Covered Entity Details

CHC26567-17 MERIDIAN SERVICES CORP (Terminated) - information as of 6/24/2025 3:07:30 AM

Main Details

Name

MERIDIAN SERVICES CORP

Subdivision Name

Meridian Health Services Corp

Type

HRSA-Funded Health Center

Site ID

BPS-H80-027144

340B ID

CHC26567-17

Grant Number

H80CS26567

Additional Details

Current Program Status

Terminated

Registration Date

1/7/2019

Participating Start Date

4/1/2019

Participating Approval Date

1/22/2019

Last Recertification Date

2/3/2021

Termination Date
Termination Reason

4/1/2022
Site closure

Contacts

Authorizing Official

Meridian Health Services
Scott Riggs, Chief Financial Officer
(765) 254-5189

Primary Contact

Meridian Health Services
Lori Mathis, Director of Community Health
(765) 730-0793

Addresses

Street Address

498 NW 18th St BLDG 416 Ste D
Richmond, IN 47374-2851

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC26567-00	Active	BPS-H80-013325	MERIDIAN SERVICES CORP	Meridian Health Services	240 N Tillotson Ave	Muncie	IN
CHC26567-01	Active	BPS-H80-013597	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	110 North Tillotson Ave	Muncie	IN
CHC26567-02	Active	BPS-H80-013596	MERIDIAN SERVICES CORP	Suzanne Gresham Center Division of Meridian Services	3620 White River Blvd	Muncie	IN
CHC26567-03	Active	BPS-H80-013360	MERIDIAN SERVICES CORP	Meridian Health Services	509 Conrad Harcourt Way	Rushville	IN
CHC26567-04	Terminated	BPS-H80-013785	MERIDIAN SERVICES CORP	Meridian Muncie Women's Health Center	2501 W JACKSON ST	MUNCIE	IN
CHC26567-05	Active	BPS-H80-017040	MERIDIAN SERVICES CORP	Meridian Health Services - Richmond	2300 Chester Blvd	Richmond	IN
CHC26567-06	Active	BPS-H80-015729	MERIDIAN SERVICES CORP	Meridian Health Services - Henry County	930 N 14TH ST	NEW CASTLE	IN
CHC26567-07	Active	BPS-H80-015710	MERIDIAN SERVICES CORP	Meridian Health Services - West Jay	1150 S MAIN ST	DUNKIRK	IN
CHC26567-08	Active	BPS-H80-015310	MERIDIAN SERVICES CORP	MeridianMD	100 North Tillotson Avenue	Muncie	IN
CHC26567-09	Terminated	BPS-H80-014235	MERIDIAN SERVICES CORP	Meridian Health Services Richmond	16 SW 5TH ST	RICHMOND	IN
CHC26567-10	Active	BPS-H80-014849	MERIDIAN SERVICES CORP	Meridian Health Services Pediatrics	205 N TILLOTSON AVE	MUNCIE	IN
CHC26567-11	Active	BPS-H80-019074	MERIDIAN SERVICES CORP	MERIDIAN HEALTH SERVICES CORP.	130 N Tillotson Ave	Muncie	IN
CHC26567-12	Active	BPS-H80-018872	MERIDIAN SERVICES CORP	MeridianMD Convenience Care	500 W Votaw St	Portland	IN
CHC26567-13	Active	BPS-H80-018018	MERIDIAN SERVICES CORP	Meridian Health Services Corp. Walnut Commons	110 E Wysor St	Muncie	IN
CHC26567-14	Terminated	BPS-H80-021350	MERIDIAN SERVICES CORP	Meridian Health Services - Chase Bldg., Suite 200	630 E Main Street	Richmond	IN
CHC26567-15	Terminated	BPS-H80-021707	MERIDIAN SERVICES CORP	Meridian Health Services - Suite 102A	2506 Willowbrook Pkwy	Indianapolis	IN
CHC26567-16	Active	BPS-H80-024663	MERIDIAN SERVICES CORP	Meridian Health Services Corp	707 W. 3rd St.	Connersville	IN
CHC26567-17	Terminated	BPS-H80-027144	MERIDIAN SERVICES CORP	Meridian Health Services Corp	498 NW 18th St BLDG 416 Ste D	Richmond	IN
CHC26567-18	Active	BPS-H80-027573	MERIDIAN SERVICES CORP	Meridian Health Services Corp	1547 Ohio Ave	Anderson	IN
CHC26567-19	Active	BPS-H80-027572	MERIDIAN SERVICES CORP	Meridian Health Services Corp	101 N Harrison St	Alexandria	IN
CHC26567-20	Active	BPS-H80-027574	MERIDIAN SERVICES CORP	Meridian Health Services Corp	1518 Main St	Elwood	IN
CHC26567-21	Active	BPS-H80-030283	Meridian Health Services Corp.	Meridian Health Services Corp.	520 S 9th St Ste A	Richmond	IN
CHC26567-22	Active	BPS-H80-030284	Meridian Health Services Corp.	Meridian Health Services Corp	303 S Main St Ste 300	Bluffton	IN
CHC26567-23	Active	BPS-H80-030477	Meridian Health Services Corp.	Meridian Health Services Corp.	1601 E 26th St # 6	Muncie	IN
