Contract Pharmacy Details

GENOA HEALTHCARE LLC
CH09244B CLINIC INC, THE

Covered Entity Details

Entity Name

CLINIC INC, THE

Subdivision Name

T.H.E. Clinic Inc. at Lennox School District

Type

HRSA-Funded Health Center

340B ID

CH09244B

Entity Address

10223 Firmona Ave
Lennox, CA 90304-1421

Grant Number

H80CS00755

Participating Start Date

4/1/2015

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

GENOA HEALTHCARE LLC

Pharmacy Address

1701 MISSION AVE STE 230 RM P1
OCEANSIDE, CA 92058

Pharmacy Comments

Contract Details

Approval Date

10/15/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

10/15/2021

340B Drug Pricing Program Database