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OPTUM PHARMACY 701, LLC
CH093110 ALTAMED Health Services Corporation
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Covered Entity Details
Entity Name
ALTAMED Health Services Corporation
Subdivision Name
AltaMed Health Services Corporation Headquarters
Type
HRSA-Funded Health Center
340B ID
CH093110
Entity Address
2040 CAMFIELD AVENUE
Commerce, CA 90040
Grant Number
H80CS00142
Participating Start Date
4/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
7/9/2024
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
EquiScript, LLC
Georgia Spiropoulos, Account Executive
(253) 363-3232
Signed By Date
7/9/2024
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