Covered Entity Details

CH03844AE WomenCare, Inc. (Active) - information as of 5/17/2025 10:47:05 PM

Main Details

Name

WomenCare, Inc.

Subdivision Name

FamilyCare Health Center - St. Albans Mobile

Type

HRSA-Funded Health Center

Site ID

BPS-H80-033543

340B ID

CH03844AE

Grant Number

H80CS00827

Additional Details

Current Program Status

Active

Registration Date

4/15/2022

Participating Start Date

7/1/2022

Participating Approval Date

4/21/2022

Last Recertification Date

2/18/2025

Contacts

Authorizing Official

Womencare, Inc DBA FamilyCare Health Centers
Craig Glover, President/CEO
(304) 760-6316

Primary Contact

FamilyCare Health Centers
Fran Coleman, Sr. VP and COO
(304) 760-6330

Addresses

Street Address

12 Kanawha Ter
Saint Albans, WV 25177-2750

Billing Address

WomenCare, Inc.
97 Great Teays Blvd
Suite 6
Scott Depot, WV 25560

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
WV	1902166945	1902166945

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
CH038440	Active	BPS-H80-001340	WOMENCARE, INC.	FamilyCare Health Center - Teays Valley	97 Great Teays Blvd STE 6	Scott Depot	WV
CH03844AA	Active	BPS-H80-022008	WomenCare, Inc.	FamilyCare Health Center SBHC - Capital High School	1500 Greenbrier Street, Suite 160	Charleston	WV
CH03844AB	Active	BPS-H80-027214	WomenCare, Inc.	FamilyCare Health Centers - West Side Middle School	812 Park Avenue, Room 035	Charleston	WV
CH03844AC	Active	BPS-H80-027348	WomenCare, Inc.	FamilyCare Health Center - OB/GYN & Birth Center	108 Washington St W STE 201	Charleston	WV
CH03844AD	Active	BPS-H80-032694	WomenCare, Inc.	FamilyCare Health Center - Lee Street	1220 Lee St E Ste 201	Charleston	WV
CH03844AE	Active	BPS-H80-033543	WomenCare, Inc.	FamilyCare Health Center - St. Albans Mobile	12 Kanawha Ter	Saint Albans	WV
CH03844AF	Active	BPS-H80-034245	WomenCare, Inc.	FamilyCare Health Centers - Hurricane West	3109 Teays Valley Rd	Hurricane	WV
CH03844AG	Active	BPS-H80-032287	WomenCare, Inc.	PCC and Distribution Center	822 6th Ave	Saint Albans	WV
CH03844AH	Active	BPS-H80-036176	WomenCare, Inc.	FamilyCare Health Center - Marmet	9709 Maccorkle Ave Ste B	Marmet	WV
CH03844AJ	Active	BPS-H80-035588	WomenCare, Inc.	FamilyCare Health Centers - South Charleston	4513 Maccorkle Ave SW	South Charleston	WV
CH03844AK	Active	BPS-H80-036359	WomenCare, Inc.	Poca School Mobile Unit	503 Roosevelt Blvd	Eleanor	WV
CH03844AL	Active	BPS-H80-036640	WOMENCARE, INC	FamilyCare Health Centers - Pennsylvania Ave	830 Pennsylvania Ave STE 402	Charleston	WV
CH03844AM	Active	BPS-H80-038729	WOMENCARE, INC	FamilyCare Health Centers - Boone County Schools Mobile Unit	515 Main St	Madison	WV
