340B Drug Pricing Program Database


CHC17157-04 REGIONAL HEALTH CARE AFFILIATES, INC. (Active) - information as of 6/14/2025 10:03:47 AM

Main Details
REGIONAL HEALTH CARE AFFILIATES, INC.
Regional Health Care Affiliates, Inc. dba Health First Community Health Center- Neel Clinic
HRSA-Funded Health Center
BPS-H80-014247
CHC17157-04
H80CS17157


Additional Details
Active
1/13/2015
4/1/2015
1/20/2015
2/13/2025

Contacts

Regional Health Care Affiliates dba Health First Community Health Center
Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104

Regional Health Care Affiliates dba Health First Community Health Center
Ronnah Ann Alexander, Chief Pharmacy Officer
(270) 667-7017 Ext: 2107

Addresses

2816 VEACH RD STE 205
OWENSBORO, KY 42303-6299

Regional Health Care Affiliates, Inc.
215 East Main Street
Providence, KY 42450-1261


  • 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
KY71001112201558692558,1588058069
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813307/03/202410/01/2024  10/01/2024
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/03/202410/01/2024  10/01/2024
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/03/202410/01/2024  10/01/2024
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/03/202410/01/2024  10/01/2024
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/03/202410/01/2024  10/01/2024
Contract DetailHOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110607/03/202410/01/2024  10/01/2024
Contract DetailKENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07940 1221 FREDERICA ST.
OWENSBOROKY4230101/13/202304/01/2023  04/01/2023
Contract DetailKENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06264 3311 HIGHWAY 54
OWENSBOROKY4230301/13/202304/01/2023  04/01/2023
Contract DetailOPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276507/03/202410/01/2024  10/01/2024
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713007/03/202410/01/2024  10/01/2024
Contract DetailOPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265507/03/202410/01/2024  10/01/2024
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983807/03/202410/01/2024  10/01/2024
Contract DetailPOOLE'S PHARMACY CARE4333 SPRINGHILL DR STE 101
OWENSBOROKY4230304/02/201507/01/2015  04/02/2015
Contract DetailWALGREEN CO.DBA: WALGREENS # 07657 2318 FREDERICA STREET
OWENSBOROKY42301-482604/02/201507/01/2015  04/02/2015
Contract DetailWALGREEN CO.WALGREENS #19331 1921 W PARRISH AVE
OWENSBOROKY42301-354201/10/202304/01/2023  04/01/2023
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818807/03/202410/01/2024  10/01/2024
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527507/03/202410/01/2024  10/01/2024
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503307/03/202410/01/2024  10/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC17157-00ActiveBPS-H80-009520REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Providence215 East Main Street ProvidenceKY
CHC17157-01ActiveBPS-H80-009519REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Calhoun295 Main Street CalhounKY
CHC17157-02ActiveBPS-H80-039369REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Clay140 Veterans Memorial Ave. ClayKY
CHC17157-03TerminatedBPS-H80-013659REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Henderson472 KLUTEY PARK PLAZA DR HENDERSONKY
CHC17157-04ActiveBPS-H80-014247REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. dba Health First Community Health Center- Neel Clinic2816 VEACH RD STE 205 OWENSBOROKY
CHC17157-05TerminatedBPS-H80-014707REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First Community Health Center Owensboro1600 BRECKENRIDGE ST OWENSBOROKY
CHC17157-06ActiveBPS-H80-015692REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. Doing Business As Health First Community Health Center - Earlington107 E MAIN ST EARLINGTONKY
CHC17157-07ActiveBPS-H80-017183REGIONAL HEALTH CARE AFFILIATES, INC.Regional Health Care Affiliates, Inc. dba Health First Community Health Center- Cabell Platt700 Martin Luther King Jr. Ave HendersonKY
