340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM FRONTIER THERAPIES II, LLC
STD16508 Central Outreach Wellness Center, LLC
Print
Covered Entity Details
Entity Name
Central Outreach Wellness Center, LLC
Subdivision Name
Central Outreach Wellness Center, LLC Erie
Type
Sexually Transmitted Diseases
340B ID
STD16508
Entity Address
3104 State Street
Erie, PA 16508
Grant Number
NH25PS005144
Participating Start Date
1/1/2021
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES II, LLC
Pharmacy Address
6425 SANTA MARGARITA ST UNIT 110
LAS VEGAS, NV 89118-1913
Pharmacy Comments
Contract Details
Approval Date
11/10/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stacy Lane, Owner
(412) 608-8313
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/2/2020
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