CH03844AN	Active	BPS-H80-038237	WOMENCARE, INC	FamilyCare Health Centers- Winfield	12803 Winfield Rd	Winfield	WV
CH03844B	Active	BPS-H80-000839	WomenCare, Inc.	FamilyCare Health Center - Hurricane	3911 TEAYS VALLEY RD	HURRICANE	WV
CH03844C	Active	BPS-H80-004362	WOMENCARE, INC.	FamilyCare Health Center - Patrick Street	116 Hills Plz	Charleston	WV
CH03844F	Active	BPS-H80-004186	WOMENCARE, INC.	FamilyCare Health Center - Madison	515 Main St	Madison	WV
CH03844G	Active	BPS-H80-008832	WOMENCARE, INC.	FamilyCare Health Center - Eleanor	503 Roosevelt Blvd.	Eleanor	WV
CH03844H	Active	BPS-H80-010614	WOMENCARE, INC.	FamilyCare Health Center - Mary C. Snow West Side Elementary	100 Florida St	Charleston	WV
CH03844K	Active	BPS-H80-012281	WOMENCARE, INC.	FamilyCare Health Center - St. Albans	12 Kanawha Ter	Saint Albans	WV
CH03844L	Active	BPS-H80-012741	WOMENCARE, INC.	FamilyCare Health Center - Putnam Career & Technical Center	300 Roosevelt Blvd.	Eleanor	WV
CH03844M	Active	BPS-H80-012738	WOMENCARE, INC.	FamilyCare Health Center SBHC - Buffalo Elementary School	19366 Buffalo Rd	Buffalo	WV
CH03844N	Active	BPS-H80-012282	WOMENCARE, INC.	Mobile Unit #1	116 Hills Plz	Charleston	WV
CH03844P	Active	BPS-H80-011238	WOMENCARE, INC.	FamilyCare Health Center SBHC - Winfield Elementary	75 Wall St	Winfield	WV
CH03844Q	Active	BPS-H80-011237	WOMENCARE, INC.	FamilyCare Health Center SBHC - Winfield Middle School	11883 Winfield Rd.	Winfield	WV
CH03844R	Active	BPS-H80-011236	WOMENCARE, INC.	FamilyCare Health Center SBHC - George Washington Middle School	RR62 N Roosevelt Blvd.	Eleanor	WV
CH03844S	Active	BPS-H80-011235	WOMENCARE, INC.	FamilyCare Health Center SBHC - George Washington Elementary	Eleanor Cir	Eleanor	WV
CH03844T	Active	BPS-H80-011239	WOMENCARE, INC.	FamilyCare Health Center SBHC - Winfield High School	11268 Winfield Road	Winfield	WV
CH03844U	Active	BPS-H80-012740	WOMENCARE, INC.	FamilyCare Health Center - Children's Medicine Center	800 Pennsylvania Ave	Charleston	WV
CH03844V	Active	BPS-H80-013924	WOMENCARE, INC.	Mobile Medical Unit	503 Roosevelt Blvd.	Eleanor	WV
CH03844W	Active	BPS-H80-017552	WOMENCARE, INC.	FamilyCare Health Center - Barboursville	#2 Chateau Lane	Barboursville	WV
CH03844X	Terminated	BPS-H80-019142	WomenCare, Inc.	Recovery Point of Charleston	501 STOCKTON ST	CHARLESTON	WV
CH03844Y	Active	BPS-H80-023375	WomenCare, Inc.	FamilyCare Health Center - Cross Lanes	5161 Washington St W	Cross Lanes	WV
CH03844Z	Active	BPS-H80-021209	WomenCare, Inc.	FamilyCare Health Center - West Virginia State University	Wilson University Union, Room 004, 301 Washington Avenue	Dunbar	WV

