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OPTUM PHARMACY 702, LLC
CH08006A DENVER HEALTH AND HOSPITAL AUTHORITY
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Covered Entity Details
Entity Name
DENVER HEALTH AND HOSPITAL AUTHORITY
Subdivision Name
EASTSIDE FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH08006A
Entity Address
501 28th St
Denver, CO 80205-3003
Grant Number
H80CS00218
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Simon Hambidge, Chief Ambulatory Care Services
(303) 602-5120
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2022
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