340B Drug Pricing Program Database


CHC26595-01 PENNYROYAL HEALTHCARE SERVICES INC. (Active) - information as of 5/13/2025 1:39:50 AM

Main Details
PENNYROYAL HEALTHCARE SERVICES INC.
Community Medical Clinic, Hopkinsville
HRSA-Funded Health Center
BPS-H80-019523
CHC26595-01
H80CS26595


Additional Details
Active
10/10/2014
1/1/2015
10/23/2014
2/11/2025

Contacts

Pennyroyal Healthcare Services, Inc.
Starla Cummings, CEO
(270) 365-0227

Cheek Consulting
Rebecca Cheek, 340b Auditor
(606) 524-1303

Addresses

1102 South Virginia St.
Hopkinsville, KY 42240-2620

Community Medical Clinic
402 N. Jefferson St.
Princeton, KY 42445


  • 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
KY71002000601124319942,1104532332
TNQ0200001124319942,1104532332
Shipping Addresses

Same as Street Address
Contract Pharmacies
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC26595-00ActiveBPS-H80-033858PENNYROYAL HEALTHCARE SERVICES INC.Community Medical Clinic, Princeton1022 W, Main St. PRINCETONKY
CHC26595-01ActiveBPS-H80-019523PENNYROYAL HEALTHCARE SERVICES INC.Community Medical Clinic, Hopkinsville1102 South Virginia St. HopkinsvilleKY
CHC26595-02ActiveBPS-H80-019597PENNYROYAL HEALTHCARE SERVICES INC.Community Medical Clinic, Oak Grove244 Thompsonville Lane OAK GROVEKY
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC26595-00ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280904/01/2024  
CHC26595-00CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/01/2024  
CHC26595-00CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/01/2024  
CHC26595-00CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/01/2024  
CHC26595-00CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/01/2024  
CHC26595-00CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/01/2024  
CHC26595-00CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/01/2024  
CHC26595-00CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/01/2024  
CHC26595-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813307/01/2023  
CHC26595-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/01/2024  
CHC26595-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/01/2024  
CHC26595-00CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2022  
CHC26595-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2022  
CHC26595-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/01/2024  
CHC26595-00CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503304/01/2018  
CHC26595-00FOUR RIVERS PHARMACY150 RALEIGH DR
ELIZABETHTOWNKY42701-713907/01/2014 07/21/2017
CHC26595-01FOUR RIVERS PHARMACY150 RALEIGH DR
ELIZABETHTOWNKY42701-713901/01/2015 07/21/2017
CHC26595-00GENOA HEALTHCARE LLC1525 CUBA RD STE P
MAYFIELDKY4206610/01/2024  
CHC26595-00KENTUCKY CENTRAL FILL FACILITY, L-0105594 SHEPHERDSVILLE ROAD
LOUISVILLEKY40228-101201/01/2017 07/21/2017
CHC26595-00KENTUCKY CENTRAL FILL FACILITY, L-0105594 SHEPHERDSVILLE ROAD
LOUISVILLEKY40228-101210/01/2020 10/09/2022
CHC26595-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04637 1021 WEST MAIN STREET
PRINCETONKY4244507/01/2022  
CHC26595-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06376 538 LONE OAK RD.
PADUCAHKY4200301/01/2023  
CHC26595-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06377 920 N. MAIN ST.
