Covered Entity Details

CH052200 DOWNRIVER COMMUNITY SERVICES INC (Active) - information as of 6/8/2025 11:59:34 PM

Main Details

Name

DOWNRIVER COMMUNITY SERVICES INC

Subdivision Name

DOWNRIVER COMMUNITY SERVICES, INC.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-000206

340B ID

CH052200

Grant Number

H80CS00497

Additional Details

Current Program Status

Active

Registration Date

10/1/2001

Participating Start Date

10/1/2001

Participating Approval Date

10/1/2001

Last Recertification Date

2/18/2025

Contacts

Authorizing Official

Downriver Community
Mike Baranowski, CEO
(586) 270-8055

Primary Contact

Community First Health Centers
Laura Huffman, COO
(586) 270-8055

Addresses

Street Address

555 St Clair River Dr
Algonac, MI 48001-1802

Billing Address
Same as Street Address

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	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/11/2023	01/01/2024	01/01/2024
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/11/2023	01/01/2024	01/01/2024
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/11/2023	01/01/2024	01/01/2024
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/11/2023	01/01/2024	01/01/2024
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/11/2023	01/01/2024	01/01/2024
Contract Detail	FRANKS PHARMACY ADVANCED CARE	39023 HARPER AVENUE		CLINTON TOWNSHIP	MI	48036	10/21/2011	10/21/2011	03/28/2013
Contract Detail	GENOA HEALTHCARE LLC	3111 ELECTRIC AVENUE		PORT HURON	MI	48060	04/15/2024	07/01/2024	07/01/2024
Contract Detail	HOMETOWN PHARMACY #56 - CLINTON	39023 HARPER AVE		CLINTON TWP	MI	48036	10/10/2017	01/01/2018	10/10/2017
Contract Detail	HOMETOWN PHARMACY #57 - WADHAMS	5277 LAPEER RD		KIMBALL	MI	48074-1422	01/06/2020	04/01/2020	04/01/2020
Contract Detail	KROGER CO OF MICHIGAN #715	1215 24TH STREET		PORT HURON	MI	48060	07/15/2015	10/01/2015	07/15/2015
Contract Detail	KROGER CO OF MICHIGAN #724	35000 23-MILE ROAD		NEW BALTIMORE	MI	48047	07/15/2015	10/01/2015	07/15/2015
Contract Detail	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	07/11/2017	10/01/2017	10/01/2017
Contract Detail	MEIJER INC #105	27255 TWENTY-THREE MILE		CHESTERFIELD	MI	48051-2023	07/11/2017	10/01/2017	10/01/2017
Contract Detail	MEIJER INC #163	4775 24TH AVENUE		FORT GRATIOT	MI	48059	01/06/2020	04/01/2020	04/01/2020
Contract Detail	MEIJER INC #177	8401 26 MILE ROAD		WASHINGTON TWP	MI	48094	01/06/2020	04/01/2020	04/01/2020
Contract Detail	MEIJER INC #229	205 S RANGE ROAD		MARYSVILLE	MI	48040	01/06/2020	04/01/2020	04/01/2020
Contract Detail	MEIJER INC #242	36865 26 MILE RD.		LENOX	MI	48048	07/11/2017	10/01/2017	10/01/2017
Contract Detail	MEIJER INC #65	15055 HALL RD		UTICA	MI	48315	01/06/2020	04/01/2020	04/01/2020
Contract Detail	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	07/11/2017	10/01/2017	10/01/2017
Contract Detail	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	07/11/2017	10/01/2017	10/01/2017
Contract Detail	MEMPHIS DRUGS	80850 MAIN ST		MEMPHIS	MI	48041-4907	03/02/2009	03/02/2009	03/28/2013
Contract Detail	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	10/11/2023	01/01/2024	01/01/2024
Contract Detail	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/15/2024	01/01/2025	01/01/2025
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	10/11/2023	01/01/2024	01/01/2024
Contract Detail	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	10/15/2024	01/01/2025	01/01/2025
