340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GENOA HEALTHCARE LLC
CH04392D Mantachie Rural Health Care Inc
Print
Covered Entity Details
Entity Name
Mantachie Rural Health Care Inc
Subdivision Name
Mantachie Rural Health Care, Inc. School Based Clinic
Type
HRSA-Funded Health Center
340B ID
CH04392D
Entity Address
311 Mustang Dr
Mantachie, MS 38855
Grant Number
H80CS00096
Participating Start Date
7/1/2022
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1101 NORTH CENTRAL AVE
STE 102
PHOENIX, AZ 85004
Pharmacy Comments
Contract Details
Approval Date
7/25/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARJORIE MCKINNEY, CEO
(662) 282-4226 Ext: 114
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/25/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session