MADISONVILLEKY4243101/01/2023  
CHC26595-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06383 307 STURGIS RD
MARIONKY4206401/01/2023  
CHC26595-00Kroger PharmacyJeffersonville Central Fill Facility 301 Logistics Ave
Suite 200 		JeffersonvilleIN4713001/01/2023  
CHC26595-00KROGER PHARMACY L5221213 SKYLINE DRIVE
HOPKINSVILLEKY4224001/01/2017  
CHC26595-00LYON DRUG STORE201 W MAIN ST PO BOX 490
EDDYVILLEKY42038-775201/01/2019  
CHC26595-00OPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302510/01/2024  
CHC26595-00OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520410/01/2024  
CHC26595-00OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC26595-00OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CHC26595-00PDC, LLCPRINCETON DRUG STORE 103 W MAIN ST
PRINCETONKY4244501/03/2018  
CHC26595-00PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999204/01/2018 10/01/2022
CHC26595-00PRINCETON DRUG CORODNEY P. WHITTINGTON 103 MAIN STREET
PRINCETONKY4244504/01/2016 10/04/2017
CHC26595-00PRINCETON DRUG CORODNEY P. WHITTINGTON 103 MAIN STREET
PRINCETONKY4244501/01/2018 10/05/2017
CHC26595-00PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/01/2024  
CHC26595-00PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/01/2024  
CHC26595-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/01/2024  
CHC26595-00RITE AID OF KENTUCKY, INC.RITE AID #7890 2626 FORT CAMPBELL BLVD
HOPKINSVILLEKY4224001/01/2017 08/08/2018
CHC26595-00SAVE MORE DRUGS2208 FORT CAMPBELL BLVD
HOPKINSVILLEKY4224004/01/2016 11/01/2021
CHC26595-00TOM'S FAMILY PHARMACY815 COUNTRY CLUB LN
HOPKINSVILLEKY42240-134604/01/2020 09/30/2024
CHC26595-00WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2018  
CHC26595-00WAL-MART PHARMACY 10-02041500 US 62 WEST
PRINCETONKY4244501/01/2018  
CHC26595-00WAL-MART PHARMACY 10-02941725 W EVERLY BROTHERS BLVD
CENTRAL CITYKY4233010/01/2024  
CHC26595-00WAL-MART PHARMACY 10-0653300 CLINIC DRIVE
HOPKINSVILLEKY4224001/01/2018  
CHC26595-00WAL-MART PHARMACY 10-0655420 FACTORY OUTLET DRIVE
HANSONKY4241301/01/2023  
CHC26595-00WAL-MART PHARMACY 10-10751680 FT CAMPBELL BLVD
CLARKSVILLETN3704201/01/2023  
CHC26595-02WAL-MART PHARMACY 10-336214800 FT. CAMBELL BLVD
OAK GROVEKY4226201/01/2018 01/01/2024
CHC26595-00WAL-MART PHARMACY 10-336214800 FT. CAMBELL BLVD
OAK GROVEKY4226201/01/2018  
CHC26595-00WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2018  
CHC26595-00WALGREEN CODBA: WALGREENS #12587 679 S. MAIN ST
MADISONVILLEKY4243104/01/2022  
CHC26595-00WALGREEN CO.DBA: WALGREENS # 06104 2901 FT CAMPBELL BLVD
HOPKINSVILLEKY4224004/01/2018  
CHC26595-00WALGREEN CO.RITE AID #07890 2626 FORT CAMPBELL BLVD
HOPKINSVILLEKY4224002/05/2018 02/05/2018
CHC26595-00WALGREEN CO.DBA: WALGREENS # 03775 1460 FT CAMPBELL BLVD
CLARKSVILLETN3704201/01/2022  
CHC26595-00WALGREEN CO.DBA: WALGREENS # 09340 2109 WILMA RUDOLPH BLVD
CLARKSVILLETN37040-666301/01/2022  
CHC26595-00WALGREEN CO.DBA: WALGREENS #11852 1751 TINY TOWN RD.
CLARKSVILLETN3704201/01/2022  
CHC26595-00WALGREEN CO.DBA: WALGREENS #12875 2975 FORT CAMPBELL BLVD.
CLARKSVILLETN3704201/01/2022  
CHC26595-00Walgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101 		MemphisTN3811807/01/2022  
CHC26595-00WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700804/01/2018 10/01/2021
