Covered Entity Details

CH03079S COMMUNITY HEALTH SYSTEMS, INC. (Active) - information as of 5/9/2025 10:51:15 PM

Main Details

Name

COMMUNITY HEALTH SYSTEMS, INC.

Subdivision Name

Woodrow Wilson School-Based Clinic

Type

HRSA-Funded Health Center

Site ID

BPS-H80-012001

340B ID

CH03079S

Grant Number

H80CS00345

Additional Details

Current Program Status

Active

Registration Date

7/9/2013

Participating Start Date

10/1/2013

Participating Approval Date

8/28/2013

Last Recertification Date

2/19/2025

Contacts

Authorizing Official

Community Health Systems, Inc
CHARLES HUNT, CEO
(304) 252-8551 Ext: 1164

Primary Contact

Community Health Systems, Inc.
ROBERT BUTCHER, CPO
(304) 252-8324 Ext: 1150

Addresses

Street Address

400 Stanaford Rd
Beckley, WV 25801-3144

Billing Address

Community Health Systems, Inc.
252 Rural Acres Drive
Beckley, WV 25801

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?
Yes

State	Medicaid Number	NPI Number
WV	0019601001,1740015627,3180008178,3810010454,3810016216,3810013656	1386682540,1780719609,1962698118,1588833115,1518190776,1740015627

