Covered Entity Details

FQHCLA297 URBAN HEALTH INITIATIVES, INC. (Terminated) - information as of 4/26/2025 11:43:41 PM

Main Details

Name

URBAN HEALTH INITIATIVES, INC.

Subdivision Name

Urban Health Initiatives

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-011500

340B ID

FQHCLA297

Grant Number

LALCS00130

Additional Details

Current Program Status

Terminated

Registration Date

5/15/2012

Participating Start Date

7/1/2012

Participating Approval Date

6/13/2012

Last Recertification Date

3/3/2015

Termination Date
Termination Reason

7/1/2015
Site closure

Contacts

Authorizing Official

Spectrum Health Services, Inc.
Phyllis B. Cater, President & CEO
(215) 471-2755

Primary Contact

Spectrum Health Services, Inc.
Phyllis B. Cater, President & CEO
(215) 471-2755

Addresses

Street Address

1408 S. Broad Street
Philadelphia, PA 19146

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
6/04/2012 CMS letter provided, eligible	06/04/2012
5/31/2012 called, left a message. appears to be ineligible	05/31/2012

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
PA	1025626480001
		1396003620

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	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11078	BEAVER BROOK 1500 BEAVER BROOK PLAZA	NEW CASTLE	DE	19720	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS #12462	700 S RIDGE AVE	MIDDLETOWN	DE	19709	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11034	NEW CASTLE 740 FERRY CUT-OFF	NEW CASTLE	DE	19720	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11035	HARMONY PLAZA 4114 STANTON-OGLETOWN RD	NEWARK	DE	19713	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3783	810 S BROAD ST	PHILADELPHIA	PA	19146-2217	04/08/2013	07/01/2013	07/01/2015	03/03/2015
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #1936	2017-2023 SOUTH BROAD ST.	PHILADELPHIA	PA	19148	04/08/2013	07/01/2013	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO INC	DBA: WALGREENS # 04115	4201 N BROAD ST	PHILADELPHIA	PA	19140	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO. INC.	DBA:WALGREENS #15336	1 SOUTH BROAD STREET	PHILADELPHIA	PA	19107	01/10/2014	04/01/2014	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07543	2310 W OREGON AVE	PHILADELPHIA	PA	19145-4122	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03791	2014-24 S BROAD ST	PHILADELPHIA	PA	19145	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	1800 SOUTH ST.	PHILADELPHIA	PA	19146	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	112 W CHELTEN AVE	PHILADELPHIA	PA	19144	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	300 N. 63RD ST.	PHILADELPHIA	PA	19139	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05522	1607 BRIDGE ST	PHILADELPHIA	PA	19124	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04429	150 N MACDADE BLVD.	GLENOLDEN	PA	19036	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07151	901 MARKET STREET	PHILADELPHIA	PA	19107-3111	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06174	13 N BLACK HORSE PIKE	WILLIAMSTOWN	NJ	08094-1402	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06367	1809 E ALLEGHENY AVE	PHILADELPHIA	PA	19134	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07740	52 CHESTER PIKE	DARBY	PA	19023-2018	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA WALGREENS SPECIALTY PHARMACY #16519	1334 BAINBRIDGE ST	PHILADELPHIA	PA	19147	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03663	4098 EDGEMONT AVE.	BROOKHAVEN	PA	19015	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04926	7001 FRANKFORD AVE	PHILADELPHIA	PA	19135	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07336	1617 JOHN F KENNEDY BLVD LBBY W8	PHILADELPHIA	PA	19103	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA WALGREENS #11897	504 KINGS HWY. NORTH	CHERRY HILL	NJ	08034	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03569	4001 KENSINGTON AVE.	PHILADELPHIA	PA	19124	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07225	1 YORKTOWN PLAZA	ELKINS PARK	PA	19027	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	1101 LOCUST ST.	PHILADELPHIA	PA	19107	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01531	625 N BLACK HORSE PIKE	BLACKWOOD	NJ	08012	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03549	630 CHEWS LANDING	LINDENWOLD	NJ	08021	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06331	2 BALTIMORE PIKE	SPRINGFIELD	PA	19064	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06894	2727 W CHELTENHAM AVENUE	WYNCOTE	PA	19095	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06929	1819 ROUTE 70 WEST	CHERRY HILL	NJ	08002	08/24/2012	08/24/2012	07/01/2015	03/03/2015
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	190 WILMINGTON-WEST CHESTER PIKE	CHADDS FORD	PA	19317-9040	08/24/2012	08/24/2012	07/01/2015	03/03/2015

