Contract Pharmacy Details

GENOA HEALTHCARE LLC
CHC28365-07 CIRCLE THE CITY

Covered Entity Details

Entity Name

CIRCLE THE CITY

Subdivision Name

Circle the City Administrative Office

Type

HRSA-Funded Health Center

340B ID

CHC28365-07

Entity Address

300 W. Clarendon, Suite 200
Phoenix, AZ 85013-8501

Grant Number

H80CS28365

Participating Start Date

4/1/2023

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

GENOA HEALTHCARE LLC

Pharmacy Address

1209 S 1ST AVE
PHOENIX, AZ 85003

Pharmacy Comments

Contract Details

Approval Date

1/16/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/13/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Kim Despres, Chief Executive Officer
(602) 776-9000 Ext: 1003

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

1/16/2023

340B Drug Pricing Program Database