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GENOA HEALTHCARE LLC
CH040600 MOUNTAIN COMPREHENSIVE HEALTH CORP., INC.
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Covered Entity Details
Entity Name
MOUNTAIN COMPREHENSIVE HEALTH CORP., INC.
Subdivision Name
Whitesburg Medical/Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH040600
Entity Address
226 Medical Plaza Ln
Whitesburg, KY 41858-7425
Grant Number
H80CS00367
Participating Start Date
10/1/2004
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1351 NEWTOWN PIKE
BUILDING 5
LEXINGTON, KY 40511-1282
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
L.M. Caudill, CEO
(606) 633-4823
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2024
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