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OPTUM PHARMACY 702, LLC
STD78754 The Wright House Wellness Center DBA ASHWELL
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Covered Entity Details
Entity Name
The Wright House Wellness Center DBA ASHWELL
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78754
Entity Address
3100 Red River St.
STE 3
Austin, TX 78705
Grant Number
NH25PS005182
Participating Start Date
7/1/2018
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Benjamin P Walker, Director
(512) 467-0088 Ext: 133
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/11/2023
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