CHC26595-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818804/01/2018  
CHC26595-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503304/01/2018  
CHC26595-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527504/01/2018  
CHC26595-00WALMART PHARMACY 10-50593106 CANTON STREET
HOPKINSVILLEKY4224001/01/2019  
CHC26595-00WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275604/01/2023  
CHC26595-00WALMART PHARMACY 10-72906501 VETERANS MEMORIAL PARKWAY
CRESTWOODKY4001410/01/2024  
CHC26595-00Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616804/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsAuthorizing OfficialUpdateProfile Change RequestCummings, Starla CFO Pennyroyal Healthcare Services, Inc. 2703650227Cummings, Starla CEO Pennyroyal Healthcare Services, Inc. 27036502273/24/2025 6:28 AM
DetailsLast Recertification DateUpdateRecertification1/29/2024 12:25:43 PM2/11/2025 7:13:01 PM2/11/2025 7:13 PM
ContactsAuthorizing OfficialUpdateGroup Change RequestFulcher, Kecia CEO Pennyroyal Healthcare Services, Inc. 2703650227Cummings, Starla CFO Pennyroyal Healthcare Services, Inc. 27036502271/16/2025 12:54 PM
ContactsPrimary ContactUpdateGroup Change RequestCummings, Starla CFO Pennyroyal Healthcare Services, Inc. 2703650227Cheek, Rebecca 340b Auditor Cheek Consulting 60652413031/16/2025 12:54 PM
DetailsLast Recertification DateUpdateRecertification2/2/2023 1:07:37 PM1/29/2024 12:25:43 PM1/29/2024 12:25 PM
Medicaid BillingNPI: NumberInsertChange Request 11045323325/8/2023 2:24 PM
Medicaid BillingNPI: StateInsertChange Request KY5/8/2023 2:24 PM
Medicaid BillingNPI: NumberInsertChange Request 11045323325/8/2023 2:24 PM
Medicaid BillingNPI: StateInsertChange Request TN5/8/2023 2:24 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False2/7/2023 3:37 PM
Medicaid BillingMedicaid: NumberInsertChange Request Q0200002/7/2023 3:37 PM
Medicaid BillingMedicaid: StateInsertChange Request TN2/7/2023 3:37 PM
Medicaid BillingNPI: NumberInsertChange Request 11243199422/7/2023 3:37 PM
Medicaid BillingNPI: StateInsertChange Request TN2/7/2023 3:37 PM
DetailsLast Recertification DateUpdateRecertification1/31/2022 11:14:41 AM2/2/2023 1:07:37 PM2/2/2023 1:07 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/7/2022 3:11 PM
Medicaid BillingMedicaid: NumberInsertChange Request 710020006011/7/2022 3:11 PM
Medicaid BillingMedicaid: StateInsertChange Request KY11/7/2022 3:11 PM
Medicaid BillingNPI: NumberInsertChange Request 112431994211/7/2022 3:11 PM
Medicaid BillingNPI: StateInsertChange Request KY11/7/2022 3:11 PM
AddressesBilling AddressUpdateRecertificationCommunity Medical Clinic 310 Hawthorne St. Princeton, KY 42445Community Medical Clinic 402 N. Jefferson St. Princeton, KY 424451/31/2022 11:14 AM
DetailsLast Recertification DateUpdateRecertification2/2/2021 6:12:12 PM1/31/2022 11:14:41 AM1/31/2022 11:14 AM
DetailsEntity SubnameUpdateChange RequestCommunity Medical ClinicCommunity Medical Clinic, Hopkinsville11/18/2021 2:19 PM
ContactsPrimary ContactUpdateProfile Change RequestCummings, Starla Fiscal Assistant Pennyroyal Healthcare Services, Inc. 2703650227Cummings, Starla CFO Pennyroyal Healthcare Services, Inc. 270365022710/29/2021 12:44 PM
