Transcription of CREDENTIALED PHARMACIES LISTING
1 157 Total CREDENTIALED PHARMACIES as of 4-1-2022 2022 NCCP Network Compound Credentialing Program CREDENTIALED PHARMACIES LISTING Please Note: You may not see a pharmacy near you (or even in your state of residence) listed, however the NCCP PHARMACIES listed for each state are licensed to dispense and ship compound medications to that state. Not all NCCP PHARMACIES participate in all networks. Please verify the compound CREDENTIALED pharmacy participates in your Plan s network. 4-12022 Introduction This user guide will assist members with the selection of a pharmacy which has been CREDENTIALED with the OptumRx Network Compound Credentialing Program (NCCP). Using the Guide This guide is in alphabetical order by state.
2 Each page provides a list of the PHARMACIES CREDENTIALED and licensed to dispense within that state. Symbols next to the PHARMACIES are also provided for reference for some of the more routine types of compounded products. If your type of product is not listed, or if you are unsure of the type of compounded product you are filling; the PHARMACIES listed should be able to answer your questions based on the prescriptions and direct you appropriately as to their ability to compound the product. Also, please be aware that not ALL compounded medications require a pharmacy that is listed within this Guide. Some of the more simple compounds which do not require a rigorous credentialing review may be made available to you from any of the network pharmacy providers that you use for your routine medications.
3 How to find a pharmacy that dispenses a specific type of compound medication The abbreviations below represent routine types of compounds. Not all PHARMACIES are CREDENTIALED to dispense all types of compounds. The charts on each page will let you know which pharmacy may be able to compound the medication you need. (For example, if the prescription appears to be for a topical product look for the TOP symbol after the PHARMACIES within your state.) TOP: denotes topical products ( pain ointments/gels and topical hormone creams) HRT: denotes hormone replacement therapy and fertility medications ( estriol) PED: denotes pediatric (children) custom products ( liquid g-tube preparations) NAS: denotes nasal or oral inhaled therapies ( antibiotic or steroid nasal compounds) STR: denotes sterile Preparations ( IV, IM, SC and epidural injections, Ophthalmic preparations, and fortified antibiotic/antifungal drops) SUP: denotes Supplements ( Enzymes, EFA s, Vitamin A/C/D and Calcium) PTD: denotes Medicare Part D ( a compound claim for a Medicare Part D beneficiary) Please Note.
4 You may not see a pharmacy near you (or even in your state of residence) listed, however the NCCP PHARMACIES listed for each state are licensed to dispense and ship compound medications to that state. Not all NCCP PHARMACIES participate in all networks. Please verify the compound CREDENTIALED pharmacy participates in your Plan s network. 4-12022 State Menu: ALABAMA(AL) ALASKA (AK) ARIZONA (AZ) ARKANSAS (AR) CALIFORNIA (CA) COLORADO (CO) CONNECTICUT (CT) DISTRICT OF COLUMBIA (DC) DELAWARE (DE) FLORIDA (FL) FLORIDA (FL) Continued GEORGIA (GA) HAWAII (HI) IDAHO (ID) ILLINOIS (IL) INDIANA (IN) IOWA (IA) KANSAS (KS) KENTUCKY (KY) LOUISIANA (LA) MAINE (ME) MARYLAND (MD) MASSACHUSETTS (MA) MICHIGAN (MI) MINNESOTA (MN) MISSISSIPPI (MS) MISSOURI (MO) MONTANA (MT) NEBRASKA (NE) NEVADA (NV) NEW HAMPSHIRE (NH) NEW JERSEY (NJ) NEW MEXICO (NM) NEW YORK (NY) NEW YORK (NY) Continued NORTH CAROLINA (NC) NORTH DAKOTA (ND) OHIO (OH) OKLAHOMA (OK) OREGON (OR) PENNSYLVANIA (PA) RHODE ISLAND (RI) SOUTH CAROLINA (SC) SOUTH DAKOTA (SD) TENNESSEE (TN) TEXAS (TX) UTAH (UT)
5 VERMONT (VT) VIRGINIA (VA) WASHINGTON (WA) WEST VIRGINIA (WV) WISCONSIN (WI) WYOMING (WY) Please Note: You may not see a pharmacy near you (or even in your state of residence) listed, however the NCCP PHARMACIES listed for each state are licensed to dispense and ship compound medications to that state. Not all NCCP PHARMACIES participate in all networks. Please verify the compound CREDENTIALED pharmacy participates in your Plan s network. 4-12022 ALABAMA(AL) Return to Instructions * Return to Menu Pharmacy NameAddressCityStatePhoneFaxTOP HRTPEDNAS STRSUPPTDA dvanced Infusion Solutions623 Highland Colony Parkway Suite 100 RidgelandMS(601)988-1700(888)298-2220 XXAnderson Compounding Pharmacy310 Bluff City HighwayBristolTN(423)764-4136(423)764-51 67 XXXXXXCareFirst Specialty Pharmacy2200 Garry Rd Ste 1 CinnaminsonNJ(844)822-7379(844)922-7379 XXCaremax Pharmacy 7255547 Normandy BlvdJacksonvilleFL(904)374-2692(866)725- 5332 XXCompound Pharmaceutical Technologies1048 Stanton Road Suite BDaphneAL(251)626-2820(866)684-6337 XXXXXXD elco Drugs 3833 Richmond AveStaten IslandNY(718)984-6600(718)
6 984-6601 XXXXE lements Compounding Pharmacy2110 E Baseline RdMesaAZ(480)625-4750(480)625-3054 XXXXFort Worth Pharmacy7833 Oakmont Blvd. Ste 120 Fort WorthTX(817)361-9960(817)361-9970 XXXXF oundation Care, LLC4010 Wedgeway CourtEarth CityMO(877)291-1122(877)291-1155 XXXXXXXI nfinity Care Solutions1204 SE 28th Street Suite 2 BentonvilleAR(888)414-5805(855)422-2400 XXXXXK eystone Pharmacy4021 Cascade Road SEGrand RapidsMI(616)974-9792(616)464-3469 XXXXXXK eystone Pharmacy, LLC106 Highland Way, Ste 206 MadisonMS(601)707-9727(601)510-3846X XLee Silsby Compounding Pharmacy23865 Mercantile RoadBeachwoodOH(216) 321-4300(216)321-4303 XXXXXXXL exington Compounding Pharmacy399 Waller Avenue Suite 110 LexingtonKY(859)276-3905(859)277-0252 XXXXXXXM alanda, Inc dba Mandell's Clinical Pharmacy 7 Cedar Grove Lane.