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH038440	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	07/01/2025
CH038440	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/01/2025
CH038440	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/01/2025
CH038440	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/01/2025
CH038440	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/01/2025
CH038440	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/01/2025
CH038440	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2025
CH038440	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2025
CH038440	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2025
CH038440	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/01/2025
CH038440	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	07/01/2025
CH038440	CHAPMANVILLE PHARMACY INC	289 CRAWLEY CREEK RD	CHAPMANVILLE PHARMACY INC	CHAPMANVILLE	WV	25508-7403	04/01/2013	06/24/2015
CH038440	CHAPMANVILLE PHARMACY INC	289 CRAWLEY CREEK RD	CHAPMANVILLE PHARMACY INC	CHAPMANVILLE	WV	25508-7403	04/01/2019	01/16/2024
CH038440	CROSS LANES FAMILY PHARMACY	107 GOFF MOUNTAIN RD		CROSS LANES	WV	25313	10/01/2018	10/11/2024
CH038440	CUSTOMSCRIPT INFUSION VITAL CARE	DBA CUSTOMSCRIPT PHARMACY	3738 TEAYS VALLEY RD SUITE C	HURRICANE	WV	25526	07/01/2015	02/19/2016
CH038440	CUSTOMSCRIPT INFUSION VITAL CARE	DBA CUSTOMSCRIPT INFUSION	3738 TEAYS VALLEY RD SUITE B	HURRICANE	WV	25526	07/01/2015	02/19/2016
CH038440	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2024
CH038440	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2024
CH038440	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2025
CH038440	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2021
CH038440	DANVILLE PHARMACY	2008 SMOOT AVENUE		DANVILLE	WV	25053	04/01/2020
CH038440	DRUG EMPORIUM	1603 KANAWHA BLVD WEST		CHARLESTON	WV	25387	04/01/2013	09/11/2024
CH038440	DRUG EMPORIUM	5101 MACCORKLE AVE SE		CHARLESTON	WV	25304-2148	04/01/2013	09/11/2024
CH038440	FRUTH	FRUTH PHARMACY #20	501 ROOSEVELT BLVD	ELEANOR	WV	25070	07/01/2013	04/20/2024
CH03844G	FRUTH	FRUTH PHARMACY #20	501 ROOSEVELT BLVD	ELEANOR	WV	25070	06/21/2010	04/20/2024
CH038440	FRUTH	FRUTH PHARMACY #19	509 SOUTH CHURCH STREET	RIPLEY	WV	25271	07/01/2019
CH038440	FRUTH PHARMACY	FRUTH PHARMACY #14	DBA FRUTH PHCY OAKWOOD RD 864 OAKWOOD RD	CHARLESTON	WV	25314-2010	01/01/2015	07/15/2019
CH038440	FRUTH PHARMACY	FRUTH PHARMACY #11	425 CAMDEN RD FRUTH PHARMACY	HUNTINGTON	WV	25704-2764	01/01/2015	06/24/2015
CH038440	FRUTH PHARMACY	FRUTH PHARMACY #13	DBA FRUTH PHCY OF WINFIELD 12803 WINFIELD RD	WINFIELD	WV	25213-9608	07/01/2019
CH038440	FRUTH PHARMACY #23	FRUTH PHARMACY #23	4539 TEAYS VALLEY ROAD	SCOTT DEPOT	WV	25560-7806	11/17/2005
CH03844G	FRUTH PHARMACY #23	FRUTH PHARMACY #23	4539 TEAYS VALLEY ROAD	SCOTT DEPOT	WV	25560-7806	06/21/2010	04/28/2025
CH038440	FRUTH PHARMACY #24	FRUTH PHARMACY #24	5455F BIG TYLER ROAD	CROSS LANES	WV	25313	01/01/2015	03/04/2016
CH038440	FRUTH PHARMACY #25	FRUTH EXPRESS	701 LEE STREET	CHARLESTON	WV	25301	01/01/2015	02/12/2025
CH038440	FRUTH PHARMACY AT PRESTERA CENTER	FRUTH PHARMACY #104	511 MORRIS ST	CHARLESTON	WV	25301	07/01/2019
CH038440	FRUTH PHARMACY INC	FRUTH PHARMACY #1	2501 JACKSON AVE	POINT PLEASANT	WV	25550	07/01/2019
CH038440	FRUTH PHARMACY OF HURRICANE	FRUTH PHARMACY #10	3109 TEAYS VALLEY RD	HURRICANE	WV	25526	01/01/2015
