Details | Last Recertification Date | Update | Recertification | 2/22/2024 9:00:48 AM | 3/7/2025 8:38:41 AM | 3/7/2025 8:38 AM |
Details | Last Recertification Date | Update | Recertification | 2/16/2023 4:29:07 PM | 2/22/2024 9:00:48 AM | 2/22/2024 9:00 AM |
Details | Last Recertification Date | Update | Recertification | 2/7/2022 11:25:34 AM | 2/16/2023 4:29:07 PM | 2/16/2023 4:29 PM |
Addresses | Shipping Address | Insert | Change Request | | White House Clinics Pharmacy Lancaster
103 Southern Soul Way
Lancaster, KY 40444 | 10/19/2022 1:21 PM |
Details | Last Recertification Date | Update | Recertification | 2/2/2021 4:47:44 PM | 2/7/2022 11:25:34 AM | 2/7/2022 11:25 AM |
Medicaid Billing | NPI: State | Update | Recertification | | KY | 2/2/2021 4:47 PM |
Medicaid Billing | NPI: State | Update | Recertification | | KY | 2/2/2021 4:47 PM |
Details | Last Recertification Date | Update | Recertification | 2/6/2020 3:52:15 PM | 2/2/2021 4:47:44 PM | 2/2/2021 4:47 PM |
Details | Is Authorizing Official EHB Data | Update | Recertification | False | | 2/2/2021 4:47 PM |
Details | Last Recertification Date | Update | Recertification | 2/6/2019 9:22:59 AM | 2/6/2020 3:52:15 PM | 2/6/2020 3:52 PM |
Details | Last Recertification Date | Update | Recertification | 3/1/2018 1:13:07 PM | 2/6/2019 9:22:59 AM | 2/6/2019 9:22 AM |
Details | Last Recertification Date | Update | Recertification | 2/17/2017 12:00:00 AM | 3/1/2018 1:13:07 PM | 3/1/2018 1:13 PM |
Contacts | Primary Contact | Update | New Registration | Blackburn, Stacey
DIRECTOR OF PHARMACY
8596267700-4021 | Blackburn, Stacey
DIRECTOR OF PHARMACY
Health Help Inc d/b/a White House Clinics
8596267700-4081 | 10/12/2017 4:42 PM |
Contacts | Authorizing Official | Update | | MOORE, STEPHANIE
CEO
8596267700-4032 | MOORE, STEPHANIE
CEO
Health Help Inc d/b/a White House Clinics
8596267700-4032 | 10/12/2017 3:20 PM |
Contacts | Signed By | Update | | MOORE, STEPHANIE
CEO
8596267700-4032 | MOORE, STEPHANIE
CEO
Health Help Inc d/b/a White House Clinics
8596267700-4032 | 10/12/2017 3:20 PM |
Addresses | Main Address | Insert | | |
1 Pirate Parkway
Berea, KY 40403-1541 | 2/17/2017 8:18 AM |
Contacts | Primary Contact | Update | | CHEEK, REBECCA
DIRECTOR OF PHARMACY
6062877104-1017 | Blackburn, Stacey
DIRECTOR OF PHARMACY
8596267700-4021 | 2/17/2017 8:18 AM |
Contacts | Authorizing Official | Insert | | | MOORE, STEPHANIE
CEO
8596267700-4032 | 2/17/2017 8:18 AM |
Contacts | Signed By | Insert | | | MOORE, STEPHANIE
CEO
8596267700-4032 | 2/17/2017 8:18 AM |
Details | Last Recertification Date | Update | | 2/18/2016 12:00:00 AM | 2/17/2017 12:00:00 AM | 2/17/2017 8:18 AM |
Details | Last Recertification Date | Update | | 2/3/2015 12:00:00 AM | 2/18/2016 12:00:00 AM | 2/18/2016 11:48 AM |
Contacts | Primary Contact | Insert | | | CHEEK, REBECCA
DIRECTOR OF PHARMACY
6062877104-1017 | 2/3/2015 12:55 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 2/3/2015 12:55 PM |
Medicaid Billing | Medicaid: Number | Insert | | | 31000243 | 2/3/2015 12:55 PM |
Medicaid Billing | Medicaid: State | Insert | | | KY | 2/3/2015 12:55 PM |
