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GENOA HEALTHCARE LLC
CH01208DP COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
CHC of Stamford @ Fifth Street
Type
HRSA-Funded Health Center
340B ID
CH01208DP
Entity Address
22 Fifth Street
Stamford, CT 06905-5030
Grant Number
H80CS00326
Participating Start Date
7/1/2019
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
22 5TH ST RM P
STAMFORD, CT 06905
Pharmacy Comments
Contract Details
Approval Date
8/28/2024
Contract Begin Date
9/4/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Masselli, President and CEO
(860) 347-6971
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
8/28/2024
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