Covered Entity Details

CHC28348-00 APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS (Active) - information as of 5/28/2025 5:19:15 PM

Main Details

Name

APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS

Subdivision Name

Dale Fell Community Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-036714

340B ID

CHC28348-00

Grant Number

H80CS28348

Additional Details

Current Program Status

Active

Registration Date

7/15/2016

Participating Start Date

10/1/2016

Participating Approval Date

7/20/2016

Last Recertification Date

2/12/2025

Contacts

Authorizing Official

Appalachian Mountain Community Health Centers
Shantelle Simpson, CEO
(828) 202-5200 Ext: 3865

Primary Contact

Appalachian Mountain Community Health Center
David Steven Taylor, Director of Pharmacy Operations
(843) 543-0004

Addresses

Street Address

77 McDowell Street
Asheville, NC 28801-4435

Billing Address

Appalachian Mountain Community Health Centers
141 Asheland Ave
300
Asheville, NC 28801

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?
Yes

State	Medicaid Number	NPI Number
NC	1376822619,1720676950,1407628043,1487451381	1376822619,1720676950,1407628043,1487451381

Shipping Addresses

Shipping Address 1

Southside Pharmacy
77 McDowell Street
Asheville, NC 28801

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AFFINITY SPECIALTY PHARMACY	DBA SONA SPECIALTY PHARMACY	1070 TUNNEL RD BLDG 3	ASHEVILLE	NC	28805-2014	04/02/2019	07/01/2019	01/01/2025	01/06/2025
Contract Detail	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	10/10/2018	01/01/2019	04/01/2020	06/30/2020
Contract Detail	APPALACHIAN SPECIALTY PHARMACY	932 HENDERSONVILLE RD STE 106		ASHEVILLE	NC	28803-6619	04/12/2019	07/01/2019	07/01/2022	08/12/2022
Contract Detail	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	10/17/2016	01/01/2017	09/30/2017	10/16/2017
Contract Detail	ASHEVILLE DISCOUNT PHARMACY	76 PATTON AVE		ASHEVILLE	NC	28801-3315	04/12/2018	07/01/2018	01/01/2025	01/06/2025
Contract Detail	AVELLA OF DEER VALLEY	23620 N 20TH DR #12		PHOENIX	AZ	85085-0621	04/06/2018	07/01/2018	07/26/2019	07/26/2019
Contract Detail	AVELLA OF DEER VALLEY, INC. #38	DBA AVELLA SPECIALTY PHARMACY	24416 N. 19TH AVE	PHOENIX	AZ	85085	04/06/2018	07/01/2018	07/26/2019	07/26/2019
Contract Detail	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/14/2019	04/01/2019	04/01/2020	06/30/2020
Contract Detail	BROOKSHIRE PHARMACY	DBA: B & B PHARMACY	462 HAYWOOD RD	ASHEVILLE	NC	28806-4263	07/08/2019	10/01/2019		10/01/2019
Contract Detail	BRYSON CITY PHARMACY INC	200 HIGHWAY 19 S		BRYSON CITY	NC	28713	10/17/2019	01/01/2020		01/01/2020
Contract Detail	CAROLINA MOUNTAIN PHARMACY INC	CAROLINA MOUNTAIN PHARMACY	7 PISGAH HIGHWAY SUITE 100	CANDLER	NC	28715	04/14/2021	07/01/2021	03/01/2022	03/01/2022
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/05/2022	07/01/2022		07/01/2022
Contract Detail	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	04/06/2018	07/01/2018	12/03/2018	12/04/2018
Contract Detail	EASTGATE PHARMACY	93 EASTGATE DR		SYLVA	NC	28779-5171	04/17/2017	07/01/2017	05/07/2025	05/07/2025
Contract Detail	HYER HEALTH, LLC	DBA KING'S PHARMACY	16 WAYNE BROOKS LN	HAYESVILLE	NC	28904-9602	04/17/2017	07/01/2017		04/17/2017
Contract Detail	HYERCARE LLC DBA KING'S PHARMACY	30 PEACHTREE ST		MURPHY	NC	28906-2940	04/17/2017	07/01/2017		04/17/2017
Contract Detail	INGLES MARKETS #62	575 NEW LEICESTER HIGHWAY		ASHEVILLE	NC	28806-2122	04/02/2019	07/01/2019	01/01/2023	01/10/2023
