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GENOA HEALTHCARE LLC
FQHCLA433G CASCADIA HEALTH
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Covered Entity Details
Entity Name
CASCADIA HEALTH
Subdivision Name
Cascadia Talbert Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA433G
Entity Address
12360 SE Sunnyside Rd
Clackamas, OR 97015-9320
Grant Number
LALCS40208
Participating Start Date
7/1/2024
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
3036 NE MARTIN LUTHER KING JR BLVD
STE 136
PORTLAND, OR 97212
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Trachtenberg, Senior Director Health Center Operations
(503) 963-7661
Contract Pharmacy Representative
Optum Rx 340B
Eric Howard, National Account Manager
(503) 601-9663
Signed By Date
4/15/2024
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