Covered Entity Details

CH042100L REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC) (Active) - information as of 5/3/2025 11:30:49 PM

Main Details

Name

REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)

Subdivision Name

ReGenesis Health Care-Phoenix Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-031524

340B ID

CH042100L

Grant Number

H80CS00298

Additional Details

Current Program Status

Active

Registration Date

4/6/2021

Participating Start Date

7/1/2021

Participating Approval Date

4/7/2021

Last Recertification Date

2/18/2025

Contacts

Authorizing Official

ReGenesis Organization Community Health Center
Marlon B Hunter, CEO
(864) 594-0190

Primary Contact

ReGenesis Organization Community Health Center
Ankitkumar Visabhai Patel, Director of Pharmacy
(864) 699-3283

Addresses

Street Address

1400 Cleveland St
Greenville, SC 29607-2410

Billing Address

ReGenesis Health Care Pharmacy
PO Box 5158
Spartanburg, SC 29304

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
SC	710852,718117,711271,7Z1262,FQC057,FQC121,FQC173,FQC127,FQC211,FQC238,FQC268,FQC303,FQC304,7Z1342	1164747929,1811476005,1740598051,1649961434,1194710426,1548528714,1265777908,1245409846,1457745952,1982248852,1558946376,1457061087,1225899594,1093532061

