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OPTUM FRONTIER THERAPIES II, LLC
CHC12855-00 MONMOUTH FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
MONMOUTH FAMILY HEALTH CENTER
Subdivision Name
Monmouth Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12855-00
Entity Address
270 Broadway
Long Branch, NJ 07740-0727
Grant Number
H80CS12855
Participating Start Date
10/14/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES II, LLC
Pharmacy Address
6425 SANTA MARGARITA ST UNIT 110
LAS VEGAS, NV 89118-1913
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/16/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Marta C Silverberg, CEO
(732) 923-7145
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/13/2023
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