Covered Entity Details

CH06082N Community Health Service Agency, Inc. Of Hunt County, The (Active) - information as of 6/9/2025 11:06:28 PM

Main Details

Name

Community Health Service Agency, Inc. Of Hunt County, The

Subdivision Name

Carevide

Type

HRSA-Funded Health Center

Site ID

BPS-H80-029450

340B ID

CH06082N

Grant Number

H80CS00675

Additional Details

Current Program Status

Active

Registration Date

2/4/2020

Participating Start Date

4/1/2020

Participating Approval Date

2/5/2020

Last Recertification Date

3/3/2025

Contacts

Authorizing Official

Community Health Service Agency, Inc. of Hunt County, The
Michelle Carter, Chief Executive Officer
(903) 455-5986

Primary Contact

Carevide
Joe Capetillo, Compliance Officer
(903) 455-5986

Addresses

Street Address

106 Medical Cir
Sulphur Springs, TX 75482-2136

Billing Address

Carevide
P.O. Box 1908
Greenville, TX 75403

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?
Yes

State	Medicaid Number	NPI Number
TX	404335801	1184275711

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
CH060820	Active	BPS-H80-001507	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	4500 Wesley St	Greenville	TX
CH06082C	Active	BPS-H80-004998	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	4311 Wesley St	Greenville	TX
CH06082D	Active	BPS-H80-039578	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	1708 W. Audie Murphy Pkwy STE 400	FARMERSVILLE	TX
CH06082G	Active	BPS-H80-030688	Community Health Service Agency, Inc., of Hunt County, The	Carevide	2600 Commerce Way Ste 100	KAUFMAN	TX
CH06082H	Active	BPS-H80-004847	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	91 W SIDE SQ	COOPER	TX
CH06082J	Active	BPS-H80-036332	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	1211 East Sixth Street STE 300 & 600	Bonham	TX
CH06082K	Active	BPS-H80-015209	Community Health Service Agency, Inc. Of Hunt County, The	Carevide Pediatrics	3005A Joe Ramsey Blvd.	Greenville	TX
CH06082L	Active	BPS-H80-030808	Community Health Service Agency, Inc. Of Hunt County, The	Carevide Dental	3005 B Joe Ramsey Blvd.	GREENVILLE	TX
CH06082M	Active	BPS-H80-028036	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	606 Culver St	Commerce	TX
CH06082N	Active	BPS-H80-029450	Community Health Service Agency, Inc. Of Hunt County, The	Carevide	106 Medical Cir	Sulphur Springs	TX

