCX07HA000512/25/2022 8:55 AM
DetailsNOFO NumberUpdateRecertificationX07HA00051HRSA-17- 0362/25/2022 8:55 AM
DetailsAssistance Received From DateUpdateRecertification 4/1/2020 12:00:00 AM2/28/2021 9:21 AM
DetailsAssistance Received To DateUpdateRecertification 3/31/2021 12:00:00 AM2/28/2021 9:21 AM
DetailsLast Recertification DateUpdateRecertification2/11/2020 3:39:17 AM2/28/2021 9:21:48 AM2/28/2021 9:21 AM
DetailsNOFO NumberUpdateRecertification X07HA000512/28/2021 9:21 AM
DetailsLast Recertification DateUpdateRecertification2/1/2019 12:18:42 AM2/11/2020 3:39:17 AM2/11/2020 3:39 AM
ContactsPrimary ContactUpdateChange RequestCozart, Rita Ann Program Manager Warren-Vance Community Health Center, Inc. 2525722610Henderson, Wanda Program Manager Warren-Vance Community Health Center, Inc. 25257226104/22/2019 9:38 AM
DetailsLast Recertification DateUpdateRecertification2/12/2018 6:12:15 PM2/1/2019 12:18:42 AM2/1/2019 12:18 AM
DetailsLast Recertification DateUpdateRecertification2/15/2017 12:00:00 AM2/12/2018 6:12:15 PM2/12/2018 6:12 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestBousley, Brian Collins Dickinson County Controller/Administrator Warren-Vance Community Health Cente 9067742573Ogle, Michelle Collins Medical Director Warren-Vance Community Health Center, Inc. 25257226102/12/2018 5:57 PM
ContactsSigned ByUpdateProfile Change RequestBousley, Brian Collins Dickinson County Controller/Administrator Warren-Vance Community Health Cente 9067742573Ogle, Michelle Collins Medical Director Warren-Vance Community Health Center, Inc. 25257226102/12/2018 5:57 PM
ContactsAuthorizing OfficialUpdateOPA EditBousley, Brian Collins Dickinson County Controller/Administration Warren-Vance Community Health Cente 9067742573Bousley, Brian Collins Dickinson County Controller/Administrator Warren-Vance Community Health Cente 906774257311/29/2017 10:14 AM
ContactsSigned ByUpdateOPA EditBousley, Brian Collins Dickinson County Controller/Administration Warren-Vance Community Health Cente 9067742573Bousley, Brian Collins Dickinson County Controller/Administrator Warren-Vance Community Health Cente 906774257311/29/2017 10:14 AM
ContactsAuthorizing OfficialUpdateOPA EditCollins-Ogle, Michelle Collins Medical Director Warren-Vance Community Health Cente 2525722610Bousley, Brian Collins Dickinson County Controller/Administration Warren-Vance Community Health Cente 906774257311/29/2017 10:12 AM
ContactsSigned ByUpdateOPA EditCollins-Ogle, Michelle Collins Medical Director Warren-Vance Community Health Cente 2525722610Bousley, Brian Collins Dickinson County Controller/Administration Warren-Vance Community Health Cente 906774257311/29/2017 10:12 AM
ContactsPrimary ContactUpdate Cozart, Rita Program Manager Warren-Vance Community Health Center, Inc. 2525722610Cozart, Rita Ann Program Manager Warren-Vance Community Health Center, Inc. 252572261011/20/2017 10:20 AM
ContactsPrimary ContactInsertChange Request Cozart, Rita Program Manager Warren-Vance Community Health Center, Inc. 252572261011/16/2017 4:46 PM
ContactsAuthorizing OfficialUpdate Collins-Ogle, Michelle Medical Director 2525722610Collins-Ogle, Michelle Collins Medical Director Warren-Vance Community Health Cente 252572261011/16/2017 4:34 PM
ContactsSigned ByUpdate Collins-Ogle, Michelle Medical Director 2525722610Collins-Ogle, Michelle Collins Medical Director Warren-Vance Community Health Cente 252572261011/16/2017 4:34 PM
ContactsAuthorizing OfficialInsert  Collins-Ogle, Michelle Medical Director 25257226107/10/2017 2:30 PM
ContactsSigned ByInsert  Collins-Ogle, Michelle Medical Director 25257226107/10/2017 2:30 PM
AddressesMain AddressInsert   511 Ruin Creek Road, Suite 105 Henderson, NC 275362/15/2017 11:40 AM
DetailsLast Recertification DateUpdate 2/28/2016 12:00:00 AM2/15/2017 12:00:00 AM2/15/2017 11:40 AM
DetailsLast Recertification DateUpdate 2/4/2015 12:00:00 AM2/28/2016 12:00:00 AM2/28/2016 5:35 PM
DetailsLast Recertification DateUpdate 2/26/2014 12:00:00 AM2/4/2015 12:00:00 AM2/4/2015 6:47 AM
DetailsLast Recertification DateUpdate 1/1/2013 12:00:00 AM2/26/2014 12:00:00 AM2/26/2014 12:10 AM
DetailsLast Recertification DateUpdate  1/1/2013 12:00:00 AM11/27/2012 8:11 AM
DetailsGrant NumberUpdate X07HA00051T2-NC11/3/2011 4:55 PM
DatesParticipating Approval DateUpdate  11/3/2011 12:00:00 AM11/3/2011 4:55 PM
DetailsStateUpdate PendingActive11/3/2011 4:55 PM
Details340B IDUpdate NEXTQ80RWII2753610/27/2011 4:32 PM
Details340B IDUpdate ONLINE_REGNEXTQ809/20/2011 5:10 PM
DatesStart DateUpdate  1/1/2012 12:00:00 AM9/20/2011 5:10 PM
DetailsLast Recertification DateInsert   9/20/2011 12:18 PM
DetailsGrant NumberInsert  X07HA000519/20/2011 12:18 PM
Details340B IDInsert  ONLINE_REG9/20/2011 12:18 PM
DetailsIs Authorizing Official EHB DataInsert   9/20/2011 12:18 PM
DatesLast Date That 340B Drugs PurchasedInsert   9/20/2011 12:18 PM
DetailsMedicare Provider NumberInsert   9/20/2011 12:18 PM
DetailsEntity NameInsert  Warren-Vance Community Health Center9/20/2011 12:18 PM
DetailsProgram CodeInsert  RWII9/20/2011 12:18 PM
DetailsEntity SubnameInsert  Northern Outreach Clinic9/20/2011 12:18 PM
DatesParticipating Approval DateInsert   9/20/2011 12:18 PM
DetailsStateInsert  Pending9/20/2011 12:18 PM
DatesRegistration DateInsert  9/20/2011 12:00:00 AM9/20/2011 12:18 PM
DatesSigned By DateInsert  9/20/2011 12:00:00 AM9/20/2011 12:18 PM
DatesStart DateInsert   9/20/2011 12:18 PM
TerminationsTermination CommentsInsert   9/20/2011 12:18 PM
TerminationsTermination DateInsert   9/20/2011 12:18 PM
TerminationsTermination Effective DateInsert   9/20/2011 12:18 PM
TerminationsTermination ReasonInsert   9/20/2011 12:18 PM