Covered Entity Details

CH08022N COMMUNITY HEALTH CENTERS, INC. (Active) - information as of 6/4/2025 1:15:18 PM

Main Details

Name

COMMUNITY HEALTH CENTERS, INC.

Subdivision Name

Community Health Centers, Inc. - Brigham City

Type

HRSA-Funded Health Center

Site ID

BPS-H80-019078

340B ID

CH08022N

Grant Number

H80CS00220

Additional Details

Current Program Status

Active

Registration Date

7/13/2017

Participating Start Date

10/1/2017

Participating Approval Date

7/13/2017

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Community Health Centers, Inc
Jennifer Lyn Thomas, Executive Director
(801) 412-6920

Primary Contact

Community Health Centers, Inc
Robert Wheadon, Grants-340B Management
(801) 412-6920

Addresses

Street Address

980 S 500 W STE 1
BRIGHAM CITY, UT 84302-3094

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

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	SMITH'S PHARMACY #87	442 N 175 E		LOGAN	UT	84321	10/08/2020	01/01/2021			01/01/2021
Contract Detail	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	08/11/2017	10/01/2017			10/01/2017

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH080220	Active	BPS-H80-010549	COMMUNITY HEALTH CENTERS, INC.	SALT LAKE COMMUNITY HEALTH CENTER	220 W 7200 S		Midvale	UT
CH08022A	Terminated	BPS-H80-020871	COMMUNITY HEALTH CENTERS, INC.	CENTRAL CITY COMMUNITY HEALTH CENTER	324 Tenth Avenue	Suite 249	SALT LAKE CITY	UT
CH08022C	Active	BPS-H80-001779	COMMUNITY HEALTH CENTERS, INC.	OQUIRRH VIEW COMMUNITY HEALTH CENTER	4745 SOUTH 3200 WEST		SALT LAKE CITY	UT
CH08022D	Active	BPS-H80-010549	COMMUNITY HEALTH CENTERS, INC.	72nd STREET CLINIC	220 WEST 7200 SOUTH	SUITE A	MIDVALE	UT
CH08022E	Active	BPS-H80-004858	COMMUNITY HEALTH CENTERS, INC.	STEPHEN D. RATCLIFFE COMMUNITY HEALTH CENTER	1365 WEST 1000 NORTH		SALT LAKE CITY	UT
CH08022J	Terminated	BPS-H80-019078	COMMUNITY HEALTH CENTERS, INC.	UTAH FARMWORKER HEALTH PROGRAM	980 Medical Drive STE 1		BRIGHAM CITY	UT
CH08022K	Active	BPS-H80-013214	COMMUNITY HEALTH CENTERS, INC.	Neighborhood Clinic at Mountainview School	1388 S Navajo St	Suite C	Salt Lake City	UT
CH08022L	Active	BPS-H80-013581	COMMUNITY HEALTH CENTERS, INC.	Bear River Health Clinic	440 W 600 N		TREMONTON	UT
CH08022M	Active	BPS-H80-015779	COMMUNITY HEALTH CENTERS, INC.	Community Health Center, Inc. Ellis R. Shipp	4535 S 5600 W		WEST VALLEY CITY	UT
CH08022N	Active	BPS-H80-019078	COMMUNITY HEALTH CENTERS, INC.	Community Health Centers, Inc. - Brigham City	980 S 500 W STE 1		BRIGHAM CITY	UT
CH08022P	Terminated	BPS-H80-020875	COMMUNITY HEALTH CENTERS, INC.	Community Health Centers, Inc - Liberty Community Learning Center	1078 S 300 E #4		Salt Lake City	UT
CH08022Q	Active	BPS-H80-024756	COMMUNITY HEALTH CENTERS, INC.	Community Health Centers, Inc - Central City	610 S 200 E STE #B		Salt Lake City	UT
CH08022R	Active	BPS-H80-038478	COMMUNITY HEALTH CENTERS, INC.	Community Health Centers, Inc.	1455 West 2200 South, 3rd Floor		West Valley City	UT