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/11/2023	01/01/2024	01/01/2024
Contract Detail	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	10/11/2023	01/01/2024	01/01/2024
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	10/11/2023	01/01/2024	01/01/2024
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	10/11/2023	01/01/2024	01/01/2024
Contract Detail	PDS-I MICHIGAN, INC.	RITE AID #4574	2910 PINE GROVE AVENUE	PORT HURON	MI	48060	10/11/2023	01/01/2024	01/01/2024
Contract Detail	RITE AID OF MICHIGAN, INC.	RITE AID #4022	59010 GRATIOT AVENUE	NEW HAVEN	MI	48048	10/11/2023	01/01/2024	01/01/2024
Contract Detail	THE KROGER CO	66900 GRATIOT		RICHMOND	MI	48062	07/15/2015	10/01/2015	07/15/2015
Contract Detail	THE KROGER CO OF MICHIGAN 450	2600 POINT TREMBLE		ALGONAC	MI	48001	07/15/2015	10/01/2015	07/15/2015
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/11/2017	10/01/2017	10/01/2017
Contract Detail	WAL-MART PHARMACY 10-1611	4845 24TH AVENUE		FORT GRATIOT	MI	48059	07/15/2015	10/01/2015	07/15/2015
Contract Detail	WAL-MART PHARMACY 10-2692	45400 MARKET PLACE BLVD.		CHESTERFIELD	MI	48051	07/15/2015	10/01/2015	07/15/2015
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/11/2017	10/01/2017	10/01/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04452	51008 GRATIOT AVENUE	CHESTERFIELD	MI	48051	07/11/2016	10/01/2016	07/11/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04608	1045 S. GRATIOT AVE.	CLINTON TOWNSHIP	MI	48036	07/11/2016	10/01/2016	07/11/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05227	51200 WASHINGTON ST	NEW BALTIMORE	MI	48047	07/11/2016	10/01/2016	07/11/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05595	1617 10TH STREET	PORT HURON	MI	48060	07/11/2016	10/01/2016	07/11/2016
Contract Detail	WALGREEN CO.	WALGREENS #21232	1221 PINE GROVE AVE STE P	PORT HURON	MI	48060-3511	01/06/2020	04/01/2020	04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06053	3990 24TH AVE	PORT HURON	MI	48060	07/15/2022	10/01/2022	10/01/2022
Contract Detail	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	10/11/2023	01/01/2024	01/01/2024
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/11/2016	10/01/2016	07/11/2016
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/11/2023	01/01/2024	01/01/2024
Contract Detail	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08148	1025 SAINT CLAIR RIVER DR.	ALGONAC	MI	48001	07/11/2017	10/01/2017	10/01/2017
Contract Detail	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08149	1229 S PARKER ST	MARINE CITY	MI	48039	07/11/2017	10/01/2017	10/01/2017
Contract Detail	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08024	67181 S MAIN ST	RICHMOND	MI	48062	01/14/2021	04/01/2021	04/01/2021
Contract Detail	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08272	52950 GRATIOT AVE.	CHESTERFIELD	MI	48051	07/15/2022	10/01/2022	10/01/2022
Contract Detail	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08301	940 LAPEER AVE.	PORT HURON	MI	48060	07/15/2022	10/01/2022	10/01/2022

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH052200	Active	BPS-H80-000206	DOWNRIVER COMMUNITY SERVICES INC	DOWNRIVER COMMUNITY SERVICES, INC.	555 St Clair River Dr	Algonac	MI
CH05220AE	Active	BPS-H80-002191	DOWNRIVER COMMUNITY SERVICES INC	DCS NEW HAVEN COMMUNITY SERVICES	58144 GRATIOT AVE	NEW HAVEN	MI
CH05220AF	Active	BPS-H80-010043	DOWNRIVER COMMUNITY SERVICES INC	DCS Port Huron Medical Clinic	1011 Military St	Port Huron	MI

