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OPTUM PHARMACY 702, LLC
CHC08240-00 HopeHealth, Inc.
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Covered Entity Details
Entity Name
HopeHealth, Inc.
Subdivision Name
HopeHealth Irby Street
Type
HRSA-Funded Health Center
340B ID
CHC08240-00
Entity Address
360 N Irby ST
Florence, SC 29501
Grant Number
H80CS08240
Participating Start Date
4/1/2013
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
5/15/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2020
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