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
FQHCLA297	Terminated	BPS-LAL-011500	URBAN HEALTH INITIATIVES, INC.	Urban Health Initiatives	1408 S. Broad Street		Philadelphia	PA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11011	CANBY PARK 1900 MARYLAND AVE	WILMINGTON	DE	19805-4605	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11017	1120 PULASKI HIGHWAY	BEAR	DE	19701	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11078	BEAVER BROOK 1500 BEAVER BROOK PLAZA	NEW CASTLE	DE	19720	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS #12462	700 S RIDGE AVE	MIDDLETOWN	DE	19709	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11034	NEW CASTLE 740 FERRY CUT-OFF	NEW CASTLE	DE	19720	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11035	HARMONY PLAZA 4114 STANTON-OGLETOWN RD	NEWARK	DE	19713	08/24/2012	07/01/2015
FQHCLA297	HAPPY HARRY'S INC.	DBA: WALGREENS # 11066	BROOKSIDE 19 MARROWS ROAD	NEWARK	DE	19713	08/24/2012	07/01/2015
FQHCLA297	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3783	810 S BROAD ST	PHILADELPHIA	PA	19146-2217	07/01/2013	07/01/2015
FQHCLA297	RITE AID OF PENNSYLVANIA, LLC	RITE AID #1936	2017-2023 SOUTH BROAD ST.	PHILADELPHIA	PA	19148	07/01/2013	07/01/2015
FQHCLA297	WALGREEN EASTERN CO INC	DBA: WALGREENS # 04115	4201 N BROAD ST	PHILADELPHIA	PA	19140	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO. INC.	DBA:WALGREENS #15336	1 SOUTH BROAD STREET	PHILADELPHIA	PA	19107	04/01/2014	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07543	2310 W OREGON AVE	PHILADELPHIA	PA	19145-4122	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03791	2014-24 S BROAD ST	PHILADELPHIA	PA	19145	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	1800 SOUTH ST.	PHILADELPHIA	PA	19146	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	112 W CHELTEN AVE	PHILADELPHIA	PA	19144	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	300 N. 63RD ST.	PHILADELPHIA	PA	19139	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05522	1607 BRIDGE ST	PHILADELPHIA	PA	19124	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04429	150 N MACDADE BLVD.	GLENOLDEN	PA	19036	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07151	901 MARKET STREET	PHILADELPHIA	PA	19107-3111	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06174	13 N BLACK HORSE PIKE	WILLIAMSTOWN	NJ	08094-1402	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06367	1809 E ALLEGHENY AVE	PHILADELPHIA	PA	19134	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07740	52 CHESTER PIKE	DARBY	PA	19023-2018	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA WALGREENS SPECIALTY PHARMACY #16519	1334 BAINBRIDGE ST	PHILADELPHIA	PA	19147	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03663	4098 EDGEMONT AVE.	BROOKHAVEN	PA	19015	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04926	7001 FRANKFORD AVE	PHILADELPHIA	PA	19135	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07336	1617 JOHN F KENNEDY BLVD LBBY W8	PHILADELPHIA	PA	19103	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA WALGREENS #11897	504 KINGS HWY. NORTH	CHERRY HILL	NJ	08034	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03569	4001 KENSINGTON AVE.	PHILADELPHIA	PA	19124	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07225	1 YORKTOWN PLAZA	ELKINS PARK	PA	19027	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	1101 LOCUST ST.	PHILADELPHIA	PA	19107	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01531	625 N BLACK HORSE PIKE	BLACKWOOD	NJ	08012	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03549	630 CHEWS LANDING	LINDENWOLD	NJ	08021	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06331	2 BALTIMORE PIKE	SPRINGFIELD	PA	19064	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06894	2727 W CHELTENHAM AVENUE	WYNCOTE	PA	19095	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06929	1819 ROUTE 70 WEST	CHERRY HILL	NJ	08002	08/24/2012	07/01/2015
FQHCLA297	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	190 WILMINGTON-WEST CHESTER PIKE	CHADDS FORD	PA	19317-9040	08/24/2012	07/01/2015

