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GENOA HEALTHCARE, LLC
CH011820 THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST DENTAL ADMIN WOONSOCKET
Type
HRSA-Funded Health Center
340B ID
CH011820
Entity Address
25 John A. Cummings Way
Woonsocket, RI 02895-3240
Grant Number
H80CS00454
Participating Start Date
10/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE, LLC
Pharmacy Address
103 BACON ST
PAWTUCKET, RI 02860-5542
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/26/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Jeanne LaChance, President/CEO
(401) 767-4100 Ext: 3015
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/14/2021
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