340B Drug Pricing Program Database


CH053763K MUSKINGUM VALLEY HEALTH CENTERS (Terminated) - information as of 5/29/2025 1:57:54 AM

Main Details
MUSKINGUM VALLEY HEALTH CENTERS
Muskingum Valley Health Centers
HRSA-Funded Health Center
BPS-H80-029415
CH053763K
H80CS08783


Additional Details
Terminated
10/8/2019
1/1/2020
10/23/2019
1/29/2024

4/1/2025
Business decision by the Covered Entity

Contacts

Muskingum Valley Health Centers
DAN J ATKINSON, CEO
(740) 891-9090

Muskingum Valley Healthcenters
Amanda K Wheeler, Director of Pharmacy
(740) 487-1932

Addresses

945 Bethesda Dr Ste 140
Zanesville, OH 43701-1872

Muskingum Valley Health Centers
33 S 5th St
Zanesville, OH 43701


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

Yes
StateMedicaid NumberNPI Number
OH03715421144876996
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailCOLER DRUG BRIGHTON LTDSHRIVERS PHARMACY 3 406 BRIGHTON BLVD
ZANESVILLEOH4370110/23/201901/01/2020 04/01/202504/01/2025
Contract DetailNORTHSIDE CAMBRIDGE PHARMACY1330 CLARK ST STE 1100
CAMBRIDGEOH43725-961410/23/201901/01/2020 03/31/202310/16/2023
Contract DetailNORTHSIDE MAYSVILLE PHARMACY15 N MAYSVILLE AVE
ZANESVILLEOH43701-611010/23/201901/01/2020 10/01/202310/16/2023
Contract DetailNORTHSIDE MVHC PHARMACY716 ADAIR AVE
ZANESVILLEOH43701-283610/23/201901/01/2020 03/31/202310/16/2023
Contract DetailNORTHSIDE NEW CONCORD PHARMACY10 E MAIN ST
NEW CONCORDOH43762-128610/23/201901/01/2020 10/01/202310/16/2023
Contract DetailNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080110/23/201901/01/2020 10/01/202310/16/2023
Contract DetailNORTHSIDE PHARMACY721 TAYLOR ST
ZANESVILLEOH4370110/23/201901/01/2020 10/01/202310/16/2023
Contract DetailROSEVILLE PHARMACY157 S MAIN ST
ROSEVILLEOH43777-123810/23/201901/01/2020 10/01/202310/16/2023
Contract DetailSHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/23/201901/01/2020 04/01/202504/01/2025
Contract DetailSHRIVERS PHARMACY #1105 N KENNEBEC AVE
MCCONNELSVILLEOH4375610/23/201901/01/2020 04/01/202504/01/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 07392 1033 MILITARY ROAD
ZANESVILLEOH43701-134210/23/201901/01/2020 04/01/202504/01/2025
Contract DetailWALGREEN CO.DBA: WALGREENS #11694 190 CHESTNUT ST.
COSHOCTONOH4381210/23/201901/01/2020 04/01/202504/01/2025
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH0537630ActiveBPS-H80-008906MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers859 N Main St MaltaOH
CH053763AActiveBPS-H80-003889MUSKINGUM VALLEY HEALTH CENTERSMUSKINGUM VALLEY HEALTH CENTERS716 ADAIR AVE ZANESVILLEOH
CH053763CActiveBPS-H80-013263MUSKINGUM VALLEY HEALTH CENTERSMUSKINGUM VALLEY HEALTH CENTERS406 S 15th St CoshoctonOH
CH053763DTerminatedBPS-H80-015302MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers2845 BELL ST ZANESVILLEOH
CH053763EActiveBPS-H80-016916MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Center - Cambridge1330 Clark Street CambridgeOH
CH053763FTerminatedBPS-H80-031039MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers - Ridgewood Schools225 W Union Ave Ste 100 West LafayetteOH
CH053763GTerminatedBPS-H80-020793MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers1230 CLARK ST CAMBRIDGEOH
CH053763HActiveBPS-H80-021163MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers2725 Pinkerton Ln ZanesvilleOH
CH053763JActiveBPS-H80-027148MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers440 Browns Ln CoshoctonOH
CH053763KTerminatedBPS-H80-029415MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers945 Bethesda Dr Ste 140 ZanesvilleOH
CH053763LTerminatedBPS-H80-031040MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Center - Rolling Hills Schools58601 Marietta Rd ByesvilleOH
