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GENOA HEALTHCARE LLC
CHC26572-01 MyCare Heatlh Center
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Covered Entity Details
Entity Name
MyCare Heatlh Center
Subdivision Name
Center Line
Type
HRSA-Funded Health Center
340B ID
CHC26572-01
Entity Address
6900 E 10 Mile Rd
Center Line, MI 48015-1168
Grant Number
H80CS26572
Participating Start Date
7/1/2014
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
22170 W 9 MILE RD
SOUTHFIELD, MI 48033
Pharmacy Comments
Contract Details
Approval Date
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Wood, Wood
(586) 619-9986 Ext: 13
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/3/2023
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