340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 601, LLC
CH043823L BREVARD HEALTH ALLIANCE INC., THE
Print
Covered Entity Details
Entity Name
BREVARD HEALTH ALLIANCE INC., THE
Subdivision Name
BHA Malabar Clinic
Type
HRSA-Funded Health Center
340B ID
CH043823L
Entity Address
775 Malabar Rd
Malabar, FL 32950-3120
Grant Number
H80CS04213
Participating Start Date
4/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 601, LLC
Pharmacy Address
1070 E BRANDON BLVD
BRANDON, FL 33511-3351
Pharmacy Comments
Contract Details
Approval Date
7/18/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/4/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Richard Austin Helton, CEO
(321) 241-6868
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
7/18/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session