Contract Detail	INGLES MARKETS PHARMACY #134	1572 SAND HILL ROAD		CANDLER	NC	28715	04/13/2021	07/01/2021	01/01/2023	01/10/2023
Contract Detail	INGLES PHARMACY #116	230 HWY 64 EAST		HAYESVILLE	NC	28904	10/17/2019	01/01/2020	03/01/2022	03/01/2022
Contract Detail	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/06/2018	07/01/2018	04/01/2020	06/30/2020
Contract Detail	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	07/20/2016	10/01/2016	02/01/2019	04/12/2019
Contract Detail	Mission Medication Assistance Pharmacy	1 Hospital Dr, Suite 2229		Asheville	NC	28801	09/14/2016	10/01/2016	02/01/2019	04/12/2019
Contract Detail	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	07/26/2016	10/01/2016	02/01/2019	04/12/2019
Contract Detail	MISSION PHARMACY - TALLULAH	MISSION MEDICAL ASSOCIATES, INC.	409 TALLULAH ROAD	ROBBINSVILLE	NC	28771	04/17/2017	07/01/2017	01/01/2019	01/07/2019
Contract Detail	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/06/2018	07/01/2018	04/01/2020	06/30/2020
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	04/05/2022	07/01/2022	05/13/2022	05/24/2022
Contract Detail	ROBBINSVILLE PHARMACY	238 RODNEY ORR BYP		ROBBINSVILLE	NC	28771	10/17/2019	01/01/2020		01/01/2020
Contract Detail	SONA HEALTH INC DBA SONA PHARMACY + CLIN	106 LONG SHOALS RD STE 100		ARDEN	NC	28704	04/15/2024	07/01/2024		07/01/2024
Contract Detail	SONA HEALTH INC DBA SONA PHARMACY + CLIN	805 FAIRVIEW RD STE 100	DBA SONA PHARMACY CLINIC	ASHEVILLE	NC	28803-1011	04/15/2024	07/01/2024		07/01/2024
Contract Detail	TURNER DISCOUNT DRUGS	451 MAIN ST		ANDREWS	NC	28901-9648	01/15/2020	04/01/2020	09/15/2023	09/20/2023
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2020	10/01/2020		10/01/2020
Contract Detail	WAL-MART PHARMACY 10-0515	93 RICK RAMSEY ST.		MURPHY	NC	28906	07/01/2020	10/01/2020		10/01/2020
Contract Detail	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	07/01/2020	10/01/2020	07/01/2020	07/01/2020
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2020	10/01/2020		10/01/2020
Contract Detail	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	01/13/2023	04/01/2023	04/08/2024	04/08/2024
Contract Detail	WALGREEN CO	WALGREENS #19160	36 SUNRISE PARK	SYLVA	NC	28779	10/01/2018	01/01/2019		01/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07823	1835 HENDERSONVILLE ROAD	ASHEVILLE	NC	28803-3236	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09458	841 MERRIMON AVENUE	ASHEVILLE	NC	28804-2404	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10212	3 S TUNNEL RD	ASHEVILLE	NC	28805	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12779	578 NEW LEICESTER HWY.	ASHEVILLE	NC	28806	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16101	286 MAIN ST	ANDREWS	NC	28901	04/16/2018	07/01/2018	02/18/2025	02/20/2025
Contract Detail	WALGREEN CO.	WALGREENS #16102	1124 PATTON AVE	ASHEVILLE	NC	28806	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16105	19 SAWMILL VILLAGE LANE	FRANKLIN	NC	28734	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16107	44 HWY. 64 WEST	HAYESVILLE	NC	28904	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16110	219 RODNEY ORR BYPASS	ROBBINSVILLE	NC	28771	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16253	1630 ANDREWS RD	MURPHY	NC	28906	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #16103	50 HIGHWAY 19	BRYSON CITY	NC	28713	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREEN CO.	WALGREENS #19219	590 RUSS AVE	WAYNESVILLE	NC	28786	04/02/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	WALGREENS #19652	244 NEW CLYDE HWY	CANTON	NC	28716	07/01/2022	10/01/2022		10/01/2022
