340B Drug Pricing Program Database

Pharmacy Name

OPTUM PHARMACY 702, LLC

Pharmacy Address

1050 PATROL RD
JEFFERSONVILLE, IN 47130

Pharmacy Comments

Approval Date

6/11/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Jose Bordon, Chief Executive Officer
(240) 426-8890

Contract Pharmacy Representative

Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677

Signed By Date

4/15/2019