CH053763MActiveBPS-H80-037594MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Center-Coshocton UC450 Downtowner Plz CoshoctonOH
CH053763NActiveBPS-H80-032427MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers915 Putnam Ave ZanesvilleOH
CH053763PActiveBPS-H80-033103MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers - Cambridge MAT316 Clark St CambridgeOH
CH053763QActiveBPS-H80-032865MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers - Mobile 12725 Pinkerton Ln ZanesvilleOH
CH053763RActiveBPS-H80-033603MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers - Coshocton City Schools1205 Cambridge Rd Ste 100 CoshoctonOH
CH053763SActiveBPS-H80-033150MUSKINGUM VALLEY HEALTH CENTERSMuskingum Valley Health Centers - Mobile Dental Unit956 Moxahala Ave ZanesvilleOH
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH0537630ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2025  
CH0537630ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/01/2025  
CH0537630ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2025  
CH0537630ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607501/01/2025  
CH0537630ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/01/2025  
CH0537630ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/01/2025  
CH0537630ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280910/01/2024  
CH053763CB AND W PHARMACY INC501 DIETZ LN P O BOX 697
BEVERLYOH4571510/01/2021  
CH053763AB AND W PHARMACY INC501 DIETZ LN P O BOX 697
BEVERLYOH4571510/01/2021  
CH0537630B AND W PHARMACY INC501 DIETZ LN P O BOX 697
BEVERLYOH4571510/01/2021  
CH0537630CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361410/01/2024  
CH0537630CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/01/2024  
CH0537630CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621910/01/2024  
CH0537630CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175710/01/2024  
CH0537630CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808310/01/2024  
CH0537630CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700410/01/2024  
CH0537630CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761710/01/2024  
CH0537630CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2024  
CH0537630CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237410/01/2024  
CH0537630CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911910/01/2024  
CH053763ACOLER DRUG BRIGHTON LTDSHRIVERS PHARMACY 3 406 BRIGHTON BLVD
ZANESVILLEOH4370107/27/2011  
CH0537630COLER DRUG BRIGHTON LTDSHRIVERS PHARMACY 3 406 BRIGHTON BLVD
ZANESVILLEOH4370110/01/2019  
CH053763KCOLER DRUG BRIGHTON LTDSHRIVERS PHARMACY 3 406 BRIGHTON BLVD
ZANESVILLEOH4370101/01/2020 04/01/2025
CH0537630COLER DRUG DRESDEN101 W DAVE LONGABERGER AVE STE C
DRESDENOH4382101/01/2023  
CH0537630COLER DRUG ZANESVILLEDBA SHRIVERS PHARMACY AND WELLNESS III 2050 EAST PIKE
ZANESVILLEOH4370101/01/2023  
CH0537630CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502810/01/2024  
CH0537630CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503310/01/2024  
CH0537630GENOA HEALTHCARE LLC1832 ADAMS STREET, SUITE P
TOLEDOOH4360401/01/2024  
CH0537630GENOA HEALTHCARE LLC701 BROOKSEDGE PLAZA DR STE C
WESTERVILLEOH4308101/01/2024  
CH0537630GENOA HEALTHCARE LLC1550 SHERIDAN DRIVE SUITE 202, ROOM P
LANCASTEROH4313001/01/2024 03/25/2024
CH0537630GENOA HEALTHCARE LLC3556 SULLIVANT AVE, ROOM 201
COLUMBUSOH4320403/26/2024  
CH0537630GENOA HEALTHCARE LLC2009 BROWN STREET SUITE 7
ANDERSONIN46016-421610/01/2024  
CH0537630GENOA HEALTHCARE LLC2458 STETZER RD RM 193
BUCYRUSOH4482010/01/2024  
CH0537630GENOA HEALTHCARE LLC6655 EAST US HIGHWAY 36
AVONIN4612310/01/2024  
CH0537630GENOA HEALTHCARE LLC741 SCHOLL ROAD, STE P1
