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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
2502 E FOURTH PLAIN BLVD RM 102
VANCOUVER, WA 98661
Pharmacy Comments
Contract Details
Approval Date
10/1/2024
Contract Begin Date
1/1/2025
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
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/1/2024
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