CHC17157-08ActiveBPS-H80-019381Regional Health Care Affiliates, Inc.Regional Health Care Affiliates, Inc. dba Health First Community Health Center- Princeton1100 S Jefferson Street PrincetonKY
CHC17157-09ActiveBPS-H80-029701Regional Health Care Affiliates, Inc.Regional Health Care Affiliates, Inc. dba Health First Community Health Center-Union County220 N Morgan St. MorganfieldKY
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC17157-00ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2021 02/25/2024
CHC17157-00ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2021 02/25/2024
CHC17157-00ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2021 02/25/2024
CHC17157-00ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/01/2021 02/25/2024
CHC17157-00ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2021 02/25/2024
CHC17157-00ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2021 02/25/2024
CHC17157-00AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291109/08/2020 08/04/2023
CHC17157-00AMERICA'S #1 HEALTH STOREDBA HOMETOWN RX 1913 S MAIN ST
MADISONVILLEKY4243110/01/2016  
CHC17157-06AMERICA'S #1 HEALTH STOREDBA HOMETOWN RX 1913 S MAIN ST
MADISONVILLEKY4243104/01/2023  
CHC17157-00BELL'S DRUGS, INC7107 STATE ROUTE 56 E P.O. BOX 66
SEBREEKY42455-213604/01/2019 05/01/2024
CHC17157-01BELL'S DRUGS, INC7107 STATE ROUTE 56 E P.O. BOX 66
SEBREEKY42455-213604/01/2023 05/01/2024
CHC17157-00BIOLOGICS, INC.BIOLOGICS BY MCKESSON 11800 WESTON PARKWAY
CARYNC2751301/01/2021 03/15/2024
CHC17157-00BLUEGRASS PHARMACIES1128 N. MAIN ST.
MADISONVILLEKY4243107/01/2017  
CHC17157-00BUTLER'S APOTHECARYBUTLER'S APOTHECARY 213 N MAIN ST
HENDERSONKY4242010/01/2022  
CHC17157-07BUTLER'S APOTHECARYBUTLER'S APOTHECARY 213 N MAIN ST
HENDERSONKY4242004/01/2023  
CHC17157-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/01/2023  
CHC17157-07CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-04CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-06CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-09CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-01CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-08CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-02CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CHC17157-00CAYCE'S EAGLE WAY PHARMACY211 BURLEY AVE
HOPKINSVILLEKY4224001/01/2021 12/20/2021
CHC17157-00CAYCE'S PHARMACY INC.1112 W 7TH ST
HOPKINSVILLEKY4224001/01/2021 12/20/2021
CHC17157-00CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506904/01/2021 01/24/2024
CHC17157-00CENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302504/01/2021 05/07/2023
CHC17157-00CLAY DRUG STORE9055 STATE ROUTE 132 W PO BOX 8
CLAYKY42404-217304/01/2011  
CHC17157-02CLAY DRUG STORE9055 STATE ROUTE 132 W PO BOX 8
CLAYKY42404-217304/01/2023  
CHC17157-00CLEMENTS PHARMACY225 N MORGAN ST
MORGANFIELDKY42437-141101/01/2020  
CHC17157-09CLEMENTS PHARMACY225 N MORGAN ST
MORGANFIELDKY42437-141104/01/2023  
CHC17157-00COFFMAN AND HART LLC DBA PROVIDENCE PHAR2141 WESTERFIELD DR
PROVIDENCEKY4245007/01/2022  
CHC17157-02COFFMAN AND HART LLC DBA PROVIDENCE PHAR2141 WESTERFIELD DR
PROVIDENCEKY4245004/01/2023  
CHC17157-00COFFMAN FAMILY DRUGS, LLCDBA NORTONVILLE PHARMACY 229 S HOPKINSVILLE ST
NORTONVILLEKY42442-944410/01/2016  
CHC17157-06COFFMAN FAMILY DRUGS, LLCDBA NORTONVILLE PHARMACY 229 S HOPKINSVILLE ST
NORTONVILLEKY42442-944404/01/2023  
CHC17157-00CORNER DRUG STORE OF STURGIS424 N ADAMS ST
STURGISKY42459-161107/01/2019  
CHC17157-02CORNER DRUG STORE OF STURGIS424 N ADAMS ST
STURGISKY42459-161104/01/2023  
CHC17157-09CORNER DRUG STORE OF STURGIS424 N ADAMS ST
STURGISKY42459-161104/01/2023  
CHC17157-00CROFTON PHARMACY235 S MADISONVILLE ST
CROFTONKY4221710/01/2020 04/06/2021
CHC17157-00CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870604/01/2021  