Shipping Addresses

Shipping Address 1

AccessHealth Pharmacy Beckley
252 Rural Acres Drive
Beckley, WV 25801

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
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH030790	Active	BPS-H80-002551	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Rural Acres Clinic	252 Rural Acres Drive	Beckley	WV
CH03079AA	Active	BPS-H80-017362	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Raleigh Psychiatric Services	28 Mallard Court	Beckley	WV
CH03079AB	Active	BPS-H80-017631	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Northern Greenbrier Clinic	8965 Shoestring Trail	Williamsburg	WV
CH03079AC	Active	BPS-H80-017820	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Beckley	202 Bill Baker Way	Beckley	WV
CH03079AD	Active	BPS-H80-020858	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Cranberry Prosperity School-Based Clinic	4575 Robert C. Byrd Drive	Beckley	WV
CH03079AE	Active	BPS-H80-020918	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Princeton	904 Harrison Street	Princeton	WV
CH03079AF	Terminated	BPS-H80-020848	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Welch Clinic	OB/GYN Suite 454 McDowell Street	Welch	WV
CH03079AG	Active	BPS-H80-023377	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Professional Park Clinic	224 Professional Park	Beckley	WV
CH03079AH	Active	BPS-H80-027936	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Mabscott Elementary School-Based Clinic	104 Pershing St	Beckley	WV
CH03079AJ	Terminated	BPS-H80-027935	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Marsh Fork Elementary School-Based Clinic	5960 Coal River Rd	Rock Creek	WV
CH03079AK	Active	BPS-H80-028157	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Daniels Elementary School-Based Clinic	351 4H Lake Rd	Daniels	WV
CH03079AL	Terminated	BPS-H80-027929	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Clear Fork School-Based Clinic	4851 Clear Fork Rd	Artie	WV
CH03079AM	Active	BPS-H80-033062	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Stanaford Elementary Clinic	950 Stanaford Road	Beckley	WV
CH03079AN	Active	BPS-H80-033065	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Park Middle School Clinic	212 Park Avenue	Beckley	WV
CH03079AP	Active	BPS-H80-033064	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Ghent Elementary Clinic	2750 Flat Top Road	Ghent	WV
CH03079AQ	Active	BPS-H80-033063	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Beckley Elementary Clinic	399 Grey Flats Rd	Beckley	WV
CH03079AR	Active	BPS-H80-008718	COMMUNITY HEALTH SYSTEMS, INC.	COMMUNITY HEALTH SYSTEMS, INC ADMINISTRATIVE	101 Cranberry Creek Drive	Beckley	WV
CH03079AS	Active	BPS-H80-032916	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Glen Daniel Clinic	7031 Harper Rd	Glen Daniel	WV
CH03079AT	Active	BPS-H80-035717	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Fairdale School-Based Clinic	772 Bolt Road	Fairdale	WV
CH03079AU	Active	BPS-H80-037635	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Stratton Elementary School-Based Clinic	1129 S Fayette St	Beckley	WV
CH03079AV	Active	BPS-H80-038039	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Fayette Clinic	5493 Maple Ln	Fayetteville	WV
CH03079AW	Active	BPS-H80-038087	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Associates OB/GYN Clinic	1731 Harper Rd	Beckley	WV
CH03079AX	Active	BPS-H80-038857	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Brookshire Clinic	124 Brookshire Ln	Beckley	WV
CH03079AY	Active	BPS-H80-038796	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Liberty High School-Based Clinic	700 Coal River Rd	Glen Daniel	WV
CH03079AZ	Active	BPS-H80-039021	COMMUNITY HEALTH SYSTEMS INC	AccessHealth School Based Shady Spring Elementary School	600 Flat Top Rd	Shady Spring	WV
CH03079BA	Active	BPS-H80-038855	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Shady Spring Middle School-Based Clinic	500 Flat Top Rd	Shady Spring	WV
CH03079BB	Active	BPS-H80-038856	COMMUNITY HEALTH SYSTEMS INC	AccessHealth School-Based Clinic Ridgeview Elementary	388 Tank Hill Rd	Crab Orchard	WV
CH03079BC	Active	BPS-H80-039399	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Beckley Pediatrics	30 Mallard Ct	Beckley	WV
CH03079BD	Approved	BPS-H80-040015	COMMUNITY HEALTH SYSTEMS INC	AccessHealth Professional Park 2	214 Professional Park	Beckley	WV
CH03079F	Active	BPS-H80-004470	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Daniels Clinic	RT 3 & 19 2157 RITTER DR	DANIELS	WV
CH03079J	Active	BPS-H80-004373	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth PMU	200 Carriage Dr	Beckley	WV
CH03079K	Active	BPS-H80-003631	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Associates	410 Carriage Dr	Beckley	WV
CH03079O	Terminated	bPS-H80-004406	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Glen Daniels Clinic	7127 HARPER ROAD	GLEN DANIELS	WV
CH03079P	Terminated	BPS-H80-003289	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Fayette Clinic	1 PHYSICIANS PLAZA	LOCHGELLY	WV
CH03079Q	Active	BPS-H80-008198	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Mabscott Clinic	200 Raleigh Ave	Beckley	WV
CH03079S	Active	BPS-H80-012001	COMMUNITY HEALTH SYSTEMS, INC.	Woodrow Wilson School-Based Clinic	400 Stanaford Rd	Beckley	WV
CH03079T	Active	BPS-H80-011968	COMMUNITY HEALTH SYSTEMS, INC.	Beckley Stratton School-Based Clinic	401 Grey Flats Rd	Beckley	WV
CH03079U	Terminated	BPS-H80-010249	COMMUNITY HEALTH SYSTEMS, INC.	Woodrow Wilson/ ACT Wellness Center	390 Stanaford Rd	Beckley	WV
CH03079V	Terminated	BPS-H80-003693	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Clear Fork Clinic	HOME SCHOOL VILLAGE	DOROTHY	WV
CH03079X	Terminated	BPS-H80-002652	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Stanaford Clinic	201 Woodcrest Dr	Beckley	WV
CH03079Y	Terminated	BPS-H80-012888	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Carriage Drive Pediatrics	194 Carriage Dr	Beckley	WV
CH03079Z	Active	BPS-H80-014860	COMMUNITY HEALTH SYSTEMS, INC.	AccessHealth Shady Spring High School-Based Clinic	300 Hinton Rd	Shady Spring	WV

