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OPTUM PHARMACY 705, LLC
CHC11298-00 TRAVIS COUNTY HEALTHCARE DISTRICT
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Covered Entity Details
Entity Name
TRAVIS COUNTY HEALTHCARE DISTRICT
Subdivision Name
CommUnityCare Kramer Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CHC11298-00
Entity Address
2115 KRAMER LN
STE 100
Austin, TX 78758
Grant Number
H80CS11298
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaeson Fournier, CEO
(512) 978-9050 Ext: 5125954337
Contract Pharmacy Representative
Optum
Nancy McCutcheon, Sr. VP of Strategic Sales
(651) 983-0677
Signed By Date
7/15/2022
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