Contract Detail	WALGREEN CO.	WALGREENS #17251	41 WESTRIDGE MARKET PL	CANDLER	NC	28715	07/01/2022	10/01/2022		10/01/2022
Contract Detail	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	07/13/2023	10/01/2023		10/01/2023
Contract Detail	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/05/2022	07/01/2022		07/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/05/2022	07/01/2022		07/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/05/2022	07/01/2022		07/01/2022
Contract Detail	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	04/16/2018	07/01/2018		04/16/2018
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/08/2024	07/01/2024		07/01/2024
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/04/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC28348-00	Active	BPS-H80-036714	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Dale Fell Community Health Center	77 McDowell Street	Asheville	NC
CHC28348-01	Terminated	BPS-H80-015099	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	South French Broad Care Center	165 S FRENCH BROAD AVE	ASHEVILLE	NC
CHC28348-02	Active	BPS-H80-015118	Appalachian Mountain Community Health Centers	May's Care Center	225 Patton Ave	Asheville	NC
CHC28348-03	Active	BPS-H80-034772	Appalachian Mountain Community Health Center	Sylva Community Health Center	154 Medical Park Loop	Sylva	NC
CHC28348-04	Terminated	BPS-H80-017971	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Balsam Community Health Center	91 Timberlane Road	Waynesville	NC
CHC28348-05	Terminated	BPS-H80-018065	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Franklin Community Health Center	100 Thomas Heights, Suite 206	Franklin	NC
CHC28348-06	Active	BPS-H80-017969	Appalachian Mountain Community Health Center	Tallulah Community Health Center	409 Tallulah Rd	Robbinsville	NC
CHC28348-07	Active	BPS-H80-037661	Appalachian Mountain Community Health Centers	Appalachian Mountain Community Health Centers at Peachtree	4226 E US Highway 64-ALT	Murphy	NC
CHC28348-08	Terminated	BPS-H80-018064	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Downtown Care Center	75 Haywood Street	Asheville	NC
CHC28348-09	Active	BPS-H80-017970	Appalachian Mountain Community Health Centers	Leicester Community Health Center	711 New Leicester Hwy	Asheville	NC
CHC28348-10	Active	BPS-H80-035376	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Appalachian Mountain Community Health Centers at Asheville High School	419 Mcdowell St	Asheville	NC
CHC28348-11	Active	BPS-H80-035101	APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	Appalachian Mountain Community Health Centers Mobile Primary Care	711 New Leicester Hwy	Asheville	NC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28348-00	AFFINITY SPECIALTY PHARMACY	DBA SONA SPECIALTY PHARMACY	1070 TUNNEL RD BLDG 3	ASHEVILLE	NC	28805-2014	07/01/2019	01/01/2025
CHC28348-00	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	01/01/2019	04/01/2020
CHC28348-00	APPALACHIAN SPECIALTY PHARMACY	932 HENDERSONVILLE RD STE 106		ASHEVILLE	NC	28803-6619	07/01/2019	07/01/2022
CHC28348-00	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	01/01/2017	09/30/2017
CHC28348-01	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	01/01/2017	01/01/2019
CHC28348-02	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	01/01/2017	09/01/2017
CHC28348-09	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	04/01/2017	09/01/2017
