Covered Entity Details

CH04563AC GASTON FAMILY HEALTH SERVICES INC (Terminated) - information as of 4/28/2025 1:50:20 AM

Main Details

Name

GASTON FAMILY HEALTH SERVICES INC

Subdivision Name

Gaston Complete Health

Type

HRSA-Funded Health Center

Site ID

BPS-H80-021002

340B ID

CH04563AC

Grant Number

H80CS00293

Additional Details

Current Program Status

Terminated

Registration Date

11/3/2017

Participating Start Date

1/1/2018

Participating Approval Date

11/7/2017

Last Recertification Date

1/30/2019

Termination Date
Termination Reason

7/1/2019
Site closure

Contacts

Authorizing Official

Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245

Primary Contact

Gaston Family Health Services, Inc.
Marvin Patrick Allen, Director, Pharmacy Services
(704) 772-4642

Addresses

Street Address

2505 Court Drive
Gastonia, NC 28052-2140

Billing Address

Gaston Family Health Services, Inc.
200 East Second Avenue
Gastonia, NC 28052

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	1518418763
		1518418763

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
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH045630	Active	BPS-H80-001955	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Hudson	991 W Hudson Blvd	Gastonia	NC
CH04563A	Active	BPS-H80-002496	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - 3rd Ave	111 E 3rd Ave	Gastonia	NC
CH04563AA	Active	BPS-H80-019203	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at Mineral Springs	4555 Ogburn Ave	Winston Salem	NC
CH04563AB	Active	BPS-H80-021144	GASTON FAMILY HEALTH SERVICES INC	Kintegra Adult and Pediatric Medicine - XRay Dr	2721 X Ray Dr	Gastonia	NC
CH04563AC	Terminated	BPS-H80-021002	GASTON FAMILY HEALTH SERVICES INC	Gaston Complete Health	2505 Court Drive	Gastonia	NC
CH04563AD	Terminated	BPS-H80-018922	GASTON FAMILY HEALTH SERVICES INC	Kintegra Customer Support	1385 E. Garrison Blvd.	Gastonia	NC
CH04563AE	Active	BPS-H80-019205	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at Ashley Wellness Center	1647 NE Ashley School Circle	Winston Salem	NC
CH04563AF	Active	BPS-H80-019676	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Thomasville	611 Randolph St.	Thomasville	NC
CH04563AG	Active	BPS-H80-027061	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA Mobile Medical Unit	4555 Ogburn Ave	Winston Salem	NC
CH04563AH	Active	BPS-H80-027050	GASTON FAMILY HEALTH SERVICES INC	Kintegra at South Newton Elementary	306 W I St	Newton	NC
CH04563AJ	Active	BPS-H80-027063	GASTON FAMILY HEALTH SERVICES INC	Kintegra at North Newton Elementary	221 W 26th St	Newton	NC
CH04563AK	Active	BPS-H80-027044	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Newton-Conover Middle	873 Northern Dr NW	Conover	NC
CH04563AL	Active	BPS-H80-027047	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at North Forsyth	5705 Shattalon Dr	Winston Salem	NC
CH04563AM	Active	BPS-H80-027067	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Dentistry - Lincolnton	111 Doctors Park	Lincolnton	NC
CH04563AN	Active	BPS-H80-018290	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Lincolnton	212 Gamble Drive	Lincolnton	NC
CH04563AP	Active	BPS-H80-024921	GASTON FAMILY HEALTH SERVICES INC	Catawba Valley Family Medicine - Claremont	3114 West Main Street	Claremont	NC
CH04563AQ	Active	BPS-H80-027528	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at Hanes Magnet School	2355 Pleasant St	Winston Salem	NC
CH04563AR	Active	BPS-H80-027722	GASTON FAMILY HEALTH SERVICES INC	Catawba Valley Family Medicine - Maiden	137 Island Ford Rd	Maiden	NC
CH04563AS	Active	BPS-H80-028395	GASTON FAMILY HEALTH SERVICES INC	Kintegra at CaroMont Womens Health - Summit	620 Summit Crossing Place	Gastonia	NC
CH04563AT	Active	BPS-H80-028013	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Shuford Elementary	810 Hunsucker Dr NE	Conover	NC
CH04563AU	Active	BPS-H80-028016	GASTON FAMILY HEALTH SERVICES INC	Kintegra Integrated Medicine - Statesville	1703 Davie Ave	Statesville	NC
CH04563AV	Active	BPS-H80-028015	GASTON FAMILY HEALTH SERVICES INC	Kintegra Mobile Dentistry Unit North	518 Brookdale Dr	Statesville	NC
CH04563AW	Active	BPS-H80-028378	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Oakwood Elementary	366 4th St NW	Hickory	NC
CH04563AX	Active	BPS-H80-028011	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Newton Conover High	338 W 15th St	Newton	NC
CH04563AY	Active	BPS-H80-028371	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Viewmont Elementary	21 16th Ave NW	Hickory	NC
CH04563AZ	Active	BPS-H80-028375	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Longview Elementary	737 12th St SW	Hickory	NC
CH04563B	Active	BPS-H80-008766	GASTON FAMILY HEALTH SERVICES INC	Kintegra Pediatric Dentistry - Gastonia	890 Summit Crossing Pl	Gastonia	NC
CH04563BA	Active	BPS-H80-028014	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Dentistry - Mocksville	100 Ridgeview Dr	Mocksville	NC
CH04563BB	Active	BPS-H80-028010	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Catawba Women's Center	1501 Tate Blvd SE	Hickory	NC
CH04563BC	Active	BPS-H80-028380	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Southwest Elementary	1580 32nd St SW	Hickory	NC
CH04563BD	Active	BPS-H80-028372	GASTON FAMILY HEALTH SERVICES INC	Catawba Valley Family Medicine - Taylorsville	50 Macedonia Church Rd	Taylorsville	NC
CH04563BE	Active	BPS-H80-028017	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Iredell County Health Department	318 Turnersburg Hwy	Statesville	NC
CH04563BF	Active	BPS-H80-028374	GASTON FAMILY HEALTH SERVICES INC	Kintegra at CaroMont Womens Health - Ashley	1225 E Garrison Blvd	Gastonia	NC
CH04563BG	Active	BPS-H80-028376	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Jenkins Elementary	3750 N Center St	Hickory	NC
CH04563BH	Active	BPS-H80-028018	GASTON FAMILY HEALTH SERVICES INC	Kintegra at A Woman's View	915 Tate Blvd SE	Hickory	NC
CH04563BJ	Active	BPS-H80-028012	GASTON FAMILY HEALTH SERVICES INC	Kintegra Behavioral Health - Mocksville	172 S Clement St	Mocksville	NC
CH04563BK	Active	BPS-H80-028394	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Woodhill Elementary	1027 Woodhill Dr	Gastonia	NC
CH04563BL	Active	BPS-H80-028377	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Hershal H Beam Elementary	200 Davis Park Rd	Gastonia	NC
CH04563BM	Active	BPS-H80-028373	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Belmont Central Elementary	310 Eagle Rd	Belmont	NC
CH04563BN	Active	BPS-H80-028379	GASTON FAMILY HEALTH SERVICES INC	Kintegra at North Belmont Elementary	210 School St	Belmont	NC
CH04563BP	Active	BPS-H80-028385	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Tryon Elementary	2620 Tryon Courthouse Rd	Bessemer City	NC
