Contract Pharmacy Details

OPTUM PHARMACY 702, LLC
STD700724 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. d/b/a ENT of New Orleans

Type

Sexually Transmitted Diseases

340B ID

STD700724

Entity Address

1151 Barataria Blvd
3100
Marrero, LA 70072

Grant Number

NH25PS005176

Participating Start Date

1/1/2024

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