Organization
OPTUM PHARMACY 705, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EUGENE BURR (SECRETARY)
(712) 310-4701
Entity
Organization
Contact information
Practice address
3539 BLUECUTT RD, COLUMBUS, MS 39705-1324
(662) 240-8900
(866) 843-2339
Mailing address
1 OPTUM CIR STE 100, EDEN PRAIRIE, MN 55344-2503
(800) 328-5979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/29/2006
Last updated
12/04/2024
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