340B Drug Pricing Program Database

Pharmacy Name

OPTUM INFUSION SERVICES 302, LLC

Pharmacy Address

8720 S 114TH ST STE 106
LA VISTA, NE 68128-5585

Pharmacy Comments

Approval Date

10/15/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Douglas Davenport, Chief Financial Officer
(319) 272-7359

Contract Pharmacy Representative

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

Signed By Date

10/15/2019