CH04563BQ	Active	BPS-H80-030343	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Fred T Foard HIgh	3407 Plateau Rd	Newton	NC
CH04563BR	Active	BPS-H80-030345	GASTON FAMILY HEALTH SERVICES INC	Kintegra at St Stephens HIgh	3205 34th Street Dr NE	Hickory	NC
CH04563BS	Active	BPS-H80-030344	GASTON FAMILY HEALTH SERVICES INC	Kintegra at North Davie Middle	497 Farmington Rd	Mocksville	NC
CH04563BT	Active	BPS-H80-030342	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Maiden High	600 W Main St	Maiden	NC
CH04563BU	Active	BPS-H80-030411	GASTON FAMILY HEALTH SERVICES INC	Iredell Psychiatry	766 Hartness Rd	Statesville	NC
CH04563BV	Terminated	BPS-H80-030859	GASTON FAMILY HEALTH SERVICES INC	Temporary Site - Sipe's Orchard Home	4431 County Home Rd	Conover	NC
CH04563BW	Active	BPS-H80-030950	GASTON FAMILY HEALTH SERVICES INC	PACE of the Southern Piedmont	6133 The Plaza	Charlotte	NC
CH04563BX	Active	BPS-H80-031022	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Boiling Springs	305 W College Ave	Shelby	NC
CH04563BY	Terminated	BPS-H80-031438	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Kings Mountain	502 W King St	Kings Mountain	NC
CH04563BZ	Active	BPS-H80-031440	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Hickory Career & Arts Magnet	409 8th Ave NE	Hickory	NC
CH04563C	Terminated	BPS-H80-000169	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Bessemer City	119 W. PENNSYLVANIA AVE	BESSEMER	NC
CH04563CA	Active	BPS-H80-031435	GASTON FAMILY HEALTH SERVICES INC	Kintegra at William Ellis Middle	144 William Ellis Dr	Advance	NC
CH04563CB	Active	BPS-H80-031434	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Bunker Hill High	4675 Oxford School Rd	Claremont	NC
CH04563CC	Active	BPS-H80-031433	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Bandys High	5040 E Bandys Xrd	Catawba	NC
CH04563CD	Active	BPS-H80-031432	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Hickory High	1234 3rd St NE	Hickory	NC
CH04563CE	Active	BPS-H80-031437	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Northview Middle	302 28th Ave NE	Hickory	NC
CH04563CF	Active	BPS-H80-031431	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Discovery High	301 W 18th St	Newton	NC
CH04563CG	Active	BPS-H80-031439	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Davie County High	180 War Eagle Dr	Mocksville	NC
CH04563CH	Active	BPS-H80-031436	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Grandview Middle	451 Catawba Valley Blvd	Hickory	NC
CH04563CJ	Terminated	BPS-H80-031441	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Sipe's Orchard Home	4431 County Home Rd	Conover	NC
CH04563CK	Active	BPS-H80-032660	GASTON FAMILY HEALTH SERVICES INC	Kintegra Pediatric Medicine - Shelby	1019 N Lafayette St	Shelby	NC
CH04563CL	Active	BPS-H80-032846	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Challenger High School	2550 US Highway 70 SE	Hickory	NC
CH04563CM	Active	BPS-H80-032847	GASTON FAMILY HEALTH SERVICES INC	Kintegra at South Davie Middle	197 S Davie Dr	Mocksville	NC
CH04563CN	Active	BPS-H80-032843	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Catawba Rosenwald Education Center	403 6th Ave SW	Catawba	NC
CH04563CP	Active	BPS-H80-032848	GASTON FAMILY HEALTH SERVICES INC	Kintegra at William R. Davie Elementary	3437 US Highway 601 N	Mocksville	NC
CH04563CQ	Active	BPS-H80-033403	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Catawba Valley Community College	2550 US Highway 70 SE Ste	Hickory	NC
CH04563CR	Active	BPS-H80-032659	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at Petree Elementary	3815 Old Greensboro Rd	Winston Salem	NC
CH04563CS	Active	BPS-H80-032844	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Davie County Early College	1211 Salisbury Rd	Mocksville	NC
CH04563CT	Active	BPS-H80-032845	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Cornatzer Elementary	529 Cornatzer Rd	Mocksville	NC
CH04563CU	Active	BPS-H80-033402	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Mocksville	154 Government Center Dr	Mocksville	NC
CH04563CV	Active	BPS-H80-033404	GASTON FAMILY HEALTH SERVICES INC	Kintegra at Cleveland County Public Health	200 S Post Rd	Shelby	NC
CH04563CW	Active	BPS-H80-033599	Gaston Family Health Services, Inc.	Kintegra at Cleveland Community College	137 S Post Rd	Shelby	NC
CH04563CX	Active	BPS-H80-033916	Gaston Family Health Services, Inc.	Kintegra Behavioral Health - Hickory	858 2nd St NE	Hickory	NC
CH04563CY	Active	BPS-H80-034340	Gaston Family Health Services, Inc.	Kintegra Family Medicine - Kings Mountain West	812 West King Street	Kings Mountain	NC
CH04563CZ	Terminated	BPS-H80-034316	Gaston Family Health Services, Inc.	Kintegra Family Medicine - Shelby	808 Schenck St	Shelby	NC
CH04563D	Active	BPS-H80-010157	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Highland	609 N Highland St	Gastonia	NC
CH04563DA	Active	BPS-H80-034317	Gaston Family Health Services, Inc.	Kintegra Family Medicine - Fallston	5009 Fallston Rd	Lawndale	NC
CH04563DB	Active	BPS-H80-034234	Gaston Family Health Services, Inc.	Kintegra Mobile Dentistry Unit East	420 N Salisbury St	Lexington	NC
CH04563DC	Active	BPS-H80-034242	Gaston Family Health Services, Inc.	Kintegra Customer Support	613 E Franklin Blvd	Gastonia	NC
CH04563DD	Terminated	BPS-H80-035109	Gaston Family Health Services, Inc.	Kintegra Family Medicine - Shelby Lee St	114 Lee St	Shelby	NC
CH04563DE	Terminated	BPS-H80-034744	Gaston Family Health Services, Inc.	Kintegra at Piedmont HealthCare Womens Center	1804 Davie Ave	Statesville	NC
CH04563DF	Active	BPS-H80-035437	Gaston Family Health Services, Inc.	Kintegra at Maiden Middle School	518 N C Ave	Maiden	NC
CH04563DG	Active	BPS-H80-035442	Gaston Family Health Services, Inc.	Kintegra at Piedmont Elementary	119 E 2nd Ave	Gastonia	NC
CH04563DH	Active	BPS-H80-035449	Gaston Family Health Services, Inc.	Kintegra at Catawba Springs Elementary	206 N Little Egypt Rd	Denver	NC
CH04563DJ	Active	BPS-H80-035443	Gaston Family Health Services, Inc.	Kintegra at St James Elementary	1774 St James Church Rd	Denver	NC
CH04563DK	Active	BPS-H80-035448	Gaston Family Health Services, Inc.	Kintegra at Battleground Elementary	301 Jeb Seagle Dr	Lincolnton	NC
CH04563DL	Terminated	BPS-H80-035439	Gaston Family Health Services, Inc.	Catawba Valley Family Medicine - Mountain View	2712 NC-127	Hickory	NC
CH04563DM	Active	BPS-H80-035450	Gaston Family Health Services, Inc.	Kintegra at Piedmont High	2596 Robinwood Rd	Gastonia	NC
CH04563DN	Active	BPS-H80-035453	Gaston Family Health Services, Inc.	Kintegra at Central Davie Academy	160 Martin Luther King Jr Rd	Mocksville	NC