CH038440	FRUTH PHARMACY OF NITRO INC	FRUTH PHARMACY #7	101 21ST STREET	NITRO	WV	25143	01/01/2015
CH038440	K MART PHARMACY	1701 4TH AVE W		CHARLESTON	WV	25387-2415	10/01/2017	10/30/2018
CH038440	K MART PHARMACY #3198	1477 MCCORKLE AVE		ST ALBANS	WV	25177	10/01/2017	02/02/2018
CH038440	KROGER #763	5450 BIG TYLER ROAD		CROSS LANES	WV	25313	10/01/2019
CH038440	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	07/01/2024
CH038440	KROGER PHARMACY	500 DELAWARE AVE		CHARLESTON	WV	25302	04/01/2013
CH038440	KROGER PHARMACY	#19 7TH AVE. WEST		HUNTINGTON	WV	25701	01/01/2025
CH038440	KROGER PHARMACY #316	1229 STAFFORD DR		PRINCETON	WV	24740	01/01/2025
CH038440	KROGER PHARMACY #668	25 HOLDEN ROAD	P.O. BOX 1264	MOUNT GAY	WV	25637	01/01/2025
CH038440	KROGER PHARMACY #708	106 MCGRAW STREET		RIPLEY	WV	25271	01/01/2025
CH038440	KROGER PHARMACY #722	80 SKYLINE PLAZA DR		BUCKHANNON	WV	26201	01/01/2025
CH038440	KROGER PHARMACY #725	1439 MACCORKLE AVENUE		ST ALBANS	WV	25177	04/01/2013
CH038440	KROGER PHARMACY #754	10635 MACCORKLE AVE. S.E.		MARMET	WV	25315	04/01/2022
CH038440	KROGER PHARMACY #768	981 DUNBAR VILLAGE		DUNBAR	WV	25064	10/01/2019
CH038440	KROGER PHARMACY #769	5 RIVERWALK MALL		SOUTH CHARLESTON	WV	25303	10/01/2019
CH038440	KROGER PHARMACY #772	5717 MACCORKLE AVENUE SE		CHARLESTON	WV	25304	01/01/2025
CH038440	KROGER PHARMACY #780	411 MALL RD.		OAK HILL	WV	25901-6115	01/01/2025
CH038440	KROGER PHARMACY #788	6360 U.S. ROUTE 60		BARBOURSVILLE	WV	25504	07/01/2016
CH038440	KROGER PHARMACY #794	101 GREAT TEAYS BLVD.		SCOTT DEPOT	WV	25560	04/01/2013
CH038440	KROGER PHARMACY #817	3265 SMOOT AVE		DANVILLE	WV	25053	01/01/2014
CH038440	LARRY'S DRIVE-IN PHARMACY INC		313 MADISON AVE	MADISON	WV	25130	04/01/2013	07/01/2017
CH038440	LOOP PLAZA DISCOUNT PHARMACY	LOOP COMPOUNDING PHARMACY	72 SIXTH AVENUE P.O. BOX 480	SAINT ALBANS	WV	25177-2517	04/01/2013	06/14/2017
CH038440	MADISON FAMILY PHARMACY, LLC	313 MADISON AVENUE		MADISON	WV	25130-1510	07/01/2017	05/10/2018
CH038440	MILLER BROTHERS PHARMACY	271 MAIN ST		MADISON	WV	25130-1219	07/01/2018
CH038440	MOUNTAINEER DRUG INC.	9709 MACCORKLE AVE SE	SUITE A	MARMET	WV	25315	04/01/2022
CH038440	POCA VALU-RITE PHARMACY	119C MAIN ST	PO BOX 962	POCA	WV	25159-9602	04/01/2025
CH038440	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	07/01/2021	12/19/2023
CH038440	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2025
CH038440	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/01/2025
CH038440	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY#2733	1601 17TH STREET NW	WASHINGTON	DC	20009	07/01/2025
CH038440	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	07/01/2025
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #141	101A ROOSEVELT BOULEVARD	ELEANOR	WV	25070	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #946	305 SIXTH AVENUE	ST ALBANS	WV	25177	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #1289	406 SMOOT AVENUE P.O. BOX 286	DANVILLE	WV	25053	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #3702	932 CROSS LANES DRIVE	CROSS LANES	WV	25313	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #947	333 MACCORKLE AVENUE,SW	SOUTH CHARLESTON	WV	25303	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #935	406 WEST WASHINGTON STREET	CHARLESTON	WV	25302	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #4731	3114 TEAYS VALLEY ROAD	HURRICANE	WV	25526	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #1562	1301 WASHINGTON STREET EAST	CHARLESTON	WV	25301	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #2571	4402 PENNSYLVANIA AVENUE	BIG CHIMNEY	WV	25302	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #934	3801 MACCORKLE AVENUE SE	CHARLESTON	WV	25304	07/01/2016	02/09/2018
