Covered Entity Details

CH03029G HAMILTON HEALTH CENTER, INC. (Terminated) - information as of 5/13/2025 11:01:56 PM

Main Details

Name

HAMILTON HEALTH CENTER, INC.

Subdivision Name

Union Deposit Family Practice

Type

HRSA-Funded Health Center

Site ID

BPS-H80-020994

340B ID

CH03029G

Grant Number

H80CS00659

Additional Details

Current Program Status

Terminated

Registration Date

1/15/2018

Participating Start Date

4/1/2018

Participating Approval Date

1/16/2018

Last Recertification Date

2/10/2022

Termination Date
Termination Reason

4/1/2023
Business decision by the Covered Entity

Contacts

Authorizing Official

Hamilton Health Center, Inc.
Terese Delaplaine, President & CEO
(717) 230-3992

Primary Contact

Hamilton Health Center
Jacque' Penn, Purchasing Director
(717) 230-3980

Addresses

Street Address

891 S Arlington Ave
Harrisburg, PA 17109-5004

Billing Address

Hamilton Health Center
110 S 17th Street
Harrisburg, PA 17104

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	MEDICINE SHOPPE 1865	110 S. 17TH STREET		HARRISBURG	PA	17104	04/15/2018	07/01/2018	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4260	4299 UNION DEPOSIT ROAD	HARRISBURG	PA	17111	04/15/2018	07/01/2018	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #866	501 SOUTH 29TH ST STE A	HARRISBURG	PA	17104	04/15/2018	07/01/2018	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3608	1941 DERRY STREET	HARRISBURG	PA	17104	04/15/2018	07/01/2018	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #7894	4999 JONESTOWN RD	HARRISBURG	PA	17109	01/14/2021	04/01/2021	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4293	5 FRIENDLY DRIVE PO BOX 157	DUNCANNON	PA	17020	01/14/2021	04/01/2021	04/01/2023	04/01/2023
Contract Detail	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4287	360 EAST MAIN STREET	MIDDLETOWN	PA	17057	01/14/2021	04/01/2021	04/01/2023	04/01/2023
Contract Detail	THE MEDICINE SHOPPE	3913 HARTZDALE DR STE 1306		CAMP HILL	PA	17011-7845	04/13/2018	07/01/2018	04/01/2023	04/01/2023

