340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 704, INC.
CH092870 CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Print
Covered Entity Details
Entity Name
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Subdivision Name
Chiricahua Community Health Centers, Inc. Cliff Whetten Clinic
Type
HRSA-Funded Health Center
340B ID
CH092870
Entity Address
10566 N Highway 191
Elfrida, AZ 85610-9021
Grant Number
H80CS00696
Participating Start Date
7/1/1998
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 704, INC.
Pharmacy Address
5627 UNIVERSITY HTS STE 108
SAN ANTONIO, TX 78249
Pharmacy Comments
Contract Details
Approval Date
7/12/2021
Contract Begin Date
8/5/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Melk, CEO
(520) 227-9167
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/12/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session