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OPTUMRX
CH041110 FETTER HEALTHCARE NETWORK INC.
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Covered Entity Details
Entity Name
FETTER HEALTHCARE NETWORK INC.
Subdivision Name
FRANKLIN C FETTER FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041110
Entity Address
51 Nassau St
Charleston, SC 29403-5513
Grant Number
H80CS09088
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
OPTUMRX
Pharmacy Address
OPTUMRX INC
6800 W 115TH ST STE 600
OVERLAND PARK, KS 66211-9838
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aretha Jones, CEO
(843) 722-4112 Ext: 3004
Contract Pharmacy Representative
Fetter Health Care Network, Inc
Sharvette Slaughter, MD
(843) 722-4112 Ext: 4115
Signed By Date
4/14/2023
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