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GENOA HEALTHCARE LLC
CHC29011-02 PACKARD HEALTH, INC.
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Covered Entity Details
Entity Name
PACKARD HEALTH, INC.
Subdivision Name
Packard East
Type
HRSA-Funded Health Center
340B ID
CHC29011-02
Entity Address
200 Arnet St
Ypsilanti, MI 48198-5753
Grant Number
H80CS29011
Participating Start Date
4/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
110 N 4TH AVE
SUITE 1100
ANN ARBOR, MI 48104
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
Todd R Montrief, Controller
(734) 926-4935
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2024
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