Organization
OPTUM PHARMACY 801, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EUGENE BURR (SECRETARY)
(712) 310-4701
Entity
Organization
Contact information
Practice address
24416 N 19TH AVE STE 100, PHOENIX, AZ 85085-1889
(877) 719-6349
(877) 719-6362
Mailing address
1 OPTUM CIR STE 100, EDEN PRAIRIE, MN 55344-2503
(800) 328-5979
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Enumeration date
05/04/2016
Last updated
12/04/2024
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