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GENOA HEALTHCARE LLC
CH01517L Sebasticook Family Doctors
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Covered Entity Details
Entity Name
Sebasticook Family Doctors
Subdivision Name
RSU19
Type
HRSA-Funded Health Center
340B ID
CH01517L
Entity Address
291 Williams Rd
Newport, ME 04953-3945
Grant Number
H80CS02448
Participating Start Date
4/1/2021
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
841 RIVERSIDE DR STE P
AUGUSTA, ME 04330
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robin Winslow, CEO
(207) 368-4213
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
1/14/2025
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