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GENOA HEALTHCARE LLC
CH03100E Tug River Health Association, Inc
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Covered Entity Details
Entity Name
Tug River Health Association, Inc
Subdivision Name
Tug River Heatlh --Princeton
Type
HRSA-Funded Health Center
340B ID
CH03100E
Entity Address
200 12th STE 101
Princeton, WV 24740
Grant Number
H80CS00701
Participating Start Date
4/1/2021
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
200 12TH STREET EXTENSION
PRINCETON, WV 24740
Pharmacy Comments
Contract Details
Approval Date
8/24/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tim Crofton, CEO
(304) 448-2101
Contract Pharmacy Representative
Genoa Healthcare
Christy Barr, Pharmacy
(304) 487-6337
Signed By Date
8/24/2021
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