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GENOA HEALTHCARE LLC
CH0516700 CEDAR-RIVERSIDE PEOPLES CENTER
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Covered Entity Details
Entity Name
CEDAR-RIVERSIDE PEOPLES CENTER
Subdivision Name
CEDAR RIVERSIDE PEOPLE'S CENTER
Type
HRSA-Funded Health Center
340B ID
CH0516700
Entity Address
425 20th Ave S
Minneapolis, MN 55454-4400
Grant Number
H80CS00859
Participating Start Date
7/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
1900 SILVER LAKE ROAD
STE 111
NEW BRIGHTON, MN 55112
Pharmacy Comments
Contract Details
Approval Date
10/26/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Rogers, CEO
(612) 332-4973
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/26/2024
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