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OPTUM PHARMACY 704, INC.
CHC28988-00 DAP HEALTH INC
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Covered Entity Details
Entity Name
DAP HEALTH INC
Subdivision Name
Desert AIDS Project, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28988-00
Entity Address
1695 N Sunrise Way
Palm Springs, CA 92262-3701
Grant Number
H80CS28988
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 704, INC.
Pharmacy Address
5627 UNIVERSITY HTS STE 108
SAN ANTONIO, TX 78249
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Brinkman, Chief Executive Officer
(760) 992-0418
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/7/2022
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