340B Drug Pricing Program Database


CH03170E CENTERVILLE CLINIC INC (Active) - information as of 5/12/2025 10:07:51 PM

Main Details
CENTERVILLE CLINIC INC
BENTLEYVILLE FAMILY PRACTICE CENTER
HRSA-Funded Health Center
BPS-H80-001702
CH03170E
H80CS00705


Additional Details
Active
4/1/1995
4/1/1995
4/1/1995
2/20/2025

Contacts

Centerville Clinics, Inc
Barry R Niccolai, Executive Director
(724) 632-6801 Ext: 1100

Centerville Clinics, Inc.
Brenda Workman, Administrative Assistant
(724) 632-6801 Ext: 1100

Addresses

100 Wilson Rd
Bentleyville, PA 15314-1028

Centerville Clinics Inc
1070 Old National Pike Road
Fredericktown, PA 15333


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Centerville Clinics - Bentleyville Family Practice
100 Wilson Road
Bentleyville, PA 15314

Centerville Clinics Inc
1070 Old National Pike Road
Fredericktown, PA 15333
Contract Pharmacies
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH031700ActiveBPS-H80-002820CENTERVILLE CLINIC INCCENTERVILLE CLINICS, INC.; Joseph Yablonski Memorial Clinic1070 OLD NATIONAL PIKE FREDERICKTOWNPA
CH03170AActiveBPS-H80-002957CENTERVILLE CLINIC INCCARMICHAELS CLINIC601 W George St CarmichaelsPA
CH03170BActiveBPS-H80-001371CENTERVILLE CLINIC INCCALIFORNIA FAMILY PRACTICE1152 Wood St CaliforniaPA
CH03170EActiveBPS-H80-001702CENTERVILLE CLINIC INCBENTLEYVILLE FAMILY PRACTICE CENTER100 Wilson Rd BentleyvillePA
CH03170FActiveBPS-H80-006804CENTERVILLE CLINIC INCWAYNESBURG CLINIC1150 7th St WaynesburgPA
CH03170GActiveBPS-H80-002448CENTERVILLE CLINIC INCREPUBLIC MEDICAL AND DENTAL CENTER1006 MAIN STREET REPUBLICPA
CH03170HActiveBPS-H80-001529CENTERVILLE CLINIC INCUNIONTOWN FAMILY DOCTORS86 Mcclellandtown Rd UniontownPA
CH03170JTerminatedBPS-H80-004156CENTERVILLE CLINIC INCCONNELLSVILLE MEDICAL &TAL CENTER208 S ARCH ST CONNELLSVILLEPA
CH03170KActiveBPS-H80-008815CENTERVILLE CLINIC INCWashington Family Doctors37 Highland Ave WashingtonPA
CH03170LActiveBPS-H80-011320CENTERVILLE CLINIC INCCharleroi Medical &tal Center200 Chamber Plz CharleroiPA
CH03170MActiveBPS-H80-002417CENTERVILLE CLINIC INCWAYNESBURG COMM MENTAL HLTH CTR190 Bonar Ave WaynesburgPA
CH03170NActiveBPS-H80-000396CENTERVILLE CLINIC INCFAIRCHANCE CLINIC93 N Morgantown St FairchancePA
CH03170PActiveBPS-H80-029658CENTERVILLE CLINIC INCDonora Family Medicine718 Mckean Ave DonoraPA
CH03170QActiveBPS-H80-028285CENTERVILLE CLINIC INCCenterville Clinics - City Mission Site84 W Wheeling St WashingtonPA
CH03170RActiveBPS-H80-031781Centerville Clinics, IncorporatedConnellsville Medical and Dental Center601 S Arch St ConnellsvillePA
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH031700ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/01/2021  
CH031700ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/01/2021  
CH031700ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2021  
CH031700ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/01/2021  
CH031700ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/01/2021  
CH031700ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624110/01/2021  
CH031700BENTLEYVILLE MEDICINE SHOPPE808 MAIN ST
BENTLEYVILLEPA15314-121401/01/2022  
CH03170MBENTLEYVILLE MEDICINE SHOPPE808 MAIN ST
BENTLEYVILLEPA15314-121401/01/2025  
CH031700BROWNSVILLE FAMILY PHARMACY27 MARKET ST
BROWNSVILLEPA1541701/01/2022  
CH031700CURTIS PHARMACY305 MAIN ST BOX K
CLAYSVILLEPA15323-330007/01/2022  
CH031700CURTIS PHARMACY802 VANDERBILT RD
