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OPTUM PHARMACY 700, LLC
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
Subdivision Name
WHITNEY M. YOUNG, JR. HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH020110
Entity Address
920 Lark Dr
Albany, NY 12207-1300
Grant Number
H80CS00433
Participating Start Date
10/1/1995
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
19 CHAPIN RD BLDG D, STE D8
PINE BROOK, NJ 07058
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
David Harold Shippee, President & CEO
(518) 591-4459
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/15/2024
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