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GENOA HEALTHCARE LLC
CH096030 Redwood Coast Medical Services Inc
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Covered Entity Details
Entity Name
Redwood Coast Medical Services Inc
Subdivision Name
REDWOOD COAST MEDICAL SERVICES
Type
HRSA-Funded Health Center
340B ID
CH096030
Entity Address
46900 Ocean Dr
Gualala, CA 95445-8353
Grant Number
H80CS00575
Participating Start Date
4/16/2019
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
245 11TH ST STE P1
SAN FRANCISCO, CA 94103
Pharmacy Comments
Contract Details
Approval Date
10/10/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ara Chakrabarti, CEO
(707) 884-4005 Ext: 137
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/10/2023
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