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OPTUM PHARMACY 704, INC.
CH060820 Community Health Service Agency, Inc. Of Hunt County, The
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Covered Entity Details
Entity Name
Community Health Service Agency, Inc. Of Hunt County, The
Subdivision Name
Carevide
Type
HRSA-Funded Health Center
340B ID
CH060820
Entity Address
4500 Wesley St
Greenville, TX 75401-5644
Grant Number
H80CS00675
Participating Start Date
12/1/1992
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
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Carter, Chief Executive Officer
(903) 455-5986
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2022
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