CONNELLSVILLEPA1542507/01/2022  
CH031700CURTIS PHARMACY575 HENDERSON AVE STE 1
WASHINGTONPA15301-190107/01/2022  
CH031700CURTIS PHARMACY555 ROUTE 88
CARMICHAELSPA1532006/08/2023  
CH03170ACURTIS PHARMACY555 ROUTE 88
CARMICHAELSPA1532001/01/2025  
CH03170HCURTIS PHARMACY575 HENDERSON AVE STE 1
WASHINGTONPA15301-190101/01/2025  
CH031700DONORA UNION PHARMACY601 MCKEAN AVE
DONORAPA15033-102001/01/2022  
CH03170BDONORA UNION PHARMACY601 MCKEAN AVE
DONORAPA15033-102001/01/2025  
CH031700ECKERD CORPORATIONRITE AID #10960 601 WEST PIKE STREET
CANONSBURGPA1531701/01/2025  
CH031700ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/01/2021  
CH031700EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/01/2021  
CH031700EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2021  
CH031700EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2021  
CH031700GENOA HEALTHCARE LLC378 WEST CHESTNUT STREET SUITE 205
WASHINGTONPA1530101/01/2025  
CH031700GIANT EAGLE PHARMACY #00121300 COUNTRY CLUB ROAD
MONONGAHELAPA1506310/01/2021  
CH031700GIANT EAGLE PHARMACY #0039331 WASHINGTON ROAD
WASHINGTONPA1530110/01/2021  
CH03170QGIANT EAGLE PHARMACY #0039331 WASHINGTON ROAD
WASHINGTONPA1530101/01/2025  
CH031700GIANT EAGLE PHARMACY #0053300 TRI-COUNTY LANE
BELLE VERNONPA1501210/01/2021  
CH03170NGIANT EAGLE PHARMACY #0053300 TRI-COUNTY LANE
BELLE VERNONPA1501201/01/2025  
CH031700GIANT EAGLE PHARMACY #00704007 WASHINGTON ROAD
MCMURRAYPA1531710/01/2021  
CH031700GIANT EAGLE PHARMACY #0098581 PITTSBURGH RD
UNIONTOWNPA1540110/01/2021  
CH03170NGIANT EAGLE PHARMACY #0098581 PITTSBURGH RD
UNIONTOWNPA1540101/01/2025  
CH031700GIANT EAGLE PHARMACY #022120160 CENTER RIDGE ROAD, SUITE 201
ROCKY RIVEROH4411610/01/2021 09/29/2024
CH031700GIANT EAGLE PHARMACY #0487100 SUGAR RUN ROAD
WAYNESBURGPA1537010/01/2021  
CH031700GIANT EAGLE PHARMACY #1689999 N EIGHTY EIGHT RD
RICES LANDINGPA1535710/01/2021  
CH03170FGIANT EAGLE PHARMACY #1689999 N EIGHTY EIGHT RD
RICES LANDINGPA1535701/01/2025  
CH031700GIANT EAGLE PHARMACY #89912500 LOVI RD
FREEDOMPA1504210/01/2021  
CH031700GIANT EAGLE SPECIALTY PHARMACY2500 LOVI RD ROOM #101
FREEDOMPA1504201/01/2025  
CH031700LIZZAS APOTHECARE PHARMACY173 MORGANTOWN STREET
UNIONTOWNPA1540101/01/2022  
CH031700MON VALLEY PHARMACY AND COMPOUNDING600 WILLOWBROOK PLAZA
ROSTRAVER TWPPA1501201/01/2022  
CH031700OPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/01/2021  
CH031700OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2021  
CH031700OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265510/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #1147 175 WILSON ROAD
BENTLEYVILLEPA1531410/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #926 1440 EAST HIGH STREET
WAYNESBURGPA1537010/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #4083 101 5TH STREET
CHARLEROIPA1502210/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #2545 1001 JEFFERSON AVENUE
WASHINGTONPA1530110/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #3443 6039 NATIONAL PIKE
GRINDSTONEPA1544210/01/2021  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #1963 262 CONNELLSVILLE STREET
UNIONTOWNPA1540104/01/2022  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #1197 446 WEST MAIN STREET
MONONGAHELAPA1506304/01/2022  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #2466 10 DONNER AVENUE
MONESSENPA1506204/01/2022  
CH031700RITE AID OF PENNSYLVANIA, LLCRITE AID #1514 404 THIRD STREET
