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OPTUM FRONTIER THERAPIES II, LLC
STD787041 Texas Health Action
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Covered Entity Details
Entity Name
Texas Health Action
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD787041
Entity Address
2800 S. IH-35
103
Austin, TX 78704
Grant Number
NH25PS005182
Participating Start Date
4/1/2020
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES II, LLC
Pharmacy Address
6425 SANTA MARGARITA ST UNIT 120
LAS VEGAS, NV 89118
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
Chris Adams, CFO
(512) 643-8770
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2022
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