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OPTUM PHARMACY 701, LLC
CHC11255-02 STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
STEPHEN F AUSTIN COMMUNITY HEALTH CENTER, INC
Subdivision Name
Women and Children's Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11255-02
Entity Address
218 E HOUSE ST
ALVIN, TX 77511-3544
Grant Number
H80CS11255
Participating Start Date
4/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4015 SHOPTON RD STE 600
CHARLOTTE, NC 28217-3025
Pharmacy Comments
Contract Details
Approval Date
4/20/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Young, CEO
(281) 824-1480
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/20/2023
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