Covered Entity Details

CHC28351-00 FAMILY HEALTH SERVICES OF ERIE COUNTY (Active) - information as of 6/27/2025 12:26:19 AM

Main Details

Name

FAMILY HEALTH SERVICES OF ERIE COUNTY

Subdivision Name

Family Health Services of Erie County, Inc.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-014958

340B ID

CHC28351-00

Grant Number

H80CS28351

Additional Details

Current Program Status

Active

Registration Date

7/13/2015

Participating Start Date

10/1/2015

Participating Approval Date

7/14/2015

Last Recertification Date

2/14/2025

Contacts

Authorizing Official

Family Health Services of Erie County
David Tatro, CEO
(419) 502-2822

Primary Contact

Family Health Services of Erie County
MarLana Binkley, Director of Finance
(419) 502-2819

Addresses

Street Address

1912 Hayes Ave
Sandusky, OH 44870

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

Family Health Services of Erie County
McKeen Pharmacy
149 E Water St 3rd Fl
Sandusky, OH 44870-2525

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	01/15/2021	04/01/2021		04/01/2021
Contract Detail	DISCOUNT DRUG MART #37	84 WHITTLESEY AVE		NORWALK	OH	44857	07/14/2015	10/01/2015	10/01/2017	03/27/2018
Contract Detail	DISCOUNT DRUG MART INC #14	3700 MILAN RD		SANDUSKY	OH	44870	07/14/2015	10/01/2015		07/14/2015
Contract Detail	DISCOUNT DRUG MART INC #24	STORE #24	420 CLEVELAND ROAD E	HURON	OH	44839	07/14/2015	10/01/2015		07/14/2015
Contract Detail	GENOA HEALTHCARE LLC	800 COMMERCE DR STE 115	P.O. BOX 209	PERRYSBURG	OH	43551	04/07/2025	07/01/2025		04/07/2025
Contract Detail	GENOA HEALTHCARE LLC	1010 N PROSPECT ST STE 56	P.O. BOX 409	BOWLING GREEN	OH	43402	04/07/2025	07/01/2025		04/07/2025
Contract Detail	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	10/08/2019	01/01/2020		01/01/2020
Contract Detail	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 02345	513 EAST MONROE STREET	SANDUSKY	OH	44870	07/12/2017	10/01/2017	03/31/2019	04/09/2019
Contract Detail	OHIO CVS STORES, L.L.C.	CVS PHARMACY # 17241	4020 MILAN RD	SANDUSKY	OH	44870	04/09/2019	07/01/2019		07/01/2019
Contract Detail	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 02345	513 EAST MONROE STREET	SANDUSKY	OH	44870	10/15/2019	10/15/2019		10/18/2019
Contract Detail	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 06173	106 MILAN AVE.	NORWALK	OH	44857	07/09/2020	10/01/2020		10/01/2020
Contract Detail	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 06177	201 WEST MAIN STREET	BELLEVUE	OH	44811	01/18/2022	04/01/2022		04/01/2022
Contract Detail	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/14/2022	01/01/2023		01/01/2023
Contract Detail	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	10/14/2022	01/01/2023		01/01/2023
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	04/15/2022	04/15/2022		04/21/2022
Contract Detail	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	10/14/2022	01/01/2023		01/01/2023
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/15/2021	04/01/2021		04/01/2021
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/15/2021	04/01/2021		04/01/2021
