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GENOA HEALTHCARE LLC
CH093640 FAMILY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FAMILY HEALTHCARE NETWORK
Subdivision Name
FAMILY HEALTHCARE NETWORK - Porterville Health Center
Type
HRSA-Funded Health Center
340B ID
CH093640
Entity Address
1107 W Poplar Ave
Porterville, CA 93257-5839
Grant Number
H80CS00786
Participating Start Date
4/1/1997
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
474 W VERMONT AVE, STE 104
ESCONDIDO, CA 92025
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
1/10/2025
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