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GENOA HEALTHCARE LLC
CH0512780 Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Administration
Type
HRSA-Funded Health Center
340B ID
CH0512780
Entity Address
1301 W Devon Ave
Chicago, IL 60660
Grant Number
H80CS00215
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
3348 W 87TH ST STE P
CHICAGO, IL 60652
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/2/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Nicole Willis, CEO
(312) 256-3496
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/13/2023
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