Contract Pharmacy Details

OPTUM PHARMACY 702, LLC
STD70002 David L. Schneider, M.D., A.P.M.C.

Covered Entity Details

Entity Name

David L. Schneider, M.D., A.P.M.C.

Subdivision Name

David L. Schneider, M.D. A.P.M.C.

Type

Sexually Transmitted Diseases

340B ID

STD70002

Entity Address

3225 Danny Park, Suite 100
Metairie, LA 70002

Grant Number

NH25PS005176

Participating Start Date

9/22/2022

Last Recertification Date

5/7/2025

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 702, LLC

Pharmacy Address

1050 PATROL RD
JEFFERSONVILLE, IN 47130

Pharmacy Comments

Contract Details

Approval Date

4/14/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Adil Aryman Fatakia, MD
(504) 895-5357 Ext: 1

Contract Pharmacy Representative

Optum
Avani Patel, VP, 340B Operations
(763) 330-5555

Signed By Date

4/14/2025

340B Drug Pricing Program Database