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GENOA HEALTHCARE LLC
CHC29001-00 WHEELER CLINIC, INC. THE
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Covered Entity Details
Entity Name
WHEELER CLINIC, INC. THE
Subdivision Name
Bristol Family Health and Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC29001-00
Entity Address
1 Hope Street
Bristol, CT 06010-8122
Grant Number
H80CS29001
Participating Start Date
1/1/2018
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
91 NORTHWEST DR
SUITE L-14
PLAINVILLE, CT 06062-1534
Pharmacy Comments
Contract Details
Approval Date
4/6/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Athena Marie Dellas, Chief Financial Officer
(860) 793-4235
Contract Pharmacy Representative
Genoa Healthcare LLC
Suzanne Tamer, Director of Operations
(860) 729-1422
Signed By Date
4/6/2018
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