340B Drug Pricing Program Database


CH03224V Peninsula Institute For Community Health, Inc (Active) - information as of 5/15/2025 11:53:57 PM

Main Details
Peninsula Institute For Community Health, Inc
Warwick Boulevard Physicians
HRSA-Funded Health Center
BPS-H80-017928
CH03224V
H80CS00073


Additional Details
Active
7/2/2019
10/1/2019
7/18/2019
2/10/2025

Contacts

Peninsula Institue for Community Health
ANGELA FUTRELL, CEO
(757) 591-0643 Ext: 1120

Peninsula Institute for Community Health
VALDA BRANCH, COO
(757) 223-7007

Addresses

9294 Warwick Blvd
Newport News, VA 23607-1535

Southeastern Virginia Health System
1033 28th Street
Newport News, VA 23607


  • 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
CH032240ActiveBPS-H80-007792PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)DBA 48TH STREET PHYSICIANS4714 MARSHALL AVENUE NEWPORT NEWSVA
CH03224CActiveBPS-H80-007794PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)MAIN STREET PHYSICIANS157 NORTH MAIN STREET, STE A SUFFOLKVA
CH03224EActiveBPS-H80-001066PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)DBA STONEYBROOK PHYSICIANS15425 WARWICK BLVD., SUITE H NEWPORT NEWSVA
CH03224JActiveBPS-H80-002976PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)DBA COMMUNITY DENTAL SERVICES1033-28TH STREET, 1ST FLOOR NEWPORT NEWSVA
CH03224KTerminatedBPS-H80-000374PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)TOWN CENTER PHYSICIANS10980 BUCKLEY HALL ROAD, BLDG 5 MATHEWSVA
CH03224MActiveBPS-H80-007798PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)EAST END PHYSICIANS1033 28TH STREET NEWPORT NEWSVA
CH03224NActiveBPS-H80-011006PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)DBA VIRGINIA BEACH FAMILY MEDICAL CENTER940 GENERAL BOOTH BLVD VIRGINIA BEACHVA
CH03224PActiveBPS-H80-011328PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)CHESAPEAKE COMMUNITY HEALTH CENTER490 LIBERTY STREET CHESAPEAKEVA
CH03224QTerminatedBPS-H80-010473PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)VICTORIA BLVD PHYSICIANS3130 VICTORIA BLVD HAMPTONVA
CH03224RTerminatedBPS-H80-017059PENINSULA INSTITUTE FOR COMMUNITY HEALTH, INCSoutheastern Virginia Health System @ Western Tidewater Community Services Board5268 Godwin Boulevard SuffolkVA
CH03224SActiveBPS-H80-014829PENINSULA INSTITUTE FOR COMMUNITY HEALTH, INCHampton Newport News Community Services Board300 Medical Dr HamptonVA
CH03224TActiveBPS-H80-017682PENINSULA INSTITUTE FOR COMMUNITY HEALTH, INCFranklin Community Health Center1357 Armory Drive FranklinVA
CH03224UActiveBPS-H80-024391Peninsula Institute For Community Health, IncVirginia Beach Housing Resource Center Health Clinic104 N Witchduck Rd Virginia BeachVA
CH03224VActiveBPS-H80-017928Peninsula Institute For Community Health, IncWarwick Boulevard Physicians9294 Warwick Blvd Newport NewsVA
CH03224WActiveBPS-H80-027934Peninsula Institute For Community Health, IncSoutheastern Virginia Health System @ Four Oaks Day Service Center7401 Warwick Blvd Newport NewsVA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH032240ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280901/01/2024  
CH032240CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2024  
CH032240CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2024  
CH032240CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2024  
CH032240CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2024  
CH032240CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2024  