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH060820	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2023
CH060820	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2023
CH060820	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2023
CH060820	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2023
CH060820	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2023
CH060820	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2023
CH060820	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	01/01/2023
CH060820	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	04/01/2017	07/14/2020
CH060820	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	07/01/2022	07/01/2022
CH060820	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/01/2019
CH060820	AMAZON PHARMACY #006	3620 PLAINFIELD RD		INDIANAPOLIS	IN	46231-7003	04/01/2025
CH060820	AVELLA OF DEER VALLEY, INC. #38	DBA AVELLA SPECIALTY PHARMACY	24416 N. 19TH AVE	PHOENIX	AZ	85085	07/01/2018	07/14/2020
CH060820	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019
CH060820	BONHAM FAMILY DRUG	MEDICINE SHOPPES, INC	100 E SAM RAYBURN DR	BONHAM	TX	75418-4333	07/01/2019
CH060820	BROOKSHIRE PHARMACY #35	2235 S. WASHINGTON		KAUFMAN	TX	75142	10/01/2022	11/15/2022
CH060820	BROOKSHIRE PHARMACY #74	6410 WESLEY STREET		GREENVILLE	TX	75402	10/01/2022	11/15/2022
CH060820	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2023
CH060820	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2023
CH060820	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10505	2710 HIGHWAY 24	COMMERCE	TX	75428	07/01/2022
CH060820	CVS PHARMACY, INC.	DBA CVS/PHARMACY# 10016	311 EAST PRINCETON DRIVE	PRINCETON	TX	75407	07/01/2022
CH060820	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07680	1870 W MOORE AVE. P.O. BOX 1268	TERRELL	TX	75160	07/01/2022
CH060820	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07404	102 E. MULBERRY ST.	KAUFMAN	TX	75142	07/01/2022
CH060820	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06806	5010 WESLEY ST	GREENVILLE	TX	75401	07/01/2022
CH060820	CVS PHARMACY, INC.	DBA CVS/PHARMACY # 10635	476 W INTERSTATE 30	ROYSE CITY	TX	75189	07/01/2022
CH060820	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	04/01/2017	02/04/2020
CH060820	DYER DRUG STORE	DYER DRUG STORE INC	133 MCKINNEY ST	FARMERSVILLE	TX	75442-2221	01/01/2019
CH060820	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	04/01/2023
CH060820	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	04/01/2023
CH060820	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	04/01/2023
CH060820	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	04/01/2023
CH060820	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/01/2025
CH060820	MEDICINE SHOPPE #2015	3001 JOE RAMSEY BLVD E		GREENVILLE	TX	75401	07/01/2022
CH060820	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/01/2022
CH060820	OPTUM PHARMACY 800, INC.	3016 GUADALUPE ST STE A		AUSTIN	TX	78705-2861	07/01/2018	12/17/2020
CH060820	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	07/06/2020	12/17/2020
CH060820	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	07/01/2022	05/16/2022
CH060820	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/01/2022
CH060820	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/01/2019
CH060820	SUPER 1 PHARMACY #615	4811 WESLEY STREET		GREENVILLE	TX	75401	10/01/2022	11/15/2022
CH060820	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2018
CH060820	WAL-MART PHARMACY 10-0158	2021 NORTH HWY. 121		BONHAM	TX	75418	10/01/2018
CH060820	WAL-MART PHARMACY 10-0240	2701 HIGHWAY 50		COMMERCE	TX	75428	10/01/2018
CH060820	WAL-MART PHARMACY 10-0265	1900 W. MOORE AVENUE		TERRELL	TX	75160	10/01/2018	08/20/2024
CH060820	WAL-MART PHARMACY 10-0427	7401 INTERSTATE 30		GREENVILLE	TX	75402	10/01/2018
CH060820	WAL-MART PHARMACY 10-4215	8801 HIGHWAY 34 SOUTH		QUINLAN	TX	75474	10/01/2018
CH060820	WAL-MART PHARMACY 10-5210	2050 N HWY 78		WYLIE	TX	75098	04/01/2019	10/10/2020
CH060820	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018
CH060820	WALMART PHARMACY 10-4164	300 KINGS FORT PKWY		KAUFMAN	TX	75142	04/01/2019
CH060820	WALMART PHARMACY 10-4453	4715 WESLEY ST.		GREENVILLE	TX	75401	10/01/2018
CH060820	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH060820	WALMART PHARMACY 10-5987	494 W INTERSTATE 30		ROYSE CITY	TX	75189	04/01/2019	10/10/2020