CHC17157-08CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-06CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-07CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-02CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-04CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-01CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-09CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2024  
CHC17157-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/01/2021  
CHC17157-02CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-06CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-09CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-08CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-07CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-01CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-04CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2024  
CHC17157-00DIXON DRUG STORE1335 US HIGHWAY 41A S
DIXONKY4240901/01/2018  
CHC17157-02DIXON DRUG STORE1335 US HIGHWAY 41A S
DIXONKY4240904/01/2023  
CHC17157-00ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111201/01/2021 04/15/2024
CHC17157-00EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313401/01/2021 04/15/2024
CHC17157-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607501/01/2021  
CHC17157-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801601/01/2021  
CHC17157-07EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-06EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-02EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-04EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-04EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-01EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-08EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-02EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-08EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-07EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-09EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-01EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-09EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CHC17157-06EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CHC17157-00HANSON PHARMACY AND WELLNESS CENTER LLC7455 HANSON RD.
HANSONKY4241310/01/2016  
CHC17157-06HANSON PHARMACY AND WELLNESS CENTER LLC7455 HANSON RD.
HANSONKY4241304/01/2023  
CHC17157-01HANSON PHARMACY AND WELLNESS CENTER LLC7455 HANSON RD.
HANSONKY4241304/01/2023  
CHC17157-00HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110601/01/2023  
CHC17157-06HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-04HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-07HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-08HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-01HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-02HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-09HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110610/01/2024  
CHC17157-00KENTUCKY CENTRAL FILL FACILITY, L-0105594 SHEPHERDSVILLE ROAD
LOUISVILLEKY40228-101201/01/2020 10/09/2022
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06384 105 US HWY 41-A S
PROVIDENCEKY4245007/01/2017 02/26/2022
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06377 920 N. MAIN ST.
MADISONVILLEKY4243101/01/2020 11/12/2019
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04637 1021 WEST MAIN STREET
PRINCETONKY4244501/01/2020 11/12/2019
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04637 1021 WEST MAIN STREET
PRINCETONKY4244504/01/2020  
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06377 920 N. MAIN ST.
MADISONVILLEKY4243104/01/2020  
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07940 1221 FREDERICA ST.
OWENSBOROKY4230104/01/2021  
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06264 3311 HIGHWAY 54
OWENSBOROKY4230301/01/2023  
CHC17157-00KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06383 307 STURGIS RD
MARIONKY4206401/01/2023  
CHC17157-08KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04637 1021 WEST MAIN STREET
PRINCETONKY4244504/01/2023  
CHC17157-04KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07940 1221 FREDERICA ST.
