Contract Pharmacy Details

OPTUM PHARMACY 706, INC.
CHC26632-00 Whitman-Walker Clinic, Inc.

Covered Entity Details

Entity Name

Whitman-Walker Clinic, Inc.

Subdivision Name

Whitman-Walker Health

Type

HRSA-Funded Health Center

340B ID

CHC26632-00

Entity Address

1525 14th Street Street Northwest
Washington, DC 20005

Grant Number

H80CS26632

Participating Start Date

4/1/2014

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

OPTUM PHARMACY 706, INC.

Pharmacy Address

30-30 47TH AVENUE
SUITE 410
LONG ISLAND CITY, NY 11101

Pharmacy Comments

Contract Details

Approval Date

1/15/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Naseema Shafi, Chief Executive Officer
(202) 797-3572

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

1/15/2021

340B Drug Pricing Program Database