History

Section	Field	Action	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Cater, Phyllis B. President & CEO 2154712755	Cater, Phyllis B. President & CEO Spectrum Health Services, Inc. 2154712755	2/9/2018 3:35 PM
Contacts	Primary Contact	Update	Cater, Phyllis B. President & CEO 2154712755	Cater, Phyllis B. President & CEO Spectrum Health Services, Inc. 2154712755	2/9/2018 3:35 PM
Contacts	Authorizing Official	Update	Bailey, Marolyn Interim CEO 2157550700-103	Cater, Phyllis B. President & CEO 2154712755	5/12/2017 12:21 PM
Contacts	Primary Contact	Update	Bailey, Marolyn Interim CEO 2157550700-103	Cater, Phyllis B. President & CEO 2154712755	5/12/2017 12:21 PM
Addresses	Main Address	Insert		1408 S. Broad Street Philadelphia, PA 19146	6/26/2015 4:08 PM
Contacts	Signed By	Insert		West, Kobie T. CEO 2157550700-132	6/26/2015 4:08 PM
Details	Grant Number	Update	LAL000130	LALCS00130	6/26/2015 4:08 PM
Dates	Last Date That 340B Drugs Purchased	Update		3/24/2015 12:00:00 AM	6/26/2015 4:08 PM
Details	State	Update	Active	Terminated	6/26/2015 4:08 PM
Terminations	Termination Date	Update		7/1/2015 12:00:00 AM	6/26/2015 4:08 PM
Terminations	Termination Effective Date	Update		3/24/2015 12:00:00 AM	6/26/2015 4:08 PM
Terminations	Termination Reason	Update		Site closure	6/26/2015 4:08 PM
Details	Last Recertification Date	Update	3/12/2014 12:00:00 AM	3/3/2015 12:00:00 AM	3/3/2015 7:50 AM
Contacts	Authorizing Official	Insert		Bailey, Marolyn Interim CEO 2157550700-103	4/29/2014 12:10 PM
Contacts	Primary Contact	Insert		Bailey, Marolyn Interim CEO 2157550700-103	4/29/2014 12:10 PM
Details	Last Recertification Date	Update	4/1/2013 12:00:00 AM	3/12/2014 12:00:00 AM	3/12/2014 9:29 PM
Details	Entity Name	Update	Urban Health Initiatives, Inc.	URBAN HEALTH INITIATIVES, INC.	3/12/2014 9:29 PM
Details	Entity Subname	Update		Urban Health Initiatives	3/12/2014 9:29 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/26/2013 9:12 AM
Details	Grant Number	Update		LAL000130	6/13/2012 5:31 PM
Details	340B ID	Update	IS-EMG-FQHCLA297	FQHCLA297	6/13/2012 5:31 PM
Dates	Participating Approval Date	Update		6/13/2012 12:00:00 AM	6/13/2012 5:31 PM
Details	State	Update	Pending	Active	6/13/2012 5:31 PM
Dates	Start Date	Update		7/1/2012 12:00:00 AM	6/13/2012 5:31 PM
Details	340B ID	Update	EMG05312012	IS-EMG-FQHCLA297	6/7/2012 12:57 PM
Details	Comments Public	Insert		6/04/2012 CMS letter provided, eligible	6/4/2012 4:23 PM
Details	340B ID	Update	ONLINE_REG	EMG05312012	5/31/2012 4:37 PM
Details	Comments Public	Insert		5/31/2012 called, left a message. appears to be ineligible	5/31/2012 4:37 PM
Medicaid Billing	Medicaid: Is Primary	Insert		False	5/15/2012 4:56 PM
Medicaid Billing	Medicaid: Number	Insert		1025626480001	5/15/2012 4:56 PM
Medicaid Billing	Medicaid: State	Insert		PA	5/15/2012 4:56 PM
Medicaid Billing	NPI: Number	Insert		1396003620	5/15/2012 4:56 PM
Details	Last Recertification Date	Insert			5/15/2012 4:56 PM
Details	Grant Number	Insert			5/15/2012 4:56 PM
Details	340B ID	Insert		ONLINE_REG	5/15/2012 4:56 PM
Details	Is Authorizing Official EHB Data	Insert			5/15/2012 4:56 PM
Dates	Last Date That 340B Drugs Purchased	Insert			5/15/2012 4:56 PM
Details	Medicare Provider Number	Insert			5/15/2012 4:56 PM
Details	Entity Name	Insert		Urban Health Initiatives, Inc.	5/15/2012 4:56 PM
Details	Program Code	Insert		FQHCLA	5/15/2012 4:56 PM
Details	Entity Subname	Insert			5/15/2012 4:56 PM
Dates	Participating Approval Date	Insert			5/15/2012 4:56 PM
Details	State	Insert		Pending	5/15/2012 4:56 PM
Dates	Registration Date	Insert		5/15/2012 12:00:00 AM	5/15/2012 4:56 PM
Dates	Signed By Date	Insert		5/15/2012 12:00:00 AM	5/15/2012 4:56 PM
Dates	Start Date	Insert			5/15/2012 4:56 PM
Terminations	Termination Comments	Insert			5/15/2012 4:56 PM
Terminations	Termination Date	Insert			5/15/2012 4:56 PM
Terminations	Termination Effective Date	Insert			5/15/2012 4:56 PM
Terminations	Termination Reason	Insert			5/15/2012 4:56 PM

340B Drug Pricing Program Database