CHC26567-24	Active	BPS-H80-031021	Meridian Health Services Corp.	Meridian Health Services Corp	801 N Walnut St # 1	Muncie	IN
CHC26567-25	Terminated	BPS-H80-031622	Meridian Health Services Corp.	Meridian Health Services Corp.	498 NW 18th St BLDG 417 STE D	Richmond	IN
CHC26567-26	Active	BPS-H80-032015	Meridian Health Services Corp.	Meridian Health Services Corp	4755 Kingsway Dr Ste 105A	Indianapolis	IN
CHC26567-27	Active	BPS-H80-032545	Meridian Health Services Corp.	Meridian Health Services Corp.	2010 Brentwood Dr Ste 1	Anderson	IN
CHC26567-28	Active	BPS-H80-032443	Meridian Health Services Corp.	Meridian Health Services Corp	931 W Water St Ste A	Portland	IN
CHC26567-29	Active	BPS-H80-035098	Meridian Health Services Corp.	Meridian Health Services Corp	2622 Lake Ave STE 1	Fort Wayne	IN
CHC26567-30	Active	BPS-H80-036195	Meridian Health Services Corp.	Meridian Health Services Corp	911 N Western Ave	Marion	IN
CHC26567-31	Active	BPS-H80-036196	Meridian Health Services Corp.	Meridian Health Services Corp	406 W Votaw St	Portland	IN
CHC26567-32	Active	BPS-H80-035549	Meridian Health Services Corp.	Meridian Health Services Corp	1026 S Main St STE 1	Bluffton	IN
CHC26567-33	Active	BPS-H80-037027	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	1001 Hadley Rd, Ste 103	Mooresville	IN
CHC26567-34	Active	BPS-H80-036944	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	5230 E Stop 11 Road STE 300	Indianapolis	IN
CHC26567-35	Active	BPS-H80-035885	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	8707 W US Highway 36 RM N2	Modoc	IN
CHC26567-36	Active	BPS-H80-036773	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	424 E Southway Blvd Ste 1	Kokomo	IN
CHC26567-37	Active	BPS-H80-033520	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	730 W Washington St STE A	Winchester	IN
CHC26567-38	Active	BPS-H80-037821	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	2072 IN-67	Portland	IN
CHC26567-39	Active	BPS-H80-035769	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	380 Hub Etchison Parkway RM R144	Richmond	IN
CHC26567-40	Active	BPS-H80-035787	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	501 1/2 S 7th St RM 1	Richmond	IN
CHC26567-41	Active	BPS-H80-037324	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	101 W 29th St	Anderson	IN
CHC26567-42	Active	BPS-H80-038092	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	323 E 2nd St STE 1	Marion	IN
CHC26567-43	Active	BPS-H80-037325	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	1 South Maish Road RM A016	Frankfort	IN
CHC26567-44	Active	BPS-H80-037822	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	50 S Maish Rd	Frankfort	IN
CHC26567-45	Active	BPS-H80-039129	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	285 W 12th St STE 102	Peru	IN
CHC26567-46	Active	BPS-H80-039128	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	285 W 12th St STE 206	Peru	IN
CHC26567-47	Active	BPS-H80-039130	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	285 W 12th St STE 205	Peru	IN
CHC26567-48	Active	BPS-H80-038918	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	1500 Salem St STE 110A	Lafayette	IN
CHC26567-49	Active	BPS-H80-038916	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	2600 County Road 600 W RM SG-1	Russiaville	IN
CHC26567-50	Active	BPS-H80-039076	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	105 Hillcrest Dr	Ossian	IN
CHC26567-51	Active	BPS-H80-039079	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	125 E Cherry St	Bluffton	IN
CHC26567-52	Active	BPS-H80-038917	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	731 N Plum St RM 107	Union City	IN
CHC26567-53	Active	BPS-H80-039077	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	201 E South St	Markle	IN
CHC26567-54	Active	BPS-H80-039358	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	303 S. Main Street STE #500	Bluffton	IN
CHC26567-55	Active	BPS-H80-039078	MERIDIAN HEALTH SERVICES CORP.	Meridian Health Services Corp	824 Huntington Ave	Warren	IN

