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OPTUM PHARMACY 702, LLC
STD70005 The Rheumatology Group, LLC
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Covered Entity Details
Entity Name
The Rheumatology Group, LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD70005
Entity Address
111 Veterans Memorial Blvd.
Suite 404
Metairie, LA 70005
Grant Number
5NU62PS924522
Participating Start Date
10/1/2024
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
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Austin Fraser, Physician Owner
(504) 899-1120
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/15/2025
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