7 Ste 24 Somerset NJ(732)907-6780(732)412-7091 XXXMega Aid Pharmacy II, Inc140 58th St Suite 8 GBrooklynNY(212)920-4500(718)744-2724 XXOptimal Wellness Pharmacy4200 Trabuco Rd Ste 190 IrvineCA(949)861-3170(949)861-3179 XXXXXXP acifica Pharmacy23560 S. Madison St #112 TorranceCA(310)530-0831(310)530-8218 XXXP atient Care America3890 Park Central Blvd. N Pompano BeachFL866-348-0441888-503-6982 XXXP erforMix Specialty Pharmacy25 Pelham RdSalemNH(603)870-9618(603)870-9621 XXXPro Compounding Pharmacy527 N State Of Franklin Rd Suite 2 Johnson CityTN(423)975-0597(423)975-0597 XXXXXSan Ysidro Pharmacy1498 East Valley RdMontecitoCA(805)969-2284(805)565-3174 XXXS andsRx4 Regency DriveWylieTX(972)535-2020(855)385-9990 XXXXXS mart Workers Pharmacy3740 St.
8 Johns Bluff Road S Suite 21 JacksonvilleFL(904)575-3571(844)904-2667 XXSoleo Health Inc 2866 Dauphin Street Suite HMobileAL(251)234-6074(251)272-3298 XXXS outh River Compounding Pharmacy3656 Mayland CourtRichmondVA(804)897-6447(804)967-644 9 XXXXXXTown & Country Compounding535 EAST CRESCENT AVENUERAMSEYNJ(201)447-2020(201)447-3253 XXXXXXXV asco Rx Specialty Pharmacy4045 E Bell Rd Suite 163 PhoenixAZ(602)971-6950(602)404-2504 XXXXXXV illage Compounding Pharmacy975 Corbindale RdHoustonTX(713)464-5069(713)464-5099 XXXXXX Please Note: You may not see a pharmacy near you (or even in your state of residence) listed, however the NCCP PHARMACIES listed for each state are licensed to dispense and ship compound medications to that state.
9 Not all NCCP PHARMACIES participate in all networks. Please verify the compound CREDENTIALED pharmacy participates in your Plan s network. 4-12022 ALASKA (AK) Return to Instructions * Return to Menu Pharmacy NameAddressCityStatePhoneFaxTOP HRTPEDNAS STRSUPPTDA dvanced Infusion Solutions623 Highland Colony Parkway Suite 100 RidgelandMS(601)988-1700(888)298-2220 XXBoothwyn Pharmacy221 Gale LaneKennett SquarePA(800)476-7496(610)497-4371 XXXXXB roadway Apothecary1515 Oak StreetEugeneOR(541)684-9352(888)963-7563 XXXXXXC ascade Specialty Pharmacy325 NE Hostmark StPoulsboWA(360)779-2737(866)749-5728 XXXXXXXC hemistry Rx829 Spruce Street Suite 100 PhiladelphiaPA(855)790-0100(267)861-0862 XCreams N Caps Michigan31035 Schoolcraft RoadLivoniaMI(800) (800)537-5193 XXXXE lements Compounding Pharmacy2110 E Baseline RdMesaAZ(480)625-4750(480)
10 625-3054 XXXXF oundation Care, LLC4010 Wedgeway CourtEarth CityMO(877)291-1122(877)291-1155 XXXXXXXI nfinity Care Solutions1204 SE 28th Street Suite 2 BentonvilleAR(888)414-5805(855)422-2400 XXXXXM alanda, Inc dba Mandell's Clinical Pharmacy 7 Cedar Grove Lane. Ste 24 Somerset NJ(732)907-6780(732)412-7091 XXXMega Aid Pharmacy II, Inc140 58th St Suite 8 GBrooklynNY(212)920-4500(718)744-2724 XXPacifica Pharmacy23560 S. Madison St #112 TorranceCA(310)530-0831(310)530-8218 XXXP atient Care America3890 Park Central Blvd. N Pompano BeachFL866-348-0441888-503-6982 XXXP harmacy Solutions5204 Jackson Road Suite CAnn ArborMI(734)821-8000(734)821-8001 XXXXXXP harmco Inc381 Van Ness Av #1506 TorranceCA(310) 783-7450(310) 783-7459 XXXXPro Compounding Pharmacy527 N State Of Franklin Rd Suite 2 Johnson CityTN(423)975-0597(423)975-0597 XXXXXS andsRx4 Regency DriveWylieTX(972)535-2020(855)385-9990 XXXXXS mart Workers Pharmacy3740 St.
