340B Drug Pricing Program Database

Pharmacy Name

OPTUM PHARMACY 702, LLC

Pharmacy Address

1050 PATROL RD
JEFFERSONVILLE, IN 47130

Pharmacy Comments

Approval Date

10/18/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Michele L Cusack, Executive Vice President
(516) 321-6058

Contract Pharmacy Representative

Optum
Avani Patel, VP, 340B Operations
(763) 330-5555

Signed By Date

10/18/2021