CALIFORNIAPA1541904/01/2022  
CH03170BRITE AID OF PENNSYLVANIA, LLCRITE AID #1514 404 THIRD STREET
CALIFORNIAPA1541901/01/2025  
CH03170PRITE AID OF PENNSYLVANIA, LLCRITE AID #2466 10 DONNER AVENUE
MONESSENPA1506201/01/2025  
CH03170ERITE AID OF PENNSYLVANIA, LLCRITE AID #1147 175 WILSON ROAD
BENTLEYVILLEPA1531401/01/2025  
CH03170LRITE AID OF PENNSYLVANIA, LLCRITE AID #4083 101 5TH STREET
CHARLEROIPA1502201/01/2025  
CH03170MRITE AID OF PENNSYLVANIA, LLCRITE AID #2545 1001 JEFFERSON AVENUE
WASHINGTONPA1530101/01/2025  
CH03170GRITE AID OF PENNSYLVANIA, LLCRITE AID #3443 6039 NATIONAL PIKE
GRINDSTONEPA1544201/01/2025  
CH031700SPAN AND TAYLOR DRUG CO175 W MAIN ST
MONONGAHELAPA1506301/01/2022  
CH031700THE MEDICINE MINE INC555 ROUTE 88
CARMICHAELSPA1532004/01/2023  
CH031700THRIFT DRUG, INC.RITE AID #10958 1396 WEST CHESTNUT ST.
WASHINGTONPA1530110/01/2021  
CH031700THRIFT DRUG, INC.RITE AID #10964 200 MEMORIAL BLVD.
CONNELLSVILLEPA1542504/01/2022  
CH031700THRIFT DRUG, INC.RITE AID #10962 575 MORGANTOWN ROAD
UNIONTOWNPA1540104/01/2022  
CH03170PTHRIFT DRUG, INC.RITE AID #10962 575 MORGANTOWN ROAD
UNIONTOWNPA1540101/01/2025  
CH03170NTHRIFT DRUG, INC.RITE AID #10958 1396 WEST CHESTNUT ST.
WASHINGTONPA1530101/01/2025  
CH031700THRIFT DRUG, INC.RITE AID #10961 4185 WASHINGTON ROAD
MCMURRAYPA1531701/01/2025  
CH031700THRIFT DRUG, INC.RITE AID #10892 417 CHARTIERS STREET
BRIDGEVILLEPA1501701/01/2025  
CH031700WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2021  
CH031700WAL-MART PHARMACY 10-173930 TRINITY POINT DRIVE
WASHINGTONPA1530110/01/2021  
CH03170RWAL-MART PHARMACY 10-173930 TRINITY POINT DRIVE
WASHINGTONPA1530101/01/2025  
CH031700WAL-MART PHARMACY 10-2019355 WAL-MART DR
UNIONTOWNPA1540110/01/2021  
CH03170HWAL-MART PHARMACY 10-2019355 WAL-MART DR
UNIONTOWNPA1540101/01/2025  
CH031700WAL-MART PHARMACY 10-2420100 SARA WAY/ ROSTRAVER SQUARE
BELLE VERNONPA1501204/01/2022  
CH031700WAL-MART PHARMACY 10-4501134 DANIEL KENDALL DR
WEST BROWNSVILLEPA1541710/01/2021  
CH03170MWAL-MART PHARMACY 10-4501134 DANIEL KENDALL DR
WEST BROWNSVILLEPA1541701/01/2025  
CH031700WAL-MART PHARMACY 10-53791450 MORRELL AVENUE
CONNELLSVILLEPA1542504/01/2022  
CH03170RWAL-MART PHARMACY 10-53791450 MORRELL AVENUE
CONNELLSVILLEPA1542501/01/2025  
CH031700WAL-MART PHARMACY 10-5446405 MURTHA DRIVE
WAYNESBURGPA1537004/01/2022  
CH031700WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2021  
CH031700WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275604/01/2023  
CH031700Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/26/2024 8:33:25 AM2/20/2025 12:54:43 PM2/20/2025 12:54 PM
DetailsLast Recertification DateUpdateRecertification2/20/2023 9:22:24 AM2/26/2024 8:33:25 AM2/26/2024 8:33 AM
DetailsLast Recertification DateUpdateRecertification2/25/2022 8:26:22 AM2/20/2023 9:22:24 AM2/20/2023 9:22 AM
DetailsLast Recertification DateUpdateRecertification2/15/2021 9:55:55 AM2/25/2022 8:26:22 AM2/25/2022 8:26 AM
DetailsLast Recertification DateUpdateRecertification2/17/2020 1:36:09 PM2/15/2021 9:55:55 AM2/15/2021 9:55 AM
DetailsLast Recertification DateUpdateRecertification2/12/2019 9:40:23 AM2/17/2020 1:36:09 PM2/17/2020 1:36 PM
ContactsAuthorizing OfficialUpdateChange RequestQUINN, JAMES CEO Centerville Clinics Inc 7246326801-2258Niccolai, Barry R Executive Director Centerville Clinics, Inc 7246326801-110010/3/2019 8:49 AM