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH052200	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2024
CH052200	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2024
CH052200	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2024
CH052200	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2024
CH052200	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2024
CH052200	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2024
CH05220AE	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2024
CH05220AF	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2024
CH052200	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2024
CH05220AF	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2024
CH05220AE	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2024
CH052200	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2024
CH05220AE	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2024
CH05220AF	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2024
CH052200	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2024
CH052200	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2024
CH05220AE	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2024
CH05220AF	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2024
CH05220AF	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2024
CH05220AE	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2024
CH052200	FRANKS PHARMACY ADVANCED CARE	39023 HARPER AVENUE		CLINTON TOWNSHIP	MI	48036	10/21/2011
CH05220AE	FRANKS PHARMACY ADVANCED CARE	39023 HARPER AVENUE		CLINTON TOWNSHIP	MI	48036	10/21/2011
CH05220AF	GENOA HEALTHCARE LLC	3111 ELECTRIC AVENUE		PORT HURON	MI	48060	10/21/2011
CH052200	GENOA HEALTHCARE LLC	3111 ELECTRIC AVENUE		PORT HURON	MI	48060	07/01/2024
CH05220AE	GENOA HEALTHCARE LLC	3111 ELECTRIC AVENUE		PORT HURON	MI	48060	07/01/2024
CH052200	HOMETOWN PHARMACY #56 - CLINTON	39023 HARPER AVE		CLINTON TWP	MI	48036	01/01/2018
CH05220AE	HOMETOWN PHARMACY #56 - CLINTON	39023 HARPER AVE		CLINTON TWP	MI	48036	01/01/2018
CH05220AF	HOMETOWN PHARMACY #56 - CLINTON	39023 HARPER AVE		CLINTON TWP	MI	48036	01/01/2018
CH05220AE	HOMETOWN PHARMACY #57 - WADHAMS	5277 LAPEER RD		KIMBALL	MI	48074-1422	04/01/2020
CH052200	HOMETOWN PHARMACY #57 - WADHAMS	5277 LAPEER RD		KIMBALL	MI	48074-1422	04/01/2020
CH05220AF	HOMETOWN PHARMACY #57 - WADHAMS	5277 LAPEER RD		KIMBALL	MI	48074-1422	04/01/2020
CH052200	KROGER CO OF MICHIGAN #715	1215 24TH STREET		PORT HURON	MI	48060	10/01/2015
CH052200	KROGER CO OF MICHIGAN #724	35000 23-MILE ROAD		NEW BALTIMORE	MI	48047	10/01/2015
CH052200	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	10/01/2017
CH052200	MEIJER INC #105	27255 TWENTY-THREE MILE		CHESTERFIELD	MI	48051-2023	10/01/2017
CH05220AF	MEIJER INC #163	4775 24TH AVENUE		FORT GRATIOT	MI	48059	04/01/2020
CH052200	MEIJER INC #163	4775 24TH AVENUE		FORT GRATIOT	MI	48059	04/01/2020
CH05220AE	MEIJER INC #163	4775 24TH AVENUE		FORT GRATIOT	MI	48059	04/01/2020
CH05220AF	MEIJER INC #177	8401 26 MILE ROAD		WASHINGTON TWP	MI	48094	04/01/2020	12/01/2020
CH052200	MEIJER INC #177	8401 26 MILE ROAD		WASHINGTON TWP	MI	48094	04/01/2020
CH05220AE	MEIJER INC #177	8401 26 MILE ROAD		WASHINGTON TWP	MI	48094	04/01/2020	12/01/2020
CH05220AE	MEIJER INC #229	205 S RANGE ROAD		MARYSVILLE	MI	48040	04/01/2020
CH052200	MEIJER INC #229	205 S RANGE ROAD		MARYSVILLE	MI	48040	04/01/2020
CH05220AF	MEIJER INC #229	205 S RANGE ROAD		MARYSVILLE	MI	48040	04/01/2020
CH052200	MEIJER INC #242	36865 26 MILE RD.		LENOX	MI	48048	10/01/2017
