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OPTUM PHARMACY 801, INC.
CH02371AG INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Family Health Center of Harlem
Type
HRSA-Funded Health Center
340B ID
CH02371AG
Entity Address
1824 Madison Ave
New York, NY 10035-3832
Grant Number
H80CS00768
Participating Start Date
10/1/2010
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 801, INC.
Pharmacy Address
24416 N 19TH AVE
STE. 100
PHOENIX, AZ 85085
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
10/31/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caroline DiCioccio, Chief Financial Officer
(212) 633-0800 Ext: 1409
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/13/2022
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