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OVERLAKE PHARMACY, LLC
CH092240 SHASTA COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SHASTA COMMUNITY HEALTH CENTER
Subdivision Name
SHASTA COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH092240
Entity Address
1035 Placer St
Redding, CA 96001-1125
Grant Number
H80CS00832
Participating Start Date
4/1/1997
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OVERLAKE PHARMACY, LLC
Pharmacy Address
4124 148TH AVE NE STE JA
REDMOND, WA 98052
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DEAN C. GERMANO, CEO
(530) 246-5704
Contract Pharmacy Representative
Overlake Pharmacy LLC
Thao Phan, Pharmacist in Charge
(425) 968-8766
Signed By Date
1/10/2020
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