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OPTUM PHARMACY 805, INC
CH090130 SUNSET COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SUNSET COMMUNITY HEALTH CENTER
Subdivision Name
SUNSET COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH090130
Entity Address
115 NORTH SOMERTON AVENUE
SOMERTON, AZ 85350-0538
Grant Number
H80CS04321
Participating Start Date
7/1/1997
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 805, INC
Pharmacy Address
1101 N CENTRAL AVE, STE 102
PHOENIX, AZ 85004-1829
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
10/21/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/28/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVID D ROGERS, CEO
(928) 819-8802
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/15/2020
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