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH030790	ARIZONA CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 08977	3501 STOCKTON HILL RD.	KINGMAN	AZ	86409	10/01/2020	04/06/2021
CH030790	BYPASS PHARMACY # 2	725 RITTER DR FL 1		BEAVER	WV	25813	10/01/2018	10/01/2021
CH030790	BYPASS PHARMACY # 3	1802 HARPER RD		BECKLEY	WV	25801-2580	10/01/2018	10/01/2021
CH030790	BYPASS PHARMACY, INC	104 S EISENHOWER DR		BECKLEY	WV	25801	10/01/2018	10/01/2021
CH030790	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2020	04/06/2021
CH030790	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/01/2021
CH030790	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2020	04/06/2021
CH030790	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/01/2021
CH030790	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2020	04/06/2021
CH030790	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/01/2021
CH030790	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2020	04/06/2021
CH030790	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/01/2021
CH030790	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2020	04/06/2021
CH030790	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/01/2021
CH030790	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2020	04/06/2021
CH030790	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2021
CH030790	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2020	04/06/2021
CH030790	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2021
CH030790	CAREMARK PUERTO RICO SPECIALTY PHARMACY,	CAREMARK PUERTO RICO SPECIALTY PHARMACY	6020 AVE ROBERTO SANCHEZ VILELLA	CAROLINA	PR	00982	10/01/2020	04/06/2021
CH030790	CAREMARK PUERTO RICO SPECIALTY PHARMACY,	CAREMARK PUERTO RICO SPECIALTY PHARMACY	6020 AVE ROBERTO SANCHEZ VILELLA	CAROLINA	PR	00982	07/01/2021	04/03/2024
CH030790	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2020	04/06/2021
CH030790	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2021
CH030790	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2020	04/06/2021
CH030790	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/01/2021
CH030790	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2020	04/06/2021
CH030790	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	07/01/2021
CH030790	COLONY DRUG	2810 ROBERT C BYRD DRIVE		BECKLEY	WV	25801	10/01/2018	03/06/2019
CH030790	COUNTRY ROADS PHARMACY INC	109 BOLT RD	PO BOX 460	GLEN DANIEL	WV	25844	04/01/2019	04/01/2019
CH030790	CRAB ORCHARD PHARMACY, INC.	1299 ROBERT C BYRD DR	PO BOX 276	CRAB ORCHARD	WV	25827	01/01/2019	11/28/2018
CH030790	CRAB ORCHARD PHARMACY, INC.	1299 ROBERT C BYRD DR	PO BOX 276	CRAB ORCHARD	WV	25827	01/01/2019	11/28/2018
CH030790	CRAB ORCHARD PHARMACY, INC.	1299 ROBERT C BYRD DR	PO BOX 276	CRAB ORCHARD	WV	25827	10/01/2020
CH030790	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2021
CH030790	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2021
CH030790	CVS PHARMACY, INC.	DBA CVS/PHARMACY #7373	3011 N. MAIN ST.	LAS CRUCES	NM	88001	10/01/2020
CH030790	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2020	04/06/2021
CH030790	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2021
CH030790	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2018
CH030790	EPPY'S DRUG STORE INC	MARY BETH WADE, PRESIDENT	2987 ROBERT C BYRD DR	BECKLEY	WV	25801	01/01/2019
CH030790	EPPY'S DRUG STORE INC	MARY BETH WADE, PRESIDENT	2987 ROBERT C BYRD DR	BECKLEY	WV	25801	01/01/2019	03/06/2021
CH030790	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00511	35799 HWY 27	HAINES CITY	FL	33844	10/01/2020	04/06/2021
CH030790	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04219	1101 NE MALABAR RD	PALM BAY	FL	32907	10/01/2020	04/06/2021
