Healthcare Provider Details

I. General information

NPI: 1669498515
Provider Name (Legal Business Name): OPTUMRX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 W 115TH ST STE 600
OVERLAND PARK KS
66211-9838
US

IV. Provider business mailing address

1 OPTUM CIR STE 100
EDEN PRAIRIE MN
55344-2503
US

V. Phone/Fax

Practice location:
  • Phone: 913-253-0600
  • Fax: 913-253-0643
Mailing address:
  • Phone: 880-032-8597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN EUGENE BURR
Title or Position: SECRETARY
Credential:
Phone: 712-310-4701