340B Drug Pricing Program Database


FP273793 CASWELL COUNTY HEALTH DEPARTMENT (Active) - information as of 4/25/2025 5:41:31 PM

Main Details
CASWELL COUNTY HEALTH DEPARTMENT
Family Planning (Title X only)
FP273793
5 FPHPA006555-03-00


Additional Details
Active
1/1/1998
1/1/1998
3/17/2010
5/6/2024

Contacts

Caswell County Health Department
JENNIFER EASTWOOD, Health Director
(336) 694-4129 Ext: 157

Caswell County Health Department
James T Eanes, Administrative Officer II
(336) 694-4129 Ext: 8178

Addresses

189 COUNTY PARK ROAD
YANCEYVILLE, NC 27379

Caswell County Health Department
PO Box 1238
Yanceyville, NC 27379


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • History
Comments
CommentLast Updated On 
3/17/10 ADDED MEDICAID #; 2/26/2006 UPDATED ADDR;03/17/2010
3/17/10 ADDED MEDICAID #; 2/26/2006 UPDATED ADDR;03/17/2010
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
NC 1194858498,1851354229,1316926348,1578914982
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailNORTH VILLAGE PHARMACY INC1493 MAIN ST
YANCEYVILLENC27379-879307/08/201910/01/2019  10/01/2019
Contract DetailYANCEYVILLE DRUG COYANCEYVILLE DRUG CO., INC. 106 COURT SQUARE
P.O. BOX 1108 		YANCEYVILLENC2737910/02/201301/01/2014 07/31/201705/14/2019
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification5/9/2023 8:22:33 AM5/6/2024 12:52:29 PM5/6/2024 12:52 PM
DetailsGrant NumberUpdateChange Request5 FPHPA006555-02-005 FPHPA006555-03-005/1/2024 12:29 PM
DetailsLast Recertification DateUpdateRecertification5/10/2022 10:55:56 AM5/9/2023 8:22:33 AM5/9/2023 8:22 AM
DetailsGrant NumberUpdateRecertification5 FPHPA006400-03-005 FPHPA006555-02-005/9/2023 8:22 AM
DetailsLast Recertification DateUpdateRecertification5/13/2021 10:31:02 AM5/10/2022 10:55:56 AM5/10/2022 10:55 AM
Medicaid BillingNPI: StateUpdateRecertification NC5/13/2021 10:31 AM
Medicaid BillingNPI: StateUpdateRecertification NC5/13/2021 10:31 AM
Medicaid BillingNPI: StateUpdateRecertification NC5/13/2021 10:31 AM
Medicaid BillingNPI: StateUpdateRecertification NC5/13/2021 10:31 AM
DetailsLast Recertification DateUpdateRecertification5/7/2020 9:38:23 AM5/13/2021 10:31:02 AM5/13/2021 10:31 AM
DetailsGrant NumberUpdateRecertification1 FPHPA006400-01-005 FPHPA006400-03-005/13/2021 10:31 AM
DetailsLast Recertification DateUpdateRecertification5/14/2019 1:27:02 PM5/7/2020 9:38:23 AM5/7/2020 9:38 AM
ContactsPrimary ContactUpdateChange RequestHendricks, Sharon Finance Officer Caswell County Health Dept 3366944129-178Eanes, James T Administrative Officer II Caswell County Health Department 3366944129-81787/9/2019 7:28 AM
AddressesBilling AddressInsertChange Request Caswell County Health Department PO Box 1238 Yanceyville, NC 273796/3/2019 10:15 AM
DetailsGrant NumberUpdateChange RequestFPHPA0460481 FPHPA006400-01-006/3/2019 10:15 AM
Medicaid BillingNPI: NumberInsertRecertification 11948584985/14/2019 1:27 PM
Medicaid BillingNPI: NumberInsertRecertification 18513542295/14/2019 1:27 PM
Medicaid BillingNPI: NumberInsertRecertification 13169263485/14/2019 1:27 PM
Medicaid BillingNPI: NumberInsertRecertification 15789149825/14/2019 1:27 PM
DetailsLast Recertification DateUpdateRecertification5/11/2018 10:22:56 AM5/14/2019 1:27:02 PM5/14/2019 1:27 PM
