Covered Entity Details

CHC28977-00 TRIANGLE AREA NETWORK, INC. (Active) - information as of 5/17/2025 10:53:02 PM

Main Details

Name

TRIANGLE AREA NETWORK, INC.

Subdivision Name

Triangle Area Network - Orange

Type

HRSA-Funded Health Center

Site ID

BPS-H80-034472

340B ID

CHC28977-00

Grant Number

H80CS28977

Additional Details

Current Program Status

Active

Registration Date

1/4/2017

Participating Start Date

4/1/2017

Participating Approval Date

2/27/2017

Last Recertification Date

2/17/2025

Contacts

Authorizing Official

Triangle Area Network
Dena Gray Hughes, CEO
(409) 832-8338 Ext: 222

Primary Contact

Triangle Area Network, Inc
AMANDA GIBSON, COO
(409) 832-8338 Ext: 256

Addresses

Street Address

3727 N. 16th St.
Orange, TX 77632

Billing Address

TRIANGLE AREA NETWORK
1495 NORTH 7TH ST
BEAUMONT, TX 77702

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

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	04/24/2023	07/01/2023		07/01/2023
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	01/17/2023	04/01/2023		04/01/2023
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/17/2023	04/01/2023		04/01/2023
Contract Detail	AVITA PHARMACY 1026	PHARMBLUE ARIZONA LLC	1260 S CAMPBELL AVE STE 1152	GREEN VALLEY	AZ	85614-0504	04/17/2017	07/01/2017		04/17/2017
Contract Detail	AVITA PHARMACY 1028	340B PARTNERS PHARMACY-DALLAS LLC DBA AV	750 FORT WORTH AVE STE H100	DALLAS	TX	75208-1811	10/11/2023	01/01/2024		01/01/2024
Contract Detail	AVITA PHARMACY 1031	PHARMBLUE HOLDINGS LLC D/B/A AVITA PHARM	1495 N 7TH ST STE B	BEAUMONT	TX	77702-1345	04/17/2017	07/01/2017		04/17/2017
Contract Detail	AVITA PHARMACY 1060	RX BLUE STAR SOLUTIONS, LLC DBA AVITA PH	40 PENNWOOD PL STE 200	WARRENDALE	PA	15086-6625	04/17/2017	07/01/2017	10/11/2023	10/11/2023
Contract Detail	BRIDGE CITY FAMILY PHARMACY	1910 TEXAS AVE		BRIDGE CITY	TX	77611	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	BUNA FAMILY PHARMACY	351 TX STATE HWY 62	PO BOX 1948	BUNA	TX	77612	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/17/2023	04/01/2023		04/01/2023
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/17/2023	04/01/2023		04/01/2023
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/17/2023	04/01/2023		04/01/2023
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/17/2023	04/01/2023		04/01/2023
Contract Detail	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	04/24/2023	07/01/2023		07/01/2023
Contract Detail	FP SPECIALTY PHARMACY	305 S ARCHIE ST		VIDOR	TX	77662	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	10/11/2023	01/01/2024		01/01/2024
Contract Detail	MALLEY'S FAMILY PHARMACY	3110 CALDER AVE		BEAUMONT	TX	77702-1411	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	MAURICEVILLE FAMILY PHARMACY	10897 HWY 12	PO BOX 1149	MAURICEVILLE	TX	77626	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	04/24/2023	07/01/2023		07/01/2023
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/24/2023	07/01/2023		07/01/2023
Contract Detail	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/24/2023	07/01/2023		07/01/2023
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	04/24/2023	07/01/2023		07/01/2023
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/17/2023	04/01/2023		04/01/2023
Contract Detail	PHARMBLUE LLC DBA AVITA PHARMACY 1059	1226 CHESTNUT ST		PHILADELPHIA	PA	19107	04/17/2017	07/01/2017		04/17/2017
Contract Detail	SPECIALTY THERAPEUTIC CARE	1311 W SAM HOUSTON PKWY N STE 150		HOUSTON	TX	77043-4015	04/24/2023	07/01/2023		07/01/2023
Contract Detail	VIDOR FAMILY PHARMACY	1130 N MAIN ST		VIDOR	TX	77662-3739	01/05/2017	04/01/2017	04/03/2017	04/17/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07614	902 N MAIN	LUMBERTON	TX	77657	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03271	3990 E. LUCAS DRIVE	BEAUMONT	TX	77708	04/11/2018	07/01/2018	03/17/2025	03/17/2025
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15513	3080 COLLEGE ST STE 1	BEAUMONT	TX	77701	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03958	4930 GULFWAY DR	PORT ARTHUR	TX	77642	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05375	3700 HWY 365	PORT ARTHUR	TX	77642	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03821	3605 COLLEGE ST	BEAUMONT	TX	77701	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03081	1408 N 16TH ST	ORANGE	TX	77630	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07638	1250 S WHEELER STREET	JASPER	TX	75951	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12355	1790 TEXAS AVE.	BRIDGE CITY	TX	77611	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06583	3885 N DOWLEN ROAD	BEAUMONT	TX	77706	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #11522	496 HIGHWAY 96 SOUTH	SILSBEE	TX	77656	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07878	209 W. HIGHWAY 90	DAYTON	TX	77535	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10139	1305 N MAIN ST	VIDOR	TX	77662	10/14/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15320	4101 GREENBRIAR DR STE 235	HOUSTON	TX	77098	07/19/2022	10/01/2022		10/01/2022
Contract Detail	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	04/13/2022	07/01/2022		07/01/2022

