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OPTUM PHARMACY 701, LLC
CH093030 ADELANTE HEALTHCARE, INC.
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Covered Entity Details
Entity Name
ADELANTE HEALTHCARE, INC.
Subdivision Name
Adelante Healthcare
Type
HRSA-Funded Health Center
340B ID
CH093030
Entity Address
3033 N. Central Ave.
Phoenix, AZ 85012-4403
Grant Number
H80CS00140
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029
Pharmacy Comments
Contract Details
Approval Date
1/24/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/27/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pedro Cons, CEO
(623) 583-3001 Ext: 011105
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/24/2022
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