CH030790	HOME CARE PHARMACY LLC	OMNICARE OF NITRO	125 LAKEVIEW DRIVE	CROSS LANES	WV	25313	01/01/2024	05/31/2024
CH030790	HOOK-SUPERX, L.L.C.	CVS/PHARMACY #11114	2800 ENTERPRISE ST STE 5	INDIANAPOLIS	IN	46219-1106	10/01/2020	04/06/2021
CH030790	JARRELLS PHARMACY	JARRELLS PHARMACY	2122 RITTER DR	DANIELS	WV	25832	04/01/2022
CH030790	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	01/01/2025
CH030790	KROGER PHARMACY	133 BECKLEY CROSSING		BECKLEY	WV	25801	04/01/2019
CH030790	KROGER PHARMACY	1734 HARPER ROAD		BECKLEY	WV	25801	04/01/2019
CH030790	KROGER PHARMACY #316	1229 STAFFORD DR		PRINCETON	WV	24740	01/01/2023
CH030790	KROGER PHARMACY #743	308 STOKES DRIVE		HINTON	WV	25951	01/01/2023
CH030790	KROGER PHARMACY #770	151 BEAVER PLAZA	PO BOX 579	BEAVER	WV	25813	04/01/2019
CH030790	KROGER PHARMACY #780	411 MALL RD.		OAK HILL	WV	25901-6115	04/01/2019
CH030790	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03574	3186 PETERS CREEK PKWY.	WINSTON SALEM	NC	27127	10/01/2020	04/06/2021
CH030790	PENNSYLVANIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01894	12 WEST INDEPENDENCE STREET	SHAMOKIN	PA	17872	10/01/2020	04/06/2021
CH030790	PREMIER PHARMACY & WELLNESS	PREMIER PHARMACY & WELLNESS	516 BECKLEY CROSSING SHPG CTR	BECKLEY	WV	25801	04/01/2022
CH030790	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	10/01/2018	10/01/2022
CH030790	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2020	04/06/2021
CH030790	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2020	04/06/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2020	04/06/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2020	04/06/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/01/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	07/01/2021
CH030790	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	07/01/2021
CH030790	TENNESSEE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02404	417 E EMORY RD	POWELL	TN	37849-3518	10/01/2020	04/06/2021
CH030790	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07526	945-A N MAIN ST	MARION	VA	24354	10/01/2020	04/06/2021
CH030790	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05582	3001 VIRGINIA AVE.	COLLINSVILLE	VA	24078	10/01/2020	04/06/2021
CH030790	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06303	2940 CLINCH ST	RICHLANDS	VA	24641	10/01/2022
CH030790	VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06302	265 MARKET ST	NORTH TAZEWELL	VA	24630	10/01/2022
CH030790	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2018
CH030790	WAL-MART PHARMACY 10-1351	1330 N EISENHOWER DR		BECKLEY	WV	25801	10/01/2018
CH030790	WAL-MART PHARMACY 10-1360	204 TOWN CENTER RD		FAYETTEVILLE	WV	25840	10/01/2018
CH030790	WAL-MART PHARMACY 10-1477	200 WAL STREET		SUMMERSVILLE	WV	26651	10/01/2018
CH030790	WAL-MART PHARMACY 10-1499	1976 JEFFERSON STREET NORTH		LEWISBURG	WV	24901	10/01/2018
CH030790	WAL-MART PHARMACY 10-2933	201 GREASY RIDGE RD		PRINCETON	WV	24739	10/01/2018
CH030790	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	10/01/2018	02/04/2019
CH030790	WAL-MART PHARMACY 10-5319	1881 ROBERT C. BYRD DRIVE		MACARTHUR	WV	25873	10/01/2018
CH030790	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018
CH030790	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018	03/06/2021
CH030790	WALGREEN CO.	WALGREENS #18397	401 MORAN AVE	MULLENS	WV	25882-1430	10/01/2018
CH030790	WALGREEN CO.	DBA: WALGREENS #10876	323 S. WALKER ST.	PRINCETON	WV	24740-2756	10/01/2018
CH030790	WALGREEN CO.	DBA: WALGREENS #11981	5870 WEBSTER RD.	SUMMERSVILLE	WV	26651	10/01/2018	11/06/2023
CH030790	WALGREEN CO.	WALGREENS #18397	401 MORAN AVE	MULLENS	WV	25882-1430	10/01/2018	03/06/2021