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CHC28977-00	Active	BPS-H80-034472	TRIANGLE AREA NETWORK, INC.	Triangle Area Network - Orange	3727 N. 16th St.		Orange	TX
CHC28977-01	Active	BPS-H80-021210	Triangle Area Network, Inc.	Triangle Area Network	1495 N. 7th St		Beaumont	TX

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28977-00	ACARIAHEALTH PHARMACY #11, INC	1311 W SAM HOUSTON PKWY N STE 130		HOUSTON	TX	77043-4015	07/01/2023
CHC28977-00	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	04/01/2023
CHC28977-00	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	04/01/2023
CHC28977-00	AVITA PHARMACY 1026	PHARMBLUE ARIZONA LLC	1260 S CAMPBELL AVE STE 1152	GREEN VALLEY	AZ	85614-0504	07/01/2017
CHC28977-00	AVITA PHARMACY 1028	340B PARTNERS PHARMACY-DALLAS LLC DBA AV	750 FORT WORTH AVE STE H100	DALLAS	TX	75208-1811	01/01/2024
CHC28977-00	AVITA PHARMACY 1031	PHARMBLUE HOLDINGS LLC D/B/A AVITA PHARM	1495 N 7TH ST STE B	BEAUMONT	TX	77702-1345	07/01/2017
CHC28977-00	AVITA PHARMACY 1060	RX BLUE STAR SOLUTIONS, LLC DBA AVITA PH	40 PENNWOOD PL STE 200	WARRENDALE	PA	15086-6625	07/01/2017	10/11/2023
CHC28977-00	BRIDGE CITY FAMILY PHARMACY	1910 TEXAS AVE		BRIDGE CITY	TX	77611	04/01/2017	04/03/2017
CHC28977-00	BUNA FAMILY PHARMACY	351 TX STATE HWY 62	PO BOX 1948	BUNA	TX	77612	04/01/2017	04/03/2017
CHC28977-00	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	04/01/2023
CHC28977-00	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	04/01/2023
CHC28977-00	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	04/01/2023
CHC28977-00	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	04/01/2023
CHC28977-00	FOUNDATION CARE LLC	111 CHESTERFIELD INDUSTRIAL BLVD STE 115		CHESTERFIELD	MO	63005	07/01/2023
CHC28977-00	FP SPECIALTY PHARMACY	305 S ARCHIE ST		VIDOR	TX	77662	04/01/2017	04/03/2017
CHC28977-00	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2024
CHC28977-00	MALLEY'S FAMILY PHARMACY	3110 CALDER AVE		BEAUMONT	TX	77702-1411	04/01/2017	04/03/2017
CHC28977-00	MAURICEVILLE FAMILY PHARMACY	10897 HWY 12	PO BOX 1149	MAURICEVILLE	TX	77626	04/01/2017	04/03/2017
CHC28977-00	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/01/2023
CHC28977-00	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2023
CHC28977-00	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	04/01/2023
CHC28977-00	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2023
CHC28977-00	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	07/01/2023
CHC28977-00	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2023
CHC28977-00	PHARMBLUE LLC DBA AVITA PHARMACY 1059	1226 CHESTNUT ST		PHILADELPHIA	PA	19107	07/01/2017
CHC28977-00	SPECIALTY THERAPEUTIC CARE	1311 W SAM HOUSTON PKWY N STE 150		HOUSTON	TX	77043-4015	07/01/2023
CHC28977-00	VIDOR FAMILY PHARMACY	1130 N MAIN ST		VIDOR	TX	77662-3739	04/01/2017	04/03/2017
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 07614	902 N MAIN	LUMBERTON	TX	77657	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 03271	3990 E. LUCAS DRIVE	BEAUMONT	TX	77708	07/01/2018	03/17/2025
