340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GENOA HEALTHCARE LLC
CHC26568-03 SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Print
Covered Entity Details
Entity Name
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Subdivision Name
Regional Health Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26568-03
Entity Address
4022 Hohman
HAMMOND, IN 46327-1242
Grant Number
H80CS26568
Participating Start Date
7/1/2016
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
8555 TAFT STREET
MERRILLVILLE, IN 46410
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
5/5/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Lopez, Executive Director
(219) 671-6047
Contract Pharmacy Representative
Genoa Healthcare
Frank Gordon, Region 25 Director of Operations
(260) 415-7746 Ext: 2604157746
Signed By Date
4/14/2020
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