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OPTUM PHARMACY 704, INC.
CH10002A ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
Anchorage Neighborhood Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH10002A
Entity Address
4951 Business Park Blvd
Anchorage, AK 99503-7174
Grant Number
H80CS00146
Participating Start Date
4/1/1999
Last Recertification Date
2/11/2025
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
7/13/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa DH Aquino, CEO
(907) 743-7305
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/13/2022
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