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OPTUM PHARMACY 702, LLC
STD327635 Central Florida Health Care Services Corp
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Covered Entity Details
Entity Name
Central Florida Health Care Services Corp
Subdivision Name
CFHCS-OC
Type
Sexually Transmitted Diseases
340B ID
STD327635
Entity Address
915 Harley Strickland Blvd.
Orange City, FL 32763
Grant Number
H25PS005131
Participating Start Date
9/16/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Misleh, Director
(513) 702-7215
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/15/2024
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