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OPTUM PHARMACY 701, LLC
RWI33316C CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
North Miami
Type
Ryan White Part A
340B ID
RWI33316C
Entity Address
18360 NW 47th Ave
Miami Gardens, FL 33055
Grant Number
H89HA00005
Participating Start Date
7/1/2020
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4100 S SAGINAW ST STE D
FLINT, MI 48507
Pharmacy Comments
Contract Details
Approval Date
1/19/2022
Contract Begin Date
1/24/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/19/2022
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