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OPTUM PHARMACY 702, LLC
CHC26614-00 APLA HEALTH & WELLNESS
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Covered Entity Details
Entity Name
APLA HEALTH & WELLNESS
Subdivision Name
APLA Health & Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC26614-00
Entity Address
3743 S. La Brea Ave.
Los Angeles, CA 90016-5309
Grant Number
H80CS26614
Participating Start Date
7/1/2014
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
7/20/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Craig E. Thompson, Chief Executive Officer
(213) 201-1456
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/14/2020
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