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC26567-00	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	01/01/2020
CHC26567-00	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	01/01/2020
CHC26567-00	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	04/01/2025
CHC26567-00	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/01/2020
CHC26567-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC26567-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC26567-00	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC26567-00	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2022
CHC26567-00	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2022
CHC26567-00	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2022
CHC26567-00	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2022
CHC26567-00	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2022
CHC26567-00	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2022
CHC26567-00	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2022
CHC26567-00	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2022
CHC26567-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2022
CHC26567-00	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2022
CHC26567-00	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	10/01/2022
CHC26567-00	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	10/01/2022
CHC26567-00	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2022
CHC26567-00	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC26567-00	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-03	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-02	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-01	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016	10/01/2019
CHC26567-04	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016	04/01/2017
CHC26567-10	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-09	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016	04/01/2018
CHC26567-08	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-07	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-06	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-05	GENOA HEALTHCARE LLC	130 N. TILLOTSON AVENUE		MUNCIE	IN	47304-3987	07/01/2016
CHC26567-00	GENOA HEALTHCARE LLC	831 DILLON DR STE 102		RICHMOND	IN	47374	01/01/2022
CHC26567-00	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06616	425 E MEMORIAL DR	MUNCIE	IN	47302	04/01/2017
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06623	201 S. TILLOTSON AVENUE	MUNCIE	IN	47304	04/01/2017
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06645	101 WEST 1ST ST.	RUSHVILLE	IN	46173	04/01/2017
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06652	301 N. GRAND AVE	CONNERSVILLE	IN	47331	10/01/2019
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06632	1130 S MAIN ST	DUNKIRK	IN	47336	10/01/2019
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06640	265 SO. SCATTERFIELD RD	ANDERSON	IN	46012	10/01/2019
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06624	802 N MERIDIAN ST	PORTLAND	IN	47371	10/01/2019
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06631	3310 E. JACKSON ST.	MUNCIE	IN	47303	01/01/2022	01/11/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 03162	2150 CHESTER BLVD.	RICHMOND	IN	47374	01/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06647	1515 EAST MAIN STREET	RICHMOND	IN	47374	01/01/2022	03/03/2025
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06515	1203 S. MAIN ST.	BLUFFTON	IN	46714	01/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06636	298 SOUTH WEST 18TH ST.,	RICHMOND	IN	47374	01/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06656	3824 MAIN STREET	ANDERSON	IN	46013	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06517	1901 N. JEFFERSON ST.	HUNTINGTON	IN	46750	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06516	1221 WEST MONROE ST.	DECATUR	IN	46733	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06643	220 S. MEMORIAL DR.	NEW CASTLE	IN	47362	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06528	928 US 27 N	BERNE	IN	46711	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY #06622	1700 N. WALNUT ST	HARTFORD CITY	IN	47348	10/01/2022
