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GENOA HEALTHCARE LLC
FP900083 T.H.E. CLINIC INC
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Covered Entity Details
Entity Name
T.H.E. CLINIC INC
Subdivision Name
CLINIC
Type
Family Planning (Title X only)
340B ID
FP900083
Entity Address
3834 SOUTH WESTERN AVENUE
LOS ANGELES, CA 90062
Grant Number
FPHPA006537
Participating Start Date
1/1/1998
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
11721 E TELEGRAPH RD UNIT I
SANTA FE SPRINGS, CA 90670
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/5/2021
Agreement registered in error
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
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