340B Drug Pricing Program Database


CH05182C CARE ALLIANCE (Active) - information as of 5/17/2025 10:58:47 PM

Main Details
CARE ALLIANCE
Central Neighborhood Clinic
HRSA-Funded Health Center
BPS-H80-014733
CH05182C
H80CS00029


Additional Details
Active
4/10/2015
7/1/2015
4/15/2015
2/10/2025

Contacts

Care Alliance Health Center
Derrick Howell, Chief Financial Officer
(216) 644-6368

Care Alliance
Lori Bush, Director of Pharmacy
(216) 535-9100

Addresses

2916 Central Ave
Cleveland, OH 44115

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
OH0143127,01329461023406469,1588049779
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381004/15/201507/01/2015 08/01/201608/31/2016
Contract DetailDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/20/201710/01/2017  10/01/2017
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH051820ActiveBPS-H80-003561CARE ALLIANCECARE ALLIANCE HEALTH CENTER1530 Saint Clair Ave NE ClevelandOH
CH05182AActiveBPS-H80-006937CARE ALLIANCECARE ALLIANCE HEALTH CENTER6001 WOODLAND AVE CLEVELANDOH
CH05182BTerminatedBPS-H80-006520CARE ALLIANCERIVERVIEW TOWERS CLINIC1795 W 25TH ST CLEVELANDOH
CH05182CActiveBPS-H80-014733CARE ALLIANCECentral Neighborhood Clinic2916 Central Ave ClevelandOH
CH05182DActiveBPS-H80-014530CARE ALLIANCEMobile Clinic1530 Saint Clair Ave NE ClevelandOH
CH05182EActiveBPS-H80-027258CARE ALLIANCECAHC East Technical High School2439 E 55th St, FL 1 ClevelandOH
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH051820DAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381008/14/2000 08/01/2016
CH051820DAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/01/2017 05/04/2017
CH051820DAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381010/01/2017  
CH05182ADAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/01/2015 08/01/2016
CH05182ADAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381010/01/2017  
CH05182BDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/01/2015 08/01/2016
CH05182BDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381010/01/2017 04/01/2021
CH05182DDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/01/2015 08/01/2016
CH05182DDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381010/01/2017  
CH05182CDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381007/01/2015 08/01/2016
CH05182CDAVE'S SUPER MARKET1929 E 61ST ST.
CLEVELANDOH44103-381010/01/2017  
CH051820WALGREEN CO.DBA: WALGREENS #21316 6401 BROADWAY AVE
CLEVELANDOH4410501/01/2018 11/14/2024
CH051820WALGREEN CO.DBA: WALGREENS # 03234 4281 W. 130TH STREET
CLEVELANDOH4413501/01/2018 11/07/2023
CH051820WALGREEN CO.DBA: WALGREENS #21259 14501 EUCLID AVE
EAST CLEVELANDOH44112-342601/01/2018 01/21/2025
CH051820WALGREEN CO.DBA: WALGREENS # 03256 11401 UNION AVENUE
CLEVELANDOH4410501/01/2018 10/09/2023
CH051820WALGREEN CO.DBA: WALGREENS # 21252 16100 LAKE SHORE BLVD
CLEVELANDOH44110-100101/01/2018 08/19/2024
CH051820WALGREEN CO.DBA: WALGREENS # 03308 4265 STATE RD.
CLEVELANDOH4410901/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 03310 16803 LORAIN AVE
CLEVELANDOH4411101/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 03312 22401 LAKE SHORE BLVD
EUCLIDOH4412301/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 04130 3020 MAYFIELD ROAD