CHC28348-08	ASHEVILLE BUNCOMBE COMMUNITY PHARMACY	356 BILTMORE AVE	SUITE 209	ASHEVILLE	NC	28801	04/01/2017	01/01/2019
CHC28348-00	ASHEVILLE DISCOUNT PHARMACY	76 PATTON AVE		ASHEVILLE	NC	28801-3315	07/01/2018	01/01/2025
CHC28348-00	AVELLA OF DEER VALLEY	23620 N 20TH DR #12		PHOENIX	AZ	85085-0621	07/01/2018	07/26/2019
CHC28348-00	AVELLA OF DEER VALLEY, INC. #38	DBA AVELLA SPECIALTY PHARMACY	24416 N. 19TH AVE	PHOENIX	AZ	85085	07/01/2018	07/26/2019
CHC28348-00	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019	04/01/2020
CHC28348-00	BROOKSHIRE PHARMACY	DBA: B & B PHARMACY	462 HAYWOOD RD	ASHEVILLE	NC	28806-4263	10/01/2019
CHC28348-00	BRYSON CITY PHARMACY INC	200 HIGHWAY 19 S		BRYSON CITY	NC	28713	01/01/2020
CHC28348-00	CAROLINA MOUNTAIN PHARMACY INC	CAROLINA MOUNTAIN PHARMACY	7 PISGAH HIGHWAY SUITE 100	CANDLER	NC	28715	07/01/2021	03/01/2022
CHC28348-00	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2022
CHC28348-00	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	07/01/2018	12/03/2018
CHC28348-00	EASTGATE PHARMACY	93 EASTGATE DR		SYLVA	NC	28779-5171	07/01/2017	05/07/2025
CHC28348-03	EASTGATE PHARMACY	93 EASTGATE DR		SYLVA	NC	28779-5171	01/01/2017	03/10/2022
CHC28348-04	EASTGATE PHARMACY	93 EASTGATE DR		SYLVA	NC	28779-5171	01/01/2017	01/01/2019
CHC28348-05	EASTGATE PHARMACY	93 EASTGATE DR		SYLVA	NC	28779-5171	01/01/2017	01/01/2019
CHC28348-00	HYER HEALTH, LLC	DBA KING'S PHARMACY	16 WAYNE BROOKS LN	HAYESVILLE	NC	28904-9602	07/01/2017
CHC28348-06	HYER HEALTH, LLC	DBA KING'S PHARMACY	16 WAYNE BROOKS LN	HAYESVILLE	NC	28904-9602	04/01/2017	03/10/2022
CHC28348-07	HYER HEALTH, LLC	DBA KING'S PHARMACY	16 WAYNE BROOKS LN	HAYESVILLE	NC	28904-9602	04/01/2017	05/04/2022
CHC28348-00	HYERCARE LLC DBA KING'S PHARMACY	30 PEACHTREE ST		MURPHY	NC	28906-2940	07/01/2017
CHC28348-06	HYERCARE LLC DBA KING'S PHARMACY	30 PEACHTREE ST		MURPHY	NC	28906-2940	04/01/2017	03/10/2022
CHC28348-07	HYERCARE LLC DBA KING'S PHARMACY	30 PEACHTREE ST		MURPHY	NC	28906-2940	04/01/2017	05/04/2022
CHC28348-00	INGLES MARKETS #62	575 NEW LEICESTER HIGHWAY		ASHEVILLE	NC	28806-2122	07/01/2019	01/01/2023
CHC28348-00	INGLES MARKETS PHARMACY #134	1572 SAND HILL ROAD		CANDLER	NC	28715	07/01/2021	01/01/2023
CHC28348-00	INGLES PHARMACY #116	230 HWY 64 EAST		HAYESVILLE	NC	28904	01/01/2020	03/01/2022
CHC28348-00	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	07/01/2018	04/01/2020
CHC28348-00	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	02/01/2019
CHC28348-01	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	01/01/2019
CHC28348-02	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	01/01/2019
CHC28348-03	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	01/01/2019
CHC28348-04	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	01/01/2019
CHC28348-05	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	10/01/2016	01/01/2019
CHC28348-09	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	04/01/2017	01/01/2019
CHC28348-08	MEDICAL CENTER PHARMACY	509 BILTMORE AVENUE		ASHEVILLE	NC	28801	04/01/2017	01/01/2019
CHC28348-00	Mission Medication Assistance Pharmacy	1 Hospital Dr, Suite 2229		Asheville	NC	28801	10/01/2016	02/01/2019
CHC28348-01	Mission Medication Assistance Pharmacy	1 Hospital Drive, Suite 2229		Asheville	NC	28801	10/01/2016	01/01/2019
CHC28348-02	Mission Medication Assistance Pharmacy	1 Hospital Drive, Suite 2229		Asheville	NC	28801	10/01/2016	01/01/2019
CHC28348-03	Mission Medication Assistance Pharmacy	1 Hospital Dr, Suite 2229		Asheville	NC	28801	10/01/2016	01/01/2019