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
CH0421000	Active	BPS-H80-001734	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Spartanburg	750 S Church St	Spartanburg	SC
CH042100A	Terminated	BPS-H80-014726	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	REGENESIS HEALTH CARE	1604 N LIMESTONE ST	GAFFNEY	SC
CH042100AA	Active	BPS-H80-037921	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Northwest Elementary School	840 Green River Rd	Gaffney	SC
CH042100AB	Active	BPS-H80-037979	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Corinth Elementary School	128 Corinth Rd	Gaffney	SC
CH042100AC	Active	BPS-H80-037985	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Chapman High School	1420 Compton Bridge Rd	Inman	SC
CH042100AD	Active	BPS-H80-037922	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Boiling Springs Elementary	700 Double Bridge Rd	Boiling Springs	SC
CH042100AE	Active	BPS-H80-037977	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Jesse Bobo Elementary School	495 Powell Mill Rd	Spartanburg	SC
CH042100AF	Active	BPS-H80-037920	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Gaffney Middle School	805 E Frederick St	Gaffney	SC
CH042100AG	Active	BPS-H80-037982	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Draytonville Elementary School	2373 Wilkinsville Hwy	Gaffney	SC
CH042100AH	Active	BPS-H80-037981	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Dorman High School	1050 Cavalier Way	Roebuck	SC
CH042100AJ	Active	BPS-H80-037917	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - High Point Academy	6655 Pottery Rd	Spartanburg	SC
CH042100AK	Active	BPS-H80-037983	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Westview Elementary School	400 Oak Grove Rd	Spartanburg	SC
CH042100AL	Active	BPS-H80-037975	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Dorman Freshman Campus	1225 Cavalier Way	Roebuck	SC
CH042100AM	Active	BPS-H80-037978	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Arcadia Elementary	375 Spring St	Spartanburg	SC
CH042100AN	Active	BPS-H80-037916	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Gaffney High School	149 Twin Lake Rd	Gaffney	SC
CH042100AP	Active	BPS-H80-037976	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Gable Middle School	198 Otts Shoals Rd	Roebuck	SC
CH042100AQ	Active	BPS-H80-037974	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Dawkins Middle School	1300 E Blackstock Rd	Moore	SC
CH042100AR	Active	BPS-H80-037915	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Grassy Pond Elementary	1146 Boiling Springs Hwy	Gaffney	SC
CH042100AS	Active	BPS-H80-037898	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Mabry Middle School	35 Oakland Ave	Inman	SC
CH042100AT	Active	BPS-H80-037897	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Hendrix Elementary School	1084 Springfield Rd	Boiling Springs	SC
CH042100AU	Active	BPS-H80-037896	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Chesnee High School	795 S Alabama Ave	Chesnee	SC
CH042100AV	Active	BPS-H80-037842	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Inman Elementary School	25 Oakland Ave	Inman	SC
CH042100B	Active	BPS-H80-012724	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Woodruff	220 Irby St	Woodruff	SC
CH042100C	Active	BPS-H80-011418	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Spartanburg Early Learning Center at Park Hills	301 Crescent Ave	Spartanburg	SC
CH042100D	Active	BPS-H80-017594	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Spartanburg Family Dentistry	362 North Pine Street	Spartanburg	SC
CH042100E	Active	BPS-H80-015062	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Administration/Family Medicine	460 LANGDON ST	SPARTANBURG	SC
CH042100F	Terminated	BPS-H80-017594	REGENESIS HEALTH CARE, INC	ReGenesis Health Care Inc.	362 North Pine Street	Spartanburg	SC
CH042100G	Active	BPS-H80-020810	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Gaffney	1341 North Limestone Street	Gaffney	SC
CH042100H	Terminated	BPS-H80-020809	Regenesis Health Care, Inc	ReGenesis Health Care - CC Woodson Community Center	210 Bomar Avenue	Spartanburg	SC
CH042100J	Active	BPS-H80-021017	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	Archibald Rutledge	764 North Church Street	Spartanburg	SC
CH042100K	Active	BPS-H80-029609	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Union	115 Thomas St	Union	SC
CH042100L	Active	BPS-H80-031524	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Phoenix Center	1400 Cleveland St	Greenville	SC
CH042100M	Active	BPS-H80-031535	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Union Family Dentistry	115 Thomas St Ste C	Union	SC
