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OPTUM PHARMACY 806, INC.
CHC28973-00 GENESIS HEALTHCARE, INC
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Covered Entity Details
Entity Name
GENESIS HEALTHCARE, INC
Subdivision Name
Olanta Family Care
Type
HRSA-Funded Health Center
340B ID
CHC28973-00
Entity Address
211 S Jones Rd
Olanta, SC 29114-9705
Grant Number
H80CS28973
Participating Start Date
6/27/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 806, INC.
Pharmacy Address
2288 AUBURN BLVD
STE. 102
SACRAMENTO, CA 95821-1618
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/19/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Tony Megna, CEO
(803) 254-3676
Contract Pharmacy Representative
Avella/Briova/Diplomat/Optum
Dorothy M Janetka, 340B HDP Inventory Specialist
(224) 231-1180
Signed By Date
7/15/2020
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