CH032240CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2024  
CH032240CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2024  
CH032240CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/01/2024  
CH032240CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/01/2024  
CH032240CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2024  
CH032240CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/01/2024  
CH032240CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/01/2024  
CH032240CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2024  
CH032240ECKERD CORPORATIONRITE AID #11291 3701 KECOUGHTAN ROAD
HAMPTONVA2366910/01/2024  
CH032240ECKERD CORPORATIONRITE AID #11251 2040 ATLANTIC AVE
CHESAPEAKEVA2332410/01/2024  
CH032240ECKERD CORPORATIONRITE AID #11290 40 TOWNE CENTRE WAY
HAMPTONVA2366610/01/2024  
CH032240PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2024  
CH032240PROCARE PHARMACY, L.L.C.CVS/PHARMACY #48637 2700 NORTHEAST EXPY NE STE B800
BUILDING B 		ATLANTAGA3034501/01/2024  
CH032240PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #48611 141 PREBLE STREET
PORTLANDME0410101/01/2024  
CH032240PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/01/2024  
CH032240PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2024  
CH032240PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2024  
CH032240RITE AID OF VIRGINIA, INC.RITE AID #3741 515 NORTH MAIN STREET
SUFFOLKVA2343410/01/2024  
CH032240RITE AID OF VIRGINIA, INC.RITE AID #3851 WARWICK SHOPPING CENTER
10818 WARWICK VILLAGE S/C 		NEWPORT NEWSVA2360110/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 1826 972 E. LITTLE CREEK RD.
NORFOLKVA2351801/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 2315 401 EAST MERCURY BLVD.
HAMPTONVA2366301/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 3052 310 SOUTH ROSEMONT RD.
VIRGINIA BEACHVA2345201/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05796 2315 W. MERCURY BLVD.
HAMPTONVA2366601/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #5911 918 W. MERCURY BLVD
HAMPTONVA2366601/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 6403 6678 EAST VIRGINIA BEACH BLVD.
NORFOLKVA2350201/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07081 11127 JEFFERSON AVE.
NEWPORT NEWSVA2360101/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 8302 2232 GENERAL BOOTH BLVD.
VIRGINIA BEACHVA2345601/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08497 13000 WARWICK BLVD.
NEWPORT NEWSVA2360201/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10202 2212 CAMPOSTELLA RD.
CHESAPEAKEVA2332401/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #10453 12755 JEFFERSON AVENUE
NEWPORT NEWSVA2360201/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.CVS/PHARMACY # 10991 12 EAST WINDSOR BLVD
WINDSORVA2348701/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.CVS/PHARMACY #11056 2775 GODWIN BLVD
SUFFOLKVA2343401/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.CVS PHARMACY # 16409 1316 GREENBRIER PKWY
CHESAPEAKEVA2332001/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.CVS PHARMACY # 17546 5001 HOLT AVE
HAMPTONVA2366601/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.CVS PHARMACY # 17627 4554 VIRGINIA BEACH BLVD
STE 500 		VIRGINIA BEACHVA2346201/01/2024  
CH032240VIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08226 1688 LASKIN RD.
VIRGINIA BEACHVA2345101/01/2024  
CH032240WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH032240WAL-MART PHARMACY 10-16311900 CUNNINGHAM DR