CH04563DP	Active	BPS-H80-035435	Gaston Family Health Services, Inc.	Kintegra at Arndt Middle School	3550 34th St DR NE	Hickory	NC
CH04563DQ	Active	BPS-H80-035441	Gaston Family Health Services, Inc.	Kintegra at Jacob's Fork Middle School	3431 Plateau Rd	Newton	NC
CH04563DR	Active	BPS-H80-035436	Gaston Family Health Services, Inc.	Catawba Valley Family Medicine– Graystone	3511 Graystone Place	Conover	NC
CH04563DS	Active	BPS-H80-035466	Gaston Family Health Services, Inc.	Kintegra Health	336 Burtonwood Dr	Gastonia	NC
CH04563DT	Active	BPS-H80-035446	Gaston Family Health Services, Inc.	Kintegra at Piedmont Middle School	2970 S New Hope Rd	Gastonia	NC
CH04563DU	Active	BPS-H80-035438	Gaston Family Health Services, Inc.	Kintegra at Riverbend Middle School	4670 Oxford School Rd	Claremont	NC
CH04563DV	Active	BPS-H80-035865	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Carr Elementary	307 South Pine St	Dallas	NC
CH04563DW	Active	BPS-H80-035862	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Cooleemee Elementary	136 Marginal St	Cooleemee	NC
CH04563DX	Active	BPS-H80-035447	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Pinebrook Elementary	477 Pinebrook School Rd	Mocksville	NC
CH04563DY	Active	BPS-H80-035445	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Norris S Childers Elementary	2595 Rock Dam Rd	Lincolnton	NC
CH04563DZ	Active	BPS-H80-035451	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Love Memorial Elementary	1463 Love Memorial School Rd	Lincolnton	NC
CH04563E	Terminated	BPS-H80-003067	GASTON FAMILY HEALTH SERVICES INC	OPEN DOOR DENTISTRY	425 Wilmington Ave	Statesville	NC
CH04563EA	Active	BPS-H80-035444	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at S Ray Lowder Elementary	350 Kennedy Dr	Lincolnton	NC
CH04563EB	Active	BPS-H80-035452	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Mill Creek Middle School	1041 Shiloh Rd	Claremont	NC
CH04563EC	Active	BPS-H80-035863	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Mocksville Elementary	295 Cemetary St	Mocksville	NC
CH04563ED	Active	BPS-H80-035454	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at G E Massey Elementary	130 New Bold St	Lincolnton	NC
CH04563EE	Active	BPS-H80-035901	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Holbrook Middle School	418 S Church St	Lowell	NC
CH04563EF	Active	BPS-H80-035884	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at North Gaston High School	1133 Ratchford Rd	Dallas	NC
CH04563EG	Active	BPS-H80-035867	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Belmont Middle School (BMS)	1020 South Point Rd	Belmont	NC
CH04563EH	Active	BPS-H80-035864	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Pleasant Ridge Elementary	1260 Floyed Ln	Gastonia	NC
CH04563EJ	Active	BPS-H80-035972	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Chiropractic	1022 Shelton Ave	Statesville	NC
CH04563EK	Active	BPS-H80-036119	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Dentistry - Randolph HD	2222 S. Fayetteville St.	Asheboro	NC
CH04563EL	Active	BPS-H80-035808	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Podiatry	2721 X Ray Dr	Gastonia	NC
CH04563EM	Active	BPS-H80-035866	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Shady Grove Elementary	3179 Cornatzer Rd	Advance	NC
CH04563EN	Active	BPS-H80-036177	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Kings Mountain Intermediate	227 Kings Mountain Blvd.	Kings Mountain	NC
CH04563EP	Active	BPS-H80-036329	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Warlick Family YMCA	2221 Robinwood Rd	Gastonia	NC
CH04563EQ	Active	BPS-H80-036178	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Washington Elementary	1907 Stony Point Rd	Shelby	NC
CH04563ER	Active	BPS-H80-036094	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Burns Middle School	215 Shady Grove Rd	Lawndale	NC
CH04563ES	Active	BPS-H80-036442	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Dentistry Unit - Randolph	611 Randolph St	Thomasville	NC
CH04563ET	Terminated	BPS-H80-036591	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine - Asheboro White Oak	425 White Oak St	Asheboro	NC
CH04563EU	Active	BPS-H80-036589	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine - Asheboro	1831 N Fayetteville St	Asheboro	NC
CH04563EV	Active	BPS-H80-036330	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Stowe Family YMCA	196 YMCA Drive	Belmont	NC
CH04563EW	Terminated	BPS-H80-036587	GASTON FAMILY HEALTH SERVICES, INC.	Administrative Offices	624 S. Fayettesville St UNIT F1, 2 & 3	Asheboro	NC
CH04563EX	Active	BPS-H80-036590	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Dentistry - Asheboro	308 Brewer St	Asheboro	NC
CH04563EY	Active	BPS-H80-036598	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine - Shelby Marketplace	1760 East Dixon Blvd	Shelby	NC
CH04563EZ	Active	BPS-H80-036599	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine - Shelby - Dixon Blvd	1758 E Dixon Blvd	Shelby	NC
CH04563F	Active	BPS-H80-002213	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine - Statesville	1022 SHELTON AVENUE	STATESVILLE	NC
CH04563FA	Active	BPS-H80-036697	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Health Admin - Shannon Bradley	1520 Shannon Bradley Rd	Gastonia	NC
CH04563FB	Active	BPS-H80-036731	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Behavioral Health - Riverwood	3050 Riverwood Pkwy, Ste B	Gastonia	NC
CH04563FC	Active	BPS-H80-037194	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra/SHA at Moore Elementary	451 Knollwood St	Winston Salem	NC
CH04563FD	Active	BPS-H80-037473	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at St. Stephens Elementary	684 30th St NE	Conover	NC
CH04563FE	Active	BPS-H80-037195	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Union Elementary	4875 Reepsville Rd	Vale	NC
CH04563FF	Active	BPS-H80-037199	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Iron Station Elementary	4207 E Highway 27	Iron Station	NC
CH04563FG	Active	BPS-H80-037143	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at W C Friday Middle	1221 Ratchford Dr	Dallas	NC
CH04563FH	Active	BPS-H80-036732	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Dentistry Unit - 5	111 E 3rd Ave	Gastonia	NC
CH04563FJ	Active	BPS-H80-037474	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Webb A. Murray Elementary	3901 Section House Rd	Hickory	NC
CH04563FK	Active	BPS-H80-037193	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Yadkinville Elementary	305 N State St	Yadkinville	NC
CH04563FL	Active	BPS-H80-037146	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Stuart Cramer High	101 Lakewood Rd	Belmont	NC
CH04563FM	Active	BPS-H80-037141	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Warlick Academy	1316 Spencer Mountain Rd	Gastonia	NC
