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OPTUM PHARMACY 700, LLC
CHC08760-00 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08760-00
Entity Address
600 Maple Ave
6
HONESDALE, PA 18431
Grant Number
H80CS08760
Participating Start Date
1/1/2010
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
5700 DOT COM CT, STE 1000
OVIEDO, FL 32765
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert J. Fortuner II, Finance Director
(570) 253-8337
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/12/2024
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