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OPTUM PHARMACY 705, LLC
STD70605 The Arthritis Center of Southwest Louisiana
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Covered Entity Details
Entity Name
The Arthritis Center of Southwest Louisiana
Subdivision Name
The Arthritis Center of Southwest Louisiana
Type
Sexually Transmitted Diseases
340B ID
STD70605
Entity Address
1727 Imperial Blvd
bldg 1b
Lake Charles, LA 70605
Grant Number
NH25PS005176
Participating Start Date
4/1/2024
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
4/8/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timeko West, Practice Manager
(337) 936-0690
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/8/2025
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