340B Drug Pricing Program Database

Pharmacy Name

OPTUM INFUSION SERVICES 204, INC

Pharmacy Address

4220 EXECUTIVE CIRCLE, SUITE 62
FORT MYERS, FL 33916

Pharmacy Comments

Approval Date

7/16/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/2/2022
Pharmacy closed

Covered Entity Signing Official

Benjamin Spence, CFO
(239) 343-6014

Contract Pharmacy Representative

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

Signed By Date

7/16/2021