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OPTUM PHARMACY 705, LLC
CH062360 BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
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Covered Entity Details
Entity Name
BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
Subdivision Name
CommuniCare Health Centers - West
Type
HRSA-Funded Health Center
340B ID
CH062360
Entity Address
1102 Barclay St
San Antonio, TX 78207
Grant Number
H80CS00672
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
3539 BLUECUTT RD
COLUMBUS, MS 39705
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
7/6/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Nguyen, President & CEO
(210) 233-7070 Ext: 7886
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/6/2020
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