CH038440	RITE AID OF WEST VIRGINIA, INC.	RITE AID #966	215 STATE ROUTE 34	HURRICANE	WV	25526	07/01/2016	02/09/2018
CH038440	TRINITY INFUSION	327 6TH AVE		SOUTH CHARLESTON	WV	25303-1231	07/01/2018
CH038440	VAN PHARMACY, INC	19024 POND FORK ROAD	PO BOX 450	VAN	WV	25206	07/01/2018
CH038440	VAN PROFESSIONAL PHARMACY	19024 POND FORK ROAD	P.O. BOX 450	VAN	WV	25206	10/01/2016	09/24/2021
CH038440	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2018
CH038440	WAL-MART PHARMACY 10-0828	2373 E MAIN STREET		PLAINFIELD	IN	46168	04/01/2024	01/26/2024
CH038440	WAL-MART PHARMACY 10-1450	200 ACADEMY DRIVE		RIPLEY	WV	25271	04/01/2024
CH038440	WAL-MART PHARMACY 10-2036	2700 MOUNTAINEER BLVD		SOUTH CHARLESTON	WV	25309	04/01/2013	06/24/2015
CH038440	WAL-MART PHARMACY 10-2036	2700 MOUNTAINEER BLVD		SOUTH CHARLESTON	WV	25309	04/01/2024
CH038440	WAL-MART PHARMACY 10-2203	702 S. W. 8TH STREET		BENTONVILLE	AR	72712	04/01/2024	01/26/2024
CH038440	WAL-MART PHARMACY 10-2576	100 NITRO MARKETPLACE		CROSS LANES	WV	25313	04/01/2013	06/24/2015
CH038440	WAL-MART PHARMACY 10-2576	100 NITRO MARKETPLACE		CROSS LANES	WV	25313	10/01/2018
CH038440	WAL-MART PHARMACY 10-2610	77 NORMAN MORGAN BLVD		LOGAN	WV	25601	04/01/2013	06/24/2015
CH038440	WAL-MART PHARMACY 10-2610	77 NORMAN MORGAN BLVD		LOGAN	WV	25601	04/01/2024
CH038440	WAL-MART PHARMACY 10-4277	167 PROGRESS WAY		HURRICANE	WV	25526	04/01/2013	06/24/2015
CH038440	WAL-MART PHARMACY 10-4277	167 PROGRESS WAY		HURRICANE	WV	25526	10/01/2018
CH038440	WAL-MART PHARMACY 10-4278	1001 WARRIOR WAY		QUINCY	WV	25015	04/01/2022
CH038440	WAL-MART PHARMACY 10-5296	25 NICHOLS DRIVE		BARBOURSVILLE	WV	25504	04/01/2024
CH038440	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2018
CH038440	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	04/01/2024	01/26/2024
CH038440	WALGREEN CO.	DBA: WALGREENS #11750	101 GOFF MOUNTAIN RD.	CROSS LANES	WV	25313	09/06/2012
CH038440	WALGREEN CO.	DBA: WALGREENS #12454	655 WASHINGTON ST. W	CHARLESTON	WV	25302	09/06/2012
CH038440	WALGREEN CO.	DBA: WALGREENS #12678	3000 TEAYS VALLEY RD.	HURRICANE	WV	25526	09/06/2012
CH038440	WALGREEN CO.	DBA: WALGREENS #11977	6414 US RTE 60 E	BARBOURSVILLE	WV	25504	07/01/2016
CH038440	WALGREEN CO.	WALGREENS #17274	101A ROOSEVELT BLVD	ELEANOR	WV	25070-4000	03/01/2018
CH038440	WALGREEN CO.	WALGREENS #17353	1301 WASHINGTON ST E	CHARLESTON	WV	25301-1916	03/01/2018
CH038440	WALGREEN CO.	WALGREENS #17409	215 STATE ROUTE 34	HURRICANE	WV	25526-7003	03/01/2018
CH038440	WALGREEN CO.	WALGREENS #17111	305 6TH AVE	SAINT ALBANS	WV	25177-2838	03/01/2018
CH038440	WALGREEN CO.	RITE AID #04731	3114 TEAYS VALLEY RD	HURRICANE	WV	25526	03/01/2018	07/10/2018
CH038440	WALGREEN CO.	WALGREENS #17738	333 MACCORKLE AVE SW	SOUTH CHARLESTON	WV	25303-1263	03/01/2018
CH038440	WALGREEN CO.	WALGREENS #19653	3801 MACCORKLE AVE SE	CHARLESTON	WV	25304-1527	03/01/2018
CH038440	WALGREEN CO.	RITE AID #03702	932 CROSS LANES DR	CROSS LANES	WV	25313	03/01/2018	07/09/2018
