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OPTUM PHARMACY 705, LLC
CHC26632-01 Whitman-Walker Clinic, Inc.
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Covered Entity Details
Entity Name
Whitman-Walker Clinic, Inc.
Subdivision Name
Max Robinson Center
Type
HRSA-Funded Health Center
340B ID
CHC26632-01
Entity Address
1201 Sycamore Dr SE
Washington, DC 20032-5956
Grant Number
H80CS26632
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1893 GENERAL GEORGE PATTON DR
STE 106
FRANKLIN, TN 37067-2655
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
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
1/12/2022
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