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 08657	1725 SALEM STREET	LAFAYETTE	IN	47904	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06509	2802 EAST STATE BOULEVARD	FORT WAYNE	IN	46805	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	CVS PHARMACY # 16860	3601 N BARR ST	MUNCIE	IN	47303	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06617	100 N ANDERSON ST.	ELWOOD	IN	46036	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06620	943 EAST WASHINGTON STREET	WINCHESTER	IN	47394	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06618	105 NORTH PARK AVE	ALEXANDRIA	IN	46001	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	CVS PHARMACY # 17294	3801 COLDWATER RD	FORT WAYNE	IN	46805	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06662	711 W. MILL ST.	MIDDLETOWN	IN	47356	01/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06519	5802 SOUTH ANTHONY BLVD.	FORT WAYNE	IN	46816	04/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02484	4630 SO. WASHINGTON ST.	MARION	IN	46953	07/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06621	415 W. 3RD ST.	MARION	IN	46952	07/01/2023
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06703	789 STATE ROAD 39 BY-PASS	MARTINSVILLE	IN	46151	01/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 04468	7935 S EMERSON AVENUE SUITE B	INDIANAPOLIS	IN	46237	01/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06610	8405 SOUTHEASTERN AVE.	INDIANAPOLIS	IN	46239	01/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06551	523 SOUTH STATE ROAD 67	MOORESVILLE	IN	46158	04/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06648	655 S. US HIGHWAY 31	GREENWOOD	IN	46142	04/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 08690	5920 MADISON AVENUE	INDIANAPOLIS	IN	46227	04/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06520	3918 SOUTH CALHOUN ST.	FORT WAYNE	IN	46807	04/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 03297	4935 S. ARLINGTON	INDIANAPOLIS	IN	46237	04/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06644	640 SOUTH STATE ROAD 135	GREENWOOD	IN	46142	10/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06654	8970 S. MERIDIAN ST.	INDIANAPOLIS	IN	46217	10/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06637	200 S. HARRISON	SHELBYVILLE	IN	46176	10/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06661	263 W MORGAN ST.	KNIGHTSTOWN	IN	46148	10/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 00684	7930 MADISON AVE.	INDIANAPOLIS	IN	46227	10/01/2024
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 08651	512 SAGAMORE PKWY WEST	WEST LAFAYETTE	IN	47906	04/01/2025
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 06545	2 SOUTH BROADWAY	PERU	IN	46970	04/01/2025
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA: CVS/PHARMACY # 02311	2215 SOUTH SHELBY STREET	INDIANAPOLIS	IN	46203	07/01/2025
CHC26567-00	HOOK-SUPERX, L.L.C.	DBA CVS/PHARMACY # 3007	6010 SOUTH EMERSON AVENUE	INDIANAPOLIS	IN	46237	07/01/2025
CHC26567-00	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2021
CHC26567-00	KROGER LIMITED PARTNERSHIP I	DBA PAYLESS PHARMACY J827	2513 MAPLE POINT DRIVE	LAFAYETTE	IN	47905	01/01/2023	08/06/2024
CHC26567-00	KROGER PHARMACY	202 S MAIN STREET		RUSHVILLE	IN	46173	04/01/2021
CHC26567-00	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	01/01/2020
CHC26567-00	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	04/01/2021
CHC26567-00	MEIJER PHARMACY #139	6260 W. MCGALLIARD RD (SR 332)		MUNCIE	IN	47304-9413	04/01/2021
CHC26567-00	MEIJER PHARMACY #155	2507 CHESTER BLVD		RICHMOND	IN	47374	04/01/2021
CHC26567-00	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	04/01/2021
CHC26567-00	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	04/01/2021
CHC26567-00	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/01/2021
CHC26567-00	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	07/01/2021	09/10/2024
