OPTUM PHARMACY 705, LLC – Community/Retail Pharmacy, NPI 1154306801
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for OPTUM PHARMACY 705, LLC
OPTUM PHARMACY 705, LLC
P.O. BOX 851378
MINNEAPOLIS, MN 554851378
Phone: (855) 577-6521
Fax: (812) 285-8541
Type: Mailing
1 OPTUM CIR STE 100
EDEN PRAIRIE, MN 553442503
Phone: (800) 328-5979
Type: Mailing
1100 LEE BRANCH LN
BIRMINGHAM, AL 352427298
Phone: (205) 995-8388
Fax: (205) 995-8897
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-01-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-10-31 (224 days ago).
Enrollment records
2
Earliest due date
2025-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930059088 | O | Pharmacy | AL | 2025-10-31 |
| O20210106001787 | O | Pharmacy | AL | 2026-02-28 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55485)
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