ContactsPrimary ContactUpdateChange RequestWorkman, Brenda Administrative Assistant Centerville Clinics, Inc. 7246326801Workman, Brenda Administrative Assistant Centerville Clinics, Inc. 7246326801-110010/1/2019 3:11 PM
ContactsPrimary ContactUpdateRecertificationMartorella, Pete Director of Operations Centerville Clinics, Inc. 7246326801-2258Workman, Brenda Administrative Assistant Centerville Clinics, Inc. 72463268012/12/2019 9:40 AM
DetailsLast Recertification DateUpdateRecertification2/20/2018 10:29:57 AM2/12/2019 9:40:23 AM2/12/2019 9:40 AM
ContactsPrimary ContactUpdateRecertificationQUINN, JAMES CEO Centerville Clinics Inc 7246326801-2258Martorella, Pete Director of Operations Centerville Clinics, Inc. 7246326801-22582/20/2018 10:29 AM
DetailsLast Recertification DateUpdateRecertification2/3/2017 12:00:00 AM2/20/2018 10:29:57 AM2/20/2018 10:29 AM
ContactsAuthorizing OfficialUpdate QUINN, JAMES CEO 7246326801-2258QUINN, JAMES CEO Centerville Clinics Inc 7246326801-22581/15/2018 9:36 AM
ContactsPrimary ContactUpdate QUINN, JAMES CEO 7246326801-2258QUINN, JAMES CEO Centerville Clinics Inc 7246326801-22581/15/2018 9:36 AM
AddressesMain AddressInsert   100 Wilson Rd Bentleyville, PA 15314-10282/3/2017 9:29 AM
ContactsAuthorizing OfficialInsert  QUINN, JAMES CEO 7246326801-22582/3/2017 9:29 AM
ContactsPrimary ContactInsert  QUINN, JAMES CEO 7246326801-22582/3/2017 9:29 AM
DetailsLast Recertification DateUpdate 2/25/2016 12:00:00 AM2/3/2017 12:00:00 AM2/3/2017 9:29 AM
DetailsLast Recertification DateUpdate 2/3/2015 12:00:00 AM2/25/2016 12:00:00 AM2/25/2016 2:20 PM
DetailsLast Recertification DateUpdate 3/19/2014 12:00:00 AM2/3/2015 12:00:00 AM2/3/2015 12:06 PM
AddressesBilling AddressInsert  Centerville Clinics Inc 1070 Old National Pike Road Fredericktown, PA 153333/19/2014 12:50 PM
AddressesShipping AddressInsert  Centerville Clinics - Bentleyville Family Practice 100 Wilson Road Bentleyville, PA 153143/19/2014 12:50 PM
AddressesShipping AddressInsert  Centerville Clinics Inc 1070 Old National Pike Road Fredericktown, PA 153333/19/2014 12:50 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM3/19/2014 12:00:00 AM3/19/2014 12:50 PM
DetailsEntity NameUpdate CENTERVILLE CLINICS INCCENTERVILLE CLINIC INC3/19/2014 12:50 PM
DetailsEntity SubnameUpdate  BENTLEYVILLE FAMILY PRACTICE CENTER3/19/2014 12:50 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM2/15/2013 12:57 PM
DetailsLast Recertification DateInsert   4/27/2001 12:00 AM
DetailsGrant NumberInsert  H80CS007054/27/2001 12:00 AM
Details340B IDInsert  CH03170E4/27/2001 12:00 AM
DetailsIs Authorizing Official EHB DataInsert   4/27/2001 12:00 AM
DatesLast Date That 340B Drugs PurchasedInsert   4/27/2001 12:00 AM
DetailsMedicare Provider NumberInsert   4/27/2001 12:00 AM
DetailsEntity NameInsert  CENTERVILLE CLINICS INC4/27/2001 12:00 AM
DetailsProgram CodeInsert  CH4/27/2001 12:00 AM
DetailsEntity SubnameInsert   4/27/2001 12:00 AM
DatesParticipating Approval DateInsert  4/1/1995 12:00:00 AM4/27/2001 12:00 AM
DetailsStateInsert  Active4/27/2001 12:00 AM
DatesRegistration DateInsert  4/1/1995 12:00:00 AM4/27/2001 12:00 AM
DatesSigned By DateInsert   4/27/2001 12:00 AM
DatesStart DateInsert  4/1/1995 12:00:00 AM4/27/2001 12:00 AM
TerminationsTermination CommentsInsert   4/27/2001 12:00 AM
TerminationsTermination DateInsert   4/27/2001 12:00 AM
TerminationsTermination Effective DateInsert   4/27/2001 12:00 AM
TerminationsTermination ReasonInsert   4/27/2001 12:00 AM