340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
CH0421240 FAIRVIEW COMMUNITY HEALTH CENTER
Print
Covered Entity Details
Entity Name
FAIRVIEW COMMUNITY HEALTH CENTER
Subdivision Name
DBA FAIRVIEW COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0421240
Entity Address
225 NATCHEZ TRACE AVE
BOWLING GREEN, KY 42103-7995
Grant Number
H80CS00856
Participating Start Date
10/1/2001
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
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Lillybridge, Executive Director
(270) 783-3573 Ext: 1032
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/11/2024
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