CHC26567-00	PAYLESS PHARMACY 848	KROGER LIMITED PARTNERSHIP I	3050 MERIDIAN ST	ANDERSON	IN	46016	01/01/2023	08/06/2024
CHC26567-00	PHILLIPS DRUG	631 E MAIN ST		RICHMOND	IN	47374-4309	04/01/2020
CHC26567-00	PHILLIPS DRUGS EAST	1626 E MAIN ST		RICHMOND	IN	47374	04/01/2020
CHC26567-00	PHILLIPS DRUGS INC	1390 NATIONAL RD WEST		RICHMOND	IN	47374	04/01/2020
CHC26567-00	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	01/01/2020
CHC26567-00	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2022
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2022	01/11/2023
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2022	01/11/2023
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2022	01/11/2023
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2023
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2023
CHC26567-00	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2023
CHC26567-00	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC26567-00	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC26567-00	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC26567-00	STERLING SPECIALTY PHARMACY	1312 NORTHLAND DRIVE	SUITE 500	MENDOTA HEIGHTS	MN	55120-1140	04/01/2020
CHC26567-00	THE KROGER CO	#920	120 S MEMORIAL DR	NEW CASTLE	IN	47362	01/01/2023	08/06/2024
CHC26567-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2021
CHC26567-00	WAL-MART PHARMACY #10-1728	2321 CHARLES STREET		ANDERSON	IN	46013	04/01/2021
CHC26567-00	WAL-MART PHARMACY 10-1480	950 EAST GREENVILLE PIKE		WINCHESTER	IN	47394	10/01/2024
CHC26567-00	WAL-MART PHARMACY 10-1665	4801 W. CLARA LN		MUNCIE	IN	47304	01/01/2022
CHC26567-00	WAL-MART PHARMACY 10-1729	4200 WESTERN AVENUE		CONNERSVILLE	IN	47331	10/01/2024
CHC26567-00	WAL-MART PHARMACY 10-1745	3601 E. MAIN		RICHMOND	IN	47374	04/01/2021
CHC26567-00	WAL-MART PHARMACY 10-1758	3167 S STATE RD #3		NEW CASTLE	IN	47362	10/01/2024
CHC26567-00	WAL-MART PHARMACY 10-2388	950 W VOTAW		PORTLAND	IN	47371	04/01/2017
CHC26567-00	WAL-MART PHARMACY 10-2819	2100 NO. MAIN STREET		BLUFFTON	IN	46714	04/01/2021
CHC26567-00	WAL-MART PHARMACY 10-3747	1501 EAST 29TH STREET		MUNCIE	IN	47302	01/01/2022
CHC26567-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2021
CHC26567-00	WALGREEN CO	DBA: WALGREENS #12676	124 W VOTAW STREET	PORTLAND	IN	47371	04/01/2017	11/16/2022
CHC26567-00	WALGREEN CO	DBA: WALGREENS #10533	3250 N MORRISON ROAD	MUNCIE	IN	47304	04/01/2017
CHC26567-00	WALGREEN CO	DBA: WALGREENS SPECIALTY PHARMACY #12470	330 N WABASH AVENUE STE 100	MARION	IN	46952	07/01/2023
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 05803	2720 W JACKSON	MUNCIE	IN	47303	04/01/2017
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 06420	400 E MEMORIAL DRIVE	MUNCIE	IN	47302	04/01/2017
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 05802	100 E MCGALLIARD RD	MUNCIE	IN	47303	04/01/2017
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 09128	3700 NATIONAL RD E	RICHMOND	IN	47374	04/01/2017
CHC26567-00	WALGREEN CO.	W002 DBA: WALGREENS #07690	100 N. MEMORIAL DR	NEW CASTLE	IN	47362	04/01/2017
CHC26567-00	WALGREEN CO.	DBA: WALGREENS SPECIALTY PHARMACY #16317	335 MASSACHUSETTS AVENUE	INDIANAPOLIS	IN	46204	04/01/2017
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 07472	1975 N MAIN ST	BLUFFTON	IN	46714-1182	01/01/2022
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 07788	320 S SCATTERFIELD RD	ANDERSON	IN	46012-3601	01/01/2022
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 06761	3736 S SCATTERFIELD RD	ANDERSON	IN	46013	01/01/2022
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 05663	1323 N BALDWIN AVE	MARION	IN	46952	01/01/2023
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 05452	2410 N COLISEUM BLVD	FT WAYNE	IN	46805	01/01/2023	03/25/2025
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 02932	1701 EAST PAULDING ROAD	FORT WAYNE	IN	46816	04/01/2024	02/20/2024
CHC26567-00	WALGREEN CO.	WALGREENS #11846	1213 N. BARRON ST	EATON	OH	45320-1013	04/01/2024
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 04190	6730 BLUFFTON RD.	FT WAYNE	IN	46809	04/01/2024
