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

7/13/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

CARRIE FREY, Director of Finance
(215) 612-4313

Contract Pharmacy Representative

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

Signed By Date

7/13/2023