340B Drug Pricing Program Database


CH061202H RIVER VALLEY PRIMARY CARE SERVICES (Active) - information as of 6/2/2025 8:28:59 AM

Main Details
RIVER VALLEY PRIMARY CARE SERVICES
Waldron Family Clinic
HRSA-Funded Health Center
BPS-H80-021894
CH061202H
H80CS04288


Additional Details
Active
10/1/2018
1/1/2019
10/3/2018
2/11/2025

Contacts

River Valley primary Care Services
JERRY WHITE, CEO
(479) 431-2057 Ext: 9040

RVPCS
Claire Elizabeth Yates, 340B Coordinator
(479) 431-2050 Ext: 9034

Addresses

2074 Rice Road
Waldron, AR 72958-7435

River Valley primary Care Services
9755 WEST STATE HWY 22
P.O. box 130
Ratcliff, AR 72951


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH061202AActiveBPS-H80-003040RIVER VALLEY PRIMARY CARE SERVICESRIVER VALLEY PRIMARY CARE SERVICES INC.9755 W State Highway 22 RatcliffAR
CH061202BActiveBPS-H80-003281RIVER VALLEY PRIMARY CARE SERVICESRVPCS - NORTHSIDE CLINIC4900 Kelley Hwy Fort SmithAR
CH061202CActiveBPS-H80-019334RIVER VALLEY PRIMARY CARE SERVICESMulberry Family Clinic421 North Main Street MulberryAR
CH061202DActiveBPS-H80-009100RIVER VALLEY PRIMARY CARE SERVICESMountainburg Family Clinic4 Highway 71 North MountainburgAR
CH061202EActiveBPS-H80-012820RIVER VALLEY PRIMARY CARE SERVICESRVPCS-Eastside Family Clinic4003 Massard Rd Fort SmithAR
CH061202FActiveBPS-H80-012808RIVER VALLEY PRIMARY CARE SERVICESLamar School District Health Center635 Childers Street LamarAR
CH061202GActiveBPS-H80-008130RIVER VALLEY PRIMARY CARE SERVICESNorthside Clinic at 6th Street3202 N 6th St Fort SmithAR
CH061202HActiveBPS-H80-021894RIVER VALLEY PRIMARY CARE SERVICESWaldron Family Clinic2074 Rice Road WaldronAR
CH061202JActiveBPS-H80-024979RIVER VALLEY PRIMARY CARE SERVICESClarksville Community Health Center708 W Main St ClarksvilleAR
CH061202KActiveBPS-H80-028170RIVER VALLEY PRIMARY CARE SERVICESLavaca Wellness Center603 S Division St LavacaAR
CH061202LActiveBPS-H80-030471RIVER VALLEY PRIMARY CARE SERVICESBonanza Wellness Center920 State Highway 45 BonanzaAR
CH061202MActiveBPS-H80-032903RIVER VALLEY PRIMARY CARE SERVICESClarksville Behavioral Health106 N Hill St ClarksvilleAR
CH061202NActiveBPS-H80-032902RIVER VALLEY PRIMARY CARE SERVICESRVPCS - Coal Hill Family Clinic1273 Hwy 64 East Coal HillAR
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH061202AALLCARE PHARMACY508 E WALNUT ST
PARISAR72855-401904/01/2016 12/09/2020
CH061202ABURNS DRUG INC615 W COMMERCIAL
OZARKAR72949-311310/01/2013 06/27/2018
CH061202ACLARKSVILLE FAMILY PHARMACY510 S ROGERS ST STE 3
CLARKSVILLEAR72830-379210/01/2019 10/12/2023
CH061202ACOLEMAN BUTLER FT SMITH, LLCDBA COLEMAN PHARMACY 3610 GRAND AVE
COLEMAN PHARMACY
FORT SMITHAR7290404/01/2018 03/30/2018
CH061202ACOLEMAN BUTLER FT SMITH, LLCDBA COLEMAN PHARMACY 3610 GRAND AVE
COLEMAN PHARMACY
FORT SMITHAR7290401/28/2020  
CH061202ACOLEMAN PHARMACY INC3610 GRAND AVE