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 03722	110 E. CREIGHTON AVE.	FT WAYNE	IN	46803	07/01/2024
CHC26567-00	WALGREEN CO.	DBA WALGREENS #16558	1400 N RITTER AVE. SUITE 140	INDIANAPOLIS	IN	46219	10/01/2024
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 06066	1804 N JEFFERSON	HUNTINGTON	IN	46750	04/01/2025
CHC26567-00	WALGREEN CO.	DBA: WALGREENS # 09827	720 N BROADWAY	PERU	IN	46970-1027	04/01/2025
CHC26567-00	Walgreens Central Fill #21399	4132Plainfield Rd	Ste 110	Indianapolis	IN	46231-7021	04/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		11/13/2020 12:00:00 AM	2/1/2022 11:44 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/1/2022 11:44 AM
Terminations	Termination Comments	Update	Recertification		The site has relocated to another location within the city of Richmond. The new site was added to Meridian Health Services Corp. scope on 11/13/2020 and was registered with OPAIS on 4/15/2021 with a participating start date of 7/1/2021 and participating approval date of 4/15/2021.	2/1/2022 11:44 AM
Terminations	Termination Date	Update	Recertification		4/1/2022 12:00:00 AM	2/1/2022 11:44 AM
Terminations	Termination Effective Date	Update	Recertification		11/13/2020 12:00:00 AM	2/1/2022 11:44 AM
Terminations	Termination Reason	Update	Recertification		Site closure	2/1/2022 11:44 AM
Details	Last Recertification Date	Update	Recertification	1/30/2020 5:02:56 PM	2/3/2021 6:48:33 AM	2/3/2021 6:48 AM
Details	Last Recertification Date	Update	Recertification		1/30/2020 5:02:56 PM	1/30/2020 5:02 PM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Riggs, Scott Chief Financial Officer Meridian Health Services 7652545189	1/22/2019 2:24 PM
Details	340B ID	Update	New Registration		CHC26567-17	1/22/2019 2:24 PM
Dates	Participating Approval Date	Update	New Registration		1/22/2019 2:24:43 PM	1/22/2019 2:24 PM
Details	State	Update	New Registration	Pending	Approved	1/22/2019 2:24 PM
Dates	Signed By Date	Update	New Registration		1/9/2019 8:56:07 AM	1/22/2019 2:24 PM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	1/22/2019 2:24 PM
Contacts	Authorizing Official	Update	Profile Change Request	Riggs, Scott Director of Finance Meridian Health Services 7652545189	Riggs, Scott Chief Financial Officer Meridian Health Services 7652545189	1/9/2019 8:56 AM
Addresses	Main Address	Insert	New Registration		498 NW 18th St BLDG 416 Ste D Richmond, IN 47374-2851	1/7/2019 9:06 AM
Contacts	Authorizing Official	Insert	New Registration		Riggs, Scott Director of Finance Meridian Health Services 7652545189	1/7/2019 9:06 AM
Contacts	Primary Contact	Insert	New Registration		Mathis, Lori Director of Community Health Meridian Health Services 7657300793	1/7/2019 9:06 AM
Details	Last Recertification Date	Insert	New Registration			1/7/2019 9:06 AM
Details	Grant Number	Insert	New Registration		H80CS26567	1/7/2019 9:06 AM
Details	340B ID	Insert	New Registration			1/7/2019 9:06 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/7/2019 9:06 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/7/2019 9:06 AM
Details	Medicare Provider Number	Insert	New Registration			1/7/2019 9:06 AM
Details	Entity Name	Insert	New Registration		MERIDIAN SERVICES CORP	1/7/2019 9:06 AM
Details	Program Code	Insert	New Registration		CH	1/7/2019 9:06 AM
Details	Entity Subname	Insert	New Registration		Meridian Health Services Corp	1/7/2019 9:06 AM
Dates	Participating Approval Date	Insert	New Registration			1/7/2019 9:06 AM
Details	State	Insert	New Registration		Pending	1/7/2019 9:06 AM
Dates	Registration Date	Insert	New Registration		1/7/2019 9:06:21 AM	1/7/2019 9:06 AM
Dates	Signed By Date	Insert	New Registration			1/7/2019 9:06 AM
Dates	Start Date	Insert	New Registration			1/7/2019 9:06 AM
Terminations	Termination Comments	Insert	New Registration			1/7/2019 9:06 AM
Terminations	Termination Date	Insert	New Registration			1/7/2019 9:06 AM
Terminations	Termination Effective Date	Insert	New Registration			1/7/2019 9:06 AM
Terminations	Termination Reason	Insert	New Registration			1/7/2019 9:06 AM

340B Drug Pricing Program Database