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OPTUM PHARMACY 705, LLC
CHC12886-00 LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
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Covered Entity Details
Entity Name
LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
Subdivision Name
Lower Lights Christian Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12886-00
Entity Address
1160 W Broad St
Columbus, OH 43222-1317
Grant Number
H80CS12886
Participating Start Date
1/1/2011
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tracy Cloud, CEO
(614) 274-1455 Ext: 6000
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/14/2021
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