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OPTUM PHARMACY 701, LLC
STD890742 LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
Olive Healthcare
Type
Sexually Transmitted Diseases
340B ID
STD890742
Entity Address
105 N. Pecos Road
Suite 111
Henderson, NV 89074
Grant Number
NH25PS005179-05-04
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029
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
Vladimir Abadjiev, COO
(702) 526-3146
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/15/2025
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