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OPTUM PHARMACY 702, LLC
CH031060A NEIGHBORHOOD HEALTH
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTH
Subdivision Name
2 EAST GLEBE RD
Type
HRSA-Funded Health Center
340B ID
CH031060A
Entity Address
2 E GLEBE RD
Alexandria, VA 22305
Grant Number
H80CS02446
Participating Start Date
1/1/2007
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Basim Khan, Executive Director
(703) 535-5568 Ext: 4104
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/17/2023
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