CH042100N	Active	BPS-H80-032348	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care – North Side Health Center	220 College St	Spartanburg	SC
CH042100P	Active	BPS-H80-032817	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Westside Center	1663 E Main St	Duncan	SC
CH042100Q	Active	BPS-H80-032375	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Mobile Health Center #1	460 Langdon St	Spartanburg	SC
CH042100R	Active	BPS-H80-033642	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Bell Hill	945 E Main St Ste A	Spartanburg	SC
CH042100S	Active	BPS-H80-036571	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Mobile Health Center #2	460 Langdon St	Spartanburg	SC
CH042100T	Active	BPS-H80-036572	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care-Mobile Health Center #3	460 Langdon St	Spartanburg	SC
CH042100U	Active	BPS-H80-037923	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Lone Oak Elementary	7314 Lone Oak Rd	Spartanburg	SC
CH042100V	Active	BPS-H80-037918	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Chesnee Middle School	805 S Alabama Ave	Chesnee	SC
CH042100W	Active	BPS-H80-037919	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Boiling Springs Middle School	4801 Highway 9	Inman	SC
CH042100X	Active	BPS-H80-037980	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Fairforest Middle School	4120 N Blackstock Rd	Spartanburg	SC
CH042100Y	Active	BPS-H80-037984	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Inman Intermediate School	10 W Miller St	Inman	SC
CH042100Z	Active	BPS-H80-037973	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	ReGenesis Health Care - Boiling Springs High School	2251 Old Furnace Rd	Boiling Springs	SC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH0421000	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	07/01/2025
CH0421000	BEVID SENIOR CARE LLC	D/B/A BEVID PHARMACY	746 OLD SPARTANBURG HWY	WELLFORD	SC	29385	10/01/2022	06/27/2023
CH0421000	BI-LO PHARMACY #5042	371 SOUTH MAIN STREET		WOODRUFF	SC	29388	07/01/2019	06/30/2020
CH0421000	BI-LO PHARMACY #5182	2401 REIDVILLE ROAD		SPARTANBURG	SC	29301	07/01/2019	06/30/2020
CH0421000	BI-LO PHARMACY #5214	1013 W. FLOYD BAKER BLVD		GAFFNEY	SC	29341	07/01/2019	06/30/2020
CH0421000	BI-LO PHARMACY #5446	12189 GREENVILLE HWY		LYMAN	SC	29365	07/01/2019	06/30/2020
CH0421000	BIOPLUS SPECIALTY PHARMACY LA, LLC	2731 MANHATTAN BLVD STE B17		HARVEY	LA	70058	04/01/2025
CH0421000	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2019
CH0421000	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	10/01/2024
CH0421000	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	10/01/2024
CH0421000	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	10/01/2024
CH0421000	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2023
CH0421000	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2025
CH0421000	CBTP PARTNERS LLC	D/B/A WOODRUFF HEALTH MART PHARMACY	10195 HIGHWAY 221 STE 5	WOODRUFF	SC	29388	01/27/2022
CH0421000	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2023
CH0421000	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2023
CH0421000	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2023
CH0421000	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/01/2023
CH0421000	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/01/2019
CH0421000	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2025
CH0421000	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/01/2025
CH0421000	RADHEY, LLC	D/B/A SMITH'S DRUG STORE NO. 1	142 E MAIN ST	SPARTANBURG	SC	29306-5113	01/27/2022
CH0421000	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2019
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C	DBA CVS/PHARMACY # 2446	820 N MAIN STREET	WOODRUFF	SC	29388	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04185	11211 ASHEVILLE HWY.	INMAN	SC	29349	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07061	5895 REIDVILLE RD.	MOORE	SC	29369	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07505	101 LOCUST STREET	LYMAN	SC	29365	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16688	8199 WARREN H ABERNATHY PKWY	SPARTANBURG	SC	29301	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07583	109 W. MANNING ST.	CHESNEE	SC	29323	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02555	229 WEST BUFORD ST.	GAFFNEY	SC	29341	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03586	2397 REIDVILLE ROAD,	SPARTANBURG	SC	29301	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03844	599 RICE AVE.	UNION	SC	29379	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04174	87 GARNER RD.	SPARTANBURG	SC	29303	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04382	1751 EAST MAIN STREET	SPARTANBURG	SC	29307	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04385	1400 UNION STREET	SPARTANBURG	SC	29302	10/01/2020
