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GENOA HEALTHCARE LLC
CH102360 TILLAMOOK, COUNTY OF
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Covered Entity Details
Entity Name
TILLAMOOK, COUNTY OF
Subdivision Name
TILLAMOOK COUNTY HEALTH DEPARTMENT
Type
HRSA-Funded Health Center
340B ID
CH102360
Entity Address
801 Pacific Ave
Tillamook, OR 97141-3926
Grant Number
H80CS00555
Participating Start Date
1/1/2004
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
115 W BOND ST STE P
ASTORIA, OR 97103
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marlene Putman, Local Health Administrator
(503) 842-3922
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/15/2025
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