OWENSBOROKY4230104/01/2023  
CHC17157-04KENTUCKY CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06264 3311 HIGHWAY 54
OWENSBOROKY4230304/01/2023  
CHC17157-00KROGER2308 EAST 4TH STREET
OWENSBOROKY4230104/01/2019 02/27/2023
CHC17157-00Kroger PharmacyJeffersonville Central Fill Facility 301 Logistics Ave
Suite 200 		JeffersonvilleIN4713001/01/2023 02/27/2023
CHC17157-00KROGER PHARMACY L-563545 ISLAND FORD ROAD
MADISONVILLEKY4243104/01/2019 02/27/2023
CHC17157-00KROGER PHARMACY L-7181670 STARLITE DR
OWENSBOROKY42301-333904/01/2019 02/27/2023
CHC17157-00KROGER PHARMACY L-7181670 STARLITE DR
OWENSBOROKY42301-333904/01/2019 01/17/2019
CHC17157-00KROGER PHARMACY L-7702630 FREDERICA STREET
OWENSBOROKY4230104/01/2019 02/27/2023
CHC17157-00LYON DRUG STORE201 W MAIN ST PO BOX 490
EDDYVILLEKY42038-775210/01/2020  
CHC17157-08LYON DRUG STORE201 W MAIN ST PO BOX 490
EDDYVILLEKY42038-775204/01/2023  
CHC17157-00MIDWAY PHARMACY1640 2ND ST
HENDERSONKY42420-336407/01/2019 09/19/2023
CHC17157-07MIDWAY PHARMACY1640 2ND ST
HENDERSONKY42420-336404/01/2023 09/19/2023
CHC17157-00MIKE'S PHARMACY104 SOUTH L.T. TODD JR HWY
EARLINGTONKY42410-424107/01/2016 12/21/2016
CHC17157-00MIKE'S PHARMACY104 SOUTH L.T. TODD JR HWY
EARLINGTONKY42410-424104/01/2018 10/29/2019
CHC17157-00OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276501/01/2021  
CHC17157-01OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2024  
CHC17157-09OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
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CHC17157-04OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2024  
CHC17157-07OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
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CHC17157-06OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
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CHC17157-02OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
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CHC17157-08OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2024  
CHC17157-00OPTUM PHARMACY 701, LLC1830 S HORNE
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CHC17157-00OPTUM PHARMACY 701, LLC1830 S HORNE
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CHC17157-00OPTUM PHARMACY 702, LLC1050 PATROL RD
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CHC17157-04OPTUM PHARMACY 702, LLC1050 PATROL RD
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CHC17157-07OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC17157-01OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC17157-02OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC17157-09OPTUM PHARMACY 702, LLC1050 PATROL RD
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CHC17157-08OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC17157-06OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CHC17157-00OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
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CHC17157-00OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
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CHC17157-00OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
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CHC17157-02OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265510/01/2024  
CHC17157-00OPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110101/01/2021 04/25/2024
CHC17157-00OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140101/01/2021 04/25/2024
CHC17157-00OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508501/01/2021 04/25/2024
CHC17157-00OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983801/01/2021  
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CARLSBADCA92010-660801/01/2021 05/27/2022
CHC17157-02OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CHC17157-06OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CHC17157-09OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
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CHC17157-07OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
