340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 701, LLC
STD21202 AIDS Healthcare Foundation
Print
Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Baltimore
Type
Sexually Transmitted Diseases
340B ID
STD21202
Entity Address
2510 Saint Paul Street
Baltimore, MD 21218
Grant Number
NH25PS005126
Participating Start Date
7/1/2019
Last Recertification Date
5/22/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/12/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/12/2024
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