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GENOA HEALTHCARE LLC
DSH220001 HealthAlliance-Clinton Hospital
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Covered Entity Details
Entity Name
HealthAlliance-Clinton Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220001
Entity Address
60 HOSPITAL ROAD
LEOMINSTER, MA 01453
Medicare Provider Number
220001
Participating Start Date
10/1/2004
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
435 SHREWSBURY ST STE P
WORCESTER, MA 01604-1689
Pharmacy Comments
Contract Details
Approval Date
1/7/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steven McCue, Chief Financial Officer
(508) 486-5804
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/7/2024
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