340B Drug Pricing Program Database


CH061068B INNIS COMMUNITY HEALTH CENTER, INC. (Active) - information as of 5/27/2025 2:31:53 PM

Main Details
INNIS COMMUNITY HEALTH CENTER, INC.
Pointe Coupee Central School Based Clinic
HRSA-Funded Health Center
BPS-H80-003060
CH061068B
H80CS00855


Additional Details
Active
4/15/2014
7/1/2014
4/17/2014
2/18/2025

Contacts

Innis Community Health Center, Inc.
cindy peavy, Executive Director
(225) 235-9627

Innis Community Health Center, Inc.
Tracy Lyn Hooper, 340B Administrator
(225) 618-5015

Addresses

8430 Pointe Coupee Rd
New Roads, LA 70760

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
LA2208969,10341851821287202,1790456499
Shipping Addresses

Arbor Family Pharmacy
6450 LA Hwy 1
Suite A
Batchelor, LA 70715
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH0610680ActiveBPS-H80-000550INNIS COMMUNITY HEALTH CENTER, INC.INNIS COMMUNITY HEALTH CENTER6450 LA HIGHWAY 1 STE B INNISLA
CH061068AActiveBPS-H80-000824INNIS COMMUNITY HEALTH CENTERLIVONIA COMMUNITY HEALTH CENTER3041 FORDOCHE ROAD LIVONIALA
CH061068BActiveBPS-H80-003060INNIS COMMUNITY HEALTH CENTER, INC.Pointe Coupee Central School Based Clinic8430 Pointe Coupee Rd New RoadsLA
CH061068CActiveBPS-H80-013562INNIS COMMUNITY HEALTH CENTER, INC.Livonia School Health Center- Suite A8387 Newfield Dr LivoniaLA
CH061068DActiveBPS-H80-012442INNIS COMMUNITY HEALTH CENTER, INC.Mobile Dental6450 LA Highway 1 InnisLA
CH061068ETerminatedBPS-H80-015419INNIS COMMUNITY HEALTH CENTER, INC.MARINGOUIN COMMUNITY HEALTH CENTER77695 WAGLEY RD MARINGOUINLA
CH061068FActiveBPS-H80-013561INNIS COMMUNITY HEALTH CENTER, INC.Mobile Unit #26450 LA Highway 1 InnisLA
CH061068GActiveBPS-H80-019660Innis Community Health Center, Inc.New Roads Community Health Center230 Roberts Drive STE H New RoadsLA
CH061068HActiveBPS-H80-024746Innis Community Health Center, Inc.MARINGOUIN COMMUNITY HEALTH CENTER77575 Landry Dr MaringouinLA
CH061068JActiveBPS-H80-017316Innis Community Health Center, Inc.Rosenwald Elementary School1100 New Roads St New RoadsLA
CH061068KActiveBPS-H80-017314Innis Community Health Center, Inc.Valverda Elementary School1653 Valverda Road MaringouinLA
CH061068LActiveBPS-H80-017312Innis Community Health Center, Inc.Livonia High School3118 LA Highway 78 LivoniaLA
CH061068MActiveBPS-H80-024713Innis Community Health Center, Inc.Livonia Community Health Center8387 Newfield Dr. STE B LivoniaLA
CH061068NActiveBPS-H80-017313Innis Community Health Center, Inc.Rougon Elementary School13258 LA Hwy 416 RougonLA
CH061068PActiveBPS-H80-017315Innis Community Health Center, Inc.Upper Pointe Coupee Elementary School4739 LA Highway 419 BatchelorLA
CH061068QActiveBPS-H80-024487Innis Community Health Center, Inc.Brusly School Based Health Center630 North Vaughn Dr. BruslyLA
CH061068RActiveBPS-H80-037971INNIS COMMUNITY HEALTH CENTER INCNorth Iberville School Based Health Center13770 hwy 77 RosedaleLA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH0610680ELLIOTT PHARMACY77395 LANDRY DR
MARINGOUINLA7075704/01/2016 07/31/2023
CH0610680ELLIOTT PHARMACY #3169 E MAIN STREET
NEW ROADSLA7076008/08/2007 02/08/2019
CH061068AELLIOTT PHARMACY #3169 E MAIN STREET
NEW ROADSLA7076010/01/2007  
CH0610680ENCORE PHARMACY #1800 8TH AVE STE 130
FORT WORTHTX7610405/04/2022  
CH0610680LIVONIA THRIF-T-WAY PHARMACY3066 HWY 78 PO BOX 187
LIVONIALA7075504/01/2017 07/06/2020
CH0610680POINTE COUPEE PHARMACY222 HOSPITAL RD
NEW ROADSLA7076004/01/2017 08/17/2022
CH0610680POINTE COUPEE PHARMACY222 HOSPITAL RD
NEW ROADSLA7076007/01/2023 07/31/2023
CH0610680RECEPT PHARMACY #1800 8TH AVE STE 130
FORT WORTHTX7610401/01/2022 05/02/2022
CH0610680SUPER 1 PHARMACY #648213 HOSPITAL RD
NEW ROADSLA7076004/01/2020 01/19/2022
CH0610680WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2022  
CH0610680WAL-MART PHARMACY 10-040159690 BELLVIEW DR
PLAQUEMINELA7076404/01/2024  
CH0610680WAL-MART PHARMACY 10-05431629 EAST CRESSWELL LANE
OPELOUSASLA7057007/01/2024  
CH0610680WAL-MART PHARMACY 10-11287162 HWY 1
MARKSVILLELA7135104/01/2024  
CH0610680WAL-MART PHARMACY 10-11363255 LA HWY 1 SOUTH
PORT ALLENLA7076704/01/2024  
CH0610680WAL-MART PHARMACY 10-1196460 HOSPITAL ROAD
NEW ROADSLA7076004/01/2020  
CH0610680WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2022  