CH038440	WALGREEN CO.	WALGREENS #17413	1662 SMOOT AVE PO BOX 286	DANVILLE	WV	25053-0286	03/01/2018
CH038440	WALGREEN CO.	RITE AID #00935	406 WASHINGTON ST W	CHARLESTON	WV	25302	03/01/2018	06/10/2019
CH038440	WALGREEN CO.	WALGREENS #19108	4402 PENNSYLVANIA AVE	BIG CHIMNEY	WV	25302-4700	03/01/2018
CH038440	WALGREEN CO.	WALGREENS # 18982	100 21ST ST.	NITRO	WV	25143-1740	01/01/2019	02/24/2025
CH038440	WALGREEN CO.	WALGREENS #19790	1101 MYERS AVE	DUNBAR	WV	25064-3118	01/01/2019
CH038440	WALGREEN CO.	WALGREENS #17408	1015 BRIDGE RD	CHARLESTON	WV	25314-1305	01/01/2019
CH038440	WALGREEN CO.	WALGREENS #18275	28 MAIN AVE PO BOX 4547	LOGAN	WV	25601-3331	07/01/2019
CH038440	WALGREEN CO.	WALGREENS #17855	6401 SISSONVILLE DR	CHARLESTON	WV	25312-9463	07/01/2019
CH038440	WALGREEN CO.	WALGREENS #17792	901 MAIN ST	CHAPMANVILLE	WV	25508-4547	07/01/2019
CH038440	WALGREEN CO.	WALGREENS #17116	635 MAIN ST W	RIPLEY	WV	25271-1107	07/01/2024
CH038440	WALGREEN CO.	WALGREENS #17534	5798 MCCLELLAN HWY	BRANCHLAND	WV	25506-8700	10/01/2024
CH038440	WALGREEN CO.	WALGREENS #19090	8 ELK PLZ	ELKVIEW	WV	25071	04/01/2025
CH038440	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH038440	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2021
CH038440	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2021
CH038440	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	07/01/2021	12/19/2023
CH038440	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2021
CH038440	WALMART PHARMACY #10-7256	3707 BUFFALO RD		BUFFALO	WV	25033	04/01/2024
CH038440	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2024
CH038440	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04425	447 W WASHINGTON AVE	HUNTINGTON	WV	25701	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	CVS/PHARMACY #10566	278 E MAIN STREET	MILTON	WV	25541	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03391	2901 FIFTH AVE	HUNTINGTON	WV	25702	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07124	3901 TEAYS VALLEY RD.	HURRICANE	WV	25526	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04207	4205 MACCORKLE AVE.	CHARLESTON	WV	25304	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #2148	885 OAKWOOD ROAD	CHARLESTON	WV	25314	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05957	221 CROSSINGS MALL ROAD	ELKVIEW	WV	25071	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04432	300 FOURTH AVE	MONTGOMERY	WV	25136	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06306	201 MACCORKLE AVE.	SAINT ALBANS	WV	25177	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04244	121 10TH ST.	DUNBAR	WV	25064	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03480	5179 US ROUTE 60 EAST	HUNTINGTON	WV	25705	04/01/2024
CH038440	WEST VIRGINIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16609	30 RHL BLVD	SOUTH CHARLESTON	WV	25309	01/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/12/2024 11:03:39 AM	2/18/2025 3:08:26 PM	2/18/2025 3:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/11/2024 2:46 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1902166945	3/11/2024 2:46 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WV	3/11/2024 2:46 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1902166945	3/11/2024 2:46 PM
Medicaid Billing	NPI: State	Insert	Change Request		WV	3/11/2024 2:46 PM
Details	Last Recertification Date	Update	Recertification	2/7/2023 2:17:46 PM	2/12/2024 11:03:39 AM	2/12/2024 11:03 AM