CHC28348-09	Mission Medication Assistance Pharmacy	1 Hospital Dr, Suite 2229		Asheville	NC	28801	04/01/2017	01/01/2019
CHC28348-08	Mission Medication Assistance Pharmacy	1 Hospital Dr, Suite 2229		Asheville	NC	28801	04/01/2017	01/01/2019
CHC28348-00	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	02/01/2019
CHC28348-01	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	01/01/2019
CHC28348-02	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	01/01/2019
CHC28348-03	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	01/01/2019
CHC28348-04	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	01/01/2019
CHC28348-05	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	10/01/2016	01/01/2019
CHC28348-06	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	04/01/2017	01/01/2019
CHC28348-09	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	04/01/2017	01/01/2019
CHC28348-08	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	04/01/2017	01/01/2019
CHC28348-07	MISSION PHARMACY - EMPLOYEE MAILORDER	MISSION HEALTH SYSTEM	400 RIDGEFIELD COURT	ASHEVILLE	NC	28806	04/01/2017	01/01/2019
CHC28348-00	MISSION PHARMACY - TALLULAH	MISSION MEDICAL ASSOCIATES, INC.	409 TALLULAH ROAD	ROBBINSVILLE	NC	28771	07/01/2017	01/01/2019
CHC28348-06	MISSION PHARMACY - TALLULAH	MISSION MEDICAL ASSOCIATES, INC.	409 TALLULAH ROAD	ROBBINSVILLE	NC	28771	04/01/2017	01/01/2019
CHC28348-07	MISSION PHARMACY - TALLULAH	MISSION MEDICAL ASSOCIATES, INC.	409 TALLULAH ROAD	ROBBINSVILLE	NC	28771	04/01/2017	01/01/2019
CHC28348-00	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	07/01/2018	04/01/2020
CHC28348-00	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	07/01/2022	05/13/2022
CHC28348-00	ROBBINSVILLE PHARMACY	238 RODNEY ORR BYP		ROBBINSVILLE	NC	28771	01/01/2020
CHC28348-00	SONA HEALTH INC DBA SONA PHARMACY + CLIN	106 LONG SHOALS RD STE 100		ARDEN	NC	28704	07/01/2024
CHC28348-00	SONA HEALTH INC DBA SONA PHARMACY + CLIN	805 FAIRVIEW RD STE 100	DBA SONA PHARMACY CLINIC	ASHEVILLE	NC	28803-1011	07/01/2024
CHC28348-00	TURNER DISCOUNT DRUGS	451 MAIN ST		ANDREWS	NC	28901-9648	04/01/2020	09/15/2023
CHC28348-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2020
CHC28348-00	WAL-MART PHARMACY 10-0515	93 RICK RAMSEY ST.		MURPHY	NC	28906	10/01/2020
CHC28348-00	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	10/01/2020	07/01/2020
CHC28348-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2020
CHC28348-00	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	04/01/2023	04/08/2024
CHC28348-00	WALGREEN CO	WALGREENS #19160	36 SUNRISE PARK	SYLVA	NC	28779	01/01/2019
CHC28348-00	WALGREEN CO.	DBA: WALGREENS # 07823	1835 HENDERSONVILLE ROAD	ASHEVILLE	NC	28803-3236	07/01/2018
CHC28348-00	WALGREEN CO.	DBA: WALGREENS # 09458	841 MERRIMON AVENUE	ASHEVILLE	NC	28804-2404	07/01/2018
CHC28348-00	WALGREEN CO.	DBA: WALGREENS # 10212	3 S TUNNEL RD	ASHEVILLE	NC	28805	07/01/2018
CHC28348-00	WALGREEN CO.	DBA: WALGREENS #12779	578 NEW LEICESTER HWY.	ASHEVILLE	NC	28806	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16101	286 MAIN ST	ANDREWS	NC	28901	07/01/2018	02/18/2025
CHC28348-00	WALGREEN CO.	WALGREENS #16102	1124 PATTON AVE	ASHEVILLE	NC	28806	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16105	19 SAWMILL VILLAGE LANE	FRANKLIN	NC	28734	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16107	44 HWY. 64 WEST	HAYESVILLE	NC	28904	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16110	219 RODNEY ORR BYPASS	ROBBINSVILLE	NC	28771	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16253	1630 ANDREWS RD	MURPHY	NC	28906	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #16103	50 HIGHWAY 19	BRYSON CITY	NC	28713	07/01/2018
