340B Drug Pricing Program Database


CH05972AA AUNT MARTHA'S HEALTH & WELLNESS, INC. (Active) - information as of 6/7/2025 4:45:09 AM

Main Details
AUNT MARTHA'S HEALTH & WELLNESS, INC.
VERMILION AREA COMM HLTH CTR
HRSA-Funded Health Center
BPS-H80-002321
CH05972AA
H80CS00685


Additional Details
Active
4/15/2013
7/1/2014
5/23/2013
2/11/2025

Contacts

Aunt Martha's
Audrey Pennington, Chief Operating Officer
(708) 747-7100

Aunt Martha's Health & Wellness
Franca Liburdi, Director of Staff Relations & Resources
(708) 747-7100

Addresses

614 N. GILBERT ST.
DANVILLE, IL 61832-3940

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
6/9/14 enrolled 7/1/13 thru 3/31/14, not enrolled 4/1/14 thru 6/30/14 due to failure to recertify, reinstated based on on-line registration submitted in April 2014;06/09/2014
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 DetailPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363410/15/201501/01/2016  10/15/2015
Contract DetailROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420004/15/201707/01/2017  04/15/2017
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH05972AAActiveBPS-H80-002321AUNT MARTHA'S HEALTH & WELLNESS, INC.VERMILION AREA COMM HLTH CTR614 N. GILBERT ST. DANVILLEIL
CH05972ABTerminatedBPS-H80-002182AUNT MARTHA'S HEALTH & WELLNESS, INC.Great River Community Health Center120 E Court St ToulonIL
CH05972ADActiveBPS-H80-007716AUNT MARTHA'S HEALTH & WELLNESS, INC.Kankakee Community Health Center1777 E. Court Street KankakeeIL
CH05972AETerminatedBPS-H80-007741AUNT MARTHA'S HEALTH & WELLNESS, INC.Community Reception Center5001 South Michigan Ave ChicagoIL
CH05972AFTerminatedBPS-H80-008536AUNT MARTHA'S YOUTH SERVICE CENTER, INC.Hazel Crest Women's Health Center17850 Kedzie Ave STE 3200 Hazel CrestIL
CH05972AGActiveBPS-H80-009028AUNT MARTHA'S HEALTH & WELLNESS, INC.South Holland Community Health Center52 W 162nd St South HollandIL
CH05972AHActiveBPS-H80-009084AUNT MARTHA'S YOUTH SERVICE CENTER, INC.Southeast Side Community Health Center3528 E 118th St ChicagoIL
CH05972AJTerminatedBPS-H80-018755AUNT MARTHA'S YOUTH SERVICE CENTER, INC.Roseland Community Health Center45 W. 111th Street3rd Floor WestChicagoIL
CH05972AMActiveBPS-H80-012219AUNT MARTHA'S HEALTH & WELLNESS, INC.Aunt Martha's Health Center West Joliet333 N Madison STE 150 JolietIL
CH05972ANActiveBPS-H80-012726AUNT MARTHA'S HEALTH & WELLNESS, INC.Aunt Martha's Chicago Heights Pediatric Health and Wellness Center500 Dixie Hwy Chicago HeightsIL
CH05972APActiveBPS-H80-012755AUNT MARTHA'S HEALTH & WELLNESS, INC.Aunt Martha's Joliet East Community Health Center1200 Eagle Street JolietIL
CH05972AQActiveBPS-H80-018754AUNT MARTHA'S HEALTH & WELLNESS, INC.Aunt Martha's Woodstock Community Health Center3703 Doty Road, MOB 1, Suite 1 WoodstockIL
CH05972ARActiveBPS-H80-018455AUNT MARTHA'S HEALTH & WELLNESS, INC.South Suburban Homeless Outreach Center15420 Dixie Hwy.Suite G HarveyIL
CH05972ASActiveBPS-H80-014388AUNT MARTHA'S HEALTH & WELLNESS INC.Hazel Crest Community Health Center17850 Kedzie Ave. Suite 1150 Hazel CrestIL
CH05972ATTerminatedBPS-H80-007744AUNT MARTHA'S HEALTH & WELLNESS, INC.Watseka Community Health Center200 E WALNUT ST WATSEKAIL
CH05972AUActiveBPS-H80-019327AUNT MARTHA'S HEALTH & WELLNESS, INC.Aunt Martha's Rockford Community Health Center1401 East State Street, Suite 3000 RockfordIL
CH05972CActiveBPS-H80-001290AUNT MARTHA'S HEALTH & WELLNESS, INC.CARPENTERSVILLE COMMUNITY HEALTH CENTER3003 WAKEFIELD BLVD. CARPENTERSVILLEIL
