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GENOA HEALTHCARE LLC
TB97045 Clackamas County
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Covered Entity Details
Entity Name
Clackamas County
Subdivision Name
Public Health Division
Type
Tuberculosis
340B ID
TB97045
Entity Address
2051 Kaen Rd.
Suite 367
Oregon City, OR 97045
Grant Number
NU52PS910205
Participating Start Date
7/1/2017
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
110 BEAVERCREEK RD, STE 102
OREGON CITY, OR 97045
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sherry Lynn Olson, Business Services Manager
(503) 742-5342 Ext: 5342
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/18/2022
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