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CHC17157-01OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
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OVERLAND PARKKS66211-983810/01/2024  
CHC17157-08OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CHC17157-00OVERLAKE PHARMACY, LLC4124 148TH AVE NE STE JA
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CHC17157-00OWENSBORO FAMILY PHARMACY AND WELLNESS720 W BYERS AVE
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CHC17157-00PDC, LLCPRINCETON DRUG STORE 103 W MAIN ST
PRINCETONKY4244501/12/2018  
CHC17157-08PDC, LLCPRINCETON DRUG STORE 103 W MAIN ST
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CHC17157-00PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310109/08/2020 08/04/2023
CHC17157-01POOLE'S PHARMACY CARE311 HENTON ST
LIVERMOREKY42352-212607/30/2010  
CHC17157-00POOLE'S PHARMACY CARE4333 SPRINGHILL DR STE 101
OWENSBOROKY4230310/01/2016  
CHC17157-00POOLE'S PHARMACY CARE311 HENTON ST
LIVERMOREKY42352-212610/01/2016  
CHC17157-04POOLE'S PHARMACY CARE4333 SPRINGHILL DR STE 101
OWENSBOROKY4230307/01/2015  
CHC17157-00PRINCETON DRUG CORODNEY P. WHITTINGTON 103 MAIN STREET
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CHC17157-00RITE AID OF KENTUCKY, INC.RITE AID #3439 115 STATE ROUTE 81 NORTH
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CHC17157-00SACRAMENTO PHARMACYASCLEPION INC. 750 MAIN STREET HIGHWAY 81
SACRAMENTOKY4237207/01/2017 02/03/2020
CHC17157-00SENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
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CHC17157-00SINA DRUG LLCD/B/A ONCO 360 13410 EASTPOINT CENTRE DR
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CHC17157-00T & T DRUGS INCT&T DRUGS 1331 CLAY ST
HENDERSONKY4242001/01/2018 10/31/2018
CHC17157-00THRIFTY PHARMACY127 E MAIN ST
PROVIDENCEKY4245007/30/2010  
CHC17157-02THRIFTY PHARMACY127 E MAIN ST
PROVIDENCEKY4245004/01/2023  
CHC17157-00TRUEPILL3121 DIABLO AVE
HAYWARDCA9454509/08/2020 08/01/2023
CHC17157-00US BIOSERVICESUS BIOSERVICE CORPORATION 5025 PLANO PARKWAY
STE 100 		CARROLLTONTX7501010/01/2020 09/30/2022
CHC17157-00WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
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CHC17157-00WAL-MART PHARMACY #10-06941195 BARRETT BLVD
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CHC17157-00WAL-MART PHARMACY 10-02041500 US 62 WEST
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CHC17157-00WAL-MART PHARMACY 10-02041500 US 62 WEST
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CHC17157-08WAL-MART PHARMACY 10-02041500 US 62 WEST
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CHC17157-00WAL-MART PHARMACY 10-0257901 US HIGHWAY 60 EAST
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CHC17157-09WAL-MART PHARMACY 10-0257901 US HIGHWAY 60 EAST
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CHC17157-00WAL-MART PHARMACY 10-0655420 FACTORY OUTLET DRIVE
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CHC17157-00WAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
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CHC17157-00WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
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CHC17157-00WALGREEN CODBA: WALGREENS #11394 1801 N MAIN ST
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CHC17157-00WALGREEN CODBA: WALGREENS #12587 679 S. MAIN ST
MADISONVILLEKY4243107/01/2013  
CHC17157-06WALGREEN CODBA: WALGREENS #12587 679 S. MAIN ST
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CHC17157-06WALGREEN CODBA: WALGREENS #11394 1801 N MAIN ST
MADISONVILLEKY4243104/01/2023  
CHC17157-00WALGREEN CO.DBA: WALGREENS # 07657 2318 FREDERICA STREET
OWENSBOROKY42301-482607/01/2013  
CHC17157-00WALGREEN CO.DBA: WALGREENS # 07925 402 2ND STREET
HENDERSONKY42420-322107/01/2013  
CHC17157-04WALGREEN CO.DBA: WALGREENS # 07657 2318 FREDERICA STREET
OWENSBOROKY42301-482607/01/2015  