CH0421000	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07567	1888 BOILING SPRINGS ROAD	BOILING SPRINGS	SC	29316	10/01/2020
CH0421000	UNION FAMILY PHARMACY LLC	UNION FAMILY PHARMACY LLC	528 RICE AVE STE A	UNION	SC	29379	10/01/2022
CH0421000	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2019
CH0421000	WAL-MART PHARMACY 10-0629	513 N DUNCAN BYPASS		UNION	SC	29379	07/01/2020
CH0421000	WAL-MART PHARMACY 10-0638	165 WALTON DRIVE		GAFFNEY	SC	29341	04/01/2019
CH0421000	WAL-MART PHARMACY 10-1035	141 DORMAN CENTRE DR		SPARTANBURG(W)	SC	29301	04/01/2019
CH0421000	WAL-MART PHARMACY 10-2806	4000 HIGHWAY #9		BOILING SPRINGS	SC	29316	04/01/2019
CH0421000	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2019
CH0421000	WALGREEN CO	DBA: WALGREENS #10100	2198 SOUTHPORT RD	SPARTANBURG	SC	29306-6528	07/01/2019
CH0421000	WALGREEN CO.	DBA: WALGREENS # 07593	3681 BOILING SPRINGS ROAD	BOILING SPRINGS	SC	29316	07/01/2019
CH0421000	WALGREEN CO.	DBA: WALGREENS # 07648	2410 REIDVILLE ROAD	SPARTANBURG	SC	29301	07/01/2019
CH0421000	WALGREEN CO.	DBA: WALGREENS # 07822	1790 E MAIN STREET	SPARTANBURG	SC	29307-2231	07/01/2019
CH0421000	WALGREEN CO.	DBA: WALGREENS # 09996	837 W FLOYD BAKER BLVD	GAFFNEY	SC	29341-1805	07/01/2019
CH0421000	WALGREEN CO.	DBA: WALGREENS #12447	2196 E. MAIN ST.	DUNCAN	SC	29334	07/01/2019
CH0421000	WALGREEN CO.	WALGREENS #17385	956 N MAIN ST	WOODRUFF	SC	29388	07/01/2019
CH0421000	WALGREEN CO.	WALGREENS #17343	1510 WO EZELL BLVD	SPARTANBURG	SC	29301	07/01/2019	02/16/2022
CH0421000	WALGREEN CO.	WALGREENS #17121	302 VILLAGE CREEK DR.	BOILING SPRINGS	SC	29316	07/01/2019	05/30/2024
CH0421000	WALGREEN CO.	WALGREENS #17381	11156 ASHEVILLE HWY	INMAN	SC	29349	07/01/2019
CH0421000	WALGREEN CO.	WALGREENS #18360	6950 SOUTH PINE STREET	PACOLET	SC	29372	07/01/2019	11/06/2023
CH0421000	WALGREEN CO.	WALGREENS #19501	5401 N MAIN ST	COWPENS	SC	29330	07/01/2019	01/21/2021
CH0421000	WALGREEN CO.	WALGREENS #17294	1000 N PINE ST STE 32	SPARTANBURG	SC	29303	07/01/2019	03/26/2025
CH0421000	WALMART PHARMACY 10-3338	203 CEDAR SPRINGS ROAD		SPARTANBURG	SC	29302	04/01/2019
CH0421000	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2023
CH0421000	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/13/2025 4:26 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7Z1342	3/13/2025 4:26 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	3/13/2025 4:26 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1093532061	3/13/2025 4:26 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	3/13/2025 4:26 PM
Details	Last Recertification Date	Update	Recertification	2/8/2024 2:45:42 AM	2/18/2025 3:01:37 PM	2/18/2025 3:01 PM
Details	Entity Name	Update	Change Request	Regenesis Health Care, Inc	REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER (ROCHC)	12/4/2024 9:18 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/29/2024 3:23 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC304	7/29/2024 3:23 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/29/2024 3:23 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC057	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC121	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC173	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC127	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC211	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC238	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC268	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		FQC303	7/25/2024 3:36 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1194710426	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1548528714	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1265777908	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1245409846	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1457745952	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1982248852	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1558946376	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1457061087	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1225899594	7/25/2024 3:36 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/25/2024 3:36 PM
Contacts	Primary Contact	Update	Profile Change Request	Patel, Ankitkumar Visabhai Director of Pharmacy ReGenesis Organization Community Health Center 8646993283-8855	Patel, Ankitkumar Visabhai Director of Pharmacy ReGenesis Organization Community Health Center 8646993283	4/5/2024 11:24 AM