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH080220	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022C	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022D	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022E	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022K	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022L	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022M	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022Q	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020
CH08022J	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020	10/01/2023
CH080220	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022C	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022D	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022E	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022K	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022L	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022M	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022Q	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020
CH08022J	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020	10/01/2023
CH080220	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022C	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022D	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022E	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022K	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022L	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022M	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022Q	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020
CH08022J	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020	10/01/2023
CH080220	SMITH MANAGEMENT CORP	DBA SMITH'S PHARMACY #69	1174 WEST 600 NORTH	SALT LAKE CITY	UT	84116	01/01/2014
CH08022E	SMITH MANAGEMENT CORP	DBA SMITH'S PHARMACY #69	1174 WEST 600 NORTH	SALT LAKE CITY	UT	84116	06/14/2004
CH08022Q	SMITH MANAGEMENT CORP	DBA SMITH'S PHARMACY #69	1174 WEST 600 NORTH	SALT LAKE CITY	UT	84116	01/01/2019
CH080220	SMITH'S DRUG #44	DBA SMITHS FOOD KING #1	876 E 8TH S	SALT LAKE CITY	UT	84102	01/01/2014
CH08022A	SMITH'S DRUG #44	DBA SMITHS FOOD KING #1	876 E 8TH S	SALT LAKE CITY	UT	84102	06/14/2004	04/01/2019
CH08022P	SMITH'S DRUG #44	DBA SMITHS FOOD KING #1	876 E 8TH S	SALT LAKE CITY	UT	84102	10/03/2017	04/01/2020
CH08022Q	SMITH'S DRUG #44	DBA SMITHS FOOD KING #1	876 E 8TH S	SALT LAKE CITY	UT	84102	01/01/2019
CH080220	SMITH'S FOOD & DRUG #72	1725 UINTA WAY		PARK CITY	UT	84098	01/01/2014	04/15/2016
CH080220	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	01/01/2014
CH080220	SMITH'S FOOD & DRUG CENTERS	SMITH'S PHARMACY # 85	980 EAST FORT UNION BLVD.	MIDVALE	UT	84047	01/01/2014
CH08022D	SMITH'S FOOD & DRUG CENTERS	SMITH'S PHARMACY # 85	980 EAST FORT UNION BLVD.	MIDVALE	UT	84047	02/23/2005
CH08022A	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	01/31/2012	04/01/2019
CH08022C	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	01/31/2012
CH08022K	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	07/01/2014
CH08022P	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	10/03/2017	04/01/2020
CH08022Q	SMITH'S FOOD & DRUG CENTERS	SMITH'S PHARMACY # 85	980 EAST FORT UNION BLVD.	MIDVALE	UT	84047	01/01/2019