CHC17157-00WALGREEN CO.WALGREENS #17444 730 MAIN ST
CALHOUNKY4232707/01/2018  
CHC17157-00WALGREEN CO.WALGREENS #19857 1355 2ND ST
HENDERSONKY4242004/01/2019 02/20/2025
CHC17157-00WALGREEN CO.WALGREENS #19331 1921 W PARRISH AVE
OWENSBOROKY42301-354207/01/2019  
CHC17157-00WALGREEN CO.WALGREENS #17148 517 N GREEN ST
HENDERSONKY4242007/01/2019  
CHC17157-01WALGREEN CO.WALGREENS #17444 730 MAIN ST
CALHOUNKY4232704/01/2023  
CHC17157-04WALGREEN CO.WALGREENS #19331 1921 W PARRISH AVE
OWENSBOROKY42301-354204/01/2023  
CHC17157-07WALGREEN CO.DBA: WALGREENS # 07925 402 2ND STREET
HENDERSONKY42420-322104/01/2023  
CHC17157-07WALGREEN CO.WALGREENS #19857 1355 2ND ST
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CHC17157-09WALGREEN CO.WALGREENS #17148 517 N GREEN ST
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CHC17157-09WALGREEN CO.WALGREENS #19857 1355 2ND ST
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CHC17157-00Walgreens Central Fill #213994132Plainfield Rd
Ste 110 		IndianapolisIN46231-702107/01/2023  
CHC17157-00WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
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CHC17157-00WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
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CHC17157-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
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CHC17157-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-01WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-04WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-04WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
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CHC17157-08WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
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CHC17157-09WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
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CHC17157-07WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2024  
CHC17157-08WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-02WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2024  
CHC17157-09WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
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CHC17157-07WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-02WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-08WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
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CHC17157-06WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
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CHC17157-01WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2024  
CHC17157-00WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275607/01/2023  
CHC17157-00Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
CHC17157-00WILSON FAMILY PHARMACY INC2845 W PARRISH AVE STE E
OWENSBOROKY42301-333701/01/2021 12/31/2021
CHC17157-00WOODBURN PHARMACYWOODBURN PHARMACY, LLC 400 E ARCADIA AVE
DAWSON SPRINGSKY4240801/01/2020  
CHC17157-06WOODBURN PHARMACYWOODBURN PHARMACY, LLC 400 E ARCADIA AVE
DAWSON SPRINGSKY4240804/01/2023  
CHC17157-08WOODBURN PHARMACYWOODBURN PHARMACY, LLC 400 E ARCADIA AVE
DAWSON SPRINGSKY4240804/01/2023  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/29/2024 2:53:08 PM2/13/2025 10:23:05 AM2/13/2025 10:23 AM
DetailsLast Recertification DateUpdateRecertification2/6/2023 12:05:56 PM1/29/2024 2:53:08 PM1/29/2024 2:53 PM
DetailsLast Recertification DateUpdateRecertification2/1/2022 11:50:17 AM2/6/2023 12:05:56 PM2/6/2023 12:05 PM
DetailsLast Recertification DateUpdateRecertification2/3/2021 10:45:18 AM2/1/2022 11:50:17 AM2/1/2022 11:50 AM
Medicaid BillingNPI: StateUpdateRecertification KY2/3/2021 10:45 AM
Medicaid BillingNPI: StateUpdateRecertification KY2/3/2021 10:45 AM
DetailsLast Recertification DateUpdateRecertification2/3/2020 10:24:23 AM2/3/2021 10:45:18 AM2/3/2021 10:45 AM
