340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM FRONTIER THERAPIES II, LLC
STD85004 Prisma Community Care
Print
Covered Entity Details
Entity Name
Prisma Community Care
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD85004
Entity Address
1101 N Central Ave
Suite 200
Phoenix, AZ 85004
Grant Number
5 NU62PS924676-03-00
Participating Start Date
1/1/2019
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES II, LLC
Pharmacy Address
6425 SANTA MARGARITA ST UNIT 110
LAS VEGAS, NV 89118-1913
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/29/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jessyca Leach, Executive Director
(602) 595-8115
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/14/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session