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OPTUM PHARMACY 707, INC
CHC28956-00 Valle Del Sol, Inc.
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Covered Entity Details
Entity Name
Valle Del Sol, Inc.
Subdivision Name
Valle del Sol_3807
Type
HRSA-Funded Health Center
340B ID
CHC28956-00
Entity Address
3807 N 7th St
Phoenix, AZ 85014-5005
Grant Number
H80CS28956
Participating Start Date
1/1/2022
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 707, INC
Pharmacy Address
4900 RIVERGRADE RD STE E110
IRWINDALE, CA 91706-1401
Pharmacy Comments
Contract Details
Approval Date
4/4/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Renaud, President & Chief Executive Officer
(602) 258-6797 Ext: 1320
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/4/2025
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