DetailsEntity SubnameUpdateChange RequestRegional Health Care Affiliates, Inc. DBA The Neel Clinc - Health First Community Health CenterRegional Health Care Affiliates, Inc. dba Health First Community Health Center- Neel Clinic11/24/2020 7:58 AM
DetailsLast Recertification DateUpdateRecertification2/5/2019 2:38:20 PM2/3/2020 10:24:23 AM2/3/2020 10:24 AM
Medicaid BillingNPI: NumberInsertChange Request 15880580693/25/2019 5:10 PM
DetailsLast Recertification DateUpdateRecertification2/7/2018 3:23:41 PM2/5/2019 2:38:20 PM2/5/2019 2:38 PM
Medicaid BillingNPI: NumberUpdateChange Request1588058069155869255810/24/2018 7:10 PM
DetailsLast Recertification DateUpdateRecertification2/13/2017 12:00:00 AM2/7/2018 3:23:41 PM2/7/2018 3:23 PM
ContactsAuthorizing OfficialUpdateChange RequestLangston, LeAnn CEO Regional Health Care Affliliates DBA Health First Community Health Center 2706677017-2101Gobin, Shelley Renea CEO Regional Health Care Affiliates dba Health First Community Health Center 2706672535-21041/3/2018 3:36 PM
DetailsIs Authorizing Official EHB DataUpdateChange RequestFalse 1/3/2018 3:36 PM
ContactsAuthorizing OfficialUpdate Langston, LeAnn CEO 2706677017-2101Langston, LeAnn CEO Regional Health Care Affliliates DBA Health First Community Health Center 2706677017-21019/25/2017 11:01 AM
ContactsPrimary ContactUpdate Alexander, Ronnah Chief Pharmacy Officer 2706677017-2107Alexander, Ronnah Ann Chief Pharmacy Officer Regional Health Care Affiliates dba Health First Community Health Center 2706677017-21079/25/2017 10:46 AM
ContactsAuthorizing OfficialInsert  Langston, LeAnn CEO 2706677017-21018/3/2017 8:45 AM
ContactsPrimary ContactUpdate Smith, Jane Chief Pharmacy Officer 2706677017-2026Alexander, Ronnah Chief Pharmacy Officer 2706677017-21078/3/2017 8:45 AM
ContactsSigned ByInsert  Smith, Bill CEO 2706677017-21018/3/2017 8:45 AM
AddressesMain AddressInsert   2816 VEACH RD STE 205 OWENSBORO, KY 42303-62997/18/2017 1:54 PM
AddressesBilling AddressInsert  Regional Health Care Affiliates, Inc. 215 East Main Street Providence, KY 42450-12617/18/2017 1:54 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False7/18/2017 1:53 PM
Medicaid BillingMedicaid: NumberInsert  71001112207/18/2017 1:53 PM
Medicaid BillingMedicaid: StateInsert  KY7/18/2017 1:53 PM
Medicaid BillingNPI: NumberInsert  15880580697/18/2017 1:53 PM
DetailsLast Recertification DateUpdate 3/1/2016 12:00:00 AM2/13/2017 12:00:00 AM2/13/2017 11:21 AM
ContactsPrimary ContactInsert  Smith, Jane Chief Pharmacy Officer 2706677017-20262/12/2017 8:37 AM
DetailsLast Recertification DateUpdate  3/1/2016 12:00:00 AM3/1/2016 4:53 PM
DatesParticipating Approval DateUpdate  1/20/2015 12:00:00 AM1/20/2015 4:10 PM
DetailsStateUpdate PendingActive1/20/2015 4:10 PM
DatesStart DateUpdate  4/1/2015 12:00:00 AM1/20/2015 4:10 PM
Details340B IDUpdate ONLINE_REG_48864CHC17157-041/13/2015 3:06 PM
Details340B IDUpdate ONLINE_REGONLINE_REG_488641/13/2015 12:33 PM
DetailsLast Recertification DateInsert   1/13/2015 12:33 PM
DetailsGrant NumberInsert  H80CS171571/13/2015 12:33 PM
Details340B IDInsert  ONLINE_REG1/13/2015 12:33 PM
DetailsIs Authorizing Official EHB DataInsert  False1/13/2015 12:33 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/13/2015 12:33 PM
DetailsMedicare Provider NumberInsert   1/13/2015 12:33 PM
DetailsEntity NameInsert  REGIONAL HEALTH CARE AFFILIATES, INC.1/13/2015 12:33 PM
DetailsProgram CodeInsert  CH1/13/2015 12:33 PM
DetailsEntity SubnameInsert  Regional Health Care Affiliates, Inc. DBA The Neel Clinc - Health First Community Health Center1/13/2015 12:33 PM
DatesParticipating Approval DateInsert   1/13/2015 12:33 PM
DetailsStateInsert  Pending1/13/2015 12:33 PM
DatesRegistration DateInsert  1/13/2015 12:00:00 AM1/13/2015 12:33 PM
DatesSigned By DateInsert  1/13/2015 12:00:00 AM1/13/2015 12:33 PM
DatesStart DateInsert   1/13/2015 12:33 PM
TerminationsTermination CommentsInsert   1/13/2015 12:33 PM
TerminationsTermination DateInsert   1/13/2015 12:33 PM
TerminationsTermination Effective DateInsert   1/13/2015 12:33 PM
TerminationsTermination ReasonInsert   1/13/2015 12:33 PM