340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM INFUSION SERVICES 501, INC.
FQHCLA437 Muslim Community & Health Center
Print
Covered Entity Details
Entity Name
Muslim Community & Health Center
Subdivision Name
Muslim Community & Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA437
Entity Address
803 W Layton Avenue
Milwaukee, WI 53221
Grant Number
LALCS46445
Participating Start Date
1/1/2023
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 501, INC.
Pharmacy Address
8131 W BOSTIAN RD
STE. A345
WOODINVILLE, WA 98072
Pharmacy Comments
Contract Details
Approval Date
10/15/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/24/2022
Agreement registered in error
Contacts
Covered Entity Signing Official
ARMAN TAHIR, CEO
(414) 254-1110
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/15/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session