CH04563FN	Active	BPS-H80-037196	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Starmount Middle	2626 Longtown Rd	Boonville	NC
CH04563FP	Active	BPS-H80-037198	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Jonesville Elementary	101 Cedarbrook Rd	Jonesville	NC
CH04563FQ	Active	BPS-H80-037476	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Balls Creek Elementary	2620 Balls Creek Rd	Newton	NC
CH04563FR	Active	BPS-H80-037475	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Mitchell Community College	500 W Broad St	Statesville	NC
CH04563FS	Active	BPS-H80-037477	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Oxford Elementary	5915 Oxford School Rd	Claremont	NC
CH04563FT	Active	BPS-H80-037145	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Turning Point Academy	409 W Sumter St	Shelby	NC
CH04563FU	Active	BPS-H80-037197	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at North Brook Elementary	642 Highway 274	Vale	NC
CH04563FV	Active	BPS-H80-037192	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Rock Springs Elementary	3633 N NC 16 Business Hwy	Denver	NC
CH04563FW	Active	BPS-H80-031558	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Health	420 N. Salisbury St	Lexington	NC
CH04563FX	Active	BPS-H80-037142	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Costner Elementary	353 Old NC 277 Loop Rd	Dallas	NC
CH04563FY	Active	BPS-H80-037144	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at New Hope Elementary	137 Stowe Rd	Gastonia	NC
CH04563FZ	Active	BPS-H80-037472	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Claremont Elementary	3384 E Main St	Claremont	NC
CH04563G	Terminated	BPS-H80-010848	GASTON FAMILY HEALTH SERVICES INC	Helping Hands Health Center	206 Gamble Dr STE C	Lincolnton	NC
CH04563GA	Active	BPS-H80-037471	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at West Lincoln Middle	260 Shoal Rd	Lincolnton	NC
CH04563GB	Active	BPS-H80-037140	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Page Primary	215 Ewing Dr	Belmont	NC
CH04563GC	Active	BPS-H80-037870	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Uwharrie Charter Academy Elementary	5326 US Highway 220 S	Asheboro	NC
CH04563GD	Active	BPS-H80-037849	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Brookside Elementary	1925 Auten Road	Gastonia	NC
CH04563GE	Active	BPS-H80-037556	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at McAdenville Elementary	275 Wesleyan Dr	Mc Adenville	NC
CH04563GF	Active	BPS-H80-037555	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at South Point High	906 S Point Rd	Belmont	NC
CH04563GG	Active	BPS-H80-037871	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Uwharrie Charter Academy Middle & High	207 Eagle Lane	Asheboro	NC
CH04563GH	Active	BPS-H80-038274	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Bessemer City High	119 Yellow Jacket Ln	Bessemer City	NC
CH04563GJ	Active	BPS-H80-038275	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Bessemer City Middle	525 Ed Wilson Road	Bessemer City	NC
CH04563GK	Active	BPS-H80-037947	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Bessemer City Central Elementary	1400 Puetts Chapel Rd	Bessemer City	NC
CH04563GL	Active	BPS-H80-038273	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Bessemer City Primary	1320 North 12th Street	Bessemer City	NC
CH04563GM	Active	BPS-H80-038447	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Mobile Optometry	1022 Shelton Ave	Statesville	NC
CH04563GN	Active	BPS-H80-038627	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at James Love Elementary	309 James Love School Rd	Shelby	NC
CH04563GP	Active	BPS-H80-038516	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Clover Garden School	5806 Pagetown Road	Burlington	NC
CH04563GQ	Active	BPS-H80-038736	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Atrium Women's Center - Monroe	1550 Faulk St. STE 2100	Monroe	NC
CH04563GR	Active	BPS-H80-038735	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Atrium Women's Center - Albemarle	105 Yadkin St., Ste. 102	Albemarle	NC
CH04563GS	Active	BPS-H80-038734	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra at Atrium Women's Center - Waxhaw	2700 Providence Rd, Ste. 200	Waxhaw	NC
CH04563GT	Active	BPS-H80-038483	GASTON FAMILY HEALTH SERVICES, INC.	Senior TLC - West	103 T R Harris Drive	Shelby	NC
CH04563GU	Active	BPS-H80-038376	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Family Medicine and Dentistry - Bessemer City	308 E Virginia Ave	Bessemer City	NC
CH04563GV	Active	BPS-H80-038698	GASTON FAMILY HEALTH SERVICES, INC.	Kintegra Behavioral Health - Statesville	1450 Fern Creek Drive	Statesville	NC
CH04563H	Terminated	BPS-H80-009409	GASTON FAMILY HEALTH SERVICES, INC.	GFHS Cherryville – Adult and Pediatric Medicine	112. S. Oak St.	CHERRYVILLE	NC
CH04563J	Active	BPS-H80-011674	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Lexington	420 NORTH SALISBURY ST.	Lexington	NC
CH04563K	Active	BPS-H80-015190	Gaston Family Health Services, Inc.	Kintegra Pediatric Medicine and Kintegra Family Dentistry -Statesville	518 Brookdale Drive	Statesville	NC
CH04563L	Active	BPS-H80-012409	GASTON FAMILY HEALTH SERVICES INC	Kintegra Health	200 E 2nd Ave	Gastonia	NC
CH04563M	Active	BPS-H80-008741	GASTON FAMILY HEALTH SERVICES INC	Kintegra Behavioral Health - Gastonia	409 S Oakland St	Gastonia	NC
CH04563N	Active	BPS-H80-013480	GASTON FAMILY HEALTH SERVICES INC	Senior Total Life Care	1875 Remount Rd	Gastonia	NC
CH04563P	Active	BPS-H80-012926	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Hickory	133 1ST AVE SE	HICKORY	NC
CH04563R	Terminated	BPS-H80-011652	GASTON FAMILY HEALTH SERVICES INC	Davidson Health Services-Thomasville	207 Old Lexington Rd	Thomasville	NC
CH04563S	Active	BPS-H80-016922	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Dentistry - Hickory	3070 11th Ave Dr SE	Hickory	NC
CH04563T	Active	BPS-H80-019599	GASTON FAMILY HEALTH SERVICES INC	Kintegra Mobile Dentistry Unit South	212 Gamble Dr	Lincolnton	NC
CH04563U	Active	BPS-H80-019034	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Dentistry - Lexington	32 Kirkwood Ave.	Lexington	NC
CH04563V	Terminated	BPS-H80-017616	GASTON FAMILY HEALTH SERVICES INC	Davidson Health Services - Thomasville	102 Forest Park Drive	Thomasville	NC
CH04563W	Terminated	BPS-H80-018499	GASTON FAMILY HEALTH SERVICES INC	Kintegra Family Medicine - Cherryville	112 S. Oak Street	Cherryville	NC
CH04563X	Active	BPS-H80-019698	GASTON FAMILY HEALTH SERVICES INC	Catawba Valley Family Medicine - Northeast Hickory	2365 Springs Road NE	Hickory	NC