CHC28348-00	WALGREEN CO.	WALGREENS #19219	590 RUSS AVE	WAYNESVILLE	NC	28786	07/01/2019
CHC28348-00	WALGREEN CO.	WALGREENS #19652	244 NEW CLYDE HWY	CANTON	NC	28716	10/01/2022
CHC28348-00	WALGREEN CO.	WALGREENS #17251	41 WESTRIDGE MARKET PL	CANDLER	NC	28715	10/01/2022
CHC28348-09	WALGREEN CO.	DBA: WALGREENS #12779	578 NEW LEICESTER HWY.	ASHEVILLE	NC	28806	01/01/2024
CHC28348-00	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CHC28348-00	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	07/01/2018
CHC28348-07	WALGREENS OF NORTH CAROLINA INC.	DBA: WALGREENS #16253	1630 ANDREWS RD	MURPHY	NC	28906	01/01/2024
CHC28348-06	WALGREENS OF NORTH CAROLINA INC.	DBA: WALGREENS #16110	219 RODNEY ORR BY-PASS	ROBBINSVILLE	NC	28771	01/01/2024
CHC28348-00	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2022
CHC28348-00	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2022
CHC28348-00	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2022
CHC28348-00	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	07/01/2018
CHC28348-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2024
CHC28348-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Shipping Address	Insert	Change Request		Southside Pharmacy 77 McDowell Street Asheville, NC 28801	3/17/2025 10:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/17/2025 10:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1487451381	3/17/2025 10:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NC	3/17/2025 10:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1487451381	3/17/2025 10:59 AM
Medicaid Billing	NPI: State	Insert	Change Request		NC	3/17/2025 10:59 AM
Details	Last Recertification Date	Update	Recertification	2/5/2024 9:20:34 AM	2/12/2025 8:26:22 AM	2/12/2025 8:26 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	5/23/2024 11:04 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1407628043	5/23/2024 11:04 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NC	5/23/2024 11:04 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1407628043	5/23/2024 11:04 AM
Medicaid Billing	NPI: State	Insert	Change Request		NC	5/23/2024 11:04 AM
Details	Last Recertification Date	Update	Recertification	1/30/2023 8:50:56 AM	2/5/2024 9:20:34 AM	2/5/2024 9:20 AM
Addresses	Main Address	Update	Change Request	77 McDowell Street Suite 200 Asheville, NC 28801-4435	77 McDowell Street Asheville, NC 28801-4435	10/18/2023 4:06 PM
Addresses	Main Address	Update	Change Request	7 McDowell Street Suite 200 Asheville, NC 28801-4116	77 McDowell Street Suite 200 Asheville, NC 28801-4435	8/16/2023 3:18 PM
Details	Entity Subname	Update	Change Request	Dale Fell Health Center	Dale Fell Community Health Center	8/16/2023 3:18 PM
Details	Last Recertification Date	Update	Recertification	1/31/2022 9:16:14 AM	1/30/2023 8:50:56 AM	1/30/2023 8:50 AM
Details	Last Recertification Date	Update	Recertification	2/4/2021 1:25:42 PM	1/31/2022 9:16:14 AM	1/31/2022 9:16 AM
Addresses	Billing Address	Insert	Change Request		Appalachian Mountain Community Health Centers 141 Asheland Ave 300 Asheville, NC 28801	10/21/2021 3:50 PM
Addresses	Shipping Address	Delete	Change Request	Appalachian Mountain Community Health Center - Lees Creek Pharmacy 711 New Leicester Hwy Asheville, NC 28806		10/15/2021 2:04 PM
