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OPTUM PHARMACY 701, LLC
CH0442510 CHOTA COMMUNITY HEALTH SERVICES
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Covered Entity Details
Entity Name
CHOTA COMMUNITY HEALTH SERVICES
Subdivision Name
CHOTA COMMUNITY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH0442510
Entity Address
1206 US Highway 411
VONORE, TN 37885
Grant Number
H80CS06461
Participating Start Date
10/20/2005
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura Harris, CEO
(423) 442-7268
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/1/2024
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