Contract Pharmacy Details

GENOA HEALTHCARE LLC
CH09244C Clinic Inc, The

Covered Entity Details

Entity Name

Clinic Inc, The

Subdivision Name

T.H.E. Clinic at Hawthorne

Type

HRSA-Funded Health Center

340B ID

CH09244C

Entity Address

10321 HAWTHORNE BLVD
INGLEWOOD, CA 90304-1500

Grant Number

H80CS00755

Participating Start Date

4/1/2018

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