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OPTUM PHARMACY 705, LLC
STD349821 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD349821
Entity Address
2247 Palm Beach Lakes Blvd
Ste 209
West Palm Beach, FL 33409
Grant Number
NH25PS005131
Participating Start Date
1/1/2019
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/17/2023
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