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OPTUM PHARMACY 701, LLC
CH071410 PEOPLES COMMUNITY HEALTH CLINIC, INC.
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Covered Entity Details
Entity Name
PEOPLES COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
PEOPLES COMMUNITY HEALTH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH071410
Entity Address
905 Franklin St
Waterloo, IA 50703-4407
Grant Number
H80CS00815
Participating Start Date
12/1/1992
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
4/7/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christine Kemp, CEO
(319) 874-3311
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/7/2025
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