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GENOA HEALTHCARE LLC
FQHCLA433F CASCADIA HEALTH
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Covered Entity Details
Entity Name
CASCADIA HEALTH
Subdivision Name
Cascadia Plaza Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA433F
Entity Address
4212 SE Division Street STE 100
Portland, OR 97206-1600
Grant Number
LALCS40208
Participating Start Date
7/1/2023
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
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Oyinda Osibanjo, Senior Director of Integrated Health Services
(503) 963-7792
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/1/2024
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