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GENOA HEALTHCARE LLC
CH02151AQ Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Harmony Healthcare Long Island at Freeport
Type
HRSA-Funded Health Center
340B ID
CH02151AQ
Entity Address
101 South Bergen Place
104
Freeport, NY 11520-1153
Grant Number
H80CS00313
Participating Start Date
7/1/2014
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
380 NASSAU RD STE P
ROOSEVELT, NY 11575
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
Allison Dubois-Adach, COO
(914) 734-8503
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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