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OPTUM PHARMACY 701, LLC
CHC26605-00 NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES
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Covered Entity Details
Entity Name
NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES
Subdivision Name
.
Type
HRSA-Funded Health Center
340B ID
CHC26605-00
Entity Address
580 W 5th St
Reno, NV 89503-4432
Grant Number
H80CS26605
Participating Start Date
4/1/2014
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sharon Chamberlain, Chief Executive Officer
(775) 348-2895
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/15/2024
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