CH05972EActiveBPS-H80-007713AUNT MARTHA'S HEALTH & WELLNESS, INC.Chicago Heights Community Health Center1536 Vincennes Chicago HeightsIL
CH05972IActiveBPS-H80-000172AUNT MARTHA'S HEALTH & WELLNESS, INC.Women's Health Clinic233 W JOE ORR ROAD BLDG S CHICAGO HEIGHTSIL
CH05972ZActiveBPS-H80-018774AUNT MARTHA'S HEALTH & WELLNESS, INC.Aurora Community Health Center2124 Ogden AvenueUnit 201AURORAIL
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH05972AQAFFINITY PHARMACY CARE LLC135 E SAINT CHARLES RD STE D
CAROL STREAMIL60188-207804/01/2021  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.WALGREENS # 16525 5401 S WENTWORTH AVE
SUITE 5A1 		CHICAGOIL6060901/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02211 5036 S COTTAGE GROVE AVE
CHICAGOIL6061501/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02558 14700 HALSTED ST
HARVEYIL6042601/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03179 820 183RD ST
HOMEWOODIL6043001/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03212 842 EAST MAIN STREET
DANVILLEIL6183201/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03651 20950 GOVERNORS HWY.
OLYMPIA FIELDSIL6046101/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03774 1207 N. RANDALL RD
AURORAIL6050601/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03928 18301 PULASKI AVE
HAZEL CRESTIL6042901/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04142 1050 N. KENNEDY DRIVE
KANKAKEEIL6090101/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04336 1401 WESTERN AVE.
CHICAGO HEIGHTSIL6041101/01/2016 12/08/2016
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04502 399 LAKE MARIAN ROAD
CARPENTERSVILLEIL6011001/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04532 15 S. ORCHARD DR.
PARK FORESTIL6046601/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #21247 15940 KEDZIE AVE
MARKHAMIL60428-401701/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04779 1799 DOUGLAS RD
MONTGOMERYIL6053801/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05086 3120 CHICAGO RD
SOUTH CHICAGO HEIGHTSIL6041101/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05123 10300 S. MICHIGAN AVE.
CHICAGOIL6062801/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05126 3564 RIDGE RD
LANSINGIL6043801/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05127 18133 TORRENCE AVE
LANSINGIL6043801/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05128 2601 E SAUK TRL
SAUK VILLAGEIL6041101/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05355 650 DIXIE HWY
CHICAGO HEIGHTSIL6041101/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05386 358 E CASS STREET
JOLIETIL6043201/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05511 500 S. MAIN STREET
KEWANEEIL6144301/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #12787 400 W FAIRCHILD ST
DANVILLEIL6183201/01/2016  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03929 1801 INGALLS AVE
JOLIETIL6043504/01/2017  
CH05972APBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 10772 1163 W. JEFFERSON ST.
JOLIETIL6043501/01/2018  
CH05972AMBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 10772 1163 W. JEFFERSON ST.
JOLIETIL6043501/01/2018  
CH05972ARBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05193 3145 W 147TH ST
POSENIL6046901/01/2018  
CH05972AQBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05469 3925 W ELM STREET
MCHENRYIL60050-436107/01/2019  
CH05972APBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04949 7209 W. LINCOLN HWY.
FRANKFORTIL6042307/01/2019  
