340B Drug Pricing Program Database

Office of Pharmacy Affairs Logo

OPTUM PHARMACY 706, INC.
FQHCLA430 MENTAL HEALTH CARE, INC.

Covered Entity Details

Gracepoint Wellness Clinic
Health Center Program Look-Alike
FQHCLA430
5707 N. 22nd Street
Tampa, FL 33610-4350
LALCS40297
1/1/2022
2/13/2025


Pharmacy Details

30-30 47TH AVENUE
SUITE 410
LONG ISLAND CITY, NY 11101

Contract Details

10/16/2023
1/1/2024


Contacts


Roaya Tyson, CEO
(813) 965-2630



Mental Health Care dba Gracepoint
Joe Lallanilla, Chief Operating Officer
(813) 317-4648
10/16/2023