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GENOA HEALTHCARE LLC
CH051750 ACCESS COMMUNITY HEALTH NETWORK
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Covered Entity Details
Entity Name
ACCESS COMMUNITY HEALTH NETWORK
Subdivision Name
ADMINISTRATIVE OFFICES
Type
HRSA-Funded Health Center
340B ID
CH051750
Entity Address
600 W Fulton
STE 300
CHICAGO, IL 60661
Grant Number
H80CS00834
Participating Start Date
7/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1400 W GREENLEAF AVE STE 101
CHICAGO, IL 60626
Pharmacy Comments
Contract Details
Approval Date
10/16/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mahomed Ouedraogo, Chief Executive Officer
(312) 526-2360
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/16/2024
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