Contract Pharmacy Details

OPTUM PHARMACY 701, LLC
CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION

Covered Entity Details

Entity Name

NORTH HUDSON COMMUNITY ACTION CORPORATION

Subdivision Name

North Hudson Community Action Corporation @ West New York

Type

HRSA-Funded Health Center

340B ID

CH024490

Entity Address

5301 BROADWAY
WEST NEW YORK, NJ 07093-2622

Grant Number

H80CS00521

Participating Start Date

1/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 701, LLC

Pharmacy Address

4100 S SAGINAW ST STE D
FLINT, MI 48507

Pharmacy Comments

Contract Details

Approval Date

7/15/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Rebecca Acosta, Executive Vice President
(201) 210-0100 Ext: 10102

Contract Pharmacy Representative

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

Signed By Date

7/15/2022

340B Drug Pricing Program Database