CH05972APBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04032 466 NELSON ROAD
NEW LENOXIL6045107/01/2019  
CH05972AMBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04949 7209 W. LINCOLN HWY.
FRANKFORTIL6042307/01/2019  
CH05972AMBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04032 466 NELSON ROAD
NEW LENOXIL6045107/01/2019  
CH05972IBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02585 3803 AUBURN STREET
ROCKFORDIL6110104/01/2024  
CH05972EPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972CPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972ZPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016 04/01/2017
CH05972ABPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016 04/01/2023
CH05972AAPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972ADPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972AEPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016 04/01/2025
CH05972AFPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016 04/01/2019
CH05972AGPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363407/01/2017  
CH05972AHPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972AJPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363407/01/2017 04/01/2019
CH05972AMPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972ANPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972APPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363401/01/2016  
CH05972ATPRAXIS SPECIALTY PHARMACY LLCPRAXIS RX PHARMACY 5455 W WATERS AVE STE 214
TAMPAFL3363407/01/2017 04/01/2025
CH05972EROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972CROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972IROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ZROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ABROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017 04/01/2023
CH05972AAROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ADROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972AEROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017 04/01/2025
CH05972AGROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972AHROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972AJROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017 04/01/2019
CH05972AMROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ANROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972APROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ATROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017 04/01/2025
CH05972ASROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972ARROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972AQROSELAND COMMUNITY HOSPITAL ASSOCIATIONDBA THE NEW ROSELAND OUTPATIENT PHARMACY 45 W 111TH ST
CHICAGOIL60628-420007/01/2017  
CH05972IWALGREEN CODBA: WALGREENS #11466 301 MADISON ST, STE 114
JOLIETIL6043501/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 06564 522 TORRENCE AVE
CALUMET CITYIL6040901/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 06937 1221 N LAKE STREET
AURORAIL60506-245401/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 07866 2101 W JEFFERSON ST
JOLIETIL60435-662101/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 09330 18300 GOVERNORS HWY
HOMEWOODIL60430-291001/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 09357 833 W 115TH ST
CHICAGOIL60643-461901/01/2016 11/09/2023
CH05972IWALGREEN CO.DBA: WALGREENS # 09404 1180 N FARNSWORTH
AURORAIL6050501/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 09924 390 EAST 162ND STREET
