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OPTUM PHARMACY 705, LLC
CH058470 COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
CNHC dba PrimaryOne Health
Type
HRSA-Funded Health Center
340B ID
CH058470
Entity Address
2780 Airport Drive, Suite 100
Columbus, OH 43219-1060
Grant Number
H80CS00118
Participating Start Date
10/1/1998
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
11142 RENNER BLVD
LENEXA, KS 66219
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Charleta B. Tavares, CEO
(614) 859-1946
Contract Pharmacy Representative
Optum
Nancy McCutcheon, Sr. VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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