Covered Entity Details

CH04492D Caswell Family Medical Center Inc., The (Terminated) - information as of 6/18/2025 1:08:14 AM

Main Details

Name

Caswell Family Medical Center Inc., The

Subdivision Name

CFMC at Caswell County Health Department

Type

HRSA-Funded Health Center

Site ID

BPS-H80-030030

340B ID

CH04492D

Grant Number

H80CS00478

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2020

Participating Start Date

10/28/2020

Participating Approval Date

10/1/2020

Last Recertification Date

2/16/2021

Termination Date
Termination Reason

4/1/2022
Business decision by the Covered Entity

Contacts

Authorizing Official

Compassion Health Care, Inc.
William Crumpton, CEO
(336) 694-9331

Primary Contact

Caswell Family Medical Center
Donita Hairston, 340B Progam Director
(336) 694-9331 Ext: 236

Addresses

Street Address

189 County Park Rd
Yanceyville, NC 27379-9376

Billing Address

Caswell Family Medical Center
PO Box 1448
439 US Hwy 158 W
Yanceyville, NC 27379

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
CH044920	Active	BPS-H80-004346	Compassion Health Care, Inc.	CASWELL FAMILY MEDICAL CENTER	439 US Highway 158 W	Yanceyville	NC
CH04492A	Active	BPS-H80-019762	Compassion Health Care, Inc.	CFMC Urgent Care	439 US HWY 158W, STE B	YANCEYVILLE	NC
CH04492B	Active	BPS-H80-036736	Compassion Health Care, Inc.	JAMES AUSTIN HEALTHCARE CENTER	250 W Kings Hwy	EDEN	NC
CH04492C	Terminated	BPS-H80-030031	Caswell Family Medical Center Inc., The	CFMC at Caswell Senior Services	649 Firetower Rd	Yanceyville	NC
CH04492D	Terminated	BPS-H80-030030	Caswell Family Medical Center Inc., The	CFMC at Caswell County Health Department	189 County Park Rd	Yanceyville	NC
CH04492E	Active	BPS-H80-037360	Compassion Health Care, Inc.	Compassion Health Care Mobile Unit	439 US Highway 158 W	Yanceyville	NC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH044920	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	10/01/2016	02/19/2018
CH044920	CAROLINA APOTHECARY	CHARLES ARNOLD BRITT	726 S SCALES ST	REIDSVILLE	NC	27320-5330	10/01/2020	09/30/2023
CH044920	EDEN DRUG STORE INC	103 W STADIUM DR		EDEN	NC	27288	07/01/2020	07/20/2022
CH044920	K MART PHARMACY #4062	3311 RIVERSIDE DRIVE		DANVILLE	VA	24541	04/01/2017	02/19/2018
CH044920	MADISON PHARMACY AND HOMECARE	125 W MURPHY ST		MADISON	NC	27025	07/01/2020	02/18/2021
CH044920	MITCHELL'S DISCNT DRUGS	544 MORGAN RD		EDEN	NC	27288-2524	07/01/2020	02/18/2021
CH044920	NORTH VILLAGE PHARMACY INC	1493 MAIN ST		YANCEYVILLE	NC	27379-8793	01/01/2016	02/14/2017
CH044920	NORTH VILLAGE PHARMACY INC	1493 MAIN ST		YANCEYVILLE	NC	27379-8793	07/01/2017
CH044920	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH044920	WAL-MART PHARMACY 10-1465	515 MOUNT CROSS ROAD		DANVILLE	VA	24540	07/01/2016
CH044920	WAL-MART PHARMACY 10-1558	304 E ARBOR LANE		EDEN	NC	27288	04/01/2024
CH044920	WAL-MART PHARMACY 10-2704	1021 HIGH POINT STREET		RANDLEMAN	NC	27317	01/01/2017	02/19/2018
CH044920	WAL-MART PHARMACY 10-3036		1593 N CAROLINA RTE. 86 NORTH	YANCEYVILLE	NC	27379	01/01/2015	09/23/2016
CH044920	WAL-MART PHARMACY 10-3304	1624 NC #14 HWY		REIDSVILLE	NC	27320	01/01/2017	07/20/2022
CH044920	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH044920	WALGREEN CO.	DBA: WALGREENS #12349	603 S. SCALES ST.	REIDSVILLE	NC	27320-5023	09/27/2012
CH044920	WALGREEN CO.	DBA: COMMONWEALTH 15218, A WALGREENS PHA	117 EXECUTIVE DRIVE SUITE L	DANVILLE	VA	24541	09/27/2012	10/13/2016
CH044920	WALGREEN CO.	DBA: WALGREENS #15291	401 S. MAIN STREET	DANVILLE	VA	24541	10/01/2014
CH044920	WALGREEN CO.	DBA: WALGREENS #15112	1500 PINEY FOREST ROAD	DANVILLE	VA	24540	01/01/2017	01/21/2025
CH044920	WALGREEN CO.	WALGREENS #19513	109 S VAN BUREN RD	EDEN	NC	27288	04/01/2024
CH044920	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CH044920	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH044920	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024
CH044920	YANCEYVILLE DRUG CO	YANCEYVILLE DRUG CO., INC.	106 COURT SQUARE P.O. BOX 1108	YANCEYVILLE	NC	27379	10/03/2006	02/19/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Crumpton, William CEO Caswell Family Medical Center 3366941181-209	Crumpton, William CEO Compassion Health Care, Inc. 3366949331	4/13/2022 7:13 AM
