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GENOA HEALTHCARE LLC
RWI30058A AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Atlanta Midtown
Type
Ryan White Part A
340B ID
RWI30058A
Entity Address
735 Piedmont Avenue NE
Atlanta, GA 30308
Grant Number
H89HA00007
Participating Start Date
4/1/2017
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1650 COUNTY SERVICES PARKWAY, SUITE 300,
MARIETTA, GA 30008
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/15/2024
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