Details | Last Recertification Date | Update | | 3/16/2014 12:00:00 AM | 2/3/2015 12:00:00 AM | 2/3/2015 12:55 PM |
Details | Is Authorizing Official EHB Data | Update | | | False | 2/3/2015 12:55 PM |
Addresses | Shipping Address | Insert | | | Irvine White House Clinic Pharmacy
30 Stacy Lane Road
Irvine, KY 40336 | 3/30/2014 5:18 PM |
Addresses | Shipping Address | Insert | | | Berea White House Clinic Pharmacy
104 Legacy Drive
Berea, KY 40403 | 3/30/2014 5:18 PM |
Addresses | Shipping Address | Insert | | | White House Clinic Pharmacy
1010 Main Street South
McKee, KY 40447 | 3/30/2014 5:18 PM |
Addresses | Shipping Address | Insert | | | Richmond White House Clinic Pharmacy
401 Highland Park Drive
Richmond, KY 40475 | 3/30/2014 5:18 PM |
Addresses | Shipping Address | Insert | | | Mount Vernon White House Clinic Pharmacy
116 Progress Drive
Mount Vernon, KY 40456 | 3/30/2014 5:18 PM |
Details | Last Recertification Date | Update | | | 3/16/2014 12:00:00 AM | 3/16/2014 5:10 PM |
Details | 340B ID | Update | | CHC11379-02 | CH04482G | 11/8/2013 5:43 PM |
Dates | Participating Approval Date | Update | | | 11/8/2013 12:00:00 AM | 11/8/2013 5:43 PM |
Details | State | Update | | Pending | Active | 11/8/2013 5:43 PM |
Dates | Start Date | Update | | | 1/1/2014 12:00:00 AM | 11/8/2013 5:43 PM |
Details | 340B ID | Update | | ONLINE_REG | CHC11379-02 | 11/8/2013 4:29 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 10/1/2013 1:27 PM |
Medicaid Billing | Medicaid: Number | Insert | | | 54005673 | 10/1/2013 1:27 PM |
Medicaid Billing | Medicaid: State | Insert | | | KY | 10/1/2013 1:27 PM |
Medicaid Billing | NPI: Number | Insert | | | 1669461109 | 10/1/2013 1:27 PM |
Medicaid Billing | NPI: Number | Insert | | | 1952733842 | 10/1/2013 1:27 PM |
Details | Last Recertification Date | Insert | | | | 10/1/2013 1:27 PM |
Details | Grant Number | Insert | | | H80CS00459 | 10/1/2013 1:27 PM |
Details | 340B ID | Insert | | | ONLINE_REG | 10/1/2013 1:27 PM |
Details | Is Authorizing Official EHB Data | Insert | | | | 10/1/2013 1:27 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 10/1/2013 1:27 PM |
Details | Medicare Provider Number | Insert | | | | 10/1/2013 1:27 PM |
Details | Entity Name | Insert | | | HEALTH HELP, INCORPORATED | 10/1/2013 1:27 PM |
Details | Program Code | Insert | | | CH | 10/1/2013 1:27 PM |
Details | Entity Subname | Insert | | | Berea Community School | 10/1/2013 1:27 PM |
Dates | Participating Approval Date | Insert | | | | 10/1/2013 1:27 PM |
Details | State | Insert | | | Pending | 10/1/2013 1:27 PM |
Dates | Registration Date | Insert | | | 10/1/2013 12:00:00 AM | 10/1/2013 1:27 PM |
Dates | Signed By Date | Insert | | | 10/1/2013 12:00:00 AM | 10/1/2013 1:27 PM |
Dates | Start Date | Insert | | | | 10/1/2013 1:27 PM |
Terminations | Termination Comments | Insert | | | | 10/1/2013 1:27 PM |
Terminations | Termination Date | Insert | | | | 10/1/2013 1:27 PM |
Terminations | Termination Effective Date | Insert | | | | 10/1/2013 1:27 PM |
Terminations | Termination Reason | Insert | | | | 10/1/2013 1:27 PM |