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GENOA HEALTHCARE LLC
CHC35351-03 WELL CARE COMMUNITY HEALTH INC
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Covered Entity Details
Entity Name
WELL CARE COMMUNITY HEALTH INC
Subdivision Name
Well Care Community Health-Foundations Family Medicine Henryville
Type
HRSA-Funded Health Center
340B ID
CHC35351-03
Entity Address
314 S Ferguson St
Henryville, IN 47126-9734
Grant Number
H80CS35351
Participating Start Date
4/7/2023
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
720 NORTH MARR ROAD
COLUMBUS, IN 47201-6660
Pharmacy Comments
Contract Details
Approval Date
6/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Eric Coulter, Chief Executive Officer
(765) 973-9369
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
6/21/2023
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