Organization
OPTUM INFUSION SERVICES 302, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE MCCABE (SECRETARY)
(952) 935-1191
Entity
Organization
Contact information
Practice address
8720 SOUTH 114TH STREET, SUITE 106, LA VISTA, NE 68128
(855) 295-3154
(844) 204-8056
Mailing address
1 OPTUM CIR STE 100, EDEN PRAIRIE, MN 55344-2956
(800) 328-5979
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
09/28/2009
Last updated
05/07/2026
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