CH04563Y	Active	BPS-H80-019204	GASTON FAMILY HEALTH SERVICES INC	Kintegra/SHA at Winston-Salem Prep Academy	1215 N Cameron Ave.	Winston Salem	NC
CH04563Z	Terminated	BPS-H80-019137	GASTON FAMILY HEALTH SERVICES INC	GFHS School Based Social Work Program	601 N Cherry St	Winston Salem	NC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH045630	A1 PHARMACY AND SURGICAL SUPPLY, LLC	124 FOREST HILL RD		LEXINGTON	NC	27295-2008	10/01/2020
CH045630	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	08/29/2022
CH045630	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	08/29/2022
CH045630	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	08/29/2022
CH045630	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	08/29/2022
CH045630	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	08/29/2022
CH045630	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	08/29/2022
CH045630	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	08/29/2022	05/31/2023
CH045630	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/01/2022
CH045630	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	04/01/2023
CH045630	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	04/01/2023
CH045630	AVITA PHARMACY 1058	MEDEXPRESS PHARMACY, LTD. DBA AVITA PHAR	1431 W. INNES ST.	SALISBURY	NC	28144	10/01/2023
CH045630	AVITA PHARMACY 1060	RX BLUE STAR SOLUTIONS, LLC DBA AVITA PH	40 PENNWOOD PL STE 200	WARRENDALE	PA	15086-6625	04/01/2023	04/03/2023
CH045630	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2022
CH045630	BEAM & PUTNAM INC	MOSS DRUGS	701 W FRANKLIN BLVD	GASTONIA	NC	28052	10/01/2013	03/17/2025
CH045630	BEAM AND WEASE OF KINGS	MOUNTAIN DBA KM PHARMACY	1106 SHELBY RD	KINGS MOUNTAIN	NC	28086-2742	07/01/2021
CH045630	BI-LO	BI-LO PHARMACY #5605	1955 DAVIS PARK RD	GASTONIA	NC	28052	01/01/2014	04/15/2018
CH045630	BI-LO	BI-LO PHARMACY #5093	6507 WILKINSON BLVD.	BELMONT	NC	28012	07/01/2018	05/25/2021
CH045630	BI-LO	BI-LO PHARMACY #5633	2601 SOUTH NEW HOPE RD	GASTONIA	NC	28056	07/01/2018	05/25/2021
CH045630	BI-LO	BI-LO PHARMACY #5420	1909 EAST BROAD STREET	STATESVILLE	NC	28625	10/01/2019	05/25/2021
CH045630	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/01/2024	03/01/2024
CH045630	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/01/2024	03/01/2024
CH045630	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/01/2024	03/01/2024
CH045630	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/01/2025
CH045630	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/01/2025
CH045630	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/01/2021
CH045630	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/01/2021
CH045630	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/01/2021
CH045630	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/01/2021
CH045630	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/01/2021
CH045630	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2020
CH045630	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2020
CH045630	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/01/2021
CH045630	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/01/2021
CH045630	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/01/2021
CH045630	CENTER PHARMACY OF MAIDEN	TAS DRUG MAIDEN	201-D ISLAND FORD RD PO BOX 123	MAIDEN	NC	28650	10/01/2020
CH045630	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	08/04/2022
CH045630	CENTERWELL PHARMACY, INC.	11010 FLORIDA CROWN DRIVE, SUITE 200		ORLANDO	FL	32824	01/01/2024	07/11/2024
CH045630	COMMUNITY FAMILY PHARMACY	1194 WYKE RD		SHELBY	NC	28150	01/01/2023
CH045630	Cooperative Christian Ministry Pharmacy	31 1st Avenue SE		Hickory	NC	28602	01/27/2016
CH045630	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2021
CH045630	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2021
CH045630	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2020
CH045630	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	03/10/2021	12/19/2023
CH045630	ECKERD CORPORATION	RITE AID #11443	3691 ROBINWOOD ROAD	GASTONIA	NC	28054	01/01/2014	02/05/2018
CH045630	ECKERD CORPORATION	RITE AID #11439	520 EAST TRADE STREET	DALLAS	NC	28034	01/01/2014	02/05/2018
CH045630	ECKERD CORPORATION	RITE AID #11441	2206 WEST FRANKLIN BLVD.	GASTONIA	NC	28052	01/01/2014	02/05/2018
CH045630	ECKERD CORPORATION	RITE AID #11442	110 WEST GARRISON BLVD.	GASTONIA	NC	28052	01/01/2014	02/05/2018
CH045630	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	08/04/2022
CH045630	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	08/04/2022
CH045630	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	08/04/2022
CH045630	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	08/04/2022
CH045630	FALLSTON PHARMACY INC	5011 FALLSTON ROAD	P O BOX 418	FALLSTON	NC	28042	08/04/2022	03/17/2025
CH045630	GARFIELD BEACH CVS, L.L.C.	CVS PHARMACY # 16223	2800 NAGLEE RD	TRACY	CA	95304	03/10/2021
CH045630	GENOA HEALTHCARE LLC	5700 EXECUTIVE CENTER DR STE 216		CHARLOTTE	NC	28212	04/01/2022
CH045630	GENOA HEALTHCARE LLC	327 1ST AVE NW STE P		HICKORY	NC	28601	04/01/2022
CH045630	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00368	3709 N TAMIAMI TRL	SARASOTA	FL	34234	04/01/2022
CH045630	LA PHARMACY LLC	1048 S GARFIELD AVE	STE 101	ALHAMBRA	CA	91801	04/01/2022	04/03/2023
CH045630	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	04/01/2023
CH045630	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/01/2022
CH045630	MEDICAL CENTER PHARMACY OF	CHERRYVILLE INC	607 EAST ACADEMY STREET	CHERRYVILLE	NC	28021	04/30/2010	03/17/2025
CH045630	MORERX, INC, DBA/	HICKORY FAMILY PHARMACY	1501 TATE BLVD, SE SUITE 102	HICKORY	NC	28602	01/01/2018	04/03/2023
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03514	442 HIGHWAY 27 SOUTH	STANLEY	NC	28164	10/01/2015
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03823	1850 WEST FRANKLIN BOULEVARD	GASTONIA	NC	28052	10/01/2015
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03899	902 GASTONIA HIGHWAY	BESSEMER CITY	NC	28016	10/01/2015
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04490	2580 COURT DRIVE	GASTONIA	NC	28054	10/01/2015
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05565	1075 EAST HUDSON BLVD	GASTONIA	NC	28054	10/01/2015
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06406	3126 DALLAS-HIGH SHOALS HWY.	DALLAS	NC	28034	10/01/2015	10/31/2023
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03808	2225 12TH AVENUE NE	HICKORY	NC	28601	01/01/2018
