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OPTUM INFUSION SERVICES 550, LLC
HM92668 CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISORDERS (CIBD)
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Covered Entity Details
Entity Name
CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISORDERS (CIBD)
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM92668
Entity Address
701 S. Parker Street
Suite 1000
Orange, CA 92868
Grant Number
H30MC24045
Participating Start Date
7/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 550, LLC
Pharmacy Address
1819 ASTON AVE STE 104
CARLSBAD, CA 92008
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
DIANE NUGENT, DIRECTOR, HEMOPHILIA TREATMENT CENTER
(714) 509-8744
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/7/2022
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