CH052200	MEIJER INC #65	15055 HALL RD		UTICA	MI	48315	04/01/2020
CH05220AF	MEIJER INC #65	15055 HALL RD		UTICA	MI	48315	04/01/2020	12/01/2020
CH05220AE	MEIJER INC #65	15055 HALL RD		UTICA	MI	48315	04/01/2020	12/01/2020
CH052200	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	10/01/2017
CH052200	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	10/01/2017
CH052200	MEMPHIS DRUGS	80850 MAIN ST		MEMPHIS	MI	48041-4907	03/02/2009
CH05220AE	MEMPHIS DRUGS	80850 MAIN ST		MEMPHIS	MI	48041-4907	03/01/2009
CH052200	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2024
CH05220AE	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2024
CH05220AF	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	01/01/2024
CH05220AE	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/01/2025
CH05220AF	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/01/2025
CH052200	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/01/2025
CH052200	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/01/2024
CH05220AE	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/01/2024
CH05220AF	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/01/2024
CH05220AF	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH05220AE	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH052200	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	01/01/2025
CH052200	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/01/2024
CH05220AF	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/01/2024
CH05220AE	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/01/2024
CH052200	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/01/2024
CH052200	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/01/2024
CH05220AE	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/01/2024
CH05220AE	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/01/2024
CH05220AF	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/01/2024
CH05220AF	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/01/2024
CH052200	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2024
CH05220AF	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2024
CH05220AE	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2024
CH052200	PDS-I MICHIGAN, INC.	RITE AID #4574	2910 PINE GROVE AVENUE	PORT HURON	MI	48060	01/01/2024
CH05220AE	PDS-I MICHIGAN, INC.	RITE AID #4574	2910 PINE GROVE AVENUE	PORT HURON	MI	48060	01/01/2024
CH05220AF	PDS-I MICHIGAN, INC.	RITE AID #4574	2910 PINE GROVE AVENUE	PORT HURON	MI	48060	01/01/2024
CH052200	RITE AID OF MICHIGAN, INC.	RITE AID #4022	59010 GRATIOT AVENUE	NEW HAVEN	MI	48048	01/01/2024
CH05220AE	RITE AID OF MICHIGAN, INC.	RITE AID #4022	59010 GRATIOT AVENUE	NEW HAVEN	MI	48048	01/01/2024
CH05220AF	RITE AID OF MICHIGAN, INC.	RITE AID #4022	59010 GRATIOT AVENUE	NEW HAVEN	MI	48048	01/01/2024
CH052200	THE KROGER CO	66900 GRATIOT		RICHMOND	MI	48062	10/01/2015
CH052200	THE KROGER CO OF MICHIGAN 450	2600 POINT TREMBLE		ALGONAC	MI	48001	10/01/2015
CH052200	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH052200	WAL-MART PHARMACY 10-1611	4845 24TH AVENUE		FORT GRATIOT	MI	48059	10/01/2015
CH052200	WAL-MART PHARMACY 10-2692	45400 MARKET PLACE BLVD.		CHESTERFIELD	MI	48051	10/01/2015
CH052200	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH052200	WALGREEN CO.	DBA: WALGREENS # 04452	51008 GRATIOT AVENUE	CHESTERFIELD	MI	48051	10/01/2016
CH052200	WALGREEN CO.	DBA: WALGREENS # 04608	1045 S. GRATIOT AVE.	CLINTON TOWNSHIP	MI	48036	10/01/2016
CH052200	WALGREEN CO.	DBA: WALGREENS # 05227	51200 WASHINGTON ST	NEW BALTIMORE	MI	48047	10/01/2016