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02521	2701 SOUTH NC HIGHWAY 127	HICKORY	NC	28602	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03806	1403 E. MAIN ST.	LINCOLNTON	NC	28092	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06408	102 ROCKBARN RD.	CONOVER	NC	28613	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06407	1017 SHELBY RD	KINGS MOUNTAIN	NC	28086	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07323	36 NORTH WEST BLVD	NEWTON	NC	28658	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02676	1220 HIGHWAY 321 NW	HICKORY	NC	28601	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03563	1504 2ND ST NE	HICKORY	NC	28601	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02233	6750 WILKINSON BLVD.	BELMONT	NC	28012	07/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07322	200 US HIGHWAY 70A E	HILDEBRAN	NC	28637-8108	10/01/2019
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07681	10478 N NC HIGHWAY 109 STE 105	WINSTON SALEM	NC	27107	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04379	875 BLOWING ROCK BLVD.	LENOIR	NC	28645	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07056	2115 BEATTIES FORD RD	CHARLOTTE	NC	28216	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04135	4310 W. WENDOVER AVE	GREENSBORO	NC	27407	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05445	5100 BEATTIES FORD RD.	CHARLOTTE	NC	28216	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04294	309 EAST CENTER ST.	LEXINGTON	NC	27292	01/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07535	3369 HICKORY BLVD.	HUDSON	NC	28638	04/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03120	301 US 70 E	VALDESE	NC	28690	07/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03524	215 NORTH CENTER STREET	STATESVILLE	NC	28677	10/01/2020
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02571	1235 PECAN AVE.,	CHARLOTTE	NC	28205	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07688	3440 WILKINSON BOULEVARD	CHARLOTTE	NC	28208	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04202	1830 WEST DIXON BOULEVARD	SHELBY	NC	28152	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06401	200 N. GREEN ST.	MORGANTON	NC	28655	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03523	274 NORTH MAIN STREET	MOORESVILLE	NC	28115	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05591	178 TURNERSBURG HIGHWAY	STATESVILLE	NC	28625	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05540	189 HICKORY TREE RD STE 120	WINSTON SALEM	NC	27107	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07539	1924 STATESVILLE BLVD.	SALISBURY	NC	28144	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05557	6901 MARKET ST	WILMINGTON	NC	28411	01/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07524	101 E. MAIN ST.	LOCUST	NC	28097	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03574	3186 PETERS CREEK PKWY.	WINSTON SALEM	NC	27127	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07031	2210 FLEMING RD.	GREENSBORO	NC	27410	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04284	1131 RANDOLPH ST.	THOMASVILLE	NC	27360	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02560	2035 NORTH SHARON AMITY RD	CHARLOTTE	NC	28205	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07696	396 W CHURCH ST	RICHFIELD	NC	28137	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07089	231 N. GRAHAM STREET	CHARLOTTE	NC	28202	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02710	6911 GARRETT RD.	DURHAM	NC	27707	03/10/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03529	520 N. CANNON BLVD.	KANNAPOLIS	NC	28083	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17576	425 COX RD	GASTONIA	NC	28054	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05588	6050 SOUTH NC 16 BUSINESS HWY	DENVER	NC	28037	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05534	3111 TAYLORSVILLE HIGHWAY	STATESVILLE	NC	28625	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07057	105 EAST COLLEGE AVE.	SHELBY	NC	28152	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03569	1550 WILKESBORO HIGHWAY	STATESVILLE	NC	28625	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03837	1803 S. NEW HOPE ROAD	GASTONIA	NC	28054	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16539	1910 CATAWBA VALLEY BLVD SE	HICKORY	NC	28602	07/01/2021
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07331	2147 BLOWING ROCK ROAD	BOONE	NC	28607	04/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03803	559 RIVER HWY	MOORESVILLE	NC	28117	04/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03896	9308 KENDALL DR.	CHARLOTTE	NC	28214	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03559	111 S. MAIN ST.	RUTHERFORDTON	NC	28139	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05757	124 QUBEIN AVE.	HIGH POINT	NC	27262	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07317	240 SPARTA ROAD	NORTH WILKESBORO	NC	28659	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06405	300 EAST GROVER ST	SHELBY	NC	28150	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05341	1142 N. BROOME ST.	WAXHAW	NC	28173	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07578	3658 SOUTH NEW HOPE RD.	GASTONIA	NC	28056	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00187	14125 STEELE CREEK RD.	CHARLOTTE	NC	28273	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03856	44 BRANCHVIEW DRIVE, NE	CONCORD	NC	28025	07/01/2022
CH045630	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04398	921 SOUTH STATE STREET	YADKINVILLE	NC	27055	07/01/2022
CH045630	OFFICE PRACTICE OF PHARMACY	24 COMMERCE DR		TAYLORSVILLE	NC	28681-6524	01/01/2021	08/22/2024
CH045630	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH045630	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/01/2022
CH045630	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/01/2022
CH045630	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	04/01/2022	10/09/2024
CH045630	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2022
CH045630	OVERLAKE PHARMACY, LLC	4124 148TH AVE NE STE JA		REDMOND	WA	98052	04/01/2022	08/22/2024
CH045630	PHARMBLUE LLC DBA AVITA PHARMACY 1059	1226 CHESTNUT ST		PHILADELPHIA	PA	19107	04/01/2023
CH045630	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/01/2022
CH045630	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	03/10/2021	11/16/2023
CH045630	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2020
CH045630	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	01/01/2021
CH045630	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/01/2021
CH045630	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/01/2021
CH045630	PROCARE PHARMACY, LLC	DBA CVS/PHARMACY#2980	601 S. KINGS DR.	CHARLOTTE	NC	28204	01/01/2021
CH045630	PUBLIX NORTH CAROLINA, LP	PUBLIX PHARMACY #1521	1949 HOFFMAN RD.	GASTONIA	NC	28054	10/01/2023	03/21/2025
CH045630	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	10/01/2023	03/21/2025
