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OPTUM PHARMACY 702, LLC
STD18901 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Doylestown Office
Type
Sexually Transmitted Diseases
340B ID
STD18901
Entity Address
11 Duane Road
Suite A
Doylestown, PA 18901
Grant Number
NH25PS005144
Participating Start Date
10/1/2019
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/11/2022
Contract Begin Date
7/13/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen C Smith, Owner
(610) 867-5365
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/11/2022
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