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OPTUM PHARMACY 701, LLC
CH041000 Advance Community Health, Inc.
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Covered Entity Details
Entity Name
Advance Community Health, Inc.
Subdivision Name
Southeast Raleigh - South
Type
HRSA-Funded Health Center
340B ID
CH041000
Entity Address
1011 Rock Quarry Rd
Raleigh, NC 27610
Grant Number
H80CS00087
Participating Start Date
7/1/2001
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scot N. McCray, Chief Executive Officer
(919) 250-2923
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/14/2024
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