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OPTUM PHARMACY 702, LLC
CH09848J COUNTY OF VENTURA
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Covered Entity Details
Entity Name
COUNTY OF VENTURA
Subdivision Name
Fillmore Family Medical Group
Type
HRSA-Funded Health Center
340B ID
CH09848J
Entity Address
828 Ventura St
Fillmore, CA 93015-1876
Grant Number
H80CS00247
Participating Start Date
10/9/2008
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
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