340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
STD73103 Community Nursing Center of Oklahoma City, LLC dba Diversity Family Health
Print
Covered Entity Details
Entity Name
Community Nursing Center of Oklahoma City, LLC dba Diversity Family Health
Subdivision Name
Shartel Towers Site
Type
Sexually Transmitted Diseases
340B ID
STD73103
Entity Address
1211 N Shartel
Suite 300 & 606
Oklahoma City, OK 73103
Grant Number
NH25PS005143
Participating Start Date
4/1/2020
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Russell Ryan Rooms, Director
(405) 848-0026
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
1/14/2025
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