340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
FQHCLA247C HEALTH AND LIFE ORGANIZATION, INC. (H.A.L.O.)
Print
Covered Entity Details
Entity Name
HEALTH AND LIFE ORGANIZATION, INC. (H.A.L.O.)
Subdivision Name
Sacramento Community Clinic - Del Paso Dental
Type
Health Center Program Look-Alike
340B ID
FQHCLA247C
Entity Address
2138 Del Paso Blvd
Sacramento, CA 95815-3002
Grant Number
LALCS00018
Participating Start Date
1/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JERRY T. BLIATOUT, CEO
(916) 428-3788 Ext: 4236
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/4/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session