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CH01127AL OPTIMUS HEALTH CARE, INC. (Terminated)
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Main Details
Name
OPTIMUS HEALTH CARE, INC.
Subdivision Name
West Haven High School - SBHC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029973
340B ID
CH01127AL
Grant Number
H80CS00377
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/23/2020
Last Recertification Date
1/31/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Optimus Health Care, Inc.
Karen A Daley, Chief Executive Officer
(203) 608-3387
Primary Contact
Optimus Health Care
Tizita Fekredengel, Clinical Pharmacist
(203) 616-2235
Addresses
Street Address
1 Mcdonough Plz
West Haven, CT 06516-5257
Billing Address
OPTIMUS HEALTHCARE
982 EAST MAIN STREET
BRIDGEPORT, CT 06608
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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