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OPTUM PHARMACY 702, LLC
CHC08737-01 Roanoke Chowan Community Health Center, Inc.
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Covered Entity Details
Entity Name
Roanoke Chowan Community Health Center, Inc.
Subdivision Name
Ahoskie Comprehensive Care
Type
HRSA-Funded Health Center
340B ID
CHC08737-01
Entity Address
120 Health Center Drive
Ahoskie, NC 27910-8131
Grant Number
H80CS08737
Participating Start Date
7/1/2005
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/29/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KIM SCHWARTZ, CEO
(252) 209-0237 Ext: 7124
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/29/2020
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