Details	Last Recertification Date	Update	Recertification	2/6/2023 2:58:42 PM	2/8/2024 2:45:42 AM	2/8/2024 2:45 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/5/2023 11:37 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7Z1262	10/5/2023 11:37 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	10/5/2023 11:37 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1649961434	7/11/2023 4:01 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	7/11/2023 4:01 PM
Details	Last Recertification Date	Update	Recertification	2/2/2022 10:43:49 AM	2/6/2023 2:58:42 PM	2/6/2023 2:58 PM
Contacts	Authorizing Official	Update	Group Change Request	Delfino, Matthew Chief Medical Officer ReGenesis Health Care, Inc. 8645292855	Hunter, Marlon B CEO ReGenesis Organization Community Health Center 8645940190	9/30/2022 12:51 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/4/2022 3:21 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		711271	4/4/2022 3:21 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		SC	4/4/2022 3:21 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1740598051	4/4/2022 3:21 PM
Medicaid Billing	NPI: State	Insert	Change Request		SC	4/4/2022 3:21 PM
Details	Last Recertification Date	Update	Recertification		2/2/2022 10:43:49 AM	2/2/2022 10:43 AM
Details	State	Update		Approved	Active	7/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Delfino, Matthew Chief Medical Officer ReGenesis Health Care, Inc. 8645292855	4/7/2021 7:35 AM
Details	340B ID	Update	New Registration		CH042100L	4/7/2021 7:35 AM
Dates	Participating Approval Date	Update	New Registration		4/7/2021 7:35:03 AM	4/7/2021 7:35 AM
Details	State	Update	New Registration	Pending	Approved	4/7/2021 7:35 AM
Dates	Signed By Date	Update	New Registration		4/6/2021 1:30:50 PM	4/7/2021 7:35 AM
Dates	Start Date	Update	New Registration		7/1/2021 12:00:00 AM	4/7/2021 7:35 AM
Addresses	Main Address	Insert	New Registration		1400 Cleveland St Greenville, SC 29607-2410	4/6/2021 1:30 PM
Addresses	Billing Address	Insert	New Registration		ReGenesis Health Care Pharmacy PO Box 5158 Spartanburg, SC 29304	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		710852	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		SC	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		718117	4/6/2021 1:30 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		SC	4/6/2021 1:30 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1164747929	4/6/2021 1:30 PM
Medicaid Billing	NPI: State	Insert	New Registration		SC	4/6/2021 1:30 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1811476005	4/6/2021 1:30 PM
Medicaid Billing	NPI: State	Insert	New Registration		SC	4/6/2021 1:30 PM
Contacts	Authorizing Official	Insert	New Registration		Delfino, Matthew Chief Medical Officer ReGenesis Health Care, Inc. 8645292855	4/6/2021 1:30 PM
Contacts	Primary Contact	Insert	New Registration		Patel, Ankitkumar Visabhai Director of Pharmacy ReGenesis Organization Community Health Center 8646993283-8855	4/6/2021 1:30 PM
Details	Assistance Received From Date	Insert	New Registration			4/6/2021 1:30 PM
Details	Assistance Received To Date	Insert	New Registration			4/6/2021 1:30 PM
Details	Last Recertification Date	Insert	New Registration			4/6/2021 1:30 PM
Details	Grant Number	Insert	New Registration		H80CS00298	4/6/2021 1:30 PM
Details	340B ID	Insert	New Registration			4/6/2021 1:30 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/6/2021 1:30 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/6/2021 1:30 PM
Details	Medicare Provider Number	Insert	New Registration			4/6/2021 1:30 PM
Details	Entity Name	Insert	New Registration		Regenesis Health Care, Inc	4/6/2021 1:30 PM
Details	NOFO Number	Insert	New Registration			4/6/2021 1:30 PM
Details	Program Code	Insert	New Registration		CH	4/6/2021 1:30 PM
Details	Entity Subname	Insert	New Registration		ReGenesis Health Care-Phoenix Center	4/6/2021 1:30 PM
Dates	Participating Approval Date	Insert	New Registration			4/6/2021 1:30 PM
Details	State	Insert	New Registration		Pending	4/6/2021 1:30 PM
Dates	Registration Date	Insert	New Registration		4/6/2021 1:30:47 PM	4/6/2021 1:30 PM
Dates	Signed By Date	Insert	New Registration			4/6/2021 1:30 PM
Dates	Start Date	Insert	New Registration			4/6/2021 1:30 PM
Terminations	Termination Comments	Insert	New Registration			4/6/2021 1:30 PM
Terminations	Termination Date	Insert	New Registration			4/6/2021 1:30 PM
Terminations	Termination Effective Date	Insert	New Registration			4/6/2021 1:30 PM
Terminations	Termination Reason	Insert	New Registration			4/6/2021 1:30 PM

340B Drug Pricing Program Database