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GENOA HEALTHCARE LLC
CH05006AA COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
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Covered Entity Details
Entity Name
COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Subdivision Name
Mobile Medical and Dental Van 02
Type
HRSA-Funded Health Center
340B ID
CH05006AA
Entity Address
202 N Schuyler Ave
Kankakee, IL 60901-3865
Grant Number
H80CS00748
Participating Start Date
7/1/2024
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
5342 W ELM STREET, STE P
MCHENRY, IL 60050-4029
Pharmacy Comments
Contract Details
Approval Date
5/20/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eleace Erica Sawyers, Chief Executive Officer
(786) 299-1724
Contract Pharmacy Representative
Genoa
Renee Pogorzelski, Director of Operations
(847) 710-9019
Signed By Date
4/13/2024
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