Covered Entity Details

CHC29020-01 COMPASS COMMUNITY HEALTH (Terminated) - information as of 5/13/2025 11:03:16 PM

Main Details

Name

COMPASS COMMUNITY HEALTH

Subdivision Name

Compass Community Health

Type

HRSA-Funded Health Center

Site ID

BPS-H80-020816

340B ID

CHC29020-01

Grant Number

H80CS29020

Additional Details

Current Program Status

Terminated

Registration Date

10/25/2017

Participating Start Date

1/1/2018

Participating Approval Date

10/26/2017

Last Recertification Date

2/7/2022

Termination Date
Termination Reason

10/1/2022
Other

Contacts

Authorizing Official

Compass Community Health
Summer M Kirby, CEO
(740) 351-1514

Primary Contact

Compass Community Health
Jamie Herrmann, Risk & Revenue Manager
(740) 355-7102

Addresses

Street Address

411 Court Street
Portsmouth, OH 45662-3932

Billing Address

Compass Community Health
1634 11th Street
Portsmouth, OH 45662

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
OH	0237609,0249180	1174047658,1154845352

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	HEPCARE PHARMACY	11209 METRIC BLVD STE B-4		AUSTIN	TX	78758-4182	04/15/2019	07/01/2019	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	04/01/2022	07/01/2022	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2022	07/01/2022	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2022	07/01/2022	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	04/01/2022	07/01/2022	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	04/01/2022	07/01/2022	10/01/2022	10/01/2022

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CHC29020-00	Active	BPS-H80-015783	COMPASS COMMUNITY HEALTH	Compass Community Health	1634 11th Street		Portsmouth	OH
CHC29020-01	Terminated	BPS-H80-020816	COMPASS COMMUNITY HEALTH	Compass Community Health	411 Court Street		Portsmouth	OH

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC29020-00	COMPASS PHARMACY	1634 11TH STREET		PORTSMOUTH	OH	45662	04/01/2016	09/01/2017
CHC29020-00	ENCORE PHARMACY #1	800 8TH AVE STE 130		FORT WORTH	TX	76104	01/01/2023
CHC29020-00	ENCORE PHARMACY #83	11209 METRIC BLVD STE B4		AUSTIN	TX	78758	09/06/2022
CHC29020-00	HEPCARE PHARMACY	11209 METRIC BLVD STE B-4		AUSTIN	TX	78758-4182	07/01/2019
CHC29020-01	HEPCARE PHARMACY	11209 METRIC BLVD STE B-4		AUSTIN	TX	78758-4182	07/01/2019	10/01/2022
CHC29020-00	K MART PHARMACY #3420		225 WEST AVENUE	NEW BOSTON	OH	45662	07/01/2016	07/06/2016
CHC29020-00	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2016	05/18/2016
CHC29020-00	KROGER PHARMACY #16664	9101 OHIO RIVER ROAD		WHEELERSBURG	OH	45694	04/01/2016	05/18/2016
CHC29020-00	KROGER PHARMACY N-575	811 GAY STREET		PORTSMOUTH	OH	45662	04/01/2016	05/18/2016
CHC29020-00	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	04/04/2022
CHC29020-01	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	07/01/2022	10/01/2022
CHC29020-00	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/04/2022
CHC29020-01	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2022	10/01/2022
CHC29020-00	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/04/2022
CHC29020-00	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	04/04/2022
CHC29020-01	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2022	10/01/2022
CHC29020-01	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	07/01/2022	10/01/2022
CHC29020-00	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	04/04/2022
CHC29020-01	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	07/01/2022	10/01/2022
CHC29020-00	SMITH DRUG CO INC	741 2ND ST.		PORTSMOUTH	OH	45662-4001	04/01/2016	01/30/2017
CHC29020-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2016	06/17/2016
CHC29020-00	WAL-MART PHARMACY 10-1368	11217 STATE ROUTE 41		WEST UNION	OH	45693	04/01/2016	06/17/2016
CHC29020-00	WAL-MART PHARMACY 10-1519	100 WAL-MART DRIVE		JACKSON	OH	45640	04/01/2016	06/17/2016
CHC29020-00	WAL-MART PHARMACY 10-1564	4490 GALLIA STREET		NEW BOSTON	OH	45662	04/01/2016	06/17/2016
CHC29020-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2016	06/17/2016