MANSFIELDOH4490710/01/2024  
CH053763ENORTHSIDE CAMBRIDGE PHARMACY1330 CLARK ST STE 1100
CAMBRIDGEOH43725-961401/01/2017 03/31/2023
CH0537630NORTHSIDE CAMBRIDGE PHARMACY1330 CLARK ST STE 1100
CAMBRIDGEOH43725-961410/01/2019 03/31/2023
CH053763KNORTHSIDE CAMBRIDGE PHARMACY1330 CLARK ST STE 1100
CAMBRIDGEOH43725-961401/01/2020 03/31/2023
CH0537630NORTHSIDE MAYSVILLE PHARMACY15 N MAYSVILLE AVE
ZANESVILLEOH43701-611006/15/2012 10/01/2023
CH053763ANORTHSIDE MAYSVILLE PHARMACY15 N MAYSVILLE AVE
ZANESVILLEOH43701-611006/15/2012 10/01/2023
CH053763KNORTHSIDE MAYSVILLE PHARMACY15 N MAYSVILLE AVE
ZANESVILLEOH43701-611001/01/2020 10/01/2023
CH053763ANORTHSIDE MVHC PHARMACY716 ADAIR AVE
ZANESVILLEOH43701-283610/01/2015 03/31/2023
CH0537630NORTHSIDE MVHC PHARMACY716 ADAIR AVE
ZANESVILLEOH43701-283610/01/2019 03/31/2023
CH053763KNORTHSIDE MVHC PHARMACY716 ADAIR AVE
ZANESVILLEOH43701-283601/01/2020 03/31/2023
CH053763KNORTHSIDE NEW CONCORD PHARMACY10 E MAIN ST
NEW CONCORDOH43762-128601/01/2020 10/01/2023
CH053763KNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH053763JNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH053763ANORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH053763DNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2021
CH0537630NORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH053763HNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH053763CNORTHSIDE PAVILION PHARMACY945 BETHESDA DR
ZANESVILLEOH43701-080101/01/2020 10/01/2023
CH0537630NORTHSIDE PHARMACY721 TAYLOR ST
ZANESVILLEOH4370106/15/2012 03/12/2023
CH053763ANORTHSIDE PHARMACY721 TAYLOR ST
ZANESVILLEOH4370106/15/2012 03/12/2023
CH053763KNORTHSIDE PHARMACY721 TAYLOR ST
ZANESVILLEOH4370101/01/2020 10/01/2023
CH0537630OPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705810/01/2024  
CH0537630OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2024  
CH0537630OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520401/01/2024  
CH0537630OPTUM PHARMACY 701, LLC4015 SHOPTON RD STE 600
CHARLOTTENC28217-302501/01/2024  
CH0537630OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850710/01/2024  
CH0537630OPTUM PHARMACY 701, LLC8131 W BOSTIAN RD STE A350
WOODINVILLEWA98072-502910/01/2024  
CH0537630OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2024  
CH0537630OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824910/01/2024  
CH0537630OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729810/01/2024  
CH0537630OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265510/01/2024  
CH0537630OPTUM PHARMACY 705, LLC3539 BLUECUTT RD
COLUMBUSMS3970510/01/2024  
CH0537630OPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110101/01/2024  
CH0537630OPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140110/01/2024  
CH0537630OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508510/01/2024  
CH0537630OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983801/01/2024  
CH0537630PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514610/01/2024  
CH0537630PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523310/01/2024  
CH0537630PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920310/01/2024  
CH0537630PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681310/01/2024  
CH0537630PROCARE PHARMACY, L.L.C.CVS/PHARMACY #48637 2700 NORTHEAST EXPY NE STE B800
BUILDING B 		ATLANTAGA3034510/01/2024  
CH0537630PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #48611 141 PREBLE STREET
PORTLANDME0410110/01/2024  
CH0537630ROSEVILLE PHARMACY157 S MAIN ST
ROSEVILLEOH43777-123806/15/2012 03/26/2023
CH053763AROSEVILLE PHARMACY157 S MAIN ST
ROSEVILLEOH43777-123806/15/2012 03/24/2023
