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GENOA HEALTHCARE LLC
FQHCLA393A Neighborhood Health Center, INC
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Covered Entity Details
Entity Name
Neighborhood Health Center, INC
Subdivision Name
Neighborhood Health Center - Union County Medical Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA393A
Entity Address
950 N Market St
Liberty, IN 47353-8496
Grant Number
LALCS32717
Participating Start Date
4/1/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
831 DILLON DR STE 102
RICHMOND, IN 47374
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie N Miles, CEO
(765) 965-4299
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/12/2024
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