Contract Pharmacy Details

OPTUM PHARMACY 705, LLC
FQHCLA400 HOPE FAMILY CARE CENTER

Covered Entity Details

Entity Name

HOPE FAMILY CARE CENTER

Subdivision Name

Hope Family Care Center, 3027 Prospect Ave., Kansas City, MO 64128

Type

Health Center Program Look-Alike

340B ID

FQHCLA400

Entity Address

3027 PROSPECT AVE
KANSAS CITY, MO 64128-1530

Grant Number

LALCS00175

Participating Start Date

1/1/2020

Last Recertification Date

1/31/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 705, LLC

Pharmacy Address

1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298

Pharmacy Comments

Contract Details

Approval Date

10/12/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Ken Klingensmith, CEO
(713) 818-5557

Contract Pharmacy Representative

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

Signed By Date

10/12/2021

340B Drug Pricing Program Database