Contract Pharmacy Details

OPTUM PHARMACY 701, LLC
RWI20748 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - TEMPLE HILLS

Type

Ryan White Part A

340B ID

RWI20748

Entity Address

4302 St. Barnabas Rd.
Suite D
Temple Hills, MD 20748

Grant Number

H89HA00012

Participating Start Date

1/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 701, LLC

Pharmacy Address

8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029

Pharmacy Comments

Contract Details

Approval Date

1/14/2021

Contract Begin Date

2/10/2021

Carve-In Effective Date

Contract Comments

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