Contacts	Primary Contact	Update	PC Change Request	Laskowski, Drew Vice President, Chief Financial Officer Womencare, Inc DBA FamilyCare Health Centers 3047606329	Coleman, Fran Sr. VP and COO FamilyCare Health Centers 3047606330	1/25/2024 2:34 PM
Contacts	Primary Contact	Update	Recertification	Belcher, Morgan Compliance Officer FamilyCare Health Centers 3047606321	Laskowski, Drew Vice President, Chief Financial Officer Womencare, Inc DBA FamilyCare Health Centers 3047606329	2/7/2023 2:17 PM
Details	Last Recertification Date	Update	Recertification		2/7/2023 2:17:46 PM	2/7/2023 2:17 PM
Details	State	Update		Approved	Active	7/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Glover, Craig President/CEO Womencare, Inc DBA FamilyCare Health Centers 3047606316	4/21/2022 2:15 PM
Details	340B ID	Update	New Registration		CH03844AE	4/21/2022 2:15 PM
Dates	Participating Approval Date	Update	New Registration		4/21/2022 2:15:20 PM	4/21/2022 2:15 PM
Details	State	Update	New Registration	Pending	Approved	4/21/2022 2:15 PM
Dates	Signed By Date	Update	New Registration		4/15/2022 11:35:16 AM	4/21/2022 2:15 PM
Dates	Start Date	Update	New Registration		7/1/2022 12:00:00 AM	4/21/2022 2:15 PM
Addresses	Main Address	Insert	New Registration		12 Kanawha Ter Saint Albans, WV 25177-2750	4/15/2022 11:35 AM
Addresses	Billing Address	Insert	New Registration		WomenCare, Inc. 97 Great Teays Blvd Suite 6 Scott Depot, WV 25560	4/15/2022 11:35 AM
Contacts	Primary Contact	Insert	New Registration		Belcher, Morgan Compliance Officer FamilyCare Health Centers 3047606321	4/15/2022 11:35 AM
Contacts	Authorizing Official	Insert	New Registration		Glover, Craig President/CEO Womencare, Inc DBA FamilyCare Health Centers 3047606316	4/15/2022 11:35 AM
Details	Assistance Received From Date	Insert	New Registration			4/15/2022 11:35 AM
Details	Assistance Received To Date	Insert	New Registration			4/15/2022 11:35 AM
Details	Last Recertification Date	Insert	New Registration			4/15/2022 11:35 AM
Details	Grant Number	Insert	New Registration		H80CS00827	4/15/2022 11:35 AM
Details	340B ID	Insert	New Registration			4/15/2022 11:35 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2022 11:35 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2022 11:35 AM
Details	Medicare Provider Number	Insert	New Registration			4/15/2022 11:35 AM
Details	Entity Name	Insert	New Registration		WomenCare, Inc.	4/15/2022 11:35 AM
Details	NOFO Number	Insert	New Registration			4/15/2022 11:35 AM
Details	Program Code	Insert	New Registration		CH	4/15/2022 11:35 AM
Details	Entity Subname	Insert	New Registration		FamilyCare Health Center - St. Albans Mobile	4/15/2022 11:35 AM
Dates	Participating Approval Date	Insert	New Registration			4/15/2022 11:35 AM
Details	State	Insert	New Registration		Pending	4/15/2022 11:35 AM
Dates	Registration Date	Insert	New Registration		4/15/2022 11:35:12 AM	4/15/2022 11:35 AM
Dates	Signed By Date	Insert	New Registration			4/15/2022 11:35 AM
Dates	Start Date	Insert	New Registration			4/15/2022 11:35 AM
Terminations	Termination Comments	Insert	New Registration			4/15/2022 11:35 AM
Terminations	Termination Date	Insert	New Registration			4/15/2022 11:35 AM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2022 11:35 AM
Terminations	Termination Reason	Insert	New Registration			4/15/2022 11:35 AM

340B Drug Pricing Program Database