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OPTUM PHARMACY 701, LLC
CH071700 FAMILY CARE HEALTH CENTERS
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Covered Entity Details
Entity Name
FAMILY CARE HEALTH CENTERS
Subdivision Name
CARONDELET
Type
HRSA-Funded Health Center
340B ID
CH071700
Entity Address
401 HOLLY HILLS AVE
ST LOUIS, MO 63111-2410
Grant Number
H80CS00492
Participating Start Date
10/1/2002
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aramide Ayorinde, Chief Executive Officer
(314) 481-1615 Ext: 1315
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
1/15/2025
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