Contract Pharmacy Details

GENOA HEALTHCARE LLC
CHC31892-01 Centerplace Health, Inc.

Covered Entity Details

Entity Name

Centerplace Health, Inc.

Subdivision Name

William L. Little Health and Human Services Center

Type

HRSA-Funded Health Center

340B ID

CHC31892-01

Entity Address

2200 Ringling Boulevard
Sarasota, FL 34237-6102

Grant Number

H80CS31892

Participating Start Date

10/1/2018

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

GENOA HEALTHCARE LLC

Pharmacy Address

379 6TH AVE W
BRADENTON, FL 34205

Pharmacy Comments

Contract Details

Approval Date

11/14/2023

Contract Begin Date

11/15/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kari Aud Ellingstad, CEO
(941) 529-2422

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

11/14/2023

340B Drug Pricing Program Database