Contract Detail	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/15/2021	04/01/2021		04/01/2021
Contract Detail	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	10/14/2022	01/01/2023		01/01/2023
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	10/14/2022	01/01/2023		01/01/2023
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	01/15/2021	04/01/2021		04/01/2021
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	10/14/2022	01/01/2023		01/01/2023
Contract Detail	RITE AID OF OHIO, INC.	RITE AID #4937	334 W PERKINS AVE	SANDUSKY	OH	44870-4804	07/06/2020	10/01/2020	06/24/2024	07/15/2024
Contract Detail	RITE AID OF OHIO, INC.	RITE AID #3180	1420 SYCAMORE LINE ROAD	SANDUSKY	OH	44870	07/06/2020	10/01/2020	09/19/2023	10/02/2023
Contract Detail	RITE AID OF OHIO, INC.	RITE AID #1433	99 WHITTLESEY AVENUE	NORWALK	OH	44857	07/06/2020	10/01/2020	07/31/2024	08/05/2024
Contract Detail	RITE AID OF OHIO, INC.	RITE AID #3357	4 EAST WALTON STREET	WILLARD	OH	44890	04/15/2022	07/01/2022	09/15/2023	10/03/2023
Contract Detail	THE KROGER PHARMACY #858	226 E. PERKINS AVE		SANDUSKY	OH	44870	07/14/2015	10/01/2015		07/14/2015
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/23/2017	04/01/2017		01/23/2017
Contract Detail	WAL-MART PHARMACY 10-1445	2826 E. HARBOR ROAD		PORT CLINTON	OH	43452	07/14/2015	10/01/2015	10/01/2017	03/27/2018
Contract Detail	WAL-MART PHARMACY 10-1628	5500 MILAN RD SUITE 200		SANDUSKY	OH	44870	07/14/2015	10/01/2015		07/14/2015
Contract Detail	WAL-MART PHARMACY 10-1986	340 WEST WIND DR		NORWALK	OH	44857	07/14/2015	10/01/2015	10/01/2017	03/27/2018
Contract Detail	WAL-MART PHARMACY 10-1986	340 WEST WIND DR		NORWALK	OH	44857	10/17/2022	01/01/2023	09/06/2023	10/02/2023
Contract Detail	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	07/15/2020	10/01/2020		10/01/2020
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/23/2017	04/01/2017		01/23/2017
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/06/2023	07/01/2023		07/01/2023
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/11/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC28351-00	Active	BPS-H80-014958	FAMILY HEALTH SERVICES OF ERIE COUNTY	Family Health Services of Erie County, Inc.	1912 Hayes Ave	Sandusky	OH
CHC28351-01	Active	BPS-H80-021118	FAMILY HEALTH SERVICES OF ERIE COUNTY	FHS – Adult Medicine	620 E. Water St., Suite A	Sandusky	OH
CHC28351-02	Terminated	BPS-H80-027145	FAMILY HEALTH SERVICES OF ERIE COUNTY	FHS - OB/GYN	1912 Hayes Ave STE E	Sandusky	OH
CHC28351-03	Active	BPS-H80-029457	FAMILY HEALTH SERVICES OF ERIE COUNTY	FHS - Sandusky High School	2130A Hayes Ave Rm 152	Sandusky	OH
CHC28351-04	Terminated	BPS-H80-031444	FAMILY HEALTH SERVICES OF ERIE COUNTY	FHS Norwalk Behavioral Health Clinic	282 Benedict Ave Ste C	Norwalk	OH
CHC28351-05	Active	BPS-H80-032947	FAMILY HEALTH SERVICES OF ERIE COUNTY	FHS Norwalk - 265 Benedict Ave	265 Benedict Ave	Norwalk	OH
CHC28351-06	Active	BPS-H80-038499	FAMILY HEALTH SERVICES OF ERIE COUNTY	Family Health Services Medical Center	149 E Water St	Sandusky	OH