CH08022Q	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	01/01/2019
CH080220	SMITH'S FOOD & DRUG CTR	SMITH'S FOOD & DRUG #144	45 SOUTH STATE	OREM	UT	84057	01/01/2014	04/10/2021
CH080220	SMITH'S FOOD & DRUG CTR	SMITH'S FOOD & DRUG #140	2353 NORTH MAIN	SUNSET	UT	84015	01/01/2014	04/15/2016
CH080220	SMITH'S FOOD & DRUG CTRS	SMITH'S FOOD & DRUG #138	1634 WEST SOUTH JORDAN PKWY	SOUTH JORDAN	UT	84095	01/01/2014	04/15/2016
CH080220	SMITH'S FOOD KING NO 1	SMITH'S DRUG KING PHARMACY #30	4275 HARRISON BLVD	OGDEN	UT	84403	01/01/2014	04/10/2021
CH08022Q	SMITH'S FOOD KING NO 1	SMITH'S DRUG KING PHARMACY #30	4275 HARRISON BLVD	OGDEN	UT	84403	01/01/2019	04/10/2021
CH080220	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	01/01/2014	04/10/2021
CH080220	SMITH'S MANAGEMENT CORP DBA	SMITH'S FOOD & DRUG #66	PHARMACY 4065 SOUTH REDWOOD ROAD	SALT LAKE CITY	UT	84123	01/01/2014
CH08022C	SMITH'S MANAGEMENT CORP DBA	SMITH'S FOOD & DRUG #66	PHARMACY 4065 SOUTH REDWOOD ROAD	SALT LAKE CITY	UT	84123	06/14/2004
CH08022Q	SMITH'S MANAGEMENT CORP DBA	SMITH'S FOOD & DRUG #66	PHARMACY 4065 SOUTH REDWOOD ROAD	SALT LAKE CITY	UT	84123	01/01/2019
CH080220	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2014	04/08/2021
CH080220	SMITH'S PHARMACY #28	922 E. 2100 S.		SALT LAKE CITY	UT	84106	01/01/2014	04/10/2021
CH08022Q	SMITH'S PHARMACY #28	922 E. 2100 S.		SALT LAKE CITY	UT	84106	01/01/2019
CH080220	SMITH'S PHARMACY #444	555 S. 200 W.		BOUNTIFUL	UT	84010	01/01/2014	04/10/2021
CH08022Q	SMITH'S PHARMACY #444	555 S. 200 W.		BOUNTIFUL	UT	84010	01/01/2019	04/10/2021
CH08022L	SMITH'S PHARMACY #477	750 N. MAIN ST.		LOGAN	UT	84321	07/01/2014	04/08/2021
CH080220	SMITH'S PHARMACY #87	442 N 175 E		LOGAN	UT	84321	01/01/2014
CH08022L	SMITH'S PHARMACY #87	442 N 175 E		LOGAN	UT	84321	04/01/2016
CH08022N	SMITH'S PHARMACY #87	442 N 175 E		LOGAN	UT	84321	01/01/2021
CH080220	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	01/01/2014
CH08022A	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	01/31/2012	04/01/2019
CH08022C	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	01/31/2012
CH08022P	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	10/03/2017	04/01/2020
CH08022Q	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	01/01/2019
CH080220	SMITHS FOOD & DRUG #142	951 WEST 1700 SOUTH		SYRACUSE	UT	84075	01/01/2014	04/15/2016
CH080220	SMITHS FOOD & DRUG CTR INC	SMITH'S PHARMACY #147	5620 W 4100 SO	WEST VALLEY CITY	UT	84128	07/01/2016
CH08022C	SMITHS FOOD & DRUG CTR INC	SMITH'S PHARMACY #147	5620 W 4100 SO	WEST VALLEY CITY	UT	84128	07/01/2016
CH08022M	SMITHS FOOD & DRUG CTR INC	SMITH'S PHARMACY #147	5620 W 4100 SO	WEST VALLEY CITY	UT	84128	10/01/2016
CH08022Q	SMITHS FOOD & DRUG CTR INC	SMITH'S PHARMACY #147	5620 W 4100 SO	WEST VALLEY CITY	UT	84128	01/01/2019
CH080220	SMITHS FOOD & DRUG CTRS	SMITH'S DRUG KING PHARMACY #75	632 SOUTH 100 WEST	PAYSON	UT	84651	01/01/2014	04/10/2021
CH080220	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	01/01/2014
CH080220	SMITHS FOOD & DRUG CTRS	DBA SMITH'S FOOD & DRUG #133	845 EAST 4500 SOUTH	SALT LAKE CITY	UT	84107	01/01/2014	04/10/2021
CH080220	SMITHS FOOD & DRUG CTRS	SMITH'S FOOD DRUG #149	1170 EAST GENTILE	LAYTON	UT	84040	01/01/2014	04/10/2021
CH080220	SMITHS FOOD & DRUG CTRS	DBA SMITH'S FOOD & DRUG #135	1316 NORTH HIGHWAY 89	FARMINGTON	UT	84025	01/01/2014	04/15/2016