Contacts	Signed By	Update	Profile Change Request	Crumpton, William CEO Caswell Family Medical Center 3366941181-209	Crumpton, William CEO Compassion Health Care, Inc. 3366949331	4/13/2022 7:13 AM
Details	State	Update		To Be Terminated	Terminated	4/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		4/1/2022 12:00:00 AM	2/10/2022 5:21 PM
Details	State	Update	Recertification	Active	To Be Terminated	2/10/2022 5:21 PM
Terminations	Termination Date	Update	Recertification		4/1/2022 12:00:00 AM	2/10/2022 5:21 PM
Terminations	Termination Effective Date	Update	Recertification		4/1/2022 12:00:00 AM	2/10/2022 5:21 PM
Terminations	Termination Reason	Update	Recertification		Business decision by the Covered Entity	2/10/2022 5:21 PM
Contacts	Primary Contact	Update	Profile Change Request	Hairston, Donita 340B Progam Director Caswell Family Medical Center 3366941181-236	Hairston, Donita 340B Progam Director Caswell Family Medical Center 3366949331-236	2/3/2022 8:43 AM
Details	Last Recertification Date	Update	Recertification		2/16/2021 6:12:42 AM	2/16/2021 6:12 AM
Details	State	Update	OPA Edit	Approved	Active	10/28/2020 6:39 PM
Dates	Start Date	Update	OPA Edit	1/1/2021 12:00:00 AM	10/28/2020 12:00:00 AM	10/28/2020 6:39 PM
Contacts	Signed By	Insert	New Registration		Crumpton, William CEO Caswell Family Medical Center 3366941181-209	10/1/2020 11:20 AM
Details	340B ID	Update	New Registration		CH04492D	10/1/2020 11:20 AM
Dates	Participating Approval Date	Update	New Registration		10/1/2020 11:20:10 AM	10/1/2020 11:20 AM
Details	State	Update	New Registration	Pending	Approved	10/1/2020 11:20 AM
Dates	Signed By Date	Update	New Registration		10/1/2020 9:27:04 AM	10/1/2020 11:20 AM
Dates	Start Date	Update	New Registration		1/1/2021 12:00:00 AM	10/1/2020 11:20 AM
Addresses	Main Address	Insert	New Registration		189 County Park Rd Yanceyville, NC 27379-9376	10/1/2020 9:26 AM
Addresses	Billing Address	Insert	New Registration		Caswell Family Medical Center PO Box 1448 439 US Hwy 158 W Yanceyville, NC 27379	10/1/2020 9:26 AM
Contacts	Authorizing Official	Insert	New Registration		Crumpton, William CEO Caswell Family Medical Center 3366941181-209	10/1/2020 9:26 AM
Contacts	Primary Contact	Insert	New Registration		Hairston, Donita 340B Progam Director Caswell Family Medical Center 3366941181-236	10/1/2020 9:26 AM
Details	Assistance Received From Date	Insert	New Registration			10/1/2020 9:26 AM
Details	Assistance Received To Date	Insert	New Registration			10/1/2020 9:26 AM
Details	Last Recertification Date	Insert	New Registration			10/1/2020 9:26 AM
Details	Grant Number	Insert	New Registration		H80CS00478	10/1/2020 9:26 AM
Details	340B ID	Insert	New Registration			10/1/2020 9:26 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/1/2020 9:26 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/1/2020 9:26 AM
Details	Medicare Provider Number	Insert	New Registration			10/1/2020 9:26 AM
Details	Entity Name	Insert	New Registration		Caswell Family Medical Center Inc., The	10/1/2020 9:26 AM
Details	NOFO Number	Insert	New Registration			10/1/2020 9:26 AM
Details	Program Code	Insert	New Registration		CH	10/1/2020 9:26 AM
Details	Entity Subname	Insert	New Registration		CFMC at Caswell County Health Department	10/1/2020 9:26 AM
Dates	Participating Approval Date	Insert	New Registration			10/1/2020 9:26 AM
Details	State	Insert	New Registration		Pending	10/1/2020 9:26 AM
Dates	Registration Date	Insert	New Registration		10/1/2020 9:26:59 AM	10/1/2020 9:26 AM
Dates	Signed By Date	Insert	New Registration			10/1/2020 9:26 AM
Dates	Start Date	Insert	New Registration			10/1/2020 9:26 AM
Terminations	Termination Comments	Insert	New Registration			10/1/2020 9:26 AM
Terminations	Termination Date	Insert	New Registration			10/1/2020 9:26 AM
Terminations	Termination Effective Date	Insert	New Registration			10/1/2020 9:26 AM
Terminations	Termination Reason	Insert	New Registration			10/1/2020 9:26 AM

340B Drug Pricing Program Database