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GENOA HEALTHCARE, LLC
CH05188I DETROIT HEALTH CARE FOR THE HOMELESS
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Covered Entity Details
Entity Name
DETROIT HEALTH CARE FOR THE HOMELESS
Subdivision Name
Advantage Health Centers-McNichols
Type
HRSA-Funded Health Center
340B ID
CH05188I
Entity Address
15400 W. McNichols St
Detroit, MI 48235-3724
Grant Number
H80CS00033
Participating Start Date
1/1/2005
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE, LLC
Pharmacy Address
15400 W MCNICHOLS, STE 500
DETROIT, MI 48235-3724
Pharmacy Comments
Contract Details
Approval Date
12/18/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph W. Ferguson, Executive Director
(313) 416-6217
Contract Pharmacy Representative
Genoa, a QoL Healthcare Company
Larry Hart, RPH
(412) 613-4434
Signed By Date
12/18/2015
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