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OPTUM INFUSION SERVICES 200, INC
STD330563 Optimal Health Foundation Inc
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Covered Entity Details
Entity Name
Optimal Health Foundation Inc
Subdivision Name
Optimal Health Foundation
Type
Sexually Transmitted Diseases
340B ID
STD330563
Entity Address
17235 NW 27th Avenue
Miami Gardens, FL 33056
Grant Number
NH25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/16/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 200, INC
Pharmacy Address
5895 CORE RD
STE 417
NORTH CHARLESTON, SC 29406
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brittney Roy, Director of Operations
(305) 705-4024
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2024
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