CH060820	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/14/2024 3:47:00 PM	3/3/2025 1:09:15 PM	3/3/2025 1:09 PM
Details	Last Recertification Date	Update	Recertification	2/21/2023 7:10:58 AM	2/14/2024 3:47:00 PM	2/14/2024 3:47 PM
Addresses	Main Address	Update	Recertification	106 Medical Circle Sulphur Springs, TX 75482-2136	106 Medical Cir Sulphur Springs, TX 75482-2136	2/21/2023 7:10 AM
Details	Last Recertification Date	Update	Recertification	2/11/2022 3:08:37 PM	2/21/2023 7:10:58 AM	2/21/2023 7:10 AM
Details	Last Recertification Date	Update	Recertification	2/25/2021 2:00:31 PM	2/11/2022 3:08:37 PM	2/11/2022 3:08 PM
Addresses	Main Address	Update	Recertification	105 ll Medical Plaza Sulphur Springs, TX 75482-2136	106 Medical Circle Sulphur Springs, TX 75482-2136	2/25/2021 2:00 PM
Addresses	Billing Address	Insert	Recertification		Carevide P.O. Box 1908 Greenville, TX 75403	2/25/2021 2:00 PM
Contacts	Primary Contact	Update	Recertification	Crawford, Kristina Director of Nursing Community Health Service Agency, Inc. 9034555986	Capetillo, Joe Compliance Officer Carevide 9034555986	2/25/2021 2:00 PM
Details	Last Recertification Date	Update	Recertification		2/25/2021 2:00:31 PM	2/25/2021 2:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	11/24/2020 2:45 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		404335801	11/24/2020 2:45 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		TX	11/24/2020 2:45 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1184275711	11/24/2020 2:45 PM
Medicaid Billing	NPI: State	Insert	Change Request		TX	11/24/2020 2:45 PM
Details	State	Update		Approved	Active	4/1/2020 12:05 AM
Contacts	Primary Contact	Update	Profile Change Request	Crawford, Kristina Director of Nursing Community Health Service Agency, Inc. 9034554586	Crawford, Kristina Director of Nursing Community Health Service Agency, Inc. 9034555986	2/5/2020 5:24 PM
Addresses	Main Address	Update	OPA Edit	Sulphur Springs, TX 75482-2136	105 ll Medical Plaza Sulphur Springs, TX 75482-2136	2/5/2020 4:29 PM
Contacts	Signed By	Insert	New Registration		Carter, Michelle Chief Executive Officer Community Health Service Agency, Inc. of Hunt County, The 9034555986	2/5/2020 4:27 PM
Details	340B ID	Update	New Registration		CH06082N	2/5/2020 4:27 PM
Dates	Participating Approval Date	Update	New Registration		2/5/2020 4:27:45 PM	2/5/2020 4:27 PM
Details	State	Update	New Registration	Pending	Approved	2/5/2020 4:27 PM
Dates	Signed By Date	Update	New Registration		2/4/2020 12:38:33 PM	2/5/2020 4:27 PM
Dates	Start Date	Update	New Registration		4/1/2020 12:00:00 AM	2/5/2020 4:27 PM
Addresses	Main Address	Insert	New Registration		Sulphur Springs, TX 75482-2136	2/4/2020 12:38 PM
Contacts	Primary Contact	Insert	New Registration		Crawford, Kristina Director of Nursing Community Health Service Agency, Inc. 9034554586	2/4/2020 12:38 PM
Contacts	Authorizing Official	Insert	New Registration		Carter, Michelle Chief Executive Officer Community Health Service Agency, Inc. of Hunt County, The 9034555986	2/4/2020 12:38 PM
Details	Last Recertification Date	Insert	New Registration			2/4/2020 12:38 PM
Details	Grant Number	Insert	New Registration		H80CS00675	2/4/2020 12:38 PM
Details	340B ID	Insert	New Registration			2/4/2020 12:38 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			2/4/2020 12:38 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			2/4/2020 12:38 PM
Details	Medicare Provider Number	Insert	New Registration			2/4/2020 12:38 PM
Details	Entity Name	Insert	New Registration		Community Health Service Agency, Inc. Of Hunt County, The	2/4/2020 12:38 PM
Details	Program Code	Insert	New Registration		CH	2/4/2020 12:38 PM
Details	Entity Subname	Insert	New Registration		Carevide	2/4/2020 12:38 PM
Dates	Participating Approval Date	Insert	New Registration			2/4/2020 12:38 PM
Details	State	Insert	New Registration		Pending	2/4/2020 12:38 PM
Dates	Registration Date	Insert	New Registration		2/4/2020 12:38:30 PM	2/4/2020 12:38 PM
Dates	Signed By Date	Insert	New Registration			2/4/2020 12:38 PM
Dates	Start Date	Insert	New Registration			2/4/2020 12:38 PM
Terminations	Termination Comments	Insert	New Registration			2/4/2020 12:38 PM
Terminations	Termination Date	Insert	New Registration			2/4/2020 12:38 PM
Terminations	Termination Effective Date	Insert	New Registration			2/4/2020 12:38 PM
Terminations	Termination Reason	Insert	New Registration			2/4/2020 12:38 PM

340B Drug Pricing Program Database