DetailsLast Recertification DateUpdateRecertification1/28/2020 10:49:37 AM2/2/2021 6:12:12 PM2/2/2021 6:12 PM
DetailsLast Recertification DateUpdateRecertification1/31/2019 11:51:42 AM1/28/2020 10:49:37 AM1/28/2020 10:49 AM
DetailsLast Recertification DateUpdateRecertification2/8/2018 11:37:02 AM1/31/2019 11:51:42 AM1/31/2019 11:51 AM
AddressesBilling AddressInsertRecertification Community Medical Clinic 310 Hawthorne St. Princeton, KY 424452/8/2018 11:37 AM
AddressesMain AddressUpdateRecertification 739 NORTH DR HOPKINSVILLE, KY 42240-2620 1102 South Virginia St. Hopkinsville, KY 42240-26202/8/2018 11:37 AM
ContactsPrimary ContactUpdateRecertificationFulcher, Kecia CEO 2703650227Cummings, Starla Fiscal Assistant Pennyroyal Healthcare Services, Inc. 27036502272/8/2018 11:37 AM
DetailsLast Recertification DateUpdateRecertification2/10/2017 12:00:00 AM2/8/2018 11:37:02 AM2/8/2018 11:37 AM
DetailsIs Authorizing Official EHB DataUpdateRecertificationFalse 2/8/2018 11:37 AM
DetailsEntity NameUpdateRecertificationPENNYROYAL HEALTHCARE SERVICE INC.PENNYROYAL HEALTHCARE SERVICES INC.2/8/2018 11:37 AM
DetailsEntity SubnameUpdateRecertificationPennyroyal Primary CareCommunity Medical Clinic2/8/2018 11:37 AM
ContactsAuthorizing OfficialInsertAO Change Request Fulcher, Kecia CEO Pennyroyal Healthcare Services, Inc. 270365022710/13/2017 2:38 PM
ContactsPrimary ContactInsert  Fulcher, Kecia CEO 27036502272/13/2017 6:52 AM
ContactsSigned ByInsert  Fulcher, Kecia CEO 27036502272/13/2017 6:52 AM
AddressesMain AddressInsert   739 NORTH DR HOPKINSVILLE, KY 42240-26202/10/2017 6:56 PM
DetailsLast Recertification DateUpdate 2/25/2016 12:00:00 AM2/10/2017 12:00:00 AM2/10/2017 6:56 PM
DetailsLast Recertification DateUpdate 3/9/2015 12:00:00 AM2/25/2016 12:00:00 AM2/25/2016 2:48 PM
DetailsLast Recertification DateUpdate  3/9/2015 12:00:00 AM3/9/2015 10:23 PM
DatesParticipating Approval DateUpdate  10/23/2014 12:00:00 AM10/23/2014 11:50 AM
DetailsStateUpdate PendingActive10/23/2014 11:50 AM
DatesStart DateUpdate  1/1/2015 12:00:00 AM10/23/2014 11:50 AM
Details340B IDUpdate ONLINE_REG_47046CHC26595-0110/21/2014 10:52 AM
Details340B IDUpdate ONLINE_REGONLINE_REG_4704610/10/2014 4:11 PM
DetailsLast Recertification DateInsert   10/10/2014 4:11 PM
DetailsGrant NumberInsert  H80CS2659510/10/2014 4:11 PM
Details340B IDInsert  ONLINE_REG10/10/2014 4:11 PM
DetailsIs Authorizing Official EHB DataInsert  False10/10/2014 4:11 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/10/2014 4:11 PM
DetailsMedicare Provider NumberInsert   10/10/2014 4:11 PM
DetailsEntity NameInsert  PENNYROYAL HEALTHCARE SERVICE INC.10/10/2014 4:11 PM
DetailsProgram CodeInsert  CH10/10/2014 4:11 PM
DetailsEntity SubnameInsert  Pennyroyal Primary Care10/10/2014 4:11 PM
DatesParticipating Approval DateInsert   10/10/2014 4:11 PM
DetailsStateInsert  Pending10/10/2014 4:11 PM
DatesRegistration DateInsert  10/10/2014 12:00:00 AM10/10/2014 4:11 PM
DatesSigned By DateInsert  10/10/2014 12:00:00 AM10/10/2014 4:11 PM
DatesStart DateInsert   10/10/2014 4:11 PM
TerminationsTermination CommentsInsert   10/10/2014 4:11 PM
TerminationsTermination DateInsert   10/10/2014 4:11 PM
TerminationsTermination Effective DateInsert   10/10/2014 4:11 PM
TerminationsTermination ReasonInsert   10/10/2014 4:11 PM