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OPTUM PHARMACY 704, INC.
CH060140 EAST ARKANSAS FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
EAST ARKANSAS FAMILY HEALTH CENTER, INC.
Subdivision Name
East Arkansas Family Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH060140
Entity Address
900 North 7th St
West Memphis, AR 72301-3550
Grant Number
H80CS00123
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 704, INC.
Pharmacy Address
5627 UNIVERSITY HTS STE 108
SAN ANTONIO, TX 78249
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUSAN WARD-JONES, CEO
(870) 735-3842
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/16/2024
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