CHC28977-00	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15513	3080 COLLEGE ST STE 1	BEAUMONT	TX	77701	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 03958	4930 GULFWAY DR	PORT ARTHUR	TX	77642	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 05375	3700 HWY 365	PORT ARTHUR	TX	77642	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 03821	3605 COLLEGE ST	BEAUMONT	TX	77701	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 03081	1408 N 16TH ST	ORANGE	TX	77630	07/01/2018
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 07638	1250 S WHEELER STREET	JASPER	TX	75951	01/01/2020
CHC28977-00	WALGREEN CO.	DBA: WALGREENS #12355	1790 TEXAS AVE.	BRIDGE CITY	TX	77611	01/01/2020
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 06583	3885 N DOWLEN ROAD	BEAUMONT	TX	77706	01/01/2020
CHC28977-00	WALGREEN CO.	DBA: WALGREENS #11522	496 HIGHWAY 96 SOUTH	SILSBEE	TX	77656	01/01/2020
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 07878	209 W. HIGHWAY 90	DAYTON	TX	77535	01/01/2020
CHC28977-00	WALGREEN CO.	DBA: WALGREENS # 10139	1305 N MAIN ST	VIDOR	TX	77662	01/01/2020
CHC28977-00	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15320	4101 GREENBRIAR DR STE 235	HOUSTON	TX	77098	10/01/2022
CHC28977-00	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	07/01/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/20/2024 1:58:48 PM	2/17/2025 2:43:12 PM	2/17/2025 2:43 PM
Details	Last Recertification Date	Update	Recertification	2/8/2023 4:50:45 PM	2/20/2024 1:58:48 PM	2/20/2024 1:58 PM
Details	Last Recertification Date	Update	Recertification	2/17/2022 3:10:45 PM	2/8/2023 4:50:45 PM	2/8/2023 4:50 PM
Addresses	Main Address	Update	Change Request	3737 N. 16th St. Orange, TX 77632	3727 N. 16th St. Orange, TX 77632	7/28/2022 1:29 PM
Details	Is Authorizing Official EHB Data	Update	Change Request	False		7/28/2022 1:29 PM
Details	Entity Subname	Update	Change Request	Triangle Area Network -	Triangle Area Network - Orange	7/28/2022 1:29 PM
Details	Last Recertification Date	Update	Recertification	2/4/2021 3:04:03 PM	2/17/2022 3:10:45 PM	2/17/2022 3:10 PM
Contacts	Primary Contact	Update	Profile Change Request	GIBSON, AMANDA Grants Management Triangle Area Network, Inc 4098328338-256	GIBSON, AMANDA COO Triangle Area Network, Inc 4098328338-256	2/10/2022 1:18 PM
Details	Last Recertification Date	Update	Recertification	1/30/2020 3:51:47 PM	2/4/2021 3:04:03 PM	2/4/2021 3:04 PM
Details	Last Recertification Date	Update	Recertification	2/4/2019 11:57:14 AM	1/30/2020 3:51:47 PM	1/30/2020 3:51 PM
Contacts	Authorizing Official	Update	Profile Change Request	Hughes, Dena Gray Executive Director Triangle Area Network 4098328338-222	Hughes, Dena Gray CEO Triangle Area Network 4098328338-222	1/30/2020 3:51 PM
Contacts	Primary Contact	Update	Profile Change Request	GIBSON, AMANDA Clinic Manager Triangle Area Network, Inc 4099204223	GIBSON, AMANDA Grants Management Triangle Area Network, Inc 4098328338-256	1/28/2020 10:04 AM