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28351-00	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	04/01/2021
CHC28351-00	DISCOUNT DRUG MART #37	84 WHITTLESEY AVE		NORWALK	OH	44857	10/01/2015	10/01/2017
CHC28351-00	DISCOUNT DRUG MART INC #14	3700 MILAN RD		SANDUSKY	OH	44870	10/01/2015
CHC28351-00	DISCOUNT DRUG MART INC #24	STORE #24	420 CLEVELAND ROAD E	HURON	OH	44839	10/01/2015
CHC28351-00	GENOA HEALTHCARE LLC	800 COMMERCE DR STE 115	P.O. BOX 209	PERRYSBURG	OH	43551	07/01/2025
CHC28351-00	GENOA HEALTHCARE LLC	1010 N PROSPECT ST STE 56	P.O. BOX 409	BOWLING GREEN	OH	43402	07/01/2025
CHC28351-00	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	01/01/2020
CHC28351-00	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 02345	513 EAST MONROE STREET	SANDUSKY	OH	44870	10/01/2017	03/31/2019
CHC28351-00	OHIO CVS STORES, L.L.C.	CVS PHARMACY # 17241	4020 MILAN RD	SANDUSKY	OH	44870	07/01/2019
CHC28351-00	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 02345	513 EAST MONROE STREET	SANDUSKY	OH	44870	10/15/2019
CHC28351-00	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 06173	106 MILAN AVE.	NORWALK	OH	44857	10/01/2020
CHC28351-00	OHIO CVS STORES, L.L.C.	DBA: CVS/PHARMACY # 06177	201 WEST MAIN STREET	BELLEVUE	OH	44811	04/01/2022
CHC28351-00	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/01/2023
CHC28351-00	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2023
CHC28351-00	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	04/15/2022
CHC28351-00	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	01/01/2023
CHC28351-00	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2021
CHC28351-00	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2021
CHC28351-00	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	04/01/2021
CHC28351-00	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	01/01/2023
CHC28351-00	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	01/01/2023
CHC28351-00	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	04/01/2021
CHC28351-00	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2023
CHC28351-00	RITE AID OF OHIO, INC.	RITE AID #4937	334 W PERKINS AVE	SANDUSKY	OH	44870-4804	10/01/2020	06/24/2024
CHC28351-00	RITE AID OF OHIO, INC.	RITE AID #3180	1420 SYCAMORE LINE ROAD	SANDUSKY	OH	44870	10/01/2020	09/19/2023
CHC28351-00	RITE AID OF OHIO, INC.	RITE AID #1433	99 WHITTLESEY AVENUE	NORWALK	OH	44857	10/01/2020	07/31/2024
CHC28351-00	RITE AID OF OHIO, INC.	RITE AID #3357	4 EAST WALTON STREET	WILLARD	OH	44890	07/01/2022	09/15/2023
CHC28351-00	THE KROGER PHARMACY #858	226 E. PERKINS AVE		SANDUSKY	OH	44870	10/01/2015
CHC28351-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2017
CHC28351-00	WAL-MART PHARMACY 10-1445	2826 E. HARBOR ROAD		PORT CLINTON	OH	43452	10/01/2015	10/01/2017
CHC28351-00	WAL-MART PHARMACY 10-1628	5500 MILAN RD SUITE 200		SANDUSKY	OH	44870	10/01/2015
CHC28351-00	WAL-MART PHARMACY 10-1986	340 WEST WIND DR		NORWALK	OH	44857	10/01/2015	10/01/2017
CHC28351-00	WAL-MART PHARMACY 10-1986	340 WEST WIND DR		NORWALK	OH	44857	01/01/2023	09/06/2023
CHC28351-00	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	10/01/2020
CHC28351-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2017
CHC28351-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CHC28351-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/2/2024 11:48:10 AM	2/14/2025 10:19:18 AM	2/14/2025 10:19 AM
Contacts	Primary Contact	Update	PC Change Request	Myerholtz, Katherine Associate Medical Director Family Health Services of Erie County 4195022826	Binkley, MarLana Director of Finance Family Health Services of Erie County 4195022819	7/11/2024 6:04 PM
Addresses	Shipping Address	Insert	Change Request		Family Health Services of Erie County McKeen Pharmacy 149 E Water St 3rd Fl Sandusky, OH 44870-2525	5/7/2024 11:34 AM
Details	Last Recertification Date	Update	Recertification	2/13/2023 9:08:25 AM	2/2/2024 11:48:10 AM	2/2/2024 11:48 AM
Details	Last Recertification Date	Update	Recertification	2/3/2022 11:39:40 AM	2/13/2023 9:08:25 AM	2/13/2023 9:08 AM
