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OPTUM PHARMACY 700, LLC
FQHCLA484 UPTOWN COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
UPTOWN COMMUNITY HEALTH CENTER INC
Subdivision Name
Uptown Community Health Center, Inc. Administration
Type
Health Center Program Look-Alike
340B ID
FQHCLA484
Entity Address
1960 N Ogden St, Ste 300
Denver, CO 80218-3674
Grant Number
LALCS54746
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
19 CHAPIN RD BLDG D, STE D8
PINE BROOK, NJ 07058
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cherise Callighan, CEO
(303) 318-2505
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/15/2025
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