CH030790	WALGREEN CO.	DBA WALGREENS #18190	292 MAIN ST	GILBERT	WV	25621	10/01/2018	10/01/2020
CH030790	WALGREEN CO.	RITE AID #00957	4077 ROBERT C BYRD DR	BECKLEY	WV	25801	10/01/2018	01/01/2021
CH030790	WALGREEN CO.	RITE AID #02789	7031 HARPER RD	GLEN DANIEL	WV	25844	10/01/2018	07/23/2019
CH030790	WALGREEN CO.	WALGREENS #17310	730 VIRGINIA AVE	WELCH	WV	24801	10/01/2018
CH030790	WALGREEN CO.	RITE AID #02667	719 JOHNSTOWN RD	BECKLEY	WV	25801	10/01/2018	05/20/2019
CH030790	WALGREEN CO.	RITE AID #02789	7031 HARPER RD	GLEN DANIEL	WV	25844	10/01/2018	07/23/2019
CH030790	WALGREEN CO.	RITE AID #01694	1731 HARPER RD	BECKLEY	WV	25801	10/01/2018	09/12/2018
CH030790	WALGREEN CO.	DBA: WALGREENS #10928	886 RITTER DR.	BEAVER	WV	25813-9513	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #19681	448 APPALACHIAN HWY	PINEVILLE	WV	24874	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #17426	1201 MAIN ST E	OAK HILL	WV	25901-3132	10/01/2018
CH030790	WALGREEN CO.	DBA: WALGREENS #11978	2933 ROBERT C. BYRD DR.	BECKLEY	WV	25801	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #18344	513 STOKES DR	HINTON	WV	25951	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #18404	1250 KANAWHA AVE	RAINELLE	WV	25962-7120	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #19450	16 RICH CREEK RD. PO BOX 799	ANSTED	WV	25812-0799	10/01/2018	11/16/2022
CH030790	WALGREEN CO.	WALGREENS #17470	294 RED OAKS SHOPPING CTR	RONCEVERTE	WV	24970	10/01/2018	11/09/2020
CH030790	WALGREEN CO.	RITE AID #03252	2198 RITTER RD	DANIELS	WV	25832	10/01/2018	09/17/2018
CH030790	WALGREEN CO.	WALGREENS #17559	69 LEWIS ST.	WHITESVILLE	WV	25209	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #18304	1561 VIRGINIA AVE PO DRAWER F	RICH CREEK	VA	24147-9757	10/01/2018	07/12/2023
CH030790	WALGREEN CO.	WALGREENS #19746	894 COOK PKWY	OCEANA	WV	24870-0019	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #19990	18116 WEBSTER RD	CRAIGSVILLE	WV	26205	10/01/2018
CH030790	WALGREEN CO.	WALGREENS #17496	4248 COAL HERITAGE RD	BLUEFIELD	WV	24701-9190	10/01/2018	11/07/2023
CH030790	WALGREEN CO.	WALGREENS #17869	121 N MAIN STREET	PEARISBURG	VA	24134-1624	10/01/2023
CH030790	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CH030790	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2018
CH030790	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/01/2018
CH030790	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2018
CH030790	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	10/01/2018	10/01/2021
CH030790	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH030790	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06312	2811 ROBERT C. BYRD DR.	BECKLEY	WV	25801	10/01/2018
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05946	72 WHITEWATER AVE.	FAYETTEVILLE	WV	25840	10/01/2018
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06313	159 BEAVER PLZ	BEAVER	WV	25813	10/01/2018
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06305	1414 N. EISENHOWER DR.	BECKLEY	WV	25801	10/01/2018
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07792	1827 HARPER ROAD	BECKLEY	WV	25801	10/01/2018
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04167	700 NORTHSIDE DR.	SUMMERSVILLE	WV	26651	01/01/2019
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06314	1298 STAFFORD DRIVE	PRINCETON	WV	24740	01/01/2019
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06333	9781 SENECA TRAIL S.	LEWISBURG	WV	24901	10/01/2020
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10124	1000 PINEVIEW DRIVE	MORGANTOWN	WV	26505	10/01/2020
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04244	121 10TH ST.	DUNBAR	WV	25064	10/01/2020