CH053763KROSEVILLE PHARMACY157 S MAIN ST
ROSEVILLEOH43777-123801/01/2020 10/01/2023
CH053763HSHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/01/2018  
CH053763ASHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/01/2018  
CH053763HSHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/01/2018  
CH053763DSHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/01/2018 10/01/2021
CH0537630SHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373110/01/2019  
CH053763KSHRIVERS PHARMACY120 S. BUCKEYE ST
CROOKSVILLEOH4373101/01/2020 04/01/2025
CH0537630SHRIVERS PHARMACY #1105 N KENNEBEC AVE
MCCONNELSVILLEOH4375607/27/2011  
CH053763KSHRIVERS PHARMACY #1105 N KENNEBEC AVE
MCCONNELSVILLEOH4375601/01/2020 04/01/2025
CH0537630WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2024 08/19/2024
CH0537630WAL-MART PHARMACY 10-193723605 AIRPORT RD
COSHOCTONOH4381201/01/2024 08/19/2024
CH0537630WAL-MART PHARMACY 10-22092850 MAPLE AVE
ZANESVILLEOH4370101/01/2024 08/19/2024
CH0537630WAL-MART PHARMACY 10-326261205 SOUTHGATE PKWY.
CAMBRIDGEOH4372501/01/2024 08/19/2024
CH0537630WAL-MART PHARMACY 10-35812850 MAYSVILLE PIKE
ZANESVILLEOH4370101/01/2024 08/19/2024
CH0537630WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2024 08/19/2024
CH0537630WALGREEN CO.DBA: WALGREENS # 07392 1033 MILITARY ROAD
ZANESVILLEOH43701-134207/01/2014  
CH0537630WALGREEN CO.DBA: WALGREENS #11694 190 CHESTNUT ST.
COSHOCTONOH4381207/01/2014  
CH053763JWALGREEN CO.DBA: WALGREENS #11694 190 CHESTNUT ST.
COSHOCTONOH4381207/01/2019  
CH053763JWALGREEN CO.DBA: WALGREENS # 07392 1033 MILITARY ROAD
ZANESVILLEOH43701-134207/01/2019  
CH053763AWALGREEN CO.DBA: WALGREENS # 07392 1033 MILITARY ROAD
ZANESVILLEOH43701-134210/01/2019  
CH053763KWALGREEN CO.DBA: WALGREENS # 07392 1033 MILITARY ROAD
ZANESVILLEOH43701-134201/01/2020 04/01/2025
CH053763KWALGREEN CO.DBA: WALGREENS #11694 190 CHESTNUT ST.
COSHOCTONOH4381201/01/2020 04/01/2025
CH0537630WALGREEN CO.WALGREENS #17826 901 E MAIN ST
BARNESVILLEOH4371301/01/2022  
CH0537630WALGREEN CO.DBA: WALGREENS # 07541 1425 N 21ST STREET
NEWARKOH43055-306901/01/2022  
CH0537630WALGREEN CO.DBA: WALGREENS # 10810 764 HEBRON RD
HEATHOH43056-135401/01/2022  
CH0537630Walgreens #21423Walgreens Central Fill #21423 6275 Winchester Blvd
Canal WInchesterOH43110-653701/01/2024  
CH0537630WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/01/2014 08/31/2015
CH053763JWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/01/2019  
CH0537630WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818810/01/2024  
CH0537630WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503310/01/2024  
CH0537630WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527510/01/2024  
CH0537630WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/01/2024 08/19/2024
CH0537630Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024 08/19/2024
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate To Be TerminatedTerminated4/1/2025 12:01 AM
DatesLast Date That 340B Drugs PurchasedUpdateRecertification 10/14/2024 12:00:00 AM2/27/2025 8:30 AM
DetailsStateUpdateRecertificationActiveTo Be Terminated2/27/2025 8:30 AM
TerminationsTermination CommentsUpdateRecertification Office closed and staff relocated to another site2/27/2025 8:30 AM
TerminationsTermination DateUpdateRecertification 4/1/2025 12:00:00 AM2/27/2025 8:30 AM
TerminationsTermination Effective DateUpdateRecertification 10/14/2024 12:00:00 AM2/27/2025 8:30 AM
TerminationsTermination ReasonUpdateRecertification Business decision by the Covered Entity2/27/2025 8:30 AM
DetailsLast Recertification DateUpdateRecertification2/9/2023 7:28:15 AM1/29/2024 12:38:47 PM1/29/2024 12:38 PM