HAMPTONVA2366607/01/2017  
CH032240WAL-MART PHARMACY 10-16871200 N. MAIN ST
SUFFOLKVA2343407/01/2017  
CH032240WAL-MART PHARMACY 10-177312401 JEFFERSON AVE
NEWPORT NEWSVA2360210/01/2024  
CH032240WAL-MART PHARMACY 10-25292021 LYNNHAVEN PARKWAY
VIRGINIA BEACHVA2345610/01/2024  
CH032240WAL-MART PHARMACY 10-27051500 ARMORY DRIVE
FRANKLINVA2385110/01/2024  
CH032240WAL-MART PHARMACY 10-32146259 COLLEGE DRIVE
SUFFOLK (N)VA2343510/01/2024  
CH032240WAL-MART PHARMACY 10-3219731 E. ROCHAMBEAU RD
WILLIAMSBURGVA2318801/01/2024  
CH032240WAL-MART PHARMACY 10-32652601 GEORGE WASHINGTON MEM.
YORKTOWNVA2369301/01/2024  
CH032240WAL-MART PHARMACY 10-46236111 JEFFERSON AVE
NEWPORT NEWSVA2360507/01/2017  
CH032240WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH032240WALGREEN CO.DBA: WALGREENS # 04446 3965 HOLLAND RD.
VIRGINIA BEACHVA2345201/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 04527 801 INDEPENDENCE BLVD.
VIRGINIA BEACHVA2345501/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 04615 13007 WARWICK BLVD.
NEWPORT NEWSVA2360201/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 04617 919 W MERCURY BLVD
HAMPTONVA2366601/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 05175 600 J CLYDE MORRIS BLVD
NEWPORT NEWSVA2360101/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 05588 9976 JEFFERSON AVE.
NEWPORT NEWSVA2360501/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 05783 5501 WESLEYAN DR
VIRGINIA BEACHVA2345501/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 05878 3326 W MERCURY BLVD
HAMPTONVA2366601/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 06633 2044 LYNNHAVEN PARKWAY
VIRGINIA BEACHVA23456-140901/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 06740 1101 NIMMO PARKWAY
VIRGINIA BEACHVA2345601/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 06790 3376 VIRGINIA BEACH BLVD
VIRGINIA BEACHVA23452-562001/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 06923 12750 JEFFERSON AVE
NEWPORT NEWSVA23602-431801/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 07240 235 E MERCURY BLVD
HAMPTONVA23669-245801/01/2014 03/09/2020
CH032240WALGREEN CO.DBA: WALGREENS # 07886 1316 BATTLEFIELD BLVD N
GREENBRIER SQ II 		CHESAPEAKEVA2332001/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS # 09195 856 S MILITARY HWY
VIRGINIA BEACHVA2346401/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS #10140 14440 WARWICK BLVD.
NEWPORT NEWSVA2360801/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS #10416 2902 GODWIN BLVD.
SUFFOLKVA23434-804001/01/2014  
CH032240WALGREEN CO.DBA: WALGREENS #11572 500 SETTLERS LANDING RD.
HAMPTONVA2366901/01/2014  
CH03224SWALGREEN CO.DBA: WALGREENS # 04617 919 W MERCURY BLVD
HAMPTONVA2366607/01/2016  
CH03224RWALGREEN CO.DBA: WALGREENS #10416 2902 GODWIN BLVD.
SUFFOLKVA23434-804007/01/2016 04/01/2023
CH03224TWALGREEN CO.DBA: WALGREENS #11986 100 S. COLLEGE DR.
FRANKLINVA23851-242410/01/2018  
CH03224UWALGREEN CO.DBA: WALGREENS #15087 4500 VIRGINIA BEACH BLVD.
VIRGINIA BEACHVA23462-300404/01/2019  
CH03224CWALGREEN CO.DBA: WALGREENS #15446 118 W CONSTANCE RD
SUFFOLKVA2343404/01/2019  
CH032240WALGREEN CO.DBA: WALGREENS #15087 4500 VIRGINIA BEACH BLVD.
VIRGINIA BEACHVA23462-300407/01/2024  
CH032240WALGREEN CO.DBA: WALGREENS #11986 100 S. COLLEGE DR.
FRANKLINVA23851-242407/01/2024  
CH032240WALGREEN CO.DBA: WALGREENS #15446 118 W CONSTANCE RD
SUFFOLKVA2343407/01/2024  
CH032240Walgreens #21420Walgreens Central Fill #21420 8440 Times Dispatch Blvd