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH030290	Active	BPS-H80-012534	HAMILTON HEALTH CENTER, INC.	HHC - South Allison Hill	110 South 17th Street	HARRISBURG	PA
CH03029C	Terminated	BPS-H80-004890	HAMILTON HEALTH CENTER, INC.	HAMILTON HEALTH CENTER	1301 Sycamore St	Harrisburg	PA
CH03029E	Terminated	BPS-H80-024840	HAMILTON HEALTH CENTER, INC.	HHC-Senior High Rise-Jackson Tower	1315 N 6th St	Harrisburg	PA
CH03029F	Terminated	BPS-H80-006986	HAMILTON HEALTH CENTER, INC.	HHC-Downey School	1313 Monroe St	Harrisburg	PA
CH03029G	Terminated	BPS-H80-020994	HAMILTON HEALTH CENTER, INC.	Union Deposit Family Practice	891 S Arlington Ave	Harrisburg	PA
CH03029H	Active	BPS-H80-022097	HAMILTON HEALTH CENTER, INC.	Perry County	46 Red Hill Court	Newport	PA
CH03029J	Active	BPS-H80-027887	Hamilton Health Center, Inc.	Hamilton Family Care at Millersburg	1000 Evelyn Dr	Millersburg	PA
CH03029K	Active	BPS-H80-030901	Hamilton Health Center, Inc.	Familycare at Union Deposit	895 S Arlington Ave	Harrisburg	PA
CH03029L	Active	BPS-H80-038079	HAMILTON HEALTH CENTER INC	Hamilton Health Center Family Practice at Steelton	120 North Front Street	Steelton	PA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH030290	MEDICINE SHOPPE 1865	110 S. 17TH STREET		HARRISBURG	PA	17104	04/15/2006	09/30/2022
CH03029C	MEDICINE SHOPPE 1865	110 S. 17TH STREET		HARRISBURG	PA	17104	04/15/2006	10/01/2022
CH03029G	MEDICINE SHOPPE 1865	110 S. 17TH STREET		HARRISBURG	PA	17104	07/01/2018	04/01/2023
CH03029J	MILLERSBURG PHARMACY INC	242 MARKET ST		MILLERSBURG	PA	17061	01/01/2023	01/01/2023
CH030290	MILLERSBURG PHARMACY INC	242 MARKET ST		MILLERSBURG	PA	17061	01/01/2023
CH03029J	MILLERSBURG PHARMACY INC	242 MARKET ST		MILLERSBURG	PA	17061	04/01/2025
CH03029H	NEWPORT PHARMACY	48 RED HILL CT		NEWPORT	PA	17074	07/01/2025
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3608	1941 DERRY STREET	HARRISBURG	PA	17104	04/01/2016
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #1304	124 SOUTH FRONT STREET	STEELTON	PA	17113	04/01/2016
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4260	4299 UNION DEPOSIT ROAD	HARRISBURG	PA	17111	04/01/2016
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #1887	2103 N. THIRD STREET	HARRISBURG	PA	17110	04/01/2016
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #0721	304 MARKET STREET	HARRISBURG	PA	17101	04/01/2016
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #866	501 SOUTH 29TH ST STE A	HARRISBURG	PA	17104	04/01/2016
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4260	4299 UNION DEPOSIT ROAD	HARRISBURG	PA	17111	07/01/2018	04/01/2023
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #866	501 SOUTH 29TH ST STE A	HARRISBURG	PA	17104	07/01/2018	04/01/2023
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3608	1941 DERRY STREET	HARRISBURG	PA	17104	07/01/2018	04/01/2023
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3804	10 NEWPORT PLAZA	NEWPORT	PA	17074	07/01/2019
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #1981	2604 LINGLESTOWN ROAD	HARRISBURG	PA	17110	07/01/2019
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #418	105 OLD YORK ROAD	NEW CUMBERLAND	PA	17070	07/01/2019	04/01/2021
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4288	3773 PETERS MOUNTAIN RD.	HALIFAX	PA	17032	07/01/2019
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4284	3601 WALNUT STREET	HARRISBURG	PA	17109	10/01/2019
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #7894	4999 JONESTOWN RD	HARRISBURG	PA	17109	04/01/2021	04/01/2023
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4293	5 FRIENDLY DRIVE PO BOX 157	DUNCANNON	PA	17020	04/01/2021	04/01/2023
CH03029G	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4287	360 EAST MAIN STREET	MIDDLETOWN	PA	17057	04/01/2021	04/01/2023
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4293	5 FRIENDLY DRIVE PO BOX 157	DUNCANNON	PA	17020	04/01/2021
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4287	360 EAST MAIN STREET	MIDDLETOWN	PA	17057	04/01/2021
CH030290	RITE AID OF PENNSYLVANIA, LLC	RITE AID #7894	4999 JONESTOWN RD	HARRISBURG	PA	17109	04/01/2021
CH03029H	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4288	3773 PETERS MOUNTAIN RD.	HALIFAX	PA	17032	04/01/2025
CH03029K	RITE AID OF PENNSYLVANIA, LLC	RITE AID #4260	4299 UNION DEPOSIT ROAD	HARRISBURG	PA	17111	04/01/2025
CH03029H	RITE AID OF PENNSYLVANIA, LLC	RITE AID #3804	10 NEWPORT PLAZA	NEWPORT	PA	17074	04/01/2025
CH030290	THE MEDICINE SHOPPE	701 BRIDGE ST		NEW CUMBERLAND	PA	17070-1624	07/01/2015	12/31/2020
CH030290	THE MEDICINE SHOPPE	48 RED HILL COURT		NEWPORT	PA	17074	01/01/2017
CH03029E	THE MEDICINE SHOPPE	3913 HARTZDALE DR STE 1306		CAMP HILL	PA	17011-7845	07/01/2018	04/01/2020
CH030290	THE MEDICINE SHOPPE	3913 HARTZDALE DR STE 1306		CAMP HILL	PA	17011-7845	07/01/2018
CH03029C	THE MEDICINE SHOPPE	3913 HARTZDALE DR STE 1306		CAMP HILL	PA	17011-7845	07/01/2018	10/01/2022
CH03029G	THE MEDICINE SHOPPE	3913 HARTZDALE DR STE 1306		CAMP HILL	PA	17011-7845	07/01/2018	04/01/2023
CH030290	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2019
CH030290	WAL-MART PHARMACY 10-1591	6535 GRAYSON RD		HARRISBURG (E)	PA	17111	07/01/2019
CH03029K	WAL-MART PHARMACY 10-1591	6535 GRAYSON RD		HARRISBURG (E)	PA	17111	04/01/2025
CH030290	WAL-MART PHARMACY 10-3412	200 KOCHER LANE		ELIZABETHVILLE	PA	17023	04/01/2024
CH03029J	WAL-MART PHARMACY 10-3412	200 KOCHER LANE		ELIZABETHVILLE	PA	17023	04/01/2025
CH030290	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2019
CH030290	WEIS PHARMACY #19	1571 ROUTE 209		MILLERSBURG	PA	17061	04/01/2021

