340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FQHCLA362B Clover Fork Outpatient Medical Project, Inc. (Active)
Print
Main Details
Name
Clover Fork Outpatient Medical Project, Inc.
Subdivision Name
Clover Fork School Based Health at Verda Headstart
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-027642
340B ID
FQHCLA362B
Grant Number
LALCS31536
Additional Details
Current Program Status
Active
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/7/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Clover Fork Outpatient Medical Project INC
Jack Miniard, Chief Executive Officer
(606) 837-2108 Ext: 122
Primary Contact
Clover Fork Outpatient Medical Project INC
Linda C Blevins, Chief financial Officer
(606) 837-2108 Ext: 5114
Addresses
Street Address
54 School House Rd
Evarts, KY 40828-6480
Billing Address
Clover Fork Outpatient Medical Project INC.
101 Chad Street
Box 39
Evarts, KY 40828
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session