CH045630	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	10/01/2023	03/21/2025
CH045630	SENTRY DRUG CENTER #11	2622 E MAIN ST		LINCOLNTON	NC	28092-4319	10/01/2024
CH045630	SMITH'S	121-125 WEST MAIN STREET		GASTONIA	NC	28052	10/01/2013	03/23/2016
CH045630	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07583	109 W. MANNING ST.	CHESNEE	SC	29323	04/01/2022
CH045630	TAS DRUG	500 W CHURCH ST		CHERRYVILLE	NC	28021	10/01/2020
CH045630	TENNESSEE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02404	417 E EMORY RD	POWELL	TN	37849-3518	04/01/2022
CH045630	TRUEPILL	3121 DIABLO AVE		HAYWARD	CA	94545	04/01/2022	12/31/2022
CH045630	TRUEPILL NY LLC	850 3RD AVE STE 404		BROOKLYN	NY	11232-1523	04/01/2022	12/31/2022
CH045630	UNION DRUGS	UNION DRUGS	1546 UNION RD STE B	GASTONIA	NC	28054	04/01/2019
CH045630	WAL-MART 10-7004	1300 DALLAS CHERRYVILLE RD		DALLAS	NC	28034	04/01/2019
CH045630	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2018
CH045630	WAL-MART PHARMACY #10-4274	7131 HWY #73		DENVER	NC	28037	03/10/2021
CH045630	WAL-MART PHARMACY #10-4410	4780 HICKORY BLVD.		GRANITE FALLS	NC	28630	10/01/2019
CH045630	WAL-MART PHARMACY #10-4594	2505 LINCOLNTON HWY		CHERRYVILLE	NC	28021	04/01/2014
CH045630	WAL-MART PHARMACY #4224	201 ZELKOVA COURT NW		CONOVER	NC	28613	01/01/2018
CH045630	WAL-MART PHARMACY 10-0948	2525 HWY. 70 S.E.		HICKORY	NC	28602	01/01/2018
CH045630	WAL-MART PHARMACY 10-1034	705 E DIXON BLVD		SHELBY	NC	28152	03/10/2021
CH045630	WAL-MART PHARMACY 10-1131	901 NC HWY 16 SOUTH		TAYLORSVILLE	NC	28681	04/01/2019
CH045630	WAL-MART PHARMACY 10-1209	306 NORTH GENERALS BLVD		LINCOLNTON	NC	28092	01/01/2018
CH045630	WAL-MART PHARMACY 10-1322	160 LOWES BLVD		LEXINGTON	NC	27292	04/01/2019
CH045630	WAL-MART PHARMACY 10-1322	160 LOWES BLVD		LEXINGTON	NC	27292	04/01/2019	09/26/2024
CH045630	WAL-MART PHARMACY 10-1385	3000 E FRANKLIN BLVD		GASTONIA	NC	28054	04/01/2014
CH045630	WAL-MART PHARMACY 10-1662	1116 CROSSROADS DR		STATESVILLE	NC	28625	04/01/2019
CH045630	WAL-MART PHARMACY 10-3503	1585 LIBERTY DRIVE, STE #1		THOMASVIELLE	NC	27360	10/01/2019
CH045630	WAL-MART PHARMACY 10-4432	1818 NORTHWEST BLVD		NEWTON	NC	28658	04/01/2019
CH045630	WAL-MART PHARMACY 10-5085	701 HAWLEY AVENUE		BELMONT	NC	28012	04/01/2014
CH045630	WAL-MART PHARMACY 10-5298	223 N MYRTLE SCHOOL RD		GASTONIA(W)	NC	28052	04/01/2014
CH045630	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2018
CH045630	WAL-MART PHARMACY 10-6263	5039 UNIVERSITY PKWY		WINSTON SALEM	NC	27106	10/01/2022
CH045630	WAL-MART PHARMACY 10-7062	2324 SOUTH NEW HOPE RD		GASTONIA	NC	28054	04/01/2019
CH045630	WAL-MART PHARMACY 10-7146	1011 SHELBY ROAD		KINGS MOUNTAIN	NC	28086	01/01/2018
CH045630	WAL-MART PHARMACY 10-7315	483 HWY 70 SW		HICKORY	NC	28602	04/01/2019
CH045630	WALGREEN CO.	DBA: WALGREENS # 02696	951 DAVIE AVE	STATESVILLE	NC	28677-5301	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 04843	6802 W WILKINSON BLVD	BELMONT	NC	28012	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 04869	3251 FREEDOM DR.	CHARLOTTE	NC	28208	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 05761	4701 SOUTH BLVD	CHARLOTTE	NC	28217	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 05877	1902 WEST FRANKLIN BLVD.	GASTONIA	NC	28052	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 06688	542 RIVER HWY	MOORESVILLE	NC	28117	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 07859	2975 UNION ROAD	GASTONIA	NC	28054-6023	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 09562	820 N DEKALB ST	SHELBY	NC	28150-3914	11/07/2011
CH045630	WALGREEN CO.	WALGREENS #10608	1000 DALLAS CHERRYVILLE HWY.	DALLAS	NC	28034	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS #10891	231 E. DIXON BLVD.	SHELBY	NC	28152	11/07/2011	02/09/2016
CH045630	WALGREEN CO.	DBA: WALGREENS #11692	500 FINCHER ST.	MONROE	NC	28112	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS #11765	1230 E. MAIN ST.	LINCOLNTON	NC	28092	11/07/2011
CH045630	WALGREEN CO.	DBA: WALGREENS # 06742	2500 E FRANKLIN BLVD	GASTONIA	NC	28056-7262	11/25/2011
CH045630	WALGREEN CO.	DBA: WALGREENS #10838	5220 HIGHWAY 557	CLOVER	SC	29710	11/25/2011
CH045630	WALGREEN CO.	DBA: WALGREENS #12437	1250 FAIRVIEW DR.	LEXINGTON	NC	27292	01/01/2015
CH045630	WALGREEN CO.	DBA: WALGREENS #15110	900 SHELBY RD.	KINGS MOUNTAIN	NC	28086	07/01/2016
CH045630	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16405	1500 E 3RD ST STE A	CHARLOTTE	NC	28204	10/01/2016
CH045630	WALGREEN CO.	DBA: WALGREENS #10891	231 E. DIXON BLVD.	SHELBY	NC	28152	01/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS # 07280	1015 RANDOLPH STREET	THOMASVILLE	NC	27360-5726	01/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS # 07646	2915 N CENTER STREET	HICKORY	NC	28601	01/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS #11629	2427 SPRINGS RD NE	HICKORY	NC	28601-3069	01/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS #12484	2700 S. NC 127 HWY	HICKORY	NC	28602	01/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS #15568	456 CONOVER BLVD W	CONOVER	NC	28613	01/01/2018
CH045630	WALGREEN CO.	RITE AID #11439	520 E TRADE ST	DALLAS	NC	28034	02/13/2018	07/31/2018
CH045630	WALGREEN CO.	WALGREENS #19342	110 W GARRISON BLVD	GASTONIA	NC	28052	02/13/2018	03/27/2023
CH045630	WALGREEN CO.	RITE AID #11443	3691 ROBINWOOD RD	GASTONIA	NC	28054	02/13/2018	07/17/2018
CH045630	WALGREEN CO.	WALGREENS #17618	995 BETHANIA RURAL HALL RD	RURAL HALL	NC	27045	10/01/2018
CH045630	WALGREEN CO.	RITE AID #11344	901 RANDOLPH ST	THOMASVILLE	NC	27360	10/01/2018	02/25/2019
CH045630	WALGREEN CO.	WALGREENS #17863	601 E KING ST	KINGS MOUNTAIN	NC	28086	10/01/2018	08/19/2024
CH045630	WALGREEN CO.	WALGREENS #18115	1716 E BROAD ST	STATESVILLE	NC	28625	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #18367	6475 OLD US HIGHWAY 52	LEXINGTON	NC	27295	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #19825	6798 SHALLOWFORD RD	LEWISVILLE	NC	27023	10/01/2018	10/14/2021
CH045630	WALGREEN CO.	WALGREENS #17014	3534 MT HOLLY-HUNTERSVILLE RD	CHARLOTTE	NC	28216	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #17901	650 S MAIN ST	KING	NC	27021	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #19943	2465 S NEW HOPE RD	GASTONIA	NC	28054	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #19937	1485 RIVER RIDGE DR	CLEMMONS	NC	27012	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #17240	305 W US HIGHWAY 64	LEXINGTON	NC	27295-2505	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #17235	3095 WAUGHTOWN ST	WINSTON-SALEM	NC	27107	10/01/2018	04/21/2025
CH045630	WALGREEN CO.	WALGREENS #17368	617 HIGHLAND ST	MOUNT HOLLY	NC	28120	10/01/2018
CH045630	WALGREEN CO.	WALGREENS #17901	650 S MAIN ST	KING	NC	27021	10/01/2018	09/26/2024