FORT SMITHAR7290401/01/2015 03/30/2018
CH061202BCOLEMAN PHARMACY INC3610 GRAND AVE
FORT SMITHAR7290404/01/2009  
CH061202ACOLEMAN PHARMACY OF ALMA110 FAYETTEVILLE AVE
ALMAAR72921-365403/15/2012 06/27/2018
CH061202DCOLEMAN PHARMACY OF ALMA110 FAYETTEVILLE AVE
ALMAAR72921-365406/18/2010  
CH061202AD&D PHARMACY LLC8908 KANIS ROAD, SUITE 350
LITTLE ROCKAR7220501/01/2020 09/22/2020
CH061202AFRED'S PHARMACY #1386409 WEST MAIN
CLARKSVILLEAR7283010/01/2017 07/18/2018
CH061202AHEALTH DEPOT #17700 HIGHWAY 271 S
FORT SMITHAR72908-802801/01/2020 09/27/2023
CH061202AHEALTH DEPOT #21610 FORT ST
BARLINGAR72923-201801/01/2020 09/27/2023
CH061202AHEALTH DEPOT #31530 W CENTER ST
GREENWOODAR72936-340001/01/2020 09/27/2023
CH061202AHEALTH-WISE PHARMACY1800 W MAIN ST
LAVACAAR72941-380201/01/2020 10/31/2023
CH061202AHEALTH-WISE PHARMACY47 HIGHWAY 71 BYP S
WALDRONAR7295801/01/2020 06/20/2022
CH061202AHNK PHARM, PLLC1800 W MAIN ST
LAVACAAR7294104/01/2024  
CH061202AMEDI SAV PHARMACY #28820 ROGERS AVE
FORT SMITHAR72903-524511/29/2011 12/16/2024
CH061202AMEDI-QUIK DISCOUNT PHARMACY#3, INC.  406 E. WALNUT
PARISAR7285509/10/2009 10/31/2016
CH061202AMEDI-QUIK PHARMACY810 W COMMERCIAL ST
OZARKAR7294905/01/2010  
CH061202AMEDI-QUIK PHARMACY BOONEVILLE1531 E MAIN ST
BOONEVILLEAR72927-492111/09/2012 05/06/2021
CH061202AMEDI-QUIK PHARMACY BOONEVILLE1531 E MAIN ST
BOONEVILLEAR72927-492110/01/2024  
CH061202AMEDI-SAV PHARMACY #1621 E MAIN ST PO BOX 8
CHARLESTONAR72933-932811/29/2011 12/16/2024
CH061202AMIDLAND DRUG STORE4900 KELLEY HWY
FORT SMITHAR7290401/01/2015 09/16/2023
CH061202BMIDLAND DRUG STORE4900 KELLEY HWY
FORT SMITHAR7290404/16/2010  
CH061202AMILLER PRINCIPLE MANAGEMENT LLCDBA SCOTT COUNTY DRUG 47 HIGHWAY 71 BYP S
WALDRONAR7295801/01/2025  
CH061202AMULBERRY MEDI-QUIK PHARMACY, INC.442 N MAIN ST P. O. BOX 390
MULBERRYAR72947-857401/01/2015 10/07/2019
CH061202CMULBERRY MEDI-QUIK PHARMACY, INC.442 N MAIN ST P. O. BOX 390
MULBERRYAR72947-857403/15/2010  
CH061202APREMIER PHARMACY SERVICES410 CLOVERLEAF DR
BALDWIN PARKCA9170601/01/2020 09/22/2020
CH061202AROSE DRUG OF CLARKSVILLE INC211 E MAIN ST
CLARKSVILLEAR72830-372304/01/2019 06/07/2019
CH061202ARVPCS COMMUNITY PHARMACY9755 W. STATE HIGHWAY 22
RATCLIFFAR7295104/01/2021 04/01/2021
CH061202AVILLAGE PHARMACYVILLAGE PHARMACY 500 W COMMERCIAL ST
OZARKAR7294904/01/2019  
CH061202AWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738604/01/2019  
CH061202AWAL-MART PHARMACY 10-00162214 FAYETTEVILLE ROAD
VAN BURENAR7295604/01/2017  
CH061202AWAL-MART PHARMACY 10-00551400 EAST MAIN STREET
BOONEVILLEAR7292704/01/2017  
CH061202AWAL-MART PHARMACY 10-0066230 MARKET ST
CLARKSVILLEAR72830-906907/01/2018  
CH061202AWAL-MART PHARMACY 10-01252425 SOUTH ZERO ST.
FORT SMITHAR7290104/01/2019  
CH061202AWAL-MART PHARMACY 10-01418301 ROGERS AVENUE
FORT SMITHAR7290304/01/2017  
CH061202AWAL-MART PHARMACY 10-02091516 NORTH 18TH STREET
