OPTUM PHARMACY 801, INC. (NPI# 1780030163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780030163 |
| Entity Type | Organization |
| Organization Name | OPTUM PHARMACY 801, INC. |
| Practice Address |
24416 N 19th Ave Ste 100 Phoenix AZ 85085-1889 |
| Practice Telephone | 8777196349 |
| Practice Fax Number | 8777196362 |
| Mailing Telephone | 6237421700 |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | DAVID OBERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 9529361300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 251F00000X | Home Infusion | Agencies | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1029015 | 05 | |
| UT | 1780030163 | 05 | |
| MT | 1780030163 | 05 | |
| WA | 2078611 | 05 | |
| OH | 218209 | 05 | |
| MD | 113465500 | 05 | |
| AK | 1664421 | 05 | |
| CO | 1780030163 | 05 | |
| MS | 829277 | 05 | |
| NC | 1780030163 | 05 | |
| OR | 1780030163 | 05 | |
| NE | 10026395601 | 05 | |
| SC | 7A6872 | 05 | |
| PA | 1022434680002 | 05 | |
| ID | 1780030163 | 05 | |
| OK | 200227450C | 05 | |
| NV | 1780030163 | 05 | |
| AZ | 195019 | 05 | |
| KS | 200587210B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649317579 | Optum Pharmacy 801, Inc. | Durable Medical Equipment & Medical Supplies | 23620 N 20th Dr, Ste 12, Phoenix, AZ 85085-0621 | 2007-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Optum Pharmacy 801, Inc. | 24416 N. 19th Ave., Phoenix, AZ 85085 |
| New York State Corporations | OPTUM PHARMACY 801, INC. | 28 Liberty Street, New York, New York 10005 |
| Washington State Corporations | OPTUM PHARMACY 801, INC. | 24416 N. 19th Ave., Phoenix, AZ 85085 |
| Street Address |
24416 N 19TH AVE STE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85085-1889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748369 | Nicole Fountain | Speech-Language Pathologist | 25700 N. 21st Avenue, Phoenix, AZ 85085 | 2020-07-24 |
| 1083138010 | Larry Leforte II | Emergency Medical Technician, Paramedic | 2018 W Blaylock Dr, Phoenix, AZ 85085 | 2017-08-01 |
| 1508318809 | Jennifer Falk | Chiropractor | 1614 W Whispering Wind Dr Ste 3, Phoenix, AZ 85085 | 2016-11-03 |
| 1053785964 | Cvs Pharmacy | Pharmacy | 28635 N North Vally Parkway, Phoenix, AZ 85085 | 2015-11-17 |
| 1417329897 | Kelly Criswell | Registered Nurse | 32150 N North Foothills Dr, Phoenix, AZ 85085 | 2015-10-26 |
| 1417333717 | Kristi Everett | Social Worker | 34225 N 27th Dr Bldg 5 Ste 146, Phoenix, AZ 85085 | 2015-08-10 |
| 1063849834 | Albertsons Pharmacy | Pharmacist | 2406 W Bramble Berry Ln, Phoenix, AZ 85085 | 2013-10-10 |
| 1427354851 | Carolyn Berg Newsome | Marriage & Family Therapist | 2060 W.whispering Wind Drive, Phoenix, AZ 85085 | 2011-02-02 |
| 1518273127 | Jamie Lynn Born | Social Worker | 34406 N 27th Dr Bldg 6, Phoenix, AZ 85085 | 2010-08-20 |
| 1023347218 | Lise Flores-reed | Psychologist | 34225 N. 27th Drive #110, Phoenix, AZ 85085 | 2009-12-17 |
| Find all providers in zip 85085 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508935719 | Apria Healthcare, Inc. | Pharmacy | 2909 E Broadway Rd, Phoenix, AZ 85040-2763 | 2006-11-06 |
| 1366447005 | Avella of Phoenix II, Inc. | Pharmacy | 5040 N 15th Ave Ste 102, Phoenix, AZ 85015-3329 | 2005-06-17 |
| 1255523155 | Optum Pharmacy 805, Inc. | Pharmacy | 1101 N Central Ave, Ste 102, Phoenix, AZ 85004-1818 | 2007-08-14 |
| 1801900766 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Pharmacy | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518473735 | Strive Pharmacy LLC | Pharmacy | 1275 E Baseline Rd Ste 104, Gilbert, AZ 85233-1224 | 2017-12-26 |
| 1174033583 | Vectrarx Mail Pharmacy Services, L.L.C. | Pharmacy | 10860 N Mavinee Dr Ste 100, Oro Valley, AZ 85737-9514 | 2017-10-11 |
| 1336554112 | Integrity Rx Specialty Pharmacy LLC | Pharmacy | 8425 N 90th St Ste 8, Scottsdale, AZ 85258-4393 | 2014-06-30 |
| 1073954970 | All-care Pharmacy LLC | Pharmacy | 9015 E Pima Center Pkwy Ste 3, Scottsdale, AZ 85258-4615 | 2013-07-09 |
| 1366782302 | Blood Systems, Inc. | Pharmacy | 2826 S Potter Dr, Suite B, Tempe, AZ 85282-3144 | 2013-02-28 |
| 1285983007 | Sun City Pharmacy Inc | Pharmacy | 9133 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4269 | 2012-09-07 |
| 1518251909 | Airpark Pharmacy, LLC | Pharmacy | 15021 N 74th St Ste 100, Scottsdale, AZ 85260-2497 | 2011-06-03 |
| 1386865269 | Ritt Medical, Inc. | Pharmacy | 6283 W Lone Cactus Dr, Glendale, AZ 85308-6304 | 2007-05-01 |
| 1598864134 | Amerita, Inc | Pharmacy | 3775 Crossings Dr, Prescott, AZ 86305-7138 | 2006-09-21 |
| 1053876813 | Genrx Corp. | Pharmacy | 17250 N Hartford Dr Ste 115, Scottsdale, AZ 85255-5496 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.