Details	Last Recertification Date	Update	Recertification	2/27/2018 11:56:22 AM	2/4/2019 11:57:14 AM	2/4/2019 11:57 AM
Details	Last Recertification Date	Update	Recertification		2/27/2018 11:56:22 AM	2/27/2018 11:56 AM
Contacts	Authorizing Official	Update		Hughes, Dena Gray Executive Director 4098328338-222	Hughes, Dena Gray Executive Director Triangle Area Network 4098328338-222	10/16/2017 10:23 AM
Contacts	Primary Contact	Update	Profile Change Request	GIBSON, AMANDA Billing and Benefits Officer Triangle Area Network, Inc 4098328338-268	GIBSON, AMANDA Clinic Manager Triangle Area Network, Inc 4099204223	9/29/2017 2:46 PM
Contacts	Primary Contact	Update		GIBSON, AMANDA Billing and Benefits Officer 4098328338-268	GIBSON, AMANDA Billing and Benefits Officer Triangle Area Network, Inc 4098328338-268	9/29/2017 2:43 PM
Contacts	Authorizing Official	Update		Hughes, Dena Gray Executive Director 4098328338-222	Hughes, Dena Gray Executive Director 4098328338-222	4/17/2017 11:11 AM
Contacts	Signed By	Insert			GIBSON, AMANDA MEDICAL BILLING COORDINATOR 4098328338-268	4/17/2017 11:09 AM
Addresses	Main Address	Insert			3737 N. 16th St. Orange, TX 77632	4/11/2017 12:49 PM
Addresses	Billing Address	Insert			TRIANGLE AREA NETWORK 1495 NORTH 7TH ST BEAUMONT, TX 77702	4/11/2017 12:49 PM
Contacts	Primary Contact	Insert			GIBSON, AMANDA Billing and Benefits Officer 4098328338-268	4/11/2017 12:49 PM
Contacts	Authorizing Official	Insert			Hughes, Dena Gray Executive Director 4098328338-222	2/27/2017 10:17 AM
Dates	Participating Approval Date	Update			2/27/2017 12:00:00 AM	2/27/2017 10:17 AM
Details	State	Update		Pending	Active	2/27/2017 10:17 AM
Dates	Start Date	Update			4/1/2017 12:00:00 AM	2/27/2017 10:17 AM
Details	340B ID	Update		ONLINE_REG_73704	CHC28977-00	2/14/2017 3:26 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_73704	1/4/2017 11:07 AM
Details	Last Recertification Date	Insert				1/4/2017 11:07 AM
Details	Grant Number	Insert			H80CS28977	1/4/2017 11:07 AM
Details	340B ID	Insert			ONLINE_REG	1/4/2017 11:07 AM
Details	Is Authorizing Official EHB Data	Insert			False	1/4/2017 11:07 AM
Dates	Last Date That 340B Drugs Purchased	Insert				1/4/2017 11:07 AM
Details	Medicare Provider Number	Insert				1/4/2017 11:07 AM
Details	Entity Name	Insert			TRIANGLE AREA NETWORK, INC.	1/4/2017 11:07 AM
Details	Program Code	Insert			CH	1/4/2017 11:07 AM
Details	Entity Subname	Insert			Triangle Area Network -	1/4/2017 11:07 AM
Dates	Participating Approval Date	Insert				1/4/2017 11:07 AM
Details	State	Insert			Pending	1/4/2017 11:07 AM
Dates	Registration Date	Insert			1/4/2017 12:00:00 AM	1/4/2017 11:07 AM
Dates	Signed By Date	Insert			1/4/2017 12:00:00 AM	1/4/2017 11:07 AM
Dates	Start Date	Insert				1/4/2017 11:07 AM
Terminations	Termination Comments	Insert				1/4/2017 11:07 AM
Terminations	Termination Date	Insert				1/4/2017 11:07 AM
Terminations	Termination Effective Date	Insert				1/4/2017 11:07 AM
Terminations	Termination Reason	Insert				1/4/2017 11:07 AM

340B Drug Pricing Program Database