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY #6311	11078 MIDLAND TRL	GAULEY BRIDGE	WV	25085	10/01/2020	04/03/2024
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04136	3521 MONONGAHELA BLVD	STAR CITY	WV	26505	10/01/2020
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04432	300 FOURTH AVE	MONTGOMERY	WV	25136	10/01/2020
CH030790	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06318	105 S. STATE ST., PO BOX 1159	ATHENS	WV	24712	10/01/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/19/2025 9:21 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1740015627	2/19/2025 9:21 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		WV	2/19/2025 9:21 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1740015627	2/19/2025 9:21 AM
Medicaid Billing	NPI: State	Insert	Recertification		WV	2/19/2025 9:21 AM
Details	Last Recertification Date	Update	Recertification	2/12/2024 3:21:23 PM	2/19/2025 9:21:16 AM	2/19/2025 9:21 AM
Details	Last Recertification Date	Update	Recertification	2/8/2023 4:17:07 PM	2/12/2024 3:21:23 PM	2/12/2024 3:21 PM
Contacts	Authorizing Official	Update	Profile Change Request	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-164	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-1164	2/6/2024 10:48 AM
Contacts	Signed By	Update	Profile Change Request	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-164	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-1164	2/6/2024 10:48 AM
Contacts	Primary Contact	Update	Profile Change Request	BUTCHER, ROBERT CPO Community Health Systems, Inc. 3042528324-150	BUTCHER, ROBERT CPO Community Health Systems, Inc. 3042528324-1150	2/6/2024 10:46 AM
Details	Last Recertification Date	Update	Recertification	2/10/2022 9:33:28 AM	2/8/2023 4:17:07 PM	2/8/2023 4:17 PM
Details	Last Recertification Date	Update	Recertification	2/5/2021 8:46:35 AM	2/10/2022 9:33:28 AM	2/10/2022 9:33 AM
Medicaid Billing	NPI: State	Update	Recertification		WV	2/5/2021 8:46 AM
Medicaid Billing	NPI: State	Update	Recertification		WV	2/5/2021 8:46 AM
Medicaid Billing	NPI: State	Update	Recertification		WV	2/5/2021 8:46 AM
Medicaid Billing	NPI: State	Update	Recertification		WV	2/5/2021 8:46 AM
Medicaid Billing	NPI: State	Update	Recertification		WV	2/5/2021 8:46 AM
Details	Last Recertification Date	Update	Recertification	2/4/2020 8:44:28 AM	2/5/2021 8:46:35 AM	2/5/2021 8:46 AM
Details	Last Recertification Date	Update	Recertification	2/4/2019 8:59:48 AM	2/4/2020 8:44:28 AM	2/4/2020 8:44 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	3810015527 (WV)		2/4/2019 8:59 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1487889010 ( )		2/4/2019 8:59 AM
Details	Last Recertification Date	Update	Recertification	2/26/2018 4:16:16 PM	2/4/2019 8:59:48 AM	2/4/2019 8:59 AM
Details	Is Authorizing Official EHB Data	Update	Recertification	False		2/4/2019 8:59 AM
Details	Last Recertification Date	Update	Recertification	2/10/2017 12:00:00 AM	2/26/2018 4:16:16 PM	2/26/2018 4:16 PM
Contacts	Authorizing Official	Update		HUNT, CHARLES CEO 3042528551-164	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-164	10/31/2017 8:23 AM
Contacts	Signed By	Update		HUNT, CHARLES CEO 3042528551-164	HUNT, CHARLES CEO Community Health Systems, Inc 3042528551-164	10/31/2017 8:23 AM
Contacts	Primary Contact	Update		BUTCHER, ROBERT CPO 3042528324-150	BUTCHER, ROBERT CPO Community Health Systems, Inc. 3042528324-150	10/30/2017 8:31 AM
Contacts	Primary Contact	Insert			BUTCHER, ROBERT CPO 3042528324-150	8/14/2017 10:46 AM
Contacts	Authorizing Official	Insert			HUNT, CHARLES CEO 3042528551-164	8/14/2017 10:46 AM
Contacts	Signed By	Insert			HUNT, CHARLES CEO 3042528551-164	8/14/2017 10:46 AM
