Covered Entity Details

STD52544 River Hills Community Health Center Appanoose County Clinic (Active) - information as of 5/13/2025 1:40:52 AM

Main Details

Name

River Hills Community Health Center Appanoose County Clinic

Subdivision Name

Centerville

Type

Sexually Transmitted Diseases

340B ID

STD52544

Grant Number

NH25PS005158

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

In-Kind products or services (see note below; must have been purchased with section 318 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
STD test kits.
1/1/2019

Additional Details

Current Program Status

Active

Registration Date

4/15/2021

Participating Start Date

7/1/2021

Participating Approval Date

5/5/2021

Last Recertification Date

5/5/2025

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Contacts

Authorizing Official

River Hills Community Health.Center
GINA THROCKMORTON, C00
(641) 954-9971 Ext: 1203

Primary Contact

River Hills Community Health Center
Kari Rupe, Family Planning Coordinator
(641) 455-5431 Ext: 1160

Addresses

Street Address

1015 N. 18th
Centerville, IA 52544

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
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
Contract Detail	NUCARA SPECIALTY PHARMACY	NUDAK VENTURES LLC	5042 MAPLE DR	PLEASANT HILL	IA	50327-2039	10/11/2023	01/01/2024			01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/7/2024 12:26:17 PM	5/5/2025 10:02:43 AM	5/5/2025 10:02 AM
Contacts	Authorizing Official	Update	Profile Change Request	THROCKMORTON, GINA CFO River Hills Community Health.Center 6416835773-101	THROCKMORTON, GINA C00 River Hills Community Health.Center 6419549971-1203	3/24/2025 11:36 AM
Contacts	Signed By	Update	Profile Change Request	THROCKMORTON, GINA CFO River Hills Community Health.Center 6416835773-101	THROCKMORTON, GINA C00 River Hills Community Health.Center 6419549971-1203	3/24/2025 11:36 AM
Details	Last Recertification Date	Update	Recertification	5/8/2023 3:12:03 PM	5/7/2024 12:26:17 PM	5/7/2024 12:26 PM
Details	Last Recertification Date	Update	Recertification	5/9/2022 9:10:03 AM	5/8/2023 3:12:03 PM	5/8/2023 3:12 PM
Details	Nature of Support: In Kind Support Description	Update	Change Request	State medications for treatment of STDs.	STD test kits.	1/5/2023 9:54 AM
Details	Last Recertification Date	Update	Recertification		5/9/2022 9:10:03 AM	5/9/2022 9:10 AM
Details	State	Update		Approved	Active	7/1/2021 12:01 AM
Addresses	Main Address	Insert	New Registration		1015 N. 18th Centerville, IA 52544	5/5/2021 4:48 PM
Details	Nature of Support: Support Received From Date	Update	New Registration	4/1/2021 12:00:00 AM	1/1/2019 12:00:00 AM	5/5/2021 4:48 PM
Contacts	Signed By	Insert	New Registration		THROCKMORTON, GINA CFO River Hills Community Health.Center 6416835773-101	5/5/2021 4:48 PM
Details	340B ID	Update	New Registration		STD52544	5/5/2021 4:48 PM
Details	NOFO Number	Update	New Registration	334984	PS19-1901	5/5/2021 4:48 PM
Dates	Participating Approval Date	Update	New Registration		5/5/2021 4:48:54 PM	5/5/2021 4:48 PM
Details	State	Update	New Registration	Pending	Approved	5/5/2021 4:48 PM
Dates	Signed By Date	Update	New Registration		4/30/2021 8:38:43 AM	5/5/2021 4:48 PM
Dates	Start Date	Update	New Registration		7/1/2021 12:00:00 AM	5/5/2021 4:48 PM
Addresses	Main Address	Insert	New Registration		1015 N. 18th Centerville, IA 52544	4/15/2021 4:03 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		State medications for treatment of STDs.	4/15/2021 4:03 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	4/15/2021 4:03 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		4/1/2021 12:00:00 AM	4/15/2021 4:03 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration			4/15/2021 4:03 PM
Contacts	Authorizing Official	Insert	New Registration		THROCKMORTON, GINA CFO River Hills Community Health.Center 6416835773-101	4/15/2021 4:03 PM
Contacts	Primary Contact	Insert	New Registration		Rupe, Kari Family Planning Coordinator River Hills Community Health Center 6414555431-1160	4/15/2021 4:03 PM
Details	Assistance Received From Date	Insert	New Registration			4/15/2021 4:03 PM
Details	Assistance Received To Date	Insert	New Registration			4/15/2021 4:03 PM
Details	Last Recertification Date	Insert	New Registration			4/15/2021 4:03 PM
Details	Grant Number	Insert	New Registration		NH25PS005158	4/15/2021 4:03 PM
Details	340B ID	Insert	New Registration			4/15/2021 4:03 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2021 4:03 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2021 4:03 PM
Details	Medicare Provider Number	Insert	New Registration			4/15/2021 4:03 PM
Details	Entity Name	Insert	New Registration		River Hills Community Health Center Appanoose County Clinic	4/15/2021 4:03 PM
Details	NOFO Number	Insert	New Registration		334984	4/15/2021 4:03 PM
Details	Program Code	Insert	New Registration		STD	4/15/2021 4:03 PM
Details	Entity Subname	Insert	New Registration		Centerville	4/15/2021 4:03 PM
Dates	Participating Approval Date	Insert	New Registration			4/15/2021 4:03 PM
Details	State	Insert	New Registration		Pending	4/15/2021 4:03 PM
Dates	Registration Date	Insert	New Registration		4/15/2021 4:03:04 PM	4/15/2021 4:03 PM
Dates	Signed By Date	Insert	New Registration			4/15/2021 4:03 PM
Dates	Start Date	Insert	New Registration			4/15/2021 4:03 PM
Terminations	Termination Comments	Insert	New Registration			4/15/2021 4:03 PM
Terminations	Termination Date	Insert	New Registration			4/15/2021 4:03 PM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2021 4:03 PM
Terminations	Termination Reason	Insert	New Registration			4/15/2021 4:03 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History