340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 701, LLC
CHC26511-11 Upper Great Lakes Family Health Center
Print
Covered Entity Details
Entity Name
Upper Great Lakes Family Health Center
Subdivision Name
Marquette Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26511-11
Entity Address
1414 W Fair Ave
Ste 249
Marquette, MI 49855
Grant Number
H80CS26511
Participating Start Date
6/10/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/7/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald A. Simila, CEO
(906) 481-8571
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/7/2024
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