340B Drug Pricing Program Database
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OPTUM PHARMACY 702, LLC
STD704032 David L. Schneider, M.D., A.P.M.C.
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Covered Entity Details
Entity Name
David L. Schneider, M.D., A.P.M.C.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD704032
Entity Address
15825 Professional Plaza, Suite A
Hammond, LA 70403
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
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