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		6/10/2022 12:00:00 AM	9/6/2022 3:04 PM
Details	State	Update	Termination Request	Active	To Be Terminated	9/6/2022 3:04 PM
Terminations	Termination Comments	Update	Termination Request		Relocated facility to new address for non-prescribing providers. All providing prescribers are located at our 1634 11th Street 340B eligible site.	9/6/2022 3:04 PM
Terminations	Termination Date	Update	Termination Request		10/1/2022 12:00:00 AM	9/6/2022 3:04 PM
Terminations	Termination Effective Date	Update	Termination Request		6/10/2022 12:00:00 AM	9/6/2022 3:04 PM
Terminations	Termination Reason	Update	Termination Request		Other	9/6/2022 3:04 PM
Details	Last Recertification Date	Update	Recertification	2/25/2021 5:28:39 PM	2/7/2022 11:53:43 AM	2/7/2022 11:53 AM
Medicaid Billing	NPI: State	Update	Recertification		OH	2/25/2021 5:28 PM
Medicaid Billing	NPI: State	Update	Recertification		OH	2/25/2021 5:28 PM
Details	Last Recertification Date	Update	Recertification	2/3/2020 6:30:29 AM	2/25/2021 5:28:39 PM	2/25/2021 5:28 PM
Addresses	Billing Address	Update	Recertification	Compass Community Health 923 Findlay Street Portsmouth, OH 45662	Compass Community Health 1634 11th Street Portsmouth, OH 45662	2/3/2020 6:30 AM
Contacts	Primary Contact	Insert	Recertification		Herrmann, Jamie Risk & Revenue Manager Compass Community Health 7403557102	2/3/2020 6:30 AM
Details	Last Recertification Date	Update	Recertification	2/4/2019 4:27:27 PM	2/3/2020 6:30:29 AM	2/3/2020 6:30 AM
Details	Last Recertification Date	Update	Recertification	2/10/2018 2:29:26 PM	2/4/2019 4:27:27 PM	2/4/2019 4:27 PM
Details	Last Recertification Date	Update	Recertification		2/10/2018 2:29:26 PM	2/10/2018 2:29 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/14/2017 4:24 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		0249180	12/14/2017 4:24 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		OH	12/14/2017 4:24 PM
Details	State	Update	Change Request	Approved	Active	12/14/2017 4:24 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/14/2017 2:53 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		0237609	12/14/2017 2:53 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		OH	12/14/2017 2:53 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1154845352	12/14/2017 2:53 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1174047658	12/14/2017 2:41 PM
Contacts	Signed By	Insert	New Registration		Kirby, Summer M CEO Compass Community Health 7403511514	10/26/2017 7:40 AM
Details	340B ID	Update	New Registration		CHC29020-01	10/26/2017 7:40 AM
Dates	Participating Approval Date	Update	New Registration		10/26/2017 7:40:47 AM	10/26/2017 7:40 AM
Details	State	Update	New Registration	Pending	Approved	10/26/2017 7:40 AM
Dates	Signed By Date	Update	New Registration		10/25/2017 8:49:30 PM	10/26/2017 7:40 AM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	10/26/2017 7:40 AM
Addresses	Main Address	Insert	New Registration		411 Court Street Portsmouth, OH 45662-3932	10/25/2017 8:49 PM
Addresses	Billing Address	Insert	New Registration		Compass Community Health 923 Findlay Street Portsmouth, OH 45662	10/25/2017 8:49 PM
Contacts	Authorizing Official	Insert	New Registration		Kirby, Summer M CEO Compass Community Health 7403511514	10/25/2017 8:49 PM
Details	Last Recertification Date	Insert	New Registration			10/25/2017 8:49 PM
Details	Grant Number	Insert	New Registration		H80CS29020	10/25/2017 8:49 PM
Details	340B ID	Insert	New Registration			10/25/2017 8:49 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/25/2017 8:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/25/2017 8:49 PM
Details	Medicare Provider Number	Insert	New Registration			10/25/2017 8:49 PM
Details	Entity Name	Insert	New Registration		COMPASS COMMUNITY HEALTH	10/25/2017 8:49 PM
Details	Program Code	Insert	New Registration		CH	10/25/2017 8:49 PM
Details	Entity Subname	Insert	New Registration		Compass Community Health	10/25/2017 8:49 PM
Dates	Participating Approval Date	Insert	New Registration			10/25/2017 8:49 PM
Details	State	Insert	New Registration		Pending	10/25/2017 8:49 PM
Dates	Registration Date	Insert	New Registration		10/25/2017 8:49:27 PM	10/25/2017 8:49 PM
Dates	Signed By Date	Insert	New Registration			10/25/2017 8:49 PM
Dates	Start Date	Insert	New Registration			10/25/2017 8:49 PM
Terminations	Termination Comments	Insert	New Registration			10/25/2017 8:49 PM
Terminations	Termination Date	Insert	New Registration			10/25/2017 8:49 PM
Terminations	Termination Effective Date	Insert	New Registration			10/25/2017 8:49 PM
Terminations	Termination Reason	Insert	New Registration			10/25/2017 8:49 PM

340B Drug Pricing Program Database