Details	Last Recertification Date	Update	Recertification	2/8/2021 9:12:14 AM	2/3/2022 11:39:40 AM	2/3/2022 11:39 AM
Details	Last Recertification Date	Update	Recertification	2/17/2020 8:40:20 AM	2/8/2021 9:12:14 AM	2/8/2021 9:12 AM
Details	Last Recertification Date	Update	Recertification	1/29/2019 9:13:58 AM	2/17/2020 8:40:20 AM	2/17/2020 8:40 AM
Contacts	Primary Contact	Update	Change Request	Robinson, Maria E CFO Family Health Services of Erie County 4195022832	Myerholtz, Katherine Associate Medical Director Family Health Services of Erie County 4195022826	9/23/2019 3:18 PM
Contacts	Authorizing Official	Update	Change Request	Rumschlag, Betty Interim CEO FHS 4195022800	Tatro, David CEO Family Health Services of Erie County 4195022822	9/23/2019 3:18 PM
Contacts	Authorizing Official	Update	Change Request	Branum, Donald Chief Executive Officer Family Health Services of Erie County 4195022822	Rumschlag, Betty Interim CEO FHS 4195022800	1/31/2019 3:13 PM
Details	Last Recertification Date	Update	Recertification	2/7/2018 1:48:40 PM	1/29/2019 9:13:58 AM	1/29/2019 9:13 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	3119682 (OH)		4/24/2018 1:22 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1689970527 ( )		4/24/2018 1:22 PM
Details	Last Recertification Date	Update	Recertification	2/15/2017 12:00:00 AM	2/7/2018 1:48:40 PM	2/7/2018 1:48 PM
Contacts	Primary Contact	Insert	Change Request		Robinson, Maria E CFO Family Health Services of Erie County 4195022832	11/6/2017 1:41 PM
Details	Is Authorizing Official EHB Data	Update	Change Request	False		11/6/2017 1:41 PM
Contacts	Authorizing Official	Update		Branum, Donald Chief Executive Officer 4195022822	Branum, Donald Chief Executive Officer Family Health Services of Erie County 4195022822	11/6/2017 12:08 PM
Contacts	Authorizing Official	Insert			Branum, Donald Chief Executive Officer 4195022822	7/12/2017 2:49 PM
Addresses	Main Address	Insert			1912 Hayes Ave Sandusky, OH 44870	2/15/2017 10:36 AM
Contacts	Signed By	Insert			Forney, Wilson Chief Executive Officer 4195022818	2/15/2017 10:36 AM
Details	Last Recertification Date	Update		3/3/2016 12:00:00 AM	2/15/2017 12:00:00 AM	2/15/2017 10:36 AM
Details	Last Recertification Date	Update			3/3/2016 12:00:00 AM	3/3/2016 2:05 PM
Dates	Participating Approval Date	Update			7/14/2015 12:00:00 AM	7/14/2015 5:06 PM
Details	State	Update		Pending	Active	7/14/2015 5:06 PM
Dates	Start Date	Update			10/1/2015 12:00:00 AM	7/14/2015 5:06 PM
Details	340B ID	Update		ONLINE_REG_53457	CHC28351-00	7/14/2015 1:10 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_53457	7/13/2015 5:09 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/13/2015 5:09 PM
Medicaid Billing	Medicaid: Number	Insert			3119682	7/13/2015 5:09 PM
Medicaid Billing	Medicaid: State	Insert			OH	7/13/2015 5:09 PM
Medicaid Billing	NPI: Number	Insert			1689970527	7/13/2015 5:09 PM
Details	Last Recertification Date	Insert				7/13/2015 5:09 PM
Details	Grant Number	Insert			H80CS28351	7/13/2015 5:09 PM
Details	340B ID	Insert			ONLINE_REG	7/13/2015 5:09 PM
Details	Is Authorizing Official EHB Data	Insert			False	7/13/2015 5:09 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/13/2015 5:09 PM
Details	Medicare Provider Number	Insert				7/13/2015 5:09 PM
Details	Entity Name	Insert			FAMILY HEALTH SERVICES OF ERIE COUNTY	7/13/2015 5:09 PM
Details	Program Code	Insert			CH	7/13/2015 5:09 PM
Details	Entity Subname	Insert			Family Health Services of Erie County, Inc.	7/13/2015 5:09 PM
Dates	Participating Approval Date	Insert				7/13/2015 5:09 PM
Details	State	Insert			Pending	7/13/2015 5:09 PM
Dates	Registration Date	Insert			7/13/2015 12:00:00 AM	7/13/2015 5:09 PM
Dates	Signed By Date	Insert			7/13/2015 12:00:00 AM	7/13/2015 5:09 PM
Dates	Start Date	Insert				7/13/2015 5:09 PM
Terminations	Termination Comments	Insert				7/13/2015 5:09 PM
Terminations	Termination Date	Insert				7/13/2015 5:09 PM
Terminations	Termination Effective Date	Insert				7/13/2015 5:09 PM
Terminations	Termination Reason	Insert				7/13/2015 5:09 PM

340B Drug Pricing Program Database