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OPTUM PHARMACY 702, LLC
CH061510 Brownsville Community Health Clinic Corporation
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Covered Entity Details
Entity Name
Brownsville Community Health Clinic Corporation
Subdivision Name
New Horizon Medical Center
Type
HRSA-Funded Health Center
340B ID
CH061510
Entity Address
191 E. Price Rd.
Brownsville, TX 78521-3527
Grant Number
H80CS00717
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hilda Marvelia Gonzalez, Acting CEO
(956) 548-7473
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/9/2023
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