SOUTH HOLLANDIL60473-024101/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 12125 9 N UNION ST
AURORAIL60505-351301/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS #12468 222 W COURT ST
KANKAKEEIL60901-371101/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 13106 11801 S. AVENUE O
CHICAGOIL6061701/01/2016  
CH05972IWALGREEN CO.DBA: WALGREENS # 06332 1150 E SIBLEY BLVD
DOLTONIL60419-282804/01/2017  
CH05972IWALGREEN CO.DBA: WALGREENS # 00147 3611 E 106TH ST
CHICAGOIL6061704/01/2017  
CH05972AQWALGREEN CO.DBA: WALGREENS # 01994 305 SOUTH EASTWOOD DR
WOODSTOCKIL6009807/01/2019  
CH05972AQWALGREEN CO.DBA: WALGREENS # 06746 151 NORTHWEST HWY
CRYSTAL LAKEIL6001407/01/2019  
CH05972AQWALGREEN CO.DBA: WALGREENS #11411 395 S. DIVISION ST.
HARVARDIL60033-325807/01/2019  
CH05972AUWALGREEN CO.DBA: WALGREENS # 06002 1201 E STATE ST
ROCKFORDIL6110407/01/2019  
CH05972AHWALGREEN CO.DBA: WALGREENS # 05192 9148 S COMMERCIAL AVE
CHICAGOIL6061707/01/2019  
CH05972ADWALGREEN CO.DBA: WALGREENS # 10339 501 N CONVENT ST
BOURBONNAISIL60914-132904/01/2020  
CH05972EWalgreens Central Fill #213994132Plainfield Rd
Ste 110 		IndianapolisIN46231-702104/01/2023  
CH05972IWalgreens Central Fill #213994132Plainfield Rd
Ste 110 		IndianapolisIN46231-702110/01/2023  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/19/2024 11:56:23 PM2/11/2025 6:20:07 PM2/11/2025 6:20 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestPennington, Audrey Executive VP Health Services Aunt Martha's 7087477100Pennington, Audrey Chief Operating Officer Aunt Martha's 70874771002/11/2025 7:06 AM
DetailsLast Recertification DateUpdateRecertification2/24/2023 1:19:47 PM2/19/2024 11:56:23 PM2/19/2024 11:56 PM
DetailsLast Recertification DateUpdateRecertification2/25/2022 8:59:24 PM2/24/2023 1:19:47 PM2/24/2023 1:19 PM
DetailsLast Recertification DateUpdateRecertification2/26/2021 4:13:12 PM2/25/2022 8:59:24 PM2/25/2022 8:59 PM
DetailsLast Recertification DateUpdateRecertification1/30/2020 11:52:40 AM2/26/2021 4:13:12 PM2/26/2021 4:13 PM
DetailsLast Recertification DateUpdateRecertification2/11/2019 2:03:09 PM1/30/2020 11:52:40 AM1/30/2020 11:52 AM
DetailsEntity NameUpdateRecertificationAUNT MARTHA'S YOUTH SERVICE CENTER, INC.AUNT MARTHA'S HEALTH & WELLNESS, INC.1/30/2020 11:52 AM
ContactsPrimary ContactUpdateRecertificationBaumgartner, Stacy Director of Performance Improvement Aunt Martha's 7088218410Liburdi, Franca Director of Staff Relations & Resources Aunt Martha's Health & Wellness 70874771002/11/2019 2:03 PM
DetailsLast Recertification DateUpdateRecertification3/7/2018 12:23:44 AM2/11/2019 2:03:09 PM2/11/2019 2:03 PM
ContactsPrimary ContactUpdateRecertificationPennington, Audrey Executive VP Health Services Aunt Martha's 7087477100Baumgartner, Stacy Director of Performance Improvement Aunt Martha's 70882184103/7/2018 12:23 AM
DetailsLast Recertification DateUpdateRecertification2/13/2017 12:00:00 AM3/7/2018 12:23:44 AM3/7/2018 12:23 AM
DetailsIs Authorizing Official EHB DataUpdateRecertificationFalse 3/7/2018 12:23 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestPennington, Audrey Director of Finance Aunt Martha's 7087477100Pennington, Audrey Executive VP Health Services Aunt Martha's 70874771003/6/2018 6:20 PM
ContactsPrimary ContactUpdateProfile Change RequestPennington, Audrey Director of Finance Aunt Martha's 7087477100Pennington, Audrey Executive VP Health Services Aunt Martha's 70874771003/6/2018 6:20 PM