OZARKAR7294904/01/2017  
CH061202AWAL-MART PHARMACY 10-02301501 EAST WALNUT P O BOX 629
PARISAR7285504/01/2017  
CH061202AWAL-MART PHARMACY 10-0358367 WEST CHERRY ST
ALMAAR7292104/01/2017  
CH061202AWAL-MART PHARMACY 10-03882100 NORTH 62ND STREET
FORT SMITHAR7290404/01/2017  
CH061202AWAL-MART PHARMACY 10-27444900 ROGERS AVENUE SUITE 101J
FORT SMITHAR7290307/01/2018  
CH061202AWAL-MART PHARMACY 10-3231551 LIBERTY DR
GREENWOODAR7293604/01/2019  
CH061202AWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283704/01/2019  
CH061202AWALGREEN CODBA: WALGREENS #11987 323 HIGHWAY 64 W
ALMAAR7292112/28/2011  
CH061202AWALGREEN CO.DBA: WALGREENS # 05260 2701 ROGERS AVE
FT SMITHAR7290112/28/2011  
CH061202AWALGREEN CO.DBA: WALGREENS # 07234 8300 ROGERS AVENUE
FT SMITHAR72903-523512/28/2011  
CH061202AWALGREEN CO.DBA: WALGREENS # 07235 1601 FAYETTEVILLE ROAD
VAN BURENAR72956-223012/28/2011 05/12/2025
CH061202AWALGREEN CO.DBA: WALGREENS # 09594 1925 S ZERO ST
FORT SMITHAR7290112/28/2011  
CH061202AWALGREEN CO.DBA: WALGREENS # 10199 1100 E MAIN ST
RUSSELLVILLEAR72801-531904/01/2017  
CH061202AWALGREEN CO.WALGREENS #15797 1125 W. 2ND STREET
WALDRONAR7295807/01/2018  
CH061202AWalgreens #21373Walgreens Central Fill #21373 4100 Dale Earnhardt Way
STE 200
NorthlakeTX7626207/01/2024  
CH061202AWALMART PHARMACY 10-45798600 US 71 SOUTH
FORT SMITHAR7290804/01/2019  
CH061202AWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275607/01/2023  
CH061202AWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/1/2024 10:14:40 AM2/11/2025 2:33:38 PM2/11/2025 2:33 PM
DetailsLast Recertification DateUpdateRecertification2/3/2023 11:50:25 AM2/1/2024 10:14:40 AM2/1/2024 10:14 AM
DetailsLast Recertification DateUpdateRecertification1/31/2022 11:38:22 AM2/3/2023 11:50:25 AM2/3/2023 11:50 AM
DetailsLast Recertification DateUpdateRecertification2/2/2021 5:40:24 PM1/31/2022 11:38:22 AM1/31/2022 11:38 AM
DetailsLast Recertification DateUpdateRecertification1/28/2020 10:07:21 AM2/2/2021 5:40:24 PM2/2/2021 5:40 PM
ContactsPrimary ContactUpdateChange RequestHamilton, Marcy Controller River Valley Primary Care Services, Inc. 4794312057Yates, Claire Elizabeth 340B Coordinator RVPCS 4794312050-90349/22/2020 6:35 AM
ContactsPrimary ContactUpdateChange RequestYates, Claire Elizabeth 340B Coordinator RVPCS 4794312050-956Hamilton, Marcy Controller River Valley Primary Care Services, Inc. 47943120574/22/2020 6:33 PM
DetailsLast Recertification DateUpdateRecertification1/30/2019 9:30:46 AM1/28/2020 10:07:21 AM1/28/2020 10:07 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestWHITE, JERRY CEO River Valley primary Care Services 4796350091-240WHITE, JERRY CEO River Valley primary Care Services 4794312057-90409/6/2019 10:40 AM
ContactsSigned ByUpdateProfile Change RequestWHITE, JERRY CEO River Valley primary Care Services 4796350091-240WHITE, JERRY CEO River Valley primary Care Services 4794312057-90409/6/2019 10:40 AM
