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OPTUM PHARMACY 702, LLC
STD328062 Bliss Cares
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Covered Entity Details
Entity Name
Bliss Cares
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328062
Entity Address
3901 E Colonial Drive
ORLANDO, FL 32803
Grant Number
NH25PS005131
Participating Start Date
7/1/2016
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
4/21/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Rodriguez, Executive Director
(407) 761-3361
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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