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GENOA HEALTHCARE LLC
CHC28363-00 SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Subdivision Name
Longview Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28363-00
Entity Address
409 N. 6th Street
LONGVIEW, TX 75601-6511
Grant Number
H80CS28363
Participating Start Date
7/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
12234 SHADOW CREEK PKWY
BLDG 4, STE 104
PEARLAND, TX 77584
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/29/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Wayne Hayes, CEO
(903) 212-7807
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/17/2023
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