340B Drug Pricing Program Database

Pharmacy Name

OPTUM PHARMACY 704, INC.

Pharmacy Address

5627 UNIVERSITY HTS STE 108
SAN ANTONIO, TX 78249

Pharmacy Comments

Approval Date

4/14/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Kelly Martin, CFO
(530) 841-6235

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

4/14/2023