Organization
OPTUM PHARMACY 704, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EUGENE BURR (SECRETARY)
(712) 310-4701
Entity
Organization
Contact information
Practice address
5627 UNIVERSITY HTS STE 108, SAN ANTONIO, TX 78249-3583
(800) 562-6223
(800) 491-7997
Mailing address
1 OPTUM CIR STE 100, EDEN PRAIRIE, MN 55344-2503
(800) 328-5979
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/04/2024
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