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OPTUM PHARMACY 701, LLC
CHC28351-00 FAMILY HEALTH SERVICES OF ERIE COUNTY
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Covered Entity Details
Entity Name
FAMILY HEALTH SERVICES OF ERIE COUNTY
Subdivision Name
Family Health Services of Erie County, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28351-00
Entity Address
1912 Hayes Ave
Sandusky, OH 44870
Grant Number
H80CS28351
Participating Start Date
10/1/2015
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4015 SHOPTON RD STE 600
CHARLOTTE, NC 28217-3025
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Tatro, CEO
(419) 502-2822
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/14/2022
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