CH052200	WALGREEN CO.	DBA: WALGREENS # 05595	1617 10TH STREET	PORT HURON	MI	48060	10/01/2016
CH052200	WALGREEN CO.	WALGREENS #21232	1221 PINE GROVE AVE STE P	PORT HURON	MI	48060-3511	04/01/2020
CH05220AF	WALGREEN CO.	WALGREENS #21232	1221 PINE GROVE AVE STE P	PORT HURON	MI	48060-3511	04/01/2020
CH05220AE	WALGREEN CO.	WALGREENS #21232	1221 PINE GROVE AVE STE P	PORT HURON	MI	48060-3511	04/01/2020
CH05220AF	WALGREEN CO.	DBA: WALGREENS # 06053	3990 24TH AVE	PORT HURON	MI	48060	10/01/2022
CH052200	WALGREEN CO.	DBA: WALGREENS # 06053	3990 24TH AVE	PORT HURON	MI	48060	10/01/2022
CH05220AE	WALGREEN CO.	DBA: WALGREENS # 06053	3990 24TH AVE	PORT HURON	MI	48060	10/01/2022
CH052200	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH05220AE	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH05220AF	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH052200	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	10/01/2016
CH052200	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH05220AE	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH05220AF	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH052200	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08148	1025 SAINT CLAIR RIVER DR.	ALGONAC	MI	48001	10/01/2017
CH052200	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08149	1229 S PARKER ST	MARINE CITY	MI	48039	10/01/2017
CH05220AE	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08024	67181 S MAIN ST	RICHMOND	MI	48062	04/01/2021
CH05220AF	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08024	67181 S MAIN ST	RICHMOND	MI	48062	04/01/2021
CH052200	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08024	67181 S MAIN ST	RICHMOND	MI	48062	04/01/2021
CH05220AE	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08272	52950 GRATIOT AVE.	CHESTERFIELD	MI	48051	10/01/2022
CH052200	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08272	52950 GRATIOT AVE.	CHESTERFIELD	MI	48051	10/01/2022
CH05220AF	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08301	940 LAPEER AVE.	PORT HURON	MI	48060	10/01/2022
CH05220AE	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08301	940 LAPEER AVE.	PORT HURON	MI	48060	10/01/2022
CH052200	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08301	940 LAPEER AVE.	PORT HURON	MI	48060	10/01/2022
CH05220AF	WOODWARD DETROIT CVS, L.L.C.	DBA: CVS/PHARMACY # 08272	52950 GRATIOT AVE.	CHESTERFIELD	MI	48051	10/01/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Recertification	Bertrand, Bob CFO Downriver Community Services, Inc. 5862708055-247	Huffman, Laura COO Community First Health Centers 5862708055	2/18/2025 8:59 AM
Details	Last Recertification Date	Update	Recertification	1/31/2024 3:28:37 PM	2/18/2025 8:59:42 AM	2/18/2025 8:59 AM
Details	Last Recertification Date	Update	Recertification	2/2/2023 8:48:48 AM	1/31/2024 3:28:37 PM	1/31/2024 3:28 PM
Details	Last Recertification Date	Update	Recertification	2/2/2022 8:32:11 AM	2/2/2023 8:48:48 AM	2/2/2023 8:48 AM
Details	Last Recertification Date	Update	Recertification	2/9/2021 10:35:20 AM	2/2/2022 8:32:11 AM	2/2/2022 8:32 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 8:49:11 AM	2/9/2021 10:35:20 AM	2/9/2021 10:35 AM
Details	Last Recertification Date	Update	Recertification	1/29/2019 9:01:04 AM	1/28/2020 8:49:11 AM	1/28/2020 8:49 AM
Contacts	Authorizing Official	Update	AO Change Request	Baranowski, Michael CEO Downriver Community 5862708055-251	Baranowski, Mike CEO Downriver Community 5862708055	1/6/2020 3:08 PM