DetailsLast Recertification DateUpdateRecertification 1/30/2019 9:30:46 AM1/30/2019 9:30 AM
ContactsPrimary ContactUpdateProfile Change RequestYates, Claire Elizabeth 340B Coordinator RVPCS 4796350091-259Yates, Claire Elizabeth 340B Coordinator RVPCS 4794312050-9561/9/2019 5:05 PM
DetailsStateUpdate ApprovedActive1/1/2019 12:05 AM
ContactsPrimary ContactUpdateChange RequestMcKinney, Nikki HR/Administrative Manager RVPCS 4796350091-239Yates, Claire Elizabeth 340B Coordinator RVPCS 4796350091-25912/14/2018 10:06 AM
ContactsSigned ByInsertNew Registration WHITE, JERRY CEO River Valley primary Care Services 4796350091-24010/3/2018 2:06 PM
Details340B IDUpdateNew Registration CH061202H10/3/2018 2:06 PM
DatesParticipating Approval DateUpdateNew Registration 10/3/2018 2:06:18 PM10/3/2018 2:06 PM
DetailsStateUpdateNew RegistrationPendingApproved10/3/2018 2:06 PM
DatesSigned By DateUpdateNew Registration 10/3/2018 9:34:12 AM10/3/2018 2:06 PM
DatesStart DateUpdateNew Registration 1/1/2019 12:00:00 AM10/3/2018 2:06 PM
AddressesMain AddressInsertNew Registration  2074 Rice Road Waldron, AR 72958-743510/1/2018 12:11 PM
AddressesBilling AddressInsertNew Registration River Valley primary Care Services 9755 WEST STATE HWY 22 P.O. box 130 Ratcliff, AR 7295110/1/2018 12:11 PM
ContactsAuthorizing OfficialInsertNew Registration WHITE, JERRY CEO River Valley primary Care Services 4796350091-24010/1/2018 12:11 PM
ContactsPrimary ContactInsertNew Registration McKinney, Nikki HR/Administrative Manager RVPCS 4796350091-23910/1/2018 12:11 PM
DetailsLast Recertification DateInsertNew Registration  10/1/2018 12:11 PM
DetailsGrant NumberInsertNew Registration H80CS0428810/1/2018 12:11 PM
Details340B IDInsertNew Registration  10/1/2018 12:11 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/1/2018 12:11 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/1/2018 12:11 PM
DetailsMedicare Provider NumberInsertNew Registration  10/1/2018 12:11 PM
DetailsEntity NameInsertNew Registration RIVER VALLEY PRIMARY CARE SERVICES10/1/2018 12:11 PM
DetailsProgram CodeInsertNew Registration CH10/1/2018 12:11 PM
DetailsEntity SubnameInsertNew Registration Waldron Family Clinic10/1/2018 12:11 PM
DatesParticipating Approval DateInsertNew Registration  10/1/2018 12:11 PM
DetailsStateInsertNew Registration Pending10/1/2018 12:11 PM
DatesRegistration DateInsertNew Registration 10/1/2018 12:11:43 PM10/1/2018 12:11 PM
DatesSigned By DateInsertNew Registration  10/1/2018 12:11 PM
DatesStart DateInsertNew Registration  10/1/2018 12:11 PM
TerminationsTermination CommentsInsertNew Registration  10/1/2018 12:11 PM
TerminationsTermination DateInsertNew Registration  10/1/2018 12:11 PM
TerminationsTermination Effective DateInsertNew Registration  10/1/2018 12:11 PM
TerminationsTermination ReasonInsertNew Registration  10/1/2018 12:11 PM