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OPTUM PHARMACY 701, LLC
CHC12885-03 HOUSTON AREA COMMUNITY SERVICES, INC
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Covered Entity Details
Entity Name
HOUSTON AREA COMMUNITY SERVICES, INC
Subdivision Name
HACS: Main Campus
Type
HRSA-Funded Health Center
340B ID
CHC12885-03
Entity Address
2150 W 18th St
Houston, TX 77008-5200
Grant Number
H80CS12885
Participating Start Date
4/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4100 S SAGINAW ST STE D
FLINT, MI 48507
Pharmacy Comments
Contract Details
Approval Date
4/16/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Charlene Antoinette Flash, CEO
(832) 384-1479 Ext: 494
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/16/2022
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