ContactsAuthorizing OfficialUpdateChange RequestCarr, Rebecca F Chief Financial Officer Muskingum Valley Health Centers 7408919094ATKINSON, DAN J CEO Muskingum Valley Health Centers 74089190902/20/2023 10:10 AM
AddressesBilling AddressInsertRecertification Muskingum Valley Health Centers 33 S 5th St Zanesville, OH 437012/9/2023 7:28 AM
ContactsPrimary ContactUpdateRecertificationATKINSON, DAN J CEO Muskingum Valley Health Centers 7408919090Wheeler, Amanda K Director of Pharmacy Muskingum Valley Healthcenters 74048719322/9/2023 7:28 AM
DetailsLast Recertification DateUpdateRecertification1/31/2022 9:10:33 AM2/9/2023 7:28:15 AM2/9/2023 7:28 AM
DetailsLast Recertification DateUpdateRecertification2/1/2021 8:58:14 AM1/31/2022 9:10:33 AM1/31/2022 9:10 AM
AddressesMain AddressUpdateChange Request 954 Bethesda Dr Ste 140 Zanesville, OH 43701-1872 945 Bethesda Dr Ste 140 Zanesville, OH 43701-187210/13/2021 9:21 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False2/1/2021 8:58 AM
Medicaid BillingMedicaid: NumberInsertRecertification 03715422/1/2021 8:58 AM
Medicaid BillingMedicaid: StateInsertRecertification OH2/1/2021 8:58 AM
Medicaid BillingNPI: StateUpdateRecertification OH2/1/2021 8:58 AM
DetailsLast Recertification DateUpdateRecertification1/28/2020 9:00:31 AM2/1/2021 8:58:14 AM2/1/2021 8:58 AM
DetailsLast Recertification DateUpdateRecertification 1/28/2020 9:00:31 AM1/28/2020 9:00 AM
DetailsStateUpdate ApprovedActive1/1/2020 12:04 AM
ContactsSigned ByInsertNew Registration Carr, Rebecca F Chief Financial Officer Muskingum Valley Health Centers 740891909410/23/2019 1:49 PM
Details340B IDUpdateNew Registration CH053763K10/23/2019 1:49 PM
DatesParticipating Approval DateUpdateNew Registration 10/23/2019 1:49:16 PM10/23/2019 1:49 PM
DetailsStateUpdateNew RegistrationPendingApproved10/23/2019 1:49 PM
DatesSigned By DateUpdateNew Registration 10/23/2019 10:15:02 AM10/23/2019 1:49 PM
DatesStart DateUpdateNew Registration 1/1/2020 12:00:00 AM10/23/2019 1:49 PM
AddressesMain AddressInsertNew Registration  954 Bethesda Dr Ste 140 Zanesville, OH 43701-187210/8/2019 8:25 AM
Medicaid BillingNPI: NumberInsertNew Registration 114487699610/8/2019 8:25 AM
ContactsAuthorizing OfficialInsertNew Registration Carr, Rebecca F Chief Financial Officer Muskingum Valley Health Centers 740891909410/8/2019 8:25 AM
ContactsPrimary ContactInsertNew Registration ATKINSON, DAN J CEO Muskingum Valley Health Centers 740891909010/8/2019 8:25 AM
DetailsLast Recertification DateInsertNew Registration  10/8/2019 8:25 AM
DetailsGrant NumberInsertNew Registration H80CS0878310/8/2019 8:25 AM
Details340B IDInsertNew Registration  10/8/2019 8:25 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/8/2019 8:25 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/8/2019 8:25 AM
DetailsMedicare Provider NumberInsertNew Registration  10/8/2019 8:25 AM
DetailsEntity NameInsertNew Registration MUSKINGUM VALLEY HEALTH CENTERS10/8/2019 8:25 AM
DetailsProgram CodeInsertNew Registration CH10/8/2019 8:25 AM
DetailsEntity SubnameInsertNew Registration Muskingum Valley Health Centers10/8/2019 8:25 AM
DatesParticipating Approval DateInsertNew Registration  10/8/2019 8:25 AM
DetailsStateInsertNew Registration Pending10/8/2019 8:25 AM
DatesRegistration DateInsertNew Registration 10/8/2019 8:25:48 AM10/8/2019 8:25 AM
DatesSigned By DateInsertNew Registration  10/8/2019 8:25 AM
DatesStart DateInsertNew Registration  10/8/2019 8:25 AM
TerminationsTermination CommentsInsertNew Registration  10/8/2019 8:25 AM
TerminationsTermination DateInsertNew Registration  10/8/2019 8:25 AM
TerminationsTermination Effective DateInsertNew Registration  10/8/2019 8:25 AM
TerminationsTermination ReasonInsertNew Registration  10/8/2019 8:25 AM