340B Drug Pricing Program Database

Pharmacy Name

OPTUM PHARMACY 702, LLC

Pharmacy Address

1050 PATROL RD
JEFFERSONVILLE, IN 47130

Pharmacy Comments

Approval Date

10/17/2017

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Gary Dene Fulbright, Chief Financial Officer
(417) 328-6402

Contract Pharmacy Representative

Briova Rx
Joe Iovino, Manager
(412) 445-4495

Signed By Date

10/17/2017