Pharmacy Details

OPTUM INFUSION SERVICES 404 LLC - information as of 6/23/2025 12:36:15 AM

Name
OPTUM INFUSION SERVICES 404 LLC

Address

2065 NE WILLIAMSON CT
STE B
BEND, OR 97701

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CAH161374-00	SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL	DBA MYRTUE MEDICAL CENTER	Critical Access Hospital	1213 GARFIELD AVE		HARLAN	IA	07/01/2023	03/24/2024	3/25/2024 11:35 AM
Details	CH100460	COLUMBIA BASIN HEALTH ASSOCIATION	OTHELLO CLINIC	HRSA-Funded Health Center	1515 E. Columbia St.		Othello	WA	10/01/2024		10/1/2024 12:01 AM
Details	CH101020	Sea Mar Community Health Centers	Sea Mar CHC - Administration	HRSA-Funded Health Center	1040 S. Henderson St.		Seattle	WA	07/01/2023		7/1/2023 12:01 AM
Details	DSH380009	OREGON HLTH SCIENCE CENTER	UNIVERSITY HOSPITAL	Disproportionate Share Hospital	3181 SW SAM JACKSON PARK RD		PORTLAND	OR	04/01/2020		4/1/2020 12:05 AM
Details	DSH380047	St. Charles Health System, Inc., d/b/a St. Charles Bend		Disproportionate Share Hospital	2500 NE NEFF ROAD		BEND	OR	04/01/2020		4/1/2020 12:05 AM
Details	DSH500003	SKAGIT VALLEY HOSPITAL		Disproportionate Share Hospital	1415 EAST KINCAID		MOUNT VERNON	WA	07/01/2021		7/1/2021 12:01 AM
Details	DSH500008	UNIVERSITY OF WASHINGTON MEDICAL CENTER		Disproportionate Share Hospital	1959 NE PACIFIC ST.,		SEATTLE	WA	10/13/2020		10/13/2020 3:49 PM
Details	DSH500050	PeaceHealth Southwest Medical Center		Disproportionate Share Hospital	400 NE Mother Joseph Place		VANCOUVER	WA	07/01/2020		7/1/2020 12:01 AM
Details	DSH500129	TACOMA GENERAL/ALLENMORE HOSPITAL		Disproportionate Share Hospital	315 MARTIN LUTHER KING JR WAY		TACOMA	WA	07/01/2020		7/1/2020 12:01 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			OPTUM INFUSION SERVICES 404 LLC 2065 NE WILLIAMSON CT STE B BEND, OR 97701	11/13/2019 4:32 PM
Details	Name	Update		BRIOVARX INFUSION SERVICES 404 LLC	OPTUM INFUSION SERVICES 404 LLC	11/13/2019 4:32 PM
Addresses	Pharmacy Address	Insert			BRIOVARX INFUSION SERVICES 404 LLC 2065 NE WILLIAMSON CT STE B BEND, OR 97701	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		HOME CARE I. V. OF BEND, LLC DBA AXELACARE 2065 NE WILLIAMSON CT STE B BEND, OR 97701	BRIOVARX INFUSION SERVICES 404 LLC 2065 NE WILLIAMSON CT STE B BEND, OR 97701	8/2/2017 8:15 AM
Details	Name	Update		HOME CARE I. V. OF BEND, LLC	BRIOVARX INFUSION SERVICES 404 LLC	8/2/2017 8:15 AM
Addresses	Pharmacy Address	Update		HOME CARE I. V. OF BEND, LLC DBA ALEXACARE 2065 NE WILLIAMSON CT STE B BEND, OR 97701	HOME CARE I. V. OF BEND, LLC DBA AXELACARE 2065 NE WILLIAMSON CT STE B BEND, OR 97701	10/19/2015 10:31 AM
Addresses	Pharmacy Address	Update		HOME CARE I. V. OF BEND, LLC 2065 NE WILLIAMSON CT BEND, OR 97701	HOME CARE I. V. OF BEND, LLC DBA ALEXACARE 2065 NE WILLIAMSON CT STE B BEND, OR 97701	8/24/2015 3:42 PM
Details	Comments	Insert				3/28/2013 4:34 PM
Details	Is Deleted	Insert			False	3/28/2013 4:34 PM
Addresses	Pharmacy Address	Insert			HOME CARE I. V. OF BEND, LLC 2065 NE WILLIAMSON CT BEND, OR 97701	3/28/2013 4:34 PM