Addresses	Shipping Address	Delete	Change Request	Appalachian Mountain Community Health Center - Tallulah Pharmacy 409 Tallulah Rd Robbinsville, NC 28771		10/15/2021 2:04 PM
Addresses	Main Address	Update	Change Request	7 McDowell Street, Suite 200 Asheville, NC 28801-4116	7 McDowell Street Suite 200 Asheville, NC 28801-4116	10/15/2021 2:04 PM
Contacts	Authorizing Official	Update	AO Change Request	Pettiford, Reuben CEO Appalachian Mountain Community Health Center 8287478690	Simpson, Shantelle CEO Appalachian Mountain Community Health Centers 8282025200-3865	9/23/2021 7:57 AM
Addresses	Shipping Address	Delete	Change Request	Appalachian Mountain Community Health Center 711 New Leicester Hwy Asheville, NC 28806		4/23/2021 10:59 AM
Addresses	Shipping Address	Insert	Change Request		Appalachian Mountain Community Health Center - Lees Creek Pharmacy 711 New Leicester Hwy Asheville, NC 28806	4/23/2021 10:59 AM
Addresses	Shipping Address	Insert	Change Request		Appalachian Mountain Community Health Center 711 New Leicester Hwy Asheville, NC 28806	4/2/2021 7:50 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/2/2021 7:50 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1720676950	4/2/2021 7:50 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NC	4/2/2021 7:50 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1720676950	4/2/2021 7:50 AM
Medicaid Billing	NPI: State	Insert	Change Request		NC	4/2/2021 7:50 AM
Addresses	Billing Address	Update	Recertification	Appalachian Mountain Community Health Centers PO Box 2597 Asheville, NC 28802-2597	Appalachian Mountain Community Health Centers 141 Asheland Ave Ste 300 Asheville, NC 28801	2/4/2021 1:25 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/4/2021 1:25 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1376822619	2/4/2021 1:25 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		NC	2/4/2021 1:25 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1376822619 ( )		2/4/2021 1:25 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1376822619	2/4/2021 1:25 PM
Medicaid Billing	NPI: State	Insert	Recertification		NC	2/4/2021 1:25 PM
Details	Last Recertification Date	Update	Recertification	1/28/2020 10:06:30 AM	2/4/2021 1:25:42 PM	2/4/2021 1:25 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1376822619	4/8/2020 11:06 AM
Details	Last Recertification Date	Update	Recertification	1/31/2019 9:48:39 AM	1/28/2020 10:06:30 AM	1/28/2020 10:06 AM
Contacts	Authorizing Official	Update	AO Change Request	Pettiford, Reuben J President and CEO Appalachian Mountain Community Health Centers 8282025335	Pettiford, Reuben CEO Appalachian Mountain Community Health Center 8287478690	10/16/2019 11:13 AM
Details	Last Recertification Date	Update	Recertification	2/7/2018 5:12:55 PM	1/31/2019 9:48:39 AM	1/31/2019 9:48 AM
Addresses	Shipping Address	Insert	Change Request		Appalachian Mountain Community Health Center - Tallulah Pharmacy 409 Tallulah Rd Robbinsville, NC 28771	1/11/2019 10:56 AM
Details	Entity Subname	Update	Change Request	7 McDowell	Dale Fell Health Center	12/4/2018 3:58 PM
Contacts	Primary Contact	Update	Change Request	Brown, Louie 340B Consultant Appalachian Mountain Community Health Center 8642554776	Taylor, David Steven Director of Pharmacy Operations Appalachian Mountain Community Health Center 8435430004	10/1/2018 4:20 PM
Contacts	Primary Contact	Update	Recertification	Tax, Paul C. Controller Appalachian Mountain Community Health Centers 8282025203	Brown, Louie 340B Consultant Appalachian Mountain Community Health Center 8642554776	2/7/2018 5:12 PM