CLEVELAND HEIGHTSOH4411801/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 05206 11701 DETROIT AVE
LAKEWOODOH4410701/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 06659 4071 LEE RD BLDG A-1
CLEVELANDOH4412801/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS #09407 14815 MADISON AVE.
LAKEWOODOH44107-400901/01/2018  
CH051820WALGREEN CO.DBA: WALGREENS # 12444 3415 CLARK AVENUE
CLEVELANDOH4410901/01/2018  
CH051820WALGREEN CO.WALGREENS SPECIALTY PHARMACY #16400 10001 CHESTER AVE
SUITE B 		CLEVELANDOH4410601/01/2018  
CH051820Walgreens #21423Walgreens Central Fill #21423 6275 Winchester Blvd
Canal WInchesterOH43110-653701/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/22/2024 3:18:16 PM2/10/2025 11:32:21 AM2/10/2025 11:32 AM
ContactsPrimary ContactUpdateGroup Change RequestSingrey, Derek Pharmacy Director Care Alliance Health Center 2167816228-580Bush, Lori Director of Pharmacy Care Alliance 21653591001/27/2025 7:42 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestKacki, Anna Controller Care Alliance 2165359100-252Howell, Derrick Chief Financial Officer Care Alliance Health Center 21664463681/27/2025 7:42 AM
DetailsLast Recertification DateUpdateRecertification2/6/2023 11:11:45 AM2/22/2024 3:18:16 PM2/22/2024 3:18 PM
ContactsAuthorizing OfficialUpdateAO Change RequestJones, Claude L. PRESIDENT / CEO CARE ALLIANCE 2165359100Kacki, Anna Controller Care Alliance 2165359100-25210/4/2023 11:38 AM
DetailsLast Recertification DateUpdateRecertification2/28/2022 2:47:45 PM2/6/2023 11:11:45 AM2/6/2023 11:11 AM
DetailsLast Recertification DateUpdateRecertification2/17/2021 8:29:05 AM2/28/2022 2:47:45 PM2/28/2022 2:47 PM
Medicaid BillingNPI: NumberDeleteRecertification1023406469 ( ) 2/17/2021 8:29 AM
Medicaid BillingNPI: NumberDeleteRecertification1588049779 ( ) 2/17/2021 8:29 AM
Medicaid BillingNPI: NumberInsertRecertification 10234064692/17/2021 8:29 AM
Medicaid BillingNPI: StateInsertRecertification OH2/17/2021 8:29 AM
Medicaid BillingNPI: NumberInsertRecertification 15880497792/17/2021 8:29 AM
Medicaid BillingNPI: StateInsertRecertification OH2/17/2021 8:29 AM
DetailsLast Recertification DateUpdateRecertification2/18/2020 8:40:18 AM2/17/2021 8:29:05 AM2/17/2021 8:29 AM
DetailsLast Recertification DateUpdateRecertification1/29/2019 9:44:45 AM2/18/2020 8:40:18 AM2/18/2020 8:40 AM
ContactsAuthorizing OfficialUpdateAO Change RequestSawyers, Eleace President & CEO Care Alliance Health Center 2167816228-243Jones, Claude L. PRESIDENT / CEO CARE ALLIANCE 21653591002/4/2020 11:48 AM
DetailsLast Recertification DateUpdateRecertification2/16/2018 10:40:05 PM1/29/2019 9:44:45 AM1/29/2019 9:44 AM
ContactsPrimary ContactUpdateChange RequestBeaty, Virginia Pharmacy Manager Care Alliance 2167816724-580Singrey, Derek Pharmacy Director Care Alliance Health Center 2167816228-58011/3/2018 11:49 AM
DetailsIs Authorizing Official EHB DataUpdateChange RequestFalse 11/3/2018 11:49 AM
ContactsAuthorizing OfficialUpdateChange RequestSawyers, Eleace President & CEO Care Alliance Health Center 2167816228Sawyers, Eleace President & CEO Care Alliance Health Center 2167816228-24311/3/2018 11:37 AM
ContactsAuthorizing OfficialUpdateAO Change RequestByrne, Terrance K. Chief Operating Officer Care Alliance Health Center 2167816228-227Sawyers, Eleace President & CEO Care Alliance Health Center 216781622810/19/2018 2:22 PM
