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OPTUM PHARMACY 800, INC.
CH068160 HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Waco Family Medicine - Central
Type
HRSA-Funded Health Center
340B ID
CH068160
Entity Address
1600 PROVIDENCE DR
WACO, TX 76707-2261
Grant Number
H80CS00719
Participating Start Date
1/1/2000
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 800, INC.
Pharmacy Address
3016 GUADALUPE ST STE A
AUSTIN, TX 78705-2861
Pharmacy Comments
Contract Details
Approval Date
7/15/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/3/2017
Covered Entity Terminated
Contacts
Covered Entity Signing Official
ROLAND A. GOERTZ, CEO
(254) 313-4201
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
7/15/2016
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