CH0610680WALKER'S PHARMACY3066 LA HIGHWAY 78
LIVONIALA70755-360107/06/2020 12/29/2023
CH0610680WALMART PHARMACY 10-51252310 S UNION STREET
OPELOUSASLA7057004/01/2024 04/01/2024
CH0610680WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2023  
CH0610680Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616804/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/31/2024 9:22:53 AM2/18/2025 1:04:09 AM2/18/2025 1:04 AM
DetailsLast Recertification DateUpdateRecertification2/3/2023 11:34:50 AM1/31/2024 9:22:53 AM1/31/2024 9:22 AM
DetailsLast Recertification DateUpdateRecertification2/3/2022 11:56:02 AM2/3/2023 11:34:50 AM2/3/2023 11:34 AM
ContactsPrimary ContactUpdatePC Change RequestLambert, Jade joseph 340B Administrator Innis Community Health Center, Inc 2254923775-225Hooper, Tracy Lyn 340B Administrator Innis Community Health Center, Inc. 22561850154/19/2022 9:28 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False4/12/2022 12:53 PM
Medicaid BillingMedicaid: NumberInsertChange Request 22089694/12/2022 12:53 PM
Medicaid BillingMedicaid: StateInsertChange Request LA4/12/2022 12:53 PM
Medicaid BillingNPI: NumberInsertChange Request 17904564994/12/2022 12:53 PM
Medicaid BillingNPI: StateInsertChange Request LA4/12/2022 12:53 PM
DetailsLast Recertification DateUpdateRecertification2/8/2021 9:34:37 AM2/3/2022 11:56:02 AM2/3/2022 11:56 AM
AddressesShipping AddressInsertChange Request Arbor Family Pharmacy 6450 LA Hwy 1 Suite A Batchelor, LA 7071511/19/2021 1:03 PM
Medicaid BillingNPI: StateUpdateRecertification LA2/8/2021 9:34 AM
DetailsLast Recertification DateUpdateRecertification2/9/2020 5:18:34 PM2/8/2021 9:34:37 AM2/8/2021 9:34 AM
DetailsLast Recertification DateUpdateRecertification1/28/2019 2:26:04 PM2/9/2020 5:18:34 PM2/9/2020 5:18 PM
AddressesMain AddressUpdateChange Request 8430 Pointe Coupee Rd Morganza, LA 70759-3320 8430 Pointe Coupee Rd New Roads, LA 707604/24/2019 7:23 AM
AddressesMain AddressUpdateChange Request 8366 Pointe Coupee Rd Morganza, LA 70759-3320 8430 Pointe Coupee Rd Morganza, LA 70759-33204/15/2019 10:03 AM
ContactsAuthorizing OfficialUpdateChange RequestPeavy, Cindy Griffin Executive Director Innis Community Health Center, Inc 2254923775-201peavy, cindy Executive Director Innis Community Health Center, Inc. 22523596271/31/2019 11:15 AM
ContactsPrimary ContactUpdateRecertificationNelson, Rachel Chief Operating Officer Innis Community Health Center, Inc 2254923775-206Lambert, Jade joseph 340B Administrator Innis Community Health Center, Inc 2254923775-2251/28/2019 2:26 PM
DetailsLast Recertification DateUpdateRecertification2/9/2018 12:23:22 PM1/28/2019 2:26:04 PM1/28/2019 2:26 PM
DetailsLast Recertification DateUpdateRecertification2/16/2017 12:00:00 AM2/9/2018 12:23:22 PM2/9/2018 12:23 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestPeavy, Cindy griffin Executive Director Innis Community Health Center, Inc 2254923775-201Peavy, Cindy Griffin Executive Director Innis Community Health Center, Inc 2254923775-2011/15/2018 4:50 PM
ContactsSigned ByUpdateProfile Change RequestPeavy, Cindy griffin Executive Director Innis Community Health Center, Inc 2254923775-201Peavy, Cindy Griffin Executive Director Innis Community Health Center, Inc 2254923775-2011/15/2018 4:50 PM
Medicaid BillingNPI: NumberInsertChange Request 18212872021/15/2018 4:30 PM
Medicaid BillingNPI: NumberDeleteChange Request1447555420 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1649372574 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1942524970 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1154542926 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1467781757 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1588099477 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1376944009 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1588077515 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1467874719 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1164817078 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1386671519 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1306399712 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1427090810 ( ) 1/15/2018 4:18 PM
Medicaid BillingNPI: NumberDeleteChange Request1912086984 ( ) 1/15/2018 4:18 PM
