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OPTUM PHARMACY 700, LLC
STD333192 IMG Helps Inc
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Covered Entity Details
Entity Name
IMG Helps Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333192
Entity Address
6470 NW 5th Way
Fort Lauderdale, FL 33309
Grant Number
NU62PS924633f
Participating Start Date
7/1/2021
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
5700 DOT COM CT, STE 1000
OVIEDO, FL 32765
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
5/9/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/17/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Steve Vixamar, COO
(954) 529-1178
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2022
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