ContactsAuthorizing OfficialUpdate Pennington, Audrey Director of Finance 7087477100Pennington, Audrey Director of Finance Aunt Martha's 708747710010/16/2017 9:12 PM
ContactsPrimary ContactUpdate Pennington, Audrey Director of Finance 7087477100Pennington, Audrey Director of Finance Aunt Martha's 708747710010/16/2017 9:12 PM
ContactsAuthorizing OfficialInsert  Pennington, Audrey Director of Finance 70874771005/23/2017 7:00 PM
ContactsPrimary ContactInsert  Pennington, Audrey Director of Finance 70874771005/23/2017 7:00 PM
ContactsSigned ByInsert  Leofanti, Gary President 70874771003/3/2017 2:13 PM
AddressesMain AddressInsert   614 N. GILBERT ST. DANVILLE, IL 61832-39402/13/2017 10:00 AM
DetailsLast Recertification DateUpdate 2/25/2016 12:00:00 AM2/13/2017 12:00:00 AM2/13/2017 10:00 AM
DetailsLast Recertification DateUpdate 3/11/2015 12:00:00 AM2/25/2016 12:00:00 AM2/25/2016 12:16 PM
DetailsLast Recertification DateUpdate 3/15/2014 12:00:00 AM3/11/2015 12:00:00 AM3/11/2015 10:58 AM
DetailsIs Authorizing Official EHB DataUpdate  False3/11/2015 10:58 AM
DatesLast Date That 340B Drugs PurchasedUpdate 4/1/2014 12:00:00 AM 6/9/2014 12:02 PM
DetailsStateUpdate TerminatedActive6/9/2014 12:02 PM
DatesStart DateUpdate 7/1/2013 12:00:00 AM7/1/2014 12:00:00 AM6/9/2014 12:02 PM
TerminationsTermination DateUpdate 4/1/2014 12:00:00 AM 6/9/2014 12:02 PM
TerminationsTermination Effective DateUpdate 4/1/2014 12:00:00 AM 6/9/2014 12:02 PM
TerminationsTermination ReasonUpdate Failure to recertify 6/9/2014 12:02 PM
DetailsComments PublicInsert  6/9/14 enrolled 7/1/13 thru 3/31/14, not enrolled 4/1/14 thru 6/30/14 due to failure to recertify, reinstated based on on-line registration submitted in April 2014;6/9/2014 12:02 PM
DetailsLast Recertification DateUpdate  3/15/2014 12:00:00 AM3/15/2014 10:13 PM
DatesLast Date That 340B Drugs PurchasedUpdate  4/1/2014 12:00:00 AM3/15/2014 10:13 PM
DetailsStateUpdate ActiveTerminated3/15/2014 10:13 PM
TerminationsTermination DateUpdate  4/1/2014 12:00:00 AM3/15/2014 10:13 PM
TerminationsTermination Effective DateUpdate  4/1/2014 12:00:00 AM3/15/2014 10:13 PM
TerminationsTermination ReasonUpdate  Failure to recertify3/15/2014 10:13 PM
Details340B IDUpdate IS-FN-CH05972AACH05972AA5/23/2013 5:20 PM
DatesParticipating Approval DateUpdate  5/23/2013 12:00:00 AM5/23/2013 5:20 PM
DetailsStateUpdate PendingActive5/23/2013 5:20 PM
DatesStart DateUpdate  7/1/2013 12:00:00 AM5/23/2013 5:20 PM
Details340B IDUpdate ONLINE_REGIS-FN-CH05972AA4/28/2013 7:52 PM
DetailsLast Recertification DateInsert   4/15/2013 5:40 PM
DetailsGrant NumberInsert  H80CS006854/15/2013 5:40 PM
Details340B IDInsert  ONLINE_REG4/15/2013 5:40 PM
DetailsIs Authorizing Official EHB DataInsert   4/15/2013 5:40 PM
DatesLast Date That 340B Drugs PurchasedInsert   4/15/2013 5:40 PM
DetailsMedicare Provider NumberInsert   4/15/2013 5:40 PM
DetailsEntity NameInsert  AUNT MARTHA'S YOUTH SERVICE CENTER, INC.4/15/2013 5:40 PM
DetailsProgram CodeInsert  CH4/15/2013 5:40 PM
DetailsEntity SubnameInsert  VERMILION AREA COMM HLTH CTR4/15/2013 5:40 PM
DatesParticipating Approval DateInsert   4/15/2013 5:40 PM
DetailsStateInsert  Pending4/15/2013 5:40 PM
DatesRegistration DateInsert  4/15/2013 12:00:00 AM4/15/2013 5:40 PM
DatesSigned By DateInsert  4/15/2013 12:00:00 AM4/15/2013 5:40 PM
DatesStart DateInsert   4/15/2013 5:40 PM
TerminationsTermination CommentsInsert   4/15/2013 5:40 PM
TerminationsTermination DateInsert   4/15/2013 5:40 PM
TerminationsTermination Effective DateInsert   4/15/2013 5:40 PM
TerminationsTermination ReasonInsert   4/15/2013 5:40 PM