CH08022J	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	07/01/2004	10/01/2023
CH08022L	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	07/01/2014
CH08022N	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	10/01/2017
CH08022Q	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	01/01/2019
CH080220	SMITHS FOOD & DRUG CTRS	DBA SMITHS FOOD & DRUG #137	4643 SOUTH 4000 WEST	WEST VALLEY CITY	UT	84120	01/01/2021
CH08022C	SMITHS FOOD & DRUG CTRS	DBA SMITHS FOOD & DRUG #137	4643 SOUTH 4000 WEST	WEST VALLEY CITY	UT	84120	01/01/2021
CH08022J	SMITHS FOOD & DRUG CTRS	DBA SMITHS FOOD & DRUG #137	4643 SOUTH 4000 WEST	WEST VALLEY CITY	UT	84120	04/01/2023	10/01/2023
CH08022Q	SMITHS FOOD AND DRUG CENTERS, INC. - #84	38 EAST 7800 SOUTH		MIDVALE	UT	84047	01/01/2019
CH080220	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022C	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022D	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022E	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022K	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022L	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022M	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022Q	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020
CH08022J	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020	10/01/2023
CH080220	WALGREEN CO.	DBA: WALGREENS # 05737	909 E 2100 S	SALT LAKE CITY	UT	84106	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS # 05929	5630 WEST 4100 SOUTH	WEST VALLEY	UT	84128	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS # 06282	4040 W 5415 S	SALT LAKE CITY	UT	84118	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS # 06961	4668 S REDWOOD ROAD	TAYLORSVILLE	UT	84123-3145	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS # 09238	531 EAST 400 SOUTH	SALT LAKE CITY	UT	84102	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS # 09239	7227 S STATE ST	MIDVALE	UT	84047-2009	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS #15623	5586 WEST 6200 SOUTH	KEARNS	UT	84118	04/01/2020
CH080220	WALGREEN CO.	WALGREENS #17870	150 N 900 W	SALT LAKE CITY	UT	84116-3334	04/01/2020	04/10/2021
CH080220	WALGREEN CO.	WALGREENS #19121	72 SOUTH MAIN ST	SALT LAKE CITY	UT	84101-1506	04/01/2020
CH080220	WALGREEN CO.	DBA: WALGREENS #10820	2555 N 400 E	NORTH OGDEN	UT	84414	01/01/2022
CH08022R	Walgreens #21435	Walgreens Central Fill #21435	6306 S Airport Rd	West Jordan	UT	84084-5601	07/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 3:53:09 PM	2/10/2025 12:13:24 PM	2/10/2025 12:13 PM
Details	Last Recertification Date	Update	Recertification	2/3/2023 6:18:01 PM	1/29/2024 3:53:09 PM	1/29/2024 3:53 PM
Contacts	Primary Contact	Update	Change Request	Hyer, Chris MEDICAL DIRECTOR Community Health Centers, Inc 8014126920	Wheadon, Robert Grants-340B Management Community Health Centers, Inc 8014126920	3/10/2023 11:43 AM
Details	Last Recertification Date	Update	Recertification	2/1/2022 10:50:36 AM	2/3/2023 6:18:01 PM	2/3/2023 6:18 PM
Contacts	Authorizing Official	Update	AO Change Request	PEARCE, DEXTER Executive Director Community Health Centers, Inc 8014126920	Thomas, Jennifer Lyn Executive Director Community Health Centers, Inc 8014126920	11/15/2022 7:00 AM
