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GENOA HEALTHCARE LLC
CH090030 SUN LIFE FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SUN LIFE FAMILY HEALTH CENTER, INC.
Subdivision Name
Sun Life Health - Casa Grande Family Practice, Dental & Orthodontics
Type
HRSA-Funded Health Center
340B ID
CH090030
Entity Address
865 N Arizola Rd
Casa Grande, AZ 85122-6011
Grant Number
H80CS00466
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1101 NORTH CENTRAL AVE
STE 102
PHOENIX, AZ 85004
Pharmacy Comments
Contract Details
Approval Date
1/18/2023
Contract Begin Date
1/19/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eddie Estrada, Chief Executive Officer
(520) 836-3446
Contract Pharmacy Representative
Optum
Kevin Hockley, optum
(612) 474-6761
Signed By Date
1/18/2023
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