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GENOA HEALTHCARE LLC
STD891043 The Gay and Lesbian Community Center of Southern Nevada
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Covered Entity Details
Entity Name
The Gay and Lesbian Community Center of Southern Nevada
Subdivision Name
Huntridge - The Center
Type
Sexually Transmitted Diseases
340B ID
STD891043
Entity Address
1820 E. Sahara Avenue
Las Vegas, NV 89104
Grant Number
NH25PS005179
Participating Start Date
7/1/2021
Last Recertification Date
5/10/2022
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
401 S MARYLAND PKWY RM P
LAS VEGAS, NV 89101
Pharmacy Comments
Contract Details
Approval Date
12/29/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John Waldron, CEO
(702) 802-5400
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
12/29/2022
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