Details	Last Recertification Date	Update	Recertification	2/1/2021 4:40:42 PM	2/1/2022 10:50:36 AM	2/1/2022 10:50 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 10:43:05 AM	2/1/2021 4:40:42 PM	2/1/2021 4:40 PM
Details	Last Recertification Date	Update	Recertification	1/28/2019 6:50:28 PM	1/28/2020 10:43:05 AM	1/28/2020 10:43 AM
Details	Last Recertification Date	Update	Recertification	2/7/2018 9:40:17 AM	1/28/2019 6:50:28 PM	1/28/2019 6:50 PM
Contacts	Primary Contact	Update	Recertification	PEARCE, DEXTER Executive Director Community Health Centers, Inc 8014126920	Hyer, Chris MEDICAL DIRECTOR Community Health Centers, Inc 8014126920	2/7/2018 9:40 AM
Details	Last Recertification Date	Update	Recertification		2/7/2018 9:40:17 AM	2/7/2018 9:40 AM
Details	Is Authorizing Official EHB Data	Update	Recertification	False		2/7/2018 9:40 AM
Contacts	Authorizing Official	Update		PEARCE, DEXTER Executive Director 8014126920	PEARCE, DEXTER Executive Director Community Health Centers, Inc 8014126920	9/28/2017 12:22 PM
Contacts	Primary Contact	Update		PEARCE, DEXTER Executive Director 8014126920	PEARCE, DEXTER Executive Director Community Health Centers, Inc 8014126920	9/28/2017 12:22 PM
Contacts	Signed By	Update		PEARCE, DEXTER Executive Director 8014126920	PEARCE, DEXTER Executive Director Community Health Centers, Inc 8014126920	9/28/2017 12:22 PM
Contacts	Authorizing Official	Insert			PEARCE, DEXTER Executive Director 8014126920	8/11/2017 2:00 PM
Contacts	Primary Contact	Insert			PEARCE, DEXTER Executive Director 8014126920	8/11/2017 2:00 PM
Contacts	Signed By	Insert			PEARCE, DEXTER Executive Director 8014126920	8/11/2017 2:00 PM
Addresses	Main Address	Insert			980 S 500 W STE 1 BRIGHAM CITY, UT 84302-3094	7/13/2017 3:57 PM
Details	State	Update		Approved	Active	7/13/2017 3:57 PM
Dates	Participating Approval Date	Update			7/13/2017 12:00:00 AM	7/13/2017 3:57 PM
Details	State	Update		Pending	Approved	7/13/2017 3:57 PM
Dates	Start Date	Update			10/1/2017 12:00:00 AM	7/13/2017 3:57 PM
Details	340B ID	Update		ONLINE_REG_78424	CH08022N	7/13/2017 12:21 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_78424	7/13/2017 11:32 AM
Details	Last Recertification Date	Insert				7/13/2017 11:32 AM
Details	Grant Number	Insert			H80CS00220	7/13/2017 11:32 AM
Details	340B ID	Insert			ONLINE_REG	7/13/2017 11:32 AM
Details	Is Authorizing Official EHB Data	Insert			False	7/13/2017 11:32 AM
Dates	Last Date That 340B Drugs Purchased	Insert				7/13/2017 11:32 AM
Details	Medicare Provider Number	Insert				7/13/2017 11:32 AM
Details	Entity Name	Insert			COMMUNITY HEALTH CENTERS, INC.	7/13/2017 11:32 AM
Details	Program Code	Insert			CH	7/13/2017 11:32 AM
Details	Entity Subname	Insert			Community Health Centers, Inc. - Brigham City	7/13/2017 11:32 AM
Dates	Participating Approval Date	Insert				7/13/2017 11:32 AM
Details	State	Insert			Pending	7/13/2017 11:32 AM
Dates	Registration Date	Insert			7/13/2017 12:00:00 AM	7/13/2017 11:32 AM
Dates	Signed By Date	Insert			7/13/2017 12:00:00 AM	7/13/2017 11:32 AM
Dates	Start Date	Insert				7/13/2017 11:32 AM
Terminations	Termination Comments	Insert				7/13/2017 11:32 AM
Terminations	Termination Date	Insert				7/13/2017 11:32 AM
Terminations	Termination Effective Date	Insert				7/13/2017 11:32 AM
Terminations	Termination Reason	Insert				7/13/2017 11:32 AM

340B Drug Pricing Program Database