Contract Pharmacy Details

OPTUM PHARMACY 702, LLC
CH09848AD COUNTY OF VENTURA

Covered Entity Details

Entity Name

COUNTY OF VENTURA

Subdivision Name

Magnolia West

Type

HRSA-Funded Health Center

340B ID

CH09848AD

Entity Address

2220 E Gonzales Rd Suite 120 A/B
Oxnard, CA 93036-3707

Grant Number

H80CS00247

Participating Start Date

4/1/2014

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 702, LLC

Pharmacy Address

1050 PATROL RD
JEFFERSONVILLE, IN 47130

Pharmacy Comments

Contract Details

Approval Date

4/14/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Theresa Cho, Chief Executive Officer, Ambulatory Care
(805) 652-6228

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

4/14/2022

340B Drug Pricing Program Database