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OPTUM PHARMACY 705, LLC
CH0412790 RURAL HEALTH SERVICES CONSORTIUM
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES CONSORTIUM
Subdivision Name
HAWKINS MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH0412790
Entity Address
4966 HIGHWAY 11 WEST
ROGERSVILLE, TN 37857
Grant Number
H80CS00421
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
7/18/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/18/2023
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