Contract Pharmacy Details

OPTUM PHARMACY 704, INC.
CH047000 HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Covered Entity Details

Entity Name

HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Subdivision Name

Health Care Partners of South Carolina, Inc. - Conway Administrative Office

Type

HRSA-Funded Health Center

340B ID

CH047000

Entity Address

1708 Oak Street
Conway, SC 29526-3086

Grant Number

H80CS00411

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

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

1/18/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jim Eubanks, Chief Executive Officer
(843) 488-6363

Contract Pharmacy Representative

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

Signed By Date

1/18/2022

340B Drug Pricing Program Database