Contract Pharmacy Details

OPTUMRX
RWII34695 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTH POSITIVE/TAMPA BAY

Type

Ryan White Part B

340B ID

RWII34695

Entity Address

3135 STATE ROAD 580
SUITE 1
SAFETY HARBOR, FL 34695

Grant Number

X07HA00057

Participating Start Date

1/1/2011

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

OPTUMRX

Pharmacy Address

2858 LOKER AVE E STE 100
CARLSBAD, CA 92010-6608

Pharmacy Comments

Contract Details

Approval Date

1/14/2021

Contract Begin Date

2/10/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Philip Ho, Senior Director of Pharmacy and 340B Compliance
(323) 860-5323

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

1/14/2021

340B Drug Pricing Program Database