DetailsLast Recertification DateUpdateRecertification4/27/2017 12:00:00 AM5/11/2018 10:22:56 AM5/11/2018 10:22 AM
ContactsAuthorizing OfficialUpdate EASTWOOD, JENNIFER Health Director 3366944129-157EASTWOOD, JENNIFER Health Director Caswell County Health Department 3366944129-1575/11/2018 10:20 AM
ContactsPrimary ContactUpdate Hendricks, Sharon Finance Officer 3366944129-178Hendricks, Sharon Finance Officer Caswell County Health Dept 3366944129-1785/9/2018 3:08 PM
ContactsAuthorizing OfficialUpdate Claggett, Elin Health Director 3366944129-157EASTWOOD, JENNIFER Health Director 3366944129-1578/11/2017 7:11 AM
ContactsPrimary ContactUpdate CLAYTON, DOLLY HEALTH DIRECTOR 3366944129-157Hendricks, Sharon Finance Officer 3366944129-1788/11/2017 7:11 AM
AddressesMain AddressInsert   189 COUNTY PARK ROAD YANCEYVILLE, NC 273798/11/2017 7:10 AM
ContactsAuthorizing OfficialUpdate CLAYTON, DOLLY HEALTH DIRECTOR 3366944129-157Claggett, Elin Health Director 3366944129-1577/25/2017 8:52 AM
ContactsAuthorizing OfficialInsert  CLAYTON, DOLLY HEALTH DIRECTOR 3366944129-1574/27/2017 1:45 PM
ContactsPrimary ContactUpdate Hodges, Betty Supply Clerk 3366944129CLAYTON, DOLLY HEALTH DIRECTOR 3366944129-1574/27/2017 1:45 PM
DetailsLast Recertification DateUpdate 5/13/2016 12:00:00 AM4/27/2017 12:00:00 AM4/27/2017 1:45 PM
ContactsPrimary ContactInsert  Hodges, Betty Supply Clerk 33669441294/27/2017 11:26 AM
DetailsLast Recertification DateUpdate 5/18/2015 12:00:00 AM5/13/2016 12:00:00 AM5/13/2016 11:54 AM
DetailsLast Recertification DateUpdate 4/21/2014 12:00:00 AM5/18/2015 12:00:00 AM5/18/2015 11:07 AM
DetailsLast Recertification DateUpdate 7/1/2013 12:00:00 AM4/21/2014 12:00:00 AM4/21/2014 8:44 AM
DetailsLast Recertification DateUpdate 4/1/2012 12:00:00 AM7/1/2013 12:00:00 AM6/6/2013 2:51 PM
DetailsGrant NumberUpdate FPHPA040694FPHPA0460489/20/2012 3:09 PM
DetailsLast Recertification DateUpdate 4/1/2010 12:00:00 AM4/1/2012 12:00:00 AM3/22/2012 9:32 AM
DetailsLast Recertification DateInsert  4/1/2010 12:00:00 AM3/17/2010 9:22 AM
DetailsGrant NumberInsert  FPHPA0406943/17/2010 9:22 AM
Details340B IDInsert  FP2737933/17/2010 9:22 AM
DetailsIs Authorizing Official EHB DataInsert   3/17/2010 9:22 AM
DatesLast Date That 340B Drugs PurchasedInsert   3/17/2010 9:22 AM
DetailsMedicare Provider NumberInsert   3/17/2010 9:22 AM
DetailsEntity NameInsert  CASWELL COUNTY HEALTH DEPARTMENT3/17/2010 9:22 AM
DetailsProgram CodeInsert  FP3/17/2010 9:22 AM
DetailsEntity SubnameInsert   3/17/2010 9:22 AM
DatesParticipating Approval DateInsert  3/17/2010 12:00:00 AM3/17/2010 9:22 AM
DetailsStateInsert  Active3/17/2010 9:22 AM
DatesRegistration DateInsert  1/1/1998 12:00:00 AM3/17/2010 9:22 AM
DatesSigned By DateInsert  4/1/2010 12:00:00 AM3/17/2010 9:22 AM
DatesStart DateInsert  1/1/1998 12:00:00 AM3/17/2010 9:22 AM
TerminationsTermination CommentsInsert   3/17/2010 9:22 AM
TerminationsTermination DateInsert   3/17/2010 9:22 AM
TerminationsTermination Effective DateInsert   3/17/2010 9:22 AM
TerminationsTermination ReasonInsert   3/17/2010 9:22 AM
DetailsComments PublicInsert  3/17/10 ADDED MEDICAID #; 2/26/2006 UPDATED ADDR;3/17/2010 9:22 AM
DetailsComments PublicInsert  3/17/10 ADDED MEDICAID #; 2/26/2006 UPDATED ADDR;3/17/2010 9:22 AM