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GENOA HEALTHCARE LLC
CH053110 INDIANA HEALTH CENTERS INCORPORATED
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Covered Entity Details
Entity Name
INDIANA HEALTH CENTERS INCORPORATED
Subdivision Name
INDIANA HEALTH CENTERS, INC.
Type
HRSA-Funded Health Center
340B ID
CH053110
Entity Address
8003 Castleway Dr
Indianapolis, IN 46250-1946
Grant Number
H80CS00668
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
720 NORTH MARR ROAD
COLUMBUS, IN 47201-6660
Pharmacy Comments
Contract Details
Approval Date
7/10/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Nicole Meyer, COO
(317) 576-1335 Ext: 4137
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/10/2023
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