DetailsLast Recertification DateUpdateRecertification2/1/2017 12:00:00 AM2/16/2018 10:40:05 PM2/16/2018 10:40 PM
ContactsPrimary ContactUpdate Beaty, Virginia Pharmacy Manager 2167816724-580Beaty, Virginia Pharmacy Manager Care Alliance 2167816724-58010/3/2017 1:42 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestByrne, Terrance K. Director of Operations Care Alliance Health Center 2167816228-227Byrne, Terrance K. Chief Operating Officer Care Alliance Health Center 2167816228-2279/29/2017 9:19 AM
ContactsAuthorizing OfficialUpdate Byrne, Terrance K. Director of Operations 2167816228-227Byrne, Terrance K. Director of Operations Care Alliance Health Center 2167816228-2279/29/2017 9:17 AM
ContactsAuthorizing OfficialInsert  Byrne, Terrance K. Director of Operations 2167816228-2277/20/2017 12:14 PM
ContactsPrimary ContactInsert  Beaty, Virginia Pharmacy Manager 2167816724-5802/22/2017 1:13 PM
ContactsSigned ByInsert  Afram-Gyening, Francis Chief Executive Officer 2167816228-2532/2/2017 8:25 AM
AddressesMain AddressInsert   2916 Central Ave Cleveland, OH 441152/1/2017 2:15 PM
DetailsLast Recertification DateUpdate 3/4/2016 12:00:00 AM2/1/2017 12:00:00 AM2/1/2017 2:15 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False4/21/2016 11:24 AM
Medicaid BillingMedicaid: NumberInsert  01329464/21/2016 11:24 AM
Medicaid BillingMedicaid: StateInsert  OH4/21/2016 11:24 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False3/4/2016 10:38 AM
Medicaid BillingMedicaid: NumberInsert  01431273/4/2016 10:38 AM
Medicaid BillingMedicaid: StateInsert  OH3/4/2016 10:38 AM
Medicaid BillingNPI: NumberInsert  15880497793/4/2016 10:38 AM
DetailsLast Recertification DateUpdate  3/4/2016 12:00:00 AM3/4/2016 10:38 AM
DatesParticipating Approval DateUpdate  4/15/2015 12:00:00 AM4/15/2015 6:01 PM
DetailsStateUpdate PendingActive4/15/2015 6:01 PM
DatesStart DateUpdate  7/1/2015 12:00:00 AM4/15/2015 6:01 PM
Details340B IDUpdate ONLINE_REG_51037CH05182C4/13/2015 8:12 AM
Details340B IDUpdate ONLINE_REGONLINE_REG_510374/10/2015 10:32 AM
Medicaid BillingNPI: NumberInsert  10234064694/10/2015 10:32 AM
DetailsLast Recertification DateInsert   4/10/2015 10:32 AM
DetailsGrant NumberInsert  H80CS000294/10/2015 10:32 AM
Details340B IDInsert  ONLINE_REG4/10/2015 10:32 AM
DetailsIs Authorizing Official EHB DataInsert  False4/10/2015 10:32 AM
DatesLast Date That 340B Drugs PurchasedInsert   4/10/2015 10:32 AM
DetailsMedicare Provider NumberInsert   4/10/2015 10:32 AM
DetailsEntity NameInsert  CARE ALLIANCE4/10/2015 10:32 AM
DetailsProgram CodeInsert  CH4/10/2015 10:32 AM
DetailsEntity SubnameInsert  Central Neighborhood Clinic4/10/2015 10:32 AM
DatesParticipating Approval DateInsert   4/10/2015 10:32 AM
DetailsStateInsert  Pending4/10/2015 10:32 AM
DatesRegistration DateInsert  4/10/2015 12:00:00 AM4/10/2015 10:32 AM
DatesSigned By DateInsert  4/10/2015 12:00:00 AM4/10/2015 10:32 AM
DatesStart DateInsert   4/10/2015 10:32 AM
TerminationsTermination CommentsInsert   4/10/2015 10:32 AM
TerminationsTermination DateInsert   4/10/2015 10:32 AM
TerminationsTermination Effective DateInsert   4/10/2015 10:32 AM
TerminationsTermination ReasonInsert   4/10/2015 10:32 AM