Contacts	Primary Contact	Update	Recertification	Ernst, Dale CFO Downriver Community Services, Inc. 5862708055-247	Bertrand, Bob CFO Downriver Community Services, Inc. 5862708055-247	1/29/2019 9:01 AM
Details	Last Recertification Date	Update	Recertification	2/22/2018 10:16:02 AM	1/29/2019 9:01:04 AM	1/29/2019 9:01 AM
Contacts	Primary Contact	Update	Recertification	Baranowski, Michael CEO Downriver Community 5862708055-251	Ernst, Dale CFO Downriver Community Services, Inc. 5862708055-247	2/22/2018 10:16 AM
Details	Last Recertification Date	Update	Recertification	2/7/2017 12:00:00 AM	2/22/2018 10:16:02 AM	2/22/2018 10:16 AM
Contacts	Authorizing Official	Update		Baranowski, Michael CEO 5862708055-251	Baranowski, Michael CEO Downriver Community 5862708055-251	10/10/2017 3:35 PM
Contacts	Primary Contact	Update		Baranowski, Michael CEO 5862708055-251	Baranowski, Michael CEO Downriver Community 5862708055-251	10/10/2017 3:35 PM
Contacts	Authorizing Official	Update		Roush, Cynthia CEO 5862708055-251	Baranowski, Michael CEO 5862708055-251	7/11/2017 9:57 AM
Contacts	Primary Contact	Update		Roush, Cynthia CEO 5862708055-251	Baranowski, Michael CEO 5862708055-251	7/11/2017 9:57 AM
Addresses	Main Address	Insert			555 St Clair River Dr Algonac, MI 48001-1802	2/7/2017 9:27 AM
Details	Last Recertification Date	Update		2/29/2016 12:00:00 AM	2/7/2017 12:00:00 AM	2/7/2017 9:27 AM
Details	Last Recertification Date	Update		2/10/2015 12:00:00 AM	2/29/2016 12:00:00 AM	2/29/2016 9:37 AM
Contacts	Authorizing Official	Update		WEATHERHEAD, GORDON CEO 8107944982-151	Roush, Cynthia CEO 5862708055-251	7/15/2015 1:33 PM
Contacts	Primary Contact	Update		ALLEN-BURTON, STAR COO 5862708055-249	Roush, Cynthia CEO 5862708055-251	7/15/2015 1:33 PM
Details	Last Recertification Date	Update		3/19/2014 12:00:00 AM	2/10/2015 12:00:00 AM	2/10/2015 3:27 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/19/2014 12:00:00 AM	3/19/2014 2:21 PM
Details	Entity Name	Update		DOWNRIVER COMMUNITY SVCS., INC.	DOWNRIVER COMMUNITY SERVICES INC	3/19/2014 2:21 PM
Details	Entity Subname	Update			DOWNRIVER COMMUNITY SERVICES, INC.	3/19/2014 2:21 PM
Contacts	Primary Contact	Insert			ALLEN-BURTON, STAR COO 5862708055-249	2/7/2013 11:22 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/7/2013 11:21 AM
Contacts	Authorizing Official	Insert			WEATHERHEAD, GORDON CEO 8107944982-151	6/8/2006 2:08 PM
Details	Last Recertification Date	Insert				8/9/2001 12:00 AM
Details	Grant Number	Insert			H80CS00497	8/9/2001 12:00 AM
Details	340B ID	Insert			CH052200	8/9/2001 12:00 AM
Details	Is Authorizing Official EHB Data	Insert				8/9/2001 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Insert				8/9/2001 12:00 AM
Details	Medicare Provider Number	Insert				8/9/2001 12:00 AM
Details	Entity Name	Insert			DOWNRIVER COMMUNITY SVCS., INC.	8/9/2001 12:00 AM
Details	Program Code	Insert			CH	8/9/2001 12:00 AM
Details	Entity Subname	Insert				8/9/2001 12:00 AM
Dates	Participating Approval Date	Insert			10/1/2001 12:00:00 AM	8/9/2001 12:00 AM
Details	State	Insert			Active	8/9/2001 12:00 AM
Dates	Registration Date	Insert			10/1/2001 12:00:00 AM	8/9/2001 12:00 AM
Dates	Signed By Date	Insert				8/9/2001 12:00 AM
Dates	Start Date	Insert			10/1/2001 12:00:00 AM	8/9/2001 12:00 AM
Terminations	Termination Comments	Insert				8/9/2001 12:00 AM
Terminations	Termination Date	Insert				8/9/2001 12:00 AM
Terminations	Termination Effective Date	Insert				8/9/2001 12:00 AM
Terminations	Termination Reason	Insert				8/9/2001 12:00 AM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

Grantee Sites

Grantee Sites Contract Pharmacies

History