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OPTUM PHARMACY 801, INC.
CH051831A HEART OF OHIO FAMILY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEART OF OHIO FAMILY HEALTH CENTERS
Subdivision Name
Capital Park Family Health Center at Innis Road
Type
HRSA-Funded Health Center
340B ID
CH051831A
Entity Address
2365 Innis Rd
Columbus, OH 43224-3730
Grant Number
H80CS07897
Participating Start Date
7/1/2014
Last Recertification Date
2/17/2025
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
1/12/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
M Buhari Mohammed, CEO
(614) 338-6818 Ext: 1118
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/12/2021
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