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OPTUM PHARMACY 700, LLC
CH0627930 EAST TEXAS BORDER HEALTH CLINIC
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Covered Entity Details
Entity Name
EAST TEXAS BORDER HEALTH CLINIC
Subdivision Name
East Texas Border Health Clinic DBA Genesis Primecare Marshall 2
Type
HRSA-Funded Health Center
340B ID
CH0627930
Entity Address
400 S Alamo Blvd
Marshall, TX 75670-4260
Grant Number
H80CS08781
Participating Start Date
10/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
5700 DOT COM CT, STE 1000
OVIEDO, FL 32765
Pharmacy Comments
Contract Details
Approval Date
1/21/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carla Roadcap, CEO
(903) 927-3782
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/21/2022
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