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OPTUM PHARMACY 707, INC
CHC26604-05 NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
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Covered Entity Details
Entity Name
NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
Subdivision Name
Desert Mission Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26604-05
Entity Address
9015 N 3rd St
PHOENIX, AZ 85020
Grant Number
H80CS26604
Participating Start Date
1/1/2016
Last Recertification Date
2/12/2025
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
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julia Karl, CFO
(480) 688-0970
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/8/2024
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