CH045630	WALGREEN CO.	WALGREENS #17292	1170 E MARION ST	SHELBY	NC	28150	10/01/2018	02/19/2024
CH045630	WALGREEN CO.	WALGREENS #17509	909 HASTY SCHOOL RD	THOMASVILLE	NC	27360	10/01/2018
CH045630	WALGREEN CO.	DBA: WALGREENS #10154	6028 S. NC 16 HWY.	MAIDEN	NC	28650	01/01/2019
CH045630	WALGREEN CO.	WALGREENS #16120	533 N MAIN ST	TROUTMAN	NC	28166	01/01/2019
CH045630	WALGREEN CO.	DBA: WALGREENS #13036	7385 NC 73 HIGHWAY	DENVER	NC	28037	04/01/2019
CH045630	WALGREEN CO.	DBA: WALGREENS #12780	3062 HICKORY BLVD.	HUDSON	NC	28638	04/01/2022
CH045630	WALGREEN CO.	WALGREENS #17560	623 S STATE ST	YADKINVILLE	NC	27055	04/01/2022
CH045630	WALGREEN CO.	DBA: WALGREENS #10614	997 E. LIBERTY ST.	YORK	SC	29745	04/01/2022
CH045630	WALGREEN CO.	DBA: WALGREENS #12047	2758 S. MAIN ST.	HIGH POINT	NC	27263	04/01/2022
CH045630	WALGREEN CO.	DBA: WALGREENS #12781	440 BLOWING ROCK BLVD.	LENOIR	NC	28645	04/01/2022
CH045630	WALGREEN CO.	WALGREENS #17880	508 HWY 29N	CHINA GROVE	NC	28023	04/01/2022
CH045630	WALGREEN CO.	DBA: WALGREENS # 07278	1906 W INNES STREET	SALISBURY	NC	28144	04/01/2022
CH045630	WALGREEN CO.	WALGREENS #17076	121 RAILROAD AVE	RUTHERFORDTON	NC	28139	07/01/2022
CH045630	WALGREEN CO.	WALGREENS #21284	200 HAWTHORNE LN STE T1578	CHARLOTTE	NC	28204	07/01/2022	01/22/2025
CH045630	WALGREEN CO.	WALGREENS #19776	1107 E DIXIE DR	ASHEBORO	NC	27203	07/01/2023
CH045630	WALGREEN CO.	WALGREENS #21438	6638 JORDAN RD	RAMSEUR	NC	27316	07/01/2023
CH045630	WALGREEN CO.	DBA: WALGREENS # 09730	207 N FAYETTEVILLE ST	ASHEBORO	NC	27203-5529	07/01/2023
CH045630	WALGREEN CO.	WALGREENS #19006	101 E FLEMING DR	MORGANTON	NC	28655	10/01/2023
CH045630	WALGREEN CO.	DBA: WALGREENS # 10133	1505 EAST INNES STREET	SALISBURY	NC	28146	10/01/2023
CH045630	WALGREEN CO.	DBA: WALGREENS # 09996	837 W FLOYD BAKER BLVD	GAFFNEY	SC	29341-1805	10/01/2023
CH045630	WALGREEN CO.	DBA: WALGREENS # 10566	901 YADKINVILLE RD	MOCKSVILLE	NC	27028-2033	10/01/2023
CH045630	WALGREEN CO.	WALGREENS #19002	868 N GREEN ST	MORGANTON	NC	28655	10/01/2023	01/15/2025
CH045630	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	01/01/2015	07/22/2015
CH045630	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2015	07/22/2015
CH045630	WALGREENS OF NORTH CAROLINA INC.	COMMUNITY, A WALGREENS PHARMACY #16313	2816 ERWIN ROAD SUITE 105	DURHAM	NC	27705	07/01/2017
CH045630	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	03/10/2021
CH045630	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	03/10/2021	10/01/2021
CH045630	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	03/10/2021
CH045630	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	03/10/2021
CH045630	WALMART PHARMACY 10-3504	2415 SPRINGS ROAD NE		HICKORY	NC	28601	01/01/2018
CH045630	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2024
CH045630	WALMART PHARMACY 10-7205	90 W US HWY 64		LEXINGTON	NC	27295	04/01/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Allen, Marvin Patrick Director, Pharmacy Services Gaston Family Health Services, Inc. 7048535086	Allen, Marvin Patrick Director, Pharmacy Services Gaston Family Health Services, Inc. 7047724642	4/21/2020 12:10 PM
Details	State	Update		To Be Terminated	Terminated	7/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		12/28/2018 12:00:00 AM	4/18/2019 9:07 AM
Details	State	Update	Termination Request	Active	To Be Terminated	4/18/2019 9:07 AM
Terminations	Termination Date	Update	Termination Request		7/1/2019 12:00:00 AM	4/18/2019 9:07 AM
Terminations	Termination Effective Date	Update	Termination Request		12/31/2018 12:00:00 AM	4/18/2019 9:07 AM
Terminations	Termination Reason	Update	Termination Request		Site closure	4/18/2019 9:07 AM
Details	Last Recertification Date	Update	Recertification	2/9/2018 12:46:35 PM	1/30/2019 7:59:35 AM	1/30/2019 7:59 AM
Details	Last Recertification Date	Update	Recertification		2/9/2018 12:46:35 PM	2/9/2018 12:46 PM
Details	State	Update		Approved	Active	1/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Spencer, Robert CEO Gaston Family Health Services 7046162245	11/7/2017 9:32 AM
Details	340B ID	Update	New Registration		CH04563AC	11/7/2017 9:32 AM
Dates	Participating Approval Date	Update	New Registration		11/7/2017 9:32:55 AM	11/7/2017 9:32 AM
Details	State	Update	New Registration	Pending	Approved	11/7/2017 9:32 AM
Dates	Signed By Date	Update	New Registration		11/3/2017 4:00:18 PM	11/7/2017 9:32 AM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	11/7/2017 9:32 AM
Addresses	Main Address	Insert	New Registration		2505 Court Drive Gastonia, NC 28052-2140	11/3/2017 2:22 PM
Addresses	Billing Address	Insert	New Registration		Gaston Family Health Services, Inc. 200 East Second Avenue Gastonia, NC 28052	11/3/2017 2:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	11/3/2017 2:22 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1518418763	11/3/2017 2:22 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	11/3/2017 2:22 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1518418763	11/3/2017 2:22 PM
Contacts	Authorizing Official	Insert	New Registration		Spencer, Robert CEO Gaston Family Health Services 7046162245	11/3/2017 2:22 PM
Contacts	Primary Contact	Insert	New Registration		Allen, Marvin Patrick Director, Pharmacy Services Gaston Family Health Services, Inc. 7048535086	11/3/2017 2:22 PM
Details	Last Recertification Date	Insert	New Registration			11/3/2017 2:22 PM
Details	Grant Number	Insert	New Registration		H80CS00293	11/3/2017 2:22 PM
Details	340B ID	Insert	New Registration			11/3/2017 2:22 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			11/3/2017 2:22 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			11/3/2017 2:22 PM
Details	Medicare Provider Number	Insert	New Registration			11/3/2017 2:22 PM
Details	Entity Name	Insert	New Registration		GASTON FAMILY HEALTH SERVICES INC	11/3/2017 2:22 PM
Details	Program Code	Insert	New Registration		CH	11/3/2017 2:22 PM
Details	Entity Subname	Insert	New Registration		Gaston Complete Health	11/3/2017 2:22 PM
Dates	Participating Approval Date	Insert	New Registration			11/3/2017 2:22 PM
Details	State	Insert	New Registration		Pending	11/3/2017 2:22 PM
Dates	Registration Date	Insert	New Registration		11/3/2017 2:22:51 PM	11/3/2017 2:22 PM
Dates	Signed By Date	Insert	New Registration			11/3/2017 2:22 PM
Dates	Start Date	Insert	New Registration			11/3/2017 2:22 PM
Terminations	Termination Comments	Insert	New Registration			11/3/2017 2:22 PM
Terminations	Termination Date	Insert	New Registration			11/3/2017 2:22 PM
Terminations	Termination Effective Date	Insert	New Registration			11/3/2017 2:22 PM
Terminations	Termination Reason	Insert	New Registration			11/3/2017 2:22 PM

340B Drug Pricing Program Database