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OPTUM PHARMACY 801, INC.
CH090470 GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - MERCED SUITES
Type
HRSA-Funded Health Center
340B ID
CH090470
Entity Address
847 W. CHILDS AVE
MERCED, CA 95341-6862
Grant Number
H80CS00742
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 801, INC.
Pharmacy Address
24416 N 19TH AVE
STE. 100
PHOENIX, AZ 85085
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
7/15/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
7/15/2020
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