Ste. 400 		MechanicsvilleVA2311610/01/2023  
CH032240WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2014 09/11/2015
CH032240WALMART PHARMACY 10-3156117 MARKETPLACE DRIVE
HAMPTONVA2366610/01/2024  
CH032240WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275610/01/2024  
CH032240Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/1/2024 8:18:23 AM2/10/2025 5:08:14 PM2/10/2025 5:08 PM
DetailsLast Recertification DateUpdateRecertification2/7/2023 9:05:46 AM2/1/2024 8:18:23 AM2/1/2024 8:18 AM
DetailsLast Recertification DateUpdateRecertification1/31/2022 9:26:05 AM2/7/2023 9:05:46 AM2/7/2023 9:05 AM
DetailsLast Recertification DateUpdateRecertification2/4/2021 9:04:30 AM1/31/2022 9:26:05 AM1/31/2022 9:26 AM
DetailsLast Recertification DateUpdateRecertification2/4/2020 9:52:21 AM2/4/2021 9:04:30 AM2/4/2021 9:04 AM
ContactsPrimary ContactUpdateProfile Change RequestBRANCH, VALDA COO Peninsula Institute for Community Health 7575910643-1119BRANCH, VALDA COO Peninsula Institute for Community Health 75722370072/1/2021 8:25 PM
DetailsLast Recertification DateUpdateRecertification 2/4/2020 9:52:21 AM2/4/2020 9:52 AM
DetailsStateUpdate ApprovedActive10/1/2019 12:04 AM
ContactsSigned ByInsertNew Registration FUTRELL, ANGELA CEO Peninsula Institue for Community Health 7575910643-11207/18/2019 11:12 AM
Details340B IDUpdateNew Registration CH03224V7/18/2019 11:12 AM
DatesParticipating Approval DateUpdateNew Registration 7/18/2019 11:12:47 AM7/18/2019 11:12 AM
DetailsStateUpdateNew RegistrationPendingApproved7/18/2019 11:12 AM
DatesSigned By DateUpdateNew Registration 7/10/2019 4:33:12 PM7/18/2019 11:12 AM
DatesStart DateUpdateNew Registration 10/1/2019 12:00:00 AM7/18/2019 11:12 AM
AddressesMain AddressInsertNew Registration  9294 Warwick Blvd Newport News, VA 23607-15357/2/2019 8:30 AM
AddressesBilling AddressInsertNew Registration Southeastern Virginia Health System 1033 28th Street Newport News, VA 236077/2/2019 8:30 AM
ContactsPrimary ContactInsertNew Registration BRANCH, VALDA COO Peninsula Institute for Community Health 7575910643-11197/2/2019 8:30 AM
ContactsAuthorizing OfficialInsertNew Registration FUTRELL, ANGELA CEO Peninsula Institue for Community Health 7575910643-11207/2/2019 8:30 AM
DetailsLast Recertification DateInsertNew Registration  7/2/2019 8:30 AM
DetailsGrant NumberInsertNew Registration H80CS000737/2/2019 8:30 AM
Details340B IDInsertNew Registration  7/2/2019 8:30 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  7/2/2019 8:30 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  7/2/2019 8:30 AM
DetailsMedicare Provider NumberInsertNew Registration  7/2/2019 8:30 AM
DetailsEntity NameInsertNew Registration Peninsula Institute For Community Health, Inc7/2/2019 8:30 AM
DetailsProgram CodeInsertNew Registration CH7/2/2019 8:30 AM
DetailsEntity SubnameInsertNew Registration Warwick Boulevard Physicians7/2/2019 8:30 AM
DatesParticipating Approval DateInsertNew Registration  7/2/2019 8:30 AM
DetailsStateInsertNew Registration Pending7/2/2019 8:30 AM
DatesRegistration DateInsertNew Registration 7/2/2019 8:30:23 AM7/2/2019 8:30 AM
DatesSigned By DateInsertNew Registration  7/2/2019 8:30 AM
DatesStart DateInsertNew Registration  7/2/2019 8:30 AM
TerminationsTermination CommentsInsertNew Registration  7/2/2019 8:30 AM
TerminationsTermination DateInsertNew Registration  7/2/2019 8:30 AM
TerminationsTermination Effective DateInsertNew Registration  7/2/2019 8:30 AM
TerminationsTermination ReasonInsertNew Registration  7/2/2019 8:30 AM