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GENOA HEALTHCARE LLC
RWI20748 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF HEALTHCARE CENTER - TEMPLE HILLS
Type
Ryan White Part A
340B ID
RWI20748
Entity Address
4302 St. Barnabas Rd.
Suite D
Temple Hills, MD 20748
Grant Number
H89HA00012
Participating Start Date
1/1/2016
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
975 N SOLOMONS ISLAND RD, STE 1A
PRINCE FREDERICK, MD 20678-3917
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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