Details	Last Recertification Date	Update	Recertification	2/21/2017 12:00:00 AM	2/7/2018 5:12:55 PM	2/7/2018 5:12 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1336528314 (NC)		12/28/2017 8:23 AM
Contacts	Authorizing Official	Update	Change Request	Apostoleris, Nicholas H. Chief Executive Officer AMCHC 8282025335	Pettiford, Reuben J President and CEO Appalachian Mountain Community Health Centers 8282025335	12/26/2017 12:35 PM
Details	Is Authorizing Official EHB Data	Update	Change Request	False		12/26/2017 12:35 PM
Contacts	Authorizing Official	Update		Apostoleris, Nicholas H. Chief Executive Officer 8282025335	Apostoleris, Nicholas H. Chief Executive Officer AMCHC 8282025335	10/16/2017 4:22 PM
Contacts	Signed By	Update		Apostoleris, Nicholas H. Chief Executive Officer 8282025335	Apostoleris, Nicholas H. Chief Executive Officer AMCHC 8282025335	10/16/2017 4:22 PM
Contacts	Primary Contact	Update		Tax, Paul C. Controller 8282025203	Tax, Paul C. Controller Appalachian Mountain Community Health Centers 8282025203	10/16/2017 2:30 PM
Contacts	Authorizing Official	Insert			Apostoleris, Nicholas H. Chief Executive Officer 8282025335	4/17/2017 4:04 PM
Contacts	Signed By	Insert			Apostoleris, Nicholas H. Chief Executive Officer 8282025335	4/17/2017 4:04 PM
Addresses	Main Address	Insert			7 McDowell Street, Suite 200 Asheville, NC 28801-4116	2/21/2017 10:25 AM
Contacts	Primary Contact	Insert			Tax, Paul C. Controller 8282025203	2/21/2017 10:25 AM
Details	Last Recertification Date	Update			2/21/2017 12:00:00 AM	2/21/2017 10:25 AM
Addresses	Billing Address	Insert			Appalachian Mountain Community Health Centers PO Box 2597 Asheville, NC 28802-2597	7/20/2016 3:34 PM
Dates	Participating Approval Date	Update			7/20/2016 12:00:00 AM	7/20/2016 3:34 PM
Details	State	Update		Pending	Active	7/20/2016 3:34 PM
Dates	Start Date	Update			10/1/2016 12:00:00 AM	7/20/2016 3:34 PM
Details	340B ID	Update		ONLINE_REG_71918	CHC28348-00	7/15/2016 2:52 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_71918	7/15/2016 12:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/15/2016 12:22 PM
Medicaid Billing	Medicaid: Number	Insert			1336528314	7/15/2016 12:22 PM
Medicaid Billing	Medicaid: State	Insert			NC	7/15/2016 12:22 PM
Details	Last Recertification Date	Insert				7/15/2016 12:22 PM
Details	Grant Number	Insert			H80CS28348	7/15/2016 12:22 PM
Details	340B ID	Insert			ONLINE_REG	7/15/2016 12:22 PM
Details	Is Authorizing Official EHB Data	Insert			False	7/15/2016 12:22 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/15/2016 12:22 PM
Details	Medicare Provider Number	Insert				7/15/2016 12:22 PM
Details	Entity Name	Insert			APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS	7/15/2016 12:22 PM
Details	Program Code	Insert			CH	7/15/2016 12:22 PM
Details	Entity Subname	Insert			7 McDowell	7/15/2016 12:22 PM
Dates	Participating Approval Date	Insert				7/15/2016 12:22 PM
Details	State	Insert			Pending	7/15/2016 12:22 PM
Dates	Registration Date	Insert			7/15/2016 12:00:00 AM	7/15/2016 12:22 PM
Dates	Signed By Date	Insert			7/15/2016 12:00:00 AM	7/15/2016 12:22 PM
Dates	Start Date	Insert				7/15/2016 12:22 PM
Terminations	Termination Comments	Insert				7/15/2016 12:22 PM
Terminations	Termination Date	Insert				7/15/2016 12:22 PM
Terminations	Termination Effective Date	Insert				7/15/2016 12:22 PM
Terminations	Termination Reason	Insert				7/15/2016 12:22 PM

340B Drug Pricing Program Database