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OPTUM PHARMACY 707, INC
CH09311BV ALTAMED HEALTH SERVICES CORPORATION
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Covered Entity Details
Entity Name
ALTAMED HEALTH SERVICES CORPORATION
Subdivision Name
AltaMed - Lake/Elizabeth
Type
HRSA-Funded Health Center
340B ID
CH09311BV
Entity Address
1595 N Lake Ave
Pasadena, CA 91104-2307
Grant Number
H80CS00142
Participating Start Date
4/1/2024
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 707, INC
Pharmacy Address
4900 RIVERGRADE RD STE E110
IRWINDALE, CA 91706-1401
Pharmacy Comments
Contract Details
Approval Date
7/3/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Contract Pharmacy Representative
WellPartner
Kristen Danahy, Advisor/Manager, Account Management
(480) 364-2573
Signed By Date
7/3/2024
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