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		4/1/2023 12:00:00 AM	2/16/2023 9:59 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/16/2023 9:59 AM
Terminations	Termination Date	Update	Recertification		4/1/2023 12:00:00 AM	2/16/2023 9:59 AM
Terminations	Termination Effective Date	Update	Recertification		4/1/2023 12:00:00 AM	2/16/2023 9:59 AM
Terminations	Termination Reason	Update	Recertification		Business decision by the Covered Entity	2/16/2023 9:59 AM
Contacts	Primary Contact	Update	Profile Change Request	Penn, Jacque' Purchasing Manager Hamilton Health Center 7172303980	Penn, Jacque' Purchasing Director Hamilton Health Center 7172303980	2/14/2023 4:03 PM
Contacts	Authorizing Official	Update	Change Request	PETERSON, JEANNINE EXECUTIVE DIRECTOR Hamilton Health Center 7172303910	Delaplaine, Terese President & CEO Hamilton Health Center, Inc. 7172303992	10/19/2022 12:51 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	100748079-0025 (PA)		2/10/2022 10:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1326566381 (PA)		2/10/2022 10:52 AM
Details	Last Recertification Date	Update	Recertification	2/15/2021 9:45:44 PM	2/10/2022 10:52:56 AM	2/10/2022 10:52 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	2/15/2021 9:45 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		100748079-0025	2/15/2021 9:45 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		PA	2/15/2021 9:45 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1326566381	2/15/2021 9:45 PM
Medicaid Billing	NPI: State	Insert	Recertification		PA	2/15/2021 9:45 PM
Details	Last Recertification Date	Update	Recertification	2/7/2020 11:31:57 AM	2/15/2021 9:45:44 PM	2/15/2021 9:45 PM
Addresses	Shipping Address	Delete	Change Request	Hamilton Health Center 110 S 17th Street Harrisburg, PA 17104		10/8/2020 7:22 AM
Details	Last Recertification Date	Update	Recertification	2/15/2019 11:13:20 AM	2/7/2020 11:31:57 AM	2/7/2020 11:31 AM
Details	Last Recertification Date	Update	Recertification		2/15/2019 11:13:20 AM	2/15/2019 11:13 AM
Contacts	Primary Contact	Update	Change Request	Delaplaine, Terese Compliance Officer Hamilton Health Center, Inc. 7172303992	Penn, Jacque' Purchasing Manager Hamilton Health Center 7172303980	3/4/2018 1:51 PM
Details	State	Update	Change Request	Approved	Active	3/4/2018 1:51 PM
Contacts	Signed By	Insert	New Registration		PETERSON, JEANNINE EXECUTIVE DIRECTOR Hamilton Health Center 7172303910	1/16/2018 9:54 AM
Details	340B ID	Update	New Registration		CH03029G	1/16/2018 9:54 AM
Dates	Participating Approval Date	Update	New Registration		1/16/2018 9:54:06 AM	1/16/2018 9:54 AM
Details	State	Update	New Registration	Pending	Approved	1/16/2018 9:54 AM
Dates	Signed By Date	Update	New Registration		1/15/2018 5:09:23 PM	1/16/2018 9:54 AM
Dates	Start Date	Update	New Registration		4/1/2018 12:00:00 AM	1/16/2018 9:54 AM
Addresses	Main Address	Insert	New Registration		891 S Arlington Ave Harrisburg, PA 17109-5004	1/15/2018 5:09 PM
Addresses	Billing Address	Insert	New Registration		Hamilton Health Center 110 S 17th Street Harrisburg, PA 17104	1/15/2018 5:09 PM
Addresses	Shipping Address	Insert	New Registration		Hamilton Health Center 110 S 17th Street Harrisburg, PA 17104	1/15/2018 5:09 PM
Contacts	Authorizing Official	Insert	New Registration		PETERSON, JEANNINE EXECUTIVE DIRECTOR Hamilton Health Center 7172303910	1/15/2018 5:09 PM
Contacts	Primary Contact	Insert	New Registration		Delaplaine, Terese Compliance Officer Hamilton Health Center, Inc. 7172303992	1/15/2018 5:09 PM
Details	Last Recertification Date	Insert	New Registration			1/15/2018 5:09 PM
Details	Grant Number	Insert	New Registration		H80CS00659	1/15/2018 5:09 PM
Details	340B ID	Insert	New Registration			1/15/2018 5:09 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/15/2018 5:09 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/15/2018 5:09 PM
Details	Medicare Provider Number	Insert	New Registration			1/15/2018 5:09 PM
Details	Entity Name	Insert	New Registration		HAMILTON HEALTH CENTER, INC.	1/15/2018 5:09 PM
Details	Program Code	Insert	New Registration		CH	1/15/2018 5:09 PM
Details	Entity Subname	Insert	New Registration		Union Deposit Family Practice	1/15/2018 5:09 PM
Dates	Participating Approval Date	Insert	New Registration			1/15/2018 5:09 PM
Details	State	Insert	New Registration		Pending	1/15/2018 5:09 PM
Dates	Registration Date	Insert	New Registration		1/15/2018 5:09:20 PM	1/15/2018 5:09 PM
Dates	Signed By Date	Insert	New Registration			1/15/2018 5:09 PM
Dates	Start Date	Insert	New Registration			1/15/2018 5:09 PM
Terminations	Termination Comments	Insert	New Registration			1/15/2018 5:09 PM
Terminations	Termination Date	Insert	New Registration			1/15/2018 5:09 PM
Terminations	Termination Effective Date	Insert	New Registration			1/15/2018 5:09 PM
Terminations	Termination Reason	Insert	New Registration			1/15/2018 5:09 PM

340B Drug Pricing Program Database