Addresses	Main Address	Insert			400 Stanaford Rd Beckley, WV 25801-3144	8/14/2017 10:44 AM
Addresses	Billing Address	Insert			Community Health Systems, Inc. 252 Rural Acres Drive Beckley, WV 25801	8/14/2017 10:44 AM
Addresses	Shipping Address	Insert			AccessHealth Pharmacy Beckley 252 Rural Acres Drive Beckley, WV 25801	8/14/2017 10:44 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/14/2017 10:44 AM
Medicaid Billing	Medicaid: Number	Insert			3810013656	8/14/2017 10:44 AM
Medicaid Billing	Medicaid: State	Insert			WV	8/14/2017 10:44 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Number	Insert			3180008178	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: State	Insert			WV	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Number	Insert			3810010454	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: State	Insert			WV	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Number	Insert			3810015527	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: State	Insert			WV	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: Number	Insert			3810016216	2/13/2017 2:19 PM
Medicaid Billing	Medicaid: State	Insert			WV	2/13/2017 2:19 PM
Medicaid Billing	NPI: Number	Insert			1780719609	2/13/2017 2:19 PM
Medicaid Billing	NPI: Number	Insert			1962698118	2/13/2017 2:19 PM
Medicaid Billing	NPI: Number	Insert			1588833115	2/13/2017 2:19 PM
Medicaid Billing	NPI: Number	Insert			1487889010	2/13/2017 2:19 PM
Medicaid Billing	NPI: Number	Insert			1518190776	2/13/2017 2:19 PM
Details	Last Recertification Date	Update		3/9/2016 12:00:00 AM	2/10/2017 12:00:00 AM	2/13/2017 2:19 PM
Details	Last Recertification Date	Update		3/3/2015 12:00:00 AM	3/9/2016 12:00:00 AM	3/9/2016 8:39 AM
Details	Last Recertification Date	Update		3/16/2014 12:00:00 AM	3/3/2015 12:00:00 AM	3/3/2015 9:03 AM
Details	Is Authorizing Official EHB Data	Update			False	3/3/2015 9:03 AM
Details	Last Recertification Date	Update			3/16/2014 12:00:00 AM	3/16/2014 12:07 PM
Dates	Participating Approval Date	Update			8/28/2013 12:00:00 AM	8/28/2013 10:33 AM
Details	State	Update		Pending	Active	8/28/2013 10:33 AM
Dates	Start Date	Update			10/1/2013 12:00:00 AM	8/28/2013 10:33 AM
Details	340B ID	Update		ONLINE_REG	CH03079S	7/25/2013 2:01 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/9/2013 10:43 AM
Medicaid Billing	Medicaid: Number	Insert			0019601001	7/9/2013 10:43 AM
Medicaid Billing	Medicaid: State	Insert			WV	7/9/2013 10:43 AM
Medicaid Billing	NPI: Number	Insert			1386682540	7/9/2013 10:43 AM
Details	Last Recertification Date	Insert				7/9/2013 10:43 AM
Details	Grant Number	Insert			H80CS00345	7/9/2013 10:43 AM
Details	340B ID	Insert			ONLINE_REG	7/9/2013 10:43 AM
Details	Is Authorizing Official EHB Data	Insert				7/9/2013 10:43 AM
Dates	Last Date That 340B Drugs Purchased	Insert				7/9/2013 10:43 AM
Details	Medicare Provider Number	Insert				7/9/2013 10:43 AM
Details	Entity Name	Insert			COMMUNITY HEALTH SYSTEMS, INC.	7/9/2013 10:43 AM
Details	Program Code	Insert			CH	7/9/2013 10:43 AM
Details	Entity Subname	Insert			Woodrow Wilson School-Based Clinic	7/9/2013 10:43 AM
Dates	Participating Approval Date	Insert				7/9/2013 10:43 AM
Details	State	Insert			Pending	7/9/2013 10:43 AM
Dates	Registration Date	Insert			7/9/2013 12:00:00 AM	7/9/2013 10:43 AM
Dates	Signed By Date	Insert			7/9/2013 12:00:00 AM	7/9/2013 10:43 AM
Dates	Start Date	Insert				7/9/2013 10:43 AM
Terminations	Termination Comments	Insert				7/9/2013 10:43 AM
Terminations	Termination Date	Insert				7/9/2013 10:43 AM
Terminations	Termination Effective Date	Insert				7/9/2013 10:43 AM
Terminations	Termination Reason	Insert				7/9/2013 10:43 AM

340B Drug Pricing Program Database