DetailsIs Authorizing Official EHB DataUpdateChange RequestFalse 1/15/2018 4:18 PM
ContactsPrimary ContactUpdateNew RegistrationNelson, Rachel Chief Operating Officer 2254923775-206Nelson, Rachel Chief Operating Officer Innis Community Health Center, Inc 2254923775-20610/5/2017 11:27 AM
ContactsAuthorizing OfficialUpdateNew RegistrationPeavy, Cindy Executive Director Innis Community Health Center, Inc 2254923775-201Peavy, Cindy griffin Executive Director Innis Community Health Center, Inc 2254923775-20110/5/2017 11:27 AM
ContactsSigned ByUpdateNew RegistrationPeavy, Cindy Executive Director Innis Community Health Center, Inc 2254923775-201Peavy, Cindy griffin Executive Director Innis Community Health Center, Inc 2254923775-20110/5/2017 11:27 AM
ContactsAuthorizing OfficialUpdate Peavy, Cindy Executive Director 2254923775-201Peavy, Cindy Executive Director Innis Community Health Center, Inc 2254923775-2019/25/2017 3:47 PM
ContactsSigned ByUpdate Peavy, Cindy Executive Director 2254923775-201Peavy, Cindy Executive Director Innis Community Health Center, Inc 2254923775-2019/25/2017 3:47 PM
AddressesMain AddressInsert   8366 Pointe Coupee Rd Morganza, LA 70759-33208/1/2017 2:41 PM
ContactsPrimary ContactInsert  Nelson, Rachel Chief Operating Officer 2254923775-2068/1/2017 2:41 PM
ContactsAuthorizing OfficialInsert  Peavy, Cindy Executive Director 2254923775-2018/1/2017 2:41 PM
ContactsSigned ByInsert  Peavy, Cindy Executive Director 2254923775-2018/1/2017 2:41 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False7/18/2017 2:03 PM
Medicaid BillingMedicaid: NumberInsert  10341857/18/2017 2:03 PM
Medicaid BillingMedicaid: StateInsert  LA7/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  14475554207/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  16493725747/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  19425249707/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  11545429267/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  14677817577/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  15880994777/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  13769440097/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  15880775157/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  14678747197/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  11648170787/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  13866715197/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  13063997127/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  14270908107/18/2017 2:03 PM
Medicaid BillingNPI: NumberInsert  19120869847/18/2017 2:03 PM
DetailsLast Recertification DateUpdate 2/22/2016 12:00:00 AM2/16/2017 12:00:00 AM2/16/2017 12:24 PM
DetailsLast Recertification DateUpdate 3/4/2015 12:00:00 AM2/22/2016 12:00:00 AM2/22/2016 11:18 AM
DetailsLast Recertification DateUpdate  3/4/2015 12:00:00 AM3/4/2015 8:40 AM
DetailsIs Authorizing Official EHB DataUpdate  False3/4/2015 8:40 AM
Details340B IDUpdate ONLINE_REGCH061068B4/17/2014 3:05 PM
DatesParticipating Approval DateUpdate  4/17/2014 12:00:00 AM4/17/2014 3:05 PM
DetailsStateUpdate PendingActive4/17/2014 3:05 PM
DatesStart DateUpdate  7/1/2014 12:00:00 AM4/17/2014 3:05 PM
DetailsLast Recertification DateInsert   4/15/2014 2:43 PM
DetailsGrant NumberInsert  H80CS008554/15/2014 2:43 PM
Details340B IDInsert  ONLINE_REG4/15/2014 2:43 PM
DetailsIs Authorizing Official EHB DataInsert   4/15/2014 2:43 PM
DatesLast Date That 340B Drugs PurchasedInsert   4/15/2014 2:43 PM
DetailsMedicare Provider NumberInsert   4/15/2014 2:43 PM
DetailsEntity NameInsert  INNIS COMMUNITY HEALTH CENTER, INC.4/15/2014 2:43 PM
DetailsProgram CodeInsert  CH4/15/2014 2:43 PM
DetailsEntity SubnameInsert  Pointe Coupee Central School Based Clinic4/15/2014 2:43 PM
DatesParticipating Approval DateInsert   4/15/2014 2:43 PM
DetailsStateInsert  Pending4/15/2014 2:43 PM
DatesRegistration DateInsert  4/15/2014 12:00:00 AM4/15/2014 2:43 PM
DatesSigned By DateInsert  4/15/2014 12:00:00 AM4/15/2014 2:43 PM
DatesStart DateInsert   4/15/2014 2:43 PM
TerminationsTermination CommentsInsert   4/15/2014 2:43 PM
TerminationsTermination DateInsert   4/15/2014 2:43 PM
TerminationsTermination Effective DateInsert   4/15/2014 2:43 PM
TerminationsTermination ReasonInsert   4/15/2014 2:43 PM